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Sample records for chronic coronary heart

  1. Shifts in the age distribution and from acute to chronic coronary heart disease hospitalizations

    NARCIS (Netherlands)

    Koopman, Carla; Bots, Michiel L.; Van Dis, Ineke; Vaartjes, Ilonca

    2016-01-01

    Background Shifts in the burden of coronary heart disease (CHD) from an acute to chronic illness have important public health consequences. Objective To assess age-sex-specific time trends in rates and characteristics of acute and chronic forms of CHD hospital admissions in the Netherlands. Methods

  2. Vascular and cardiac contractile reserve in the dog heart with chronic multiple coronary occlusions.

    Science.gov (United States)

    Schwarz, F; Flameng, W; Mack, B; Türschmann, W; Schaper, W

    1976-11-01

    areas that were supplied by a normal coronary artery, whereas areas supplied by collaterals became ischemic. Opening of an aortocoronary bypass restored normal flow to previously ischemic areas, and reduced the flow to areas supplied by a normal artery. With the bypass open no differences existed between normal dogs and those with two occluded coronary arteries. We conclude that the norepinephrine-stimulated contractile reserve of hearts with chronic coronary occlusion was comparable to that of normal hearts; however, norepinephrine forced these hearts to spend the entire flow reserve of the remaining normal artery while producing ischemia in collateral-dependent areas. The same dose of norepinephrine did not require the entire flow reserve of normal dogs.

  3. Lysophospholipids in coronary artery and chronic ischemic heart disease

    Science.gov (United States)

    Abdel-Latif, Ahmed; Heron, Paula M.; Morris, Andrew J.; Smyth, Susan S.

    2015-01-01

    Purpose of review The bioactive lysophospholipids, lysophosphatidic acid (LPA) and sphingosine 1 phosphate (S1P) have potent effects on blood and vascular cells. This review focuses their potential contributions to the development of atherosclerosis, acute complications, such as acute myocardial infarction, and chronic ischemic cardiac damage. Recent findings Exciting recent developments have provided insight into the molecular underpinnings of LPA and S1P receptor signaling. New lines of evidence suggest roles for these pathways in the development of atherosclerosis. In experimental animal models, the production, signaling and metabolism of LPA may be influenced by environmental factors in the diet that synergize to promote the progression of atherosclerotic vascular disease. This is supported by observations of human polymorphisms in the lysophospholipid metabolizing enzyme, PPAP2B, that are associated with risk of coronary artery disease and myocardial infarction. S1P signaling protects from myocardial damage that follows acute and chronic ischemia both by direct effects on cardiomyocytes and through stem cell recruitment to ischemic tissue. Summary This review will suggest novel strategies to prevent the complications of coronary artery disease by targeting LPA production and signaling. Additionally, ways in which S1P signaling pathways may be harnessed to attenuate ischemia-induced cardiac dysfunction will be explored. PMID:26270808

  4. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  5. [Heart rhythm disturbances in patients with chronic obstructive pulmonary disease in aggregate with coronary heart disease].

    Science.gov (United States)

    Shoĭkhet, Ia N; Klester, E B; Golovin, V A

    2008-01-01

    The purpose of the research was to study kinds, frequencies and features of heart rhythm disturbances (HRD) in patients with chronic obstructive pulmonary disease (COPD) subject to degree of severity, including presence of coronary heart disease (CHD). 1189 of patients with registered HRD were examined. 315 of them had COPD (group 1), 531--combination of COPD and CHD (group 2), 343 were CHD patients (group 3). The extent of examinations included electrocardiogram (ECG), Halter monitoring (HM), bicycle ergometry (BEM), external respiration function estimation. Supraventricular HRD were registered statistically more frequently in group 1: according to ECG data in rest - in 37.2% patients, by BEM results--in 18.8%, by HM--in 50%. Combined (supraventricular and ventricular) HRD were registered most frequently in group 2: 41.2 24.4, and 45.5% respectively. Ventricular HRD dominated in group 3: 47.6, 29.3 and 48.6% respectively. The results of the study indicate that supraventricular HRDprevaile in patients with COPD, combined HRD - in patients with COPD and CHD. Ventricular HRD, which most informatively reflect changes in intracardiac geometry and left ventricle hemodynamics, dominate in CHD patients. The optimization of therapy correction consists in early diagnostics of HRD subject to features of cardiorespiratory system functional state.

  6. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... slow down or stop. A risk factor for heart disease is something that increases your chance of getting ...

  7. Evaluation of proinflammatory cytokines and brain natriuretic peptide in patients with rheumatic heart diseases and coronary heart disease complicated by chronic heart insufficiency

    OpenAIRE

    2005-01-01

    Objective. To study proinflammatory cytokines and brain natriuretic peptide (BNP) in patients with rheumatic heart diseases (RHD) and coronary heart disease (CHD) complicated by chronic heart insufficiency (CHI). Material and methods. 54 pts with CHI (among them 16 with RHD and 38 with CHD with signs of CHI ofll-IV functional class according to NYHA that correspond to 11A-III stage according to N.D. Strazesko-V.H. \\frsilenko classification) and 30 healthy persons of control group were examine...

  8. Living with Coronary Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

  9. Exhaustion of the Frank-Starling mechanism in conscious dogs with heart failure induced by chronic coronary microembolization.

    Science.gov (United States)

    Gill, Robert M; Jones, Bonita D; Corbly, Angela K; Ohad, Dan G; Smith, Gerald D; Sandusky, George E; Christe, Michael E; Wang, Jie; Shen, Weiqun

    2006-07-04

    The role of the Frank-Starling mechanism in the regulation of cardiac systolic function in the ischemic failing heart was examined in conscious dogs. Left ventricular (LV) dimension, pressure and systolic function were assessed using surgically implanted instrumentations and non-invasive echocardiogram. Heart failure was induced by daily intra-coronary injections of microspheres for 3-4 weeks via implanted coronary catheters. Chronic coronary embolization resulted in a progressive dilation of the left ventricle (12+/-3%), increase in LV end-diastolic pressure (118+/-19%), depression of LV dP/dt(max) (-19+/-4%), fractional shortening (-36+/-7%), and cardiac work (-60+/-9%), and development of heart failure, while the LV contractile response to dobutamine was depressed. A brief inferior vena caval occlusion in dogs with heart failure decreased LV preload to match the levels attained in their control state and caused a further reduction of LV dP/dt(max), fractional shortening, stroke work and cardiac work. Moreover, in response to acute volume loading, the change in the LV end-diastolic dimension-pressure (DeltaLVEDD-DeltaLVEDP) curve in the failing heart became steeper and shifted significantly to the left, while the increases in LV stroke work and cardiac work were blunted. Thus, our results suggest that the Frank-Starling mechanism is exhausted in heart failure and unable to further respond to increasing volume while it plays an important compensatory role in adaptation to LV dysfunction in heart failure.

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

    Directory of Open Access Journals (Sweden)

    Peng Yu

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  12. Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease.

    Science.gov (United States)

    Alfakry, Hatem; Malle, Ernst; Koyani, Chintan N; Pussinen, Pirkko J; Sorsa, Timo

    2016-01-01

    Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.

  13. Prognostic impact of atrial fibrillation on clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Nileshkumar; J; Patel; Aashay; Patel; Kanishk; Agnihotri; Dhaval; Pau; Samir; Patel; Badal; Thakkar; Nikhil; Nalluri; Deepak; Asti; Ritesh; Kanotra; Sabeeda; Kadavath; Shilpkumar; Arora; Nilay; Patel; Achint; Patel; Azfar; Sheikh; Neil; Patel; Apurva; O; Badheka; Abhishek; Deshmukh; Hakan; Paydak; Juan; Viles-Gonzalez

    2015-01-01

    Atrial fibrillation(AF) is the most common type of sustained arrhythmia,which is now on course to reach epidemic proportions in the elderly population. AF is a commonly encountered comorbidity in patients with cardiac and major non-cardiac diseases. Morbidity and mortality associated with AF makes it a major healthcare burden. The objective of our article is to determine the prognostic impact of AF on acute coronary syndromes,heart failure and chronic kidney disease. Multiple studies have been conducted to determine if AF has an independent role in the overall mortality of such patients. Our review suggests that AF has an independent adverse prognostic impact on the clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease.

  14. The influence of genotype on vascular endothelial growth factor and regulation of myocardial collateral blood flow in patients with acute and chronic coronary heart disease

    DEFF Research Database (Denmark)

    Ripa, R.S.; Jorgensen, E.; Baldazzi, F.;

    2009-01-01

    OBJECTIVE: To test the hypothesis that mutations in the vascular endothelial growth factor (VEGF) gene are associated with plasma concentration of VEGF and subsequently the ability to influence coronary collateral arteries in patients with coronary heart disease (CHD). METHODS: Blood samples from...... patients with chronic ischemic heart disease (n=53) and acute coronary syndrome (n=61) were analysed. Coronary collaterals were scored from diagnostic biplane coronary angiograms. RESULTS: The plasma concentration of VEGF was increased in patients with acute compared to chronic CHD (p=0.01). The genotype......-1154 and coronary collateral size (p=0.03) and a significant association between the VEGF plasma concentration and the collateral size (p=0.03). CONCLUSION: VEGF plasma concentration seems related to coronary collateral function in patients with CHD. The results did not support the hypothesis...

  15. Ivabradine Prevents Heart Rate Acceleration in Patients with Chronic Obstructive Pulmonary Disease and Coronary Heart Disease after Salbutamol Inhalation

    Directory of Open Access Journals (Sweden)

    Uta C. Hoppe

    2012-04-01

    Full Text Available Accelerated sinus rhythm is an important side effect of inhaled salbutamol which is especially harmful in patients with chronic obstructive pulmonary disease (COPD and coronary heart disease (CHD. Cross-over, randomized, open label study design. 20 patients (18 males and two females with COPD stage II–IV and comorbide CHD NYHA class I–III were included. Spirometry with 400 mg salbutamol inhalation was performed at two consecutive days of the study. Patients in group I were prescribed 5 mg ivabradine per os 3 h before salbutamol inhalation solely on the first day of the study and patients of group II received 5 mg ivabradine only on the second day of the study. Salbutamol caused a significant increase of HR by 5.5 bpm (95% CI 0.8; 10.2, p < 0.03. After ivabradine ingestion salbutamol did not change HR significantly by −2.4 bpm (−7.0; 2.3, p = 0.33. The attenuation of HR elevation by ivabradine was significant, p < 0.01. Salbutamol alone increased FEV1 by 6.0% (2.7; 9.3, p < 0.01. This effect was not impaired by ivabradine (FEV1 increase by 7.7% (2.8; 12.6, p < 0.01 versus baseline, p = 0.5 versus no ivabradine. Ivabradine 5 mg per os prevents heart rate acceleration after inhalation of 400 mg salbutamol. Ivabradine has no impact on lung function in patients with moderate-to-very-severe COPD and CHD comorbidity.

  16. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008277 Relationship between pulse wave velocity and the NYHA classification of coronary insufficiency.SUN Weiping(孙卫平),et al.Dept Cardiol,Tongji Hosp Tongji Univ,Shanghai 200065.Chin J Intern Med 2008;47(5):382-384.Objective To investigate the relationship between brachial-ankle pulse wave velocity(baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease

  17. What Is Coronary Heart Disease?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Coronary Heart Disease? Español Coronary heart disease (CHD) is a disease in which a waxy ... medical procedures can help prevent or treat coronary heart disease. These treatments may reduce the risk of related ...

  18. Depression and Coronary Heart Disease

    OpenAIRE

    2012-01-01

    There are exciting findings in the field of depression and coronary heart disease. Whether diagnosed or simply self-reported, depression continues to mark very high risk for a recurrent acute coronary syndrome or for death in patients with coronary heart disease. Many intriguing mechanisms have been posited to be implicated in the association between depression and heart disease, and randomized controlled trials of depression treatment are beginning to delineate the types of depression manage...

  19. Clinical therapeutic efficacy of intra-aortic balloon pump as an adjuvant treatment after percutaneous coronary intervention in patients with coronary heart disease associated with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Zi-lan JING

    2015-06-01

    Full Text Available Objective To explore the clinical efficacy of intra-aortic balloon pump (IABP as an auxiliary treatment of percutaneous coronary intervention (PCI in patients with coronary heart disease (CHD associated with chronic kidney disease. Methods One hundred and twenty CHD patients with concomitant chronic kidney disease and receiving PCI in our hospital from Jan. 2000 to Jul. 2014, and 123 simple CHD patients without renal dysfunction, who had undergone PCI with concomitant IABP for the cardiac pump failure, cardiogenic shock, acute left heart failure, unstable angina pectoris (UP which was not allayed by medical treatment, or acute myocardial infarction (AMI, were selected for observation of preoperative condition, in-hospital mortality and prognosis of patients in two groups. Results There was no statistically significant difference in general clinical data including gender, age, and concomitant hypertension and diabetes, and preoperative blood lipid, AST, D-dimer, APTT, and international normalized ratio (INR showed also no statistically significant difference before surgery between two groups of patients (P>0.05. The difference in proportion of AMI, the left main trunk and (or three-branches involvement was of no statistical significance (P>0.05, but there was significant difference in the incidence of previous myocardial infarction, TnT, CK-MB, Cr, BUN, stent number, IABP application time (P0.05 between the two groups. Logistic regression analysis revealed that diabetes and the number of stents were independent risk factors for in-hospital and long-term mortalities. Conclusions By means of the effective cardiac assistance of IABP, CHD patients with renal insufficiency have the same short and long term clinical prognosis as simple CHD patients without renal dysfunction who has undergone PCI. Diabetes and the number of stents are independent risk factors for in-hospital and 1-year mortality. DOI: 10.11855/j.issn.0577-7402.2015.04.03

  20. Evaluation of left ventricular function by radionuclide angiography during exercise in normal subjects and in patients with chronic coronary heart disease.

    Science.gov (United States)

    Iskandrian, A S; Hakki, A H; DePace, N L; Manno, B; Segal, B L

    1983-06-01

    Radionuclide angiography permits evaluation of left ventricular performance during exercise. There are several factors that may affect the results in normal subjects and in patients with chronic coronary heart disease. Important among these are the selection criteria: age, sex, level of exercise, exercise end points, ejection fraction at rest and effects of pharmacologic agents. An abnormal ejection fraction response to exercise is not a specific marker for coronary heart disease but may be encountered in other cardiac diseases. In addition to the diagnostic considerations, important prognostic data can be obtained. Further studies are needed to determine the prognostic implications of anatomic findings versus the functional abnormalities induced by exercise in patients with coronary artery disease.

  1. Is Chronic Low Back Pain Associated with the Prevalence of Coronary Heart Disease when Genetic Susceptibility Is Considered? A Co-Twin Control Study of Spanish Twins

    Science.gov (United States)

    Fernandez, Matt; Ordoñana, Juan R.; Hartvigsen, Jan; Ferreira, Manuela L.; Refshauge, Kathryn M.; Sánchez-Romera, Juan F.; Pinheiro, Marina B.; Simpson, Stephen J.; Hopper, John L.; Ferreira, Paulo H.

    2016-01-01

    Objective To investigate the chronic low back pain and coronary heart disease relationship, after adjusting for relevant confounders, including genetics. Methods In a cross-sectional design, 2148 twins were recruited from the Murcia Twin Registry, Spain. The exposure was chronic LBP and the outcomes were myocardial infarction and other coronary heart diseases—lifetime and in the last 2 years–based on standardized health-related questionnaires. First, logistic regression analysis investigated associations of the total sample followed by a matched co-twin control analyses, with all complete twin pairs discordant for chronic LBP utilised, separated for zygosity—dizygotic (DZ) and monozygotic (MZ) pairs, which adjusted for shared familial factors, including genetics. Results Chronic LBP pain is associated with lifetime myocardial infarction [odds ratio (OR) = 2.69, 95% confidence interval (CI) = 1.35–5.36], other coronary heart diseases over a lifetime (OR = 2.58, 95% CI: 1.69–3.93) and in the last two years (OR = 2.19, 95% CI: 1.33–3.60), while there was a borderline association with myocardial infarction in the last 2 years (OR = 2.64, 95% CI: 0.98–7.12). Although the magnitude of the association remained or increased in the co-twin control analyses, none reached statistical significance. Conclusion Chronic LBP is associated with a higher prevalence of myocardial infarction and coronary heart disease. It is possible that this association remains even when controlling for genetics and early shared environment, although this should be investigated with larger samples of twins discordant for LBP. PMID:27171210

  2. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008417 Efficacy comparison with low and high dose natroparin for patients with acute coronary syndrome underwent percutancous coronary intervention. SUN Chaoyu(孙超宇), et al. Dept Cardiol, 4th Affili Hosp, Harbin Med Univ, Harbin 150001. Chin J Cardiol 2008;36(6):493-496. Objective To evaluate the safety and optimal piror percutaneous coronary intervention (PCI) natroparin dose in patients with acute coronary syndrome (ACS).

  3. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease.

  4. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008042 Analysis of coronary artery lesion characteristics and its clinical implications in patients with acute non-ST-segment elevation myocardial infarction. BAI Taizhu(柏太柱), et al. Cardiovasc Dept, Hengyang Centr Hosp & Hengyang Cardiovasc Intervention Center, Hengyang 421001. Chin J Arterioscler 2007;15(10):780-782. Objective To investigate the coronary artery lesion characteristics and its clinical implications in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI).

  5. Serum neutrophil gelatinase-associated lipocalin concentration reflects severity of coronary artery disease in patients without heart failure and chronic kidney disease.

    Science.gov (United States)

    Katagiri, Mikako; Takahashi, Masao; Doi, Kent; Myojo, Masahiro; Kiyosue, Arihiro; Ando, Jiro; Hirata, Yasunobu; Komuro, Issei

    2016-10-01

    Serum neutrophil gelatinase-associated lipocalin (NGAL) is recognized as a useful biomarker for acute kidney injury. Recently, elevated NGAL levels were reported in patients with heart failure and cardiac events, but the association between serum NGAL and severity of coronary artery disease (CAD) has not been investigated adequately. This study aimed to evaluate the association between serum NGAL concentration and CAD severity in patients without heart failure and chronic kidney disease. Two-hundred thirteen patients [mean age: 66.2 ± 9.2 (SD)] without heart failure and chronic kidney disease (estimated glomerular filtration rate >60 mL/min/1.73 m(2)) who underwent coronary angiography were retrospectively analyzed using the SYNTAX score. The mean concentration of serum NGAL was 134.3 ± 111.3 ng/mL. A statistically significant correlation was observed between serum NGAL levels and the SYNTAX score (R = 0.18, P = 0.0091). Multivariable analysis also showed elevated serum NGAL as an independent risk factor for a high SYNTAX score (P 100 ng/mL) and high levels of BNP (>25 pg/mL) had a higher SYNTAX score (low-low vs. high-high: 13.8 ± 13.4 vs. 20.8 ± 18.9, P heart failure. Serum NGAL might be a biomarker for CAD severity.

  6. [Stress, mental disorders and coronary heart disease].

    Science.gov (United States)

    Lederbogen, F; Ströhle, A

    2012-11-01

    There are numerous associations between stress, mental disorders and coronary heart disease (CHD). Exposure to an acute stressor leads to activation of the hypothalamus-pituitary-adrenal and sympathoadrenal systems and chronic stressors are associated with sustained functional changes of these systems. Experiencing acute and chronic stress is paralleled by an increased incidence of mental disorders with the most consistent evidence on the triggering of major depressive episodes. Various mental disorders, including depression, anxiety and schizophrenia, are associated with an increased risk of CHD. Furthermore, acute and chronic stressors have been identified as risk factors or triggers of acute coronary syndromes. Thus therapeutic strategies aim at reducing subjective stress experience, therapy of mental disorders and treatment of cardiac risk factors known to be more prevalent in increased stress states and mental disorders.

  7. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  8. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950286 Percutaneous transluminal coronary angio-plasty for unstable angina.LIU Meilin(刘梅林),et.al.1st Teach Hosp,Beijing Med Univ,Beijing,100034.Chin J Intern Med 1995;34(3):169-172.Percutaneous transluminal coronary angioplasty(PTCA) was performed in 190 patients with 250 dis-eased vessels and 278 lesions from Dec.1987 to Feb.1994.All the patients had unstable angina (UA).There were 52(18.7%) type A lesions,175(62.9%)type B lesions and 51(18.3%) type C lesions.Of the

  9. Vital Exhaustion and Coronary Heart Disease Risk

    DEFF Research Database (Denmark)

    Frestad, Daria; Prescott, Eva

    2017-01-01

    OBJECTIVES: The construct of vital exhaustion has been identified as a potential independent psychological risk factor for incident and recurrent coronary heart disease (CHD). Despite several decades of research, no systematic review or meta-analysis has previously attempted to collate.......22-1.85) for prospective studies, and 2.61 (95% CI = 1.66-4.10) for case-control studies using hospital controls. Risk of recurrent events in patients with CHD was 2.03 (95% CI = 1.54-2.68). The pooled adjusted risk of chronic heart failure in healthy populations was 1.37 (95% CI = 1.21-1.56), but this was based...

  10. Homocysteine and coronary heart disease

    DEFF Research Database (Denmark)

    Clarke, Robert; Bennett, Derrick A; Parish, Sarah

    2012-01-01

    Moderately elevated blood levels of homocysteine are weakly correlated with coronary heart disease (CHD) risk, but causality remains uncertain. When folate levels are low, the TT genotype of the common C677T polymorphism (rs1801133) of the methylene tetrahydrofolate reductase gene (MTHFR...

  11. Coronary collaterals improve prognosis in patients with ischemic heart disease

    NARCIS (Netherlands)

    J.J. Regieli; J.W. Jukema; H.M. Nathoe; A.H. Zwinderman; S. ng; D.E. Grobbee; Y. van der Graaf; P.A. Doevendans

    2009-01-01

    BACKGROUND: The recruitment of coronary collateral vessels results from an endogenous adaptation to ischemic heart disease (IHD). Presence of collaterals may exert protection at the time of acute or chronic obstructive coronary disease. The protective role of collaterals in patients with extensive c

  12. Performance measures for management of chronic heart failure patients with acute coronary syndrome in China: results from the Bridging the Gap on Coronary Heart Disease Secondary Prevention in China (BRIG)Project

    Institute of Scientific and Technical Information of China (English)

    WANG Na; ZHAO Dong; LIU Jing; LIU Jun; Cheuk-Man Yu; WANG Wei; SUN Jia-yi

    2013-01-01

    Background Chronic heart failure (CHF) is a severe clinical syndrome associated with high morbidity and mortality,and with high health care expenditures.No nationwide data are currently available regarding the quality of clinical management of CHF patients in China.The aim of this study was to assess the quality of care of CHF inpatients in China.Methods The American College of Cardiology/American Heart Association Clinical Performance Measures for Adults with Chronic Heart Failure (Inpatient Measurement Set) with slight modifications was used to measure the performance status in 612 CHF patients with acute coronary syndrome (ACS) from 65 hospitals across all regions of China.Results The implementation rates of guideline recommended strategies for CHF management were low.Only 57.5% of the CHF patients received complete discharge instructions,53.6% of the patients received evaluation of left ventricular systolic function,62.8% received an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker at discharge,and 52.7% received a β-blocker at discharge,56.3% of the smokers received smoking cessation counseling.The rate of warfarin utilization was only 9.7% in CHF patients with atrial fibrillation.Most patients (81.4%) did not receive all the first four treatments.There were marked differences in the quality of CHF management among patients with different characteristics.Conclusions Performance measures provide a standardized method of assessing quality of care,and can thus highlight problems in disease management in clinical practice.The quality of care for CHF patients with ACS in China needs to be improved.

  13. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920658 Assessment of plasma catechola-mine and β-endorphin contents in patientswith silent myocardial ischemia and anginapectoris. WU Lin(吴林), et al. 1st Hosp, BeijingMed Univ, Beijing, 100034. Cbin J Cardiol1992; 20(2): 90-91. Thirteen Patients with totally silent myocar-dial ischemia(group 1)and 15 patients with ef-fort angina(group 2)were studied. The coronary

  14. What Are the Signs and Symptoms of Coronary Heart Disease?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Coronary Heart Disease? A common symptom of coronary heart disease (CHD) ... and Symptoms of Heart Problems Related to Coronary Heart Disease Some people who have CHD have no signs ...

  15. THE ROLE OF LIPOTROPIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE BEFORE AND AFTER CORONARY REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    R. N. Adzhiev

    2015-09-01

    Full Text Available Review of large of trials that prove the positive impact of high-dose lipid-lowering therapy on the prognosis in patients with ischemic heart disease (IHD are presented. The data on the efficacy of the lipid profile correction by lipid apheresis in patients with hypercholesterolemia that is refractory to optimal medical therapy are showed. The results of the large trials (LIPS, ARMYDA, NAPLES II, ARMYDA-RECAPTURE, Post-CABG, TNT and meta-analyzes on the role of statins, prescribed before and after coronary artery bypass surgery and stenting, in reducing the risk of early and late cardiac events and the need for repeat myocardial revascularization are analyzed. The issue of therapeutic apheresis should be considered in cases of refractory hypercholesterolemia according to ESC/EAS Guidelines for the management of dyslipidaemias (2011. The tendency to reduction in the risk of stent restenosis and vein graft lesions after lipid apheresis is found in very high risk patients with IHD and refractory hypercholesterolemia that underwent coronary stenting or bypass surgery.

  16. THE ROLE OF LIPOTROPIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE BEFORE AND AFTER CORONARY REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    R. N. Adzhiev

    2013-01-01

    Full Text Available Review of large of trials that prove the positive impact of high-dose lipid-lowering therapy on the prognosis in patients with ischemic heart disease (IHD are presented. The data on the efficacy of the lipid profile correction by lipid apheresis in patients with hypercholesterolemia that is refractory to optimal medical therapy are showed. The results of the large trials (LIPS, ARMYDA, NAPLES II, ARMYDA-RECAPTURE, Post-CABG, TNT and meta-analyzes on the role of statins, prescribed before and after coronary artery bypass surgery and stenting, in reducing the risk of early and late cardiac events and the need for repeat myocardial revascularization are analyzed. The issue of therapeutic apheresis should be considered in cases of refractory hypercholesterolemia according to ESC/EAS Guidelines for the management of dyslipidaemias (2011. The tendency to reduction in the risk of stent restenosis and vein graft lesions after lipid apheresis is found in very high risk patients with IHD and refractory hypercholesterolemia that underwent coronary stenting or bypass surgery.

  17. Who Is at Risk for Coronary Heart Disease?

    Science.gov (United States)

    ... on Twitter. Who Is at Risk for Coronary Heart Disease? In the United States, coronary heart disease (CHD) ... type of fat. Other Risks Related to Coronary Heart Disease Other conditions and factors also may contribute to ...

  18. [EFFICIENCY OF COMBINATION OF ROFLUMILAST AND QUERCETIN FOR CORRECTION OXYGEN- INDEPENDENT MECHANISMS AND PHAGOCYTIC ACTIVITY OF MACROPHAGE CELLS OF PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WHEN COMBINED WITH CORONARY HEART DISEASE].

    Science.gov (United States)

    Gerych, P; Yatsyshyn, R

    2015-01-01

    Studied oxygen independent reaction and phagocytic activity of macrophage cells of patients with chronic obstructive pulmonary disease (COPD) II-III stage when combined with coronary heart disease (CHD). The increasing oxygen independent reactions monocytes and neutrophils and a decrease of the parameters that characterize the functional state of phagocytic cells, indicating a decrease in the functional capacity of macrophage phagocytic system (MPS) in patients with acute exacerbation of COPD, which runs as its own or in combination with stable coronary heart disease angina I-II. FC. Severity immunodeficiency state in terms of cellular component of nonspecific immunity in patients with acute exacerbation of COPD II-III stage in conjunction with the accompanying CHD increases with the progression of heart failure. Inclusion of basic therapy of COPD exacerbation and standard treatment of coronary artery disease and drug combinations Roflumilastand quercetin causes normalization of phagocytic indices MFS, indicating improved immune status and improves myocardial perfusion in terms of daily ECG monitoring.

  19. How Is Coronary Heart Disease Treated?

    Science.gov (United States)

    ... healthy lifestyle changes if you have coronary heart disease. Heart-healthy lifestyle changes include: Heart-healthy eating Maintaining a healthy ... CAD risk factors and prevent or delay the disease. Lifestyle changes include ... following a healthy eating plan, maintaining a healthy weight, and being ...

  20. 慢性肺源性心脏病并冠心病80例治疗探讨%Treatment of chronic pulmonary heart disease and coronary heart disease 80 cases

    Institute of Scientific and Technical Information of China (English)

    马雪梅

    2013-01-01

    Objective To explore and examine the clinical and prevention measures of chronic pulmonary heart disease and coronary heart disease in.Methods Totally 80 cases of patients suffering from chronic pulmonary heart disease and coronary heart disease study in patients with acute exacerbation of the application on the basis of carrying out comprehensive treatment of macrolide antibiotics,according to the specific circumstances of the patients' anticoagulant,thrombolytic and invasive or noninvasive mechanical ventilation and other processing of remission in patients followed up at the same time the long-term home oxygen therapy and oral empty platelet aggregation drugs,non-invasive airway of the double -barreled such as positive pressure ventilation for treatment of patients with heart and lung function improved ; lung coronary heart disease associated with elevated blood lipids in patients with oral lipid-lowering drugs and low-fat diet intervention.Results This group of patients after treatment effective in 26 cases (32.5%),effective in 34 (42.5%),ineffective in 20 cases (25%),of which 10 died (12.5%).Conclusions The long-term prevention and followed up for chronic pulmonary heart disease and coronary heart disease are very important and adhere to the long-term home oxygen therapy can also reduce patients'readmission rates.%目的 探讨慢性肺源性心脏病并冠心病在临床上的表现及防治措施.方法 本文选择80例患有慢性肺源性心脏病并冠心病的患者进行研究,对于处在急性发作期的患者,在进行综合治疗的基础上应用大环内酯类抗生素,再根据患者的具体情况进行抗凝、溶栓以及有创或者是无创机械通气等的处理,对缓解期的患者进行随诊,同时进行长期的家庭氧疗及口服抗血小板凝集药物、无创双管气道正压通气等治疗对患者的心肺功能进行改善;对伴随血脂增高的患者应采用口服降脂药及低

  1. Reducing cholesterol to prevent coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Matthew J. Sorrentino

    2005-01-01

    @@ Coronary heart disease (CHD) remains the number one killer of men and women in the United States of America despite major advances in interventional technologies for the treatment of coronary artery disease. CHD is rapidly becoming a major cause of morbidity and mortality in developing nations as well and is now recognized as the leading cause of death worldwide.

  2. Coronary Artery Disease - Coronary Heart Disease

    Science.gov (United States)

    ... result of coronary artery disease, or CAD, said Edward A. Fisher, M.D., Ph.D., M.P. ... Problems and Disease • High Blood Pressure (HBP) • Metabolic Syndrome • Pericarditis • Peripheral Artery Disease (PAD) • Stroke • Vascular Health • ...

  3. 老年慢性肺心病伴发冠心病60例临床分析%Clinical Analysis of 60 Cases Chronic Pulmonary Heart Disease in Elderly Combined with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    田茂琼

    2012-01-01

    目的:探讨慢性肺心病伴冠心病的临床特点,为临床的诊断及治疗提供依据.方法:慢性肺心病合并冠心病患者60例列入研究组,单纯肺心病患者60例列入对照组,收集和分析两组患者的临床资料,分别对两组基本资料、病史、临床表现、心电图检测进行比较.结果:两组患者性别、心律失常、肺性P波无显著差异(P>0.05),研究组有吸烟史、肥胖、夜间阵发性呼吸困难、高血压史、高血脂症史、糖尿病史、心绞痛史、心肌梗死、左束支传导阻滞、心肌梗死表现、持续性缺血、电轴左偏、持续房颤的患者比例明显高于对照组,研究组患者重度右心衰、电轴右偏比例明显低于对照组,数据经统计学比较具有显著差异(P<0.05).结论:对慢性肺心病合并冠心病的确诊,应结合患者的基本情况、临床表现、病史、心电图变化等综合判断.%Objective; To discuss the clinical features of chronic pulmonary heart disease combined with coronary heart disease, in comparing with simple pulmonary heart disease. Method; 60 cases with chronic pulmonary heart disease combined with coronary heart disease were distributed into study group and 60 cases with simple pulmonary heart disease were distributed into control group. Collected the clinical information of two groups and compared the basic information, medical history, clinical manifestations and electrocardiogram. Result; Sex, arrhythmia and pulmonary P wave had no significantly difference of two groups (P>0. 05). The patients rate of smoking history, obesity, paroxysmal nocturnal dyspnea, history of hypertension, hyperlipidemia, history, history of diabetes, history of angina, myocardial infarction, left bundle branch block, myocardial infarction, performance, persistent ischemia, electrical left axis deviation and continuous AF in study group were significantly higher than control group ( P<0. 05). The rate of severe right heart

  4. PLACENTAL GROWTH FACTOR AND CORONARY NEOANGIOGENESIS IN CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    M. V. Tulikov

    2013-01-01

    Full Text Available Neoangiogenesis in coronary heart disease is a protective reaction aimed to improve ischemic myocardial perfusion, by increasing the number and size of arterial collaterals. Placental growth factor (PlGF is one of the key peptides regulating angiogenic processes in atherosclerosis. In particular, a number of investigators have shown that injection of recombinant PlGF into the system or regional blood flow can stimulate neoangiogenesis. On the other hand, there is evidence confirming the involvement of PlGF in the progression of atherosclerosis and in the development of acute coronary syndrome. In this connection, the problem of investigating the efficiency and safety of possible use of PlGF preparations, as well as its place in the diagnosis of coronary heart disease and acute coronary syndrome remains urgent

  5. Smoking, Stress, and Coronary Heart Disease.

    Science.gov (United States)

    Epstein, Leonard H.; Perkins, Kenneth A.

    1988-01-01

    Focuses on the interrelation between stressors and smoking, and on its potential impact on coronary heart disease risk beyond that due to stressors or to smoking alone. Reviews evidence supporting the stress-smoking interrelationship, its relevance to the risk of heart disease, and mechanisms explaining why smokers smoke more during stress and why…

  6. Genetic research in coronary heart disease.

    Science.gov (United States)

    Motulsky, A G

    1984-01-01

    Coronary heart disease research along genetic lines is difficult. Studies in molecular genetics of apolipoprotein and receptor variability appear most promising in the near future. However, unexpected discoveries and methodology may turn up that may completely change the field. Exclusive concentration on lipid research therefore should be avoided. It is likely that most advances will come from carefully designed studies that ask specific questions. Such research design is appropriate not only for laboratory studies but also for clinical and epidemiological investigations. The collaboration of clinicians, biochemists, geneticists, epidemiologists, and statisticians is likely to lead to better understanding of coronary heart disease.

  7. 慢性肺源性心脏病合并冠心病临床研究%Clinical Study of Chronic Pulmonary Heart Disease Complicated With Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    郭睿蓉; 吴明; 张尧

    2015-01-01

    目的:探讨慢性肺源性心脏病(简称肺心病)合并冠心病的临床特点。方法选取2013年1~2014年12月于我院就诊的肺心病患者共134例作为研究对象,根据是否合并冠心病分为伴发组(n=64)和非伴发组(n=70)。比较两组患者易患因素、X线检查、治疗转归等临床特点。结果与非伴发组相比,伴发组高脂血症、高血压、糖尿病、肥胖发生率显著升高,比较有统计学差异(P均<0.05),而吸烟发生比例组间比较无统计学差异(P>0.05)。X线检查显示,伴发组左心室肥大和左右心室肥大的发生率分别为23.4%和14.06%,高于非伴发组10.0%和4.28%的发生率(P均<0.05)。治疗后,与非伴发组相比,伴发组好转比例降低,比较有统计学意义(P<0.05),治疗无效及死亡人数增加,但组间比较无统计学差异(P均>0.05)。结论肺心病合并冠心病患者病情复杂,高脂血症、高血压、糖尿病、肥胖等易患因素、左心室肥大及左右心室肥大发生率明显升高,且治疗转归效果还有待进一步改善,应综合考虑进行相关诊断及治疗。%Objective To investigate the clinical characteristic of chronic pulmonary heart disease complicated with coronary heart disease.Methods From January, 2014 to December, 2014, 134 cases were selected as research subjects to retrospectively analyze their clinical characteristics. Those cases were divided into the none concomitant coronary heart disease group (NCCHD, n=84) and the concomitant coronary heart disease group (CCHD, n=92) according to if they were complicated with coronary heart disease. Then, the susceptible factors, x-ray examination, and outcomes were compared between the two groups.ResultsCompared to NCCHD group, CCHD group has higher rates of hypertension, hyperlipemia, obesity, and diabetes and same rates of smoke. The x-ray examination indicates CCHD group has higher rates of

  8. 慢性肺心病合并冠心病的临床诊治分析%Clinical diagnosis analysis on chronic pulmonary heart disease complicated with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李顺辉; 涂颉洪; 张卫; 刘丽赟; 熊强珍

    2010-01-01

    目的 探讨慢性肺心病合并冠心病的临床特点和诊断依据,总结分析其治疗方法,从而提高临床诊断率、降低病死率.方法 回顾性分析98例慢性肺心病合并冠心病患者的临床特点、心电图、X线摄片、超声心电图以及治疗资料.结果 肺心病出现典型心绞痛、心肌梗死,心电图左心导联动态缺血性改变、左前半或完全性左束支传导阻滞,反复出现左心衰竭伴有左心扩大者,应考虑合并冠心病.处理时要在常规治疗的基础上区别对待.结论 肺心病合并冠心病引起的心力衰竭患者,要根据诊断结果,在常规基础治疗的同时,针对病因与并发症取有效的个体化治疗措施进行处理,可获得较满意的临床效果.%Objective To discuss the chronic pulmonary heart disease merge coronary artery disease's clinical characteristic and the diagnosis basis, then summarizes and analyzes its method of treatment,to improve the clinical diagnosis rates and reduce mortality. Methods Retrospective analyzing 98 cases of chronic pulmonary heart disease merge coronary artery disease patients' clinical characteristic, the electrocardiogram, X absorb the piece, the supersonic electrocardiogram and the treatment material. Results Pulmonary heart disease patients appear typical angina pectoris, myocardial infarction, 12-lead electrocardiography ischemic dynamic changes in ST-T segment, left anterior hemi block or CLBBB (Complete Left Bundle Branch Block), recurring the left heart failure with left heart amplification, we should consider merge coronary heart disease. When dealing with the disease, we must distinguish in the conventional treatment foundation. Conclusion Pulmonary heart disease merge coronary artery disease patients with heart failure, while taking conventional foundation treatment, aim at causes and complications to take effective measures to deal with individual treatment, can get a satisfactory clinical effect.

  9. Antioxidant vitamins and coronary heart disease risk

    DEFF Research Database (Denmark)

    Knekt, Paul; Ritz, John; Pereira, Mark A

    2004-01-01

    BACKGROUND: Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear. OBJECTIVE: We studied the relation between the intake...

  10. Education and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Nordahl, Helene; Rod, Naja Hulvej; Frederiksen, Birgitte Lidegaard

    2013-01-01

    Educational-related gradients in coronary heart disease (CHD) and mediation by behavioral risk factors are plausible given previous research; however this has not been comprehensively addressed in absolute measures. Questionnaire data on health behavior of 69,513 participants, 52 % women, from...

  11. Effects of Chronic Stress on Occurrence,Progress and Prognosis of Coronary Heart Disease%慢性压力对冠心病发生、进展及预后的影响

    Institute of Scientific and Technical Information of China (English)

    杨燕飞

    2013-01-01

    Coronary heart disease has become a serious threat to human life and health of chronic non-communicable diseases. In recent years, lots of research and epidemiological investigation showed that social and psychological factors of chronic pressure play an important role in the occurrence, progress and prognosis of coronary heart disease. There are complicated mechanisms why coronary heart disease caused by chronic stress. Negative emotional responses such as anxiety, depression and burnout produced by the pressure of events have effect in increasing incidence of cardiovascular diseases, exacerbations illness and poor prognosis. This paper described the clinical and epidemiological investigation in recent years progress.%冠心病已成为严重威胁人类生命和健康的慢性非传染性疾病,近年来大量研究及流行病学调查表明慢性压力等社会心理因素对冠心病的发生、进展及预后起着重要作用.慢性压力引发冠心病的机制复杂多样,因压力事件所产生的焦虑、抑郁及倦怠等负性情感反应使心血管疾病的发病率增加、病情加重、预后不佳.文章就其近几年的临床研究及流行病学调查进展进行简述.

  12. Dietary fiber and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Pereira, Mark A; O'Reilly, Eilis; Augustsson, Katarina

    2004-01-01

    of coronary heart disease. METHODS: We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease. RESULTS: Over 6 to 10 years of follow-up, 5249 incident total coronary cases......BACKGROUND: Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk...... associated with risk of coronary heart disease....

  13. Ivabradine in acute coronary syndromes: Protection beyond heart rate lowering.

    Science.gov (United States)

    Niccoli, Giampaolo; Borovac, Josip Anđelo; Vetrugno, Vincenzo; Camici, Paolo G; Crea, Filippo

    2017-02-22

    Ivabradine is a heart rate reducing agent that exhibits anti-ischemic effects through the inhibition of funny electrical current in the sinus node resulting in heart rate reduction, thus enabling longer diastolic perfusion time, and reduced myocardial oxygen consumption without detrimental changes in arterial blood pressure, coronary vasomotion, and ventricular contractility. The current guideline-based clinical use of Ivabradine is reserved for patients with stable angina pectoris who cannot tolerate or whose symptoms are inadequately controlled with beta blockers. In patients with chronic heart failure and reduced ejection fraction, Ivabradine has demonstrated beneficial effects in improving clinical outcomes when added to conventional therapy. However, the role of Ivabradine in acute coronary syndromes has not been established. Based on the results from some relevant preclinical studies and a limited amount of clinical data that were reported recently, the role of Ivabradine in acute ischemic events warrants further investigation. The aim of this review is to provide an overview of the available literature on the potential role of Ivabradine in the clinical context of acute coronary syndromes.

  14. Control of drug treatment of chronic coronary artery disease: possibilities of a regional registry

    Directory of Open Access Journals (Sweden)

    Rachkova S.A.

    2016-03-01

    Full Text Available The article describes the results of the Register of hypertension, coronary artery disease, chronic heart failure (Register of AH, CAD, HF in the Ivanovo region in 2015. The frequency of prescribing of the main groups of drugs in patients with coronary artery disease was estimated.

  15. Study the relationship between adiponectin and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  16. Ivabradine, coronary artery disease, and heart failure: beyond rhythm control

    Directory of Open Access Journals (Sweden)

    Scicchitano P

    2014-06-01

    Full Text Available Pietro Scicchitano,1 Francesca Cortese,1 Gabriella Ricci,1 Santa Carbonara,1 Michele Moncelli,1 Massimo Iacoviello,1 Annagrazia Cecere,1 Michele Gesualdo,1 Annapaola Zito,1 Pasquale Caldarola,2 Domenico Scrutinio,3 Rocco Lagioia,3 Graziano Riccioni,4 Marco Matteo Ciccone1 1Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy; 2Section of Cardiovascular Diseases, Policlinic, San Paolo Hospital, Bari, Italy; 3Section of Cardiovascular Diseases, Fondazione Maugeri, Cassano Murge, Italy; 4Intensive Cardiology Care Unit, San Camillo de Lellis Hospital, Manfredonia, Foggia, Italy Abstract: Elevated heart rate could negatively influence cardiovascular risk in the general population. It can induce and promote the atherosclerotic process by means of several mechanisms involving endothelial shear stress and biochemical activities. Furthermore, elevated heart rate can directly increase heart ischemic conditions because of its skill in unbalancing demand/supply of oxygen and decreasing the diastolic period. Thus, many pharmacological treatments have been proposed in order to reduce heart rate and ameliorate the cardiovascular risk profile of individuals, especially those suffering from coronary artery diseases (CAD and chronic heart failure (CHF. Ivabradine is the first pure heart rate reductive drug approved and currently used in humans, created in order to selectively reduce sinus node function and to overcome the many side effects of similar pharmacological tools (ie, β-blockers or calcium channel antagonists. The aim of our review is to evaluate the role and the safety of this molecule on CAD and CHF therapeutic strategies. Keywords: chronic heart failure, heart rate reduction, cardiac ischemic disease, heart-rate lowering drugs, funny current

  17. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases.

  18. The educational gradient in coronary heart disease

    DEFF Research Database (Denmark)

    Ariansen, Inger; Mortensen, Laust Hvas; Igland, Jannicke

    2015-01-01

    BACKGROUND: Independently of cardiovascular disease (CVD) risk factors, cognitive ability may account for some of the excess risk of coronary heart disease (CHD) associated with lower education. We aimed to assess how late adolescence cognitive ability and midlife CVD risk factors are associated...... with the educational gradient in CHD in Norway. METHODS: In a cohort of 57 279 men born during 1949-1959, health survey information was linked to military conscription records of cognitive ability, to national educational data, to hospitalisation records from the Cardiovascular Disease in Norway (CVDNOR) project...

  19. 10.9.Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930272 Clinical relevant factors of the my-ocardial ischemic threshold.LU Duan (鲁端),et al.1st Affil Hosp,Zhejiang Med Univ,Hangzhou,310003.Chin J cardiol 1992;20(6):357—358.The myocardial ischemic threshold (heart rateat the onset of ischemia) was assessed in 92 pa-tients with coronary heart disease.The highestmyocardial ischemic threshold (HMIT) rangedfrom 83 to 163 (122±18) beats/min usuallyhappened during activities at the daytime.Thelowest myocardial ischemic threshold (LMIT)ranged from 45 to 115 (82±17) beats/min usu-ally happened when awaken in early morning orasleep at night.The differences were statistical-

  20. Bone marrow dysfunction in chronic heart failure patients

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Voors, Adriaan A.; de Boer, Rudolf A.; Schuringa, Jan J.; Klinkenberg, Theo; van der Harst, Pim; Vellenga, Edo; van Veldhuisen, Dirk J.; van Gilst, Wiek H.

    2010-01-01

    To investigate whether chronic heart failure (CHF) is associated with a general dysfunction of the haematopoietic compartment. Bone marrow was obtained during coronary artery bypass graft surgery from 20 patients with CHF (age 67 +/- 6 years, 75% NYHA class >= III, LVEF 32 +/- 6%), and 20 age- and g

  1. Job strain as a risk factor for coronary heart disease

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Nyberg, Solja T; Batty, G David

    2012-01-01

    Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished...

  2. [Passive smoking and the risk of coronary heart disease

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2004-01-01

    Over the past 10 years it has become clear that passive smoking is correlated with an increased risk of coronary heart disease. The relative risk of 25-30% is comparable to that of lung cancer due to passive smoking. Since coronary heart disease is the most common cause of death, it is likely that p

  3. Fruits, vegetables and coronary heart disease.

    Science.gov (United States)

    Dauchet, Luc; Amouyel, Philippe; Dallongeville, Jean

    2009-09-01

    Diet plays an important part in the maintenance of optimal cardiovascular health. This Review summarizes the evidence for a relationship between fruit and vegetable consumption and the occurrence of coronary heart disease. This evidence is based on observational cohort studies, nutrition prevention trials with fruit and vegetables, and investigations of the effects of fruit and vegetables on cardiovascular risk factors. Most of the evidence supporting a cardioprotective effect comes from observational epidemiological studies; these studies have reported either weak or nonsignificant associations. Controlled nutritional prevention trials are scarce and the existing data do not show any clear protective effects of fruit and vegetables on coronary heart disease. Under rigorously controlled experimental conditions, fruit and vegetable consumption is associated with a decrease in blood pressure, which is an important cardiovascular risk factor. However, the effects of fruit and vegetable consumption on plasma lipid levels, diabetes, and body weight have not yet been thoroughly explored. Finally, the hypothesis that nutrients in fruit and vegetables have a protective role in reducing the formation of atherosclerotic plaques and preventing complications of atherosclerosis has not been tested in prevention trials. Evidence that fruit and vegetable consumption reduces the risk of cardiovascular disease remains scarce thus far.

  4. Analysis of the Relationship between Anemia and Heart Function in Patients with Chronic Heart Failure Caused by Coronary Heart Disease%冠心病慢性心力衰竭患者贫血与心功能关系的研究

    Institute of Scientific and Technical Information of China (English)

    赵媛媛; 王林; 宋芳; 郭慧卿

    2011-01-01

    Objective: To investigate the relationship between anemia and heart function in hospitalized patients with chronic heart failure caused by coronary heart disease. Methods: Patients with chronic heart failure caused by coronary heart disease, who were hospitalized in the Second Hospital of Tianjin Medical University between December 2005 and January 2007, were included in this study. Based on hemoglobin (Hb) levels, patients were divided into anemia group and non-anemia group. The relationship of the incidence data and the cardiac functions was retrospectively analyzed between two groups. Results: There were 1 816 patients in this study, and the proportion of male and female patients with anemia were 16.34% (151/925) and 17.28% (154/891) respectively. The average age was higher in patients of anemia group than that of the non-anemia gronp (t = 6.823, P < 0.01). The proportion of ≥60 years of age was higher in patients of anemia group than that of non-anemia group (x2=13.312, P < 0.01 ). With the progression of the heart function classification, the value of hemoglobin had a lower gradually trend, and the proportion of anemia had a higher gradually trend. There was a negative correlation between the heart function classification and the value of hemoglobin ( r= -0.192, P <0.05). The value of left ventricular end diastolic diameter (LVEDD) was higher, but interventricular septum thickness (IVS) was lower. in patients of anemia group than that of non-anemia group. The majority proportion of left ventricular ejection fraction (LVEF)was ≤0.45 in patients of anemia group. The proportion of E/A ≤ 1 was significantly higher than E/A>1 in patients of two groups.Conclusion: The chronic heart failure should be treated with the correction of anemia at the same time. which could significantly improve the prognosis of patients with chronic heart failure.%目的:探讨冠心病慢性心力衰竭住院患者贫血与心功能之间的

  5. 磷酸肌酸钠对冠心病并慢性心力衰竭患者B型利钠肽及心功能的影响%The effects of Creatine Phosphate Sodium on B-type natriuretic peptide and heart function in patients combination with coronary heart disease and chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    滕伟; 薛永亮; 何兆辉; 刘朋

    2012-01-01

    目的 探讨注射用磷酸肌酸钠对冠心病并慢性心力衰竭患者B型利钠肽及心功能的影响.方法 选择冠心病慢性心力衰竭患者80例,随机分为对照组(n=40)以及磷酸肌酸钠治疗组(n=40),应用超声心动图检测患者左心室收缩末直径( LV ESD),左心室舒张末直径(LVEDD)及左室射血分数(LVEF);实验室检测B型利钠肽水平.用药治疗2周,观察治疗前后的指标变化.结果 治疗后磷酸肌酸钠治疗组LVESD、LVEDD与对照组比较均明显下降(P<0.05),LVEF明显增加(P<0.05).治疗2周后两组患者B型利钠肽均较治疗前降低,磷酸肌酸钠治疗组与对照组比较下降更显著(P<0.05).结论 磷酸肌酸钠可以改善冠心病并慢性心力衰竭患者的心功能,提高活动耐受.%Objective To assess the effects of Creatine Phosphate Sodium on heart function and B-type natriuretic peptide in patients combination with coronary heart disease and chronic heart failure. Methods 80 cases of coronary heart disease combined with chronic heart failure patients were randomly divided into the control group (n = 40) and the Creatine Phosphate Sodium treatment group (n = 40). Echocardiography was used to detect left ventricular end -systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF); B-type natriuretic peptide was tested by laboratory of the two groups. Drug treatment for 2 weeks, the changes of the indicators before and after treatment were observed. Results After treatment, compared with the control group, LVESD, LVEDD of the Creatine Phosphate Sodium treatment significantly decreased (P < 0.05), LVEF increased significantly (P < 0.05). After two weeks of treatment, levels of B-type natriuretic peptide decreased in both two groups than before treatment, and the decrease degree of the Creatine Phosphate Sodium treatment group was more obvious than the control group (P < 0.05). Conclusion Creatine

  6. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Køber, Lars;

    2005-01-01

    BACKGROUND: The level of the inactive N-terminal fragment of pro-brain (B-type) natriuretic peptide (BNP) is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic marker in patients with chronic coronary heart disease as well. We assessed...... the relationship between N-terminal pro-BNP (NT-pro-BNP) levels and long-term mortality from all causes in a large cohort of patients with stable coronary heart disease. METHODS: NT-pro-BNP was measured in baseline serum samples from 1034 patients referred for angiography because of symptoms or signs of coronary...... of myocardial infarction, angina, hypertension, diabetes, or chronic heart failure; creatinine clearance rate; body-mass index; smoking status; plasma lipid levels; LVEF; and the presence or absence of clinically significant coronary artery disease on angiography. CONCLUSIONS: NT-pro-BNP is a marker of long...

  7. Novel Risk Factors for Type II Diabetes Mellitus and Coronary Heart Disease

    NARCIS (Netherlands)

    A. Dehghan (Abbas)

    2010-01-01

    textabstractDespite the huge advances made in the understanding of type II diabetes and coronary heart disease (CHD), these diseases still constitute a major health problem. Since the 1950s, epidemiologists focused on chronic disorders, including type II diabetes and CHD. Major aims of their researc

  8. Identification of a shared genetic susceptibility locus for coronary heart disease and periodontitis

    NARCIS (Netherlands)

    Schaefer, A.S.; Richter, G.M.; Groessner-Schreiber, B.; Noack, D.; Nothnagel, M.; El Mokhtari, N.E.; Loos, B.G.; Jepsen, S.; Schreiber, S.

    2009-01-01

    Recent studies indicate a mutual epidemiological relationship between coronary heart disease (CHD) and periodontitis. Both diseases are associated with similar risk factors and are characterized by a chronic inflammatory process. In a candidate-gene association study, we identify an association of a

  9. Predictive Value of Auricular Diagnosis on Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Lorna Kwai-Ping Suen

    2012-01-01

    Full Text Available The ear has a reflexive property; therefore, various physical attributes may appear on the auricle when disorders of the internal organs or other parts of the body exist. Auricular diagnostics is an objective, painless, and noninvasive method that provides rapid access to information. Thus, the association between auricular signals and coronary heart disease (CHD should be further investigated. A case control study was conducted to determine the predictive value of auricular signals on 100 cases of CHD (CHD+ve = 50; CHD−ve = 50 via visual inspection, electrical skin resistance measurement, and tenderness testing. The results showed that the presence of an ear lobe crease (ELC was significantly associated with coronary heart disease. The “heart” zone of the CHD+ve group significantly exhibited higher conductivity on both ears than that of the controls. The CHD+ve group experienced significant tenderness in the “heart” region compared with those in the CHD−ve group in both acute and chronic conditions. Further studies that take into consideration the impact of age, race, and earlobe shape on ELC prevalence in a larger sample should be done.

  10. Manifestation of severe coronary heart disease after anabolic drug abuse.

    Science.gov (United States)

    Mewis, C; Spyridopoulos, I; Kühlkamp, V; Seipel, L

    1996-02-01

    Anabolic steroids are frequently abused, thus increasing the risk of cardiovascular disease, despite the known unfavorable influence on lipid profiles. We report on a young bodybuilder who presented with ventricular tachycardia as the first manifestation of severe underlying coronary heart disease. Coronary angiogram revealed severe stenotic lesions in the right coronary artery and the left descending coronary artery, and hypokinetic regions corresponded to posterolateral and anterior myocardial infarctions. This young patient had a history without any coronary risk factors, but with a 2-year abuse of the anabolic steroid stanazolol. No report published so far has shown possible atherogenic consequences of long-term abuse of stanazolol.

  11. Pathogenetic relationship between coronary heart disease and osteopenic syndrome

    Directory of Open Access Journals (Sweden)

    N. S. Mykhailovskaya

    2015-02-01

    Full Text Available The importance of the comorbidity problem of coronary heart disease and osteoporosis is caused by the rising prevalence, lack of early detection, prevention, severe complications and significant impact on the quality of life of the patients. Aim. In order to compile and submit a current point of view on the pathogenetic relationship between the coronary heart disease and the osteopenic syndrome we reviewed specialized literature. Conclusion. We established that coronary heart disease and osteoporosis have common mechanisms of progression involving a cascade of proinflammatory cytokines, osteoprotegerin, endothelial dysfunction, estrogen, calcium deficiency, the renin-angiotensin-aldosterone and sympathetic nervous system.

  12. An Update on Gender Disparities in Coronary Heart Disease Care.

    Science.gov (United States)

    Shah, Tina; Palaskas, Nicolas; Ahmed, Ameera

    2016-05-01

    Coronary heart disease (CHD), traditionally considered a male disease, causes far more deaths in women than cancer. The prevalence of CHD is lower in women at any age, but with advancing age, this differential decreases. The clinical outcomes including myocardial infarction mortality, all-cause mortality, and reinfarction rates are also worse in women with cardiovascular diseases (CVD) than in men. Yet, women appear to be underdiagnosed and undertreated for coronary heart disease. There is still a gap in the knowledge, understanding, and general awareness of CHD in women. This review provides updates in gender disparities in the management of risk factors, treatments, and outcomes of coronary heart disease.

  13. Psychological Perspectives on the Development of Coronary Heart Disease

    Science.gov (United States)

    Matthews, Karen A.

    2005-01-01

    Psychological science has new opportunities to have major input into the understanding of the development of coronary heart disease. This article provides an overview of advances in understanding the etiology of heart disease, recently applied technologies for measuring early stages of heart disease, and an accumulating base of evidence on the…

  14. Pathology of Coronary Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    Kenichi Sakakura

    2016-06-01

    Full Text Available There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO, because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.

  15. Benefits of Heart Rate Slowing With Ivabradine in Patients With Systolic Heart Failure and Coronary Artery Disease.

    Science.gov (United States)

    Borer, Jeffrey S; Deedwania, Prakash C; Kim, Jae B; Böhm, Michael

    2016-12-15

    Heart rate (HR) is a risk factor in patients with chronic systolic heart failure (HF) that, when reduced, provides outcome benefits. It is also a target for angina pectoris prevention and a risk marker in chronic coronary artery disease without HF. HR can be reduced by drugs; however, among those used clinically, only ivabradine reduces HR directly in the sinoatrial nodal cells without other known effects on the cardiovascular system. This review provides current information regarding the safety and efficacy of HR reduction with ivabradine in clinical studies involving >36,000 patients with chronic stable coronary artery disease and >6,500 patients with systolic HF. The largest trials, Morbidity-Mortality Evaluation of the If Inhibitor Ivabradine in Patients With Coronary Disease and Left Ventricular Dysfunction and Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients With Coronary Artery Disease, showed no effect on outcomes. The Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial, a randomized controlled trial in >6,500 patients with HF, revealed marked and significant HR-mediated reduction in cardiovascular mortality or HF hospitalizations while improving quality of life and left ventricular mechanical function after treatment with ivabradine. The adverse effects of ivabradine predominantly included bradycardia and atrial fibrillation (both uncommon) and ocular flashing scotomata (phosphenes) but otherwise were similar to placebo. In conclusion, ivabradine improves outcomes in patients with systolic HF; rates of overall adverse events are similar to placebo.

  16. The epidemic of the 20(th) century: coronary heart disease.

    Science.gov (United States)

    Dalen, James E; Alpert, Joseph S; Goldberg, Robert J; Weinstein, Ronald S

    2014-09-01

    Heart disease was an uncommon cause of death in the US at the beginning of the 20th century. By mid-century it had become the commonest cause. After peaking in the mid-1960s, the number of heart disease deaths began a marked decline that has persisted to the present. The increase in heart disease deaths from the early 20th century until the 1960s was due to an increase in the prevalence of coronary atherosclerosis with resultant coronary heart disease, as documented by autopsy studies. This increase was associated with an increase in smoking and dietary changes leading to an increase in serum cholesterol levels. In addition, the ability to diagnose acute myocardial infarction with the aid of the electrocardiogram increased the recognition of coronary heart disease before death. The substantial decrease in coronary heart disease deaths after the mid-1960s is best explained by the decreased incidence, and case fatality rate, of acute myocardial infarction and a decrease in out-of-hospital sudden coronary heart disease deaths. These decreases are very likely explained by a decrease in coronary atherosclerosis due to primary prevention, and a decrease in the progression of nonobstructive coronary atherosclerosis to obstructive coronary heart disease due to efforts of primary and secondary prevention. In addition, more effective treatment of patients hospitalized with acute myocardial infarction has led to a substantial decrease in deaths due to acute myocardial infarction. It is very likely that the 20th century was the only century in which heart disease was the most common cause of death in America.

  17. Pulpal inflammation and incidence of coronary heart disease.

    Science.gov (United States)

    Joshipura, Kaumudi J; Pitiphat, Waranuch; Hung, Hsin-Chia; Willett, Walter C; Colditz, Graham A; Douglass, Chester W

    2006-02-01

    Pulpal inflammation is primarily caused by coronal caries, and leads to root canal therapy (RCT). Chronic inflammation has been associated with various cardiovascular diseases. This study evaluates the association between pulpal inflammation (using RCT as a surrogate) and incident coronary heart disease (CHD). We report results among males from the Health Professionals Follow-Up Study (HPFS), excluding participants with prior cardiovascular disease or diabetes. We obtained RCT data from the HPFS cohort (n = 34,683). Compared to men without RCT, those with >/=1 RCT had a multivariate RR of 1.21 (95% CI 1.05-1.40) for CHD. The association was limited to dentists (RR = 1.38; 95% CI 1.14-1.67). There was no association among nondentists (RR = 1.03). Dental caries was not associated with CHD. The results suggest a possible modest association between pulpal inflammation and CHD.

  18. Dietary fat and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Jakobsen, Marianne U; Overvad, Kim; Dyerberg, Jørn

    2004-01-01

    , total energy and protein intake were fixed. Differences in intake of energy from fat thus reflected complementary differences in intake of energy from carbohydrates. A 5% higher level of energy from saturated fat intake was associated with a 36% greater risk of coronary heart disease among women (hazard...... ratio (HR) = 1.36, 95% confidence interval (CI): 0.98, 1.88). No overall association between saturated fat and coronary heart disease was found among men. However, age-dependent analyses showed that saturated fat was positively associated with coronary heart disease among the younger men (HR = 1.29, 95......In a 16-year follow-up study (ending in 1998) of 3,686 Danish men and women aged 30-71 years at recruitment, the association between energy intake from dietary fat and the risk of coronary heart disease was evaluated while assessing the possible modifying role of gender and age. In the models used...

  19. Influence of drug treatment on glucocorticoid receptor levels in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    JI Hong; GUO Wei-zao; YAN Zhi-hong; LI Di; LU Cui-lian

    2010-01-01

    Background Glucocorticoid signaling exerts major roles in inflammation, metabolism and depression, which are three crucial factors accompanying or underlying coronary heart disease. Although accumulating evidence indicates the influence of glucocorticoids on the pathology and treatment of coronary heart disease, there is still a dearth of pharmaceutical mechanisms for this relationship. This study aimed to investigate the influence of drug treatment on glucocorticoid receptor levels in coronary heart disease.Methods Eighty hospitalized patients (average age (59.0 7.5) years, 46 male and 34 female) with coronary heart disease were categorized into four groups with 20 members in each according to one of the four drugs they were treated with. The four drugs were: nitrated derivative isosorbide dinitrate, the beta-adrenergic receptor blocker metoprolol, the calcium antagonist nifedipine, and the HMG-CoA reductase inhibitor lovastatin. Glucocorticoid receptor protein levels of peripheral blood lymphocytes were tested using immunoblotting analysis before and after one month of treatment. Results Immunoblotting analysis showed increased glucocorticoid receptor levels after treatment with metoprolol and nifedipine. There were no statistically significant changes of glucocorticoid receptor levels after treatment with isosorbide dinitrate or lovastatin, although there were trends of up-regulation of glucocorticoid receptor expression after both treatments.Conclusions Both the beta-blocker and the calcium blocker can increase glucocorticoid receptor levels after chronic administration. This effect suggests a mechanism for their anti-inflammatory and other therapeutic roles for coronary heart disease and comorbid disorders.

  20. Reconstitution of coronary vasculature by an active fraction of Geum japonicum in ischemic hearts

    Science.gov (United States)

    Chen, Hao; Cheng, Lei; Lin, Xiaoli; Zhou, Xiaping; Cai, Zhiming; Li, Ming

    2014-02-01

    Chronic coronary heart disease (cCHD) is characterized by atherosclerosis, which progressively narrows the coronary artery lumen and impairs myocardial blood flow. Restoration of occluded coronary vessels with newly formed collaterals remains an ideal therapeutic approach due to the need for redirecting blood flow into the ischemic heart. In this study, we investigated the effect of an active fraction isolated from Geum joponicum (AFGJ) on angiogenesis in cCHD hearts. Our results demonstrated that AFGJ not only enhanced capillary tube formation of endothelial cells, but also promoted the growth of new coronary collaterals (at the diameter 0.021-0.21 mm) in the ischemic region of hearts in rat cCHD model. Our study also indicated that the growth of new collaterals in ischemic hearts resulted in improved functional recovery of the cCHD hearts as demonstrated by ECG and echocardiography analyses. These data suggest that AFGJ may provide a novel therapeutic method for effective treatment of cCHD.

  1. Coronary angiographic findings in patients with glucometabolic abnormality and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    李勇

    2012-01-01

    Objective To analyze the characteristics of coronary angiographic(CAG) findings in patients with glucometabolic abnormality and coronary heart disease (CAD).Methods A total of 130 patients with CAD confirmed by CAG were included in this study. The blood pressure, blood glucose

  2. Fabric heart retractor for coronary artery bypass operations.

    Science.gov (United States)

    Kazama, S; Ishihara, A

    1993-06-01

    A new device for heart retraction during coronary artery bypass operations has been developed. It provides safe and steady support and an unobstructed view of the lateral, posterior, and inferior surfaces of the heart; in addition, it is easy to handle.

  3. On Two Hearts and Other Coronary Reflections.

    Science.gov (United States)

    Flannery, Maura C.

    1998-01-01

    Speculates as to how understanding of heart disease has developed and provides insight into how medical science makes progress. Summarizes the state of knowledge on arteriosclerosis, heart attacks, and exercising the heart. Contains 23 references. (DDR)

  4. MORPHOLOGICAL STUDY OF CORONARY SINUS IN HUMAN CADAVERIC HEARTS

    Directory of Open Access Journals (Sweden)

    R. Manoranjitham

    2015-09-01

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

  5. Relationship of left heart size and left ventricular mass with exercise capacity in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    SHEN Yu-qin; WANG Le-min; CHE Lin; SONG Hao-ming; ZHANG Qi-ping

    2011-01-01

    Background Impaired exercise capacity is one of the most common clinical manifestations in patients with chronic heart failure (CHF). The severity of reduced exercise capacity is an indicator of disease prognosis. The aim of the current study was to investigate the association between left heart size and mass with exercise capacity.Methods A total of 74 patients were enrolled in the study, with 37 having congestive heart failure (left ventricular ejection fraction (LVEF) <0.45) and the other 37 with coronary heart disease (by coronary angiography) serving as the control group (LVEF >0.55). Echocardiography and cardiopulmonary exercise test were performed. The multiply linear regression model was used to evaluate the association between echocardiogrphic indices and exercise capacities.Results The study showed that left ventricular end diastolic / systolic diameter (LVEDD/LVESD), left atrial diameter (LAD) and left ventricular mass index (LVMI) were significantly enlarged in patients with chronic heart failure compared with controls (P <0.01). The VO2AT, Peak VO2, Load AT, and Load Peak in chronic heart failure patients were also significantly reduced compared with controls (P <0.05), VE/VCO2 slope was increased in patients with chronic heart failure (P <0.01). Multivariate linear regression analysis indicated that the patients' exercise capacity was significantly associated with the left heart size and mass, however, the direction and/or strength of the associations sometimes varied in chronic heart failure patients and controls. Load AT correlated negatively with LVEDD in chronic heart failure patients (P=0.012), while Load AT correlated positively with LVEDD in control patients (P=0.006). VE/VCO2 slope correlated positively with LAD (B=0.477, P <0.0001) in chronic heart failure patients, while the VE/VCO2 slope correlated negatively with LAD in control patients (P=0.009).Conclusion The study indicates that the size of LVEDD and LAD are important

  6. Successful percutaneous coronary intervention for chronic total occlusion of right coronary artery in patient with dextrocardia.

    Science.gov (United States)

    Munawar, Muhammad; Hartono, Beny; Iskandarsyah, Kurniawan; Nguyen, Thach N

    2013-07-01

    Situs inversus with dextrocardia is rare congenital anomaly. Coronary artery disease in such patients is quite rare. We reported a 52-year-old man with dextrocardia and chronic total occlusion at the proximal right coronary artery just after conus branch and severe stenosis at the proximal left anterior descending artery. He underwent successful percutaneous coronary intervention with stenting of total occluded right coronary artery and simultaneously stenting of the proximal left anterior descending artery.

  7. Echocardiographic evaluation of coronary arteries in congenital heart disease.

    Science.gov (United States)

    Freire, Grace; Miller, Michelle S

    2015-12-01

    Among populations of patients with the congenital heart disease, there is considerable diversity in the anatomy of the coronary arteries. Understanding these anatomical differences is vitally important in directing interventions and surgical repair. In this report, the authors describe the echocardiographic evaluation of the variants of coronary artery anatomy in the following lesions: transposition of the great arteries, congenitally corrected transposition of the great arteries, double-inlet left ventricle, common arterial trunk, tetralogy of Fallot, and double-outlet right ventricle.

  8. [CHARACTERISTIC OF ALTERATIONS OF ARTERIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEPATITIS C].

    Science.gov (United States)

    Guliaev, N I; Kuznetsov, V V; Poltareĭko, D S; Qleksiuk, I B; Gordienko, A V; Barsukov, A V

    2015-01-01

    The article presents an assessment of degree and type of atherosclerosis of coronary and non-coronary vessels in old patients with ischemic heart disease associated with chronic viral hepatitis C (VHC), the incidence of myocardial infarction and the possibility of participation chronic VHC in atherogenesis. Patients with ischemic heart disease have correlation of atherosclerosis of arteries with age, hypercholesterinemia. Patients without chronic VHC more often give a higher risk of myocardial infarction, especially in early period (1-1,5 years) of onset of ischemic heart disease clinical implications. Patients with ischemic heart disease associated with chronic viral hepatitis C more often have generalized alterations in vessels, multifocal type of alteration. So, participation of VHC in atherogenesis is most probably connected with maintenance of chronic immune inflammation in vascular endothelium.

  9. Ivabradine in stable coronary artery disease without clinical heart failure

    DEFF Research Database (Denmark)

    Fox, Kim; Ford, Ian; Steg, Philippe Gabriel

    2014-01-01

    BACKGROUND: An elevated heart rate is an established marker of cardiovascular risk. Previous analyses have suggested that ivabradine, a heart-rate-reducing agent, may improve outcomes in patients with stable coronary artery disease, left ventricular dysfunction, and a heart rate of 70 beats per...... minute or more. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of ivabradine, added to standard background therapy, in 19,102 patients who had both stable coronary artery disease without clinical heart failure and a heart rate of 70 beats per minute or more (including 12......,049 patients with activity-limiting angina [class ≥II on the Canadian Cardiovascular Society scale, which ranges from I to IV, with higher classes indicating greater limitations on physical activity owing to angina]). We randomly assigned patients to placebo or ivabradine, at a dose of up to 10 mg twice daily...

  10. Diagnosing Coronary Heart Disease using Ensemble Machine Learning

    Directory of Open Access Journals (Sweden)

    Kathleen H. Miao

    2016-10-01

    Full Text Available Globally, heart disease is the leading cause of death for both men and women. One in every four people is afflicted with and dies of heart disease. Early and accurate diagnoses of heart disease thus are crucial in improving the chances of long-term survival for patients and saving millions of lives. In this research, an advanced ensemble machine learning technology, utilizing an adaptive Boosting algorithm, is developed for accurate coronary heart disease diagnosis and outcome predictions. The developed ensemble learning classification and prediction models were applied to 4 different data sets for coronary heart disease diagnosis, including patients diagnosed with heart disease from Cleveland Clinic Foundation (CCF, Hungarian Institute of Cardiology (HIC, Long Beach Medical Center (LBMC, and Switzerland University Hospital (SUH. The testing results showed that the developed ensemble learning classification and prediction models achieved model accuracies of 80.14% for CCF, 89.12% for HIC, 77.78% for LBMC, and 96.72% for SUH, exceeding the accuracies of previously published research. Therefore, coronary heart disease diagnoses derived from the developed ensemble learning classification and prediction models are reliable and clinically useful, and can aid patients globally, especially those from developing countries and areas where there are few heart disease diagnostic specialists.

  11. Chronic oral pathology and ischemic heart disease and its complications

    Directory of Open Access Journals (Sweden)

    Ivaschenko Y.Y.

    2013-09-01

    Full Text Available Objective: to establish the relationship of chronic generalized periodontitis, multiple cavities and dentofacial anomalies with various forms of coronary heart disease and its complications. Material and methods. The study included 294 patients with coronary heart disease and its complications. The patients were divided into two groups. Group I included 89 patients with acute Q-myocardial infarction, which was placed in the presence of at least 2 of the following criteria identified on the basis of a comprehensive clinical and instrumental examination: clinical, laboratory confirmation (CK-MB, electrocardiographic signs of damage or myocardial necrosis. The following statistical methods were used: multi-variate and univariate analysis of variance, non-parametric tests, crosstabulation, chi-square test, Fisher»s exact test. As a measure of variability of the normal distribution standard deviation was used. Results. It is noted that in patients with myocardial infarction more likely than in patients without coronary heart attack in history severe generalized periodontitis, dentofacial anomalies and multiple dental caries have appeared. In patients with acute myocardial infarction, severe periodontal disease has been associated with increased fibrinogen levels in the blood and an increase in the dispersion of the interval QT, which are known to be indicators of poor prognosis in acute coronary disease.

  12. Perceived job insecurity as a risk factor for incident coronary heart disease

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Nyberg, Solja T; Batty, George David;

    2013-01-01

    To determine the association between self reported job insecurity and incident coronary heart disease.......To determine the association between self reported job insecurity and incident coronary heart disease....

  13. Coronary artery disease in patients with chronic kidney disease: a brief literature review

    Directory of Open Access Journals (Sweden)

    Mostafa Dastani

    2015-09-01

    Full Text Available Cardiovascular is the major cause of death in chronic kidney disease and end-stage renal disease. The cardiovascular mortality rate of patients with renal impairment is evaluated to be higher than general population. Coronary artery disease seems to be an important type of cardiovascular complication among patients with chronic kidney disease and end-stage renal disease before the renal replacement therapy. Due to the strong association between chronic kidney disease and the incidence of coronary artery disease, accurate screening, diagnosis, and management of cardiovascular complications would be essential in patients at different stages of renal dysfunction. Despite the need for the comprehensive knowledge about different aspects of coronary artery disease in patients with renal failure, there is not sufficient evidence regarding the pathophysiology, ideal diagnosis, and treatment strategies for coronary heart disease in population with chronic kidney disease. In this study, we briefly reviewed the existing literatures about the possible screening, diagnosis, and the treatment approaches of risk of coronary heart disease in patients with kidney dysfunction.

  14. Clinical Significance of Serum Bilirubin Detection of Patient with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    TAO Li; LUO Rui; ZHUANG Diankui

    2004-01-01

    Objective To explore the relation between serum bilirubin and coronary heart disease.Methods Compare the level of serum bilirubin among patients with coronary heart disease, patients with other disease and normal persons. Results The level of serum bilirubin of patients with coronary heart disease is higher than that of normal persons. Conclusion The reduction of density of serum bilirubin is one of the independent risk factors of coronary heart disease.

  15. The role of coronary artery disease in heart failure.

    Science.gov (United States)

    Lala, Anuradha; Desai, Akshay S

    2014-04-01

    Enhanced survival following acute myocardial infarction and the declining prevalence of hypertension and valvular heart disease as contributors to incident heart failure (HF) have fueled the emergence of coronary artery disease (CAD) as the primary risk factor for HF development. Despite the acknowledged role of CAD in the development of HF, the role of coronary revascularization in reducing HF-associated morbidity and mortality remains controversial. The authors review key features of the epidemiology and pathophysiology of CAD in patients with HF as well as the emerging data from recent clinical trials that inform the modern approach to management.

  16. 75 FR 76525 - Food Labeling; Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2010-12-08

    ...; Phytosterols and Risk of Coronary Heart Disease; Proposed Rule #0;#0;Federal Register / Vol. 75 , No. 235...; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug Administration, HHS. ACTION: Proposed... risk of coronary heart disease (CHD) for use on food labels and in food labeling. The agency is...

  17. 77 FR 9842 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2012-02-21

    ...; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug Administration, HHS. ACTION: Notification... phytosterols and risk of coronary heart disease (CHD), in a manner that is consistent with FDA's February 14... use of a health claim regarding reduced risk of coronary heart disease (CHD) for...

  18. What Are Coronary Heart Disease Risk Factors?

    Science.gov (United States)

    ... t even on Jennifer's radar. And when this television news reporter suffered a heart attack at age ... part of the National Institutes of Health (NIH). Sleep Apnea Research: The HeartBeat Study 06/07/2012 ...

  19. How Is Coronary Heart Disease Diagnosed?

    Science.gov (United States)

    ... signs of a previous or current heart attack . Stress Testing During stress testing , you exercise to make ... 2009, this project provided six awards at five academic institutions to identify genetic connections to heart, lung, ...

  20. Anemic syndrome in patients with ischemic heart disease and chronic heart failure (review

    Directory of Open Access Journals (Sweden)

    Shvarts Y.G.

    2011-12-01

    Full Text Available Anemic syndrome of different severity often accompanies ischemic heart disease (IHD and chronic heart failure (CHF. Anemia has association with unfavorable prognosis in patients with all forms of CVD — acute and chronic. In this article the authors summarize a literature review of English articles dedicated to the problem of anemia and ischemic heart disease (IHD and the results of original research on the relationship between anemic syndrome and prognosis in the hospitalized patients with IHD and chronic heart failure (CHF. Anemia is frequently observed in patients with CHF, and evidence suggests that anemia might be associated with an increased mortality in both systolic and diastolic chronic heart failure (CHF, morbidity and rate of hospitalization in CHF patients. Moreover, CHF itself could be involved in the pathogenesis of anemia. Early studies suggested a pathogenic role of inflammation mediators. The normalization of hemoglobin concentration by EPO and iron supply in patients with CHF and chronic renal insufficiency results in improved exercise capacity by increasing oxygen delivery and improving cardiac function. However, there is limited information concerning the association of hemoglobin concentration and new onset of clinically recognized coronary artery disease, and lack of information about the effect of anemia treatment on prognosis of acute forms of IHD

  1. Diet and coronary heart disease. The National Heart Foundation of Australia.

    Science.gov (United States)

    Shrapnel, W S; Calvert, G D; Nestel, P J; Truswell, A S

    1992-05-04

    Over the last four decades there has been extensive research into the links between diet and coronary heart disease. The most recent literature is reviewed in this position statement. The clinical and public health aspects of the National Heart Foundation's nutrition policy are based on this review. The key points are as follows: 1. Saturated fatty acids A high intake of saturated fatty acids is strongly associated with elevated serum cholesterol and LDL-cholesterol levels and increased risk of coronary heart disease. 2. The n-6 polyunsaturated fatty acids The n-6 polyunsaturated fatty acids (principally linoleic acid) lower serum cholesterol levels when substituted for saturated fats and probably have an independent cholesterol-lowering effect. 3. The n-3 polyunsaturated fatty acids (fish oils) The n-3 polyunsaturated fatty acids reduce serum triglyceride levels, decrease the tendency to thrombosis and may further reduce coronary risk through other mechanisms. 4. Monounsaturated fatty acids Monounsaturated fatty acids reduce serum cholesterol levels when substituted for saturated fatty acids. It is not clear whether this is an independent effect or simply the result of displacement of saturates. 5. Trans fatty acids Trans fatty acids may increase serum cholesterol levels and can be reckoned to be equivalent to saturated fatty acids. 6. Total fat Total fat intake, independent of fatty acid type, is not strongly associated with coronary heart disease but may contribute to obesity. Associations between total fat intake and coronary heart disease are primarily mediated through the saturated fatty acid component. 7. Dietary cholesterol Dietary cholesterol increases serum cholesterol levels in some people and may increase risk of coronary heart disease. 8. Alcohol A high intake of alcohol increases blood pressure and serum triglyceride levels and increases mortality from cardiovascular disease. Light alcohol consumption reduces the risk of coronary heart disease. 9

  2. Impacts of chronic kidney disease and albuminuria on associations between coronary heart disease and its traditional risk factors in type 2 diabetic patients – the Hong Kong diabetes registry

    Directory of Open Access Journals (Sweden)

    Cockram Clive S

    2007-12-01

    Full Text Available Abstract Background Glycated haemoglobin (HbA1c, blood pressure and body mass index (BMI are risk factors for albuminuria, the latter in turn can lead to hyperlipidaemia. We used novel statistical analyses to examine how albuminuria and chronic kidney disease (CKD may influence the effects of other risk factors on coronary heart disease (CHD. Methods A prospective cohort of 7067 Chinese type 2 diabetic patients without history of CHD enrolled since 1995 were censored on July 30th, 2005. Cox proportional hazard regression with restricted cubic spline was used to auto-select predictors. Hazard ratio plots were used to examine the risk of CHD. Based on these plots, non-linear risk factors were categorised and the categorised variables were refitted into various Cox models in a stepwise manner to confirm the findings. Results Age, male gender, duration of diabetes, spot urinary albumin: creatinine ratio, estimated glomerular filtration rate, total cholesterol (TC, high density lipoprotein cholesterol (HDL-C and current smoking status were risk factors of CHD. Linear association between TC and CHD was observed only in patients with albuminuria. Although in general, increased HDL-C was associated with decreased risk of CHD, full-range HDL-C was associated with CHD in an A-shaped manner with a zenith at 1.1 mmol/L. Albuminuria and CKD were the main contributors for the paradoxically positive association between HDL-C and CHD for HDL-C values less than 1.1 mmol/L. Conclusion In type 2 diabetes, albuminuria plays a linking role between conventional risk factors and CHD. The onset of CKD changes risk associations between lipids and CHD.

  3. 白细胞介素-1基因型与慢性牙周炎、冠心病相关性研究%Interleukin-1 genotype and its assocation with chronic periodontitis and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    钟良军; 张琼; 张蕾; 孙大磊; 张源明

    2010-01-01

    目的:探讨白细胞介素-1A+4845(interleukin-1A+4845,IL-1A+4845)、白细胞介素-1B-31(interleukin-1B-31,IL-1B-31)基因型与慢性牙周炎(chronic periodontitis,CP)、冠心病(coronary heart disease,CHD)易感性的关系.方法:收集中重度慢性牙周炎病人127例,冠心病病人123例,慢性牙周炎合并冠心病病人87例和健康对照117例的颊黏膜拭子,提取DNA,用聚合酶链反应一限制性片段长度多态性法(poly-merase chain reaction-restriction fragment length polymorphism,PCR-RFLP)对IL-1A+4845/Fnu 4H1、IL-1B-31/Alu I位点的基因型进行检测,比较各基因型在4组间检出率的差别.结果:①IL-IA+4845基因型在4组间基因型的分布无统计学差异;②IL-1B-31等位基因T在中重度慢性牙周炎组中的检出率显著高于健康对照组,而在冠心病组与健康组、慢性牙周炎合并冠心病组与健康组间的分布无统计学意义.结论:IL-1B-31等位基因T可能是中重度慢性牙周炎的一个遗传学标志.

  4. Helicobacter pylori vs coronary heart disease- searching for connections

    Institute of Scientific and Technical Information of China (English)

    Magdalena; Chmiela; Adrian; Gajewski; Karolina; Rudnicka

    2015-01-01

    In this review,we discussed the findings and concepts underlying the potential role of Helicobacter pylori(H.pylori) infections in the initiation,development or persistence of atherosclerosis and coronary heart disease(CHD).This Gram-negative bacterium was described by Marshall and Warren in 1984.The majority of infected subjects carries and transmits H.pylori with no symptoms; however,in some individuals these bacteria may cause peptic ulcers,and even gastric cancers.The widespread prevalence of H.pylori infections and the fact that frequently they remain asymptomatic may suggest that,similarly to intestinal microflora,H.pylori may deliver antigens that stimulate not only local,but also systemic inflammatory response.Recently,possible association between H.pylori infection and extragastric disorders has been suggested.Knowledge on the etiology of atherosclerosis together with current findings in the area of H.pylori infections constitute the background for the newly proposed hypothesis that those two processes may be related.Many research studies confirm the indirect association between the prevalence of H.pylori and the occurrence of CHD.According to majority of findings the involvement of H.pylori in this process is based on the chronic inflammation which might facilitate the CHDrelated pathologies.It needs to be elucidated,if the infection initiates or just accelerates the formation of atheromatous plaque.

  5. Interleukin-6 receptor pathways in coronary heart disease

    DEFF Research Database (Denmark)

    Sarwar, Nadeem; Butterworth, Adam S; Freitag, Daniel F

    2012-01-01

    Persistent inflammation has been proposed to contribute to various stages in the pathogenesis of cardiovascular disease. Interleukin-6 receptor (IL6R) signalling propagates downstream inflammation cascades. To assess whether this pathway is causally relevant to coronary heart disease, we studied...

  6. Inflammatory cytokines and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Kaptoge, Stephen; Seshasai, Sreenivasa Rao Kondapally; Gao, Pei

    2014-01-01

    Because low-grade inflammation may play a role in the pathogenesis of coronary heart disease (CHD), and pro-inflammatory cytokines govern inflammatory cascades, this study aimed to assess the associations of several pro-inflammatory cytokines and CHD risk in a new prospective study, including meta...

  7. Tea and coronary heart disease : protection through estrogenlike activity?

    NARCIS (Netherlands)

    Geleijnse, J.M.; Witteman, J.C.; Launer, L.J.; Lamberts, S.J.; Pols, H.A.

    2000-01-01

    Tea drinking appears to be protective against coronary heart disease in a number of epidemiologic studies. It has been suggested that tea flavonols with antioxidative activity, including quercetin, kaempferol, and myricetin,1 could account for the favorable effect on cardiovascular health. In the ol

  8. Genetic and metabolomic approaches for coronary heart disease risk prediction

    NARCIS (Netherlands)

    Vaarhorst, Anika Antoinette Maria

    2014-01-01

    The prediction of coronary heart disease (CHD) risk is currently based on traditional risk factors (TRFs) like age, sex, lipid levels, blood pressure. Here we investigated, using the CAREMA cohort, whether this prediction can potentially be improved by applying a metabolomics approach and by includi

  9. Prospective studies on diet and coronary heart disease

    NARCIS (Netherlands)

    Oomen, C.M.

    2001-01-01

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

  10. Parity, breastfeeding and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Peters, Sanne Ae; van der Schouw, Yvonne T; Wood, Angela M;

    2016-01-01

    OBJECTIVE: There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among...

  11. Environmental Stress and Biobehavioral Antecedents of Coronary Heart Disease.

    Science.gov (United States)

    Krantz, David S.; And Others

    1988-01-01

    Provides an overview of research on the biobehavioral antecedents of coronary heart disease, including stressful occupational settings characterized by high demands and little control over the job, and the Type A pattern, particularly hostility and mode of anger expression (anger-in). Discusses research on physiologic responsiveness (reactivity)…

  12. Dyslipidaemia and coronary heart disease: nature vs nurture.

    Science.gov (United States)

    Hegele, R A

    In order to enhance health care for patients with coronary heart disease (CHD), genetic markers of susceptibility could be incorporated into a formula for risk evaluation that includes traditional factors. Preventive measures could then be targeted towards 'high-risk' subjects. But can the genetic component be dissected from the environmental component in an intermediate CHD phenotype, such as plasma lipoproteins.

  13. Effect of initial periodontal therapy on chronic periodontitis patients with stable coronary heart disease%伴冠心病牙周炎患者牙周基础治疗的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    段向青; 欧阳翔英; 胡荣

    2009-01-01

    目的 观察伴有冠状动脉粥样硬化性心脏病(以下简称冠心病)的牙周炎患者牙周基础治疗后临床指标的变化,并评价其治疗效果.方法 32例伴有冠心病的牙周炎患者,在1个月内完成口腔卫生指导、洁治、刮治和根面平整术,治疗后6周复查,进行牙周维护,在治疗前和治疗后3个月时记录全口牙周情况:菌斑指数(plaque index,PLI)、探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、牙龈出血指数(bleeding index,BI),并进行血清超敏C-反应蛋白(high-sensitivity C-reactive,hs-CRP)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(high-density lipoprotein,HDL)、低密度脂蛋白胆固醇(low-density lipoprotein,LDL)及血糖的检测.结果 牙周治疗后3个月患者的临床指标显著改善,平均PD由(3.95±0.15)mm减少至(2.93±0.21)mm,平均AL由(3.08±0.43)mm降至(2.43±0.37)mm,PD≥5 mm的位点百分比由(22.37±6.88)%降至(3.00±1.80)%,差异均有统计学意义(P<0.01).牙周治疗后3个月患者的hs-CRP水平显著降低,由(2.71±2.69)mg/L降至(1.99±2.14)mg/L,差异有统计学意义(P<0.01);总胆固醇,甘油三酯、HDL、LDL及血糖的测定值与治疗前相比差异均无统计学意义(P>0.05).结论 在本研究范围内,对于伴有冠心病的牙周炎患者,牙周基础治疗取得良好的治疗效果,患者的牙周临床指标改善,血清hs-CRP水平降低.%Objective To investigate the clinical results of initial periodontal therapy on chronic periodontitis patients with stable coronary heart disease. Methods Thirty-two chronic periodontitis patients with stable coronary heart disease were included in this prospective study. All subjects received oral hygiene instruction, scaling and root planing and clinically monitored for 3 months. The clinical parameters,including plaque index(PLI) , probing depth (PD) , attachment loss(AL) and bleeding index(BI) , were recorded at baseline and 3 months after

  14. 10.9.Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920084 Clinical and radiological analysesof 100 cases of selective coronary angiogra-phy.ZENG Xingde (曾行德),et al.Dept Radiol,Nanfang Hosp,1st Milit Med Coll.Chin Cir J 1991;6 (5): 399-401.Clinical and radiological analyses of 100 cases(89 males and 11 females),with age ranged 29-72yrs (mean 53.3 yrs.),of selective coronaryangiography were presented.Among the 100

  15. Job Dissatisfaction and Coronary Heart Disease

    Science.gov (United States)

    Friis, Robert

    1976-01-01

    Based on the psychosocial factor that life dissatisfactions may be associated with physical illnesses, this research examines the relationship between job dissatisfaction and its causal link to premature death from heart disease. (Author/RK)

  16. Chronic heart failure and micronutrients.

    Science.gov (United States)

    Witte, K K; Clark, A L; Cleland, J G

    2001-06-01

    Heart failure (HF) is associated with weight loss, and cachexia is a well-recognized complication. Patients have an increased risk of osteoporosis and lose muscle bulk early in the course of the disease. Basal metabolic rate is increased in HF, but general malnutrition may play a part in the development of cachexia, particularly in an elderly population. There is evidence for a possible role for micronutrient deficiency in HF. Selective deficiency of selenium, calcium and thiamine can directly lead to the HF syndrome. Other nutrients, particularly vitamins C and E and beta-carotene, are antioxidants and may have a protective effect on the vasculature. Vitamins B6, B12 and folate all tend to reduce levels of homocysteine, which is associated with increased oxidative stress. Carnitine, co-enzyme Q10 and creatine supplementation have resulted in improved exercise capacity in patients with HF in some studies. In this article, we review the relation between micronutrients and HF. Chronic HF is characterized by high mortality and morbidity, and research effort has centered on pharmacological management, with the successful introduction of angiotensin-converting enzyme inhibitors and beta-adrenergic antagonists into routine practice. There is sufficient evidence to support a large-scale trial of dietary micronutrient supplementation in HF.

  17. CPAP in chronic heart failure

    Directory of Open Access Journals (Sweden)

    F. Lari

    2013-05-01

    Full Text Available BACKGROUND Chronic Heart Failure (CHF represents worldwide a clinical condition with increasing prevalence, high social, economical and epidemiological impact. Even if new pharmacological and non-pharmacological approachs have been recently used, mortality remains high in general population and quality of life is poor in these patients. DISCUSSION The association between CHF and sleep disorders is frequent but still undervalued: sleep apnoeas in CHF produce negative effects on cardiovascular system and an aggravation of prognosis. CPAP (Continuous Positive Airway Pressure is commonly used to treat sleep apnoeas in patients without cardiac involvement and it is also used in first line treatment of acute cardiogenic pulmonary oedema thanks to its hemodynamic and ventilatory effects. The addition of nightly CPAP to standard aggressive medical therapy in patients with CHF and sleep apnoeas reduces the number of apnoeas, reduces the blood pressure, and the respiratory and cardiac rate, reduces the activation of sympathetic nervous system, the left ventricular volume and the hospitalization rate; besides CPAP increases the left ventricular ejection fraction, amd the oxygenation, it improves quality of life, tolerance to exercise and seems to reduce mortality in patients with a higher apnoeas suppression. CONCLUSIONS These implications suggest to investigate sleep apnoeas in patients with CHF in order to consider a possible treatment with CPAP. Further studies need to be developed to confirm the use of CPAP in patients with CHF without sleep disorders.

  18. Clinical significance of change of various indexes levels in patients with coronary heart disease complicating chronic chro-nic heart failure%各项指标水平变化在冠心病慢性心力衰竭患者的临床意义

    Institute of Scientific and Technical Information of China (English)

    许淑文; 李艳; 郑红云; 戴雯

    2015-01-01

    目的:探讨血清同型半胱氨酸(Hcy)、血尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL‐C)、低密度脂蛋白胆固醇(LDL‐C)与脂蛋白 a[Lp(a)]联合检测在冠心病慢性心力衰竭发生、发展中的应用价值。方法分别检测319例慢性心力衰竭患者和102例健康对照者血液中 Hcy 、UA 、TC 、TG 、HDL‐C 、LDL‐C 、Lp(a)水平。结果与健康对照组比较,冠心病慢性心力衰竭组 Hcy 、UA 和 Lp(a)水平均明显升高,差异有统计学意义(P<0.05);TC 、HDL‐C 、LDL‐C 水平降低,差异有统计学意义(P <0.05);而 TG 水平差异无统计学意义(P>0.05);随着心功能分级增加,Hcy 、UA 、Lp(a)水平升高,而 TC 、HDL‐C 、LDL‐C 水平降低,差异有统计学意义(P<0.05),而 TG 水平差异无统计学意义(P>0.05);两两比较不同心功能之间 UA 水平,差异有统计学意义(P<0.05),心功能Ⅲ级、Ⅳ级比Ⅰ级、Ⅱ级的 Lp(a)水平高(P<0.05),而 TC 、HDL‐C 、LDL‐C 水平降低(P<0.05);冠心病慢性心力衰竭患者 Hcy 与 UA ,TC 与 TG 、HDL‐C 、LDL‐C 、Lp(a),TG 与 LDL‐C ,HDL‐C 与 LDL‐C ,LDL‐C 与 Lp (a)呈正相关(P<0.05)。 UA 与 HDL‐C 、LDL‐C ,TG 与 Lp(a)呈负相关(P<0.05)。结论 Hcy 、UA 、TC 、HDL‐C 、LDL‐C 、Lp(a)和冠心病慢性心力衰竭密切相关,对这些生化指标的检测有助于监测和控制冠心病慢性心力衰竭的发生和发展。%Objective To observe the application value of the combined detection of homocysteine(Hcy) ,uric acid(UA) ,plasma total cholesterol(TC) ,triglyceride(TG) ,HDL‐cholesterol(HDL‐C) ,LDL‐cholesterin(LDL‐C) and lipoprotein[Lp(a)] in the occurrence and development of coronary heart disease(CHD) complicating chronic heart failure

  19. Transplant coronary heart disease: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Jentzer JC

    2014-12-01

    Full Text Available Jacob C Jentzer,1 Gavin W Hickey,1 Sameer J Khandhar2,3 1Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 2Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3Heart and Vascular Institute, Penn-Presbyterian Medical Center, Philadelphia, PA, USAAbstract: Cardiac allograft vasculopathy (CAV remains one of the leading causes of death and graft failure after heart transplantation. A variety of causes, including donor heart characteristics, recipient risk factors, and immune-mediated influences, are associated with developing CAV. In this review, we will focus on the pathophysiology of developing CAV and various methods to screen for this condition. The pathogenesis of CAV likely involves repeated injuries to the endothelium from a variety of factors such as cellular-mediated rejection, and alloimmune factors, including antibody-mediated injury, ischemia-reperfusion injury at time of transplant, cytomegalovirus infections, immunosuppression medications, systemic inflammation, and traditional atherosclerosis risk factors. Patients with significant CAV are often asymptomatic, and therefore early detection by routine screening prior to graft dysfunction is crucial. There are a variety of invasive, noninvasive, and blood tests that have been studied as screening methods, and we will discuss the role of each of these in this review article. Although some treatment regimens have been established for CAV, this is an area where further studies and research are necessary.Keywords: cardiac allograft vasculopathy, orthotopic heart transplantation, intra-vascular imaging

  20. Importance of personality traits and psychosocial factors for the development of coronary heart disease

    Directory of Open Access Journals (Sweden)

    Jovanović Dragana

    2006-01-01

    Full Text Available Background/Aim. Numerous studies have provided clear and convincing evidence that psychosocial factors contribute to the pathogenesis and expression of coronary heart disease (CHD. These factors have been related to the following psychosocial domains: personality factors and character traits, depression, anxiety, social isolation and chronic life stress. The aim of this study was to estimate the influence of personality traits and psychosocial risk factors for the development of coronary heart disease. Methods. The investigation was conducted as observational cross-sectional (case-control study. Based on medical records all subjects were divided into two groups: the group of patients with CHD (61 participants, and the control group of 41 healthy participants. All participants fulfilled the Eysenck Inventory Questionnaire, Paykel stress scale and Bortner scale of A-B self-estimation. Results. The participants with CHD were shown to have lower education than healthy participants, but were comparable by gender, age and place of residence. According to the Bortner scale, most participants with CHD expressed type A personality, whereas most healthy participants expressed types B and AB. The patients with CHD achieved higher scores on the Paykel stress scale of life events, and they had the higher level of neurotic and psychotic tendencies, as well as the lower level of extroversion compared to the healthy participants. Multivariate logistic regression model identified chronic stress (odds ratio 1.018; 95% confidence interval 1.007−1.028 as an important predictor for the occurrence of coronary heart disease, when adjusted for age, gender, nourishment and blood pressure. On the other side, the lower risk for the occurrence of CHD was observed among the participants who had the higher level of extroversion (odds ratio 0.859; 95% confidence interval 0.636−0.902. Conclusion. Chronic stress and introversion can be considered important risk factors for

  1. The Counselor and Coronary Heart Disease

    Science.gov (United States)

    Ottens, Allen J.

    1977-01-01

    It is clear that steps can be taken for heart disease prevention and that counselors must give thought to adapting existing ideas and techniques and to developing and experimenting with new and innovative preventive tactics. Of utmost importance is the belief that behavioral intervention is both warranted and worthwhile. (Author)

  2. Diabetes is a predictor of coronary artery stenosis in patients hospitalized with heart failure.

    Science.gov (United States)

    Kosuga, Tsuneharu; Komukai, Kimiaki; Miyanaga, Satoru; Kubota, Takeyuki; Nakata, Kotaro; Suzuki, Kenichiro; Yamada, Takayuki; Yoshida, Jun; Kimura, Haruka; Yoshimura, Michihiro

    2016-05-01

    In patients with heart failure, coronary artery disease is the most common underlying heart disease, and is associated with increased mortality. However, estimating the presence or absence of coronary artery disease in patients with heart failure is sometimes difficult without coronary imaging. We reviewed 155 consecutive patients hospitalized with heart failure who underwent coronary angiography. The patients were divided into two groups: patients with (N = 59) and without (N = 96) coronary artery stenosis. The clinical characteristics and blood sampling data were compared between the two groups. The patients with coronary artery stenosis were older than those without. The prevalence of diabetes mellitus (DM), dyslipidemia and a history of revascularization was higher in the patients with coronary artery stenosis. Patients with coronary artery stenosis tended to have wall motion asynergy more frequently than those without. On the other hand, the prevalence of atrial fibrillation (AF) was lower in patients with coronary artery stenosis. The serum hemoglobin level and estimated glomerular filtration rate were lower in patients with coronary artery stenosis than in those without. In the multivariate analysis, DM (odds ratio 3.517, 95 % CI 1.601-7.727) was found to be the only the predictor of the presence of coronary artery stenosis in patients with heart failure. In conclusion, coronary imaging is strongly recommended for heart failure patients with DM to confirm the presence of coronary artery stenosis.

  3. STUDY OF A TREND IN THE FREQUENCY OF USING MAIN DRUG CLASSES INDICATED FOR THE TREATMENT OF PATIENTS WITH CHRONIC CORONARY HEART DISEASE IN 2004 TO 2014: DATA FROM THE CHD PROGNOSIS REGISTRY

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2016-01-01

    Full Text Available Objective: to estimate a trend in the frequency of using drugs with their proven effect on disease outcome in patients with chronic coronary heart disease (CHD in 2004–2014 within the CHD PROGNOSIS registry. Materials and methods. The investigation included data from the CHD PROGNOSIS registry on 303 patients with verified CHD during the 2004–2007 reference hospitalization at the National Research Center for Preventive Medicine, who made a control visit 4 years later, and those on 125 patients who had come following 7 years. Results. There was a low frequency of prescribing the drugs that were able to improve prognosis in patients with stable CHD prior to the 2004–2007 reference hospitalization with an increase at discharge and with a further reduction during outpatient treatment. 7.6 and 86.5% of the patients took statins; 68 and 96 % received disaggregants; 24.8 and 94 % used β-adrenoblockers (β-AB, and 19 and 83 % had angiotensin-converting enzyme (ACE inhibitors before hospitalization and at discharge, respectively (p < 0.001. Four and seven years after discharge, there were reductions in the frequency of using statins to 67 and 70 %, disaggregants to 80 and 90 %, β-AB to 80 and 75 %, and ACE inhibitors to 66 and 65 %, respectively (p < 0.01. At the same time, the above-mentioned drugs were taken by 15 and 69 % of patients on admission and at discharge, respectively (p < 0.001, by 41 and 35 % after 4 and 7 years (p < 0.01. In 2004 to 2014, most drugs were used at low and moderate doses with a gradual increase in the share of generics. Conclusion. The therapy in patients with stable CHD was characterized by a low frequency of using the drugs with their proven effect on prognosis prior to the 2004–2007 reference hospitalization with an increase and a decrease in the frequency of their use on discharge and after 4 and 7 years. During 10 years, β-AB, ACE inhibitors/angiotensin II receptor antagonists, and statins were used mainly at

  4. 精氨酸酶Ⅰ基因型与慢性牙周炎、冠心病的相关性研究%Relationship of arginase Ⅰprotein genetic polymorphisms with chronic periodontitis and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    孙继军; 王晶; 张燕; 王青山; 王爱芹

    2016-01-01

    Objective:To investigate the association of arginase Ⅰ(ArgⅠ)rs2781 666 G/T genotype with the susceptibility of mod-erate and severe chronic periodontitis(MSP)and coronary heart disease(CHD).Methods:DNA was obtained from buccal swabs of 50 patients with MSP,46 with CHD,42 with MSP and CHD,and 50 matched healthy controls.Genotypes of rs2781 666 G/T was analyzed by PCR-PFLP method.The genotype distribution in the 4 groups was compared.Results:Higher representation of ArgⅠrs2781 666 al-lele T was found in CHD group than that in the healthy control individuals(P <0.01 ),and there was no statistical differences among the other 3 groups.Conclusion:Allele T of ArgⅠrs2781 666 may be associated with CHD susceptibility.%目的:探讨精氨酸酶Ⅰ(ArgⅠ)rs2781666 G/T 基因型与中重度慢性牙周炎(MSP)、冠心病(CHD)易感性的关系。方法:收集 MSP 患者50例(MSP 组)、CHD 患者46例(CHD 组)、MSP 伴 CHD 患者42例(MSP +CHD 组)与50例同族健康对照组(HC)的颊黏膜拭子,提取 DNA,采用聚合酶反应-限制性片段长度多态性法(PCR-PFLP)对 ArgⅠrs2781666 G/T 位点的基因型进行检测,比较其在4组间检出率的差别。结果:ArgⅠ rs2781666等位基因 T 在 CHD 组中的检出率显著高于健康组,在其余各组间无统计学意义。结论:ArgⅠrs2781666等位基因 T 可能是 CHD 的一个易感基因。

  5. The independent relationship between triglycerides and coronary heart disease

    OpenAIRE

    Alan Morrison, John E Hokanson

    2008-01-01

    Alan Morrison1, John E Hokanson21SCRIBCO, Blue Bell, PA, USA; 2Department of Epidemiology, Colorado School of Public Health, University of Colorado at Denver Denver, CO, USAAims: The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD).Methods and results: We systematically reviewed population-based cohort studies in which basel...

  6. Non-invasive coronary angiography with multislice spiral computed tomography: impact of heart rate

    NARCIS (Netherlands)

    B.J.W.M. Rensing (Benno); R.J.M. van Geuns (Robert Jan); J. Vos (Jeroen); P.M.T. Pattynama (Peter); G.P. Krestin (Gabriel); P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); K. Nieman (Koen)

    2002-01-01

    textabstractOBJECTIVE: To evaluate the impact of heart rate on the diagnostic accuracy of coronary angiography by multislice spiral computed tomography (MSCT). DESIGN: Prospective observational study. PATIENTS: 78 patients who underwent both conventional and MSCT coronary angiograp

  7. Associaton between plasma osteopontin levels and severity of coronary heart disease in non-diabetic subjects

    Institute of Scientific and Technical Information of China (English)

    魏芹

    2014-01-01

    Objective To seek the association between plasma osteopontin(OPN)levels and severity of coronary heart disease in non-diabetic subjects.Methods A total of 166stable angina patients free of diabetes were enrolled in the study.Clinical characteristic of patients was recorded.Plasma OPN levels were measured by an enzymelinked immunosorbent assay method.Coronary heart disease was determined by coronary artery angiography.The extent of coronary artery stenosis was represented as the

  8. 76 FR 9525 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2011-02-18

    ... Coronary Heart Disease AGENCY: Food and Drug Administration, HHS. ACTION: Extension of enforcement... of coronary heart disease (CHD), in a manner that is consistent with FDA's February 14, 2003, letter... supplement products with claims regarding free phytosterols and heart disease that were marketed prior...

  9. Low-dose copper infusion into the coronary circulation induces acute heart failure in diabetic rats: New mechanism of heart disease.

    Science.gov (United States)

    Cheung, Carlos Chun Ho; Soon, Choong Yee; Chuang, Chia-Lin; Phillips, Anthony R J; Zhang, Shaoping; Cooper, Garth J S

    2015-09-01

    Diabetes impairs copper (Cu) regulation, causing elevated serum Cu and urinary Cu excretion in patients with established cardiovascular disease; it also causes cardiomyopathy and chronic cardiac impairment linked to defective Cu homeostasis in rats. However, the mechanisms that link impaired Cu regulation to cardiac dysfunction in diabetes are incompletely understood. Chronic treatment with triethylenetetramine (TETA), a Cu²⁺-selective chelator, improves cardiac function in diabetic patients, and in rats with heart disease; the latter displayed ∼3-fold elevations in free Cu²⁺ in the coronary effluent when TETA was infused into their coronary arteries. To further study the nature of defective cardiac Cu regulation in diabetes, we employed an isolated-perfused, working-heart model in which we infused micromolar doses of Cu²⁺ into the coronary arteries and measured acute effects on cardiac function in diabetic and non-diabetic-control rats. Infusion of CuCl₂ solutions caused acute dose-dependent cardiac dysfunction in normal hearts. Several measures of baseline cardiac function were impaired in diabetic hearts, and these defects were exacerbated by low-micromolar Cu²⁺ infusion. The response to infused Cu²⁺ was augmented in diabetic hearts, which became defective at lower infusion levels and underwent complete pump failure (cardiac output = 0 ml/min) more often (P hearts. To our knowledge, this is the first report describing the acute effects on cardiac function of pathophysiological elevations in coronary Cu²⁺. The effects of Cu²⁺ infusion occur within minutes in both control and diabetic hearts, which suggests that they are not due to remodelling. Heightened sensitivity to the acute effects of small elevations in Cu²⁺ could contribute substantively to impaired cardiac function in patients with diabetes and is thus identified as a new mechanism of heart disease.

  10. Honolulu Heart Program

    Science.gov (United States)

    2016-04-13

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Heart Failure, Congestive; Myocardial Infarction; Asthma; Emphysema; Lung Diseases, Obstructive; Aortic Aneurysm, Abdominal; Bronchitis; Dementia; Hypertension; Chronic Obstructive Pulmonary Disease; Heart Failure

  11. [Biomarkers of iron metabolism and inflammation in patients with chronic heart failure and various types of left ventricular dysfunction].

    Science.gov (United States)

    Kazymyrko, V K; Kutovyĭ, V V; Ivanyts'ka, L M; Dubkova, A G; Silant'ieva, T S

    2013-09-01

    Study the level of some of the indicators of iron metabolism and inflammatory markers in patients with chronic heart failure due to hypertension and coronary heart disease. The results of the study in systolic and diastolic dysfunction of the left ventricle, the varying degrees of severity of heart failure. The level of the studied parameters determined by the severity of heart failure and does not depend on the nature of left ventricular dysfunction.

  12. Therapeutic effects of adenosine cyclophosphate combined with Shenmai injection on chronic heart failure in aged patients with coronary heart disease%环磷腺苷联合参麦注射液治疗老年冠心病慢性心力衰竭的疗效

    Institute of Scientific and Technical Information of China (English)

    李建平; 付细娥

    2011-01-01

    Objective: To observe the therapeutic effects of adenosine cyclophosphate combined with Shenmai injection on chronic heart failure (CHF) in aged patients with coronary heart disease (CHD). Methods: A total of 126 aged CHD patients with CHF were randomly divided into routine treatment group (n = 62, received routine anti-heart failure treatment) and observation group (n=64, received adenosine cyclophosphate and Shenmai injection intravenous drip for 14d based on routine treatment). Clinical therapeutic effects and changes of plasma level of brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and peak early diastolic velocity/peak late dias-tolic velocity (E/A) were observed and compared between the two groups before and after treatment. Results: After treatment, all indicators in the two groups significantly improved except for E/A in routine treatment group, P <0. 01 all. Compared with routine treatment group, there were significant increase in total effective rate (77. 42% vs. 89.06%), LVEF[ (44. 51±7. 85)% vs. (58.35 + 7.80)%], E/A [ (0. 69±0. 35) vs. (0. 88±0. 36)] , 6 min walking distance [ (526. 70± 12. 00) m vs. (629. 20± 12. 20) m], and significant decrease in BNP concentration [ (558. 20±79. 30) ng/L vs. (437.10±67. 90) ng/L] in observation group, P<0. 01 all. Conclusion: Adenosine cyclophosphate combined with Shenmai injection is safe and effective in treatment of chronic heart failure in aged patients with coronary heart disease.%目的:观察环磷腺苷联合参麦注射液治疗老年冠心病慢性心力衰竭(CHF)的临床疗效.方法:老年冠心病CHF患者126例,随机分为常规治疗组62例,给予常规抗心衰治疗;观察组64例,在常规治疗的基础上静脉滴注环磷腺苷及参麦注射液14d.观察两组治疗前后血浆脑钠肽(BNP)水平、左室射血分数(LVEF),舒张早期/晚期最大血流速度比值(E/A)等指标的变化及临床疗效.结果:治疗后,两组各指标(常规治疗组

  13. Effects of Psychoeducation on Mental Health in Patients With Coronary Heart Disease

    OpenAIRE

    Bashiri, Zahra; Aghajani, Mohammad; Masoudi Alavi, Negin

    2016-01-01

    Background Patients with coronary heart disease are at high risk for mental health disorders, such as depression and anxiety. Psychoeducation is a well-known intervention for psychiatric patients, but its use has been limited in other health conditions, such as coronary heart disease. Objectives The aim of this study was to evaluate the effect of psychoeducation on mental health in coronary heart disease patients. Patients and Methods This randomized clinical trial included 70 patients with c...

  14. 'Ins' and 'outs' of triple therapy: Optimal antiplatelet therapy in patients on chronic oral anticoagulation who need coronary stenting.

    NARCIS (Netherlands)

    Dewilde, W.; Verheugt, F.W.A.; Breet, N.; Koolen, J.J.; Berg, J.M. ten

    2010-01-01

    Chronic oral anticoagulant treatment is obligatory in patients (class I) with mechanical heart valves and in patients with atrial fibrillation with CHADS2 score >1. When these patients undergo percutaneous coronary intervention with placement of a stent, there is also an indication for treatment

  15. Comparison of mesenchymal stromal cells from young healthy donors and patients with severe chronic coronary artery disease

    DEFF Research Database (Denmark)

    Friis, Tina; Haack-Sørensen, Mandana; Hansen, Susanne Kofoed;

    2011-01-01

    It has been questioned whether bone marrow-derived mesenchymal stromal cells (MSCs) from patients with ischemic heart disease are suitable for use in regenerative stem cell therapy. We compared MSCs from patients with chronic coronary artery disease (CAD) and MSCs from young healthy donors...

  16. 21 CFR 101.81 - Health claims: Soluble fiber from certain foods and risk of coronary heart disease (CHD).

    Science.gov (United States)

    2010-04-01

    ... and risk of coronary heart disease (CHD). 101.81 Section 101.81 Food and Drugs FOOD AND DRUG... of coronary heart disease (CHD). (a) Relationship between diets that are low in saturated fat and... means diseases of the heart and circulatory system. Coronary heart disease (CHD) is one of the...

  17. Effects of bileaflet mechanical heart valve orientation on coronary flow

    Science.gov (United States)

    Haya, Laura; Tavoularis, Stavros

    2015-11-01

    The aortic sinus is approximately tri-radially symmetric, but bileaflet mechanical heart valves (BMHVs), which are commonly used to replace diseased aortic valves, are bilaterally symmetric. This mismatch in symmetry suggests that the orientation in which a BMHV is implanted within the aortic sinus affects the flow characteristics downstream of it. This study examines the effect of BMHV orientation on the flow in the coronary arteries, which originate in the aortic sinus and supply the heart tissue with blood. Planar particle image velocimetry measurements were made past a BMHV mounted at the inlet of an anatomical aorta model under physiological flow conditions. The complex interactions between the valve jets, the sinus vortex and the flow in the right coronary artery were elucidated for three valve orientations. The coronary flow rate was directly affected by the size, orientation, and time evolution of the vortex in the sinus, all of which were sensitive to the valve's orientation. The total flow through the artery was highest when the valve was oriented with its axis of symmetry intersecting the artery's opening. The findings of this research may assist surgeons in choosing the best orientation for BMHV implantation. The bileaflet valve was donated by St. Jude Medical. Financial support was provided by the Natural Sciences and Engineering Research Council of Canada.

  18. Independent associations of fasting insulin, glucose, and glycated haemoglobin with stroke and coronary heart disease in older women.

    Directory of Open Access Journals (Sweden)

    Debbie A Lawlor

    2007-08-01

    Full Text Available BACKGROUND: Evidence suggests that variations in fasting glucose and insulin amongst those without frank type 2 diabetes mellitus are important determinants of cardiovascular disease. However, the relative importance of variations in fasting insulin, glucose, and glycated haemoglobin as risk factors for cardiovascular disease in women without diabetes is unclear. Our aim was to determine the independent associations of fasting insulin, glucose, and glycated haemoglobin with coronary heart disease and stroke in older women. METHODS AND FINDINGS: We undertook a prospective cohort study of 3,246 British women aged 60-79 y, all of whom were free of baseline coronary heart disease, stroke, and diabetes, and all of whom had fasting glucose levels below 7 mmol/l. Fasting insulin and homeostasis model assessment for insulin sensitivity (HOMA-S were linearly associated with a combined outcome of coronary heart disease or stroke (n = 219 events, but there was no association of fasting glucose or glycated haemoglobin with these outcomes. Results were similar for coronary heart disease and stroke as separate outcomes. The age, life-course socioeconomic position, smoking, and physical activity adjusted hazard ratio for a combined outcome of incident coronary heart disease or stroke per one standard deviation of fasting insulin was 1.14 (95% CI 1.02-1.33. Additional adjustment for other components of metabolic syndrome, low-density lipoprotein cholesterol, fasting glucose, and glycated haemoglobin had little effect on this result. CONCLUSIONS: Our findings suggest that in women in the 60-79 y age range, insulin resistance, rather than insulin secretion or chronic hyperglycaemia, is a more important risk factor for coronary heart disease and stroke. Below currently used thresholds of fasting glucose for defining diabetes, neither fasting glucose nor glycated haemoglobin are associated with cardiovascular disease.

  19. Clinical Significance of Heart Chronotropic Incompetence in Patients With Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    Yingjun Feng; Handong Yang; Xinwen Min; Xin Chen; Dongfeng Li; Hao Xu

    2008-01-01

    Objectives To investigate the relationship between the chronotropic incompetence and angiographic severity of coro-nary artery disease, and the clinical value of inappropriate chronotropic responses in exercise. Methods Coronary an-giography was performed in 130 patients suspected or diagnosed as coronary heart disease (CHD), and angiographic se-verity of coronary artery disease was quantitated by Duke score and Gensini score. The patients were divided into 4groups: non-CHD group (39 cases), CHD group with only one coronary artery involved (CHD1, 30 cases), CHD group with two coronary arteries involved (CHD2, 31 cases) and CHD group with three coronary arteries involved (CHD3 group, 30 cases). A month before coronary angiography, symptom-limited bicycle ergometor exercise had been accomplished, the chronotropic response had been measured and expressed as ratio of heart rate reserve (HRR)and the maximal age-predicted heart rate achieved (rHR). Results Analysis of variance showed that rHR and HRR were much significantly lower (all P 0.05)and between CHD2 group and CHD3 group(P>0.05). HRR has no difference between CHD2 group and CHD3 group (P >0.05), but was significandy different between non-CHD group and CHD1 group (P <0. 05). There was a significantly negative correlation between rHR, HRR and Duke score(r = -0. 554, -0. 578, respectively, all P <0. 01), Gensini score (r = -0. 453, -0. 467 ,respectively, all P <0. 01). CHD propor-tion reached 75% in patients who had positive rHR (or HRR) and non-ST depression. Diagnostic value [sensitivity 0. 868 (P < 0. 01), 0. 846 (P < 0. 01), specificity 0. 462, 0. 462, accuracy 0. 746 (P < 0. 05), 0. 731, positive predic-tive value 0. 790, 0. 786, negative predictive value 0. 600, 0. 563, respectively] ofrHR <85% or HRR <72% which were used as annexed positive. Standard in the patients without ST depression in symptom-limited exercise treadmill tests was a little higher than that of traditional ST standard (sensitivity 0. 637

  20. Angiotensin II type 1 receptor blockade restores angiotensin-(1-7)-induced coronary vasodilation in hypertrophic rat hearts.

    Science.gov (United States)

    Souza, Álvaro P S; Sobrinho, Deny B S; Almeida, Jônathas F Q; Alves, Gisele M M; Macedo, Larissa M; Porto, Juliana E; Vêncio, Eneida F; Colugnati, Diego B; Santos, Robson A S; Ferreira, Anderson J; Mendes, Elizabeth P; Castro, Carlos H

    2013-11-01

    The aim of the present study was to investigate the coronary effects of Ang-(1-7) [angiotensin-(1-7)] in hypertrophic rat hearts. Heart hypertrophy was induced by abdominal aorta CoA (coarctation). Ang-(1-7) and AVE 0991, a non-peptide Mas-receptor agonist, at picomolar concentration, induced a significant vasodilation in hearts from sham-operated rats. These effects were blocked by the Mas receptor antagonist A-779. Pre-treatment with L-NAME (N(G)-nitro-L-arginine methyl ester) or ODQ (1H-[1,2,4]oxadiazolo[4,3-a]quinozalin-1-one) [NOS (NO synthase) and soluble guanylate cyclase inhibitors respectively] also abolished the effect of Ang-(1-7) in control hearts. The coronary vasodilation produced by Ang-(1-7) and AVE 0991 was completely blunted in hypertrophic hearts. Chronic oral administration of losartan in CoA rats restored the coronary vasodilation effect of Ang-(1-7). This effect was blocked by A-779 and AT2 receptor (angiotensin II type 2 receptor) antagonist PD123319. Acute pre-incubation with losartan also restored the Ang-(1-7)-induced, but not BK (bradykinin)-induced, coronary vasodilation in hypertrophic hearts. This effect was inhibited by A-779, PD123319 and L-NAME. Chronic treatment with losartan did not change the protein expression of Mas and AT2 receptor and ACE (angiotensin-converting enzyme) and ACE2 in coronary arteries from CoA rats, but induced a slight increase in AT2 receptor in aorta of these animals. Ang-(1-7)-induced relaxation in aortas from sham-operated rats was absent in aortas from CoA rats. In vitro pre-treatment with losartan restored the Ang-(1-7)-induced relaxation in aortic rings of CoA rats, which was blocked by the Mas antagonist A-779 and L-NAME. These data demonstrate that Mas is strongly involved in coronary vasodilation and that AT1 receptor (angiotensin II type 1 receptor) blockade potentiates the vasodilatory effects of Ang-(1-7) in the coronary beds of pressure-overloaded rat hearts through NO-related AT2- and Mas

  1. Acute myocardial infarction in chronic Chagas' cardiomyopathy: report of two cases with no obstructive coronary artery lesions

    Directory of Open Access Journals (Sweden)

    Silvia G. Lage

    1986-04-01

    Full Text Available This report describes two patients with chronic Chagas' Heart Disease who developed clinical and laboratorial signs of myocardial infarction. Both patients presented sudden oppressive chest pain, without precipitating factor. In the first case, the highest MB-CK value was 65 IU, 22 hours after the beginning of the pain. On the second case, it was 77 IU at 18 hours after the beginning of the pain. In both cases ECG changes suggesting non-transmural infarction were present. The 99mTc PYP myocardial scintigram of the first case was positive. Coronary angiograms performed on the 18th and 9th day, respectively, after the acute infarction did not display obstructive lesions. Possible mechanisms causing myocardial infarction with normal coronary arteries in Chagas' Disease may include: embolic event's, particularly when there is associated congestive heart failure; coronary thrombosis and coronary spasms.

  2. Fate of Patients With Coronary Perforation Complicating Percutaneous Coronary Intervention (from the Euro Heart Survey Percutaneous Coronary Intervention Registry).

    Science.gov (United States)

    Bauer, Timm; Boeder, Niklas; Nef, Holger M; Möllmann, Helge; Hochadel, Matthias; Marco, Jean; Weidinger, Franz; Zeymer, Uwe; Gitt, Anselm K; Hamm, Christian W

    2015-11-01

    Coronary perforation (CP) is a life-threatening complication that can occur during percutaneous coronary intervention (PCI). Little is known, however, about the incidence and clinical outcome of CP. We sought to investigate the occurrence of CP and its determinants and risk profile in a large-scale, prospective registry. From 2005 to 2008, unselected patients (n = 42,068) from 175 centers in 33 countries who underwent a PCI procedure were prospectively enrolled in the PCI registry of the Euro Heart Survey program. For the present analysis, patients experiencing CP during PCI (n = 124, 0.3%) were compared with those who underwent PCI without CP. Patients with CP were older, more often women, had more severe coronary disease, and underwent more complex types of coronary intervention. Independent factors associated with CP were the use of rotablation, intravascular ultrasound-guided PCI, bypass PCI, a totally occluded vessel, a type C lesion, peripheral arterial disease, and body mass index <25. More than 10% of the patients developed cardiac tamponade. In a small minority (3.3%), emergency bypass surgery had to be performed. The inhospital death rate was markedly elevated in patients with CP (7.3% vs 1.5%, p <0.001). After adjustment for the EuroHeart score, CP remained a strong predictor of hospital mortality (odds ratio 5.21, 95% confidence interval 2.34 to 11.60). In conclusion, in this real world, all-comers registry, the incidence of CP was low, occurred more often in patients who underwent more complex coronary interventions, and was associated with a fivefold higher hospital mortality.

  3. Efficacy analysis of ezetimibe on lipid management in elderly patients with coronary heart disease after coronary intervention

    Institute of Scientific and Technical Information of China (English)

    段明勤

    2013-01-01

    Objective To observe the clinical efficacy of ezetimibe combined with atorvastatin calcium on hyperlipidemia,and to evaluate the role of ezetimibe on lipid management in elderly patients with coronary heart disease (CHD) after coronary intervention.Methods A total of 150 elderly CHD patients with hyperlipidemia

  4. [Adipokines: adiponectin, leptin, resistin and coronary heart disease risk].

    Science.gov (United States)

    Kopff, Barbara; Jegier, Anna

    2005-01-01

    lesions. Correlation between resistin concentration and the extent of atherosclerotic plaques in the coronary vessels has also been found. The disturbances in secretion, function and balance of adiponectin, leptin and resistin are to be considered not only a link between visceral adiposity and cardiovascular risk but also independent risk factor of coronary heart disease.

  5. Ivabradine, heart failure and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  6. Clinical Significance of Serum Bilirubin Detection of Patient with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    TAOLi; LUORui; ZHUANGDiankui

    2004-01-01

    To explore the relation between serum bilinabin and eoronary heart disease Methods Compare the level of serum bilinabin among patients with eoronary heart disease, patients with other disease and normal persons. Results The level of serum bilinabin of patients with coronary heart disease is higher than that of normal persons. Conclusion The reduction of density of serum bihrubin is one of the independent risk factors of coronary heart disease.

  7. The Myers-Briggs type indicator and coronary heart disease.

    Science.gov (United States)

    Thorne, B M; Fyfe, J H; Carskadon, T G

    1987-01-01

    Researchers have for many years attempted to establish a relationship between coronary heart disease (CHD) and personality type. In our study, 103 subjects completed Form G of the Myers-Briggs Type Indicator (MBTI). Comparisons were made between 93 CHD patients and an age-appropriate control group (Group C) on each of the four MBTI dimensions: Extraversion-Introversion, Sensing-Intuition, Thinking-Feeling, and Judging-Perceiving. The comparison between CHD patients and Group C showed that CHD patients were significantly more likely to prefer sensing and feeling.

  8. Common clinical practice versus new PRIM score in predicting coronary heart disease risk

    DEFF Research Database (Denmark)

    Frikke-Schmidt, Ruth; Tybjærg-Hansen, Anne; Schnohr, Peter;

    2010-01-01

    To compare the new Patient Rule Induction Method (PRIM) Score and common clinical practice with the Framingham Point Score for classification of individuals with respect to coronary heart disease (CHD) risk.......To compare the new Patient Rule Induction Method (PRIM) Score and common clinical practice with the Framingham Point Score for classification of individuals with respect to coronary heart disease (CHD) risk....

  9. Smoking and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults

    DEFF Research Database (Denmark)

    Tolstrup, Janne S; Hvidtfeldt, Ulla Arthur; Flachs, Esben Meulengracht;

    2014-01-01

    Objectives. We investigated associations of smoking and coronary heart disease (CHD) by age. Methods. Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192 067 women and 74 720 men, aged 40-89 years). Results. During follow-up, 4326 cases...

  10. Coronary CT Angiography as a Diagnostic and Prognostic Tool: Perspectives from the SCOT-HEART Trial.

    Science.gov (United States)

    Doris, Mhairi; Newby, David E

    2016-02-01

    Coronary artery disease is the leading cause of death worldwide. Many trials to date have investigated the diagnostic accuracy of coronary computed tomography angiography (CCTA) when compared to the gold standard diagnostic test, invasive coronary angiography. However, whether the use of a non-invasive anatomical test, such as CCTA, can translate into improved patient risk stratification, management and outcome has yet to be established. The Scottish COmputed Tomography of the HEART (SCOT-HEART) trial sought to address these questions and determined whether CCTA, when used in addition to standard care, could aid the diagnosis, further investigation and treatment of patients referred to the cardiology clinic with suspected angina due to coronary heart disease. In this trial, CCTA clarified the diagnosis of angina due to coronary heart disease in a quarter of patients and this led to major alterations in treatment and management that appeared to reduce the risk of subsequent coronary heart disease death or non-fatal myocardial infarction. The SCOT-Heart trial has established that CCTA is a valuable diagnostic test in patients with suspected angina pectoris due to coronary heart disease and leads to greater clarity, more focused appropriate treatments and better coronary heart disease outcomes.

  11. Advanced glycation endproducts in chronic heart failure

    NARCIS (Netherlands)

    Smit, Andries J.; Hartog, Jasper W. L.; Voors, Adriaan A.; van Veldhuisen, Dirk J.; Schleicher, E; Somoza,; Shieberle, P

    2008-01-01

    Advanced glycation endproducts (AGEs) have been proposed as factors involved in the development and progression of chronic heart failure (CHF). Cross-linking by AGEs results in vascular and myocardial stiffening, which are hallmarks in the pathogenesis of CHE Additionally, stimulation of receptors b

  12. New pharmacological strategies in chronic heart failure

    NARCIS (Netherlands)

    van de Wal, RMA; Voors, AA; Plokker, HWM; van Gilst, WH; van Veldhuisen, DJ

    2004-01-01

    Diuretics, ACE inhibitors and betablockers form the cornerstone of pharmacological treatment of chronic heart failure (CHF), while angiotensin receptor blockers are gaining ground. However, despite optimal treatment CHF remains a syndrome with poor prognosis. For this reason, a large number of new a

  13. Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting: which is better in patients with chronic obstructive pulmonary disease?

    Institute of Scientific and Technical Information of China (English)

    朱亚彬; 许建屏; 刘志勇; 杨丹宁; 李旭东; 李鸿雁

    2004-01-01

    To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications.

  14. Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting:which is better in patients with chronic obstructive pulmonary disease?

    Institute of Scientific and Technical Information of China (English)

    朱亚彬; 许建屏; 刘志勇; 杨丹宁; 李旭东; 李鸿雁

    2004-01-01

    To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications.

  15. Elevated serum secretory type Ⅱ phospholipase A2 in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    于路

    2006-01-01

    Objective To measure the serum level of secretory type H phospholipase A2 (sPLA2) in patients with coronary heart disease and investigate the possible relationship with IL-8 and LPA. Methods A total of 110 patients with acute coronary syndrome (ACS) , 63 patients with stable coronary heart disease (SCHD) group and 89 non-CHD control patients were studied. Serum levels of sPLA2, IL-8, LPA and hs-CRP were measured and the

  16. The efficacy of hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency.

    Science.gov (United States)

    Zhai, Hongxia; Li, Liang; Yin, Yaxin; Zhang, Jinjin; Chen, Haiwei; Liu, Runmei; Xia, Yun-feng

    2016-01-01

    The aim of this study was to explore the efficacy and safety of hemodialysis in interventional therapy for patients with coronary artery disease combined with chronic renal insufficiency. With the aging and social development, the number of coronary artery disease patients with chronic renal insufficiency gradually increased. Total 58 coronary heart disease patients with chronic renal dysfunction were selected. These patients were characterized with typical angina symptoms and typical electrocardiogram (ECG) changes of onset angina. Continuous oral administration of sodium bicarbonate tablets 1 g 3/day × 3 days and slow intravenous input sodium chloride 1000 ∼1500 mL 3-12 h before operation were given. By this way, all patients were treated by hydration and alkalization. After percutaneous coronary intervention (PCI) treatment, patients were immediately transferred to undergo 4 h of dialysis treatment without removing indwelling of femoral artery puncture sheath tube to protect renal function. Changes in renal function including serum creatinine, glomerular filtration rate, and urine were observed and recorded. All patients were successfully underwent PCI treatment. Within one month after PCI, there were no obvious complication and no stent thrombosis occurred. Among of 58 patients, 56 cases showed no significant increase in serum creatinine levels compared with those before operation. However, serum creatinine level of one patient increased to 251 umol/L and one patient still required permanent dialysis. Using hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency could significantly improve the prognosis of the patients.

  17. Ultrasound screening of multifocal atherosclerosis: markers for coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Lachezar Grozdinski; Mario Stankev; Alexander Doganov

    2009-01-01

    Background and Objective The frequency of multifocal atherosclerosis (MFA) in patients with coronary heart disease (CHD) has not been thoroughly studied. The purpose of our study was to perform ultrasound screening for MFA in patients with coronary atherosclerosis and make evaluation of the sensitivity and significance of different atherosclerosis markers. Methods Using Color Dupplex Ultrasound (CDU), we studied 32 clinically healthy persons and 87 patients of the city of B with clinical data for CHD where we also performed coronarography. Results In patients with coronary atherosclerosis we found high frequency of carotid atherosclerosis (93%) and peripheral artery disease (PAD) (81%). We established verifiable thickening of the intima-media (IMT) of the common carotid artery (CCA) and common femoral artery (CFA) in patients with CHD. There is a correlation between the frequency of carotid and femoral stenoses and CHD proven by coronarography. Patients with CHD had a high relative risk to develop carotid (RR = 5) and peripheral atherosclerosis (RR=3.5) and high frequency of asymptomatic stenoses and thromboses of the internal carotid artery (86.9%) and femoral artery (78.3%), as well as aneurisms of the abdominal aorta (8.1%). Markers for CAD with high sensitivity were the atherosclerotic plaques of ICA (0.93) and CFA (0.81) as well as IMT of the CFA (0.84). Conclusions MFA are common among patients with CHD. Ultrasound diagnosis is the method of choice for simultaneous non-invasive screening of carotid, peripheral and MFA and provides sensitive markers for coronary atherosclerosis. The most sensitive and specific markers for CHD are the combination of the IMT and atherosclerotic plaques of CCA, ICA and CFA (100% sensitivity and 0.92 specificity).

  18. EVALUATION CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. J. Fishman

    2011-01-01

    Full Text Available Objective — studying dyssynchrony characteristics and evaluation correction effectiveness in patients with chronic heart failure (CHF of ischemic origin.Materials and methods. The study included 125 patients with chronic heart failure of ischemic etiology, 28 of them — with coronary heart disease (CHD who had undergone aorto-and / or mammarokoronary bypass and / or percutaneous coronary intervention, 42 — with coronary artery disease and postinfarction cardiosclerosis, 32 — with arrhythmic variant of coronary artery disease, 23 — with stable angina without evidence of arrhythmia. Among included patients, biventricular pacemakers were implanted for 17 patients. All patients underwent echocardiography with determination of the parameters of dyssynchrony.Results and conclusion. Among patients with CHF ischemic symptoms dyssynchrony was diagnosed in 36 (28.8 % cases. Statistically significant association between patients with cardiac arrhythmias and dyssynchrony was determined. At the same time the incidence of dyssynchrony was not associated with various forms of ischemic heart disease, and did not depend on the anamnesis of cardiac surgery. Dependence of the frequency of occurrence of dyssynchrony on the severity of CHF was revealed. Patients selected for implantation of biventricular pacemakers, especially in view of echocardiographic signs of dyssynchrony had significant improvement after providing cardiac resynchronization therapy. Effect of the treatment does not depend on the atrial fibrillation rhythm presence.

  19. EVALUATION CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. J. Fishman

    2014-07-01

    Full Text Available Objective — studying dyssynchrony characteristics and evaluation correction effectiveness in patients with chronic heart failure (CHF of ischemic origin.Materials and methods. The study included 125 patients with chronic heart failure of ischemic etiology, 28 of them — with coronary heart disease (CHD who had undergone aorto-and / or mammarokoronary bypass and / or percutaneous coronary intervention, 42 — with coronary artery disease and postinfarction cardiosclerosis, 32 — with arrhythmic variant of coronary artery disease, 23 — with stable angina without evidence of arrhythmia. Among included patients, biventricular pacemakers were implanted for 17 patients. All patients underwent echocardiography with determination of the parameters of dyssynchrony.Results and conclusion. Among patients with CHF ischemic symptoms dyssynchrony was diagnosed in 36 (28.8 % cases. Statistically significant association between patients with cardiac arrhythmias and dyssynchrony was determined. At the same time the incidence of dyssynchrony was not associated with various forms of ischemic heart disease, and did not depend on the anamnesis of cardiac surgery. Dependence of the frequency of occurrence of dyssynchrony on the severity of CHF was revealed. Patients selected for implantation of biventricular pacemakers, especially in view of echocardiographic signs of dyssynchrony had significant improvement after providing cardiac resynchronization therapy. Effect of the treatment does not depend on the atrial fibrillation rhythm presence.

  20. Coronary Artery Calcium Distribution and Interscan Measurement Variability in End-Stage Renal and Coronary Heart Disease Patients

    Energy Technology Data Exchange (ETDEWEB)

    Serafin, Z.; Laskowska, K.; Marzec, M.; Lasek, W. (Dept. of Radiology and Diagnostic Imaging, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland)); Sinjab, T.A.; Wlodarczyk, Z. (Dept. of Transplantology, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland))

    2009-04-15

    Background: Coronary heart disease patients and end-stage renal disease patients have been documented to have an increased amount of coronary artery calcifications (CAC). Purpose: To evaluate the distribution of CAC and its influence on interscan variability of measurement in end-stage renal disease and coronary heart disease patients, proven to have calcifications. Material and Methods: 69 patients having CAC, including 34 with coronary heart disease and 35 with end-stage renal disease, were scanned twice with multidetector-row computed tomography (MDCT). Amount of CAC was determined as the number of calcified lesions (CN), total calcium score (CS), calcium volume (CV), and calcium mass (CM). Distribution of CAC was evaluated on a per-patient basis as the median CS and CM of a single lesion. Density of the calcifications was calculated as the patient's CM divided by CV. Results: The overall median CS was 457.2, and the median CM was 75.6 mg. There were no significant differences in the number of calcified lesions, CS, or CM between the two groups. Both CS and CM of a single lesion, as well as the mean calcium density were lower in renal disease patients (P<0.05) than in coronary heart disease subjects. The relative interscan variability of coronary calcium measurement was higher in the renal disease group (P<0.05). There was a negative correlation between the calcium concentration and the relative interscan variability. Conclusion: The results indicate that the coronary calcium distribution influences the measurement interscan reproducibility, and the distribution may differ between end-stage renal disease patients and coronary heart disease patients, reflecting the dissimilar nature of coronary calcifications in those groups.

  1. Atypical presentation of acute and chronic coronary artery disease in diabetics

    Institute of Scientific and Technical Information of China (English)

    Hadi; AR; Hadi; Khafaji; Jassim; M; Al; Suwaidi

    2014-01-01

    In patients with diabetes mellitus, cardiovascular disease is the principal cause of mortality and chest pain is the most frequent symptom in patients with stable and acute coronary artery disease. However, there is little knowledge concerning the pervasiveness of uncommon presentations in diabetics. The symptomatology of acute coronary syndrome, which comprises both pain and non-pain symptoms, may be affected by traditional risk factors such as age, gender, smoking, hypertension, diabetes, and dyslipidemia. Such atypical symptoms may range from silent myocardial ischemia to a wide spectrum of non-chest pain symptoms. Worldwide, few studies have highlighted this under-investigated subject, and this aspect of ischemic heart disease has also been under-evaluated in the major clinical trials. The results of these studies are highly diverse which makes definitive conclusions regarding the spectrum of atypical presentation of acute and even stable chronic coronay artery disease difficult to confirm. This may have a significant impact on the morbidity and mortality of coronary artery disease in diabetics. In this up-to-date review we will try to analyze the most recent studies on the atypical presentations in both acute and chronic ischemic heart disease which may give some emphasis to this under-investigated topic.

  2. Effects of Percutaneous Coronary Intervention on Serum Angiopoietin-2 in Patients with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yu Zeng; Chun Gui; Lang Li; Xiao-Min Wei

    2016-01-01

    Background:Angiopoietin-2 (Ang-2) plays a crucial role in hypoxia-induced angiogenesis and is expressed only in sites of vascular remodeling.Ang-2 expression can be regulated by hypoxia inducible factors and other regulators with exposure to hypoxia.The objective of this study was to investigate the influence of percutaneous coronary intervention (PCI) on serum Ang-2 concentrations,and analyze the correlation between serum Ang-2 and the severity of coronary artery stenosis in patients with coronary heart disease (CHD).Methods:Sixty-four patients with CHD were selected as the study group,each undergone PCI.Thirty-two healthy subjects were selected as the control group.Pre-PCI and post-PCI serum Ang-2 were measured by enzyme-linked immunosorbent assay.The severity of coronary artery stenosis was evaluated using angiographic Gensini scores,and the coronary collateral vessels were scored according to Rentrop's classification.Results:Concentrations of pre-PCI serum Ang-2 in the study group were significantly higher than those in the control group (4625.06 ± 1838.06 vs.1945.74 ± 1588.17 pg/ml,P < 0.01);however,concentrations of post-PCI serum Ang-2 were significantly lower than those of pre-PCI (3042.63 ± 1845.33 pg/ml vs.4625.06 ± 1838.06 pg/ml,P < 0.01).Concentrations of pre-PCI serum Ang-2 were significantly correlated with Gensini scores (r =0.488,P < 0.01);however,the decrease in serum Ang-2 after PCI was not correlated with Gensini scores,coronary collateral vessel grading,or left ventricular ejection fraction.Conclusions:Serum Ang-2 concentrations significantly increased in patients with CHD,and PCI treatment significantly decreased these concentrations.Serum Ang-2 concentrations,but not the decrease in serum Ang-2 concentrations,were significantly correlated with the severity of coronary artery stenosis.These results suggested that Ang-2 may be a biomarker of myocardial ischemia and vessel remodeling.

  3. 冠心病慢性心功能不全与慢性阻塞性肺疾病对右心功能及结构的影响%Effects of chronic heart dysfunction in patients with coronary heart disease and with chronic obstructive pulmonary disease on right ventricular function and structural changes

    Institute of Scientific and Technical Information of China (English)

    王梦义; 郑成环; 李广平

    2011-01-01

    COPD无肺心痛组及冠心痛心功能Ⅱ、Ⅲ级组,差异有统计学意义;COPD无肺心病组及冠心痛心功能Ⅱ、Ⅲ级组3组之间比较差异无统计学意义.结论 冠心痛心功能不全(心功能Ⅱ、Ⅲ级)患者右心结构(PAD、RVED、RAWT)无明显变化.冠心痛心功能不全患者在左心功能不良的同时亦存在右心功能不良.右心室Tei指数可早期评价冠心病患者及COPD患者右心收缩及舒张功能.%Objective To investigate the effects of chronic heart dysfunction in patients with coronary heart disease(CHD) and with chronic obstructive pulmonary disease(COPD) on right ventricular function and structural changes,different cardiac function class CHD patients and the COPD patients with or without cot pulmonale were studied,and the differences were compared to find the dysfunction of right heart early.Methods According to the cardiac function(NYHA) ,68 CHD patients hospitalized in Dec.2008-Feb.2010 were divided to class Ⅱ group( n =32)and class Ⅲ group( n =36).86 COPD patients hospitalized at the same time were divided to cor pulmonale group( n =40) and without cor pulmonale group ( n = 46).50 normal volunteers served as control group.Pulmonary artery dimension(PAD), right ventricular end-diastolic dimension (RVED), right ventricular anterior wall thickness (RVAWT),left ventricular ejection fraction,left and right ventircular Tei index(L, R-Tei index) and pulmonary artery pressure(PAP) were measured and compared.Results PAD, RVED and RAWT between two CHD groups were similar to control group( P >0.05).The R-Tei indexes of cardiac function in class Ⅱ group(0.62±0.19) and class Ⅲ group(0.66 ±0.13) were higher than that of control group (0.29 ± 0.09)( P < 0.05).The Tei index was not significantly different between the two CHD groups.The R-Tei index was significantly negative related to LVEF, and was significantly positive related to L-Tei index.There were 23, 10 and 6 subjects observed tricuspid valve

  4. The role of statins in chronic heart failure.

    Science.gov (United States)

    Szyguła-Jurkiewicz, Bożena; Szczurek, Wioletta; Król, Bogumiła; Zembala, Marian

    2014-09-01

    The efficacy of statins in reducing morbidity and mortality in patients with documented coronary artery disease is unquestionable. However, in chronic heart failure (CHF), evidence regarding the beneficial effects of statin therapy remains contradictory. Although numerous retrospective studies have demonstrated improved prognosis in CHF patients treated with statins, two randomized trials, GISSI-HF and CORONA, have not confirmed the benefit of rosuvastatin in this group of patients. The benefits of using statins in CHF probably result mostly from their pleiotropic action, including the improvement of endothelial function, the inhibition of neurohormonal activation, and the reduction of proinflammatory activation. On the other hand, it has been recognized that low cholesterol is associated with worse morbidity and mortality in patients with CHF. It appears that it is necessary to conduct further randomized clinical trials using different kinds of statins in different populations of patients with CHF.

  5. 'Ins' and 'outs' of triple therapy: Optimal antiplatelet therapy in patients on chronic oral anticoagulation who need coronary stenting.

    Science.gov (United States)

    Dewilde, W; Verheugt, F W A; Breet, N; Koolen, J J; Ten Berg, J M

    2010-09-01

    Chronic oral anticoagulant treatment is obligatory in patients (class I) with mechanical heart valves and in patients with atrial fibrillation with CHADS2 score >1. When these patients undergo percutaneous coronary intervention with placement of a stent, there is also an indication for treatment with aspirin and clopidogrel. Unfortunately, triple therapy is known to increase the bleeding risk. For this group of patients, the bottom line is to find the ideal therapy in patients with indications for both chronic anticoagulation therapy and percutaneous intervention to prevent thromboembolic complications such as stent thrombosis without increasing the risk of bleeding. (Neth Heart J 2010;18:444-50.).

  6. Chronic heart failure part 2: treatment and management.

    Science.gov (United States)

    Brake, Rebecca; Jones, Ian David

    2017-01-11

    Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition. Treatment of patients with chronic heart failure may involve a combination of pharmacological therapy, device implantation and cardiac rehabilitation. This is the second of two articles on chronic heart failure. Part 1 discussed the pathophysiology of chronic heart failure, its causes, assessment, signs and symptoms. Part 2 outlines the treatment and management of patients with the condition, including pharmacological strategies, device implantation, lifestyle modification, cardiac rehabilitation and palliative care.

  7. Isometric exercise and chronic heart failure

    Directory of Open Access Journals (Sweden)

    Efthimia Zerva

    2013-07-01

    Full Text Available The resistance exercise is an important part of all rehabilitation programs in patients with chronic heart failure. Among several kinds of resistance exercises, the one mainly applied is isotonic exercise, whereas, in the contrary, isometric is not heavily used although it affects the daily lives of patients who, trying to look after themselves (moving, walking, lifting objects, twitch in an isometric way their peripheral muscles due to reduced cardiovascular endurance. Purpose: The purpose of the present review was to present the data available so far for isometric exercise in cardiovascular patients and to examine the importance of applying this kind of exercise in rehabilitation programs in the context of, firstly, evaluation, and secondly therapeutic intervention. Material - Methods: The methodology followed included searching inquiries and reviews from international databases (Pubmed, Medline, Scopus on the effects of isometric exercise in patients with chronic heart failure. The progress and development of the studies are of particular importance to this work and, to this end, the literature refers to the entire range of time in the last three decades, from 1985 to 2012 according the key words noted. Results: In rehabilitation programs for patients with chronic heart failure, resistance exercise if applied in an isotonic way helps improve hemodynamic and functional parameters. In contrast, resistance exercise applied in an isometric way requires further investigation because most findings are related to hemodynamic disturbances. The data which is encouraging for isometric exercise programs are few and, therefore, it cannot be directly recommended as a proper way to exercise. Conclusions: Isometric exercise has an important place in the evaluation of patients with chronic heart failure, and limits should be "placed" in its application as a therapeutic tool to prevent complications.

  8. Effect of Cardiac Rehabilitation Program on Heart Rate Recovery in Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Leila Mahdavi Anari

    2015-12-01

    Full Text Available Background: It has been suggested that the autonomic system function and the metabolic syndrome can significantly affect patients' survival. The aim of the current study was to investigate the impact of the cardiac rehabilitation program on the autonomic system balance in patients with coronary artery disease.Methods: Patients with a previous diagnosis of coronary artery disease who were referred to the Cardiovascular Rehabilitation Center of Afshar Hospital (Yazd, Iran between March and November 2011 were enrolled. All the patients participated in rehabilitation sessions 3 times a week for 12 weeks. Heart rate recovery (HRR was measured as an indicator of the autonomic system balance. In order to calculate HRR, the maximum heart rate during the exercise test was recorded. At the end of the exercise test, the patients were asked to sit down without having a cooldown period and their heart rate was recorded again after 1 minute. The difference between these 2 measurements was considered as HRR.Results: A total of 108 patients, including 86 (79.6% men and 22 (20.4% women, completed the rehabilitation course. The mean age of the study participants was 58.25 ± 9.83 years. A statistically significant improvement was observed in HRR (p value = 0.040. Significant declines were also observed in the patients' waist circumference (p value < 0.001 and systolic and diastolic blood pressures (p value = 0.018 and 0.003, respectively. A decreasing trend was observed in the patients' body mass index, but it failed to reach statistical significance (p value = 0.063. No statistically meaningful changes were noted in fasting blood glucose (p value = 0.171, high-density lipoprotein (p value = 0.070, or triglyceride concentrations (p value = 0.149. Conclusion: The cardiac rehabilitation program may help to improve HRR and several components of the metabolic syndrome in patients with coronary heart disease.

  9. Autonomic dysfunction in patients with mild heart failure and coronary artery disease and the effects of add-on beta-blockade

    NARCIS (Netherlands)

    Szabo, BM; van Wijk, LM; Brouwer, J; Tio, RA; Crijns, HJGM; van Veldhuisen, DJ

    2001-01-01

    Aim: Autonomic impairment is related to the incidence of sudden death in chronic heart failure (CHF). Our objective was to study autonomic profiles in patients with mild CHF due to coronary artery disease, and to investigate the value of add-on P-blockade. Methods and results: Measures of autonomic

  10. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Oldridge, Neil; Thompson, David R

    2016-01-01

    BACKGROUND: Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). OBJECTIVES: The goal of this study is to update the Cochrane...... of 20) showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects. CONCLUSIONS: This study confirms that exercise-based CR reduces cardiovascular mortality and provides important data showing reductions in hospital admissions...... systematic review and meta-analysis of exercise-based CR for CHD. METHODS: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included...

  11. Exercise-based cardiac rehabilitation for coronary heart disease

    DEFF Research Database (Denmark)

    2016-01-01

    BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve...... outcomes across follow-up, we focused on reporting findings pooled across all trials at their longest follow-up (median 12 months). Exercise-based CR reduced cardiovascular mortality compared with no exercise control (27 trials; risk ratio (RR) 0.74, 95% CI 0.64 to 0.86). There was no reduction in total......-based CR reduces the risk of cardiovascular mortality but not total mortality. We saw a significant reduction in the risk of hospitalisation with CR but not in the risk of MI or revascularisation. We identified further evidence supporting improved HRQL with exercise-based CR. More recent trials were more...

  12. Reductionism and holism in coronary heart disease and cardiac nursing.

    Science.gov (United States)

    Chummun, Harry

    Reductionism and holism are two contrasting philosophies which provide scientific knowledge of disease processes, health dynamics and care interventions. While reductionism focuses on specific and perhaps narrow concepts, it enhances our in-depth knowledge of key health issues. Holism focuses on understanding how all the significant factors affecting the particular health issue are involved, so a more informed decision can be made about health intervention. This article explores the contribution each makes to our understanding of coronary heart disease (CHD) and to the preparation of nurses working in cardiac nursing. It proposes that pre- and post-registration nursing curricula reflect both reductionist and holistic approaches and therefore cardiac nurses are suitably trained to manage reductionist as well as holistic care for clients with CHD.

  13. Saturated and trans fatty acids and coronary heart disease.

    Science.gov (United States)

    Woodside, Jayne V; McKinley, Michelle C; Young, Ian S

    2008-12-01

    Dietary intake of both saturated and trans fatty acids has been associated with an increase in the risk of coronary heart disease (CHD). Evidence comes mainly from controlled dietary experiments with intermediate end points, such as blood lipoproteins, and from observational studies. A few small, randomized controlled trials with clinical end points have been carried out in which saturated fat was replaced with polyunsaturated fat, leading to a reduction in low-density lipoprotein cholesterol and a reduction in CHD risk. However, no such studies exist for trans fatty acids. More high-quality, randomized controlled trials on fatty acids and CHD are required, but public health recommendations to reduce intake of both saturated and trans fatty acids are appropriate based on the current evidence.

  14. The rarity of coronary heart disease in South African blacks.

    Science.gov (United States)

    Seftel, H C

    1978-07-15

    Coronary heart disease (CHD) remains an uncommon disorder in the South African Black population. It has been suggested that herein lies an enigma, since it is believed that these people are considerably exposed to the conventional risk factors for CHD. To test this belief I have assessed the exposure of Black people, in time and degree, to the following CHD risk factors: affluence, age, hypertension, hyperlipidaemia, dietary excess, smoking, physical inactivity, diabetes, obesity, hyperuricaemia and hyperinsulinism. Among males only hypertension, and among females only hypertension and obesity, emerged as prominent factors. However, neither of these is significantly atherogenic in the social, nutritional and metabolic milieu in which Blacks generally live, and obesity is a doubtful atherogenic factor, even in westernized populations. It is therefore concluded that the rarity of CHD in Blacks is not enigmatic, but is appropriate to their environmental circumstances.

  15. 阿托伐他汀与瑞舒伐他汀治疗冠心病合并慢性肾脏疾病3期的效果比较%Effect comparison of atorvastatin and rosuvastatin in the treatment of coronary heart disease combining with third-stage chronic renal disease

    Institute of Scientific and Technical Information of China (English)

    谭本超

    2015-01-01

    Objective To compare the effect of atorvastatin and rosuvastatin in the treatment of coronary heart disease combining with third-stage chronic renal disease. Methods 100 patients with coronary heart disease combining with third-stage chronic renal disease admitted into our hospital From January 2009 to January 2012 were selected and randomly divided into experimental group and control group,50 cases in each group.In experimental group,atorvastatin was applied, while in control group,rosuvastatin was used.The therapeutic difference after 3 years treatment was observed at premises of ensuring blood lipid control reaching the standard as well as blood pressure and blood glucose provided with stan-dard second-level prevention drug for coronary heart disease. Results The decrease rate of creatinine clearance rate in the experimental group was 22%,which was lower than 54%of control group (P0.05),and no sudden death case oc-curred in two groups. Conclusion Compared with rosuvastatin, the renal damage by atorvastatin is slighter,which is the better choice in the treatment of coronary heart disease combining with third-stage chronic renal disease.%目的:比较阿托伐他汀与瑞舒伐他汀治疗冠心病合并慢性肾脏疾病3期的效果。方法选择2009年1月~2012年1月本院收治的100例冠心病合并慢性肾脏疾病3期患者,将其随机分为实验组和对照组,每组50例。实验组应用阿托伐他汀治疗,对照组应用瑞舒伐他汀治疗,保证两组患者血脂控制均达标,同时均给予规范冠心病Ⅱ级预防用药,保证血压、血糖等危险因素控制达标,观察两组患者治疗3年后的差异。结果实验组的肌酐清除率下降率为22%,低于对照组的54%(P0.05),且均未发生猝死。结论与瑞舒伐他汀比较,阿托伐他汀对肾损害更小,是治疗冠心病合并慢性肾脏疾病3期更好的选择。

  16. Association of changes in health-related quality of life in coronary heart disease with coronary procedures and sociodemographic characteristics

    Directory of Open Access Journals (Sweden)

    Rollag Arnfinn

    2004-10-01

    Full Text Available Abstract Background Few studies have focused on the association between the sociodemographic characteristics of a patient with the change in health-related quality of life (HRQOL following invasive coronary procedures, and the results remain inconclusive. The objective of the present study was to measure the temporal changes in HRQOL of patients with coronary heart disease, and assess how these changes are associated with invasive coronary procedures and sociodemographic characteristics. Methods This was a prospective study of 254 patients with angina pectoris and 90 patients with acute coronary syndrome. HRQOL was assessed with the multi-item scales and summary components of the SF-36, both 6 weeks and 2 years after baseline hospitalization in 1998. Paired t-tests and multiple regression analyses were used to assess temporal changes in HRQOL and to identify the associated factors. Results Physical components of HRQOL had improved most during the 2 years following invasive coronary procedures. Our findings indicated that patients with angina pectoris who were younger, male, and more educated were most likely to increase their HRQOL following invasive coronary procedures. When adjusting for baseline HRQOL scores, invasive coronary procedures and sociodemographic characteristics did not explain temporal changes in patients with acute coronary syndrome, possibly due to higher comorbidity. Conclusion Sociodemographic characteristics should be taken into account when comparing and interpreting changes in HRQOL scores in patients with and without invasive coronary procedures.

  17. 21 CFR 101.82 - Health claims: Soy protein and risk of coronary heart disease (CHD).

    Science.gov (United States)

    2010-04-01

    ... heart disease (CHD). 101.82 Section 101.82 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Health Claims § 101.82 Health claims: Soy protein and risk of coronary heart disease (CHD). (a... risk of CHD. (1) Cardiovascular disease means diseases of the heart and circulatory system. CHD is...

  18. Correlation between calcium and phosphate levels to calculus accumulation on coronary heart disease patients

    Science.gov (United States)

    Cahaya, Cindy; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni

    2017-02-01

    Coronary Artery Disease (CAD) or Coronary Heart Disease (CHD) is a disease that happened because of blood flow being blocked by atherosclerosis. Atherosclerosis is a process of hardening of the arteries which characterized by thickening and loss of elasticity of the intimal layer of vascular wall, by lipid deposit. Periodontitis is a chronic multifactorial inflammatory disease caused by microorganism and characterized by progressive destruction of the tooth supporting apparatus leading to tooth loss. Many studies use saliva as a valuable source for clinically information, as an asset for early diagnosis, prognostic and reviewer for pascatherapy status. Dental calculus had happened as a consequence of saliva supersaturation by calcium and phosphate. Salivary flow rate and its composition influence the formation of calculus. Increasing salivary calcium levels is characteristic of periodontitis patients. An important hipotesis in Cardiology is chronic infections contribute in atherosclerosis. Objective: To analyse the correlation between calcium and phosphate levels in saliva to calculus accumulation on CHD patients. Result: Correlation analysis between salivary calcium levels with calculus accumulation in patients with CHD and non-CHD showed no significant p value, p=0.59 and p=0.518. Correlation analysis between salivary phosphate levels and calculus accumulation showed no significant p value, p=0.836 for CHD patients and p=0.484 for non-CHD patients. Conclusion: There are no correlation between calcium levels and phosphate levels with calculus accumulation in CHD patients. Further research need to be done.

  19. Association between Six Minute Walk Test and All-Cause Mortality, Coronary Heart Disease-Specific Mortality, and Incident Coronary Heart Disease

    Science.gov (United States)

    Yazdanyar, Ali; Aziz, Michael M; Enright, Paul L; Edmundowicz, Daniel; Boudreau, Robert; Sutton-Tyrell, Kim; Kuller, Lewis; Newman, Anne B

    2015-01-01

    Objectives To examine the association between six-minute walk test (6 MWT) performance and all-cause mortality, coronary heart disease mortality, and incident coronary heart disease in older adults. Methods We conducted a time-to-event analysis of 1,665 Cardiovascular Health Study participants with a 6 MWT and without prevalent cardiovascular disease. Results During a mean follow-up of 8 years, there were 305 incident coronary heart disease events, 504 deaths of which 100 were coronary heart disease-related deaths. The 6 MWT performance in the shortest two distance quintiles was associated with increased risk of all-cause mortality (290-338 meters: HR 1.7; 95% CI, 1.2-2.5; <290 meters: HR 2.1; 95% CI, 1.4-3.0). The adjusted risk of coronary heart disease mortality incident events among those with a 6 MWT <290 meters was not significant. Discussion Performance on the 6 MWT is independently associated with all-cause mortality and is of prognostic utility in community-dwelling older adults. PMID:24695552

  20. PREVALENCE OF CORONARY ARTERY DISEASE IN PATIENTS WITH VALVULAR HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Hiranya Kumar Saharia

    2016-07-01

    Full Text Available BACKGROUND Heart disease is a growing problem, particularly in developing countries. India has quoted to have 12.2% and 12% prevalence of coronary artery disease and rheumatic valvular heart disease respectively. Some older reports suggest that rheumatic fever, in addition to producing specific injuries to small coronary arterial branches may accelerate the development of coronary atherosclerosis. AIM To assess the prevalence of Coronary Artery disease in patients with Valvular Heart disease in some selected hospitals of Guwahati, Assam. SETTING AND DESIGN It was conducted in Gauhati Medical College and Hospital and Hayat Hospital, Guwahati. Explorative approach, survey design was selected for the study. MATERIALS AND METHODS Purposive sampling technique was used to select 126 patients who were diagnosed with valvular heart disease. Data was collected through a self-structured interview scheduled on prevalence of coronary artery disease. RESULTS Of the total 126 patients of valvular heart disease, 108 (85.71% cases were rheumatic valvular heart disease and 18 (14.29% were non-rheumatic valvular heart disease. Majority (56.34% of cases with CAD and RHD were in the range of 45 to 54 years. The prevalence of typical angina was significantly high among men (41.18%. Most of the rheumatic patients (72.22% did not complain about angina. Diabetes mellitus, hypertension and dyslipidaemia are significantly high among non-rheumatic group and Coronary artery disease group. In our study, the overall prevalence of significant coronary artery disease in patients with valvular heart disease was 14.28%. CONCLUSION Coronary artery disease prevalence is very high in this part of the country. Health professionals should actively participate in health promotion activities, apply the findings of the study to identify high risk individuals and prevent the occurrence of coronary artery disease.

  1. Risk factors for coronary heart disease and actual diagnostic criteria for diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mitrović-Perišić Nataša

    2009-01-01

    Full Text Available Background/Aim. Recent studies indicate that the prevalence of diabetes mellitus (DM type 2 is increasing in the world. Chronic hyperglycemia in DM is associated with a long term damage, dysfunction and failure of various organs, especially retina, kidney, nerves and, in addition, with an increased risk of cardiovasclar disease. For a long time the illness has been unknown. Early diagnosis of diabetes could suspend the development of diabetic complications. The aim of the study was to establish risk for the development of coronary disease in the patients evaluated by the use of new diagnostic criteria for DM. Methods. The study included 930 participants without diagnosis of DM, hypertension, dyslipidemia, nor coronary heart disease two years before the study. The patients went through measuring of fasting plasma glycemia, erythrocytes, hematocrit, cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase. In the group with hyperglycemia the 2-hour oral glucose tolerance test was performed. We analyzed ECG and made blood pressure monitoring, and also measured body mass, height, waist and hip circumference. We analyzed life style, especially smoking, and exercise and family history. Results. Diabetes prevalence was 2.68%, and prevalences of impaired fasting glucose, impaired glucose tolerance and DM were 12.15%. Average age of males and females was 38 and 45 years, respectively. In the healthy population there was higher frequency of smokers (55% vs 42%, but in the population with hyperglycemia there were more obesity (23% vs 10.5%, hypertension (39% vs 9%, hypercholesterolemia (76% vs 44.1%, lower HDL-C (52.2% vs 25.7%. Cummulative risk factor in healthy subjects, and those with hyperglycemia were 5.6% and 14%, respectively. Conclusion. Subjects with hyperglicemia without diagnosis of DM have higher risk factors for coronary heart disease.

  2. Coronary stenting versus bypass surgery in heart failure patients with preserved ejection fraction

    Institute of Scientific and Technical Information of China (English)

    XUE Zeng-ming; WANG Xiao; CHEN Fang; ZHOU Yu-jie; L(0) Shu-zheng; HUANG Fang-jiong; GU Cheng-xiong; WU Xue-si; LI Wei-ju; MA Chang-sheng; NIE Shao-ping; DONG Jian-zeng; LIU Xiao-hui; KANG Jun-ping; L(O) Qiang; DU Xin

    2012-01-01

    Background The optimal revascularization strategy in patients with heart failure with preserved ejection fraction (HFPEF) remains unclear.The aim of the present study was to compare the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with HFPEF.Methods From July 2003 through September 2005,a total of 920 patients with coronary artery disease (CAD) and HFPEF (ejection fraction ≥50%) underwent PCI (n=350) or CABG (n=570).We compared the groups with respect to the primary outcome of mortality,and the secondary outcomes of main adverse cardiac and cerebral vascular events (MACCE),including death,myocardial infarction,stroke and repeat revascularization,at a median follow-up of 543 days.Results In-hospital mortality was significantly lower in the PCI group than in the CABG group (0.3% vs.2.5%,adjusted P=0.016).During follow-up,there was no significant difference in the two groups with regard to mortality rates (2.3% vs.3.5%,adjusted P=0.423).Patients receiving PCI had higher MACCE rates as compared with patients receiving CABG (13.4% vs.4.0%,adjusted P <0.001),mainly due to higher rate of repeat revascularization (adjusted P <0.001).Independent predictors of mortality were age,New York Heart Association (NYHA) class and chronic total occlusion.Conclusion Among patients with CAD and HFPEF,PCI was shown to be as good as CABG with respect to the mortality rate,although there was a higher rate of repeat revascularization in patients undergoing PCI.

  3. Changes in Heart Rate Variability after Coronary Artery Bypass Grafting and Clinical Importance of These Findings.

    Science.gov (United States)

    Lakusic, Nenad; Mahovic, Darija; Kruzliak, Peter; Cerkez Habek, Jasna; Novak, Miroslav; Cerovec, Dusko

    2015-01-01

    Heart rate variability is a physiological feature indicating the influence of the autonomic nervous system on the heart rate. Association of the reduced heart rate variability due to myocardial infarction and the increased postinfarction mortality was first described more than thirty years ago. Many studies have unequivocally demonstrated that coronary artery bypass grafting surgery generally leads to significant reduction in heart rate variability, which is even more pronounced than after myocardial infarction. Pathophysiologically, however, the mechanisms of heart rate variability reduction associated with acute myocardial infarction and coronary artery bypass grafting are different. Generally, heart rate variability gradually recovers to the preoperative values within six months of the procedure. Unlike the reduced heart rate variability in patients having sustained myocardial infarction, a finding of reduced heart rate variability after coronary artery bypass surgery is not considered relevant in predicting mortality. Current knowledge about changes in heart rate variability in coronary patients and clinical relevance of such a finding in patients undergoing coronary artery bypass grafting are presented.

  4. Potential benefits of cell therapy in coronary heart disease.

    Science.gov (United States)

    Grimaldi, Vincenzo; Mancini, Francesco Paolo; Casamassimi, Amelia; Al-Omran, Mohammed; Zullo, Alberto; Infante, Teresa; Napoli, Claudio

    2013-11-01

    Cardiovascular disease is the leading cause of morbidity and mortality in the world. In recent years, there has been an increasing interest both in basic and clinical research regarding the field of cell therapy for coronary heart disease (CHD). Several preclinical models of CHD have suggested that regenerative properties of stem and progenitor cells might help restoring myocardial functions in the event of cardiac diseases. Here, we summarize different types of stem/progenitor cells that have been tested in experimental and clinical settings of cardiac regeneration, from embryonic stem cells to induced pluripotent stem cells. Then, we provide a comprehensive description of the most common cell delivery strategies with their major pros and cons and underline the potential of tissue engineering and injectable matrices to address the crucial issue of restoring the three-dimensional structure of the injured myocardial region. Due to the encouraging results from preclinical models, the number of clinical trials with cell therapy is continuously increasing and includes patients with CHD and congestive heart failure. Most of the already published trials have demonstrated safety and feasibility of cell therapies in these clinical conditions. Several studies have also suggested that cell therapy results in improved clinical outcomes. Numerous ongoing clinical trials utilizing this therapy for CHD will address fundamental issues concerning cell source and population utilized, as well as the use of imaging techniques to assess cell homing and survival, all factors that affect the efficacy of different cell therapy strategies.

  5. Management of chronic heart failure in the older population

    Institute of Scientific and Technical Information of China (English)

    Nahid Azad; Genevieve Lemay

    2014-01-01

    Chronic heart failure (CHF) is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

  6. Efficacy of trimetazidine combining with metoprolol on plasma BNP in coronary heart disease patients with heart failure

    Institute of Scientific and Technical Information of China (English)

    Ping Li; You-Mei Li

    2016-01-01

    Objective:To explore the effect of combined application of trimetazidine and metoprolol on plasma BNP in coronary heart disease patients with heart failure and the clinical efficacy. Methods:A total of 140 cases of coronary heart disease patients with heart failure treated in Cardiology Department of our hospital from May 2012 to January 2015 were selected and divided into study group and control group by random number table method. The control group received digitalis, diuretics, ACEI (angiotensin-converting enzyme inhibitor) and other conventional drugs for treatment, the study group received combined use of trimetazidine and metoprolol on the basis of routine treatment of the control group, and treatment duration was 12 weeks. Then plasma BNP, systolic blood pressure, heart rate, left ventricular end diastolic diameter (LVEDD), left ventricular end systolic end (LVESD) and left ventricular ejection fraction (LVEF) of two groups before and after treatment were statistically analyzed, and the overall effect was evaluated.Results:Before treatment, there were no significant differences in plasma BNP, blood pressure, heart rate, LVEDD, LVESD and LVEF between the two groups; after treatment, plasma BNP, blood pressure, heart rate, LVEDD and LVESD of both groups decreased and LVEF increased, but the changes in study group were better than those in control group.Conclusion:Trimetazidine combined with metoprolol has better application effect in plasma BNP decrease and heart function improvement in coronary heart disease patients with heart failure.

  7. Intervention Experiment of Xinkeshu Pian on Anorexia at Symptoms Remission of Coronary Heart Disease Patients with Chronic Heart Failure%心可舒片对冠心病慢性心力衰竭患者症状缓解期食欲减退干预的研究

    Institute of Scientific and Technical Information of China (English)

    郭宏伟; 张爱军; 罗芳

    2011-01-01

    Objective To observe the effect of Xinkeshu Pian on anorexia, serum motilin and gastrin at symptom remission among coronary heart disease (CHD) patients with chronic heart failure. Methods 98 of CHD inpatients complicated with chronic heart failure were selected and divided into 2 groups: observation group (n=50) and control group (n=48). On the basis of conventional treatment, the observation group took Xinkeshu Pian, 4 tablets, 3 times per day; while the control group took isosorbide dinitrate, 10 mg, 3 times per day. Remission of symptoms, changes of serum motilin and gastrin were observed and compared between two groups. Results The number of days from admission to remission of heart failure was (4.5 ±2.1) d in observation group and (4.4±1.9) d in the control, the left ventricular ejection fraction was (56.3±23.1) % in the observation and (58.4±24.2)% in the control, the differences were no statistics significant (P>0.05). When remission of heart failure symptoms, the ratios of anorexia in both group decreased and it was lower in the observation group than in the control (P<0.05); and the levels of motilin and gastrin increased and it was higher in the observation group (P<0.01). Conclusion The Xinkeshu Pian has better effect on the remission of main symptoms of heart failure than isosorbide dinitrate dose, and more obvious on the secretion level of motilin and gastrin.%目的 观察心可舒片是否对冠心病慢性心力衰竭患者症状缓解期食欲减退、血清胃动素和胃泌素浓度有干预,并探讨其机制.方法 选取98例冠心病合并慢性心力衰竭的住院病例为研究对象.随机将其分为观察组50例,对照组48例.在常规治疗的基础上,观察组加服心可舒片4片,每日3次;对照组加服单硝酸异山梨酯片10 mg,每日3次.观测两组患者从入院到心衰主要症状(胸闷、心慌、呼吸困难、浮肿等)缓解时所需天数以及上述两个时间点的左室射血分数、食欲减退患

  8. Dr. Li Chuanjie's Experience in the Acupuncture and Herbal Treatment for Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Having been engaged in TCM clinical practice, teaching, and scientific research for 55 years, Dr. Li Chuanjie has obtained rich experience in treating coronary heart disease with acupuncture and herbs and got remarkable therapeutic effects.

  9. Depressive Symptoms, Health Behaviors, and Risk of Cardiovascular Events in Patients With Coronary Heart Disease

    NARCIS (Netherlands)

    Whooley, Mary A.; de Jonge, Peter; Vittinghoff, Eric; Otte, Christian; Moos, Rudolf; Carney, Robert M.; Ali, Sadia; Dowray, Sunaina; Na, Beeya; Feldman, Mitchell D.; Schiller, Nelson B.; Browner, Warren S.

    2008-01-01

    Context Depressive symptoms predict adverse cardiovascular outcomes in patients with coronary heart disease, but the mechanisms responsible for this association are unknown. Objective To determine why depressive symptoms are associated with an increased risk of cardiovascular events. Design and Part

  10. The role of levosimendan in acute heart failure complicating acute coronary syndrome

    DEFF Research Database (Denmark)

    Nieminen, Markku S; Buerke, Michael; Cohen-Solál, Alain

    2016-01-01

    Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been...... defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease. In acute heart failure......, and especially in cardiogenic shock related to ischemic conditions, vasopressors and inotropes are used. However, both pathophysiological considerations and available clinical data suggest that these treatments may have disadvantageous effects. The inodilator levosimendan offers potential benefits due to a range...

  11. Coronary risk stratification of patients undergoing surgery for valvular heart disease

    DEFF Research Database (Denmark)

    Hasselbalch, Rasmus Bo; Engstrøm, Thomas; Pries-Heje, Mia

    2016-01-01

    BACKGROUND: Multislice computed tomography (MSCT) is a non-invasive, less expensive, low-radiation alternative to coronary angiography (CAG) prior to valvular heart surgery. MSCT has a high negative predictive value for coronary artery disease (CAD) but previous studies of patients with valvular ...

  12. Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves

    NARCIS (Netherlands)

    Habets, Jesse; van den Brink, Renee B. A.; Uijlings, Ruben; Spijkerboer, Anje M.; Mali, Willem P. Th. M.; Chamuleau, Steven A. J.; Budde, Ricardo P. J.

    2012-01-01

    Objectives Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT. Methods ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of p

  13. 麝香保心丸治疗冠心病慢性心力衰竭患者临床疗效观察%Clinical Observation on Shexiang Baoxin Pil in the Treatment of Chronic Heart Failure Induced by Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    李蓉; 吴泰蓉; 朱灿宏; 黄根牙; 彭良欢

    2015-01-01

    Objective To investigate the efficacy of Shexiang Baoxin pil (SBP)in treating chronic heart failure(CHF)induced by coro-nary heart disease(CHD).Methods One hundred patients with CHF induced by CHD were randomly divided into two groups:The control group(n=50)treated with routine treatment,and the treatment group(n=50)treated with routine treatment plus SBP for 6 weeks.The cardiac function,plasma N terminal pro brain type natriuretic peptide (NT proBNP)and serum heart fatty acid binding protein (H FABP)levels were observed.Results After treatment,left ventricular(LV)ejection fraction (LVEF),LV end di-astolic diameter (LVEDD),LV end systolic diameter(LVESD),cardiac output (CO),SV and 6 min walking distance were improved in two groups,the degree of improvement in treatment group was better than that in control group(P<0.05).The levels of plasma NT proBNP and serum H FABP in treatment group was lower than that in control group(P<0.05).The clinical efficacy in treat-ment group was better than that in control group(P<0.05).Conclusion SBP can improve the cardiac function,reduce the levels of plasma NT proBNP and serum H FABP in patients with CHF induced by CHD.%目的:观察麝香保心丸对冠心病慢性心力衰竭患者的心功能、血流动力学及相关指标影响。方法100例冠心病慢性心力衰竭患者随机分为观察组和对照组,各50例。对照组采用西医常规治疗,观察组在西医常规治疗的基础上加用麝香保心丸。治疗6周后比较两组患者心功能、血浆 N末端脑钠肽前体(NT proBNP)和血清心型脂肪酸结合蛋白(H FABP)水平。结果两组治疗后左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、心输出量(CO)、每搏量(SV)及6 min步行距离均较治疗前有改善,观察组改善的程度优于对照组(P<0.05);治疗后观察组血浆 NT proBNP和血清 H FABP水平均低于对照组(P<0.05),观察组临床疗效优于对照组(P<0.05)。结

  14. Side effects of using nitrates to treat heart failure and the acute coronary syndromes, unstable angina and acute myocardial infarction.

    Science.gov (United States)

    Thadani, Udho; Ripley, Toni L

    2007-07-01

    Nitrates are potent venous dilators and anti-ischemic agents. They are widely used for the relief of chest pain and pulmonary congestion in patients with acute coronary syndromes and heart failure. Nitrates, however, do not reduce mortality in patients with acute coronary syndromes. Combination of nitrates and hydralazine when given in addition to beta-blockers and angiotensin-converting enzyme (ACE) inhibitors reduce mortality and heart failure hospitalizations in patients with heart failure due to left ventricular systolic dysfunction who are of African-American origin. Side effects during nitrate therapy are common but are less well described in the literature compared with the reported side effects in patients with stable angina pectoris. The reported incidence of side effects varies highly among different studies and among various disease states. Headache is the most commonly reported side effect with an incidence of 12% in acute heart failure, 41-73% in chronic heart failure, 3-19% in unstable angina and 2-26% in acute myocardial infarction. The reported incidence of hypotension also differs: 5-10% in acute heart failure, 20% in chronic heart failure, 9% in unstable angina and < 1-48% in acute myocardial infarction, with the incidence being much higher with concomitant nitrate therapy plus angiotensin-converting enzyme inhibitors. Reported incidence of dizziness is as low as 1% in patients with acute myocardial infarction to as high as 29% in patients with heart failure. Severe headaches and/or symptomatic hypotension may necessitate discontinuation of nitrate therapy. Severe life threatening hypotension or even death may occur when nitrates are used in patients with acute inferior myocardial infarction associated with right ventricular dysfunction or infarction, or with concomitant use of phosphodiesterase-5 inhibitors or N-acetylcysteine. Despite the disturbing observational reports in the literature that continuous and prolonged use of nitrates may lead to

  15. Dietary fat and risk of coronary heart disease: possible effect modification by gender and age

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Uhre; Overvad, Kim; Dyerberg, Jørn

    2004-01-01

    In a 16-year follow-up study (ending in 1998) of 3,686 Danish men and women aged 30–71 years at recruitment, the association between energy intake from dietary fat and the risk of coronary heart disease was evaluated while assessing the possible modifying role of gender and age. In the models used...... not significantly. In conclusion, the present study suggests that coronary heart disease risk relates to both the quantity and the quality of dietary fats....

  16. Ruling out coronary heart disease in primary care patients with chest pain: a clinical prediction score

    Directory of Open Access Journals (Sweden)

    Burnand Bernard

    2010-01-01

    Full Text Available Abstract Background Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify coronary heart disease in emergency settings, but not in primary care. Methods Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one of 59 family practitioners' offices. Using delayed diagnosis we derived a prediction rule to rule out coronary heart disease by means of a logistic regression model. Known cardiovascular risk factors, pain characteristics, and physical signs associated with coronary heart disease were explored to develop a clinical score. Patients diagnosed with angina or acute myocardial infarction within the year following their initial visit comprised the coronary heart disease group. Results The coronary heart disease score was derived from eight variables: age, gender, duration of chest pain from 1 to 60 minutes, substernal chest pain location, pain increasing with exertion, absence of tenderness point at palpation, cardiovascular risks factors, and personal history of cardiovascular disease. Area under the receiver operating characteristics curve was of 0.95 with a 95% confidence interval of 0.92; 0.97. From this score, 413 patients were considered as low risk for values of percentile 5 of the coronary heart disease patients. Internal validity was confirmed by bootstrapping. External validation using data from a German cohort (Marburg, n = 774 revealed a receiver operating characteristics curve of 0.75 (95% confidence interval, 0.72; 0.81 with a sensitivity of 85.6% and a specificity of 47.2%. Conclusions This score, based only on history and physical examination, is a complementary tool for ruling out coronary heart disease in primary care patients complaining of chest pain.

  17. Current Role of Ivabradine in Stable Coronary Artery Disease Without Heart Failure.

    Science.gov (United States)

    Porres-Aguilar, Mateo; Muñoz, Oscar C; Abbas, Aamer

    2016-02-01

    Increase in heart rate represents a significant contribution in the pathophysiology of coronary artery disease and heart failure, by promoting atherosclerotic process and endothelial dysfunction. Thus, it negatively influences cardiovascular risk in the general population. The aim of this review is to analyze the current, controversial, and future role of ivabradine as an anti-anginal agent in the setting of coronary artery disease without heart failure. Ivabradine represents a selective heart rate-lowering agent that increased diastolic perfusion time and improving energetics in the ischemic myocardium.

  18. [Childhood body mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, L.W.; Sørensen, Thorkild I.A.

    2008-01-01

    The severity of the long term consequences of the current childhood obesity epidemic on coronary heart disease is unknown. Therefore we investigated the association between body mass index (BMI) at ages 7-13 years and heart disease in adulthood among 276,835 Danish schoolchildren. We found...... that higher BMI during this period of childhood is associated with an increased risk of any, non-fatal and fatal heart disease in adulthood. Worldwide, as children are becoming heavier, our findings suggest that greater numbers of children are at risk of having coronary heart disease in adulthood...

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  20. The relationship of age, blood pressure, serum cholesterol and smoking habits with the risk of typical and atypical coronary heart disease death in the European cohorts of the Seven Countries Study

    NARCIS (Netherlands)

    Menotti, A.; Lanti, M.; Nedeljkovic, S.; Nissinen, A.; Kafatos, A.; Kromhout, D.

    2006-01-01

    Objective: To explore whether "typical" coronary heart disease (CHD) such as fatal myocardial infarction and sudden death relate to major cardiovascular risk factors in the same way as the "atypical" CHD, such as fatal heart failure and chronic arrhythmias. Design and setting: Ten cohorts (6633 card

  1. [Anatomy and physiology of the heart and coronary arteries].

    Science.gov (United States)

    Leclercq, Florence

    2015-03-01

    The myocardium assures the supply of oxygen to the body. The provision of oxygen to the myocardium by the coronary arteries is dependent on two key parameters: the coronary blood flow and the ability to extract oxygen from the arterial blood. Coronary artery disease is almost always the consequence of atherosclerosis and can lead to myocardial infarction.

  2. An Update on the Utility of Coronary Artery Calcium Scoring for Coronary Heart Disease and Cardiovascular Disease Risk Prediction.

    Science.gov (United States)

    Kianoush, Sina; Al Rifai, Mahmoud; Cainzos-Achirica, Miguel; Umapathi, Priya; Graham, Garth; Blumenthal, Roger S; Nasir, Khurram; Blaha, Michael J

    2016-03-01

    Estimating cardiovascular disease (CVD) risk is necessary for determining the potential net benefit of primary prevention pharmacotherapy. Risk estimation relying exclusively on traditional CVD risk factors may misclassify risk, resulting in both undertreatment and overtreatment. Coronary artery calcium (CAC) scoring personalizes risk prediction through direct visualization of calcified coronary atherosclerotic plaques and provides improved accuracy for coronary heart disease (CHD) or CVD risk estimation. In this review, we discuss the most recent studies on CAC, which unlike historical studies, focus sharply on clinical application. We describe the MESA CHD risk calculator, a recently developed CAC-based 10-year CHD risk estimator, which can help guide preventive therapy allocation by better identifying both high- and low-risk individuals. In closing, we discuss calcium density, regional distribution of CAC, and extra-coronary calcification, which represent the future of CAC and CVD risk assessment research and may lead to further improvements in risk prediction.

  3. 心功能不全合并冠状动脉慢性完全闭塞患者行介入治疗开通后对心功能的影响分析%Influence of successful revascularization by percutaneous coronary intervention on heart function of patients with heart dysfunction combined with chronic total occlusion

    Institute of Scientific and Technical Information of China (English)

    陈海坚; 林薇; 莫逆; 梁金春; 乌汉东

    2012-01-01

    目的 观察心功能不全合并冠状动脉慢性完全闭塞(CTO)患者行经皮冠状动脉介入治疗(PCI)开通后对心功能的影响.方法 选择272例心功能不全合并CTO患者,按PCI结果分为PCI开通成功组(246例)与PCI开通失败组(26例).术后6个月复查心脏超声,对比分析两组患者心功能的差别.结果 开通成功组与开通失败组分别有229例及24例患者于术后6个月复查心脏超声.开通失败组术后6个月左室射血分数(LVEF)和左室舒张末期容积指数(LVEDVI)与术前比较差异无统计学意义(P>0.05),开通成功组术后6个月LVEF和LVEDVI均较术前及开通失败组术后6个月明显改善[(51±5)%比(43±6)%和(45±2)%、(77±13)ml/m2比(86±12)ml/m2和(86±10)ml/m2,P<0.05].开通失败组术后6个月心功能分级与术前比较差异无统计学意义(P>0.05);开通成功组术后6个月心功能分级较术前和开通失败组术后6个月有明显改善(P<0.05).结论 心功能不全合并CTO患者行PCI开通后心功能明显改善.%Objective To evaluate the influence of successful revascularization by percutaneous coronary intervention(PCI)on heart function of patients with heart dysfunction combined with chronic total occlusion(CTO).Methods The clinical data of 272 patients with heart dysfunction combined with CTO were analyzed.The patients were divided into PCI success group(246 cases)and PCI failure group(26 cases)respectively according to the results of PCI.Six months after PCI,the patients underwent cardiac ultrasound examination to compare the heart function between the two groups.Results Cardiac ultrasound examination was successfully performed in 229 patients in PCI success group and 24 patients in PCI failure group at 6 months after PCI.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume index(LVEDVI)showed no significant difference in PCI failure group at 6 months after PCI compared with that before PCI(P>0

  4. Spirituality and Negative Emotions in Individuals With Coronary Heart Disease.

    Science.gov (United States)

    Ginting, Henndy; Näring, Gérard; Kwakkenbos, Linda; Becker, Eni S

    2015-01-01

    Many individuals with coronary heart disease (CHD) experience disease-related anxiety, depressive symptoms, and anger. Spirituality may be helpful to cope with these negative emotions. Research findings on the role of spirituality in dealing with negative emotions are inconsistent. In this study, we examined the associations between 7 dimensions of spirituality (ie, meaningfulness, trust, acceptance, caring for others, connectedness with nature, transcendent experiences, and spiritual activities) and negative emotions among individuals with CHD in Indonesia, controlling for perceived social support as well as demographic and clinical characteristics. In total, 293 individuals with CHD were recruited from the 3 largest hospitals in Bandung, Indonesia. They completed the Spiritual Attitude and Involvement List, the Beck Depression Inventory-II, the Trait Anxiety Scale of the State Trait Anxiety Inventory, the Multidimensional Anger Inventory, and the Multidimensional Scale of Perceived Social Support. Hierarchical linear regression analyses indicated that a higher overall level of spirituality was associated with lower levels of depressive symptoms, less anxiety, and less anger. Specifically, a higher level of trust was significantly associated with both less depressive symptoms and less anxiety. Higher levels of caring for others and spiritual activities were associated with less anxiety, and a higher level of connectedness with nature was associated with less anger. These findings underscore the importance of specific dimensions of spirituality as a potentially independent buffer against negative emotions in individuals with CHD.

  5. Coronary heart disease in women: why the disproportionate risk?

    Science.gov (United States)

    Colhoun, Helen

    2006-02-01

    Women with diabetes experience much greater relative risks of coronary heart disease (CHD) compared with the nondiabetic population than do men with diabetes. In type 2 diabetes, much of the greater elevation in risk in women is explained by a more adverse pattern of known CHD risk factors. In type 1 diabetes the picture is less clear, but current evidence suggests that a cardioprotective lipid profile is found in type 1 diabetic men, thus reducing the effect of diabetes on CHD, but that in women this is not the case. Also, in type 1 diabetic women there is some evidence of altered body fat distribution and a greater elevation in blood pressure. Whether these reflect a greater degree of insulin resistance in type 1 women, and what the origin of this might be, remains controversial. The practical consequence is that clinicians need to be aware that the usual cardioprotective effect of sex does not apply in diabetic women and that risk factor intervention is needed at an early age.

  6. [Trans-fatty acids--effects on coronary heart disease].

    Science.gov (United States)

    Karbowska, Joanna; Kochan, Zdzisław

    2011-07-01

    Trans-fatty acids (TFA) are formed during the industrial process of hydrogenation of vegetable oils. The consumption of hydrogenated fats has increased significantly over the last few decades. In Poland, the average daily intake of TFA for adults was estimated to be 2.8 to 6.9 g; which greatly exceeds the recommended daily maximum of 2 g/day (less than 1% of total energy intake). Increasing trans-fatty acid intake has detrimental effects on the lipid profile: TFA raise total cholesterol, LDL-cholesterol and triglyceride concentrations, and decrease HDL-cholesterol levels. Moreover, dietary trans-fatty acids may increase plasma levels of lipoprotein (a) and biomarkers of inflammation and endothelial dysfunction. Several studies have demonstrated that a high intake of TFA is associated with an increased risk of coronary heart disease. In addition, TFA consumption has been implicated as an independent risk factor for sudden cardiac arrest. It is therefore necessary to reduce the intake of hydrogenated fats rich in trans-fatty acids in order to minimize the adverse effects of TFA on health.

  7. Depression risk in patients with coronary heart disease in Germany

    Science.gov (United States)

    Konrad, Marcel; Jacob, Louis; Rapp, Michael A; Kostev, Karel

    2016-01-01

    AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices. METHODS Longitudinal data from nationwide general practices in Germany (n = 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1:1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders. RESULTS Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9% of patients were men. After a five-year follow-up, 21.8% of the CHD group and 14.2% of the control group were diagnosed with depression (P risk factor for developing depression (HR = 1.54, 95%CI: 1.49-1.59, P risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively. CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management.

  8. C-reactive protein, inflammation and coronary heart disease

    Directory of Open Access Journals (Sweden)

    Amit Kumar Shrivastava

    2015-06-01

    Full Text Available Inflammation is widely considered to be an important contributing factor of the pathophysiology of coronary heart disease (CHD, and the inflammatory cascade is particularly important in the atherosclerotic process. In consideration of the important role that inflammatory processes play in CHD, recent work has been focused on whether biomarkers of inflammation may help to improve risk stratification and identify patient groups who might benefit from particular treatment strategies. Of these biomarkers, C-reactive protein (CRP has emerged as one of the most important novel inflammatory markers. CRP an acute phase protein is synthesized by hepatocytes in response to proinflammatory cytokines, in particular interleukin-6. Many large-scale prospective studies demonstrate that CRP strongly and independently predicts adverse cardiovascular events, including myocardial infarction, ischemic stroke, and sudden cardiac death in individuals both with and without overt CHD. CRP is believed to be both a marker and a mediator of atherosclerosis and CHD. CRP plays a pivotal role in many aspects of atherogenesis including, activation of complement pathway, lipids uptake by macrophage, release of proinflammatory cytokines, induces the expression of tissue factor in monocytes, promotes the endothelial dysfunction and inhibits nitric oxide production. The commercial availability of CRP high sensitive assays has made screening for this marker simple, reliable, and reproducible and can be used as a clinical guide to diagnosis, management, and prognosis of CHD.

  9. Effects of whole grains on coronary heart disease risk.

    Science.gov (United States)

    Harris, Kristina A; Kris-Etherton, Penny M

    2010-11-01

    Characterizing which types of carbohydrates, including whole grains, reduce the risk for coronary heart disease (CHD) is challenging. Whole grains are characterized as being high in resistant carbohydrates as compared with refined grains, meaning they typically are high in fiber, nutrients, and bound antioxidants. Whole grain intake consistently has been associated with improved cardiovascular disease outcomes, but also with healthy lifestyles, in large observational studies. Intervention studies that assess the effects of whole grains on biomarkers for CHD have mixed results. Due to the varying nutrient compositions of different whole grains, each could potentially affect CHD risk via different mechanisms. Whole grains high in viscous fiber (oats, barley) decrease serum low-density lipoprotein cholesterol and blood pressure and improve glucose and insulin responses. Grains high in insoluble fiber (wheat) moderately lower glucose and blood pressure but also have a prebiotic effect. Obesity is inversely related to whole grain intake, but intervention studies with whole grains have not produced weight loss. Visceral fat, however, may be affected favorably. Grain processing improves palatability and can have varying effects on nutrition (e.g., the process of milling and grinding flour increases glucose availability and decreases phytochemical content whereas thermal processing increases available antioxidants). Understanding how individual grains, in both natural and processed states, affect CHD risk can inform nutrition recommendations and policies and ultimately benefit public health.

  10. Effect of Non-surgical Periodontal Therapy on the Level of Serum IL-6 and hs-CRP in Coronary Heart Disease Patients with Chronic Periodontitis%牙周非手术治疗对冠心病伴牙周炎患者血清白细胞介素6及高敏C反应蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    常春荣; 潘亚萍; 钟慧敏; 关丽; 孙晓菊

    2013-01-01

    目的:观察牙周非手术治疗对冠心病伴牙周炎患者牙周状况、血清白细胞介素-6(interleukin 6,IL-6)及高敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)的影响,探讨其可能的影响机制.方法:选取冠心病合并中、重度慢性牙周炎的患者(CHD组)50例、单纯中、重度慢性牙周炎患者(CP组)40例、冠心病病人(C组)35例及健康者(H组)50例,对CHD组和CP组实施牙周非手术治疗,进行基线及治疗后1、3个月的临床牙周检查并采集血清;采用酶联免疫吸附法测定血清IL-6及hs-CRP.结果:基线时血清IL-6及hs-CRP在CHD组、CP组、C组高于H组,差异有统计学意义(P<0.05);CHD组和CP组的牙周临床指标显著高于H组和C组(P<0.05);CHD组和CP组经过治疗后所有病人的牙周临床指标、血清IL-6和hs-CRP水平均明显降低(P<0.05).结论:牙周非手术治疗可改善局部炎症状态,降低冠心病伴牙周炎患者血清中IL-6及hs-CRP水平,有利于冠心病的预防和治疗.%Objective: To evaluate the effect of non-surgical periodontal therapy on periodontal status, the level of serum interleukin-6(IL-6) and high sensitive C-reactive protein (hs - CRP) in coronary heart disease patients with chronic periodontitis. Methods: 50 patients were coronary heart disease and chronic periodontitis(CHD group). 40 patients were with chronic periodontitis(CP group). The two groups received non-surgical periodontal therapy. Blood samples were taken for measurement before and after periodontal therapy. 50 healthy controls (H group) and 35patients with coronary heart diseaseCC group) were detected and were taken samples. IL-6 and hs - CRP were measured by sensitive enzyme-linked immunosorbent assay. Results; The basic concentration of IL- 6 and hs -CRP in serum in CHD group> CP group and C group were significantly higher than in H group (P

  11. 应变/应变率成像技术评价冠心病慢性心力衰竭患者左心房功能%Strain and Strain Rate Imaging for Evaluating Left Atrial Function in Patients with Chronic Heart Failure Secondary to Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    刘佳

    2011-01-01

    Echocardiographic strain and strain rate imaging are new technologies used to evaluate myocardial function.Strain and strain rate derived from either tissue Doppler imaging ( TDI ) or two - dimensional speckle tracking have a high sensitivity for the early detection of myocardial dysfunction.Strain and strain rate imaging are used to evaluate left atrial local function of patients with chronic heart failure secondary to coronary artery disease.Left atrial local dysfunction of patients with chronic heart failure can be detected by strain and strain rate imaging in patients without other echocardiographic features of cardiac diastolic function compromise.This article reviews left atrial function, concepts and imaging characteristics of strain and strain rate imaging for evaluating left atrial function, limitations of these technologies, and development prospects.%超声心动图应变和应变率成像是一种评估心肌功能的新技术.源于组织多普勒和二维斑点跟踪的应变和应变率对及早发现心肌功能障碍具有很高的敏感性,可应用于评价冠心病慢性心力衰竭患者左心房的局部功能.应变率成像能够在左心室舒张功能尚无明显改变的情况下,早期发现慢性心力衰竭患者左心房局部功能的异常.现对左心房的功能及其评价价值,应变和应变率的基本概念、成像特点、对左心房功能的评价以及其存在的局限性和发展前景进行简要阐述.

  12. Coronary heart disease mortality among young adults in Scotland in relation to social inequalities:time trend study

    OpenAIRE

    O'Flaherty, Martin; Bishop, Jennifer; Redpath, Adam; McLaughlin, Terry; Murphy, David; Chalmers, James; Capewell, Simon

    2009-01-01

    Objective To examine recent trends and social inequalities in age specific coronary heart disease mortality.Design Time trend analysis using joinpoint regression.Setting Scotland, 1986-2006.Participants Men and women aged 35 years and over.Main outcome measures Age adjusted and age, sex, and deprivation specific coronary heart disease mortality.Results Persistent sixfold social differentials in coronary heart disease mortality were seen between the most deprived and the most affluent groups a...

  13. Roma coronary heart disease patients have more medical risk factors and greater severity of coronary heart disease than non-Roma

    NARCIS (Netherlands)

    Sudzinova, A.; Nagyova, I.; Studencan, M.; Rosenberger, J.; Skodova, Z.; Vargova, H.; Middel, B.; Reijneveld, S. A.; van Dijk, J. P.

    2013-01-01

    Coronary heart disease (CHD) is the most common cause of mortality and morbidity world-wide. Evidence on ethnic differences between the Roma and non-Roma regarding medical risk factors is scarce. The aim of this study was to assess differences in medical risk factors and the severity of CHD in Roma

  14. Nutrition in the prevention of Coronary Heart Disease and the management of lipoprotein disorders

    Science.gov (United States)

    Cardiovascular disease (CVD) is comprised of coronary heart disease (CHD), stroke, and peripheral vascular disease (PVD). CVD is caused by progressive narrowing and blockage of arteries supplying the heart, brain, and other tissues and organs. CVD is the leading cause of death and disability in our ...

  15. Genotype frequency of gelatinase B C-1562 T polymorphism in coronary heart disease and myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Hong JIANG; Dieter Niederacher; Ming DU; Roger Marx; Thomas Scheffold; Rolf Michael Klein

    2004-01-01

    Background One of the characteristics of atherosclerosis is a change in the content of extracellular matrix in the arterial wall. Gelatinase B, a member of the family of matrix metalloproteinase, can regulate extracellular matrix metabolismand play a role in the pathogenesis of atherosclerosis, coronary heart disease (CHD) and myocardial infarction (MI). Gelatinase B is polymorphic due to a C to T change at the position -1562 bp in the promoter region.Its relationship with gene product concentration in serum and its role in mediating the risk of CHD and MI in Germans is still unknown. Methods We enrolled 102 controls and 322 patients with angiographically documented CHD,including a sub-group of 173 patients with acute or chronic MI and 80 patients with acute coronary syndrome (ACS).All patients and controls were Germans and genotyped by polymerase chain reaction and digestion with SphI. Results We found that several classical risk factors for CHD and MI, including hypercholesterolemia and cigarette smoking,were significantly increased in CHD and MI patients compared with controls. Serum levels of gelatinase B and tissue inhibitor of metalloproteinase-1 were increased in the peripheral blood of patients with acute coronary syndrome. No significant differences in genotype or allelic frequencies between CHD, MI and control subjects of either men or women were found. Our search for a possible association of the polymorphisms with CHD and MI by logistic regression analysis was also negative. The serum concentrations of gelatinase B showed no differences between genotypes. Conclusions Our data showed that gelatinase B might provide an index of plaque activity in ACS, but gelatinase B protein was not affected by genotypes. Also, the T variant of gelatinase B was not associated with CHD or MI in Germans. (J Geriatr Cardiol 2004;1(2):114-118.)

  16. Higher coronary heart disease and heart attack morbidity in Appalachian coal mining regions

    Energy Technology Data Exchange (ETDEWEB)

    Hendryx, M.; Zullig, K.J. [West Virginia University, Morgantown, WV (United States). Dept. of Community Medicine

    2009-11-15

    This study analyzes the U.S. 2006 Behavioral Risk Factor Surveillance System survey data (N = 235,783) to test whether self-reported cardiovascular disease rates are higher in Appalachian coal mining counties compared to other counties after control for other risks. Dependent variables include self-reported measures of ever (1) being diagnosed with cardiovascular disease (CVD) or with a specific form of CVD including (2) stroke, (3) heart attack, or (4) angina or coronary heart disease (CHD). Independent variables included coal mining, smoking, BMI, drinking, physician supply, diabetes co-morbidity, age, race/ethnicity, education, income, and others. SUDAAN Multilog models were estimated, and odds ratios tested for coal mining effects. After control for covariates, people in Appalachian coal mining areas reported significantly higher risk of CVD (OR = 1.22, 95% CI = 1.14-1.30), angina or CHO (OR = 1.29, 95% C1 = 1.19-1.39) and heart attack (OR = 1.19, 95% C1 = 1.10-1.30). Effects were present for both men and women. Cardiovascular diseases have been linked to both air and water contamination in ways consistent with toxicants found in coal and coal processing. Future research is indicated to assess air and water quality in coal mining communities in Appalachia, with corresponding environmental programs and standards established as indicated.

  17. Physiological importance of the coronary arterial blood supply to the rattlesnake heart

    DEFF Research Database (Denmark)

    Hagensen, Mette; Abe, Augusto S.; Falk, Erling;

    2008-01-01

    supply to the outer compact layer in untreated snakes. Electrocardiogram (ECG), blood pressure (Psys) and heart rate (fH) were measured at rest and during enforced activity at day 1 and 4. Four days after occlusion of the coronary circulation, the snakes could still maintain a Psys and fH of 5.2±0.2 k......Pa and 58.2±2.2 beats min-1, respectively, during activity and the ECG was not affected. This was not different from sham-operated snakes. Thus, while the outer compact layer of the rattlesnake heart clearly has an extensive coronary supply, rattlesnakes sustain a high blood pressure and heart rate during...... remains unknown. In the present study we investigate the effects of permanent coronary artery occlusion in the South American rattlesnake (Crotalus durissus) on the ability to maintain heart rate and blood pressure at rest and during short term activity. We used colored silicone rubber (Microfil...

  18. Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009.

    Directory of Open Access Journals (Sweden)

    Olfa Saidi

    Full Text Available BACKGROUND: In Tunisia, Cardiovascular Diseases are the leading causes of death (30%, 70% of those are coronary heart disease (CHD deaths and population studies have demonstrated that major risk factor levels are increasing. OBJECTIVE: To explain recent CHD trends in Tunisia between 1997 and 2009. METHODS: DATA SOURCES: Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys. ANALYSIS: Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (inumber of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina(ii uptake of specific medical and surgical treatments, and(iii population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP, body mass index (BMI, diabetes and physical inactivity. RESULTS: CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98% of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L generated 440 additional deaths. In women, a fall (-0.43 mmol/L, apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI (95 fewer deaths, initial AMI treatments (90, antihypertensive medications (80 and unstable angina (75. CONCLUSIONS: Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and

  19. Relationship between quantitative measurement of Porphyromonas gingivalis on dental plaque with periodontal status of patients with coronary heart disease

    Science.gov (United States)

    Dwiyanti, Stephani; Soeroso, Yuniarti; Sunarto, Hari; Radi, Basuni

    2017-02-01

    Coronary heart disease is a narrowing of coronary artery due to plaque build-up. [1] Chronic periodontitis increases risk of cardiovascular disease. P.gingivalis is linked to both diseases. Objective: to analyse quantitative difference of P.gingivalis on dental plaque and its relationship with periodontal status of CHD patient and control. Methods: Periodontal status of 66 CHD patient and 40 control was checked. Subgingival plaque was isolated and P.gingivalis was measured using real-time PCR. Result: P.gingivalis of CHD patient differs from control. P.gingivalis is linked to pocket depth of CHD patient. Conclusion: P.gingivalis count of CHD patient is higher than control. P.gingivalis count is not linked to any periodontal status, except for pocket depth of CHD patient.

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

    Directory of Open Access Journals (Sweden)

    Slavica Stevanović

    2011-08-01

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

  1. Home monitoring of chronic heart failure

    Directory of Open Access Journals (Sweden)

    Bockeria O. L.

    2012-06-01

    Full Text Available Being a common syndrome chronic heart failure (CHF results in high mortality among cardiosurgical patients and requires very high expenditures for the treatment. All over the world the number of patients with CHF syndrome is about 22 millions. Heart failure is difficult to treat because of high level of hospitalization due to decompensation. Care aimed at constant home observation of patients could have been more efficient and not only symptomatic and as a response to complications induced. There are methods controlling CHF patients at home. These methods vary from increase of self-care and telephone support to telemonitoring and remote monitoring of implantable devices. Self-care includes such components as maintenance of drug intake, keeping to a diet, physical exercises and active control over edemas. Telephone calls are also a source of monitoring and treatment of heart failure at home. Meta-analysis of programs for structured phone support showed that telephone support could reduce the level of readmission of HF patients approximately by 25%. Telemonitoring implies transmission of such physiological data as blood pressure, body weight, electrocardiographic signals or oxygen saturation using phone lines, broadband and satellite or wireless networks. Having cardiac pacemakers, implantable cardioverter defibrillators and cardiac resynchronization therapy devices that are placed in HF patients, it is possible to use their opportunities for the further evaluation of the patient. Some regularly controlled parameters can show the clinical state of the patient and predict the following heart failure. For example, atrial fibrillation, decrease of cardiac rhythm variability and decrease of the level of the patient`s activity (according to integrated accelerometer can predict clinical decompensation. Also, implantable hemodynamic monitors for immediate pressure measuring in the left atrium, sensor system of pressure measuring in the right atrium are

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

  3. Predictors of exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure

    DEFF Research Database (Denmark)

    Uddin, Jamal; Zwisler, Ann-Dorthe; Lewinter, Christian

    2016-01-01

    BACKGROUND: The aim of this study was to undertake a comprehensive assessment of the patient, intervention and trial-level factors that may predict exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure. DESIGN: Meta-analysis and meta...... intensity was found to be significantly associated with VO2max (P = 0.04); those trials with the highest average exercise intensity had the largest mean post-rehabilitation VO2max compared to control. CONCLUSIONS: We found considerable heterogeneity across randomized controlled trials in the magnitude...... of improvement in exercise capacity following exercise-based rehabilitation compared to control among patients with coronary heart disease or heart failure. Whilst higher exercise intensities were associated with a greater level of post-rehabilitation exercise capacity, there was no strong evidence to support...

  4. Metabolic remodeling in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Jing WANG; Tao GUO

    2013-01-01

    Although the management of chronic heart failure (CHF) has made enormous progress over the past decades,CHF is still a tremendous medical and societal burden.Metabolic remodeling might play a crucial role in the pathophysiology of CHF.The characteristics and mechanisms of metabolic remodeling remained unclear,and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability.In the early phases of the disease,metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation.Along with the progress of the disease,the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation.In addition,a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate.

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

    Directory of Open Access Journals (Sweden)

    Natasha

    2015-07-01

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

  6. Drug-eluting stents vs. coronary artery bypass-grafting in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2008-12-01

    Full Text Available Background: Coronary artery bypass graft (CABG and percutaneous revascularisations with implantation of drug-eluting stents (DES are important treatment methods in coronary heart disease (CHD. Research questions: The evaluation addresses questions on medical efficacy, health economic parameters as well as ethic, social and legal implications in the use of DES vs. CABG in CHD patients. Methods: A systematic literature search was conducted in December 2006 in the most important electronic databases beginning from 2004. Register data and controlled clinical studies were included in the evaluation. Additionally, a health economic modelling was conducted. Results: Medical evaluation: The literature search yielded 2,312 hits. 14 publications about six controlled clinical studies and five publications about two registers were included into the evaluation. Register data showed low mortality (0.2% to 0.7% and low rates of myocardial infarction (0.5% to 1.4% during hospital stay. In patients with stenosis of the left anterior descending coronary artery one study showed in several analyses a significantly higher rate of reinterventions and a significantly higher rate of repeated angina pectoris for DES up to two years after the implantation (16.8% vs. 3.6% and 35% vs. 8%. In patients with left main coronary artery stenosis two studies revealed a significantly higher survival without myocardial infarction and stroke for DES up to one year (96% vs. 79% and 95% vs. 91% and two studies a significantly higher rate of revascularisations up to two years (20% vs. 4% and 25% vs. 5% after the primary intervention. In patients with multivessel disease, one study found a significantly higher mortality and myocardial infarction rate for CABG at one year (2.7% vs. 1.0% and 4.2% vs. 1.3%. The rate of revascularisations was significantly higher in two studies up to two years after DES implantation (8.5% vs. 4.2% and 14.2% vs. 5.3%. The rate at repeated angina pectoris was

  7. 冠心病心力衰竭中医证候相关因素研究%Research on TCM syndrome related fators of chronic heart failure caused by coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    陈婵; 王娟; 张鹏; 赵慧辉; 陈建新; 王伟

    2012-01-01

    目的:探讨性别、年龄、心功能分级、合并病与冠心病心力衰竭中医证候的相关特点.方法:运用临床流行病学横断面调查方式,采用Logistic回归方法对数据进行分析.结果:阴虚证、阳虚证与女性正相关(P<0.05),气滞证与51-60岁年龄正相关(P<0.05),阳虚证与71-80岁年龄正相关(P<0.05),水停证、阴虚证、热证与心功能Ⅲ级正相关(P<0.05),气虚证、水停证、痰浊证、阳虚证、气滞证与心功能Ⅳ级正相关(P<0.05),水停证、热证与合并脑血管意外正相关(P<0.05).结论:临床用药时应当综合考虑性别、年龄、心功能分级及合并病因素.女性患者可酌情配伍滋阴药、温药;较年轻患者可酌情配伍健脾疏肝理气之品,年老高龄患者可酌加温阳之品;合并脑血管意外患者可以酌情运用清热、利水等治法.%Objective: To investigate the relation law between gender, age, cardiac function, combined diseases and TCM syndrome of heart failure caused by coronary artery disease. Methods: Clinical cross-sectional epidemiological study was applied, and then activated by Logistic methods. Results: Yin deficiency and yang deficiency had a positive correlation with femail patients (P<0.05), qi stagnation had a positive correlation with the age of 51 to 60 (P<0.05), yang deficiency had a positive correlation with the age of 71 to 80 (P<0.05). Water retention, phlegm turbid, yin deficiency, yang deficiency, heat and cardiac function had negative correlations with grade Ⅱ (P<0.05); water retention, yin deficiency, heat and cardiac function had positive correlations with grade Ⅲ (P<0.05 ), water retention and heat had positive correlations with cerebral vascular accident (P<0.05). Conclusion: Gender, age, cardiac function and combined diseases should be considered before clinical treatment. Female patients can plus drugs of reinforcing body fluid and wanning yang. The younger patients can plus drugs of

  8. Population assessment of future trajectories in coronary heart disease mortality.

    Directory of Open Access Journals (Sweden)

    Rosa Björk Thorolfsdottir

    Full Text Available BACKGROUND: Coronary heart disease (CHD mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends. METHODS AND FINDINGS: The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25-74. Calculations were based on combining: i data on population numbers and projections (Statistics Iceland, ii population risk factor levels and projections (Refine Reykjavik study, and iii effectiveness of specific risk factor reductions (published meta-analyses. Projections for three contrasting scenarios were compared: (1 If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. (2 If recent trends in risk factors (past 5 years continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3 Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040. CONCLUSIONS: The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future.

  9. Association between blood cholesterol level with periodontal status of coronary heart disease patients

    Science.gov (United States)

    Valensia, Rosy; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni

    2017-02-01

    Coronary heart disease (CHD) is an abnormal narrowing of heart arteries associated with local accumulation of lipids, in the form of cholesterol and triglycerides. Periodontal disease is a chronic inflammatory that suggests link to the development of CHD. In periodontitis have been reported changes in lipid profile, include increased of cholesterol levels of blood. Objective: to analyse correlation between blood cholesterol level with periodontal status of CHD and non CHD subjects. Methods: Periodontal status and blood cholesterol level of 60 CHD and 40 non CHD subjects was measured. Result: Blood cholesterol level in CHD subjects differs from non CHD subjects (p=0.032). Blood cholesterol level correlates with pocket depth (p=0.003) and clinical attachment loss (CAL) (p=0.000) in CHD subjects. Blood cholesterol level correlates with pocket depth (p=0.010) in non CHD subjects. There is no significant correlation between blood cholesterol level and bleeding on probing (BOP) in CHD subjects. There is no significant correlation between blood cholesterol level with BOP and CAL in non CHD subjects. Conclusion: Blood cholesterol level in control group is higher than CHD patients. Blood cholesterol level positively associated with pocket depth (r=0.375) and CAL (r=0.450) in CHD patients. Blood cholesterol level is positively associated with pocket depth (r=0.404) in control group.

  10. Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010.

    LENUS (Irish Health Repository)

    Bennett, Kathleen

    2009-01-01

    OBJECTIVE: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland. METHODS: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model. This model calculates the number of life-years gained (LYGs) by specific cardiology interventions to generate incremental cost-effectiveness ratios (ICERs) per LYG for each intervention. RESULTS: In 2000, medical and surgical treatments together prevented or postponed approximately 1885 CHD deaths in patients aged 25 to 84 years, and thus generated approximately 14,505 extra life-years (minimum 7270, maximum 22,475). In general, all the cardiac interventions investigated were highly cost-effective in the Irish setting. Aspirin, beta-blockers, ACE inhibitors, spironolactone, and warfarin for specific conditions were the most cost-effective interventions (< euro 3000\\/LYG), followed by the statins for secondary prevention (< euro 6500\\/LYG). Revascularization for chronic angina and primary angioplasty for myocardial infarction, although still cost-effective, had the highest ICER (between euro 12,000 and euro 20,000\\/LYG). CONCLUSIONS: Using a comprehensive standardized methodology, cost-effectiveness ratios in this study clearly favored simple medical treatments for myocardial infarction, secondary prevention, angina, and heart failure.

  11. [Advance in diagnosis and treatment of psycho-cardiological abnormality of patients with coronary heart disease with traditional Chinese medicines].

    Science.gov (United States)

    Yuan, Rong; Wang, Jiel; Liu, Wei

    2015-02-01

    To discuss the etiology, pathogenesis, therapies and prescriptions of psycho-cardiological abnormality of patients with coronary heart disease. According to the advance in modern diagnosis and treatment, the authors believed that psycho-cardiological abnormality of patients with coronary heart disease is closely related with mental stresses, like anxiety, depression and insomnia. It is mostly caused by emotional injury and expressed in heart, liver, spleen and kidney. The pathogenesis is heart-liver hyperactivity, yin deficiency in heart and kidney, and insufficiency in heart and spleen. The full recognition of etiology and pathogenesis of psycho-cardiological abnormality of patients with coronary heart disease and the combined treatment of disease and syndromes are of great significance to reduce mental stress and other risk factors, prevent and treat coronary heart disease and improve prognosis.

  12. [DIAGNOSIS OF ISCHEMIC HEART DISEASE CAUSED BY TORTUOSITY OF CORONARY ARTERIES].

    Science.gov (United States)

    Lebedeva, E O; Lazoryshynets, V V; Beshliaga, V M; Grusha, M M

    2015-01-01

    This article is devoted to the problems of diagnostics of coronary artery tortuosity phenomenon. Given the lack of literature about the role of phenomenon tortuosity of coronary arteries in the genesis of ischemic myocardial damage, the purpose of study was to determine the clinical relevance as well as necessity for prevention and treatment of this vascular anomaly. Therefore were analyzed medical history, laboratory and clinical database as well as data functional studies of the heart and cardiovascular system in 1404 patients which were divided into four groups on the results of coronary angiography. The results of the study indicate tortuosity of coronary arteries may be independent and additional burdening factor in the development of ischemic heart disease.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  16. Angiotensin II vaccine promising for patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    CHEN Yang-xin; YAO You-jie; NIE Ru-qiong; ZHOU Shu-xian; WANG Jing-feng

    2009-01-01

    @@ Chronic heart failure (CHF), as the end-stage presentation of all kinds of heart diseases, is a major public health problem as well as a pressing public policy issue. There are more than 5 million patients diagnosed with CHF in USA alone and approximately 550 000 new cases appear per year. About 0.4%-2% of the European population is affected by symptomatic heart failure. Hence heart failure is the leading cause of hospitalization especially in older people around the world.

  17. On-pump beating heart coronary surgery for high risk patients requiring emergency multiple coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    von Segesser Ludwig K

    2008-07-01

    Full Text Available Abstract Background Cardiopulmonary bypass (CPB with aortic cross-clamping and cardioplegic arrest remains the method of choice for patients requiring standard myocardial revascularization. Therefore, very high-risk patients presenting with acute coronary syndrome, unstable angina, onset of cardiac decompensation and requiring emergency multiple myocardial revascularization, can have a poor outcome. The on-pump beating heart technique can reduce the mortality and the morbidity in such a selected group of patients and this report describes our clinical experience. Methods Out of 290 patients operated for CABG from January 2005 to January 2006, 25 (8.6% selected high-risk patients suffering from life threatening coronary syndrome (mean age 69 ± 7 years and requiring emergency multiple myocardial revascularization, underwent on-pump beating heart surgery. The mean pre-operative left ventricle ejection fraction (LVEF was 27 ± 8%. The majority of them (88% suffered of tri-vessel coronary disease and 6 (24% had a left main stump disease. Nine patients (35% were on severe cardiac failure and seven among them (28% received a pre-operative intra-aortic balloon pump. The pre-operative EuroScore rate was equal or above 8 in 18 patients (73%. Results All patients underwent on-pump-beating heart coronary revascularization. The mean number of graft/patient was 2.9 ± 0.6 and the internal mammary artery was used in 23 patients (92%. The mean CPB time was 84 ± 19 minutes. Two patients died during the recovery stay in the intensive care unit, and there were no postoperative myocardial infarctions between the survivors. Eight patients suffered of transitorily renal failure and 1 patient developed a sternal wound infection. The mean hospital stay was 12 ± 7 days. The follow-up was complete for all 23 patients survived at surgery and the mean follow-up time was 14 ± 5 months. One patient died during the follow-up for cardiac arrest and 2 patients required an

  18. Chronic use of the calcium channel blocker nifedipine effected on bone metabolism in elder with coronary heart disease%老年冠心病患者长期应用硝苯地平对骨代谢及功能的影响

    Institute of Scientific and Technical Information of China (English)

    陈斌

    2013-01-01

    目的:硝苯地平(NIF)临床广泛用于调节心率,本文主要研究年冠心病患者长期应用NIF对骨代谢及功能的影响。探讨NIF应用1年后对碱性磷酸酶(ALP)活性、骨钙蛋白(OCN)和钙离子水平的影响,为治疗骨代谢性疾病提供理论性的依据。方法:本研究筛选160名老年冠心病患者,均参加NIF治疗临床跟踪随访1年,观测并评价NIF的疗效及对骨代谢及功能。结果:本研究所有病例用药前与用药后,男性和女性体内的钙离子水平均显著升高(P0.05)。结论:对于长期使用NIF的老年患者,应当及时监测骨骼代谢水平以及骨骼发育状况评价指标,提前预防骨质疏松。%Calcium channel blockers have been reported to have such diverse effects as reduction in protein synthesis, diminished incorporation of proline into new col agen, and decreased hormone release in vitro. The study screened 160 elderly patients with coronary heart disease, are members of nifedipine treatment of clinical fol ow-up 1 year, observation and evaluation of nifedipine and its effect on bone metabolism and function. Results: In this study, al cases before treatment and after treatment, the average male and female body calcium ion water was significantly higher (P 0.05). Conclusion: In patients with long-term use of nifedipine should be timely monitoring of bone metabolism and bone development status evaluation, prevention of osteoporosis in advance. In summary, chronic nifedipine use in males is associated with adverse effect on bone metabolism in elder with coronary heart disease.

  19. Ranking of psychosocial and traditional risk factors by importance for coronary heart disease

    DEFF Research Database (Denmark)

    Schnohr, Peter; Marott, Jacob L; Kristensen, Tage S;

    2015-01-01

    AIMS: To rank psychosocial and traditional risk factors by importance for coronary heart disease. METHODS AND RESULTS: The Copenhagen City Heart Study is a prospective cardiovascular population study randomly selected in 1976. The third examination was carried out from 1991 to 1994, and 8882 men...... and women free of cardiovascular diseases were included in this study. Events were assessed until April 2013. Forward selection, population attributable fraction, and gradient boosting machine were used for determining ranks. The importance of vital exhaustion for risk prediction was investigated by C......-statistics and net reclassification improvement. During the follow-up, 1731 non-fatal and fatal coronary events were registered. In men, the highest ranking risk factors for coronary heart disease were vital exhaustion [high vs. low; hazard ratio (HR) 2.36; 95% confidence interval (CI), 1.70-3.26; P

  20. Long working hours and risk of coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    BACKGROUND: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. METHODS: We......·02-1·26; p=0·02) and incident stroke (1·33, 1·11-1·61; p=0·002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1·30-1·42). We recorded a dose...... long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours. FUNDING: Medical Research Council...

  1. Heart Failure with Transient Left Bundle Branch Block in the Setting of Left Coronary Fistula

    Directory of Open Access Journals (Sweden)

    Stephen P. Juraschek

    2011-01-01

    Full Text Available Coronary arterial fistulas are rare communications between vessels or chambers of the heart. Although cardiac symptoms associated with fistulas are well described, fistulas are seldom considered in the differential diagnosis of acute myocardial ischemia. We describe the case of a 64-year-old man who presented with left shoulder pain, signs of heart failure, and a new left bundle branch block (LBBB. Cardiac catheterization revealed a small left anterior descending (LAD-to-pulmonary artery (PA fistula. Diuresis led to subjective improvement of the patient's symptoms and within several days the LBBB resolved. We hypothesize that the coronary fistula in this patient contributed to transient ischemia of the LAD territory through a coronary steal mechanism. We elected to observe rather than repair the fistula, as his symptoms and ECG changes resolved with treatment of his heart failure.

  2. Effect of mibefradil on heart rate variability in patients with chronic heart failure

    NARCIS (Netherlands)

    Brouwer, J; de Kam, PJ; Haaksma, J; Crijns, HJGM; van Veldhuisen, DJ

    2000-01-01

    Background: Mibefradil was recently withdrawn from the market because of an unfavorable clinical profile in patients with chronic heart failure. Although drug interactions appear to play a role, other mechanisms such as proarrhythmia and autonomic deterioration could also be relevant. Chronic heart

  3. Increased interleukin-13 levels in patients with chronic heart failure.

    Science.gov (United States)

    Nishimura, Yuki; Inoue, Teruo; Nitto, Takeaki; Morooka, Toshifumi; Node, Koichi

    2009-01-24

    A great number of basic and clinical studies have demonstrated that inflammatory cytokines play an important role in development and progress of heart failure. However, there is limited information about allergic cytokine interleukin-13 (IL-13). The inflammatory responses mediated by allergic cytokines can cause significant morbidity and mortality when they become chronic. Therefore, we elucidated the role of IL-13 in the pathophysiology of chronic heart failure. We measured plasma IL-13 levels by enzyme-linked immunosorbent assay in 110 patients with chronic heart failure and 20 control subjects. Plasma IL-13 levels were increased in heart failure patients, compared with the controls, in association with NYHA functional class. In addition, IL-13 levels were correlated positively with plasma levels of brain natriuretic peptide and C-reactive protein, and negatively with left ventricular ejection fraction. Plasma IL-13 levels may be useful for evaluating disease severity in chronic heart failure.

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

    Directory of Open Access Journals (Sweden)

    Sandra C. Fuchs

    2013-01-01

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

  5. 76 FR 49707 - Food Labeling; Health Claim; Phytosterols and Risk of Coronary Heart Disease; Reopening of the...

    Science.gov (United States)

    2011-08-11

    ... and Risk of Coronary Heart Disease; Reopening of the Comment Period AGENCY: Food and Drug... (esterified with food- grade fatty acids) but not on nonesterified phytosterol-containing dietary supplements... reconsider its proposed amendments to the phytosterols and risk of coronary heart disease health ] claim....

  6. A Health Education Program for Parents and Children Who Exhibit High Risk Factors of Coronary Heart Disease.

    Science.gov (United States)

    Hopp, Joyce W.; And Others

    This study demonstrated the feasibility of joint parent-child education to change the behaviors known to be associated with increased risk of coronary heart disease. Earlier studies have shown that parents who are at increased risk of coronary heart disease can be identified by studying certain factors in the children. Utilizing a combined risk…

  7. Effect of the smoking cessation services in the out-patient department for patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    赵菁

    2014-01-01

    Objective To evaluate the effects and clinical prognosis of out-patient department-based smoking cessation services for coronary heart disease(CHD)patients.Methods A total of 140 smoking patients diagnosed with coronary heart disease in our cardiovascular department were randomly divided into the intensive

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

    LENUS (Irish Health Repository)

    Moran, D

    2014-08-23

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

  9. [Coronary heart disease in Mexico and the clinical epidemiological and preventive relevance].

    Science.gov (United States)

    Chávez Domínguez, Rafael; Ramírez Hernández, Jorge A; Casanova Garcés, José Miguel

    2003-01-01

    Coronary heart disease is dominant among heart diseases in the population, a problem to control. Heart diseases have been first place in the general mortality for the last 20 years. The trend show an annual increase without control. Atherosclerosis is responsible for at least for one fourth of all deaths in the country. The combined data of mortality and morbidity, from hospital discharges or the whole country, disclose that one out of three die of acute myocardial infarction (AMI). While only 8% of all deaths registered were admitted to a hospital. Most, 92% were never admitted to any hospital for some reason. The estimated annual incidence of AMI cases is 140,000, on the basis of 3 cases surviving for each case death, accounted by the Death Certification System, which rounds 35,000. Standardized mortality rates of AMI in Mexico are greater than in USA o Canada creating a more concerned worry. The most probable explanation to that situation is lack of preventive care, which should also include the acute care and before reaching the hospital facilities. Running the same chances are hypertension crisis and strokes and diabetic complications. The appropriate care for critical situations might reduce significantly the cardiovascular mortality in the country, in a short and middle term. Prevention is not only for chronic conditions but for acute and critical situations. The programs of preventive care should also include cultural promotion and community awareness. The timely care is life and myocardium saving. The reinforcement of prior to hospital care reduces the delay for AMI adequate intervention. These activities agree quite well with the ongoing programs of CPR, organizing the surviving chain and the training programs for paramedical emergency technicians.

  10. Coronary heart disease risk assessment and characterization of coronary artery disease using coronary CT angiography: comparison of asymptomatic and symptomatic groups

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Y. [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Kim, Y., E-mail: yookkim@ewha.ac.k [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Chung, I.-M. [Division of Cardiology in Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Ryu, J.; Park, H. [Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2010-08-15

    Aim: To evaluate the prevalence of coronary artery disease (CAD) in relation to risk of coronary heart disease (CHD) and assess plaque characteristics from coronary computed tomography (CT) angiography in asymptomatic and symptomatic patients. Materials and methods: Three hundred and ninety consecutive patients [asymptomatic group, n = 138; symptomatic group (atypical or non-anginal chest pain), n = 252] were retrospectively enrolled. They were subsequently classified into three CHD risk categories, based on the National Cholesterol Education Program guidelines, and 10 year risks of coronary events were calculated using Framingham risk score. CT was evaluated for stenosis, plaque composition, and coronary calcium scores. Results: CAD was observed in 42% of the asymptomatic group and 62% of the symptomatic group. In the former, the prevalence of CAD in low-, moderate- and high-risk subgroups was 21.4, 47.4 and 65%, respectively, and was 33.3, 74.4, and 72.4% in the symptomatic group. Framingham 10-year risks of coronary events were significantly higher in patients with CAD than in normal participants, and receiver operating characteristics curves showed that discriminatory power was poor in the asymptomatic group and symptomatic men, and good in symptomatic women. Of the participants in the asymptomatic group, 12% exhibited only non-calcified plaques and of the symptomatic group, 7% exhibited only non-calcified plaques. The coronary calcium score was significantly higher for significant stenosis than for non-significant stenosis in both groups. Conclusions: The prevalence of CAD was not negligible even in subgroups with low-to-moderate CHD risk. Additionally, the Framingham risk score was effective for predicting CAD only in symptomatic women. Coronary calcium scores correlated with significant stenosis; however, a sizeable percentage of both groups had only non-calcified plaques.

  11. Factors predictive of stress, organizational effectiveness, and coronary heart disease potential.

    Science.gov (United States)

    Hendrix, W H

    1985-07-01

    Research to predict stress, organizational effectiveness, and potential for developing coronary heart disease (CHD) is presented based on two samples (n = 357 and n = 225). Results indicate that perceived stress is predicted by a combination of individual and job related characteristics. The data suggest that stress, in turn, affects individual and organizational health and effectiveness, by causing increases in cold/flu episodes, somatic symptoms, while decreasing job satisfaction. In addition, stress has an indirect effect on job performance and absenteeism. Models for predicting the ratio of total serum cholesterol divided by HDL cholesterol as an indicator of coronary heart disease potential are provided and a CHD screening model is proposed.

  12. Ischemic heart disease induces upregulation of endothelin receptor mRNA in human coronary arteries

    DEFF Research Database (Denmark)

    Wackenfors, Angelica; Emilson, Malin; Ingemansson, Richard;

    2004-01-01

    and controls using real-time polymerase chain reaction (real-time PCR). In addition, the suitability of organ culture as a model mimicking endothelin receptor changes in cardiovascular disease was evaluated by in vitro pharmacology and real-time PCR. Endothelin ETA and ETB receptor mRNA levels were......Endothelin has been implicated in the pathogenesis of ischemic heart disease and congestive heart failure. The aims were to quantify endothelin type A (ETA) and type B (ETB) receptor mRNA levels in human coronary arteries from patients with ischemic heart disease, congestive heart failure...

  13. Two congenital coronary abnormalities affecting heart function: anomalous origin of the left coronary artery from the pulmonary artery and congenital left main coronary artery atresia

    Institute of Scientific and Technical Information of China (English)

    Xiao Yanyan; Jin Mei; Han Ling; Ding Wenhong; Zheng Jianyong; Sun Chufan; Lyu Zhenyu

    2014-01-01

    Background The anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) and congenital left main coronary artery atresia (CLMCA-A) are two kinds of very rare coronary heart diseases which affect heart function profoundly.This study aimed to retrospectively illustrate the clinical features and therapy experience of ALCAPA and CLMCA-A patients.Methods From April 1984 to July 2012,in Beijing Anzhen Hospital,23 patients were diagnosed with ALCAPA and 4 patients with CLMCA-A.We summarized the clinical data of the 27 cases and retrospectively analyzed the clinical manifestation,diagnosis,and treatments of these two kinds of congenital coronary abnormalities.Results The 23 patients (13 males and 10 females,aged ranging from 2.5 months to 65 years) identified with ALCAPA were classified into infantile type (age of onset younger than 12 months,16 cases) and adult type (age of onset older than 12 months,7 cases).Four patients were diagnosed with CLMCA-A (three males and one female,aged ranging from 3 months to 2 years).The main clinical manifestations of infantile-type ALCAPA and CLMCA-A include repeated respiratory tract infection,heart failure,dyspnea,feeding intolerance,diaphoresis,and failure to thrive.And these two congenital coronary abnormalities might be misdiagnosed as endocardial fibroelastosis,dilated cardiomyopathy,and acute myocardial infarction.As for the adult-type ALCAPA,cardiac murmurs and discomfort of the precordial area are the most common presentations and might be misdiagnosed as coronary heart disease,myocarditis,or patent ductus arteriosus.In ECG examination:Infantile-type ALCAPA and CLMCA-A showed abnormal Q waves with T wave inversion in leads I,avL,and V4-V6,especially in lead avL.However,ECG of adult-type ALCAPA lacked distinct features.In chest radiography:pulmonary congestion and cardiomegaly were the most common findings in infantile-type ALCAPA and CLMCA-A,while pulmonary artery segment dilation was more common in

  14. Serum inflammatory cytokine and adhesion molecule content in patients with coronary heart disease and their value for disease severity diagnosis

    Institute of Scientific and Technical Information of China (English)

    Wei Hu; Li-juan Fu; Jiang-Qiao Hu; Peng Liang; Lin Pi; Gui-Hua Li

    2016-01-01

    Objective:To detect inflammatory cytokine and adhesion molecule content in patients with coronary heart disease and analyze their value for disease severity diagnosis.Methods:A total of 113 patients with coronary heart disease and 107 healthy subjects were included in the study and further divided into mild group (n=40), moderate group (n=52) and severe group (n=21) according to the severity of coronary heart disease. Serum inflammatory cytokine and adhesion molecule content of all subjects were detected, and the value of inflammatory cytokine and adhesion molecule content for judging the severity of coronary heart disease was further analyzed.Results:Serum CRP, TNF-α and YKL-40 levels of coronary heart disease group were higher than those of healthy control group while IL-35 level was lower than that of healthy control group (P<0.05); serum E-selectin, ICAM-1, VCAM-1 and sICAM-1 levels of coronary heart disease group were higher than those of healthy control group (P<0.05); serum CRP, TNF-α, YKL-40, E-selectin, ICAM-1, VCAM-1 and sICAM-1 levels of mild group were lower than those of moderate group and severe group, IL-35 level was higher than those of moderate group and severe group (P<0.05), and with the aggravation of coronary heart disease, CRP, TNF-α, YKL-40, E-selectin, ICAM-1, VCAM-1 and sICAM-1 levels increased while IL-35 level decreased (P<0.05).Conclusions: Serum inflammatory cytokine and adhesion molecule content change significantly in patients with coronary heart disease, are directly correlated with the severity of coronary heart disease and can be used as the reliable means to assess the condition and prognosis of patients with coronary heart disease.

  15. [Explore Xueshuan Xinmaining tablet effecting on treatment outcome of coronary heart disease based on propensity score].

    Science.gov (United States)

    Li, Yuan; Xie, Yan-ming; Liu, Yan; Zhao, Wei

    2015-12-01

    Xueshuan Xinmaining tablet is a Chinese patent medicine for treating chest pain caused by blood stasis. It is widely used in clinical prevention and treatment of coronary heart disease. In order to understand the treatment effect of Xueshuan Xinmaining tablet in patients with coronary heart disease, we extracted electronic medical record data from 18 large hospitals nationwide. We matched the coronary artery disease patients with or without Xueshuan Xinmaining tablet treatment on gender, age, condition at admission and whether combined with cardiac insufficiency on a one to one ratio. After matching, both groups, patients using Xueshuan Xinmaining tablet (group A) and patients not using Xueshuan Xinmaining tablet (group B), ended up with 1,122 people. In order to evaluate the effectiveness of treatment, the endpoint of effective group was defined as "cure" and "better" while the endpoint of invalid group was defined as "invalid" and "death". Chi-square test showed a statistical significant difference (P coronary heart disease, with a higher efficiency in Xueshuan Xinmaining group. Classic logistic regression analysis showed no statistical significant difference between the two groups on treatment outcome efficiency. Generalized boosted models (GBM) and propensity score (PS) weighted Logistic regression were then applied to balance 45 variables between the two groups. The results showed a regression coefficient greater than 0 and a statistical significant difference (P coronary heart disease patients using Xueshuan Xinmaining tablet had a higher efficiency in clinical efficiency than the patients not using Xueshuan Xinmaining tablet. Since this study did not certainly eliminate all the possible confounders and patients from the hospitals included in this study were not yet well represent the overall situation of the source population, the study conclusion only provided drug use reference for clinical doctors for coronary heart disease. Large randomized controlled

  16. Downregulation of aquaporin-1 in alveolar microvessels in lungs adapted to chronic heart failure

    DEFF Research Database (Denmark)

    Müllertz, Katrine M; Strøm, Claes; Trautner, Simon

    2011-01-01

    The threshold pressure for lung edema formation is increased in severe chronic heart failure (CHF) due to reduced microvascular permeability. The water channel aquaporin-1 (AQP1) is present in the pulmonary microvascular endothelium, and a number of studies suggest the importance of AQP1...... as a compensatory mechanism to protect against formation of excessive pulmonary edema in CHF....... as a molecular determinant of pulmonary microvascular water transport. The present study examined the abundance and localization of AQP1 in lungs from rats with CHF. We used two different models of CHF: ligation of the left anterior descending coronary artery (LAD ligation) and aorta-banding (AB). Sham...

  17. An apparent case of undiagnosed donor Kawasaki disease manifesting as coronary artery aneurysm in a pediatric heart transplant recipient.

    Science.gov (United States)

    Friedland-Little, Joshua; Aiyagari, Ranjit; Gajarski, Robert J; Schumacher, Kurt R

    2013-02-01

    We present a case of coronary ectasia and LAD coronary artery aneurysm with angiographic characteristics of Kawasaki disease in a three-yr-old girl two-yr status post-orthotopic heart transplant. Coronary anomalies were noted during initial screening coronary angiography two yr after transplant. Subsequent review of the donor echocardiogram revealed that the LMCA had been mildly dilated prior to transplant. In the absence of any symptoms consistent with Kawasaki disease in the transplant recipient, this appears to be a case of Kawasaki disease in the organ donor manifesting with coronary anomalies in the transplant recipient. The patient has done well clinically, and repeat coronary angiography has revealed partial regression of coronary anomalies. Given multiple reports in the literature of persistent abnormalities of coronary artery morphology and function after Kawasaki disease, close monitoring is warranted, with consideration of potential coronary protective medical therapies.

  18. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

    Directory of Open Access Journals (Sweden)

    Abdul-rahman R. Abdel-karim

    2016-01-01

    Full Text Available Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO percutaneous coronary interventions (PCI with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome.

  19. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

    Science.gov (United States)

    Abdel-karim, Abdul-rahman R.; Main, Michael L.

    2016-01-01

    Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI) with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA) CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome. PMID:27668097

  20. Relationship between coronary artery calcification and osteopenic syndrome in men with coronary heart disease

    Directory of Open Access Journals (Sweden)

    T. A. Raskina

    2016-01-01

    Full Text Available Objective: to investigate the relationship between coronary artery calcification (CAC and osteopenic syndrome in men with coronary heart disease (CHD.Subjects and methods. A total of 102 men aged 51 to 75 years (mean age 61 (55; 65 years with verified CHD were examined. Bone mineral density (BMD and its T-score of LI–IV and femoral neck were determined by dual-energy X-ray absorptiometry. According to the T-score, the men were divided into 3 groups: 1 33 (32.4% patients with osteoporosis (OP (T-score <-2.5; 2 48 (47.0% patients with osteopenia (OSP (T-score -1 to -2.5 and 3 21 (20.6% examinees with normal BMD (NBMD (T-score ≥-1. In all the patients, CAC was quantified by multislice spiral computed tomography. The investigators calculated CA calcium scores by the Agatston method and rated the extent of calcification: none (0, minimal (1–10, mild (11–100, moderate (101–400, or severe (>400.Results and discussion. Severe CAC was detected in 57.8% of the men; moderate CAC was in 25.5%; mild CAC was in 6.9; minimal CAC was in 2.0%; and none CAC was in 7.8%. In the OP group, the majority (69.7% of the patients had severe CAC; 15.1% had moderate CAC, 6.1% had mild CAC; 3.0% had minimal CAC; CAC was undetected in 6.1% of cases. In the OSP group, there was severe CAC in 60.4%, moderate CAC in 33.3%, mild CAC in 4.2%, and minimal CAC in 2.1%. The patients without CAC were absent in this group. In the NBMD group, 33.3% of the examinees were recorded to have severe CAC; 23.8% had moderate CAC; 14.3% had mild CAC; CAC was undetected in 28.6%. Minimal CAC was also undetected in the patients of this group. There was a preponderance of patients with severe CAC in all the groups of those identified by the T-score. The extent of CAC was significantly lower in the NBMD group than in the OSP group (p<0.05. CAC was significantly more frequently absent in the NBMD group than in the low BMD group (p<0.05. There was an inverse correlation between

  1. Significance of epicardial fat in the diagnosis of coronary atherosclerosis before heart valve surgery

    Directory of Open Access Journals (Sweden)

    Joanna de Zayas Galguera

    2016-01-01

    Full Text Available Introduction: Epicardial fat has been shown to be related not only with clinical atherosclerosis, but also with subclinical atherosclerosis.Objective: To determine the significance of epicardial fat in the diagnosis of coronary atherosclerosis in patients with valvular heart disease.Method: The study included 62 patients scheduled for valve replacement surgery who had previously undergone invasive coronary angiography. Before surgery, epicardial fat measurement was performed by echocardiogram. Sensitivity, specificity, and positive and negative predictive values were determined, as well as the validity index and likelihood ratios for positive and negative tests.Results: 88.7% of patients with heart valve disease had no lesions in the coronary arteries. The most relevant parameters obtained from the measurement of epicardial fat were 78% sensitivity and 93% negative predictive value, and a ratio of positive and negative likelihood of 2.23 and 0.34 respectively.Conclusions: The group of patients with significant coronary lesions showed higher levels of epicardial fat than the group without coronary lesions. It confirms the diagnostic validity of this test for the detection of coronary atherosclerosis in the study patients.

  2. Nonrigid retrospective respiratory motion correction in whole-heart coronary MRA.

    Science.gov (United States)

    Schmidt, Johannes F M; Buehrer, Martin; Boesiger, Peter; Kozerke, Sebastian

    2011-12-01

    A nonrigid retrospective respiratory motion correction scheme is presented for whole-heart coronary imaging with interleaved acquisition of motion information. The quasi-periodic nature of breathing is exploited to populate a 3D nonrigid motion model from low-resolution 2D imaging slices acquired interleaved with a segmented 3D whole-heart coronary scan without imposing scan time penalty. Reconstruction and motion correction are based on inversion of a generalized encoding equation. Therein, a forward model describes the transformation from the motion free image to the motion distorted k-space data, which includes nonrigid spatial transformations. The effectiveness of the approach is demonstrated on 10 healthy volunteers using free-breathing coronary whole-heart scans. Although conventional respiratory-gated acquisitions with 5-mm gating window resulted in an average gating efficiency of 51% ± 11%, nonrigid motion correction allowed for gate-free acquisitions, and hence scan time reduction by a factor of two without significant penalty in image quality. Image scores and quantitative image quality measures for the left coronary arteries showed no significant differences between 5-mm gated and gate-free acquisitions with motion correction. For the right coronary artery, slightly reduced image quality in the motion corrected gate-free scan was observed as a result of the close vicinity of anatomical structures with different motion characteristics. Magn Reson Med, 2011. © 2011 Wiley Periodicals, Inc.

  3. Exploration of Syndrome Differentiation Patterns in Coronary Heart Disease Patients during Peri-Operative Stage of Coronary Artery Bypass Graft

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To explore the patterns of Syndrome Differentiation (SD) of coronary heart disease (CHD) patients in peri-operative stage of coronary artery bypass graft (CABG). Methods: One week after operation, thirty-seven CHD patients, who received CABG of internal mammary artery or great saphena vein under conventional general anesthesia with low or middle temperature extracorporeal circulation were differentiated as various syndromes, with the pre- or post-operational EKG, color Doppler echocardiography were done during and after operation. The hemodynamic parameters were monitored. Results: In the CHD patients, 64.9% were differentiated as Qi-Yin deficiency, 67.6% were complicated with phlegm syndrome and 62.2% with blood stasis, suggesting that Qi-deficiency, phlegm and stasis are the basic pathogenetic factors in patients with CABG. Moreover, the peri-operative syndrome was correlated with the condition of coronary artery lesion, heart and lung functions before operation, and the extracorporeal circulation time during the operation. Conclusion: TCM SD conducting in peri-operative stage might be useful in exploring the patterns of syndrome alteration which provided a basis for preventing peri-operative complications and elevating success rate of operation.

  4. Diagnosis of Coronary Heart Diseases Using Gene Expression Profiling; Stable Coronary Artery Disease, Cardiac Ischemia with and without Myocardial Necrosis.

    Science.gov (United States)

    Kazmi, Nabila; Gaunt, Tom R

    2016-01-01

    Cardiovascular disease (including coronary artery disease and myocardial infarction) is one of the leading causes of death in Europe, and is influenced by both environmental and genetic factors. With the recent advances in genomic tools and technologies there is potential to predict and diagnose heart disease using molecular data from analysis of blood cells. We analyzed gene expression data from blood samples taken from normal people (n = 21), non-significant coronary artery disease (n = 93), patients with unstable angina (n = 16), stable coronary artery disease (n = 14) and myocardial infarction (MI; n = 207). We used a feature selection approach to identify a set of gene expression variables which successfully differentiate different cardiovascular diseases. The initial features were discovered by fitting a linear model for each probe set across all arrays of normal individuals and patients with myocardial infarction. Three different feature optimisation algorithms were devised which identified two discriminating sets of genes, one using MI and normal controls (total genes = 6) and another one using MI and unstable angina patients (total genes = 7). In all our classification approaches we used a non-parametric k-nearest neighbour (KNN) classification method (k = 3). The results proved the diagnostic robustness of the final feature sets in discriminating patients with myocardial infarction from healthy controls. Interestingly it also showed efficacy in discriminating myocardial infarction patients from patients with clinical symptoms of cardiac ischemia but no myocardial necrosis or stable coronary artery disease, despite the influence of batch effects and different microarray gene chips and platforms.

  5. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of an

  6. Cardiac rehabilitation programs improve metabolic parameters in patients with the metabolic syndrome and coronary heart disease.

    Science.gov (United States)

    Pérez, Ignacio P; Zapata, Maria A; Cervantes, Carlos E; Jarabo, Rosario M; Grande, Cristina; Plaza, Rose; Garcia, Sara; Rodriguez, Miriam L; Crespo, Silvia; Perea, Jesús

    2010-05-01

    This study was performed to determine the effectiveness of a cardiac rehabilitation and exercise training program on metabolic parameters and coronary risk factors in patients with the metabolic syndrome and coronary heart disease. The study involved 642 patients with coronary heart disease. Of them, 171 (26.7%) fulfilled criteria for the metabolic syndrome. Clinical data, laboratory tests, and exercise testing were performed before and after the program, which lasted 2 to 3 months. Except for waist circumference, there were no significant differences between groups; blood pressure, high-density lipoprotein cholesterol, triglycerides, and fasting glucose improvements during the follow-up were higher in patients with the metabolic syndrome (all Pmetabolic syndrome, functional capacity increased by 26.45% ( Pmetabolic equivalents, with a slight increase of 1.25% ( P=not significant) in the double product. Patients with the metabolic syndrome who took part in this secondary prevention program reported improvements in cardiovascular risk profile and functional capacity.

  7. Central Mechanisms of Abnormal Sympathoexcitation in Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Takuya Kishi

    2012-01-01

    Full Text Available It has been recognized that the sympathetic nervous system is abnormally activated in chronic heart failure, and leads to further worsening chronic heart failure. In the treatment of chronic heart failure many clinical studies have already suggested that the inhibition of the abnormal sympathetic hyperactivity by beta blockers is beneficial. It has been classically considered that abnormal sympathetic hyperactivity in chronic heart failure is caused by the enhancement of excitatory inputs including changes in peripheral baroreceptor and chemoreceptor reflexes and chemical mediators that control sympathetic outflow. Recently, the abnormalities in the central regulation of sympathetic nerve activity mediated by brain renin angiotensin system-oxidative stress axis and/or proinflammatory cytokines have been focused. Central renin angiotensin system, proinflammatory cytokines, and the interaction between them have been determined as the target of the sympathoinhibitory treatment in experimental animal models with chronic heart failure. In conclusion, we must recognize that chronic heart failure is a syndrome with an abnormal sympathoexcitation, which is caused by the abnormalities in the central regulation of sympathetic nerve activity.

  8. Angiotensin II, sympathetic nerve activity and chronic heart failure.

    Science.gov (United States)

    Wang, Yutang; Seto, Sai-Wang; Golledge, Jonathan

    2014-03-01

    Sympathetic nerve activity has been reported to be increased in both humans and animals with chronic heart failure. One of the mechanisms believed to be responsible for this phenomenon is increased systemic and cerebral angiotensin II signaling. Plasma angiotensin II is increased in humans and animals with chronic heart failure. The increase in angiotensin II signaling enhances sympathetic nerve activity through actions on both central and peripheral sites during chronic heart failure. Angiotensin II signaling is enhanced in different brain sites such as the paraventricular nucleus, the rostral ventrolateral medulla and the area postrema. Blocking angiotensin II type 1 receptors decreases sympathetic nerve activity and cardiac sympathetic afferent reflex when therapy is administered to the paraventricular nucleus. Injection of an angiotensin receptor blocker into the area postrema activates the sympathoinhibitory baroreflex. In peripheral regions, angiotensin II elevates both norepinephrine release and synthesis and inhibits norepinephrine uptake at nerve endings, which may contribute to the increase in sympathetic nerve activity seen in chronic heart failure. Increased circulating angiotensin II during chronic heart failure may enhance the sympathoexcitatory chemoreflex and inhibit the sympathoinhibitory baroreflex. In addition, increased circulating angiotensin II can directly act on the central nervous system via the subfornical organ and the area postrema to increase sympathetic outflow. Inhibition of angiotensin II formation and its type 1 receptor has been shown to have beneficial effects in chronic heart failure patients.

  9. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment stra

  10. The impact of a chronic total coronary occlusion on clinical outcome

    NARCIS (Netherlands)

    Hoebers, L.P.C.

    2016-01-01

    Ever since it was possible to view the status of the coronary arteries through angiography in 1958, it is known that mortality increases with the severity and extent of coronary artery disease (CAD). Multivessel disease (MVD) is present in more than half of the patients with CAD and a chronic total

  11. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel S.); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment str

  12. Risk profile of coronary heart disease among the staff members of Qassim University, Saudi Arabia

    Science.gov (United States)

    Nohair, Sultan A. L.; Mohaimeed, Abdulrahman A. L.; Sharaf, Fawzy; Naeem, Zahid; Midhet, Farid; Homaidan, Homaidan A. L.; Winter, Sandra J.

    2017-01-01

    Objective: To estimate the risk profile of coronary heart disease (CHD) among the staff members of Qassim University and assess their knowledge in a screening campaign in Qassim region, Saudi Arabia. Methods: A cross-sectional study was conducted among male and female staff at Qassim University campus. All employees of Qassim University were invited to participate in the study. Data were collected through a self-administered questionnaire. The study sample size was 233 staff and employees. The data were entered and analyzed using SPSS version 18. The data analysis focused on providing point estimates for the risk factors. Results: The study found that 30% of participants have one or more risk factors for CHD, namely obesity 20.6%, diabetes 10.3%, hypertension 12.4%, dyslipidemia 10.7%, and smokers (11.6%). About 54% of the participants have a family history of at least one chronic disease as a risk factor for CHD. Conclusion: The most common risk factor of CHD among the staff members is obesity by 20.6%. Risk factors for CHD are quite common among Qassim University staff. These findings need to increase the health education and disease promotion program as an important intervention to reduce the occurrence and severity of CHD risk factors and to improve the quality of the life of the staff members of Qassim University.

  13. Coronary heart disease prevention: nutrients, foods, and dietary patterns.

    Science.gov (United States)

    Bhupathiraju, Shilpa N; Tucker, Katherine L

    2011-08-17

    Diet is a key modifiable risk factor in the prevention and risk reduction of coronary heart disease (CHD). Results from the Seven Countries Study in the early 1970s spurred an interest in the role of single nutrients such as total fat in CHD risk. With accumulating evidence, we have moved away from a focus on total fat to the importance of considering the quality of fat. Recent meta-analyses of intervention studies confirm the beneficial effects of replacing saturated fat with polyunsaturated fatty acids on CHD risk. Scientific evidence for a detrimental role of trans fat intake from industrial sources on CHD risk has led to important policy changes including listing trans fatty acid content on the "Nutrition Facts" panel and banning the use of trans fatty acids in food service establishments in some cities. The effects of such policy changes on changes in CHD incidence are yet to be evaluated. There has been a surging interest in the protective effects of vitamin D in primary prevention. Yet, its associations with secondary events have been mixed and intervention studies are needed to clarify its role in CHD prevention. Epidemiological and clinical trial evidence surrounding the benefit of B vitamins and antioxidants such as carotenoids, vitamin E, and vitamin C, have been contradictory. While pharmacological supplementation of these vitamins in populations with existing CHD has been ineffective and, in some cases, even detrimental, data repeatedly show that consumption of a healthy dietary pattern has considerable cardioprotective effects for primary prevention. Results from these studies and the general ineffectiveness of nutrient-based interventions have shifted interest to the role of foods in CHD risk reduction. The strongest and most consistent protective associations are seen with fruit and vegetables, fish, and whole grains. Epidemiological and clinical trial data also show risk reduction with moderate alcohol consumption. In the past decade, there has

  14. Coated stents to prevent restenosis in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2005-11-01

    Full Text Available Background: In-stent-restenosis (ISR is considered to be an essential limiting factor of stenting in coronary heart disease (CHD. The development of coated stents has raised expectations on substantial lowering restenosis after stenting with decreasing the rate of restenosis and a reduction in the rate of clinical events. Objectives: The present analysis addresses the questions on medical effectiveness and cost-effectiveness of the use of various coated stent types in CHD. Methods: The literature was searched in December 2004 in the most relevant medical and economic databases. The medical evaluation was conducted on the basis of published RCT. The data from the studies regarding various angiographic, sonographic and clinical endpoints were checked for methodical quality and summarised in meta-analyses. Within the scope of economic evaluation the primary studies were analysed and modelling was performed, applying clinical effect estimates from the meta-analyses of the medical evaluation and current estimates of German costs. Results: Medical evaluation: Ten different stenttypes were used in the included 26 RCT. The results for heparin, silicon-carbide, carbon and PTFE coated stenttypes could not reveal any significant differences between the medical effectiveness of coated and uncoated stents. The application of sirolimus, paclitaxel, everolimus and 7-hexanoyltaxol eluting stents showed a significant lower restenosis at 6-9 months with decrease in the rate of restenosis for polymer-based sirolimus, paclitaxel and 7-hexanoyltaxol eluting stents. In contrast, the use of gold-coated and actinomycin-D eluting stents was associated with a significantly higher restenosis. The polymer-based sirolimus and paclitaxel eluting stents also showed a significant and considerable reduction in the rate of repeated percutaneous revascularisations at 6-12 months (3.5% vs. 19.7%; p<0.0001, RR=0.19 [95%CI: 0.11; 0.33] and 3.5% vs. 12.2%; p<0.0001, RR=0.30 [95%CI: 0

  15. Education and Coronary Heart Disease Risk: Potential Mechanisms Such as Literacy, Perceived Constraints, and Depressive Symptoms

    Science.gov (United States)

    Loucks, Eric B.; Gilman, Stephen E.; Howe, Chanelle J.; Kawachi, Ichiro; Kubzansky, Laura D.; Rudd, Rima E.; Martin, Laurie T.; Nandi, Arijit; Wilhelm, Aude; Buka, Stephen L.

    2015-01-01

    Objective: Education is inversely associated with coronary heart disease (CHD) risk; however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in…

  16. Short and long-term labour market consequences of coronary heart disease

    DEFF Research Database (Denmark)

    Kruse, Marie; Sørensen, Jan; Davidsen, Michael

    2009-01-01

    OBJECTIVE: The aim of this study was to analyse to what extent individuals with coronary heart disease (CHD) leave the labour market earlier than individuals without CHD and to discuss the implications for rehabilitation. DATA AND METHODS: Individuals with CHD were identified from the Danish...

  17. Clinical course of isolated stable angina due to coronary heart disease

    NARCIS (Netherlands)

    Poole-Wilson, Philip A.; Voko, Zoltan; Kirwan, Bridget-Anne; de Brouwer, Sophie; Dunselman, Peter H. J. M.; Lubsen, Jacobus

    2007-01-01

    Aims To describe the clinical course of patients with stable angina due to coronary heart disease without a history of cardiovascular (CV) events or revascutarization (isolated angina). Methods and results Of 7665 patients in a trial comparing long-acting nifedipine with placebo, 2170 (28%) had isol

  18. Coronary heart disease risk : family history and gene-environment interaction

    NARCIS (Netherlands)

    Boer, J.

    1999-01-01

    The first part of this thesis describes research into lifestyle, genetic, and biological factors that may underlie the increased risk for coronary heart disease (CHD) in individuals with a family history of this disorder. The second part of this thesis describes whether levels of plasma lipids and l

  19. Educational class inequalities in the incidence of coronary heart disease in Europe

    DEFF Research Database (Denmark)

    Veronesi, Giovanni; Ferrario, Marco M; Kuulasmaa, Kari

    2016-01-01

    Objective: To estimate the burden of social inequalities in coronary heart disease (CHD) and to identify their major determinants in 15 European populations. Methods: The MORGAM (MOnica Risk, Genetics, Archiving and Monograph) study comprised 49 cohorts of middle-aged European adults free of CHD ...

  20. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality

    DEFF Research Database (Denmark)

    (Tybjaerg-Hansen, A.) The Fibrinogen Studies Collaboration.The Copenhagen City Heart Study; Tybjærg-Hansen, Anne

    2009-01-01

    CONTEXT: Circulating concentration of lipoprotein(a) (Lp[a]), a large glycoprotein attached to a low-density lipoprotein-like particle, may be associated with risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationship of Lp(a) concentration with risk of major vascular ...

  1. Intake of ruminant trans fatty acids and risk of coronary heart disease - An overview

    DEFF Research Database (Denmark)

    Jakobsen, Marianne U.; Bysted, Anette; Andersen, Niels Lyhne;

    2006-01-01

    Epidemiological studies have shown a strong direct (positive) association between the intake of trans fatty acids (TRA) and the risk of coronary heart disease (CHD), primarily accounted for by industrially produced TFA (IP-TFA). However, comparisons, between ruminant TEA (R-TFA) and IP-TFA and risk...

  2. Omega-3 fatty acids and coronary heart disease. The final verdict?

    NARCIS (Netherlands)

    Kromhout, D.

    2012-01-01

    Purpose of review: The fish fatty acids eicosapentenoic acid (EPA) and docosahexenoic acid (DHA) may be protective against fatal coronary heart disease (CHD) and sudden cardiac death. This review summarizes the recent findings of prospective cohort studies and randomized controlled trials. Recent fi

  3. Managing antithrombotic therapy in patients with both atrial fibrillation and coronary heart disease

    NARCIS (Netherlands)

    Thompson, P.L.; Verheugt, F.W.A.

    2014-01-01

    PURPOSE: Atrial fibrillation (AF) and coronary heart disease (CHD) commonly occur together. Previous consensus guidelines were published before the wide availability of novel oral anticoagulants (NOACs) and newer P2Y12 antiplatelet agents. We examine recent evidence to guide management in 3 categori

  4. Acute and long-term cardiovascular effects of coffee: implications for coronary heart disease.

    NARCIS (Netherlands)

    Riksen, N.P.; Rongen, G.A.P.J.M.; Smits, P.

    2009-01-01

    Despite decades of research, the question as to whether coffee intake increases the risk of coronary heart disease (CHD) remains controversial. In the current paper, we discuss the acute and long-term cardiovascular effects of coffee, and its major constituents, which could underlie such an associat

  5. Regular physical activity in old age. Effect on coronary heart disease risk factors and well- being.

    NARCIS (Netherlands)

    Schuit, A.J.

    1997-01-01

    Background. Regular physical activity is considered an important aspect of a healthy lifestyle. It may improve fitness, physical competence and may lower the risk of coronary heart disease (CHD). However, until now, data on the effects of regular exercise on CHD risk factors in elde

  6. Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

    Science.gov (United States)

    Holly, Deirdre; Sharp, John

    2014-01-01

    People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

  7. Overweight Status, Obesity, and Risk Factors for Coronary Heart Disease in Adults with Intellectual Disability

    Science.gov (United States)

    Henderson, C. Michael; Robinson, Laura M.; Davidson, Philip W.; Haveman, Meindert; Janicki, Matthew P.; Albertini, Giorgio

    2008-01-01

    Research indicates that adults with intellectual disabilities (ID) have high rates of overweight status/obesity (OSO). OSO is associated with several important risk factors for coronary heart disease (CHD). This study focused on assessing whether such risk factors are being identified in adults with ID who are receiving their healthcare in…

  8. Risk Factors for Coronary Heart Disease Among Inpatients Who Have Mild Intellectual Disability and Mental Illness

    Science.gov (United States)

    Merriman, S.; Haw, C.; Kirk, J.; Stubbs, J.

    2005-01-01

    Coronary heart disease (CHD) is a major cause of morbidity and mortality in the UK. The aim of this study was to screen inpatients with mild or borderline intellectual disability, many of whom also have mental illness, for risk factors for CHD. Participants were interviewed, measured and had blood samples taken. Of the 53 participants, 20 (37.7%)…

  9. The Effect of a Physiological Evaluation Program on Coronary Heart Disease Risk Scores for Sedentary Individuals.

    Science.gov (United States)

    Finkenberg, Mel; And Others

    The purpose of this study was to compare the coronary heart disease (CHD) probability estimates of a group of sedentary males involved in an exercise stress test program from 1968 through 1974 with those of a comparison group of sedentary males not involved in the program. The program was designed to evaluate cardiopulmonary function and improve…

  10. Sociodemographic differences in myocardial infarction risk perceptions among people with coronary heart disease

    DEFF Research Database (Denmark)

    Aalto, Anna-Mari; Weinman, John; French, David P;

    2007-01-01

    This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) (N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared...

  11. Growth in height in childhood and risk of coronary heart disease in adult men and women

    DEFF Research Database (Denmark)

    Silventoinen, Karri; Baker, Jennifer L; Sørensen, Thorkild I A

    2012-01-01

    Adult height is inversely associated with the risk of coronary heart disease (CHD), but it is still unknown which phase of the human growth period is critical for the formation of this association. We investigated the association between growth in height from 7 to 13 years of age and the risk...

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

    Science.gov (United States)

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

    2009-01-01

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

  13. Hospitalization Cost Offset of a Hostility Intervention for Coronary Heart Disease Patients

    Science.gov (United States)

    Davidson, Karina W.; Gidron, Yori; Mostofsky, Elizabeth; Trudeau, Kimberlee J.

    2007-01-01

    The authors evaluated hospitalization cost offset of hostility management group therapy for patients with coronary heart disease (CHD) from a previously published randomized controlled trial (Y. Gidron, K. Davidson, & I. Bata, 1999). Twenty-six male patients with myocardial infarction or unstable angina were randomized to either 2 months of…

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

    Science.gov (United States)

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

  15. Coronary Heart Disease Risk Factors in Young People of Differing Socio-Economic Status

    Science.gov (United States)

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Williams, Simon P.; Baker, Julien S.; Davies, Bruce

    2005-01-01

    This study determined the prevalence of coronary heart disease (CHD) risk factors in young people of differing socio-economic status (SES). A cohort of 100 boys and 108 girls, aged 12.9, SD 0.3 years drawn of differing SES were assessed for CHD risk factors. Measurements included indices of obesity, blood pressure, aerobic fitness, diet, blood…

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

    NARCIS (Netherlands)

    Zock, P.L.

    1995-01-01

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

  17. Effect of caffeine on the risk of coronary heart disease- A re-evaluation.

    Science.gov (United States)

    Adebayo, J O; Akinyinka, A O; Odewole, G A; Okwusidi, J I

    2007-03-01

    The effect of caffeine intake on the risk of coronary heart disease was studied. Twenty-one rats used were randomly divided into three experimental groups, the first group served as the control while the second and third groups were administered caffeine orally at doses of 10mg/kg body weight and 20mg/kg body weight respectively for fourteen days. Caffeine, at 10mg/kg body weight, significantly increased (P<0.05) serum LDL- cholesterol concentration and coronary heart disease risk ratio while it significantly reduced (P<0.05) serum triacylglycerol concentration when compared with controls. At 20mg/kg body weight, caffeine significantly increased (P<0.05) coronary heart disease risk ratio while it significantly reduced (P<0.05) serum HDL-cholesterol concentration and serum triacylgycerol concentration when compared with controls. No dose response effect was observed possibly suggestive of a threshold effect. These results suggest that caffeine predisposes consumers of caffeine containing beverages to coronary heart disease.

  18. Metabolic syndrome and mortality in stable coronary heart disease: relation to gender

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Køber, Lars; Faber, Jens;

    2007-01-01

    BACKGROUND: Metabolic syndrome (MS) is associated with subsequent development of type 2 diabetes and cardiovascular disease in the general population. The impact of MS on mortality in patients with stable coronary heart disease is less well defined, and the association of prognosis to gender...

  19. Anxiety and Risk of Incident Coronary Heart Disease : A Meta-Analysis

    NARCIS (Netherlands)

    Roest, Annelieke M.; Martens, Elisabeth J.; de Jonge, Peter; Denollet, Johan

    2010-01-01

    Objectives The purpose of this study was to assess the association between anxiety and risk of coronary heart disease (CHD). Background Less research has focused on the association of anxiety with incident CHD in contrast to other negative emotions, such as depression. Methods A meta-analysis of ref

  20. Risk of Coronary Heart Disease in Men With Poor Emotional Control : A Prospective Study

    NARCIS (Netherlands)

    Potijk, Marieke R.; Janszky, Imre; Reijneveld, Sijmen A.; Falkstedt, Daniel

    2016-01-01

    Objective Many psychosocial factors have been associated with coronary heart disease (CHD), including hostility, anger, and depression. We tested the hypothesis that these factors may have their basis in emotion regulation abilities. Our aim was to determine whether poor emotional control predicted

  1. Elders' Knowledge about Risk Factors of Coronary Heart Disease, Their Perceived Risk, and Adopted Preventive Behaviors

    Science.gov (United States)

    Al Khayyal, Hatem; El Geneidy, Moshera; El Shazly, Somaya Abdel Moneim

    2016-01-01

    Coronary heart disease is the most frequent single cause of death among persons over 65 years of age and it seems to continue to be a significant threat to the health and wellbeing of the elderly population all over the world, yet the condition is largely preventable. The aims of this study to assess and determine the relations among elder's…

  2. Clinical Observation in 40 Cases of Postmenopausal Coronary Heart Disease Treated with Yanghuo Sanzi Tang

    Institute of Scientific and Technical Information of China (English)

    张培钦; 邱仁斌; 沈瑞子; 梁劲荃

    2003-01-01

    @@ Modern researches have shown that the incidence of coronary heart disease (CHD) among the women before menopause is only 30% of that in men.However, the incidence and mortality of CHD among the women after menopause jumps by 400% over those before menopause, higher than that in men1.

  3. Involvement of interleukin-1 genotypes in the association of coronary heart disease with periodontitis

    DEFF Research Database (Denmark)

    Geismar, Karen; Enevold, Christian; Sørensen, Lars Korsbaek

    2008-01-01

    Epidemiologic studies demonstrated an association between periodontitis (PE) and coronary heart disease (CHD). The coexistence of the two disease entities could be dependent on mutual risk factors, and polymorphism of the interleukin (IL)-1 gene cluster associated with the severity of PE might also...

  4. Contribution of the risk factor concept to patient care in coronary heart disease

    NARCIS (Netherlands)

    Meijler, F.L.

    1983-01-01

    This article deals with the question of whether or not the risk factor concept, a principal aspect of preventive cardiology, has contributed to patient care in coronary heart disease. The risk factors considered are plasma cholesterol, high blood pressure, smoking, diabetes and marked obesity. With

  5. Intake of ruminant trans fatty acids and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Uhre; Overvad, Kim; Dyerberg, Jørn

    2008-01-01

    BACKGROUND: Studies have shown a positive association between trans fatty acids (TFA) intake and risk of coronary heart disease (CHD), primarily accounted for by industrially produced TFA. Some of these studies indicate an inverse association between ruminant TFA (R-TFA) intake and CHD implying...

  6. Childhood body-mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, Lina Wøhlk; Sørensen, Thorkild I A

    2007-01-01

    BACKGROUND: The worldwide epidemic of childhood obesity is progressing at an alarming rate. Risk factors for coronary heart disease (CHD) are already identifiable in overweight children. The severity of the long-term effects of excess childhood weight on CHD, however, remains unknown. METHODS: We...

  7. Association of paraoxonase polymorphisms and serum homocysteine thiolactone complex with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    秦勤

    2006-01-01

    Objective To investigate the relationship between paraoxonase (PON) polymorphisms and serum homocysteine thiolactone (HTL) and coronary heart diseases. Method In this prospective study, serum complex of HTL levels using ELISA, and the level of serum Hcy using high pressure liquid chromatography (HPLC) , de-

  8. Adult height, coronary heart disease and stroke : a multi-locus Mendelian randomization meta-analysis

    NARCIS (Netherlands)

    Nüesch, Eveline; Dale, Caroline; Palmer, Tom M; White, Jon; Keating, Brendan J; van Iperen, Erik Pa; Goel, Anuj; Padmanabhan, Sandosh; Asselbergs, Folkert W; Verschuren, W M; Wijmenga, C; Van der Schouw, Y T; Onland-Moret, N C; Lange, Leslie A; Hovingh, G K; Sivapalaratnam, Suthesh; Morris, Richard W; Whincup, Peter H; Wannamethe, Goya S; Gaunt, Tom R; Ebrahim, Shah; Steel, Laura; Nair, Nikhil; Reiner, Alexander P; Kooperberg, Charles; Wilson, James F; Bolton, Jennifer L; McLachlan, Stela; Price, Jacqueline F; Strachan, Mark Wj; Robertson, Christine M; Kleber, Marcus E; Delgado, Graciela; März, Winfried; Melander, Olle; Dominiczak, Anna F; Farrall, Martin; Watkins, Hugh; Leusink, Maarten; Maitland-van der Zee, Anke H; de Groot, Mark Ch; Dudbridge, Frank; Hingorani, Aroon; Ben-Shlomo, Yoav; Lawlor, Debbie A; Amuzu, A; Caufield, M; Cavadino, A; Cooper, J; Davies, T L; Drenos, F; Engmann, J; Finan, C; Giambartolomei, C; Hardy, R; Humphries, S E; Hypponen, E; Kivimaki, M; Kuh, D; Kumari, M; Ong, K; Plagnol, V; Power, C; Richards, M; Shah, S; Shah, T; Sofat, R; Talmud, P J; Wareham, N; Warren, H; Whittaker, J C; Wong, A; Zabaneh, D; Davey Smith, George; Wells, Jonathan C; Leon, David A; Holmes, Michael V; Casas, Juan P

    2015-01-01

    BACKGROUND: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. METHODS: We developed an allele score based on 69 single nucleotide poly

  9. Validating the Type D personality construct in Chinese patients with coronary heart disease

    DEFF Research Database (Denmark)

    Yu, Doris S F; Thompson, David R; Yu, Cheuk Man

    2010-01-01

    Type D personality predicts poor prognosis in coronary heart disease (CHD) but little is known about Type D in non-Western cultures. We examined the (a) validity of the Type D construct and its assessment with the DS14 scale in the Chinese culture, (b) prevalence of Type D, and (c) gender vs. Type...

  10. Functional characterisation of polymorphisms in candidate genes for coronary heart disease

    OpenAIRE

    van't Hooft, Ferdinand M.

    1999-01-01

    Coronary heart disease (CHD) is a multifactorial disorder. Several important risk factors, in particular cigarette smoking, hypertension, hypercholesterolaemia, reduced high density lipoprotein (HDL) cholesterol concentration and hyperglycaemia, have been defined. It appears that most risk factors are influenced by genetic components, suggesting that genetic variants in candidate genes play an important role in the development of CHD. In view of the importance of transcripti...

  11. Coronary Heart Disease Knowledge and Risk Factors among Tri-Ethnic College Students

    Science.gov (United States)

    Koutoubi, Samer; Huffman, Fatma G.; Ciccazzo, Michele W.; Himburg, Susan P.; Johnson, Paulette

    2005-01-01

    Objectives: Coronary heart disease (CHD) is the leading cause of death in the United States and Europe. This study identified and compared nutritional knowledge associated with CHD risk factors among tri-ethnic college students. Design: A quantitative, cross-sectional, observational study using questionnaires. Setting: University laboratory.…

  12. Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve

    DEFF Research Database (Denmark)

    Kofoed, Klaus F; Bangsgaard, Regitze; Carstensen, Steen;

    2002-01-01

    OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have...

  13. Abdominal fat and risk of coronary heart disease in patients with peripheral arterial disease

    NARCIS (Netherlands)

    Brouwer, Beate G.; Visseren, Frank L. J.; Stolk, Ronald P.; van der Graaf, Yolanda

    2007-01-01

    Objective: We investigated whether the presence of concomitant coronary heart disease (CHD) in patients with peripheral arterial disease (PAD) can be explained by intra-abdominal fat accumulation and compared different measures of adiposity as predictors of CHD in patients with PAD. Research Methods

  14. Discrepancy between coronary artery calcium score and HeartScore in middle-aged Danes

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Sand, Niels Peter; Nørgaard, Bjarne;

    2012-01-01

    Background: Coronary artery calcification (CAC) is an independent and incremental risk marker. This marker has previously not been compared to the HeartScore risk model. Design: A random sample of 1825 citizens (men and women, 50 or 60 years of age) was invited for screening. Methods: Using...

  15. Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

    NARCIS (Netherlands)

    de Groot, S.; Post, M. W.; Snoek, G. J.; Schuitemaker, M.; van der Woude, L. H.

    2013-01-01

    Objective: To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related t

  16. Socioeconomic Status and the Course of Quality of Life in Older Patients with Coronary Heart Disease

    NARCIS (Netherlands)

    Barbareschi, Giorgio; Sanderman, Robbert; Kempen, Gertrudis I. J. M.; Ranchor, Adelita V.

    2009-01-01

    Previous research suggests that socioeconomic status (SES) might be related to the course of quality of life (QoL) in coronary heart disease (CHD) patients. The authors sought to determine whether there are differences in the course of QoL before and after the incidence of CHD among older persons of

  17. Multivariate Meta-Analysis of Preference-Based Quality of Life Values in Coronary Heart Disease

    NARCIS (Netherlands)

    Stevanović, Jelena; Pechlivanoglou, Petros; Kampinga, Marthe A; Krabbe, Paul F M; Postma, Maarten J

    2016-01-01

    BACKGROUND: There are numerous health-related quality of life (HRQol) measurements used in coronary heart disease (CHD) in the literature. However, only values assessed with preference-based instruments can be directly applied in a cost-utility analysis (CUA). OBJECTIVE: To summarize and synthesize

  18. Multivariate meta-analysis of preference-based quality of life values in coronary heart disease

    NARCIS (Netherlands)

    Stevanović, Jelena; Pechlivanoglou, Petros; Kampinga, Marthe A.; Krabbe, Paul F. M.; Postma, Maarten J.

    2016-01-01

    Background: There are numerous health-related quality of life (HRQol) measurements used in coronary heart disease (CHD) in the literature. However, only values assessed with preferencebased instruments can be directly applied in a cost-utility analysis (CUA). Objective: To summarize and synthesize i

  19. Exploring causal associations between alcohol and coronary heart disease risk factors

    DEFF Research Database (Denmark)

    Lawlor, Debbie A; Nordestgaard, Børge G; Benn, Marianne

    2013-01-01

    AimsTo explore the causal effect of long-term alcohol consumption on coronary heart disease risk factors.Methods and resultsWe used variants in ADH1B and ADH1C genes as instrumental variables (IV) to estimate the causal effect of long-term alcohol consumption on body mass index (BMI), blood...

  20. Genetic APOC3 mutation, serum triglyceride concentrations, and coronary heart disease

    Science.gov (United States)

    Recent decades have witnessed an increased awareness of the importance of lowering triglyceride concentrations in conjunction with lowering LDL cholesterol (LDL-C) to achieve optimal reduction of the risk for coronary heart disease (CHD). Historically, LDL-C was the only target of pharmacologic ther...

  1. Small dense low density lipoprotein cholesterol and coronary heart disease: results from the Framingham Offspring Study

    Science.gov (United States)

    We sought to establish reference values for a new direct assay for small dense LDL cholesterol (sdLDL-C) and to measure sdLDL-C concentrations in patients with established coronary heart disease (CHD) vs controls. Direct LDL-C and sdLDL-C were measured in samples from 3188 male and female participan...

  2. Prevalence, correlative and statistical relationships of renal dysfunction in patients with chronic ischemic heart failure

    Directory of Open Access Journals (Sweden)

    D. A. Lashkul

    2014-02-01

    Full Text Available Chronic heart failure (CHF is one of the most common complications of cardiovascular disease. According multicenter studies conducted during recent years, coronary heart disease was the leading cause of heart failure and has been on average 64% of patients with chronic heart failure. The tight functional relationship of cardiovascular and urinary system causes a lot of interest to the functional state of kidneys in various cardiovascular diseases. Most risk factors for cardiovascular disease are common risk factors of renal failure. Causes significant differences in the prevalence of chronic kidney disease (CKD in patients with chronic heart failure, defined as coronary artery disease and hypertension remain unclear. Need clarification prevalence of CKD among patients with CHF in general and in specific groups of patients. The aim of the study was to examine the prevalence, correlation and statistical relationships of renal dysfunction with functional class, age and gender of patients with coronary heart disease and heart failure, were hospitalized. Materials and methods. Analyzed the medical cards 344 patients (286 men and 58 women with ischemic chronic heart failure, mean age 59.2±9.4 years. The etiology of heart failure in 298 (86.6% patients had a combination of coronary artery disease and essential hypertension in 46 (13.4% - CHD. Chronic heart failure 1 functional class (FC was diagnosed in 10 (2.9% patients, 2 FC - in 106 (31%, 3 FC - 207 (60.5% and 4 FC - 19 (5, 6% patients. Diabetes was 62 (18% patients. Myocardial infarction had a history of 245 (71.2% patients. Glomerular filtration rate was calculated using the formula MDRD (Modification of Diet in Renal Disease. Descriptive statistics are presented as mean±standard deviation for continuous variables and as percentages for categorical variables. Depending on the distribution of the analyzed parameters used unpaired Student's t-test or U-Mann-Whitney test. Comparisons among all

  3. Reconsidering the back door approach by targeting the coronary sinus in ischaemic heart disease.

    Science.gov (United States)

    De Maria, Giovanni Luigi; Kassimis, George; Raina, Tushar; Banning, Adrian P

    2016-08-15

    Coronary sinus interventions (CSI) are a class of invasive techniques (surgical and percutaneous) originally proposed in the first half of the 20th century, aiming to treat ischaemic heart disease by acting on the venous coronary system. Three main classes of CSI have been proposed and tested: (1) retroperfusion technique, (2) retroinfusion technique and (3) coronary sinus occlusion techniques. They all share the principle that a controlled increased pressure within the coronary sinus may promote a retrograde perfusion of the ischaemic myocardium with consequent cardioprotection. Development of arterial treatments including coronary aortic bypass grafting and then percutaneous coronary intervention deflected interest from interventions on the coronary venous system. However, CSI may still have a possible niche role today in specific and selected clinical contexts in which existing therapies are insufficient. In this review paper, we aim to revise the rationale for CSI, describing the details and the evidence collected so far about these techniques and to provide insights about the main clinical scenarios in which these strategies may find a contemporary application in combination or as an alternative to existing approaches.

  4. Radiologic evaluation of coronary artery disease in adults with congenital heart disease.

    Science.gov (United States)

    Valenzuela, David M; Ordovas, Karen G

    2016-01-01

    Improved surgical and medical therapy have prolonged survival in patients with congenital heart disease (CHD) such that general medical conditions like coronary artery disease (CAD) are now the main determinants of mortality. A summary of the association of CAD with CHD, as well as a discussion of the radiologic evaluation of the coronary arteries in adults with CHD is described herein. Cross sectional imaging to evaluate CAD in adults with CHD should follow the same appropriateness criteria as gender and aged matched patients without CHD. Coronary CT imaging may be particularly valuable in evaluating the coronary arteries in this patient population as invasive coronary angiography may prove challenging secondary to complicated or unconventional anatomy of the coronary arteries. Further, typical methods for evaluating CAD such as stress or echocardiography may be impractical in adults with CHD. Finally, delineating the anatomic relationship of the coronary arteries and their relationship with the sternum, chest wall, conduits, grafts, and valves is highly recommended in patients with CHD prior to reintervention to avoid iatrogenic complications.

  5. [ANALYSIS OF ARACHIDONIC ACID RELATIVE CONTENT CHANGES IN ERYTHROCYTES AND PLATELETS PHOSPHOLIPIDS MEMBRANES FEATURES IN CORONARY HEART DISEASE WITH ATRIAL FIBRILLATION PATIENTS].

    Science.gov (United States)

    Lizogub, V G; Zavalska, T V; Merkulova, I O; Bryuzgina, T S

    2015-01-01

    Erythrocytes and platelets phospholipid membranes fatty acid spectrum was detected in coronary heart disease and atrial fibrillation patients and in patients with coronary heart disease without atrial fibrillation. 87 patients were investigated. Significant decrease in the arachidonic acid relative content in coronary heart disease patients compared with healthy individuals was related. As well as a significant decrease in the arachidonic acid relative content in coronary heart disease and atrial fibrillation patients compared with coronary heart disease patients without atrial fibrillation was related too. These dates may indicate that decreasing relative content arachidonic acid can be possible pathogenetic link in the development of arrhythmias.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  8. Association between chronic kidney dysfunction and the complexity of coronary artery disease in elderly patients

    Institute of Scientific and Technical Information of China (English)

    颜利求

    2013-01-01

    Objective To investigate the association between chronic kidney dysfunction and the complexity of coronary artery disease in elderly patients.Methods A prospective study was conducted on 1380 consecutive patients

  9. Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions.

    LENUS (Irish Health Repository)

    Rodríguez-Granillo, Gastón A

    2012-01-05

    Hypoenhanced regions on multidetector CT (MDCT) coronary angiography correlate with myocardial hyperperfusion. In addition to a limited capillary density, chronic myocardial infarction (MI) commonly contains a considerable amount of adipose tissue.

  10. Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study

    Science.gov (United States)

    Almagro, Pere; Lapuente, Anna; Pareja, Julia; Yun, Sergi; Garcia, Maria Estela; Padilla, Ferrán; Heredia, Josep Ll; De la Sierra, Alex; Soriano, Joan B

    2015-01-01

    Background Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) following percutaneous coronary intervention (PCI). The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD – previously or newly diagnosed – in patients with IHD treated with PCI. Methods Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed. Results A total of 133 patients (78%) male, with a mean (SD) age of 63 (10.12) years were included. Of these, 33 (24.8%) met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%–75%]: 546–1,160). COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76–44.47) and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04–3.33), even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12–2.83). These differences remained after adjustment for sex, age, number of coronary vessels affected, and previous myocardial infarction (P=0.025; HR: 1.83; 95% CI: 1.08–3.1). Conclusion Prevalence and underdiagnosis of COPD in patients with IHD who undergo PCI are both high. These patients have an independent greater mortality and a higher number of cardiovascular events during follow-up. PMID:26213464

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  12. 白细胞介素-1基因型与慢性牙周炎、冠心病相关性研究%Reaserch of interleukin-1 genotype and its association between chronic periodontitis and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    杨柯; 钟良军; 褚萌; 李丹

    2009-01-01

    目的:探讨白细胞介素-1α-889(interleukin-1α-889,IL-1α-889)、白细胞介素-1β-511(interleukin-1β-511,IL-1β-511)基凶型与慢性牙周炎(chronic periodontitis,CP)、冠心病(coronary heart disease,CHD)易感性的关系.方法:收集中蕈度CP 44例、CHD 41例、中重度CP并CHD 40例和同族健康对照49例个体的颊黏膜拭子,提取DNA.用聚合酶反应-限制性片段长度多态性法(polymerase chain reaction-restriction fragment length polymorphism,PCR-PFLP)对IL-1α-889/Ncol,IL-1β-511/Aval位点的基因型进行检测,比较各基因型在4组间检出率的差别.结果:①IL-1α-889基因犁在4组间的分布无统计学差异.②IL-1β-511等位基因T在CHD组中的检出率显著高于健康组,而在中重度CP与健康组、中重度CP并CHD与健康组间的分布差异无统计学意义.结论:IL-1β-51l等位基因T可能是冠心病的一个遗传学标志.

  13. Vitamin B-12 and folate deficiency in chronic heart failure

    NARCIS (Netherlands)

    van der Wal, Haye H.; Comin-Colet, Josep; Klip, Ijsbrand T.; Enjuanes, Cristina; Grote Beverborg, Niels; Voors, Adriaan A.; Banasiak, Waldemar; van Veldhuisen, Dirk J.; Bruguera, Jordi; Ponikowski, Piotr; Jankowska, Ewa A.; van der Meer, Peter

    2015-01-01

    Objective To determine the prevalence, clinical correlates and the effects on outcome of vitamin B-12 and folic acid levels in patients with chronic heart failure (HF). Methods We studied an international pooled cohort comprising 610 patients with chronic HF. The main outcome measure was all-cause m

  14. Iron deficiency in chronic heart failure : An international pooled analysis

    NARCIS (Netherlands)

    Klip, IJsbrand T.; Comin-Colet, Josep; Voors, Adriaan A.; Ponikowski, Piotr; Enjuanes, Cristina; Banasiak, Waldemar; Lok, Dirk J.; Rosentryt, Piotr; Torrens, Ainhoa; Polonski, Lech; van Veldhuisen, Dirk J.; van der Meer, Peter; Jankowska, Ewa A.

    2013-01-01

    Background Iron deficiency (ID) is an emerging problem in patients with chronic heart failure (HF) and can be a potential therapeutic target. However, not much is known about the prevalence, predictors, and prognosis of ID in patients with chronic HF. Methods In an international pooled cohort compri

  15. Coronary artery fistula

    Science.gov (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  16. Target heart rate to determine the normal value of coronary flow reserve during dobutamine stress echocardiography

    Directory of Open Access Journals (Sweden)

    Rousse Maria G

    2011-04-01

    Full Text Available Abstract Background The determination of coronary flow reserve (CFR is an essential concept at the moment of decision-making in ischemic heart disease. There are several direct and indirect tests to evaluate this parameter. In this sense, dobutamine stress echocardiography is one of the pharmacological method most commonly used worldwide. It has been previously demonstrated that CFR can be determined by this technique. Despite our wide experience with dobutamine stress echocardiography, we ignored the necessary heart rate to consider sufficient the test for the analysis of CFR. For this reason, our main goal was to determine the velocity of coronary flow in each stage of dobutamine stress echocardiography and the heart rate value necessary to double the baseline values of coronary flow velocity in the territory of the left anterior descending (LAD coronary artery. Methods A total of 33 consecutive patients were analyzed. The patients included had low risk for coronary artery disease. All the participants underwent dobutamine stress echocardiography and coronary artery flow velocity was evaluated in the distal segment of LAD coronary artery using transthoracic color-Doppler echocardiography. Results The feasibility of determining CFR in the territory of the LAD during dobutamine stress echocardiography was high: 31/33 patients (94%. Mean CFR was 2.67 at de end of dobutamine test. There was an excellent concordance between delta HR (difference between baseline HR and maximum HR and the increase in the CFR (correlation coefficient 0.84. In this sense, we found that when HR increased by 50 beats, CFR was ≥ 2 (CI 93-99.2%. In addition, 96.4% of patients reached a CFR ≥ 2 (IC 91.1 - 99% at 75% of their predicted maximum heart rate. Conclusions We found that the feasibility of dobutamine stress echocardiography to determine CFR in the territory of the LAD coronary artery was high. In this study, it was necessary to achieve a difference of 50 bpm

  17. Ethnic Minorities and Coronary Heart Disease: an Update and Future Directions.

    Science.gov (United States)

    Leigh, J Adam; Alvarez, Manrique; Rodriguez, Carlos J

    2016-02-01

    Heart disease remains the leading cause of death in the USA. Overall, heart disease accounts for about 1 in 4 deaths with coronary heart disease (CHD) being responsible for over 370,000 deaths per year. It has frequently and repeatedly been shown that some minority groups in the USA have higher rates of traditional CHD risk factors, different rates of treatment with revascularization procedures, and excess morbidity and mortality from CHD when compared to the non-Hispanic white population. Numerous investigations have been made into the causes of these disparities. This review aims to highlight the recent literature which examines CHD in ethnic minorities and future directions in research and care.

  18. Treatment of Coronary Heart Dise ase from Kidney%从肾论治冠心病

    Institute of Scientific and Technical Information of China (English)

    唐天娜; 张明雪

    2016-01-01

    冠心病为心血管系统多发疾病之一,并随着人口老龄化呈逐年上升趋势。冠心病病位虽在心,但亦与其他四脏相关,尤与肾脏关系密切。从心与肾的生理病理关系为切入点阐述冠心病的理论依据,并提出以“补肾”为主的治疗方法。%Coronary heart disease ( CHD) is one of the cardiovascular system diseases ,and with the aging of the population it is increasing year by year .Although the coronary heart disease is positioned in heart ,but also re-lated to other four viscera , especially to the kidney .From the physiological and pathological relationship of heart and kidney , this paper expounds the theoretical basis of coronary heart disease , and puts forward the treatment method of“kidney”.

  19. A Fuzzy Optimization Technique for the Prediction of Coronary Heart Disease Using Decision Tree

    Directory of Open Access Journals (Sweden)

    Persi Pamela. I

    2013-06-01

    Full Text Available Data mining along with soft computing techniques helps to unravel hidden relationships and diagnose diseases efficiently even with uncertainties and inaccuracies. Coronary Heart Disease (CHD is akiller disease leading to heart attack and sudden deaths. Since the diagnosis involves vague symptoms and tedious procedures, diagnosis is usually time-consuming and false diagnosis may occur. A fuzzy system is one of the soft computing methodologies is proposed in this paper along with a data mining technique for efficient diagnosis of coronary heart disease. Though the database has 76 attributes, only 14 attributes are found to be efficient for CHD diagnosis as per all the published experiments and doctors’ opinion. So only the essential attributes are taken from the heart disease database. From these attributes crisp rules are obtained by employing CART decision tree algorithm, which are then applied to the fuzzy system. A Particle Swarm Optimization (PSO technique is applied for the optimization of the fuzzy membership functions where the parameters of the membership functions are altered to new positions. The result interpreted from the fuzzy system predicts the prevalence of coronary heart disease and also the system’s accuracy was found to be good.

  20. Clinical and morphologic features of acute, subacute and chronic cor pulmonale (pulmonary heart disease).

    Science.gov (United States)

    Roberts, William Clifford; Shafii, Alexis E; Grayburn, Paul A; Ko, Jong Mi; Weissenborn, Matthew R; Rosenblatt, Randall L; Guileyardo, Joseph M

    2015-03-01

    Described are certain clinical and morphologic features of one patient with acute, another with subacute, and one with chronic cor pulmonale. All 3 had evidence of severe pulmonary hypertension. The patient with acute cor pulmonale 4 days after coronary bypass for unstable angina pectoris suddenly developed severe breathlessness with cyanosis and had fatal cardiac arrest and necropsy disclosed massive pulmonary embolism. The patient with subacute cor pulmonale had severe right-sided heart failure for 5 weeks and necropsy disclosed microscopic-sized neoplastic pulmonary emboli from a gastric carcinoma without parenchymal pulmonary metastases. The patient with chronic cor pulmonale had evidence of right-sided heart failure for years, the result of primary or idiopathic pulmonary hypertension almost certainly present from birth because the pattern of elastic fibers in the pulmonary trunk was that seen in newborns where the pressure in the pulmonary trunk and ascending aorta are similar. The patient with chronic cor pulmonale had plexiform pulmonary lesions indicative of irreversible pulmonary hypertension. Neither the acute nor the subacute patient had chronic pulmonary vascular changes. All 3 patients had dilated right ventricular cavities and non-dilated left ventricular cavities and only the patient with chronic cor pulmonale had right ventricular hypertrophy.

  1. sTNF-R Levels: Apical Periodontitis Linked to Coronary Heart Disease

    Science.gov (United States)

    Singhal, Rajnish K.; Rai, Balwant

    2017-01-01

    BACKGROUND: Different studies have implicated the exposure to systemic conditions in the aetiology of cardiovascular diseases like chronic inflammation including chronic periodontitis. AIM: The present study has been conducted to examine whether biomarker sTNF-R was elevated in apical periodontitis as sTNF-R is a systemic marker of inflammation and has been identified as risk factors for cardiovascular diseases. MATERIAL AND METHODS: sTNF-R levels were measured in 52 patients with apical periodontitis (M:F::25:27), aged 20-45 years and in 20 control patients without periodontitis (M:F::10:10, aged 20-48 years). Measurement of sTNF-R1 and sTNF-R2 was carried out in duplicate with standardised, commercially available enzyme immunoassays (R&D Systems Europe, Abingdon, UK). RESULTS: The mean sTNF-R1 and sTNF-R2 levels in periodontitis were 820 (240) pg/ml (413 – 1620 pg/ml) and 1309 (403) pg/ml (540 – 2430 pg/ml), while in normal sTNF-R1 and sTNF – R2 levels were 740 (340) pg/ml (407-1240 pg/ml) and 1283 (414) pg (480 – 2340 pg/ml) respectively. Results indicated a positive high relationship between cardiovascular markers such as sTNF-R1 and sTNF – R2 and apical periodontitis. CONCLUSION: Elevated levels of sTNF-R1 and sTNF – R2 in apical periodontitis patients indicate an increased independent risk of coronary heart disease. PMID:28293320

  2. Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes - results from the BASKET PROVE trial

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik;

    2013-01-01

    Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment...

  3. The Effects of Acupuncture in Treatment of Coronary Heart Diseases

    Institute of Scientific and Technical Information of China (English)

    孟竞壁

    2004-01-01

    A clinical study on acupuncture at point Neiguan (PC 6) was conducted on the basis of successful treatment of patients with angina pectoris and acute myocardial infarct. The effective rate (91.3%) was found to be far superior to isosorbide dinitrate and nifedipine (P<0.01). The experimental studies in animal models demonstrated that electro-acupuncture could decrease the elevated ST segments in ECGs and reduce the infarct areas induced by coronary ligation.

  4. 21 CFR 101.83 - Health claims: plant sterol/stanol esters and risk of coronary heart disease (CHD).

    Science.gov (United States)

    2010-04-01

    .... (1) Cardiovascular disease means diseases of the heart and circulatory system. Coronary heart disease (CHD) is one of the most common and serious forms of cardiovascular disease and refers to diseases of... benefits of exercise and management of body weight to help lower the risk of heart disease. (2) The...

  5. Increased Risk of Acute Coronary Syndrome in Patients With Chronic Pancreatitis: A Nationwide Cohort Analysis.

    Science.gov (United States)

    Hsu, Ming-Tse; Lin, Cheng-Li; Chung, Wei-Sheng

    2016-05-01

    Chronic inflammation may promote development of coronary heart disease. Studies on the relationship between chronic pancreatitis (CP) and cardiovascular diseases are scant.We conducted a nationwide retrospective cohort study to determine the risk of acute coronary syndrome (ACS) in patients with CP.We randomly selected a comparison cohort of individuals without CP from the Taiwan National Health Insurance Research Database (N = 23.74 million) and frequency-matched them with patients with CP from 2000 to 2010 in a 1:4 ratio according to age, sex, and index year. The follow-up period lasted from the index date of the new CP diagnosis to the date of ACS diagnosis, censoring, or the end of 2011. We analyzed the risk of ACS by using Cox proportional-hazard models.In total, 17,405 patients with CP and 69,620 individuals without CP were followed for 84,430 and 417,426 person-years. Most patients with CP were men, and the mean age of the patients was 48.3 ± 15.0 years. The overall ACS incidence was 2.15-fold higher in the CP cohort than in the non-CP cohort (4.89 vs 2.28 per 10,000 person-years) with an adjusted hazard ratio (aHR) of 1.40 (95% confidence interval [CI] 1.20-1.64). Compared with individuals without CP, patients with CP aged ≤39 years exhibited the highest risk of ACS (aHR 2.14, 95% CI 1.13-4.02), followed by those aged 40 to 54 years (aHR 1.66, 95% CI 1.23-2.24) and those aged 55 to 69 years (aHR 1.53, 95% CI 1.15-2.03).CP may become an independent risk factor for ACS.

  6. Cardiogenic shock and coronary endothelial dysfunction predict cardiac allograft vasculopathy after heart transplantation.

    Science.gov (United States)

    Lopez-Fernandez, Silvia; Manito-Lorite, Nicolas; Gómez-Hospital, Joan Antoni; Roca, Josep; Fontanillas, Carles; Melgares-Moreno, Rafael; Azpitarte-Almagro, José; Cequier-Fillat, Angel

    2014-12-01

    Cardiac allograft vasculopathy remains one of the major causes of death post-heart transplantation. Its etiology is multifactorial and prevention is challenging. The aim of this study was to prospectively determine factors related to cardiac allograft vasculopathy after heart transplantation. This research was planned on 179 patients submitted to heart transplant. Performance of an early coronary angiography with endothelial function evaluation was scheduled at three-month post-transplant. Patients underwent a second coronary angiography after five-yr follow-up. At the 5- ± 2-yr follow-up, 43% of the patients had developed cardiac allograft vasculopathy (severe in 26% of them). Three independent predictors of cardiac allograft vasculopathy were identified: cardiogenic shock at the time of the transplant operation (OR: 6.49; 95% CI: 1.86-22.7, p = 0.003); early coronary endothelial dysfunction (OR: 3.9; 95% CI: 1.49-10.2, p = 0.006), and older donor age (OR: 1.05; 95% CI: 1.00-1.10, p = 0.044). Besides early endothelial coronary dysfunction and older donor age, a new predictor for development of cardiac allograft vasculopathy was identified: cardiogenic shock at the time of transplantation. In these high-risk patient subgroups, preventive measures (treatment of cardiovascular risk factors, use of novel immunosuppressive agents such as mTOR inhibitors) should be earlier and much more aggressive.

  7. HEART RATE-LOWERING THERAPY IN THE TREATMENT OF CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    S. V. Shalaev

    2015-01-01

    Full Text Available Aspects of heart rate-lowering therapy in patients with chronic heart failure using If-channel blocker ivabradine are discussed. The evidence-based data on ivabradine use reveal its advantages, disadvantages and place in the treatment of cardiac patients.

  8. HEART RATE-LOWERING THERAPY IN THE TREATMENT OF CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    S. V. Shalaev

    2015-09-01

    Full Text Available Aspects of heart rate-lowering therapy in patients with chronic heart failure using If-channel blocker ivabradine are discussed. The evidence-based data on ivabradine use reveal its advantages, disadvantages and place in the treatment of cardiac patients.

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

    Directory of Open Access Journals (Sweden)

    Sculpher Mark

    2009-07-01

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

  10. Deteriorated function of cutaneous microcirculation in chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Marie-Louise Edvinsson; Erik Uddman; Sven E Andersson

    2011-01-01

    Background Chronic congestive heart failure is a complex condition that leads to dysfunction in the peripheral microcirculation. We have previously shown that vascular reactivity is reduced with increasing age.In this study,we examined a group of very old patients with severe chronic heart failure to test the hypothesis that vascular function is further compromised by a combination of heart failure and aging.Methods Cutaneous forearm blood flow was measured by laser Doppler flownretry and compared among three groups:Group 1 (n=20,men±SE:85.54 years),heart failure patients with New York Heart Association class Ⅳ(NYHA IV) and with a NT-proBNP level =10,mean±SE:67.6 ± 3.0 years),healthy controls with no clinical signs of heart failure.The vasodilator response to the iontophoretic administration of acetylcholine (ACh),acting via an endothelial mechanism,and sodium nitroprusside (SNP),acting via a smooth muscle cell mechanism,were studied. Results All patients with heart failure had significantly reduced vascular reactivity independent of the mode of stimulation (ACh,SNP or heat) when compared to healthy controls.However,the responses did not differ between the two groups of heart failure patients.Conclusions Cutaneous vascular reactivity is reduced in heart failure patients and does not correlate with the severity of the condition or age of patients.

  11. Components of the complete blood count as risk predictors for coronary heart disease: in-depth review and update.

    Science.gov (United States)

    Madjid, Mohammad; Fatemi, Omid

    2013-01-01

    Atherosclerosis is an inflammatory disease, and several inflammatory biomarkers, such as C-reactive protein, have been used to predict the risk of coronary heart disease. High white blood cell count is a strong and independent predictor of coronary risk in patients of both sexes, with and without coronary heart disease. A high number of white blood cells and their subtypes (for example, neutrophils, monocytes, lymphocytes, and eosinophils) are associated with the presence of coronary heart disease, peripheral arterial disease, and stroke. The coronary heart disease risk ratios associated with a high white blood cell count are comparable to those of other inflammatory markers, including C-reactive protein. In addition, other components of the complete blood count, such as hematocrit and the erythrocyte sedimentation rate, also are associated with coronary heart disease, and the combination of the complete blood count with the white blood cell count can improve our ability to predict coronary heart disease risk. These tests are inexpensive, widely available, and easy to order and interpret. They merit further research.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  13. Dietary catechins in relation to coronary heart disease death among postmenopausal women

    NARCIS (Netherlands)

    Arts, I.C.W.; Jacobs, D.R.; Harnack, L.J.; Gross, M.; Folsom, A.R.

    2001-01-01

    Catechins, one of the major groups of flavonoids, are bioactive compounds present in a variety of plant foods and beverages. Experimental data suggest that they might prevent chronic diseases in humans. We studied whether the intake of catechins was inversely associated with the risk of coronary hea

  14. Particulate air pollution, coronary heart disease and individual risk assessment: a general overview

    NARCIS (Netherlands)

    C. Hassing; M. Twickler; B. Brunekreef; F. Cassee; P. Doevendans; J. Kastelein; M.J. Cramer

    2009-01-01

    Both long-term and short-term exposure to air pollution is associated with a marked increase in cardiovascular morbidity and mortality because of the coronary syndrome and its complications. The exact molecular mechanism that is responsible for these acute and chronic effects is not elucidated yet.

  15. Correlation among obstructive sleep apnea syndrome, coronary atherosclerosis and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    LU Gan; XU Zhuo-wen; ZHANG Yu-lin; YANG Zhi-jian; ZHANG Xi-long; YIN Kai-sheng

    2007-01-01

    @@ Epidemiologic investigations have shown that the morbidity of obstructive sleep apnea syndrome (OSAS) among adults is 2%-4%, among the population aged 30 years and over is 4.63%, and among patients with hypertension or coronary atherosclerostic disease (CAD) is as high as 30%-50%.

  16. Anemia associated with chronic heart failure: current concepts

    Directory of Open Access Journals (Sweden)

    Shah R

    2013-02-01

    Full Text Available Ravish Shah, Anil K AgarwalDivision of Nephrology, The Ohio State University, Columbus, Ohio, USAAbstract: Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies.Keywords: anemia, heart failure, chronic kidney disease, elderly population

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

    Directory of Open Access Journals (Sweden)

    Paul Walters

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

  18. CYP11B2 gene polymorphism among coronary heart disease patients and blood donors in Malaysia.

    Science.gov (United States)

    Normaznah, Y; Azizah, M R; Kuak, S H; Rosli, M A

    2015-04-01

    Various previous studies have reported the implication of CYP11B2 gene polymorphism in the pathophysiology of cardiovascular diseases. In particular, the -344T/C polymorphism, which is located at a putative binding site for the steroidogenic transcription factor (SF-1) has been associated with essential hypertension, left ventricular dilation and coronary heart disease. In the present study, we aim to determine the allele and genotype frequencies of the CYP11B2 gene in patients with clinical manifestation of coronary heart disease and confirmed by angiography and blood donors and to calculate the association of the gene polymorphism with CHD. A total of 79 DNA from patients with coronary heart disease admitted to the National Heart Institute and 84 healthy blood donors have been genotyped using polymerase chain reaction technique followed by restriction enzyme digestion (RFLP). Results of the study demonstrated that out of 79 for the patients, 40 were homozygous T, 10 were homozygous C and 29 were heterozygous TC. The frequencies of genotype TT, CC and TC for patients were 0.5, 0.13 and 0.36 respectively. The frequencies of allele T and C in patients were 0.68 and 0.31 respectively. While for the blood donors, 40 subjects were of homozygous T, 7 were homozygous C and 37 were heterozygous TC. The genotype frequencies for the TT, CC and TC were 0.47, 0.08 and 0.44 respectively. The frequency of the allele T was 0.69 and allele C was 0.3. Chi-Square analysis showed that there was no significant difference in the genotype and C allele frequencies between the CHD patients and the blood donors. Our study suggests that there is lack of association between -344T/C polymorphism of CYP11B2 gene and coronary heart disease.

  19. Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study

    Directory of Open Access Journals (Sweden)

    Almagro P

    2015-07-01

    Full Text Available Pere Almagro,1 Anna Lapuente,2 Julia Pareja,1 Sergi Yun,1 Maria Estela Garcia,3 Ferrán Padilla,4 Josep Ll Heredia,2 Alex De la Sierra,1 Joan B Soriano5 1Department of Internal Medicine, 2Pneumology Service, Mutua de Terrassa University Hospital, Terrassa, Spain; 3Medical Department, Menarini Pharmaceutical, Barcelona, Spain; 4Cardiology Service, Mutua de Terrassa University Hospital, Terrassa, Spain; 5Instituto de Investigación Sanitaria Princesa (IP, Universidad Autónoma de Madrid, Madrid, Spain Background: Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD and chronic obstructive pulmonary disease (COPD following percutaneous coronary intervention (PCI. The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD – previously or newly diagnosed – in patients with IHD treated with PCI.Methods: Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed.Results: A total of 133 patients (78% male, with a mean (SD age of 63 (10.12 years were included. Of these, 33 (24.8% met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%–75%]: 546–1,160. COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76–44.47 and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04–3.33, even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12–2.83. These differences remained after adjustment for sex, age, number of coronary vessels affected

  20. Genetics and genomics of cholesterol and polyunsaturated fatty acid metabolism in relation to coronary heart disease risk

    NARCIS (Netherlands)

    Lu Yingchang (Kevin), Y.

    2011-01-01

    Background Coronary heart disease (CHD) continues to be a leading cause of morbidity and mortality among adults worldwide. Deregulated lipid metabolism (dyslipidemia) that manifests as hypercholesterolemia, hypertriglyceridemia, low high-density-lipoprotein (HDL) chol

  1. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies

    DEFF Research Database (Denmark)

    Jakobsen, Marianne U; O'Reilly, Eilis J; Heitmann, Berit

    2009-01-01

    BACKGROUND: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance. OBJECTIVE: We...

  2. Comparison of conventional risk factors, clinical and angiographic profile between younger and older coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Gajanan D. Khadkikar

    2016-02-01

    Conclusions: Young patients with Coronary heart disease had different risk profile and less extensive coronary artery disease as compared to older counterparts. Emphasis should be given on diagnosis and management of major modifiable risk factors. [Int J Res Med Sci 2016; 4(2.000: 567-570

  3. Brief report: Coronary Heart Disease: an Unknown Association to Pathological Gambling

    Directory of Open Access Journals (Sweden)

    Candice eGermain

    2011-03-01

    Full Text Available Pathological gamblers, because of their high level of stress, depression and alcohol or nicotine consumption may be overexposed to coronary heart disease (CHD. To test this association, we assessed pathological gambling (DSM-IV-TR criteria and SOGS scale among 73 patients hospitalized in cardiology for CHD and 61 in-patients from the same department hospitalized for a non coronary disorder. We found six cases of PG (8.2% and one case of problem gambling in the CHD group versus no case in the non-coronary group (p=0.01. Pathological gambling was not associated to a higher level of alcohol or nicotine consumption neither to a higher level of sensation-seeking.

  4. Association of coronary heart disease with age-adjusted aortocoronary calcification in patients with familial hypercholesterolaemia

    DEFF Research Database (Denmark)

    Jensen, J M; Gerdes, Lars Ulrik; Jensen, H K;

    2000-01-01

    OBJECTIVES: Existing algorithms of risk of coronary heart disease (CHD) do not pertain to patients with familial hypercholesterolaemia (FH), whose arteries have been exposed to hypercholesterolaemia since birth. We studied a cohort of FH patients to compare four diagnostic models of CHD......: traditional risk factors of CHD (age, sex, cholesterol, hypertension, smoking and body mass index), cholesterol year score, and aortic as well as coronary calcium measured by spiral computed tomography (CT). SUBJECTS: We invited 88 individuals with molecularly defined FH of whom 80 (91%) decided...... to participate. RESULTS: Analysis of receiver operating characteristic curves showed that the age-adjusted coronary calcium score was more strongly associated with clinical manifestations of CHD than were traditional risk factors (P

  5. Beta-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Shilane, David; Go, Alan S

    2014-01-01

    BACKGROUND: The effectiveness of beta-blockers for preventing cardiac events has been questioned for patients who have coronary heart disease (CHD) without a prior myocardial infarction (MI). OBJECTIVES: The purpose of this study was to assess the association of beta-blockers with outcomes among...... patients with new-onset CHD. METHODS: We studied consecutive patients discharged after the first CHD event (acute coronary syndrome or coronary revascularization) between 2000 and 2008 in an integrated healthcare delivery system who did not use beta-blockers in the year before entry. We used time......-varying Cox regression models to determine the hazard ratio (HR) associated with beta-blocker treatment and used treatment-by-covariate interaction tests (pint) to determine whether the association differed for patients with or without a recent MI. RESULTS: A total of 26,793 patients were included, 19...

  6. Need to combine individual strategies with population-level strategies in the prevention of coronary heart disease

    DEFF Research Database (Denmark)

    Vinther, Johan Lerbech; Jørgensen, Torben; Borglykke, Anders

    2013-01-01

    The aim of this paper was to examine the relation between the distribution of risk, the distribution of coronary heart disease (CHD) events and the proportion who develop CHD according to risk.......The aim of this paper was to examine the relation between the distribution of risk, the distribution of coronary heart disease (CHD) events and the proportion who develop CHD according to risk....

  7. The changes of serum BDNF, blood lipid and PCI in the elderly patients with coronary heart disease complicated with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Chun-Xia He; Jing-Jing Yang; Mei-Jin Yuan; Xiao-Juan Ding

    2016-01-01

    Objective:To compare the clinic from coronary heart disease complicated with diabetes mellitus patients serum BDNF changes, blood tests and PCI, for the clinical treatment of coronary heart disease in patients with diabetes mellitus provide certain reference and ideas.Methods: In outpatient of our hospital of elderly patients with coronary heart disease in patients with diabetes mellitus complicated with 126 cases into coronary heart disease combined with diabetes mellitus group, CHD patients admitted in the same period of 125 cases into coronary heart disease group and healthy subjects during the same period in 120 cases into the healthy control group, 61 males, 59 females, aged 58 to 79 years old, mean age (64.36± 2.20) to exclude coronary heart disease, diabetes and liver and other diseases. All patients according to Gensini integration system and coronary artery vascular image segmentation evaluation criteria for each of the degree of vascular stenosis were evaluated. Total cholesterol (TC), glycerin three fat (TG), low density protein (LDL-C), high density protein (HDL-C), apolipoprotein A1 (APOA-1) and apolipoprotein B (APOB) and other indicators were detected. The number of stents, mean diameter and length of stent in patients with coronary heart disease combined with diabetes mellitus and coronary heart disease group were compared. Results: Coronary heart disease with diabetes mellitus group Gensini score and serum BDNF concentrations were higher in CHD group and control group, CHD group Gensini score and serum BDNF concentrations were significantly higher than the control group, the differences were statistically significant; coronary heart disease and coronary heart disease group and blood fat group in TC, TG, LDL-C, diabetes, APO-B levels were significantly higher than that of control group HDL-C and APOA-1 were significantly lower than control group, coronary heart disease and diabetes group in TC, TG, LDL-C, blood lipid and APO-B level were

  8. Extra-aortic implantable counterpulsation pump in chronic heart failure.

    Science.gov (United States)

    Mitnovetski, Sergei; Almeida, Aubrey A; Barr, Althea; Peters, William S; Milsom, F Paget; Ho, Betty; Smith, Julian A

    2008-06-01

    Extra-aortic counterpulsation for the management of chronic heart failure is a novel approach. We report the use of an extra-aortic implantable counterpulsation pump in the management of a 73-year-old patient with severe heart failure refractory to medical therapy. The implantable counterpulsation pump prolonged his life and greatly improved its quality. The patient lived almost 7 months after the implantation of the device and died of septic complications secondary to gas line infection.

  9. Impaired mitochondrial function in chronically ischemic human heart

    DEFF Research Database (Denmark)

    Stride, Nis Ottesen; Larsen, Steen; Hey-Mogensen, Martin;

    2013-01-01

    , and finally to assess myocardial antioxidant levels. Mitochondrial respiration in biopsies from ischemic and nonischemic regions from the left ventricle of the same heart was compared in nine human subjects. Maximal oxidative phosphorylation capacity in fresh muscle fibers was lower in ischemic compared.......05), and the levels of antioxidant protein expression was lower. Diminished mitochondrial respiration capacity and excessive ROS production demonstrate an impaired mitochondrial function in ischemic human heart muscle. No chronic ischemic preconditioning effect was found....

  10. [Off-pump coronary artery bypass grafting for unstable angina pectoris combined with hypothyroidism and chronic renal failure; report of a case].

    Science.gov (United States)

    Hirano, Y; Matsumoto, Y; Endoh, M; Kasashima, F; Abe, Y; Sasaki, H

    2002-08-01

    Coronary artery bypass grafting for patients with ischemic heart disease and hypothyroidism contains many controversies, and chronic renal failure causes perioperative water-electrolyte balance disorders. We experienced a case of unstable angina pectoris combined with hypothyroidism and chronic renal failure successfully treated by off-pump coronary artery bypass grafting (OPCAB). A 68-year-old man with a history of hypothyroidism and chronic renal failure was hospitalized with chest pain. Cardiac catheterisation revealed a 90% stenosis of segment 3, 11 and right ventricular (RV) branch, 75% stenosis of segment 6 and 50% stenosis of segment 5. His thyroid function was normal with orally administered levothyroxine. OPCAB was performed safely with hemodialysis until a day before operation and hemofiltration from a day after operation, and postoperative course was uneventful.

  11. The role of Homocysteine as a predictor for coronary heart disease

    Directory of Open Access Journals (Sweden)

    Schramm, Susanne

    2007-11-01

    Full Text Available Background and objective: There is an ongoing debate on the role of the cytotoxic aminoacid homocysteine as a causal risk factor for the development of coronary heart disease. Results from multiple case control-studies demonstrate, that there is a strong association between high plasma levels of homoysteine and prevalent coronary heart disease, independent of other classic risk factors. Furthermore, results from interventional studies point out that elevated plasma levels of homocysteine may effectively be lowered by the intake of folic acid and B vitamins. In order to use this information for the construction of a new preventive strategy against coronary heart disease, more information is needed: first, whether homocysteine actually is a causal risk factor with relevant predictive properties and, second, whether by lowering elevated homocysteine plasma concentrations cardiac morbidity can be reduced. Currently in Germany the determination of homocysteine plasma levels is reimbursed for by statutory health insurance in patients with manifest coronary heart disease and in patients at high risk for coronary heart disease but not for screening purposes in asymptomatic low risk populations.Against this background the following assessment sets out to answer four questions: 1. Is an elevated homocysteine plasma concentration a strong, consistent and independent (of other classic risk factors predictor for coronary heart disease? 2. Does a therapeutic lowering of elevated homoysteine plasma levels reduce the risk of developing coronary events? 3. What is the cost-effectiveness relationship of homocysteine testing for preventive purposes? 4. Are there morally, socially or legally relevant aspects that should be considered when implementing a preventive strategy as outlined above? Methods: In order to answer the first question, a systematic overview of prospective studies and metaanalyses of prospective studies is undertaken. Studies are included that

  12. Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease: a meta-analysis.

    Science.gov (United States)

    Tully, Phillip J; Cosh, Suzanne M

    2013-12-01

    Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease patients remain unquantified. Systematic searching of Medline, Embase, SCOPUS and PsycINFO databases revealed 1025 unique citations. Aggregate generalized anxiety disorder prevalence (12 studies, N = 3485) was 10.94 per cent (95% confidence interval: 7.8-13.99) and 13.52 per cent (95% confidence interval: 8.39-18.66) employing Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria (random effects). Lifetime generalized anxiety disorder prevalence was 25.80 per cent (95% confidence interval: 20.84-30.77). In seven studies, modest correlation was evident between generalized anxiety disorder and depression, Fisher's Z = .30 (95% confidence interval: .19-.42), suggesting that each psychiatric disorder is best conceptualized as contributing unique variance to coronary heart disease prognosis.

  13. Perceived job insecurity as a risk factor for incident coronary heart disease

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Nyberg, Solja T; Batty, George David

    2013-01-01

    OBJECTIVE: To determine the association between self reported job insecurity and incident coronary heart disease. DESIGN: A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. DATA SOURCES: We obtained individual...... level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches....... REVIEW METHODS: Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models...

  14. Alkaline phosphatase levels in patients with coronary heart disease saliva and its relation with periodontal status

    Science.gov (United States)

    Yunita, Dina Suci; Masulili, Sri Lelyati C.; Tadjoedin, Fatimah M.; Radi, Basuni

    2017-02-01

    Coronary heart disease (CHD) is a disease that causes narrowing of the coronary arteries. Currently, there is a hypothesis regarding periodontal infection that increases risk for heart disease. Alkaline phosphatase (ALP) as a marker of inflammation will increase in atherosclerosis and periodontal disease. The objective of this research is analyzing the relationship between the levels of alkaline phosphatase in saliva with periodontal status in patients with CHD and non CHD. Here, saliva of 104 subjects were taken, each 1 ml, and levels of Alkaline Phosphatase was analyzed using Abbott ci4100 architect. We found that no significant difference of Alkaline Phosphatase levels in saliva between CHD patients and non CHD. Therefore, it can be concluded that Alkaline Phosphatase levels in patients with CHD saliva was higher than non CHD and no association between ALP levels with periodontal status.

  15. Effects of N-3 Fatty Acids on the Coronary Heart Disease Patients

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    To evaluate the effects of n-3 fatty acids on the coronary heart disease patients. Methods From September 2007 to March 2008, 60 patients with coronary heart disease were randomly assigned to n-3 fatty acids group (group N) and control group (group C). Both groups received standard coronary artery disease secondary prevention treatment and group N also received eicosapentaenoic acid (EPA) 1.8 g plus docosahexaenoic acid (DHA) 1.2 g per day for 12 weeks. Plasma triacylglycerols, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and blood pressure were measured before and after the study. Results Plasma triacylglycerols, blood pressure and LDL-C level were lower in group N after n-3 fatty acids treatment while no change was found in group C ( P< 0. 05). HDL-C level slightly increased and total cholesterol level slightly decreased after n-3 fatty acids but both change were not significant ( P > 0. 05 ). Conclusions N-3 fatty acids have beneficial effects on the coronary artery disease patients.

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

    Directory of Open Access Journals (Sweden)

    Jyoti Mohitey

    2012-07-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  18. Diagnostic accuracy of dual-source CT coronary angiography in a population unselected for degree of coronary artery calcification and without heart rate modification

    Energy Technology Data Exchange (ETDEWEB)

    Lin, C.-J., E-mail: bcjlin@gmail.co [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Yang-Ming University School of Medicine, Taipei, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Hsu, J.-C. [National Yang-Ming University School of Medicine, Taipei, Taiwan (China); Division of Cardiovascular Medicine, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Lai, Y.-J. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Yang-Ming University School of Medicine, Taipei, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Wang, K.-L. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); Department of Radiological Technology, Yuanpei University, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Lee, J.-Y. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Li, A.-H. [Division of Cardiovascular Medicine, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Chu, S.-H. [Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China)

    2010-02-15

    Aim: To assess the ability of coronary angiography performed using dual-source computed tomography (DSCT) to evaluate coronary artery disease (CAD) in a population with unselected heart rates and extensive coronary calcification. Materials and methods: Forty-four patients at intermediate to high risk for CAD underwent both DSCT coronary angiography and invasive coronary angiography (ICA) within 30 days. No beta blockers were administered prior to imaging. Image quality and quantitatively stenosis of all coronary segments with a diameter >=1.5 mm were accessed. Patients were stratified according to mean heart rate (<70 versus >=70 bpm) and heart rate variability (<10 versus >=10 bpm). DSCT detection of coronary stenosis by segment, vessel, and patient characteristics were compared to the reference standard of ICA. Results: Diagnostic accuracy for all patients was high regarding sensitivity (97%), positive predictive value (PPV, 84.2%), and negative predictive value (NPV, 83.3%) but low regarding specificity (45.5%) with a moderate interobserver agreement (Kappa = 0.50). The accuracy for vessel-based diagnosis was high regarding sensitivity (96.6%), specificity (80.8%), PPV (80.3%), and NPV (96.7%). The segment-based diagnostic results revealed a moderate interobserver agreement for image quality and sensitivity, specificity, PPV and NPV for all segments of 66.9, 97.8, 90.8, and 89.9%, respectively. Conclusion: DSCT coronary angiography has high diagnostic accuracy in assessing CAD among patients at intermediate to high risk without using heart rate-modulating premedication. DSCT is not superior to ICA for diagnosis of calcified segments.

  19. Identification of a shared genetic susceptibility locus for coronary heart disease and periodontitis.

    Directory of Open Access Journals (Sweden)

    Arne S Schaefer

    2009-02-01

    Full Text Available Recent studies indicate a mutual epidemiological relationship between coronary heart disease (CHD and periodontitis. Both diseases are associated with similar risk factors and are characterized by a chronic inflammatory process. In a candidate-gene association study, we identify an association of a genetic susceptibility locus shared by both diseases. We confirm the known association of two neighboring linkage disequilibrium regions on human chromosome 9p21.3 with CHD and show the additional strong association of these loci with the risk of aggressive periodontitis. For the lead SNP of the main associated linkage disequilibrium region, rs1333048, the odds ratio of the autosomal-recessive mode of inheritance is 1.99 (95% confidence interval 1.33-2.94; P = 6.9 x 10(-4 for generalized aggressive periodontitis, and 1.72 (1.06-2.76; P = 2.6 x 10(-2 for localized aggressive periodontitis. The two associated linkage disequilibrium regions map to the sequence of the large antisense noncoding RNA ANRIL, which partly overlaps regulatory and coding sequences of CDKN2A/CDKN2B. A closely located diabetes-associated variant was independent of the CHD and periodontitis risk haplotypes. Our study demonstrates that CHD and periodontitis are genetically related by at least one susceptibility locus, which is possibly involved in ANRIL activity and independent of diabetes associated risk variants within this region. Elucidation of the interplay of ANRIL transcript variants and their involvement in increased susceptibility to the interactive diseases CHD and periodontitis promises new insight into the underlying shared pathogenic mechanisms of these complex common diseases.

  20. Correlation between blood lipids and serum uric acid in the elderly patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Jie; Geng; Bin; Yu; Shu; Tao; Chen; Qing; Liang; Chen; Hong; Liang; Cong; Bo; Li; Lin; Wang

    2014-01-01

    Objective:To explore the relationship between blood lipids and serum uric acid(UA)in the elderly patients with coronary heart disease(CHD).Method:Quartered patients according to their uric acid level.Systematic review and compare lipid level among this four groups.Polynary logistic stepwise regression analysis were employed to analyze independent risk factor of coronary heart disease.Results:Serum level of triglycerides(TAG)and very low density lipoprotein cholesterol(VLDL-C)increase significantly(F=7.42,p<0.01;F=5.42,p<0.01 respectively)while high density lipoprotein cholesterol(HDL-C)and Apolipoprotein A1(Apo A1)decrease(F=5.03,p<0.01;F=7.03,p<0.01)upon elevated serum uric acid level among coronary heart disease patients.Gender(OR=0.16,95%CI 0.078~0.315,p=0.001),Ccr(OR=0.95,CI=0.935~0.969,p=0.001),associated hypertension(OR=2.23,CI=1.156~4.285,p=0.017)or DM(OR=2.44,CI=1.154~5.168,p=0.02),TC(OR=1.56,CI=1.119~2.186,p=0.009),HDL-C(OR=0.02,CI=0.004~0.076,p=0.001),UA(OR=1.09,1.086~1.094,p=0.001)are all independent risk factors for coronary heart disease.Conclusion:TAG,VLDL-C were positively related to UA while HDL-C and Apo A1were negatively linked to UA among CHD patients.Gender,Ccr,Hypertension,DM,TC,HDL-C and UA are independent risk factors for CHD while BMI,TAG,LDL-C were not.

  1. Aldosterone does not predict cardiovascular events following acute coronary syndrome in patients initially without heart failure

    OpenAIRE

    Pitts, Reynaria; Gunzburger, Elise; Ballantyne, Christie M.; Barter, Philip J.; Kallend, David; Leiter, Lawrence A.; Leitersdorf, Eran; Nicholls, Stephen J.; Prediman K Shah; Tardif, Jean-Claude; Olsson, Anders G.; McMurray, John J.V.; Kittelson, John; Schwartz, Gregory G.

    2017-01-01

    Background: Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk.\\ud \\ud Methods and Results: To address this question, we exa...

  2. Individuals at Risk of Coronary Heart Disease (CHD), its Prevention and Management by an Indigenous Compound

    OpenAIRE

    Dubey, G.P.; Agrawal, Aruna; S. P. Dixit; Pathak, S.R.

    2000-01-01

    A variety of rist factors have been suspected for causing the coronary heart disease. 406 cases of both sex groups with age range of 35 to 55 years were selected from three distinct localities of varanasi city. Individuals who reported single or more risk factors of CHD were isolated from the population of the particular areas. After a detailed preliminary screening of the subjects various physical, physiological, psychological and biochemical measurements were carried out. Other basis of ini...

  3. Effect of caffeine on the risk of coronary heart disease— A re-evaluation

    OpenAIRE

    Adebayo, J. O.; Akinyinka, A. O.; Odewole, G. A.; Okwusidi, J.I.

    2007-01-01

    The effect of caffeine intake on the risk of coronary heart disease was studied. Twenty-one rats used were randomly divided into three experimental groups, the first group served as the control while the second and third groups were administered caffeine orally at doses of 10mg/kg body weight and 20mg/kg body weight respectively for fourteen days. Caffeine, at 10mg/kg body weight, significantly increased (P

  4. Stress resilience and physical fitness in adolescence and risk of coronary heart disease in middle age

    OpenAIRE

    Bergh, Cecilia; Udumyan, Ruzan; Fall, Katja; Almroth, Henrik; Montgomery, Scott

    2015-01-01

    Objective Psychosocial stress is a suggested risk for coronary heart disease (CHD). The relationship of stress resilience in adolescence with subsequent CHD risk is underinvestigated, so our objective was to assess this and investigate the possible mediating role of physical fitness. Methods In this register-based study, 237 980 men born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Stress resilience was measured at a compulsory military consc...

  5. Dietary Glycemic Index, Dietary Glycemic Load, Blood Lipids, and Coronary Heart Disease

    OpenAIRE

    2010-01-01

    Objective. To examine the associations of dietary glycemic index (GI) and dietary glycemic load (GL) with blood lipid concentrations and coronary heart disease (CHD) in nondiabetic participants in the Health Worker Cohort Study (HWCS). Materials and Methods. A cross-sectional analysis was performed, using data from adults who participated in the HWCS baseline assessment. We collected information on participants' socio-demographic conditions, dietary patterns and physical activity via self-adm...

  6. Coronary bifurcations as you have never seen them: the Visible Heart® Laboratory bifurcation programme.

    Science.gov (United States)

    Burzotta, Francesco; Cook, Brian; Iaizzo, Paul A; Singh, Jasvindar; Louvard, Yves; Latib, Azeem

    2015-01-01

    The Visible Heart® Laboratory is an original experimental laboratory in which harvested animal hearts are resuscitated and connected to a support machine in order to beat outside the animal body. Resuscitated animal hearts may be exposed to various types of endovascular intervention under full, multimodality inspection. This unique experimental setting allows the performance of percutaneous coronary intervention (PCI) in a setting which resembles a standard catheterisation laboratory set-up, and contemporaneously allows unique multimodality imaging. For these reasons, the performance of PCI on bifurcations in the Visible Heart® Laboratory may improve the knowledge of the dynamic stent deformations and stent-vessel wall interactions associated with the different steps of the various techniques for bifurcation stenting. Furthermore, the collected images may also serve as a novel educative resource for physicians. The performance of bifurcation stenting in the Visible Heart® Laboratory is a promising experimental setting to gain novel information regarding any existing or future PCI technique to treat coronary bifurcations.

  7. Relationship Between Renin-Angiotensin System Gene Polymorphism and Ischemic Chronic Heart Failure in Aged Coronary Artery Disease Patient%肾素-血管紧张素系统双基因多态性与老年人冠心病慢性心力衰竭的关系

    Institute of Scientific and Technical Information of China (English)

    彭健; 罗礼云; 李铁; 梅啸; 牛云茜; 龚五星

    2011-01-01

    Objective :To investigate the relationship between angiotensin-converting enzyme (ACE)gene insertion/deletion (l/D) and angiotensinogen (AGT) gene M235T polymorphism with the onset of ischemic chronic heart failure (CHF) in aged coronary artery disease (CAD) patients in South China.Methods: A total of 396 consecutive CAD patients with the age of (60 ~ 91 ) years were divided into two groups, CHF group,n = 196 ,and Control group,n = 200 ,the patients had stable angina pectoris and with the left ventricular ejection fraction ≥ 45%.Genotype distributions, ACE gene I/D and AGT gene M235T polymorphisms were analyzed by PCR and restriction fragment length polymorphism (RFLP) methods in both groups.Results:①The frequencies of DD genotype of ACE gene and D allele of ACE gene were higher in CHF group than that in Control group respectively. ②The frequencies of TI genotype and T allele of AGT gene were higher in CHF group than that in Control group. ③In combined genotype analysis,the genotype of DD in ACE + TI in AGT was significantly higher in CHF group than that in Control group (28. 6% vs. 15.0% ).Conclusion: ACE gene I/D polymorphism and AGT gene M235T polymorphisms are related to the onset of ischemic chronic heart failure in aged CAD patients in South China,ACE and AGT gene have an interaction role in the onset of CHF.%目的:探讨中国南方部分汉族人群的老年冠心病患者中,肾素-血管紧张素系统中的关键成分即血管紧张素转换酶(ACE)及血管紧张素原(AGT)双基因多态性与慢性心力衰竭(心衰)发病的关系.方法:应用聚合酶链反应及限制性片断长度多态性技术,对396例老年冠心病患者的ACE基因插入/缺失(I/D)及AGT基因M235T多态性进行检测.将其中196例合并慢性心衰患者作为病例组,其余200例心功能正常者作为对照组.结果:①病例组DD基因型频率及D等位基因频率均高于对照组;②病例组TT基因型频率及T等位基因频率均高

  8. Quantitative determination of fibrinogen of patients with coronary heart diseases through piezoelectric agglutination sensor.

    Science.gov (United States)

    Chen, Qinghai; Hua, Xing; Fu, Weiling; Liu, Dongbo; Chen, Ming; Cai, Guoru

    2010-01-01

    Fibrinogen can transform fibrin through an agglutination reaction, finally forming fibrin polymer with grid structure. The density and viscosity of the reaction system changes drastically during the course of agglutination. In this research, we apply an independently-developed piezoelectric agglutination sensor to detect the fibrinogen agglutination reaction in patients with coronary heart diseases. The terminal judgment method of determining plasma agglutination reaction through piezoelectric agglutination sensor was established. In addition, the standard curve between plasma agglutination time and fibrinogen concentration was established to determinate fibrinogen content quantitatively. The results indicate the close correlation between the STAGO paramagnetic particle method and the method of piezoelectric agglutination sensor for the detection of Fibrinogen. The correlation coefficient was 0.91 (γ = 0.91). The determination can be completed within 10 minutes. The fibrinogen concentration in the coronary heart disease group was significantly higher than that of the healthy control group (P high fibrinogen concentration is closely correlated to the incurrence, development and prognosis of coronary heart diseases. Compared with other traditional methods, the method of piezoelectric agglutination sensor has some merits such as operation convenience, small size, low cost, quick detecting, good precision and the common reacting agents with paramagnetic particle method.

  9. Historical overview of n-3 fatty acids and coronary heart disease.

    Science.gov (United States)

    Leaf, Alexander

    2008-06-01

    The first evidence that fish oil fatty acids might have a beneficial effect on coronary heart disease came from the discovery that Greenland Eskimos, who have a diet high in n-3 fatty acids, have a lower mortality from coronary heart disease than do Danes and Americans. Long-chain polyunsaturated fatty acids are essential in our diets and can be classified in 2 groups: n-6 fatty acids found in plant seeds and n-3 fatty acids found in marine vertebrates. Further evidence of n-3 benefits to human health include a 1989 study demonstrating a 29% reduction in fatal cardiac arrhythmias among subjects with a recent myocardial infarction who had been advised to consume fish oil. The GISSI-Prevenzione Trial found a significant reduction in relative reduction of death, cardiac death, nonfatal myocardial infarction, and stroke in subjects consuming n-3 fatty acids. In a recent study, subjects with implanted cardiac defibrillators (ICDs) at high risk for fatal ventricular arrhythmias were randomly assigned to four 1-g capsules of either an ethyl ester concentrate of n-3 fatty acids or olive oil daily for 12 mo. Subjects receiving n-3 who thus had significantly higher levels of eicosapentaenoic acid and docosahexaenoic acid in their red blood cell membranes showed a longer time to first ICD events and had a significantly lower relative risk of having an ICD event or probable event (P = 0.033). These studies demonstrate that fish oil fatty acids have beneficial effects on coronary heart disease.

  10. Long working hours and risk of coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Jokela, Markus; Nyberg, Solja T;

    2015-01-01

    BACKGROUND: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. METHODS: We......-response association for stroke, with RR estimates of 1·10 (95% CI 0·94-1·28; p=0·24) for 41-48 working hours, 1·27 (1·03-1·56; p=0·03) for 49-54 working hours, and 1·33 (1·11-1·61; p=0·002) for 55 working hours or more per week compared with standard working hours (ptrendwork...... long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours. FUNDING: Medical Research Council...

  11. Quantitative Determination of Fibrinogen of Patients with Coronary Heart Diseases through Piezoelectric Agglutination Sensor

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2010-03-01

    Full Text Available Fibrinogen can transform fibrin through an agglutination reaction, finally forming fibrin polymer with grid structure. The density and viscosity of the reaction system changes drastically during the course of agglutination. In this research, we apply an independently-developed piezoelectric agglutination sensor to detect the fibrinogen agglutination reaction in patients with coronary heart diseases. The terminal judgment method of determining plasma agglutination reaction through piezoelectric agglutination sensor was established. In addition, the standard curve between plasma agglutination time and fibrinogen concentration was established to determinate fibrinogen content quantitatively. The results indicate the close correlation between the STAGO paramagnetic particle method and the method of piezoelectric agglutination sensor for the detection of Fibrinogen. The correlation coefficient was 0.91 (γ = 0.91. The determination can be completed within 10 minutes. The fibrinogen concentration in the coronary heart disease group was significantly higher than that of the healthy control group (P < 0.05. The results reveal that high fibrinogen concentration is closely correlated to the incurrence, development and prognosis of coronary heart diseases. Compared with other traditional methods, the method of piezoelectric agglutination sensor has some merits such as operation convenience, small size, low cost, quick detecting, good precision and the common reacting agents with paramagnetic particle method.

  12. [Risk factor management of coronary heart disease : what is evidence-based?].

    Science.gov (United States)

    Winzer, E B; Schuler, G C

    2014-06-01

    In patients with coronary heart disease the further course of the disease can be substantially influenced by means of a targeted treatment of risk factors. A reduction of hospital referrals, an improvement in quality of life and an extension in life expectation by secondary prophylactic measures have been well documented. In addition to an optimized medicinal therapy, an often drastic change in lifestyle with a focus on a consistent abstinence from nicotine, a healthy diet and regular physical exercise is necessary. Data from healthcare research show that these targets are only insufficiently achieved. The implementation of current guidelines should therefore be rigorously applied. There is a need for research particularly with respect to the prognostic significance of beta blocker therapy for patients with stable coronary heart disease and preserved left ventricular function, the prognostic significance of targeted weight loss for overweight or obese coronary heart disease patients, the effectiveness of psychosocial interventions in the various patient groups and their implementation into routine care. Research is also necessary with respect to optimization of structured rehabilitation programs and improvement in patient compliance.

  13. Effect of Shengmai Injection on Vascular Endothelial and Heart Functions in Patients with Coronary Heart Disease Complicated with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ya-chen; LU Bao-jing; ZHAO Mei-hua; RONG Ye-zhi; CHEN Rui-ming

    2008-01-01

    Objective: To study the effect of Shengrnai injection (生脉注射液, SMI) on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus (CHD-DM). Methods: One hundred and twenty patients with CHD-DM, their diagnosis confirmed by coronary arteriography, were equally randomized into a control group treated with conventional treatment and a treated group treated with conventional treatment plus SMI. The changes in blood levels of nitric oxide (NO), endothelin-1 (ET-1) and angiotensin Ⅱ (Ang Ⅱ ), as well as endothelium-dependent vascular dilating function and heart function in the patients were observed before treatment and after the 3-week treatment. Results: After being treated with SMI for 3 weeks, in the treated group, blood level of NO was raised significantly from 69.8 ± 33.1 μ mol/L to 120.1 ± 50.8 μ mol/L, and ET-1 was lowered from 70.1 ± 32.1 ng/L to 46.2±21.3 ng/L, respectively (P<0.01); that of Ang Ⅱ was lowered from 81.3 ± 24.3 ng/L to 50.2 ± 27.3 ng/L (P<0.01); brachial arterial post-congestion blood flow increasing rate was raised from 389.4 ± 26.3% to 459.3 ± 27.8% (P<0.01); and the improvement in heart function as seen through the ejection fraction (EF) was increased from 44 ± 5% to 68 ± 6% (P<0.01), all the changes being more significant than those in the control group (all P<0.01). Conclusion: SMI can improve not only the endothelial function in CHD-DM patients, but also heart contraction significantly.

  14. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation.

    Science.gov (United States)

    Paulus, Walter J; Tschöpe, Carsten

    2013-07-23

    Over the past decade, myocardial structure, cardiomyocyte function, and intramyocardial signaling were shown to be specifically altered in heart failure with preserved ejection fraction (HFPEF). A new paradigm for HFPEF development is therefore proposed, which identifies a systemic proinflammatory state induced by comorbidities as the cause of myocardial structural and functional alterations. The new paradigm presumes the following sequence of events in HFPEF: 1) a high prevalence of comorbidities such as overweight/obesity, diabetes mellitus, chronic obstructive pulmonary disease, and salt-sensitive hypertension induce a systemic proinflammatory state; 2) a systemic proinflammatory state causes coronary microvascular endothelial inflammation; 3) coronary microvascular endothelial inflammation reduces nitric oxide bioavailability, cyclic guanosine monophosphate content, and protein kinase G (PKG) activity in adjacent cardiomyocytes; 4) low PKG activity favors hypertrophy development and increases resting tension because of hypophosphorylation of titin; and 5) both stiff cardiomyocytes and interstitial fibrosis contribute to high diastolic left ventricular (LV) stiffness and heart failure development. The new HFPEF paradigm shifts emphasis from LV afterload excess to coronary microvascular inflammation. This shift is supported by a favorable Laplace relationship in concentric LV hypertrophy and by all cardiac chambers showing similar remodeling and dysfunction. Myocardial remodeling in HFPEF differs from heart failure with reduced ejection fraction, in which remodeling is driven by loss of cardiomyocytes. The new HFPEF paradigm proposes comorbidities, plasma markers of inflammation, or vascular hyperemic responses to be included in diagnostic algorithms and aims at restoring myocardial PKG activity.

  15. ST Elevation Infarction after Heart Transplantation Induced by Coronary Spasms and Mural Thrombus Detected by Optical Coherence Tomography

    DEFF Research Database (Denmark)

    Clemmensen, Tor Skibsted; Holm, Niels Ramsing; Eiskjær, Hans

    2016-01-01

    The case illustrates the possible link between coronary spasms, intraluminal thrombus formation, and widespread organized and layered thrombi in HTx patients. Furthermore, the case underlines the clinical value of OCT as a novel method for high-resolution vessel imaging in heart-transplanted (HTx...... due to acute myocardial infarction induced by severe coronary spasms. The patients remained unstable on conservative therapy. Therefore, an optical coherence tomography (OCT) was performed and revealed massive, organized thrombi in the left main coronary artery, the circumflex coronary artery...

  16. [Using the Tabu-search-algorithm-based Bayesian network to analyze the risk factors of coronary heart diseases].

    Science.gov (United States)

    Wei, Z; Zhang, X L; Rao, H X; Wang, H F; Wang, X; Qiu, L X

    2016-06-01

    Under the available data gathered from a coronary study questionnaires with 10 792 cases, this article constructs a Bayesian network model based on the tabu search algorithm and calculates the conditional probability of each node, using the Maximum-likelihood. Pros and cons of the Bayesian network model are evaluated to compare against the logistic regression model in the analysis of coronary factors. Applicability of this network model in clinical study is also investigated. Results show that Bayesian network model can reveal the complex correlations among influencing factors on the coronary and the relationship with coronary heart diseases. Bayesian network model seems promising and more practical than the logistic regression model in analyzing the influencing factors of coronary heart disease.

  17. Coronary artery problems and disease in adults with congenital heart disease: how to evaluate, how to prevent, how to treat.

    Science.gov (United States)

    Cataldo, S; Stuart, A G

    2014-10-01

    There are a wide variety of coronary artery anomalies and disease in adults with congenital heart disease (CHD). In fact, the increasing burden of acquired coronary artery disease (CAD) has to be considered in addition to congenital abnormalities of the coronary arteries, isolated or associated to other congenital diseases. This is largely a consequence of the increasing number of patients reaching older age. Due to complex underlying cardiac anatomy, previous surgery and comorbidities, treatment can be challenging. Individualized and multidisciplinary management involving congenital heart cardiologists, cardiac surgeons, coronary interventionists and imaging specialists is essential. This review gives an overview of coronary artery involvement in adults with CHD, summarizes the current literature and focuses on prevention, diagnosis and treatment. The potential role of cardiovascular risk factors for CAD is also discussed.

  18. Short-term effects of ivabradine in patients with chronic stable ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Hosam Zaky

    2013-01-01

    Full Text Available Introduction: Ivabradine is a novel selective If current inhibitor with anti-ischemic and antianginal activity. Objectives: To assess the effect of the selective If current inhibitor ivabradine on heart rate, angina pectoris, and functional capacity in stable patients with chronic coronary artery disease on maximally tolerated medical therapy. Materials and Methods: Consecutive patients from the out-patient cardiology clinic with stable coronary artery disease documented by coronary angiography were included. Patients had to be on maximally tolerated medical therapy with β-blockers, angiotensin-converting enzyme inhibitors or receptor blockers (ACE-I or ARB, antiplatelets, statins, nitrates, and anti-metabolics with a baseline heart rate of at least 70 beats per minute. All patients underwent assessment of angina (Canadian Cardiovascular Society Angina Class: CCS I to IV and functional capacity (using a validated self-administered questionnaire, at baseline and after 4 months of ivabradine therapy. Results: Twenty patients were enrolled (mean age 47 ± 7 years, all male, 60% with hypertension, 30% with diabetes mellitus. Patients were on optimal medical regimen of aspirin (100%, β-blocker (100%, statins (100%, clopidogrel (90%, nitrates (35%, anti-metabolics (90%, and ACE-I or ARB (95%. At baseline, the majority of patients (90% were in CCS class II-IV. All patients were started on ivabradine 5 mg twice daily, and in 12 patients the dose was increased to 7.5 mg twice daily. After 4 months of treatment, the heart rate was significantly reduced from an average of 82 ± 8 to 68 ± 6 bpm ( P < 0.001. The reduction in heart rate was accompanied by a significant improvement in functional capacity (score 3.5 ± 0.9 to 4.7 ± 0.7, P < 0.001 and angina classification; at baseline 10% of the patients were in CCS class I compared to 50% after 4 months of therapy ( P = 0.01. No symptomatic bradycardia was reported with ivabradine. Conclusion: The addition

  19. Image Quality of Coronary Computed Tomography Angiography with 320-Row Area Detector Computed Tomography in Children with Congenital Heart Disease.

    Science.gov (United States)

    Tada, Akihiro; Sato, Shuhei; Kanie, Yuichiro; Tanaka, Takashi; Inai, Ryota; Akagi, Noriaki; Morimitsu, Yusuke; Kanazawa, Susumu

    2016-03-01

    The objective of this study was to assess factors affecting image quality of 320-row computed tomography angiography (CTA) of coronary arteries in children with congenital heart disease (CHD). We retrospectively reviewed 28 children up to 3 years of age with CHD who underwent prospective electrocardiography (ECG)-gated 320-row CTA with iterative reconstruction. We assessed image quality of proximal coronary artery segments using a five-point scale. Age, body weight, average heart rate, and heart rate variability were recorded and compared between two groups: patients with good diagnostic image quality in all four coronary artery segments and patients with at least one coronary artery segment with nondiagnostic image quality. Altogether, 96 of 112 segments (85.7 %) had diagnostic-quality images. Patients with nondiagnostic segments were significantly younger (10.0 ± 11.6 months) and had lower body weight (5.9 ± 2.9 kg) (each p heart rate and heart rate variability between the two imaging groups were not significant. Receiver operating characteristic analyses for predicting patients with nondiagnostic image quality revealed an optimal body weight cutoff of ≤5.6 kg and an optimal age cutoff of ≤12.5 months. Prospective ECG-gated 320-row CTA with iterative reconstruction provided feasible image quality of coronary arteries in children with CHD. Younger age and lower body weight were factors that led to poorer image quality of coronary arteries.

  20. SERUM YKL-40 LEVELS IN CHRONIC HEART FAILURE.

    Directory of Open Access Journals (Sweden)

    Maria Kazakova

    2014-06-01

    Full Text Available Inflammatory processes are involved in the pathogenesis and development of chronic heart disease. The promising novel inflammatory biomarker YKL-40 is related to the degree of inflammation and pathological tissue remodeling. The aim of this study was to determine serum YKL-40 levels in patients with chronic heart failure and to evaluate the potential relationship with ultrasonography findings. Forty-three individuals were enrolled in the study – 24 patients (10 females and 14 males with chronic heart failure, aged 70±11 (mean ± standard deviation and 16 healthy people as age-matched controls (above 50 years. The serum YKL-40 levels were assessed by ELISA. Sonographic measurements such as two-dimensional, Power wave, Continuous Wave, Colour mode and M-Mode were performed using a diagnostic ultrasound system (PHILIPS Ultrasound, Washington, US with a L11-3 probe of 3-11 MHz. The six minute walk test was used to assess functional capability of patients. Our study revealed significantly higher serum YKL-40 levels in patients compared to the control group (P=0.010. No relation was found between the glycoprotein and the results from the ultrasonographic and functional examination. We suppose that increased serum YKL-40 levels in patients with chronic heart failure might reflect the inflammatory route in the development of the disease.

  1. TREATMENT OF CHRONIC HEART FAILURE: FOCUS ON METOPROLOL SUCCINATE

    Directory of Open Access Journals (Sweden)

    O. D. Ostroumova

    2015-12-01

    Full Text Available Advantages of metoprolol succinate in patients with chronic heart failure (CHF are covered. Results of MERIT-HF study are taken as the main evidences. Patterns of the metoprolol succinate use in the treatment of different categories of patients with CHF (women, the elderly , severe CHF forms, CHF with concomitant hypertension or diabetes are considered.

  2. High prevalence of microalbuminuria in chronic heart failure patients

    NARCIS (Netherlands)

    Van De Wal, RMA; Asselbergs, FW; Plokker, HWT; Smilde, TDJ; Lok, D; Van Veldhuisen, DJ; Van Gilst, WH; Voors, AA

    2005-01-01

    Background: Microalbuminuria is associated with increased risk for cardiovascular morbidity and mortality. However, the relation between microalbuminuria and chronic heart failure has not been well described yet. In this cross-sectional study, we aim to evaluate the prevalence of microalbuminuria an

  3. Nebivolol in chronic heart failure : current evidence and future perspectives

    NARCIS (Netherlands)

    Lipsic, Erik; van Veldhuisen, Dirk J.

    2010-01-01

    Areas covered in the review: We describe the role of the sympathetic nervous system, beta-blockers and specifically nebivolol in chronic heart failure. What the reader will gain: Nebivolol is a third-generation beta-blocker, with high beta(1)/beta(2) selectivity. Moreover, it has important vasodilat

  4. Hope in elderly adults with chronic heart failure. Concept analysis.

    Science.gov (United States)

    Caboral, Meriam F; Evangelista, Lorraine S; Whetsell, Martha V

    2012-01-01

    This topic review employed Walker and Avant's method of concept analysis to explore the construct of hope in elderly adults with chronic heart failure. The articles analyzed revealed that hope, as the belief of the occurrence of a positive result without any guarantee that it will be produced, is necessary for the survival and wellbeing of the elderly adults enduring this disease.

  5. Trends in mortality, incidence, hospitalisation, cardiac procedures and outcomes of care for coronary heart disease in Singapore, 1991-1996.

    Science.gov (United States)

    Ng, T P; Mak, K H; Phua, K H; Tan, C H

    1999-05-01

    proportion of payment made through this method was only 12%. Out-of-pocket payments, Medisave, Medishield and private insurance have increased steadily. These data indirectly suggest that primary prevention and medical care interventions might have begun to succeed in reducing the rates of coronary heart disease in Singapore. The sharp increases in cardiac procedures may be explained by changing supply and demand factors for care of AMI and chronic ischaemic heart disease, including consumer preference for cardiac procedures, overuse of medical intervention, and technological change. More studies are needed to test these hypotheses.

  6. Association of Polymorphisms in Angiotensin-converting Enzyme and Type 1 Angiotensin Ⅱ Receptor Genes with Coronary Heart Disease and the Severity of Coronary Artery Stenosis

    Institute of Scientific and Technical Information of China (English)

    QIU Chunguang; HAN Zhanying; LU Wenjie; ZHANG Cuntai

    2007-01-01

    To explore the relation of angiotensin-converting enzyme (ACE) and angiotensin Ⅱ type 1 receptor (AT1R) gene polymorphism with coronary heart disease (CHD) and the severity of coronary artery stenosis, 130 CHD patients who underwent coronary angiography were examined for the number of affected coronary vessels (≥75% stenosis) and coronary Jeopardy score. The inser- tion/deletion of ACE gone polymorphism and ATIR gene polymorphism (an A→C transversion at nucleotide position 1166) were detected by using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) in CHD patients and 90 healthy serving as controls. The re- sults showed that DD genotype and of ACE were more frequent in CHD patients than that in control group (38.5% vs 14.4%, P<0.001). The frequency of the AT1R A/C genotypes did not differ between the patients and the controls (10% vs 13.1%, P0.05). The relative risk associated with the ACE-DD was increased by ATIR-AC genotype. Neither the number of affected coronary vessels nor the coro-nary score differed among the ACE I/D genotypes (P0.05). But the number of affected coronary vessels and the coronary score were significantly greater in the patients with the AT1R-AC genotype than in those with the AA genotype (P<0.05). In conclusion, DD genotype may he risk factor for CHD and MI in Chinese people, and is not responsible for the development of the coronary artery stenosis. The AT1R-C allele may increase the relative risk associated with the ACE-DD genotype, and may be involved in the development of the stenosis of coronary artery.

  7. Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

    Directory of Open Access Journals (Sweden)

    Kono Y

    2014-08-01

    Full Text Available Yasushi Kono,1 Shota Fukuda,1 Akihisa Hanatani,2 Koki Nakanishi,2 Kenichiro Otsuka,2 Haruyuki Taguchi,1 Kenei Shimada2 1Department of Medicine, Osaka Ekisaikai Hospital, Osaka, Japan; 2Department of Internal Medicine and Cardiology, Osaka City University School of Medicine, Osaka, Japan Background: Remote ischemic conditioning (RIC is a treatment modality that suppresses inflammation and improves endothelial function, which are factors involved in the pathogenesis of heart failure (HF with reduced left ventricular ejection fraction. Coronary flow reserve (CFR is a physiological index of coronary microcirculation and is noninvasively measured by transthoracic Doppler echocardiography (TTDE. This study aimed to investigate the effects of RIC on CFR in healthy subjects and patients with HF, through the assessment by TTDE. Methods: Ten patients with HF with left ventricular ejection fraction of less than 40%, and ten healthy volunteers were enrolled in this study. RIC treatment was performed twice a day for 1 week. Our custom-made RIC device was programmed to automatically conduct 4 cycles of 5 minutes inflation and 5 minutes deflation of a blood pressure cuff to create intermittent arm ischemia. CFR measurements and laboratory tests were examined before, and after 1 week of RIC treatment. Results: One week of RIC treatment was well tolerated in both groups. RIC treatment increased CFR from 4.0±0.9 to 4.6±1.3 (mean ± standard deviation in healthy subjects (P=0.02, and from 1.9±0.4 to 2.3±0.7 in patients with HF (P=0.03, respectively. Systolic blood pressure in healthy subjects, and heart rate in HF patients decreased after RIC treatment (both P<0.01. Conclusion: This study demonstrated that a 1 week course of RIC treatment improved coronary microcirculation in healthy subjects and patients with HF associated with reduced left ventricular ejection fraction. Keyword: echocardiography, coronary flow reserve, heart failure, preconditioning

  8. Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model

    OpenAIRE

    Zohreh Khayyam Nekouei; Alireza Yousefy; Hamid Taher Neshat Doost; Gholamreza Manshaee; Masoumeh Sadeghei

    2014-01-01

    Background: Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. Materials and M...

  9. A focus on the prognosis and management of ischemic heart disease in patients without evidence of obstructive coronary artery disease.

    Science.gov (United States)

    Scalone, Giancarla; Niccoli, Giampaolo

    2015-01-01

    Ischemic heart disease without evidence of obstructive coronary artery disease is a common phenotype comprising different coronary syndromes with either stable or unstable clinical presentation. In this context, the clinical outcome and management appear extremely variable, due to different etiologies. Of note, coronary microvascular dysfunction is the pathogenetic mechanism linking different clinical scenarios in most of the cases. Hence, in this article, we aim to provide a systematic approach of reviewing the prognosis and management of angina or myocardial infarction without evidence of obstructive coronary artery disease. Moreover, we will propose a new scheme of classification by distinguishing between angina with normal coronary artery and myocardial infarction with normal coronary artery in order to facilitate clinicians to perform a proper management workflow.

  10. Heart rate variability in patients with chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Smyshlaeva О.М.

    2010-12-01

    Full Text Available The purpose of the work is to estimate the status of autonomic nervous system in patients with chronic cerebral ischemia by means of the analysis of heart rate variability at various stages of disease. 120 patients with chronic cerebral ischemia aged from 45 to 65 took part in the research. The comparison group included 30 patients with an arterial hypertension and without chronic cerebral ischemia. Heart rate variability analisis included time-domain and frequency-domain methods of five-minute sequence of the electrocardiographic intervals registered in at rest and in or-thostatic probe. The results of research have shown, that autonomic disorders with prevalence of sympathetic nervous system accompany initial implications of chronic cerebral ischemia. The second stage of disease is characterized by depression of activity of both autonomic, and central regulation. The expressed depression of autonomic maintenance of regulation of heart rhythm of both from sympathetic, and from parasympathetic nervous system was observed at the third stage of chronic cerebral ischemia

  11. Men's and Women's Health Beliefs Differentially Predict Coronary Heart Disease Incidence in a Population-Based Sample

    Science.gov (United States)

    Korin, Maya Rom; Chaplin, William F.; Shaffer, Jonathan A.; Butler, Mark J.; Ojie, Mary-Jane; Davidson, Karina W.

    2013-01-01

    Objective: To examine gender differences in the association between beliefs in heart disease preventability and 10-year incidence of coronary heart disease (CHD) in a population-based sample. Methods: A total of 2,688 Noninstitutionalized Nova Scotians without prior CHD enrolled in the Nova Scotia Health Study (NSHS95) and were followed for 10…

  12. Depressed heart rate variability is associated with events in patients with stable coronary artery disease and preserved left ventricular function

    NARCIS (Netherlands)

    van Boven, AJ; Jukema, JW; Haaksma, J; Zwinderman, AH; Crijns, HJGM; Lie, KI

    1998-01-01

    Background Little is known about the value of heart rate variability in patients with symptomatic coronary artery disease with a preserved left ventricular function. We hypothesized that in these patients heart rate variability might be a helpful adjunct to conventional parameters to predict clinica

  13. Inter-observer variation in delineation of the heart and left anterior descending coronary artery in radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Lorenzen, Ebbe L.; Taylor, Carolyn W.; Maraldo, Maja;

    2013-01-01

    BACKGROUND AND PURPOSE: To determine the extent of inter-observer variation in delineation of the heart and left anterior descending coronary artery (LADCA) and its impact on estimated doses. METHODS AND MATERIALS: Nine observers from five centres delineated the heart and LADCA on fifteen patient...

  14. [Combined surgical treatment for coronary heart disease as well as heart valve diseases and carotid artery stenosis].

    Science.gov (United States)

    Reichart, B; Kemkes, B M; Klinner, W; Kreuzer, E; Becker, H M; Harrington, O B; Crosby, V G; Wolf, R Y

    1979-04-26

    This is an account on combined procedures in 124 patients suffering from arteriosclerotic vessel disease. In order to judge the proceedings and the results the patients were divided up into two groups. in 15 patients (group I) a carotid endarterectomy combined with an aorto-coronary bypass operation was performed; once a subclavian artery stenosis was resected at the same time. One patient of that group died after 31 days (7%). In group II 108 heart valve operations were performed together with a coronary artery revascularisation. Early and late mortality divided up as follows: aortic stenosis 6/44 (14%) respectively 2/44 (5%); aortic insufficiency 1/14 (7%) resp. 0; combined aortic disease 1/8 )13%) resp. 0; mitral stenosis 1/11 (9%) resp. 0; mitral insufficiency 6/26 (23%) resp. 2/26 (8%); combined mitral valve disease 1/2 (50%) resp. 0; three times both valves (aorta, mitral) were replaced without mortality. In our opinion combined procedures, resection of supraaortic artery stenosis respectively cardiac valve operations and aorto-coronary bypass are indicated especially since the functional long-term results are excellent. Though one should consider the high operative risk in patients with mitral insufficiency and combined mitral valve disease.

  15. Intravascular Ultrasound in Percutaneous Coronary Intervention for Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    M Mohandes

    2010-09-01

    Full Text Available Background: Percutaneous coronary intervention (PCI of chronic total occlusion (CTO is one of the most challenging procedures in interventional cardiology. New techniques and devices have made possible to face these complex procedures. Intravascular ultrasound (IVUS reveals special features and contributes greatly to procedural success.Method: We analysed retrospectively IVUS contribution and findings in 23 cases of a total 46 CTOs PCI from February 2009 to August 2010 in our cath lab. Both true and functional CTO were included in this study. The procedure was considered successful when a TIMI III flow was reached in the occluded vessel after stent implantation with a residual stenosis less than 30%. IVUS features and contribution in CTO-PCI were analysed. All data were introduced in SPSS version 15 (SPSS Inc. Chicago, Illinois, USA. Continuous variables were described by mean ± SD and categorical variables were expressed as percentage. A P<0.05 was considered statistically significant.Results: 46 PCIs in 34 patients were performed during 19 months in our centre. The procedure was successful in 28 cases (60.9%.. IVUS was performed in 23 (82.1% of successful procedures. IVUS revealed calcium somewhere in 17 (73.9%. Despite wire angiographic verification in true lumen distally IVUS showed subintimal wire position in part of CTO segment in 6(26.1%. In 22(95.7% of cases IVUS allowed both the wire position verification in true lumen and the vessel measurement before stent implantation. In 1(4.3% case a second wire was introduced into true lumen guided by IVUS after realising that the first wire was in false lumen. We could not find significant relation between calcium presence and subintimal wire penetration in CTO segment (p: 0.14 Conclusions: IVUS showed calcium in CTO segment in a high percentage of cases. It is not unusual to find wire penetration in subintimal space in part of CTO segment. IVUS has a key contribution in the step by step

  16. Increased prevalence of coronary artery disease risk markers in patients with chronic hepatitis C

    DEFF Research Database (Denmark)

    Roed, Torsten; Kristoffersen, Ulrik Sloth; Knudsen, Andreas

    2014-01-01

    % confidence interval [CI] 0.9-2.7) and smoked more (53% versus 38%, PR 1.4; 95% CI 0.9-2.1). The two groups had similar body mass index (mean 25.0 versus 25.7 kg/m(2)), whereas those with chronic hepatitis C had less dyslipidemia (including significantly lower low-density lipoprotein and cholesterol...... of several coronary artery disease risk markers. These results may be important when evaluating the appropriateness of screening for coronary artery disease and its risk factors in chronic hepatitis C....

  17. X-ray intravital microscopy for functional imaging in rat hearts using synchrotron radiation coronary microangiography

    Energy Technology Data Exchange (ETDEWEB)

    Umetani, K. [Japan Synchrotron Radiation Research Institute, SPring-8, Sayo-cho, Sayo-gun, Hyogo 679-5198 (Japan); Fukushima, K. [National Cerebral and Cardiovascular Center Hospital, Fujishirodai, Suita-shi, Osaka 565-8565 (Japan)

    2013-03-15

    An X-ray intravital microscopy technique was developed to enable in vivo visualization of the coronary, cerebral, and pulmonary arteries in rats without exposure of organs and with spatial resolution in the micrometer range and temporal resolution in the millisecond range. We have refined the system continually in terms of the spatial resolution and exposure time. X-rays transmitted through an object are detected by an X-ray direct-conversion type detector, which incorporates an X-ray SATICON pickup tube. The spatial resolution has been improved to 6 {mu}m, yielding sharp images of small arteries. The exposure time has been shortened to around 2 ms using a new rotating-disk X-ray shutter, enabling imaging of beating rat hearts. Quantitative evaluations of the X-ray intravital microscopy technique were extracted from measurements of the smallest-detectable vessel size and detection of the vessel function. The smallest-diameter vessel viewed for measurements is determined primarily by the concentration of iodinated contrast material. The iodine concentration depends on the injection technique. We used ex vivo rat hearts under Langendorff perfusion for accurate evaluation. After the contrast agent is injected into the origin of the aorta in an isolated perfused rat heart, the contrast agent is delivered directly into the coronary arteries with minimum dilution. The vascular internal diameter response of coronary arterial circulation is analyzed to evaluate the vessel function. Small blood vessels of more than about 50 {mu}m diameters were visualized clearly at heart rates of around 300 beats/min. Vasodilation compared to the control was observed quantitatively using drug manipulation. Furthermore, the apparent increase in the number of small vessels with diameters of less than about 50 {mu}m was observed after the vasoactive agents increased the diameters of invisible small blood vessels to visible sizes. This technique is expected to offer the potential for direct

  18. Left ventricular mechanoenergetics under altered coronary perfusion in guinea pig hearts.

    Science.gov (United States)

    Matsushita, T; Takaki, M; Fujii, W; Matsubara, H; Suga, H

    1995-01-01

    Coronary perfusion pressure (CPP) is well known to affect left ventricular (LV) mechanoenergetics (Gregg's phenomenon). The garden hose effect via the Frank-Starling mechanism caused by coronary distension has long been considered to be the underlying mechanism of this phenomenon. However, recent studies have revealed a close correlation between CPP and the excitation-contraction coupling in myocytes. The aim of this study was to investigate the mechanoenergetic aspects of Gregg's phenomenon by the ventricular contractility (Emax) dependency of the myocardial oxygen consumption (VO2)-total mechanical energy (PVA, systolic pressure-volume area) relationship. Experiments were performed in the excised, cross-circulated guinea pig heart preparation. The protocol consisted of LV volume loading (VOL run), changing coronary perfusion pressure at a fixed LV volume (CPP run) and intracoronary calcium (Ca) infusion also at the same LV volume (Ca run). In all seven hearts, we obtained a linear VO2-PVA relation in VOL run. The VO2-PVA relations in CPP and Ca runs, which equally enhanced Emax, were highly linear and had no significant difference in their slopes, both significantly steeper than in VOL run. These findings suggest no significant difference in the oxygen cost of Emax between CPP and Ca runs. The enhanced LV mechanoenergetics under increasing CPP is characterized by increases in the VO2 component primarily for the excitation-contraction coupling to a greater degree than expected from the mechanical (garden hose) effect.

  19. Dynamics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease

    Science.gov (United States)

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

    2007-02-01

    Dynamics of glucose concentration in human organism is an important diagnostic characteristic for it's parameters correlate significantly with the severity of metabolic, vessel and perfusion disorders. 36 patients with stable angina pectoris of II and III functional classes were involved in this study. All of them were men in age range of 45-59 years old. 7 patients hospitalized with acute myocardial infarction (aged from 49 to 59 years old) form the group of compare. Control group (n = 5) was of practically healthy men in comparable age. To all patients intravenous glucose solution (40%) in standard loading dose was injected. Capillary and vein blood samples were withdrawn before, and 5, 60, 120, 180 and 240 minutes after glucose load. At these time points blood pressure and glucose concentration were measured. In prepared blood smears shape, deformability and sizes of erythrocytes, quantity and degree of shear stress resistant erythrocyte aggregates were studied. Received data were approximated by polynomial of high degree to receive concentration function of studied parameters, which first derivative elucidate velocity characteristics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease and practically healthy persons. Received data show principle differences in dynamics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease as a possible mechanism of coronary blood flow destabilization.

  20. Enhanced Myocardial Vascularity and Contractility by Novel FGF-1 Transgene in a Porcine Model of Chronic Coronary Occlusion

    Directory of Open Access Journals (Sweden)

    Janet L. Parker

    2008-12-01

    Full Text Available Background: Angiogenesis gene therapy has long been sought as a novel alternative treatment for restoring the blood flow and improving the contractile function of the ischemic heart in selected clinical settings. Angiogenic fibroblast growth factor-1 (FGF-1 is a promising candidate for developing a promising gene therapy protocol due to its multipotent ability to stimulate endothelial cell (EC growth, migration, and tube formation. Despite these advantages, however, FGF gene therapy has suffered setbacks mainly due to the inefficient delivery rate of the growth factor in vivo. Given the potent angiogenic effect of FGF-1, we reasoned that constitutively synthesized minute quantities of this polypeptide hormone, when empowered with the ability to escape the cellular constraint, could freely act in a paracrine/autocrine fashion on nearby existing capillary plexuses and lead to neovascularization and restoration of the blood flow to ischemic tissues for reparative purpose. Methods: We report the direct gene transfer of a retroviral-based mammalian expression vector encoding a secreted form of FGF-1 (sp-FGF-1 for the purpose of therapeutic angiogenesis into the porcine myocardium subjected to the surgical placement of an ameroid occluder to induce the chronic coronary occlusion of the left circumflex coronary artery (LCx and regional myocardial ischemia. Coronary angiography, performed 3 weeks after surgery, confirmed the interruption of the blood flow in the LCx distal to the site of ameroid placement. Results: Immunohistochemical analysis using antibody specific to von Willebrand factor (vWF, an endothelial marker, showed a significant increase (p<0.05 in myocardial vascularity in the sp-FGF-1 hearts compared to the control (vector alone. Importantly, an assessment of the cardiac function by echocardiography, performed 3 weeks after surgery, demonstrated improved cardiac contractility due to increased left ventricular free wall contraction in the

  1. Heart Failure Update: Chronic Disease Management Programs.

    Science.gov (United States)

    Fountain, Lorna B

    2016-03-01

    With high mortality and readmission rates among patients with heart failure (HF), multiple disease management models have been and continue to be tested, with mixed results. Early postdischarge care improves outcomes for patients. Telemonitoring also can assist in reducing mortality and HF-related hospitalizations. Office-based team care improves patient outcomes, with important components including rapid access to physicians, partnerships with clinical pharmacists, education, monitoring, and support. Pay-for-performance measures developed for HF, primarily use of angiotensin-converting enzyme inhibitors and beta blockers, also improve patient outcomes, but the influence of adherence to other measures has been minimal. Evaluating comorbid conditions, including diabetes and hypertension, and making drug adjustments for patients with HF to include blood pressure control and use of metformin, when possible, can reduce mortality and morbidity.

  2. Correlation of coronary artery stenosis evaluation with left heart structure and function by multi-slice computed tomography.

    Science.gov (United States)

    Song, L N; Cao, A D; Niu, Y J; Liu, N

    2014-08-07

    The aim of this study was to determine the impact of multi-slice computed tomography (MSCT) evaluation of coronary artery stenosis on left heart structure and systolic function. Coronary artery CT angiography was performed in 200 patients diagnosed with coronary heart disease, and then according to the AHA coronary artery 17-segment fractionation method, the Gensini score (GS) was determined for every narrow segment, and one-stop assessment of the correlation between left heart structure and function was performed. After the grouping of GS quartiles from low to high, there were differences between different patients with regard to LVDD, LADD, LVEDV, LVESV, MM, LVEF, and FS, while no difference in SV and CO. GS showed linear negative correlation with LVEF and FS, and linear positive correlation with LVDD, LADD, LVEDV, LVESV, and MM, while no correlation with SV and CO. That is, GS of coronary artery stenosis was negatively correlated with left ventricular systolic function and positively correlated with myocardial mass. The narrower the coronary artery, the worse the cardiac function and the higher the myocardial hypertrophy. Coronary artery stenosis was one of the important causes of the decrease in left ventricular systolic function and cardiac remodeling.

  3. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies

    Science.gov (United States)

    Zong, Geng; Li, Yanping; Wanders, Anne J; Alssema, Marjan; Zock, Peter L; Willett, Walter C; Hu, Frank B

    2016-01-01

    Objectives To investigate the association between long term intake of individual saturated fatty acids (SFAs) and the risk of coronary heart disease, in two large cohort studies. Design Prospective, longitudinal cohort study. Setting Health professionals in the United States. Participants 73 147 women in the Nurses’ Health Study (1984-2012) and 42 635 men in the Health Professionals Follow-up Study (1986-2010), who were free of major chronic diseases at baseline. Main outcome measure Incidence of coronary heart disease (n=7035) was self-reported, and related deaths were identified by searching National Death Index or through report of next of kin or postal authority. Cases were confirmed by medical records review. Results Mean intake of SFAs accounted for 9.0-11.3% energy intake over time, and was mainly composed of lauric acid (12:0), myristic acid (14:0), palmitic acid (16:0), and stearic acid (18:0; 8.8-10.7% energy). Intake of 12:0, 14:0, 16:0 and 18:0 were highly correlated, with Spearman correlation coefficients between 0.38 and 0.93 (all P<0.001). Comparing the highest to the lowest groups of individual SFA intakes, hazard ratios of coronary heart disease were 1.07 (95% confidence interval 0.99 to 1.15; Ptrend=0.05) for 12:0, 1.13 (1.05 to 1.22; Ptrend<0.001) for 14:0, 1.18 (1.09 to 1.27; Ptrend<0.001) for 16:0, 1.18 (1.09 to 1.28; Ptrend<0.001) for 18:0, and 1.18 (1.09 to 1.28; Ptrend<0.001) for all four SFAs combined (12:0-18:0), after multivariate adjustment of lifestyle factors and total energy intake. Hazard ratios of coronary heart disease for isocaloric replacement of 1% energy from 12:0-18:0 were 0.92 (95% confidence interval 0.89 to 0.96; P<0.001) for polyunsaturated fat, 0.95 (0.90 to 1.01; P=0.08) for monounsaturated fat, 0.94 (0.91 to 0.97; P<0.001) for whole grain carbohydrates, and 0.93 (0.89 to 0.97; P=0.001) for plant proteins. For individual SFAs, the lowest risk of coronary heart disease was observed when the most abundant SFA

  4. Nerve Growth Factor Decreases in Sympathetic and Sensory Nerves of Rats with Chronic Heart Failure

    Science.gov (United States)

    Lu, Jian

    2014-01-01

    Nerve growth factor (NGF) plays a critical role in the maintenance and survival of both sympathetic and sensory nerves. Also, NGF can regulate receptor expression and neuronal activity in the sympathetic and sensory neurons. Abnormalities in NGF regulation are observed in patients and animals with heart failure (HF). Nevertheless, the effects of chronic HF on the levels of NGF within the sympathetic and sensory nerves are not known. Thus, the ELISA method was used to assess the levels of NGF in the stellate ganglion (SG) and dorsal root ganglion (DRG) neurons of control rats and rats with chronic HF induced by myocardial infarction. Our data show for the first time that the levels of NGF were significantly decreased (P < 0.05) in the SG and DRG neurons 6–20 weeks after ligation of the coronary artery. In addition, a close relation was observed between the NGF levels and the left ventricular function. In conclusion, chronic HF impairs the expression of NGF in the sympathetic and sensory nerves. Given that sensory afferent nerves are engaged in the sympathetic nervous responses to somatic stimulation (i.e. muscle activity during exercise) via a reflex mechanism, our data indicate that NGF is likely responsible for the development of muscle reflex-mediated abnormal sympathetic responsiveness observed in chronic HF. PMID:24913185

  5. Psychophysical rehabilitation aspects of patient with coronary heart disease and Angina.

    Directory of Open Access Journals (Sweden)

    Mohammed Ali Khaleel.

    2012-03-01

    Full Text Available It is analyzed scientific and methodological literature, considered the views of scientists on the link of stress and cardiovascular diseases. It is determined causes of stress, with recommendations for combating stress and its prevention. A program of rehabilitation for patients with coronary artery disease after hospital discharge is shown. The experiment involved 88 patients of coronary heart disease and angina, II and III functional class at the age of 40-65 years. Participants were divided into two groups the main and control. The control group performed a program of physical rehabilitation, including breathing and physical exercises, in the program we have added to the main group autogenic exercises. At the end the experiment revealed that the health indicators of main group better than the control group in 23%.

  6. Ultrasound assessment of mitral annular displacement in patients with coronary heart disease and its correlation with left heart function and serum indexes

    Institute of Scientific and Technical Information of China (English)

    Bing-Yan Lai

    2016-01-01

    Objective:To analyze the ultrasound assessment of mitral annular displacement in patients with coronary heart disease and its correlation with left heart function and serum indexes. Methods:A total of 89 patients with coronary heart disease were divided into angina pectoris group 42 cases and myocardial infarction group 47 cases according to the illness, and 58 cases of healthy subjects were included in control group. Values of mitral annular displacement (MAD) parameters, left heart function indexes and serum illness-related indexes of three groups were detected, and the correlation between values of MAD parameters and values of cardiac function indexes and serum illness-related indexes were further analyzed.Results:MAD parameters TMAD1, TMAD2 and TMADmid values, heart function LVEF values and serum CysC level of myocardial infarction group and angina pectoris group were lower than those of control group, and cardiac function LVEDD, LVESD and A/E values as well as serum H-FABP, ICTP, Hcy and vWF levels were higher than those of control group (P<0.05); MAD parameters TMAD1, TMAD2 and TMADmid values of patients with coronary heart disease were negatively correlated with LVEDD, LVESD and A/E values as well as H-FABP, ICTP, Hcy and vWF levels, and were positively correlated with LVEF value and CysC level (P<0.05). Conclusions:Ultrasound assessment of mitral annular displacement in patients with coronary heart disease can early diagnose coronary heart disease and judge the disease severity, and it plays a positive role in optimizing disease prognosis.

  7. Amaranth oil application for coronary heart disease and hypertension

    Directory of Open Access Journals (Sweden)

    Pogojeva Ala V

    2007-01-01

    Full Text Available Abstract Cardiovascular disease (CVD is the Nation's leading killer for both men and women among all racial and ethnic groups. Development and progression of CVD is linked to the presence of risk factors such as hyperlipidemia, hypertension, obesity, and diabetes mellitus. It is known that cholesterol is an indicator of increased risk of heart attack and stroke. Low-density cholesterol (LDL above 130 mg/dl high-density cholesterol (HDL cholesterol below 35 mg/dl and total blood cholesterol above 200 mg/dl are indicators of problematic cholesterol. Proper ranges of cholesterol are important in the prevention of CVD. It has been suggested that a reduction in the consumption of saturated and an increase in unsaturated fatty acids is beneficial and prevents CVD. Amaranth grain contains tocotrienols and squalene compounds, which are known to affect cholesterol biosynthesis. The cholesterol precursors squalene, lanosterol and other methyl sterols, reflect cholesterol synthesis 123, whereas plant sterols and cholestanol, a metabolite of cholesterol, reflect the efficiency of cholesterol absorption in normal and hyperlipidemic populations 456. Qureshi with co-authors 7 showed that feeding of chickens with amaranth oil decreases blood cholesterol levels, which are supported by the work of others 8. Previously, we have shown that Amaranth oil modulates the cell membrane fluidity 9 and stabilized membranes that could be one reason as to why it is beneficial to those who consume it. It is known that in hypertension, the cell membrane is defective and hence, the movement of the Na and K ions across the cell membranes could defective that could contribute to the development of increase in blood pressure. Based on these properties of amaranth oil we hypothesize that it could be of significant benefit for patients with CVD.

  8. Ivabradine in chronic stable angina: Effects by and beyond heart rate reduction.

    Science.gov (United States)

    Camici, Paolo G; Gloekler, Steffen; Levy, Bernard I; Skalidis, Emmanouil; Tagliamonte, Ercole; Vardas, Panos; Heusch, Gerd

    2016-07-15

    Heart rate plays a major role in myocardial ischemia. A high heart rate increases myocardial performance and oxygen demand and reduces diastolic time. Ivabradine reduces heart rate by inhibiting the If current of sinoatrial-node cells. In contrast to beta-blockers, ivabradine has no negative inotropic and lusitropic effect for a comparable heart rate reduction. Consequently, diastolic duration is increased with ivabradine compared to beta-blockers. This has potential consequences on coronary blood flow since compression of the vasculature by the surrounding myocardium during systole impedes flow and coronary blood flow is mainly diastolic. Moreover, ivabradine does not unmask alpha-adrenergic vasoconstriction and, unlike beta-blockers, maintains coronary dilation during exercise. In comparison with beta-blockers, ivabradine increases coronary flow reserve and collateral perfusion promoting the development of coronary collaterals. Ivabradine attenuates myocardial ischemia and its consequences even in the absence of heart rate reduction, possibly through reduced formation of reactive oxygen species. In conclusion, ivabradine differs from other anti-anginal agents by improving coronary blood flow and by additional pleiotropic effects. These properties make ivabradine an effective anti-anginal and anti-ischemic agent for the treatment of patients with coronary artery disease.

  9. Systolic reconstruction in patients with low heart rate using coronary dual-source CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Munemasa, E-mail: radokada@yamaguchi-u.ac.jp [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Nakashima, Yoshiteru; Shigemoto, Youko; Matsunaga, Naofumi [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Miura, Toshiro; Nao, Tomoko [Department of Cardiology, Yamaguchi University Graduate School of Medicine (Japan); Sano, Yuichi; Narazaki, Akiko [Department of Radiology, Yamaguchi University Hospital (Japan); Kido, Shoji [Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University (Japan)

    2011-11-15

    Objectives: The purpose of our study was to determine the relationship between the predictive factors and systolic reconstruction (SR) as an optimal reconstruction window in patients with low heart rate (LHR; less than 65 bpm). Methods: 391 patients (262 male and 129 female, mean age; 67.1 {+-} 10.1 years of age) underwent coronary CTA without the additional administration of a beta-blocker. Affecting factors for SR were analyzed in age, gender, body weight (BW), diabetes mellitus (DM), coronary arterial disease (CAD), ejection fraction (EF), systolic and diastolic body pressure (BP) and heart rate variability (HRV) during coronary CTA. Results: In 29 (7.4%) of the 391 patients, SR was needed, but there was no apparent characteristic difference between the systolic and diastolic reconstruction groups in terms of gender, age, BW, DM, CAD and EF. In a multivariate analysis, the co-existence of DM [P < 0.05; OR, 0.27; 95% CI, 0.092-0.80], diastolic BP [P < 0.01; OR, 0.95; 95% CI, 0.92-0.98] and HRV [P < 0.01; OR, 0.98; 95% CI, 0.96-0.99] were found to be the factors for SR. In gender-related analysis, HRV was an important factor regardless of sex, but co-existence of DM affected especially for female and BP for male. Conclusion: Especially in the patients with LHR who had a medication of DM, high HRV or high BP, SR, in addition to DR, was needed to obtain high-quality coronary CTA images.

  10. Premature Coronary Heart Disease and Traditional Risk Factors-Can We Do Better?

    Directory of Open Access Journals (Sweden)

    Roxana Sadeghi

    2013-06-01

    Full Text Available Background: Traditional cardiovascular risk factors are strong predictors of an increased likelihood for premature CHD. Considering the benefits of risk factors᾿ management, it is imperative to find and treat them before looking for more unknown and weak risk factors. Objectives: Limited information is available about the demographic and historical characteristics of the patients with premature Coronary Heart Disease (CHD in IR Iran. The main objective of this study was to determine the prevalence of the traditional risk factors in these patients. Also, the researchers hypothesized that there are insufficient risk assessment and preventive intervention methods for the asymptomatic adult population. Methods: This study was conducted on 125 patients with premature CHD (age<50 years who were admitted in two academic hospitals with acute coronary syndromes. The patients were accepted since they had a definite CHD on the basis of acute myocardial infarction (elevated cardiac enzymes or documented CAD in coronary angiography. Results: The mean age of the study population was 42.50±5.65 (26 to 49 years. Among the patients,92 (73.6% were male, 113 (90.4% were married, 58 (46.4% were smokers,19 (15.2% were opium users, 97 (77.6% had dyslipidemia, 44 (35.2% had hypertension, and 33 (26.4% had diabetes mellitus. In addition, family history was presented in 54 patients (43.2%. Conclusions: Premature Coronary Heart Disease is a public health problem. However, there is lack of effective and intensive treatments of well-defined traditional risk factors and prevention methods for the majority of the patients experiencing premature CHD. In sum, there is still plenty of room for improvement of risk management in IR Iran.

  11. The registry of anomalous aortic origin of the coronary artery of the Congenital Heart Surgeons' Society.

    Science.gov (United States)

    Brothers, Julie A; Gaynor, J William; Jacobs, Jeffrey P; Caldarone, Christopher; Jegatheeswaran, Anusha; Jacobs, Marshall L

    2010-12-01

    The anomalous aortic origin of a coronary artery from the wrong sinus of Valsalva with interarterial, intramural, and/or intraconal course is a rare congenital anomaly that is associated with a high risk of sudden death in children. The Congenital Heart Surgeons' Society established the Registry of Anomalous Aortic Origin of the Coronary Artery to help determine the outcome of children and young adults managed with surgical intervention versus observation and to test the hypothesis that subsets of patients with anomalous aortic origin of a coronary artery can be identified in whom the risk of intervention is less than the risk of observation. All institutional members of the Congenital Heart Surgeons' Society were recruited for participation. The registry consists of a retrospective cohort of patients diagnosed between 1 January, 1998 and 20 January, 2009 and a prospective, population-based cohort of patients newly diagnosed from 21 January, 2009 onwards. Baseline demographics, diagnoses, and results of tests will be obtained through a review of the medical records. Annual follow-up data will be collected. Data will be analysed for different factors of risk at diagnosis, different strategies of treatment, and the impact of both on the outcomes of the patients. As of June 2010, 28 institutions had applied for approval from their institutional review board and 16 institutions had received approval from their institutional review board. Seventy-four patients have enrolled to date. We hope to use the established Pediatric Cardiomyopathy Registry as a guide to successful implementation, with a cooperative effort between institutions. The overall purpose of the Registry of Anomalous Aortic Origin of the Coronary Artery is to determine the outcome of surgical intervention versus observation in children and young adults with anomalous aortic origin of a coronary artery, and to describe the natural and "unnatural" history of these patients over the course of their lifetime

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  13. Chronic exposure to zinc oxide nanoparticles increases ischemic-reperfusion injuries in isolated rat hearts

    Science.gov (United States)

    Milivojević, Tamara; Drobne, Damjana; Romih, Tea; Mali, Lilijana Bizjak; Marin, Irena; Lunder, Mojca; Drevenšek, Gorazd

    2016-10-01

    The use of zinc oxide nanoparticles (ZnO NPs) in numerous products is increasing, although possible negative implications of their long-term consumption are not known yet. Our aim was to evaluate the chronic, 6-week oral exposure to two different concentrations of ZnO NPs on isolated rat hearts exposed to ischemic-reperfusion injury and on small intestine morphology. Wistar rats of both sexes ( n = 18) were randomly divided into three groups: (1) 4 mg/kg ZnO NPs, (2) 40 mg/kg ZnO NPs, and (3) control. After 6 weeks of treatment, the hearts were isolated, the left ventricular pressure (LVP), the coronary flow (CF), the duration of arrhythmias and the lactate dehydrogenase release rate (LDH) were measured. A histological investigation of the small intestine was performed. Chronic exposure to ZnO NPs acted cardiotoxic dose-dependently. ZnO NPs in dosage 40 mg/kg maximally decreased LVP (3.3-fold) and CF (2.5-fold) and increased the duration of ventricular tachycardia (all P < 0.01) compared to control, whereas ZnO NPs in dosage 4 mg/kg acted less cardiotoxic. Goblet cells in the small intestine epithelium of rats, treated with 40 mg ZnO NPs/kg, were enlarged, swollen and numerous, the intestinal epithelium width was increased. Unexpectedly, ZnO NPs in both dosages significantly decreased LDH. A 6-week oral exposure to ZnO NPs dose-dependently increased heart injuries and caused irritation of the intestinal mucosa. A prolonged exposure to ZnO NPs might cause functional damage to the heart even with exposures to the recommended daily doses, which should be tested in future studies.

  14. hHGF overexpression in myoblast sheets enhances their angiogenic potential in rat chronic heart failure.

    Directory of Open Access Journals (Sweden)

    Antti Siltanen

    Full Text Available After severe myocardial infarction (MI, heart failure results from ischemia, fibrosis, and remodeling. A promising therapy to enhance cardiac function and induce therapeutic angiogenesis via a paracrine mechanism in MI is myoblast sheet transplantation. We hypothesized that in a rat model of MI-induced chronic heart failure, this therapy could be further improved by overexpression of the antiapoptotic, antifibrotic, and proangiogenic hepatocyte growth factor (HGF in the myoblast sheets. We studied the ability of wild type (L6-WT and human HGF-expressing (L6-HGF L6 myoblast sheet-derived paracrine factors to stimulate cardiomyocyte, endothelial cell, or smooth muscle cell migration in culture. Further, we studied the autocrine effect of hHGF-expression on myoblast gene expression profiles by use of microarray analysis. We induced MI in Wistar rats by left anterior descending coronary artery (LAD ligation and allowed heart failure to develop for 4 weeks. Thereafter, we administered L6-WT (n = 15 or L6-HGF (n = 16 myoblast sheet therapy. Control rats (n = 13 underwent LAD ligation and rethoracotomy without therapy, and five rats underwent a sham operation in both surgeries. We evaluated cardiac function with echocardiography at 2 and 4 weeks after therapy, and analyzed cardiac angiogenesis and left ventricular architecture from histological sections at 4 weeks. Paracrine mediators from L6-HGF myoblast sheets effectively induced migration of cardiac endothelial and smooth muscle cells but not cardiomyocytes. Microarray data revealed that hHGF-expression modulated myoblast gene expression. In vivo, L6-HGF sheet therapy effectively stimulated angiogenesis in the infarcted and non-infarcted areas. Both L6-WT and L6-HGF therapies enhanced cardiac function and inhibited remodeling in a similar fashion. In conclusion, L6-HGF therapy effectively induced angiogenesis in the chronically failing heart. Cardiac function, however, was not further

  15. Intelligence System for Diagnosis Level of Coronary Heart Disease with K-Star Algorithm

    Science.gov (United States)

    Kusnanto, Hari; Herianto, Herianto

    2016-01-01

    Objectives Coronary heart disease is the leading cause of death worldwide, and it is important to diagnose the level of the disease. Intelligence systems for diagnosis proved can be used to support diagnosis of the disease. Unfortunately, most of the data available between the level/type of coronary heart disease is unbalanced. As a result system performance is low. Methods This paper proposes an intelligence systems for the diagnosis of the level of coronary heart disease taking into account the problem of data imbalance. The first stage of this research was preprocessing, which included resampled non-stratified random sampling (R), the synthetic minority over-sampling technique (SMOTE), clean data out of range attribute (COR), and remove duplicate (RD). The second step was the sharing of data for training and testing using a k-fold cross-validation model and training multiclass classification by the K-star algorithm. The third step was performance evaluation. The proposed system was evaluated using the performance parameters of sensitivity, specificity, positive prediction value (PPV), negative prediction value (NPV), area under the curve (AUC) and F-measure. Results The results showed that the proposed system provides an average performance with sensitivity of 80.1%, specificity of 95%, PPV of 80.1%, NPV of 95%, AUC of 87.5%, and F-measure of 80.1%. Performance of the system without consideration of data imbalance provide showed sensitivity of 53.1%, specificity of 88,3%, PPV of 53.1%, NPV of 88.3%, AUC of 70.7%, and F-measure of 53.1%. Conclusions Based on these results it can be concluded that the proposed system is able to deliver good performance in the category of classification. PMID:26893948

  16. Effect of coronary heart disease combined with hyperhomocysteinemia on carotid plaque features and stroke

    Institute of Scientific and Technical Information of China (English)

    Ya-Ling Ning; Gang Tian

    2016-01-01

    Objective:To analyze the effect of coronary heart disease combined with hyperhomocysteinemia on carotid plaque features and stroke.Methods:A total of 110 patients with coronary heart disease treated from May 2011 to May 2012 were selected for study, and according to the levels of plasma homocysteine (Hcy), they were divided into high Hcy groups (plasma Hcy ≥10 μmol/L) and normal Hcy group (plasma Hcy <10 μmol/L). Carotid ultrasonography was conducted and the plaque features were assessed, plasma levels of plaque stability-related molecules, lipid metabolism indexes and inflammatory mediators of two groups were detected, and the incidence of stroke were followed up for 3 years.Results: The number of instable carotid plaques of high Hcy group was more than that of normal Hcy group, and carotid intima-media thickness was higher than that of normal Hcy group; plasma TG, TC, LDL-C, PAPP-A, OPN, PTX3, ANGPTL4, MMP7, MMP9, IL-6, IL-8, TNF-α and MCP-1 levels of high Hcy group were significantly higher than those of normal Hcy group, HDL-C, IL-10, IL-13, TGFβ and IL-4 levels were significantly lower than those of normal Hcy group, and plasma ApoA and ApoB levels were not statistically different from those of normal Hcy group; 3 years of follow-up showed that the incidence of stroke of high Hcy group on the 1st year, 2nd year and 3rd year were higher than those of normal Hcy group.Conclusions:Carotid plaque instability increases, and the risk of long-term stroke is higher in coronary heart disease patients with hyperhomocysteinemia.

  17. Mother's body size and placental size predict coronary heart disease in men

    Science.gov (United States)

    Eriksson, Johan G.; Kajantie, Eero; Thornburg, Kent L.; Osmond, Clive; Barker, David J.P.

    2011-01-01

    Aims People whose birthweights were towards the lower end of the normal range are at increased risk of coronary heart disease. This is attributed to foetal programming through malnutrition, but the cause of the malnutrition is unknown. Methods and results We studied 6975 men born in Helsinki during 1934–44. Their size at birth was recorded. Babies who later developed coronary heart disease tended to have a low ponderal index (birthweight/length3). Three different placental phenotypes predicted the disease. In primiparous mothers who were short, having below median height, the hazard ratio for the disease was 1.14 (95% confidence interval 1.08–1.21, P< 0.0001) for each centimetre increase in the difference between the length and breadth of the placental surface. In tall mothers whose body mass index was above the median, the hazard ratio was 1.25 (1.10–1.42, P= 0.0007) per 40 cm2 decrease in the surface area. In tall mothers whose body mass index was below the median, the hazard ratio was 1.07 (1.02–1.13, P= 0.01) per 1% increase in the placental weight/birthweight ratio. Conclusions Three different combinations of maternal and placental size predicted coronary heart disease. The mother's body size determines the availability of nutrients and is linked to the development and function of the placenta, reflected in its shape and size. We speculate that variations in three processes of normal placental development lead to foetal malnutrition. The processes are (i) implantation and spiral artery invasion, (ii) growth of the chorionic surface, and (iii) compensatory expansion of the chorionic surface. PMID:21632601

  18. Long-Term Outcome of Percutaneous Coronary Intervention for Chronic Total Occlusions

    NARCIS (Netherlands)

    R. Mehran; B.E. Claessen; C. Godino; G.D. Dangas; K. Obunai; S. Kanwal; M. Carlino; J.P.S. Henriques; C. di Mario; Y.H. Kim; S.J. Park; G.W. Stone; M.B. Leon; J.W. Moses; A. Colombo

    2011-01-01

    Objectives The aim of this study was to evaluate long-term clinical outcomes after percutaneous coronary intervention (PCI) for chronic total occlusions (CTO). Background Despite technical advancements, there is a paucity of data on long-term outcomes after PCI of CTO. Methods We evaluated long-term

  19. Exercise training upregulates nitric oxide synthases in the kidney of rats with chronic heart failure.

    Science.gov (United States)

    Ito, Daisuke; Ito, Osamu; Mori, Nobuyoshi; Cao, Pengyu; Suda, Chihiro; Muroya, Yoshikazu; Hao, Kiyotaka; Shimokawa, Hiroaki; Kohzuki, Masahiro

    2013-09-01

    There is an interaction between heart and kidney diseases, which is a condition termed cardiorenal syndrome. Exercise training has cardioprotective effects, involving upregulation of endothelial (e) nitric oxide synthase (NOS) in the cardiovascular system. However, the effects of exercise training on NOS in the kidney with heart disease are unknown. The aim of the present study was to investigate whether exercise training upregulates NOS in the kidney, left ventricle and aorta of rats with chronic heart failure (CHF). Male Sprague-Dawley rats underwent left coronary artery ligation (LCAL) to induce CHF and were randomly assigned to sedentary or treadmill exercise groups 4 weeks after LCAL. Three days after exercising for 4 weeks, urine samples were collected for 24 h and blood samples were collected following decapitation. Nitric oxide synthase activity and protein expression were examined. Significant interactions between CHF and exercise training were observed on parameters of cardiac and renal function. Exercise training improved cardiac function, decreased plasma B-type natriuretic peptide levels, decreased urinary albumin excretion and increased creatinine clearance in CHF rats. Nitric oxide synthase activity, eNOS expression and neuronal (n) NOS expression were significantly decreased in the left ventricle and kidney of CHF rats. Exercise training significantly increased NOS activity and eNOS and nNOS expression. Upregulation of NOS in the kidney and left ventricle may contribute, in part, to the renal and cardiac protective effects of exercise training in cardiorenal syndrome in CHF rats.

  20. Biomarkers in Cardiology - Part 2: In Coronary Heart Disease, Valve Disease and Special Situations

    Directory of Open Access Journals (Sweden)

    2015-05-01

    Full Text Available Cardiovascular diseases are the main causes of mortality and morbidity in Brazil. Their primary and secondary preventions are a priority for the health system and require multiple approaches for increased effectiveness. Biomarkers are tools used to identify with greater accuracy high-risk individuals, establish a faster diagnosis, guide treatment, and determine prognosis. This review aims to highlight the importance of biomarkers in clinical cardiology practice and raise relevant points regarding their application and perspectives for the next few years. This document was divided into two parts. This second part addresses the application of biomarkers in coronary heart disease, valvular diseases, cardio-oncology, pulmonary embolism, and cardiorenal syndrome.

  1. COMPARATIVE EFFICACY OF THE STATINS IN PREVENTING AND TREATING OF THE CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    S. V. Shalaev

    2010-01-01

    Full Text Available The possibility to stabilize and reverse the atherosclerotic plaques in coronary arteries due to therapy with atorvastatin and rosuvastatin was demonstrated in recent studies. The advantage of aggressive lipid-lowering therapy compared with standard therapy is proven in patients with both stable and acute forms of ischemic heart disease (IHD. Pleiotropic effects, in particular, effect on endothelial function, ability to reduce the blood level of C-reactive protein are important in the statins mode of action. Risk reduction of cardiovascular complications and slow down of atherosclerosis progression in patients with IHD was significantly associated with decrease in levels of both atherogenic lipids and C-reactive protein.

  2. Executive function, but not memory, associates with incident coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Rostamian, Somayeh; van Buchem, Mark A; Westendorp, Rudi G J

    2015-01-01

    from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to Z scores and averaged into a composite...... executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression...

  3. Childhood intelligence in relation to adult coronary heart disease and stroke risk

    DEFF Research Database (Denmark)

    Batty, G David; Mortensen, Erik L; Nybo Andersen, Anne-Marie;

    2005-01-01

    is unknown. We investigated the relation of childhood intelligence with coronary heart disease (CHD) and stroke risk in a cohort of 6910 men born in 1953 in the Copenhagen area of Denmark. Events were ascertained from 1978 to 2000 using a cause-of-death register and hospital discharge records. There were 150......While recent studies have reported an inverse relation between childhood intelligence test scores and all-cause mortality in later life, the link with disease-specific outcomes has been rarely examined. Furthermore, the potential confounding effect of birthweight and childhood social circumstances...

  4. Consumption of industrial and ruminant trans fatty acids and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Bendsen, Nathalie Tommerup; Christensen, R.; Bartels, Else Marie

    2011-01-01

    The aim of this systematic review and meta-analysis was to summarize the evidence from observational studies assessing the association between intake of trans fatty acids (TFA) and the risk of coronary heart disease (CHD), with a specific emphasis on distinguishing between TFA of industrial...... and ruminant origin. By searching five bibliographic databases, analyses from six published and two unpublished prospective cohort studies, assessing the association of intake of TFA with fatal and/or non-fatal CHD, were identified. Four and three studies reported separate associations for intake of ruminant...

  5. Analysis of physical fitness and coronary heart disease risk of Dallas area police officers.

    Science.gov (United States)

    Pollock, M L; Gettman, L R; Meyer, B U

    1978-06-01

    Two hundred thirteen male police officers between 21 and 52 years of age volunteered to participate in a physical evaluation and conditioning program. Information concerning the physical fitness status and risk of coronary heart disease (CHD) of police officers were shown. Younger police officers (less than 30 years of age) were average in physical fitness levels and CHD risk compared to the population of the same age. Middle-aged police officers were shown to be lower in physical fitness levels and higher in CHD risk compared to their cohorts. The results from this investigation support the need for physical fitness and preventive medicine programs for police officers.

  6. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-02

    Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF

  7. Relationship Between gamma-Glutamyltransferase (gamma-GT with High Sensitive C-Reactive Protein (hs-CRP, Oxidized (Ox-LDL and Glutathione Peroxidase (GPx on Coronary Heart Disease (CHD Patient

    Directory of Open Access Journals (Sweden)

    Marissa Arifin

    2009-08-01

    Full Text Available BACKGROUND: Recent clinical studies have suggested that γ-glutamyltransferase (γ-GT can trigger oxidative stress within the plaque. This study aimed to investigate whether serum γ-GT might be as a risk factor of coronary heart disease (CHD, and measure the associations of serum γ-GT with high sensitive C-Reactive Protein (hs-CRP, Oxidized LDL (Ox-LDL and Glutathione Peroxidase (GPx. METHODS: This study recruited 48 patients aged 30-70 year who underwent coronary angiography at Haji Adam Malik Medical Center at Medan between February and April 2008 and who presented at least one coronary stenosis of >50% of the luminar diameter. The sample subjects were consecutively selected. RESULTS: γ-Glutamyltransferase was positively associated (r=0.546 with hs-CRP as a marker of chronic inflammation after careful adjustment for other established risk factors in CHD patient. But, there was no significant difference between γ-GT in male and female patients. Further, there were no correlations between γ-GT and Ox-LDL and GPx. Ratio of γ-GT/GPx was measured as well, and it was associated with hs-CRP. CONCLUSIONS: Ratio of γ-GT/GPx was associated with inflammation process in coronary heart disease patients. KEYWORDS: γ-glutamyltransferase (γ-GT, inflammation, oxidative stress, coronary heart disease.

  8. Clinical feasibility and safety of a novel miniature mobile cardiac catheterization laboratory in diagnosis and treatment for coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Liang Ming; Han Yaling; Wang Geng; Yao Tianming; Sun Jingyang; Li Fei; Xu Kai

    2014-01-01

    Background The lack of medical facilities causes delayed diagnosis and treatment of coronary heart disease in remote mountainous area and/or at disaster site.The miniature mobile cardiac catheterization laboratory was developed to be an intervention platform for coronary heart disease diagnosis and treatment by our team.Pre-clinical research indicated that the miniature mobile cardiac catheterization laboratory performed well in the rescue of critical cardiovascular diseases,even ST-segment elevation myocardial infarction.The present study aimed to evaluate the clinical safety and timeliness of the miniature mobile cardiac catheterization laboratory for emergent coronary interventional diagnosis and treatment.Methods X-ray radiation safety and disinfection efficacy in the miniature mobile cardiac catheterization laboratory were tested during working status.Coronary angiography and/or percutaneous coronary intervention were performed in remote mountainous areas on patients who were first diagnosed as having coronary heart disease by senior interventional cardiologists.The percutaneous coronary intervention procedures and results from patients in the miniature mobile cardiac catheterization laboratory were compared with patients who were treated in the hospital catheter lab.Results The X-ray radiation dosages in the miniature mobile cardiac catheterization laboratory were 39.55 μGy/s,247.4 μGy/h,90.3 μGy/h and 39.4 μGy/h which were corresponded to 0 m,1 m,2 m and 3 m away from the tube central of the medium C-arm.And the radiation dosages used in the miniature mobile cardiac catheterization laboratory were less than the corresponding positions in the hospital catheter lab.The numbers of bacteria colonies in the miniature mobile cardiac catheterization laboratory in different environments range from (60±8) cfu/m3 to (120±10) cfu/m3 and met the demands of percutaneous coronary intervention.A total of 17 patients who received angiography in the miniature mobile

  9. Design and baseline characteristics of a coronary heart disease prospective cohort: two-year experience from the strategy of registry of acute coronary syndrome study (ERICO study

    Directory of Open Access Journals (Sweden)

    Alessandra C. Goulart

    2013-01-01

    Full Text Available OBJECTIVES: To describe the ERICO study (Strategy of Registry of Acute Coronary Syndrome, a prospective cohort to investigate the epidemiology of acute coronary syndrome. METHODS: The ERICO study, which is being performed at a secondary general hospital in São Paulo, Brazil, is enrolling consecutive acute coronary syndrome patients who are 35 years old or older. The sociodemographic information, medical assessments, treatment data and blood samples are collected at admission. After 30 days, the medical history is updated, and additional blood and urinary samples are collected. In addition, a retinography, carotid intima-media thickness, heart rate variability and pulse-wave velocity are performed. Questionnaires about food frequency, physical activity, sleep apnea and depression are also applied. At six months and annually after an acute event, information is collected by telephone. RESULTS: From February 2009 to September 2011, 738 patients with a diagnosis of an acute coronary syndrome were enrolled. Of these, 208 (28.2% had ST-elevation myocardial infarction (STEMI, 288 (39.0% had non-ST-elevation myocardial infarction (NSTEMI and 242 (32.8% had unstable angina (UA. The mean age was 62.7 years, 58.5% were men and 77.4% had 8 years or less of education. The most common cardiovascular risk factors were hypertension (76% and sedentarism (73.4%. Only 29.2% had a prior history of coronary heart disease. Compared with the ST-elevation myocardial infarction subgroup, the unstable angina and non-ST-elevation myocardial infarction patients had higher frequencies of hypertension, diabetes, prior coronary heart disease (p<0.001 and dyslipidemia (p = 0.03. Smoking was more frequent in the ST-elevation myocardial infarction patients (p = 0.006. CONCLUSIONS: Compared with other hospital registries, our findings revealed a higher burden of CV risk factors and less frequent prior CHD history.

  10. Stroke is predicted by low visuospatial in relation to other intellectual abilities and coronary heart disease by low general intelligence.

    Directory of Open Access Journals (Sweden)

    Eero Kajantie

    Full Text Available BACKGROUND: Low intellectual ability is associated with an increased risk of coronary heart disease and stroke. Most studies have used a general intelligence score. We studied whether three different subscores of intellectual ability predict these disorders. METHODS: We studied 2,786 men, born between 1934 and 1944 in Helsinki, Finland, who as conscripts at age 20 underwent an intellectual ability test comprising verbal, visuospatial (analogous to Raven's progressive matrices and arithmetic reasoning subtests. We ascertained the later occurrence of coronary heart disease and stroke from validated national hospital discharge and death registers. RESULTS: 281 men (10.1% had experienced a coronary heart disease event and 131 (4.7% a stroke event. Coronary heart disease was predicted by low scores in all subtests, hazard ratios for each standard deviation (SD lower score ranging from 1.21 to 1.30 (confidence intervals 1.08 to 1.46. Stroke was predicted by a low visuospatial reasoning score, the corresponding hazard ratio being 1.23 (95% confidence interval 1.04 to 1.46, adjusted for year and age at testing. Adjusted in addition for the two other scores, the hazard ratio was 1.40 (1.10 to 1.79. This hazard ratio was little affected by adjustment for socioeconomic status in childhood and adult life, whereas the same adjustments attenuated the associations between intellectual ability and coronary heart disease. The associations with stroke were also unchanged when adjusted for systolic blood pressure at 20 years and reimbursement for adult antihypertensive medication. CONCLUSIONS: Stroke is predicted by low visuospatial reasoning scores in relation to scores in the two other subtests. This association may be mediated by common underlying causes such as impaired brain development, rather than by mechanisms associated with risk factors shared by stroke and coronary heart disease, such as socio-economic status, hypertension and atherosclerosis.

  11. Stroke Is Predicted by Low Visuospatial in Relation to Other Intellectual Abilities and Coronary Heart Disease by Low General Intelligence

    Science.gov (United States)

    Kajantie, Eero; Räikkönen, Katri; Henriksson, Markus; Leskinen, Jukka T.; Forsén, Tom; Heinonen, Kati; Pesonen, Anu-Katriina; Osmond, Clive; Barker, David J. P.; Eriksson, Johan G.

    2012-01-01

    Background Low intellectual ability is associated with an increased risk of coronary heart disease and stroke. Most studies have used a general intelligence score. We studied whether three different subscores of intellectual ability predict these disorders. Methods We studied 2,786 men, born between 1934 and 1944 in Helsinki, Finland, who as conscripts at age 20 underwent an intellectual ability test comprising verbal, visuospatial (analogous to Raven's progressive matrices) and arithmetic reasoning subtests. We ascertained the later occurrence of coronary heart disease and stroke from validated national hospital discharge and death registers. Results 281 men (10.1%) had experienced a coronary heart disease event and 131 (4.7%) a stroke event. Coronary heart disease was predicted by low scores in all subtests, hazard ratios for each standard deviation (SD) lower score ranging from 1.21 to 1.30 (confidence intervals 1.08 to 1.46). Stroke was predicted by a low visuospatial reasoning score, the corresponding hazard ratio being 1.23 (95% confidence interval 1.04 to 1.46), adjusted for year and age at testing. Adjusted in addition for the two other scores, the hazard ratio was 1.40 (1.10 to 1.79). This hazard ratio was little affected by adjustment for socioeconomic status in childhood and adult life, whereas the same adjustments attenuated the associations between intellectual ability and coronary heart disease. The associations with stroke were also unchanged when adjusted for systolic blood pressure at 20 years and reimbursement for adult antihypertensive medication. Conclusions Stroke is predicted by low visuospatial reasoning scores in relation to scores in the two other subtests. This association may be mediated by common underlying causes such as impaired brain development, rather than by mechanisms associated with risk factors shared by stroke and coronary heart disease, such as socio-economic status, hypertension and atherosclerosis. PMID:23144789

  12. Effect of Cytochrome P450 2C19 681G>A Polymorphism on Premature Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Zhong-hai Chi

    2016-03-01

    Full Text Available Objective: The aim of our study was to evaluate the association between cytochrome P450 2C19 (CYP2C19 681G>A polymorphisms and the age of development of coronary heart disease. Additionally, the study might find some biological indicators at the gene level that could help to predict and evaluate the risk of coronary heart disease in time. Methods: This study included 352 individuals with coronary heart disease. Polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP was used to identify CYP2C19 681G>A. The objects were divided into wild type (GG or homozygous CYP2C19*1 wild-type and mutant type (GA/AA or the mutant CYP2C19*2 allele on the basis of genotype. The association between CYP2C19 gene polymorphism and the age of onset of coronary heart disease was assessed by multivariate linear regression analysis. Results: There was a significant association in the age of onset between the two groups (t=3.398, P=0.001, which was 58.51+12.72 years in the wild type and 53.95+11.63 years in the mutant group. The frequency of CYP2C19 681A (CYP2C19*2 allele was 3.32, 0.268, 0.227 in different age groups, which was significantly different (χ2=10.745, P=0.005 in different groups, as well as in the genotype. The result, assessed by multiple linear regression, showed that genotype, smoking, obesity, and hyperlipidemia affect the age of onset of coronary heart disease (β was -0.167, 0.156, 0.155, and 0.112, PA gene polymorphism may be one of the risk factors in susceptibility to early onset of coronary heart disease, but not an independent factor because other factors may play a synergistic role.

  13. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

    NARCIS (Netherlands)

    Kivimäki, M.; Jokela, M.; Nyberg, S.T.; Singh-Manoux, A.; Fransson, E.I.; Alfredsson, L.; Bjorner, J.B.; Borritz, M.; Burr, H.; Casini, A.; Clays, E.; Bacquer, D. de; Dragano, N.; Erbel, R.; Geuskens, G.A.; Hamer, M.; Hooftman, W.E.; Houtman, I.L.; Jöckel, K.H.; Kittel, F.; Knutsson, A.; Koskenvuo, M.; Lunau, T.; Madsen, I.E.; Nielsen, M.L.; Nordin, M.; Oksanen, T.; Pejtersen, J.H.; Pentti, J.; Rugulies, R.; Salo, P.; Shipley, M.J.; Siegrist, J.; Steptoe, A.; Suominen, S.B.; Theorell, T.; Vahtera, J.; Westerholm, P.J.M.; O'Reilly, D.; Kumari, M.; Batty, G.D.; Ferrie, J.E.; Virtanen, M.

    2015-01-01

    Background: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. Methods: We identified

  14. Prognosis by C-reactive protein and matrix metalloproteinase-9 levels in stable coronary heart disease during 15 years of follow-up

    DEFF Research Database (Denmark)

    Eldrup, N; Kragelund, C; Steffensen, R;

    2012-01-01

    associate with prognosis in patients with stable coronary heart disease. METHODS AND RESULTS: We measured baseline plasma CRP and matrix metalloproteinase-9 in 1090 patients with stable coronary heart disease and as the primary composite endpoint detected incident unstable angina, myocardial infarction...

  15. The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies

    Directory of Open Access Journals (Sweden)

    Natalya Anatolyevna Khramtsova

    2012-01-01

    Full Text Available Coronary heart disease (CHD and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA. Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987. The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years. Results. The incidence of CHD in RA was as much as 45.9% (n = 118, including 52.5% (n = 62 for typical angina pectoris on exertion; 25.4% (n = 30 and 22.1% (n = 26 for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100 were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1, smoking (OR = 10.2, early menopause (OR = 3.6, decreased glomerular filtration rate (OR = 3.5, cardiovascular heredity (OR = 3.1, overweight (OR = 2.5, a heart rate of more than 70 beats/min (OR = 2.3, atherogenic dyslipidemia (OR = 2.3, hyperglycemia (OR = 2.1, and age (OR = 1.7. Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0, concomitant anemia as a common complication of RA (OR = 4.7, high DAS 28 scores (OR = 3.7, visual analog scale pain scores of > 50 mm (OR = 2.6, and RA duration of >10 years (OR = 2.2. Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.

  16. Plasma Catestatin: A Useful Biomarker for Coronary Collateral Development with Chronic Myocardial Ischemia

    Science.gov (United States)

    Xu, Weixian; Yu, Haiyi; Li, Weihong; Gao, Wei; Guo, Lijun; Wang, Guisong

    2016-01-01

    Backgrounds Catestatin is an endogenous multifunctional neuroendocrinepeptide. Recently, catestatin was discovered as a novel angiogenic cytokine. The study was to investigate the associations between endogenous catestatin and coronary collateral development among the patients with chronic myocardial ischemia. Methods Thirty-eight patients with coronary artery chronic total occlusions (CTO) (CTO group) and 38 patients with normal coronary arteries (normal group) were enrolled in the series. Among the patients with CTO, coronary collateral development was graded according to the Rentrop score method. Rentrop score 0–1 collateral development was regarded as poor collateral group and 2–3 collateral development was regarded as good collateral group. Plasma catestatin level and vascular endothelial growth factor (VEGF) were measured by ELISA kits. Results The plasma catestatin levels in CTO group were significantly higher than that in normal group (1.97±1.01 vs 1.36±0.97ng/ml, p = 0.009). In the CTO group, the patients with good collateral development had significantly higher catestatin and VEGF levels than those with poor collateral development (2.36±0.73 vs 1.61±1.12 ng/ml, p = 0.018; 425.23±140.10 vs 238.48±101.00pg/mL, pCTO. However, there is no correlations between plasma catestatin levels and VEGF (r = -0.06, p = 0.744). In the multiple linear regression models, plasma catestatin level was one of the independent factors of coronary collateral development after adjustment for confounders. Conclusions Plasma catestatin was associated with coronary collateral developments. It may be a useful biomarker for coronary collateral development and potential target for therapeutic angiogenesis in patients with CTO. PMID:27304618

  17. Coronary heart disease incidence in women by waist circumference within categories of body mass index.

    Science.gov (United States)

    Canoy, Dexter; Cairns, Benjamin J; Balkwill, Angela; Wright, F Lucy; Green, Jane; Reeves, Gillian; Beral, Valerie

    2013-10-01

    High body mass index (BMI) and large waist circumference are separately associated with increased coronary heart disease (CHD) risk but these measures are highly correlated. Their separate associations with incident CHD, cross-classifying one variable by the other, are less investigated in large-scale studies. We examined these associations in a large UK cohort (the Million Women Study), which is a prospective population-based study. We followed 496,225 women (mean age 60 years) with both waist circumference and BMI measurements who had no vascular disease or cancer. Adjusted relative risk and 20-year cumulative CHD incidence (first coronary hospitalization or death) from age 55 to 74 years were calculated using Cox regression. Plasma apolipoproteins were assayed in 6295 randomly selected participants. There were 10,998 incident coronary events after mean follow up of 5.1 years. Within each BMI category (waist circumference; within each waist circumference category (waist circumference waist circumference ≥80 cm, with 1 in 8 (95% confidence interval 1 in 7 to 9) women developing CHD over the same period. Similar associations for apolipoprotein B to A1 ratio across adiposity categories were observed, particularly in non-obese women. Our conclusions were that both waist circumference and BMI are independently associated with incident CHD.

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

    Science.gov (United States)

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

    2007-02-01

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

  19. Differentiation of acute total occlusion of coronary artery from chronic total occlusion in coronary computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kwag, Hyon Joo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    To compare the features of coronary computed tomography angiography (CCTA) imaging of the patients with acute total occlusion (ATO) of coronary artery with those of chronic total occlusion (CTO). CCTA of 26 patients with complete interruption of the coronary artery in CCTA and occlusion in conventional coronary angiography, were retrospectively analyzed. Discrimination between the ATO group (n = 11, patients with non ST elevation myocardial infarction or unstable angina) and the CTO group (n = 15, patients with stable angina or nonspecific symptom) was arbitrarily determined by clinical diagnosis. Lesion length, remodeling index (RI), plaque density measured by Hounsfield units (HU), plaque composition, percentage attenuation drop across the lesion, and presence of myocardial thinning were evaluated. Comparisons between the ATO and CTO groups revealed significantly shorter lesion length in the ATO group (0.40 cm vs. 1.87 cm, respectively; p = 0.001), and significantly higher RI (1.56 vs. 1.10, respectively; p = 0.004). Plaque density of the ATO group was lower (37.0 HU vs. 104.7 HU, respectively; p < 0.001) and non calcified plaque was frequently seen in the ATO group (72.7% vs. 26.7%, respectively; p = 0.02). Percentage attenuation drop across the lesion was lower for the ATO group (10.92% vs. 25.44%, respectively; p = 0.005). Myocardial thinning was exclusively observed in the CTO group (seven of 15 patients, p = 0.01). CCTA shows various statistically significant differences between the ATO and CTO groups.

  20. Exercise training-induced adaptations in mediators of sustained endothelium-dependent coronary artery relaxation in a porcine model of ischemic heart disease

    Science.gov (United States)

    Heaps, Cristine L.; Robles, Juan Carlos; Sarin, Vandana; Mattox, Mildred L.; Parker, Janet L.

    2014-01-01

    Objective Test the hypothesis that exercise training enhances sustained relaxation to persistent endothelium-dependent vasodilator exposure via increased nitric oxide contribution in small coronary arteries of control and ischemic hearts. Methods Yucatan swine were designated to a control group or a group in which an ameroid constrictor was placed around the proximal LCX. Subsequently, pigs from both groups were assigned to exercise (5 days/week; 16 weeks) or sedentary regimens. Coronary arteries (~100–350 μm) were isolated from control pigs and from both nonoccluded and collateral-dependent regions of chronically-occluded hearts. Results In arteries from control pigs, training significantly enhanced relaxation responses to increasing concentrations of bradykinin (10−10 to 10−7 M) and sustained relaxation to a single bradykinin concentration (30 nM), which were abolished by NOS inhibition. Training also significantly prolonged bradykinin-mediated relaxation in collateral-dependent arteries of occluded pigs, which was associated with more persistent increases in endothelial cellular Ca2+ levels, and reversed with NOS inhibition. Protein levels for eNOS and p-eNOS-(Ser1179), but not caveolin-1, Hsp90, or Akt, were significantly increased with occlusion, independent of training state. Conclusions Exercise training enhances sustained relaxation to endothelium-dependent agonist stimulation in small arteries of control and ischemic hearts by enhanced nitric oxide contribution and endothelial Ca2+ responses. PMID:24447072

  1. Identification of metabolic biomarkers in patients with type 2 diabetic coronary heart diseases based on metabolomic approach

    OpenAIRE

    2016-01-01

    Type 2 diabetic coronary heart disease (T2DM-CHD) is a kind of serious and complex disease. Great attention has been paid to exploring its mechanism; however, the detailed understanding of T2DM-CHD is still limited. Plasma samples from 15 healthy controls, 13 coronary heart disease (CHD) patients, 15 type 2 diabetes mellitus (T2DM) patients and 28 T2DM-CHD patients were analyzed in this research. The potential biomarkers of CHD and T2DM were detected and screened out by 1H NMR-based plasma me...

  2. Ischemic heart disease down-regulates angiotensin type 1 receptor mRNA in human coronary arteries

    DEFF Research Database (Denmark)

    Wackenfors, Angelica; Emilson, Malin; Ingemansson, Richard;

    2004-01-01

    Angiotensin II is important in the development of cardiovascular disease. In the present study, angiotensin II receptor mRNA levels were quantified by real-time polymerase chain reaction (real-time PCR) in human coronary arteries from patients with ischemic heart disease and controls. Furthermore......, the suitability of artery culture for studying angiotensin receptor changes was evaluated by in vitro pharmacology and real-time PCR. The angiotensin type 1 (AT1) receptor mRNA levels were down-regulated in human coronary arteries from patients with ischemic heart disease as compared to controls (P

  3. The Effects of Open Heart Surgery (Coronary Bypass on Depression and Social Adjustment of Hospitalized Heart Patients

    Directory of Open Access Journals (Sweden)

    Farah Naderi

    2009-01-01

    Full Text Available Problem statement: Post treatment preparation is critical period, as patients may have difficulties with psychosocial adjustment, especially related to dissatisfaction with side effects of medicine taking therapy and a lack of socialization skills/social competence. Different psychological issues arise for patients depending upon where they are in the medical treatment process. Approach: The current research was processed with the intention of examining and presenting the effects of open heart surgery (coronary bypass on male and female hospitalized heart patients' depression and social adjustment in Tehran Shahid Modarress Hospital; regarding age, sex, employment and marital status The research sample particularized 118 patients (42 female and 76 male whom were selected by simple random sampling procedure. To obtain data, Beck Depression Inventory (BDI and Social Adjustment Scale Self-Report (SAS-SR were implemented a couple weeks before and after surgery procedure as pretest and post test with one group. The research design was quasi-experimental. Results: Results were considered significant at p value less than to equal to 0.0001 (p≤0.0001 and revealed that: Heart surgery decreased social adjustment but had no significant impact on heart inpatients' depression. Conclusion: After treatment, it was common for patients to exhibit behavior problems, depression, poor social adaptation and/or noncompliance with the medical regimen. The psychosocial adaptation of surgery procedure can be promoted through support and counseling by one or all members of the surgery team caring for the patients and their families. This process must start during the first visit to the treatment center.

  4. Incidence status of senile coronary heart disease complicating chronic kidney disease and its influence on long-term prognosis%老年冠心病合并慢性肾脏病发病状况及其对远期预后的影响

    Institute of Scientific and Technical Information of China (English)

    伊双艳; 付士辉; 肖铁卉; 朱兵; 朱启伟; 杜瑞雪; 叶平; 骆雷鸣

    2013-01-01

    Objective To survey the incidence status of senile coronary heart disease ( CHD ) complicating chronic kidney disease ( CKD ) and its influence on long-term prognosis. Methods The method of retrospective cohort study was used to choose 795 elderly patients with CHD, and then they were divided into CHD complicating CKD group ( CKD group, n=228 ) and CHD group ( n=567 ) according to whether the patients had CHD complicating CKD at baseline. The baseline level and relevant risk factors were surveyed in two groups. Taking all-cause mortality as study endpoint, the influence of CHD complicating CKD on long-term prognosis and other risk factors were analyzed after following up for 10 years. Results The incidence of CKD was 28.7% in elderly patients with CHD, which showed an increase trend as age increasing. The independent risk factors of CKD included age, history of chronic heart failure, hemoglobin level and blood uric acid level. After following up for 10 years, all-cause mortality was 32.8% in elderly patients with CHD. All-cause mortality was significantly higher in CKD group than that in CHD group ( 41.7% vs. 28.9%, P<0.05 ) . The mortality risk in CKD group was 1.725 times higher than that in CHD group ( 95%CI: 25.6%-33.0% ) . The multi-factor analysis on 10-year all-cause mortality showed that CKD was an independent risk factor of all-cause mortality in elderly patients with CHD. Conclusion The incidence of CKD is higher in hospitalized elderly patients with CHD and prognosis is poor. CKD is an independent risk factor of all-cause mortality.%目的 调查老年冠心病(CHD)患者合并慢性肾脏病(CKD)的发病状况及其对远期预后的影响.方法 采用回顾性队列研究的方法.纳入795例老年冠心病患者,依照基线时是否合并CKD,分为合并CKD组(n=228)与单纯CHD组(n=567),调查两组患者的基线指标水平及相关危险因素情况.以全因死亡作为研究终点,进行10年随访,分析合并CKD对老年冠心病患者

  5. Analysis of heart rate variability in patients with coronary heart disease%冠心病患者心率变异性分析

    Institute of Scientific and Technical Information of China (English)

    韩健; 杨靖宇; 高志刚

    2012-01-01

    目的 研究冠心病患者心率变异(HRV)的变化规律及临床意义.方法 选择50例无心律失常冠心病患者(冠心病组)、30例伴心律失常冠心病患者(心率失常组)与52例正常成人自愿者(正常组)进行24 h动态心电图HRV指标比较研究.结果 与正常组比较,冠心病患者SDNN、SDANN、RMSSD、PNN50和HF指标均降低,LF指标升高,具有显著差异.伴心律失常与无心律失常冠心病患者比较,HRV指标异常变化趋于恶化.结论 冠心病患者心脏自主神经调节功能受到损害,迷走神经活性减弱,交感神经活动占优势.%Objective To study the variation and clinical significance of heart rate variability ( HRV ) in patients with coronary heart disease. Methods Totally 50 coronary heart disease patients without arrhythmia( coronary heart disease group ), 30 coronary heart disease patients with arrhythmia ( arrhythmia group ) and 52 normal persons ( control group ) were enrolled. The 24-hours dynamic electrocardiograph HRV indicator comparison was made between the three groups. Results The indicators of HRV time domain analysis were: SDNN, SDANN, RMSSD, PNN50, HF and LF. The indicators of SDNN, SDANN, RMSSD, PNN50 and HF were lower and the indicator of HF was higher in coronary heart disease group and arrhythmia group compared with those in control group, with significant differences. The abnormal changes of HRV indicators were worsen in arrhythmia group compared with those in coronary heart disease group. Conclusion In patients with coronary heart disease, the regulatory function of the cardiac autonomic nerve is damaged, the activity of the vagus nerve is decreased and the sympathetic nerve activity is dominant.

  6. Mild and moderate pre-dialysis chronic kidney disease is associated with increased coronary artery calcium

    Directory of Open Access Journals (Sweden)

    Budoff M

    2011-12-01

    Full Text Available Sion K Roy, Albert Cespedes, Dong Li, Tae-Young Choi, Matthew J BudoffDivision of Cardiology, Department of Medicine, Los Angeles Biomedical Research Center at Harbor-UCLA Medical Center, Torrance, California, USABackground: It is increasingly evident that patients with chronic kidney disease (CKD are more likely to die from heart disease than kidney failure. This study evaluated whether pre-dialysis CKD is an independent risk factor for coronary artery calcium (CAC.Methods: A total of 544 consecutive patients who underwent CAC scoring were analyzed. Eleven patients requiring hemodialysis were excluded. Patients were divided into three groups: normal glomerular filtration rate (GFR (GFR > 90 mL/min/1.73 m2, mild CKD (90 ≥ GFR > 60 mL/min/1.73 m2, and moderate CKD (60 ≥ GFR > 30 mL/min/1.73 m2. Continuous and categorical variables were compared using analysis of variance and the χ2 statistic. A multiple logistic regression model was used for detecting the association between total CAC score and GFR. An unadjusted model was used, followed by a second model adjusted for covariates known to be related to CAC. Another multivariable binary logistic model predicting the presence of CAC (>10 was performed and odds of incidence of CAC (>10 were calculated among the three GFR subgroups.Results: After adjustment for covariates, patients with mild CKD had mean CAC scores 175 points higher than those with the referent normal GFR (P = 0.048, while those with moderate CKD had mean CAC scores 693 points higher than the referent (P < 0.001. After adjustment for covariates, patients with mild CKD were found to be 2.2 times more likely (95% confidence interval 1.3–3.7, P = 0.004 and patients with moderate CKD were 6.4 times more likely (95% confidence interval 2.9–14.3, P < 0.001 to have incident CAC compared with the group with normal GFR.Conclusion: Mild and moderate pre-dialysis CKD are independent risk factors for increased mean and incident CAC

  7. Cigarette smoking inhibits the anti-platelet activity of aspirin in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    LI Wei-ju; ZHANG Hong-yin; MIAO Cheng-long; TANG Ri-bo; DU Xin; SHI Ji-hui; MA Chang-sheng

    2011-01-01

    Objective Tobacco smoking results in increased platelet aggregability, which suggests that low-dose aspirin used in common clinical practice may not effectively inhibit platelet activity in smokers with coronary heart disease (CHD). This review was performed to assess the effect of aspirin on platelet aggregation in patients with CHD.Data sources We performed an electronic literature search of MEDLINE (starting from the beginning to March 15, 2009)using the term "smoking" or "tobacco" paired with the following: "platelet", "aspirin" or "coronary heart disease".Study selection We looked for review articles regarding the effect of tobacco smoking on platelet activity and on the anti-platelet efficacy of aspirin in healthy people and patients with CHD. The search was limited in "core clinical journal".In total, 1321 relevant articles were retrieved, and 36 articles were ultimately cited.Results Tobacco smoking results in increased platelet aggregability, which can be inhibited by low-dose aspirin in the healthy population. However, in patients with CHD, the increased platelet aggregability can not be effectively inhibited by the same low-dose of aspirin. A recent study indicated that clopidogrel or an increased dose of aspirin can effectively inhibit the increased platelet aggregability induced by tobacco smoking in patients with CHD.Conclusions It is important for patients with CHD to quit smoking. For the current smoker, it may be necessary to take larger doses of aspirin than normal or take an adenosine diphosphate receptor inhibitor along with aspirin to effectively inhibit the increased platelet activity.

  8. Perceptions of coronary heart disease: the development and psychometric testing of a measurement scale.

    Science.gov (United States)

    Chan, C W

    2014-01-01

    Individuals' perceptions of coronary heart disease (CHD) have implications for the ways in which they respond to the disease, process risks, make decisions, and take action to reduce CHD risks. This study aimed to develop and evaluate the psychometric properties of the perceptions of coronary heart disease scale (PCS) among a Hong Kong Chinese population. A cross-sectional study was conducted using a convenient sample (n = 232) of participants recruited from a variety of catchments including public domains, a cardiac unit, and a cardiac rehabilitation and prevention center. Exploratory factor analysis identified a nine-item, two-factor model that accounted for 52.5% of the total explained variance. The two factors were the perceived risk (five items) and perceived seriousness (four items) of CHD. The PCS demonstrated good content validity; acceptable total, and subscale internal consistency (.73, .61 - .81); and significant contrast-group differences with higher levels of CHD perceptions among males (p = .002), younger participants (p psychometric properties as a short measurement scale, which supports its use in future research. Future validation of this scale is warranted.

  9. [Competitive sports and leisure-time physical activity in patients with coronary heart disease].

    Science.gov (United States)

    Pedrinazzi, Claudio; Durin, Ornella; Inama, Giuseppe

    2012-10-01

    During recent years, the central role of exercise in the prevention of cardiovascular disease has gradually been demonstrated, and in 2003 the consensus document of the Council on Clinical Cardiology and Council on Nutrition, Physical Activity and Metabolism on the role of physical exercise in the prevention and treatment of coronary artery disease defined sedentary lifestyle as a modifiable independent cardiovascular risk factor, responsible for 12% of total mortality in the United States and for a 1.9-fold increase in the risk of ischemic heart disease. The reduction in cardiovascular mortality and cardiac ischemic events in subjects who perform regular physical activity is mainly due to the action that exercise plays on the control of cardiovascular risk factors. In particular, physical training has proved capable of improving lipid profile, reducing blood pressure and body weight, and improving glycemic control in diabetic subjects. In patients with coronary artery disease, combined exercise training, including both aerobic activities and strength training, is currently recommended. However, physical training in patients suffering from ischemic heart disease should be carefully prescribed, in order to maximize the positive effects and minimize the risks. It is also important that physical training programs are conducted in suitable facilities, with appropriately trained staff and with technical equipment suitable to deal with any emergency situations.

  10. Radiologically revealed spine osteoporosis in male with hypertension and coronary heart disease

    Directory of Open Access Journals (Sweden)

    P A Chizhov

    2005-01-01

    Full Text Available Radiologically revealed spine osteoporosis in male with hypertension and coronary heart disease Objective. To study prevalence and intensity of spine osteoporosis (OP in men suffering from hypertension (H and coronary heart disease (CHD. Material and methods. 101 men with H and CHD aged 50 to 78 years (mean age 60,6±0,85 years and 37 men of control group without cardiovascular diseases aged 50-66 years (mean age 58,6±0,74 years were examined. Clinical examination, radiological, radiomorphometric spine examination and echocardioscopy were performed. Results. OP was revealed in 34,65% of main group pts what is 3,2 times more frequent than in control group (10,8%, p<0,05. OP intensity in men with H and CHD was significantly higher than in healthy people. Vfertebral fractures were revealed in 12,87+3,3% of main group pts and only in 2,7±2,7% in control group (p<0,05. OP development dependence from cardiac history duration and cardiac pathology severity was demonstrated. Conclusion. The results of the study show significantly higher prevalence of spine OP among men suffering from H and CHD. Long history and severity of cardiovascular pathology clinical signs promote OP frequency and severity increase.

  11. Relationship between chronic obstructive pulmonary disease and subclinical coronary artery disease in long-term smokers

    DEFF Research Database (Denmark)

    Rasmussen, Thomas; Køber, Lars; Pedersen, Jesper Holst;

    2013-01-01

    Cardiovascular conditions are reported to be the most frequent cause of death in patients with chronic obstructive pulmonary disease (COPD). However, it remains unsettled whether severity of COPD per se is associated with coronary artery disease (CAD) independent of traditional cardiovascular risk...... factors. The aim of this study was to examine the relationship between the presence and severity of COPD and the amount of coronary artery calcium deposit, an indicator of CAD and cardiac risk, in a large population of current and former long-term smokers....

  12. Assessment of the risk factors of coronary heart events based on data mining with decision trees.

    Science.gov (United States)

    Karaolis, Minas A; Moutiris, Joseph A; Hadjipanayi, Demetra; Pattichis, Constantinos S

    2010-05-01

    Coronary heart disease (CHD) is one of the major causes of disability in adults as well as one of the main causes of death in the developed countries. Although significant progress has been made in the diagnosis and treatment of CHD, further investigation is still needed. The objective of this study was to develop a data-mining system for the assessment of heart event-related risk factors targeting in the reduction of CHD events. The risk factors investigated were: 1) before the event: a) nonmodifiable-age, sex, and family history for premature CHD, b) modifiable-smoking before the event, history of hypertension, and history of diabetes; and 2) after the event: modifiable-smoking after the event, systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and glucose. The events investigated were: myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABG). A total of 528 cases were collected from the Paphos district in Cyprus, most of them with more than one event. Data-mining analysis was carried out using the C4.5 decision tree algorithm for the aforementioned three events using five different splitting criteria. The most important risk factors, as extracted from the classification rules analysis were: 1) for MI, age, smoking, and history of hypertension; 2) for PCI, family history, history of hypertension, and history of diabetes; and 3) for CABG, age, history of hypertension, and smoking. Most of these risk factors were also extracted by other investigators. The highest percentages of correct classifications achieved were 66%, 75%, and 75% for the MI, PCI, and CABG models, respectively. It is anticipated that data mining could help in the identification of high and low risk subgroups of subjects, a decisive factor for the selection of therapy, i.e., medical or surgical. However, further investigation with larger datasets is

  13. Introducing the Tehran Heart Center's Premature Coronary Atherosclerosis Cohort: THC-PAC Study

    Directory of Open Access Journals (Sweden)

    SeyedHesameddin Abbasi

    2015-10-01

    Full Text Available Background: Data on premature coronary artery disease (CAD are scarce. The Tehran Heart Center's Premature Coronary Atherosclerosis Cohort Study (THC-PAC is the first study of its kind in the Middle East to assess major adverse cardiac events (MACE in young CAD patients.Methods: The cohort consists of CAD patients, males ≤ 45 years old and females ≤ 55 years old. The participants are residents of Tehran or its suburbs and underwent coronary angiography between June 2004 and July 2011. A 10-year follow-up, via either clinical visits or telephone calls at least once a year, was commenced in August 2012. The end point is considered MACE, encompassing death, myocardial infarction, stroke, new coronary involvement, percutaneous coronary intervention, and coronary artery bypass grafting.Results: The cohort comprises 1232 eligible patients (613 [49.8%] males at a mean age of 45.1 years (SD = 5.8. High frequencies of conventional risk factors, including hyperlipidemia (884 [71.8%], hypertension (575 [46.7%], positive family history (539 [43.8%], cigarette smoking (479 [38.8%], and diabetes mellitus (390 [31.7%], were seen in the participants. The mean body mass index (BMI of the enrolled patients was high (29.2 ± 4.8 kg/m2, and 532 (43.3% and 440 (35.8% of them were overweight and obese, respectively. The females’ BMI was higher (30.4 ± 5.3 vs. 28.0 ± 3.9 kg/m2; P < 0.001 and they had a greater mean abdominal circumference (99.9 ± 13.5 vs. 98.1 ± 9.3 cm; P = 0.035. Between August 2012 and August 2013, follow-up was successful in 1173 (95.2% patients (median follow-up duration = 55.3 months, 95%CI: 53.5-57.0 months.Conclusion: Our younger patients with CAD had a high frequency of risk factors compared to the same-age general population and all-age CAD patients, which may predispose them to higher incidence of recurrent MACE.

  14. Up-Beat UK: A programme of research into the relationship between coronary heart disease and depression in primary care patients

    Directory of Open Access Journals (Sweden)

    Pariante Carmine M

    2011-05-01

    Full Text Available Abstract Background Coronary heart disease and depression are both common health problems and by 2020 will be the two leading causes of disability worldwide. Depression has been found to be more common in patients with coronary heart disease but the nature of this relationship is uncertain. In the United Kingdom general practitioners are now being remunerated for case-finding for depression in patients with coronary heart disease, however it is unclear how general practitioners should manage these patients. We aim to explore the relationship between coronary heart disease and depression in a primary care population and to develop an intervention for patients with coronary heart disease and depression. Methods/design This programme of research will consist of 4 inter-related studies. A 4 year prospective cohort study of primary care patients with coronary heart disease will be conducted to explore the relationship between coronary heart disease and depression. Within this, a nested case-control biological study will investigate genetic and blood-biomarkers as predictors of depression in this sample. Two qualitative studies, one of patients' perspectives of treatments for coronary heart disease and co-morbid depression and one of primary care professionals' views on the management of patients with coronary heart disease and depression will inform the development of an intervention for this patient group. A feasibility study for a randomised controlled trial will then be conducted. Discussion This study will provide information on the relationship between coronary heart disease and depression that will allow health services to determine the efficiency of case-finding for depression in this patient group. The results of the cohort study will also provide information on risk factors for depression. The study will provide evidence on the efficacy and feasibility of a joint patient and professional led intervention and data necessary to plan a

  15. Correlation of radiation dose and heart rate in dual-source computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Laspas, Fotios; Roussakis, Arkadios; Kritikos, Nikolaos; Efthimiadou, Roxani; Kehagias, Dimitrios; Andreou, John (CT and MRI Dept., Hygeia Hospital, Athens (Greece)), e-mail: fotisdimi@yahoo.gr; Tsantioti, Dimitra (Statistician, Hygeia Hospital, Athens (Greece))

    2011-04-15

    Background: Computed tomography coronary angiography (CTCA) has been widely used since the introduction of 64-slice scanners and dual-source CT technology, but the relatively high radiation dose remains a major concern. Purpose: To evaluate the relationship between radiation exposure and heart rate (HR), in dual-source CTCA. Material and Methods: Data from 218 CTCA examinations, performed with a dual-source 64-slices scanner, were statistically evaluated. Effective radiation dose, expressed in mSv, was calculated as the product of the dose-length product (DLP) times a conversion coefficient for the chest (mSv = DLPx0.017). Heart rate range and mean heart rate, expressed in beats per minute (bpm) of each individual during CTCA, were also provided by the system. Statistical analysis of effective dose and heart rate data was performed by using Pearson correlation coefficient and two-sample t-test. Results: Mean HR and effective dose were found to have a borderline positive relationship. Individuals with a mean HR >65 bpm observed to receive a statistically significant higher effective dose as compared to those with a mean HR =65 bpm. Moreover, a strong correlation between effective dose and variability of HR of more than 20 bpm was observed. Conclusion: Dual-source CT scanners are considered to have the capability to provide diagnostic examinations even with high HR and arrhythmias. However, it is desirable to keep the mean heart rate below 65 bpm and heart rate fluctuation less than 20 bpm in order to reduce the radiation exposure

  16. Analysis of risk factors of coronary heart disease%冠心病的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    付丽莉; 刘芳; 韩晓燕; 李敦彤

    2014-01-01

    目的:分析探究冠心病的危险因素。方法随机选取2011年2月至2013年2月来我院救治的冠心病患者34例,根据临床特征及冠状动脉造影检查,分析冠心病患者的危险因素。结果被选取的34例患者中13例体重指数严重超标,17例有严重吸烟史,9例合并高血压,6例合并糖尿病。结论超重及肥胖是冠心病的主要潜在危险因素,高血压是冠心病的独立因素,冠心病的危险性与血糖水平相关。了解冠心病和动脉粥样硬化危险因素,对于进行危险因素的干预治疗,尤其是进行有效的血脂异常的防治具有非常重要的意义。%Objective to analyze the risk factors of coronary heart disease. Methods 34 patients with coronary heart disease admitted in our hospital were randomly selected from february 2011 to february 2013. according to the clinical characteristics and coronary angiography in patients with coronary heart disease, risk factors were analyzed. Results of 34 cases selected, 13 patients performed with body mass index severely exceeding the standard, 17 cases with serious smoking history, 9 cases with hypertension, 6 patients with diabetes mellitus. Conclusion overweight and obesity are the main potential risk factors for coronary heart disease and hypertension is an independent factor for coronary heart disease, and coronary heart disease risk is associated with blood glucose levels. Understanding the risk factors for coronary heart disease and atherosclerosis and given therapeutic intervention for risk factors, especially has very important signiifcance for effective prevention and treatment of dyslipidemia.

  17. The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization.

    Science.gov (United States)

    Moe, Gordon W; Ezekowitz, Justin A; O'Meara, Eileen; Howlett, Jonathan G; Fremes, Steve E; Al-Hesayen, Abdul; Heckman, George A; Ducharme, Anique; Estrella-Holder, Estrellita; Grzeslo, Adam; Harkness, Karen; Lepage, Serge; McDonald, Michael; McKelvie, Robert S; Nigam, Anil; Rajda, Miroslaw; Rao, Vivek; Swiggum, Elizabeth; Virani, Sean; Van Le, Vy; Zieroth, Shelley; Arnold, J Malcolm O; Ashton, Tom; D'Astous, Michel; Dorian, Paul; Giannetti, Nadia; Haddad, Haissam; Isaac, Debra L; Kouz, Simon; Leblanc, Marie-Hélène; Liu, Peter; Ross, Heather J; Sussex, Bruce; White, Michel

    2014-03-01

    The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure.

  18. Deciphering the genetic and modular connections between coronary heart disease, idiopathic pulmonary arterial hypertension and pulmonary heart disease.

    Science.gov (United States)

    Yuan, Ye; Zhang, Yingying; Zhang, Xiaoxu; Yu, Yanan; Li, Bing; Wang, Pengqian; Li, Haixia; Zhao, Yijun; Shen, Chunti; Wang, Zhong

    2016-07-01

    Coronary heart disease (CHD), idiopathic pulmonary arterial hypertension (IPAH) and pulmonary heart disease (PHD) are circulatory system diseases that may simultaneously emerge in a patient and they are often treated together in clinical practice. However, the molecular mechanisms connecting these three diseases remain unclear. In order to determine the multidimensional characteristic correlations between these three diseases based on genomic networks to aid in medical decision-making, genes from the Online Mendelian Inheritance in Man database were obtained, and applied network construction and modularized analysis were conducted. Functional enrichment analysis was conducted to explore the associations between overlapping genes, modules and pathways. A total of 29 overlapping genes and 3 common modules were identifed for the 3 diseases. Glycosphingolipid biosynthesis and the arachidonic acid metabolism are common pathways, and the biosynthetic process is suggested to be the major function involved in the three diseases. The current study reported, to the best of our knowledge for the first time, the role of glycosphingolipid biosynthesis in IPAH and PHD. The present study provided an improved understanding of the pathological mechanisms underlying CHD, IPAH and PHD. The overlapping genes, modules and pathways suggest novel areas for further research, and drug targets. The observations of the current study additionally suggest that drug indications can be broadened because of the presence of common targets.

  19. Association of total cholesterol and HDL-C levels and outcome in coronary heart disease patients with heart failure

    Science.gov (United States)

    Zhao, Qin; Li, Jianfei; Yang, Jin; Li, Rongshan

    2017-01-01

    Abstract The aim of the study was to evaluate associations of total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) levels with prognosis in coronary heart disease (CHD) patients with heart failure (HF). Patients who were angiographical-diagnosis of CHD and echocardiographical-diagnosis of left ventricular ejection fraction (LVEF) Hs-CRP) was observed. TC was positively correlated with BMI and albumin, and HDL-C was inversely correlated with Hs-CRP. The associations of TC level and rehospitalization for HF and all-cause mortality were attenuated but consistently significant through model 1 to 4, with odds ratio (OR) of 0.97 (95% confidence interval [CI]: 0.92–0.99). Associations of HDL-C level and rehospitalization for HF and all-cause mortality were also consistently significant through model 1 to 4, with OR of 0.95 (95% CI: 0.90–0.98). Strength of association was attenuated prominently in model 3 after adjusted for Hs-CRP, and no change was observed after further adjusted for BMI and albumin. Higher baseline TC and HDL-C levels are associated with better outcome in CHD patients with HF. PMID:28248864

  20. Effects of chronic exposure to air pollution from Sao Paulo city on coronary of Swiss mice, from birth to adulthood.

    Science.gov (United States)

    Akinaga, Lícia Mioko Yoshizaki; Lichtenfels, Ana Julia; Carvalho-Oliveira, Regiani; Caldini, Elia Garcia; Dolhnikoff, Marisa; Silva, Luiz Fernando Ferraz; Bueno, Heloisa Maria De Siqueira; Pereira, Luiz Alberto Amador; Saldiva, Paulo Hilário Nascimento; Garcia, Maria Lúcia Bueno

    2009-04-01

    To explore the hypothesis that air pollution promotes cardiovascular changes, Swiss mice were continuously exposed, since birth, in two open-top chambers (filtered and nonfiltered for airborne particles hearts were analyzed by morphometry. There was a reduction of the PM(2.5) inside the filtered chamber (filtered = 8.61+/-0.79 microg/m(3), nonfiltered = 18.05+/-1.25 microg/m(3), p < .001). Coronary arteries showed no evidence of luminal narrowing in the exposed group but presented higher collagen content in the adventitia of LV large-sized and RV midsized vessels (p = .001) and elastic fibers in both tunicae adventitia and intima-media of almost all sized arterioles from both ventricles (p = .03 and p = .001, respectively). We concluded that chronic exposure to urban air since birth induces mild but significant vascular structural alterations in normal individuals, presented as coronary arteriolar fibrosis and elastosis. These results might contribute to altered vascular response and ischemic events in the adulthood.

  1. [Approaches potentiating cardioprotective effect of ambulatory physical training in patients with ischemic heart disease and multivessel coronary artery involvement after coronary stenting].

    Science.gov (United States)

    Liamina, N P; Kotel'nikova, E V; Biziaeva, E A; Karpova, É S

    2014-01-01

    Cardiorehabilitation of patients with multivessel coronary lesions is an obligatory component of ambulatory stage of care. With the aim of potentiating cardioprotective and antiischemic impact of rehabilitative preventive measures in 36 patients with ischemic heart disease (IHD) and multivessel coronary artery involvement who had undergone percutaneous coronary intervention we studied cardioprotective and antiischemic effect of long-term (24 weeks) administration of 70 mg/day trimetazidine in combination with moderate intensity physical training with the use of distance surveillance by a physician. The chosen therapeutic approach in patients with residual ischemia after incomplete anatomical revascularization provided early persistent formation of cardioprotective and antiischemic effect proven by increase of tolerance to physical exercise, improvement of diastolic function, and positive dynamics of both ECG parameters and biochemical markers of myocardial ischemia.

  2. Beneficial effect of prolonged heme oxygenase 1 activation in a rat model of chronic heart failure

    Directory of Open Access Journals (Sweden)

    Massimo Collino

    2013-07-01

    We and others have previously demonstrated that heme oxygenase 1 (HO-1 induction by acute hemin administration exerts cardioprotective effects. Here, we developed a rat model of heart failure to investigate whether a long-term induction of HO-1 by chronic hemin administration exerted protective effects. Sprague Dawley rats that underwent permanent ligation of the left coronary artery were closely monitored for survival rate analysis and sacrificed on day 28 post-operation. Administration of hemin (4 mg/kg body weight every other day for 4 weeks induced a massive increase in HO-1 expression and activity, as shown by the increased levels of the two main metabolic products of heme degradation, bilirubin and carbon monoxide (CO. These effects were associated with significant improvement in survival and reduced the extension of myocardial damage. The ischemic hearts of the hemin-treated animals displayed reduced oxidative stress and apoptosis in comparison with the non-treated rats, as shown by the decreased levels of lipid peroxidation, free-radical-induced DNA damage, caspase-3 activity and Bax expression. Besides, chronic HO-1 activation suppressed the elevated levels of myeloperoxidase (MPO activity, interleukin 1β (IL-1β production and tumor necrosis factor-α (TNFα production that were evoked by the ischemic injury, and increased the plasma level of the anti-inflammatory cytokine IL-10. Interestingly, HO-1 inhibitor zinc protoporphyrin IX (ZnPP-IX; 1 mg/kg lowered bilirubin and CO concentrations to control values, thus abolishing all the cardioprotective effects of hemin. In conclusion, the results demonstrate that chronic HO-1 activation by prolonged administration of hemin improves survival and exerts protective effects in a rat model of myocardial ischemia by exerting a potent antioxidant activity and disrupting multiple levels of the apoptotic and inflammatory cascade.

  3. Plasma Matrix Metalloproteinase-9 Levels Predict First-Time Coronary Heart Disease: An 8-Year Follow-Up of a Community-Based Middle Aged Population.

    Directory of Open Access Journals (Sweden)

    Peter Garvin

    Full Text Available The enzyme in matrix metalloproteinase (MMP-9 has been suggested to be an important determinant of plaque degradation. While several studies have shown elevated levels in patients with coronary heart disease, results in prospective population based studies evaluating MMP-9 in relation to first time coronary events have been inconclusive. As of today, there are four published studies which have measured MMP-9 in serum and none using plasma. Measures of MMP-9 in serum have been suggested to have more flaws than measures in plasma.To investigate the independent association between plasma levels of MMP-9 and first-time incidence of coronary events in an 8-year follow-up.428 men and 438 women, aged 45-69 years, free of previous coronary events and stroke at baseline, were followed-up. Adjustments were made for sex, age, socioeconomic position, behavioral and cardiovascular risk factors, chronic disease at baseline, depressive symptoms, interleukin-6 and C-reactive protein.53 events were identified during a risk-time of 6 607 person years. Hazard ratio (HR for MMP-9 after adjustment for all covariates were HR = 1.44 (1.03 to 2.02, p = 0.033. Overall, the effect of adjustments for other cardiovascular risk factors was low.Levels of plasma MMP-9 are independently associated with risk of first-time CHD events, regardless of adjustments. These results are in contrast to previous prospective population-based studies based on MMP-9 in serum. It is essential that more studies look at MMP-9 levels in plasma to further evaluate the association with first coronary events.

  4. The effects of exercise capacity and sedentary lifestyle on haemostasis among middle-aged women with coronary heart disease.

    Science.gov (United States)

    Nagy, Edit; Janszky, Imre; Eriksson-Berg, Margita; Al-Khalili, Faris; Schenck-Gustafsson, Karin

    2008-11-01

    Previous studies have established a link/relationship between haemostatic factors and increased risk of cardiovascular disease. In addition, physical conditioning is associated with lower coronary heart disease risk. The purpose of this study was to assess the association between physical exercise and haemostatic factors among middle-aged women surviving an acute coronary event. The Stockholm Female Coronary Risk Study included 292 women aged < 65 years, resident in the greater Stockholm area, who were hospitalized for an acute coronary syndrome. Extensive clinical screening including exercise testing, and blood tests were performed 3-6 months after the coronary event. Self-reported physical activity was assessed by a WHO questionnaire. Patients on warfarin treatment were excluded from our analyses. Haemostatic factors were generally higher among physically inactive patients when compared to physically active women in our univariate models. Exercise capacity had a statistically significant relationship with factor VII antigen (p = 0.039) and vWFag (p = 0.038) even in our multiadjusted analyses. Physical inactivity and poor physical fitness are associated with a potentially prothrombotic blood profile in middle aged women with coronary heart disease.

  5. The Effects Of L-Arginine And L-Name On Coronary Flow And Oxidative Stress In Isolated Rat Hearts

    Directory of Open Access Journals (Sweden)

    Sobot Tanja

    2015-12-01

    Full Text Available The aim of this experimental study was to assess the effects of the acute administration of L-arginine alone and in combination with L-NAME (a non-selective NO synthase inhibitor on the coronary flow and oxidative stress markers in isolated rat hearts. The experimental study was performed on hearts isolated from Wistar albino rats (n=12, male, 8 weeks old, body mass of 180-200 g. Retrograde perfusion of the isolated preparations was performed using a modified method according to the Langendorff technique with a gradual increase in the perfusion pressure (40–120 cmH2O. The following values were measured in the collected coronary effluents: coronary flow, released nitrites (NO production marker, superoxide anion radical and the index of lipid peroxidation (measured as thiobarbiturate reactive substances. The experimental protocol was performed under controlled conditions, followed by the administration of L-arginine alone (1 mmol and L-arginine (1 mmol + L-NAME (30 μmol. The results indicated that L-arginine did not significantly increase the coronary flow or the release of NO, TBARS and the superoxide anion radical. These effects were partially blocked by the joint administration of L-arginine + L-NAME, which indicated their competitive effect. Hence, the results of our study do not demonstrate significant effects of L-arginine administration on the coronary flow and oxidative stress markers in isolated rat hearts.

  6. Abnormalities of skeletal muscle in patients with chronic heart failure.

    Science.gov (United States)

    Lipkin, D P; Jones, D A; Round, J M; Poole-Wilson, P A

    1988-02-01

    We have examined muscle strength, mitochondrial enzyme activity, histochemistry and fibre size in the quadriceps muscle of 9 patients with severe chronic heart failure. A needle biopsy of the quadriceps muscle was taken with patients at rest. Maximum oxygen uptake was measured during treadmill exercise. Mean maximal oxygen consumption was 11.7 ml.kg-1.min-1. Isometric maximum voluntary contraction was reduced to 55% of the predicted value for weight. Eight biopsies were abnormal. Findings included increased acid phosphatase, increased interstitial cellularity, excess intracellular lipid accumulation, atrophy of both type I and II fibres and variation in size with hypertrophy and atrophy of fibers. Muscle fibre capillary density and the activity of mitochondrial enzymes were normal. Changes in skeletal muscle strength may play a role in the limitation of exercise capacity seen in patients with congestive heart failure.

  7. Quality of life in patients with chronic congestive heart failure

    Directory of Open Access Journals (Sweden)

    Anca D. Farcaş

    2011-12-01

    Full Text Available Objective: Quality of life (QOL is severely decreased in patients with chronic heart failure (CHF. Our study aims to identify the factors affecting the evaluation of QOL. Material and Methods: Clinical, demographic, social and economic data was collected from patients with CHF in NYHA class III and IV as part of a complex workup. The Minnesota Living with Heart Failure Questionnaire (MLHFQ was used to evaluate QOL. Results: QOL decreases as the NYHA class increases. Women evaluate their QOL as more severely affected than men. Age, social and economic factors modulate the perception of QOL. Conclusion: Combining demographic, social and economic data and evaluation of QOL can provide valuable and useful information for the medical management of patients with CHF.

  8. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study...... a possible relationship between right and left ventricular function and pulmonary function. DESIGN: Prospective substudy. SETTING: Systematic screening at 11 centres. SUBJECTS: Consecutive patients (n = 532) admitted with HF requiring medical treatment with diuretics and an episode with symptoms...... corresponding to New York Heart Association class III-IV within a month prior to admission. INTERVENTIONS: Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were measured by spirometry and ventricular function by echocardiography. The diagnosis of COPD and HF were made according...

  9. Heart rate and heart rate variability modification in chronic insomnia patients.

    Science.gov (United States)

    Farina, Benedetto; Dittoni, Serena; Colicchio, Salvatore; Testani, Elisa; Losurdo, Anna; Gnoni, Valentina; Di Blasi, Chiara; Brunetti, Riccardo; Contardi, Anna; Mazza, Salvatore; Della Marca, Giacomo

    2014-01-01

    Chronic insomnia is highly prevalent in the general population, provoking personal distress and increased risk for psychiatric and medical disorders. Autonomic hyper-arousal could be a pathogenic mechanism of chronic primary insomnia. The aim of this study was to investigate autonomic activity in patients with chronic primary insomnia by means of heart rate variability (HRV) analysis. Eighty-five consecutive patients affected by chronic primary insomnia were enrolled (38 men and 47 women; mean age: 53.2 ± 13.6). Patients were compared with a control group composed of 55 healthy participants matched for age and gender (23 men and 32 women; mean age: 54.2 ± 13.9). Patients underwent an insomnia study protocol that included subjective sleep evaluation, psychometric measures, and home-based polysomnography with evaluation of HRV in wake before sleep, in all sleep stages, and in wake after final awakening. Patients showed modifications of heart rate and HRV parameters, consistent with increased sympathetic activity, while awake before sleep and during Stage-2 non-REM sleep. No significant differences between insomniacs and controls could be detected during slow-wave sleep, REM sleep, and post-sleep wake. These results are consistent with the hypothesis that autonomic hyper-arousal is a major pathogenic mechanism in primary insomnia, and confirm that this condition is associated with an increased cardiovascular risk.

  10. Using a Markov simulation model to assess the impact of changing trends in coronary heart disease incidence on requirements for coronary artery revascularization procedures in Western Australia

    OpenAIRE

    Knuiman Matthew; Mannan Haider R; Hobbs Michael

    2010-01-01

    Abstract Background The population incidence of coronary heart disease (CHD) has been declining in Australia and many other countries. This decline has been due to reduced population levels of risk factors for CHD and improved medical care for those at higher risk of CHD. However, there are signs that there may be a slowing down or even reversal in the decline of CHD incidence due to the 'obesity epidemic' and other factors and this will have implications for the requirements for surgical tre...

  11. Sex differences in the hypertensive population with chronic ischemic heart disease.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Bertomeu, Vicente; Murga, Nekane; de Pablo, Carmen; Calderón, Alberto

    2008-10-01

    Cardiopatía Isquémica Crónica e Hipertensión Arterial en la Práctica Clínica en España (CINHTIA) was a survey designed to assess the clinical management of hypertensive outpatients with chronic ischemic heart disease. Sex differences were examined. Blood pressures (BP) was considered controlled at levels of <140/90 or <130/80 mm Hg in diabetics (European Society of Hypertension/European Society of Cardiology 2003); low-density lipoprotein cholesterol (LDL-C) was considered controlled at levels <100 mg/dL (National Cholesterol Education Program Adult Treatment Panel III). In total, 2024 patients were included in the study. Women were older, with a higher body mass index and an increased prevalence of atrial fibrillation. Dyslipidemia, smoking, sedentary lifestyle, and peripheral arterial disease were more frequent in men. In contrast, diabetes, left ventricular hypertrophy, and heart failure were more common in women. BP and LDL-C control rates, although poor in both groups, were better in men (44.9% vs 30.5%, P<.001 and 33.0% vs 25.0%, P<.001, respectively). Stress testing and coronary angiography were more frequently performed in men.

  12. Whole grains, type 2 diabetes, coronary heart disease, and hypertension: links to the aleurone preferred over indigestible fiber.

    Science.gov (United States)

    Lillioja, Stephen; Neal, Andrew L; Tapsell, Linda; Jacobs, David R

    2013-01-01

    Higher whole grain cereal intakes are associated with substantially lower risks of type 2 diabetes, coronary heart disease, and hypertension. These reduced risks have been established in large prospective studies that now include millions of person-years of follow-up. We analyze the results of 11 major prospective studies to provide recommendations about whole grain consumption. The following review establishes the amount of whole grains that should ideally be consumed based on prospective evidence; defines the nature of whole grains; identifies that the whole grain evidence is robust and not due to confounding; and provides a detailed assessment of several potential mechanisms for the effect of whole grains on health. We draw the following conclusions. Firstly, to maintain health, 40 grams or more of whole grains should be consumed daily. This is about a bowl of whole grain breakfast cereal daily, but 80% of the population does not achieve this. Secondly, aleurone in bran is a critical grain component generally overlooked in favor of indigestible fiber. Live aleurone cells constitute 50% of millers' bran. They store minerals, protein, and the antioxidant ferulic acid, and are clearly more than just indigestible fiber. Finally, we suggest potential roles for magnesium, zinc, and ferulic acid in the development of chronic disease. If the results of prospective studies were applied to the life-style practices of modern societies there exists the potential for enormous personal health and public financial benefits.

  13. A longitudinal analysis of the risk factors for diabetes and coronary heart disease in the Framingham Offspring Study

    Directory of Open Access Journals (Sweden)

    Bhargava Alok

    2003-04-01

    Full Text Available Abstract Background The recent trends in sedentary life-styles and weight gain are likely to contribute to chronic conditions such as hypertension, diabetes, and cardiovascular diseases. The temporal sequence and pathways underlying these conditions can be modeled using the knowledge from the biomedical and social sciences. Methods The Framingham Offspring Study in the U.S. collected information on 5124 subjects at baseline, and 8, 12, 16, and 20 years after the baseline. Dynamic random effects models were estimated for the subjects' weight, LDL and HDL cholesterol, and blood pressure using 4 time observations. Logistic and probit models were estimated for the probability of diabetes and coronary heart disease (CHD events. Results The subjects' age, physical activity, alcohol consumption, and cigarettes smoked were important predictors of the risk factors. Moreover, weight and height were found to differentially affect the probabilities of diabetes and CHD events; body weight was positively associated with the risk of diabetes while taller individuals had lower risk of CHD events. Conclusion The results showed the importance of joint modeling of body weight, LDL and HDL cholesterol, and blood pressure that are risk factors for diabetes and CHD events. Lower body weight and LDL concentrations and higher HDL levels achieved via physical exercise are likely to reduce diabetes and CHD events.

  14. B cells and plasma cells in coronaries of chronically rejected cardiac transplants.

    Science.gov (United States)

    Wehner, Jennifer R; Fox-Talbot, Karen; Halushka, Marc K; Ellis, Carla; Zachary, Andrea A; Baldwin, William M

    2010-05-15

    BACKGROUND.: Previously, we reported that transcripts of immunoglobulins were increased in coronary arteries dissected from cardiac transplants with arteriopathy, but the prevelance and patterns of B cell and plasma cell infiltration in cardiac allografts has not been documented. METHODS.: In this study, we documented the frequency and distribution of B cells and plasma cells in 16 cardiac transplants with advanced chronic rejection that were explanted during a second transplant procedure. Coronary arteries with pathologically confirmed allograft vasculopathy and controls with native atherosclerosis were immunohistologically stained for markers of T cells, B cells, plasma cells, IgG subclasses, C4d, CD21, and CXCL13. RESULTS.: We found that B cells and plasma cells were prevalent in most of the samples analyzed (14 of 16) and were distributed in three patterns: adventitial nodules, diffuse adventitial infiltrates, and neointimal infiltrates. These cells were found most frequently in nodules, some of which had distinct compartmentalization and granular C4d deposits on follicular dendritic cells (FDCs) that typify tertiary lymphoid nodules. FDCs also stained for CD21 and CXCL13. Diffuse infiltrates of B cells and plasma cells were found in fibrotic areas of the neointima and adventitia. Only a minority of control coronaries with atherosclerosis contained B cells. CONCLUSIONS.: B cells and plasma cell infiltrates are consistent findings in and around coronary arteries with allograft vasculopathy and are significantly more frequent than in coronaries with native atherosclerosis. The presence of C4d on FDCs in tertiary lymphoid nodules suggests active antigen presentation.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  16. Changes in Coronary Heart Disease Risk Profile of Adults with Intellectual Disabilities following a Physical Activity Intervention

    Science.gov (United States)

    Moss, S. J.

    2009-01-01

    Background: Regular physical activity is one of the modifiable risk factors for coronary heart disease (CHD). With an increasing age profile and similar patterns of morbidity to the general population, persons with intellectual disabilities (ID) and their caregivers would benefit from data that indicate CHD risk factors. Knowledge of the CHD risk…

  17. Red blood cell membrane concentration of cis-palmitoleic and cis-vaccenic acids and risk of coronary heart disease

    Science.gov (United States)

    Although previous studies have suggested associations between plasma palmitoleic acid and coronary heart disease (CHD) risk factors, including blood pressure, inflammation, and insulin resistance, little is known about the relation of palmitoleic acid and CHD. This ancillary study of the Physicians'...

  18. Regular Exercise and Plasma Lipid Levels Associated with the Risk of Coronary Heart Disease: A 20-Year Longitudinal Study

    Science.gov (United States)

    Teramoto, Masaru; Golding, Lawrence A.

    2009-01-01

    We investigated the effects of regular exercise on the plasma lipid levels that contribute to coronary heart disease (CHD), of 20 sedentary men who participated in an exercise program over 20 consecutive years. The men, whose initial ages ranged from 30-51 years, participated in the University of Nevada-based exercise program for an average of 45…

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  20. PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis

    NARCIS (Netherlands)

    P.C.M. de Groot; O.M. Dekkers; J.A. Romijn; S.W.M. Dieben; F.M. Helmerhorst

    2011-01-01

    BACKGROUND: Patients with polycystic ovary syndrome (PCOS) are at risk of arterial disease. We examined the risk of (non) fatal coronary heart disease (CHD) or stroke in patients with PCOS and ovulatory women without PCOS, and assessed whether obesity might explain a higher risk of CHD or stroke. ME