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Sample records for chronic ischemic heart

  1. 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....

  2. [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.

  3. Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Denollet, Johan; Zwisler, Ann-Dorthe;

    2009-01-01

    Growing evidence supports the importance of psychological factors in the etiology and progression of cardiovascular disease (CVD). However, this research has been criticized due to overlap between psychological constructs. We examined whether psychological questionnaires frequently used...... in cardiovascular research assess distinct constructs in a mixed group of ischemic heart disease (IHD) and chronic heart failure (CHF) patients....

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

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    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.

  5. Adjustment and Characterization of an Original Model of Chronic Ischemic Heart Failure in Pig

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    Laurent Barandon

    2010-01-01

    Full Text Available We present and characterize an original experimental model to create a chronic ischemic heart failure in pig. Two ameroid constrictors were placed around the LAD and the circumflex artery. Two months after surgery, pigs presented a poor LV function associated with a severe mitral valve insufficiency. Echocardiography analysis showed substantial anomalies in radial and circumferential deformations, both on the anterior and lateral surface of the heart. These anomalies in function were coupled with anomalies of perfusion observed in echocardiography after injection of contrast medium. No demonstration of myocardial infarction was observed with histological analysis. Our findings suggest that we were able to create and to stabilize a chronic ischemic heart failure model in the pig. This model represents a useful tool for the development of new medical or surgical treatment in this field.

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

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    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.

  7. Diabetes and ischemic heart disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille;

    2014-01-01

    The aim of this study was to test i) whether patients having diabetes and ischemic heart disease (IHD), i.e., patients suffering from two chronic diseases, demonstrate a higher degree of chronic stress when compared with patients suffering from IHD alone, and ii) whether suffering from the two...

  8. 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.

  9. Evaluation of left ventricular remodelling in patients with chronic ischemic heart disease using multislice computer tomography and magnetic resonance tomography

    International Nuclear Information System (INIS)

    The article presents the results of MSCT and MRI of the heart in 57 patients with chronic coronary heart disease. It determined the relationship between structural and functional changes in the left ventricle and the degree of left coronary artery stenosis. Also determined were the link between the ischemic left ventricular remodeling and depth of myocardial damage in patients with coronary heart disease and postinfarction cardiosclerosis. MSCT and MRI are highly reliable imaging technique used to evaluate the infarcted and viable myocardium and post infarct cardiac remodeling process

  10. MAGNESIUM METABOLISM AND CLINICAL CHARACTERISTICS OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

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    A. V. Yezhov

    2010-01-01

    Full Text Available Aim. To study relationship of the clinical state and cardiac functional parameters with magnesium metabolism indices in patients with chronic ischemic heart disease (IHD.Material and methods. Patients with stable angina pectoris, II-III class (n=480 were involved into the study. Evaluation of the following items was performed: disease course, anxiodepressive syndrome intensity, exercise tolerance, blood and urine electrolyte profile, systolic and diastolic left ventricle function, endothelium-dependent and endotheliumnondependent vasodilatation, i/v magnesium load test, Holter electrocardiogram monitoring.Results. High prevalence of systemic magnesium deficiency (17.9 and 37.5% according to serum and erythrocyte levels, respectively was found in IHD patients. Severity of magnesium deficiency in IHD patients depended on duration of disease, experience of myocardial infarction, myocardial ischemia seriousness, disorders of endothelium vasodilating function and left ventricle diastolic function, severity of concomitant anxiety. Exercise tests were changed in IHD patients with magnesium deficiency.Conclusion. The study data let to consider that magnesium deficiency involves into the IHD pathogenesis.

  11. Short-term effects of ivabradine in patients with chronic stable ischemic heart disease

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    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

  12. CHRONIC HEART FAILURE OF ISCHEMIC GENESIS AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: POSSIBILITIES OF COMBINATION THERAPY INCLUDING NEBIVOLOL

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    P. A. Fedotov

    2014-07-01

    Full Text Available Objective: to reveal the features of chronic heart failure (CHF of ischemic genesis concurrent with chronic obstructive pulmonary disease (COPD and to investigate the effect of the cardioselective β1-adrenoblocker (β1-AB nebivolol on the course of COPD and the parameters of the bronchopulmonary system in patients with CHF of ischemic genesis during treatment.Subjects and methods.The investigation enrolled 63 patients aged 40–70 years, including 43 patients with functional class (FC II–IV CHF with a Simpson left ventricular ejection fraction of  45 % concurrent with COPD (a study group and 20 patients with CHF and no bronchopulmonary pathology (a control group. The study group patients were randomly divided into 2 subgroups: 1 23 patients who received nebivolol in addition to background therapy; 2 20 patients in whom the therapy ruled out the use of β1-AB. The control patients were switched to nebivolol therapy. During 6-month follow-up, the authors made clinical examination, recorded the rate, duration, and severity of COPD exacerbations, performed a 6-minute walking test (6MWT, and used a clinical status scale modified by R. Cody, a dyspnea 0–10 category ratio (Borg scale, and a Medical Research Council Dyspnoea Scale (MRS scale. Besides, quality of life in patients was assessed using the specific Minnesota Living with Heart Failure Questionnaire. All the patients underwent echocardiography, bronchodilatation-induced external respiratory function test, peak flowmetry, and blood brain natriuretic peptide quantification. These studies were conducted at baseline and at 1 and 6 months of therapy.Results. During the investigation, the patients with CHF concurrent with COPD were found to have a high rate of hypertensive disease, prior myocardial infarctions, atrial fibrillations, and higher FC exertional angina. These patients also showed a delayed optimal result achievement during the combination therapy involving the use of β1-AB

  13. [The use of metabolic therapy in the treatment of ischemic heart disease in hemodynamically formed insignificant aortic stenosis with chronic heart failure].

    Science.gov (United States)

    Kuriata, A V; Karavanskaia, I L; Kushnir, Iu S

    2011-01-01

    Analysis of medical treatment was conducted with justified using of the metabolic component in a complex therapy of ischemic heart disease with chronic heart failure in hemodynamically formed insignificant aortic stenoses. The effect of metabolic correction is shown for pharmaceutical compounds Meldoniya in the form of Vasonat manufactured by "OlainFarm" (Latvia). Positive results of maintenance of systolic activity and prevention of diastolic dysfunction of myocardium were presented. The application of Vasonat in appropriate for the stabilization of adaptive properties of the myocardium and prophylaxis of the development of critical indicators of heart failure in this combined. PMID:22768738

  14. Amlodipine versus nifedipine retard in the treatment of chronic ischemic heart disease.

    Science.gov (United States)

    Circo, A; Scaccianoce, G; Platania, F; Castelli, D; Cardillo, R; Mangiameli, S

    1992-01-01

    The efficacy of amlodipine, a long half-life dihydropyridine calcium antagonist, at the dosage of 5-10 mg/day in a single daily administration, has been compared with that of nifedipine R, a short half-life dihydropyridine, at the dosage of 20-40 mg b.i.d. in 29 patients with chronic ischemic heart disease. After a one week placebo period, patients were assigned to the treatment with amlodipine or nifedipine R, according to a randomized sequence and a cross-over, single-blind design, for two control periods of four weeks and without a wash-out interval between these two phases. During the stress test, a significant increase from baseline in test duration and in time to onset of ischemia and of angina have been obtained with both treatments; moreover amlodipine increased significantly the time to onset of ST segment deviation (-1 mm) and the time to maximum ST segment deviation compared with nifedipine R changes. Also with Holter monitoring and in the angina diary there was a significant reduction of anginal episodes. As regards safety profile, amlodipine treatment was associated with a significantly lower incidence of side effects compared with nifedipine R. This is probably due to the particular pharmacokinetics of amlodipine which, besides the long half-life which allows a single daily administration, shows a retarded peak (between the 6th and the 12th hour) with consequent reduction of phenomena connected with fast and excessive peripheral vasodilatation. In conclusion, amlodipine was as effective in reducing the signs of ischemia as nifedipine R, but compliance was better due to the single daily administration and so was tolerability. PMID:1388115

  15. MYOCARDIAL PERFUSION ASSESSMENT IN FORECASTING EFFECT OF CORONARY ANGIOPLASTY IN PATIENTS WITH ISCHEMIC CHRONIC HEART FAILURE

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    A. B. Mironkov

    2015-01-01

    Full Text Available Aim. To define influence of the left ventricle (LV perfusion defects on the clinical status dynamics after coronary angioplasty in patients with the expressed myocardium dysfunction of ischemic etiology. Materials and methods. Examined 86 patients (81 men and 5 women aged from 46 to 73 years before and in 2–3 days after percutaneous coronary intervention with diagnosis: CAD, CHF with NYHA class III–IV, echocardiography parameters of LV: ejection fraction less than 40%, end-diastolic volume is more than 200 ml. Perfusion defects of myocardium estimated with use of ECG-gated single photon emission computed tomography. Predictors were defined: perfusion defects on LV apex (in score, perfusion defects in the area of LAD, LCx and RCA (%, the LV global perfusion defects (in score and %. Results. In 42% of cases 6-minute walk test increased to 3 times; The NYHA class decreased by 2 classes (group 1. In 28 cases 6-minute walk test increased to 2 times and the NYHA class decreased on 1 class. In 22 patients 6-minute walk test increased less than 50% of reference values and there was no dynamics NYHA class (50 patients of the group 2. Initial extent of LV global perfusion defects in group 1 – 41,2 ± 4,0%, in group 2 – 58,3 ± 2,4% (р = 0,0004. Similar values are received for perfusion indicators in the area of LAD and the LV apex. Prevalence of myocardial perfusion defects at rest reflects prevalence of a cardiosclerosis in a cardiac muscle. Conclusion. Degree of LV myocardial perfusion defects in patients with the expressed heart failure of ischemic etiology is the key indicator influencing clinical efficiency of coronary angioplasty. Critical size for definition of the favorable forecast of revascularization are 60% and more perfusion defects testifying that in a cardiac muscle the focal cardiosclerosis prevails over the functioning myocardium. 

  16. Resilience in Patients with Ischemic Heart Disease

    OpenAIRE

    Conceição Maria Martins de Lemos; David William Moraes; Lucia Campos Pellanda

    2016-01-01

    Background: Resilience is a psychosocial factor associated with clinical outcomes in chronic diseases. The relationship between this protective factor and certain diseases, such heart diseases, is still under-explored. Objective: The present study sought to investigate the frequency of resilience in individuals with ischemic heart disease. Method: This was a cross-sectional study with 133 patients of both genders, aged between 35 and 65 years, treated at Rio Grande do Sul Cardiology Institu...

  17. A Novel Closed-Chest Porcine Model of Chronic Ischemic Heart Failure Suitable for Experimental Research in Cardiovascular Disease

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    Giuseppe Biondi-Zoccai

    2013-01-01

    Full Text Available Cardiac pathologies are among the leading causes of mortality and morbidity in industrialized countries, with myocardial infarction (MI representing one of the major conditions leading to heart failure (HF. Hitherto, the development of consistent, stable, and reproducible models of closed-chest MI in large animals, meeting the clinical realism of a patient with HF subsequent to chronic ischemic necrosis, has not been successful. We hereby report the design and ensuing application of a novel porcine experimental model of closed-chest chronic ischemia suitable for biomedical research, mimicking post-MI HF. We also emphasize the key procedural steps involved in replicating this unprecedented model, from femoral artery and vein catheterization to MI induction by permanent occlusion of the left anterior descending coronary artery through superselective deployment of platinum-nylon coils, as well as endomyocardial biopsy sampling for histologic analysis and cell harvesting. Our model could indeed represent a valuable contribution and tool for translational research, providing precious insights to understand and overcome the many hurdles concerning, and currently quenching, the preclinical steps mandatory for the clinical translation of new cardiovascular technologies for personalized HF treatments.

  18. Noninvasive monitoring of cardiac function in a chronic ischemic heart failure model in the rat: Assessment with tissue Doppler and non-Doppler 2D strain echocardiography

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    Baumann Gert

    2011-05-01

    Full Text Available Abstract Objectives Feasibility of noninvasive monitoring of cardiac function after surgically induced ischemic cardiomyopathy with tissue Doppler and non-Doppler 2D strain echocardiography in rats. Background The optimal method for quantitative assessment of global and regional ventricular function in rats with chronic heart failure for research purposes remains unclear. Methods 20 rats underwent suture ligation of the left anterior descending coronary artery via a left thoracotomy to induce ischemic cardiomyopathy. Echocardiographic examination with estimation of left ventricular wall thickness, diameters, fractional shortening, ejection fraction, wall velocities as well as radial strain were performed before and 4 weeks after surgery. Results Mean LVEF decreased from 70 ± 6% to 40 ± 8% (p Conclusion It is feasible to assess dimensions, global function, and regional contractility with echocardiography in rats suffering from chronic heart failure after myocardial infarction. Particularly regional function can be exactly evaluated if tissue Doppler and 2D strain is used.

  19. COMPARISON OF EFFICACY AND SAFETY OF RAMIPRIL, MOLSIDOMINE AND THEIR COMBINATION IN PATIENTS WITH CHRONIC HEART FAILURE, WHICH COMPLICATED ISCHEMIC HEART DISEASE

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    I. I. Sinitsina

    2008-01-01

    Full Text Available Aim. To study effects of ramipril, molsidomine and their combinations on morphofunctional heart indices and clinical status of patients with chronic heart failure (CHF, which complicated an ischemic heart disease (IHD.Material and methods. 41 patients with CHF class II-III (NYHA, which complicated IHD (postinfarction cardiosclerosis were included in the study. Patients did not receive ACE inhibitors. Patients were split in 3 groups: patients of the 1st group received ramipril, patients of the 2nd group - molsidomine and patients of the 3rd group – combination of ramipril and molsidomine. Clinical examination, laboratory tests, electrocardiogram, cardiac ultrasonograthy, exercise tolerance test was performed before treatment and after 3 months and 1 year of treatment.Results. Improvement of clinical status and decrease of class NYHA was found in 38,5% of patients in ramipril group; in 33,3% of patients in molsidomine group and in 23,1 % of patients in combined therapy group. Increase of ejection fraction on 17 % from initial level was found in patients receiving combined therapy; on 25,2% - in patients receiving molsidomine; and on 12,4% - in patients receiving ramipril. Decrease of residual volumes of a left ventricle also was detected.Conclusion. All therapies (ramipril, molsidomine and their combination in patients with CHF class II-III and postinfarction cardiosclerosis are clinically and hemodynamically effective in long term implementation.

  20. DETERMINANTS OF PREVENTIVE BEHAVIOR REGARDING CARDIOVASCULAR DISEASES AND RISK FACTORS IN PATIENTS WITH ESSENTIAL HYPERTENSION AND CHRONIC ISCHEMIC HEART DISEASE

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    D. Yu. Platonov

    2011-01-01

    Full Text Available Aim. To analyze potential determinants of preventive behavior (PB in patients with essential hypertension (HT and chronic ischemic heart disease (CIHD, and to establish their significance and hierarchy. Material and methods. Patients with HT (n=285 and CIHD (n=223 were studied. Questioning of all patients was performed to assess the characteristics of their PB. Differentiated multivariate analysis of activity and efficacy of PB determinants was performed in HT and CIHD patients by the method of step-by-step backward logistic regression. Results. Awareness of the cardiovascular diseases (CVD and its prevention (odds ratio [OR] 6.08 as well as high level of general education (OR=2.29 were the most significant determinants of active PB in HT patients. Sufficient social support (OR=3.77, awareness of CVD and its prevention (OR=3.16 were the most significant determinants of active PB in patients with CIHD. Efficacy of PB in patients with HT and CIHD mostly depends on satisfaction of medical service (OR=10.2 and 6.63, respectively, social support (OR=6.25 and 10.5, respectively, adequate awareness of CVD and its prevention (OR, 6.92 and 6.64, respectively. Conclusion. PB activity and efficacy in patients with HT and CIHD depends on many contributing and impeding factors. Disregarding these factors can result in failure in preventive efforts at both individual and population levels.

  1. Monocytes in ischemic heart disease

    NARCIS (Netherlands)

    A.M. van der Laan

    2013-01-01

    The link between the immune system and ischemic heart disease has been recognized for years and great improvements have been made in understanding the role of immune cells in the context of infarct healing, atherosclerosis and arteriogenesis, using experimental and in vitro models. However, the role

  2. Inhalation of diluted diesel engine emission impacts heart rate variability and arrhythmia occurrence in a rat model of chronic ischemic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Anselme, Frederic [Rouen University Hospital, Service de Cardiologie, Rouen (France); Loriot, Stephane; Henry, Jean-Paul; Thuillez, Christian; Morin, Jean-Paul [University of Rouen France, INSERM U644, School of Medicine-Pharmacy, Rouen, Cedex (France); Dionnet, Frederic [Centre d' Etudes et de Recherches Technologiques en Aerothermique et Moteurs, Saint Etienne du Rouvray (France); Napoleoni, Jean-Gerard [EMKA Technologies, Paris (France)

    2007-04-15

    Both increase in cardiac arrhythmia incidence and decrease in heart rate variability (HRV) have been described following human and experimental animal exposures to air pollutants. However, the potential causal relationship between these two factors remains unclear. Incidence of ventricular arrhythmia and HRV were evaluated during and after a 3 h period of Diesel engine exhaust exposure in ten healthy and ten chronic ischemic heart failure (CHF, 3 months after coronary ligation) Wistar rats using implantable ECG telemetry. Air pollutants were delivered to specifically designed whole body individual exposure chambers at particulate matter concentrations similar to those measured inside cabins of cars inserted in congested urban traffic. Recordings were obtained from unrestraint and unsedated vigil rats. Immediate decrease in RMSSD was observed in both healthy (6.64 {+-} 2.62 vs. 4.89 {+-} 1.67 ms, P < 0.05) and CHF rats (8.01 {+-} 0.89 vs. 6.6 {+-} 1.37 ms, P < 0.05) following exposure. An immediate 200-500% increase in ventricular premature beats was observed in CHF rats only. Whereas HRV progressively returned to baseline values within 2.5 h after exposure start, the proarrhythmic effect persisted as late as 5 h after exposure termination in CHF rats. Persistence of ventricular proarrhythmic effects after HRV normalization suggests that HRV reduction is not the mechanism of cardiac arrhythmias in this model. Our methodological approach, closely reflecting the real clinical situations, appeared to be a unique tool to provide further insight into the pathophysiological mechanisms of traffic related airborne pollution health impact. (orig.)

  3. 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

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

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    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.

  5. 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.

  6. Quantification of late gadolinium enhanced CMR in viability assessment in chronic ischemic heart disease: a comparison to functional outcome

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    Afsharzada Farshid

    2009-03-01

    Full Text Available Abstract Background Quantification of late gadolinium enhanced cardiovascular magnetic resonance (LGE CMR by objective window setting increases reproducibility and facilitates multicenter comparison and cooperation. So far, quantification methods or models have only been validated to postmortem animal studies. This study was undertaken to evaluate quantification of LGE in relation to the clinical standard of viability, i.e. functional outcome after revascularization. Thirty-eight patients with chronic ischemic myocardial dysfunction underwent cine and LGE 1 month before and cine CMR 6 months after coronary revascularization. Enhancement was quantified by thresholding window setting at: 2-8SD above mean signal intensity of a remote normal region, and according to the full width at half maximum method (FWHM. Dysfunctional segments were divided in 5 groups according to segmental extent of enhancement (SEE: SEE 1 – no enhancement to SEE 5 – 76–100% with each quantification method. Results Quantification methods had a strong influence on SEE and total infarct size. Multilevel analysis showed that thresholding contrast images at 6SD best predicted segmental functional outcome after revascularization, but the difference with other methods was small and non-significant. Conclusion Simple thresholding techniques strongly influence global and segmental extent of LGE, but have relatively little influence on the accuracy to predict segmental functional improvement after revascularization.

  7. Mortality by Heart Failure and Ischemic Heart Disease in Brazil from 1996 to 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gaui, Eduardo Nagib, E-mail: engaui@cardiol.br; Oliveira, Gláucia Maria Moraes de [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Klein, Carlos Henrique [Escola Nacional de Saúde Pública Sérgio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro, RJ (Brazil)

    2014-06-15

    Circulatory system diseases are the first cause of death in Brazil. To analyze the evolution of mortality caused by heart failure, by ischemic heart diseases and by ill-defined causes, as well as their possible relations, in Brazil and in the geoeconomic regions of the country (North, Northeast, Center-West, South and Southeast), from 1996 to 2011. Data were obtained from DATASUS and death declaration records with codes I20 and I24 for acute ischemic diseases, I25 for chronic ischemic diseases, and I50 for heart failure, and codes in chapter XIII for ill-defined causes, according to geoeconomic regions of Brazil, from 1996 to 2011. Mortality rates due to heart failure declined in Brazil and its regions, except for the North and the Northeast. Mortality rates due to acute ischemic heart diseases increased in the North and Northeast regions, especially from 2005 on; they remained stable in the Center-West region; and decreased in the South and in the Southeast. Mortality due to chronic ischemic heart diseases decreased in Brazil and in the Center-West, South and Southeast regions, and had little variation in the North and in the Northeast. The highest mortality rates due to ill-defined causes occurred in the Northeast until 2005. Mortality due to heart failure is decreasing in Brazil and in all of its geoeconomic regions. The temporal evolution of mortality caused by ischemic heart diseases was similar to that of heart failure. The decreasing number of deaths due to ill-defined causes may represent the improvement in the quality of information about mortality in Brazil. The evolution of acute ischemic heart diseases ranged according to regions, being possibly confused with the differential evolution of ill-defined causes.

  8. A Common Polymorphism of the Human Cardiac Sodium Channel Alpha Subunit (SCN5A Gene Is Associated with Sudden Cardiac Death in Chronic Ischemic Heart Disease.

    Directory of Open Access Journals (Sweden)

    Boglárka Marcsa

    Full Text Available Cardiac death remains one of the leading causes of mortality worldwide. Recent research has shed light on pathophysiological mechanisms underlying cardiac death, and several genetic variants in novel candidate genes have been identified as risk factors. However, the vast majority of studies performed so far investigated genetic associations with specific forms of cardiac death only (sudden, arrhythmogenic, ischemic etc.. The aim of the present investigation was to find a genetic marker that can be used as a general, powerful predictor of cardiac death risk. To this end, a case-control association study was performed on a heterogeneous cohort of cardiac death victims (n=360 and age-matched controls (n=300. Five single nucleotide polymorphisms (SNPs from five candidate genes (beta2 adrenergic receptor, nitric oxide synthase 1 adaptor protein, ryanodine receptor 2, sodium channel type V alpha subunit and transforming growth factor-beta receptor 2 that had previously been shown to associate with certain forms of cardiac death were genotyped using sequence-specific real-time PCR probes. Logistic regression analysis revealed that the CC genotype of the rs11720524 polymorphism in the SCN5A gene encoding a subunit of the cardiac voltage-gated sodium channel occurred more frequently in the highly heterogeneous cardiac death cohort compared to the control population (p=0.019, odds ratio: 1.351. A detailed subgroup analysis uncovered that this effect was due to an association of this variant with cardiac death in chronic ischemic heart disease (p=0.012, odds ratio = 1.455. None of the other investigated polymorphisms showed association with cardiac death in this context. In conclusion, our results shed light on the role of this non-coding polymorphism in cardiac death in ischemic cardiomyopathy. Functional studies are needed to explore the pathophysiological background of this association.

  9. Particulate air pollution and chronic ischemic heart disease in the eastern United States: a county level ecological study using satellite aerosol data

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    Rao K Ranga

    2009-06-01

    Full Text Available Abstract Background There are several known factors that cause ischemic heart disease. However, the part played by air pollution still remains something of a mystery. Recent attention has focused on the chronic effect of particulate matter on heart disease. Satellite-derived aerosol optical depth (AOD was found to be correlated with PM2.5 in the eastern US. The objective of this study was to examine if there is an association between aerosol air pollution as indicated by AOD and chronic ischemic heart disease (CIHD in the eastern US. Methods An ecological geographic study method was employed. Race and age standardized mortality rate (SMR of CIHD was computed for each of the 2306 counties for the time period 2003–2004. A mean AOD raster grid for the same period was derived from Moderate Resolution Imaging Spectrometer (MODIS aerosol data and the average AOD was calculated for each county. A bivariate Moran's I scatter plot, a map of local indicator of spatial association (LISA clusters, and three regression models (ordinary least square, spatial lag, and spatial error were used to analyze the relationship between AOD and CIHD SMR. Results The global Moran's I value is 0.2673 (p = 0.001, indicating an overall positive spatial correlation of CIHD SMR and AOD. The entire study area is dominated by spatial clusters of AOD against SMR (high AOD and high SMR in the east, and low AOD and low SMR in the west (permutations = 999, p = 0.05. Of the three regression models, the spatial error model achieved the best fit (R2 = 0.28. The effect of AOD is positive and significant (beta = 0.7774, p = 0.01. Conclusion Aerosol particle pollution has adverse effect on CIHD mortality risk in the eastern US. High risk of CIHD mortality was found in areas with elevated levels of outdoor aerosol air pollution as indicated by satellite derived AOD. The evidence of the association would support targeting of policy interventions on such areas to reduce air pollution

  10. Ischemic heart disease among subjects with and without chronic obstructive pulmonary disease – ECG-findings in a population-based cohort study

    OpenAIRE

    Nilsson, Ulf; Johansson, Bengt; Eriksson, Berne; Blomberg, Anders; Lundbäck, Bo; Lindberg, Anne

    2015-01-01

    Background Cardiovascular comorbidity in COPD is common and contributes to increased mortality. A few population-based studies indicate that ischemic electrocardiogram (ECG)-changes are more prevalent in COPD, while others do not. The aim of the present study was to estimate the presence of ischemic heart disease (IHD) in a population-based COPD-cohort in comparison with subjects without COPD. Methods All subjects with obstructive lung function (COPD, n = 993) were identified together with ag...

  11. HYPOLIPIDEMIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN 2004-2010 ACCORDING TO THE PROGNOZ IBS REGISTER

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-01-01

    Full Text Available Aim. To evaluate the frequency of prescription, efficacy and patients adherence to statin therapy in a cohort of patients with ischemic heart disease (IHD, confirmed by coronary angiography data, during the period from 2004 to 2010 based on the data from the PROGNOZ IBS register.Material and methods. The PROGNOZ IBS register database was used in the study. The data of 550 patients from a cohort of patients with the confirmed IHD, who had undergone coronary angiography from 2004 to 2008 (303 of them were on the follow-up visit were included in the final analysis.Results. Low frequency of statins prescription in patients with stable IHD prior to hospitalization in 2004-2007 and a significant improvement of its quality during the stay in a specialized cardiology unit were revealed in the PROGNOZ IBS register. The frequency of statin prescription at discharge increased from 10% to 85.5% (in most cases original drugs were used, but the prescribed doses were usually inadequate. Target blood lipid levels were not achieved in the majority of patients. The level of low density cholesterol <2.5 mmol/L at discharge was present in 6.3% of the patients (the short period of hospitalization insufficient for the achievement of statins maximum effect should be taken into consideration. 67% of patients had good adherence to lipid-lowering therapy 3.9 years after the admission, however, the original drugs had been replaced by a variety of generics in most patients. The efficacy of the therapy was inadequate: the target levels of total cholesterol (<4.5 mmol/L and low density cholesterol (<2.5 mmol/L were achieved in 40% of patients, of low density cholesterol (<2.0 mmol/l - in 15.8%.Conclusion. Low frequency of statins prescription in patients with stable IHD before the admission to the hospital, its significant growth during the stay and its reduction after the discharge were revealed. The treatment efficacy was low at all stages of the observation. Patients

  12. HYPOLIPIDEMIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN 2004-2010 ACCORDING TO THE PROGNOZ IBS REGISTER

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-09-01

    Full Text Available Aim. To evaluate the frequency of prescription, efficacy and patients adherence to statin therapy in a cohort of patients with ischemic heart disease (IHD, confirmed by coronary angiography data, during the period from 2004 to 2010 based on the data from the PROGNOZ IBS register.Material and methods. The PROGNOZ IBS register database was used in the study. The data of 550 patients from a cohort of patients with the confirmed IHD, who had undergone coronary angiography from 2004 to 2008 (303 of them were on the follow-up visit were included in the final analysis.Results. Low frequency of statins prescription in patients with stable IHD prior to hospitalization in 2004-2007 and a significant improvement of its quality during the stay in a specialized cardiology unit were revealed in the PROGNOZ IBS register. The frequency of statin prescription at discharge increased from 10% to 85.5% (in most cases original drugs were used, but the prescribed doses were usually inadequate. Target blood lipid levels were not achieved in the majority of patients. The level of low density cholesterol <2.5 mmol/L at discharge was present in 6.3% of the patients (the short period of hospitalization insufficient for the achievement of statins maximum effect should be taken into consideration. 67% of patients had good adherence to lipid-lowering therapy 3.9 years after the admission, however, the original drugs had been replaced by a variety of generics in most patients. The efficacy of the therapy was inadequate: the target levels of total cholesterol (<4.5 mmol/L and low density cholesterol (<2.5 mmol/L were achieved in 40% of patients, of low density cholesterol (<2.0 mmol/l - in 15.8%.Conclusion. Low frequency of statins prescription in patients with stable IHD before the admission to the hospital, its significant growth during the stay and its reduction after the discharge were revealed. The treatment efficacy was low at all stages of the observation. Patients

  13. Remnant cholesterol and ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G

    2014-01-01

    PURPOSE OF REVIEW: To review recent advances in the field of remnant cholesterol as a contributor to the development of ischemic heart disease (IHD). RECENT FINDINGS: Epidemiologic, mechanistic, and genetic studies all support a role for elevated remnant cholesterol (=cholesterol in triglyceride...

  14. The influence of concomitant diseases on a long-term prognosis in patients with chronic ischemic heart disease according to the PROGNOZ IBS register

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    S. N. Tolpygina

    2015-12-01

    Full Text Available Aim. To study the incidence of comorbidities and their impact on the prognosis in patients with ischemic heart disease (IHD included into the PROGNOZ IBS Register.Material and methods. Data from the PROGNOZ IBS register of patients diagnosed with IHD using coronary angiography during the reference hospitalization (n=541; 432 male and 109 female was included in the analysis. 504 (93% patients were included in the survival analysis. Risk factors of cardiovascular diseases, associated with atherosclerosis, or those that were complications of IHD were considered as comorbidities as well as not cardiovascular diseases – chronic obstructive pulmonary disease, bronchial asthma andchronic kidney disease (CKD.Results. The average duration of follow-up was 7.3±2.19 years. The average number of comorbidities in patients with IHD was 1.83. Comorbidities worsened the prognosis of life: the presence of diabetes mellitus (DM increased the relative risk (RR of primary endpoint occurrence by 1.7 times, the combination of DM with hypertension – by 2.4 times, a history of stroke – by 2.3 times (p<0.05; 2 and 3 heart diseases – respectively, by 2.3 and 3.2 times (p<0.05; a combination of chronic lung diseases and CKD stages 3-5 – by 1.4 times (p=0.06; the presence of 2, 3, 4 and 5 comorbidities – respectively, by 4, 5, 6.4 and 13 times (p<0.001. The risk of death from all causes was determined by the number of concomitant cardiovascular diseases: 2 diseases increased RR by 2.3 times, 3 diseases – by 4.6 times, a combination of any 4 diseases – by 3.5 times, of 5 diseases – by 5 times (p<0.05.Conclusion. Prognosis of life in IHD patients is worsened by the presence of several comorbidities: risk factors of cardiovascular disease (DM and hypertension, cardiovascular diseases associated with atherosclerosis or those that are complications of IHD, chronic lung diseases and CKD.

  15. Spinal cord stimulation for ischemic heart disease

    NARCIS (Netherlands)

    DeJongste, MJL

    2000-01-01

    An increasing number of patients are suffering from angina pectoris that is chronically refractory to standard anti-ischemic treatment such as pharmacological and surgical strategies. To improve the quality of life of these severely disabled patients, without adversely affecting their prognosis, a n

  16. ENDOTHELIAL DYSFUNCTION IN ISCHEMIC HEART DISEASE

    OpenAIRE

    N. E. Zakirova; R. G. Oganov; A. N. Zakirova; M. P. Plotnikova; G. M. Salakhova

    2016-01-01

    Aim. To assess the role of endothelial vasodilating, vasoconstrictive and adhesive dysfunction in the development of angina pectoris (AP) in patients with ischemic heart disease (IHD).Material and methods. 83 patients with IHD were included in the study. 30 patients had AP of functional class (FC)-II, 27 patients - FC-III and 26 patients - FC-IV. The control group consisted of 25 healthy persons. Bicycle ergometry, daily ECG monitoring and echocardiography were used for verification of IHD. E...

  17. Clinical evaluation of ischemic heart diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, Fumio (Sendai Railway Hospital (Japan))

    1983-09-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhance sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful for objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis.

  18. Cardiac Magnetic Resonance Imaging in Ischemic Heart Disease

    NARCIS (Netherlands)

    S.W.M. Kirschbaum (Sharon)

    2011-01-01

    textabstractIschemic heart disease is the leading cause of morbidity and mortality in the western world in particularly in the elderly and as medical and revascularization therapy is improving and life expectancy is increasing, the number of patients having ischemic heart disease is expected to incr

  19. Nonfasting glucose, ischemic heart disease, and myocardial infarction

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjaerg-Hansen, Anne; McCarthy, Mark I;

    2012-01-01

    The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI).......The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI)....

  20. Perceived stress and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Kristensen, Tage Søndergård; Prescott, Eva;

    2006-01-01

    It is unclear whether the commonly recognized link between stress and cardiovascular disease is causal or the result of reporting bias. The objective of this study was to address the association between perceived stress and first incidence of ischemic heart disease and to evaluate the suggested...... reporting bias by addressing subdiagnoses of ischemic heart disease separately....

  1. TREATMENT OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN REAL CLINICAL PRACTICE ACCORDING TO THE DATA FROM PROGNOZ IBS REGISTER. (Part 1

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-09-01

    Full Text Available According to the data from PROGNOZ IBS register drugs with proven efficacy in secondary prevention of cardiovascular complications (antiplatelets, β-blockers, ACE inhibitors, statins were not often prescribed in patients with stable ischemic heart disease prior to hospitalization. Significant improvement of the treatment quality was found during the cardiology hospital stay. The prescription rate of ACE inhibitors increased from 20% to 84.4%, statins - from 10% to 85.5%, β-blockers - from 20% to 91%, acetylsalicylic acid - from 74% to 96%. However, some drugs (statins have been used in inadequate doses. Low-density lipoprotein level <2.5 mmol/L was achieved at discharge only in 6.3% of patients.

  2. Targeting acid sphingomyelinase reduces cardiac ceramide accumulation in the post-ischemic heart.

    Science.gov (United States)

    Klevstig, Martina; Ståhlman, Marcus; Lundqvist, Annika; Scharin Täng, Margareta; Fogelstrand, Per; Adiels, Martin; Andersson, Linda; Kolesnick, Richard; Jeppsson, Anders; Borén, Jan; Levin, Malin C

    2016-04-01

    Ceramide accumulation is known to accompany acute myocardial ischemia, but its role in the pathogenesis of ischemic heart disease is unclear. In this study, we aimed to determine how ceramides accumulate in the ischemic heart and to determine if cardiac function following ischemia can be improved by reducing ceramide accumulation. To investigate the association between ceramide accumulation and heart function, we analyzed myocardial left ventricle biopsies from subjects with chronic ischemia and found that ceramide levels were higher in biopsies from subjects with reduced heart function. Ceramides are produced by either de novo synthesis or hydrolysis of sphingomyelin catalyzed by acid and/or neutral sphingomyelinase. We used cultured HL-1 cardiomyocytes to investigate these pathways and showed that acid sphingomyelinase activity rather than neutral sphingomyelinase activity or de novo sphingolipid synthesis was important for hypoxia-induced ceramide accumulation. We also used mice with a partial deficiency in acid sphingomyelinase (Smpd1(+/-) mice) to investigate if limiting ceramide accumulation under ischemic conditions would have a beneficial effect on heart function and survival. Although we showed that cardiac ceramide accumulation was reduced in Smpd1(+/-) mice 24h after an induced myocardial infarction, this reduction was not accompanied by an improvement in heart function or survival. Our findings show that accumulation of cardiac ceramides in the post-ischemic heart is mediated by acid sphingomyelinase. However, targeting ceramide accumulation in the ischemic heart may not be a beneficial treatment strategy. PMID:26930027

  3. Xenotransplantation of Human Cardiomyocyte Progenitor Cells Does Not Improve Cardiac Function in a Porcine Model of Chronic Ischemic Heart Failure. Results from a Randomized, Blinded, Placebo Controlled Trial

    OpenAIRE

    Jansen of Lorkeers, SJ; Gho, Johannes M. I. H.; Koudstaal, Stefan; van Hout, Geert; Zwetsloot, Peter Paul M; van Oorschot, Joep W M; Esther C M van Eeuwijk; Leiner, Tim; Höfer, Imo E.; Goumans, Marie-José; Doevendans, Pieter A.; Sluijter, Joost P. G.; Chamuleau, Steven A J

    2015-01-01

    BACKGROUND: Recently cardiomyocyte progenitor cells (CMPCs) were successfully isolated from fetal and adult human hearts. Direct intramyocardial injection of human CMPCs (hCMPCs) in experimental mouse models of acute myocardial infarction significantly improved cardiac function compared to controls. AIM: Here, our aim was to investigate whether xenotransplantation via intracoronary infusion of fetal hCMPCs in a pig model of chronic myocardial infarction is safe and efficacious, in view of tra...

  4. Life style modification for patients with ischemic heart disease.

    Science.gov (United States)

    Mahalingam, V

    2013-01-01

    With a view to assess the effectiveness of lifestyle modification in patients with ischemic heart disease, a quasi-experimental study with quantitative approach was undertaken on 60 patients of ischemic heart disease. Purposive sampling technique was used in selecting the patients. The results showed that educating the patients about cessation of smoking, taking proper diet, anxiety reduction and counselling helped in preventing the progression of ischaemic heart disease.

  5. Circulating Endothelial-Derived Apoptotic Microparticles in the Patients with Ischemic Symptomatic Chronic Heart Failure: Relevance of Pro-Inflammatory Activation and Outcomes

    Directory of Open Access Journals (Sweden)

    Alexander E. Berezin

    2014-09-01

    Full Text Available Background: Endothelial-derived apoptotic microparticles (EMPs play a pivotal role in endothelial dysfunction in hronic Heart Failure (CHF. Objectives: The present study aimed to evaluate the association between EMPs and pro-inflammatory biomarkers, clinical status, and outcomes in the patients with ischemic CHF. Patients and Methods: This study was conducted on 154 patients with ischemic symptomatic moderate-to-severe CHF on discharge from hospital. The observation period was up to 3 years. Circulating NT-pro-BNP, TNF-alpha, sFas, and sFas ligand were determined at baseline. Flow cytometry analysis was used for quantifying the number of EMPs. All-cause mortality, CHF-related death, and CHD-re-hospitalization rate were examined. The data were analyzed using descriptive statistics, Receive Operation Characteristic Curve (ROC, and logistic regression analysis. Besides, P 0.514 n/mL and those with a low level of the biomarker (< 0.514 n/mL regarding their survival. The number of circulating EPMs independently predicted all-cause mortality (OR = 1.58; 95% CI = 1.20 – 1.88; P = 0.001, CHF-related death (OR = 1.22; 95% CI: 1.12 – 1.36; P < 0.001, and CHF-related re-hospitalization (OR = 1.20; 95% CI: 1.11 – 1.32; P < 0.001. Conclusions: Among the patients with symptoms of CHF, increased number of circulating EMPs was associated with increased 3-year CHF-related death, all-cause mortality, and risk of recurrent hospitalization due to CHF.

  6. Gender and post-ischemic recovery of hypertrophied rat hearts

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    Popov Kirill M

    2006-03-01

    Full Text Available Abstract Background Gender influences the cardiac response to prolonged increases in workload, with differences at structural, functional, and molecular levels. However, it is unknown if post-ischemic function or metabolism of female hypertrophied hearts differ from male hypertrophied hearts. Thus, we tested the hypothesis that gender influences post-ischemic function of pressure-overload hypertrophied hearts and determined if the effect of gender on post-ischemic outcome could be explained by differences in metabolism, especially the catabolic fate of glucose. Methods Function and metabolism of isolated working hearts from sham-operated and aortic-constricted male and female Sprague-Dawley rats before and after 20 min of no-flow ischemia (N = 17 to 27 per group were compared. Parallel series of hearts were perfused with Krebs-Henseleit solution containing 5.5 mM [5-3H/U-14C]-glucose, 1.2 mM [1-14C]-palmitate, 0.5 mM [U-14C]-lactate, and 100 mU/L insulin to measure glycolysis and glucose oxidation in one series and oxidation of palmitate and lactate in the second. Statistical analysis was performed using two-way analysis of variance. The sequential rejective Bonferroni procedure was used to correct for multiple comparisons and tests. Results Female gender negatively influenced post-ischemic function of non-hypertrophied hearts, but did not significantly influence function of hypertrophied hearts after ischemia such that mass-corrected hypertrophied heart function did not differ between genders. Before ischemia, glycolysis was accelerated in hypertrophied hearts, but to a greater extent in males, and did not differ between male and female non-hypertrophied hearts. Glycolysis fell in all groups after ischemia, except in non-hypertrophied female hearts, with the reduction in glycolysis after ischemia being greatest in males. Post-ischemic glycolytic rates were, therefore, similarly accelerated in hypertrophied male and female hearts and higher in

  7. Trends in Mortality from Ischemic Heart Disease, Stroke, and Stomach Cancer: from past to future

    NARCIS (Netherlands)

    M. Amiri (Masoud)

    2010-01-01

    textabstractThe common occurrence of chronic diseases – such as ischemic heart diseases (IHD, stroke, and stomach cancer in most populations and the attendant mortality, loss of independence, impaired quality of life, and social and economic costs are compelling reasons for public health concern. A

  8. Visible aging signs as risk markers for ischemic heart disease

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Tybjærg-Hansen, Anne

    2016-01-01

    Association of common aging signs (i.e., male pattern baldness, hair graying, and facial wrinkles) as well as other age-related appearance factors (i.e., arcus corneae, xanthelasmata, and earlobe crease) with increased risk of ischemic heart disease was initially described in anecdotal reports from...... clinicians observing trends in the physical appearance of patients with ischemic heart disease. Following these early observations numerous epidemiological studies have reported these associations. Since the prevalences of both visible aging signs and ischemic heart disease have a strong correlation......, and are mostly speculative. As a consequence of inconsistent findings and lack of mechanistic explanations for the observed associations with ischemic heart disease, consensus on the clinical importance of these visible aging signs has been lacking. The aim of this review is for each of the visible aging signs...

  9. Arterial hypertension, microalbuminuria, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Jensen, J S; Feldt-Rasmussen, B; Strandgaard, S;

    2000-01-01

    Albumin excretion in urine is positively correlated with the presence of ischemic heart disease and atherosclerotic risk factors. We studied prospectively whether a slight increase of urinary albumin excretion, ie, microalbuminuria, adds to the increased risk of ischemic heart disease among...... hypertensive subjects. In 1983 and 1984, blood pressure, urinary albumin/creatinine concentration ratio, plasma total and HDL cholesterol levels, body mass index, and smoking status were obtained in a population-based sample of 2085 subjects, aged 30 to 60 years, who were free from ischemic heart disease......, diabetes mellitus, and renal or urinary tract disease. Untreated arterial hypertension or borderline hypertension was present in 204 subjects, who were followed until 1993 by the National Hospital and Death Certificate Registers with respect to development of ischemic heart disease. During 1978 person...

  10. Long noncoding RNA dysregulation in ischemic heart failure

    OpenAIRE

    Greco, Simona; Zaccagnini, Germana; Perfetti, Alessandra; Fuschi, Paola; Valaperta, Rea; Voellenkle, Christine; Castelvecchio, Serenella; Gaetano, Carlo; Finato, Nicoletta; Beltrami, Antonio Paolo; Menicanti, Lorenzo; Martelli, Fabio

    2016-01-01

    Background Long noncoding RNAs (lncRNAs) are non-protein coding transcripts regulating a variety of physiological and pathological functions. However, their implication in heart failure is still largely unknown. The aim of this study is to identify and characterize lncRNAs deregulated in patients affected by ischemic heart failure. Methods LncRNAs were profiled and validated in left ventricle biopsies of 18 patients affected by non end-stage dilated ischemic cardiomyopathy and 17 matched cont...

  11. Granulocyte-colony stimulating factor therapy to induce neovascularization in ischemic heart disease

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten

    2012-01-01

    Cell based therapy for ischemic heart disease has the potential to reduce post infarct heart failure and chronic ischemia. Treatment with granulocyte-colony stimulating factor (G-CSF) mobilizes cells from the bone marrow to the peripheral blood. Some of these cells are putative stem or progenitor...... infarction or severe chronic ischemic heart disease. In addition, we assed a number of factors that could potentially affect the effect of cell based therapy. Finally, we intended to develop a method for in vivo cell tracking in the heart. Our research showed that subcutaneous G-CSF along with gene therapy...... cells. G-CSF is injected subcutaneously. This therapy is intuitively attractive compared to other cell based techniques since repeated catheterizations and ex vivo cell purification and expansion are avoided. Previous preclinical and early clinical trials have indicated that treatment with G-CSF leads...

  12. Curbing Inflammation in the Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Paulo Roberto B. Evora

    2013-01-01

    Full Text Available A modern concept considers acute coronary syndrome as an autoinflammatory disorder. From the onset to the healing stage, an endless inflammation has been presented with complex, multiple cross-talk mechanisms at the molecular, cellular, and organ levels. Inflammatory response following acute myocardial infarction has been well documented since the 1940s and 1950s, including increased erythrocyte sedimentation rate, the C-reactive protein analysis, and the determination of serum complement. It is surprising to note, based on a wide literature overview including the following 30 years (decades of 1960, 1970, and 1980, that the inflammatory acute myocardium infarction lost its focus, virtually disappearing from the literature reports. The reversal of this historical process occurs in the 1990s with the explosion of studies involving cytokines. Considering the importance of inflammation in the pathophysiology of ischemic heart disease, the aim of this paper is to present a conceptual overview in order to explore the possibility of curbing this inflammatory process.

  13. ENDOTHELIAL DYSFUNCTION IN ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    N. E. Zakirova

    2016-01-01

    Full Text Available Aim. To assess the role of endothelial vasodilating, vasoconstrictive and adhesive dysfunction in the development of angina pectoris (AP in patients with ischemic heart disease (IHD.Material and methods. 83 patients with IHD were included in the study. 30 patients had AP of functional class (FC-II, 27 patients - FC-III and 26 patients - FC-IV. The control group consisted of 25 healthy persons. Bicycle ergometry, daily ECG monitoring and echocardiography were used for verification of IHD. Endothelial vasodilating function was assessed by endothelium-dependent (EDVD and endothelium-independent vasodilatation (EIDVD of brachial artery. Vasoconstrictive function was assessed by the level of endothelin (ET-1. Endothelial adhesive function was evaluated by plasma concentration of intracellular adhesion molecules – JCAM-1, VCAM-1 and Е-selectin.Results. Normal EDVD and EIDVD were observed in patients with AP of FC-II. The more severe FC of AP the more prominent endothelial vasodilating dysfunction was revealed as well as the higher levels of ET-1 and intracellular adhesion molecules. Patients with AP of FC-IV had hyperexpression of JCAM-1, VCAM-1, Е-selectin and ET-1 and low levels of EDVD and EIDVD.Conclusion. Progression of IHD related with growing endothelial vasodilating, vasoconstrictive and adhesive dysfunction.

  14. LONG-TERM RESULTS OF TRANSMYOCARDIAL LASER REVASCULARIZATION COMBINED WITH IMPLANTATION OF AUTOLOGOUS BONE MARROW MONONUCLEAR FRACTION IN THE TREATMENT OF CHRONIC ISCHEMIC HEART DISEAS

    Directory of Open Access Journals (Sweden)

    A. M. Chernyavsky

    2016-01-01

    Full Text Available Aim. Clinical and instrumental assessment of long-term results of autologous bone marrow cells (BMC implantation in laser channels in surgery of ischemic heart disease with diffuse and distal coronary disease.Materials and Methods. In the period of 2007–2008 35 CHD patients with diffuse and distal coronary disease underwent BMC implantation in laser channels during coronary artery bypass grafting (CABG. The control group consisted of 29 patients. All patients in this group underwent only direct myocardial revascularization (DMR. In the long-term period we examined only 30 patients of the first group. Clinical and instrumental assessment of the method efficacy was carried out in 2 weeks, 6 months and 6 years after surgery.Results. FC (NYHA mean value in indirect revascularization group significantly decreased from 2.57 ± 0.61 preoperatively to 1.77 ±0.66 in6 months after surgery (p = 0.043. After 6 years FC (NYHA was not significantly changed – 1.84 ± 0.42 (p = 0.053. Perfusion scintigraphy revealed a slight decrease of stable perfusion defect (SPD in the immediate postoperative period, a more pronounced reduction of SPD in 6 months after surgery. The average value of SPD before surgery was 20.46 ± 10.75%, in 2 weeks after the operation – 19.07 ± 9.69%, in 6 months after surgery – 15.22 ± 9.49%. In the long-term period (6 years SPD was 14.8 ± 8.43% (p = 0.047. A similar pattern was observed in the analysis of transient perfusion defect: baseline – 30 ± 2.2%, in 6 months – 15 ± 1.3%, in the long term period – 20 ± 6.1% (p = 0.047. The average value of left ventricular ejection fraction (LVEF before surgery was 55 ± 10.4%, in 2 weeks after the operation – 55.7 ± 9.3%, in 6 months – 56.7 ± 10%, after 6 years – 54 ± 12%. The dynamics is unauthentic (p = 0.068.Conclusion. BMC implantation in laser channels in addition to CABG is a safe and effective method of surgical treatment in case of CABG inability. The effect of

  15. Blood pressure, risk of ischemic cerebrovascular and ischemic heart disease, and longevity in alpha(1)-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Dahl, Morten; Tybjaerg-Hansen, Anne; Sillesen, Henrik;

    2003-01-01

    Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity.......Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity....

  16. Xenotransplantation of Human Cardiomyocyte Progenitor Cells Does Not Improve Cardiac Function in a Porcine Model of Chronic Ischemic Heart Failure. Results from a Randomized, Blinded, Placebo Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Sanne J Jansen of Lorkeers

    Full Text Available Recently cardiomyocyte progenitor cells (CMPCs were successfully isolated from fetal and adult human hearts. Direct intramyocardial injection of human CMPCs (hCMPCs in experimental mouse models of acute myocardial infarction significantly improved cardiac function compared to controls.Here, our aim was to investigate whether xenotransplantation via intracoronary infusion of fetal hCMPCs in a pig model of chronic myocardial infarction is safe and efficacious, in view of translation purposes.We performed a randomized, blinded, placebo controlled trial. Four weeks after ischemia/reperfusion injury by 90 minutes of percutaneous left anterior descending artery occlusion, pigs (n = 16, 68.5 ± 5.4 kg received intracoronary infusion of 10 million fetal hCMPCs or placebo. All animals were immunosuppressed by cyclosporin (CsA. Four weeks after infusion, endpoint analysis by MRI displayed no difference in left ventricular ejection fraction, left ventricular end diastolic and left ventricular end systolic volumes between both groups. Serial pressure volume (PV-loop and echocardiography showed no differences in functional parameters between groups at any timepoint. Infarct size at follow-up, measured by late gadolinium enhancement MRI showed no difference between groups. Intracoronary pressure and flow measurements showed no signs of coronary obstruction 30 minutes after cell infusion. No premature death occurred in cell treated animals.Xenotransplantation via intracoronary infusion of hCMPCs is feasible and safe, but not associated with improved left ventricular performance and infarct size compared to placebo in a porcine model of chronic myocardial infarction.

  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. 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

    2016-01-01

    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 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. PMID:27547136

  19. 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. PMID:27547136

  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. The Relationship between Ischemic Heart Disease and Diabete

    DEFF Research Database (Denmark)

    Norgaard, Mette Lykke

    2012-01-01

    THE FOLLOWING OBJECTIVES ON THE SUBJECT: The relationship between ischemic heart disease and diabetes: 1. To examine the short- and long-term risk of death and cardiovascular outcomes in patients with incident diabetes and in patients with first-time MI during a 10 year period in Denmark, using the general...... diabetes increases with increasing severity of heart failure. Focus on the development of diabetes in patients with ischemic heart disease with or without the presence of heart failure still compose a public health matter, because early and aggressive evidence-based therapy is thought to reduce......Diabetes is a well-established risk factor for cardiovascular disease and is common among patients with acute myocardial infarction (MI), where the prevalence is as high as 20%. Patients with diabetes requiring glucose-lowering medication (GLM) have been reported as having the same long-term risk...

  2. Remodeling in the ischemic heart: the stepwise progression for heart

    Directory of Open Access Journals (Sweden)

    J.G. Mill

    2011-09-01

    Full Text Available Abstract Coronary artery disease is the leading cause of death in the developed world and in developing countries. Acute mortality from acute myocardial infarction (MI has decreased in the last decades. However, the incidence of heart failure (HF in patients with healed infarcted areas is increasing. Therefore, HF prevention is a major challenge to the health system in order to reduce healthcare costs and to provide a better quality of life. Animal models of ischemia and infarction have been essential in providing precise information regarding cardiac remodeling. Several of these changes are maladaptive, and they progressively lead to ventricular dilatation and predispose to the development of arrhythmias, HF and death. These events depend on cell death due to necrosis and apoptosis and on activation of the inflammatory response soon after MI. Systemic and local neurohumoral activation has also been associated with maladaptive cardiac remodeling, predisposing to HF. In this review, we provide a timely description of the cardiovascular alterations that occur after MI at the cellular, neurohumoral and electrical level and discuss the repercussions of these alterations on electrical, mechanical and structural dysfunction of the heart. We also identify several areas where insufficient knowledge limits the adoption of better strategies to prevent HF development in chronically infarcted individuals.

  3. Study on the relation between ischemic chronic heart failure and anemia%缺血性慢性心力衰竭与贫血的相关性研究

    Institute of Scientific and Technical Information of China (English)

    黄自平; 郑刚; 王静; 李斌

    2011-01-01

    Objective To study the relation between ischemic chronic heart failure(CHF) and anemia. Methods 196 patients were divided into anemia group(54 cases) and non- anemia group(142 cases) according to hemoglobin levels. The clinical characteristics and prognosis between the two groups were compared. The incidence and hematological examination results of anemia between the patients with mild and severe CHF were compared. Results Fifty-four cases had anemia (27.6 %). There was significant difference in incidence rate of anemia between patients with mild and severe CHF(16.0% vs 39.6 %, P < 0.01). There were significant differences in the number of males,age, serum creatinine and the levels of LVEF between the two groups (P < 0.05, P <0.01). Compared with non-anemia group, the rehospitalization rate, average rehospitalization days and the mortality were higher in anemia group (P< 0.05). Compared with the patients with mild CHF,the level of Hb and MCHC was significantly lower in the patients with severe CHF (P <0.05). Conclusion The patients with ischemic heart disease complicated with chronic heart failure often suffer from anemia. The degree of anemia is correlated with serverity of heart failure.Patients with CHF complicated with anemia have bad outcomes.%目的 探讨缺血性慢性心力衰竭(CHF)与贫血的相关性.方法 根据血红蛋白水平将196例患者分为贫血组54例和非贫血组142例,比较2组临床特征、预后、不同程度CHF患者贫血患病率及各项生化指标.结果 196例患者中,有54例出现贫血,占27.6%;轻度心力衰竭贫血患病率16.0%.明显低于重度心力衰竭(39.6%,P<0.01).与非贫血组比较,贫血组年龄、男性比率及血肌酐明显升高,差异有统计学意义(P<0.05,P<0.01),LVEF明显降低(P<0.05);再次住院、再住院平均天数及随访期病死率明显升高(P<0.05).与轻度心力衰竭患者比较,重度心力衰竭患者血红蛋白、红细胞平均血红蛋

  4. Medications Used in the Treatment of Ischemic Heart Disease.

    Science.gov (United States)

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on medications used in the treatment of ischemic heart disease is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first.…

  5. Urinary and plasma magnesium and risk of ischemic heart disease

    NARCIS (Netherlands)

    Joosten, Michel M.; Gansevoort, Ron T.; Mukamal, Kenneth J.; van der Harst, Pim; Geleijnse, Johanna M.; Feskens, Edith J. M.; Navis, Gerjan; Bakker, Stephan J. L.

    2013-01-01

    Background: Previous studies on dietary magnesium and risk of ischemic heart disease (IHD) have yielded inconsistent results, in part because of a lack of direct measures of actual magnesium uptake. Urinary excretion of magnesium, an indicator of dietary magnesium uptake, might provide more consiste

  6. Echocardiographic evaluation of left ventricular function in ischemic heart disease

    NARCIS (Netherlands)

    Mollema, Sjoerd Adriaan

    2010-01-01

    The presence of a decreased left ventricular (LV) function after myocardial infarction has demonstrated to be of considerable clinical importance. In this thesis, the role of 2D echocardiography to evaluate LV function in ischemic heart disease was investigated. In the first part of the thesis, rece

  7. Lasers in the treatment of ischemic heart disease in China

    Science.gov (United States)

    Zhang, Yongzhen; Chen, Mingzhe

    2000-10-01

    Myocardial revascularization by laser is a new treatment modality for chronic, severe, refractory angina in the patients with coronary heart disease that is not amenable to angioplasty (PTCA) or bypass surgery (CABG). Transmyocardial revascularization (TMR), typically requiring open thoracotomy, uses laser to create channels that would directly carry blood from left ventricular cavity into the ischemic myocardium. Current data indicate that TMR may provide these patients with improvement in angina severity, quality of life, and myocardial perfusion. The greatest potential future use of TMR is as an adjunct to CABG in patients with disease that prevents bypass grafting due to lack of distal targets or a conduit. Recently, as percutaneous (catheter-based) myocardial revascularization (PMR) has been developed with laser technology that permits the creation of channels from the endocardial surface of the left ventricle. The early results with PMR seem encouraging. Randomized clinical trial has demonstrated symptomatic improvement and increased exercise capacity. The risk: benefit ratio for PMR appears to be much more favorable than that for TMR. The mechanisms of action of them have not yet been clearly elucidated, and several theories have been proposed, including channel patency, angiogenesis, denervation, and placebo effect. The challenge of TMR/PMR is related to improvement of perioperative outcomes and long-term survival without worsening of left ventricular function. In future, it may be feasible to combine TMR/PMR with intramyocardial delivery of angiogenic growth factors to induce further new blood vessel formation.

  8. Adiponectin, diabetes and ischemic heart failure: a challenging relationship

    Directory of Open Access Journals (Sweden)

    Baldasseroni Samuele

    2012-12-01

    Full Text Available Abstract Background Several peptides, named adipokines, are produced by the adipose tissue. Among those, adiponectin (AD is the most abundant. AD promotes peripheral insulin sensitivity, inhibits liver gluconeogenesis and displays anti-atherogenic and anti-inflammatory properties. Lower levels of AD are related to a higher risk of myocardial infarction and a worse prognosis in patients with coronary artery disease. However, despite a favorable clinical profile, AD increases in relation to worsening heart failure (HF; in this context, higher adiponectinemia is reliably related to poor prognosis. There is still little knowledge about how certain metabolic conditions, such as diabetes mellitus, modulate the relationship between AD and HF. We evaluated the level of adiponectin in patients with ischemic HF, with and without type 2 diabetes, to elucidate whether the metabolic syndrome was able to influence the relationship between AD and HF. Results We demonstrated that AD rises in patients with advanced HF, but to a lesser extent in diabetics than in non-diabetics. Diabetic patients with reduced systolic performance orchestrated a slower rise of AD which began only in face of overt HF. The different behavior of AD in the presence of diabetes was not entirely explained by differences in body mass index. In addition, NT-proBNP, the second strongest predictor of AD, did not differ significantly between diabetic and non-diabetic patients. These data indicate that some other mechanisms are involved in the regulation of AD in patients with type 2 diabetes and coronary artery disease. Conclusions AD rises across chronic heart failure stages but this phenomenon is less evident in type 2 diabetic patients. In the presence of diabetes, the progressive increase of AD in relation to the severity of LV dysfunction is hampered and becomes evident only in overt HF.

  9. Intracoronary Delivery of Mitochondria to the Ischemic Heart for Cardioprotection

    Science.gov (United States)

    Cowan, Douglas B.; Yao, Rouan; Akurathi, Vamsidhar; Snay, Erin R.; Thedsanamoorthy, Jerusha K.; Zurakowski, David; Ericsson, Maria; Friehs, Ingeborg; Wu, Yaotang; Levitsky, Sidney; del Nido, Pedro J.; Packard, Alan B.

    2016-01-01

    We have previously shown that transplantation of autologously derived, respiration-competent mitochondria by direct injection into the heart following transient ischemia and reperfusion enhances cell viability and contractile function. To increase the therapeutic potential of this approach, we investigated whether exogenous mitochondria can be effectively delivered through the coronary vasculature to protect the ischemic myocardium and studied the fate of these transplanted organelles in the heart. Langendorff-perfused rabbit hearts were subjected to 30 minutes of ischemia and then reperfused for 10 minutes. Mitochondria were labeled with 18F-rhodamine 6G and iron oxide nanoparticles. The labeled mitochondria were either directly injected into the ischemic region or delivered by vascular perfusion through the coronary arteries at the onset of reperfusion. These hearts were used for positron emission tomography, microcomputed tomography, and magnetic resonance imaging with subsequent microscopic analyses of tissue sections to confirm the uptake and distribution of exogenous mitochondria. Injected mitochondria were localized near the site of delivery; while, vascular perfusion of mitochondria resulted in rapid and extensive dispersal throughout the heart. Both injected and perfused mitochondria were observed in interstitial spaces and were associated with blood vessels and cardiomyocytes. To determine the efficacy of vascular perfusion of mitochondria, an additional group of rabbit hearts were subjected to 30 minutes of regional ischemia and reperfused for 120 minutes. Immediately following regional ischemia, the hearts received unlabeled, autologous mitochondria delivered through the coronary arteries. Autologous mitochondria perfused through the coronary vasculature significantly decreased infarct size and significantly enhanced post-ischemic myocardial function. In conclusion, the delivery of mitochondria through the coronary arteries resulted in their rapid

  10. Role of nuclear medicine in ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Hayashida, Kohei; Nishimura, Tsunehiko; Uehara, Toshiisa; Naito, Hiroaki; Omine, Hiromi; Kozuka, Takahiro (National Cardiovascular Center, Suita, Osaka (Japan))

    1982-08-01

    With the progress in gamma camera and computer system, nuclear medicine has been applied for diagnostic tool in ischemic heart disease. There are two devices for cardiac images; (1) Radionuclide angiocardiography (RNA) by in vivo sup(99m)Tc-RBC labeling (2) Myocardial imaging by /sup 201/Tlcl. RNA can evaluate the kinesis of wall motion of left ventricle with gated pool scan and also detect reserve of cardiac function with exercise study. Myocardial imaging at rest can identify myocardial necrosis and the imaging in exercise can detect myocardial ischemia. The elaborateness and reproducibility of cardiac image in nuclear medicine will play the great role to evaluate clinical stage of ischemic heart disease by not only imaging but also functional diagnosis.

  11. [Multimodal imaging of ischemic heart diseases: A 2015 update].

    Science.gov (United States)

    Di Marco, L; Rosset, M; Zhang-Yin, J; Ohana, M

    2016-05-01

    Current realities and future possibilities of imaging in the ischemic heart diseases are very broad and constantly evolving, with the improvement of existing technologies and the introduction of new features such as dual-energy CT, strain ultrasound, multimodality fusion or perfusion MRI. Regular collaboration between prescribing clinicians, cardiologists, radiologists and nuclear radiologists is therefore essential to tailor the examination to the specific clinical question. The indications for each modality will therefore depend on its diagnostic performance, cost, acquisition and post-processing times and eventual radiation exposure. This review will detail principles and applications of current cardiac imaging examinations: echocardiography, nuclear medicine, MRI, CT and coronary angiography, emphasizing their current strengths and weaknesses in the ischemic heart diseases management. PMID:26775644

  12. Data mining of magnetocardiograms for prediction of ischemic heart disease

    OpenAIRE

    Kangwanariyakul, Yosawin; Naenna, Thanakorn; Nantasenamat, Chanin; Tantimongcolwat, Tanawut

    2010-01-01

    Ischemic Heart Disease (IHD) is a major cause of death. Early and accurate detection of IHD along with rapid diagnosis are important for reducing the mortality rate. Magnetocardiogram (MCG) is a tool for detecting electro-physiological activity of the myocardium. MCG is a fully non-contact method, which avoids the problems of skin-electrode contact in the Electrocardiogram (ECG) method. However, the interpretation of MCG recordings is time-consuming and requires analysis by an expert. Ther...

  13. Blueberry-enriched diet protects rat heart from ischemic damage.

    Directory of Open Access Journals (Sweden)

    Ismayil Ahmet

    Full Text Available OBJECTIVES: to assess the cardioprotective properties of a blueberry enriched diet (BD. BACKGROUND: Reactive oxygen species (ROS play a major role in ischemia-related myocardial injury. The attempts to use synthetic antioxidants to block the detrimental effects of ROS have produced mixed or negative results precipitating the interest in natural products. Blueberries are readily available product with the highest antioxidant capacity among fruits and vegetables. METHODS AND RESULTS: Following 3-mo of BD or a regular control diet (CD, the threshold for mitochondrial permeability transition (t(MPT was measured in isolated cardiomyocytes obtained from young male Fischer-344 rats. Compared to CD, BD resulted in a 24% increase (p<0.001 of ROS indexed t(MPT. The remaining animals were subjected to a permanent ligation of the left descending coronary artery. 24 hrs later resulting myocardial infarction (MI in rats on BD was 22% less than in CD rats (p<0.01. Significantly less TUNEL(+ cardiomyocytes (2% vs 9% and 40% less inflammation cells were observed in the myocardial area at risk of BD compared to CD rats (p<0.01. In the subgroup of rats, after coronary ligation the original diet was either continued or switched to the opposite one, and cardiac remodeling and MI expansion were followed by serial echocardiography for 10 weeks. Measurements suggested that continuation of BD or its withdrawal after MI attenuated or accelerated rates of post MI cardiac remodeling and MI expansion. CONCLUSION: A blueberry-enriched diet protected the myocardium from induced ischemic damage and demonstrated the potential to attenuate the development of post MI chronic heart failure.

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

    Directory of Open Access Journals (Sweden)

    Banović Marko

    2015-01-01

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

  15. Heart failure in the general Danish population and among individuals with ischemic heart disease

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach

    /co-existing IHD. Trends of prevalence and incidence of HF in the population and in IHD patients during 1997-2006 was estimated, applying logistic and Poisson regression analyses, adjusting for gender, age, income and origin (Danish, foreign (western non-western)). Survival time without subsequent or contemporary...... MI. Yet, the treatment of heart failure has also improved. It is unknown to what extent the incidence, prevalence and survival with heart failure in the general population and among patients with ischemic heart disease has changed over time. Aim The aim of this study is to estimate incidence...... and prevalence of heart failure (HF) in the Danish population and among individuals with ischemic heart disease (IHD) during 1996-2006, applying register data from the national patient register (NPR) and the national dispensing register (NDR). Data and methods All Danish inhabitants (aged >15) by January 1996...

  16. Is opium addiction a risk factor for ischemic heart disease and ischemic stroke?

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Rezvani

    2012-01-01

    Full Text Available Background: The main source of studies about effects of opium consumption on heart and brain attacks originates from Iran Therefore the aim of the present study was to assess opium addiction as a probable influencing factor for ischemic heart disease and ischemic stroke. Materials and Methods: A cross-sectional study was carried out in two Cardiology and Neurology clinics in Eastern Iran in 2011. Diagnosis of Ischemic Heart Disease (IHD and Ischemic Stroke (IS was made by Cardiologist and Stroke Neurologist respectively. The influence of gender, hypertension, diabetes, hyperlipidemia, cigarette smoking, oral and inhaled opium consumption on distribution of IHD and IS were evaluated. Results: Five hundred fifty eight patients (307 females, 251 males with mean age 56.2 years enrolled the study. On adjusted odds ratios of our whole 558 patients, only hypertension and diabetes had a significant influence on occurrence of IHD; (P = 0.000 and P = 0.000 respectively. Oral and inhaled routes of opium addiction did not have a significant effect on occurrence of IHD; [OR = 1.172, 95% CI = 0.624-2.203, P = 0.621] and [OR = 1.820, 95% CI = 0.811-4.085, P = 0.147] respectively. Hypertension and diabetes were significant risk factors of IS in our 558 patients at multivariate analysis; (P = 0.000, P = 0.020. Oral opium addiction was as significant protective factor of IS in our study group; OR = 0.211, 95% CI = 0.079-0.564, P = 0.002, while inhaled opium addiction did not have a significant effect on occurrence of IS in our patients at; OR = 1.760, 95% CI = 0.760-4.076, P = 0.187. Conclusion: Oral opium consumption is a protective factor of IS but not IHD. Inhaled opium addiction does not have a significant influence on occur r ence of IS and IHD.

  17. Prevalence of electrocardiographic ST-T changes during acute ischemic stroke in patients without known ischemic heart disease

    DEFF Research Database (Denmark)

    Jensen, Jesper K; Bak, Søren; Flemming Høilund-Carlsen, Poul;

    2008-01-01

    We evaluated characteristics and prevalence of ST-segment depression and/or T-wave inversion in the resting electrocardiogram of 244 consecutive patients with acute ischemic stroke, but without ischemic heart disease. The prevalence of ST-T changes ranged from 13% to 16% and this is what to expect...

  18. Phosphoproteomic profiling of human myocardial tissues distinguishes ischemic from non-ischemic end stage heart failure.

    Directory of Open Access Journals (Sweden)

    Matthew A Schechter

    Full Text Available The molecular differences between ischemic (IF and non-ischemic (NIF heart failure are poorly defined. A better understanding of the molecular differences between these two heart failure etiologies may lead to the development of more effective heart failure therapeutics. In this study extensive proteomic and phosphoproteomic profiles of myocardial tissue from patients diagnosed with IF or NIF were assembled and compared. Proteins extracted from left ventricular sections were proteolyzed and phosphopeptides were enriched using titanium dioxide resin. Gel- and label-free nanoscale capillary liquid chromatography coupled to high resolution accuracy mass tandem mass spectrometry allowed for the quantification of 4,436 peptides (corresponding to 450 proteins and 823 phosphopeptides (corresponding to 400 proteins from the unenriched and phospho-enriched fractions, respectively. Protein abundance did not distinguish NIF from IF. In contrast, 37 peptides (corresponding to 26 proteins exhibited a ≥ 2-fold alteration in phosphorylation state (p<0.05 when comparing IF and NIF. The degree of protein phosphorylation at these 37 sites was specifically dependent upon the heart failure etiology examined. Proteins exhibiting phosphorylation alterations were grouped into functional categories: transcriptional activation/RNA processing; cytoskeleton structure/function; molecular chaperones; cell adhesion/signaling; apoptosis; and energetic/metabolism. Phosphoproteomic analysis demonstrated profound post-translational differences in proteins that are involved in multiple cellular processes between different heart failure phenotypes. Understanding the roles these phosphorylation alterations play in the development of NIF and IF has the potential to generate etiology-specific heart failure therapeutics, which could be more effective than current therapeutics in addressing the growing concern of heart failure.

  19. The Mitochondrial Translocator Protein and Arrhythmogenesis in Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Lukas J. Motloch

    2015-01-01

    Full Text Available Mitochondrial dysfunction is a hallmark of multiple cardiovascular disorders, including ischemic heart disease. Although mitochondria are well recognized for their role in energy production and cell death, mechanisms by which they control excitation-contraction coupling, excitability, and arrhythmias are less clear. The translocator protein (TSPO is an outer mitochondrial membrane protein that is expressed in multiple organ systems. The abundant expression of TSPO in macrophages has been leveraged to image the immune response of the heart to inflammatory processes. More recently, the recognition of TSPO as a regulator of energy-dissipating mitochondrial pathways has extended its utility from a diagnostic marker of inflammation to a therapeutic target influencing diverse pathophysiological processes. Here, we provide an overview of the emerging role of TSPO in ischemic heart disease. We highlight the importance of TSPO in the regenerative process of reactive oxygen species (ROS induced ROS release through its effects on the inner membrane anion channel (IMAC and the permeability transition pore (PTP. We discuss evidence implicating TSPO in arrhythmogenesis in the settings of acute ischemia-reperfusion injury and myocardial infarction.

  20. Health benefits of vegetarianism on ischemic heart disease (IHD)

    OpenAIRE

    Fimognari, Lorenzo; Xiao, Wence; Thakur, Kumar Ramesh

    2009-01-01

    Background: A reduced risk of about 24-30% of mortality for Ischemic heart disease (IHD) in western vegetarians compared to non-vegetarians has been shown by several studies but there are doubts about the causes of the reduced mortality rate among the vegetarian population. Aim: The aim of this project is to identify the reasons for the health promoting effect of vegetarianism with focus on IHD, and to suggest if these are due to avoiding meat consumption or other factors relating to diffe...

  1. Risk of ischemic heart disease in women after radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Darby, Sarah C.; Ewertz, Marianne; McGale, Paul;

    2013-01-01

    Radiotherapy for breast cancer often involves some incidental exposure of the heart to ionizing radiation. The effect of this exposure on the subsequent risk of ischemic heart disease is uncertain....

  2. Ischemic preconditioning in immature hearts: mechanism and compatibility with cardioplegia

    Institute of Scientific and Technical Information of China (English)

    朱斌; 闵苏; 龙村; 叶铁虎

    2003-01-01

    Objective To investigate (1) whether ischemic preconditioning (IPC) could protect immature rabbit hearts against ischemia-reperfusion injury and (2) the role of KATP channel in the mechanism of myocardial protection. Since cardioplegia is a t raditional and effective cardioprotective measure in clinic, our study is also d esigned to probe the compatibility between IPC and cardioplegia.Results The recovery of CF, HR, LVDP and ±dp/dtmax in preconditioned hearts was b est am ong the four groups. The incidence of arrhythmia was low and less CK-MB leaked out in the IPC group. Myocardial ATP content was better preserved by IPC. Pre treatment with glibenclamide completely abolished the myocardial protection prov ided by IPC, but did not affect ischemia-reperfusion injury.Conclusions While applying cardioplegia, IPC provides significant cardioprotective effects. Activation of KATP channels is involved in the mechanism of IPC-produced cardioprotection.

  3. PROSPECTS FOR CYTOPROTECTORS USE IN THE ELDERLY PATIENTS THROUGH THE EXAMPLE OF CALCIFIED AORTIC STENOSIS AND ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    N. Yu. Karpova

    2015-09-01

    Full Text Available Issues of pathogenesis of the calcified aortic stenosis and ischemic heart disease in the elderly are considered. The relevance of early detection of angina, syncope, and dyspnea in view of their non-specific and subclinical course for early detection of heart disease is specified. Current scientific views on the myocardial bioenergy and its role in the genesis of chronic heart failure are presented. Particular attention is paid to the place of cytoprotectors, especially trimetazidine, in the management of patients with cardiac N.Yu. Karpova1diseases.

  4. Elevated Remnant Cholesterol Causes Both Low-Grade Inflammation and Ischemic Heart Disease, Whereas Elevated Low-Density Lipoprotein Cholesterol Causes Ischemic Heart Disease Without Inflammation

    DEFF Research Database (Denmark)

    Varbo, Anette; Tybjærg-Hansen, Anne; Nordestgaard, Børge G;

    2013-01-01

    Elevated nonfasting remnant cholesterol and low-density lipoprotein (LDL) cholesterol are causally associated with ischemic heart disease (IHD), but whether elevated nonfasting remnant cholesterol and LDL cholesterol both cause low-grade inflammation is currently unknown....

  5. High risk of ischemic heart disease in patients with lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Mellemkjaer, Lene; Starklint, Henrik;

    2011-01-01

    To investigate the occurrence of ischemic heart disease (IHD) in a cohort of 104 Danish patients with biopsy-proven lupus nephritis (LN).......To investigate the occurrence of ischemic heart disease (IHD) in a cohort of 104 Danish patients with biopsy-proven lupus nephritis (LN)....

  6. Preconditioning in globally ischemic isolated rat hearts: effect on function and metabolic indices of myocardial damage

    NARCIS (Netherlands)

    M. Arad; J.W. de Jong (Jan Willem); R. de Jonge (Robert); T. Huizer (Tom); B. Rabinowitz

    1996-01-01

    textabstractWe assessed the effects of ischemic preconditioning on heart recovery and metabolic indices of damage following global ischemia and reperfusion, in relationship to post-ischemic lactate release. Three groups of Langendorff rat hearts were studied: (1) A control group of

  7. Epidemiology and Risk Factors of Cerebral Ischemia and Ischemic Heart Diseases: Similarities and Differences

    OpenAIRE

    Soler, Ernest Palomeras; Ruiz, Virgina Casado

    2010-01-01

    Cerebral ischemia and ischemic heart diseases, common entities nowadays, are the main manifestation of circulatory diseases. Cardiovascular diseases, followed by stroke, represent the leading cause of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. However, each entity has its own particularities. Ischemic stroke shows a variety of pathogenic mechanisms not present in ischemic heart disease. An ...

  8. Insomnia and chronic heart failure.

    Science.gov (United States)

    Hayes, Don; Anstead, Michael I; Ho, Julia; Phillips, Barbara A

    2009-09-01

    Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options. PMID:18758945

  9. High expression of arachidonate 15-lipoxygenase and proinflammatory markers in human ischemic heart tissue

    International Nuclear Information System (INIS)

    Highlights: ► We found a 17-fold upregulation of ALOX15 in the ischemic heart. ► Incubation of human muscle cells in hypoxia showed a 22-fold upregulation of ALOX15. ► We observed increased levels of proinflammatory markers in ischemic heart tissue. ► Suggesting a link between ischemia and inflammation in ischemic heart biopsies. -- Abstract: A common feature of the ischemic heart and atherosclerotic plaques is the presence of hypoxia (insufficient levels of oxygen in the tissue). Hypoxia has pronounced effects on almost every aspect of cell physiology, and the nuclear transcription factor hypoxia inducible factor-1α (HIF-1α) regulates adaptive responses to low concentrations of oxygen in mammalian cells. In our recent work, we observed that hypoxia increases the proinflammatory enzyme arachidonate 15-lipoxygenase (ALOX15B) in human carotid plaques. ALOX15 has recently been shown to be present in the human myocardium, but the effect of ischemia on its expression has not been investigated. Here we test the hypothesis that ischemia of the heart leads to increased expression of ALOX15, and found an almost 2-fold increase in HIF-1α mRNA expression and a 17-fold upregulation of ALOX15 mRNA expression in the ischemic heart biopsies from patients undergoing coronary bypass surgery compared with non ischemic heart tissue. To investigate the effect of low oxygen concentration on ALOX15 we incubated human vascular muscle cells in hypoxia and showed that expression of ALOX15 increased 22-fold compared with cells incubated in normoxic conditions. We also observed increased mRNA levels of proinflammatory markers in ischemic heart tissue compared with non-ischemic controls. In summary, we demonstrate increased ALOX15 in human ischemic heart biopsies. Furthermore we demonstrate that hypoxia increases ALOX15 in human muscle cells. Our results yield important insights into the underlying association between hypoxia and inflammation in the human ischemic heart disease.

  10. Effect of mobilization of bone marrow stem cells by granulocyte colony stimulating factor on clinical symptoms, left ventricular perfusion and function in patients with severe chronic ischemic heart disease

    DEFF Research Database (Denmark)

    Wang, Yongzhong; Tägil, Kristina; Ripa, Rasmus S.;

    2005-01-01

    OBJECTIVES: A phase I safety and efficacy study with granulocyte colony stimulating factor (G-CSF) mobilization of bone marrow stem cells to induce vasculogenesis in patients with severe ischemic heart disease (IHD) was conducted. DESIGN, PATIENTS AND RESULTS: 29 patients with IHD participated...... with echocardiography. CONCLUSIONS: Treatment by G-CSF improved symptoms but not signs of myocardial ischemia in patients with severe IHD. The effects seemed related to mobilization of stem cells. An adverse effect on ejection fraction could not be excluded...... in the study. Thirteen patients were treated with G-CSF for 6 days and 16 patients served as controls. G-CSF treatment was without any serious adverse events. Four patients were 'poor mobilizers' with a maximal increase in CD34+ cells to 5,000+/-700/mL blood (mean+/-S.D.) compared to 28,900+/-5,100/mL blood...

  11. Stromal Vascular Fraction Transplantation as an Alternative Therapy for Ischemic Heart Failure: Anti-inflammatory Role

    Directory of Open Access Journals (Sweden)

    Lin Xue

    2011-03-01

    Full Text Available Abstract Background The aims of this study were: (1 to show the feasibility of using adipose-derived stromal vascular fraction (SVF as an alternative to bone marrow mono nuclear cell (BM-MNC for cell transplantation into chronic ischemic myocardium; and (2 to explore underlying mechanisms with focus on anti-inflammation role of engrafted SVF and BM-MNC post chronic myocardial infarction (MI against left ventricular (LV remodelling and cardiac dysfunction. Methods Four weeks after left anterior descending coronary artery ligation, 32 Male Lewis rats with moderate MI were divided into 3 groups. SVF group (n = 12 had SVF cell transplantation (6 × 106 cells. BM-MNC group (n = 12 received BM-MNCs (6 × 106 and the control (n = 10 had culture medium. At 4 weeks, after the final echocardiography, histological sections were stained with Styrus red and immunohistochemical staining was performed for α-smooth muscle actin, von Willebrand factor, CD3, CD8 and CD20. Results At 4 weeks, in SVF and BM-MNC groups, LV diastolic dimension and LV systolic dimension were smaller and fractional shortening was increased in echocardiography, compared to control group. Histology revealed highest vascular density, CD3+ and CD20+ cells in SVF transplanted group. SVF transplantation decreased myocardial mRNA expression of inflammatory cytokines TNF-α, IL-6, MMP-1, TIMP-1 and inhibited collagen deposition. Conclusions Transplantation of adipose derived SVF cells might be a useful therapeutic option for angiogenesis in chronic ischemic heart disease. Anti-inflammation role for SVF and BM transplantation might partly benefit for the cardioprotective effect for chronic ischemic myocardium.

  12. Prothrombin and risk of venous thromboembolism, ischemic heart disease and ischemic cerebrovascular disease in the general population

    DEFF Research Database (Denmark)

    Weischer, Maren; Juul, Klaus; Zacho, Jeppe;

    2010-01-01

    -control studies. METHODS: 9231 individuals from the Danish general population were followed for VTE (VTE=DVT+PE), deep venous thrombosis (DVT), pulmonary embolism (PE), IHD, myocardial infarction (MI), ICVD, and ischemic stroke (IS) for a median of 24 years. Case-control studies included 2461 IHD cases and 867......OBJECTIVE: We tested the hypotheses that Prothrombin G20210A heterozygosity associate with increased risk of venous thromboembolism (VTE), ischemic heart disease (IHD), and ischemic cerebrovascular disease (ICVD) in the general population and re-tested risk of IHD and ICVD in two case...

  13. Women and Ischemic Heart Disease: Recognition, Diagnosis and Management.

    Science.gov (United States)

    Park, Seong-Mi; Merz, C Noel Bairey

    2016-07-01

    Cardiovascular disease is one of the most frequent causes of death in both males and females throughout the world. However, women exhibit a greater symptom burden, more functional disability, and a higher prevalence of nonobstructive coronary artery disease (CAD) compared to men when evaluated for signs and symptoms of myocardial ischemia. This paradoxical sex difference appears to be linked to a sex-specific pathophysiology of myocardial ischemia including coronary microvascular dysfunction, a component of the 'Yentl Syndrome'. Accordingly, the term ischemic heart disease (IHD) is more appropriate for a discussion specific to women rather than CAD or coronary heart disease. Following the National Heart, Lung, and Blood Institute Heart Truth/American Heart Association, Women's Ischemia Syndrome Evaluation and guideline campaigns, the cardiovascular mortality in women has been decreased, although significant gender gaps in clinical outcomes still exist. Women less likely undergo testing, yet guidelines indicate that symptomatic women at intermediate to high IHD risk should have further test (e.g. exercise treadmill test or stress imaging) for myocardial ischemia and prognosis. Further, women have suboptimal use of evidence-based guideline therapies compared with men with and without obstructive CAD. Anti-anginal and anti-atherosclerotic strategies are effective for symptom and ischemia management in women with evidence of ischemia and nonobstructive CAD, although more female-specific study is needed. IHD guidelines are not "cardiac catheterization" based but related to evidence of "myocardial ischemia and angina". A simplified approach to IHD management with ABCs (aspirin, angiotensin-converting enzyme inhibitors/angiotensin-renin blockers, beta blockers, cholesterol management and statin) should be used and can help to increases adherence to guidelines. PMID:27482251

  14. Women and Ischemic Heart Disease: Recognition, Diagnosis and Management

    Science.gov (United States)

    Park, Seong-Mi

    2016-01-01

    Cardiovascular disease is one of the most frequent causes of death in both males and females throughout the world. However, women exhibit a greater symptom burden, more functional disability, and a higher prevalence of nonobstructive coronary artery disease (CAD) compared to men when evaluated for signs and symptoms of myocardial ischemia. This paradoxical sex difference appears to be linked to a sex-specific pathophysiology of myocardial ischemia including coronary microvascular dysfunction, a component of the 'Yentl Syndrome'. Accordingly, the term ischemic heart disease (IHD) is more appropriate for a discussion specific to women rather than CAD or coronary heart disease. Following the National Heart, Lung, and Blood Institute Heart Truth/American Heart Association, Women's Ischemia Syndrome Evaluation and guideline campaigns, the cardiovascular mortality in women has been decreased, although significant gender gaps in clinical outcomes still exist. Women less likely undergo testing, yet guidelines indicate that symptomatic women at intermediate to high IHD risk should have further test (e.g. exercise treadmill test or stress imaging) for myocardial ischemia and prognosis. Further, women have suboptimal use of evidence-based guideline therapies compared with men with and without obstructive CAD. Anti-anginal and anti-atherosclerotic strategies are effective for symptom and ischemia management in women with evidence of ischemia and nonobstructive CAD, although more female-specific study is needed. IHD guidelines are not "cardiac catheterization" based but related to evidence of "myocardial ischemia and angina". A simplified approach to IHD management with ABCs (aspirin, angiotensin-converting enzyme inhibitors/angiotensin-renin blockers, beta blockers, cholesterol management and statin) should be used and can help to increases adherence to guidelines. PMID:27482251

  15. Women and Ischemic Heart Disease: Recognition, Diagnosis and Management.

    Science.gov (United States)

    Park, Seong-Mi; Merz, C Noel Bairey

    2016-07-01

    Cardiovascular disease is one of the most frequent causes of death in both males and females throughout the world. However, women exhibit a greater symptom burden, more functional disability, and a higher prevalence of nonobstructive coronary artery disease (CAD) compared to men when evaluated for signs and symptoms of myocardial ischemia. This paradoxical sex difference appears to be linked to a sex-specific pathophysiology of myocardial ischemia including coronary microvascular dysfunction, a component of the 'Yentl Syndrome'. Accordingly, the term ischemic heart disease (IHD) is more appropriate for a discussion specific to women rather than CAD or coronary heart disease. Following the National Heart, Lung, and Blood Institute Heart Truth/American Heart Association, Women's Ischemia Syndrome Evaluation and guideline campaigns, the cardiovascular mortality in women has been decreased, although significant gender gaps in clinical outcomes still exist. Women less likely undergo testing, yet guidelines indicate that symptomatic women at intermediate to high IHD risk should have further test (e.g. exercise treadmill test or stress imaging) for myocardial ischemia and prognosis. Further, women have suboptimal use of evidence-based guideline therapies compared with men with and without obstructive CAD. Anti-anginal and anti-atherosclerotic strategies are effective for symptom and ischemia management in women with evidence of ischemia and nonobstructive CAD, although more female-specific study is needed. IHD guidelines are not "cardiac catheterization" based but related to evidence of "myocardial ischemia and angina". A simplified approach to IHD management with ABCs (aspirin, angiotensin-converting enzyme inhibitors/angiotensin-renin blockers, beta blockers, cholesterol management and statin) should be used and can help to increases adherence to guidelines.

  16. Hypertension and ischemic heart disease. Role of dipyridamole echocardiography test.

    Science.gov (United States)

    Gulizia, M M; Lo Giudice, P; Doria, G; Valenti, R; Circo, A G

    1994-11-01

    The aim of this study is to try to evaluate the relationship between arterial hypertension and ischemic heart disease (IHD) in the light of the physiopathologic response pattern to the dipyridamole echocardiography test (DET) in hypertensive patients, in pharmacologic washout, without any electrocardiographic ST segment depression during exercise tests or at rest. Sixty patients affected by mild to moderate asymptomatic essential arterial hypertension were studied: the subjects had a sitting diastolic blood pressure > or = 95 1.0 mV during DET, sometimes with the presence of ventricular and/or supraventricular extrasystoles. In this group of patients the left ventricular mass index (LVMI) and duration of hypertension (in months) were higher as compared with those of the other 42 patients (respectively: 160.2 +/- 5.1 vs 129.2 +/- 9.2 g/m2, P < 0.02; and 30 +/- 4.8 vs 9 +/- 5.4 months, P < 0.007). In conclusion it is reasonable to speculate from these data that the ischemic-like" dipyridamole-induced ST segment depression, like that shown by patients affected by Syndrome X, might involve a worse prognosis in hypertensive patients. This may be because of increased coronary resistance due to structural modification or anatomic background. PMID:7978508

  17. Hereditary hemochromatosis and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Ellervik, Christina; Tybjaerg-Hansen, Anne; Grande, Peer;

    2005-01-01

    BACKGROUND: We tested the hypothesis that the hereditary hemochromatosis genotypes C282Y/C282Y, C282Y/H63D, or C282Y/wild-type are risk factors for ischemic heart disease (IHD) and myocardial infarction (MI). METHODS AND RESULTS: We performed a prospective study of 9178 individuals from the Danish...... or MI in case-control studies, overall or stratified by gender. We had 90% power to detect an odds ratio for IHD of 3.6 for C282Y/C282Y, 1.8 for C282Y/H63D, and 1.3 for C282Y/wild-type versus wild-type/wild-type. CONCLUSIONS: In these studies, hereditary hemochromatosis C282Y/C282Y, C282Y/H63D, and C282...

  18. Fatigue, General Health, and Ischemic Heart Disease in Older Adults

    DEFF Research Database (Denmark)

    Ekmann, Anette; Petersen, Inge; Mänty, Minna Regina;

    2013-01-01

    Backgrounds.Fatigue has been shown to predict ischemic heart disease (IHD) and mortality in nonsmoking middle-aged men free of cardiovascular disease. The aim of this study was to investigate the predictive value of fatigue for IHD and general health in nondisabled individuals free of cardiovascu.......08-2.00) compared with participants without fatigue. CONCLUSION: We concluded that fatigue in nondisabled older adults free of cardiovascular disease is an early predictor for development of subsequent poor general health and IHD....... of cardiovascular disease and older than 70 years. METHODS: The study population was drawn from The Longitudinal Study of Aging Danish Twins. In total, 1,696 participants were followed up for 2-10 years by questionnaires and 10-16 years through registries. Kaplan Meier, Cox Proportional Hazard and logistic...

  19. Mental vulnerability--a risk factor for ischemic heart disease

    DEFF Research Database (Denmark)

    Eplov, Lene Falgaard; Jørgensen, Torben; Birket-Smith, Morten;

    2006-01-01

    OBJECTIVE: The purpose of this study is to examine whether mental vulnerability is a risk factor for the development of ischemic heart disease (IHD) after adjustment for well-established risk factors. METHODS: In three prospective cohort studies in Copenhagen County, Denmark, we recorded the level...... of mental vulnerability and possible risk factors to IHD at baseline. For follow-up, the sample was linked to relevant registries to identify all cases of fatal and nonfatal IHD. The relationship between mental vulnerability and IHD was examined using both Kaplan-Meir and Cox proportional hazard models...... adjusting for possible confounding factors. RESULTS: Mental vulnerability was significantly associated with the risk for IHD (medium mental vulnerability: hazard ratio 1.41, 95% confidence interval 1.04-1.91; and high mental vulnerability: hazard ratio 2.05; 95% confidence interval 1.46-2.88), after...

  20. Perceived stress and risk of ischemic heart disease: causation or bias?

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Kristensen, Tage S; Prescott, Eva;

    2006-01-01

    BACKGROUND: It is unclear whether the commonly recognized link between stress and cardiovascular disease is causal or the result of reporting bias. The objective of this study was to address the association between perceived stress and first incidence of ischemic heart disease and to evaluate...... the suggested reporting bias by addressing subdiagnoses of ischemic heart disease separately. METHODS: The 11,839 men and women who participated in the Copenhagen City Heart Study were at baseline (1981-1983) asked about their stress level. The participants were followed in nationwide registries until the year...... 2000, and fewer than 0.1% were lost to follow-up. During follow-up, 2316 individuals were diagnosed with ischemic heart disease. RESULTS: High levels of stress were associated with slightly higher risk of incident ischemic heart disease in both women (hazard ratio = 1.23; 95% confidence interval = 1...

  1. COGNITIVE DYSFUNCTION IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    O. V. Yeremina

    2014-01-01

    Full Text Available Coronary artery bypass graft surgery (CABG is one of the most effective methods of surgical treatment of ischemic heart disease (IHD. However, even improvement of life quality is evident in patients underwent CABG, some neuropsychological, cognitive alterations may appear. Therefore, the problem of neurological complications in cardiac surgery is still of current interest. Prevalence of cognitive dysfunction after CABG varies from 12 to 79%. One third of the patients have alterations of cognitive functions for 1 year and more after the operation. In this review, we will discuss the current understandings on etiology, pathogenesis and prevalence of cognitive dysfunction in patients with IHD after CABG. The following factors determine development of long-lasting cognitive deficiency: lower educational level, advanced age, significant alterations of cognitive functions in preoperative period. At present, age, comorbid pathology (arterial hypertension, diabetes mellitus, vascular diseases, lung diseases, heart fai­lure, alcohol and drug abuse, preoperative cognitive dysfunction are considered as major risk factors for CABG-induced neurological complications. Importance of timely diagnostics and early beginning of treatment of cognitive dysfunction will be discussed.

  2. Sonographic fatty liver, overweight and ischemic heart disease

    Institute of Scientific and Technical Information of China (English)

    Yu-Cheng Lin; Huey-Ming Lo; Jong-Dar Chen

    2005-01-01

    AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors.RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), respectively.CONCLUSION: The presence of fatty liver and its severity should

  3. Clarithromycin use and risk of death in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Andersen, Søren Skøtt; Hansen, Morten Lock; Norgaard, Mette Lykke;

    2010-01-01

    Objectives: To examine whether treatment with clarithromycin was associated with an increased risk of death in patients with preexisting ischemic heart disease (IHD). Methods: Employing nationwide registers, all patients with IHD events from 1997 to 2007 who subsequently claimed prescriptions...

  4. Occupational class and ischemic heart disease mortality in the United States and 11 European countries

    NARCIS (Netherlands)

    A.E. Kunst (Anton); F. Pagnanelli; G. Costa (Giuseppe); G. Desplanques; H. Filakti; B. Nolan (Brian); D. Vagero; R. Giraldes Mdo; F. Faggiano (Fabrizio); J.P. Mackenbach (Johan); C. Minder; S. Harding; P. Martikainen; E. Regidor (Enrique); C. Junker; F. Groenhof (Feikje); O. Andersen (Otto); T. Valkonen (Tapani); J.K. Borgan

    1999-01-01

    textabstractOBJECTIVES: Twelve countries were compared with respect to occupational class differences in ischemic heart disease mortality in order to identify factors that are associated with smaller or larger mortality differences. METHODS: Data on mortality by occupat

  5. Genetic variation in ABCA1 predicts ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Frikke-Schmidt, Ruth; Nordestgaard, Børge G; Jensen, Gorm B;

    2008-01-01

    We tested the hypothesis that 6 nonsynonymous single nucleotide polymorphisms (SNPs) in ATP-Binding-Cassette transporter A1 (ABCA1) affect risk of ischemic heart disease (IHD) in the general population....

  6. 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.

  7. Experiences of peer support in self-management interventions among people with ischemic heart disease

    DEFF Research Database (Denmark)

    Enggaard, Helle; Uhrenfeldt, Lisbeth

    2016-01-01

    Review question/objective: The objective of this review is to identify, appraise and synthesize the best available evidence regarding people with ischemic heart disease and their experiences with peer support in self-management interventions. More specifically, the review question is: How do people...... with ischemic heart disease experience peer support in structured self-management interventions led or co-led by peers?...

  8. Cells and Angiogenic Cytokines in Therapeutic Angiogenesis for Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Luo, Yu; Zhang, Dai-Fu; Liang, Bo

    2005-01-01

    In the past 20 to 30 years,great developments had been achieved in the applying of cells and angiogenic cytokines for ischemic heart disease.The thesis reviews latest studies of mechanism and clinic application of this novel therapy.......In the past 20 to 30 years,great developments had been achieved in the applying of cells and angiogenic cytokines for ischemic heart disease.The thesis reviews latest studies of mechanism and clinic application of this novel therapy....

  9. Sleep duration and ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Åse Marie; Holtermann, Andreas;

    2013-01-01

    This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association.......This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association....

  10. Remnant cholesterol as a causal risk factor for ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Benn, Marianne; Tybjærg-Hansen, Anne;

    2013-01-01

    The aim of this study was to test the hypothesis that elevated nonfasting remnant cholesterol is a causal risk factor for ischemic heart disease independent of reduced high-density lipoprotein (HDL) cholesterol.......The aim of this study was to test the hypothesis that elevated nonfasting remnant cholesterol is a causal risk factor for ischemic heart disease independent of reduced high-density lipoprotein (HDL) cholesterol....

  11. Effects of Ischemic Postconditioning on the Hemodynamic Parameters and Heart Nitric Oxide Levels of Hypothyroid Rats

    OpenAIRE

    Sajad Jeddi; Jalal Zaman; Asghar Ghasemi

    2015-01-01

    Background: Ischemic postconditioning (IPost) is a method of protecting the heart against ischemia-reperfusion (IR) injury. However, the effectiveness of IPost in cases of ischemic heart disease accompanied by co-morbidities such as hypothyroidism remains unclear. Objective: The aim of this study was to determine the effect of IPost on myocardial IR injury in hypothyroid male rats. Methods: Propylthiouracil in drinking water (500 mg/L) was administered to male rats for 21 days to induce hypot...

  12. The effect of elevated body mass index on ischemic heart disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Palmer, Tom M; Benn, Marianne;

    2012-01-01

    Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal.......Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal....

  13. Helicobacter pylori infection and ischemic heart disease: could experimental data lead to clinical studies?

    Science.gov (United States)

    Ribaldone, Davide G; Fagoonee, Sharmila; Hickman, Ingrid; Altruda, Fiorella; Saracco, Giorgio M; Pellicano, Rinaldo

    2016-12-01

    Despite the remarkable advances made in primary prevention and treatment, ischemic heart disease (IHD) remains the leading cause of death and a significant cause of disability in developed countries. Since traditional cardiovascular risk factors failed to predict all cases of IHD, there is an intensive research to explore other potential etiologic factors. Among these, numerous studies have considered the theoretical link between IHD and chronic infections, including Helicobacter pylori (H. pylori). Considering that epidemiologic studies have produced conflicting results, due to geographical variations of IHD and H. pylori prevalence as well as heterogeneity of study designs, an alternative way to analyze this topic is to assess if consistency for a biological plausibility exists. In this review we critically analyzed the experimental data on this topic, to assess whether their results could lead future clinical studies. PMID:27603552

  14. Early predictors of renal dysfunction in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Umida Kamilova

    2013-04-01

    Full Text Available Study was aimed at an early detection of subclinical disorders in renal function in patients with chronic heart failure (CHF. Fifty-two patients with ischemic heart disease (IHD with post-infarction cardiosclerosis were examined. All the patients were underwent complex clinical examination, a level of serum creatinine, residual nitrogen and urine enzymes. Determination of urine enzymes level in CHF patients may be considered as diagnostic approach for an early diagnosis of renal dysfunction.

  15. 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...

  16. Diet, hypertension, hypercholesterolemia and diabetes in ischemic heart diseases

    International Nuclear Information System (INIS)

    Ischemic Heart Diseases (IHD) have the highest cause of mortality in the Islamic Republic of Iran. Unhealthy dietary habits as a major threat make our country prone to an epidemic of non-communicable diseases in the next two decades. The aim of this study was to determine the association of diet, hypertension, hypercholesterolemia and diabetes with risk of developing IHD in Tehran. This case - control study was conducted during 2003 and 2004 in Tehran Heart Center and Tehran Shahid Rajaii Hospital. A sample of 100 IHD patients (cases) and 100 individuals free of cardiovascular symptoms (controls) were entered into the study; the Controls were matched to the IHD patients by age (+- years) and sex. Information was recorded by Food Frequency Questionnaire (FFQ). All data were analyzed with the SPSS for windows, version11. Multivariate analysis showed a significant and positive association between Hypertension, Hypercholesterolemia and Diabetes and risk of developing IHD. Odds ratios for these three risk factors with 95% confidence interval (CI) were: 3.9, 12 and 8.6 respectively. In he cases consumption of high dairy fat and fried foods were significantly high, that increased the risk of IHD 9.8 and 54.6 times, respectively. Also low intake of fish was directly associated with increase of the IHD risk (95% CI, OR: 13.9). Moreover low consumption of vegetables and fruits independently increased the risk of IHD 19.8 times in cases group. Hypertension, hypercholesterolemia and diabetes have a significant association with development of IHD. High consumption of fatty food and low consumption of fish, vegetables and fruits also contribute to development of IHD. (author)

  17. IMMUNO-INFLAMATORY RESPONSE IN ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    N. E. Zakirova

    2007-01-01

    Full Text Available Aim. To estimate the role of immuno-inflammatory response in developing of angina pectoris in patients with ischemic heart disease (IHD.Material and methods: The study included 83 patients with IHD and angina pectoris of functional class (FC II (30 patients, III (27 patients and IV (26 patients. The control group included 25 healthy persons. Bicycle burden test, daily ECG monitoring and echocardiography were used to verify of IHD. Levels of С-reactive protein (CRP, pro-inflammatory cytokines: interleukin-1β, interleukin-6 (IL-1β, IL-6 and tumor necrosis factor alpha (TNF-α were examined by immunoenzyme method. Levels of anti-inflammatory cytokines were also defined: interleukin-4 and interleukin-10 (IL-4, IL-10.Results. Increased levels of IL-4 and IL-10 with normal CRP and pro-inflammatory cytokine levels were observed in patients with angina of FC-II. Angina of FC-III was associated with a moderate increase in CRP level and normal levels of IL-4 and IL-10. The maximal levels of CRP and pro-inflammatory cytokines as well as minimal levels of anti-inflammatory cytokines were observed in patients with FC-IV angina pectoris.Conclusion. The immuno-inflammatory response depends on angina pectoris severity in patients with IHD. Severe angina pectoris is accompanied by raised expression of pro-inflammatory cytokines and deficiency of anti-inflammatory cytokines.

  18. IMMUNO-INFLAMATORY RESPONSE IN ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    N. E. Zakirova

    2015-12-01

    Full Text Available Aim. To estimate the role of immuno-inflammatory response in developing of angina pectoris in patients with ischemic heart disease (IHD.Material and methods: The study included 83 patients with IHD and angina pectoris of functional class (FC II (30 patients, III (27 patients and IV (26 patients. The control group included 25 healthy persons. Bicycle burden test, daily ECG monitoring and echocardiography were used to verify of IHD. Levels of С-reactive protein (CRP, pro-inflammatory cytokines: interleukin-1β, interleukin-6 (IL-1β, IL-6 and tumor necrosis factor alpha (TNF-α were examined by immunoenzyme method. Levels of anti-inflammatory cytokines were also defined: interleukin-4 and interleukin-10 (IL-4, IL-10.Results. Increased levels of IL-4 and IL-10 with normal CRP and pro-inflammatory cytokine levels were observed in patients with angina of FC-II. Angina of FC-III was associated with a moderate increase in CRP level and normal levels of IL-4 and IL-10. The maximal levels of CRP and pro-inflammatory cytokines as well as minimal levels of anti-inflammatory cytokines were observed in patients with FC-IV angina pectoris.Conclusion. The immuno-inflammatory response depends on angina pectoris severity in patients with IHD. Severe angina pectoris is accompanied by raised expression of pro-inflammatory cytokines and deficiency of anti-inflammatory cytokines.

  19. Transplanted Bone Marrow Cells Repair Heart Tissue and Reduce Myocarditis in Chronic Chagasic Mice

    OpenAIRE

    MILENA B. P. SOARES; Lima, Ricardo S.; Rocha, Leonardo L.; Takyia, Christina M; Pontes-de-Carvalho, Lain; Campos de Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo

    2004-01-01

    A progressive destruction of the myocardium occurs in ∼30% of Trypanosoma cruzi-infected individuals, causing chronic chagasic cardiomyopathy, a disease so far without effective treatment. Syngeneic bone marrow cell transplantation has been shown to cause repair and improvement of heart function in a number of studies in patients and animal models of ischemic cardiopathy. The effects of bone marrow transplant in a mouse model of chronic chagasic cardiomyopathy, in the presence of the disease ...

  20. High expression of arachidonate 15-lipoxygenase and proinflammatory markers in human ischemic heart tissue

    Energy Technology Data Exchange (ETDEWEB)

    Magnusson, Lisa U.; Lundqvist, Annika [Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Asp, Julia [Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden); Synnergren, Jane [Systems Biology Research Center, School of Life Sciences, University of Skoevde, Skoevde (Sweden); Johansson, Cecilia Thalen [Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Palmqvist, Lars [Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden); Jeppsson, Anders [Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg (Sweden); Hulten, Lillemor Mattsson, E-mail: Lillemor.Mattsson@wlab.gu.se [Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden)

    2012-07-27

    Highlights: Black-Right-Pointing-Pointer We found a 17-fold upregulation of ALOX15 in the ischemic heart. Black-Right-Pointing-Pointer Incubation of human muscle cells in hypoxia showed a 22-fold upregulation of ALOX15. Black-Right-Pointing-Pointer We observed increased levels of proinflammatory markers in ischemic heart tissue. Black-Right-Pointing-Pointer Suggesting a link between ischemia and inflammation in ischemic heart biopsies. -- Abstract: A common feature of the ischemic heart and atherosclerotic plaques is the presence of hypoxia (insufficient levels of oxygen in the tissue). Hypoxia has pronounced effects on almost every aspect of cell physiology, and the nuclear transcription factor hypoxia inducible factor-1{alpha} (HIF-1{alpha}) regulates adaptive responses to low concentrations of oxygen in mammalian cells. In our recent work, we observed that hypoxia increases the proinflammatory enzyme arachidonate 15-lipoxygenase (ALOX15B) in human carotid plaques. ALOX15 has recently been shown to be present in the human myocardium, but the effect of ischemia on its expression has not been investigated. Here we test the hypothesis that ischemia of the heart leads to increased expression of ALOX15, and found an almost 2-fold increase in HIF-1{alpha} mRNA expression and a 17-fold upregulation of ALOX15 mRNA expression in the ischemic heart biopsies from patients undergoing coronary bypass surgery compared with non ischemic heart tissue. To investigate the effect of low oxygen concentration on ALOX15 we incubated human vascular muscle cells in hypoxia and showed that expression of ALOX15 increased 22-fold compared with cells incubated in normoxic conditions. We also observed increased mRNA levels of proinflammatory markers in ischemic heart tissue compared with non-ischemic controls. In summary, we demonstrate increased ALOX15 in human ischemic heart biopsies. Furthermore we demonstrate that hypoxia increases ALOX15 in human muscle cells. Our results yield

  1. Direct effects of smoking on the heart: silent ischemic disturbances of coronary flow

    International Nuclear Information System (INIS)

    Cigarette smoking is strongly associated with ischemic heart disease and acute coronary events. The effect of smoking a single cigarette on regional myocardial perfusion was studied in 13 chronic smokers with typical stable angina pectoris using positron emission tomography and rubidium-82 (82Rb). Findings were compared with the effects of physical exercise. After exercise, 8 patients (61%) had angina, ST depression and abnormal regional myocardial perfusion. Uptake of 82Rb increased from 49 +/- 8 to 60 +/- 7 in remote myocardium, but decreased from 46 +/- 3 to 37 +/- 5 in an ischemic area. The remaining 5 patients (39%) had homogeneous increases in 82Rb uptake without angina or ST depression. After smoking, 6 of the 8 patients with positive exercise test responses had a decrease in 82Rb uptake, from 47 +/- 3 to 35 +/- 6 in the same segment of myocardium affected during exercise. However, in contrast to exercise, the events during smoking were largely silent. The absolute decreases in regional 82Rb uptake after smoking occurred at significantly lower levels of myocardial oxygen demand than after exercise. This suggests that an impairment of coronary blood supply is responsible. Thus, in smokers with coronary artery disease, each cigarette can cause profound silent disturbances of regional myocardial perfusion that are likely to occur frequently during daily life. Such repeated insults may represent an important mechanism linking smoking with coronary events

  2. Applications of laser in ischemic heart disease in China

    Science.gov (United States)

    Chen, Mingzhe; Zhang, Yongzhen

    1999-09-01

    Current data demonstrate that laser coronary angioplasty is most useful in complex lesions not well suited for percutaneous transluminal coronary angioplasty (PTCA). It is not `stand-alone' procedure, and should be considered an adjunct to PTCA or stenting. To date, there are not data supporting reduction of restenosis. Direct myocardial revascularization (DMR), either transmyocardial revascularization (TMR) or percutaneous (catheter-based) myocardial revascularization (PMR), uses laser to create channels between ischemic myocardium and left ventricular cavity. Candidates include patients with chronic, severe, refractory angina and those unable to undergo angioplasty or bypass surgery because conduits or acceptable target vessels are lacking. Although the mechanisms of action of DMR have not yet been clearly elucidated, but several theories have been proposed, including channel patency, angiogenesis, and denervation. TMR, typically requiring open thoracotomy, is effective for improving myocardial perfusion and reducing angina. Pilot studies demonstrate that clinical application of PMR is feasible and safe and effective for decreasing angina. Late sequelae also remain to be determined. An ongoing randomized clinical trial is comparing PMR with conventional medical therapy in patients with severe, refractory angina and disease unamenable to angioplasty or bypass surgery.

  3. Fruit and vegetable consumption, ethnicity and risk of fatal ischemic heart disease

    Science.gov (United States)

    Sharma, Sangita; Vik, Shelly; Kolonel, Laurence N.

    2016-01-01

    Objective Mortality rates from ischemic heart disease vary among ethnic groups. Dietary intake of fruit and vegetables has been associated with a lower risk of ischemic heart disease, but ethnic-specific data are limited. Design Prospective cohort study. Setting Hawaii and Los Angeles County, between 1993 and 1996. Participants These analyses included 164,617 older adults age 45 to 75, representing five ethnic groups who were enrolled in the Multiethnic Cohort Study. Dietary data were collected at baseline using a validated food frequency questionnaire and fatal ischemic heart disease cases were identified up to December 31, 2001. Associations between fruit and vegetable consumption and fatal ischemic heart disease were examined using multivariate Cox proportional hazard models. Results The associations between fruit and vegetable intake and fatal ischemic heart disease were similar among the five ethnic groups. When data for the ethnic groups were combined, higher vegetable intake was associated with a protective effect against ischemic heart disease in men with all intake levels above 2.3 servings per day (over 6.6 servings per day: hazard ratio, 0.73; 95% confidence interval, 0.58–0.92), and for women with intakes levels between 3.4 and 6.6 servings per day (4.6 to 6.6 servings per day: hazard ratio, 0.77; 95% confidence interval, 0.59–0.99). There was no evidence of an association for fruit intake. Conclusions Associations between fruit and vegetable intake and ischemic heart disease do not appear to vary among ethnic groups. Additional research is needed to clarify associations for fruit versus vegetable intake and impact on cardiovascular outcomes. PMID:24950146

  4. Pentanucleotide repeat polymorphism, lipoprotein(a) levels, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Kamstrup, P.R.; Tybjaerg-Hansen, A.; Steffensen, R.;

    2008-01-01

    predicts elevated lipoprotein(a) levels and risk of myocardial infarction (MI) and ischemic heart disease (IHD) in the general population. DESIGN: We used a cohort study of the Danish general population, The Copenhagen City Heart Study, including 10,276 individuals of which 860 and 1,781 developed MI...

  5. Occupational noise and ischemic heart disease: A systematic review.

    Science.gov (United States)

    Dzhambov, Angel M; Dimitrova, Donka D

    2016-01-01

    Noise exposure might be a risk factor for ischemic heart disease (IHD). Unlike residential exposure, however, evidence for occupational noise is limited. Given that high-quality quantitative synthesis of existing data is highly warranted for occupational safety and policy, we aimed at conducting a systematic review and meta-analysis of the risks of IHD morbidity and mortality because of occupational noise exposure. We carried out a systematic search in MEDLINE, EMBASE, and on the Internet since April 2, 2015, in English, Spanish, Russian, and Bulgarian. A quality-scoring checklist was developed a priori to assess different sources of methodological bias. A qualitative data synthesis was performed. Conservative assumptions were applied when appropriate. A meta-analysis was not feasible because of unresolvable methodological discrepancies between the studies. On the basis of five studies, there was some evidence to suggest higher risk of IHD among workers exposed to objectively assessed noise >75-80 dB for <20 years (supported by one high, one moderate, and one low quality study, opposed by one high and one moderate quality study). Three moderate and two low quality studies out of six found self-rated exposure to be associated with higher risk of IHD, and only one moderate quality study found no effect. Out of four studies, a higher mortality risk was suggested by one moderate quality study relying on self-rated exposure and one of high-quality study using objective exposure. Sensitivity analyses showed that at higher exposures and in some vulnerable subgroups, such as women, the adverse effects were considerably stronger. Despite methodological discrepancies and limitations of the included studies, occupational noise appeared to be a risk factor for IHD morbidity. Results suggested higher risk for IHD mortality only among vulnerable subgroups. Workers exposed to high occupational noise should be considered at higher overall risk of IHD. PMID:27569404

  6. Alcohol consumption, Lewis phenotypes, and risk of ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Hein, H.O.; Suadicani, P.; Gyntelberg, F. (Rigshospitalet State Univ. Hospital, Copenhagen (Denmark). Epidemiological Research Unit); Sorenson, H. (Rigshospitalet State Univ. Hospital, Copenhagen (Denmark). Dept. of Chemical Immunology); Hein, H.O. (Univ. of Copenhagen (Denmark). Dept. of Internal Medicine)

    1993-02-13

    The authors have previously found an increased risk of ischemic heart disease (IHD) in men with the Lewis phenotype Le(a[minus]b[minus]) and suggested that the Lewis blood group has a close genetic relation with insulin resistance. The authors have investigated whether any conventional risk factors explain the increased risk in Le(a[minus]b[minus]) men. 3,383 men aged 53-75 years were examined in 1985-86, and morbidity and mortality during the next 4 years were recorded. At baseline, the authors excluded 343 men with a history of myocardial infarction, angina pectoris, intermittent claudication, or stroke. The potential risk factors examined were alcohol consumption, physical activity, tobacco smoking, serum cotinine, serum lipids, body-mass index, blood pressure, prevalence of hypertension and non-insulin-dependent diabetes mellitus, and social class. In 280 (9.6%) men with Le(a[minus]b[minus]), alcohol was the only risk factor significantly associated with risk of IHD. There was a significant inverse dose-effect relation between alcohol consumption and risk; trend tests, with adjustment for age, were significant for fatal IHD (p=0.02), all IHD (p=0.03), and all causes of death (p=0.02). In 2649 (90.4%) men with other phenotypes, there was a limited negative association with alcohol consumption. In Le(a[minus]b[minus]) men, a group genetically at high risk of IHD, alcohol consumption seems to be especially protective. The authors suggest that alcohol consumption may modify insulin resistance in Le(a[minus]b[minus]) men.

  7. Occupational noise and ischemic heart disease: A systematic review

    Directory of Open Access Journals (Sweden)

    Angel M Dzhambov

    2016-01-01

    Full Text Available Noise exposure might be a risk factor for ischemic heart disease (IHD. Unlike residential exposure, however, evidence for occupational noise is limited. Given that high-quality quantitative synthesis of existing data is highly warranted for occupational safety and policy, we aimed at conducting a systematic review and meta-analysis of the risks of IHD morbidity and mortality because of occupational noise exposure. We carried out a systematic search in MEDLINE, EMBASE, and on the Internet since April 2, 2015, in English, Spanish, Russian, and Bulgarian. A quality-scoring checklist was developed a priori to assess different sources of methodological bias. A qualitative data synthesis was performed. Conservative assumptions were applied when appropriate. A meta-analysis was not feasible because of unresolvable methodological discrepancies between the studies. On the basis of five studies, there was some evidence to suggest higher risk of IHD among workers exposed to objectively assessed noise >75–80 dB for <20 years (supported by one high, one moderate, and one low quality study, opposed by one high and one moderate quality study. Three moderate and two low quality studies out of six found self-rated exposure to be associated with higher risk of IHD, and only one moderate quality study found no effect. Out of four studies, a higher mortality risk was suggested by one moderate quality study relying on self-rated exposure and one of high-quality study using objective exposure. Sensitivity analyses showed that at higher exposures and in some vulnerable subgroups, such as women, the adverse effects were considerably stronger. Despite methodological discrepancies and limitations of the included studies, occupational noise appeared to be a risk factor for IHD morbidity. Results suggested higher risk for IHD mortality only among vulnerable subgroups. Workers exposed to high occupational noise should be considered at higher overall risk of IHD.

  8. Ivabradine: An Intelligent Drug for the Treatment of Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Graziano Riccioni

    2012-11-01

    Full Text Available Heart rate (HR is a precisely regulated variable, which plays a critical role in health and disease. Elevated resting HR is a significant predictor of all-cause and cardiovascular mortality in the general population and patients with cardiovascular disease (CVD. β-blocking drugs exert negative effects on regional myocardial blood flow and function when HR reduction is eliminated by atrial pacing; calcium channel antagonists (CCAs functionally antagonize coronary vasoconstriction mediated through α-adreno-receptors and are thus devoid of this undesired effect, but the compounds are nevertheless negative inotropes. From these observations derives the necessity to find alternative, more selective drugs to reduce HR through inhibition of specific electrical current (If. Ivabradine (IVA is a novel specific HR-lowering agent that acts in sinus atrial node (SAN cells by selectively inhibiting the pacemaker If current in a dose-dependent manner by slowing the diastolic depolarization slope of SAN cells, and by reducing HR at rest during exercise in humans. Coronary artery diseases (CAD represent the most common cause of death in middle–aged and older adults in European Countries. Most ischemic episodes are triggered by an increase in HR, that induces an imbalance between myocardial oxygen delivery and consumption. IVA, a selective and specific inhibitor of the If current which reduced HR without adverse hemodynamic effects, has clearly and unequivocally demonstrated its efficacy in the treatment of chronic stable angina pectoris (CSAP and myocardial ischemia with optimal tolerability profile due to selective interaction with If channels. The aim of this review is to point out the usefulness of IVA in the treatment of ischemic heart disease.

  9. Proportional Mortality due to Heart Failure and Ischemic Heart Diseases in the Brazilian Regions from 2004 to 2011

    Science.gov (United States)

    Gaui, Eduardo Nagib; Klein, Carlos Henrique; de Oliveira, Glaucia Maria Moraes

    2016-01-01

    Background: Heart failure (HF) and ischemic heart diseases (IHD) are important causes of death in Brazil. Objective: To assess proportional mortality (PM) due to HF and IHD as underlying causes stratified by sex and age groups in the Brazilian geoeconomic regions from 2004 to 2011. Methods: Data from death certificates were obtained in the DATASUS site under the following International Statistical Classification of Diseases and Related Health Problems codes, 10th Revision: 1) from chapter IX: I20 to I24 for acute IHD, I25 for chronic IHD, and I50 for HF; and 2) from chapter XVIII, for ill-defined causes (IDC). Results: Proportional mortality due to HF increased with age in both sexes and all regions, the highest percentages being found among elderly women. Among men, the highest percentages were observed in the West-Central region up to the ninth decade, but, among the eldest individuals, the highest percentages were identified in the Southern region. Among women, the regions did not differ up to the age group of 70-79 years, although the West-Central region took the lead from 50 to 79 years; however, from the age of 80 years on, the Southern region showed the highest PM due to HF. Proportional mortality due to acute IHD in all Brazilian regions and in both sexes increased up to the age group of 60-69 years, from which it decreased. Among men, the Southeastern region had the highest percentages in the age group of 50-59 years, while women had lower PM due to acute IHD than men in all regions. In both sexes, PM due to chronic IHD increased with age in the Southern and Southeastern regions, which did not happen in the others, while the Southern region had the highest rate of all regions for all age groups. Conclusions: Regional differences were more prominent at more advanced ages, especially when deaths due to IDC were excluded. PMID:27533259

  10. Chronic Heart Failure: Contemporary Diagnosis and Management

    OpenAIRE

    Ramani, Gautam V.; Uber, Patricia A.; Mehra, Mandeep R.

    2010-01-01

    Chronic heart failure (CHF) remains the only cardiovascular disease with an increasing hospitalization burden and an ongoing drain on health care expenditures. The prevalence of CHF increases with advancing life span, with diastolic heart failure predominating in the elderly population. Primary prevention of coronary artery disease and risk factor management via aggressive blood pressure control are central in preventing new occurrences of left ventricular dysfunction. Optimal therapy for CHF...

  11. Automatic classification of long-term ambulatory ECG records according to type of ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Smrdel Aleš

    2011-12-01

    Full Text Available Abstract Background Elevated transient ischemic ST segment episodes in the ambulatory electrocardiographic (AECG records appear generally in patients with transmural ischemia (e. g. Prinzmetal's angina while depressed ischemic episodes appear in patients with subendocardial ischemia (e. g. unstable or stable angina. Huge amount of AECG data necessitates automatic methods for analysis. We present an algorithm which determines type of transient ischemic episodes in the leads of records (elevations/depressions and classifies AECG records according to type of ischemic heart disease (Prinzmetal's angina; coronary artery diseases excluding patients with Prinzmetal's angina; other heart diseases. Methods The algorithm was developed using 24-hour AECG records of the Long Term ST Database (LTST DB. The algorithm robustly generates ST segment level function in each AECG lead of the records, and tracks time varying non-ischemic ST segment changes such as slow drifts and axis shifts to construct the ST segment reference function. The ST segment reference function is then subtracted from the ST segment level function to obtain the ST segment deviation function. Using the third statistical moment of the histogram of the ST segment deviation function, the algorithm determines deflections of leads according to type of ischemic episodes present (elevations, depressions, and then classifies records according to type of ischemic heart disease. Results Using 74 records of the LTST DB (containing elevated or depressed ischemic episodes, mixed ischemic episodes, or no episodes, the algorithm correctly determined deflections of the majority of the leads of the records and correctly classified majority of the records with Prinzmetal's angina into the Prinzmetal's angina category (7 out of 8; majority of the records with other coronary artery diseases into the coronary artery diseases excluding patients with Prinzmetal's angina category (47 out of 55; and correctly

  12. 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.

  13. A prospective cohort study of quality of life and ischemic heart disease

    DEFF Research Database (Denmark)

    Schou Mikkelsen, Stine; Mortensen, Erik Lykke; Flensborg-Madsen, Trine

    2014-01-01

    Aims: To examine the role of self-rated quality of life, as a whole, on the risk of developing ischemic heart disease. Methods: Information on self-rated quality of life and covariates was obtained from 4497 people from the Copenhagen Perinatal Cohort. The study population, consisting of both men...... and women aged 31-33 years at baseline, was followed for registration of ischemic heart disease in national registers. Two different follow-up periods were examined. Results: Using a follow-up of 13 years, the basis-adjusted hazard ratio among women who rated their quality of life as poor was 2.93 (95% CI...... were insignificant. All hazard ratios among men were below two and none were statistically significant. Conclusions: Among women, the risk for ischemic heart disease was two to four times greater for those who rated their quality of life as poor or good, than for women with the most positive rating...

  14. Preventive Effects of the Angiotensin-II Receptor Blocker on Atrial Remodeling in an Ischemic Heart Failure Model of Rats

    OpenAIRE

    Yoon, Namsik; Kim, Kye Hun; Park, Keun Ho; Sim, Doo Sun; Youn, Hyun Ju; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Ahn, Youngkeun; Jeong, Myung Ho; Cho, Jeong Gwan; Park, Jong Chun

    2013-01-01

    Background and Objectives It is widely known that angiotensin-II receptor blockers (ARBs) have reverse remodeling effects in atrium. Although atrial fibrillation is frequent in ischemic heart failure clinically, experiments to demonstrate ARB's effects on atrial remodeling in a heart failure model are rare. Materials and Methods A heart failure model and a sham-operated group were formed in 25 Sprague-Dawley male rats of roughly 260 g in weight. Ischemic heart failure models were obtained via...

  15. Shift work and the risk of ischemic heart disease - a systematic review of the epidemiologic evidence

    DEFF Research Database (Denmark)

    Frost, P.; Kolstad, H.A.; Bonde, Jens Peter

    2009-01-01

    Objective The objective of this review was to evaluate the epidemiologic evidence for a causal relation between shift work and ischemic heart disease. Methods We conducted a systematic search until the end of March 2008 for studies providing information on the relative risk of ischemic heart...... combined fatal and non-fatal events, while one study reported separately on both types of events. Relative risks ranged from 0.6-1.4 in 12 papers while two papers reported relative risks around 2.0. Most studies based on fatal events showed no or weak associations while studies that combined fatal and non...

  16. Combined analysis of six lipoprotein lipase genetic variants on triglycerides, high-density lipoprotein, and ischemic heart disease

    DEFF Research Database (Denmark)

    Wittrup, Hans H; Andersen, Rolf V; Tybjaerg-Hansen, Anne;

    2006-01-01

    Genetic variants in lipoprotein lipase may affect triglycerides, high-density lipoprotein (HDL), and risk of ischemic heart disease (IHD).......Genetic variants in lipoprotein lipase may affect triglycerides, high-density lipoprotein (HDL), and risk of ischemic heart disease (IHD)....

  17. Multiscale Entropy of the Heart Rate Variability for the Prediction of an Ischemic Stroke in Patients with Permanent Atrial Fibrillation

    OpenAIRE

    Eiichi Watanabe; Ken Kiyono; Junichiro Hayano; Yoshiharu Yamamoto; Joji Inamasu; Mayumi Yamamoto; Tomohide Ichikawa; Yoshihiro Sobue; Masehide Harada; Yukio Ozaki

    2015-01-01

    Background Atrial fibrillation (AF) is a significant risk factor for ischemic strokes, and making a robust risk stratification scheme would be important. Few studies have examined whether nonlinear dynamics of the heart rate could predict ischemic strokes in AF. We examined whether a novel complexity measurement of the heart rate variability called multiscale entropy (MSE) was a useful risk stratification measure of ischemic strokes in patients with permanent AF. Methods and Results We examin...

  18. 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

  19. Body mass index in chronic heart failure

    DEFF Research Database (Denmark)

    Christensen, Heidi M; Schou, Morten; Goetze, Jens P;

    2013-01-01

    Low body mass index (BMI) is associated with a poor outcome in chronic heart failure (CHF). An inverse association between BMI and adiponectin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been reported. The aim of the present study was to investigate whether novel markers...

  20. Increased expression of vascular endothelin type B and angiotensin type 1 receptors in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Dimitrijevic, Ivan; Edvinsson, Marie-Louise; Chen, Qingwen;

    2009-01-01

    expression in subcutaneous arteries from patients with different degrees of ischemic heart disease. METHODS: Subcutaneous arteries were obtained, by biopsy from the abdomen, from patients undergoing coronary artery bypass graft (CABG) surgery because of ischemic heart disease (n = 15), patients with angina...... receptors in vascular smooth muscle cells in ischemic heart disease. These receptors may play a role in the pathophysiology of ischemic heart disease and could provide important targets for pharmaceutical interventions.......BACKGROUND: Endothelin-1 and angiotensin II are strong vasoconstrictors. Patients with ischemic heart disease have elevated plasma levels of endothelin-1 and angiotensin II and show increased vascular tone. The aim of the present study was to examine the endothelin and angiotensin II receptor...

  1. Increased expression of vascular endothelin type B and angiotensin type 1 receptors in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Dimitrijevic, Ivan; Edvinsson, Lars; Chen, Qingwen;

    2009-01-01

    expression in subcutaneous arteries from patients with different degrees of ischemic heart disease. METHODS: Subcutaneous arteries were obtained, by biopsy from the abdomen, from patients undergoing coronary artery bypass graft (CABG) surgery because of ischemic heart disease (n = 15), patients with angina......BACKGROUND: Endothelin-1 and angiotensin II are strong vasoconstrictors. Patients with ischemic heart disease have elevated plasma levels of endothelin-1 and angiotensin II and show increased vascular tone. The aim of the present study was to examine the endothelin and angiotensin II receptor...... receptors in vascular smooth muscle cells in ischemic heart disease. These receptors may play a role in the pathophysiology of ischemic heart disease and could provide important targets for pharmaceutical interventions....

  2. Acute Myocardial Infarction: The First Manifestation of Ischemic Heart Disease and Relation to Risk Factors

    Directory of Open Access Journals (Sweden)

    Manfroi Waldomiro Carlos

    2002-01-01

    Full Text Available OBJECTIVE: To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings. METHODS: We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed. RESULTS: Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04 and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03. The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.

  3. Pentaerythritol Tetranitrate Targeting Myocardial Reactive Oxygen Species Production Improves Left Ventricular Remodeling and Function in Rats With Ischemic Heart Failure.

    Science.gov (United States)

    Fraccarollo, Daniela; Galuppo, Paolo; Neuser, Jonas; Bauersachs, Johann; Widder, Julian D

    2015-11-01

    Reduced nitric oxide bioavailability contributes to progression of cardiac dysfunction and remodeling in ischemic heart failure. Clinical use of organic nitrates as nitric oxide donors is limited by development of nitrate tolerance and reactive oxygen species formation. We investigated the effects of long-term therapy with pentaerythritol tetranitrate (PETN), an organic nitrate devoid of tolerance, in rats with congestive heart failure after extensive myocardial infarction. Seven days after coronary artery ligation, rats were randomly allocated to treatment with PETN (80 mg/kg BID) or placebo for 9 weeks. Long-term PETN therapy prevented the progressive left ventricular dilatation and improved left ventricular contractile function and relaxation in rats with congestive heart failure. Mitochondrial superoxide anion production was markedly increased in the failing left ventricular myocardium and nearly normalized by PETN treatment. Gene set enrichment analysis revealed that PETN beneficially modulated the dysregulation of mitochondrial genes involved in energy metabolism, paralleled by prevention of uncoupling protein-3, thioredoxin-2, and superoxide dismutase-2 downregulation. Moreover, PETN provided a remarkable protective effect against reactive fibrosis in chronically failing hearts. Mechanistically, induction of heme oxygenase-1 by PETN prevented mitochondrial superoxide generation, NOX4 upregulation, and ensuing formation of extracellular matrix proteins in fibroblasts from failing hearts. In summary, PETN targeting reactive oxygen species generation prevented the changes of mitochondrial antioxidant enzymes and progressive fibrotic remodeling, leading to amelioration of cardiac functional performance. Therefore, PETN might be a promising therapeutic option in the treatment of ischemic heart diseases involving oxidative stress and impairment in nitric oxide bioactivity.

  4. Congestive heart failure in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Poskurica Mileta

    2014-01-01

    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  5. ACE INHIBITORS IN PATIENTS WITH ISCHEMIC HEART DISEASE WITHOUT HEART FAILURE: CLASS EFFECTS AND EFFICACY OF ITS REPRESENTATIVES

    Directory of Open Access Journals (Sweden)

    Y. A. Karpov

    2015-12-01

    Full Text Available Results of large-scale studies (QUIET, HOPE, EUROPA, PEACE, CAMELOT, devoted to assessment of the role of ACE inhibitors in treatment of patients with stable form of ischemic heart disease without heart failure are analyzed. Different efficacy of the representatives of this class toward risks of coronary events development and cerebral-vascular complications is shown, as well as the overall mortality risk due to cardiovascular reasons. Favorable therapeutic effects of inhibiting RAS activity in patients without left ventricle dysfunction are demonstrated in studies EUROPA with perindopril 8 mg, and HOPE with ramipril 10 mg. That became the ground of inclusion of these drugs into recommendations for treatment of all patients with ischemic heart disease after myocardial infarction, in addition to antiplatelet, lipid reducing remedies and beta-blockers.

  6. ACE INHIBITORS IN PATIENTS WITH ISCHEMIC HEART DISEASE WITHOUT HEART FAILURE: CLASS EFFECTS AND EFFICACY OF ITS REPRESENTATIVES

    Directory of Open Access Journals (Sweden)

    Y. A. Karpov

    2005-01-01

    Full Text Available Results of large-scale studies (QUIET, HOPE, EUROPA, PEACE, CAMELOT, devoted to assessment of the role of ACE inhibitors in treatment of patients with stable form of ischemic heart disease without heart failure are analyzed. Different efficacy of the representatives of this class toward risks of coronary events development and cerebral-vascular complications is shown, as well as the overall mortality risk due to cardiovascular reasons. Favorable therapeutic effects of inhibiting RAS activity in patients without left ventricle dysfunction are demonstrated in studies EUROPA with perindopril 8 mg, and HOPE with ramipril 10 mg. That became the ground of inclusion of these drugs into recommendations for treatment of all patients with ischemic heart disease after myocardial infarction, in addition to antiplatelet, lipid reducing remedies and beta-blockers.

  7. Angiogenesis effects of adenovirus-mediated gene transfer of VEGF-B on chronic ischemic myocardium

    Institute of Scientific and Technical Information of China (English)

    DONG Shu-qiang; ZHANG Bao-ren; MEI Ju; XU Zhi-yun; ZOU Liang-jian; HUANG Sheng-dong

    2002-01-01

    Objective: To study the angiogenesis effects of adenovirus-mediated gene transfer of VEGF-B on chronic ischemic myocardium. Methods: Domestic pigs underwent thoracotomy and placement of an ameroid constrictor on the circumflex coronary artery. Four weeks later, Ad. VEGF-B, Ad. LacZ or PBS were administrated directly into the myocardium at 10 sites in the circumflex distribution (109 PFU or 100 μl) according to groups. Echocardiography and ex vivo coronary angiography were performed. The injection sites around myocardium were harvested and subjected to histological analysis and immunochemical staining. Results: Echocardiography assessment 4 weeks after vector administration demonstrated significant improvement of regional wall systolic function. Collateral vesseldevelopment assessed by angiography was also significantly greater in Ad. VEGF-B animals than that in control animals. Vascular density analysis revealed a mean of 43±5 neovessels per high-power field in Ad.VEGF-B group versus 19±4 and 17±6 in Ad.LacZ and PBS group. Conclusion:Direct intramyocardial administration of Ad.VEGF-B can induce focal angiogenesis and result in improvement in regional myocardial function, which may be useful in patients with ischemic heart disease who are not eligible for conventional therapies.

  8. Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

    Energy Technology Data Exchange (ETDEWEB)

    El Demerdash, Salah [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Khorshid, Hazem, E-mail: hazemkhorshid@yahoo.com [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salah, Iman; Abdel-Rahman, Mohamed A. [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salem, Alaa M. [Department of Internal Medicine, Medical Division, National Research Centre, Cairo (Egypt)

    2015-07-15

    Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

  9. Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

    International Nuclear Information System (INIS)

    Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

  10. Short Term Administration of L-Carnitine can be Detrimental to the Ischemic Heart

    OpenAIRE

    Moslem Najafi; Alireza Garjani

    2013-01-01

    Previous studies have shown that L-carnitine (LC) supplementation may exert a cardioprotective effect in cardiomyopathy, prevent arrhythmias in myocardial infarction and increase exercise tolerance in angina. Interestingly, we demonstrated that short term preischemic administration of LC can be detrimental to ischemic heart. In isolated rat hearts treated with LC for 10 min before ischemia, a marked and concentration dependent arrhythmogenic activity were produced during both ischemia and rep...

  11. Influence of Kinesitherapy on Gait in Patients with Ischemic Stroke in the Chronic Period

    Directory of Open Access Journals (Sweden)

    Danche Vasileva

    2015-10-01

    CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as exercise program at home, which significantly improved gait cadence and speed of movement in patients with ischemic stroke in the chronic period and is with a supportive prolonged exposure.

  12. [RELATIONSHIP BETWEEN INFLAMMATIONAND HEART DYSSYNCHRONY IN PATIENTS WITH CHRONIC HEART FAILURE AND DIABETES MELLITUS TYPE 2].

    Science.gov (United States)

    Asoyan, I; Bilchenko, A; Pavlov, S

    2016-07-01

    The study involved 100 patients with chronic heart failure of ischemic origin II-III functional class (NYNA) and diabetes mellitus type 2. The concentration of serum markers of inflammation was determined by enzyme immunoassay. Сardiac dyssynchrony was detected echocardiographic and electrocardiographic methods. The study showed that the presence of cardiac dyssynchrony is accompanied by significant increase concentrations of inflammatory markers (CRP (p=2•10-9), TNF-α (p=4•10-6), IL-1β (p=0,01596), IL-6 (р=2•10-6) in patients. Аlso revealed statistically significant direct correlations between levels: Ts and CRP (r=0,604; pdiabetes. PMID:27661275

  13. Is the demand-control model still a usefull tool to assess work-related psychosocial risk for ischemic heart disease? Results from 14 year follow up in the Copenhagen City Heart study

    DEFF Research Database (Denmark)

    Netterstrøm, Bo; Kristensen, Tage S; Jensen, Gorm;

    2010-01-01

    To test the usefulness of the Demand-Control Model as predictor for ischemic heart disease (IHD).......To test the usefulness of the Demand-Control Model as predictor for ischemic heart disease (IHD)....

  14. Occupational heavy lifting and risk of ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Petersen, Christina Bjørk; Eriksen, Louise; Tolstrup, Janne S;

    2012-01-01

    ABSTRACT: BACKGROUND: Occupational heavy lifting is known to impose a high cardiovascular strain, but the risk of ischemic heart disease (IHD) from occupational heavy lifting is unknown. The objective was to investigate the association between occupational heavy lifting and risk of IHD and all...

  15. Increased morbidity from ischemic heart disease in patients with Wegener's granulomatosis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Mellemkjaer, Lene; Sørensen, Inge Juul;

    2009-01-01

    OBJECTIVE: Experimental studies indicate that patients with Wegener's granulomatosis (WG) experience accelerated atherosclerosis. The purpose of this study was to investigate whether the occurrence of overt ischemic heart disease (IHD) is increased in WG. METHODS: A total of 293 WG patients were...

  16. CASE-COHORT STUDY OF STYRENE EXPOSURE AND ISCHEMIC HEART DISEASE INVESTIGATORS

    Science.gov (United States)

    Investigators examined workers exposed to styrene while working in styrene-butadiene polymer manufacturing plants between 1943 and 1982. Workers who had died from ischemic heart disease were compared to a subgroup of all men employed in two styrene-butadiene polymer manufac...

  17. Short Telomere Length, Myocardial Infarction, Ischemic Heart Disease, and Early Death

    DEFF Research Database (Denmark)

    Weischer, Maren; Bojesen, Stig E; Cawthon, Richard M;

    2012-01-01

    OBJECTIVE: We tested the hypothesis that short telomere length is associated with increased risk of myocardial infarction, ischemic heart disease, and early death. METHODS AND RESULTS: We measured leukocyte telomere length in 2 prospective studies of 19 838 Danish general population participants ...

  18. Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women

    DEFF Research Database (Denmark)

    Benn, Marianne; Voss, Sidsel Skou; Holmegard, Haya N;

    2015-01-01

    OBJECTIVE: Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk of i...

  19. Heart rate variability characterized by refined multiscale entropy applied to cardiac death in ischemic cardiomyopathy patients

    OpenAIRE

    Caminal Magrans, Pere; Valencia Murillo, José Fernando; Vallverdú Ferrer, Montserrat; Schroeder, Rico; Cygankiewicz, I.; Vázquez, Rafael; Bayes de Luna, Antonio; Porta, Alberto; Voss, Andreas

    2010-01-01

    In this work, Refined Multiscale Entropy (RMSE) was applied to characterize risk of cardiac death in ischemic cardiomyopathy patients, analyzing heart rate variability (HRV) by means of RR series during daytime and nighttime. RMSE approach measures an entropy rate in different time scales of a series, giving a multiscale characterization of complexity of that series. RMSE showed statistically significant differences (p

  20. Visible Age-Related Signs and Risk of Ischemic Heart Disease in the General Population

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter;

    2014-01-01

    BACKGROUND: Cardiovascular disease is 1 of the most common age-related diseases, and also 1 of the most common causes of death in the general population. We tested the hypothesis that visible age-related signs associate with risk of ischemic heart disease (IHD), myocardial infarction (MI), and de...

  1. Silent Ischemic Heart Disease and Pericardial Fat Volume in HIV-Infected Patients

    DEFF Research Database (Denmark)

    Kristoffersen, Ulrik S; Lebech, Anne-Mette; Wiinberg, Niels;

    2013-01-01

    to determine the prevalence of asymptomatic ischemic heart disease (IHD) in HIV patients by myocardial perfusion scintigraphy (MPS) and to determine the value of coronary artery calcium score (CACS), carotid intima-media thickness (cIMT) and pericardial fat volume as screening tools for detection...

  2. 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...

  3. INFLUENCE OF COMPLETENESS HEART REVASCULARIZATION ON A FUNCTIONAL CONDITION OF MYOCARDIUM AT ISCHEMIC CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    V. V. Chestukhin

    2013-01-01

    Full Text Available The aim of this study was to define influence of completeness heart revascularization on a functional condition of myocardium at ischemic cardiomyopathy. Materials and methods. 61 men and 5 women aged from 46 till 73 years with the diagnosis an ischemic cardiomyopathy were investigated before and after coronary angioplasty (EDV LV – 256,1 ± 7,4 ml, EF LV – 36,1 ± 1,1%. 46 patients had at receipt CHF with NYHA functional class 4, 20 – CHF with NYHA functional class 3. Functional status (6-minute walking test – 109,7 ± 20,5 m. Chronic total occlusion was the major type of coronary artery disease (92 of 176 epicardial branches. By means of echocardiography and quantitative gated SPECT estimated dynamics of systolic and diastolic function, change of perfusion, thickening and myocardial movement. Results. The full revascularization managed to be executed to 32 patients, incomplete – to 34 patients (34 occluded arteries didn't manage to be opened. In the whole group the 6-minute walking test incre- ased to 268,2 ± 19,9 m (p < 0,001, EF LV grew to 39,9±1,1% (p < 0,01 due to reduction of end systolic volume, degree of mitral regurgitation decreased from 1,6 ± 0,1 to 1,2 ± 0,1 (p < 0,007, pulmonary artery pressure decreased from 39,1 ± 1,7 to 32,1 ± 1,2 mm Hg (p < 0,01. Distinctions in dynamics of the main functional indicators between groups of complete and incomplete revascularization it isn't revealed. The factor of expressiveness of collateral blood flow in the region of occluded arteries probably compensates violation of an antegrade blood flow and defines a myocardial condition. Conclusion. The volume of myocardial revascularization at patients with ischemic cardio- myopathy isn't defining factor in a clinical condition of them after executed percutaneous coronary intervention. 

  4. Prospective memory and chronic heart failure

    OpenAIRE

    Habota, Tina; Cameron, Jan; McLennan, Skye N; Ski, Chantal F; Thompson, David R; Peter G Rendell

    2013-01-01

    Background Patients with chronic heart failure (CHF) experience a number of debilitating symptoms, which impact on activities of daily living and result in poor quality of life. Prospective memory, which is defined as memory to carry out future intentions, has not been investigated in this group. However, emerging evidence suggests CHF patients have difficulties with cognitive processes related to prospective memory. Self-care, which partly relies on prospective memory, is essential in sympto...

  5. 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.

  6. 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.

  7. Comparative analysis of myocardial revascularization methods for ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Sinkeev M.S.

    2012-09-01

    Full Text Available The review of literature is devoted to the comparative analysis of clinical researches of efficiency and frequency of complications after application of surgical and medicamentous methods of treatment of coronary heart disease.

  8. Morbidity of ischemic heart disease in early breast cancer 15-20 years after adjuvant radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gyenes, G.; Rutqvist, L.E. (Karolinksa Hospital, Stockholm (Sweden)); Fornander, T.; Carlens, P.

    1994-03-30

    The purpose of this study was to assess the cardiac side effects, primarily the occurrence of ischemic heart disease, in symptom-free patients with early breast cancer treated with radiotherapy. Thirty-seven survivors of a former randomized study of early breast cancer were examined. Twenty patients irradiated pre- or postoperatively for left sided disease (study group patients) were compared with 17 controls who were either treated for right sided disease, or were nonirradiated patients. Radiotherapy was randomized in the original study; either tangential field [sup 60]Co, or electron-therapy was delivered. Echocardiography and bicycle ergometry stress test with [sup 99m]Tc SestaMIBI myocardial perfusion scintigraphy were carried out and the patients' major risk factors for ischemic heart disease were also listed. Our results showed a significant difference between the scintigraphic findings of the two groups. Five of the 20 study group patients (25%), while none of the 17 controls exhibited some kind of significant defects on scintigraphy, indicating ischemic heart disease (p < 0.05). No deterioration in left ventricular systolic and/or diastolic function could be detected by echocardiography. Radiotherapy for left sided breast cancer with the mentioned treatment technique may present as an independent risk factor in the long-term development of ischemic heart disease, while left ventricular dysfunction could not be related to the previous irradiation. The authors emphasize the need to optimize adjuvant radiotherapy for early breast cancer by considering the dose both to the heart as well as the cancer. 39 refs., 4 tabs.

  9. The potential for nanotechnology to improve delivery of therapy to the acute ischemic heart.

    Science.gov (United States)

    Evans, Cameron W; Iyer, K Swaminathan; Hool, Livia C

    2016-04-01

    Treatment of acute cardiac ischemia remains an area in which there are opportunities for therapeutic improvement. Despite significant advances, many patients still progress to cardiac hypertrophy and heart failure. Timely reperfusion is critical in rescuing vulnerable ischemic tissue and is directly related to patient outcome, but reperfusion of the ischemic myocardium also contributes to damage. Overproduction of reactive oxygen species, initiation of an inflammatory response and deregulation of calcium homeostasis all contribute to injury, and difficulties in delivering a sufficient quantity of drug to the affected tissue in a controlled manner is a limitation of current therapies. Nanotechnology may offer significant improvements in this respect. Here, we review recent examples of how nanoparticles can be used to improve delivery to the ischemic myocardium, and suggest some approaches that may lead to improved therapies for acute cardiac ischemia. PMID:26980180

  10. Perfusion delay causes unintentional ischemic preconditioning in isolated heart preparation.

    Science.gov (United States)

    Minhaz, U; Koide, S; Shohtsu, A; Fujishima, M; Nakazawa, H

    1995-01-01

    This study sought to show that unintentional preconditioning can be induced in the isolated perfused heart during the preparation procedure. The following four groups were compared: hearts were placed in ice cold saline and cooled for 15 s and then mounted to the Langendorff apparatus (n = 5; cool immediate group); hearts were cooled for 60 s and mounted (n = 5; cool delay group); hearts were mounted directly to the apparatus within 15 s after the isolation without cooling (n = 5; noncool immediate group); hearts were mounted without cooling, but the mounting was delayed for 60 s after the isolation (n = 5; noncool delay group). All hearts were paced at a fixed rate of 300 bpm, and an occlusion of left coronary (LCA) for 60 min was performed, which was followed by reperfusion for another 60 min. Coronary flow (CBF), left ventricular developed pressure (LVDP), and creatine phosphokinase (CPK) release did not change among the four groups during ischemia. At the end of reperfusion the LVDP values were 70 +/- 1%, 66 +/- 2%, 62 +/- 3%, and 73 +/- 2% of preischemic values in cool immediate, cool delay, noncool immediate, and noncool delay groups, respectively. CPK values were 116 +/- 4, 121 +/- 7, 138 +/- 6, and 29 +/- 1 x 10(3) U/g myocardium, and percentage necrosis/risk areas were 24 +/- 1.0%, 21 +/- 1.7%, 38 +/- 2.6%, and 13 +/- 0.5% in cool immediate, cool delay, noncool immediate, and noncool delay groups, respectively. The noncool delay group demonstrated high LVDP, least amount of CPK release, and smallest size of necrosis. These results indicate that an unintentional preconditioning effect can be induced when the cooling procedure is not applied and perfusion is delayed. PMID:8585864

  11. 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

  12. Effect of fiberoptic intubation on myocardial ischemia and hormonal stress response in diabetics with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Nashwa Nabil Mohamed

    2014-01-01

    Conclusion: The optimum use of fiberoptic bronchoscope with avoidance of jaw thrust maneuver attenuates the hemodynamic response to intubation which is beneficial in diabetic patients with ischemic heart disease. Stress response hormones showed no statistically significant difference between groups.

  13. TRIB1 and GCKR polymorphisms, lipid levels, and risk of ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Varbo, Anette; Benn, Marianne; Tybjærg-Hansen, Anne;

    2011-01-01

    The goal of this study was to test whether TRIB1-rs2954029 and GCKR-rs1260326 associate with lipid levels and risk of ischemic heart disease (IHD) and myocardial infarction (MI) in the general population....

  14. Genetically elevated apolipoprotein A-I, high-density lipoprotein cholesterol levels, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Lundegaard, Christiane; Tybjærg-Hansen, Anne; Grande, Peer;

    2010-01-01

    Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD)....

  15. [Chronic ischaemic heart disease in the elderly].

    Science.gov (United States)

    Martínez-Sellés, Manuel; Gómez Huelgas, Ricardo; Abu-Assi, Emad; Calderón, Alberto; Vidán, María Teresa

    2016-01-01

    It is the aim of this manuscript to take into account the peculiarities and specific characteristics of elderly patients with chronic ischaemic heart disease from a multidisciplinary perspective, with the participation of the Spanish Society of Cardiology (sections of Geriatric Cardiology and Ischaemic Heart Disease/Acute Cardiovascular Care), the Spanish Society of Internal Medicine, the Spanish Society of Primary Care Physicians and the Spanish Society of Geriatrics and Gerontology. This consensus document shows that in order to adequately address these elderly patients a comprehensive assessment is needed, which includes comorbidity, frailty, functional status, polypharmacy and drug interactions. We conclude that in most patients medical treatment is the best option and that this treatment must take into account the above factors and the biological changes associated with aging. PMID:27102136

  16. ATP-loading 201Tl myocardial SPECT for the detection of ischemic heart disease

    International Nuclear Information System (INIS)

    To evaluate the usefulness for the detection of ischemic heart disease, ATP myocrdial SPECT was performed in 35 patients (mean; 59±9.4 years) with angina pectoris or old myocardial infarction. Coronary angiography (CAG) was performed in all patients. The ultra-short half-life of ATP required a continuous infusion for its use. ATP was infused intravenously at a rate of 0.16 mg/kg/min for 5 min, with 201Tl injection taking place at 3 min. Myocardial SPECT imaging was begun 5 min and 4 hr later after the end of ATP infusion. ATP caused a significant decrease in arterial blood pressure (p201Tl myocardial SPECT for the detection of coronary artery disease (CAD) was evaluated using CAG as a golden standard. The sensitivity and specificity for CAD detection were 82% and 90%, respectively. ATP myocardial SPECT is a promising new test for the detection of ischemic heart disease. (author)

  17. Association of ischemic heart disease to global and regional longitudinal strain in asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian;

    2015-01-01

    Longitudinal deformation has been shown to deteriorate with progressive aortic stenosis as well as ischemic heart disease. Despite that both conditions share risk factors and are often coexisting, studies have not assessed the influence on longitudinal deformation for both conditions simultaneously....... Thus the purpose of this study was to evaluate the association between subclinical ischemic heart disease and global and regional longitudinal strain in asymptomatic patients with significant aortic stenosis. Prevalent patients with a diagnosis of aortic stenosis at six hospitals in the Greater...... coronary stenosis but not aortic valve area. Conversely, basal longitudinal strain was significantly associated to aortic valve area (p = 0.001), but not to significant coronary stenosis. Subclinical coronary artery disease is frequent in moderate and severe aortic stenosis, and should be suspected when...

  18. FREEDOM, SYNTAX, FAME and FUNCTIONALITY: the future of surgical revascularization in stable ischemic heart disease.

    Science.gov (United States)

    Ferguson, T Bruce; Chen, Cheng

    2014-01-01

    At the age of nearly 50 years, the procedure of coronary artery bypass grafting (CABG) now has the most solid evidence supporting its role in revascularization for stable ischemic heart disease in its history. In what is a relatively infrequent occurrence in medicine, the results from large-scale observational database analyses are now aligned with and supported by data from recent randomized trials, providing important contemporary evidence in support of CABG. However, even with strong evidence, the changing landscape of revascularization for stable ischemic heart disease threatens to make this evidence irrelevant in deciding which patients should be referred for CABG in the future. How the procedure of CABG could be modified and optimized for incorporation into this new landscape is discussed in this article. PMID:24344664

  19. [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.

  20. Prevalence of ischemic heart disease among urban population of Siliguri, West Bengal

    Directory of Open Access Journals (Sweden)

    Mandal Sukanta

    2009-01-01

    Full Text Available Objectives: To determine the prevalence of ischemic heart disease and the associated risk factors among the urban population of Siliguri. Materials and Methods: A cross-sectional survey of a random sample of the population aged ≥40 years old in the Municipal Corporation area of Siliguri. Study variables were age, sex, occupation, addiction, food habit, physical activity, body mass index, blood pressure, and electrocardiogram change. Results: Out of 250 individuals who took part in this study, 29 (11.6% had ischemic heart disease (IHD and 118 (47.2% had hypertension. Males had a higher (13.5% prevalence of IHD than females (9.4%. About 5% of the patients had asymptomatic IHD. IHD among the study population is significantly associated with hypertension and smoking.

  1. Ischemic heart disease in the emergency room: state of the art, innovation and research

    Directory of Open Access Journals (Sweden)

    Giuseppe Lippi

    2013-07-01

    Full Text Available This opinion paper is aimed to provide an overview about the state of the art, innovation and research in ischemic heart disease in the emergency room, and is a synopsis of the lectures of the 3rd Italian GREAT Network Congress (Rome, 15-19 October 2012. The leading issues of a multidisciplinary risk stratification and diagnosis of patients presenting to the emergency department with suspected ischemic heart disease will be discussed taking into consideration the variable onset of clinical signs and symptoms, the role of novel highly-sensitive troponin immunoassays, the promising use of an 80-lead electrocardiogram, echocardiography and risk stratification scores. Preliminary information will also be provided about the ongoing Italian multicentric registry on chest pain patients in emergency department, an observational prospective study aimed to collect data about patients presenting at the emergency department with typical chest pain suggesting an acute coronary syndrome.

  2. Prevalence of risk factors of ischemic heart disease among students of J N Medical College in Belgaum, Karnataka, India

    OpenAIRE

    Akheel MM; Mubashir BA; Dixit MD

    2012-01-01

    Ischemic heart disease (IHD) is the important cause of death in economically developed countries and is assuming epidemic forms in developing countries. Research related to risk factors for IHD, especially among medical students is essential, considering their role as future physicians and role models for the general population. Objectives: To know the prevalence of risk factors of Ischemic Heart Disease among medical students. To know the level of awareness of these risk factors amongst the ...

  3. TRIB1 and GCKR polymorphisms, lipid levels, and risk of ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Varbo, Anette; Tybjærg-Hansen, Anne; Grande, Peer;

    2011-01-01

    The goal of this study was to test whether TRIB1-rs2954029 and GCKR-rs1260326 associate with lipid levels and risk of ischemic heart disease (IHD) and myocardial infarction (MI) in the general population.......The goal of this study was to test whether TRIB1-rs2954029 and GCKR-rs1260326 associate with lipid levels and risk of ischemic heart disease (IHD) and myocardial infarction (MI) in the general population....

  4. Genetically elevated apolipoprotein A-I, high-density lipoprotein cholesterol levels, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Lundegaard, Christiane; Tybjærg-Hansen, Anne; Grande, Peer;

    2010-01-01

    Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD).......Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD)....

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

    Directory of Open Access Journals (Sweden)

    Lokesh

    2015-05-01

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

  6. Depression, not anxiety, is independently associated with 5-year hospitalizations and mortality in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Hoogwegt, Madelein T; Hansen, Tina B;

    2013-01-01

    The objective of the current study was to examine whether depression and anxiety are independently associated with 5-year cardiac-related hospitalizations and all-cause mortality in patients with ischemic heart disease (IHD).......The objective of the current study was to examine whether depression and anxiety are independently associated with 5-year cardiac-related hospitalizations and all-cause mortality in patients with ischemic heart disease (IHD)....

  7. [Contemporary views on estrogen replacement therapy. II. Hormonal therapy in women with imminent ischemic heart disease].

    Science.gov (United States)

    Krasomski, G

    1995-02-01

    The frequence of ischemic heart disease occurring increases 2-3 fold in postmenopausal period. It is a result of serum lipid profile changes. Estrogenotherapy restores correct lipid relations and protect coronary vessels in this way, preventing stenocardia and cardiac infarcts. Divergent opinions coexist with including progestogens to estrogen replacement therapy. However a view that well selected doses and kind of hormone effectively enhance serum HDL level, begins to prevail. PMID:8575683

  8. Work-related psychosocial factors and the development of ischemic heart disease: a systematic review

    DEFF Research Database (Denmark)

    Eller, Nanna H; Netterstrøm, Bo; Gyntelberg, Finn;

    2009-01-01

    The literature on the relationship between work-related psychosocial factors and the development of ischemic heart disease (IHD) was systematically reviewed: 33 articles presented 51 analyses of studies involving male participants, 18 analyses involving female participants, and 8 analyses with both...... risk. Insufficient evidence was found for a relationship between IHD and effort-reward imbalance, injustice, job insecurity, or long working hours. Studies involving women are too few to draw any conclusion concerning women, work stress, and IHD....

  9. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

    OpenAIRE

    Vardosanidze S.L.; Galstyan A.S.

    2010-01-01

    158 patients with ischemic heart disease (IHD) have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients) received clinical way method of treatment. Patients of the comparison group (40 patients) after provided treatment were cared by their local therapeutists (cardiologists). The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-pa...

  10. Ischemic heart disease risk factors in lead exposed workers: research study

    OpenAIRE

    Ghiasvand, Masoumeh; Aghakhani, kamran; Salimi, Ahmad; Kumar, Ranjit

    2013-01-01

    Background Review of other epidemiological studies reveal inconsistent results of relationships between high blood lead level and risk of hypertension, hyperlipidemia and hyperglycemia. In this study we wanted to find if there is a relationship between blood lead level and these ischemic heart disease risk factors. Methods This cross-sectional study was conducted in a battery recycling plant, and 497 male workers with the mean age of 41.7 (±6.50) years were recruited from all over the plant (...

  11. A Neuro-Fuzzy Approach to Classification of ECG Signals for Ischemic Heart Disease Diagnosis

    OpenAIRE

    Neagoe, Victor-Emil; Iatan, Iuliana-Florentina; Grunwald, Sorin

    2003-01-01

    The paper focuses on the neuro-fuzzy classifier called Fuzzy-Gaussian Neural Network (FGNN) to recognize the ECG signals for Ischemic Heart Disease (IHD) diagnosis. The proposed ECG processing cascade has two main stages: (a) Feature extraction from the QRST zone of ECG signals using either the Principal Component Analysis (PCA) or the Discrete Cosine Transform (DCT); (b) Pattern classification for IHD diagnosis using the FGNN. We have performed the software implementation and have experiment...

  12. Tandem action of exercise training and food restriction completely preserves ischemic preconditioning in the aging heart.

    Science.gov (United States)

    Abete, P; Testa, G; Galizia, G; Mazzella, F; Della Morte, D; de Santis, D; Calabrese, C; Cacciatore, F; Gargiulo, G; Ferrara, N; Rengo, G; Sica, V; Napoli, C; Rengo, F

    2005-01-01

    Ischemic preconditioning (IP) has been proposed as an endogenous form of protection against ischemia reperfusion injury. IP, however, does not prevent post-ischemic dysfunction in the aging heart but may be partially corrected by exercise training and food restriction. We investigated the role of exercise training combined with food restriction on restoring IP in the aging heart. Effects of IP against ischemia-reperfusion injury in isolated hearts from adult (A, 6 months old), sedentary 'ad libitum' fed (SL), trained ad libitum fed (TL), sedentary food-restricted (SR), trained- and food-restricted senescent rats (TR) (24 months old) were investigated. Norepinephrine release in coronary effluent was determined by high performance liquid cromatography. IP significantly improved final recovery of percent developed pressure in hearts from A (p<0.01) but not in those from SL (p=NS) vs unconditioned controls. Developed pressure recovery was partial in hearts from TL and SR (64.3 and 67.3%, respectively; p<0.05 vs controls) but it was total in those from TR (82.3%, p=NS vs A; p<0.05 vs hearts from TL and SR). Similarly, IP determined a similar increase of norepinephrine release in A (p<0.001) and in TR (p<0.001, p=NS vs adult). IP was abolished by depletion of myocardial norepinephrine stores by reserpine in all groups. Thus, IP reduces post-ischemic dysfunction in A but not in SL. Moreover, IP was preserved partially in TR and SR and totally in TR. Complete IP maybe due to full restoration of norepinephrine release in response to IP stimulus. PMID:15664731

  13. Cardioprotection by remote ischemic preconditioning of the rat heart is mediated by extracellular vesicles.

    Science.gov (United States)

    Giricz, Zoltán; Varga, Zoltán V; Baranyai, Tamás; Sipos, Péter; Pálóczi, Krisztina; Kittel, Ágnes; Buzás, Edit I; Ferdinandy, Péter

    2014-03-01

    Remote ischemic preconditioning (RIPC) of the heart is exerted by brief ischemic insults affected on a remote organ or a remote area of the heart before a sustained cardiac ischemia. To date, little is known about the inter-organ transfer mechanisms of cardioprotection by RIPC. Exosomes and microvesicles/microparticles are vesicles of 30-100 nm and 100-1000 nm in diameter, respectively (collectively termed extracellular vesicles [EVs]). Their content of proteins, mRNAs and microRNAs, renders EV ideal conveyors of inter-organ communication. However, whether EVs are involved in RIPC, is unknown. Therefore, here we investigated whether (1) IPC induces release of EVs from the heart, and (2) EVs are necessary for cardioprotection by RIPC. Hearts of male Wistar rats were isolated and perfused in Langendorff mode. A group of donor hearts was exposed to 3 × 5-5 min global ischemia and reperfusion (IPC) or 30 min aerobic perfusion, while coronary perfusates were collected. Coronary perfusates of these hearts were given to another set of recipient isolated hearts. A group of recipient hearts received IPC effluent depleted of EVs by differential ultracentrifugation. Infarct size was determined after 30 min global ischemia and 120 min reperfusion. The presence or absence of EVs in perfusates was confirmed by dynamic light scattering, the EV marker HSP60 Western blot, and electron microscopy. IPC markedly increased EV release from the heart as assessed by HSP60. Administration of coronary perfusate from IPC donor hearts attenuated infarct size in non-preconditioned recipient hearts (12.9 ± 1.6% vs. 25.0 ± 2.7%), similarly to cardioprotection afforded by IPC (7.3 ± 2.7% vs. 22.1 ± 2.9%) on the donor hearts. Perfusates of IPC hearts depleted of EVs failed to exert cardioprotection in recipient hearts (22.0 ± 2.3%). This is the first demonstration that EVs released from the heart after IPC are necessary for cardioprotection by RIPC, evidencing the importance of vesicular

  14. [Risk factors of ischemic heart disease in various occupational groups. II. Complex analysis of risk factors].

    Science.gov (United States)

    Gałuszka, Z; Kolarzyk, E; Stepniewski, M; Salwińska-Ciećkiewicz, B; Szpak, D

    1991-01-01

    Four hundred four men aged 30 to 59 years, belonging to one of 4 occupational groups were investigated in a standard clinical conditions. Two from those groups were characteristic for steel mill professions: 121 blast furnace workers; exerting strenuous physical effort and working in hot microclimate. 131 operators (the second group) performed work in comfort microclimate conditions not demanding much effort. The third group comprised 73 executives of industry. The fourth group consisted of 79 monks. For all subjects of investigations 8 selected risk factors of ischemic heart disease were evaluated. They included: age, sex, family history, habit of smoking, systolic blood pressure, fasting blood cholesterol level, obesity index and professional physical activity. The level of each risk factor had numerical value in a span from "0" to "8". The sum of all points was decisive to which of 3 groups of risk given man should be accounted. Those 3 groups were arbitrary divided into "low, intermediate and high risk". The highest risk was found for the executives group, and the lowest for blast furnace workers. From the risk factors under investigation highest overall influence on incidence of ischemic heart disease had habit of smoking and obesity. Described here point classification system seems to be very simple and useful for estimation of risk of ischemic heart disease in a given population. PMID:1845321

  15. How to Improve the Survival of Transplanted Mesenchymal Stem Cell in Ischemic Heart?

    Directory of Open Access Journals (Sweden)

    Liangpeng Li

    2016-01-01

    Full Text Available Mesenchymal stem cell (MSC is an intensely studied stem cell type applied for cardiac repair. For decades, the preclinical researches on animal model and clinical trials have suggested that MSC transplantation exerts therapeutic effect on ischemic heart disease. However, there remain major limitations to be overcome, one of which is the very low survival rate after transplantation in heart tissue. Various strategies have been tried to improve the MSC survival, and many of them showed promising results. In this review, we analyzed the studies in recent years to summarize the methods, effects, and mechanisms of the new strategies to address this question.

  16. Protective effects of drag-reducing polymers on ischemic reperfusion injury of isolated rat heart.

    Science.gov (United States)

    Hu, Feng; Wang, Yali; Gong, Kaizheng; Ge, Gaoyuan; Cao, Mingqiang; Zhao, Pei; Sun, Xiaoning; Zhang, Zhengang

    2016-01-01

    Drag-reducing polymers (DRPs) are blood-soluble macromolecules that can increase blood flow and reduce vascular resistance. The purpose of the present study was to observe the effect of DRPs on ischemic reperfusion (I/R) injury of isolated rat hearts. Experiments were performed on isolated rat hearts subjected to 30 min of ischemia followed by 90 min of reperfusion in Langendorff preparations. Adult Wistar rats were divided into the following five groups: control group, I/R group, group III (I/R and 2×10(-7)  g/ml PEO reperfusion), group IV (I/R and 1×10(-6)  g/ml PEO reperfusion), and group V (I/R and 5×10(-6)  g/ml PEO reperfusion). Left ventricular end-diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), maximum rate of ventricular pressure increase and decrease ( ± dp/dtmax), heart rate (HR) and coronary flow were measured. Lactate dehydrogenase (LDH) and creatine kinase (CK) activity and coronary flow, myocardial infarction size and cardiomyocytes apoptosis were also assayed. Our results showed that PEO decreased LVEDP and increased LVSP, ± dP/dtmax in group IV and group V compared with the I/R group (all P rat hearts and it may offer a new potential approach for the treatment of acute ischemic heart diseases. PMID:25633566

  17. Incidence and predictors of ischemic stroke during hospitalization for congestive heart failure.

    Science.gov (United States)

    Hamatani, Yasuhiro; Iguchi, Moritake; Nakamura, Michikazu; Ohtani, Ryo; Yamashita, Yugo; Takagi, Daisuke; Unoki, Takashi; Ishii, Mitsuru; Masunaga, Nobutoyo; Ogawa, Hisashi; Hamatani, Mio; Abe, Mitsuru; Akao, Masaharu

    2016-07-01

    Heart failure (HF) increases the risk of ischemic stroke. Data regarding the incidence and predictors of ischemic stroke during hospitalization for HF are limited. The study population of this retrospective cohort study consisted of patients with congestive HF, consecutively admitted to our center from October 2010 to April 2014. We excluded patients complicated with acute myocardial infarction, infective endocarditis, and takotsubo cardiomyopathy. We also excluded those with dialysis or mechanical circulatory support. We investigated the incidence of ischemic stroke during hospitalization for HF. Thereafter, we divided the patients without oral anticoagulants at admission into two groups: patients with ischemic stroke and those without it, and explored the predictors of ischemic stroke. A total of 558 patients (287 without atrial fibrillation (AF), 271 with AF) were enrolled. The mean age was 76.8 ± 12.3 years, and 244 patients (44 %) were female. The mean left-ventricular ejection fraction was 47.4 %. Oral anticoagulants were prescribed in 147 patients (8 without AF, 139 with AF). During hospitalization (median length 18 days), symptomatic ischemic stroke (excluding catheter-related) occurred in 15 patients (2.7 % of the total, 8 without AF, 7 with AF). Predictors significantly associated with increased risk of ischemic stroke in patients without oral anticoagulants were as follows; short-term increases in blood urea nitrogen after admission (at day 3; odds ratio (per 1 md/dl): 1.06, 95 % confidence interval (CI) 1.01-1.11, p = 0.02, and at day 7; odds ratio: 1.03, 95 % CI 1.00-1.07, p = 0.03, respectively), and previous stroke (odds ratio; 3.33, 95 % CI 1.01-11.00, p = 0.04). The incidence of ischemic stroke during hospitalization for HF was high, even in patients without AF. Previous stroke and short-term increases in blood urea nitrogen was significantly associated with the incidence of ischemic stroke. PMID:26219729

  18. Effect of Psychosocial Work Environment on Sickness Absence Among Patients Treated for Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Biering, Karin; Lund, Thomas; Andersen, Johan Hviid;

    2015-01-01

    Introduction During the last decades mortality has declined in patients with coronary heart disease due to improvements in treatments and changes in life style, resulting in more people living with chronic heart disease. This implies that focus on rehabilitation and re-integration to the work...

  19. Reexamining the Efficacy and Value of Percutaneous Coronary Intervention for Patients With Stable Ischemic Heart Disease.

    Science.gov (United States)

    Weintraub, William S; Boden, William E

    2016-08-01

    Percutaneous coronary intervention (PCI) continues to be performed frequently for patients with stable ischemic heart disease, despite uncertain efficacy. Individual randomized trial data and meta-analyses have not demonstrated that PCI in addition to optimal medical therapy reduces the incidence of death or myocardial infarction in patients with stable disease. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) Trial did not show benefit for cardiovascular outcomes or mortality but did find a modest improvement in quality of life that did not persist at 3 years. Long-term follow-up from COURAGE (up to 15 years) found no differences in mortality, consistent with other published literature. How PCI could reduce long-term mortality or prevent myocardial infarction is not clear because sites of future plaque rupture leading to myocardial infarction are unpredictable and PCI can only treat localized anatomic segments of obstructive atherosclerosis. In addition, PCI is expensive, and the value to society of PCI for stable disease has not been demonstrated. The ISCHEMIA trial will assess the role of PCI for stable ischemic heart disease using newer technology and in patients with greater ischemic burden than in COURAGE. After nearly a decade, the COURAGE trial and other studies have given us pause to critically reexamine the role of PCI for patients with stable ischemic heart disease. Until further research can show that PCI can reduce cardiovascular events in these patients, a first-line strategy of optimal medical therapy is known to be safe, effective, and noninferior to PCI, and our practice should more closely follow this strategy. PMID:27380178

  20. [Various lipoprotein fractions and their relation to ischemic heart disease].

    Science.gov (United States)

    Palazzuoli, V; Mondillo, S; Kristodhullu, A; De Stefano, R; Amatucci, G

    1983-01-01

    In a study carried out on over 700 patients with three different manifestations of aterosclerosis (cerebrovascular, coronary and peripheral), we could not find any statistically significant difference between the total cholesterol and triglyceride concentration in these three groups. Also, there was o difference in cholesterol and triglyceride levels between these three groups and 200 normal subjects. The same held true when we compared a selected group of 76 patients with ischaemic heart disease who had no other risk factor, with a group of 80 control subjects. On the contrary, when we compared several fractions of serum lipoproteins and the ratios of apolipoprotein A to Apolipoprotein B, LDL Cholesterol to HDL Cholesterol, and total Cholesterol to HDL Cholesterol of the two groups, the differences were statistically significant. We conclude that when other risk factors are excluded, the protein component, rather than the lipid component of the plasma lipoproteins correlates the presence of coronary artery disease.

  1. Effects of Ischemic Postconditioning on the Hemodynamic Parameters and Heart Nitric Oxide Levels of Hypothyroid Rats

    Energy Technology Data Exchange (ETDEWEB)

    Jeddi, Sajad; Zaman, Jalal; Ghasemi, Asghar, E-mail: ghasemi@endocrine.ac.ir [Endocrine Physiology Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Endocrine Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2015-02-15

    Ischemic postconditioning (IPost) is a method of protecting the heart against ischemia-reperfusion (IR) injury. However, the effectiveness of IPost in cases of ischemic heart disease accompanied by co-morbidities such as hypothyroidism remains unclear. The aim of this study was to determine the effect of IPost on myocardial IR injury in hypothyroid male rats. Propylthiouracil in drinking water (500 mg/L) was administered to male rats for 21 days to induce hypothyroidism. The hearts from control and hypothyroid rats were perfused in a Langendorff apparatus and exposed to 30 min of global ischemia, followed by 120 min of reperfusion. IPost was induced immediately following ischemia. Hypothyroidism and IPost significantly improved the left ventricular developed pressure (LVDP) and peak rates of positive and negative changes in left ventricular pressure (±dp/dt) during reperfusion in control rats (p < 0.05). However, IPost had no add-on effect on the recovery of LVDP and ±dp/dt in hypothyroid rats. Furthermore, hypothyroidism significantly decreased the basal NO metabolite (NO{sub x}) levels of the serum (72.5 ± 4.2 vs. 102.8 ± 3.7 μmol/L; p < 0.05) and heart (7.9 ± 1.6 vs. 18.8 ± 3.2 μmol/L; p < 0.05). Heart NO{sub x} concentration in the hypothyroid groups did not change after IR and IPost, whereas these were significantly (p < 0.05) higher and lower after IR and IPost, respectively, in the control groups. Hypothyroidism protects the heart from IR injury, which may be due to a decrease in basal nitric oxide (NO) levels in the serum and heart and a decrease in NO after IR. IPost did not decrease the NO level and did not provide further cardioprotection in the hypothyroid group.

  2. Effects of Ischemic Postconditioning on the Hemodynamic Parameters and Heart Nitric Oxide Levels of Hypothyroid Rats

    International Nuclear Information System (INIS)

    Ischemic postconditioning (IPost) is a method of protecting the heart against ischemia-reperfusion (IR) injury. However, the effectiveness of IPost in cases of ischemic heart disease accompanied by co-morbidities such as hypothyroidism remains unclear. The aim of this study was to determine the effect of IPost on myocardial IR injury in hypothyroid male rats. Propylthiouracil in drinking water (500 mg/L) was administered to male rats for 21 days to induce hypothyroidism. The hearts from control and hypothyroid rats were perfused in a Langendorff apparatus and exposed to 30 min of global ischemia, followed by 120 min of reperfusion. IPost was induced immediately following ischemia. Hypothyroidism and IPost significantly improved the left ventricular developed pressure (LVDP) and peak rates of positive and negative changes in left ventricular pressure (±dp/dt) during reperfusion in control rats (p < 0.05). However, IPost had no add-on effect on the recovery of LVDP and ±dp/dt in hypothyroid rats. Furthermore, hypothyroidism significantly decreased the basal NO metabolite (NOx) levels of the serum (72.5 ± 4.2 vs. 102.8 ± 3.7 μmol/L; p < 0.05) and heart (7.9 ± 1.6 vs. 18.8 ± 3.2 μmol/L; p < 0.05). Heart NOx concentration in the hypothyroid groups did not change after IR and IPost, whereas these were significantly (p < 0.05) higher and lower after IR and IPost, respectively, in the control groups. Hypothyroidism protects the heart from IR injury, which may be due to a decrease in basal nitric oxide (NO) levels in the serum and heart and a decrease in NO after IR. IPost did not decrease the NO level and did not provide further cardioprotection in the hypothyroid group

  3. Effects of Ischemic Postconditioning on the Hemodynamic Parameters and Heart Nitric Oxide Levels of Hypothyroid Rats

    Directory of Open Access Journals (Sweden)

    Sajad Jeddi

    2015-02-01

    Full Text Available Background: Ischemic postconditioning (IPost is a method of protecting the heart against ischemia-reperfusion (IR injury. However, the effectiveness of IPost in cases of ischemic heart disease accompanied by co-morbidities such as hypothyroidism remains unclear. Objective: The aim of this study was to determine the effect of IPost on myocardial IR injury in hypothyroid male rats. Methods: Propylthiouracil in drinking water (500 mg/L was administered to male rats for 21 days to induce hypothyroidism. The hearts from control and hypothyroid rats were perfused in a Langendorff apparatus and exposed to 30 min of global ischemia, followed by 120 min of reperfusion. IPost was induced immediately following ischemia. Results: Hypothyroidism and IPost significantly improved the left ventricular developed pressure (LVDP and peak rates of positive and negative changes in left ventricular pressure (±dp/dt during reperfusion in control rats (p < 0.05. However, IPost had no add-on effect on the recovery of LVDP and ±dp/dt in hypothyroid rats. Furthermore, hypothyroidism significantly decreased the basal NO metabolite (NOx levels of the serum (72.5 ± 4.2 vs. 102.8 ± 3.7 μmol/L; p < 0.05 and heart (7.9 ± 1.6 vs. 18.8 ± 3.2 μmol/L; p < 0.05. Heart NOx concentration in the hypothyroid groups did not change after IR and IPost, whereas these were significantly (p < 0.05 higher and lower after IR and IPost, respectively, in the control groups. Conclusion: Hypothyroidism protects the heart from IR injury, which may be due to a decrease in basal nitric oxide (NO levels in the serum and heart and a decrease in NO after IR. IPost did not decrease the NO level and did not provide further cardioprotection in the hypothyroid group.

  4. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2009-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  5. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2016-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  6. Pivotal effects of phosphodiesterase inhibitors on myocyte contractility and viability in normal and ischemic hearts

    Institute of Scientific and Technical Information of China (English)

    Yuan James RAO; Lei XI

    2009-01-01

    Phosphodiesterases (PDEs) are enzymes that degrade cellular cAMP and cGMP and are thus essential for regulating the cyclic nucleotides. At least 11 families of PDEs have been identified, each with a distinctive structure, activity, expression, and tissue distribution. The PDE type-3, -4, and -5 (PDE3, PDE4, PDE5) are localized to specific regions of the cardiomyo-cyte, such as the sarcoplasmic reticulum and Z-disc, where they are likely to influence cAMP/cGMP signaling to the end effectors of contractility. Several PDE inhibitors exhibit remarkable hemodynamic and inotropic properties that may be valuable to clinical practice. In particular, PDE3 inhibitors have potent cardiotonic effects that can be used for short-term inotropic support, especially in situations where adrenergic stimulation is insufficient. Most relevant to this review, PDE in-hibitors have also been found to have cytoprotective effects in the heart. For example, PDE3 inhibitors have been shown to be cardioprotective when given before ischemic attack, whereas PDE5 inhibitors, which include three widely used erectile dysfunction drugs (sildenafil, vardenafil and tadalafil), can induce remarkable cardioprotection when administered either prior to ischemia or upon reperfusion. This article provides an overview of the current laboratory and clinical evidence, as well as the cellular mechanisms by which the inhibitors of PDE3, PDE4 and PDE5 exert their beneficial effects on normal and ischemic hearts. It seems that PDE inhibitors hold great promise as clinically applicable agents that can improve car-diac performance and cell survival under critical situations, such as ischemic heart attack, cardiopulmonary bypass surgery, and heart failure.

  7. Sildenafil Improves Erectile Function in Men with Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Niloufar Samiei

    2015-06-01

    Full Text Available Background: Patients with Chronic Heart Failure (CHF have been shown to have enhanced risk of Erectile Dysfunction (ED due to low cardiac output, endothelial dysfunction, medications, co-morbid conditions, and psychogenic factors. Objectives: The present study aimed to evaluate the effects of sildenafil on erectile function of patients with stable CHF using the abridged 5-item version of the International Index of Erectile Function (IIEF-5. Patients and Methods: Using convenience sampling, 222 sexually-active adult males with NYHA class I-III stable CHF were included in this cross-sectional study. All the patients filled out the IIEF-5 questionnaire, in which they were required to score the five domains of male sexual function, including erectile function, orgasm function, sexual desire, intercourse satisfaction, and overall satisfaction. All the analyses were performed using the SPSS statistical software (v. 19 and P < 0.05 was considered as statistically significant. Results: In our sample, the patients’ mean age was 47.14 ± 11.86 years, their mean left ventricular ejection fraction was 20% (15% - 25%, and the prevalence of ED was 70.3%. In addition, severe, moderate, mild to moderate, and mild ED were seen in 57%, 17%, 7%, and 19% of the patients with ED, respectively. ED was significantly more prevalent in the patients with ischemic heart failure compared to those with idiopathic dilated cardiomyopathy (84.68% vs. 55.85%, P < 0.001. Moreover, the prevalence of ED was significantly lower in the patients taking sildenafil compared to the other group (42.85% vs. 82.89%, P < 0.001. Conclusions: Sildenafil appears to provide satisfactory results toward improving sexual function in patients with CHF.

  8. Assessment of left atrial volume and mechanical function in ischemic heart disease: a multi slice computed tomography study

    DEFF Research Database (Denmark)

    Kühl, Jørgen Tobias; Kofoed, Klaus F; Møller, Jacob E;

    2010-01-01

    and mechanical function with Multi Slice Computed Tomography (MSCT) in patients with ischemic heart disease. Furthermore, the LA and left ventricular (LV) function was evaluated in relation to signs of clinical heart failure. METHODS AND RESULTS: MSCT was performed in 40 patients with sinus rhythm and ischemic...... heart disease. We enrolled 20 patients with reduced LV ejection fraction (LVEF=45%) and 20 with preserved LVEF (>45%). LA volumes, reservoir, channel and pump function were measured. Interobserver variation for LA volume measures was 1.5% (SD: 6.6%). In patients with reduced LVEF, LA volumes were larger...

  9. 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

  10. Allele-specific regulation of MTTP expression influences the risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Aminoff, Anna; Ledmyr, Helena; Thulin, Petra;

    2010-01-01

    Promoter polymorphisms in microsomal triglyceride transfer protein (MTTP) have been associated with decreased plasma lipids but an increased risk for ischemic heart disease (IHD), indicating that MTTP influences the susceptibility for IHD independent of plasma lipids. The objective of this study...... was to characterize the functional promoter polymorphism in MTTP predisposing to IHD and its underlying mechanism. Use of pyrosequencing technology revealed that presence of the minor alleles of the promoter polymorphisms -493G>T and -164T>C result in lower transcription of MTTP in vivo in the heart, liver...... including a total of 544 IHD patients and 544 healthy control subjects. We concluded that carriers of the minor -164C allele have lower expression of MTTP in the heart, mediated at least partly by the transcription factor CCAAT/enhancer binding protein, and that reduced concentration of MTTP...

  11. 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.

  12. Inflamação sistêmica causada pela periodontite crônica em pacientes vítimas de ataque cardíaco isquêmico agudo Systemic inflammation caused by chronic periodontitis in acute ischemic heart attack patients

    Directory of Open Access Journals (Sweden)

    Fernando José de Oliveira

    2010-03-01

    Full Text Available OBJETIVO: Processos inflamatórios e infecciosos mediados por bactérias em sítios distantes têm sido descritos como fator de risco à doença coronariana isquêmica aguda (DCIA. MÉTODOS: Cento e oitenta e um pacientes com DCIA, com e sem periodontites crônicas, foram incluídos neste estudo. Os pacientes foram admitidos no HC da UNICAMP e estratificados em três grupos: grupo 1 - pacientes com periodontite crônica grave (31 homens e 19 mulheres; média de idade 55,1 ± 11,29 anos; grupo 2 - pacientes com periodontite crônica leve (40 homens e 28 mulheres; média de idade 54,8 ± 10,37 anos; grupo 3 - pacientes desdentados (43 homens e 20 mulheres; média de idade 67,5 ± 8,55 anos. Amostras sanguíneas foram coletadas para mensurar os perfis lipídico, hematológico e glicêmico. Além disso, biópsias de 17 artérias coronárias com aterosclerose e igual número de artérias mamárias internas sem degeneração aterosclerótica no grupo 1 foram investigadas. Para análise estatística utilizou-se a análise de variância (ANOVA e o teste de Scheffé para comparações múltiplas. RESULTADOS: Triglicérides e LDL estavam elevados no grupo 1 em relação ao grupo 2. O HDL apresentou-se reduzido em 20% dos pacientes do grupo 1, e em 8% nos desdentados. A glicemia estava elevada no grupo 1. DNA de bactérias periodontais foram detectados em 58,8% das artérias coronárias. CONCLUSÕES: Pacientes com DCIA e periodontite crônica grave podem apresentar perfil lipídico alterado, como também microorganismos associados com as periodontites crônicas graves podem permear dentro de vasos coronarianos.OBJECTIVE: Infectious and inflammatory processes mediated by bacteria in distant sites have been described as a risk factor for acute ischemic heart disease (AIHD. METHODS: One hundred one patients with AIHD with and without chronic periodontitis (CP were included in this study. Patients were admitted to the HC UNICAMP and stratified into three

  13. API expert consensus document on management of ischemic heart disease.

    Science.gov (United States)

    2006-06-01

    bypass surgery. Early reperfusion is key to management of patients presenting with STEMI. If facilities are available, primary percutaneous coronary intervention (angioplasty with stenting) is treatment of choice for patients with STEMI. In our country, thrombolysis still remains the most frequently utilized reperfusion therapy and all efforts should be devoted to provide this therapy at the earliest. All high risk patients with STEMI (including cardiogenic shock) are best treated in higher centres and these patients should be promptly transported to such centres. Early coronary angiography is recommended for majority of patients following thrombolysis for risk stratification and further treatment. In acute coronary syndromes there is drift towards early invasive treatment and this is reflected in marked increase in cardiac care (catheterization laboratories and cardiac surgery centers) facilities throughout India. All patients with CAD require life-long supervised treatment which includes medication, control of risk factors and lifestyle modification. Avoidance of smoking, heart healthy diet, proper exercise, ideal weight management are important for all the patients. Statins, ACE inhibitors, beta-blockers, antiplatelet agents have a great role to play in treatment and prevention and these drugs should be utilized under medical supervision. It is important that the medical profession play an important role in critically evaluating the use of diagnostic procedures and therapies as they are introduced and tested in the detection and management of cardiac disorders. The American College of Cardiology (ACC), American Heart Association (AHA), European Society of Cardiology (ESC), Society for Cardiovascular Angiography and Interventions (SCAI) and several other societies engage in production of guidelines in the area of cardiovascular diseases from time to time. These guidelines attempt to define practices that meet the needs of most patients in most circumstances. The aim of

  14. A "second window of protection" occurs 24 h after ischemic preconditioning in the rat heart.

    Science.gov (United States)

    Yamashita, N; Hoshida, S; Taniguchi, N; Kuzuya, T; Hori, M

    1998-06-01

    We and others found that cardioprotection is acquired not only soon after, but also 24 h after ischemic preconditioning in canine and rabbit myocardial infarction models (second window of protection). However, a second window phenomenon against myocardial infarction was dependent on species limitations and has not been observed in porcine hearts. In this study, we examined whether the "second window of protection" against myocardial infarction is observed in the rat heart. In the ischemic preconditioning (IP) group, the left main coronary artery (LCA) of rats was occluded four times for 3 min. each separated by reperfusion for 10 min. After 0, 3, and 24 h, the rats were subjected to a 20-min LCA occlusion followed by 48-h reperfusion. At 0 and 24 h after IP, infarct size and the incidence of ventricular fibrillation (VF) during ischemia were significantly reduced compared with corresponding sham-operated groups without preconditioning. After 3 h of IP, there were no differences either in the incidence of VF during ischemia or in infarct size. Manganese superoxide dismutase (Mn-SOD) content in ischemic (LCA) region of myocardium significantly increased as compared with that of sham-operated rats 24 h after IP. Treatment with N-2-mercaptopropionyl glycine, an antioxidant and a hydroxyl radical scavenger, during IP abolished the early-phase (0 h after IP) and late-phase (24 h after IP) cardioprotection and the corresponding late increase in Mn-SOD content. These results indicate that a "second window of protection" against myocardial infarction also exists in rat hearts and the induction of an intrinsic scavenger, Mn-SOD, via free radical production during IP may be important in the second window of protection. PMID:9689592

  15. 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.

  16. The Role of Ozone Therapy in Neurohumoral Regulation in Patients with Ischemic Heart Diseases

    Directory of Open Access Journals (Sweden)

    Elena I. Sycheva

    2012-11-01

    Full Text Available Diseases, caused by atherosclerosis, first of all, ischemic heart disease are major cause of mortality in many countries, including Russia. Despite the different existing theories of atherosclerosis formation, pathogeny of this disease is mainly connected with lipid storage disease, blood rheological properties, activation of lipid peroxidation. Ozone therapy is one of the upcoming trends of preventive medicine. The findings of its application in the course of resort treatment showed homeostasis indicators improvement, which can serve as a basis for ozone therapy application in the course of multiple-factor treatment and prevention of cardiovascular diseases in patients.

  17. Percutaneous Implantation of A Parachute Device For Treatment of Ischemic Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com; Rollefson, William A.; Mego, David

    2013-07-15

    Congestive heart failure (CHF) secondary to ischemic cardiomyopathy is associated with significant morbidity and mortality despite currently available medical therapy. The Parachute{sup TM} device is a novel left ventricular partitioning device that is delivered percutaneously in the left ventricle (LV) in patients with anteroapical regional wall motion abnormalities, dilated LV and systolic dysfunction after anterior myocardial infarction with favorable clinical and LV hemodynamic improvements post-implantation. Here, we do review the current literature and present a case of the Parachute device implantation.

  18. Effect of dietary palm olein oil on oxidative stress associated with ischemic-reperfusion injury in isolated rat heart

    OpenAIRE

    Narang, Deepak; Sood, Subeena; Thomas, Mathew Kadali; Dinda, Amit Kumar; Maulik, Subir Kumar

    2004-01-01

    Background Palm olein oil (PO), obtained from refining of palm oil is rich in monounsaturated fatty acid and antioxidant vitamins and is widely used as oil in diet in many parts of the world including India. Palm oil has been reported to have beneficial effects in oxidative stress associated with hypertension and arterial thrombosis. Oxidative stress plays a major role in the etiopathology of myocardial ischemic-reperfusion injury (IRI) which is a common sequel of ischemic heart disease. Anti...

  19. Changes of deceleration and acceleration capacity of heart rate in patients with acute hemispheric ischemic stroke

    Directory of Open Access Journals (Sweden)

    Xu YH

    2016-03-01

    Full Text Available Yan-Hong Xu,1 Xing-De Wang,2 Jia-Jun Yang,1 Li Zhou,2 Yong-Chao Pan1 1Department of Neurology, 2Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China Background and purpose: Autonomic dysfunction is common after stroke, which is correlated with unfavorable outcome. Phase-rectified signal averaging is a newly developed technique for assessing cardiac autonomic function, by detecting sympathetic and vagal nerve activity separately through calculating acceleration capacity (AC and deceleration capacity (DC of heart rate. In this study, we used this technique for the first time to investigate the cardiac autonomic function of patients with acute hemispheric ischemic stroke. Methods: A 24-hour Holter monitoring was performed in 63 patients with first-ever acute ischemic stroke in hemisphere and sinus rhythm, as well as in 50 controls with high risk of stroke. DC, AC, heart rate variability parameters, standard deviation of all normal-to-normal intervals (SDNN, and square root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals (RMSSD were calculated. The National Institutes of Health Stroke Scale (NIHSS was used to assess the severity of stroke. We analyzed the changes of DC, AC, SDNN, and RMSSD and also studied the correlations between these parameters and NIHSS scores. Results: The R–R (R wave to R wave on electrocardiogram intervals, DC, AC, and SDNN in the cerebral infarction group were lower than those in controls (P=0.003, P=0.002, P=0.006, and P=0.043, but the difference of RMSSD and the D-value and ratio between absolute value of AC (|AC| and DC were not statistically significant compared with those in controls. The DC of the infarction group was significantly correlated with |AC|, SDNN, and RMSSD (r=0.857, r=0.619, and r=0.358; P=0.000, P=0.000, and P=0.004. Correlation analysis also showed that DC, |AC|, and SDNN

  20. 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.

  1. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Thomsen, Henrik F; Kronborg, Gitte;

    2007-01-01

    BACKGROUND: There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control...... group. METHODS: We determined the rate of first hospitalization for ischemic heart disease in all Danish patients with HIV infection (3953 patients) from 1 January 1995 through 31 December 2004 and compared this rate with that for 373,856 subjects in a population-based control group. Data on first...... hospitalization for ischemic heart disease and comorbidity were obtained from the Danish National Hospital Registry for all study participants. We used Cox's regression to compute the hospitalization rate ratio as an estimate of relative risk, adjusting for comorbidity. RESULTS: Although the difference...

  2. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Thomsen, Henrik F; Kronborg, Gitte;

    2007-01-01

    BACKGROUND: There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control...... group. METHODS: We determined the rate of first hospitalization for ischemic heart disease in all Danish patients with HIV infection (3953 patients) from 1 January 1995 through 31 December 2004 and compared this rate with that for 373,856 subjects in a population-based control group. Data on first...... was not statistically significant, patients with HIV infection who had not initiated HAART were slightly more likely to be hospitalized for the first time with ischemic heart disease than were control subjects (adjusted relative risk, 1.39; 95% confidence interval, 0.81-2.33). After HAART initiation, the risk increase...

  3. Ischemic colitis during interferon-ribavirin therapy for chronic hepatitis C: A case report

    Institute of Scientific and Technical Information of China (English)

    Su Jung Baik; Tae Hun Kim; Kwon Yoo; Il Hwan Moon; Min-Sun Cho

    2012-01-01

    Ischemic colitis is a rare complication of interferon administration.Only 9 cases in 6 reports have been described to-date.This report describes a case of ischemic colitis during pegylated interferon and ribavirin treatment for chronic hepatitis C,and includes a review of the relevant literature.A 48-year-old woman was treated with pegylated interferon α-2a and ribavirin for chronic hepatitis C,genotype Ib.After 19 wk of treatment,the patient complained of severe afebrile abdominal pain with hematochezia.Vital signs were stable and serum white blood cell count was within the normal range.Abdominal computed tomography showed diffuse colonic wall thickening from the splenic flexure to the proximal sigmoid colon,which is the most vulnerable area for the development of ischemic colitis.Colonoscopy revealed an acute mucosal hyperemic change,with edema and ulcerations extending from the proximal descending colon to the sigmoid colon.Colonic mucosal biopsy revealed acute exudative colitis.Polymerase chain reaction and culture for Mycobacterium tuberculosis were negative and the cultures for cytomegalovirus,Salmonella and Shigel/a species were negative.After discontinuation of interferon and ribavirin therapy,abdominal pain and hematochezia subsided and,following colonoscopy showed improvement of the mucosal ulcerations.Ischemic colitis cases during interferon therapy in patients with chronic hepatitis C reported so far have all involved the descending colon.Ischemic colitis is a rarely encountered complication of interferon administration in patients with chronic hepatitis C and should be considered when a patient complains of abdominal pain and hematochezia.

  4. Role of platelet-rich plasma in ischemic heart disease: An update on the latest evidence

    Institute of Scientific and Technical Information of China (English)

    Eleftherios; Spartalis; Periklis; Tomos; Demetrios; Moris; Antonios; Athanasiou; Charalampos; Markakis; Michael; D; Spartalis; Theodore; Troupis; Dimitrios; Dimitroulis; Despina; Perrea

    2015-01-01

    Myocardial infarction is the most common cause of congestive heart failure. Novel strategies such as directly reprogramming cardiac fibroblasts into cardiomyocytes are an exciting area of investigation for repair of injured myocardial tissue. The ultimate goal is to rebuild functional myocardium by transplanting exogenous stem cells or by activating native stem cells to induce endogenous repair. Cell-based myocardial restoration, however, has not penetrated broad clinical practice yet. Plateletrich plasma, an autologous fractionation of whole blood containing high concentrations of growth factors, has been shown to safely and effectively enhance healing and angiogenesis primarily by reparative cell signaling. In this review, we collected all recent advances in novel therapies as well as experimental evidence demonstrating the role of platelet-rich plasma in ischemic heart disease, focusing on aspects that might be important for future successful clinical application.

  5. Short Term Administration of L-Carnitine Can Be Detrimental to the Ischemic Heart

    Directory of Open Access Journals (Sweden)

    Moslem Najafi

    2014-03-01

    Full Text Available Previous studies have shown that L-carnitine (LC supplementation may exert a cardioprotective effect in cardiomyopathy, prevent arrhythmias in myocardial infarction and increase exercise tolerance in angina. Interestingly, we demonstrated that short term preischemic administration of LC can be detrimental to ischemic heart. In isolated rat hearts treated with LC for 10 min before ischemia, a marked and concentration dependent arrhythmogenic activity were produced during both ischemia and reperfusion as increases in the number of ventricular ectopic beats, ventricular tachycardia and incidence of ventricular fibrillation. We hypothesized that preischemic using of LC for an inadequate time may pose arrhythmogenic activity, due to incomplete metabolism of fatty acids which in turn lead to production of toxic long chain fatty acid metabolites and also because of interruption in glucose oxidation.

  6. Gene electro transfer of plasmid encoding vascular endothelial growth factor for enhanced expression and perfusion in the ischemic swine heart.

    Science.gov (United States)

    Hargrave, Barbara; Strange, Robert; Navare, Sagar; Stratton, Michael; Burcus, Nina; Murray, Len; Lundberg, Cathryn; Bulysheva, Anna; Li, Fanying; Heller, Richard

    2014-01-01

    Myocardial ischemia can damage heart muscle and reduce the heart's pumping efficiency. This study used an ischemic swine heart model to investigate the potential for gene electro transfer of a plasmid encoding vascular endothelial growth factor for improving perfusion and, thus, for reducing cardiomyopathy following acute coronary syndrome. Plasmid expression was significantly greater in gene electro transfer treated tissue compared to injection of plasmid encoding vascular endothelial growth factor alone. Higher gene expression was also seen in ischemic versus non-ischemic groups with parameters 20 Volts (ptransfer of plasmid encoding vascular endothelial growth factor had increased perfusion in the area at risk compared to control groups. Troponin and creatine kinase increased across all groups, suggesting equivalent ischemia in all groups prior to treatment. Echocardiography was used to assess ejection fraction, cardiac output, stroke volume, left ventricular end diastolic volume, and left ventricular end systolic volume. No statistically significant differences in these parameters were detected during a 2-week time period. However, directional trends of these variables were interesting and offer valuable information about the feasibility of gene electro transfer of vascular endothelial growth factor in the ischemic heart. The results demonstrate that gene electro transfer can be applied safely and can increase perfusion in an ischemic area. Additional study is needed to evaluate potential efficacy.

  7. EFFECTS OF GLIBENCLAMIDE, GLIMEPIRIDE, AND GLICLAZIDE ON ISCHEMIC PRECONDITIONING IN RAT HEART

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To compare the influence of different sulfonylureas on the myocardial protection effect of ischemic preconditioning (IPC) in isolated rat hearts, and ATP-sensitive potassium channel current (IKATP ) of rat ventricular myocytes.Methods Isolated Langendorff perfused rat hearts were randomly assigned to five groups: ( 1 ) control group, (2)IPC group, (3) IPC + glibenclamide (GLB, 10 μmol/L) group, (4) IPC + glimepiride (GLM, 10 μmol/L) group,(5) IPC + gliclazide ( GLC, 50 μmol/L ) group. IPC was defined as 3 cycles of 5 -minute zero-flow global ischemia followed by 5-minute reperfusion. The haemodynamic parameters and the infarct size of each isolated heart were recorded.And the sarcolemmal IKATP of dissociated ventricular myocytes reperfused with 10 μmol/L GLB, 1 μmol/L GLM, and 1μmol/L GLC was recorded with single-pipette whole-cell voltage clamp under simulated ischemic condition.Results The infarct sizes of rat hearts in IPC (23.7% ± 1.3% ), IPC + GLM (24. 6% ± 1.0% ), and IPC +GLC (33. 1% ±1.3% ) groups were all significantly smaller than that in control group (43.3% ±1.8%; P <0. 01, n=6). The infarct size of rat hearts in IPC + GLB group (40.4% ± 1.4% ) was significantly larger than that in IPC group (P <0. 01, n =6). Under simulated ischemic condition, GLB ( 10 μmol/L) decreased IKATP from 20. 65 ± 7.80 to 9. 09 ± 0. 10 pA/pF (P < 0. 01, n = 6), GLM ( 1 μ mol/L) did not significantly inhibit IKATP ( n = 6 ), and GLC ( 1μmol/L) decreased IKATP from 16.73 ± 0. 97 to 11.18 ± 3.56 pA/pF ( P < 0. 05, n = 6).Conclusions GLM has less effect on myocardial protection of IPC than GLB and GLC. Blockage of sarcolemmal ATP-sensitive potassium channels in myocardium might play an important role in diminishing IPC-induced protection of GLM, GLB, and GLC.

  8. Low serum insulin-like growth factor I is associated with increased risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Juul, Anders; Scheike, Thomas Harder; Davidsen, Michael;

    2002-01-01

    Insulin-like growth factor I (IGF-I) has been suggested to be involved in the pathogenesis of atherosclerosis. We hypothesize that low IGF-I and high IGFBP-3 levels might be associated with increased risk of ischemic heart disease (IHD).......Insulin-like growth factor I (IGF-I) has been suggested to be involved in the pathogenesis of atherosclerosis. We hypothesize that low IGF-I and high IGFBP-3 levels might be associated with increased risk of ischemic heart disease (IHD)....

  9. Dietary a-linolenic acid, linoleic acid, and n-3 long-chain PUFA and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Vedtofte, Mia Sadowa; Jakobsen, Marianne Uhre; Lauritzen, Lotte;

    2011-01-01

    n-3 (omega-3) PUFA has been proposed as having health-promoting effects, primarily in relation to ischemic heart disease (IHD). Whether these benefits can be achieved by both α-linolenic acid (ALA, 18:3n-3) and n-3 long-chain PUFA (LC-PUFA) is debatable.......n-3 (omega-3) PUFA has been proposed as having health-promoting effects, primarily in relation to ischemic heart disease (IHD). Whether these benefits can be achieved by both α-linolenic acid (ALA, 18:3n-3) and n-3 long-chain PUFA (LC-PUFA) is debatable....

  10. 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

  11. High pre-beta1 HDL concentrations and low lecithin: cholesterol acyltransferase activities are strong positive risk markers for ischemic heart disease and independent of HDL-cholesterol

    DEFF Research Database (Denmark)

    Sethi, Amar A; Sampson, Maureen; Warnick, Russell;

    2010-01-01

    We hypothesized that patients with high HDL-cholesterol (HDL-C) and ischemic heart disease (IHD) may have dysfunctional HDL or unrecognized nonconventional risk factors.......We hypothesized that patients with high HDL-cholesterol (HDL-C) and ischemic heart disease (IHD) may have dysfunctional HDL or unrecognized nonconventional risk factors....

  12. Physical fitness and perceived psychological pressure at work: 30-year ischemic heart disease and all-cause mortality in the Copenhagen Male Study

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann;

    2011-01-01

    Investigate if workers with low physical fitness have an increased risk of ischemic heart disease (IHD) mortality from regular psychological work pressure.......Investigate if workers with low physical fitness have an increased risk of ischemic heart disease (IHD) mortality from regular psychological work pressure....

  13. Physical work demands and physical fitness in low social classes--30-year ischemic heart disease and all-cause mortality in the copenhagen male study

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann;

    2011-01-01

    Investigate whether high physical work demands increase risk of ischemic heart disease (IHD) mortality among men of low social class with low physical fitness.......Investigate whether high physical work demands increase risk of ischemic heart disease (IHD) mortality among men of low social class with low physical fitness....

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

    NARCIS (Netherlands)

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

    1999-01-01

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

  15. Protective effects of calmodulin antagonists (trifluoperazine and W-7 on hypothermic ischemic rat hearts.

    Directory of Open Access Journals (Sweden)

    Sugawara,Eiji

    1991-06-01

    Full Text Available The cardioprotective effect of calmodulin antagonists, trifluoperazine (TFP and N-(6-aminohexyl-5-chloro-1-naphthalene sulfonamide (W-7 was examined on the isolated rat heart exposed to hypothermic and ischemic conditions by measuring distribution of lysosomal enzymes in myocardial cells, and leakage of creatine kinase (CK during reperfusion and postischemic recovery in myocardial systolic function. Experimental hearts were infused with 20 degrees C Krebs-Henseleit bicarbonate buffer (KHB or KHB containing TFP or W-7 for 2min every 30min during hypothermic ischemia. After ischemia for 120min at 20 degrees C, rat hearts were reperfused at 37 degrees C for 30min. TFP and W-7 improved functional recovery and prevented CK release. In TFP treated hearts, leakage of lysosomal enzymes was reduced significantly, whereas stabilization of lysosomes by W-7 did not occur. These results suggest that calcium-calmodulin dependent enzymes may play an important role in the development of cellular damage of the myocardium during hypothermic ischemia, although levels of leakage of lysosomal enzymes may be unreliable predictors of functional recovery after hypothermic ischemia.

  16. Optimal time duration for low-pressure controlled reperfusion to efficiently protect ischemic rat heart.

    Science.gov (United States)

    Bopassa, J C; Nemlin, C; Sebbag, L; Rodriguez, C; Ovize, M; Ferrera, R

    2007-10-01

    Previous studies have shown the capacity of low-pressure (LP) reperfusion to protect the ischemic heart. The present study sought to determine the optimal time for the application of LP reperfusion. Isolated rat hearts (n = 30) were exposed to 40 minutes of global warm ischemia followed by 70 minutes of reperfusion. Reperfusion was performed under LP (LP = 70 cm H(2)O) for 0 (control group), 5 (group LP-5), 10 (group LP-10), 30 (group LP-30), or 60 (group LP-60) minutes. Following the LP period the hearts were reperfused with normal pressure (100 cm H(2)O) until the end of reperfusion. Cardiac function was assessed during reperfusion using the Langendorff model. Myocardial necrosis was assessed by measuring LDH leakage in the coronary effluents. Functional recovery was reduced among the control and LP-5 groups with rate-pressure products (RPP) averaging 3788 +/- 499 and 5333 +/- 892 mm Hg/min, respectively. RPP was significantly improved in other groups with RPP averaging 7363 +/- 1159, 7441 +/- 863, and 7269 +/- 692 mm Hg/min in LP-10, LP-30, and LP-60 (P < .01). Similarly, necrosis measured by LDH leakage was significantly reduced in LP-10, LP-30, and LP-60 hearts (P < .01). This study demonstrated that LP reperfusion improves postischemic contractile dysfunction and attenuates necrosis when applied for at least 10 minutes. PMID:17954191

  17. Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR

    Directory of Open Access Journals (Sweden)

    Nagao Michinobu

    2012-02-01

    Full Text Available Abstract Background The purpose of this study was to quantify myocardial strain on the subendocardial and epicardial layers of the left ventricle (LV using tagged cardiovascular magnetic resonance (CMR and to investigate the transmural degree of contractile impairment in the chronic ischemic myocardium. Methods 3T tagged CMR was performed at rest in 12 patients with severe coronary artery disease who had been scheduled for coronary artery bypass grafting. Circumferential strain (C-strain at end-systole on subendocardial and epicardial layers was measured using the short-axis tagged images of the LV and available software (Intag; Osirix. The myocardial segment was divided into stenotic and non-stenotic segments by invasive coronary angiography, and ischemic and non-ischemic segments by stress myocardial perfusion scintigraphy. The difference in C-strain between the two groups was analyzed using the Mann-Whitney U-test. The diagnostic capability of C-strain was analyzed using receiver operating characteristics analysis. Results The absolute subendocardial C-strain was significantly lower for stenotic (-7.5 ± 12.6% than non-stenotic segment (-18.8 ± 10.2%, p Conclusions Analysis of tagged CMR can non-invasively demonstrate predominant impairment of subendocardial strain in the chronic ischemic myocardium at rest.

  18. 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

  19. A randomized pilot trial of remote ischemic preconditioning in heart failure with reduced ejection fraction.

    Directory of Open Access Journals (Sweden)

    Michael A McDonald

    Full Text Available BACKGROUND: Remote ischemic preconditioning (RIPC induced by transient limb ischemia confers multi-organ protection and improves exercise performance in the setting of tissue hypoxia. We aimed to evaluate the effect of RIPC on exercise capacity in heart failure patients. METHODS: We performed a randomized crossover trial of RIPC (4×5-minutes limb ischemia compared to sham control in heart failure patients undergoing exercise testing. Patients were randomly allocated to either RIPC or sham prior to exercise, then crossed over and completed the alternate intervention with repeat testing. The primary outcome was peak VO2, RIPC versus sham. A mechanistic substudy was performed using dialysate from study patient blood samples obtained after sham and RIPC. This dialysate was used to test for a protective effect of RIPC in a mouse heart Langendorff model of infarction. Mouse heart infarct size with RIPC or sham dialysate exposure was also compared with historical control data. RESULTS: Twenty patients completed the study. RIPC was not associated with improvements in peak VO2 (15.6+/-4.2 vs 15.3+/-4.6 mL/kg/min; p = 0.53, sham and RIPC, respectively. In our Langendorff sub-study, infarct size was similar between RIPC and sham dialysate groups from our study patients, but was smaller than expected compared to healthy controls (29.0%, 27.9% [sham, RIPC] vs 51.2% [controls]. We observed less preconditioning among the subgroup of patients with increased exercise performance following RIPC (p<0.04. CONCLUSION: In this pilot study of RIPC in heart failure patients, RIPC was not associated with improvements in exercise capacity overall. However, the degree of effect of RIPC may be inversely related to the degree of baseline preconditioning. These data provide the basis for a larger randomized trial to test the potential benefits of RIPC in patients with heart failure. TRIAL REGISTRATION: ClinicalTrials.gov +++++NCT01128790.

  20. 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

  1. Plasma renin activity and its association with ischemic heart disease, congestive heart failure, and cerebrovascular disease in a large hypertensive cohort

    OpenAIRE

    Sim, John J.; Shi, Jiaxiao; Al-Moomen, Rushdy; Behayaa, Hind; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.

    2014-01-01

    Plasma renin activity (PRA) may be a surrogate for vascular damage. We hypothesize that PRA is associated with cardiovascular and cerebrovascular disease. Cross sectional study (1/1/1998–12/31/2009) on hypertensive individuals >/=18yrs using multivariable logistic regression models to estimate odds ratios (OR) for ischemic heart disease (IHD), congestive heart failure (CHF), and cerebrovascular disease (CED) based on PRA quartiles controlling for age, sex, race, diabetes mellitus (DM), and me...

  2. Functional independence in patients with ischemic stroke in the chronic period

    OpenAIRE

    Vasileva, Dance; Lubenova, Daniela

    2013-01-01

    Objective: To investigate the influence of the specialized physical therapy on functional independence and to compare the impact of usual physical therapy in patients with ischemic stroke in the chronic period. Аn indisputable fact is that exercises have a positive contribution to the human body. It is well known that daily physical activities can improve the performance of many systems and organs by increasing its resistance and vital body tone, and also, can significantly improve the abi...

  3. Aging aggravates ischemic stroke-induced brain damage in mice with chronic peripheral infection.

    Science.gov (United States)

    Dhungana, Hiramani; Malm, Tarja; Denes, Adam; Valonen, Piia; Wojciechowski, Sara; Magga, Johanna; Savchenko, Ekaterina; Humphreys, Neil; Grencis, Richard; Rothwell, Nancy; Koistinaho, Jari

    2013-10-01

    Ischemic stroke is confounded by conditions such as atherosclerosis, diabetes, and infection, all of which alter peripheral inflammatory processes with concomitant impact on stroke outcome. The majority of the stroke patients are elderly, but the impact of interactions between aging and inflammation on stroke remains unknown. We thus investigated the influence of age on the outcome of stroke in animals predisposed to systemic chronic infection. Th1-polarized chronic systemic infection was induced in 18-22 month and 4-month-old C57BL/6j mice by administration of Trichuris muris (gut parasite). One month after infection, mice underwent permanent middle cerebral artery occlusion and infarct size, brain gliosis, and brain and plasma cytokine profiles were analyzed. Chronic infection increased the infarct size in aged but not in young mice at 24 h. Aged, ischemic mice showed altered plasma and brain cytokine responses, while the lesion size correlated with plasma prestroke levels of RANTES. Moreover, the old, infected mice exhibited significantly increased neutrophil recruitment and upregulation of both plasma interleukin-17α and tumor necrosis factor-α levels. Neither age nor infection status alone or in combination altered the ischemia-induced brain microgliosis. Our results show that chronic peripheral infection in aged animals renders the brain more vulnerable to ischemic insults, possibly by increasing the invasion of neutrophils and altering the inflammation status in the blood and brain. Understanding the interactions between age and infections is crucial for developing a better therapeutic regimen for ischemic stroke and when modeling it as a disease of the elderly.

  4. Enhancing stem cell survival in an ischemic heart by CRISPR-dCas9-based gene regulation

    OpenAIRE

    Pan, Alexander; Weintraub, Neal L.; Tang, Yaoliang

    2014-01-01

    Ischemic heart disease has remained the number one killer around the world for over the past twenty years. While stem cell therapy has become a promising new frontier to repair the damaged heart, limited stem cell survivability post-transplantation has precluded widespread use of this therapy. Strategies to genetically modify stem cells to activate pro-survival and anti-apoptotic and anti-inflammatory pathways, such as Akt and heme oxygenase-1, have been shown to improve the lifespan of trans...

  5. Creatinine, eGFR and association with myocardial infarction, ischemic heart disease and early death in the general population

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L; Benn, Marianne; Nordestgaard, Børge G

    2014-01-01

    OBJECTIVE: We tested the hypothesis that moderately elevated plasma creatinine levels and decreased levels of estimated glomerular filtration rate (eGFR) are associated with increased risk of myocardial infarction, ischemic heart disease, and early death in the general population. METHODS: We...... studied 10,489 individuals with a plasma creatinine measurement and calculated eGFR from the Danish general population, of which 1498 developed myocardial infarction, 3001 ischemic heart disease, and 7573 died during 32 years follow-up. RESULTS: Cumulative incidences of myocardial infarction and ischemic.......06-1.32) and 1.43 (1.30-1.57), and 0.97 (0.87-1.09) and 1.13 (1.02-1.24), respectively. Low eGFR did not associate consistently with increased risk of these endpoints. CONCLUSION: In the general population, moderately elevated plasma creatinine was associated with increased risk of myocardial infarction...

  6. Exercise mediates the association between positive affect and 5-year mortality in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Versteeg, Henneke; Hansen, Tina B;

    2013-01-01

    Background- Positive affect has been associated with better prognosis in patients with ischemic heart disease, but the underlying mechanisms remain unclear. We examined whether positive affect predicted time to first cardiac-related hospitalization and all-cause mortality, and whether exercise me...... between positive affect and mortality. Interventions aimed at increasing both positive affect and exercise may have better results with respect to patients' prognosis and psychological well-being than interventions focusing on 1 of these factors alone.......Background- Positive affect has been associated with better prognosis in patients with ischemic heart disease, but the underlying mechanisms remain unclear. We examined whether positive affect predicted time to first cardiac-related hospitalization and all-cause mortality, and whether exercise...... mediated this relationship in patients with established ischemic heart disease. Methods and Results- The sample comprised 607 patients with ischemic heart disease from Holbæk Hospital, Denmark. In 2005, patients completed the Global Mood Scale (GMS) to assess positive affect and a purpose-designed question...

  7. Cost-effectiveness of nutritional counseling for obese patients and patients at risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Olsen, Jens; Willaing, Ingrid; Ladelund, Steen;

    2005-01-01

    OBJECTIVES: Obesity and dyslipidemia are risk factors for ischemic heart disease, and prevention and treatment in primary care can reduce these risks. The objective of this cost-effectiveness analysis was to compare the costs and effects (in terms of life years gained) of providing nutritional...

  8. Symptoms of fatigue and depression in ischemic heart disease are driven by personality characteristics rather than disease stage

    DEFF Research Database (Denmark)

    Smith, Otto R F; Pedersen, Susanne S.; Van Domburg, Ron T;

    2008-01-01

    Symptoms of fatigue and depression are prevalent across stages of ischemic heart disease (IHD). We examined (i) the effect of both the IHD stage and type-D personality on fatigue and depressive symptoms at 12-month follow-up, and (ii) whether the effect of type-D personality on these symptoms...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  10. 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

  11. Mobilization of bone marrow stem cells by G-CSF in patients with chronic ischemic heart disease after revascularization%骨髓干细胞动员结合冠状动脉介入在慢性缺血性心脏病患者中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭士遵; 王宁夫; 叶显华; 周亮; 潘浩; 李虹; 童国新

    2014-01-01

    目的:探究骨髓干细胞动员结合冠状动脉介入(PCI)治疗对慢性缺血性心脏病患者心功能的影响及其安全性。方法收集41例合并有粒细胞减少的慢性缺血性心脏病患者。随机将患者分入对照组和粒细胞集落刺激因子(G- CSF)组。在规范药物治疗和成功进行PCI治疗基础上,G- CSF组接受G- CSF皮下注射。住院及随访期间进行血液学检查、超声心动图检查并进行6min步行试验。结果治疗前两组基线资料、冠状动脉造影以及PCI相关参数差异均无统计学意义(均P>0.05)。在6个月随访时,两组患者缺血节段室壁增厚率、LVEF均较治疗前增加,而Tei指数较治疗前降低(均P<0.05);两组室壁运动评分指数均在随访时得到改善,但与治疗前比较差异无统计学意义,随访变化值差异亦无统计学意义(均P>0.05)。6个月随访时两组LVEDV、Tei指数差异有统计学意义,随访变化值差异亦有统计学意义(均P<0.05)。两组患者6min步行距离的随访变化值无统计学意义(P>0.05)。住院及随访期间两组患者均未出现严重不良心脏事件。结论对慢性缺血性心脏病患者在成功地进行PCI治疗后利用G- CSF进行干细胞动员是安全的,对心功能的改善有一定的积极作用。%Objective To evaluate the efficacy of bone marrow stem cellmobilization by G- CSF in patients with chronic ischemic heart disease (CIHD) after revascularization. Methods Forty one patients with CIHD and granulopenia who had suc-cessful fractional Percutaneous coronary intervention (PCI) were included in the study. Patients were randomized into G- CSF group (G- CSF10μg/kg for 7d) and control group (no G- CSF was given). Patients were fol owed up for 6 months. Results De-mographics, clinical characteristics, and parameter of CAG and PCI were homogeneous between two groups (P>0.05). The wal thickening in severe impaired segment

  12. Ischemic risk stratification by means of multivariate analysis of the heart rate variability

    International Nuclear Information System (INIS)

    In this work, a univariate and multivariate statistical analysis of indexes derived from heart rate variability (HRV) was conducted to stratify patients with ischemic dilated cardiomyopathy (IDC) in cardiac risk groups. Indexes conditional entropy, refined multiscale entropy (RMSE), detrended fluctuation analysis, time and frequency analysis, were applied to the RR interval series (beat-to-beat series), for single and multiscale complexity analysis of the HRV in IDC patients. Also, clinical parameters were considered. Two different end-points after a follow-up of three years were considered: (i) analysis A, with 151 survivor patients as a low risk group and 13 patients that suffered sudden cardiac death as a high risk group; (ii) analysis B, with 192 survivor patients as a low risk group and 30 patients that suffered cardiac mortality as a high risk group. A univariate and multivariate linear discriminant analysis was used as a statistical technique for classifying patients in risk groups. Sensitivity (Sen) and specificity (Spe) were calculated as diagnostic criteria in order to evaluate the performance of the indexes and their linear combinations. Sen and Spe values of 80.0% and 72.9%, respectively, were obtained during daytime by combining one clinical parameter and one index from RMSE, and during nighttime Sen = 80% and Spe = 73.4% were attained by combining one clinical factor and two indexes from RMSE. In particular, relatively long time scales were more relevant for classifying patients into risk groups during nighttime, while during daytime shorter scales performed better. The results suggest that the left atrial size, indexed to body surface and RMSE indexes are those that allow enhanced classification of ischemic patients in their respective risk groups, confirming that a single measurement is not enough to fully characterize ischemic risk patients and the clinical relevance of HRV complexity measures. (paper)

  13. THE EFFECT OF ACUTE MYOCARDIUM ISCHEMIC ON HEART FUNCTION OF PREGNANCY RAT

    Institute of Scientific and Technical Information of China (English)

    Zheng Xiaopu; Ma Aiqun; Niu Changmin; Dong Anping; Han Ke; Liu Yu; Zhang Wei; Geng Tao

    2006-01-01

    Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat.Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myocardial infarction and early pregnant group with acute myocardial infarction. The anterior branch of the left coronary artery was ligated. 3 weeks later, Image 1.31 software was used to measure areas of myocardial infarction,and to evaluate hemodynamics of heart with powerLAB4.12, and cardiac tissues were stained with Massion. Results Compared with unpregnant group with acute myocardial infarction , the early pregnant group with acute myocardial infarction had less myocardial infarction area (28. 86% vs. 36. 8%), and had a higher left ventricle end systolic pressure, ±dp/dt max, and lower left ventricle end diastolic pressure. Massion stain showed the amount of collagen of the lesion was less in the early pregnant group with acute myocardial infarction than that in unpregnant group.Conclusion The early pregnant group with acute myocardial infarction had better heart contractive and diastolic function.

  14. Short-term versus long-term heart rate variability in ischemic cardiomyopathy risk stratification

    Directory of Open Access Journals (Sweden)

    Andreas eVoss

    2013-12-01

    Full Text Available In industrialized countries with aging populations, heart failure affects 0.3%-2% of the general population. The investigation of 24h-ECG recordings revealed the potential of nonlinear indices of heart rate variability (HRV for enhanced risk stratification in patients with ischemic heart failure (IHF. However, long-term analyses are time-consuming, expensive and delay the initial diagnosis. The objective of this study was to investigate whether 30min short-term HRV analysis is sufficient for comparable risk stratification in IHF in comparison to 24h-HRV analysis. From 256 IHF patients (221 at low risk (IHFLR and 35 at high risk (IHFHR a 24h beat-to-beat time series b the first 30min segment c the 30min most stationary day segment and d the 30min most stationary night segment were investigated. We calculated linear (time and frequency domain and nonlinear HRV analysis indices. Optimal parameter sets for risk stratification in IHF were determined for 24 hours and for each 30min segment by applying discriminant analysis on significant clinical and non-clinical indices. Long- and short-term HRV indices from frequency domain and particularly from nonlinear dynamics revealed high univariate significances (p

  15. Cardiac Procedures among American Indians and Alaska Natives compared to Non-Hispanic Whites Hospitalized with Ischemic Heart Disease in California

    OpenAIRE

    Jolly, Stacey; Kao, Chi; Bindman, Andrew B.; Korenbrot, Carol

    2010-01-01

    Background American Indians/Alaska Natives (AIAN) experience a high burden of cardiovascular disease with rates for fatal and nonfatal heart disease approximately twofold higher than the U.S. population. Objective To determine if disparities exist in cardiac procedure rates among AIAN compared to non-Hispanic whites hospitalized in California for ischemic heart disease defined as acute myocardial infarction or unstable angina. Design Cross-sectional study. Events A total of 796 ischemic heart...

  16. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency.

    Science.gov (United States)

    Mehta, Nandita; Gupta, Sunana; Sharma, Atul; Dar, Mohd Reidwan

    2015-01-01

    Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. The goal of anesthetic management in laparoscopic procedures includes management of pneumoperitoneum, achieving an adequate level of sensory blockade without any respiratory compromise, management of shoulder tip pain, provision of adequate postoperative pain relief, and early ambulation. Regional anesthesia fulfills all the aforementioned criteria and aids in quick recovery and thus has been suggested to be a suitable alternative to general anesthesia for laparoscopic surgeries, particularly in patients who are at high risk while under general anesthesia or for patients unwilling to undergo general anesthesia. In conclusion, we report results of successful management with thoracic combined spinal epidural for laparoscopic cholecystectomy of a geriatric patient with ischemic heart disease with chronic obstructive pulmonary disease and renal insufficiency.

  17. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency

    Directory of Open Access Journals (Sweden)

    Mehta N

    2015-12-01

    Full Text Available Nandita Mehta, Sunana Gupta, Atul Sharma, Mohd Reidwan Dar Department of Anesthesiology and Intensive Care, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India Abstract: Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. The goal of anesthetic management in laparoscopic procedures includes management of pneumoperitoneum, achieving an adequate level of sensory blockade without any respiratory compromise, management of shoulder tip pain, provision of adequate postoperative pain relief, and early ambulation. Regional anesthesia fulfills all the aforementioned criteria and aids in quick recovery and thus has been suggested to be a suitable alternative to general anesthesia for laparoscopic surgeries, particularly in patients who are at high risk while under general anesthesia or for patients unwilling to undergo general anesthesia. In conclusion, we report results of successful management with thoracic combined spinal epidural for laparoscopic cholecystectomy of a geriatric patient with ischemic heart disease with chronic obstructive pulmonary disease and renal insufficiency. Keywords: geriatric anesthesia, bupivacaine, segmental anesthesia, laparoscopic surgery

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    OBJECTIVES: This study aimed to investigate whether sedentary work is a distinct risk factor for ischemic heart disease (IHD) when the effect of occupational sitting is disentangled from that of occupational physical activity. METHODS: Data on occupational sitting time and several covariates were...... derived from the Danish Work Environment Cohort Study (DWECS) conducted every five years from 1990-2005 among the active Danish population. This study was designed as a multi-wave longitudinal study including participants employed at entry. Respondents were followed in national registers, first for death...... or hospital treatment due to IHD and second for purchase of medication that may prevent IHD from (re)occurring serving as a proxy for IHD. RESULTS: During 145 850 person-years of follow-up, 510 cases of fatal and non-fatal IHD occurred. After adjustment for age, sex, body mass index (BMI), and socioeconomic...

  19. Lipoprotein(a) and ischemic heart disease-A causal association? A review

    DEFF Research Database (Denmark)

    Kamstrup, P.R.

    2010-01-01

    randomized clinical trials, genetic studies, such as Mendelian randomization studies, can also support claims of causality. Levels of lipoprotein(a) are primarily determined by variation in the LPA gene coding for the apolipoprotein(a) moiety of lipoprotein(a), and genetic epidemiologic studies have......The aim of this review is to summarize present evidence of a causal association of lipoprotein(a) with risk of ischemic heart disease (IHD). Evidence for causality includes reproducible associations of a proposed risk factor with risk of disease in epidemiological studies, evidence from in vitro...... documented association of LPA copy number variants, influencing levels of lipoprotein(a), with risk of IHD. In conclusion, results from epidemiologic, in vitro, animal, and genetic epidemiologic studies support a causal association of lipoprotein(a) with risk of IHD, while results from randomized clinical...

  20. Social network diversity and risks of ischemic heart disease and total mortality

    DEFF Research Database (Denmark)

    Barefoot, John C; Grønbaek, Morten; Jensen, Gorm;

    2005-01-01

    colleagues and children differed by gender. Most types of contacts that occurred at least monthly were just as protective as those occurring more frequently. An index of intimate social contact diversity with family and friends had graded relations with both outcomes. Comparisons of persons reporting three...... or more types of contacts with those reporting fewer types yielded age- and gender-adjusted hazard ratios of 0.73 (95% confidence interval (CI): 0.64, 0.82) for mortality and 0.75 (95% CI: 0.61, 0.91) for ischemic heart disease. Comparable fully adjusted hazard ratios were 0.83 (95% CI: 0.73, 0.95) and 0...

  1. Functional promoter variant in zinc finger protein 202 predicts severe atherosclerosis and ischemic heart disease

    DEFF Research Database (Denmark)

    Frikke-Schmidt, R.; Nordestgaard, Børge; Grande, Peer;

    2008-01-01

    Objectives This study was designed to test the hypotheses that single nucleotide polymorphisms ( SNPs), in zinc finger protein 202 ( ZNF202), predict severe atherosclerosis and ischemic heart disease ( IHD). Background ZNF202 is a transcriptional repressor controlling promoter elements in genes...... involved in vascular maintenance and lipid metabolism. Methods We first determined genotype association for 9 ZNF202 SNPs with severe atherosclerosis ( ankle brachial index >0.7 vs. ...,998 controls. Finally, we determined whether g. -660A>G altered transcriptional activity of the ZNF202 promoter in vitro. Results Cross-sectionally, ZNF202 g. -660 GG versus AA homozygosity predicted an odds ratio for severe atherosclerosis of 2.01 ( 95% confidence interval [CI]: 1.34 to 3.01). Prospectively...

  2. IMMUNOLOGIC INDICES IN GERONTOLOGICAL PATIENTS WITH ISCHEMIC HEART DESEASE AND URINARY SYSTEM PATHOLOGY

    Directory of Open Access Journals (Sweden)

    G.V. Korschunov

    2009-09-01

    Full Text Available Patients of middle and old age with ischemic heart desease and diseases of urinary system (DUS have been examined. Leukocytic index of intoxication (Lll, hematologic parameter of intoxication (HPI, parameter of immunity intensity (Pll have been significantly increased in groups of patients with benign prostatic hyperplasia, diabetes and DUS. These indices have been directly correlated with content of IL6 and TNFa, and examined autoantibodies (AAb, especially with contents of antibodies to DNA, to collagen, to fiber-regulator of differentiation and migration immature neuroblast S100. Indices of Lll, HPI and Pll have been decreased in group of patients with normal body weight and urolithiasis. In this group the increase of allergization index (Al and content of IL6, TNFa has been noticed. Indices of AAb pointed to metabolic disorders. The increase of cytokines in patients with pyelonephritis has been revealed. Content of AAb has been slightly increased in comparison with normal indices

  3. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

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    Vardosanidze S.L.

    2010-12-01

    Full Text Available 158 patients with ischemic heart disease (IHD have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients received clinical way method of treatment. Patients of the comparison group (40 patients after provided treatment were cared by their local therapeutists (cardiologists. The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-patient conditions enabled to raise patient motivation to treatment, thereby assisting them to feel better, promoting normalization of arterial pressure data. The research results stated that clinical way method of treatment may be considered as rational and effective

  4. The predictive value of fatigue for nonfatal ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Ekmann, Anette; Osler, Merete; Avlund, Kirsten

    2012-01-01

    Objective To investigate whether fatigue predicts nonfatal ischemic heart disease (IHD) and all-cause mortality in middle-aged men. Methods The study population consisted of 5216 middle-aged men born in the Copenhagen metropolitan area in 1953. At baseline, men free of angina pectoris and previou...... is a potential risk indicator for IHD and mortality. Further research is needed to establish the role of smoking and other life-style characteristics.......% confidence interval [CI] = 1.09-3.61) and all-cause mortality (HR = 3.99, 95% CI = 2.27-7.02). These associations became nonsignificant in multivariable-adjusted models (HR = 1.57, 95% CI = 0.82-3.01 and HR = 1.90, 95% CI = 0.95-3.80). Imputation of missing data did not modify conclusions. Fatigue...

  5. Roles of Chinese herbal medicines in ischemic heart diseases (IHD) by regulating oxidative stress.

    Science.gov (United States)

    Wang, Dawei; Wang, Jin; Liu, Yuntao; Zhao, Zhen; Liu, Qing

    2016-10-01

    Ischemic heart disease (IHD) basing on atherosclerosis (AS) is known as a top killer for decades. Oxidative stress, representing excessive oxidation and insufficient elimination, has been proved to be a critical molecular mechanism of IHD and accompanying myocardium dysfunction. Therefore, anti-oxidation therapy may be efficient. Chinese herbal medicine, including extractive compounds, decoctions, patent drugs, and injections, has shown its enormous potential in prevention and treatment of IHD as an effective antioxidant in experimental studies. The aim of this review is to highlight recent studies of Chinese herbal medicine in regulating oxidative stress in IHD. These studies represent recent progress of IHD treatment and indicate the possible pathways and target spots of Chinese herbal medicine. PMID:27390948

  6. Myocardial Infarction and Ischemic Heart Disease in Overweight and Obesity With and Without Metabolic Syndrome

    DEFF Research Database (Denmark)

    Thomsen, Mette; Nordestgaard, Børge G

    2014-01-01

    IMPORTANCE: Overweight and obesity likely cause myocardial infarction (MI) and ischemic heart disease (IHD); however, whether coexisting metabolic syndrome is a necessary condition is unknown. OBJECTIVE: To test the hypothesis that overweight and obesity with and without metabolic syndrome...... syndrome. MAIN OUTCOMES AND MEASURES: Hazard ratios for incident MI and IHD according to combinations of BMI category and absence or presence of metabolic syndrome. RESULTS: During a median of 3.6 years' follow-up, we recorded 634 incident MI and 1781 incident IHD events. For MI, multivariable adjusted...... hazard ratios vs normal weight individuals without metabolic syndrome were 1.26 (95% CI, 1.00-1.61) in overweight and 1.88 (95% CI, 1.34-2.63) in obese individuals without metabolic syndrome and 1.39 (95% CI, 0.96-2.02) in normal weight, 1.70 (95% CI, 1.35-2.15) in overweight, and 2.33 (95% CI, 1...

  7. Cell Therapy in Ischemic Heart Disease: Interventions That Modulate Cardiac Regeneration

    Directory of Open Access Journals (Sweden)

    Maximiliano I. Schaun

    2016-01-01

    Full Text Available The incidence of severe ischemic heart disease caused by coronary obstruction has progressively increased. Alternative forms of treatment have been studied in an attempt to regenerate myocardial tissue, induce angiogenesis, and improve clinical conditions. In this context, cell therapy has emerged as a promising alternative using cells with regenerative potential, focusing on the release of paracrine and autocrine factors that contribute to cell survival, angiogenesis, and tissue remodeling. Evidence of the safety, feasibility, and potential effectiveness of cell therapy has emerged from several clinical trials using different lineages of adult stem cells. The clinical benefit, however, is not yet well established. In this review, we discuss the therapeutic potential of cell therapy in terms of regenerative and angiogenic capacity after myocardial ischemia. In addition, we addressed nonpharmacological interventions that may influence this therapeutic practice, such as diet and physical training. This review brings together current data on pharmacological and nonpharmacological approaches to improve cell homing and cardiac repair.

  8. Increased expression of vascular endothelin type B and angiotensin type 1 receptors in patients with ischemic heart disease

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    Malmsjö Malin

    2009-08-01

    Full Text Available Abstract Background Endothelin-1 and angiotensin II are strong vasoconstrictors. Patients with ischemic heart disease have elevated plasma levels of endothelin-1 and angiotensin II and show increased vascular tone. The aim of the present study was to examine the endothelin and angiotensin II receptor expression in subcutaneous arteries from patients with different degrees of ischemic heart disease. Methods Subcutaneous arteries were obtained, by biopsy from the abdomen, from patients undergoing coronary artery bypass graft (CABG surgery because of ischemic heart disease (n = 15, patients with angina pectoris without established myocardial infarction (n = 15 and matched cardiovascular healthy controls (n = 15. Endothelin type A (ETA and type B (ETB, and angiotensin type 1 (AT1 and type 2 (AT2 receptors expression and function were examined using immunohistochemistry, Western blot and in vitro pharmacology. Results ETA and, to a lesser extent, ETB receptor staining was observed in the healthy vascular smooth muscle cells. The level of ETB receptor expression was higher in patients undergoing CABG surgery (250% ± 23%; P B receptor agonist sarafotoxin S6c, compared to healthy controls (P A receptors. AT1 and, to a lesser extent, AT2 receptor immunostaining was seen in the vascular smooth muscle cells. The level of AT1 receptor expression was higher in both the angina pectoris (128% ± 25%; P 1 receptor expression was confirmed by Western blotting. Myograph experiment did however not show any change in vasoconstriction to angiotensin II in CABG patients compared to healthy controls (P = n.s. Conclusion The results demonstrate, for the first time, upregulation of ETB and AT1 receptors in vascular smooth muscle cells in ischemic heart disease. These receptors may play a role in the pathophysiology of ischemic heart disease and could provide important targets for pharmaceutical interventions.

  9. Ischemic heart disease and primary care: identifying gender-related differences. An observational study

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    Real Jordi

    2008-10-01

    Full Text Available Abstract Background Gender-related differences are seen in multiple aspects of both health and illness. Ischemic heart disease (IHD is a pathology in which diagnostic, treatment and prognostic differences are seen between sexes, especially in the acute phase and in the hospital setting. The objective of the present study is to analyze whether there are differences between men and women when examining associated cardiovascular risk factors and secondary pharmacological prevention in the primary care setting. Methods Retrospective descriptive observational study from January to December of 2006, including 1907 patients diagnosed with ischemic heart disease in the city of Lleida, Spain. The clinical data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies with official prescriptions. Data was analyzed using bivariate descriptive statistical analysis as well as logistic regression. Results There were no gender-related differences in screening percentages for arterial hypertension, diabetes, obesity, dyslipemia, and smoking. A greater percentage of women were hypertensive, obese and diabetic compared to men. However, men showed a tendency to achieve control targets more easily than women, with no statistically significant differences. In both sexes cardiovascular risk factors control was inadequate, between 10 and 50%. For secondary pharmaceutical prevention, the percentages of prescriptions were greater in men for anticoagulants, beta-blockers, lipid-lowering agents and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, with age group variations up to 10%. When adjusting by age and specific diagnoses, differences were maintained for anticoagulants and lipid-lowering agents. Conclusion Screening of cardiovascular risk factors was similar in men and women with IHD. Although a greater percentage of women were hypertensive, diabetic or obese, their management of risk

  10. Effects of moderate aerobic exercise training on hemorheological and laboratory parameters in ischemic heart disease patients.

    Directory of Open Access Journals (Sweden)

    Barbara Sandor

    Full Text Available BACKGROUND AND DESIGN: In this study we set out to determine the effects of long-term physical training on hemorheological, laboratory parameters, exercise tolerability, psychological factors in cardiac patients participating in an ambulatory rehabilitation program. METHODS: Before physical training, patients were examined by echocardiography, tested on treadmill by the Bruce protocol, and blood was drawn for laboratory tests. The enrolled 79 ischemic heart disease patients joined a 24-week cardiac rehabilitation training program. Blood was drawn to measure hematocrit (Hct, plasma and whole blood viscosity (PV, WBV, red blood cell (RBC aggregation and deformability. Hemorheological, clinical chemistry and psychological measurements were repeated 12 and 24 weeks later, and a treadmill test was performed at the end of the program. RESULTS: After 12 weeks Hct, PV, WBV and RBC aggregation were significantly decreased, RBC deformability exhibited a significant increase (p<0.05. Laboratory parameters (triglyceride, uric acid, hsCRP and fibrinogen were significantly decreased (p<0.05. After 24 weeks the significant results were still observed. By the end of the study, IL-6 and TNF-α levels displayed decreasing trends (p<0.06. There was a significant improvement in MET (p<0.001, and the BMI decrease was also significant (p<0.05. The vital exhaustion parameters measured on the fatigue impact scale indicated a significant improvement in two areas of the daily activities (p<0.05. CONCLUSIONS: Regular physical training improved the exercise tolerability of patients with ischemic heart disease. Previous publications have demonstrated that decreases in Hct and PV may reduce cardiovascular risk, while a decrease in RBC aggregation and an increase in deformability improve the capillary flow. Positive changes in laboratory parameters and body weight may indicate better oxidative and inflammatory circumstances and an improved metabolic state. The psychological

  11. Anemia associated with chronic heart failure: current concepts

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    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

  12. Metformin in patients with ischemic heart disease and type 2 diabetes mellitus: mechanism of action and clinical efficiency

    Directory of Open Access Journals (Sweden)

    E N Kravchuk

    2013-03-01

    Full Text Available Diabetes mellitus is one of the leading causes of death in modern society, primarily due to its cardiovascular complications. This factor drives search for novel pharmacologic agents to affect not only glycemic levels, but also the cardiovascular prognosis in diabetic patients with ischemic heart disease. Recent studies demonstrate that aside from basic blood glucose lowering action, metformin shows beneficial influence on blood rheology and vascular tone, hemostasis, oxidative stress, lipid spectrum and delivers and an ant-ischemic effect. Here we review clinical and experimental evidence on cardio- and vasoprotective effects of metformin, highlighting their molecular mechanisms.

  13. Advanced Imaging and Diagnostic Methods in the Assessment of Suspected Ischemic Heart Disease in Women.

    Science.gov (United States)

    Joly, Joanna M; Bittner, Vera

    2016-09-01

    Although differences diminish with age, outcomes are overall worse for women compared to men who present with suspected acute coronary syndrome. The reasons for this discrepancy are multifactorial, including sex-related differences in atherosclerosis biology and fluid dynamics, as well as a premature conclusion by providers that chest pain must be noncardiac in the absence of obstructive coronary artery disease. In this review of existing literature, we explore the diverse differential diagnosis in this unique set of patients. Especially in women with persistent symptoms, absence of occlusive disease should prompt consideration for subangiographic plaque disruption, epicardial or microvascular endothelial dysfunction, transient neurohormonal imbalance predisposing to Takotsubo cardiomyopathy or spontaneous coronary artery dissection, underlying systemic inflammatory conditions, thromboembolic disease, myocarditis, and sequelae of congenital heart disease. As always, a thorough history and attentive physical exam will help guide further work-up, which in many cases may warrant noninvasive imaging, such as contrast-enhanced echocardiography, cardiac magnetic resonance imaging, or positron emission tomography, with their respective means of measuring myocardial perfusion and myocardial tissue pathology. Lastly, intracoronary imaging such as intravascular ultrasound and optical coherence tomography and invasive diagnostic methods such as coronary reactivity testing continue to add to our understanding that what appear to be atypical presentations of ischemic heart disease in women may in fact be typical presentations of pathologic cousin entities that remain incompletely defined. PMID:27443380

  14. Optimal Cardiac Resynchronization Therapy Pacing Rate in Non-Ischemic Heart Failure Patients

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Sander, Mikael; Køber, Lars;

    2015-01-01

    patients with non-ischemic heart failure (NYHA class II-III) were enrolled in a randomized, double-blind, crossover trial, in which the basal pacing rate was set at DDD-60 and DDD-80 for 3 months (DDD-R for 2 patients). At baseline, 3 months and 6 months, we assessed sympathetic nerve activity...... by microneurography (MSNA), peak oxygen consumption (pVO2), N-terminal pro-brain natriuretic peptide (p-NT-proBNP), echocardiography and QoL. RESULTS: DDD-80 pacing for 3 months increased the mean heart rate from 77.3 to 86.1 (p = 0.001) and reduced sympathetic activity compared to DDD-60 (51±14 bursts/100 cardiac...... cycles vs. 64±14 bursts/100 cardiac cycles, pDDD-60 to 16.7±6 mL/min/kg during DDD-80, and p-NT-proBNP remained unchanged. The QoL score indicated that DDD-60 was better tolerated. CONCLUSION: In CRT patients with non...

  15. Ischemic heart disease,factor predisposing to Barrett’s adenocarcinoma: A case control study

    Institute of Scientific and Technical Information of China (English)

    Panagiotis; Tsibouris; Mark; T; Hendrickse; Panagiota; Mavrogianni; Peter; ET; Isaacs

    2014-01-01

    AIM:To define the significance of ischemic heart disease(IHD)(stable angina to infarction) co-existance in Barrett esophagus(BE) patients and patients with esophageal adenocarcinoma(AdE).METHODS: All BE/AdE patients in Blackpool-Wyre-Fylde area and Trikala prefecture identified from medical records. Patient clinical details were obtained from hospital and General Practitioner records. Additional information was gathered from validated questionnaire.RESULTS: Forty(33%) AdE and 83(19%) BE patients had IHD(P = 0.002). Eighteen(15%) AdE and 34(8%) BE patients had suffered a myocardial infarction(P = 0.03). Three(3%) AdE and 7(2%) BE patients had severe heart failure(P = 0.82). Thirty-nine(47%) BE with IHD and 8(20%) AdE patients with IHD consumed aspirin daily(P = 0.004). Seventh-seven(93%) BE patients with IHD and 36(90%) AdE patients with IHD were on statins(P = 0.86). Logistic regression analysis: AdE was more frequent in the elderly,with long termreflux,long BE and concurrent IHD(odds ratio: 2.086,P = 0.001) not consuming statins. Eighteen(22%) BE patients with IHD [16(84%) with myocardial infarction] vs 33(10%) without IHD died from non-neoplastic causes within 24 mo from BE diagnosis(P = 0.005). CONCLUSION: IHD is more prevalent in AdE than BE patients. Increased prevalence of AdE is related with the presence of myocardial infarction but not severe heart failure,possibly because patients with BE and se-vere IHD have low life expectancy.

  16. 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

  17. Left ventricular dysfunction in ischemic heart disease: fundamental importance of the fibrous matrix.

    Science.gov (United States)

    Swan, H J

    1994-05-01

    The contractile function of the myocardium is coordinated by a fibrous matrix of exquisite organization and complexity. In the normal heart, and apparently in physiological hypertrophy, this matrix is submicroscopic. In pathological states changes are frequent, and usually progressive. Thickening of the many elements of the fine structure is due to an increased synthesis of Type I collagen, This change, which affects the myocardium in a global manner, can be observed by light microscopy using special techniques. Perivascular fibrosis, with an increase in vascular smooth muscle, is accompanied by development of fibrous septa, with a decrease in diastolic compliance. These structural changes are believed to be due to increased activation of the renin-angiotensin-aldosterone system, and to be independent of the processes of myocyte hypertrophy. Reparative or replacement fibrosis is a separate process by means of which small and large areas of necrosis heal, with the development of coarse collagen structures, which lack a specific organizational pattern. Regarding ischemic heart disease, an increase in tissue collagenase is found in experimental myocardial "stunning" and in the very early phase of acute infarction. Absence of elements of the fibrous matrix allow for myocyte slippage, and--if the affected area is large--cardiac dilatation. If, subsequently, the necrosis becomes transmural, there is further disturbance of collagen due to both mechanical strain and continued autolysis, During healing collagen synthesis increases greatly to allow for reparative scarring in the available tissue matrix. In cases of infarction with moderate or severe initial dilatation, pathological hypertrophy of the spared myocardium is progressive, accounting for late heart failure and poor survival.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Effects of denopamine with or without diltiazem on the ischemic heart of anesthetized dogs.

    Science.gov (United States)

    Chibana, T; Noguchi, K; Ojiri, Y; Matsuzaki, T; Nakasone, J; Uezu, K; Itomine, T; Higuchi, M; Sakanashi, M

    1992-11-01

    Effects of denopamine with or without diltiazem on the ischemic heart were investigated in anesthetized open-chest dogs. Partial occlusion of the left circumflex coronary artery (LCX) produced significant decreases in LCX flow and regional myocardial segment shortening rate (%SS) in the LCX-perfused area, and a significant increase in left ventricular enddiastolic pressure (LVEDP). Heart rate (HR) and mean aortic pressure (mAoP) were not altered, but aortic flow (AoF), positive first derivative of left ventricular pressure ((+)LVdP/dt), stroke volume (SV), stroke work index (SWI) and double product showed a tendency to decrease. Total peripheral vascular resistance (TPR) tended to increase. During coronary stenosis, saline infusion (vehicle group) did not change any parameter, but diltiazem infusion (diltiazem group) decreased HR, mAoP, TPR and double product and increased SV and SWI. Under these conditions, denopamine infusion produced increases in HR, mAoP, AoF, (+)LVdP/dt and double product and decreases in LVEDP and TPR in both groups. %SS in the left anterior descending coronary artery-perfused area was increased, but %SS in the LCX-perfused area was slightly decreased in both groups. SV and SWI were decreased by denopamine infusion in the vehicle group, while they were increased in the diltiazem group. Differences in changes in SV and SWI between the groups were statistically significant. Results suggest that combined treatment of denopamine and diltiazem may exert an advantage in alleviation of heart failure due to coronary stenosis. PMID:1363733

  19. Multiscale Entropy of the Heart Rate Variability for the Prediction of an Ischemic Stroke in Patients with Permanent Atrial Fibrillation.

    Directory of Open Access Journals (Sweden)

    Eiichi Watanabe

    Full Text Available Atrial fibrillation (AF is a significant risk factor for ischemic strokes, and making a robust risk stratification scheme would be important. Few studies have examined whether nonlinear dynamics of the heart rate could predict ischemic strokes in AF. We examined whether a novel complexity measurement of the heart rate variability called multiscale entropy (MSE was a useful risk stratification measure of ischemic strokes in patients with permanent AF.We examined 173 consecutive patients (age 69 ± 11 years with permanent AF who underwent 24-hour Holter electrocardiography from April 2005 to December 2006. We assessed several frequency ranges of the MSE and CHA2DS2-VASc score (1 point for congestive heart failure, hypertension, diabetes, vascular disease, an age 65 to 74 years, and a female sex and 2 points for an age ≥ 75 years and a stroke or transient ischemic attack. We found 22 (13% incident ischemic strokes during a mean follow up of 3.8-years. The average value of the MSE in the very-low frequency subrange (90-300 s, MeanEnVLF2 was significantly higher in patients who developed ischemic strokes than in those who did not (0.68 ± 0.15 vs. 0.60±0.14, P<0.01. There was no significant difference in the C-statistic between the CHA2DS2-VASc score and MeanEnVLF2 (0.56; 95% confidence interval, 0.43-0.69 vs. 0.66; 95% confidence interval, 0.53-0.79. After an adjustment for the age, CHA2DS2-VASc score, and antithrombotic agent, a Cox hazard regression model revealed that the MeanEnVLF2 was an independent predictor of an ischemic stroke (hazard ratio per 1-SD increment, 1.80; 95% confidence interval, 1.17-2.07, P<0.01.The MeanEnVLF2 in 24-hour Holter electrocardiography is a useful risk stratification measure of ischemic strokes during the long-term follow-up in patients with permanent AF.

  20. Methylenetetrahydrofolate reductase polymorphism (C677T), hyperhomocysteinemia, and risk of ischemic cardiovascular disease and venous thromboembolism: prospective and case-control studies from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Frederiksen, Jeppe; Juul, Klaus; Grande, Peer;

    2004-01-01

    for sex, age, cholesterol, high-density lipoprotein cholesterol, lipoprotein(a), fibrinogen, triglycerides, body mass index, smoking, diabetes mellitus, hypertension, and factor V Leiden genotype. Finally, in case-control studies odds ratios for ischemic heart disease and ischemic cerebrovascular disease...

  1. Atrial Fibrillation Following Surgical Management of Ischemic Heart Disease; One Year, Single Center, Single Surgeon Results

    Directory of Open Access Journals (Sweden)

    Ahmet Barış Durukan

    2012-08-01

    Full Text Available Introduction: Postoperative atrial fibrillation is the most common arrhythmia following bypasssurgery with significant morbidity, mortality and increased healthcare costs. The aim of this studyis to determine the incidence and timing of atrial fibrillation, identify the risk factors coveringpreoperative and intraoperative periods, evaluate rate of return to sinus rhythm by disharge, andexplore the impact on postoperative outcomes in a large group of patients operated in a singlecenter by a single surgeon.Patients and Methods: Between January 2011 and January 2012, 418 patients on preoperativesinus rhythm were operated for ischemic heart disease and associated complications (left ventricleaneurysm repair and ischemic mitral insufficiency in a single center, by a single surgeon.The preoperative, intraoperative and postoperative variables were studied.Results: The mean age of the patients were 61.92 ± 10.05, and 77.5% were male. Atrial fibrillationdeveloped in 68 (16.3% patients. The incidence peaked at second day. Patients with atrialfibrillation were older (p< 0.001. Gender, preoperative comorbidities, ejection fraction, left atrialdiameter, preoperative beta-blocker use, leukocyte count, type of operation and intraoperativevariables did not affect its occurence. Intensive care unit and hospital length of stay were longer(p< 0.05. 95.5% (n= 65 of patients were in normal sinus rhythm at discharge.Conclusion: Postoperative atrial fibrillation is a popular subject with unknowns and controversialresults which may lead to wrong interpretations. We believe that every center has its own risk factors related with the population of that region. Discussion will last, but simple precautions and close monitoring will help to minimizeadverse outcomes.

  2. PROTHROMBOTIC POLYMORPHISMS AND LONG-TERM PROGNOSIS OF PATIENTS WITH STABLE ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. L. Komarov

    2011-01-01

    Full Text Available Aim. To estimate influence of thrombosis associated genetic factors on cardiovascular complications (CVC occurrence in patients with stable ischemic heart disease (IHD on the base of 5-year prospective survey. Material and methods. A total of 503 patients with the mean age of 59.4 years were enrolled into the study. The follow-up period was 5.4 years. Composite endpoint included the following cases of fatal and nonfatal CVC: death, acute coronary syndrome, ischemic stroke/transient ischemic attack, peripheral arterial thrombosis and revascularization of affected vascular system. We determined prevalence and prognostic value of mutations and polymorphisms in genes that encode blood clotting factors (factor V Leiden G1691A, prothrombin G20210A, ß-fibrinogen 455G> A, platelet GPIIIa receptor (C1565T and enzymes involved in homocysteine metabolism (methylentetrahydrofolate reductase  (C667 T MTHFR and A1298C, methionine synthase (MTR A2756G, methionine synthase-reductase (MTRR A66G and transcobalamin (TCN C776G. Results. Overall incidence rate of vascular events made up 31.0%. MTHFR and TCN polymorphisms proved to be significant in regard to cardiovascular risk among all studied genetic indices. Carriage of at least C667 T one MTHFR polymorphic allele increased risk of CVC 1.64 times (95% confidence interval (CI 1.2-2.3, p=0.003. Homozygous carriage of MTHFR 1298 AА and TCN 776 СС “wild” genotypes increased risk of CVC 1.63 times (95% CI 1.2-2.3, р=0.006 and 1.37 times (95% CI 1.001-1.89, р=0.04, respectively. Such genetic variants as MTHFR C667 T/СТ and 1298 AА impacted prognosis only given concomitant decrease in plasma folate level, which was observed in 56.1% of the patients. Conclusion. It can be recommended to test the presence of MTHFR C667 T, MTHFR 1298 AА and TCN 776 СС, and to simultaneously assess folate level in IHD patients in order to clarify risk of unfavorable cardiovascular events.

  3. Association of β-Blocker Therapy With Risks of Adverse Cardiovascular Events and Deaths in Patients With Ischemic Heart Disease Undergoing Noncardiac Surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Mérie, Charlotte; Jørgensen, Mads Wissenberg;

    2014-01-01

    , ischemic stroke, cardiovascular death, and all-cause death). OBJECTIVE: To assess the association of β-blocker treatment with major cardiovascular adverse events (MACE) and all-cause mortality in patients with ischemic heart disease undergoing noncardiac surgery. DESIGN, SETTING, PARTICIPANTS, AND EXPOSURE......: Individuals with ischemic heart disease with or without heart failure (HF) and with and without a history of myocardial infarction undergoing noncardiac surgery between October 24, 2004, and December 31, 2009, were identified from nationwide Danish registries. Adjusted Cox regression models were used...... myocardial infarction), but with no significant association in the remaining patients. Results were similar in propensity score-matched analyses. CONCLUSIONS AND RELEVANCE: Among patients with ischemic heart disease undergoing noncardiac surgery, use of β-blockers was associated with lower risk of 30-day...

  4. MORTALITY FROM DIABETES MELLITUS (TYPE 2) AND ISCHEMIC HEART DISEASE IN FOUR U.S. WHEAT-PRODUCING STATES: A HYPOTHESIS

    Science.gov (United States)

    In this ecologic study we examined ischemic heart disease (IHD) and diabetes mortality in rural agricultural counties of Minnesota, Montana, North Dakota, and South Dakota, in association with environmental exposure to chlorophenoxy herbicides, using wheat acreage as a surrogate ...

  5. Sex-dependent effects of chronic psychosocial stress on myocardial sensitivity to ischemic injury.

    Science.gov (United States)

    Rorabaugh, Boyd R; Krivenko, Anna; Eisenmann, Eric D; Bui, Albert D; Seeley, Sarah; Fry, Megan E; Lawson, Joseph D; Stoner, Lauren E; Johnson, Brandon L; Zoladz, Phillip R

    2015-01-01

    Individuals with post-traumatic stress disorder (PTSD) experience many debilitating symptoms, including intrusive memories, persistent anxiety and avoidance of trauma-related cues. PTSD also results in numerous physiological complications, including increased risk for cardiovascular disease (CVD). However, characterization of PTSD-induced cardiovascular alterations is lacking, especially in preclinical models of the disorder. Thus, we examined the impact of a psychosocial predator-based animal model of PTSD on myocardial sensitivity to ischemic injury. Male and female Sprague-Dawley rats were exposed to psychosocial stress or control conditions for 31 days. Stressed rats were given two cat exposures, separated by a period of 10 days, and were subjected to daily social instability throughout the paradigm. Control rats were handled daily for the duration of the experiment. Rats were tested on the elevated plus maze (EPM) on day 32, and hearts were isolated on day 33 and subjected to 20 min ischemia and 2 h reperfusion on a Langendorff isolated heart system. Stressed male and female rats gained less body weight relative to controls, but only stressed males exhibited increased anxiety on the EPM. Male, but not female, rats exposed to psychosocial stress exhibited significantly larger infarcts and attenuated post-ischemic recovery of contractile function compared to controls. Our data demonstrate that predator stress combined with daily social instability sex-dependently increases myocardial sensitivity to ischemic injury. Thus, this manipulation may be useful for studying potential mechanisms underlying cardiovascular alterations in PTSD, as well as sex differences in the cardiovascular stress response.

  6. Morbidity from ischemic heart disease in workers at a stainless steel welding factory

    Directory of Open Access Journals (Sweden)

    Bjørn Hilt

    2009-10-01

    Full Text Available  ABSTRACTObjectives:  Methods:  Results:  Conclusion:  Key terms:  Angina pectoris, cardiovascular diseases, grinding, ischemic heart disease, metal workers,myocardial infarction, stainless steel, weldingIn accord with some other studies, the results of the study support a hypothesis that there maybe a relation between exposure factors to which stainless steel metal workers are exposed and an increasedrisk of ischemic heart disease.There were 236 men from the study group and 989 men from the control group who fulfilled theinclusion criteria, and who answered the questionnaires. The bivariate analysis showed that the study grouphad an increased age and smoking adjusted prevalence of "chest pain on exercise" and "angina pectoris"with ratios 2.3 (95% CI 1.5–4.9 and 2.6 (95% 1.2–5.7 respectively. When using multiple logistic regressionanalysis with control for potential confounding factors, the odds ratios for the study group as comparedto the control group, were 2.6 (95% CI 1.3–5.3 for "chest pain on exercise", 2.5 (95% CI 1.1–5.8 for"angina pectoris", and 2.4 (95% CI 1.1–4.9 for myocardial infarction. The only explanatory variable whichshowed statistically significant increased odds ratios for all three outcome variables was work with grinding,with 2.4 (95% CI 1.0–5.5, 3.3 (1.3–8.5, and 2.5 (1.1–5.9 respectively.All the men who had worked at the plant for more than one year since 1960, and who were underthe age of 70 years at the time of the study, were included in the study group. The control group wasrandomly selected from the male population of the same town, and was categorically matched for age. A selfadministered questionnaire was used to collect information on the occurrence of CVD and related symptoms,background variables, and exposure factors. The validity of the outcome variables for a subgroup ofthe participants was checked with their appointed general practitioners. This validation revealed a low

  7. Diurnal Changes of Heart Rate and Sympathovagal Activity for Temporal Patterns of Transient Ischemic Episodes in 24-Hour Electrocardiograms

    Directory of Open Access Journals (Sweden)

    F. Jager

    2007-01-01

    Full Text Available We test the hypothesis that different temporal patterns of transient ST segment changes compatible with ischemia (ischemic episodes are a result of different physiologic mechanisms responsible for ischemia. We tested the hypothesis using records of the Long-Term ST Database. Each record was divided into three intervals of records: morning, day, and night intervals; and was inserted into one of three sets according to the temporal pattern of ischemia: salvo, periodic, and sporadic pattern. We derived time- and frequency-domain parameters of the heart rate time series in selected intervals in the neighborhood of ischemic episodes. We used the adaptive autoregressive method with a recursive least-square algorithm for consistent spectral tracking of heart rate time series and to study frequency-domain sympathovagal behavior during ischemia. The results support the hypothesis that there are at least two distinct populations, which differ according to mechanisms and temporal patterns of ischemia.

  8. Impact of myocardial ischemia on myocardial revascularization in stable ischemic heart disease. Lessons from the COURAGE and FAME 2 trials.

    Science.gov (United States)

    Torosoff, M T; Sidhu, M S; Boden, W E

    2013-06-01

    In patients with stable ischemic heart disease (SIHD), myocardial revascularization should be performed to either improve survival or improve symptoms and functional status among patients who are not well controlled with optimal medical therapy (OMT). A general consensus exists on the core elements of OMT, which include both lifestyle intervention and intensive secondary prevention with proven pharmacotherapies. By contrast, however, there is less general agreement as to what constitutes the optimal approach to revascularization in SIHD patients. The COURAGE and FAME 2 randomized trials form the foundation of the current clinical evidence base and raise the important question: "What is the impact of myocardial ischemia on myocardial revascularization in stable ischemic heart disease?" PMID:23695652

  9. [Structural and functional changes of external and intracranial arteries in elderly patients of different ethnic groups with ischemic heart disease].

    Science.gov (United States)

    Fedorets, V N; Abramov, E A; Bartosh-Zelenaia, S Iu; Naĭden, T V

    2014-01-01

    The present article discusses the problem of structural and functional changes in extra-and intracranial arteries in elderly patients with ischemic heart disease (CHD) belonging to different ethnic groups before the upcoming coronary arteriography research and planned operative intervention. We examined 120 elderly patients with ischemic heart disease, including 50 patients of Korean nationality and 70 patients of Slavic ethnicity. Average values of IMT of the right and left CCA patients of South Asian group were significantly lower than those of Slavic ethnicity. Elderly patients with CHD the violation of cerebral circulation were due to atherosclerotic lesions of the extracranial vessels and local hemodynamic disturbances in their area of pathological tortuosity. Korean ethnicity elderly patients with CHD were observed more pronounced signs of stenosis and deformation of the main arteries of the neck, as well as lower collateral reserve of cerebral circulation.

  10. Influence of Psychosocial Work-Related Factors on Conventional Risk Factors of Ischemic Heart Disease and Homocysteine in Slovenian Male Workers

    OpenAIRE

    Ratkajec, Tihomir; Bilban, Marjan; Starc, Radovan

    2008-01-01

    The influence of psychosocial work-related factors on the conventional risk factors of ischemic heart disease (IHD), particularly on the lipid changes and their effect on homocysteine is studied in this paper. Employed males aged 35 to 55 with angina pectoris or a myocardial infarction (IHD group) were compared to a group of individuals without ischemic heart disease (Control Group). Psychosocial factors were assessed using a Swedish Theorell questionnaire. The IHD Group was found...

  11. PCSK9 R46L, low-density lipoprotein cholesterol levels, and risk of ischemic heart disease: 3 independent studies and meta-analyses

    DEFF Research Database (Denmark)

    2010-01-01

    The aim of this study was to examine the effect of PCSK9 R46L on low-density lipoprotein cholesterol (LDL-C), risk of ischemic heart disease (IHD), and mortality.......The aim of this study was to examine the effect of PCSK9 R46L on low-density lipoprotein cholesterol (LDL-C), risk of ischemic heart disease (IHD), and mortality....

  12. Genetically determined high serum levels of mannose-binding lectin and agalactosyl IgG are associated with ischemic heart disease in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Troelsen, Lone N; Garred, Peter; Madsen, Hans O.;

    2007-01-01

    Patients with rheumatoid arthritis (RA) have excess morbidity and mortality due to ischemic heart disease. It has been suggested that high serum levels of mannose-binding lectin (MBL) and agalactosyl IgG (IgG-G0) are associated with increased inflammation in RA. MBL also enhances inflammation......-mediated tissue injury during postischemic reperfusion. This study was undertaken to examine whether these factors are associated with increased risk of ischemic heart disease in RA....

  13. Variations in the development of ischemic heart disease in women, viewed in relation to selected personality features

    OpenAIRE

    Nasiłowska-Barud, Alicja

    2016-01-01

    The aim of this paper is to characterize some personality traits of women with ischemic heart disease, in order to (a) determine their relationship to activity and inactivity, and (b) define the implications of that relationship for ways of coping with coronary pain. The study comprised N = 100 women aged 33 to 80 years (M = 60:36; SD = 9:55), hospitalized in the Department of Cardiology, who underwent angiography for the assessment of coronary arteries. Psychological studies have been conduc...

  14. A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease.

    OpenAIRE

    Ahrén Bo; Erlanson-Albertsson Charlotte; Granfeldt Yvonne; Jönsson Tommy; Lindeberg Staffan

    2010-01-01

    Abstract Background We found marked improvement of glucose tolerance and lower dietary energy intake in ischemic heart disease (IHD) patients after advice to follow a Paleolithic diet, as compared to a Mediterranean-like diet. We now report findings on subjective ratings of satiety at meals and data on the satiety hormone leptin and the soluble leptin receptor from the same study. Methods Twenty-nine male IHD patients with impaired glucose tolerance or diabetes type 2, and waist circumference...

  15. 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

  16. 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...

  17. Complement activation, endothelial dysfunction, insulin resistance and chronic heart failure

    DEFF Research Database (Denmark)

    Bjerre, M.; Kistorp, C.; Hansen, T.K.;

    2010-01-01

    Objectives. Patients with chronic heart failure (CHF) have an exaggerated immune response, endothelial damage/dysfunction, and increased risk of diabetes mellitus (DM). The inter-relationship(s) between indices of complement activation (soluble membrane attack complex, sMAC), inflammation (hs......, IR was an independent predictor of sMAC in the CHF group beta = 0.37 (p complement system and thus...

  18. The case for statin therapy in chronic heart failure

    NARCIS (Netherlands)

    van der Harst, Pim; Boehm, Michael; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Both primary and secondary prevention studies have provided a wealth of evidence that statin therapy effectively reduces cardiovascular events. However, this general statement on the efficacy and safety of statin treatment has not been validated in patients with chronic heart failure (CHF). Recently

  19. Discrimination power of long-term heart rate variability measures for Chronic Heart Failure detection

    OpenAIRE

    Melillo, Paolo; Fusco, Roberta; Sansone, Mario; Bracale, Marcello; Pecchia, Leandro

    2011-01-01

    The aim of this study was to investigate the discrimination power of standard long-term Heart Rate Variability (HRV) measures for the diagnosis of Chronic Heart Failure (CHF). We performed a retrospective analysis on 4 public Holter databases, analyzing the data of 72 normal subjects and 44 patients suffering from CHF. To assess the discrimination power of HRV measures, we adopted an exhaustive search of all possible combinations of HRV measures and we developed classifiers based on Classi...

  20. Novel approach for identification of left ventricle geometry in patients with chronic heart failure, AH and IHD in combination with COPD

    Directory of Open Access Journals (Sweden)

    Potabashniy V.A.

    2016-05-01

    Full Text Available The aim of this study was to examine the direction of change of left ventricle (LV geometry in patients with chronic heart failure (CHF, arterial hypertension (AH and ischemic heart disease (IHD in combination with chronic obstructive pulmonary disease (COPD in dependence on severity of clinical signs of CHF and COPD based on recommendation of American Society of Echocardiography and European Association of Cardiovascular Images (2015. We examined 67 patients with CHF, associated with AH and stable IHD and stable COPD. By the results of this study there were determined different types of left ventricle geometry: concentric LV hypertrophy (LVH, eccentric LVH, mixed LVH, dilated LVH, dependent on blood pressure level, fibrosic and ischemic myocardial changes,, primary predominant disease – AH, IHD or COPD.

  1. Plasma Fibrinogen in Type 2 Diabetic Patients with Metabolic Syndrome and its Relation with Ischemic Heart Disease (IHD) and Retinopathy

    Science.gov (United States)

    Mahendra, J.V.; Anuradha, T.S.; Talikoti, Prashanth; Nagaraj, R.S.; Vishali, V.

    2015-01-01

    Introduction: Metabolic syndrome or Syndrome X is characterized by hyperlipidemia, increased blood pressure, abdominal obesity and hyperglycemia, which increases the risk of cardiovascular complications. In addition to these, it is also associated with nontraditional risk factor like C- reactive protein, Plasminogen activator and fibrinogen. Various studies have documented association of these nontraditional risk factor, in Type 2 diabetes mellitus. Thus patients with diabetes mellitus are higher risk of developing micro and macro vascular complications like ischemic heart disease (IHD) and diabetic retinopathy. Diabetic retinopathy is the leading cause of decreased visual acuity, which is associated with maculopathy and profierative complications of it. Chronic hyperglycemia and its associated nonenzymatic glycation play an important role in the development of microangiopathy. Aims and Objectives: To study the prevalence of the metabolic syndrome in type 2 diabetes mellitus. To study the plasma fibrinogen and its relationship with IHD and retinopathy in type 2 Diabetes mellitus patients with metabolic syndrome. Materials and Methods: Patients of type 2 diabetes Mellitus were recruited based on the inclusion and exclusion criteria. History of IHD and ECG evidence of ischemia was obtained. Retinopathy was diagnosed by direct opthalmoscopy. Fasting glucose, lipid profile and plasma fibrinogen were analyzed. Stastical analysis was carried by Chi square test and student‘t’ test. Results: The prevalence of metabolic syndrome in study population of 100 type 2 diabetic patients is 58% and is significantly associated with duration of the disease (p<0.001). Fifty eight patients have hyperfibrinogenemia and mean fibrinogen level is significantly high in diabetic patients with metabolic syndrome when compared to diabetic patients without metabolic syndrome (p<0.001). Diabetic patient with metabolic syndrome and hyperfibrinogenemia have higher prevalence of IHD and

  2. Relationship between advanced glycation end-products with the severity of chronic heart failure in 85 patients

    Directory of Open Access Journals (Sweden)

    Amir Farhang Zand Parsa

    2013-12-01

    Full Text Available Background: Advanced glycation end-products (AGEs came up with the recent researches regarding new biomarkers for the diagnosis of heart failure. AGEs are the end products of non-enzymatic glycation and oxidation of proteins, lipids and nucleotides during Maillard biochemical reaction. Although it has been known that AGEs have a role in the pathogenesis of chronic heart failure (CHF, information regarding its role and its pathogenetic mechanism is very limited. The aim of this study was to find any relationship between AGEs with the etiology and severity of chronic heart failure.Methods: This study is a prospective cross sectional study that enrolled 85 patients with chronic heart failure. Measurement of left ventricle ejection fraction (LVEF was done by echocardiography. Blood samples were collected for measuring AGEs just before or after echocardiography assessment (in the same session. Measurement of AGEs was done by the enzyme-linked immunosorbent assay (ELISA method. The relationship between AGEs with the severity of CHF and as well as the etiology of CHF were evaluated via SPSS-15.Results: Of 85 patients 48 (56.5% patients were male and 37 (43.5% were female; Mean±SD of their ages was 55.8±13.4 years old (ranges from 27 to 84 years. Correlation coefficient between LVEF and AGEs was 0.269 (P=0.013. Mean of AGEs in patients with and without ischemic etiology of their heart failure were 16.8±9.8µg/ml and 11.6±7.3 µg/ml, respectively. Although trend was in favor of ischemic heart failure, the difference between two groups was not statistically significant (P= 0.141.Conclusion: According to this study the rate of AGES could be helpful in the diagnosis and assessment of severity of CHF. Based on our findings, higher blood levels of AGEs in the ischemic CHF cases, also it could be concluded that in the future this marker may be used for etiologic differentiation of heart failure syndrome.

  3. Effect of geomagnetic storms upon blood sedimentation dynamics in ischemic heart disease patients

    Science.gov (United States)

    Gurfinkel, Youri I.; Voeikov, Vladimir L.; Kondakov, Sergey E.; Demidion, P. Y.; Dmitriev, Andey Y.; Ozerskii, S. Y.

    2000-11-01

    The sedimentation properties of blood of 13 ischemic heart disease patients and 2 healthy volunteers have been analyzed using a special computerized optical device for high temporal resolution tracing of red blood/plasma boundary movement rate (ESR-graphy). The kinetic curves of red blood sedimentation are substantially nonmonotonic and exhibit multiple accelerations, decelerations and even backwards movement of the red blood/plasma boundary. The intensity of blood sedimentation rate oscillations is significantly higher in the blood of patients and voluteers on days of enhanced geomagnetic activity than on quiet days. In healthy donors, blood oscillations were also observed on active geomagnetic days, however, their intensity was lower, the sedimentation rate started to oscillate after a longer time upon pipette installation, and the oscillation frequency was lower than in the patients' blood. Thus, blood is highly responsive to changes in geomagnetic field activity. Possibly oscillatory behavior mechanism of blood sedimentation rate and the diagnostic and prognostic merits of the ESR graphs are discussed.

  4. HEMODYNAMIC INSIGNIFICANT CAROTID ARTERIES STENOSIS AND RISK OF EMBOLIC STROKE IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    V. V. Semenova

    2009-01-01

    Full Text Available Aim. To assess a risk of vascular embolism in patients with ischemic heart disease (IHD and hemodynamic insignificant asymptomatic carotid stenosis.Material and methods. 100 patients with IHD were examined. Ultrasound scanning of the main cranial arteries and transcranial Dopplerography was performed in all patients as well as lipid spectrum, fibrinogen level and blood D-diameter concentration were evaluated.Results. 165 carotid atherosclerotic plaques (AP were detected in patients with IHD independently on angina severity. In IHD patients with nonhomogeneous hypoechogenic AP microembolic signals (MES were revealed in 44,78%, with nonhomogeneous hyperechogenic AP - in 25%, with homogeneous hypoechogenic AP - in 4,16% of patients. MES were not recorded in patients with homogeneous hyperechogenic AP. There were not relations between MES and parameters of lipid spectrum as well as fibrinogen and Ddiameter plasma levels.Conclusion. Thus, during transcranial dopplerographic monitoring MES were recorded in the third part (27,9% of IHD patients with hemodynamically insignificant carotid arteries stenosis. MES were predominantly observed in patients with nonhomogeneous AP especially with hypoechogenic components.

  5. Work-related psychosocial factors and the development of ischemic heart disease: a systematic review.

    Science.gov (United States)

    Eller, Nanna H; Netterstrøm, Bo; Gyntelberg, Finn; Kristensen, Tage S; Nielsen, Finn; Steptoe, Andrew; Theorell, Töres

    2009-01-01

    The literature on the relationship between work-related psychosocial factors and the development of ischemic heart disease (IHD) was systematically reviewed: 33 articles presented 51 analyses of studies involving male participants, 18 analyses involving female participants, and 8 analyses with both genders. Twenty of the studies originated in the Nordic countries, and the major dimensions of the Demand-Control Model were the focus of 23 articles. A balanced evaluation of the studies indicates moderate evidence that high psychologic demands, lack of social support, and iso-strain are risk factors for IHD among men. Studies performed during recent years have not shown evidence for lack of control as a risk factor for IHD. Several studies have shown that job strain is a risk factor, but in the more recent ones, these associations can be fully explained by the association between demands and disease risk. Insufficient evidence was found for a relationship between IHD and effort-reward imbalance, injustice, job insecurity, or long working hours. Studies involving women are too few to draw any conclusion concerning women, work stress, and IHD. PMID:19367150

  6. Association of Hemostatic Gene Polymorphisms With Early-Onset Ischemic Heart Disease in Egyptian Patients.

    Science.gov (United States)

    Alkhiary, Wael; Azzam, Hanan; Yossof, Mahmoud Mohammed Abdo; Aref, Salah; Othman, Maha; El-Sharawy, Solafa

    2016-09-01

    The association between hereditary thrombophilia and venous thrombosis is well established but controversial data exist with respect to arterial thrombosis. We performed a pilot study on 31 patients with acute myocardial infarction (AMI), 21 patients with unstable angina (UA), and 20 healthy volunteers to investigate the role of various hemostatic gene polymorphisms in young Egyptian patients, who survived their first ischemic heart disease (IHD). Thrombophilic gene polymorphisms were tested using multiplex polymerase chain reaction and reverse-hybridization technique. We showed an increased risk of AMI with factor V (FV) Leiden and prothrombin G20210A heterozygosity. The increased risks of UA was associated with GA and A allele of fibrinogen β-455G→A polymorphism. Conversely, factor XIII (FXIII) Val34Leu GT and T allele were protective in the UA group. Nevertheless, the prevalence of FV H1299R, plasminogen activator inhibitor 1 4G/5G, glycoprotein IIIa C1565T, 5,10-methylenetetrahydrofolate reductase C677T, and A1298C mutations did not differ between patients with IHD and controls. The data have clinical implications regarding screening and thromboprophylaxis in high-risk individuals younger than 40 years. PMID:25693916

  7. The Role of Mitochondrial Functional Proteins in ROS Production in Ischemic Heart Diseases

    Directory of Open Access Journals (Sweden)

    Haifeng Pei

    2016-01-01

    Full Text Available Ischemic heart diseases (IHD have become the leading cause of death around the world, killing more than 7 million people annually. In IHD, the blockage of coronary vessels will cause irreversible cell injury and even death. As the “powerhouse” and “apoptosis center” in cardiomyocytes, mitochondria play critical roles in IHD. Ischemia insult can reduce myocardial ATP content, resulting in energy stress and overproduction of reactive oxygen species (ROS. Thus, mitochondrial abnormality has been identified as a hallmark of multiple cardiovascular disorders. To date, many studies have suggested that these mitochondrial proteins, such as electron transport chain (ETC complexes, uncoupling proteins (UCPs, mitochondrial dynamic proteins, translocases of outer membrane (Tom complex, and mitochondrial permeability transition pore (MPTP, can directly or indirectly influence mitochondria-originated ROS production, consequently determining the degree of mitochondrial dysfunction and myocardial impairment. Here, the focus of this review is to summarize the present understanding of the relationship between some mitochondrial functional proteins and ROS production in IHD.

  8. EFFECTS OF ENALAPRIL ON ENDOTHELIUM FUNCTION IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    L. I. Katelnizkaya

    2006-01-01

    Full Text Available Aim. To study endothelium vasomotor function (EF in patients with ischemic heart disease (IHD and the influence of angiotensin converting enzyme inhibitor enalapril (Enam, Dr .Reddy’s, India on it. Material and methods. 87 patients were examined totally. 49 patients were suffering from IHD: 18 patients were younger than 60 years old and 31 patients were older . The combination of arterial hypertension (HT and IHD were registered in 38 patients: 18 patients were below and 20 patients were above 60 years old. All patients additionally to basic IHD therapy took enalapril in dose 2,5-30 mg/daily during 12 weeks. Before the beginning and in the end of treatment cuff test, test with nitroglycerine, bicycle exercise test and Holter monitoring were made, the thickness of intima-media complex of carotid artery and the level of endothelin-1 in blood plasma were defined. Results. EF disorders were shown in IHD, maximal disorders were determined in patients with combination of IHD and HT. EF disorders were also more expressive in patients of elder group. Enalapril restored of cuff tests results, nitroglycerine tests results, reduced a number of myocardial ischemia episodes and provided target blood pressure in 60, 5% patients with HT. Conclusion. Enalapril improves endothelium vasomotor function, endothelium reaction on nitroglycerine and clinical course of IHD and HT.

  9. Prevalence of extracardiac findings in the evaluation of ischemic heart disease by multidetector computed tomography

    Institute of Scientific and Technical Information of China (English)

    Jeong-Hwan Cho; Jong-Seon Park; Dong-Gu Shin; Young-Jo Kim; Sang-Hee Lee; Yoon-Jung Choi; Ihn-Ho Cho

    2013-01-01

    Objective Multidector computed tomography (MDCT) is now commonly used for the evaluation of coronary artery disease. Because MDCT images include many non-cardiac organs and the patient population evaluated is highly susceptible to extracardiac diseases, this study was designed to evaluate the prevalence of extracardiac findings in the MDCT evaluation of ischemic heart disease. Methods From March 2007 to March 2008, a total of six-hundred twenty patients, who underwent 64-slice MDCT evaluations for chest pain, or dyspnea, were enrolled in this study. Cardiac and non-cardiac findings were comprehensively evaluated by a radiologist. Results Enrolled patients included 306 men (49.4%), with a mean age of 66 years. Significant coronary artery stenosis was found in 41.6%of the patients. A total of 158 extracardiac findings were observed in 110 (17.7%) patients. Commonly involved extracardiac organs were lung (36.7%), hepatobiliary system (21.5%), thyroid (19.6%), kidney (10.8%), spine (9.7%) and breast (0.6%). Of those 110 patients, 50 (45.5%) patients underwent further diagnostic investigations. Malignant disease was detected in three (2.7%) patients (lung cancer, pancreatic cancer, and thyroid cancer). Conclusions Extracardiac findings are frequently present and should be a concern in the MDCT evaluation of chest pain syndrome.

  10. Long-term, regular remote ischemic preconditioning improves endothelial function in patients with coronary heart disease.

    Science.gov (United States)

    Liang, Y; Li, Y P; He, F; Liu, X Q; Zhang, J Y

    2015-06-01

    Remote ischemic preconditioning (RIPre) can prevent myocardial injury. The purpose of this study was to assess the beneficial effects of long-term regular RIPre on human arteries. Forty patients scheduled for coronary artery bypass graft (CABG) surgery were assigned randomly to a RIPre group (n=20) or coronary heart disease (CHD) group (n=20). Twenty patients scheduled for mastectomy were enrolled as a control group. RIPre was achieved by occluding arterial blood flow 5 min with a mercury sphygmomanometer followed by a 5-min reperfusion period, and this was repeated 4 times. The RIPre procedure was repeated 3 times a day for 20 days. In all patients, arterial fragments discarded during surgery were collected to evaluate endothelial function by flow-mediated dilation (FMD), CD34(+) monocyte count, and endothelial nitric oxide synthase (eNOS expression). Phosphorylation levels of STAT-3 and Akt were also assayed to explore the underlying mechanisms. Compared with the CHD group, long-term regular RIPre significantly improved FMD after 20 days (8.5±2.4 vs 4.9±4.2%, Parteries. Long-term, regular RIPre improved endothelial function in patients with CHD, possibly due to STAT-3 activation, and this may have led to an increase in endothelial progenitor cells.

  11. Effect of Dementia on the Use of Drugs for Secondary Prevention of Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Nicole R. Fowler

    2014-01-01

    Full Text Available Background. Dementia and cardiovascular disease (CVD are frequently comorbid. The presence of dementia may have an effect on how CVD is treated. Objective. To examine the effect of dementia on the use of four medications recommended for secondary prevention of ischemic heart disease (IHD: angiotensin-converting enzyme inhibitors, beta-blockers, lipid-lowering medications, and antiplatelet medications. Design. Retrospective analysis of data from the Cardiovascular Health Study: Cognition Study. Setting and Subjects. 1,087 older adults in four US states who had or developed IHD between 1989 and 1998. Methods. Generalized estimating equations to explore the association between dementia and the use of guideline-recommended medications for the secondary prevention of IHD. Results. The length of follow-up for the cohort was 8.7 years and 265 (24% had or developed dementia during the study. Use of medications for the secondary prevention of IHD for patients with and without dementia increased during the study period. In models, subjects with dementia were not less likely to use any one particular class of medication but were less likely to use two or more classes of medications as a group (OR, 0.60; 95% CI, 0.36–0.99. Conclusions. Subjects with dementia used fewer guideline-recommended medications for the secondary prevention of IHD than those without dementia.

  12. Comorbidity Influences Multiple Aspects of Well-Being of Patients with Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2013-12-01

    Full Text Available Background: Comorbidity is prevalent among patients with Ischemic Heart Disease (IHD and may influence patients’ subjective and objective domains of well-being. Objectives: We aimed to investigate the associations between comorbidity and different measures of well-being (i.e. health related quality of life, psychological distress, sleep quality, and dyadic adjustment among patients with IHD. Methods: In this cross-sectional study, 796 outpatients with documented IHD were enrolled from an outpatient cardiology clinic in 2006. Comorbidity (Ifudu index, quality of life (SF36, psychological distress (Hospital Anxiety Depression Scale; HADS, sleep quality (Pittsburg Sleep Quality Index; PSQI, and dyadic adjustment quality (Revised Dyadic Adjustment Scale; RDAS were measured. Associations between comorbidity and different measures of well-being were determined. Results: Significant correlations were found between comorbidity score and all measures of well-being. Comorbidity score was correlated with physical quality of life (r = -0.471, P < 0.001, mental quality of life (r = -0.447, P < 0.001, psychological distress (r = 0.344, P < 0.001, sleep quality (r = 0.358, P < 0.001, and dyadic adjustment (r = -0.201, P < 0.001. Conclusions: This study showed a consistent pattern of associations between somatic comorbidities and multiple aspects of well-being among patients with IHD. Findings may increase cardiologists’ interest to identify and treat somatic conditions among IHD patients.

  13. Ischemic heart disease in workers at Mayak PA: latency of incidence risk after radiation exposure.

    Directory of Open Access Journals (Sweden)

    Cristoforo Simonetto

    Full Text Available We present an updated analysis of incidence and mortality from atherosclerotic induced ischemic heart diseases in the cohort of workers at the Mayak Production Association (PA. This cohort constitutes one of the most important sources for the assessment of radiation risk. It is exceptional because it comprises information on several other risk factors. While most of the workers have been exposed to external gamma radiation, a large proportion has additionally been exposed to internal radiation from inhaled plutonium. Compared to a previous study by Azizova et al. 2012, the updated dosimetry system MWDS-2008 has been applied and methods of analysis have been revised. We extend the analysis of the significant incidence risk and observe that main detrimental effects of external radiation exposure occur after more than about 30 years. For mortality, significant risk was found in males with an excess relative risk per dose of 0.09 (95% CI: 0.02; 0.16 [Formula: see text] while risk was insignificant for females. With respect to internal radiation exposure no association to risk could be established.

  14. Methylenetetrahydrofolate reductase polymorphism (C677T), hyperhomocysteinemia, and risk of ischemic cardiovascular disease and venous thromboembolism: prospective and case-control studies from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Frederiksen, Jeppe; Juul, Klaus; Grande, Peer;

    2004-01-01

    for sex, age, cholesterol, high-density lipoprotein cholesterol, lipoprotein(a), fibrinogen, triglycerides, body mass index, smoking, diabetes mellitus, hypertension, and factor V Leiden genotype. Finally, in case-control studies odds ratios for ischemic heart disease and ischemic cerebrovascular disease...... from the general population were followed for 23 years. Second, 2125 whites with ischemic heart disease and 836 whites with ischemic cerebrovascular disease were compared with 7568 controls from the general population. Plasma homocysteine was elevated 25% in homozygotes versus noncarriers (P ...Hyperhomocysteinemia is associated with ischemic cardiovascular disease (ICD) and venous thromboembolism (VTE). We tested the hypothesis that methylenetetrahydrofolate reductase (MTHFR) C677T homozygosity with hyperhomocysteinemia is associated with ICD and VTE. First, 9238 randomly selected whites...

  15. Therapeutic options in chronic heart failure. Findings on chest X-ray

    International Nuclear Information System (INIS)

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  16. Remote patient monitoring in chronic heart failure.

    Science.gov (United States)

    Palaniswamy, Chandrasekar; Mishkin, Aaron; Aronow, Wilbert S; Kalra, Ankur; Frishman, William H

    2013-01-01

    Heart failure (HF) poses a significant economic burden on our health-care resources with very high readmission rates. Remote monitoring has a substantial potential to improve the management and outcome of patients with HF. Readmission for decompensated HF is often preceded by a stage of subclinical hemodynamic decompensation, where therapeutic interventions would prevent subsequent clinical decompensation and hospitalization. Various methods of remote patient monitoring include structured telephone support, advanced telemonitoring technologies, remote monitoring of patients with implanted cardiac devices such as pacemakers and defibrillators, and implantable hemodynamic monitors. Current data examining the efficacy of remote monitoring technologies in improving outcomes have shown inconsistent results. Various medicolegal and financial issues need to be addressed before widespread implementation of this exciting technology can take place. PMID:23018667

  17. 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.

  18. 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. PMID:26974003

  19. Decreased renal clearance of digoxin in chronic congestive heart failure.

    Science.gov (United States)

    Naafs, M A; van der Hoek, C; van Duin, S; Koorevaar, G; Schopman, W; Silberbusch, J

    1985-01-01

    Renal digoxin clearance was compared in patients suffering from atrial fibrillation with well preserved cardiac function (n = 9; salt intake +/- 170 mmol daily) and patients with chronic congestive heart failure (n = 10; salt intake 50 mmol daily and maintenance treatment with diuretics). There was no difference between the groups concerning digoxin dosage, creatinine clearance, diuresis or sodium excretion in the urine. Digoxin clearance in chronic heart failure proved to be significantly lower than in atrial fibrillation (48 +/- 21 vs 71 +/- 36 ml X min-1, p less than 0.05), and Cdig/Ccreat was similarly reduced at 0.73 +/- 0.15 compared to 1.09 +/- 0.27 (p less than 0.005). Steady state serum digoxin concentration was significantly higher in patients with congestive heart failure (1.44 +/- 0.47 vs 0.87 +/- 0.33 micrograms X 1(-1), p less than 0.01). Chronic congestive heart failure is a state with reduced digoxin clearance by the kidney, which could lead to digoxin intoxication not explicable by overdose, reduced renal function or the effect of interacting drugs. PMID:4007028

  20. Novel topical formulation for ischemic chronic wounds. Technological design, quality control and safety evaluation.

    Science.gov (United States)

    Cabrera, Carla Agostina; Ramos, Alberto Nicolas; Loandos, María Del Huerto; Valdez, Juan Carlos; Sesto Cabral, Maria Eugenia

    2016-01-01

    Ulceration of the foot in diabetes is common and disabling, and frequently leads to amputation of the leg. The pathogenesis of foot ulceration is complex, clinical presentation variable and management requires early expert assessment. Despite treatment, ulcers readily become chronic wounds. Chronic wounds are those that remain in a chronic inflammatory state failing a normal healing process patterns. This is partially caused by inefficient eradication of opportunistic pathogens like Pseudomonas aeruginosa. We propose its control or eradication will promote wound healing. Lactobacillus plantarum cultures supernatants (LAPS) shows antipathogenic and pro-healing properties. The main objective was to design two pharmaceutical dosage forms by using LAPS as active pharmaceutical ingredient and to perform its quality control, in vitro activity conservation tests and human trials (safety evaluation). Both selected formulations reach the technological quality expected for 120 days, shows adequate occlusive characteristics and proper adhesion to human skin. From the in vitro release assays were found that LAPS shows adequate release from matrix and maintain its antimicrobial and anti-biofilm activity. First human trials were developed and neither edema nor erythema on healthy skin voluntaries was found. We conclude that C80 and C100 are adequate for their use in future clinical trials to demonstrate a comprehensive therapeutic effectiveness in ischemic chronic wounds.

  1. The increased susceptibility to hydrogen peroxide of the (post)-ischemic rat heart is associated with the magnitude of the low molecular weight iron pool

    NARCIS (Netherlands)

    A. Voogd (Arthur); W.J. Sluiter (Wim); J.F. Koster (Johan)

    1994-01-01

    textabstractRecently we have shown that intracellular low molecular weight (LMW) iron increases during ischemia. It is hypothesized that this increase in LMW iron during ischemia underlies the reported hydrogen peroxide toxicity toward ischemic hearts. To investigate this hypothesis, rat hearts were

  2. Long-term, regular remote ischemic preconditioning improves endothelial function in patients with coronary heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Y.; Li, Y.P.; He, F.; Liu, X.Q.; Zhang, J.Y. [Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou (China)

    2015-04-28

    Remote ischemic preconditioning (RIPre) can prevent myocardial injury. The purpose of this study was to assess the beneficial effects of long-term regular RIPre on human arteries. Forty patients scheduled for coronary artery bypass graft (CABG) surgery were assigned randomly to a RIPre group (n=20) or coronary heart disease (CHD) group (n=20). Twenty patients scheduled for mastectomy were enrolled as a control group. RIPre was achieved by occluding arterial blood flow 5 min with a mercury sphygmomanometer followed by a 5-min reperfusion period, and this was repeated 4 times. The RIPre procedure was repeated 3 times a day for 20 days. In all patients, arterial fragments discarded during surgery were collected to evaluate endothelial function by flow-mediated dilation (FMD), CD34{sup +} monocyte count, and endothelial nitric oxide synthase (eNOS expression). Phosphorylation levels of STAT-3 and Akt were also assayed to explore the underlying mechanisms. Compared with the CHD group, long-term regular RIPre significantly improved FMD after 20 days (8.5±2.4 vs 4.9±4.2%, P<0.05) and significantly reduced troponin after CABG surgery (0.72±0.31 and 1.64±0.19, P<0.05). RIPre activated STAT-3 and increased CD34{sup +} endothelial progenitor cell counts found in arteries. Long-term, regular RIPre improved endothelial function in patients with CHD, possibly due to STAT-3 activation, and this may have led to an increase in endothelial progenitor cells.

  3. CLINICAL AND ECONOMICAL ASSESSMENTS OF METOPROLOL TARTRATE/SUCCINATE USAGE IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    M. V. Soura

    2008-01-01

    Full Text Available Clinical and clinicoeconomical studies review is presented as well as results of author’s comparative cost analysis on metoprolol tartrate (Betaloc and metoprolol succinate (Betaloc ZOK usage in patients with ischemic heart disease. Efficacy of metoprolol therapy is proven in randomized clinical studies in patients with angina and myocardial infarction (MI. In angina patients metoprolol prevents cardiac attacks, MI, reduces nitroglycerine consumption, increases exercise tolerability, prolongs the exercise time before ST segment depression (succinate better than tartrate, decrease of angina intensity. In MI patients metoprolol therapy reduces mortality, sudden death, recurring MI and the rate of early post MI angina attacks. Nowadays metoprolol is the only β-blocker having indication on secondary MI prevention. Besides for the present metoprolol succinate is the only β-blocker with proven direct antisclerosis effect. According to Swedish clinicoeconomical study in patients after MI secondary prevention with metoprolol therapy saves the costs in comparison with placebo. American clinicoeconomical model of metoprolol and atenolol usage in all patients with MI could result in significant reduction in mortality and recurring MI rate, prolong the life and improve its quality, save financial resources. The cost of monthly treatment of angina patient with metoprolol tartrate (Betaloc and metoprolol succinate (Betaloc ZOK is 135 and 354 rubles, respectively. The price range of comparative β-blockers in ascending order is the following: atenolol (Atenolol Nicomed → metoprolol tartrate (Betaloc → metoprolol succinate (Betaloc ZOK → bisoprolol (Concor → nebivolol (Nebilet. In conclusion, metoprolol therapy is the one of mostly economically reasonable approach.

  4. Delivery of a small for gestational age infant and greater maternal risk of ischemic heart disease.

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    Full Text Available BACKGROUND: Delivery of a small for gestational age (SGA infant has been associated with increased maternal risk of ischemic heart disease (IHD. It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. METHODS AND FINDINGS: Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999-2006, a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012. The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011 as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025. Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36 years. CONCLUSIONS: Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD.

  5. Association between Sexual Function and Marital Relationship in Patients with Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2015-10-01

    Full Text Available Background:  Patients  with  ischemic  heart  disease  (IHD  may  report  difficulties with  sexual  function  and  marital relationship. However, there is a dearth of studies focusing on the association between these aspects in IHD patients. The present study sought to assess the association between sexual function and marital relationship among IHD patients and also test the effect modification of gender, education level, and marital distress on the above association.Methods: In this cross-sectional study, 551 patients with IHD were enrolled and their sexual function and marital relationship quality were assessed with the Relation and Sexuality Scale (RSS and Revised Dyadic Adjustment Scale (RDAS, respectively. Association between marital relationship quality and sexual function was assessed with respect to gender, education level, and marital distress.Results: Most participants (72% were men at a mean age of 57 ± 11 (range = 36-80 years. Total sexual function was significantly correlated with total marital quality (r = -0.28, marital consensus (r = -0.17, marital coherence (r = -0.19, marital affection expression (r = -0.22, and marital satisfaction (r = -0.25. Total marital quality also showed a significant association with sexual fear (r = -0.11. These associations were moderated by gender, education level, and marital distress level.Conclusion: Among the IHD patients, sexual function and marital relationship quality showed a mild to moderate association. Association between sexual function and marital relationship quality, however, may depend on gender, education level, and marital distress level.

  6. Efficacy of atorvastatin therapy in prevention of postoperative atrial fibrillation in patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    O. A. Rubanenko

    2015-11-01

    Full Text Available Aim. To evaluate the efficacy of atorvastatin therapy in prevention of atrial fibrillation (AF development after coronary artery bypass graft (CABG surgery in patients with ischemic heart disease (IHD with the assessment of inflammation, sheer stress and myocardial injury indicators. Material and methods. The study included 105 patients with IHD who were divided into two groups: patients of group 1 were treated with atorvastatin (59 patients, 81% males, mean age 62.1±7.5 years; patients of group 2 received no HMG-CoA reductase inhibitors (46 patients, 89% males, and mean age 61.7±8.1 years. Results. Postoperative AF occurred more often in patients of group 2 (41.3% vs 16.9%; р=0.047. Laboratory analysis revealed the following: the levels of total leukocytes, interleukin-8, interleukin-10, C-reactive protein, fibrinogen, superoxide dismutase and troponin did not different significantly among the patients of two groups. Interleukin-6 level in preand postoperative period was significantly higher in patients of group 2 (35.4±28.5 pg/ml vs 24.1±14.8 pg/ml, р=0.03; 63.7±54.8 pg/ml vs 50.7±40.8 pg/ml, р=0.04, respectively. Conclusion. Our study has shown that atorvastatin therapy contributed to the reduction of number of new cases of AF after CABG in patients with IHD. At that, the efficacy of atorvastatin therapy correlated with the size of left atrium and the severity of inflammatory response. Patients with atorvastatin therapy had significantly lower interleukin-6 level, as a proinflammatory marker, in preand postoperational period as compared with the patients without such treatment.

  7. Long-term, regular remote ischemic preconditioning improves endothelial function in patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Y. Liang

    2015-06-01

    Full Text Available Remote ischemic preconditioning (RIPre can prevent myocardial injury. The purpose of this study was to assess the beneficial effects of long-term regular RIPre on human arteries. Forty patients scheduled for coronary artery bypass graft (CABG surgery were assigned randomly to a RIPre group (n=20 or coronary heart disease (CHD group (n=20. Twenty patients scheduled for mastectomy were enrolled as a control group. RIPre was achieved by occluding arterial blood flow 5 min with a mercury sphygmomanometer followed by a 5-min reperfusion period, and this was repeated 4 times. The RIPre procedure was repeated 3 times a day for 20 days. In all patients, arterial fragments discarded during surgery were collected to evaluate endothelial function by flow-mediated dilation (FMD, CD34+ monocyte count, and endothelial nitric oxide synthase (eNOS expression. Phosphorylation levels of STAT-3 and Akt were also assayed to explore the underlying mechanisms. Compared with the CHD group, long-term regular RIPre significantly improved FMD after 20 days (8.5±2.4 vs 4.9±4.2%, P<0.05 and significantly reduced troponin after CABG surgery (0.72±0.31 and 1.64±0.19, P<0.05. RIPre activated STAT-3 and increased CD34+ endothelial progenitor cell counts found in arteries. Long-term, regular RIPre improved endothelial function in patients with CHD, possibly due to STAT-3 activation, and this may have led to an increase in endothelial progenitor cells.

  8. Adherence to recommendations for fruit and vegetable intake, ethnicity and ischemic heart disease mortality

    Science.gov (United States)

    Sharma, Sangita; Vik, Shelly A.; Pakseresht, Mohammedreza; Kolonel, Laurence N

    2016-01-01

    Background and aims Ischemic heart disease (IHD) accounts for one-third of annual deaths in the U.S. and mortality rates vary by ethnicity. The association between adherence to dietary guidelines for fruit and vegetable intake with IHD mortality among different ethnic groups has not previously been examined. Methods and results A prospective cohort design was used to examine the incidence of fatal IHD among participants in the Multiethnic Cohort Study. Participants included 164,617 men and women from five ethnic groups: African American, Native Hawaiian, Japanese American, Latino, and Caucasian. Cox proportional hazards models, stratified by ethnicity and sex, were used to examine associations between adherence with recommended dietary guidelines for fruit and vegetable intake and risk for fatal IHD. The results did not provide evidence that the association between adherence with dietary recommendations for fruit or vegetable intake and IHD mortality varies by ethnicity. Pooled data did provide evidence that adhering to the recommendations for vegetables lowered risk among men (RR Z 0.84, 95% CI: 0.74e0.96) and women (RR Z 0.80, 95% CI: 0.69e0.94). No significant effects were observed for fruit intake. Conclusions The effect of dietary intake of fruit and vegetables did not vary by ethnicity, providing evidence that recommendations do not need to be individualized for these special populations. The protective effect observed for vegetable intake among both sexes confirms previous findings and supports the evidence base for promoting diet modification in this direction. PMID:23725771

  9. Cardiac MRI of ischemic heart disease at 3 T: Potential and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Wieben, Oliver [Department of Radiology, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Medical Physics, University of Wisconsin, Madison, WI 53792-3252 (United States)], E-mail: owieben@wisc.edu; Francois, Christopher [Department of Radiology, University of Wisconsin, Madison, WI 53792-3252 (United States)], E-mail: cfrancois@uwhealth.org; Reeder, Scott B. [Department of Radiology, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Medical Physics, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Biomedical Engineering, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Medicine, University of Wisconsin, Madison, WI 53792-3252 (United States)], E-mail: sreeder@wisc.edu

    2008-01-15

    Cardiac MRI has become a routinely used imaging modality in the diagnosis of cardiovascular disease and is considered the clinically accepted gold standard modality for the assessment of cardiac function and myocardial viability. In recent years, commercially available clinical scanners with a higher magnetic field strength (3.0 T) and dedicated multi-element coils have become available. The superior signal-to-noise ratio (SNR) of these systems has lead to their rapid acceptance in cranial and musculoskeletal MRI while the adoption of 3.0 T for cardiovascular imaging has been somewhat slower. This review article describes the benefits and pitfalls of magnetic resonance imaging of ischemic heart disease at higher field strengths. The fundamental changes in parameters such as SNR, transversal and longitudinal relaxation times, susceptibility artifacts, RF (B{sub 1}) inhomogeneity, and specific absorption rate are discussed. We also review approaches to avoid compromised image quality such as banding artifacts and inconsistent or suboptimal flip angles. Imaging sequences for the assessment of cardiac function with CINE balanced SSFP imaging and MR tagging, myocardial perfusion, and delayed enhancement and their adjustments for higher field imaging are explained in detail along with several clinical examples. We also explore the use of parallel imaging at 3.0 T to improve cardiac imaging by trading the SNR gain for higher field strengths for acquisition speed with increased coverage or improved spatial and temporal resolution. This approach is particularly useful for dynamic applications that are usually limited to the duration of a single breath-hold.

  10. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-01

    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

  11. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-01

    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

  12. Experiences of air travel in patients with chronic heart failure

    OpenAIRE

    Ingle, Lee; Hobkirk, James; Damy, Thibaud; Nabb, Samantha; Clark, Andrew L.; Cleland, John G F

    2012-01-01

    Aim To conduct a survey in a representative cohort of ambulatory patients with stable, well managed chronic heart failure (CHF) to discover their experiences of air travel. Methods An expert panel including a cardiologist, an exercise scientist, and a psychologist developed a series of survey questions designed to elicit CHF patients' experiences of air travel (Appendix 1). The survey questions, information sheets and consent forms were posted out in a self-addressed envelope to 1293 CHF pati...

  13. Optimal medical therapy in chronic heart failure-an audit

    International Nuclear Information System (INIS)

    Objective: Systolic heart failure is a chronic condition with significant morbidity and mortality. Evidence based optimal medical therapy (OMT) has been shown to reduce mortality. Underuse of OMT due to multiple reasons has been a consistent problem. The study objective was to audit the use of OMT in patients with heart Failure. Study Design: Descriptive study. Place and Duration of study: This audit was carried out in AFIC-NIHD from April 2011- February 2012. Material and Methods: Seventy consecutive stage D heart failure patients were included in the study. The patients were assessed clinically by a cardiologist and all previous documentations, referral letters, prescriptions, and purchase receipts were reviewed. To identify any other medication patients might have been taking (which did not appear on the prescriptions) patients were asked to identify common medicine packs. The patients underwent a detailed clinical evaluation including history, physical examination. Relevant investigations were done. ACCF/AHA (American College of Cardiology Foundation / American Heart Association) and ESC (European Society of Cardiology) guidelines for the diagnosis and treatment of acute and chronic heart failure were taken as standard of care. Results: In our audit we found that a large proportion of patients who were at high risk as per the Seattle Heart Failure Model (SHFM) were not on OMT, only 4.3% of the patients were on beta blockers that have been shown to improve mortality in the large randomized clinical trials, 64.3% were not taking any beta blockers where as 55.7% were not on ACE inhibitors and adding the OMT greatly reduced their mortality risk. Conclusions: We concluded that a large proportion of patients were not on OMT despite not having any contraindication to such therapy. This deprives them of significant survival benefit. (author)

  14. On the use of the resting potential and level set methods for identifying ischemic heart disease: An inverse problem

    Science.gov (United States)

    Nielsen, Bjørn Fredrik; Lysaker, Marius; Tveito, Aslak

    2007-01-01

    The electrical activity in the heart is modeled by a complex, nonlinear, fully coupled system of differential equations. Several scientists have studied how this model, referred to as the bidomain model, can be modified to incorporate the effect of heart infarctions on simulated ECG (electrocardiogram) recordings. We are concerned with the associated inverse problem; how can we use ECG recordings and mathematical models to identify the position, size and shape of heart infarctions? Due to the extreme CPU efforts needed to solve the bidomain equations, this model, in its full complexity, is not well-suited for this kind of problems. In this paper we show how biological knowledge about the resting potential in the heart and level set techniques can be combined to derive a suitable stationary model, expressed in terms of an elliptic PDE, for such applications. This approach leads to a nonlinear ill-posed minimization problem, which we propose to regularize and solve with a simple iterative scheme. Finally, our theoretical findings are illuminated through a series of computer simulations for an experimental setup involving a realistic heart in torso geometry. More specifically, experiments with synthetic ECG recordings, produced by solving the bidomain model, indicate that our method manages to identify the physical characteristics of the ischemic region(s) in the heart. Furthermore, the ill-posed nature of this inverse problem is explored, i.e. several quantitative issues of our scheme are explored.

  15. Antenatal hypoxia induces epigenetic repression of glucocorticoid receptor and promotes ischemic-sensitive phenotype in the developing heart.

    Science.gov (United States)

    Xiong, Fuxia; Lin, Thant; Song, Minwoo; Ma, Qingyi; Martinez, Shannalee R; Lv, Juanxiu; MataGreenwood, Eugenia; Xiao, Daliao; Xu, Zhice; Zhang, Lubo

    2016-02-01

    Large studies in humans and animals have demonstrated a clear association of an adverse intrauterine environment with an increased risk of cardiovascular disease later in life. Yet mechanisms remain largely elusive. The present study tested the hypothesis that gestational hypoxia leads to promoter hypermethylation and epigenetic repression of the glucocorticoid receptor (GR) gene in the developing heart, resulting in increased heart susceptibility to ischemia and reperfusion injury in offspring. Hypoxic treatment of pregnant rats from day 15 to 21 of gestation resulted in a significant decrease of GR exon 14, 15, 16, and 17 transcripts, leading to down-regulation of GR mRNA and protein in the fetal heart. Functional cAMP-response elements (CREs) at -4408 and -3896 and Sp1 binding sites at -3425 and -3034 were identified at GR untranslated exon 1 promoters. Hypoxia significantly increased CpG methylation at the CREs and Sp1 binding sites and decreased transcription factor binding to GR exon 1 promoter, accounting for the repression of the GR gene in the developing heart. Of importance, treatment of newborn pups with 5-aza-2'-deoxycytidine reversed hypoxia-induced promoter methylation, restored GR expression and prevented hypoxia-mediated increase in ischemia and reperfusion injury of the heart in offspring. The findings demonstrate a novel mechanism of epigenetic repression of the GR gene in fetal stress-mediated programming of ischemic-sensitive phenotype in the heart. PMID:26779948

  16. In vitro cultured progenitors and precursors of cardiac cell lineages from human normal and post-ischemic hearts

    Directory of Open Access Journals (Sweden)

    F Di Meglio

    2009-08-01

    Full Text Available The demonstration of the presence of dividing primitive cells in damaged hearts has sparked increased interest about myocardium regenerative processes. We examined the rate and the differentiation of in vitro cultured resident cardiac primitive cells obtained from pathological and normal human hearts in order to evaluate the activation of progenitors and precursors of cardiac cell lineages in post-ischemic human hearts. The precursors and progenitors of cardiomyocyte, smooth muscle and endothelial lineage were identified by immunocytochemistry and the expression of characteristic markers was studied by western blot and RT-PCR. The amount of proteins characteristic for cardiac cells (a-SA and MHC, VEGFR-2 and FVIII, SMA for the precursors of cardiomyocytes, endothelial and smooth muscle cells, respectively inclines toward an increase in both a-SA and MHC. The increased levels of FVIII and VEGFR2 are statistically significant, suggesting an important re-activation of neoangiogenesis. At the same time, the augmented expression of mRNA for Nkx 2.5, the trascriptional factor for cardiomyocyte differentiation, confirms the persistence of differentiative processes in terminally injured hearts. Our study would appear to confirm the activation of human heart regeneration potential in pathological conditions and the ability of its primitive cells to maintain their proliferative capability in vitro. The cardiac cell isolation method we used could be useful in the future for studying modifications to the microenvironment that positively influence cardiac primitive cell differentiation or inhibit, or retard, the pathological remodeling and functional degradation of the heart.

  17. EFFECTIVE TREATMENT OF PATIENTS WITH CHRONIC HEART FAILURE AND DEPRESSIVE DISORDERS WITH NOOTROPICS DRUG PANTOGAM ACTIV

    OpenAIRE

    Baranov, A. P.; A. V. Strutynsky; O. Sh. Oynotkinova; Gorbacheva, E. V.; V. V. Trishina; A. S. Gusev-Scherbakov; J. J. Golubev

    2016-01-01

    We investigate the efficiency of the inclusion nootropic drug Pantogam Activ in the complex therapy of 82 patients with heart failure, ischemic heart diseases, anxiety and depressive disorders. It was shown that an 8-week treatment with Pantogam Activ in most patients is accompanied by a significant reduction of anxiety and depressive disorders, increase exercise tolerance, improved autonomic regulation of heart function and decrease the frequency of supraventricular and ventricular arrhythmi...

  18. CLINICAL STUDY ON TREATMENT OF ACUTE ISCHEMIC STROKE WITH ACUPUNCTURE OF ACUPOINTS OF THE PERICARDIUM MERIDIAN AND THE HEART MERIDIAN

    Institute of Scientific and Technical Information of China (English)

    ZHU Hongying; ZHANG Jiong; WANG Yuelan; WANG Keming

    2002-01-01

    Objective: To research the protective effect of acupuncture on the cardiac performance and cerebral function in acute ischemic stroke (AIS) patients. Methods: Forty AIS patients were randomly divided into acupuncture group (n=20) and medication group (n=20) according to their admission sequence. Acupoints, bilateral Neiguan (PC 6) end Tongli (HT 5) were punctured with Gauge-28 filiform needles, once daily, with 10 sessions being a therapeutic course. Patients of the medication group were treated with oral administration of persantine and aspirin as well as intravenous drip of 20% mannitol, low molecular dextran and compound Danshen (red sage root) injectio. Cerebral infarction volume, ECG (heart rate, STⅡ and TⅡ ), plasma CGRP, thromboxane (TX) B2 and 6-Keto-prostanglandin (PG) F1a and scores of the neurological deficit were used as the indexes. Results: After 2 courses of treatment, self comparison of pre- and post treatment of each group showed that the therapeutic effects of acupuncture in reducing infarction volume ( P< 0.01 ), lowering heart rate (HR, P< 0.01 ) and STⅡ ( P<0.01 ), raising TⅡ wave amplitude (P < 0.01 ), elevating plasma CGRP ( P < 0.001 ) and 6-keto-PGF la ( P < 0.01 ) and reducing plasma TXB2 ( P <0.01) were superior to those of medication group. Conclusion: Acupuncture of acupoints of the Pericardium Meridian and Heart Meridian has a significant protective action on the cardiac performance and cerebral function in acute ischemic stroke patients.

  19. Risk factors for mortality and ischemic heart disease in patients with long-term type 1 diabetes

    DEFF Research Database (Denmark)

    Grauslund, Jakob; Mejnert Jørgensen, Trine; Nybo, Mads;

    2010-01-01

    AIMS: The purpose of this study is to evaluate the effect of glycemic regulation, dyslipidemia, and renal dysfunction on mortality (all-cause and cardiovascular) and ischemic heart disease (IHD) in a long-term follow-up of a population-based cohort of Danish type 1 diabetic patients with at least......-density lipoprotein cholesterol (inversely), total cholesterol, creatinine, and macroalbuminuria. Furthermore, all markers except macroalbuminuria were associated with IHD. Microalbuminuria at baseline was not related to any of the endpoints. CONCLUSIONS: Glycemic regulation, dyslipidemia, and renal dysfunction were...

  20. Mortality from diabetes mellitus, ischemic heart disease, and cerebrovascular disease among blacks in a higher income area.

    OpenAIRE

    Polednak, A P

    1990-01-01

    According to the 1980 census, blacks in Suffolk County on Long Island, NY, had a median family income of almost $20,000 versus $12,618 for blacks in the entire United States, or only 20 percent lower than that for whites in the county. Black-white ratios of age-specific death rates for 1979-83 in Suffolk County were elevated for all causes for men and women in age groups from 35-44 to 55-64 years (but not for those 75 years or older), for ischemic heart disease for women (but not men) for age...

  1. Early changes in contractility and coronary blood flow in the normal areas of the ischemic porcine heart.

    Science.gov (United States)

    Pashkow, F; Holland, R; Brooks, H

    1977-03-01

    The regional responses of normal myocardium distant from an ischemic area were studied during acute anterior descending occlusion in the open-chest chloralose-anesthetized pig. Three markers of regional response in both normal and ischemic areas were used: surface ECG electrode, a force gauge in series with left ventricular outer wall fibers, and coronary blood inflow to each region as determined by electromagnetic cuff-probes. Following brief anterior descending artery occlusion (120 sec)., a characteristic rapid decline in contractile force and evolution of TQ-ST segment changes was observed in the ischemic area. In contrast, in the distant area increases in contractil force (p less than 0.001) and coronary blood flow (p less than 0.002) occurred. These distant responses were essentially obliterated following transection and cannulation of the artery supplying this region (p less than 0.05). The findings are consistent with a reflex neurovascular mechanism operating within the intact heart. This reflex is rapidly activated in order to maintain adequate levels of cardiac performance despite sudden loss of functional myocardial mass.

  2. Using Cytokines in Treatment of Ischemic Heart Disease%细胞因子治疗缺血性心脏病最新进展

    Institute of Scientific and Technical Information of China (English)

    黄浙勇; 沈运丽

    2011-01-01

    Ischemic heart disease is a prevalent and serious disease. Cytokine therapy promises to provide a noninvasive treatment option for ischemic heart disease through mobilizing progenitor cells and other factors to promote angiogenesis. This article reviews recent research using cytokine therapy to treat ischemic heart disease.%缺血性心脏病是严重危害人类健康的常见疾病.细胞因子可通过祖细胞的动员归巢或激活其他血管生成因子以促进血管新生,从而具有治疗缺血性心脏病潜能.近年来越来越多的细胞因子进行了相关的实验研究和临床试验,现就其最新进展作一综述.

  3. Genetically high plasma vitamin C, intake of fruit and vegetables, and risk of ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Kobylecki, Camilla J; Afzal, Shoaib; Davey Smith, George;

    2015-01-01

    BACKGROUND: High intake of fruit and vegetables as well as high plasma vitamin C concentrations have been associated with low risk of ischemic heart disease in prospective studies, but results from randomized clinical trials have been inconsistent. OBJECTIVE: We tested the hypothesis...... that genetically high concentrations of plasma vitamin C, such as with high intake of fruit and vegetables, are associated with low risk of ischemic heart disease and all-cause mortality. DESIGN: We used a Mendelian randomization approach and genotyped for solute carrier family 23 member 1 (SLC23A1) rs33972313...... disease and 0.88 (0.72, 1.08; P = 0.22) for all-cause mortality. CONCLUSIONS: High intake of fruit and vegetables was associated with low risk of ischemic heart disease and all-cause mortality. Although the 95% CI for genetically high plasma vitamin C concentrations overlapped 1.0, which made certain...

  4. Spatio-Temporal Variation and Prediction of Ischemic Heart Disease Hospitalizations in Shenzhen, China

    Directory of Open Access Journals (Sweden)

    Yanxia Wang

    2014-05-01

    Full Text Available Ischemic heart disease (IHD is a leading cause of death worldwide. Urban public health and medical management in Shenzhen, an international city in the developing country of China, is challenged by an increasing burden of IHD. This study analyzed the spatio-temporal variation of IHD hospital admissions from 2003 to 2012 utilizing spatial statistics, spatial analysis, and space-time scan statistics. The spatial statistics and spatial analysis measured the incidence rate (hospital admissions per 1,000 residents and the standardized rate (the observed cases standardized by the expected cases of IHD at the district level to determine the spatio-temporal distribution and identify patterns of change. The space-time scan statistics was used to identify spatio-temporal clusters of IHD hospital admissions at the district level. The other objective of this study was to forecast the IHD hospital admissions over the next three years (2013–2015 to predict the IHD incidence rates and the varying burdens of IHD-related medical services among the districts in Shenzhen. The results show that the highest hospital admissions, incidence rates, and standardized rates of IHD are in Futian. From 2003 to 2012, the IHD hospital admissions exhibited similar mean centers and directional distributions, with a slight increase in admissions toward the north in accordance with the movement of the total population. The incidence rates of IHD exhibited a gradual increase from 2003 to 2012 for all districts in Shenzhen, which may be the result of the rapid development of the economy and the increasing traffic pollution. In addition, some neighboring areas exhibited similar temporal change patterns, which were also detected by the spatio-temporal cluster analysis. Futian and Dapeng would have the highest and the lowest hospital admissions, respectively, although these districts have the highest incidence rates among all of the districts from 2013 to 2015 based on the prediction

  5. Ischemic Stroke

    OpenAIRE

    Eleni Dokoutsidou; Konstantina Antoniou

    2009-01-01

    Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etio...

  6. Spatial Patterns of Ischemic Heart Disease in Shenzhen, China: A Bayesian Multi-Disease Modelling Approach to Inform Health Planning Policies

    Directory of Open Access Journals (Sweden)

    Qingyun Du

    2016-04-01

    Full Text Available Incorporating the information of hypertension, this paper applies Bayesian multi-disease analysis to model the spatial patterns of Ischemic Heart Disease (IHD risks. Patterns of harmful alcohol intake (HAI and overweight/obesity are also modelled as they are common risk factors contributing to both IHD and hypertension. The hospitalization data of IHD and hypertension in 2012 were analyzed with three Bayesian multi-disease models at the sub-district level of Shenzhen. Results revealed that the IHD high-risk cluster shifted slightly north-eastward compared with the IHD Standardized Hospitalization Ratio (SHR. Spatial variations of overweight/obesity and HAI were found to contribute most to the IHD patterns. Identified patterns of IHD risk would benefit IHD integrated prevention. Spatial patterns of overweight/obesity and HAI could supplement the current disease surveillance system by providing information about small-area level risk factors, and thus benefit integrated prevention of related chronic diseases. Middle southern Shenzhen, where high risk of IHD, overweight/obesity, and HAI are present, should be prioritized for interventions, including alcohol control, innovative healthy diet toolkit distribution, insurance system revision, and community-based chronic disease intervention. Related health resource planning is also suggested to focus on these areas first.

  7. Controlled dual delivery of fibroblast growth factor-2 and Interleukin-10 by heparin-based coacervate synergistically enhances ischemic heart repair.

    Science.gov (United States)

    Chen, William C W; Lee, Brandon G; Park, Dae Woo; Kim, Kyobum; Chu, Hunghao; Kim, Kang; Huard, Johnny; Wang, Yadong

    2015-12-01

    Myocardial infarction (MI) causes myocardial necrosis, triggers chronic inflammatory responses, and leads to pathological remodeling. Controlled delivery of a combination of angiogenic and immunoregulatory proteins may be a promising therapeutic approach for MI. We investigated the bioactivity and therapeutic potential of an injectable, heparin-based coacervate co-delivering an angiogenic factor, fibroblast growth factor-2 (FGF2), and an anti-inflammatory cytokine, Interleukin-10 (IL-10) in a spatially and temporally controlled manner. Coacervate delivery of FGF2 and IL-10 preserved their bioactivities on cardiac stromal cell proliferation in vitro. Upon intramyocardial injection into a mouse MI model, echocardiography revealed that FGF2/IL-10 coacervate treated groups showed significantly improved long-term LV contractile function and ameliorated LV dilatation. FGF2/IL-10 coacervate substantially augmented LV myocardial elasticity. Additionally, FGF2/IL-10 coacervate notably enhanced long-term revascularization, especially at the infarct area. In addition, coacervate loaded with 500 ng FGF2 and 500 ng IL-10 significantly reduced LV fibrosis, considerably preserved infarct wall thickness, and markedly inhibited chronic inflammation at the infarct area. These results indicate that FGF2/IL-10 coacervate has notably greater therapeutic potential than coacervate containing only FGF2. Overall, our data suggest therapeutically synergistic effects of FGF-2/IL-10 coacervate, particularly coacervate with FGF2 and 500 ng IL-10, for the treatment of ischemic heart disease.

  8. Impaired cerebral autoregulation is associated with brain atrophy and worse functional status in chronic ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Mikio C Aoi

    Full Text Available Dynamic cerebral autoregulation (dCA is impaired following stroke. However, the relationship between dCA, brain atrophy, and functional outcomes following stroke remains unclear. In this study, we aimed to determine whether impairment of dCA is associated with atrophy in specific regions or globally, thereby affecting daily functions in stroke patients.We performed a retrospective analysis of 33 subjects with chronic infarctions in the middle cerebral artery territory, and 109 age-matched non-stroke subjects. dCA was assessed via the phase relationship between arterial blood pressure and cerebral blood flow velocity. Brain tissue volumes were quantified from MRI. Functional status was assessed by gait speed, instrumental activities of daily living (IADL, modified Rankin Scale, and NIH Stroke Score.Compared to the non-stroke group, stroke subjects showed degraded dCA bilaterally, and showed gray matter atrophy in the frontal, parietal and temporal lobes ipsilateral to infarct. In stroke subjects, better dCA was associated with less temporal lobe gray matter atrophy on the infracted side ([Formula: see text] = 0.029, faster gait speed ([Formula: see text] = 0.018 and lower IADL score ([Formula: see text]0.002. Our results indicate that better dynamic cerebral perfusion regulation is associated with less atrophy and better long-term functional status in older adults with chronic ischemic infarctions.

  9. Pivotal importance of STAT3 in protecting the heart from acute and chronic stress: new advancement and unresolved issues

    Directory of Open Access Journals (Sweden)

    Foaud A. Zouein

    2015-11-01

    Full Text Available The transcription factor Signal Transducer and Activator of Transcription 3 (STAT3 has been implicated in protecting the heart from acute ischemic injury under both basal conditions and as a crucial component of pre- and post-conditioning protocols. A number of anti-oxidant and antiapoptotic genes are upregulated by STAT3 via canonical means involving phosphorylation on Y705 and S727, although other incompletely defined posttranslational modifications are involved. In addition, STAT3 is now known to be present in cardiac mitochondria and to exert actions that regulate the electron transport chain, reactive oxygen species (ROS production, and mitochondrial permeability transition pore (mPTP opening. These non-canonical actions of STAT3 are enhanced by S727 phosphorylation. The molecular basis for the mitochondrial actions of STAT3 are poorly understood, but STAT3 is known to interact with a critical subunit of complex I and to regulate complex I function. Dysfunctional complex I has been implicated in ischemic injury, heart failure, and the aging process. Evidence also indicates that STAT3 is protective to the heart under chronic stress conditions, including hypertension, pregnancy, and advanced age. Paradoxically, the accumulation of unphosphorylated STAT3 (U-STAT3 in the nucleus has been suggested to drive pathological cardiac hypertrophy and inflammation via noncanonical gene expression, perhaps involving a distinct acetylation profile. U-STAT3 may also regulate chromatin stability. Our understanding of how the noncanonical genomic and mitochondrial actions of STAT3 in the heart are regulated and coordinated with the canonical actions of STAT3 is rudimentary. Here we present an overview of what is currently known about the pleotropic actions of STAT3 in the heart in order to highlight controversies and unresolved issues.

  10. 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.

  11. Stem cell therapy for ischemic heart disease%干细胞治疗缺血性心脏病

    Institute of Scientific and Technical Information of China (English)

    苗磊; 刘培良

    2016-01-01

    背景:干细胞移植对缺血性心脏病患者而言是一种富有前景的治疗策略,且近年来相关临床研究也已取得重要进展。目的:分析2001至2015年Medline、中国知网、万方数据库收录的干细胞治疗缺血性心脏病的临床研究及北美临床试验注册中心和中国临床试验注册中心注册的干细胞治疗缺血性心脏病的临床项目的发展趋势。方法:①检索关键词:“stem cell transplantation”(干细胞移植),“ischemic heart disease”(缺血性心脏病)。②检索文献时间范围:2001至2015年,分为3个统计时间段:2001至2005年,2006至2010年,2011至2015年。③检索信息来源:Medline、中国知网、万方数据库及北美临床试验注册中心和中国临床试验注册中心的临床试验项目。结果与结论:①在Medline数据库:2001至2015年关于干细胞治疗缺血性心脏病的临床研究的文献共219篇,其中2006至2010年最多,而在2011至2015年时间段出现下降。②中国知网和万方数据库:2001至2015年收录的关于干细胞治疗缺血性心脏病的临床研究的文献数量变化的整体趋势与Medline数据库相似,且2011年后的数量减少更为明显。③北美临床试验注册中心:在2001至2015年注册的干细胞治疗缺血性心脏病的临床试验共63项,主要在2006至2015年注项目较多册,注册机构主要集中于欧洲和北美洲。④中国临床试验注册中心:没有查询到2001至2015年关于干细胞治疗缺血性心脏病的临床试验注册项目,这可能与国内相关管理较为严格有关。%BACKGROUND:Stem cel transplantation is a promising strategy for treatment of ischemic heart diseases, which has obtained great achievements in recent years. OBJECTIVE: To analyze the clinical trends of stem cel therapy for ischemic heart diseases reported from 2001 to 2015 in Medline, CNKI, Wanfang, ClinicalTrials.gov and Chinese Clinical

  12. Major depression and first-time hospitalization with ischemic heart disease, cardiac procedures and mortality in the general population

    DEFF Research Database (Denmark)

    Gasse, Christiane; Laursen, Thomas M; Baune, Bernhard T

    2014-01-01

    Objective: We investigated the association between unipolar depression and incident hospital admissions due to ischemic heart disease, invasive cardiac procedures and mortality independent of other medical illnesses.Methods: A population-based cohort of 4.6 million persons aged 15 years or older ......-59 years of age and during the first weeks following psychiatric admission. Our findings support recent cardiovascular disease prevention guidelines on assessing depression among other psychosocial factors in patients at increased cardiovascular disease (CVD) risk.......Objective: We investigated the association between unipolar depression and incident hospital admissions due to ischemic heart disease, invasive cardiac procedures and mortality independent of other medical illnesses.Methods: A population-based cohort of 4.6 million persons aged 15 years or older...... were significantly increased by up to 15% and 68%, respectively, in persons with hospital admissions due to depression, and were most increased in 15-59 year old women (IRR: 1.64; MRR: 2.57) and men with depression (IRR: 1.39; MRR: 2.21), and during the first 180 days after being diagnosed...

  13. Antihypertensive treatment, high triglycerides, and low high-density lipoprotein cholesterol and risk of ischemic heart disease mortality: a 16-year follow-up in the Copenhagen male study

    DEFF Research Database (Denmark)

    Suadicani, Poul; Hein, Hans Ole; Gyntelberg, Finn

    2010-01-01

    The aim of this study was to test the hypothesis that metabolic syndrome dyslipidemia is a major risk factor for ischemic heart disease (IHD) mortality among men taking antihypertensive medication.......The aim of this study was to test the hypothesis that metabolic syndrome dyslipidemia is a major risk factor for ischemic heart disease (IHD) mortality among men taking antihypertensive medication....

  14. 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.

  15. Reverse left ventricular remodeling is more likely in non ischemic cardiomyopathy patients upgraded to biventricular stimulation after chronic right ventricular pacing

    Directory of Open Access Journals (Sweden)

    Morales Maria-Aurora

    2011-12-01

    Full Text Available Abstract Background Chronic right ventricular (RV apical pacing may lead to left ventricular (LV dyssynchrony and LV dysfunction. In heart failure due to RV pacing, upgrading to biventricular stimulation (CRT can improve NYHA Class and LV function. A proportion of patients do not respond to upgrading. Aim was to assess whether etiology of LV dysfunction accounts for responses to CRT in RV-paced patients. Methods Sixty-two patients treated by CRT, under RV pacing from 50.2 ± 5.4 months, were studied. Cause of LV dysfunction was non-ischemic (NIC in 28 and ischemic cardiomyopathy (IC in 34 patients. Clinical and conventional echocardiographic parameters were available within 1 month before RV pacing, within 1 month before CRT and at 12 ± 2 months of follow-up (FU. Results Decreased LVEF (from 37.0 ± 8.8 to 25.6 ± 6.1%, p 10% decrease in LVESD was observed in 24 patients: 5 with IC, 19 with NIC (p 10% decrease in LVESD remained highly significant (p Conclusions CRT improves functional class even after long-lasting pacing. Reverse remodeling is evident in a small population, more likely with NIC.

  16. Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Eleni Dokoutsidou

    2009-05-01

    Full Text Available Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive, carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet.Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

  17. Management of chronic heart failure in the older population

    OpenAIRE

    Azad, Nahid; Lemay, Genevieve

    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 pati...

  18. [Chronic heart failure and its consequences on the partner relationship].

    Science.gov (United States)

    Sztajzel, Juan

    2015-12-01

    There are presently few data on chronic heart failure (CHF) and its consequences on the partner relationship. The aim of our study was to assess how patients with severe CHF and their female partners were affected in their relationship. First, there was a need to address the issue of sexuality with the doctor because of fear of the occurrence of a cardiac event or an implantable cardioverter defibrillator shock. Second, there was often a significant decrease in libido and erectile dysfunction associated with general depressive symptoms. Finally, the female partners in several couples developed an overprotective behavior leading to resentment and frustration in patients towards them. PMID:26790235

  19. Increased Circulating Cathepsin K in Patients with Chronic Heart Failure

    OpenAIRE

    Guangxian Zhao; Yuzi Li; Lan Cui; Xiang Li; Zhenyi Jin; Xiongyi Han; Ennan Fang; Yihua Gao; Dongmei Zhou; Haiying Jiang; Xueying Jin; Guanghao Piao; Xiangshan Li; Guang Yang; Jiyong Jin

    2015-01-01

    Cysteinyl cathepsin K (CatK) is one of the most potent mammalian collagenases involved in cardiovascular disease. Here, we investigated the clinical predictive value of serum CatK levels in patients with chronic heart failure (CHF). We examined 134 patients with CHF, measuring their serum CatK, troponin I, high-sensitive C-reactive protein, and pre-operative N-terminal pro-brain natriuretic peptide levels. The patients were divided into two groups: the 44 patients who showed a left ventricula...

  20. Chronic ischemic mitral regurgitation and papillary muscle infarction detected by late gadolinium-enhanced cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Bouma, Wobbe; Willemsen, Hendrik M; Lexis, Chris P H; Prakken, Niek H; Lipsic, Erik; van Veldhuisen, Dirk J; Mariani, Massimo A; van der Harst, Pim; van der Horst, Iwan C C

    2016-01-01

    BACKGROUND: Both papillary muscle infarction (PMI) and chronic ischemic mitral regurgitation (CIMR) are associated with reduced survival after myocardial infarction. The influence of PMI on CIMR and factors influencing both entities are incompletely understood. OBJECTIVES: We sought to determine the

  1. Epidemiological and Pathogenic Relationship between Sleep Apnea and Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Carlos Carpio

    2013-01-01

    Full Text Available Obstructive sleep apnea is recognized as having high prevalence and causing remarkable cardiovascular risk. Coronary artery disease has been associated with obstructive sleep apnea in many reports. The pathophysiology of coronary artery disease in obstructive sleep apnea patients probably includes the activation of multiple mechanisms, as the sympathetic activity, endothelial dysfunction, atherosclerosis, and systemic hypertension. Moreover, chronic intermittent hypoxia and oxidative stress have an important role in the pathogenesis of coronary disease and are also fundamental to the development of atherosclerosis and other comorbidities present in coronary artery diseases such as lipid metabolic disorders. Interestingly, the prognosis of patients with coronary artery disease has been associated with obstructive sleep apnea and the severity of sleep disordered breathing may have a direct relationship with the morbidity and mortality of patients with coronary diseases. Nevertheless, treatment with CPAP may have important effects, and recent reports have described the benefits of obstructive sleep apnea treatment on the recurrence of acute heart ischaemic events in patients with coronary artery disease.

  2. Exaggerated Pressor Response in Relation to Attenuated Muscle Temperature Response during Contraction in Ischemic Heart Failure

    Directory of Open Access Journals (Sweden)

    Jianhua eLi

    2012-11-01

    Full Text Available It is known that muscle temperature (Tm increases with exercise. The purpose of this study was to examine if contraction-induced increase in Tm was altered in rats with heart failure (HF induced by chronic myocardial infraction (MI as compared with healthy control animals. A temperature probe was inserted in the triceps surae muscle to continuously measure Tm throughout experiments. Static muscle contraction was induced by electrical stimulation of the sciatic nerve for 1 min. As baseline Tm was 34 °C, contraction increased temperature by 1.6±0.18 °C in nine health control rats and by 1.0±0.15 °C in ten MI rats (P<0.05 vs. control. Note that there were no differences in developed muscle tension and muscle weight between the two groups. In addition, muscle contraction increased mean arterial pressure by 23±3 mmHg in control rats and by 31±3 mmHg in MI rats (P<0.05 vs. control. A regression analysis further shows that there is an inverse liner relationship between the pressor response and static contraction-induced increase in Tm. Our data suggest that Tm increase evoked by contraction is impaired in MI rats. The abnormal alteration in Tm likely modifies the reflex cardiovascular responses in MI via mechanisms of temperature sensitive receptors on muscle afferent nerves.

  3. Atrial fibrillation is associated with a lower exercise capacity in male chronic heart failure patients

    OpenAIRE

    Pardaens, K; Van Cleemput, J.; Vanhaecke, J.; Fagard, R.

    1997-01-01

    Objective—To study the influence of atrial fibrillation on peak oxygen uptake (peak V̇O2) in chronic heart failure. An unfavourable effect of atrial fibrillation has been shown in several patient populations, but the results have not been consistent in chronic heart failure.
Methods—Data were analysed from male heart transplant candidates who were able to perform graded bicycle ergometry until exhaustion with respiratory gas analysis and measurement of heart rate. Patients in atrial fibrillat...

  4. THE INFLUENCE OF LONG-TERM THERAPY WITH PERINDOPRIL ON THE HEART INOTROPIC FUNCTION IN PATIENTS WITH CHRONIC POSTINFARCTION ANEURISM

    Directory of Open Access Journals (Sweden)

    I. G. Fomina

    2006-01-01

    Full Text Available Aim. To study the influence of long-term therapy with perindopril on the heart inotropic function in patients with chronic postinfarction aneurism. Material and methods. 21 patients suffering ischemic heart disease with postinfarction cardiosclerosis, chronic aneurism of left ventricle and chronic heart failure of functional class III-IV according to NYHA were observed. All patients took perindopril, 2-4 mg daily. Before and after 6 months of therapy myocardial contractile function of left and right ventricles was studied by balanced radioventriculography with segmental and phase analysis of histogram. Results. In patients with chronic postinfarction aneurism significant structural and functional abnormalities were revealed: reduction of left ventricular ejection fraction up to 17,8 ± 3,2 %, the same for right ventricular up to 22,1±4,4 %, their considerable dilation with reduction of filling and expulsion velocity. After 6 months of therapy with  perindopril  improvement of clinic status of patients, tendency towards  increase of both ventricles general ejection fraction, enlargement of maximal filling velocity and filling velocity during 1/3 of diastole as well as tendency to reduction of both ventricles end diastolic and systolic volumes were registered. In left ventricle there were normokinetic zones in 35 (21% segments, hypokinetic zones in 24 (14%, akinetic zones in 54 (32% and dyskinetic zones in 17 (10% segments. In right ventricle there were normokinetic zones in 45 (27% segments, hypokinetic zones in 62(37%, akinetic zones in 54 (32% and dyskinetic zones in 7 (4% segments. After 6 months of therapy with perindopril tendency towards improvement of local myocardial contractility was registered. Conclusion. In patients with chronic postinfarction aneurism deterioration of general and local myocardial contractility were registered. Accurate link between left ventricle local myocardial contractility and localization of aneurism were

  5. Smoking and Ischemic Heart Disease Disparities Between Studies, Genders, Times, and Socioeconomic Strata

    OpenAIRE

    Leistikow, Bruce N

    2009-01-01

    Large, unexplained, but possibly related disparities exist between heart disease risks observed in differing genders, educational levels, times, and studies. Such heart disease disparities might be related to cumulative tobacco smoke damage (smoke load) disparities that are overlooked in standard assessments of point smoking status. So, I reviewed possible relationships between smoke load and heart disease levels across genders, educational strata, years, and leading studies. Smoker heart dis...

  6. Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

    Directory of Open Access Journals (Sweden)

    Amirmasoud Zangiabadi

    2014-01-01

    Full Text Available Group 3 pulmonary hypertension (PH is a common complication of chronic lung disease (CLD, including chronic obstructive pulmonary disease (COPD, interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.

  7. [Chronic heart failure and cachexia: role of endocrine system].

    Science.gov (United States)

    Dei Cas, A; Muoio, A; Zavaroni, I

    2011-12-01

    Chronic heart failure (CHF) is a major health problem that carries a devastating prognosis. The prognosis worsens considerably once cardiac cachexia has been diagnosed. Neurohormonal, metabolic, hemodynamic and immunological alterations are involved in the initiation and progression of cardiac cachexia. Cachexia is characterized by a hypothalamic inappropriate response to the mechanisms controlling energy homeostasis. Levels of the anorexigenic hormone leptin are decreased whereas the orexigenic gherlin hormone levels are normal or elevated. Nevertheless, energy intake is not increased as expected due to a persistent activation of the proopiomelanocortin (POMC) system (anorexigenic) paralleled by a decreased activity of the neuropeptide Y (NPY, orexigenic) neurons. Cachexia is also characterized by an imbalance in anabolic (impairment in the growth hormone/insulin-like growth factor-I axis, insulin resistance) and catabolic (increased levels of catecholamines, increased cortisol/dehydroepiandrosterone ratio and activation of proinflammatory cytokines such as tumor necrosis factor-alpha, interleuchin-6, interleuchin-1') at the basis of the wasting process. This review discusses the complex role of the endocrine system in modulating energy balance, appetite and metabolism in patients with chronic heart failure. A joint multidisciplinary effort of the cardiologists, immunologists and endocrinologists might be useful to identify the precise mechanisms involved in the neuroendocrine alteration and to develop therapeutic strategies able to improve the prognosis of CHF patients.

  8. Chronic Losartan Treatment Up-Regulates AT1R and Increases the Heart Vulnerability to Acute Onset of Ischemia and Reperfusion Injury in Male Rats.

    Science.gov (United States)

    Song, Minwoo A; Dasgupta, Chiranjib; Zhang, Lubo

    2015-01-01

    Inhibition of angiotensin II type 1 receptor (AT1R) is an important therapy in the management of hypertension, particularly in the immediate post-myocardial infarction period. Yet, the role of AT1R in the acute onset of myocardial ischemia and reperfusion injury still remains controversial. Thus, the present study determined the effects of chronic losartan treatment on heart ischemia and reperfusion injury in rats. Losartan (10 mg/kg/day) was administered to six-month-old male rats via an osmotic pump for 14 days and hearts were then isolated and were subjected to ischemia and reperfusion injury in a Langendorff preparation. Losartan significantly decreased mean arterial blood pressure. However, heart weight, left ventricle to body weight ratio and baseline cardiac function were not significantly altered by the losartan treatment. Of interest, chronic in vivo losartan treatment significantly increased ischemia-induced myocardial injury and decreased post-ischemic recovery of left ventricular function. This was associated with significant increases in AT1R and PKCδ expression in the left ventricle. In contrast, AT2R and PKCε were not altered. Furthermore, losartan treatment significantly increased microRNA (miR)-1, -15b, -92a, -133a, -133b, -210, and -499 expression but decreased miR-21 in the left ventricle. Of importance, addition of losartan to isolated heart preparations blocked the effect of increased ischemic-injury induced by in vivo chronic losartan treatment. The results demonstrate that chronic losartan treatment up-regulates AT1R/PKCδ and alters miR expression patterns in the heart, leading to increased cardiac vulnerability to ischemia and reperfusion injury.

  9. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    OpenAIRE

    Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy

    2014-01-01

    This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner.Background: The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation.Methods: This...

  10. Effects of autologous bone marrow stem cell transplantation on beta-adrenoceptor density and electrical activation pattern in a rabbit model of non-ischemic heart failure

    Directory of Open Access Journals (Sweden)

    Ullmann Cris

    2006-06-01

    Full Text Available Abstract Background Since only little is known on stem cell therapy in non-ischemic heart failure we wanted to know whether a long-term improvement of cardiac function in non-ischemic heart failure can be achieved by stem cell transplantation. Methods White male New Zealand rabbits were treated with doxorubicine (3 mg/kg/week; 6 weeks to induce dilative non-ischemic cardiomyopathy. Thereafter, we obtained autologous bone marrow stem cells (BMSC and injected 1.5–2.0 Mio cells in 1 ml medium by infiltrating the myocardium via a left anterolateral thoracotomy in comparison to sham-operated rabbits. 4 weeks later intracardiac contractility was determined in-vivo using a Millar catheter. Thereafter, the heart was excised and processed for radioligand binding assays to detect β1- and β2-adrenoceptor density. In addition, catecholamine plasma levels were determined via HPLC. In a subgroup we investigated cardiac electrophysiology by use of 256 channel mapping. Results In doxorubicine-treated animals β-adrenoceptor density was significantly down-regulated in left ventricle and septum, but not in right ventricle, thereby indicating a typical left ventricular heart failure. Sham-operated rabbits exhibited the same down-regulation. In contrast, BMSC transplantation led to significantly less β-adrenoceptor down-regulation in septum and left ventricle. Cardiac contractility was significantly decreased in heart failure and sham-operated rabbits, but was significantly higher in BMSC-transplanted hearts. Norepinephrine and epinephrine plasma levels were enhanced in heart failure and sham-operated animals, while these were not different from normal in BMSC-transplanted animals. Electrophysiological mapping revealed unaltered electrophysiology and did not show signs of arrhythmogeneity. Conclusion BMSC transplantation improves sympathoadrenal dysregualtion in non-ischemic heart failure.

  11. Género y cardiopatía isquémica Gender and ischemic heart disease

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    Izabella Rohlfs

    2004-05-01

    Full Text Available Tanto el sexo como los aspectos sociológicos y antropológicos relacionados con el género son factores que contribuyen a particularizar los procesos fisiológicos y patológicos de mujeres y hombres. Sin embargo, el abordaje integral de muchas enfermedades se realiza desde la perspectiva masculina. En este sentido, la cardiopatía isquémica (CI es una de las enfermedades donde se pueden ejemplificar claramente las diferencias biológicas y las desigualdades sociales. Las mujeres presentan la enfermedad en edades más avanzadas que los hombres, la forma de aparición es más frecuentemente «atípica» y está asociada con una mayor comorbilidad y gravedad. Por tanto, el tratamiento y el pronóstico es diferente. Además, también se han observado diferencias en relación con el conocimiento y las creencias sobre la enfermedad, así como en las actitudes adoptadas cuando aparecen los primeros síntomas. Es preciso tener en cuenta todos estos aspectos biológicos y de género porque frecuentemente ocasionan desigualdades entre los hombres y las mujeres, tanto en relación con el diagnóstico certero de la CI como en el tratamiento, la prevención o la rehabilitación posterior.Physiological and pathological processes differ in men and women, depending on factors such as sex and sociological and anthropological characteristics. However, many diseases are still approached from a masculine point of view. In this respect, ischemic heart disease is one of the diseases that most clearly reflects biological differences and social inequalities. In women, the disease presents at a more advanced age, and presentation is frequently atypical with a higher prevalence of comorbidities and greater severity. Consequently, treatment and outcome differ from those in men. Additionally, women differ in their knowledge, and beliefs regarding ischemic heart disease, as well as in their attitudes at symptom onset. Therefore, clinical practice should place significant

  12. Relationship between tap water hardness, magnesium, and calcium concentration and mortality due to ischemic heart disease or stroke in the Netherlands

    NARCIS (Netherlands)

    Leurs, L.J.; Schouten, L.J.; Mons, M.N.; Goldbohm, R.A.; Brandt, P.A. van den

    2010-01-01

    BACKGROUND: Conflicting results on the relationship between the hardness of drinking water and mortality related to ischemic heart disease (IHD) or stroke have been reported. OBJECTIVES: We investigated the possible association between tap water calcium or magnesium concentration and total hardness

  13. The interplay between physical activity at work and during leisure time - risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men

    DEFF Research Database (Denmark)

    Holtermann, A.; Mortensen, O.S.; Burr, H.;

    2009-01-01

    Objective our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. Methods We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caueasian...

  14. [Problems in the use of cardiac glycosides in ischemic heart disease].

    Science.gov (United States)

    Modersohn, D; Urbaszek, W

    1975-08-01

    With the help of instances from literature and own experimental and clinical experiences is described that a schematic digitalisation in ischaemic heart diseases is not worth being advocated scientifically. Heart glycosides are indicated especially then, when a heart insufficiency stands in the foreground. In the acute phase of infarction, without manifest heart insufficiency, however, in individual cases they can deteriorate the myocardial oxygen balance and thus the clinical course. In myocardial infarction with severe heart insufficiency up to the cardiogenic shock all therapeutic possibilities should be utilized; to this belongs also the application of glycosides. As a rule in cardiogenic shock after myocardial infarction glycosides have no sufficient measurable influence on haemodynamics. Heart glycosides together with an individually adapted kinetotherapy are of importance for the metaphylaxis in patients with infarction. PMID:1189495

  15. [Heart rate and outcome in patients with acute and chronic heart failure].

    Science.gov (United States)

    Oliva, Fabrizio; Ammirati, Enrico; Campana, Carlo; Carubelli, Valentina; Cirò, Antonio; Di Tano, Giuseppe; Mortara, Andrea; Senni, Michele; Morandi, Fabrizio; Metra, Marco

    2016-03-01

    Heart rate (HR) is not only a physical sign but also a biomarker. High HR in several cardiac disorders is associated with increased mortality. In heart failure (HF), HR represents an important therapeutic target, both in the acute and chronic phase. Beta-blockers are a milestone of recommended treatments in HF patients with reduced ejection fraction. However, hemodynamic profile or intolerance may limit the use or the optimization of beta-blocker treatment, both during hospitalization and outpatient follow-up. More recently, ivabradine has become available, a drug that lowers HR by blocking the I(f) current in the pacemaker cells at the sinoatrial node level. In the SHIFT trial, ivabradine was shown to improve the outcome of patients with chronic HF, in sinus rhythm, with HR >70 b/min while on beta-blockers. Preliminary data have shown that this drug has a good safety profile and lowers effectively HR even during hospitalization due to worsening HF. However, further studies are warranted to understand if an earlier administration of ivabradine can lead to a better prognosis beyond symptom control and improved hemodynamics. In patients with atrial fibrillation and HF, the target is the restoration of sinus rhythm, alternatively rate control should be pursued with beta-blockers, amiodarone or digitalis, even if there is no clear evidence of an association between ventricular rate response in patients with atrial fibrillation at discharge after an HF hospitalization and major cardiovascular events. In this review, the studies that point to a role of HR both as a biomarker and a therapeutic target in patients with acute and chronic HF are described. In addition, the proportions of patients who do not reach target HR values at discharge after an acute decompensated HF episode or in the chronic phase are evaluated based on the Italian registries. PMID:27030005

  16. 内质网应激与缺血性心脏病%Endoplasmic reticulum stress and ischemic heart disease

    Institute of Scientific and Technical Information of China (English)

    刘谋杰; 贾大林

    2014-01-01

    内质网应激(endoplasmic reticulum stress,ERS)与缺血性心脏病(ischemic heart disease,IHD)的发病机制密切相关.内质网应激的保护机制有利于心肌细胞应付缺血、维持细胞稳态;而过度内质网应激引起的损伤机制则在心肌缺血后心肌细胞凋亡中发挥了重要作用.本文主要就内质网应激及缺血性心脏病的研究进展作一综述,为缺血性心脏病发病机制的研究及临床治疗提供新的理论依据.

  17. Genetic variation in the ABCA1 gene, HDL cholesterol, and risk of ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Frikke-Schmidt, Ruth

    2010-01-01

    Epidemiological studies consistently demonstrate a strong inverse association between low levels of high-density lipoprotein (HDL) cholesterol and increased risk of ischemic heart disease (IHD). This review focuses on whether both rare and common genetic variation in ABCA1 contributes to plasma...... levels of HDL cholesterol and to risk of IHD in the general population, and further seeks to understand whether low levels of HDL cholesterol per se are causally related to IHD. Studies of the ABCA1 gene demonstrate a general strategy for detecting functional genetic variants, and show that both common...... and rare ABCA1 variants contribute to levels of HDL cholesterol and risk of IHD in the general population. The association between ABCA1 variants and risk of IHD appears, however, to be independent of plasma levels of HDL cholesterol. With the recent identification of the largest number of individuals...

  18. Remnant Cholesterol, Low-Density Lipoprotein Cholesterol, and Blood Pressure as Mediators From Obesity to Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Benn, Marianne; Smith, George Davey;

    2015-01-01

    RATIONALE: Obesity leads to increased ischemic heart disease (IHD) risk, but the risk is thought to be mediated through intermediate variables and may not be caused by increased weight per se. OBJECTIVE: To test the hypothesis that the increased IHD risk because of obesity is mediated through...... variables and using genetic variants associated with these. During ≤22 years of follow-up 13 945 participants developed IHD. The increased IHD risk caused by obesity was partly mediated through elevated levels of nonfasting remnant cholesterol and low-density lipoprotein cholesterol, through elevated blood...... obesity were low-density lipoprotein cholesterol with 8%, systolic blood pressure with 7%, and remnant cholesterol with 7% excess risk of IHD. Corresponding observational excess risks using conventional body mass index were 21%, 11%, and 20%, respectively. CONCLUSIONS: The increased IHD risk because...

  19. 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.

  20. Cost-effectiveness of nutritional counseling for obese patients and patients at risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Olsen, Jens; Willaing, Ingrid; Ladelund, Steen;

    2005-01-01

    patient groups and interventions report effects within the same magnitude. The GP group was the most cost-effective, but it must be concluded that both counseling strategies were relatively cost-effective. Even though the cost of gaining an extra life year was estimated to be 59,987 DKK in the dietician......OBJECTIVES: Obesity and dyslipidemia are risk factors for ischemic heart disease, and prevention and treatment in primary care can reduce these risks. The objective of this cost-effectiveness analysis was to compare the costs and effects (in terms of life years gained) of providing nutritional...... counseling by a general practitioner (GP) or a dietician. METHODS: A total of 60 GPs, who accepted to participate, were randomized either to give nutritional counseling or to refer patients to a dietician for counseling. The life years gained was estimated using a Cox regression model. Costs were estimated...

  1. Microvascular Disease and Ischemic Heart Disease%微血管病变与缺血性心脏病

    Institute of Scientific and Technical Information of China (English)

    田骆冰; 夏岳; 刘超; 刘坤申

    2009-01-01

    冠状动脉微血管在心肌的血供中起着重要作用,冠状动脉微循环对冠心病的发生、发展、疗效及预后具有重要影响而备受人们重视.目前冠状动脉微血管病变主要分为X综合征和冠脉内慢血流现象,二者都与缺血性心脏病存在着密切的关系,但发病机制有所不同.X综合征主要是冠状动脉微血管痉挛所致,而冠脉内慢血流现象传统上被认为与微血管功能失调有关.此外慢血流现象可能是缺血性心脏病的一种新的发病机制,它可能代表了动脉粥样硬化和内皮功能失调的早期阶段.并且二者在治疗上有所不同.%Small coronary arteries play an important role in the blood supply of the myocardial tissues. Microcirculation has an important effect on the pathogenesis, development, therapy, and prognosis of coronary artery disease. At present, coronary microvascular disease mainly includes syndrome X and coronary slow flow phenomenon, which is closely related to ischemic heart disease. However, their pathogenesis differs;syndrome X is caused by a spasm of the microvessels, while coronary slow flow phenomenon is related to a microvascular disfunction. Coronary slow flow phenomenon may be a new pathogenic mechanism for ischemic heart disease.

  2. Telomere length of circulating leukocyte subpopulations and buccal cells in patients with ischemic heart failure and their offspring.

    Directory of Open Access Journals (Sweden)

    Liza S M Wong

    Full Text Available BACKGROUND: We aimed to find support for the hypothesis that telomere length (TL is causally involved in the pathogenesis of ischemic heart failure (IHF. We measured TL in IHF patients and their high-risk offspring and determined whether mean leukocyte TL reflects TL in CD34+ progenitor. We additionally measured TL of offspring of patients and controls to examine heritability throughout different cell types. METHODS AND RESULTS: TL was measured by qPCR in overall leukocytes, CD34+ progenitor cells, mononuclear cells (MNCs, and buccal cells in 27 IHF patients, 24 healthy controls and 60 offspring. TL in IHF patients was shorter than healthy controls in leukocytes (p = 0.002, but not in CD34+ cells (p = 0.39, MNCs (p = 0.31 or buccal cells (p = 0.19. Offspring of IHF patients had shorter TL in leukocytes than offspring of healthy subjects (p = 0.04 but not in other cell types. Controls and offspring showed a good within person correlation between leukocytes and CD34+ cells (r 0.562; p = 0.004 and r 0.602; p = 0.001, respectively. In IHF patients and offspring the correlation among cell types was blunted. Finally, we found strong correlations between parent and offspring TL in all four cell types. CONCLUSIONS: Reduced leukocyte TL in offspring of IHF subjects suggests a potential causal link of TL in ischemic heart disease. However, this causality is unlikely to originate from exhaustion of TL in CD34+ progenitor or MNC cells as their lengths are not well captured by overall leukocyte TL. Additionally, we found strong correlations between parent and offspring TL in all examined cell types, suggesting high heritability of TL among cell types.

  3. 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...

  4. Clinical significance of pain in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    GAN Qian; ZHANG Feng-ru; ZHOU Qing-fen; DAI Li-ying; LIU Ye-hong; CHAI Xi-chen; WU Fang; SHEN Wei-feng

    2012-01-01

    Background There is a paucity of studies investigating the clinical and biochemical characteristics of pain in chronic heart failure (CHF) patients.This study aimed to determine the clinical and biochemical characteristics and outcomes in Chinese patients with CHF and symptoms of pain.Methods Sociodemographics,serum levels of creatinine,NT-proBNP,high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-6 and IL-10,and two-dimensional echocardiographic left ventricular ejection fraction (LVEF) were determined in 305 patients with CHF.A questionnaire packet including the Brief Pain Inventory (BPI) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to assess the degree of pain rated on a 0-10 scale and the quality of life (QOL).A six-minute walking test was performed during routine clinic visits.Major adverse cardiac events (MACE) were recorded; including all-cause or cardiac mortality and rehospitalization because of myocardial infarction,worsening heart failure or stroke at follow-up.Results Pain occurred in 25.6% of CHF patients,and was more common when the New York Heart Association (NYHA) functional class was worse.More patients with pain were female in gender,and had more co-morbidities,lower LVEF,and shorter distance during the 6-minute walking test.Despite similar serum levels of creatinine,N-terminal prohormone of brain natriuretic peptide (NT-proBNP),IL-6 and IL-10,the TNF-α levels were higher and MLHFQ scores were greater in CHF patients with pain.At follow-up,CHF patients with moderate to severe pain (≥4 scale) had higher rates of all-cause and cardiac mortality and rehospitalization because of myocardial infarction,worsening heart failure or stroke.Multivariate regression analysis revealed that the presence of pain was an independent risk factor for MACE and reduced QOL in CHF patients.Conclusions Pain occurs in all stages of the CHF trajectory,and its incidence increases as clinical

  5. Hemostatic biomarkers in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Tarnow, Inge; Falk, Torkel; Tidholm, Anna;

    2007-01-01

    Background: Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium could...... contribute to increased mortality. Hypothesis: That plasma concentration or activity of hemostatic biomarkers is altered in dogs with CHF and that these factors predict mortality. Animals: Thirty-four dogs with CHF caused by either dilated cardiomyopathy (DCM, n = 14) or degenerative valvular disease (CDVD......, n = 20) compared with 23 healthy age-matched control dogs were included in this study. Dogs with CHF were recruited from 2 referral cardiology clinics, and control dogs were owned by friends or colleagues of the investigators. Methods: Clinical examination and echocardiography were performed in all...

  6. [Optimization of energy metabolism in patients with chronic heart failure].

    Science.gov (United States)

    Korzh, A N

    2010-01-01

    Nowadays particular interest of clinicians is attracted by metabolic therapy of patients with chronic heart failure (CHF). The objective of this study was to investigate the influence of complex therapy with addition of Vasonat on the dynamics of remodeling indexes of left ventricle and functional class of CHF on classification of NYHA. It has been shown that application of metabolic modulator Vasonat in addition to conventional therapy of CHF facilitated the clinical improvement and significant decline of functional class. Vasonat use resulted in the meaningful improvement of the contractive function of myocardium and increase of tolerance to the physical exercise. Moreover, high efficiency of Vasonat has been demonstrated in the control of the syndrome of oxidizing stress, by decrease in intensity of free-radical processes and activation of the antioxidant defense system. PMID:21265120

  7. 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. PMID:26336439

  8. Compromised Blood-Brain Barrier Competence in Remote Brain Areas in Ischemic Stroke Rats at Chronic Stage

    Science.gov (United States)

    Garbuzova-Davis, Svitlana; Haller, Edward; Williams, Stephanie N.; Haim, Eithan D.; Tajiri, Naoki; Hernandez-Ontiveros, Diana G.; Frisina-Deyo, Aric; Boffeli, Sean M.; Sanberg, Paul R.; Borlongan, Cesario V.

    2014-01-01

    Stroke is a life threatening disease leading to long-term disability in stroke survivors. Cerebral functional insufficiency in chronic stroke might be due to pathological changes in brain areas remote from initial ischemic lesion, i.e. diaschisis. Previously, we showed that the damaged blood-brain barrier (BBB) was implicated in subacute diaschisis. The present study investigated BBB competence in chronic diaschisis using a transient middle cerebral artery occlusion (tMCAO) rat model. Our results demonstrated significant BBB damage mostly in the ipsilateral striatum and motor cortex in rats at 30 days after tMCAO. The BBB alterations were also determined in the contralateral hemisphere via ultrastructural and immunohistochemical analyses. Major BBB pathological changes in contralateral remote striatum and motor cortex areas included: (1) vacuolated endothelial cells containing large autophagosomes, (2) degenerated pericytes displaying mitochondria with cristae disruption, (3) degenerated astrocytes and perivascular edema, (4) Evans Blue extravasation, and (5) appearance of parenchymal astrogliosis. Importantly, discrete analyses of striatal and motor cortex areas revealed significantly higher autophagosome accumulation in capillaries of ventral striatum and astrogliosis in dorsal striatum in both cerebral hemispheres. These widespread microvascular alterations in ipsilateral and contralateral brain hemispheres suggest persistent and/or continued BBB damage in chronic ischemia. The pathological changes in remote brain areas likely indicate chronic ischemic diaschisis, which should be considered in the development of treatment strategies for stroke. PMID:24610730

  9. The heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Dümcke, Christine Winkler; Krag, Aleksander

    2009-01-01

    Cardiac failure affects the liver and liver dysfunction affects the heart. Chronic and acute heart failure can lead to cardiac cirrhosis and cardiogenic ischemic hepatitis. These conditions may impair liver function and treatment should be directed towards the primary heart disease and seek...... against the heart failure. Transjugular intrahepatic portosystemic shunt insertion and liver transplantation affect cardiac function in portal hypertensive patients and cause stress to the cirrhotic heart, with a risk of perioperative heart failure. The risk and prevalence of coronary artery disease...

  10. EFFECTIVE TREATMENT OF PATIENTS WITH CHRONIC HEART FAILURE AND DEPRESSIVE DISORDERS WITH NOOTROPICS DRUG PANTOGAM ACTIV

    Directory of Open Access Journals (Sweden)

    A. P. Baranov

    2016-01-01

    Full Text Available We investigate the efficiency of the inclusion nootropic drug Pantogam Activ in the complex therapy of 82 patients with heart failure, ischemic heart diseases, anxiety and depressive disorders. It was shown that an 8-week treatment with Pantogam Activ in most patients is accompanied by a significant reduction of anxiety and depressive disorders, increase exercise tolerance, improved autonomic regulation of heart function and decrease the frequency of supraventricular and ventricular arrhythmias, which is accompanied by a marked improvement in the quality of life. 

  11. Association of loss-of-function mutations in the ABCA1 gene with high-density lipoprotein cholesterol levels and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Frikke-Schmidt, R.; Nordestgaard, B.G.; Stene, M.C.A.;

    2008-01-01

    Context Low levels of high- density lipoprotein ( HDL) cholesterol are inversely related to cardiovascular risk. Whether this is a causal effect is unclear. Objective To determine whether genetically reduced HDL cholesterol due to heterozygosity for 4 loss- of- function mutations in ABCA1 cause...... increased risk of ischemic heart disease ( IHD). Design, Setting, and Participants Three studies of white individuals from Copenhagen, Denmark, were used: the Copenhagen City Heart Study ( CCHS), a 31-year prospective general population study ( n= 9022; 28 heterozygotes); the Copenhagen General Population...... Study ( CGPS), a cross- sectional general population study ( n= 31 241; 76 heterozygotes); and the Copenhagen Ischemic Heart Disease Study ( CIHDS), a case- control study ( n= 16 623; 44 heterozygotes). End points in all 3 studies were recorded during the period of January 1, 1976, through July 9, 2007...

  12. The clinical significance of detection to heart rate deceleration capacity and heart rate variability in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Jiang-rong Zhou

    2015-01-01

    Full Text Available Objective: To study the change of heart rate deceleration capacity ( DC and heart rate variability in patients with chronic heart failure (CHF and its relationship with left ventricular ejection fraction (LVEF. Methods: DC, LVEF, time and frequency domain parameters of HRV were measured in 66 patients with CHF and 34 healthy adults (control group by using 24h Holter recordings and Echocardiography. The standard deviation of normal R-R intervals( SDNN, squares of differences between adjacent NN intervals ( RMSSD,low frequency power( LFn and high frequency power( HFn and the changes of LVEF were compared between  the two groups,the relationship between DC,LVEF and HRV were studied in patients with CHF. Results: The median value of DC in the patients with CHF was significantly lower than that in control group( 3.1 ± 2.4 ms vs 7.2 ± 1.3 ms,P <0.01.Incidence of abnormal DC in the CHF group was 57.5%,which was significantly higher than that in the control group (P <0.01.The HRV index, including SDNN、RMSSD、LFn、HFn, in the CHF group was significantly lower than that in normal control group (P < 0.01. Significant positive correlation between HRV index and LVEF were confirmed (P < 0.01. Conclusions: DC and HRV index are lower in patients with CHF and have a good correlation with the left ventricular ejection fraction.

  13. «MEMORIES OF FUTURE»: CHANGE IN VERAPAMIL SIGNIFICANCE IN THE TREATMENT OF PATIENTS WITH ISCHEMIC HEART DISEASE AND ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevskiy

    2015-09-01

    Full Text Available The significance of verapamil in the treatment of patients with ischemic heart disease (IHD and hypertension (HT is considered. Data on the limited role of beta-blockers in the improvement of patient’s status in stable IHD, data about negative effect of heart rate (HR reduction on the central aortic pressure, as well as the relationship between HR and risk of complications in the INVEST trial are presented. Verapamil therapy in patients with HT and IHD without heart failure/systolic dysfunction and/or recent myocardial infarction may have advantages due to achievement of the sufficient antiischemic effect with less HR reduction.

  14. Long-term expression of periostin during the chronic stage of ischemic stroke in mice.

    Science.gov (United States)

    Shimamura, Munehisa; Taniyama, Yoshiaki; Nakagami, Hironori; Katsuragi, Naruto; Wakayama, Kouji; Koriyama, Hiroshi; Kurinami, Hitomi; Tenma, Akiko; Tomioka, Hideki; Morishita, Ryuichi

    2014-06-01

    Periostin is an extracellular matrix glycoprotein and has various cellular effects. Previously, we demonstrated the neuroprotective effects of periostin during the acute stage of cerebral ischemia. However, its expression during the chronic stage remains unknown. Herein, we examined the expression of full-length periostin (periostin 1; Pn1) and its splicing variant lacking exon 17 (periostin 2; Pn2) during the 28 days following transient middle cerebral artery occlusion in mice. Real-time reverse transcription-PCR showed that the expression of Pn2 was dramatically upregulated between days 3 and 28, and the highest expression was observed on day 7. The expression of Pn1 was also increased, but delayed compared with Pn2. Immunohistochemistry showed that periostin was weakly expressed in reactive astrocytes in the peri-infarct region and in microglia/macrophages in infarct regions, on days 3 and 7. Periostin was also expressed around CD31-positive cells in both the peri-infarct and the sub-ventricular zone (SVZ) on days 3 and 7. SOX-2 positive cells, which are neural stem cells, also expressed periostin on day 7. The highest periostin immunoreactivity that occurred co-localized with collagen I and fibronectin in the peri-infarct region between days 7 and 28. Thus, the expression pattern of periostin mRNA was dependent on the splicing variant, and it continued to be expressed up to 28 days after cerebral ischemia. As periostin was expressed in various cells, such as reactive astrocytes/microglia, fibroblasts and neuronal progenitor cells, periostin might be associated with pathophysiology in post-ischemic inflammation and neurogenesis.

  15. Leukotriene C4 synthase and ischemic cardiovascular disease and obstructive pulmonary disease in 13,000 individuals

    DEFF Research Database (Denmark)

    Freiberg, Jacob J; Dahl, Morten; Tybjaerg-Hansen, Anne;

    2009-01-01

    Ischemic cardiovascular disease and obstructive pulmonary disease involve inflammation. Leukotrienes may be important pro-inflammatory mediators. We tested the hypothesis that the (-1072)G > A and (-444)A > C promoter polymorphisms of leukotriene C4 synthase confer risk of transient ischemic attack...... (TIA), ischemic stroke, ischemic heart disease (IHD), asthma, and chronic obstructive pulmonary disease (COPD). We genotyped individuals from the Danish general population, the Copenhagen City Heart Study, and Danish patients with IHD/coronary atherosclerosis, the Copenhagen Ischemic Heart Disease...... genotype (log-rank: p = 0.03). Cumulative incidence for ischemic stroke was also lower for (-444)CC versus AA genotype (log-rank: p = 0.04). Multifactorially adjusted hazard ratios for TIA were 5.2(95% CI:1.9-14) for (-1072)AA versus GG genotype, and 0.4(0.2-1.0) for (-444)CC versus AA genotype...

  16. Vascular Disease and Risk Stratification for Ischemic Stroke and All-Cause Death in Heart Failure Patients without Diagnosed Atrial Fibrillation: A Nationwide Cohort Study

    Science.gov (United States)

    Melgaard, Line; Gorst-Rasmussen, Anders; Rasmussen, Lars Hvilsted; Lip, Gregory Y. H.; Larsen, Torben Bjerregaard

    2016-01-01

    Background Stroke and mortality risk among heart failure patients previously diagnosed with different manifestations of vascular disease is poorly described. We conducted an observational study to evaluate the stroke and mortality risk among heart failure patients without diagnosed atrial fibrillation and with peripheral artery disease (PAD) or prior myocardial infarction (MI). Methods Population-based cohort study of patients diagnosed with incident heart failure during 2000–2012 and without atrial fibrillation, identified by record linkage between nationwide registries in Denmark. Hazard rate ratios of ischemic stroke and all-cause death after 1 year of follow-up were used to compare patients with either: a PAD diagnosis; a prior MI diagnosis; or no vascular disease. Results 39,357 heart failure patients were included. When compared to heart failure patients with no vascular disease, PAD was associated with a higher 1-year rate of ischemic stroke (adjusted hazard rate ratio [HR]: 1.34, 95% confidence interval [CI]: 1.08–1.65) and all-cause death (adjusted HR: 1.47, 95% CI: 1.35–1.59), whereas prior MI was not (adjusted HR: 1.00, 95% CI: 0.86–1.15 and 0.94, 95% CI: 0.89–1.00, for ischemic stroke and all-cause death, respectively). When comparing patients with PAD to patients with prior MI, PAD was associated with a higher rate of both outcomes. Conclusions Among incident heart failure patients without diagnosed atrial fibrillation, a previous diagnosis of PAD was associated with a significantly higher rate of the ischemic stroke and all-cause death compared to patients with no vascular disease or prior MI. Prevention strategies may be particularly relevant among HF patients with PAD. PMID:27015524

  17. [Chronic systolic heart failure - dosing recommendations at beginning and end of treatment].

    Science.gov (United States)

    Zugck, Christian; Remppis, Andrew; Katus, Hugo A; Frankenstein, Lutz

    2008-10-01

    As a multi-system disease, chronic heart failure requires a complex, multimodal therapy. Achieving maximum guideline adherence in (advanced) chronic heart failure can therefore become a challenge. The important decrease in morbidity and mortality seen lately largely depends on consequent and sometime tedious implementation of guideline targets. The present paper provides a comprehensive overview on medical therapeutic strategies with a particular focus of onset and discontinuation of drugs in patients with chronic systolic dysfunction.

  18. Salt Intake Is Associated with Inflammation in Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Alper Azak

    2015-09-01

    Full Text Available Background: Chronic Heart Failure (CHF is highly prevalent and is associated with high morbidity and mortality rates. It has been well established that excessive intake of sodium chloride (salt induced hypertension in some populations. Although salt seems to induce cardiovascular diseases through elevation of blood pressure, it has also been indicated that salt can induce cardiovascular diseases independently from blood pressure elevation. Objectives: The present study aimed to evaluate the association between salt consumption and inflammation in CHF patients. Patients and Methods: This study was conducted on 86 patients between 18 and 65 years old who were diagnosed with New York Heart Association (NYHA functional class I and II heart failure. Salt intake was calculated by using 24 hour urine sodium excretion. Besides, the association between inflammation and daily salt intake was evaluated regarding C - reactive protein (CPR, High sensitive CRP (HsCPR, Erythrocyte Sedimentation Rate (ESR, and ferritin and fibrinogen levels using Pearson correlation analysis. Results: Our results showed a statistically significant difference between the low (n = 41 and high (n = 45 salt intake groups in terms of serum HsCRP levels (5.21 ± 2.62 vs. 6.36 ± 2.64 (P < 0.048. Additionally, a significant correlation was observed between the amount of salt consumption and HsCRP levels. In this study, daily salt consumption of the enrolled patients was 8.53 gram/day. The medications and even the blood pressures were similar in the two groups, but daily pill count, prevalence of hypertension, and coronary heart disease were higher in the high salt intake group; however, the differences were not statistically significant (P = 0.065. Also, no significant difference was observed between the groups concerning the inflammation markers, such as CRP, ESR, ferritin, and fibrinogen. Conclusions: Neurohumoral and inflammatory factors are thought to contribute to high mortality

  19. Mitochondrial KATP channel inhibition blunts arrhythmia protection in ischemic exercised hearts

    OpenAIRE

    Quindry, John C.; Schreiber, Lindsey; Hosick, Peter; Wrieden, Jenna; Irwin, J. Megan; Hoyt, Emily

    2010-01-01

    The mechanisms responsible for anti-arrhythmic protection during ischemia-reperfusion (IR) in exercised hearts are not fully understood. The purpose of this investigation was to examine whether the ATP-sensitive potassium channels in the mitochondria (mito KATP) and sarcolemma (sarc KATP) provide anti-arrhythmic protection in exercised hearts during IR. Male Sprague-Dawley rats were randomly assigned to cardioprotective treadmill exercise or sedentary conditions before IR (I = 20 min, R = 30 ...

  20. [Thallium-201 myocardial perfusion imaging during adenosine-induced coronary vasodilation in patients with ischemic heart disease].

    Science.gov (United States)

    Takeishi, Y; Chiba, J; Abe, S; Ikeda, K; Tonooka, I; Komatani, A; Takahashi, K; Nakagawa, Y; Shiraishi, T; Tomoike, H

    1992-09-01

    201Tl myocardial perfusion imaging during adenosine infusion was performed in consecutive 55 patients with suspected coronary artery disease. Adenosine was infused intravenously at a rate of 0.14 mg/kg/min for 6 minutes and a dose of 111 MBq of 201Tl was administered in a separate vein at the end of third minute of infusion. Myocardial SPECT imaging was begun 5 minutes and 3 hours after the end of adenosine infusion. For evaluating the presence of perfusion defects, 2 short axis images at the basal and apical levels and a vertical long axis image at the mid left ventricle were used. The regions with decreased 201Tl uptake were assessed semi-quantitatively. Adenosine infusion caused a slight reduction in systolic blood pressure and an increase in heart rate. The rate pressure products increased slightly (9314 +/- 2377 vs. 10360 +/- 2148, p < 0.001). Chest pain (24%) and headache (13%) were the frequent side effects. The second-degree atrioventricular block was developed in 11 of 55 (20%) patients. All symptoms and hemodynamic changes were well tolerated and disappeared within 1 or 2 minutes after discontinuing adenosine infusion. The sensitivity and specificity for the detection of patients with coronary artery disease were 100% (31/31) and 88% (7/8), respectively. 201Tl myocardial imaging during adenosine infusion was considered to be safe and useful for evaluating the patients with ischemic heart disease. PMID:1453559

  1. Evolution of cardiovascular risk factors and ischemic heart disease in an elderly urban Romanian population over the course of 1 year

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-11-01

    Full Text Available Dana Pop, Alexandra Dădârlat, Mihnea Zdrenghea, Dumitru Tudor Zdrenghea, Adela Viviana Sitar-Taăut Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania Background: Romania has some of the highest mortality figures in the world attributable to ischemic heart disease and stroke among both men and women. Objectives: To assess the changes in cardiovascular risk factors and ischemic heart disease in a group of subjects over 65 years of age during 1 year in an urban community of Romania. Materials and methods: We studied 515 subjects (264 women and 251 men with a mean age of 73.41±6.44 years, followed up over the course of 1 year in order to determine the changes that occurred in cardiovascular risk factors and in the evolution of ischemic heart disease. At the beginning and after 1 year, we determined the following parameters: anthropometric measurements, blood pressure, smoking status, lipid profile (total cholesterol, triglycerides, high-density lipid cholesterol, low-density lipid cholesterol, fasting plasma glucose, and the presence of ischemic heart disease. Results: There were no differences between the first and second assessments concerning the incidence of smoking (12.3% versus (vs 12.5%, obesity (25% vs 26%, diabetes mellitus (19% vs 22.9%, or hypertension (88.2% vs 92.2%. Statistically significant differences were recorded regarding dyslipidemia (40.6% vs 30.3%, P<0.001. Cholesterol median values decreased (204 mg/dL vs 194 mg/dL, P=0.003, while median concentrations of plasma glucose increased (101 mg/dL vs 105 mg/dL, P<0.05. At the same time, we noted a higher incidence of ischemic heart disease (51.65% vs 63%. Conclusion: Our data show that in subjects over 65 years of age, cardiovascular disease occurs more often in women, but with certain features that should be taken into account. In addition, we point out the importance of reducing cardiovascular risk factors. However, we should not

  2. Continuous intravenous infusion of prostaglandin E1 improves myocardial perfusion reserve in patients with ischemic heart disease assessed by positron emission tomography. A pilot study

    International Nuclear Information System (INIS)

    Recent investigation has demonstrated that prostaglandin E1 (PGE1) therapy increased capillary density in explanted hearts. Dynamic 13N-ammonia positron emission tomography (PET) is reliable for non-invasive measurement of myocardial blood flow and myocardial perfusion reserve (MPR). The aim of this study was to investigate the effects of PGE1 therapy during 4 weeks on reduction of myocardial perfusion abnormalities and increase of MPR in the patients with ischemic heart disease. In this double-blind, placebo-controlled trial, we randomly assigned 11 patients who had symptomatic heart failure and documented myocardial ischemia to 4 weeks intravenous infusion of PGE1 (2.5 ng/kg/min; 8 patients, age 60±13 years) or saline (3 patients, age 57±13 years). Dynamic 13N-ammonia PET scans at rest and during adenosine stress were obtained at baseline and 12 weeks after treatment completion. Quantitative size/severity of perfusion defects and MPR change from baseline to follow-up PET were determined using a 17-segment model. Compared with the control group, baseline MPR in the PGE1 group was significantly lower (1.96±0.78 vs. 2.71±0.73; P1 infusion (1.96±0.78 to 2.16±0.77; P1 infusion sustained MPR improvement in patients with ischemic heart disease. This may be an attractive therapeutic approach for no-option patients with severe ischemic cardiomyopathy. (author)

  3. Influence of kinesitherapy on motor recovery and functional independence in patients with ischemic stroke in the chronic period

    OpenAIRE

    Vasileva, Dance; Lubenova, Daniela; Mihova, Marija; Grigorova-Petrova, Kristin; Dimitrova, Antoaneta

    2015-01-01

    The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on motor recovery and functional independence in patients with ischemic stroke in the chronic period (ISChP). Material and Methods The study was conducted with 56 patients with ISChP (32 men and 24 women, mean age 63.2 ± 8.8 years old, weight 77.9 ± 10.1 kg, height 169.2 ± 6.4 centimeters and duration of illness up to 1 year). Assessment of motor recovery and the level of functional independence...

  4. Vascular Disease and Risk Stratification for Ischemic Stroke and All-Cause Death in Heart Failure Patients without Diagnosed Atrial Fibrillation

    DEFF Research Database (Denmark)

    Melgaard, Line; Gorst-Rasmussen, Anders; Rasmussen, Lars Hvilsted;

    2016-01-01

    rate ratios of ischemic stroke and all-cause death after 1 year of follow-up were used to compare patients with either: a PAD diagnosis; a prior MI diagnosis; or no vascular disease. RESULTS: 39,357 heart failure patients were included. When compared to heart failure patients with no vascular disease......BACKGROUND: Stroke and mortality risk among heart failure patients previously diagnosed with different manifestations of vascular disease is poorly described. We conducted an observational study to evaluate the stroke and mortality risk among heart failure patients without diagnosed atrial...... fibrillation and with peripheral artery disease (PAD) or prior myocardial infarction (MI). METHODS: Population-based cohort study of patients diagnosed with incident heart failure during 2000-2012 and without atrial fibrillation, identified by record linkage between nationwide registries in Denmark. Hazard...

  5. Pathophysiology and diagnosis of hibernating myocardium in patients with post-ischemic heart failure. The contribution of PET

    International Nuclear Information System (INIS)

    Identification and treatment of hibernating myocardium (HM) lead to improvement in left ventricular (LV) function and prognosis in patients with post-ischemic heart failure. Different techniques are used to diagnose HM: echocardiography, MRI, SPECT and PET and, in patients with moderate LV impairment, their predictive values are similar. There are few data on patients with severe LV dysfunction and heart failure in whom the greatest benefits are apparent after revascularization. Quantification of FDG uptake with PET during hyperinsulinemic euglycemic clamp is accurate in these patients with the greatest mortality risk in whom other techniques may give high false negative rates. The debate on whether resting myocardial blood flow to HM is reduced or not has stimulated new research on heart failure in patients with coronary artery disease. PET with H215O or 13NH3 has been used for the absolute quantification of regional blood flow in human HM. When HM is properly identified, resting blood flow is not different from that in healthy volunteers although a reduction of ∼20% can be demonstrated in a minority of cases. PET studies have shown that the main feature of HM is a severe impairment of coronary vasodilator reserve that improves after revascularization in parallel with LV function. Thus, the pathophysiology of HM is more complex than initially postulated. The recent evidence that repetitive ischemia in patients can be cumulative and lead to more severe and prolonged stunning, lends further support to the hypothesis that, at least initially, stunning and HM are two facets of the same coin. (author)

  6. Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome.

    LENUS (Irish Health Repository)

    Murray, Deirdre M

    2012-01-31

    Despite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24\\/35 (69%), suspicious in 8\\/35 (23%), and pathological in 3\\/35 (8%). All CTGs developed nonreassuring features prior to delivery. Three patterns of fetal heart rate abnormalities were seen: group 1, abnormal CTGs on admission in 11\\/35 (31%); group 2, normal CTGs on admission with gradual deterioration to pathological in 20\\/35 cases (57%); and group 3, normal CTGs on admission with acute sentinel events in 4\\/35 (11.5%). The median (interquartile range) duration between the development of pathological CTGs and delivery was 145 (81, 221) minutes in group 2 and 22 (12, 28) minutes in group 3. There was no correlation between duration of pathological CTG trace and grade of encephalopathy (R = 0.09, P = 0.63) or neurological outcome (P = 0.75). However, the grade of encephalopathy was significantly worse in group 3 (P = 0.001), with a trend to worse outcomes. The majority of infants with HIE have normal CTG traces on admission but develop pathological CTG patterns within hours of delivery. More severe encephalopathy was associated with normal admission CTG and acute sentinel events shortly before delivery.

  7. Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome.

    LENUS (Irish Health Repository)

    Murray, Deirdre M

    2009-09-01

    Despite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24\\/35 (69%), suspicious in 8\\/35 (23%), and pathological in 3\\/35 (8%). All CTGs developed nonreassuring features prior to delivery. Three patterns of fetal heart rate abnormalities were seen: group 1, abnormal CTGs on admission in 11\\/35 (31%); group 2, normal CTGs on admission with gradual deterioration to pathological in 20\\/35 cases (57%); and group 3, normal CTGs on admission with acute sentinel events in 4\\/35 (11.5%). The median (interquartile range) duration between the development of pathological CTGs and delivery was 145 (81, 221) minutes in group 2 and 22 (12, 28) minutes in group 3. There was no correlation between duration of pathological CTG trace and grade of encephalopathy (R = 0.09, P = 0.63) or neurological outcome (P = 0.75). However, the grade of encephalopathy was significantly worse in group 3 (P = 0.001), with a trend to worse outcomes. The majority of infants with HIE have normal CTG traces on admission but develop pathological CTG patterns within hours of delivery. More severe encephalopathy was associated with normal admission CTG and acute sentinel events shortly before delivery.

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

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1996-01-01

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

  9. End-of-life matters in chronic heart failure patients

    OpenAIRE

    Sobanski, Piotr; Jaarsma, Tiny; Krajnik, Malgorzata

    2014-01-01

    Purpose of review Until recently, concepts of care for people with heart failure had rarely included preparation for unavoidable imminent death or caring for the dying. The purpose of this review is to provide an update on current end-of-life issues specific to heart failure patients. Recent findings Mortality in the heart failure population remains high, especially shortly after the first acute heart failure hospitalization. Patients with systolic heart failure die more frequently from progr...

  10. Associations of NINJ2 sequence variants with incident ischemic stroke in the Cohorts for Heart and Aging in Genomic Epidemiology (CHARGE consortium.

    Directory of Open Access Journals (Sweden)

    Joshua C Bis

    Full Text Available Stroke, the leading neurologic cause of death and disability, has a substantial genetic component. We previously conducted a genome-wide association study (GWAS in four prospective studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE consortium and demonstrated that sequence variants near the NINJ2 gene are associated with incident ischemic stroke. Here, we sought to fine-map functional variants in the region and evaluate the contribution of rare variants to ischemic stroke risk.We sequenced 196 kb around NINJ2 on chromosome 12p13 among 3,986 European ancestry participants, including 475 ischemic stroke cases, from the Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, and Framingham Heart Study. Meta-analyses of single-variant tests for 425 common variants (minor allele frequency [MAF] ≥ 1% confirmed the original GWAS results and identified an independent intronic variant, rs34166160 (MAF = 0.012, most significantly associated with incident ischemic stroke (HR = 1.80, p = 0.0003. Aggregating 278 putatively-functional variants with MAF≤ 1% using count statistics, we observed a nominally statistically significant association, with the burden of rare NINJ2 variants contributing to decreased ischemic stroke incidence (HR = 0.81; p = 0.026.Common and rare variants in the NINJ2 region were nominally associated with incident ischemic stroke among a subset of CHARGE participants. Allelic heterogeneity at this locus, caused by multiple rare, low frequency, and common variants with disparate effects on risk, may explain the difficulties in replicating the original GWAS results. Additional studies that take into account the complex allelic architecture at this locus are needed to confirm these findings.

  11. Discrimination power of long-term heart rate variability measures for chronic heart failure detection.

    Science.gov (United States)

    Melillo, Paolo; Fusco, Roberta; Sansone, Mario; Bracale, Marcello; Pecchia, Leandro

    2011-01-01

    The aim of this study was to investigate the discrimination power of standard long-term heart rate variability (HRV) measures for the diagnosis of chronic heart failure (CHF). The authors performed a retrospective analysis on four public Holter databases, analyzing the data of 72 normal subjects and 44 patients suffering from CHF. To assess the discrimination power of HRV measures, an exhaustive search of all possible combinations of HRV measures was adopted and classifiers based on Classification and Regression Tree (CART) method was developed, which is a non-parametric statistical technique. It was found that the best combination of features is: Total spectral power of all NN intervals up to 0.4 Hz (TOTPWR), square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and standard deviation of the averages of NN intervals in all 5-min segments of a 24-h recording (SDANN). The classifiers based on this combination achieved a specificity rate and a sensitivity rate of 100.00 and 89.74%, respectively. The results are comparable with other similar studies, but the method used is particularly valuable because it provides an easy to understand description of classification procedures, in terms of intelligible "if … then …" rules. Finally, the rules obtained by CART are consistent with previous clinical studies. PMID:21203855

  12. Antihypertensive treatment, high triglycerides, and low high-density lipoprotein cholesterol and risk of ischemic heart disease mortality: a 16-year follow-up in the Copenhagen male study

    DEFF Research Database (Denmark)

    Suadicani, Poul; Hein, Hans Ole; Gyntelberg, Finn

    2010-01-01

    The aim of this study was to test the hypothesis that metabolic syndrome dyslipidemia is a major risk factor for ischemic heart disease (IHD) mortality among men taking antihypertensive medication....

  13. [Transesophageal electric stimulation of the left atrium in the diagnosis of ischemic heart disease].

    Science.gov (United States)

    Liakishev, A A; Kozlov, S G; Grosu, A A; Kulikova, T V; Sidorenko, B A

    1984-10-01

    The clinical picture and the results of bicycle ergometry and selective coronarography were compared with the findings of electrical stimulation of the left atrium in 24 patients. It was demonstrated that transesophagus electric stimulation of the left atrium may serve as a diagnostic method in coronary heart disease.

  14. ECG signal analysis for detection of Heart Rate and Ischemic Episodes

    OpenAIRE

    Goutam Kumar Sahoo, Samit Ari, Sarat Kumar Patra

    2013-01-01

    Electrocardiogram (ECG) is generally used fordiagnosis ofcardiovascularabnormalitiesanddisorders.Anefficient method for analysingtheECG signal towards the detection ofheartrate(HR)andischemic episodesfollows mainly fivestages:pre-processing, feature extraction,heart ratedetection,beat classification and ischemicepisoderecognition.Theheart rate is calculatedusing theextracted featuresoftheECG signal. Thecalculated HRvaluecan beanalysedforthedetectionofvariouscardiovascularabnormalities.Theabil...

  15. Heart rate increment analysis is not effective for sleep-disordered breathing screening in patients with chronic heart failure.

    OpenAIRE

    Damy, Thibaud; d'Ortho, Marie-Pia; Estrugo, Brigitte; Margarit, Laurent; Mouillet, Gauthier; Mahfoud, Mohannad; Roudot-Thoraval, Francoise; Vermes, Emmanuelle; Hittinger, Luc; Roche, Frederic; Macquin-Mavier, Isabelle

    2010-01-01

    Frequency domain analysis of heart rate variation has been suggested as an effective screening tool for sleep-disordered breathing (SDB) in the general population. The aim of this study was to assess this method in patients with chronic congestive heart failure (CHF). We included prospectively 84 patients with stable CHF, left ventricular ejection fraction (LVEF) or =15 h(-1) was diagnosed in 57.4% of patients. Percent VLFI was not correlated with AHI (r = 0.12). Receiver-operating character...

  16. 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

  17. Features of The Heart Remodeling in Patients with Chronic Obstructive Pulmonary Diseases, Combined with Coronary Heart Diseases

    Directory of Open Access Journals (Sweden)

    A.Yu. Ryabova

    2009-09-01

    Full Text Available The characteristics of heart remodeling in patients with chronic obstructive pulmonary diseases ( COPD, associated with coronary heart diseases (CHD were examined. The changes of structural and functional state of myocardium, intracardiac relationships with associated pathology were under study. The role of blood inflammatory cytokines (IL-6, IL-8, TNF-a and the level of cell adhesion molecules (ICAM-1, VCAM-1 in exacerbating myocardial dysfunction was clarified.

  18. Bone Marrow Stem Cell Treatment for Ischemic Heart Disease in Patients with No Option of Revascularization: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Sheila A Fisher

    Full Text Available To evaluate bone marrow stem cell treatment (BMSC in patients with ischemic heart disease (IHD and no option of revascularization.Autologous BMSC therapy has emerged as a novel approach to treat patients with acute myocardial infarction or chronic ischemia and heart failure following percutaneous or surgical revascularization, respectively. However, the effect of the treatment has not been systematic evaluated in patients who are not eligible for revascularization.MEDLINE (1950-2012, EMBASE (1980-2012, CENTRAL (The Cochrane Library 2012, Issue 8 and ongoing trial databases were searched for relevant randomized controlled trials. Trials where participants were diagnosed with IHD, with no option for revascularization and who received any dose of stem cells by any delivery route were selected for inclusion. Study and participant characteristics, details of the intervention and comparator, and outcomes measured were recorded by two reviewers independently. Primary outcome measures were defined as mortality and measures of angina; secondary outcomes were heart failure, quality of life measures, exercise/performance and left ventricular ejection fraction (LVEF.Nine trials were eligible for inclusion. BMSC treatment significantly reduced the risk of mortality (Relative Risk 0.33; 95% Confidence Interval 0.17 to 0.65; P = 0.001. Patients who received BMSC showed a significantly greater improvement in CCS angina class (Mean Difference -0.55; 95% Confidence Interval -1.00 to -0.10; P = 0.02 and significantly fewer angina episodes per week at the end of the trial (Mean Difference -5.21; 95% Confidence Interval -7.35 to -3.07; P<0.00001 than those who received no BMSC. In addition, the treatment significantly improved quality of life, exercise/performance and LVEF in these patients.BMSC treatment has significant clinical benefit as stand-alone treatment in patients with IHD and no other treatment option. These results require confirmation in large

  19. Coronary heart disease risk in patients with stroke or transient ischemic attack and no known coronary heart disease: findings from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

    DEFF Research Database (Denmark)

    Amarenco, Pierre; Goldstein, Larry B; Sillesen, Henrik;

    2010-01-01

    Noncoronary forms of atherosclerosis (including transient ischemic attacks or stroke of carotid origin or >50% stenosis of the carotid artery) are associated with a 10-year vascular risk of >20% and are considered as a coronary heart disease (CHD) -risk equivalent from the standpoint of lipid...... management. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial included patients with stroke or transient ischemic attack and no known CHD regardless of the presence of carotid atherosclerosis. We evaluated the risk of developing clinically recognized CHD in SPARCL patients....

  20. Cardioprotective Effect of Angiotensin Ⅱ Receptor Antagonist on Perfused Ischemic Reper-fusion Injury of Whole Isolated Rat Hearts

    Institute of Scientific and Technical Information of China (English)

    徐延敏; 黄体钢; 陈元禄; 李广平

    2003-01-01

    Objectives Investigated the cardioprotective and mechanisms of losartan onwhole isolated ischemic reperfused rat heart. Meth-ods Langendorff perfused systems was used to in-vestigate losartan effect on whole isolated rat hearts inCPK, LDH, MDA, SOD, ang Ⅱ and arrhythmia. Re-sults Losartan decreased incidence of arrhythmia,improved atrial ventricular block recovery in reperfu-sion period, during ischemic period, CPK and LDH inI/R group increased significantly compared with con-trol group, 51.33±27.02 vs 22.42±13.33, 31.80±4.56 vs 22.28 ± 15.96, respectively, but greatlydecreased in losartan group compared with I/R group,23.90±21.74 vs 51.33±27.02 and 11.50±13.20vs 31.80 ± 4. 56, respectively. During reperfusion pe-riod CPK, LDH increased significantly in I/R groupcompared with control group, 49.11 ± 20.63 vs 12.14±5.92 and 28.70±4.69 vs 23.10±21.38, re-spectively, but decreased greatly in losartan groupcompared with I/R group, 39.40 ± 9.60 vs 49.11 ±20.63 and 14.50±13.75 vs 28.70±4.69. Thecontent of MDA, ang Ⅱ in I/R group myocytes ishigher than control group's , 26. ±9. 25 vs 17.2 ±3.37 and 8.43±3.81 vs 4. 80±0.20. However thecontent of SOD in two groups has no significantlychange, 148. 20 ± 8. 72 vs 145.08±6.82. the con-tent of MDA in losartan group myocardial tissue ismuch lower than control group, 15.92±4.05 vs26.80± 9.25 and the content of ang Ⅱ in losartangroup myocardial tissue is much higher than I/Rgroup, 12.44 ± 6.09 vs 8.43 ± 3.21. The departmentof cardiology of second hospital of Tianjin medical u-niversity Tianjin 300211 However, SOD has nosignificant change in two groups, 143.47 ±7.91 vs145.08 ± 6.82. Conclusions Losartan against is-chemic-reperfusion injury of whole isolated rathearts, those beneficial effects are mediate primarily bythe inhibited of angiotensin Ⅱ binding with its receptorand inhibited oxygen free radical scavenging potential.

  1. The Inuit diet. Fatty acids and antioxidants, their role in ischemic heart disease, and exposure to organochlorines and heavy metals. An international study

    DEFF Research Database (Denmark)

    Mulvad, G; Pedersen, H S; Hansen, J C;

    1996-01-01

    Traditional food is culturally, economically and nutritionally important for the Greenlandic Inuit people. In the 1970s the preventive effect of marine fat on cardiovascular disease, thrombosis and atherosclerosis was described. The low incidence of ischemic heart disease among Greenlanders has...... have analysed specimens in relation to ischemic heart disease as a benefit related to diet, as well as the level of heavy metals and organochlorine in organs as a risk related to diet. High amounts of mono-unsaturated and Omega-3 poly-unsaturated fatty acid were found in adipose tissue. Liver analyses...... of selenium have confirmed the expected high intake among Greenlanders. Reduced atherosclerotic lesions were found in the coronary arteries. Blood pressure levels calculated from renovascholopathia of hypertension indicate prevailing levels similar to those in industrialized countries. Some factors...

  2. The Analysis of Anemia in Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Yuan Guiyi; Wu Wei; Luo Yilong; Li Yiqing; Zhou Shuxian; Fang Chang

    2006-01-01

    objectives To demonstrate the phenomena and explore the causes of anemia in patients with chronic heart failure (CHF). Methods To observe the phenomena of anemia in patients with CHF, a total of 276 patients with CHF were included in this retrospective study. The clinical characteristics of the patients are: mean age 69.2±11.0 years; male 151,female 125; NYHA Ⅲ and Ⅳ 115 (41.7%). Results ①Among the 276 patients with CHF, 81 (29.4%)had anemia (Mean hemoglobulin concentration 101.5±13.0g/L). ② Patients with Anemia were more likely to be female and to have greater NYHA (Ⅲ or Ⅳ) (P<0.05), higher serum creatinine, as well as lower serum albumin and low-density lipoprotein levels (P<0.01).③ A weak negative correlation was also noted between the level of NYHA and hemoglobulin. ④ There was no significant difference in age, the primary cardiac etiology of the CHF, the history of diabetes, left ventricular end diastolic diameter, and left ventricular ejection fraction between CHF patient with and without anemia. Conclusions The prevalence of anemia is high among patients with CHF. The anemia patients with CHF tend to be female, have greater cardiac and renal functional impairment, but with lower serum albumin and LDL that suggests some degree of malnutrition.

  3. Different effects of calcium antagonist and beta-blocker therapy on left-ventricular diastolic function in ischemic heart disease. A direct comparison of the impact of mibefradil and atenolol

    DEFF Research Database (Denmark)

    Hassager, C; Thygesen, K; Grande, P;

    2001-01-01

    OBJECTIVE: To compare the effect of a calcium antagonist and a beta-blocker on left-ventricular diastolic function in patients with ischemic heart disease. METHODS: 138 patients with chronic stable angina pectoris were randomized in a multicenter, double-blind trial to treatment with either...... mibefradil or atenolol for 6 weeks (50 mg once daily for 2 weeks followed by 100 mg once daily for 4 weeks). The ratio between early (E) and late (A) diastolic mitral flow velocities (E/A), the E wave deceleration time (DT) and the left ventricular isovolumetric relaxation time (IRT) were measured by Doppler...... echocardiography as parameters of left-ventricular diastolic function initially, after 4 and after 6 weeks of treatment. RESULTS: Mibefradil did not change the E/A ratio significantly (+4%, NS), while atenolol treatment resulted in a significant increase in the E/A ratio (+20%, p treatment...

  4. Modifications to the Patient Rule-Induction Method that utilize non-additive combinations of genetic and environmental effects to define partitions that predict ischemic heart disease

    DEFF Research Database (Denmark)

    Dyson, Greg; Frikke-Schmidt, Ruth; Nordestgaard, Børge G;

    2009-01-01

    This article extends the Patient Rule-Induction Method (PRIM) for modeling cumulative incidence of disease developed by Dyson et al. (Genet Epidemiol 31:515-527) to include the simultaneous consideration of non-additive combinations of predictor variables, a significance test of each combination...... that assesses the utility of genetic variants in predicting the presence of ischemic heart disease beyond the established risk factors....

  5. The Correlation between Left and Right Ventricular Ejection Fractions in Patients with Ischemic Heart Disease, Documented by Cardiac Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Ali Eshraghi

    2016-03-01

    Full Text Available Introduction: The correlation between right and left ventricular ejection fractions (RVEF and LVEF, respectively has been studied in only a small number of patients with a marked decrease in RVEF and LVEF. The aim of the present study was to compare LVEF and RVEF in patients with ischemic heart disease. RVEF and LVEF were measured by Cardiovascular Magnetic Resonance (CMR imaging. Materials and Methods: This observational study was done in Ghaem general hospital in 2014.  LVEF and RVEF were measured in a series of 33 patients with ischemic heart disease, undergoing CMR for the evaluation of myocardial viability. The correlation between RVEF and LVEF in patients with ischemic heart disease was studied, using Pearson product-moment correlation coefficient analysis.   This study was done in Ghaem general hospital in 2014 with simple sapling. Results: Right ventricular end diastolic volume (186.33±58.90 and left ventricular end diastolic volume (121.72±61.64 were significantly correlated (r=0.223, P=0.005. Moreover, there was a significant correlation between right ventricular end systolic volume (88.18±40.90 and left ventricular end systolic volume (140.96±35.33 (r=0.329, P=0.000. The most significant association was observed between RVEF and LVEF (r=0.913, P=0.000. Conclusion: Based on the findings, RVEF and LVEF were significantly correlated in patients with ischemic heart disease, although this association was not always present in all cardiac patients. The cause of this discrepancy is still unknown.

  6. Increased levels of the calcification marker matrix Gla Protein and the inflammatory markers YKL-40 and CRP in patients with type 2 diabetes and ischemic heart disease

    DEFF Research Database (Denmark)

    Thomsen, Stine B; Rathcke, Camilla N; Zerahn, Bo;

    2010-01-01

    Low grade inflammation is of pathogenic importance in atherosclerosis and in the development of cardiovascular disease (CVD) and type 2 diabetes (T2D). Matrix GLA protein (MGP), an inhibitor of medial calcification of arteries, is increased in patients with atherosclerosis. In the present study...... levels of markers of calcification (MGP) and inflammation (YKL-40, hsCRP) were evaluated in patients with T2 D and/or ischemic heart disease (IHD)....

  7. A comparative study on the effects of Gemfibrozil, Diltiazem and Isosorbide dinitrate on lipid profile in patients of ischemic heart disease in India

    OpenAIRE

    Sharma, H. O.; Sharma, S K

    1997-01-01

    Effects of three drugs, Gemfibrozil, Diltiazem and lsosorbide dinitrate (ISDN) on various lipid parameters were studied in patients with ischemic heart disease (IHD) with positive treadmill stress response. Gemfibrozil and diltiazem significantly lowered the levels of serum total lipids (TL), triglycerides (TG), phospholipids (PL), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C), and incroased the levels of serum high d...

  8. Regional differences of standardised mortality rates for ischemic heart diseases in the Slovak Republic for the period 1996–2013 in the context of income inequality

    OpenAIRE

    Gavurová, Beáta; Vagašová, Tatiana

    2016-01-01

    Background The aim of paper is to analyse the development of standardised mortality rates for ischemic heart diseases in relation to the income inequality in the regions of Slovakia. This paper assesses different types of income indicators, such as mean equivalised net income per household, Gini coefficient, unemployment rate, at risk of poverty threshold (60 % of national median), S80/S20 and their effect on mortality. Methods Using data from the Slovak mortality database 1996–2013, the meth...

  9. Impact of Hypertension, Diabetes and Dyslipidemia on Ischemic Heart Disease among Japanese: A Case-Control Study Based on National Health Insurance Medical Claims

    OpenAIRE

    Huang, Hairong; Ye, Zhaojia; Nagahama, Iyoko; Tazoe, Hideaki; Abe, Yasuyo; Aoyagi, Kiyoshi

    2012-01-01

    Aim Although the important role of conventional risk factors (cigarette smoking, hypertension, diabetes and dyslipidemia) in the pathogenesis of ischemic heart disease (IHD) has been established, how frequently IHD is preceded by exposure to conventional risk factors remains controversial. The present study aimed to identify the prevalence of hypertension, diabetes and dyslipidemia among patients with IHD and examine associations between each of them with IHD in a Japanese population...

  10. Percutaneous Cell Delivery Into the Heart Using Hydrogels Polymerizing In Situ

    OpenAIRE

    Martens, Timothy P.; Godier, Amandine F. G.; Parks, Jonathan J.; Wan, Leo Q.; Koeckert, Michael S; Eng, George M.; Hudson, Barry I.; Sherman, Warren; Vunjak-Novakovic, Gordana

    2009-01-01

    Heart disease is the leading cause of death in the US. Following an acute myocardial infarction, a fibrous, noncontractile scar develops, and results in congestive heart failure in more than 500,000 patients in the US each year. Muscle regeneration and the induction of new vascular growth to treat ischemic disorders of the heart can have significant therapeutic implications. Early studies in patients with chronic ischemic SLVD using skeletal myoblasts or bone marrow-derived cells report impro...

  11. DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-01-01

    Full Text Available Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF. Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM type 2 is not well-studied.Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction and DM type 2. The patients were divided into two groups according to the left ventricle (LV ejection fraction (EF: a group with CHF and preserved ejection fraction (PEF (EF≥50% and with CHF and reduced ejection fraction (EF<50%. Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP and galeсtin-3 were measured.Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007. In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01. A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05, while in the group with PEF, the correlation was not significant (p=0.225. In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05.Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

  12. DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-09-01

    Full Text Available Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF. Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM type 2 is not well-studied.Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction and DM type 2. The patients were divided into two groups according to the left ventricle (LV ejection fraction (EF: a group with CHF and preserved ejection fraction (PEF (EF≥50% and with CHF and reduced ejection fraction (EF<50%. Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP and galeсtin-3 were measured.Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007. In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01. A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05, while in the group with PEF, the correlation was not significant (p=0.225. In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05.Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

  13. Characterization of mitochondria isolated from normal and ischemic hearts in rats utilizing atomic force microscopy.

    Science.gov (United States)

    Lee, Gi-Ja; Chae, Su-Jin; Jeong, Jae Hoon; Lee, So-Ra; Ha, Sang-Jin; Pak, Youngmi Kim; Kim, Weon; Park, Hun-Kuk

    2011-04-01

    Mitochondria play critical roles in both the life and the death of cardiac myocytes. Various factors, such as the loss of ATP synthesis and increase of ATP hydrolysis, impairment in ionic homeostasis, formation of reactive oxygen species (ROS), and release of proapoptotic proteins are related to the generation of irreversible damage. It has been proposed that the release of cytochrome c is caused by a swelling of the mitochondrial matrix triggered by the apoptotic stimuli. However, there is a controversy about whether or not the mitochondria, indeed, swell during apoptosis. The major advantages of atomic force microscopy (AFM) over conventional optical and electron microscopes for bio-imaging include the fact that no special coating and vacuum are required and imaging can be done in all environments--air, vacuum or aqueous conditions. In addition, AFM force-distance curve measurements have become a fundamental tool in the fields of surface chemistry, biochemistry, and material science. In this study, we used AFM to observe the morphological and property changes in heart mitochondria that were isolated from a rat myocardial infarction model. From the shape parameters of the mitochondria in the AFM topographic image, it seemed that myocardial infarction caused the mitochondrial swelling. Also, the results of force-distance measurements showed that the adhesion force of heart mitochondria was significantly decreased by myocardial in infarction. Therefore, we suggested that myocardial infarction might be the cause of mitochondrial swelling and the changes in outer membrane of heart mitochondria. PMID:21050769

  14. [Attitude of district physicians and the population toward measures regarding the prevention of ischemic heart disease].

    Science.gov (United States)

    Chazova, L V; Ivanov, V M; Manukian, L M; Patoka, N A; Sats, L M

    1984-11-01

    The experience of the work on multifactorial prophylaxis of coronary heart disease performed on the basis of an urban out-patient center among 40-59-year-old males points to an inadequate response of the population to the primary (57 % after the mailing of 4 invitations) and repeated annual (50-60% of those who have had the primary examination) prophylactic examinations. Over 4 years, 22 % of patients with coronary heart disease and 32 % of patients with arterial hypertension refused to come for out-patient examinations. The number of responses was greater among individuals with risk factors of coronary heart disease. Most therapists from out-patient clinics believe it necessary to carry out prophylactic measures and would like to have more time for this purpose. Yet, many of them doubt that the population will follow medical advice with regard to changing the life style. The population is poorly aware of the role of prophylactic examinations, the effect of nutrition and bad habits on the development of cardiovascular diseases. PMID:6521209

  15. EFFECT OF CYTOPROTECTION ON THE OXIDATIVE PROCESSES AND ENDOTHELIAL FUNCTION IN ELDERLY PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. V. Shabalin

    2006-01-01

    Full Text Available Aim. To investigate the effects of cytoprotection with mildronate (Grindex, Latvia on oxidative processes and endothelial function in elderly patients with ischemic heart disease (IHD. Material and methods. 117 elderly (upwards 60 y.o. patients with IHD were included into controlled study. They were also suffering from heart failure II-III functional class (according to NYHA classification and from arterial hypertension (AH. All patients were randomized into 2 groups: 1 67 patients (75,4±0,5 y. o. were treated with mildronate 500 mg/day simultaneously with basic therapy during 12 weeks (the main group and 2 50 patients (74,0±0,6 y. o. were treated only with basic therapy during 12 weeks (the compare group. Total cholesterol (CH, triglycerides (TG, low density lipoprotein cholesterol (LDL, high density lipoprotein CH (HDL, LDL antioxidant potential (concentration of α-tocopherol and retinol in LDL, initial level of lipid peroxidation (LPO products in LDL, LDL resistance to oxidation and blood level of NO metabolites were determined before and after 4 and 12 weeks of the therapy. Results. Mildronate did not have any effect on the blood lipid profile in elderly patients with IHD. The initial level of LPO products in LDL was decreased by 33% and LDL resistance to oxidation was increased by 26% in the main group after 12 weeks of therapy in comparison with the same parameters before the study and in comparison with control group of patients (p<0,05. The blood level of NO metabolites was 1,4 fold higher in the main group of patients after 12 weeks of therapy in comparison with the same parameters before therapy and in comparison with control group of patients (p<0,05. More prominent growth of LDL resistance to oxidation after 12 week therapy with mildronate was revealed in men than in women, in patients with angina II class than in patients with angina III class, in patients with heart failure II class than in patients with heart failure III class

  16. Effects of Chronic Oral Administration of Natural Honey on Ischemia/Reperfusion-induced Arrhythmias in Isolated Rat Heart

    Directory of Open Access Journals (Sweden)

    Moslem Najafi

    2011-01-01

    Full Text Available Objective(sIn this study, effects of chronic administration of oral natural honey against ischemia/reperfusion (I/R-induced cardiac arrhythmias were investigated in isolated rat heart. Materials and MethodsMale Wistar rats were divided into four groups (n= 10-14 rats in each group and fed with natural honey (1%, 2% and 4% dissolved in the drinking water for 45 days except for the control group. After anesthesia, the rats’ hearts were isolated quickly, mounted on a Langendorff apparatus and perfused with a modified Krebs-Henseleit solution during stabilization, 30 min regional ischemia followed by 30 min reperfusion. The ECGs were recorded throughout the experiments to analyze cardiac arrhythmias based on the Lambeth conventions. ResultsIn the ischemic phase, honey (1% significantly reduced (P<0.05 the number and duration of ventricular tachycardia (VT. Honey (1% and 2% also significantly decreased number of ventricular ectopic beats (VEBs. In addition, incidence and duration of reversible ventricular fibrillation (Rev VF were lowered by honey 2% (P<0.05. During reperfusion time, VT incidence was 73% in the control group, however natural honey (1% decreased it to 22% (P<0.05. Honey also produced significant reduction in the incidences of total VF, Rev VF, duration and number of VT. ConclusionFor the first time, the results of present study demonstrated protective effects of chronic oral honey administration against I/R-induced arrhythmias in isolated rat heart. Antioxidant activity, the existence of energy sources such as glucose and fructose and improvement of some hemodynamic functions might be responsible for these effects.

  17. Adverse effects of AMP-activated protein kinase alpha2-subunit deletion and high-fat diet on heart function and ischemic tolerance in aged female mice.

    Science.gov (United States)

    Slámová, K; Papoušek, F; Janovská, P; Kopecký, J; Kolář, F

    2016-03-14

    AMP-activated protein kinase (AMPK) plays a role in metabolic regulation under stress conditions, and inadequate AMPK signaling may be also involved in aging process. The aim was to find out whether AMPK alpha2-subunit deletion affects heart function and ischemic tolerance of adult and aged mice. AMPK alpha2(-/-) (KO) and wild type (WT) female mice were compared at the age of 6 and 18 months. KO mice exhibited subtle myocardial AMPK alpha2-subunit protein level, but no difference in AMPK alpha1-subunit was detected between the strains. Both alpha1- and alpha2-subunits of AMPK and their phosphorylation decreased with advanced age. Left ventricular fractional shortening was lower in KO than in WT mice of both age groups and this difference was maintained after high-fat feeding. Infarct size induced by global ischemia/reperfusion of isolated hearts was similar in both strains at 6 months of age. Aged WT but not KO mice exhibited improved ischemic tolerance compared with the younger group. High-fat feeding for 6 months during aging abolished the infarct size-reduction in WT without affecting KO animals; nevertheless, the extent of injury remained larger in KO mice. The results demonstrate that adverse effects of AMPK alpha2-subunit deletion and high-fat feeding on heart function and myocardial ischemic tolerance in aged female mice are not additive. PMID:26596312

  18. A Comparative Study of the Efficacy and Psychological States between Patients with Senile Ischemic Heart Failure Undergone ICU and Conventional Therapies

    Science.gov (United States)

    2016-01-01

    Background: Our aim was to forward an effective therapeutic approach by comparing efficacy and psychological states between patients with senile ischemic heart failure undergone ICU and conventional therapies. Methods: We selected 64 patients from Hospital of Traditional Chinese Medicine of Rizhao (Shandong, China) between June 2013 and June 2014. The patients had ischemic heart disease, and were monitored for one-year time span. They were randomly divided into the experiment and control group, each of which of 32 cases. The experimental group received an ICU therapy, whereas the control group was treated with conventional therapy. The result of patients’ cardiac function, SDSSAS index and clinical efficacies were monitored and compared. Results: Both groups, especially the experiment group showed significant improvement in the left ventricular end-diastolic diameter, left ventricular ejection fraction and cardiac NYHA rating (P0.05). In comparison to control group, the experiment group showed significantly lower mortality rate in short and long term (P<0.05). The SDSSAS rating of the 2 groups, especially the control group was significantly increased (P< 0.05). Conclusion: We observed improvement in clinical efficacy and depressed anxiety among patients with serious senile ischemic heart failure, after specialized ICU therapy.

  19. Upregulation of eNOS and unchanged energy metabolism in increased susceptibility of the aging type 2 diabetic GK rat heart to ischemic injury

    OpenAIRE

    Desrois, Martine; Clarke, Kieran; Lan, Carole; Dalmasso, Christiane; Cole, Mark; Portha, Bernard; Cozzone, Patrick J; Bernard, Monique

    2010-01-01

    We investigated the tolerance of the insulin-resistant diabetic heart to ischemic injury in the male Goto-Kakizaki (GK) rat, a model of type 2 diabetes. Changes in energy metabolism, nitric oxide (NO) pathway, and cardiac function were assessed in the presence of physiological substrates. Age-matched control Wistar (n = 19) and GK (n = 18) isolated rat hearts were perfused with 0.4 mM palmitate, 3% albumin, 11 mM glucose, 3 U/l insulin, 0.2 mM pyruvate, and 0.8 mM lactate for 24 min before sw...

  20. Should All Patients with Risk Factors for Ischemic Heart Disease Receive Aspirin?

    OpenAIRE

    Willerson, James T.; Mueller, Susan D.; Ferguson, James J.

    1992-01-01

    Unstable angina appears to be caused by relatively brief, repetitive episodes of myocardial oxygen impairment secondary to platelet aggregation and dynamic vasoconstriction at sites of coronary stenosis and endothelial injury. With chronic endothelial injury, the accumulation of thromboxane A2, serotonin, and other mediators may contribute to platelet aggregation and dynamic vasoconstriction. Aspirin acetylates the platelet enzyme, cyclooxygenase, thereby inhibiting the formation of thromboxa...

  1. NEW POSSIBILITIES FOR EVALUATION OF SEVERITY AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE BASED ON N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE PLASMA LEVEL

    Directory of Open Access Journals (Sweden)

    A. S. Galjavich

    2016-01-01

    Full Text Available Aim. To study an importance of plasma N-terminal pro-brain natriuretic peptide (N-proBNP in evaluation of severity and prognosis in patients with chronic heart failure (CHF of ischemic genesis.Material and methods. 77 patients (60 men and 17 women; 59,4±10,7 y.o. with CHF of ischemic genesis were included in the study. All patients had sinus rhythm and history of Q wave myocardial infarction. Standard examination was performed to all patients. Besides N-proBNP plasma level and patients yearly survival were evaluated.Results. N-proBNP plasma level had direct correlation with clinical indices (exercise tolerance, blood pressure, heart rate and echocardiographic heart sizes. N-proBNP plasma level had relationship with prognosis of CHF patients. Baseline N-proBNP level was more than 2 times higher in died patients in comparison with survived patients. The yearly survival rate of CHF patients was 51,3% if N-proBNP level had been more than 400 fmol/ml (>15% of normal value. The clinico-laboratory index (based on N-proBNP plasma level of severity and prognosis in CHF patients was developed.Conclusion. The clinico-laboratory index based on N-proBNP plasma level is easy to use and can improve medical practice.

  2. NEW POSSIBILITIES FOR EVALUATION OF SEVERITY AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE BASED ON N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE PLASMA LEVEL

    Directory of Open Access Journals (Sweden)

    A. S. Galjavich

    2009-01-01

    Full Text Available Aim. To study an importance of plasma N-terminal pro-brain natriuretic peptide (N-proBNP in evaluation of severity and prognosis in patients with chronic heart failure (CHF of ischemic genesis.Material and methods. 77 patients (60 men and 17 women; 59,4±10,7 y.o. with CHF of ischemic genesis were included in the study. All patients had sinus rhythm and history of Q wave myocardial infarction. Standard examination was performed to all patients. Besides N-proBNP plasma level and patients yearly survival were evaluated.Results. N-proBNP plasma level had direct correlation with clinical indices (exercise tolerance, blood pressure, heart rate and echocardiographic heart sizes. N-proBNP plasma level had relationship with prognosis of CHF patients. Baseline N-proBNP level was more than 2 times higher in died patients in comparison with survived patients. The yearly survival rate of CHF patients was 51,3% if N-proBNP level had been more than 400 fmol/ml (>15% of normal value. The clinico-laboratory index (based on N-proBNP plasma level of severity and prognosis in CHF patients was developed.Conclusion. The clinico-laboratory index based on N-proBNP plasma level is easy to use and can improve medical practice.

  3. Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Paulson, O B; Lassen, N A

    1986-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They...

  4. [Immediate and remote results of stenting of left coronary artery trunk in patients with ischemic heart disease].

    Science.gov (United States)

    Bokeriia, L A; Alekian, B G; Buziashvili, Iu I; Golukhova, E Z; Staferov, A V; Zakarian, N V; Al-Sharjabi, R M

    2006-01-01

    The aim of this investigation was assessment of efficacy of stenting in patients with ischemic heart disease with lesions of left coronary artery (LCA) trunk. In the A.N. Bakulev Scientific Center of Cardiovascular Surgery between June 1997 and March 2005 stenting of LCA trunk was carried out in 50 patients (33 with stable effort angina and 17 with acute coronary syndrome). Immediate success rate was 100% in patients with stable angina. In a group of patients with acute coronary syndrome angiographic success rate was 100%. Total lethality in this group was (3 cases) 17.7%. In remote period (6 to 60 months) 33 of 39 patients were examined and recurrence of angina was noted in 7 of them (21.1%). Control angiography was carried out in 16 patients and restenosis of LCA was revealed in 18.75% of cases. The authors believe that stenting of LCA trunk is an effective and safe method of treatment of patients with stable angina and sufficiently safe method in patients with acute coronary syndrome. Roentgenoendovascular treatment may serve as an alternative to aortocoronary bypass surgery especially in isolated lesions of LCA trunk. Application of stents with drug coating allows to cardinally improve long term results of stenting. PMID:16710248

  5. [Effect of therapy with rosuvastatin on lipid spectrum, factors of inflammation and endothelial function in patients with ischemic heart disease].

    Science.gov (United States)

    Sergienko, I V; Samoĭlenko, E Iu; Masenko, V P; Ezhov, M V; Sumarokov, A B; Tkachev, G A; Pogorelova, O A; Balakhonova, T V; Naumov, V G

    2006-01-01

    Rosuvastatin (10 mg) was given for 3 months to 30 men (mean age 57+/-9 years) with total cholesterol (CH) above 5.2 mmol/l. Questioning, physical examination, registration of ECG, measurement of levels of total, low density lipoprotein (LDL), high density lipoprotein (HDL) CH, and triglycerides (TG), assessment of endothelium-dependent brachial artery dilation were carried out at baseline and in 3 months. It was noted that 3 months therapy with rosuvastatin exerted positive effect on blood lipid spectrum: lowering of concentration of total CH (-31%, baseline 6.52+/-0.92, after therapy 4.47+/-0.96 mmol/l, ptherapy 1.67+/-0.71 mmol/l, ptherapy 2.40+/-0.90 mmol/l, ptherapy 1.22+/-0.34 mmol/l, p=0.08). Target LDL CH level (therapy mean flow dependent dilation was 6.1+/-1.64%, after therapy -- 10.4+/-5.0% (p<0.05). Treatment of men with ischemic heart disease with rosuvastatin (10 mg for 3 months) led to achievement of target values of LDLCH in 77% of them, to significant lowering of concentrations of CRP and interleukin 6, and to improvement of endothelial function.

  6. THE USE OF ATORVASTATIN FOR THE PREVENTION OF RECURRENT ATRIAL FIBRILLATION AFTER ELECTRICAL CARDIOVERSION IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    S. N. Tereshchenko

    2010-01-01

    Full Text Available Aim. To study the effect of atorvastatin on the rate of atrial fibrillation (AF recurrence after electrical cardioversion in patients with ischemic heart disease (IHD and paroxysmal AF.Material and Methods. Sixty outpatients and inpatients (aged 30-70 y.o. with IHD and paroxysmal AF were included into the open controlled randomized study immediately after the restoration of sinus rhythm by electrical cardioversion. Patients were randomized into 2 groups. Patients in Group 1 (n=30 received standard therapy recommended for maintenance of sinus rhythm in paroxysmal AF and atorvastatin (average dose 23.5±3.7 mg/day, and patients in Group 2 (n=30 had only the standard therapy. Routine blood analysis, blood chemistry (transaminases, creatine phosphokinase, creatinine, bilirubin, glucose, lipid profile, daily ECG monitoring, treatment safety evaluation were performed. AF relapse was considered as a primary endpoint.Results. Significant reduction in the rate of AF recurrence in was revealed in patients treated with atorvastatin. According to daily ECG monitoring AF relapse was recorded in 8.3 and 48% of patients in Group 1 and Group 2, respectively (p<0.001. Episodes of sinus tachycardia decreased on 52.3% (p<0.001 and 48,5% (p<0.01 in patients of the 1st and the 2 nd group, respectively.Conclusion. The addition of atorvastatin to the standard therapy for maintenance of sinus rhythm reduces effectively the rate of AF recurrence in patients with IHD and paroxysmal AF.

  7. Expression of VEGF, b-FGF, and their receptors after injection of VEGF on ischemic heart muscle

    Institute of Scientific and Technical Information of China (English)

    XU Xun-yu; SUN Lin; HAN Tao; CHEN Wen-hong; CUI Yong; LI Yan

    2004-01-01

    Objective: To study the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF) and their receptors after injection of external VEGF on ischemic heart muscle and to investigate the mechanism of therapeutic myocardial angiogenesis of VEGF. Methods: Standard experimental pigs underwent placement of a left circumflex artery ameroid occluder. Six weeks later, the animals in the experimental group were treated with VEGF (20μg) by direct epicardial injection ( n = 8) and other animals in the control group did not receive any treatment ( n = 8).Four weeks after therapy, the animals were evaluated with regard to mRNA and protein expression of VEGF and b-FGF and their receptors by RT-PCR and Western blotting. Results: The mRNA expression of VEGF and b-FGF and their receptors by RT-PCR expressing as percentage of density ratio to the GAPDH control was increased in experimental group versus control group. The protein expression of VEGF and b-FGF and their receptors by Western blot expressing as percentage of density ratio to the Commassie Blue control was increased in experimental group versus control Group. Conclusion: Exogenous VEGF can induce the expression of endogenous VEGF, b-FGF, and their receptors; b-FGF may play a role in the angiogenesis of VEGF.

  8. Experimental Model of Gene Transfection in Healthy Canine Myocardium: Perspectives of Gene Therapy for Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Renato A. K. Kalil

    2002-09-01

    Full Text Available OBJECTIVE: To assess the transfection of the gene that encodes green fluorescent protein (GFP through direct intramyocardial injection. METHODS: The pREGFP plasmid vector was used. The EGFP gene was inserted downstream from the constitutive promoter of the Rous sarcoma virus. Five male dogs were used (mean weight 13.5 kg, in which 0.5 mL of saline solution (n=1 or 0.5 mL of plasmid solution containing 0.5 µg of pREGFP/dog (n=4 were injected into the myocardium of the left ventricular lateral wall. The dogs were euthanized 1 week later, and cardiac biopsies were obtained. RESULTS: Fluorescence microscopy showed differences between the cells transfected and not transfected with pREGFP plasmid. Mild fluorescence was observed in the cardiac fibers that received saline solution; however, the myocardial cells transfected with pREGFP had overt EGFP expression. CONCLUSION: Transfection with the EGFP gene in healthy canine myocardium was effective. The reproduction of this efficacy using vascular endothelial growth factor (VEGF instead of EGFP aims at developing gene therapy for ischemic heart disease.

  9. Is Pancreatic Exocrine Insufficiency A Result of Decreased Splanchnic Circulation in Patients with Chronic Heart Failure?

    OpenAIRE

    Vujasinovic Miroslav; Martin Tretjak; Bojan Tepes; Apolon Marolt; Cirila Slemenik Pusnik; Mateja Kotnik Kerbev; Sasa Rudolf

    2016-01-01

    Introduction Pancreatic exocrine insufficiency is associated with various pancreatic illnesses and could be associated with extra pancreatic diseases. In chronic heart failure patients, the splanchnic circulation is decreased. If the reduced circulation is prolonged, tissue damage to the splanchnic organs is possible. The aim of our study was to determine the prevalence of pancreatic exocrine insufficiency in chronic heart failure patients as well as its clinical importance. Patients and Meth...

  10. Febuxostat, a nonpurine selective inhibitor of xanthine oxidase: a promising medical therapy for chronic heart failure?

    Institute of Scientific and Technical Information of China (English)

    GAO Ling-gen; YAO Xiu-ping; ZHANG Lin; WEN Dan; LUO Fang; ZHOU Xian-liang; HUI Ru-tai

    2010-01-01

    @@ Heart failure is currently one of the most common and most cost-intensive of the chronic diseases.1 The main cause of chronic heart failure (CHF) is the abnormalities of both cardiac contractile performance and myocardial energy metabolism. Elevated levels of reactive oxygen species (ROS) have been proposed to contribute to both of them. Xanthine oxidoreductase (XO)is a major source of ROS in the cardiovascular system.

  11. COMPARACIÓN DE ESTRATEGIAS TERAPÉUTICAS PARA EL CONTROL DE LA TENSIÓN ARTERIAL Y LA ANGINA DE PECHO EN PACIENTES CON HIPERTENSIÓN ARTERIAL Y CARDIOPATÍA ISQUÉMICA CRÓNICA EN LA PROVINCIA DE VILLA CLARA. APÉNDICE DEL ESTUDIO INVEST / Comparison of therapeutic strategies for the control of blood pressure and angina in patients with hypertension and chronic ischemic heart disease in the province of Villa Clara. Appendix of INVEST study

    Directory of Open Access Journals (Sweden)

    Omaida J. López Bernal

    2011-06-01

    Full Text Available Background and Objectives: The treatment of hypertension and its complications are a worldwide problem. In our country nearly 25 % of the population over 15 years old is hypertensive, and this figure nearly doubles in those over 60. This research aims to compare two treatment strategies for controlling hypertension in outpatients with chronic coronary ischemic syndrome. Method: A total of 150 patients was included, 73 were randomized to receive calcium antagonist and non-calcium antagonist respectively, as 4 patients were subsequently excluded. Each was asked to sign consent, underwent clinical examination and a 12-lead, conventional electrocardiogram. Blood pressure and episodes of angina were evaluated at 6 months and one year. All variables were entered into a database and statistical analysis was performed using Student's t and Chi square. Results: The mean age was 61,5 years. Women and white skin color were predominant. At 12 months of treatment, blood pressure normalized in more than 80 % of patients without significant differences between the two treatment strategies. Over 75 % of patients in both groups controlled the angina episodes and more than 85 % said the quality of life was good. Conclusions: Control of blood pressure and angina was achieved and there were no significant differences between the two treatment strategies.

  12. Rhythminotropic Reactions of Human Myocardium in Ischemic and Rheumatic Heart Diseases against the Background of Amiodarone

    Directory of Open Access Journals (Sweden)

    Boris N. Kozlov, PhD, ScD

    2012-03-01

    Full Text Available In human heart failure, Ca2+ homeostasis gets disturbed due to a decrease in the function of the sarcoplasmic reticulum (SR. We studied the differences in the SR function in patients with rheumatic and coronary heart disease, against the background of amiodarone. Cardiac preparations from the atrium of 21 patients with coronary artery disease (CAD and 14 patients with rheumatic heart disease (RHD were used in this study. Myocardial strips perfused with oxygenated Krebs-Henzelait solution without and with amiodarone (1 mM/l at 37°C. The steady state stimulation rate of the muscle strips was 0.5 Hz. The single extraordinary impulse was given as 0.2-1.5 sec after the steady state beat. Then, the first beat after a 4- to 60-sec rest period was evaluated. The extrasystoles of the myocardium in both groups, after long intervals, were decreased after amiodarone treatment. The amplitude of post extrasystoles of amiodarone-treated myocardium showed differences only after long intervals in both groups. Two types of inotropic responses of a failing myocardium after rest periods were observed. Type I post-rest contractions maintained the steady state amplitude after all rests. However, type II was characterized by a reduction in the amplitude of the contractions. Amiodarone treatment of the myocardium showing type I reactions led to an increase in the potentiation after rests, but showed no effect on the reaction of the muscle with the type II response. The results suggested that SR dysfunction was different in CAD and RHD. The realization of the therapeutic effect of amiodarone was found to be dependent on the functional activity of the SR.

  13. THE EFFECT OF ACUTE MYOCARDIUM ISCHEMIC ON HEART FUNCTION OF PREGNANCY RAT

    Institute of Scientific and Technical Information of China (English)

    郑小璞; 马爱群; 牛常民; 董安平; 韩克; 刘宇; 张炜; 耿涛

    2006-01-01

    In recent years,extensive research is underwayto investigate characteristics of coronary heart dis-ease(CHD)among women.Epidemiology has in-dicatedthat sex difference has an obvious presenceinCHD incidence and mortality.Womenprior tomenopause have a muchlower presence inincidenceof CHD[1-2].Whilethe incidence and mortality raterise significantly among post menopausal women orthose who have ovary removed,si milar to that ofsame-age men.It showed that the estrogenlevel hasa close relationship with CHD.Whilepr...

  14. [Therapeutic efficacy of pantothenic acid preparations in ischemic heart disease patients].

    Science.gov (United States)

    Borets, V M; Lis, M A; Pyrochkin, V M; Kishkovich, V P; Butkevich, N D

    1987-01-01

    The therapeutic effectiveness of the pantothenic acid drugs: calciipantothenas and pantethine, was studied in 182 patients with coronary heart disease and stable angina of effort. It is shown that both the drugs produce favourable effects on certain parameters of hemodynamics, on the metabolism of lipids, riboflavin and ascorbic acid. It is recommended that the administration of calciipantothenas in a dose of 300 mg/day, during 3 weeks, be included into the combined treatment of coronary patients with no manifest disorders of lipid metabolism. Patients with manifest hyperlipidemia should be administered pantethine in a dose of 500 mg/day. PMID:3590676

  15. Is oxidative stress primarily involved in reperfusion injury of the ischemic heart

    Energy Technology Data Exchange (ETDEWEB)

    Nohl, H.; Stolze, K.; Napetschnig, S.; Ishikawa, T. (Institute of Pharmacology and Toxicology, Vet. Med. Univ., Vienna (Austria))

    1991-01-01

    Reperfusion injury of ischemic organs is suggested to result from metabolic derangements initiating an imbalanced formation of free oxygen radicals. Most investigators in this field have used the spin-trap 5,5'-dimethyl-N-pyrroline-N-oxide (DMPO) to stabilize these short-lived radicals and make them visible by means of the electron spin resonance (ESR) technique. ESR signals obtained from intravascular DMPO were reported to indicate the formation of free OH. radicals and, in some cases, also carbon-centered radicals. We were unable to confirm these findings. Carbon-centered radicals were not obtained irrespectively of conditions studied, while oxygen-centered DMPO-adducts could only be detected in minor amounts. Instead, we observed an ascorbyl-related ESR signal. The addition of ethylenediaminetetraacetic acid (EDTA), which was used by many investigators in this field, was found to greatly influence ESR-spectra of the reperfusion fluid. The ascorbyl radical concentration was clearly reduced and the DMPO-OH. adduct became more prominent. The addition of iron further stimulated this change eliciting a Fenton-type reaction responsible for DMPO-OH.-related ESR spectra in the perfusate after ischemia. Accordingly, we observed the release of iron and ascorbic acid into the perfusate as a consequence of ischemia. We could demonstrate that iron in the presence of ascorbate and EDTA causes both types of radicals detected in the perfusate. DMPO-OH. generation in the presence of EDTA was found to result from free OH. radicals that were not generated in the absence of EDTA.

  16. Serious adverse events experienced by patients with chronic heart failure taking spironolactone

    OpenAIRE

    C. Berry; McMurray, J.

    2001-01-01

    In patients with chronic heart failure, spironolactone added to conventional treatment may lead to serious and, occasionally, fatal hyperkalaemia. In some cases this seems to happen because spironolactone causes diarrhoea. Four cases involving men with New York Heart Association functional class III heart failure are presented. As these cases revealed, close monitoring of blood chemistry is mandatory after starting spironolactone, and patients should be advised to stop spironolactone immediat...

  17. Increased Circulating Cathepsin K in Patients with Chronic Heart Failure.

    Directory of Open Access Journals (Sweden)

    Guangxian Zhao

    Full Text Available Cysteinyl cathepsin K (CatK is one of the most potent mammalian collagenases involved in cardiovascular disease. Here, we investigated the clinical predictive value of serum CatK levels in patients with chronic heart failure (CHF. We examined 134 patients with CHF, measuring their serum CatK, troponin I, high-sensitive C-reactive protein, and pre-operative N-terminal pro-brain natriuretic peptide levels. The patients were divided into two groups: the 44 patients who showed a left ventricular (LV ejection fraction (LVEF < 40% (the "lowLVEF" group and the 90 patients showing LVEF values ≥ 40% (the "highLVEF" group. The lowLVEF patients had significantly higher serum CatK levels compared to the highLVEF patients (58.4 ± 12.2 vs. 44.7 ± 16.4, P < 0.001. Overall, a linear regression analysis showed that CatK levels correlated negatively with LVEF (r = -0.4, P < 0.001 and positively with LV end-diastolic dimensions (r = 0.2, P < 0.01, LV end-systolic dimensions (r = 0.3, P < 0.001, and left atrial diameters (r = 0.3, P < 0.01. A multiple logistic regression analysis showed that CatK levels were independent predictors of CHF (odds ratio, 0.90; 95% confidence interval, 0.84-0.95; P < 0.01. These data indicate that elevated levels of CatK are closely associated with the presence of CHF and that the measurement of circulating CatK provides a noninvasive method of documenting and monitoring the extent of cardiac remodeling and dysfunction in patients with CHF.

  18. 干细胞治疗缺血性心脏病的临床研究进展%Clinical Trials Using Stem Cell Therapy for Ischemic Heart Diseases

    Institute of Scientific and Technical Information of China (English)

    何华

    2012-01-01

    缺血性心脏病及其所致的心力衰竭是全球范围内的主要死因,急性心肌梗死导致不可逆的大范围心肌细胞损失和随后的心室重塑是慢性心功能不全和劳动力永久丧失的主要原因.干细胞治疗缺血性心脏病的实验研究已显示出巨大的潜力,而近年进行的相关临床研究也已取得重要进展.现对干细胞治疗缺血性心脏病的相关临床研究进展作一综述.%Globally, ischemic heart diseases (IHD) and heart failure resulting from IHD are major causes of death. Additionally, the loss of myocardial cells due to acute myocardial infarction and subsequent ventricle remodeling is a cause of chronic heart failure. Experimental studies and related clinical trials using stem cell therapy for IHD have shown potential. This article reviews clinical studies using stem cell therapy for IHD.

  19. Type D personality and cardiac mortality in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Smith, Otto R F; Pedersen, Susanne S.;

    2010-01-01

    Clinical predictors of cardiac mortality in chronic heart failure (CHF) are established, but less is known about chronic psychological predictors. Therefore, we examined the prognostic value of Type D personality (tendency to experience negative feelings and inhibit self-expression) in CHF patients....

  20. Chronic beta-blocker treatment in patients with advanced heart failure - Effects on neurohormones

    NARCIS (Netherlands)

    Teisman, ACH; van Veldhuisen, DJ; Boomsma, F; de Kam, PJ; Pinto, YM; de Zeeuw, D; van Gilst, WH

    2000-01-01

    Background: To date, the use of beta-blockers in treating patients with chronic heart failure gains support, this since several large clinical trials reported reduced mortality after chronic beta-blockade. Part of these beneficial effects may result from inhibition of deleterious neurohormone activa

  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. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  3. Association between variants in the genes for leptin, leptin receptor, and proopiomelanocortin with chronic heart failure in the Czech population.

    Science.gov (United States)

    Bienertová-Vasků, Julie Anna; Spinarová, Lenka; Bienert, Petr; Vasků, Anna

    2009-03-01

    Patients with chronic heart failure (CHF) express enhanced catabolic metabolism finally resulting in overall weight loss, whereas adipokines might play a crucial role in signaling among tissues. The aim of this study was to investigate the possible associations of defined variability in leptin (dbSNP ID rs7799039), proopiomelanocortin (dbSNP ID rs3754860 and dbSNP ID rs1009388), and leptin receptor gene (dbSNP rs1137101) with CHF and evaluate their potential as the CHF susceptibility genes. The case-control study comprised a total of 372 patients of Caucasian origin with chronic heart failure (New York Heart Association [NYHA] functional classes II-IV, ejection fraction (EF) <40%) and 407 healthy controls. They were genotyped for the leptin (LEP) -2548 G/A, leptin receptor (LEPR) Gln223Arg, and proopiomelanocortin (POMC) RsaI (5'-untranslated region) and C1032G variants (intron 1) using PCR-based methodology. No case-control differences in genotype as well as allele frequencies were observed between CHF patients and controls. We constructed POMC RsaI/C1032G haplotypes, having found no significant association with body mass index (BMI), left ventricle ejection fraction (LVEF), left ventricle hypertrophy (LVH) and diabetes mellitus (DM). Multivariate regression analyses revealed an approximately 2-fold risk for NYHA class IV associated with the LEPR Gln223Arg (P = 0.0000001, odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.56-2.84); it also displayed an independent prediction role for LVEF in heart failure cases of all etiologies (P = 0.002, OR = 4.05, 95% CI = 1.36-10.06). In subanalyses according to CHF etiology the LEPR Gln223Arg showed an independent prediction role for NYHA IV in IHD patients (P = 0.0001, OR = 2.50, 95% CI = 1.69-3.82) and both for NYHA IV(P = 0.007, OR = 2.04, 95% CI = 1.20-3.84) and LVEF (P = 0.004, OR = 11.87, 95% CI = 2.08-55.6) in DCMP patients. The role of the polymorphic variants in the genes encoding for adipokines as potential

  4. Effects of heme oxygenase-1 gene modulated mesenchymal stem cells on vasculogenesis in ischemic swine hearts

    Institute of Scientific and Technical Information of China (English)

    JIANG Yi-bo; ZHANG Xiao-li; TANG Yao-liang; MA Gen-shan; SHEN Cheng-xing; WEI Qin; ZHU Qi; YAO Yu-yu; LIU Nai-feng

    2011-01-01

    Background Mesenchymal stem cells (MSCs) transplantation may partially restore heart function in the treatment of acute myocardial infarction (AMI). The aim of this study was to explore the beneficial effects of MSCs modified with heme xygenase-1 (HO-1) on post-infarct swine hearts to determine whether the induction of therapeutic angiogenesis is modified by the angiogenic cytokines released from the implanted cells.Methods In vitro, MSCs were divided into four groups: (1) non-transfected MSCs (MSCs group), (2) MSCs transfected with the pcDNA3.1-Lacz plasmid (Lacz-MSCs group), (3) MSCs transfected with pcDNA3.1-hHO-1 (HO-1-MSCs group),and (4) MSCs transfected with pcDNA3.1-hHO-1 and pretreatment with an HO inhibitor, tin protoporphyrin (SnPP)(HO-1-MSCs+SnPP group). Cells were cultured in an airtight incubation bottle for 24 hours, in which the oxygen concentration was maintained at <1%, followed by 12 hours of reoxygenation. After hypoxia/reoxygen treatment, ELISA was used to measure transforming growth factor (TGF-β) and fibroblast growth factor (FGF-2) in the supernatant. In vivo,28 Chinese mini-pigs were randomly allocated to the following treatment groups: (1) control group (saline), (2)Lacz-MSCs group, (3) HO-1-MSCs group, and (4) HO-1-MSCs + SnPP group. About 1×107 of autologous stem cells or an idertical volume of saline was injected intracoronary into porcine hearts 1 hour after MI. Magnetic resonance imaging (MRI) assay and postmortem analysis were assessed four weeks after stem cell transplantation.Results Post hypoxia/reoxygenation in vitro, TGF-β in the supernatant was significantly increased in the HO-1-MSCs ((874.88±68.23) pg/ml) compared with Lacz-MSCs ((687.81±57.64) pg/ml, P <0.001). FGF-2 was also significantly increased in the HO-1-MSCs ((1106.48±107.06) pg/ml) compared with the Lacz-MSCs ((853.85±74.44) pg/ml, P <0.001 ).In vivo, at four weeks after transplantation, HO-1 gene transfer increased the capillary density in the peri

  5. Adipose-derived Mesenchymal Stem Cells and Their Reparative Potential in Ischemic Heart Disease.

    Science.gov (United States)

    Badimon, Lina; Oñate, Blanca; Vilahur, Gemma

    2015-07-01

    Adipose tissue has long been considered an energy storage and endocrine organ; however, in recent decades, this tissue has also been considered an abundant source of mesenchymal cells. Adipose-derived stem cells are easily obtained, show a strong capacity for ex vivo expansion and differentiation to other cell types, release a large variety of angiogenic factors, and have immunomodulatory properties. Thus, adipose tissue is currently the focus of considerable interest in the field of regenerative medicine. In the context of coronary heart disease, numerous experimental studies have supported the safety and efficacy of adipose-derived stem cells in the setting of myocardial infarction. These results have encouraged the clinical use of these stem cells, possibly prematurely. Indeed, the presence of cardiovascular risk factors, such as hypertension, coronary disease, diabetes mellitus, and obesity, alter and reduce the functionality of adipose-derived stem cells, putting in doubt the efficacy of their autologous implantation. In the present article, white adipose tissue is described, the stem cells found in this tissue are characterized, and the use of these cells is discussed according to the preclinical and clinical trials performed so far.

  6. Influence of sex on treatment and outcome in chronic heart failure.

    Science.gov (United States)

    Frankenstein, Lutz; Clark, Andrew L; Ribeiro, Jorge P

    2012-06-01

    The population is aging, the prevalence of heart failure increases with age, and on average women live longer than men. There is evidence for sex-specific effects of individual, guideline-recommended drugs used for treatment of chronic heart failure. Women are underrepresented in most clinical trials and only a minority of drug applications to regulatory authorities have included sex analyses. The present review focuses on the potential female survival benefit in heart failure, the influence of sex on medical treatment in a broader sense, and the potential benefit to be derived from guideline recommended treatment and common adjunctive heart failure medication.

  7. Color Doppler imaging of the ophthalmic artery in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Daniela B. Almeida-Freitas

    2011-10-01

    Full Text Available Purpose: To evaluate the ophthalmic artery hemodynamics in patients with chronic heart failure. Methods: Doppler parameters of ophthalmic artery of 18 patients with chronic heart failure in different stages of the disease were compared with 21 healthy volunteers (control group. These parameters were also correlated with echocardiographic assessments and clinical cardiologic status. Results: Mean diastolic velocity was 5.14 ± 2.4 cm/s in the chronic heart failure group and 7.44 ± 3.5 cm/s in the control group (p=0.007. Mean resistance index of the ophthalmic artery was 0.76 ± 0.08 in the chronic heart failure group and 0.70 ± 0.08 in the control group (p=0.04. Mean systolic velocity of the ophthalmic artery was 22.03 ± 7.7 cm/s in the chronic heart failure group and 25.32 ± 9.2 cm/s in the control group (p=0.24. There was a negative correlation between the resistance index of the ophthalmic artery and systemic blood pressure of patients with chronic heart failure (r= -0.47, p=0.007. Diastolic velocity of the ophthalmic artery correlated positively with systemic blood pressure (r=0.44, p=0.02. Conclusion: Lower diastolic velocity and higher resistance index were observed in the ophthalmic artery of chronic heart failure patients when compared to the control group, which probably reflects the presence of orbital vasoconstriction in response to low cardiac output. Therefore, the influence of these findings on the structure and function of the optic nerve head deserves investigation.

  8. 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-...

  9. Aspirin and heart disease

    Science.gov (United States)

    ... the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology ... NE, et al. Antithrombotic and thrombolytic therapy for ischemic ... of coronary heart disease. In: Mann DL, Zipes DP, Libby P, et ...

  10. The role of autonomic cardiovascular neuropathy in pathogenesis of ischemic heart disease in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Popović-Pejičić Snježana

    2006-01-01

    Full Text Available Introduction. Diabetes is strongly associated with macrovascular complications, among which ischemic heart disease is the major cause of mortality. Autonomic neuropathy increases the risk of complications, which calls for an early diagnosis. The aim of this study was to determine both presence and extent of cardiac autonomic neuropathy, in regard to the type of diabetes mellitus, as well as its correlation with coronary disease and major cardiovascular risk factors. Material and methods. We have examined 90 subjects, classified into three groups, with 30 patients each: those with type 1 diabetes, type 2 diabetes and control group of healthy subjects. All patients underwent cardiovascular tests (Valsalva maneuver, deep breathing test, response to standing, blood pressure response to standing sustained, handgrip test, electrocardiogram, treadmill exercise test and filled out a questionnaire referring to major cardiovascular risk factors: smoking, obesity, hypertension, and dyslipidemia. Results. Our results showed that cardiovascular autonomic neuropathy was more frequent in type 2 diabetes, manifesting as autonomic neuropathy. In patients with autonomic neuropathy, regardless of the type of diabetes, the treadmill test was positive, i.e. strongly correlating with coronary disease. In regard to coronary disease risk factors, the most frequent correlation was found for obesity and hypertension. Discussion Cardiovascular autonomic neuropathy is considered to be the principal cause of arteriosclerosis and coronary disease. Our results showed that the occurrence of cardiovascular autonomic neuropathy increases the risk of coronary disease due to dysfunction of autonomic nervous system. Conclusions. Cardiovascular autonomic neuropathy is a common complication of diabetes that significantly correlates with coronary disease. Early diagnosis of cardiovascular autonomic neuropathy points to increased cardiovascular risk, providing a basis for preventive

  11. Role of genetic polymorphisms of ion channels in the pathophysiology of coronary microvascular dysfunction and ischemic heart disease.

    Science.gov (United States)

    Fedele, Francesco; Mancone, Massimo; Chilian, William M; Severino, Paolo; Canali, Emanuele; Logan, Suzanna; De Marchis, Maria Laura; Volterrani, Maurizio; Palmirotta, Raffaele; Guadagni, Fiorella

    2013-11-01

    Conventionally, ischemic heart disease (IHD) is equated with large vessel coronary disease. However, recent evidence has suggested a role of compromised microvascular regulation in the etiology of IHD. Because regulation of coronary blood flow likely involves activity of specific ion channels, and key factors involved in endothelium-dependent dilation, we proposed that genetic anomalies of ion channels or specific endothelial regulators may underlie coronary microvascular disease. We aimed to evaluate the clinical impact of single-nucleotide polymorphisms in genes encoding for ion channels expressed in the coronary vasculature and the possible correlation with IHD resulting from microvascular dysfunction. 242 consecutive patients who were candidates for coronary angiography were enrolled. A prospective, observational, single-center study was conducted, analyzing genetic polymorphisms relative to (1) NOS3 encoding for endothelial nitric oxide synthase (eNOS); (2) ATP2A2 encoding for the Ca²⁺/H⁺-ATPase pump (SERCA); (3) SCN5A encoding for the voltage-dependent Na⁺ channel (Nav1.5); (4) KCNJ8 and KCNJ11 encoding for the Kir6.1 and Kir6.2 subunits of K-ATP channels, respectively; and (5) KCN5A encoding for the voltage-gated K⁺ channel (Kv1.5). No significant associations between clinical IHD manifestations and polymorphisms for SERCA, Kir6.1, and Kv1.5 were observed (p > 0.05), whereas specific polymorphisms detected in eNOS, as well as in Kir6.2 and Nav1.5 were found to be correlated with IHD and microvascular dysfunction. Interestingly, genetic polymorphisms for ion channels seem to have an important clinical impact influencing the susceptibility for microvascular dysfunction and IHD, independent of the presence of classic cardiovascular risk factors.

  12. Advanced chronic heart failure : A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

    NARCIS (Netherlands)

    Metra, Marco; Ponikowski, Piotr; Dickstein, Kenneth; McMurray, John J. V.; Gavazzi, Antonello; Bergh, Claes-Hakan; Fraser, Alan G.; Jaarsma, Tiny; Pitsis, Antonis; Mohacsi, Paul; Boehm, Michael; Anker, Stefan; Dargie, Henry; Brutsaert, Dirk; Komajda, Michel

    2007-01-01

    Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition. Patients that are generally recognised as ACHF often exhibit the following c

  13. Hybrid approach of ventricular assist device and autologous bone marrow stem cells implantation in end-stage ischemic heart failure enhances myocardial reperfusion

    Directory of Open Access Journals (Sweden)

    Khayat Andre

    2011-01-01

    Full Text Available Abstract We challenge the hypothesis of enhanced myocardial reperfusion after implanting a left ventricular assist device together with bone marrow mononuclear stem cells in patients with end-stage ischemic cardiomyopathy. Irreversible myocardial loss observed in ischemic cardiomyopathy leads to progressive cardiac remodelling and dysfunction through a complex neurohormonal cascade. New generation assist devices promote myocardial recovery only in patients with dilated or peripartum cardiomyopathy. In the setting of diffuse myocardial ischemia not amenable to revascularization, native myocardial recovery has not been observed after implantation of an assist device as destination therapy. The hybrid approach of implanting autologous bone marrow stem cells during assist device implantation may eventually improve native cardiac function, which may be associated with a better prognosis eventually ameliorating the need for subsequent heart transplantation. The aforementioned hypothesis has to be tested with well-designed prospective multicentre studies.

  14. EFFICACY AND SAFETY OF IVABRADINE AND BISOPROLOL IN PATIENTS WITH ISCHEMIC HEART DISEASE: RESULTS OF COMPARATIVE RANDOMIZED OPEN STUDY

    Directory of Open Access Journals (Sweden)

    R. D. Kurbanov

    2011-01-01

    Full Text Available Aim. To study influence of ivabradine as compared with bisoprolol on clinical and hemodynamic indices, exercise tolerance, endothelial function, quality of life (QL and erectile function in patients with ischemic heart disease. Material and methods. 60 males with stable angina pectoris were enrolled into comparative randomized crossover open study. One half of patients randomly received ivabradine during 14 days with replace it with bisoprolol for the next 3 months, another half of patients received compared drugs in the reverse order . Treadmill-test and flow-mediated dilatation (FMD test were performed initially and after 14 days of treatment with each drug. QL and erectile function were evaluated after 3 months with Seattle Angina Questionnaire (SAQ and International Index of Erectile Function (IIEF-5, respectively. Results. Heart rate reduced by 16.7±4.6 (p<0.005 and 16.4±4.8 bpm (p<0.005 after 2 weeks of treatment with bisoprolol and ivabradine, respectively. 30 (50.0% and 31 (51.7% patients treated with bisoprolol and ivabradine, respectively , increased exercise tolerance ≥1 min in the treadmill-test. Ivabradine treatment, in comparison with bisoprolol one, was associated by more expressed increase in chronotropic reserve in treadmill-test (p<0.05 and significant improvement of sensitivity coefficient of brachial artery to tension shift in FMD (p<0.005. In patients with endothelial dysfunction bisoprolol (69.4 % and ivabradine (52.8% efficacy did not differ significantly. At the same time in patients with normal endothelial functions increase in exercise tolerance ≥1 min in treadmill-test was observed in 50% (p<0.05 and 20.8% of patients treated with ivabradine and bisoprolol, respectively. Both drugs significantly increased QL, and ivabradine improved erectile function (p<0.005 in comparison with bisoprolol. Conclusion. The If-channel inhibitor ivabradine and beta-blocker bisoprolol have a similar antianginal efficacy in patients

  15. High risk of ischemic heart disease in patients with lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Mellemkjaer, Lene; Starklint, Henrik;

    2011-01-01

    infarction (O:E ratio 7.9, 95% CI 3.8-15), and other IHD-related diagnoses combined (O:E ratio 6.9, 95% CI 3.3-13). A high IHD risk was observed for patients aged renal biopsy (O:E ratio 17.1, 95% CI 9.1-29) and for patients aged 30-39 years during followup (O:E ratio 42.3, 95% CI....... Occurrence of IHD after date of first renal biopsy in the LN cohort was compared to the occurrence of IHD in the general population by calculation of standardized ratios of observed to expected events (O:E ratios) for different manifestations of IHD registered during inpatient and outpatient hospital visits...... 21-76). Patients undergoing chronic renal replacement therapy also had a pronounced risk of IHD (O:E ratio 19.4, 95% CI 7.8-40). CONCLUSION: LN is associated with markedly increased morbidity from IHD. Our findings indicate that patients with early-onset LN have a disturbingly high risk of IHD...

  16. Research Progress of MicroRNAs in Ischemic Heart Disease%MicroRNAs与缺血性心脏病关系的研究进展

    Institute of Scientific and Technical Information of China (English)

    杨阳

    2013-01-01

    微小RNA(miRNAs)是一类内源性高度保守的非编码小分子RNA,通过碱基互补或部分碱基互补与目标mRNA结合,降解目标mRNA和抑制目标mRNA的翻译,在转录后水平调节基因表达.miRNA在心血管系统高度表达,与缺血性心脏病的发生、发展密切相关,可能是潜在的药物治疗靶点.该文主要对miRNA在细胞凋亡和纤维化、缺血预适应、血管生成等方面的研究进展进行综述,为探索缺血性心脏病提供新视野.%MicroKINAs( miRNAs ) are tiny, endogenously expressed noncoding RJNAs that regulate gene expression, mainly at the post-transcriptional level, via degradation or translational inhihition of their target mRNAs. Studies have shown that miRNAs are highly expressed in cardiovascular system. Recently, several studies have suggested that miRNAs contribute to ischemic heart disease, thus making them potential therapeutic targets. Here is to make a review on the recent research progress of miRNAs involvement in multiple aspects of ischemic heart disease including apoptosis and fibrosis, ischemic preconditioning, and angiogene-sis,to provide us with new insights into ischemic cardiac diseases.

  17. Role of Coagulation Factor Ⅶ in Pathogenesis of Ischemic Heart Disease

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To study the variation and significance of plasma coagulation factor Ⅶ (FⅦ) in differ ent kinds of ischemia heart disease (IHD) and examine its relation with plasma lipid and gene polymorphism. FⅦa was determined with one stage clotting assay by using a recombinant soluble tissue factor (rsTF). FⅦc was measured with one stage clotting assay. FⅦag was quantified with an enzyme-linked immunosorbent assay (ELISA). Polymorphism was analyzed with PCR-urea-polyacrylamide gel electrophoresis. Our results showed that FⅦa in stable angina (SA),unstable angina (UA), obsolete and acute myocardial infraction (OMI, AMI) patients was higher than those of normal group with the differences being significant within any two groups. FⅦag in UA, OMI and AMI was higher than those in SA and normal groups. There were positive correlations between FⅦa and serum triglycerides, FⅦa and FⅦc, FⅦc and FⅦag. FⅦ-323 0/10 bp polymorphism analysis was performed in 60 patients and 0/10 bp polymorphism was found in 5 cases. FⅦc and FⅦag were much lower in cases of 0/10 bp groups than those in cases of 0/0 bp groups. It is concluded that there was activation of extrinsic coagulation pathway in every kind of IHD to different extent. FⅦa was the risk factor in the development of IHD, and more sensitive in reflecting the severity of cardiovacutar disease than FⅦc or FⅦag. FⅦa was higher in OMI, which may be one of the risk factors of re-infraction. Serum triglyceride may indirectly lead to the development of IHD by increasing the level of FⅦa. FⅦ-323 0/10 bp polymorphism was present in Chinese patients with IHD and it was correlated with the level of FⅦc, FⅦag in plasma. 10 bp allelomorphic gene was a protective factor against thrombogenesis.

  18. EEG patterns from acute to chronic stroke phases in focal cerebral ischemic rats: correlations with functional recovery

    International Nuclear Information System (INIS)

    Monitoring the neural activities from the ischemic penumbra provides critical information on neurological recovery after stroke. The purpose of this study is to evaluate the temporal alterations of neural activities using electroencephalography (EEG) from the acute phase to the chronic phase, and to compare EEG with the degree of post-stroke motor function recovery in a rat model of focal ischemic stroke. Male Sprague–Dawley rats were subjected to 90 min transient middle cerebral artery occlusion surgery followed by reperfusion for seven days (n = 58). The EEG signals were recorded at the pre-stroke phase (0 h), acute phase (3, 6 h), subacute phase (12, 24, 48, 72 h) and chronic phase (96, 120, 144, 168 h) (n = 8). This study analyzed post-stroke seizures and polymorphic delta activities (PDAs) and calculated quantitative EEG parameters such as the alpha-to-delta ratio (ADR). The ADR represented the ratio between alpha power and delta power, which indicated how fast the EEG activities were. Forelimb and hindlimb motor functions were measured by De Ryck's test and the beam walking test, respectively. In the acute phase, delta power increased fourfold with the occurrence of PDAs, and the histological staining showed that the infarct was limited to the striatum and secondary sensory cortex. In the subacute phase, the alpha power reduced to 50% of the baseline, and the infarct progressed to the forelimb cortical region. ADRs reduced from 0.23 ± 0.09 to 0.04 ± 0.01 at 3 h in the acute phase and gradually recovered to 0.22 ± 0.08 at 168 h in the chronic phase. In the comparison of correlations between the EEG parameters and the limb motor function from the acute phase to the chronic phase, ADRs were found to have the highest correlation coefficients with the beam walking test (r = 0.9524, p < 0.05) and De Ryck's test (r = 0.8077, p < 0.05). This study measured EEG activities after focal cerebral ischemia and showed that functional recovery was closely

  19. Indicators psychological status in patients with chronic heart failure

    OpenAIRE

    KADIROVA SHAHLO; KAMILOVA UMIDA KABIROVNA

    2016-01-01

    In patients with heart failure to study the psychological status of the relationship between indicators of psychological status and progression of the disease: patients with FC III identified more often more severe disorders with revalence of depressive disorders.

  20. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies.

    NARCIS (Netherlands)

    Detaille, S.I.; Heerkens, Y.F.; Engels, J.A.; Gulden, J.W.J. van der; Dijk, F.J. van

    2009-01-01

    OBJECTIVE: Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD

  1. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies

    NARCIS (Netherlands)

    S.I. Detaille; Y.F. Heerkens; J.A. Engels; J.W.J. van der Gulden; F.J.H. van Dijk

    2009-01-01

    Objective Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD)

  2. Recent advances in the management of chronic stable angina II. Anti-ischemic therapy, options for refractory angina, risk factor reduction, and revascularization

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-08-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas, USAAbstract: The objectives in treating angina are relief of pain and prevention of disease ­progression through risk reduction. Mechanisms, indications, clinical forms, doses, and side effects of the traditional antianginal agents – nitrates, ß-blockers, and calcium channel ­blockers – are reviewed. A number of patients have contraindications or remain unrelieved from anginal discomfort with these drugs. Among newer alternatives, ranolazine, recently approved in the United States, indirectly prevents the intracellular calcium overload involved in cardiac ischemia and is a welcome addition to available treatments. None, however, are disease-modifying agents. Two options for refractory angina, enhanced external counterpulsation and spinal cord stimulation (SCS, are presented in detail. They are both well-studied and are effective means of treating at least some patients with this perplexing form of angina. Traditional modifiable risk factors for coronary artery disease (CAD – smoking, hypertension, dyslipidemia, ­diabetes, and obesity – account for most of the population-attributable risk. Individual therapy of high-risk patients differs from population-wide efforts to prevent risk factors from appearing or reducing their severity, in order to lower the national burden of disease. Current American College of Cardiology/American Heart Association guidelines to lower risk in patients with chronic angina are reviewed. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE trial showed that in patients with stable angina, optimal medical therapy alone and percutaneous coronary intervention (PCI with medical therapy were equal in preventing myocardial infarction and death. The integration of COURAGE results into current practice is discussed. For patients who are unstable, with very high risk, with left main coronary artery lesions, in

  3. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013

    Science.gov (United States)

    Kyu, Hmwe H; Bachman, Victoria F; Alexander, Lily T; Mumford, John Everett; Afshin, Ashkan; Estep, Kara; Veerman, J Lennert; Delwiche, Kristen; Iannarone, Marissa L; Moyer, Madeline L; Cercy, Kelly; Vos, Theo; Murray, Christopher J L

    2016-01-01

    Objective To quantify the dose-response associations between total physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events. Design Systematic review and Bayesian dose-response meta-analysis. Data sources PubMed and Embase from 1980 to 27 February 2016, and references from relevant systematic reviews. Data from the Study on Global AGEing and Adult Health conducted in China, Ghana, India, Mexico, Russia, and South Africa from 2007 to 2010 and the US National Health and Nutrition Examination Surveys from 1999 to 2011 were used to map domain specific physical activity (reported in included studies) to total activity. Eligibility criteria for selecting studies Prospective cohort studies examining the associations between physical activity (any domain) and at least one of the five diseases studied. Results 174 articles were identified: 35 for breast cancer, 19 for colon cancer, 55 for diabetes, 43 for ischemic heart disease, and 26 for ischemic stroke (some articles included multiple outcomes). Although higher levels of total physical activity were significantly associated with lower risk for all outcomes, major gains occurred at lower levels of activity (up to 3000-4000 metabolic equivalent (MET) minutes/week). For example, individuals with a total activity level of 600 MET minutes/week (the minimum recommended level) had a 2% lower risk of diabetes compared with those reporting no physical activity. An increase from 600 to 3600 MET minutes/week reduced the risk by an additional 19%. The same amount of increase yielded much smaller returns at higher levels of activity: an increase of total activity from 9000 to 12 000 MET minutes/week reduced the risk of diabetes by only 0.6%. Compared with insufficiently active individuals (total activity <600 MET minutes/week), the risk reduction for those in the highly active category (≥8000 MET minutes/week) was 14% (relative risk 0.863, 95% uncertainty

  4. Thoracic endovascular aortic repair for complicated chronic type B aortic dissection in a patient on hemodialysis with recurrent ischemic colitis.

    Science.gov (United States)

    Miyazaki, Yuko; Furuyama, Tadashi; Matsubara, Yutaka; Yoshiya, Keiji; Yoshiga, Ryosuke; Inoue, Kentaro; Matsuda, Daisuke; Aoyagi, Yukihiko; Kato, Masaaki; Matsumoto, Takuya; Maehara, Yoshihiko

    2016-12-01

    We present a successful case of thoracic endovascular aortic repair (TEVAR) for chronic Stanford type B aortic dissection (B-AD) with recurrent ischemic colitis. The patient was a 56-year-old woman with abdominal pain as the main complaint who had two operations previously: the total arch replacement 8 years ago and the Bentall 7 years ago for acute Stanford type A aortic dissection. Her abdominal pain worsened as her blood pressure became low during her hemodialysis treatment. An enhanced computed tomography scan was performed on the patient and showed chronic B-AD that occurred from the distal anastomotic part of the total arch graft to the bilateral common iliac arteries. The celiac artery and superior mesenteric artery (SMA) arose from the true lumen, and these were compressed by the expanded false lumen. Her complicated chronic B-AD was treated with the Zenith Dissection Endovascular System, and its procedure was performed as her proximal entry tear was covered by a proximal tapered Zenith TX2 stent graft, supplemented by a noncovered aortic stent extending across both renal arteries, the SMA, and the celiac artery. Seven days after this operation, enhanced computed tomography showed that the patient's true lumen was expanded and her blood flow to the true lumen and SMA was improved. On the other hand, her false lumen tended to be thrombosed. Consequently, she was discharged 10 days after the operation without any postoperative complications as she had no abdominal complaints even though she underwent hemodialysis three times per week after the operation. We believe that TEVAR supplemented by a noncovered aortic stent is an effective treatment, even for highly chronic B-AD in dialysis patients. PMID:27090121

  5. [The features of myocardial deformation of left ventricle in patients with ischemic heart disease defined by the two dimensional strain method].

    Science.gov (United States)

    Galimskaia, V A; Donchenko, I A; Romanovskaia, E M; Oleĭnikov, V É

    2014-01-01

    Aim of this study was to assess qualitative and quantitative features of deformation parameters of left ventricular myocardium in patients with ischemic heart disease (IHD) with and without history of myocardial infarction (MI) using two-dimensional strain imaging. We examined 30 patients with clinical IHD with (group 1, n = 15) and without (group 2, n = 15) history of MI and 20 healthy volunteers. Compared with healthy subjects IHD patients of both groups had reduced longitudinal and circular myocardial deformation. There were no significant differences between patients with IHD and controls in parameters of radial, global, and regional deformation.

  6. Acute and long term outcomes of catheter ablation using remote magnetic navigation for the treatment of electrical storm in patients with severe ischemic heart failure

    DEFF Research Database (Denmark)

    Jin, Qi; Jacobsen, Peter Karl; Pehrson, Steen;

    2015-01-01

    BACKGROUND: Catheter ablation with remote magnetic navigation (RMN) can offer some advantages compared to manual techniques. However, the relevant clinical evidence for how RMN-guided ablation affects electrical storm (ES) due to ventricular tachycardia (VT) in patients with severe ischemic heart...... failure (SIHF) is still limited. METHODS: Forty consecutive SIHF patients (left ventricular ejection fraction, 21 ± 6.9%) presenting with ES underwent ablation using RMN. All the patients received implantable cardioverter-defibrillators (ICDs) either before or after ablation. Acute ablation success...... before ablation (30% vs 69%, PRMN is safe and effective to suppress ES in SIHF patients. RMN...

  7. Sudden cardiac death in patients with diabetes mellitus and chronic heart failure.

    Science.gov (United States)

    Walker, Andrew Mn; Cubbon, Richard M

    2015-07-01

    In patients with diabetes mellitus, around 50% of deaths due to cardiovascular causes are sudden cardiac deaths. The prevalence of diabetes in cohorts with chronic heart failure is increasing, and while sudden cardiac death is an increasingly rare mode of death in chronic heart failure patients as a whole, the risk of this outcome remains high in those with diabetes. This review summarises the current knowledge on the incidence of sudden cardiac death in patients with diabetes and chronic heart failure, before discussing the causes of the excess risk seen in those with these coexistent conditions. We then describe current strategies for risk stratification and prevention of sudden cardiac death in these patients before discussing the priorities for further study in this area.

  8. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    Directory of Open Access Journals (Sweden)

    Evi Willemse

    2014-07-01

    Full Text Available This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner.Background: The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation.Methods: This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model.Results: The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse.Conclusion: Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.

  9. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    Directory of Open Access Journals (Sweden)

    Evi Willemse

    2014-07-01

    Full Text Available This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. Background: The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. Methods: This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. Results: The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Conclusion: Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.

  10. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors

    OpenAIRE

    Bruno-Pierre Dubé; Piergiuseppe Agostoni; Pierantonio Laveneziana

    2016-01-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology. Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators o...

  11. IS THERE AN ALTERNATIVE TO EJECTION FRACTION IN INSTRUMENTAL EVALUATION OF CHRONIC HEART FAILURE SEVERITY IN POST-MYOCARDIAL INFARCTION PATIENTS?

    Directory of Open Access Journals (Sweden)

    T. A. Kazakovtseva

    2010-01-01

    Full Text Available Aim. To find echocardiographic indicators of the heart remodeling which provide the best evaluation of chronic heart failure (CHF severity in post-myocardial infarction patients.Material and methods. Patients (n=100 with CHF related with ischemic heart disease (post-myocardial infarction have been examined. The CHF severity was assessed by Scale of Clinical State Evaluation (SCSE in V.Yu. Mareev's modification and 6-minute walk test. The echocardiography was performed with registration of the heart cavities size, left ventricle (LV myocardium mass, LV asynergy index, LV sphericity index, time of LV isovolumic contraction and relaxation, Е/А ratio for mitral flow, grade of valvular regurgitation and pulmonary hypertension.Results. The maximal correlation values of CHF severity was observed with intensity of diastolic dysfunction, systolic LV size and volume, LV asynergia index, integrated systolic remodeling index, degree of mitral regurgitation. Correlation value of CHF severity with LV ejection fraction was less than this with above mentioned indices.Conclusion. The early echocardiographic markers of CHF were found. These are LV systolic sphericity index, LV integrated systolic remodeling index, LV systolic myocardial stress.

  12. Intracoronary Injection of CD34-Cells in Chronic Ischemic Heart Failure

    DEFF Research Database (Denmark)

    Hansen, Morten; Nyby, Sebastian; Eifer Møller, Jacob;

    2014-01-01

    × 10(6) CD34(+) cells and 14 ± 7 × 10(6) CD133(+) cells). Patients were followed for 7 years and deaths were recorded. Results: During follow-up, 10 patients died (31%). In univariate regression analysis, the total number of BMSCs, CD34(+) cell count and CD133(+) cell count did not significantly...

  13. Health-related quality of life in elderly patients hospitalized with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Erceg P

    2013-11-01

    Full Text Available Predrag Erceg,1,2 Nebojsa Despotovic,1,2 Dragoslav P Milosevic,1,2 Ivan Soldatovic,3 Sanja Zdravkovic,2 Snezana Tomic,2 Ivana Markovic,2 Gordana Mihajlovic,2 Milan D Brajovic,4,5 Ognjen Bojovic,6 Bojana Potic,2 Mladen Davidovic1 1Department of Gerontology, Faculty of Medicine, University of Belgrade, 2Clinical Department of Geriatrics, Zvezdara University Hospital, 3Institute of Medical Statistics and Informatics, Faculty of Medicine, 4Department of Internal Medicine, Faculty of Dentistry, University of Belgrade, 5Clinical Department of Cardiology, Zvezdara University Hospital, Belgrade, Serbia; 6Department of Biomedicine, University of Bergen, Bergen, Norway Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL. Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001, higher NYHA class (P=0.021, lower income (P=0.029, and longer duration of heart failure (P=0.049 were

  14. Plasma calprotectin levels reflect disease severity in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Jensen, Louise Jn; Kistorp, Caroline Michaela Nervil; Bjerre, Mette;

    2011-01-01

    Background: Low-grade inflammation has been associated with cardiovascular disease (CVD) and chronic heart failure (CHF). The aim of the present study was to investigate the potential usefulness of the inflammatory protein calprotectin as a biomarker in CHF. Methods: Plasma calprotectin was measu......Background: Low-grade inflammation has been associated with cardiovascular disease (CVD) and chronic heart failure (CHF). The aim of the present study was to investigate the potential usefulness of the inflammatory protein calprotectin as a biomarker in CHF. Methods: Plasma calprotectin...

  15. The effects of physical exercise on plasma levels of relaxin, NTproANP, and NTproBNP in patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Heringlake M

    2009-03-01

    Full Text Available Abstract The insulin-like and vasodilatatory polypeptide relaxin (RLX, formerly known as a pregnancy hormone, has gained interest as a potential humoral mediator in human heart failure. Controversy exists about the relation between plasma levels of RLX and the severity of heart failure. The present study was designed to determine the course of RLX, atrial, and brain natriuretic peptide (NT-proANP and NT-proBNP during physical exercise in patients with ischemic heart disease (IHD and to relate hormone levels to peak cardiac power output (CPO as a measure of cardiopulmonary function with prognostic relevance. 40 patients with IHD were studied during right-heart-catheterization at rest and during supine bicycle ergometry. RLX, NTproBNP, and NTproANP were determined before, during exercise, and after recovery. NT-proANP and NT-proBNP levels increased during maximal charge, and recovery while RLX levels decreased. Cardiac power output at maximal charge correlated inversely with NTproANP and NTproBNP but positively with RLX. Patients with high degree heart failure (CPO

  16. Higher circulating levels of chemokines CXCL10, CCL20 and CCL22 in patients with ischemic heart disease.

    Science.gov (United States)

    Safa, A; Rashidinejad, H R; Khalili, M; Dabiri, S; Nemati, M; Mohammadi, M M; Jafarzadeh, A

    2016-07-01

    Recruitment of leukocytes is one of the earliest events in the pathogenesis of ischemic heart disease (IHD) and chemokines play an important role in the migration of these cells into the inflammation sites. The aim of this study was to evaluate the CXCL10, CCL20 and CCL22 levels and the single nucleotide polymorphisms (SNPs) rs4508917, rs6749704 and rs4359426 in chemokine genes in patients with IHD to clarify any association. A total of 300 patients with IHD as having acute myocardial infarction (AMI; n=100), stable angina (SA; n=100) or unstable angina (UA; n=100) and 100 healthy subjects as a control group were enrolled to study. Serum samples from all participants were tested for the CXCL10, CCL20 and CCL22 levels by using ELISA. The SNPs were determined by polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method. The mean serum concentrations of CXCL10, CCL20 and CCL22 in AMI patients (395.97±21.20Pg/mL, 108.38±10.31Pg/mL and 1852.58±205.77Pg/mL), SA patients (405.48±27.36Pg/mL, 90.20±7.69Pg/mL and 2322.04±231.23Pg/mL) and UA patients (396.69±22.79Pg/mL, 141.87±18.10Pg/mL and 2754.89±211.70Pg/mL) were significantly higher than in the healthy group (179.38±8.85Pg/mL, 51.92±4.62Pg/mL and 451.82±23.76Pg/mL, respectively; PACE) inhibitors and patients without mentioned treatment regarding the levels of chemokines. The frequency of the GG genotype at SNP rs4508917 in CXCL10 gene was higher, whereas the frequency of the AA genotype at SNP rs4359426 in CCL22 gene was lower in total patients with IHD as compared with healthy subjects (P<0.04 and P<0.002, respectively). These results showed that the higher levels of CXCL10, CCL20 and CCL22 were associated with IHD. The serum levels of chemokines may influence by the certain traditional risk factors of IHD and some studied SNPs, but did not influence by treatment and gender of patients. PMID:27152707

  17. Burden of ischemic heart diseases in Iran, 1990-2010: Findings from the Global Burden of Disease study 2010

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Maracy

    2015-01-01

    Full Text Available Background: Cardiovascular diseases are viewed worldwide as one of the main causes of death.This study aims to report the burden of ischemic heart diseases (IHDs in Iran by using data of the global burden of disease (GBD study, 1990-2010. Materials and Methods: The GBD study 2010 was a systematic effort to provide comprehensive data to calculate disability-adjusted life years (DALYs for diseases and injuries in the world. Years of life lost (YLLs due to premature mortality were computed on the basis of cause-of-death estimates, using Cause of Death Ensemble model (CODEm. Years lived with disability (YLDs were assessed by the multiplication of prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was performed to evaluate the distribution of diseases, and consequently prevalence estimates were calculated with a Bayesian meta-regression method (DisMod-MR. Data from population-based surveys were used for producing disability weights. Uncertainty from all inputs into the calculations of DALYs was disseminated by Monte Carlo simulation techniques. Results: The age-standardized IHDs DALY specified rate decreased 31.25% over 20 years from 1990 to 2010 [from 4720 (95% uncertainty interval (UI: 4,341-5,099 to 3,245 (95% UI: 2,810-3,529 person-years per 100,000]. The decrease were 38.14% among women and 26.87% among men. The age-standardized IHDs death specefied rate decreased by 21.17% [from 222 95% UI: 207-243 (to 175 (95% UI:152-190 person-years per 100,000] in both the sexes. The age-standardized YLL and YLD rates decreased 32.05% and 4.28%, respectively, in the above period. Conclusion: Despite decreasing age-standardized IHD of mortality, YLL, YLD, and DALY rates from 1990 to 2010, population growth and aging increased the global burden of IHD. YLL has decreased more than IHD deaths and YLD since 1990 but IHD mortality remains the greatest contributor to disease burden.

  18. Burden of ischemic heart diseases in Iran, 1990-2010: Findings from the Global Burden of Disease study 2010

    Science.gov (United States)

    Maracy, Mohammad Reza; Isfahani, Motahareh Tabar; Kelishadi, Roya; Ghasemian, Anoosheh; Sharifi, Farshad; Shabani, Reihaneh; Djalalinia, Shirin; Majidi, Somayye; Ansari, Hossein; Asayesh, Hamid; Qorbani, Mostafa

    2015-01-01

    Background: Cardiovascular diseases are viewed worldwide as one of the main causes of death. This study aims to report the burden of ischemic heart diseases (IHDs) in Iran by using data of the global burden of disease (GBD) study, 1990-2010. Materials and Methods: The GBD study 2010 was a systematic effort to provide comprehensive data to calculate disability-adjusted life years (DALYs) for diseases and injuries in the world. Years of life lost (YLLs) due to premature mortality were computed on the basis of cause-of-death estimates, using Cause of Death Ensemble model (CODEm). Years lived with disability (YLDs) were assessed by the multiplication of prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was performed to evaluate the distribution of diseases, and consequently prevalence estimates were calculated with a Bayesian meta-regression method (DisMod-MR). Data from population-based surveys were used for producing disability weights. Uncertainty from all inputs into the calculations of DALYs was disseminated by Monte Carlo simulation techniques. Results: The age-standardized IHDs DALY specified rate decreased 31.25% over 20 years from 1990 to 2010 [from 4720 (95% uncertainty interval (UI): 4,341-5,099) to 3,245 (95% UI: 2,810-3,529) person-years per 100,000]. The decrease were 38.14% among women and 26.87% among men. The age-standardized IHDs death specefied rate decreased by 21.17% [from 222) 95% UI: 207-243 (to 175 (95% UI:152-190) person-years per 100,000] in both the sexes. The age-standardized YLL and YLD rates decreased 32.05% and 4.28%, respectively, in the above period. Conclusion: Despite decreasing age-standardized IHD of mortality, YLL, YLD, and DALY rates from 1990 to 2010, population growth and aging increased the global burden of IHD. YLL has decreased more than IHD deaths and YLD since 1990 but IHD mortality remains the greatest contributor to disease burden. PMID

  19. A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease

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    Ahrén Bo

    2010-11-01

    Full Text Available Abstract Background We found marked improvement of glucose tolerance and lower dietary energy intake in ischemic heart disease (IHD patients after advice to follow a Paleolithic diet, as compared to a Mediterranean-like diet. We now report findings on subjective ratings of satiety at meals and data on the satiety hormone leptin and the soluble leptin receptor from the same study. Methods Twenty-nine male IHD patients with impaired glucose tolerance or diabetes type 2, and waist circumference > 94 cm, were randomized to ad libitum consumption of a Paleolithic diet (n = 14 based on lean meat, fish, fruit, vegetables, root vegetables, eggs, and nuts, or a Mediterranean-like diet (n = 15 based on whole grains, low-fat dairy products, vegetables, fruit, fish, and oils and margarines during 12 weeks. In parallel with a four day weighed food record the participants recorded their subjective rating of satiety. Satiety Quotients were calculated, as the intra-meal quotient of change in satiety during meal and consumed energy or weight of food and drink for that specific meal. Leptin and leptin receptor was measured at baseline and after 6 and 12 weeks. Free leptin index was calculated as the ratio leptin/leptin receptor. Results The Paleolithic group were as satiated as the Mediterranean group but consumed less energy per day (5.8 MJ/day vs. 7.6 MJ/day, Paleolithic vs. Mediterranean, p = 0.04. Consequently, the quotients of mean change in satiety during meal and mean consumed energy from food and drink were higher in the Paleolithic group (p = 0.03. Also, there was a strong trend for greater Satiety Quotient for energy in the Paleolithic group (p = 0.057. Leptin decreased by 31% in the Paleolithic group and by 18% in the Mediterranean group with a trend for greater relative decrease of leptin in the Paleolithic group. Relative changes in leptin and changes in weight and waist circumference correlated significantly in the Paleolithic group (p Conclusions A

  20. Infrared fluorescent protein 1.4 genetic labeling tracks engrafted cardiac progenitor cells in mouse ischemic hearts.

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    Lijuan Chen

    Full Text Available Stem cell therapy has a potential for regenerating damaged myocardium. However, a key obstacle to cell therapy's success is the loss of engrafted cells due to apoptosis or necrosis in the ischemic myocardium. While many strategies have been developed to improve engrafted cell survival, tools to evaluate cell efficacy within the body are limited. Traditional genetic labeling tools, such as GFP-like fluorescent proteins (eGFP, DsRed, mCherry, have limited penetration depths in vivo due to tissue scattering and absorption. To circumvent these limitations, a near-infrared fluorescent mutant of the DrBphP bacteriophytochrome from Deinococcus radiodurans, IFP1.4, was developed for in vivo imaging, but it has yet to be used for in vivo stem/progenitor cell tracking. In this study, we incorporated IFP1.4 into mouse cardiac progenitor cells (CPCs by a lentiviral vector. Live IFP1.4-labeled CPCs were imaged by their near-infrared fluorescence (NIRF using an Odyssey scanner following overnight incubation with biliverdin. A significant linear correlation was observed between the amount of cells and NIRF signal intensity in in vitro studies. Lentiviral mediated IFP1.4 gene labeling is stable, and does not impact the apoptosis and cardiac differentiation of CPC. To assess efficacy of our model for engrafted cells in vivo, IFP1.4-labeled CPCs were intramyocardially injected into infarcted hearts. NIRF signals were collected at 1-day, 7-days, and 14-days post-injection using the Kodak in vivo multispectral imaging system. Strong NIRF signals from engrafted cells were imaged 1 day after injection. At 1 week after injection, 70% of the NIRF signal was lost when compared to the intensity of the day 1 signal. The data collected 2 weeks following transplantation showed an 88% decrease when compared to day 1. Our studies have shown that IFP1.4 gene labeling can be used to track the viability of transplanted cells in vivo.