Cardiology RSS : Gourt

Permanent Cardiology Job in Instant Patient Base Delaware with CompHealth Inc

Job 511608 SSG - Coastal beach community Replace departing Invasive Cardiologist 3 year track to partnership New Cath lab being built in 2006 Echo and Nuclear experience preferred Incentives/bonus Malpractice

Permanent Cardiology Job in Beautiful Southern California Valley Needs Cardiologist California with CompHealth Inc

Job 658631 Invasive or Non-Invasive Competitive salary, productive bonus Four-day work week available New, 7,000 sq. ft. facility Approximately 30 minutes from major metropolitan city Wonderful climate

Permanent Cardiology Job in Outstanding Upstate New York Invasive Opportunity New York with CompHealth Inc

Job 658453 Income guarantee position with full benefits Call of 1:4 Partnership track Top 100 ranked Heart Hospital by U.S. World Report Great schools and family communities Office hours Monday - Friday;

Permanent Cardiology Job in Outstanding Interventional Opportunity in Upstate New York New York with CompHealth Inc

Job 658452 Employed position with full benefits Call 1:4 Partnership track Top 100 Ranked Heart Hospital by U.S. World Report Great schools and family communities Office hours Monday - Friday, 8:00

Permanent Cardiology Job in Come Work and Play in One of North Carolina's Most Beautiful Resort Areas North Carolina with CompHealth Inc

Job 656850 SSG group looking to add 4th Cardiologist due to growth Large waiting patient base already in place - - step in and be busy from day one Very light call schedule -- first call is handled

Permanent Cardiology Job in Cardiology Partner Needed with an Amazing Lifestyle! North Carolina with CompHealth Inc

Job 657749 $300,000 Salary DOE, $500,000 earning potential Great community and schools - - top 5 growing area in the U.S. Four-day work week Partner by end of 2nd year SSG of 3 Light call of 1:4 Close

Permanent Cardiology Job in Metro North Dakota Needs an Interventionalist North Dakota with CompHealth Inc

Job 615889 MSG of over 160 physicians representing over 40 specialties Join 3 other Interventional Cardiologists Potential teaching opportunity Participate in research studies and clinical trials Admit

Permanent Cardiology Job in Columbus Ohio Ohio with CompHealth Inc

Job 656392 Successful established Cardiology Group seeks Invasive or Non-Invasive Specialist 2 years to partnership Strong starting salary with an earning potential of $600K 5 weeks paid time off Complete

Locum Tenens Cardiology Job in Government Job for a Invasive Cardiologist in Salem, VA Virginia with CompHealth Inc

Job 0322437-0119 BC/BE Invasive Cardiologist or Non-Invasive Cardiologist Any State License BLS and ACLS required Computerized patient record system Outpatient/Inpatient/Consults On-call Adult to geriatric

Permanent Cardiology Job in Cardiologist Needed One Hour to Columbus Ohio with CompHealth Inc

Job 656672 Join 5 General Cards and 1 Interventionalist No competition in a service area of 300,000 Hospital has state of the art services including open heart program Base salary at the top of MGMA

Permanent Cardiology Job in EP Cardiology Opening in Central Pennsylvania Pennsylvania with CompHealth Inc

Job 657778 Join a multispecialty group seeking their first EP physician Very heavy patient base - - huge referrals Very competitive compensation - - all benefits for physician and family Affordable

Permanent Cardiology Job in Superior Opportunity To Practice Cardiology On The East Coast Of Florida Florida with CompHealth Inc

Job 319406 Prestigious multi specialty group Comprehensive compensation and benefit program Partnership after year 2 Beautiful coastal community Excellent schools and recreational activities CompHealth

Permanent Cardiology Job in EP Cardiologist needed for well respected MSG - very large service area - 50,000 - lots of referral Tennessee with CompHealth Inc

Job 656470 EP needed to join 4 Cardiologists Dominant group in the area Top salary and benefits Production bonus year 2 Call 1:5 Sign on bonus Malpractice Vacation, CME - TBD Life insurance, relocation

Permanent Cardiology Job in Interventional Cardiology with well respected MSG large service area Tennessee with CompHealth Inc

Job 656469 MSG looking for Interventional Cardiologist Well established group with waiting patients Desirable location Top salary and benefits Production bonus Call 1:5 Sign on bonus Malpractice Vacation,

Permanent Cardiology Job in Calling All Cards!!! Well Established MSG Looking for Invasive or Non Invasive Cardiologist for Ve Tennessee with CompHealth Inc

Job 656451 Join 4 Cards in this expanding MSG Dominant group in the area Top salary and benefits Production bonus year 2 Call 1:5 Sign on bonus Malpractice Vacation, CME - TBD Life insurance, relocation

Permanent Cardiology Job in One of Tennessee's Fastest-Growing Communities Needs Cardiologists! Tennessee with CompHealth Inc

Job 658210 Excellent income - $400K+ Your choice: solo-employed or group State-of-the-art, 270-bed medical center Booming suburb of Nashville Admit to one hospital Full benefit package Malpractice

Permanent Cardiology Job in Cardiologists Needed in Jackson, Tennessee! Tennessee with CompHealth Inc

Job 658259 Call is 1:4 Salary open Loan assist Great community, lifestyle, growing market Grow a practice Good schools, cultural center Bonus/incentives Malpractice paid Tax shelters Pension plan

Permanent Cardiology Job in Cardiologist Needed for Tennessee's #1 Ranked Metropolitan City Tennessee with CompHealth Inc

Job 658277 Salary range exceeding $300,000 Aggressive sign-on incentives Interventional or Invasive Cardiologist Great recreational area, diversity, high quality of life Join 26 physicians and support

Permanent Cardiology Job in Interventionalist Needed in Tennessee! Tennessee with CompHealth Inc

Job 658258 Great lifestyle - - expanding market Open salary Call is 1:4 Friendly community Opportunity to build practice Bonus/incentive Malpractice paid Tax shelter Relocation package CompHealth

Permanent Cardiology Job in Southern California Awaits California with CompHealth Inc

Job 616264 220-250K base Invasive or Non-Invasive needed Dynamic single specialty group Great benefit package, paid relocation, sign on bonus, partnership after year 2 80 miles west of Los Angeles,

Therapeutic Angiogenesis: A New Treatment Approach for Ischemic Heart Disease-Part II.

Page: 219DOI: 10.1097/CRD.0b013e3181620e50Authors: Ahn, Anna MD *; Frishman, William H. MD +; Gutwein, Andrew MD +; Passeri, Jonathan MD ++; Nelson, Michael MD [S]

Treatment of Atrial Fibrillation and Atrial Flutter: Part II.

Page: 230DOI: 10.1097/CRD.0b013e3181723694Authors: Aronow, Wilbert S. MD, FACC, FAHA

Natriuretic Peptide Testing in Clinical Medicine.

Page: 240DOI: 10.1097/CRD.0b013e3181815333Authors: Rehman, Shafiq U. MD; Januzzi, James L. Jr MD

Investigational Antiplatelet Drugs for the Treatment and Prevention of Coronary Artery Disease.

Page: 250DOI: 10.1097/CRD.0b013e3181804336Authors: Zeidner, Joshua F. MD *; Frishman, William H. MD +; Lerner, Robert G. MD +

Acute Inferior Wall Myocardial Infarction and Percutaneous Coronary Intervention of the Right Coronary During Active Labor: A Clinical Report and Review of the Literature.

Page: 260DOI: 10.1097/CRD.0b013e3181827292Authors: Pierre-Louis, Bredy MD; Singh, Parminder MD; Frishman, William H. MD

Metformin Use in Decompensated Heart Failure.

Page: 269DOI: 10.1097/CRD.0b013e3181846c53Authors: Boyd, Alex PharmD *; Nawarskas, James PharmD, BCPS +

Study Identifies Key Factor that Links Metabolic Syndrome

A new study led by researchers at Joslin Diabetes Center has identified insulin resistance in the liver as a key factor in the cause of metabolic syndrome and its associated atherosclerosis Additional topics at Heart Disease More research-related news at Consumer Information

CT Scans Effective in Detecting Artery Disease

Additional topics at Heart Disease More research-related news at Consumer Information

Successful alcohol septal ablation for late recurrence of left ventricular outflow tract obstruction after surgical myectomy in hypertrophic obstructive cardiomyopathy.

Related Articles Successful alcohol septal ablation for late recurrence of left ventricular outflow tract obstruction after surgical myectomy in hypertrophic obstructive cardiomyopathy. Acta Cardiol. 2008 Apr;63(2):271-5 Authors: Tromp F, Devos D, De Backer J An 18-year-old male patient, known with familial hypertrophic obstructive cardiomyopathy underwent a septal myectomy 10 years ago for significant left ventricular outflow tract (LVOT) obstruction. During follow-up a progressive increase in LVOT gradient was noted in association with severe mitral valve regurgitation. The patient underwent percutaneous alcohol septal ablation to induce regression of left ventricular hypertrophy. Coronary angiography, with intracoronary contrast and guided by echocardiographic imaging, was applied for localisation of the appropriate septal branch. The vessel was subsequently injected with 1.5 cc ethanol. No procedure-related complications were reported. The LVOT gradient decreased from 90 mmHg to 48 and 45 mmHg at rest 6 weeks and 6 months, respectively, after the procedure. Mitral valve regurgitation was significantly reduced. This case nicely illustrates the feasibility of percutaneous alcohol septal ablation for recurrent LVOT obstruction 10 years after myectomy. PMID: 18468210 [PubMed - indexed for MEDLINE]

A pseudo sinus tachycardia originating from the right superior pulmonary vein. Successful ablation by a simplified, targeted ablation strategy.

Related Articles A pseudo sinus tachycardia originating from the right superior pulmonary vein. Successful ablation by a simplified, targeted ablation strategy. Acta Cardiol. 2008 Apr;63(2):265-9 Authors: Scavee C, Brasseur A, Weerasooriya R We report the case of a young woman suffering from a permanent ectopic atrial tachycardia originating from the right superior pulmonary vein and mimicking a sinus tachycardia on the ECG. Using only 2 quadripolar catheters after a transseptal approach, the focus was successfully mapped to the posterior wall of the right superior pulmonary vein. The focus was successfully ablated during the same procedure using a 4-mm tip-irrigated catheter. PMID: 18468209 [PubMed - indexed for MEDLINE]

Arrhythmias in cardiac catheterization laboratories.

Related Articles Arrhythmias in cardiac catheterization laboratories. Acta Cardiol. 2008 Apr;63(2):259-63 Authors: Gorenek B Several kinds of arrhythmias, such as ventricular arrhythmias, atrial fibrillation, bradycardias and conduction disturbances can occur in cardiac catheterization laboratories. The patients' characteristics, the type of procedure, the features of the target vessel and the type of lesion play important roles in the occurrence of arrhythmia. A majority of the arrhythmias tend to revert spontaneously, but special treatment must be given promptly when necessary. In this paper, we will review the pathophysiology, clinical importance and treatment strategies for arrhythmias that occurred during diagnostic cardiac catheterization and PCI in cardiac catheterization laboratories. PMID: 18468208 [PubMed - indexed for MEDLINE]

Rehabilitation of patients with implantable cardioverter/defibrillator: a literature review.

Related Articles Rehabilitation of patients with implantable cardioverter/defibrillator: a literature review. Acta Cardiol. 2008 Apr;63(2):249-57 Authors: Hussein NA, Thomas MA The implantable cardioverter/defibrillator (ICD) has established superiority in reducing mortality for survivors of cardiac arrest or patients at high risk for sudden death. However, patients with ICD suffer from many problems that affect their daily living activity. They also refrain to do exercise, for fear of precipitating life-threatening arrhythmia or receiving an ICD shock. This review outlines the problems that those patients usually face and describes the possible exercise programs as well as the rehabilitative approach for managing their daily living activities. PMID: 18468207 [PubMed - indexed for MEDLINE]

Belgian expert opinion: how to reduce the residual risk in atherogenic dyslipidaemic patients: place of fibrates.

Related Articles Belgian expert opinion: how to reduce the residual risk in atherogenic dyslipidaemic patients: place of fibrates. Acta Cardiol. 2008 Apr;63(2):235-48 Authors: Ducobu J, Scheen A, Van Gaal L, Velkeniers B, Hermans M The demographics of dyslipidaemia have changed towards a more complex atherogenic dyslipidaemia involving increased levels of LDL-C, in particular highly atherogenic small dense particles, hypertriglyceridaemia and low HDL, together with increased levels of markers of cardiovascular inflammation, thrombogenesis and endothelial dysfunction. Statins were shown to significantly lower cardiovascular morbidity and mortality, but there still remains a high residual risk in dyslipidaemic patients, in particular with metabolic syndrome, type 2 diabetes, or low HDL levels. Fibrates have been shown to reduce plasma triglycerides and increase HDL-C, while improving inflammation, thrombogenesis and endothelial dysfunction. Clinical trials with fibrates have demonstrated their potential to reduce cardiovascular morbidity and mortality too, often through other mechanisms than these of statins. Combination trials of statins with fibrates have shown a more complete improvement of lipid profile and risk markers than each class separately. In contrast with gemfibrozil, fenofibrate does not interact significantly with the pharmacokinetics of statins, and up to now its combination with statins has been shown to have a low risk of muscular side effects or liver toxicity. The ACCORD outcome trial is exploring the possible benefits of the combination of fenofibrate with statins on morbidity and mortality of patients with atherogenic dyslipidaemia. PMID: 18468206 [PubMed - indexed for MEDLINE]

Lack of evidence for contribution of intron4a/b polymorphism of endothelial nitric oxide synthase (NOS3) gene to plasma nitric oxide levels.

Related Articles Lack of evidence for contribution of intron4a/b polymorphism of endothelial nitric oxide synthase (NOS3) gene to plasma nitric oxide levels. Acta Cardiol. 2008 Apr;63(2):229-34 Authors: Salimi S, Firoozrai M, Nourmohammadi I, Shabani M, Shafiee SM, Mohebbi A, Tavilani H OBJECTIVE: Nitric oxide (NO) is synthesized from L-arginine by endothelium nitric oxide synthase (NOS3). It has been shown that reduced NO synthesis in endothelial cells has been implicated in the development of coronary atherosclerosis. We hypothesized that polymorphisms of NOS3 gene might be associated with increased susceptibility of coronary artery disease (CAD) and plasma NO concentrations. METHODS AND RESULTS: We studied the NOS3 intron4 gene polymorphism in 141 unrelated CAD patients with positive coronary angiograms in the Shahid Rajaee Heart Hospital and 159 age-matched control subjects without a history of symptomatic CAD. The NOS3 gene polymorphism was analysed by polymerase chain reaction. Plasma NO was also determined. The genotype frequencies for NOS34a/b polymorphism differed significantly between CAD patients and controls (P = 0.041). Mean plasma NOx concentration was significantly higher (P = 0.0009) in CAD patients (87.5 microM) than in controls (62.7 microM). Mean plasma NOx concentrations in the subjects with 4a allele and in the subjects without 4a allele were not significantly different. Plasma lipids, except HDL-C were also remarkably increased in the CAD group. CONCLUSIONS: The present study provides evidence that the intron4a/b polymorphism of the NOS3 gene is associated with CAD. Mean plasma NO was higher in CAD patients than in control subjects. The NOS34a/b polymorphism was not associated with increased plasma NO. PMID: 18468205 [PubMed - indexed for MEDLINE]

Evaluation of left ventricular systolic and diastolic function in patients with atrioventricular re-entrant tachycardia treated by radiofrequency current ablation.

Related Articles Evaluation of left ventricular systolic and diastolic function in patients with atrioventricular re-entrant tachycardia treated by radiofrequency current ablation. Acta Cardiol. 2008 Apr;63(2):221-7 Authors: Duszanska A, Lenarczyk R, Kowalski O, Streb W, Kukulski T, Kalarus Z Little is known about the long-term influence of radiofrequency current ablation (RFCA) on left ventricular (LV) systolic and diastolic function in patients with atrioventricular re-entrant tachycardia (AVRT). METHOD: The study group consisted of 65 patients (33 M, mean age 39 +/- 11 y) with WPW syndrome and recurrent episodes of AVRT without any concomitant diseases. The control group consisted of 50 age-matched healthy volunteers. In both study and control groups transthorasic echocardiography (TTE) and Doppler were performed in order to assess LV systolic and diastolic function. In WPW patients TTE was followed by electrophysiology study and RFCA. TTE was repeated in 6-months time in the study group. RESULTS: At 6-month follow-up a decrease in LV end-systolic diameters (1.77 +/- 0.22 vs. 1.67 +/- 0.22 cm/m2, P < 0.001) and volumes (20 +/- 6 vs. 17 +/- 5 ml, P < 0.001) and an increase in LV FS (33 +/- 6 vs. 37 +/- 5%, P < 0.001), EF (54 +/- 6 vs. 60 +/- 5%, P < 0.001), IVS (44 +/- 13 vs. 49 +/- 14%, P < 0.05) and LV PW thickening (58 +/- 19 vs. 62 +/- 16%, P < 0.05) was found. Doppler analysis revealed an increase in E wave (78 +/- 17 vs. 82 +/- 14 cm/s, P < 0.001), E/A ratio (1.14 +/- 0.37 vs. 1.33 +/- 0.24, P < 0.001) and a decrease in A wave (68 +/- 19 vs. 63 +/- 12 cm/s, P < 0.05), DT (219 +/- 33 vs. 180 +/- 20 ms, P < 0.001 ), IVRT (105 +/- 13 vs. 88 +/- 13 ms, P < 0.001), AR (26 +/- 8 vs. 18 +/- 12 cm/s, P < 0.001 ) and difference between duration of AR and A waves (5 +/- 24 vs. -12 +/- 21 ms, P < 0.001). No significant differences in regard to LV systolic and diastolic variables were found between patients and controls post RFCA. CONCLUSION: RFCA of accessory pathway in patients with WPW syndrome and AVRT is associated with improvement of LV systolic and diastolic function. PMID: 18468204 [PubMed - indexed for MEDLINE]

Screening and identification of differentially expressed genes in myocardial ischaemia/reperfusion injury using suppression subtractive hybridization.

Related Articles Screening and identification of differentially expressed genes in myocardial ischaemia/reperfusion injury using suppression subtractive hybridization. Acta Cardiol. 2008 Apr;63(2):213-9 Authors: Liu YW, Liu SP, Cheng JD, Wang K, Chen YC OBJECTIVE: Myocardial ischaemia/reperfusion (MI/R) injury is characterized by metabolic and ultrastructural changes, which lead to irreversible injury. Several mechanisms have been postulated for the pathogenesis of MI/R injury although little is known regarding the role of myocardial gene expression. METHODS AND RESULTS: In this study, suppression subtractive hybridization (SSH) was employed to systematically isolate and screen the differentially expressed genes in the MI/R injury rat model. The characteristics of these specific genes were analysed using bioinformatics. Our results showed that among the 119 identified genes, 54 genes were expressed at higher levels and 65 genes were at lower levels compared with the control group. CONCLUSIONS: These genes are closely associated with energy metabolism, iron transport, signalling transduction and may provide important clues for the elucidation of the mechanisms of MI/R injury. Our results further indicated that myocardial injury is likely the result of summation of functional impairment of multiple genes rather than the result of damage to a single critical gene. PMID: 18468203 [PubMed - indexed for MEDLINE]

Value of clinical, electrocardiographic, echocardiographic and neurohumoral parameters in non-ischaemic dilated cardiomyopathy.

Related Articles Value of clinical, electrocardiographic, echocardiographic and neurohumoral parameters in non-ischaemic dilated cardiomyopathy. Acta Cardiol. 2008 Apr;63(2):207-12 Authors: Tigen K, Karaahmet T, Tanalp AC, Gurel E, Cevik C, Mutlu B, Basaran Y AIM: The aim of this study was to assess the predictive value of electrocardiographic, echocardiographic and neurohumoral parameters for adverse outcomes in non-ischaemic dilated cardiomyopathy patients with sinus rhythm. METHODS: Seventy-eight patients with non-ischaemic dilated cardiomyopathy (LVEF < 40%) and sinus rhythm were enrolled. All patients underwent electrocardiographic, echocardiographic examination and coronary angiography. Blood samples for plasma NT pro-BNP levels were obtained at rest, following echocardiographic examination. Patients were followed up for clinical end points of death from worsening heart failure, sudden cardiac death and heart transplantation. RESULTS: The study population consisted of 24 (30.8%) women and 54 (69.2%) men. Forty-four patients (65.4%) suffered from clinical end points during a mean of 1278 +/- 188 days follow-up; cardiac transplantation was performed in 5 (11%), sudden cardiac death occurred in 10 (23%) and death due to worsening heart failure in 29 (66%) patients. The patients were grouped according to the presence (group 1, 44 patients) or absence (group 2, 34 patients) of clinical end points. The patients in group 1 had lower systolic blood pressures (P = 0.006) and higher NYHA functional classes (P < 0.0001). When echocardiographic parameters and NT pro-BNP values were compared, the patients in group 1 had lower left ventricular ejection fractions (P < 0.0001), higher E/A ratios (P < 0.0001), shorter E wave deceleration times (P = 0.004), pulmonary acceleration times (P < 0.0001) and isovolumetric relaxation times (P = 0.03), increased mitral regurgitant volumes (P = 0.033) and higher plasma NT pro-BNP levels (P < 0.0001). There was no significant difference between the two groups regarding electrocardiographic parameters. In univariate analysis, the prognostic predictors of life expectancy were identified as plasma NT pro-BNP, NYHA functional class, left ventricular ejection fraction, E/A ratio and E wave deceleration time. However, in multivariate analysis by logistic regression only plasma NT pro-BNP was determined as independent predictor of life expectancy (P = 0.04, HR (95% CI) = 1.0003 (1.0000-1.0007), chi2 = 3.9). CONCLUSION: Electrocardiographic parameters failed to predict clinical end points in this group of patients. Plasma NT pro-BNP is a useful biochemical marker to define the high-risk group that warrants closer follow-up in dilated cardiomyopathy patients with sinus rhythm. PMID: 18468202 [PubMed - indexed for MEDLINE]

Spontaneous and catheter-induced secondary coronary artery dissection: a single-centre experience.

Related Articles Spontaneous and catheter-induced secondary coronary artery dissection: a single-centre experience. Acta Cardiol. 2008 Apr;63(2):203-6 Authors: Bulum J, Strozzi M, Smalcelj A 6497 consecutive patients who underwent coronary angiography in our institution in a three-year period were analysed. Spontaneous coronary artery dissection was noted in five, and unexpected dissection secondary to coronary arteriography in three patients. All patients with spontaneous dissection presented clinically as myocardial infarction. Three patients (two of them with spontaneous dissection) underwent urgent coronary artery bypass grafting. Percutaneous coronary intervention was successful in two patients with spontaneous and in one with unexpected secondary dissection. One patient with spontaneous and one with secondary dissection were treated medically after failed intervention. In conclusion, spontaneous coronary artery dissection is rare, but not exceptional. Its true incidence might have been underestimated before the advent of coronary interventions in acute myocardial infarction. Survival of all our patients, in contrast to earlier reports on mortality rates up to 50%, may be attributed to the benefits of modern surgery and interventional cardiology. PMID: 18468201 [PubMed - indexed for MEDLINE]

Association between -514C-->T polymorphism of the hepatic lipase gene and coronary artery disease in a Turkish population.

Related Articles Association between -514C-->T polymorphism of the hepatic lipase gene and coronary artery disease in a Turkish population. Acta Cardiol. 2008 Apr;63(2):197-202 Authors: Gündoğdu F, Gurlertop Y, Pirim I, Aksakal E, Dogan H, Islamoglu Y, Ozkan A, Senocak H OBJECTIVE: The main function of hepatic lipase (HL) with respect to high-density lipoprotein (HDL) is hydrolysis of phospholipids and triglycerides. The -514C-->T polymorphism in the promoter region of the hepatic lipase gene affects HL activity. We aimed to investigate the association between the frequency of the -514C-->T polymorphism of hepatic lipase (PHL) and CAD in the East Anatolian region of Turkey. METHODS AND RESULTS: We conducted a case-control study in 302 unrelated subjects who were referred for coronary angiography. One hundred fifty-one patients with angiographically documented CAD and one hundred fifty-one subjects without angiographically documented CAD were studied to examine the association of the frequency of the -514C-->T polymorphism with CAD. Genotyping was determined by polymerase chain reaction. The PCR products were analysed for the -514C-->T polymorphism by enzyme digestion. The frequency of the -514C-->T polymorphism was found in 20 of 151 (13.2%) patients with CAD and in 9 of 151 (6%) of the control subjects (P < 0.05). There was a significant difference in terms of smoking (P = 0.001), gender (P < 0.05), total cholesterol levels (P < 0.05) and low-density lipoprotein (LDL) levels (P < 0.01) but there was no association with diabetes mellitus, hypertension, family history of CAD and HDL levels in the PHL (+) and PHL (-) patients with CAD. CONCLUSIONS: The results of this study suggest that the -514C-->T polymorphism of the hepatic lipase gene could act as a risk factor in the development of CAD in the East Anatolian region of Turkey as well as male gender, diabetes mellitus, hypertension, and a positive family history of CAD. PMID: 18468200 [PubMed - indexed for MEDLINE]

Relationship between serum uric acid levels and urinary albumin excretion in patients with heart failure.

Related Articles Relationship between serum uric acid levels and urinary albumin excretion in patients with heart failure. Acta Cardiol. 2008 Apr;63(2):191-5 Authors: Pinelli M, Bindi M, Moroni F, Castiglioni M OBJECTIVES: Hyperuricaemia is a constant finding in patients with heart failure (HF). Upregulated xanthine-oxidase activity seems to contribute to progression of the disease through the production of oxidative stress and the development of vascular and endothelial dysfunction. On this basis we speculated that in HF serum uric acid levels correlated with a reliable marker of endothelial dysfunction as urinary albumin excretion. METHODS: Fifty-three patients with HF underwent assessment of serum uric acid, N-terminal probrain natriuretic peptide (NT-proBNP), glomerular filtration rate (GFR), other metabolic parameters and determination of urinary albumin concentration (UAC) in a morning urine sample. RESULTS: In univariate analysis there is a direct correlation between serum uric acid levels and log UAC (r = 0.43, P < 0.01); uric acid correlates also positively with log NT-proBNP (r = 0.31, P < 0.05) and negatively with log-GFR (r = -0.38, P < 0.01). In stepwise regression analysis serum uric acid emerged as the only predictor of increased UAC (standardized coefficient = 0.42, P = 0.001) independent of other clinical determinants and metabolic factors. CONCLUSION: Serum uric acid represents the strongest predictor of elevated UAC in HF. Regression of albuminuria may be a simple target to verify the efficacy of xanthine-oxidase inhibition in these patients. PMID: 18468199 [PubMed - indexed for MEDLINE]

Symptomatic arrhythmogenic right ventricular dysplasia/cardiomyopathy. A two-centre retrospective study of 15 symptomatic ARVD/C cases and focus on the diagnostic value of MRI in symptomatic ARVD/C patients.

Related Articles Symptomatic arrhythmogenic right ventricular dysplasia/cardiomyopathy. A two-centre retrospective study of 15 symptomatic ARVD/C cases and focus on the diagnostic value of MRI in symptomatic ARVD/C patients. Acta Cardiol. 2008 Apr;63(2):181-9 Authors: Dewilde W, Boersma L, Delanote J, Pollet P, Scholzel B, Wever E, Vandekerckhove Y BACKGROUND: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is associated with sudden death in the young and heart failure in the elderly. The purpose is to review 15 symptomatic ARVD/C cases and also to describe the use of MRI as a diagnostic tool. METHODS AND RESULTS: This retrospective analysis includes 15 patients who presented with symptomatic ARVD/C. Diagnosis was made upon the criteria proposed by the European Society of Cardiology. In all patients there was at least 1 or more abnormal MRI sign. The most frequent abnormalities were focal right ventricular dyskinesia (64%), MRI fatty infiltration (57%) and right ventricular aneurysm or right ventricular outflow tract microaneurysms (57%). Presenting symptoms were palpitations (60%), atypical chest pain (46%), syncope (40%), and aborted sudden death (26%). T-inversion in V2-V3 was seen in 60% of the patients. Thirteen patients (86%) received an ICD implantation. The mean follow-up per patient was 89 months, which resulted in a total follow-up of 111 patient years. Forty-six percent of the patients with an ICD had one or more appropriate shocks during follow-up. To this date no mortality was reported. CONCLUSION: This retrospective study demonstrates that symptomatic ARVD/C patients typically present with symptoms of syncope, palpitations in association with ventricular tachycardia and in a quarter of the cases with aborted sudden cardiac death. The electrocardiogram mostly shows T inversion in the anterior leads. All patients were treated with medication and ICD-implantation or VT-ablation. The malignant nature of the disease in symptomatic ARVD/C patients is stressed by the fact that the presenting symptom is aborted sudden death in a quarter of the cases and the fact that nearly half of the patients with an ICD had at least one appropriate shock during follow-up. There was an abnormal MRI in 100% of the investigated patients. In 20% (3 patients), the MRI criterion (right ventricular dilatation/bulging/aneurysm) was necessary to meet the ESC criteria. Therefore it has become an important tool in our diagnostic work-up when ARVD/C is suspected. We also suggest a change in the diagnostic criteria of ARVD/C. Whereas fatty infiltration seen on RV biopsy is a major criterion, MRI fatty infiltration is not regarded as a diagnostic criterion by the task force to this day. PMID: 18468198 [PubMed - indexed for MEDLINE]

Chlamydia pneumoniae infection and hyperlipidaemia-induced expression of P50 and c-Fos in the heart of C57BL6J mice.

Related Articles Chlamydia pneumoniae infection and hyperlipidaemia-induced expression of P50 and c-Fos in the heart of C57BL6J mice. Acta Cardiol. 2008 Apr;63(2):175-9 Authors: Huang B, Dong Y, Cheng Y, Xie Q, Lin G, Wu Y, Feng Y, Li J, Mai W OBJECTIVE: The objective of this study was to investigate infection by Chlamydia pneumoniae (C. pneumoniae) and the combined effects of an atherogenic diet on the expression of AP-1 or the subunit of AP-1 (c-Fos) and NF-kappaB or the subunit of NF-kappaB (P50) in myocardial cells of C57BL/6J mice. METHODS AND RESULTS: Thirty-six 8-week-old female C57BL/6J mice were divided into three groups: A, B and C (twelve mice in each group). Mice in group A were fed an atherogenic diet (consisting of 15% fat and 2.5% cholesterol). Those in group B and C (as blank control) were fed a regular diet. The mice in group B were infected with C. pneumoniae. Fourteen weeks later, the expression of P50 (subunit of NF-kappaB) and c-Fos (subunit of AP-1) in the heart was determined by indirect immunofluorescence in the myocardial cells. Binding activity of NF-kappaB and AP-1 in the heart was determined by electrophoretic mobility shift assay (EMSA). The expression of NF-kappaB and AP-1 in the myocardial cells was upregulated in group A and B, compared with group C (P < 0.05). There was no significant difference between group A and B. CONCLUSION: The inflammatory process was already initiated in the myocardial cells in C57BL/6J mice at the early stage of C. pneumoniae infection and hyperlipidaemia. The expression of NF-kappaB and AP-1 was upregulated in mice infected by C. pneumoniae or fed an atherogenic diet. C. pneumoniae or hyperlipidaemia may involve the pathogenesis and progression of ischaemic cardiomyopathy. PMID: 18468197 [PubMed - indexed for MEDLINE]

Initiation patterns of monomorphic ventricular tachycardia in acute myocardial infarction: analysis of rhythm strips.

Related Articles Initiation patterns of monomorphic ventricular tachycardia in acute myocardial infarction: analysis of rhythm strips. Acta Cardiol. 2008 Apr;63(2):171-4 Authors: Gorenek B, Dogan V, Yasar B, Birdane A, Cavusoglu Y, Unalir A, Ata N, Timuralp B OBJECTIVE: Monomorphic ventricular tachycardias (MVT) frequently occur in the acute phase of myocardial infarction (MI). In the past, some studies aimed to investigate the initiation pattern of ventricular tachycardias, although not in acute MI patients. The aim of the present study was to analyse the initiation pattern of MVT in acute MI using rhythm strips. METHODS: This study utilized data on 255 rhythm strips defined as MVT, from 173 patients with acute ST-segment elevation MI. Monomorphic ventricular tachycardias that were not preceded by ventricular ectopic beats were defined as sudden onset MVT. Monomorphic ventricular tachycardias which were preceded by a single or multiple ectopic beats, including a short-long-short sequence, were defined as non-sudden onset MVT. RESULTS: Non-sudden onset episodes were more common than sudden onset episodes (172 episodes, 67.4% versus 83 episodes, 32.5%). The morphology of the ventricular ectopic beat initiating tachycardia was similar to the first beat of MVT in 127 episodes (73.8%), but not in the remaining 45 episodes (26.1%). In the non-sudden onset group, 117 episodes (68%) initiated with a single ectopic beat, while 55 episodes (32%) initiated with multiple complexes. The left ventricular ejection fraction of the patients with non-sudden onset MVT was lower (50 +/- 6 versus 56 +/- 5, P < 0.05). Monomorphic ventricular tachycardias with no sudden onset also had shorter coupling intervals (CI) (P < 0.001) and shorter prematurity index (PI) (P < 0.001) than MVT with sudden onset. Similarly, the ventricular tachycardia cycle length was shorter in the group of MVT subjects with non-sudden onset as compared with sudden onset (P < 0.05). In contrast, tachycardias with sudden onset were associated with a shorter preceding RR interval (P < 0.01). CONCLUSIONS: Analysis of rhythm strips demonstrated that MVT is most often preceded by ventricular ectopic beats in the acute phase of MI. PMID: 18468196 [PubMed - indexed for MEDLINE]

M2 and M3-muscarinic acetylcholine receptors remodelling in patients with a dilated atrium.

Related Articles M2 and M3-muscarinic acetylcholine receptors remodelling in patients with a dilated atrium. Acta Cardiol. 2008 Apr;63(2):166-70 Authors: Zhao Q, Huang C, Jiang H, Okello E, Tang YH, Wang Z, Wu Z BACKGROUND: Studies have shown that autonomic tone plays an important role in the pathogenesis of atrial fibrillation (AF) and remodelling of I(K, ACh) in chronic AF serves as a compensatory mechanism for the AF. The relation between atrial size and AF has been established. We investigated the remodelling of muscarinic receptors in patients with dilated atrium and assessed the relationship between the muscarinic receptor remodelling and the dilated atrium. METHODS: A small piece of the tip of the right atrial appendage was obtained from 19 patients in sinus rhythm (SR), 28 patients with mitral stenosis and 10 patients with chronic AF (AF > 6 months). Western-blot was used to determine the expression of M2 and M3 receptors. RESULTS: Patients with mitral stenosis and chronic AF had a larger left atrial diameter than patients in SR. The densities of the M2 receptor in patients with mitral stenosis (with AF and with SR) and chronic AF were lower than that in patients with SR (0.54 +/- 0.08 vs. 0.29 +/- 0.06, 0.26 +/- 0.05 and 0.28 +/- 0.06, P < 0.05). However, the densities of the M3 receptor in patients with mitral stenosis and chronic AF were higher than that in patients with SR (0.07 +/- 0.01 vs. 0.18 +/- 0.02, 0.17 +/- 0.01 and 0.15 +/- 0.01, P< 0.05). Furthermore, there was no significant difference in M2 and M3 receptors between AF and SR in patients with mitral stenosis. CONCLUSION: Remodelling of M2 and M3 receptors is not associated with AF, but with the dilated left atrium. PMID: 18468195 [PubMed - indexed for MEDLINE]

The association between plasma adiponectin level and hypertension.

Related Articles The association between plasma adiponectin level and hypertension. Acta Cardiol. 2008 Apr;63(2):160-5 Authors: Shankar A, Marshall S, Li J BACKGROUND: Lower plasma adiponectin levels are related to dyslipidaemia and components of the metabolic syndrome. It is not clear whether adiponectin levels are independently related to hypertension. Also, previous studies that examined the putative adiponectin-hypertension association studied only men. We examined the relationship between plasma adiponectin and hypertension after controlling for important confounding factors and also performed separate analyses among men and women. METHODS: Cross-sectional study of 664 participants (mean age: 52.5 years, 50.3% men). Main outcome-of-interest was presence of hypertension (systolic blood pressure (BP) > or = 140 mmHg, diastolic > or = 90 mmHg, or combination of self-reported hypertension diagnosis and antihypertensive medication use). RESULTS: Lower plasma adiponectin levels were found to be positively associated with hypertension. Multivariable odds ratio (OR) (95% confidence intervals [CI]) comparing gender-specific tertile I of plasma adiponectin to tertile 3 (referent) was 3.40 (2.04-5.68), P-trend < 0.0001. This association was consistently present in separate analyses among men (P-trend < 0.0001) and women (P-trend = 0.01). CONCLUSIONS: These data provide new evidence clarifying the putative relation between plasma adiponectin and hypertension, suggesting that this association is independent of traditional cardiovascular factors, including dyslipidaemia and renal function and present in both men and women. PMID: 18468194 [PubMed - indexed for MEDLINE]

Short-term effects of a hypocaloric diet and a physical activity programme on weight loss and exercise capacity in obese subjects with chronic ischaemic heart disease: a study in everyday practice.

Related Articles Short-term effects of a hypocaloric diet and a physical activity programme on weight loss and exercise capacity in obese subjects with chronic ischaemic heart disease: a study in everyday practice. Acta Cardiol. 2008 Apr;63(2):153-9 Authors: Gondoni LA, Titon AM, Nibbio F, Caetani G, Augello G, Mian O, Tuzzi C, Averna E, Parisio C, Liuzzi A OBJECTIVE: The objective of this paper is to describe the effects of a rehabilitation programme in obese patients affected with chronic ischaemic heart disease; to identify the factors that influence weight loss and improvement in exercise capacity in everyday practice. METHODS AND RESULTS: We studied 562 white patients (381 men) who followed a 23.3 +/- 3.9 days in-hospital programme. They attended daily sessions of aerobic activity (cycloergometer, walking, and strength exercise); a low-calorie diet was set at approximately 80% of resting energy expenditure. By the end of the programme BMI decreased from 38.0 +/- 4.9 to 36.7 +/- 4.8 kg/m2 (P < 0.001 ). Attained metabolic equivalents (METs) increased from 6.2 +/- 2.5 METs to 7.3 +/- 2.7 (P < 0.001). Age, sex, presence of diabetes and education level were significantly related to the outcomes. Patients who took beta-blockers and statins had less BMI improvement: -1.2 +/- 0.7 kg/m2 vs. -1.4 +/- 0.6 (P = 0.013) and -1.3 +/- 0.6 vs. -1.4 +/- 0.7 (P = 0.023), respectively. Patients that took diuretics and angiotensin receptor blockers (ARB) had less improvement in exercise capacity: 0.9 +/- 1.0 METS vs. 1.3 +/- 1.3 (P < 0.001) and 0.8 +/- 1.3 vs. 1.2 +/- 1.3 (P = 0.011 ), respectively. After a median interval of 358 days, 152 patients were seen at a follow-up visit: their BMI increased by 1.0 +/- 2.4 kg/m2 and only 21% of patients lost weight. CONCLUSIONS: Rehabilitation improves exercise capacity and induces significant weight loss in obese patients with stable IHD, but women, diabetic, elderly and poorly educated subjects obtained unsatisfactory results. Use of diuretics and ARB seem to worsen the results. At follow-up only a small percentage of patients further improves BMI. PMID: 18468193 [PubMed - indexed for MEDLINE]

Plasma myeloperoxidase is related to the severity of coronary artery disease.

Related Articles Plasma myeloperoxidase is related to the severity of coronary artery disease. Acta Cardiol. 2008 Apr;63(2):147-52 Authors: Düzgünçinar O, Yavuz B, Hazirolan T, Deniz A, Tokgözoğlu SL, Akata D, Demirpençe E OBJECTIVE: It has been shown that the main apolipoprotein of HDL, Apo A-1, is subjected to nitration by myeloperoxidase (MPO) and this oxidative modification renders HDL proatherogenic. The aim of this study is to evaluate the relationship between plasma MPO levels, and the severity of coronary artery disease. METHODS AND RESULTS: Forty-eight patients with coronary artery narrowing and 30 control subjects were enrolled in this study. The severity of the disease was assessed by Gensini scoring after angiography. MPO concentrations were determined by using an enzyme immunoassay. A subgroup of 30 patients underwent computerized tomography to determine the calcium load of coronary arteries. Plasma MPO levels were found significantly higher in patients with coronary artery disease than controls (4.27 [1.60 to 42.43] ng/mL vs. 2.93 [1.00 to 9.25] ng/mL, P = 0.002). MPO was positively correlated with both Gensini (r = 0.228, P = 0.044) and coronary calcium scores (r = 0.433, P = 0.017). The atherosclerotic burden was more strongly correlated with MPO levels than the traditional markers such as total cholesterol and HDL. CONCLUSIONS: We found that MPO levels were elevated in patients with coronary artery disease and this increase correlated with the extent and severity of atherosclerosis. Although it is a preliminary study with a relatively small group of subjects, we suggest that MPO might be evaluated as a new marker indicating the presence and severity of coronary artery disease. PMID: 18468192 [PubMed - indexed for MEDLINE]

Effect of glucometabolic disorders on the formation of coronary collaterals in occlusive coronary artery disease.

Related Articles Effect of glucometabolic disorders on the formation of coronary collaterals in occlusive coronary artery disease. Acta Cardiol. 2008 Apr;63(2):141-6 Authors: Nurkalem Z, Gorgulu S, Uslu N, Alper AT, Orhan AL, Sahin I, Erer B, Sargin M, Eren M OBJECTIVE: The primary aim of this study was to assess the effect of glucometabolic disorders on coronary collateral vessels in patients with occlusive coronary artery disease. METHODS AND RESULTS: Hundred and ninety-five consecutive patients with at least single-vessel occlusion were enrolled in this study prospectively. The standard oral glucose tolerance test was performed according to the criteria of the World Health Organization. Collateral circulation was graded according to the Rentrop classification.The mean Rentrop scores in normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and diabetes were 1.40 +/- 1.02, 1.05 +/- 0.84, 1.00 +/- 0.98, respectively (P = 0.043).The percentage of patients without collateral circulation (Rentrop-0) was greatest in the diabetic group (44.4%), while the percentage was 21.8% in the IGT group and 22.0% in the NGT group. Ninety-five patients with at least one totally occluded coronary artery were analysed as a subgroup. In the totally occluded artery subgroup postprandial glycaemia was the only parameter that was associated with the Rentrop score in the univariate analysis (r = -0.34, P = 0.002) CONCLUSIONS: In conclusion, our study results, which are in agreement with previous results, indicate that not only diabetic glucose tolerance but also impaired glucose tolerance has an adverse impact on the development of coronary collaterals. PMID: 18468191 [PubMed - indexed for MEDLINE]

Smoking mentholated cigarettes impairs coronary microvascular function as severely as does smoking regular cigarettes.

Related Articles Smoking mentholated cigarettes impairs coronary microvascular function as severely as does smoking regular cigarettes. Acta Cardiol. 2008 Apr;63(2):135-40 Authors: Ciftci O, Topcu S, Caliskan M, Gullu H, Erdogan D, Yildirim E, Yildirir A, Muderrisoglu H OBJECTIVE: Smoking mentholated cigarettes inhibits the metabolism of nicotine and increases systemic exposure to cigarette smoke toxins. However, the possible effects of smoking mentholated cigarettes on coronary microvascular functions are unknown. We sought to investigate whether smoking mentholated cigarettes impairs coronary flow reserve (CFR) more so than smoking regular cigarettes. METHODS: Twenty otherwise healthy smokers of regular cigarettes (6 women, 14 men; mean age, 25.6 +/- 6.4 years) and 22 non-smoking control subjects were included in the study. To compare the acute effects of mentholated (0.9 mg nicotine, 11 mg tar, 12 mg carbon monoxide) and regular (0.9 mg nicotine, 12 mg tar, 12 mg carbon monoxide) cigarettes on CFR, all subjects underwent an echocardiographic examination that included CFR measurements at baseline. Twenty to 30 minutes after subjects had smoked 2 regular cigarettes and 2 mentholated cigarettes, CFR was again measured in subjects in the smoking group. RESULTS: In response to smoking 2 regular and 2 mentholated cigarettes, CFR values declined from 2.56 +/- 0.60 to 2.06 +/- 0.38 (P < 0.004) and from 2.56 +/- 0.60 to 2.14 +/- 0.30 (P < 0.005), respectively. Smoking mentholated and regular cigarettes impaired CFR to the same degree (P = 0.547). CONCLUSIONS: When compared with smoking regular cigarettes, smoking mentholated cigarettes has similar acute detrimental effects on coronary microvascular functions. PMID: 18468190 [PubMed - indexed for MEDLINE]