Search

Statins constitute the first-line medication in the primary and secondary prevention of cardiovascular accidents in patients with hypercholesterolemia, reducing by 25-30% the risk of myocardial infarction, ischemic stroke and cardiovascular lethality. Clinical studies over the past 10-15 years have demonstrated the likelihood of developing de novo diabetes after statin use. From these considerations, a series of problems are addressed, such as: Is the diabetogenic effect specific to the class of statins?; Does it depend on the dose used?; What is the benefit/risk ratio?; Which patients are more prone to developing diabetes?; what are the mechanisms of diabetes development?; Are there needed or developed diabetes prevention strategies for statin treatment?; Is it necessary to change the tactics of using statins in the development of diabetes?. [ABSTRACT FROM AUTHOR]

Dietary fibers provide many health benefits, studies in recent decades confirming their role in reducing the incidence of diseases such as diabetes, obesity, coronary heart disease, heart attack, hypertension, gastroesophageal reflux, duodenal ulcer and diverticulitis. Moreover, fibers intake stabilizes serum lipid levels, modulates the absorption of lipids and simple carbohydrates in the intestine, reduces blood pressure by adversely affecting the development of atheromatous plaques and stimulates the immune system by developing bifidobacteria in the large intestine. The current recommendations regarding the daily fibers must take into account the age, sex and caloric needs of the individual in relation to lifestyle (physical activity). The adequate intake of dietary fibers is 14 g/1000 kcal ingested. Therefore, considering the caloric requirement of 2000 kcal/day for a healthy woman and 2600 kcal/day for a healthy man, the daily fibers intake is 28 g/day for women and 36 g/day for men, respectively. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases, such as acute myocardial infarction, stroke, peripheral arterial disease, chronic kidney disease, are a major health problem for the patient, in terms of declining quality of life, but also increasing spending on the health system. The aim of this study is to demonstrate the involvement of cardiovascular risk factors related to patients' lifestyle (salt intake, saturated fats, alcohol, smoking, sedentary lifestyle) or other modifiable risk factors (total cholesterol, triglycerides, obesity, hypertension arterial blood sugar, glycemia, metabolic syndrome), in the occurrence of cardiovascular disease and the impact of the association of risk factors in increasing the risk of cardiovascular complications. [ABSTRACT FROM AUTHOR]

Purpose. The study aims to determine the impact of dystyroidism on the type of acute coronary syndrome, on vascular function and coronary impairment, as well as on the myocardium and last but not least the general biological resonance of these hormones, emphasizing the role of thyroid hormones in the cardiovascular system. Methods. We introduced in the study 100 patients recently diagnosed with acute coronary syndrome, without history of ischemic heart disease or thyroid disease, hospitalized in the Cardiology Clinic of the Emergency Clinical Hospital Bagdasar-Arseni Bucharest, for the interventional treatment of acute coronary syndrome. The studied patients were hospitalized between November 2014 - April 2015, with follow-up up to 5 years, evaluated clinically, bio-humorally, by echocardiography, coronary angiography with SYNTAX score calculation and electrocardiogram and pulse wave. The obtained data were integrated in Excel sheets and statistically processed with the Python program. Results. The prevalence of dystyroidism in the study group was 44% (44 patients). Hypothyroidism is predominant (34 patients; 77%), and subclinical hypothyroidism occurs in 20 (59%) of subjects with hypothyroidism. Unstable angina is the predominant type of acute coronary syndrome, both in the whole group (54 patients; 54%) and in the group of patients with hyperthyroidism (7 patients; 70%), while acute myocardial infarction without ST-segment elevation was the type majority of presentation in patients with hypothyroidism (19 patients, 56%). Coronary heart disease varied as follows: in the total group unicoronary lesion (31 subjects; 31%), in patients with hyperthyroidism unicoronary lesion (5 subjects; 50%), in patients with hypothyroidism bicoronary lesion (10 subjects; 29%). And the calculated SYNTAX score is higher in the group of patients with dysthyroidism compared to the group of patients with euthyroidism. Discussions. Unstable angina (p = 0.006) and ventricular wall hypertrophy (p = 0.008) are predictive factors for dysthyroidism. Hypothyroidism correlates with high LDL-cholesterol levels (p = 0.0176) and hyposideremia (p = 0.0083), while hyperthyroidism correlates with thrombocytosis (p = 0.0122) and a significant nonspecific inflammatory syndrome (p = 0.0043). Dystyroidism has a direct correlation with the presence of kinetic disorders (Person correlation coefficient 0.21). Conclusion. Thyroid disease, with hypothyroidism or hyperthyroidism, can also be a risk factor for cardiovascular disease, and especially for ischemic heart disease. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to identify m-Health services in Romania and evaluate their effectiveness in line with international experience. Material and method. The study provides for the analysis of telemedicine services and applications focusing on the specific mobile health of international and national literature and practice through the Internet. We accessed and analyzed m-Health applications and programs, articles or reports, starting from the objectives, procedures, services belonging to, the cost, the impact, the behavior of the beneficiaries. Results. Relevant m-Health WHO reports, studies on applications used in Europe, recent reviews on the systematic analysis of the impact of m-Health applications, examples of applications in Romania have been identified. The main areas where these applications / services are present on the Romanian medical services market have been identified, specifying the objectives, the beneficiaries of services, their impact and their behavior Discussions. The applications of mobile medicine (m-Health) are becoming more frequent, more diversified, using various sensors and addressing chronic diseases such as: diabetes, asthma, chronic lung disease, epilepsy, coronary pathology, follow-up and management of susceptible patients as well as concerning communicable diseases and tracing of vectors of certain communicable diseases and endemic areas. Applications are also used for emergency and disaster management. The cost of accessing and receiving health services is decreasing, with higher accessibility, including in remote areas and with deficient medical services (for Romania as the Danube Delta, mountain areas etc.). Conclusions. Although m-Health services have begun to spread also in Romania, we still can not assess their effectiveness because the impact is still quite limited. Positive results are reported especially in the management of chronic conditions such as diabetes (especially juvenile diabetes) and epilepsy, significant decrease in the time of presentation of the patient with myocardial infarction to a hospital capable of initiating angiographic intervention per primum, better management of the urgency, and pre-hospital assistance. It also increases the addressability of patients in rural and remote areas to quality medical services. [ABSTRACT FROM AUTHOR]

Copyright of Studia Universitatis Vasile Goldis, Physical Education & Physical Therapy Series is the property of Vasile Goldis University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patients with psoriasis are prone to develop cardiovascular disease, being one of the main causes of mortality. Risk factors for patients with psoriasis for cardiovascular disease are very common either on their own or in combination. Among these risk factors we can mention: diabetes, obesity, hypertension, dyslipidemia, metabolic syndrome, smoking. The presence of arthritis along with psoriasis is a negative prognosis in terms of cardiovascular disease. Sleep disturbances, depression and anxiety disorders also contribute to the increase in the frequency of cardiovascular disease in patients with psoriasis. [ABSTRACT FROM AUTHOR]

Accurate non-invasive detection of myocardial ischemia remains an actual issue. Despite advanced technologies, 12-lead ECG, a cheap, repeatable and accessible method, represents a „gold standard“ for the initial evaluation of patients with symptoms suggestive of myocardial ischemia. ECG is an essential element in differential diagnosis, choosing the appropriate treatment method and risk stratification. For acute coronary syndrome patients, it provides information about the presence, extent and severity of myocardial ischemia. Although its' detection is mainly based on the strong prediction related to the ST segment deviation, other indicators associated with suggestive QRS changes should be taken into consideration in order to further improve the diagnostic accuracy of myocardial ischemia. QRS changes in acute myocardial infarction are of great interest. Together with ST modifications, these features may ameliorate the early risk stratification in patients with acute transmural ischemia and infarction. Conclusions. Considering both the ST segment changes and those occurring in the QRS complex remains a promising direction. The value of these events from the perspective of ECG prediction of mortality and morbidity in the short, as well as long term, in patients with myocardial infarction is questionable. [ABSTRACT FROM AUTHOR]

Friedman and Rosenman are highlighting behavioral type A as a major riskfactor for evolution worsening of myocardial infarction, was first and decisive step for clearly specifying the role of supportive psychosocial factors in etiopathogenesis of the coronary heart disease. Then, the reason that this type of behavior has been highlighted in other psychosomatic diseases (and even some healthy subjects) led to the need to fi nd other psychological variables - of personality, especially - associated with type A and convincing predictive value numerous epidemiological and experimental studies. In the last two decades has been it's presence in some carriers of type A - which showed clinical and laboratory manifestations of coronary artery disease (including exploration angiographic coronary flow and computerized measurements) - this constant in varying degrees of complex traits emotional underpinning of increased aggression: hostility (cognitive and/or behavioral) - in particular internalized anger (anger-in) and ruminative anger. These variables have the correspondent psychological, somatic plan, vascular hyperreactivity to stress hormones (catecholamines and cortisol in particular) resulting in increased plasma cholesterol, myocardial oxygen consumption, the platelets aggregation etc. In essentially agressive featuters frequently expressed to the many distress "collected" by holders type A, pressed myocardium with pathophysiological changes specific for aggression. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cell may become a therapeutic option in patients with acute myocardial infarction, due to its capacity of differentiation and its immunological status. This effect is supported by numerous clinical and experimental studies, demonstrating the usefulness of mesenchymal stem cells in early post-infarction administration. Despite the great advantages of interventional therapy, prognosis of patients with acute myocardial infarction is still reserved, even in developed countries. Mesenchymal stem cell may be a therapeutic option, restoring the functional capacity of the heart, especially due to its proangiogenic capacity, limiting and revascularising the myocardial infarcted territory(1.2). [ABSTRACT FROM AUTHOR]

The present paper reports the research conducted on the mechanisms of the cardiovascular diseases, with focus on the myocardial infarction - diseases responsible for the largest number of sudden deaths worldwide. Statistics show that, each year, myocardial infarction is the cause of half of all the demises in the world and of 4.5 million deaths in Europe. The animal model of the myocardial infarction plays a vital role in the prevention, diagnosis, and therapy of the human myocardial infarction. The experimental myocardial infarction in animals induced by means of isoprenaline is a documented, common mechanism that enables one to study of the protective role of various cardioprotecting agents. Many studies have shown so far the antioxidant and anti-inflammatory effects of Hedera helix on diverse apparatuses and systems, yet not on the cardiovascular apparatus too. That has prompted us to test the cardioprotective role of the Hedera helix extract in experimental myocardial ischemia induced by isoprenaline. The 14-day long experimental laboratory research consisted in specific methods applied to several groups of rats. The present paper reports the results and conclusions being reached. In the future we intend to have the effect of Hedera helix tested on humans too. [ABSTRACT FROM AUTHOR]

The survey summarizes the results obtained by monitoring a group of 87 patients postmyocardial infarction, divided into two study groups, according to the selected tactics of treatment: conservative or interventional. There were studied and analyzed the clinical and instrumental results obtained by these patients, during a follow up period of one year. The results showed that the delayed angioplasty (>72 h) improved the contractile function of the left ventricle in interventional treated patients, compared to conservative treated patients. [ABSTRACT FROM AUTHOR]

The study showed that among patients admitted with suspected acute coronary syndrome, whose symptoms resolved following 24 hours, the diagnosis of myocardial infarction can be eliminated if the TnT remains ≤ 0.10 ng / l for 12-24 hours and CK-MB ≤5.0 ng / l up to 10-12 hours of onset of symptoms. If the TnT and CK-MB remains in the normal range for 12 hours after admission, the diagnosis of myocardial infarction can be eliminated if the 99% and 96% of patients. Moreover, for patients whose diagnosis of myocardial infarction was excluded, the risk of persistent over a period of one year manifest coronary disease was correlated with positive history of the disease. [ABSTRACT FROM AUTHOR]

The experimental evidence of an association between the risk of lethal arrhythmias and the signs of an increase of sympathetic activity or decrease of vagal activity encouraged the study of some quantitative markers of the autonomous nervous activity. Heart rate variability (HRV) represents one of such most promising markers. The significance and importance of HRV parameters are more complex than are generally appreciated and there exist also the risk to draw incorrect conclusions or to make excessive and groundless extrapolations. This is why appeared the necessity to standardize nomenclature, to exactly define the terms, to specify the standard measurement methods, to establish the physiological and physiopathological correlations, to identify clinical applications. HRV became the term accepted to describe variations, as well as instantaneous variations of AV and RR intervals. Due to new types of electrocardiographic, digital, high frequency, 24-channel registrations, improved the knowledge about the physiological and physiopathological correlations of HRV and the possibility to quantify risk of mortality. [ABSTRACT FROM AUTHOR]

This article presents data from the literature and the results of some multi-centre studies, emphasizing the way in which certain drugs act on the parameters of sinus rhythm variability (HRV). There is evidence that the therapeutic effectiveness of some radioactive drugs, such as tonicardiac glycosides, some antiarrhythmic drugs, beta-blockers and some calcium channel blockers are due, directly or indirectly, to the action on the vegetative nervous system. Sinus rhythm variability, represents a simple noninvasive method to appreciate the prognosis of arrhythmia in patients who suffered a myocardial infarction. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is the most common cardiovascular disorder as a chronic, progressive and disabling disease. The prevalence and incidence of the disease rises with age, so that in Western countries, about 1 to 2% of adults suffer from this disease. Because of advances in surgical and medical therapy for patients who have survived a myocardial infarction, heart failure can develop subsequently. Therefore, finding new and effective laboratory tests for early detection and monitoring of the disease is important. In this review, heart failure, Galectin-3 and fibrosis keywords were searched in the PubMed, SID, Google Scholar, Science Direct, Springer and Iranmedex databases. Five and more than fifty articles were found in English and Persian language, respectively during 1992 to 2014. Finally two Persian and fifty English articles were selected. The results of these studies was suggested that Galectin-3 is involved in numerous physiological and pathological processes some of which, inflammation and fibrosis, are pivotal contributing pathophysiological mechanisms to the development and progression of HF. Because galectin-3 expression is maximal at peak cardiac fibrosis and virtually absent after recovery, routine measurement in patients with HF may prove valuable to identify those patients at highest risk for readmission or death. This review summarizes the most recent advances in galectin-3 research, with an emphasis on the role galectin-3 plays in the development and progression of HF. [ABSTRACT FROM AUTHOR]

Blockade of the renin-angiotensin system has become one of the most successful therapeutic approaches in recent years, leading to a decrease in cardiovascular morbidity and mortality in patients with chronic heart failure as well as in patients with myocardial infarction. Multiple well-known randomized clinical trials have established the value of the angiotensin-converting enzyme inhibitors at these patients. Several more recent trials have compared combination therapy with angiotensin receptor blockers and angiotensin-converting enzyme inhibitors with the respective monotherapies in patients with MI and in patients with chronic heart failure. In contrast to the most recent trials involving patients with chronic heart failure (CHARM-Added and Val-HeFT) in which dual renin-angiotensin system blockade was shown to be beneficial in terms of cardiovascular morbidity and mortality, VALIANT trial failed to demonstrate the superiority of combination therapy in improving survival in patients with acute myocardial infarction complicated with heart failure. Some experimental and clinical studies associate angiotensin II AT1 receptor blockers therapy with an unexplained increase in myocardial infarction, but several rigorous meta-analyses did not confirm this hypothesis. The dual renin-angiotensin system blockade has proved its beneficial effect on the improvement of the left ventricular function, without increasing all-cause mortality, cardiovascular mortality and morbidity. [ABSTRACT FROM AUTHOR]

A higher rate of composite values representing mortality, reinfarction and stroke were observed in individuals with established clinical myocardial infarction versus those who had evolving over a period of 2.5 years follow-up (10.6 [9.4-13.9 ] and 6.6 [5.6-8.0] per 100 person - years and RR 1.6, p <0.001). The difference was explained by a higher mortality in the group showing clinical myocardial established. This result is explained by the fact that the time from symptom onset to randomization and the treatment time was higher in patients with clinical myocardial established. We found that the pattern of evolving myocardial infarction was associated with a lower rate of events with overall long-term effects in patients undergoing primary percutaneous coronary intervention compared to those receiving fibrinolytic therapy. (4.5 [3.4 to 5.9] and 7.5 [6.0-9.4] per 100 person - years, RR = 0.6, p = 0.004) [ABSTRACT FROM AUTHOR]

In patients with severe coronary injuries, anterograde cardioplegia does not provide adequate protection due to an inhomogenous distribution. In these situations, combined administration (anterograde and retrograde) of cardioplegic solution may be an alternative for myocardial protection during aortic crossclamp. The aim of our work is to present a case in which myocardial protection was achieved by intermittent anterograde and retrograde administration of warm blood cardioplegia. A 62 years old patient presented to interventional cardiology with symptoms of severe pectoral angina and severe dyspnea followed by acute pulmonary edema. ECG demonstrates acute postero-inferior myocardial infarction. Echocardiography reveals severe mitral regurgitation by rupture of the posterior papillary muscle. Coronary angiography showed critical stenosis of the left main coronary artery, 70- 80% stenosis of the anterior descending artery, obtuse marginal artery and right coronary artery. Given the severe and the severe altered clinical status, the proximal coronary lesions and the mechanical complications of the myocardial infarction, emergency surgical intervention was performed: replacement of the mitral valve with a mechanical prosthesis and double aorto-coronary bypass with autologous saphenous vein During aortic crossclamp (109 minutes) myocardial protection was achieved by combined administration of 500 ml warm blood administered antegrade in the aortic root, followed by another 500 ml administered ratrograde in the coronary sinus, this cycle being repeted intermittent every 20 minutes. After aortic declamping aortei the heart start beating spontaneously, at the weaning of the extracorporeal circulation being needed only small doses of Dobutamine (7 μg/kg/minute) and Norepinephrine (180 ng/kg/minute) and intraaortic balob contrapulsation (IABP). The postoperative recovery was good, the pacientul being discharged home at 12 days after the operation. In conclusion we can say that the cardioplegic solution administered intermittently in combined mode (anterograde and retrograde) offers a good myocardial protection in the patient with of severe coronary lesions. [ABSTRACT FROM AUTHOR]

Systemic atherosclerosis process has a long asymptomatic development, timing of symptoms corresponding manifest cardiovascular disease such as heart attack or ischemic stroke that result in patient disability, decreased quality of life, his lower life expectancy, higher spending on public health system or death. Application of primary prevention in hypertensive patients in the period of subclinical atherosclerosis, the improper lifestyle, lack of exercise, the predominant saturated fat calorie diet, smoking, alcohol consumption, obesity and control of cardiovascular risk factors such as dyslipidemia, diabetes, hypertension, are intended to slow the process of atherosclerosis and decrease the incidence of fatal and non-fatal cardiovascular events. During of 2013 we conducted a study on a group of 80 hypertensive patients from urban area Bucharest, followed up within primary care, of both sexes, aged between 48 and 82 years, in which we assessed the carotid atherosclerosis by ultrasound Doppler measurement of intima media thickness of the walls of the common carotid artery and also determined the prevalence of cardiovascular risk factors for each patient based on a personal interview and to perform biochemical analysis. In research conducted we determined the weighting of cardiovascular risk factors involved in determining subclinical atherosclerosis process as well as evaluating the correlation between carotid atheromatosis and risk of cardiovascular events in the next decade, quantified by SCORE. Prevalence of cardiovascular risk factors was increased in patients with carotid atheromatosis present, proving their involvement in the production of subclinical atherosclerosis and carotid atheromatosis was also present proportional and statistically associated with the risk of fatal cardiovascular events in the next 10 years which proves the role of process of atherosclerosis in the production of cardiovascular disease. In Romania, which is a European country with increased SCORE risk of fatal cardiovascular events, application of primary preventive measures in hypertensive patients in the period of subclinical atherosclerosis, the improper lifestyle, lack of exercise, the predominant saturated fat calorie diet, smoking, alcohol, obesity and control of cardiovascular risk factors such as dyslipidemia, diabetes, high blood pressure, are designed to slow the process of atherosclerosis and decrease the incidence of fatal and non-fatal cardiovascular events. [ABSTRACT FROM AUTHOR]

The inclusion of cardiac troponin in the criteria for diagnosis of myocardial infarction led to an increase in this diagnosis. Magnitude is closely related to criteria, such as enzymes and higher values are used in conventional diagnosis of myocardial infarction since the definition varies in different studies. Increased number of myocardial infarctions generated by introducing more precise diagnostic methods and specific is not a new phenomenon in the evolution of myocardial diagnostics. It was demonstrated in the 1980s in Minnesota Heart Study that heart attacks increased attack rate by 17% or 24% when CK or CK MB activity was added diagnostic algorithm (1). A significant proportion of patients who were initially unstable angina have now received a new diagnosis of myocardial infarction. Lately have become increasingly active pharmacological treatment and practice revascularization in patients with acute coronary syndrome. Patients with elevated levels of cardiac troponin appear to benefit most from such treatment strategies.(2) [ABSTRACT FROM AUTHOR]

We performed a study of MTWA in post-myocardial infarction patients to clarify the predictive accuracy and usefulness of MTWA compared to other invasive and non-invasive techniques. We enrolled 120 patients (74 men, 46 women, mean age 62.3 ± 15.2 years in men, and 64.2 ± 13.8 years in women) with a history of myocardial infarction but no prior sustained ventricular arrhythmias. Patients were assessed by ECG, echocardiography, Holter, signal averaged ECG, MTWA, and electrophysiology study. Mean follow-up was 14 months. The MTWA test had a good negative predictive value for arrhythmic events in post-MI patients and can be used for risk stratification. We consider that in patients with positive MTWA further invasive evaluation, respectively electrophysiology study, is necessary. [ABSTRACT FROM AUTHOR]

Aims. The relevance of peridialytic blood pressure in predicting death of patients on chronic hemodialysis is controversial. The aim of the study is to describe the association between standardized peridialytic blood pressures and 2-year cardiovascular mortality. Patients and methods. A prospective, observational, open study was conducted on 131 chronic hemodialysis patients in the Alba-Iulia Dialysis Centre, who were followed up for 2 years. The patients were divided in 2 sub-groups, group S (Survivors) (n=121) and group D (Deceased) (n=10). During the first week of the study, preand postdialysis blood pressures were measured, during all 3 dialysis sessions of the week, using standardized methods. Clinical, biological and treatment parameters were recorded. The association between the above variables and cardiovascular mortality was investigated. Results. In the survival curve analysis, a mean predialytic systolic blood pressure (m SBP) over 155 mm Hg was significantly associated with death, with a RR of 4.7; CI 95%= 1.48-14.9 (p=0.01); mean predialysis diastolic blood pressure (mDBP) >95 mm Hg was associated with a RR of death of 6.59; CI 95%=2.09-20.7 (p=0.001). Intradialytic hypotension was associated with a RR of 4.28; CI 95%=1.28- 14.26 (p=0.02). In logistic regression, statistically significant correlations with death were found for the following variables: predialysis mSBP ≥155 mm Hg, predialysis mDBP >95 mm Hg, intradialytic hypotension, Charlson comorbidity index >5, history of myocardial infarction, albuminemia <3.6 g/dl, cholesterolemia <150 mg/dl. Conclusions. Standardized predialysis m SBP over 155 mm Hg, standardized predialysis mDBP over 95 mm Hg and intradialytic hypotension were significant predictors of death in our study group. [ABSTRACT FROM AUTHOR]

Periodontal disease is one of the most common chronic diseases of microbial origin. We have recently witnessed a significant increase in scientific research aimed at the direct link between periodontal disease and various systemic diseases: atherosclerosis, myocardial infarction, stroke, diabetes and not least in pregnancy complications: premature birth, miscarriage or pregnancy that stopped developing, preeclampsia, and low birth weight. Improving periodontal health in patients before or during pregnancy can reduce or prevent these complications and therefore may significantly contribute to decrease perinatal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Atherosclerosis was observed at young individuals, HIV infected without coronary risk. Antiretroviral therapy of HIV infection would cause major disturbances în lipid metabolism and early atherosclerosis. The chronic inflammatory states maintained by cancer, opportunistic infections could be associate to atheromatous vascular disease. [ABSTRACT FROM AUTHOR]

The association of stroke to acute myocardial infarction (AMI) may be considered either a consequence of the myocardial ischemia, or separate entity. Purpose: To appreciate the short term(30- days)evolution of subjects that associate an ischemic cerebral stroke to an AMI within minimum one and maximum 6 days from the onset of the myocardial infarction. Material and Methods: There were included 97 subjects during 2005-2008, divided in two groups: group A-association of stroke to AMI; groupB-case control, subjects with stroke and no AMI. Results: The cardiovascular burden did not differ significantly in the two groups.In the intra-group analysis the presence of peripheral arterial disease, high total cholesterol/HDL-cholesterol ratio and post-AMI atrial fibrillation correlated to a more severe neurological status (p<0.05,CI95%). The association of stroke to the AMI paradoxically leads to an appreciation of the neurological status at 30days (p<0.05,CI95%). The mortality did not differ significantly. Conclusions: The association of a an ischemic stroke to a myocardial infarction is not a negative shot term neurological prognostic factor, without significantly influencing the mortality. [ABSTRACT FROM AUTHOR]

The association of stroke and acute myocardial infarction may be considered either a consequence of stroke, or a separate entity. Purpose: To appreciate the short term (30-days) evolution of subjects that associate acute myocardial infarction to cerebral stroke within minimum one and maximum 7 days from the onset of the cerebral stroke using several parameters. Material and Methods: There were included 55 subjects divided in two groups: group A - association of myocardial infarction to stroke within 1 - 7 days from stroke's onset; group B - case control group having subjects with stroke and no myocardial infarction. Results: The burden of cardiovascular diseases did not differ significantly in the two groups, with the exception of hypertension and stroke history that were associated to group A, together with CRP presence, lower HDL cholesterol and higher CT/HDL cholesterol ratio when screened. In the intra-group analysis, persistent hypertension at 72 hours and hyperglycemia at 48 hours correlated to a severe neurological status (p<0.05, CI95%). The occurrence of myocardial infarction leads to a depreciation of the neurological status in group A subjects at 15 and 30 days when compared to group B subjects (p<0.05,CI95%). The mortality in the groups did not differ significantly. Conclusions: The association of a myocardial infarction to an ischemic stroke is an independent negative prognostic factor without influencing the mortality. When other risk factors are present they may be omitted in favor for myocardial infarction on the respect to 30-days prognosis. [ABSTRACT FROM AUTHOR]

Objective - To compare the main characteristics, outcome and prognosis in four age-groups of patients enrolled in the Romanian Registry for ST-elevation myocardial infarction (RO-STEMI). Methods - RO-STEMI enrolled 19510 STEMI patients addmitted in 43 sites between 01.01.1997-31.12.2009. From them, 15484 were directly enrolled in the central electronic database and data of 4026 patients were obtained from RO-STEMI tables sent to some sites. This sub-report was obtained on the 15484 patients enrolled only in the central database, and divided in four age-groups: A= < 45; B=45-59; C=60-74 and D= >75 years old, respectively. Results - The age-groups distribution of the RO-STEMI patients was the follows: A=1329 (8,5%); B=5152 (33,2%); C=6054 (39,0%); D=2949 (19,0%). The incidence of hypertension and diabetes mellitus increased with the age-group (28.2%, 48.8%, 57.7% and, respectively, 59.7% for hypertension and 9.7%, 20.82%, 25.5% and 21.08% respectively, for diabetes). An inverse relationship was seen for smoking (76.0%, 65.2%, 37.85% and, 20.7% respectively) and hiperlypidemia (41.7%, 45.0%, 37.16% and 28.17%, respectively (p<0.0001 for all trends). Only 60.6% of patients over 60 have been admitted within the first 6 hours after the STEMI onset compared with 80.9% of patients under 60. The percentage of patients with Killip class III/IV at presentation increased with age: 6.16%, 9.12%, 15.02%, and 22.55%, respectively. Rates of reperfusion therapy decreased with age (thrombolysis: 54.77%, 54.28%, 44.26% and 24.41%, respectively; primary angioplasty: 9.2%, 6.39%, 4.26%, and 3.38%, respectively, p<0.0001 for both trends. The same negative trend was seen for beta-blockers, ACEIs and statins. The in-hospital mortality was 4.4%, 6.29%, 13.32% and 22.39%, respectively. Conclusions - Compared with young patients, old patients have a more severe risk and haemodynamic profile, are admitted later and are less frequent treated with reperfusion procedures or with the STEMI medication currently recommended. These peculiarities can contribute to the worsening of prognosis in older patients. [ABSTRACT FROM AUTHOR]

Serum cholinesterase hydrolises choline esters and some drugs (local anaesthetics, myorelaxants, analgetics). CHE activity is a marker of hepatic protein synthesis, its activity being impaired in patients with cirrhosis and chronic hepatitis, in cases of malnutrition and/or malabsorbtion as well as in leukemic patients treated with L asparaginase (which is known to affect protein synthesis in the liver). A transient reduction of CHE activity accompanies the acute phase reaction (in women with septic abortion and in patients during the first days following the onset of a myocardial infarction). Hypothyroidism evolves with impaired activity of CHE, while in hyperthyroidism these values are enhanced. High values of CHE activity are noticed in patients with nephrotic syndrome, in patients with hyperlipoproteinemia type IIb and IV (associated with an accelerated hepatic synthesis of VLDL), and in subjects with abdominal obesity. Clinical and experimental studies seem to agree that an acceleration of fatty acids and subsequently of triglyceride synthesis, as well as an enhancement of fatty acids catabolism are associated with an enhanced CHE activity, which could be considered as a marker of the metabolic syndrome without being directly involved in its pathogenesis. [ABSTRACT FROM AUTHOR]

Background - Diabetes mellitus (DM) negatively influences the prognosis of patients withST-elevation myocardial infarction (STEMI). Objective - To compare the peculiarities of patients with or without DM enrolled in the Romanian registry for STEMI. Methods - The RO-STEMI registry enrolled 19510 STEMI patients addmitted in 43 centres between 01.01.1997 - 31.12.2009. From them, 15484 were directly enrolled in the central electronic database and data of 4026 patients were obtained from other registries or from RO-STEMI tables sent to some centres. For this sub-report only the data recorded in the central data base were used. Results - A group of 3327 RO-STEMI patients (21,49%) was identified with DM. The incidence of anterior STEMI was similar in patients withor without DM (49.28% vs. 50,5%). The mean age of DM patients was 2 years higher (64±11 vs 62±13 ani, p<0,0001) compared with non-diabetics. Patients with DM had more frequent hypertension (67,51% vs 48,0%), hiperlipydemia (52,51% vs 32,63%), obesity (34,81% vs 17,04%), a previous infarction (12,35% vs 8,27%) and a Killip class III/IV at their presentation (19,83% vs 11,65%) (p < 0,0001 for all comparisons). Diabetes patients received less frequent thrombolytics (43,79% vs 51,70%, p<0,0001) but more frequent antiplatelets (90,62% vs 87,60%, p<0,001), angiotensin converting enzyme inhibitors (74,93% vs 69,27%, p<0,0001), beta-blockers (71,85% vs 69,81%, p<0,028) and statins (72,42% vs 67,42%, p <0,0001). The rates of primary angioplasty were non-significant different (6,27% vs 4,19%, p=0,08). Postponed angioplasty after a conservative therapy or thrombolysis was nonsignificantly less used in patients with DM (10,34% vs 12,84% for angioplasty and 9,76% vs 12,45% for stents p>0,05). The in-hospital mortality was significant higher in patients with DM compared withnon-diabetes the differences being significant for p<0,0001 not only globally (15,53% vs 11,04%) but also in patients treated with thrombolytics (12,39% vs 8,48%), with angioplasty (16,08% vs 3,71%) or conservative (17,73% vs 14,25%). Conclusion - Diabetes RO-STEMI patients had a more severe risk profile and were less frequent treated with interventional procedures. These peculiarities explain their worse in-hospital prognosis. [ABSTRACT FROM AUTHOR]

From necrosis enzymes troponine is known to be faithful along with the increase dynamics of some inflamation markers, (PCR, fibrinogen, but specially proBNT, NT -- proBNP, that reveal major changes from the stable angina phase, unstable angina and myocardial infarct). They have been proved in the evolution of acute coronary syndroms, and this is the reason we started this study. [ABSTRACT FROM AUTHOR]

Coronary artery by-pass graft(CABG) and surgical ventricular restoration (SVR) are two techniques which can contributes to the restoring of the left-ventricle (LV) size and function in patients (pts) with ischaemic dilated cardiomyopathy (IDC). In these pts mitral regurgitation (MR) due to the changing in the shape and function of the LV is in important issue. Aim - To evaluate the LV and right ventricle (RV) systolic and diastolic function and the MR in pts with IDC and heart failure undergoing CABG and SVR. Methods - In 33 patients (67 +/-3 years/ 6 F) with previous anterior myocardial infarction, LV aneurism and depressed ejection fraction (EF <35%) a trans-thoracic echocardiography and a tissue doppler study was performed before and one year after complete CABG combined with SVR. Th e systolic and diastolic myocardial velocities at the level of the lateral and septal mitral annulus and of the lateral tricuspid annulus have been evaluated. All pts had pre-surgery severe MR. I split the patients in 2 subgroups according to the answer of the ecocardiographic parameters to surgery. Results - Early mortality was 11, 11%. In group A, EF increased from 29+/-6% to 42+/-8% (p <0.0001) and in group B from 27+/- 4% to 33+/- 6 % (NS). Th e diastolic function did not improve in any of the 2 subgroups. For the first group, LV peak systolic velocities significantly improved from 0.05+/-0.01 m/s (lateral wall and septum as well) to 0.102+/- 0.03 m/s (lateral wall; p= 0,0001) and respectively 0.112 +/- 0.01m/s (septum; p <0.001); but for the second one did not exist significant improvements. For RV velocities increased from 0.10+/- 0.02 m/s to 0.178+/- 0.03 m/s after surgery (p <0.001) in group A and from 0.09+/- 0.04ms to 0.110+/-0.05ms (p=0.462) in group B, with statistically significant diff erencies between groups after the surgery(p <0.0001). Before surgery, the ratio E/E′ was between 8-15 in 20 pts and more than 15 in 7 pts (group A), and between 8-15 in 3 pts and greater than 15 in 3 pts in group B. After CABG and SVR E/E′ became less than 8 in 12 pts and between 8-15 in 12 pts - in group A and between 8-15 in 5 pts from group B. Twenty two pts had mild MR and two pts. still had moderate MR after surgery in group A and 5 pts still had moderate MR in group B. In the first group mitral ring diameter decreased from 33+/- 6 mm to 31 +/- 8 mm (NS), protosistolic tenting area decreased from 3,3 cm² to 3,1 cm² (p= 0.02) and end-sistolic one from 2,3 cm² to 1,8 cm² (p=0.05). In group B, mitral ring diameter increased from 35+/-4mm to 38+/-3 mm (p=0.172) and protosistolic tenting area from 3.4 cm² to 3.5 cm² (NS). Conclusions - 1. Th e systolic LV function improved in group A after CABG and SVR combination. Th is benefit could be better evaluated using the tissue Doppler measurement than the classical EF. 2. A combination between the two echo methods showed the decrease of the LV end-diastolic pressures in almost all pts. 3. A significant improvement of the diastolic function after CABG and SVR was not detected. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular morbidity is the first factor that influences survival in chronically hemodialyzed patients. For this reason a permanent evaluation of cardiovascular risk and of efficient therapeutic methods are necessary This study followed the cardiovascular events and deceased frequency in chronically hemodialyzed patients under ACEI and beta-blocker therapy, in our region. We also followed, the effects of these therapies on some cardiovascular risk factors and on plasma potassium and we registered the use frequency of the study medication in the chronically hemodialyzed patients. Metods: 106 chronically hemodialyzed patients were investigated; among these 58 patients were selected, under beta-blocker±ACEI therapy. Two groups were formed: group A: 36 patients under beta-blocker therapy and group B: 22 patients under ACEI and beta-blocker therapy. Clinical and biological data were also recorded when the study started, including diabetes mellitus, cardiovascular history, some cardiovascular risk factors. Taking into consideration the age, sex, diabetes mellitus and cardiovascular history presence, we formed the subgroups. We followed the groups for 24 month and we noted the deceased and the cardiovascular events frequency: angina pectoris, including acute myocardial infarction, peripheral arterial disease events, stroke. We analyzed the groups and subgroups by comparison. Results: The frequency use of ACEI therapy was not frequent: 20,75%. No significant differences in the frequency of CE, or deceased number, were found between the groups and subgroups with and without ACEI therapy. Among the monitored cardiovascular risk factors, only SBP was lower and the serum albumin levels was higher in patients under association ACEI betablokers therapy (p=0,05 for SBP and p=0,08 for serum albumin, if mean values were compared between groups A and B, respectively p=0,02 for SBP and p=0,05 for serum albumin if mean values was compared between subgroup older than 50 years). The mean value of serum potassium did not reach dangerous levels in either group, and there were no significant differences between two groups Conclusion: The therapeutic beta-blockers-ACEI association was rarely use in our chronically hemodialyzed patients. Even if this therapeutic association didn`t significantly reduce the cardiovascular events and deceased number, in that period, when we compared it with isolated betablokers use, it significantly decreased BP, and it was associated with a higher serum albumin. The mean value of serum potassium was not significantly modified in ACEI beta-blokers association groups. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include coronary stenting technique in true bifurcation lesions, the role of cerebal natriuretic peptide (BNP) in assessing the reperfusion injury in patients with ST-segment elevation myocardial infarction (STEMI) and the effects of atrial fibrillation (AF) after the coronary artery bypass graft surgery (CABG) and betablockers (BB) in patients with left ventricular (LV).

The article presents abstracts on topics related to the human heart which include the use of izovolumetric acceleration in the inferior myocardial infarction, the evaluation of coronary atherosclerosis with the use of matrix metalloproteinases, and the study of congenital mitral valve regurgitation in adult patients.

Objective - To establish the impact of endothelial dysfunction (assessed by flow mediated vasodilatation - FMD and plasma level of von Willebrand factor - vWF) on long term (15 month) cardiovascular risk at patients with peripheral arterial disease undergoing nonemergent vascular surgery. Methods - We studied the relation between endothelial dysfunction asessed by FMD and vWF value and cardiovascular events at 90 consecutive patients with peripheral arterial disease proposed for nonemergent vascular surgery. Cardiovascular events (cardiac death, cardiac arrest, acute myocardial infarction, unstable angina, stroke) were followed 15 months (± 3 months) after surgical intervention. Results - Sixteen patients (17.8%) had cardiovascular events (cardiac death - 4 patients; cardiac arrest - 2 patients; myocardial infarction - 4 patients; unstable angina - 3 patients; stroke - 3 patients). Preoperative endothelium dependent FMD was between 4.87 % and 15%, with a mean value of 8.82 ± 2.13%; at the patients with a postoperative cardiovascular event FMD was significantly lower (5.96 ± 1.37%) than in those without an event (9.43 ± 1.73%; p = 0.0001), whereas nonendothelium-dependent vasodilation to nitroglycerin was similar in both groups (13.68 ± 1.77% versus 14.92 ± 2.76%, p = 0,088). Preoperative vWF levels were between 70 - 296 U/dl, with a mean value of 176.6 ± 55.28 U/dl, significantly higher at the patients with cardiovascular events (214.43 ± 54.78 U/dl versus 168.41 ± 52.22 U/dl, p= 0,002). Relative risk of cardiovascular events was higher at the patients with FMD below 7.2% (lower tertile) associated with vWF above 216 U/dl (higher tertile) - 3.51 (CI: 1.05 - 11.69) relative to patients with only FMD below 7.2% (lower tertile) - 2.51 (CI: 1.45 - 4.34) and only vWF above 216 U/dl (higher tertile)- 1.49 (CI: 1.04 - 2.23). Also, independent predictors for cardiovascular events were: ejection fraction (p=0.0003), ankle-brachial index (p=0.0001), type of surgical intervention (p=0.004), PDW (p=0.001), but PAI-1 was not significantly different at patients with cardiovascular events. Conclusions - Impaired endothelial function assessed by flow mediated dilatation and plasma von Willebrand levels predicts long-term cardiovascular events in patients with peripheral arterial disease undergoing a nonemergent vascular surgical intervention. [ABSTRACT FROM AUTHOR]

We know from literature that moderate alcohol consumption combined with physical strain leads to HDL-cholesterol increase, platelet adhesion impact through the antioxidant effect of the resveratrol and quercetine contained in red wine, and positively influences fibrinogen decrease and NO increase, and all these effects play an eventual inhibition role of the blood vessels muscles' proliferation, a stabilization of the aterosclerotic plate and endothelial disfunction correction. [ABSTRACT FROM AUTHOR]

Cardiovascular autonomic neuropathy (CAN) is one of the most overlooked of all complications of diabetes, which encompasses damage to the autonomic nerve fibres that innervate the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. CAN represents a prevalent and serious complication as it carries an approximately fivefold risk of mortality in the patients with diabetes, but it is one of the least frequently diagnosed. The high mortality rate may be related to silent myocardial infarction, cardiac arrhythmia, cardiovascular and cardiorespiratory instability. Patient's history and physical examination are not effective for the early detection of the autonomic nerve dysfunction, therefore it is important to identify the early stages of CAN with an easily available tool, such as the non-invasive cardiovascular reflex test. Tight glycemic control is the tool for preventing the development and the progression of CAN. [ABSTRACT FROM AUTHOR]

Autorii prezintă cazul unui sugar în vârstă se 2 luni, care se internează pentru semne clinice de insuficienţă cardiacă congestivă ce asociază hipotensiune arterială şi timp de recolorare prelungit, cu cardiomiopatie dilatativă la ecocardiografia Doppler şi modificări ischemice pe EKG. În ciuda tratamentului medicamentos, evoluţia a fost nefavorabilă, iar examenul anatomopatologic confirmă originea anormală a arterei coronare stângi (ACS) din artera pulmonară (AP), cardiomiopatia dilatativă a ventriculului stâng şi evidenţiază fibroelastoză şi necroză subendocardică secundare. [ABSTRACT FROM AUTHOR]

Coronary artery disease is the major cause of mortality and morbidity in hypertensive patients. Myocardial infarction or severe ischemia are the most common causes of let ventricular kinetic abnormalities, which may reduce its pump function. However, there are limited data about frequency and correlation with kinetic abnormalities in hypertensive patients. Two dimensional ultrasound can semiquantitatively assess the left ventricular kinetic abnormalities, which are pathophysiologically associated with ischemic heart disease. Assessment of the frequency of global and segmental let ventricular kinetic abnormalities and their correlations with ECG and echocardiographic data is useful for identifying patients with higher risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Dilated cardiomyopathy (DCM) has a higher incidence in children than the other forms. It is characterized by an important cavity dilation and left and/or right ventricle impaired contractility. Because of a familial incidence up to 30%, there were performed extended genetic studies at the patients and their relatives. We can describe several forms: autosomal dominant DCM, DCM with or without the impairment of the conduction system, DCM with neurosensorial deafness and X-linked transmitted DCM. The imunopathogenesis of DCM has been demonstrated on experimental models and confirmed on human subjects. Viral infection is the most common cause of myocarditis and can contribute to the evolution towards DCM. There are many studies that proved the presence of antibodies in the myocardial tissue of the patients with DCM. [ABSTRACT FROM AUTHOR]

Brain natriuretic peptide (BNP), a neurohormone peptide synthesized in ventricular myocardium and effused into circulation in response to ventricular dilatation and pressure overload, leading to an increase in natriuresis, vasodilatation, inhibition of angiotensin-aldosterone axis and sympathetic activity, becomes elevated in heart failure. It is possible to differentiate it by dosing inspiratory dyspnea due to cardiac infarction normal ejection fraction (EF) without left ventricular (LV) dysfunction. BNP superior to a prohormone ANP is then cleaved at the N-terminus to produce the BNP peptide and N-terminal proBNP (NT-proBNP). This hormone has been incriminated as present in the acute coronary syndromes with ST which increased in the first 24 hours after MI. [ABSTRACT FROM AUTHOR]

The third universal definition of AMI (acute myocardial infarction) in 2012 emphasizes the role of biomarkers in this situation. The objective of our study was to assess the significance of TnI in improving diagnostic accuracy and prognosis in a population - IMASST (ST segment elevation myocardial infarction) in Arges County. We retrospectively studied a cohort of 1,008 patients with STEMI admitted to the USTACC clinic, between January 1 2009-31 May 2013 with the following locations: anteriorly 38.79 %, inferiorly 30.06 %, laterally 12.70 %, posteriorly 3.77 % and associated 14.68 %. We stratified the cohort according to the following criteria: clinical (pain or equivalent), ECG (area under the ST in the relevant branch), biomarkers (TnI - troponin I), echocardiography and we followed the correlation of these parameters both in the diagnosis of STEMI, and regarding the following six events: thrombolysis, PCI (percutaneous coronary intervention), CABG (aortocoronary bypass), cardiogenic shock, acute pulmonary edema (APE), mortality. TnI relevant values group (80.26 %) correlates much better with all six events compared with group TnI <0.05 pg / mL. In addition, the subgroup with TnI more than 10 ng / mL developed acute pulmonary edema and / or cardiogenic shock in 90.67 % with PCI and CABG growth and high mortality. In this STEMI population, TnI improves diagnostic accuracy and the management of complications. "Troponin blindness" rate of 19.74 % can be explained either by the quality of the biomarker, either by the late presentation of the majority of the patients. [ABSTRACT FROM AUTHOR]