Cardiovascular disorders

Acute coronary syndrome (ACS) in pregnancy has traditionally been considered to be a rare event, but the combination of normal physiological changes of pregnancy and more prevalent cardiovascular risk factors are increasing its incidence in this population. The present report describes a 39 year-old woman that is seven weeks pregnant...

OWR is a genetic disease, transmitted as an autosomal dominant disorder characterized by arteriovenous malformations pre-dominantly involving the mucocutaneous epithelium. One of the significant complications is the development of arteriovenous fistulas in different organs like the liver and brain. One of the rarest complications of this arteriovenous conduit is a...

We experienced a successful surgical Williams’s syndrome case of extended aortoplasty by means of Doty’s method (two sinus reconstructions) for congenital supravalvular aortic stenosis. Case was 29-year-old woman, who had no complaint except heart murmur and dyspnea. The retrograde aortography and Digital Subtraction Angiography (DSA) demonstrated localized stenosis just above...

Objective: Earlier studies have reported that a decrease in exercise capacity might indicate endothelial dysfunction. However, the effects of improvement of endothelial functions on exercise capacity have not been evaluated. The aim of the present study is to investigate the effects of nebivolol on flow-mediated dilatation (FMD), and on the...

Objectives: There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g. angina, myocardial infarction, congestive heart failure, stroke, and mortality due to...

Hypertension is the leading cause of disability and cardiovascular mortality world-wide. Approximately one-third of the US adult population and over a billion people world-wide have hypertension. Despite increased awareness of hypertension and availability of many effective antihypertensive agents, only one third of patients achieve their target blood pressure (BP). All...

Pitavastatin is an HMG-CoA reductase inhibitor that significantly reduces the plasma levels of total cholesterol, LDL-C and triglycerides, while also causing modest elevation of the plasma high-density cholesterol (HDL-C) level. This statin is minimally metabolized by the cytochrome P-450 (CYP) isozymes; it is glucuronized and converted to the inactive lactone...

Prevention is better than cure best applies here. As per many authors, posterior leaflet chordae preservation prevent Left ventricular rupture (LVR) and preserve LV geometry. We are presenting here 5 types of left ventricular rupture (LVR) post Mitral valve replacement (MVR) with different methods to repair with the advantages and...

The renin-angiotensin system can be inhibited through inhibition of angiotensin I generation from angiotensinogen by direct renin inhibitors, inhibition of angiotensin II generation from angiotensin I by angiotensin-converting enzyme inhibitors and by direct inhibition of the action of angiotensin II receptor level. Aliskiren, the first direct renin inhibitor to reach...

Background: Due to the rise in the number of reports of stress cardiomyopathy in the literature, awareness of this condition is increasing. Although different names have been used to describe this condition, the similarities in clinical, electrocardiographic, echocardiographic, and angiographic features suggest that they represent the same spectrum of diseases...

Hypertension can lead to significant morbidity and mortality, and requires lifestyle modifications with or without drug therapy to achieve target blood pressure control. Various classes of anti-hypertensive medications are available to healthcare providers. Choice of medications is based not only on efficacy but also tolerability and cost. Aliskiren is the...

Aspirin and clopidogrel are the most commonly used antiplatelet agents in patients with coronary artery disease. The existence of resistance to these agents has been a controversial issue and new drugs are being developed to overcome this problem. Laboratory tests, which can identify resistance and correlate this with clinical outcome,...

Several clinical studies demonstrate a beneficial role of angiotensin-converting enzyme (ACE) inhibitors in patients with myocardial infarction, hypertension and diabetes mellitus. This review focuses on the effects of ramipril, a weak inhibitor of ACE that is rapidly hydrolyzed to ramiprilat, an active metabolite. The Heart Outcome Prevention Evaluation (HOPE) study...

Once used only as third-line therapy in the management of chronic pain states, methadone is now being used as first- and second-line therapy. Most risks and the stigma associated with methadone use have been known for years. Only over the past decade or so have the unique pharmacokinetic-pharmacodynamic properties and...

Suppression of the Renin-Angiotensin-Aldosterone system (RAAS) is an established intervention in the management of cardiovascular disease. Large, randomized controlled trials have provided a sound evidence base for the use of mineralocorticoid receptor antagonists to block the end product of the RAAS in the treatment of heart failure. However, the place...

Antiplatelet therapy is the cornerstone in the modern therapy of patients with acute coronary syndromes (ACS), because of the unique role of platelets in coronary thrombosis. Clopidogrel in combination with aspirin is the current “gold standard” for reducing cardiovascular events in such patients, providing a synergistic platelet inhibition through different...

Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective) thereby improving survival, and/or relieve ischemic symptoms (antianginal) thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents,...

In the 1970s, pharmacological therapy interrupting the renin-angiotensin system was considered beneficial for patients with high-renin hypertension. Angiotensin-converting enzyme (ACE) inhibitors proved to be effective not only in patients with high renin and elevated blood pressure, but also in many hypertensive patients with normal levels of plasma renin activity. ACE...

Garry Walsh Reader in Inflammation and Immunity, University of Aberdeen Scotland, United Kingdom.

Garry Walsh Reader in Inflammation and Immunity, University of Aberdeen Scotland, United Kingdom.

Hypertension is one of the most important modifiable risk factor for cardiovascular morbidity and mortality and is highly prevalent. Recent guidelines and advisory statements have recommended lower thresholds and goals for patients with hypertension. However, approximately two-thirds of hypertensive patients do not achieve the goals. Poor adherence to anti-hypertensive medication...

Dementia is a syndrome characterized by a decline in cognitive function. Alzheimer’s disease and cerebro-vascular disease are the most common causes of dementia. Many factors (genetic, life style, vascular etc.) appear to play some role in the development of dementia. Statins significantly reduce vascular disease and could reduce cognitive impairment...

Excessive sleepiness (ES) is responsible for significant morbidity and mortality due to its association with cardiovascular disease, cognitive impairment, and occupational and transport accidents. ES is also detrimental to patients’ quality of life, as it affects work and academic performance, social interactions, and personal relationships. Armodafinil is the R-enantiomer of...

Background: Bone-marrow derived progenitor cells (PCs) may play a role in maintaining vascular health by actively repairing damaged endothelium. The purpose of this study in asymptomatic Old Order Amish men (n = 90) without hyper- tension or diabetes was to determine if PC count, as determined by CD34+ cell count...

Background: Acute aortic dissection (AAD) is a life-threatening condition with high mortality and a relatively unclarified pathophysiological mechanism. Although differentially expressed genes in AAD have been recognized, interactions between these genes remain poorly defined. This study was conducted to gain a better understanding of the molecular mechanisms underlying AAD and...

Toshio Imanishi, Hiroto Tsujioka and Takashi AkasakaDepartment of Cardiovascular Medicine, Wakayama Medical University. 811-1, Kimiidera, Wakayama City, Wakayama, Japan.AbstractThe renin-angiotensin system (RAS) activity is a key factor in the pathophysiology and development of hypertension, atherosclerosis, heart failure, and renal disease. It is unclear whether angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers...

Christos Chatzikyrkou, Hermann Haller and Jan MenneDepartment of Nephrology, Hannover Medical School, Germany.AbstractHypertension is the most important preventable cause of premature death in the developed countries, and the benefits of antihypertensive drugs regarding cardiovascular morbidity and mortality are well established. Nevertheless, adequate control is achieved only in the minority of...

Jérôme Roncalli1,2, Laurence Perez1, Atul Pathak1,3, Laure Spinazze1, Sandrine Mazon1, Olivier Lairez1, Daniel Curnier2, Joëlle Fourcade1, Meyer Elbaz1, Didier Carrié1, Jacques Puel1,4, Jean-Marie Fauvel1 and Michel Galinier1,21Rangueil University Hospital, Department of Cardiology and Heart Failure Educational Centre (Centre d’ Education pour Patient Insuffisant Cardiaque (CEPIC)), Toulouse, France. 2INSERM U858-I2MR, Hôpital...