"iDoctor – Medical Blog"

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 664-666

Carmelo V., Venero , Jose V., Venero , Dale C., Wortham , Paul D., Thompson

Chinese red yeast rice is a dietary supplement containing monacolins, unsaturated fatty acids, and phytosterols capable of lowering low-density lipoprotein (LDL) cholesterol. Few studies have reported on its use in clinical practice or in statin-intolerant patients. We reviewed approximately 1,400 clinical charts and identified 25 patients treated with red yeast rice for ≥4 weeks. The patients were included if they had pre- and post-treatment lipid levels without simultaneous changes in other lipid-lowering medications. These patients had experienced myalgias (68%), gastrointestinal intolerance (16%), and/or elevated alanine aminotransferase levels (8%) with previous use of other lipid-lowering agents. The total cholesterol decreased 15%…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 667-671

Michel, Krempf , Klaus G., Parhofer , Ph. Gabriel, Steg , Deepak L., Bhatt , E. Magnus, Ohman , …

The objective of this study was to determine cardiovascular event rates in diabetic patients and nondiabetic subjects from the REACH Registry with established coronary artery disease, cerebrovascular disease, peripheral arterial disease, or multiple risk factors for atherothrombosis. REACH is an international, prospective, and contemporaneous cohort of patients with ≥3 atherothrombotic risk factors only or established atherothrombotic disease, of which 30,043 have diabetes. The main outcomes after 1-year follow-up were cardiovascular death, myocardial infarction, stroke, major adverse cardiovascular events (MACEs; cardiovascular death, myocardial infarction, or stroke), and MACEs/hospitalization. The MACE rate at 1 year was positively related to the number of…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 672-676

Brian W., Zagol , Richard A., Krasuski

Physical inactivity increases cardiovascular risk. The possible adverse effects of regular motorized scooter use, recently popularized for patients with physical limitations, has not been previously examined. We performed a single-center, retrospective cohort study of 102 consecutive patients who had obtained medical approval for, and subsequently received, a motorized scooter during a 6-year period. The clinical data were collected for the 12 months before and after the intervention. Surveys assessing 11 different facets of health-related quality of life were returned by 28% of patients. The patients receiving a scooter were 68 ± 19 years old, and 55% were women. The medical…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 677-680

Ricardo, Stein , Patricia, Nguyen , Joshua, Abella , Harold, Olson , Jonathan, Myers , …

Exercise-induced (EI) right bundle branch block (RBBB) is an infrequent electrocardiographic phenomenon, and controversy exists regarding its association with cardiovascular disease. We compared the prevalence and prognostic significance of RBBB, abnormal ST depression, and normal electrocardiographic findings in response to exercise testing in 9,623 consecutive veterans who underwent exercise testing from 1987 to 2007. EI RBBB, EI ST depression, and a normal exercise electrocardiographic response occurred in 0.24%, 15.2%, and 71.9% veterans, respectively. After appropriate exclusions, of the 8,047 patients analyzed, 6 patients in the EI RBBB subgroup died. Of these 6 deaths, 3 were cardiovascular deaths during the 9…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 681-686

Sami, Gritli , Mamia, Ben Salah , Abdessalem, Shili , Caroline D., Robson , Mohamed, Ferjaoui , …

We report on the long QT syndrome occurring in conjunction with nontoxic multinodular goiter and sensorineural deafness in several siblings of a large family. Autosomal and X-linked recessive and dominant modes of inheritance are possible for the different phenotypes. The affected family members had various phenotype combinations, suggesting variable expressivity and incomplete penetrance.

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 694-700

Howard S., Gordon , Patrick R., Nowlin , Daniel, Maynard , Michael L., Berbaum , Anita, Deswal

Heart failure (HF) disproportionately affects black compared to white Americans, and overall mortality from HF is greater among blacks. Paradoxically, mortality rates after a hospitalization for HF are lower in black than in white patients. These racial differences might reflect hospital, physician, and patient factors and could have implications for comparative hospital profiles. We identified published studies reporting the posthospitalization mortality for black and white patients with a discharge diagnosis of HF and conducted random-effects meta-analyses with the outcome of all-cause mortality. We included 29 cohorts of hospitalized black and white patients with HF. The unadjusted mean mortality rate after…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 701-708

David S., Owens , Ronit, Katz , Junichiro, Takasu , Richard, Kronmal , Matthew J., Budoff , …

Aortic valve calcium (AVC) is common among older adults and shares epidemiologic and histopathologic similarities to atherosclerosis. However, prospective studies have failed to identify meaningful risk associations with incident (“new”) AVC or its progression. In the present study, AVC was quantified from serial computed tomographic images from 5,880 participants (aged 45 to 84 years) in the Multi-Ethnic Study of Atherosclerosis, using the Agatston method. Multivariate backward selection modeling was used to identify the risk factors for incident AVC and AVC progression. During a mean follow-up of 2.4 ± 0.9 years, 210 subjects (4.1%) developed incident AVC. The incidence rate (mean…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 709-715

Shih-Hung, Hsiao , Wei-Chun, Huang , Ko-Long, Lin , Kuan-Rau, Chiou , Feng-You, Kuo , …

Echocardiograms and left ventricular (LV) filling pressure were obtained from 95 patients with chronic severe mitral regurgitation (MR) and 16 patients with acute severe MR. All patients underwent catheterization for preoperative examinations and LV filling pressure measurements. A total of 52 age-, gender- and co-morbidity–matched patients with negative coronary angiographic results served as the controls. Echocardiography, including assessment of left atrial (LA) distensibility, was performed simultaneously. LA distensibility correlated logarithmically with the LV filling pressure. However, the early-diastolic mitral inflow velocity divided by the early-diastolic mitral annular velocity (mitral E/E′) correlated linearly with the LV filling pressure. Bivariate correlation analysis…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 716-720

Giuseppe, Limongelli , Giuseppe, Pacileo , Roberta, Ancona , Giuseppina, Eusebio , Antonello, D’Andrea , …

We sought to analyze the prevalence, clinical course, and risk profile of left ventricular systolic dysfunction in adolescents with idiopathic dilated cardiomyopathy. Patients with clinical onset at 19 years (n = 14) of age and/or patients followed up for <12 months were excluded. Clinical and biochemical markers were evaluated during 4 ± 3 years of follow-up to determinate predictors of adverse outcome. A composite end point (hospitalization for worsening heart failure, cardiac transplantation, and death) was investigated. The final cohort consisted of 48 patients (median age 17 years) with idiopathic dilated cardiomyopathy. During follow-up,…

Publication year: 2010
Source: The American Journal of Cardiology, Volume 105, Issue 5, 1 March 2010, Pages 721-726

Philipp, Lurz , Alessandro, Giardini , Andrew M., Taylor , Johannes, Nordmeyer , Vivek, Muthurangu , …

The data describing the change in exercise capacity after surgical or interventional management of the patient with right ventricular (RV) outflow tract (OT) dysfunction are conflicting. The pathophysiologic consequences of RVOT interventions and the subsequent change in exercise performance are still poorly understood. We sought to assess the effect of percutaneous pulmonary valve implantation (PPVI) on exercise capacity in (1) patients with predominantly pulmonary stenosis (PS) and (2) in patients with predominantly pulmonary regurgitation (PR). A total of 63 patients with either predominantly PS (n = 37) or PR (n = 26) underwent PPVI. Cardiopulmonary exercise testing and magnetic resonance…