The Open Cardiovascular Medicine Journal最新文献

{"title":"Soft Tissue Attenuation Patterns Associated with Supine Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study.","authors":"Rami Doukky,&nbsp;Mouyyad Rahaby,&nbsp;Tareq Alyousef,&nbsp;Raj Vashistha,&nbsp;Dave Chawla,&nbsp;Amit P Amin","doi":"10.2174/1874192401206010033","DOIUrl":"https://doi.org/10.2174/1874192401206010033","url":null,"abstract":"<p><strong>Purpose: </strong>Soft-tissue attenuation patterns in SPECT-myocardial perfusion imaging (MPI) of supine acquisition systems are well recognized. Their prevalence and interaction with body-habitus and gender are ill-defined, which we sought to describe in this study.</p><p><strong>Methods: </strong>In a cross-sectional study, we described the prevalence of soft-tissue attenuation patterns in normal SPECT-MPI studies acquired with a supine patient-position SPECT system.</p><p><strong>Results: </strong>In 263 normal, clinically-indicated, supine-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (35.4%), inferior (41.8%) and lateral (13.3%). Anterior attenuation was more prevalent among women (50.7% vs. 15.7%, P<0.001) and was associated with chest circumference among men. Conversely, inferior attenuation was more prevalent among men (78.3% vs. 13.5%, P<0.001) and was not affected by body-habitus. Lateral attenuation was more common among women (19.6% vs. 5.2%, p=0.001) and was associated with obesity (p=0.015).</p><p><strong>Conclusions: </strong>Soft-tissue attenuation artifacts are common in supine-acquisition SPECT-MPI. The recognition of their prevalence and association with body-habitus and gender is critical for the accurate interpretation of SPECT-MPI.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"33-7"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/5b/TOCMJ-6-33.PMC3339431.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30587449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Characteristics, and In-Hospital Outcomes of Metabolic Syndrome among Patients with Acute Coronary Syndrome in the United Arab Emirates.","authors":"Abdulla Shehab,&nbsp;Bayan Al-Dabbagh,&nbsp;Wael Almahmeed,&nbsp;Nazar Bustani,&nbsp;Nicolaas Nagelkerke,&nbsp;Abdulla Alnaeemi,&nbsp;Alawi A Alsheikh-Ali","doi":"10.2174/1874192401206010081","DOIUrl":"https://doi.org/10.2174/1874192401206010081","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate clinical profiles, management and in-hospital outcomes of acute coronary syndrome (ACS) patients with metabolic syndrome (MetS) in the United Arab Emirates (UAE).</p><p><strong>Methods: </strong>MetS was defined according to the criteria for its diagnosis by the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI). Participants were admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 as part of the Gulf Registry of Acute Coronary Events (Gulf RACE) project. We compared baseline characteristics, treatment patterns, and in-hospital outcomes stratified by MetS status.</p><p><strong>Results: </strong>Of 1259 patients with ACS in the UAE (mean age: 52 ± 11 years, 88.8% males), the majority (n = 851, 67.6%) had MetS. MetS patients were more frequently males (86.4 vs 13.6%; P < 0.001). They were more obese (waist circumference and BMI, P < 0.001) as compared with non-MetS patients. MetS was more frequently associated with hypertension (51.1 vs 37.7%; P < 0.001) and diabetes mellitus (45.6 vs 24.3%; P < 0.001). After multivariate adjustment, certain MetS criteria rather than MetS itself were associated with higher in-hospital mortality and heart failure. Paradoxically, hypertension was associated with lower in-hospital mortality.</p><p><strong>Conclusions: </strong>Prevalence of MetS among patients with ACS in our study population was high. Certain MetS criteria were associated with higher in-hospital mortality and heart failure.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"81-7"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/bd/TOCMJ-6-81.PMC3414714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30830336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of psychobiological and neuroendocrine mechanisms in appetite regulation and obesity.","authors":"Ioanna Paspala,&nbsp;Niki Katsiki,&nbsp;Dorothea Kapoukranidou,&nbsp;Dimitri P Mikhailidis,&nbsp;Anna Tsiligiroglou-Fachantidou","doi":"10.2174/1874192401206010147","DOIUrl":"https://doi.org/10.2174/1874192401206010147","url":null,"abstract":"<p><p>Obesity is a multifactorial disease. Among its causes are physical inactivity and overeating. In addition, other factors may play an important role in the development of overweight/obesity. For example, certain hormones including leptin, insulin and ghrelin, may influence appetite and consequently body weight. Obesity frequently co-exists with metabolic disorders including dyslipidemia, hypertension and insulin resistance, thus constituting the metabolic syndrome which is characterized by increased cardiovascular risk. Lack of comprehensive knowledge on obesity-related issues makes both prevention and treatment difficult. This review considers the psychobiological and neuroendocrine mechanisms of appetite and food intake. Whether these factors, in terms of obesity prevention and treatment, will prove to be relevant in clinical practice (including reducing the cardiovas-cular risk associated with obesity) remains to be established.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"147-55"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/04/TOCMJ-6-147.PMC3549543.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender and Socio-economic Differences in Daily Smoking and Smoking Cessation Among Adult Residents in a Greek Rural Area.","authors":"Evangelia Birmpili,&nbsp;Niki Katsiki,&nbsp;Aseem Malhotra,&nbsp;Evelina Dimopoulou,&nbsp;Dimitri P Mikhailidis,&nbsp;Anna Tsiligiroglou-Fachantidou","doi":"10.2174/1874192401206010015","DOIUrl":"https://doi.org/10.2174/1874192401206010015","url":null,"abstract":"<p><p>Despite the well-known health risks, smoking is still highly prevalent worldwide. Greece has the highest level of adult smoking rate (40%) across the European Union. We investigated gender and socio-economic differences in daily smoking and smoking cessation among Greek adults. We conducted a cross-sectional survey between October and November 2009 in 434 adults residing in a Greek rural area. Data were collected with the use of the World Health Organization Global Adult Tobacco Survey (WHO GATS) Core Questionnaire. Respondents were classified into smokers (if they had smoked at least 100 cigarettes in their lifetime and continued to smoke) or non-smokers. Overall, 58.1% (n=252) were smokers (58.5% male, n=127 and 57.8% female, n=125); 51.2% (n=222) were younger than 18 years-old when they started smoking. Men tended to start smoking at a younger age, to smoke more cigarettes/day and to have smoked a greater average of cigarettes during the last 5 days. Overall, 82.5% of smokers attempted to stop smoking a year prior to the study, with women having a greater difficulty in quitting smoking. The main source of information on smoking was the mass media (73.5%) and books (53.7%), whereas doctors and other health professionals were the least listed source of relative information (27.7 and 8.1%, respectively). Smoking rates among Greek adults were high, but a considerable number of individuals who smoked, wished to quit and had attempted to do so. Smoking cessation clinics are not perceived as a valuable support in quitting effort.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"15-21"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/64/TOCMJ-6-15.PMC3308319.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30517476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft Tissue Attenuation Patterns Associated with Upright Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study.","authors":"Rami Doukky,&nbsp;Mouyyad Rahaby,&nbsp;Dave Chawla,&nbsp;Raj Vashistha,&nbsp;Tareq Alyousef,&nbsp;Amit P Amin","doi":"10.2174/1874192401206010022","DOIUrl":"https://doi.org/10.2174/1874192401206010022","url":null,"abstract":"<p><strong>Background: </strong>Little is known about soft tissue attenuation artifacts when an upright patient-position SPECTmyocardial perfusion imaging (MPI) system is used. In this investigation we sought to describe the patterns and frequency of attenuation artifacts associated with this type of instruments and we explored the impact of gender and body habitus on these artifacts.</p><p><strong>Methods: </strong>In a cross-sectional study, we described the prevalence of various soft-tissue attenuation patterns in 212 normal SPECT-MPI studies acquired with an upright patient-position imaging system.</p><p><strong>Results: </strong>In these 212 normal, clinically-indicated, upright-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (6.1%), inferior (63.7%) and lateral (24.1%). Though uncommon, anterior attenuation trended to being more prevalent among women [9.5% vs. 3.4%, P=0.07] and was independently associated with chest circumference. Lateral attenuation was more common among women [34.7% vs. 15.4%, p=0.001] and was strongly associated with obesity (p<0.001). Inferior attenuation was more prevalent among men than women (75.2% vs. 49.5% respectively, P<0.001).</p><p><strong>Conclusions: </strong>Soft-tissue attenuation artifacts are common in upright-acquisition SPECT-MPI. Recognizing the frequency of these attenuation patterns and their interaction with gender and body habitus is critical for the accurate interpretation of SPECT-MPI.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"22-7"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/e7/TOCMJ-6-22.PMC3308262.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30517477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a role for hypolipidaemic drug therapy in the prevention or treatment of microvascular complications of diabetes?","authors":"Eydoxia K Mitsiou,&nbsp;Vasilios G Athyros,&nbsp;Asterios Karagiannis,&nbsp;Dimitri I Mikhailidis","doi":"10.2174/1874192401206010028","DOIUrl":"https://doi.org/10.2174/1874192401206010028","url":null,"abstract":"A plethora of statin survival trials and meta-analyses have demonstrated a substantial reduction in cardiovascular disease (CVD) morbidity and mortality, mainly related to a low-density lipoprotein cholesterol (LDL-C) reduction [1]. One of them, the prospective, randomised, double-blind, secondary prevention Treating to New Targets (TNT, n = 10,001) trial, randomised patients to either 10 or 80 mg/day of atorvastatin. During a 5-year period the 10 mg/day patients had a rate of major CVD events of 10.9%, while those randomised to 80 mg/day had an 8.7% event rate. This was despite the concurrent and successful treatment of other CVD risk factors, the 22% (p&lt;0.001) CVD risk reduction compared with atorvastatin 10 mg/day, and the achievement of LDL-C levels of 77 mg/dl (well below those suggested by guidelines at that time) [2]. Similar were the data from the prespecified post hoc subgroup analysis of TNT that included patients (n = 1,401) with type 2 diabetes mellitus (T2DM) that had mild to moderate chronic kidney disease (CKD, a microvascular complication of DM) or normal renal function [3]. Compared with 10 mg of atorvastatin, 80 mg of atorvastatin reduced the relative risk (RR) of major CVD events by 35% (absolute event rate 21 vs 14%; hazard ratio (HR) = 0.65; 95% confidence interval (CI) = 0.43-0.98; p = 0.04) in those with CKD and by 10% in patients with T2DM and normal renal function (14.8 vs 14%; HR = 0.90; p = 0.56) [3]. In any case (with or without diabetic nephropathy) a residual CVD risk was present, as in all statin survival trials [1]. In the Steno-2 study, intensive multifactorial intervention in patients with T2DM during a 5-year follow-up, significantly reduced CVD events (HR = 0.47, 95% CI = 0.24-0.73, p = 0.008) and CVD mortality (HR = 0.43, 95% CI = 0.19-0.94, p = 0.04), but failed to prevent the development or the progression of microvascular complications of T2DM in up to 50% of patients [4, 5]. This contributed to a lesser reduction of CVD mortality or morbidity rates, and was recorded despite the effort to control glycaemia, blood pressure, body weight, smoking, physical activity, and LDL-C levels [4,5]. Thus, residual risk is related both to macrovascular complications connected to atherogenic dyslipidaemia [high triglycerides (TGs) and low high density lipoprotein cholesterol (HDL-C) levels, prevalent in DM] and to microvascular complications of T2DM, which contribute to the excess CVD and all cause morbidity and mortality [6-8]. \u0000 \u0000The gains in CVD prevention and treatment are being challenged by the impact of global epidemics of obesity, metabolic syndrome (MetS) and T2DM [9]. Recent data suggest a possible reversal in CVD mortality rates, especially in younger men and women [10, 11]. These trends have a negative impact on life expectancy (each year 4.3 million CVD deaths are reported in Europe [12]) and quality of life as well as on the cost of managing CVD, estimated in 2008 at about $450 billion per annum in the Unite","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"28-32"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/ff/TOCMJ-6-28.PMC3319909.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30557037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombospondin-1 in early flow-related remodeling of mesenteric arteries from young normotensive and spontaneously hypertensive rats.","authors":"P Lemkens,&nbsp;Gem Boari,&nbsp;Ge Fazzi,&nbsp;Gmj Janssen,&nbsp;Je Murphy-Ullrich,&nbsp;Pmh Schiffers,&nbsp;Jgr De Mey","doi":"10.2174/1874192401206010050","DOIUrl":"https://doi.org/10.2174/1874192401206010050","url":null,"abstract":"<p><p>We tested the hypotheses that TSP-1 participates in the initiation of remodeling of small muscular arteries in response to altered blood flow and that the N-terminal domain of TSP-1 (hepI) can reverse the pathological inward remodeling of resistance arteries from SHR.We measured (1) changes in gene/protein expression in MA of 6 week old WKY and SHR exposed to either increased (+ 100 %) or reduced blood flow (- 90 %) for 24-40 hours and (2) structural changes in MA of 12 week old SHR exposed for 3 days to hepI in organ culture.In both HF and LF of WKY, mRNA expression of eNOS, sGCα1 and PKG1β were significantly reduced (p < 0.05), whereas mRNA of TSP1 was markedly increased (p < 0.05). In MA of young SHR, similar results were obtained except that eNOS mRNA was not reduced in LF. Expression of TSP1 protein was significantly increased in LF of young WKY and SHR (p < 0.05). Exposure of MA of 12 week old SHR to hepI (1 µmol/L) resulted in a rapid lumen diameter increase (+ 12 ± 2% after 3 days) without alteration in vascular reactivity, distensibility, media surface area or cell number.These are the first observations of reduced gene expression of eNOS/sGC/PKG and increased expression of TSP1 at the initiation of arterial remodeling in young WKY and SHR, irrespective of its outward or inward outcome. Furthermore, a fragment of TSP-1 rapidly and directly reversed pathological inward arterial remodeling of SHR in vitro.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"50-9"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/94/TOCMJ-6-50.PMC3367304.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30669642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Clinical Presentation and Findings between Idiopathic Dilated and Ischaemic Cardiomyopathy in an Unselected Population of Heart Failure Patients.","authors":"Lilian Mantziari,&nbsp;Antonis Ziakas,&nbsp;Ioannis Ventoulis,&nbsp;Vasileios Kamperidis,&nbsp;Leonidas Lilis,&nbsp;Niki Katsiki,&nbsp;Savvato Karavasiliadou,&nbsp;Konstantinos Kiraklidis,&nbsp;Christodoulos Pliakos,&nbsp;Konstantinos Gemitzis,&nbsp;Haralambos Karvounis,&nbsp;Ioannis H Styliadis","doi":"10.2174/1874192401206010098","DOIUrl":"https://doi.org/10.2174/1874192401206010098","url":null,"abstract":"<p><p>We explored the differences in epidemiologic, clinical, laboratory and echocardiographic characteristics between idiopathic dilated (IDCM) and ischaemic cardiomyopathy (ICM).Consecutive patients with stable chronic heart failure evaluated at a tertiary cardiac centre were enrolled. Clinical examination, blood tests and echocardiographic study were performed. A total of 76 patients (43 IDCM, 33 ICM) were studied. IDCM patients were younger (p<0.001) and female gender was more prevalent (p=0.022). NYHA class and left ventricular ejection fraction were similar. IDCM patients had lower rates of dyslipidaemia (p<0.001) but smoked more than ICM patients (p=0.023) and had higher rates of family history of sudden cardiac death (p=0.048). Blood pressure was similar but resting heart rate was higher in IDCM patients (p=0.022). IDCM patients presented less frequently with peripheral oedema or ascites (p=0.046 and 0.020, respectively) and showed better right ventricular function on echocardiogram. QRS duration was similar between groups but only in IDCM patients there was a positive correlation between QRS duration and age (r=0.619, p<0.001). Cardiac output was similar but functional capacity assessed by the Duke Activity Status Index was better in IDCM (p=0.036). Despite these differences, IDCM and ICM patients received similar treatments. Patients with IDCM were younger, presented lower rates of right ventricular dysfunction and clinical right ventricular failure and had better functional capacity. Additional differences in clinical and laboratory findings exist pointing to a different patient population with diverse prognosis and potential need for individualized management.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"98-105"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874192401206010098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30926907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High prevalence and diminished awareness of overweight and obesity in a mediterranean population. An alarming call for action.","authors":"George Andrikopoulos,&nbsp;Dimitrios Richter,&nbsp;Dimitrios Sakellariou,&nbsp;Stylianos Tzeis,&nbsp;George Goumas,&nbsp;Panagiotis Kribas,&nbsp;Dimitrios Athanasias,&nbsp;Pavlos Toutouzas","doi":"10.2174/1874192401206010141","DOIUrl":"https://doi.org/10.2174/1874192401206010141","url":null,"abstract":"<p><strong>Introduction: </strong>The epidemic proportions of overweight, obesity and diabetes in most European countries stress the need for the implementation of an effective action plan for the prevention of cardiovascular (CV) disease. This ques-tionnaire study was designed to evaluate the viewpoint of the general population regarding the relative significance of CV risk factors in the cumulative risk of CV disease.</p><p><strong>Methods: </strong>All participants answered a questionnaire regarding the self-reported presence of CV disease risk factors and the perceived notion of having excess weight. They were also asked to list CV disease risk factors, ranking them in order of perceived relative significance. Participants were also subjected to total cholesterol measurement using a portable total cholesterol testing meter.</p><p><strong>Results: </strong>The survey population consisted of 32,736 individuals (49.1% males). According to participant self reporting, 32.9% were smokers, 24.7% had hypertension, 9.8% had diabetes, 74.8% reported having stress, 41.9% had insufficient physical activity and 43.3% had hyperlipidemia. The prevalence of overweight was 43.9% and the prevalence of obesity (BMI ≥30 kg/m(2)) was 18.6%. Only 24.4% of participants reported that they had excess weight. The 45.2% of the ques-tioned individuals considered that stress was the most important CV risk factor.</p><p><strong>Conclusions: </strong>Despite the high prevalence of overweight and obesity, the majority of participants were unaware of the contribution of these well-established risk factors to the occurrence of CV disease. Improving public awareness is impor-tant in order to control the epidemic proportions of these modifiable risk factors.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"141-6"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/1e/TOCMJ-6-141.PMC3514707.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31115284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension in elderly patients with diastolic dysfunction and preserved ejection fraction.","authors":"Majid Afshar,&nbsp;Fareed Collado,&nbsp;Rami Doukky","doi":"10.2174/1874192401206010001","DOIUrl":"https://doi.org/10.2174/1874192401206010001","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with diastolic dysfunction may have a disproportionate degree of elevation in pulmonary pressure, particularly in the elderly. Higher pulmonary vascular resistance in the elderly patients with heart failure but preserved ejection fraction suggests that beyond the post-capillary contribution of pulmonary venous congestion, a pre-capillary component of pulmonary arterial hypertension occurs. We aim to identify if pulmonary vascular resistance in elderly patients with diastolic dysfunction is disproportionately higher than patients with systolic dysfunction independent of filling pressures.</p><p><strong>Methods: </strong>389 patients identified retrospectively between 2003- 2010; elderly with preserved ejection fraction, elderly with depressed ejection fraction, and primary arterial hypertension who underwent right-heart catheterization at Rush University.</p><p><strong>Results: </strong>No significant difference in pulmonary vascular resistance between systolic and diastolic dysfunction. The mean difference in pulmonary vascular resistance was not statistically significant at 0.40 mmHg·min/l (95% CI -3.03 to 3.83) with similar left ventricular filling pressures with mean difference of 3.38 mmHg (95% CI, -1.27 to 8.02). When adjusted for filling pressures, there remained no difference in pulmonary vascular resistance for systolic and diastolic dysfunction. The mean pulmonary vascular resistance is more elevated in systolic heart failure compared to diastolic heart failure with means 3.13 mmHg·min/l and 3.52 mmHg·min/l, respectively.</p><p><strong>Conclusion: </strong>There was no other association identified for secondary pulmonary hypertension other than diastolic dysfunction and chronic venous pulmonary hypertension. Our results argue against any significant arterial remodeling that would lead to disproportionate pre-capillary hypertension, and implies that treatment should focus on lowering filling pressure rather than treating the pulmonary vascular tree.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"6 ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/d1/TOCMJ-6-1.PMC3263443.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30418447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}