Cardiology and Angiology: An International Journal

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https://imsear.searo.who.int/handle/123456789/151218

ISSN: 2347-520X

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.sciencedomain.org/journal-home.php?id=26

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Now showing 1 - 20 of 344

The Adverse Effects of Wealth on Cardiovascular Health: A Scientific Statement of the International College of Cardiology.
(2013-01) Singh, R B; Hristova, K; Muthusamy, V V; Rastogi, S S; Basu, T K; Toda, E; Takahashi, T; Fedacko, J; Pella, D; Meester, F De; Wilson, D W; Mondal, R N; Ishaq, M; Mohideen, M R
Background and Aims: Increase in economic status may be associated with increased consumption of Western type of foods and sedentary behaviour. In the present review, we discuss that increase in wealth may be associated with adverse effects on health behaviour Study Design and Methods: Internet search and discussion with colleagues. Results: Review of studies indicate that with increase in wealth, there is increased consumption of high fat, ready prepared foods and decrease in physical activity in most of the countries resulting in obesity and metabolic syndrome, leading to cardiovascular diseases (CVDs) and other chronic conditions. Many experts during the United Nations High Level Meeting in Sept 2011, misinterpreted the WHO estimates and proposed that, of total deaths, 22·4 million arise in the poorest countries, and 13.7 million in high-income and upper-middle-income countries and therefore poverty may be the major cause of deaths due to non-communicable diseases (NCDs). A recent study shows that 57.0 % of deaths in adults (aged 25-64 years) were due to CVDs and other chronic diseases, 25.5% due to communicable diseases and 15.9% due to injury and accidents. The deaths due to NCDs were highly prevalent among higher social classes compared to lower social classes who had greater deaths due to communicable diseases. It is interesting to know from new data from United States, that there is ‘Wealth’ without cardiovascular health in America. The whole world is likely to have the same scenario in the near future. Conclusions: Increase in wealth may be associated with altered health behaviour; greater consumption of unhealthy foods, tobacco consumption, mental load and sedentary behaviour resulting in increased risk of deaths due to CVDs and other chronic diseases which may change with knowledge about health education. Wealth may cause extension in life by buying of expensive drug therapy, intervention and surgery which are known to add income and employment in the west.
Endothelial Progenitor Cells in Coronary Artery Disease: The 5-Year Experience at a Single Center.
(2013-01) Pelliccia, Francesco; Greco, Cesare; Franzoni, Ferdinando; Gaudio, Carlo
Endothelial progenitor cells (EPCs) are a heterologous population of bone marrowderived cells that play a key role in maintaining homeostasis of the endothelium, as they home to areas of endothelial injury, replace damaged endothelium, and participate in neovascularisation. The relationship between EPCs number and the severity of atherosclerosis is still a matter of debate. Abnormalities in EPCs have been associated with coronary artery disease, as experimental investigations have shown that a decrease in the endogenous pool of EPCs may accelerate the course of atherosclerosis, and the number of EPCs has been reported to be reduced in patients with atherosclerosis and in apparently healthy subjects without overt disease. On the opposite, other studies have found that the number of EPCs in the blood is increased in patients with angiographically significant coronary artery disease. The potential exists that EPCs constitute a therapeutic target, because persistent stimulation of EPCs by pharmacological intervention may, at least theoretically, repair endothelial injury and prevent the progression of atherosclerosis in patients at risk. Indeed, experimental and clinical studies have revealed that the number of EPCs can be increased by several pharmacological interventions such as hormones, statins, recombinant human EPO, and blockage of the angiotensin converting enzyme system. This review addresses the clinical correlates and prognostic significance of EPCs in a large cohort of patients with coronary artery disease that has been evaluated at a single Academic center in Italy.
Age Related Hemodynamic Blood Pressure Changes for Cardiovascular Disease and Stroke: A Mini-review.
(2013-01) Chrysant, Steven G; Chrysant, George S
The blood pressure (BP) changes with the advancement of age from the predominant diastolic BP (DBP) in the young to the predominant systolic BP (SBP) in the older person. This shift is due to the stiffening of the large arteries as a result of the ageing process and the replacement of the elastic fibers with collagen fibers resulting in the loss of compliance and the elastic recoil of these vessels. The end result is augmentation in pulse wave velocity (PWV) and widening of pulse pressure (PP). The SBP rises linearly with the advancement of age whereas, the DBP rises up to the age 50 years and begins to decline after the age of 60 years leading to a progressive increase in PP. These hemodynamic changes of BP are frequently associated with an increased incidence in cardiovascular disease (CVD) and strokes. Several studies have shown an inverse relationship between DBP and CVD, whereas no such a relationship has been demonstrated for stroke. However, recently, an inverse relationship has been reported between DBP and stroke for subjects 50 years of age or older. The implications of BP changes with age as they are related to CVD and strokes will be discussed in this mini review. It appears from these recent findings that in treating the hypertension in the elderly to reduce CVD and stroke, care should be taken not to allow the DBP to drop below 55-80 mmHg, since below this DBP level the incidence of CVD and strokes increase.
A Systematic Review and Meta-Analysis of the Incidence of Paravalvular Leak Incidence Post Procedure, Six Months and One-Year Following TAVI.
(2013-07) Sullivan, KE O; Gough, A; Early, S A; Barry, M; Segurado, R; D Sugrue; J Hurley
Aims: Paravalvular regurgitation (PVR) post transcatheter aortic valve implantation (TAVI) is associated with poor survival however considerable variability exists between incidences of PVR in current literature. The primary aim of this study was to establish the incidence of PVR post-procedure, at 6-months and 1-year following TAVI. The secondary aims of this study were to review the impact of moderate to severe PVR on mortality and examine strategies employed to reduce PVR. Methods: PubMed searches included articles detailing paravalvular leak rates post TAVI published between 2002 and 2013. A systematic review and meta-analysis of current literature to identify PVR incidence at three time points was performed using the random effects model of DerSimonian and Laird. A total of 19 studies were identified. For post procedure to 30 days, six months and one year; 7,652, 3,340 and 3,673 patients were included in the analysis of incidence of PVR. Results: The pooled analysis of PVR incidence was 8.21, 10.2 and 10.98% in each group respectively. Moderate-severe PVR is associated with an increased risk of mortality in all studies reviewed. Management strategies include balloon valvuloplasty, transcatheter aortic valve implantation-in-transcatheter aortic valve (TAVI-in-TAV), valve repositioning and the use of occlusion devices. Conclusion: Moderate-severe PVR occurs in approximately one in ten patients directly following TAVI and does not appear to change significantly in the first year. A number of feasible strategies can be employed to treat PVR. Consideration should be given to the development of early-intervention management algorithms for this patient cohort in order to improve survival post TAVI.
Telemonitoring Boosts Atrial Fibrillation Detection in Cryptogenic Stroke Patients – Preliminary Findings.
(2013-07) Simova, Iana; Mateev, Hristo; Katova, Tzvetana; Haralanov, Lyubomir; Dimitrov, Nikolay
Background: Approximately 25% of strokes are cryptogenic in origin and identifying atrial fibrillation (AF) as an etiologic factor in this situation has major therapeutic implication. Standard Holter ECG has a low sensitivity for AF detection in this patient group. Aim: To assess the diagnostic yield of prolonged ambulatory noninvasive ECG telemonitoring for AF detection in cryptogenic stroke or transitory ischemic attack (TIA) patients. Methods and Results: We prospectively included 36 patients (mean age 53 ± 15 years, 17% women) with cryptogenic stroke or TIA in the previous 3 months and without previously documented episodes of AF. We employed a validated ECG telemonitoring system (TEMEO). The median monitoring period was 22 days, ranging from 13 to 36 days. AF was detected in 10 patients (27%): in 7 patients (70%) AF episodes lasted <30 sec and in the other 3 episodes of absolute arrhythmia were longer. AF runs were asymptomatic in 6 of the patients with arrhythmia detection (60%). The mean time from initiation of telemonitoring to AF detection was 10 days, ranging from 2 to 29 days. Anticoagulation therapy for secondary prevention of stroke and systemic embolism was initiated in all of the patients with AF detected during telemonitoring. Conclusion: ECG telemonitoring after cryptogenic stroke or TIA results in AF detection in at least one in every four patients. Considering the important therapeutic implication of this finding we believe that prolonged ECG monitoring should become the standard of care in this patient group.
Prolactin Hormone and Cardiovascular System.
(2014-01) Mostafa, R M; Moustafa, K M; Mirghani, Z; Moustafa, Y M
The Prolactin (PRL) hormone, a very ancient hormone, first discovered by Oscar Riddle and his colleagues in the late 1920s, is a 199 amino acid multifunctional polypeptide hormone, that has been found in all vertebrates to influence more than 300 physiologic functions of the body. This review discusses the prolactin structure, mechanism of synthesis, control of secretions, receptors, its intracellular signal transduction and its possible implications on the cardiovascular system.
Non-pharmacological Prophylaxis of Venous Thromboembolism in Acutely Ill Medical Patients.
(2014-01) Masotti, Luca; Napoli, Mario Di; Lorenzini, Gianni; Godoy, Daniel Agustin; Cappelli, Roberto; Panigada, Grazia; Bettoni, Niccolò; Landini, Giancarlo
Venous thromboembolism (VTE) represents one of the leading causes of mortality and morbidity in acutely ill medical patients. VTE prophylaxis can be assured by pharmacological strategies and, when contraindicated, by non pharmacological measures, such as early mobilization, graduated compression stockings (GCS), intermittent pneumatic compression (IPC) or inferior vena caval filters. Literature evidence on non pharmacological VTE prophylaxis lacks and guidelines are not standardized for hospitalized ill medical patients. Much recently randomized clinical trials in patients with stroke and other medical diseases, seem to increase doubts and reduce certainties in this context. In this review we provide information about non pharmacological thromboprophylaxis in acutely hospitalized ill medical patients.
Cerebrovascular Diseases and Associated Risk Factors in WHO Eastern Mediterranean Countries.
(2014-01) Boutayeb, A; Derouich, M; Boutayeb, W; Lamlili, M E N
Background: In the WHO Eastern Mediterranean region, nearly one million deaths are caused by cardio-vascular diseases every year. During the last decade, the number of deaths caused by stroke increased by 23%. Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, alcohol, unhealthy diet, physical inactivity, and metabolic risk factors like obesity, high blood pressure, diabetes and raised lipids. Methods: This is a systematic review on cerebrovascular diseases and associated risk factors in WHO Eastern Mediterranean countries. Medline, Science Direct, and other sources were used to get peer reviewed papers dealing with the review theme. The search was limited to publications between 1990 and 2013 (30th June). Results and Discussion: According to the inclusion criteria, 45 papers were included in the present review. The prevalence was found greater than 50% in 38 studies for hypertension, greater than 25% in 36 studies for diabetes, greater than 15% in 26 studies for smoking and greater than 25% in 19 studies for dyslipidemia. It was also indicated that incidence of stroke increases with ageing. The majority of studies found a prevalence of stroke higher in men than in women with a ratio male: female reaching 3.55:1 in one study. Conclusion: Although at different levels of importance, all the studies reveal that hypertension, diabetes, dyslipidemia and smoking are crucial risk factors for stroke. This review also indicates a lack or scarcity of studies in many countries with an uneven contribution by country since 33% of studies are from Pakistan whereas North Africa (Egypt, Morocco, Libya, Tunisia) contributed with only 2 papers.
Are Biodegradable Third Generation Drug Eluting Stents the Answer to Instent Restenosis.
(2014-01) Amritphale, Amod; Amritphale, Nupur; Ahsan, Chowdhury H
The third generation biodegradable Drug Eluting Stent (DES) are being evaluated and being introduced in clinical practice. They have been DESigned to overcome limitations associated with durable polymer and a persistent metallic stent scaffold which could be related to late target lesion revascularization (TLR) and very late stent thrombosis (VLST). Although a recent pooled data analysis found that biodegradable polymer stents were superior for TLR and VLST compared with first generation Sirolimus Eluting Stent (SES), superiority has not been demonstrated against second generation Everolimus eluting stents (EES) and is yet to be conclusively proven in randomized trials. This paper reviews the key features, recent trial data, and future directions of the third generation of DES technology including stents with fully biodegradable scaffolds, stents with biodegradable polymer, and polymer free stents.
Coronary Anomalies: Understanding of Normal Coronary Artery Development for Insight in Treatment of Coronary Artery Disease.
(2014-01) Sidiqi, Ibrahim; David, Mourad; Cole, Daniel; David, Shukri
Coronary artery anomalies (CAA) are rare congenital abnormalities with incidence of about 1% in the general population.2Unfortunately, despite the low incidence, CAA can cause sudden cardiac death. Identifying the course of the artery is critical for appropriate management. We present a rare case of the left coronary artery arising from the right coronary ostium with special emphasis on normal coronary artery development as possible insight for treatment of diseased heart.
Evaluation of Arterial Pulse Amplitude Ratio and Valsalva Ratio in Different Age Groups.
(2014-04) AL-Shamma, Yesar M H; AL-Hamdany, Ahlam K A; AL-Mu’min, Amir S
Aims: To construct normal values of Valsalva ratio for heart rate responses during Valsalva maneuver (VM) and arterial pulse amplitude ratio as reference values for different age groups, and to investigate the effect of aging alone , without , the presence of risk factors, on autonomic nervous system. This is a case control study, performed in Marjan teaching hospital, in Hilla city, from February 2012 to June 2012. Methodology: 40 subjects were included in this study, all were healthy males, group 1 (G1) mean age 28.3±9.7 years, group 2 (G2) mean age 48.4±7.1 years. Strips of lead II of ECG were recorded during performance of VM for calculation R-R intervals and measurement of blood pressure during phase I and phase II by mercury sphygmomanometer. Calculation of Valsalva ratio for heart rate and arterial pulse amplitude ratio for both groups were done. Results: The systolic and diastolic blood pressures of G2 were significantly higher than values of systolic and diastolic blood pressures of G1 at phase I and phase II of VM (P=0.05). Pulse pressure for the two groups at phase I (G1:51±11, G2: 53±13mmHg) and phase II (G1:41±5, G2:41±3.99) of VM were not significant (P>0.05). Valsalva ratio for G1 was (1.5±0.3) and for G2 was (1.39±0.29), pulse amplitude ratio for G1 was (0.80±0.19) and for G2 was (0.77±0.19). There were no significant differences between the two groups (P>0.05). All values were expressed as mean±SD. Conclusions: The results showed that the autonomic nervous system is intact in the older group. The aging process, without the presence of risk factors, does not affect the autonomic nervous system.
Assessment of a Cardiac Rehabilitation Program Based on the Borg RPE Scale by Six-minute Walk Test: A Pilot Study.
(2014-04) Jelinek, Herbert F; Collins, Thomas; Smith, Megan; Kiat, Hosen
Aims: The ability of cardiac rehabilitation to reduce mortality in those with cardiovascular disease is well established. Despite its widespread use in the clinical setting, the Borg Rating of Perceived Exertion (RPE) scale is yet to be validated for its ability to lead to improvements in functional capacity. Study Design: A closed cohort pilot study. Place and Duration of Study: Department of Physiotherapy, Albury Base Hospital and School of Community Health, between November 2008 and November 2009. Methodology: Fifteen participants were assessed prior to and following completion of a cardiac rehabilitation program. Exercise was prescribed according to the Borg RPE scale. Pre and post Six-Minute Walk Test (6MWT) scores were obtained to determine the impact of the cardiac rehabilitation program. Results: Fifteen cardiac rehabilitation participants completed all requirements of the study after an initial enrolment of 22 patients. Wilcoxon signed-ranks test showed statistically significant improvements in 6MWT scores following participation in the cardiac rehabilitation program (p=.033) from a median value of 412 metres to 475 metres. Conclusion: In this pilot study, cardiac rehabilitation programs based on the Borg RPE scale may improvefunctional capacity measured by 6MWT during a 6-week period.
Cost-effectiveness Analysis of Interventions to Improve Control of High Blood Pressure in Low Resource Settings: The Case of Nigeria.
(2014-04) Ekwunife, Obinna I; Aguwa, Cletus N
Objectives: Prevalence of hypertension is on the rise in most African countries while control remains poor. In the literature, there are effective interventions which could be implemented in hospitals of low resource setting such as Nigeria to improve control of blood pressure. This study aimed to evaluate the cost-effectiveness of three of such interventions namely: self-monitoring; health professional led care; and organization driven care interventions. Methods: A Markov model was used to represent a life cycle of Nigerian hypertensive female patients in low risk of having a cardiovascular event. Health care costs were obtained from existing databases and calibrated to Nigerian setting or derived through a cost analysis using a Nigerian hospital. Costs were presented in 2013 US dollars value. Uncertainties in the input parameters used in the analyses were captured using distributions appropriate for each parameter. Probabilistic cost-effectiveness analysis was performed using Markov Chain Monte Carlo simulation, and presented as costeffectiveness acceptability frontiers. Population expected value of perfect information analysis was conducted. Results: Compared to null scenario (i.e. no intervention), professional led care intervention will require $190/QALY to emerge the most cost-effective option. The Population Expected Value of Perfect Information (EVPI) analysis showed that the opportunity cost surrounding the choice of professional led care intervention as the most cost-effective option does not amount to very much. Conclusions: The result of this study shows that among the interventions compared health professional led care through a pharmaceutical care model or nurse led care is the most cost-effective option for ensuring that patients with high blood pressure are adequately followed for better control of blood pressure.
Which Graft must be Preferred in Firearm Injury of the Axillary Artery.
(2014-04) Aşkın, Ender Topal
Aims: Interposition graft technique is used mostly in firearm wounds of axillary artery, because of excessive defect of the vessel. Autologous vein has been preferred in general application, even though there is a mild size discrepancy between native artery and autologous vein. However, in many series, prosthetic graft infection risk has been reported as low. Presentation of Case: I am presenting a patient with a gunshot wound to the right upper chest. As a first choice I preferred saphenous vein which was occluded by thrombosis at the post-repair third week in spite of anticoagulant therapy and was replaced with prosthetic graft which was patent at the eight month follow-up. Discussion: Although the theoretical risk of infection of prosthetic grafts, many previous reports have demonstrated that prosthetic grafts are nearly as safe as autologous grafts and they have high long-term patency rate. Conclusion: There is no point in insisting on autologous grafts in cases of the diameter discrepancy between native artery and autologous graft, prosthetic graft may be used more frequently in axillary artery trauma, and post-repair anticoagulants may be administered in the consequences of size discrepancy between the native artery and the graft.
Central Venous Catheter in Obese Patient May Even Cause Cor Pulmonale.
(2014-04) Topal, Aşkın Ender
Introduction: Sometimes the needless usage of central venous catheter, conflicting with indications, has been witnessed. Unfortunately, incidence of axillary-subclavian venous thrombosis has risen gradually because of increased use of the subclavian vein for central venous access. Furthermore obesity is common among patients with deep vein thrombosis, with a prevalence of 20-25%. Presentation of Case: I am presenting a 35-year old morbidly-obese woman with cor pulmonale resulting from post-catheterization thrombosis of jugular, axillary, subclavian veins, and superior vena cava. Discussion: Obese individuals have higher levels of factor VIII and factor IX. Obesity promotes deep vein thrombosis by inducing plasma viscosity and erythrocyte aggregation as well. Obesity causes, via leptin, increasing activity of coagulation cascade and decreasing fibrinolysis. Also it increases inflammation, oxidative stress and endothelial dysfunction. Obesity together with central venous catheter use may increase the risk for the development of deep vein thrombosis and subsequent cor pulmonale. Conclusion: Requirement of central venous catheter must be reconsidered before introducing, especially in an obese patient.
Tricuspid Valve Replacement in an Adult with Destroyed Tricuspid Valve and Refractory Right Heart Failure.
(2014-07) Ponangi, Udaya Prashant; Kaulkantla, Hemanth Kumar; Rao, Koneti Nageshwar; Kirshnam, Raju P; Soma, Raju B
22 year old woman with no previous heart disease history, presented with progressive worsening of right heart failure symptoms due to severe tricuspid valve regurgitation which had become refractory to medical management. Echocardiogram revealed probable rare case of dysplastic tricuspid valve with large calcified mobile masses attached to leaflets. Calcified masses were thought to be due to healed vegetations from silent infective endocarditis of abnormal tricuspid valve which she had suffered in the past. There were no known acquired causes of tricuspid valve endocarditis. She had successfully undergone tricuspid valve replacement with bio-prosthetic valve along with a right atrial reduction surgery after which her heart failure symptoms improved markedly.
β-blockers in Post ST Elevation Myocardial Infarction Patient with Low Left Ventricular Systolic Function: A Retrospective Study at Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
(2014-07) Adhikari, Chandra Mani; Rajbhandari, Sujeeb; Prajapati, Dipanker; Shrestha, Nagma; Baniya, Bibek; Bogati, Amrit; Gurung, Prakash; Thapaliya, Suman
Aims: Despite well developed guidelines in the management of ST elevation myocardial infarction with low left ventricular ejection fraction, β-blockers remain an underutilized therapy. We aim to assess the adherence of β-blocker use during the discharge in Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Study Design: Retrospective, Observational study. Place and Duration of Study: Department of cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Between January 2012 to December 2012. Methodology: Medical records of 160ST elevation myocardial infarction patients with left ventricular ejection fraction ≤40% and discharged from our centre were retrospectively reviewed regarding the use of β-blocker. Results: Among the 160 patients, 112 (70%) were males and 48 (30%) were females, mean age was 59.1±13.4 years. Anterior wall myocardial infarction followed by extensive anterior wall was the common in patient with low left ventricular ejection fraction after ST elevation myocardial infarction. Only in 67.5% patients β-blockers were prescribed. Metoprolol tartrate was the most commonly used β-blocker. Conclusion: β-blocker use in patients ST elevation myocardial infarction patients with low left ventricular ejection fraction in our study is comparable to international studies. We still need some more effort to improve our prescription rate.
Prevalence and Effects of Various Risk Factors Influencing the Blood Pressure Values.
(2014-07) Kaur, Jaspinder; Singh, Sargun; Kaur, Kawaljit
Aim: Hypertension is major cardiovascular risk factor contributing to all cause mortality. The present study was aimed to determine the impact of socio-demographic variables and risk factors on the blood pressures (BP) of the subjects. Place and Duration of the Study: A cross sectional study was conducted at Ex- Servicemen Contributory Health Scheme (ECHS) Polyclinic, Sultanpur Lodhi, Kapurthala, India from June to Oct, 2013. Methodology: All retired defense personnel and their family members (N= 351) who attended polyclinic during study period were recruited to assess physical activity, body mass index, dietary habits, alcohol, family history, sleep, stress, over the counter (OTC) medications, employment status, and education as determinants of BP. The results were analyzed by Chi Square test with statistically significance of P value <0.05. Results: The frequency of high BP as per JNC VII guidelines was observed as 47.90% with higher range in females (51.19%) than males (48.80%). The frequency significantly increased with age >50years (88.08%; P<0.001), unemployment status (76.19%; P<0.05) and low education levels (37.50%; P<0.05). An association of high BP with inadequate sleep (35.11%; P<0.05), sedentary lifestyle (63.69%), alcohol (26.78%), positive family history (36.30%), stress (20.83%), non-vegetarian dietary habits (44.64%), increased BMI (67.26%; P<0.05) and OTC medications misuse (15.47%) was found. Half of the subjects were diagnosed with high BP for more than five years (49.40%), two-third had controlled (67.26%) and compliant (69.64%) status, and more than two-third had awareness about their diagnosis of high BP (83.60%). The uncontrolled status, non-compliance towards treatment, and low awareness level regarding high blood pressure values was found among 32.73%, 30.35% and 08.19% of subjects, respectively. Conclusion: This rising frequency of high BP and its associated factors must be monitored, treated and controlled by appropriate preventive and therapeutic approaches including lifestyle modifications, Dietary Approach to Stop Hypertension, weight loss and maintenance, physical activity, stress management and pharmacotherapy.
Early Detection of Atherosclerosis in Primary School Children.
(2014-07) Nedog, Viljemka; Lobnik, Eva; Lobnik, Anja; Bevc, Sebastjan
Purpose: The aim of this study was to determine the correlations of age, sex, anthropometric measurements, pulse rate, blood pressure, and family history of cardiovascular disease with early atherosclerosis in children. Methods: Between December 2011 and January 2012 we included 112 children of primary school »Osnovna šola Bojana Ilicha Maribor«, whose parents consented and signed the inform consensus. We made a questionnaire about cardiovascular diseases in child's family. We measured blood pressure, pulse rate, body height, weight, waist circumference. We performed ultrasound measurement of carotid artery intima-media thickness (IMT). The data were processed using the SPSS statistical program. Results: Body mass index (BMI) (r=0.246; p<0.009), waist circumference (r=0.198; p<0.036) systolic (r=0.282; p<0.003) and diastolic blood pressure (r=0.282; p<0.003) were positively correlated with carotid artery IMT. In addition, those with family history of cardiovascular diseases had higher carotid artery IMT (p<0.0001) at baseline. A multivariable logistic regression analysis revealed that family history of cardiovascular disease was associated with carotid artery IMT (p<0.0001). Conclusion: Higher levels of BMI, waist circumference, and arterial blood pressure were correlated with higher carotid artery IMT in children. In addition, the presence of family history of cardiovascular disease was independently associated with carotid artery IMT in children.
Aortic Pathologies and Pregnancy: A Special Focus on Connective Tissue Disorders.
(2014-07) Bara, Petrit; Gjyli, Lidra; Gega, Marsela; Belshi, Xhina; Vyshka, Gentian
Pregnancy represents a physiological status which, due to clear and typical hormonal and hemodynamic changes, is frequently accompanied by a high morbidity of aortic structures, in all of its segments. Such morbidity might become patent when a pregestational situation exists, especially with the mother suffering from connective tissue disorders. Nevertheless, morbid occurrences that will be met only during pregnancy are well known, with particular pathophysiological and etiological theories, as well as a diversity of treatments proposed in such an unusual setting. The authors discuss the main pathologies of aorta that are seen during pregnancy, from a theoretical point of view, and from a historical perspective as well. A special focus is made to the connective tissue disorders, and the theoretical considerations are illustrated with images of dissecting aneurysms of aorta.

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