Research: – 1
The Prevalence of Extra-cranial Carotid Artery Disease in Chronic Heart Failure
Background: The prevalence of carotid disease in patients with heart failure (HF) has not been described. This may be of importance for the implementation of novel interventions for heart failure that require surgery close to the carotid artery.
Objective: The aim of this study was to determine the prevalence of extra-cranial carotid artery stenosis (ECAS) in patients with HF.
Methods: The study population comprised consecutive, patients with chronic stable HF due to left ventricular systolic dysfunction (LVSD). Patients were invited to have an ultrasound duplex scan of the internal and common extra-cranial carotid arteries (ECA) and stenoses were classified as minor if <50%, moderate if 50-69% and severe if >70%.
Results: Of 102 patients, the median age was 73 (IQR: 66-78) years and 95 were men. Ten patients had moderate ECAS of whom one also had severe ECAS in the contra-lateral artery. Thirteen patients gave a prior history of stroke or transient ischaemic attack. Of patients with ECAS, only three (30%) had had a neurological event and only three (23%) of those with a neurological event had moderate or severe ECAS (95% CI; 6-55%). Most neurological events had occurred in patients without ECAS.
Conclusion: There is a moderately high prevalence of ECAS in patients with HF. However, most patients with chronic heart failure (CHF) who have had a neurological event do not have ECAS and most patients with ECAS do not have neurological symptoms. The value of screening for and management of ECAS in patients with HF remains to be established.
Research: – 2
Resveratrol Reduces C-reactive Protein and Cholesterol in Schizophrenia
Patients with schizophrenia (SZ) are generally found with overweight and obesity and several metabolic disorders. Additionally these patients have less life expectancy, with cardiovascular disease (CVD) the main cause of increased mortality in these patients. This is a case-report study of a male, 46 years old, with Diagnosis of SZ following a 1-month resveratrol supplementation program. In summary, we observed association of resveratrol supplementation (200 mg/day) with reduced C-reactive protein (CRP), and reduced cholesterol and triglycerides. The benefits included the improvement in Framingham score and mean reduction of 3% of risk of a heart attack over the next 10 years.
Research: – 3
Coronary Vasospasm Mimicking Acute Myocardial Infarction
Chest pain frightens many people into thinking that they might be having a heart attack. There are many causes of chest pain, few of which are life-threatening. One of the causes of chest pain is vasospasms, which is transient in nature and prolonged episodes can lead to tissue necrosis. Therefore, a prompt diagnosis and treatment is vital to the management. We are reporting a case of a young female presented with chest pain with no history of drug use, previous episodes, palpitations, and hypertension being her only risk factor found to have elevated Troponin I and was diagnosed with non-ST elevation myocardial infarction (NSTEMI), later found to have coronary vasospasm.
Research: – 4
A Possible Effect of Concentrated Oolong Tea Causing Transient Ischemic Attack-Like Symptoms
Aims: Tea (green, oolong, and black) is the second most widely consumed beverage worldwide, second only to water. Aside from a few reported adverse effects, tea, particularly green tea, appears to be beneficial for human health. In the case described herein, a male experienced several transient ischemic attack-like symptoms immediately following the consumption of a cup of high quality oolong tea. A thorough medical evaluation uncovered no evidence of such an attack and leads to the suggestion of a heretofore unreported response to oolong tea.
Presentation of Case: A 72-year old male with hypertension and atrial fibrillation, who takes valsartan/hydrochlorothiazide to control hypertension and warfarin to reduce the risk of thrombosis and thromboembolism, presented at the emergency room of a local hospital describing several transient ischemic attack-like symptoms immediately after consuming a cup of oolong tea. His symptoms included presyncope, disequilibrium, bilateral hand parathesias, mild dysphasia, and visual problems (but apparently not presbyopia or amaurosis fugax), all of which had disappeared in approximately two hours after drinking the tea. (Mild presyncope was previously noted by the patient when ingesting a strong green tea.) No unusual features emerged from his physical examination, and his blood work was unremarkable except for elevation of his partial thromboplastin time (39 sec) and prothrombin time (22.5 sec), giving an international reference of 2.0, all consistent with the effects of warfarin. A battery of tests by the emergency room physician, a cardiologist, and a neurologist, e.g. electrocardiogram, brain computerized tomography, 2-dimensional transthoracic echocardiogram, brain magnetic resonance imaging, with and without 20 ml Gadolinium, and a magnetic resonance angiogram, confirmed the earlier diagnosis of atrial fibrillation but disclosed no additional malfunction in his heart. His brain showed no evidence of a prior hemorrhage, and his carotid arteries were clear.
Methodology and Results: Analysis of the oolong tea by high performance liquid chromatography and mass spectrometry identified the major catechins and two methylxanthines, caffeine and theophylline, as well as other constituents, but there was no evidence of any extraneous chemicals that could lead to the symptoms.
Conclusion: In view of the rapid onset of symptoms after the consumption of oolong tea, bilateral as opposed to unilateral parathesis, and the absence of any evidence of a hemorrhage or the presence of impurities in the tea, we suggest that the transient ischemic attack-like symptoms could possibly be attributable to one or more components of the oolong tea and was not an atypical magnetic resonance imaging-negative transient ischemic attack.
Research: – 4
Size dependent effects of Gold Nanoparticles in ISO-induced Hyperthyroid Rats
In this study, we applied different sizes of gold nanoparticles (Au-NPs) to isoproterenol (ISO)-induced hyperthyroid heart disease rats (HHD rats). Single dose of 5, 40, 100 nm Au-NPs were injected intravenously. Cardiac safety tests were evaluated by cardiac marker enzymes in serum and cardiac accumulation of Au-NPs were measured by ICP-MS. Our results showed that size-dependent cardiac effects of Au-NPs in ISO-induced hyperthyroid rats. 5 nm Au-NPs had some cardiac protective effect but little accumulation in heart, probably due to smaller size Au-NPs can adapt to whole body easily in vivo. Histological analysis and TUNEL staining showed that Au-NPs can induce pathological alterations including cardiac fibrosis, apoptosis in control groups, however they can protect HHD groups from these harmful effects. Furthermore, transmission electron microscopy and western blotting employed on H9C2 cells showed that autophagy presented in Au-NPs treated cells and that Au-NPs can decrease LC3 II turning to LC3 I and decrease APG7 and caspase 12 in the process in HHD groups, while opposite effects on control groups were presented, which could be an adaptive inflammation reacts. As there are few animal studies about using nanoparticles in the treatment of heart disease, our in vivoand in vitro studies would provide valuable information before they can be considered for clinical use in general.