bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermodynamic Parameters Governing the Self‐Assembly of Head–Head–Head Lanthanide Bimetallic Helicates
Authors: Jensen Thomas B. , Scopelliti Rosario , Bünzli Jean‐Claude G. 
Published: June 2007

AbstractThe heterobitopic ligands LABX (X=1, 2, 3, 4 or 5), differing only by a Cl or NEt2 substituent, have been designed to complex with a pair of lanthanide ions to form triple‐stranded bimetallic helicates of overall composition [Ln2(LABX)3]6+. The percentage of HHH (head–head–head) isomer, in which each of the three ligand strands coordinates to the same lanthanide ion with the same coordination unit, is deciding the ability of the ligands to selectively form heterobimetallic complexes containing one luminescent and one magnetic or two different luminescent ions. It deviates significantly from the statistical value of 25 % and ranges from 6–20 % for LAB2 complexes to 93–96 % for LAB4 complexes. The equilibrium between HHT (head–head–tail) and HHH isomers has been investigated in detail for homobimetallic helicates (Ln=Y, La, Ce, Pr, Nd, Sm, Eu, Lu) by means of variable temperature NMR and thermodynamic parameters have been determined. The equilibrium is characterized by small values of ΔH and ΔS, which vary in opposite direction along the lanthanide series for complexes with the same ligand in a way that keeps the value of ΔG almost constant. The results are interpreted in terms of differences in interstrand stacking, ion–dipole interactions and metal–metal repulsion.
A Fluorescent Polymeric Heparin Sensor
Authors: Sun Wei , Bandmann Heinz , Schrader Thomas 
Published: June 2007

AbstractLinear copolymers have been developed which carry binding sites tailored for sulfated sugars. All binding monomers are based on the methacrylamide skeleton and ensure statistical radical copolymerization. They are decorated with o‐aminomethylphenylboronates for covalent ester formation and/or alkylammonium ions for noncovalent Coulomb attraction. Alcohol sidechains maintain a high water solubility; a dansyl monomer was constructed as a fluorescence label. Statistical copolymerization of comonomer mixtures with optimized ratios was started by AIBN (AIBN=2,2′‐azoisobutyronitrile) and furnished water‐soluble comonomers with an exceptionally high affinity for glucosaminoglucans. Heparin can be quantitatively detected with an unprecedented 30 nM sensitivity, and a neutral polymer without any ammonium cation is still able to bind the target with almost micromolar affinity. From this unexpected result, we propose a new binding scheme between the boronate and a sulfated ethylene glycol or aminoethanol unit. Although the mechanism of heparin binding involves covalent boronate ester formation, it can be completely reversed by protamine addition, similar to heparin's complex formation with antithrombin III.
Preventive therapy in patients with insignificantly narrowed coronary arteries: Evaluation of physician attitude and practice
Authors: Henkin Yaakov , Abuful Akram , Yosefi Chaim , Elis Avishay , Ilia Reuven , Gidron Yori 
Published: June 2007

AbstractBackground: Although the outcome of patients with angiographically insignificantly narrowed coronary arteries (INCA) is not clearly defined, such lesions can progress or rupture, thus causing cardiovascular morbidity. Preventive therapy with aspirin and lipid‐lowering drugs therefore seems warranted in these patients.Hypothesis: The study was undertaken to evaluate the attitude and practice of physicians toward the provision of preventive treatment to patients with INCA.Methods: The attitude of physicians was evaluated using written case histories of three patients with identical clinical features but different angiographic diagnoses. We then examined randomly chosen files of 130 patients with angiographically normal coronary arteries, 130 patients with INCA, and 130 patients with significant coronary artery disease, in relation to the use of lipid‐lowering medications and achieved lipoprotein levels.Results: For the hypothetical patients, more physicians prescribed statins (78 vs. 47%, p < 0.0001) and aspirin (89 vs. 74%, p < 0.003) for patients with significant disease than they did for those with INCA. A target low‐density lipoprotein (LDL) cholesterol of < 100 mg/dl was considered appropriate for significant disease by 85% of physicians compared with 40% for INCA (p < 0.0001). In the real patients, more of those with significant disease received lipid‐lowering drugs and achieved the LDL target level than did those with INCA.Conclusions: Many physicians regard the need to prescribe preventive treatment as less important for patients with INCA than for patients with significant coronary disease. Additional long‐term studies are warranted to elucidate the prognostic significance of INCA and the efficacy of preventive therapy in these patients.
Hemodynamic and tissue oxygenation responses to exercise and beta‐adrenergic blockade in patients with hyperthyroidism
Authors: Monachini Maristela C. , Lage Silvia G. , Rati Miguel A. N. , Cardoso Rita H. A. , Medeiros Caio , Caramelli Bruno , Sposito Andrei C. , Ramires José A. F. 
Published: June 2007

AbstractBackground: Exercise‐induced dyspnea is a frequent feature in patients with hyperthyroidism.Hypothesis: Data from clinical studies to elucidate the origin of this symptom are lacking. In the current study, we examined the hemodynamic and oxygenation responses to exercise and beta‐adrenergic blockade in patients with hyperthyroidism and their relationship with dyspnea.Methods: Hemodynamic studies were performed under resting conditions and after isotonic exercise in 15 patients with hyperthyroidism and 11 control subjects. Exercise was applied using a bicycle ergometer, with progressive loads. In the hyperthyroid group, measurements were repeated at rest and during supine exercise after administering 15 mg of intravenous metoprolol.Results: End‐diastolic pulmonary artery pressure and cardiac index were higher in the hyperthyroid group than in controls (18.6 ± 5.3 vs. 11.2 ± 4.9 mmHg; p = 0.02, and 6.0 ± 1.7 vs. 2.8 ± 0.5 1/min/m2; p = 0.0001, respectively). After exercise, there was an increase in end‐diastolic pulmonary artery pressure in the hyperthyroid group (18.6 ± 5.3 to 25.5 ± 9.9 mmHg; p = 0.02), revealing impaired cardiocirculatory reserve. Pulmonary arteriolar resistance increased significantly in parallel with end‐diastolic pulmonary artery pressure after drug administration, suggesting an inadequate cardiovascular response after beta blockade in patients with hyperthyroidism.Conclusion: We observed that functional left ventricular reserve is impaired in patients with hyperthyroidism, suggesting an explanation for the frequent symptom of dyspnea and impaired exercise tolerance. Moreover, we also suggest that beta‐adrenergic blockade may adversely affect cardiovascular function in patients with hyperthyroidism.
Transthoracic echocardiography for precardioversion screening during atrial flutter/fibrillation in young patients
Authors: Horenstein M. Silvana , Karpawich Peter P. , Epstein Michael L. , Singh Tajinder P. 
Published: June 2007

AbstractBackground: Transthoracic echocardiography (TTE) is reliable for detection of thrombi in the left ventricle and right atrium, but not in the left atrial appendage. Therefore, transesophageal echocardiography (TEE) is routinely performed in adults prior to electric cardioversion for atrial flutter/fibrillation (AFF). Whetheryoung survivors of congenital heart disease repair with AFF need routine TEE prior to electric cardioversion is unknown.Hypothesis: Electric cardioversion for AFF is safe in survivors of congenital heart disease repair/palliation if an intracardiac thrombus is not suspected on TTE imaging.Methods: This study reports the outcome of patients in a pediatric tertiary care cardiac unit where electric cardioversion was performed if no intracardiac thrombus was suspected on TTE. We performed a retrospective chart review of all patients treated with electric cardioversion for AFF at Children's Hospital of Michigan during 1997‐2002.Results: Of 35 patients who presented with 110 episodes of AFF requiring electric cardioversion during the study duration, 32 (age 3 months‐49 years, median age 20.5 years, 104 AFF episodes) had previously undergone palliative surgery or repair of their congenital heart disease. Of these 32 patients, 18 were survivors of a Fontan palliation (for a single‐ventricle variant) and the remaining 14 were survivors of other defects and repairs (septal defects, valve replacements, and tetralogy of Fallot). During 81% of the episodes, patients were receiving aspirin, warfarin, or heparin for anticoagulation at presentation. Transthoracic echocardiography was performed in 74 AFF episodes; of these, 10 TTE studies were suspicious for atrial thrombi. Transesophageal echocardiography confirmed the presence of athrombus in 3 of these 10 patients. These patients received warfarin for 2 weeks and then underwent electric cardioversion. No thromboembolic events occurred immediately after or on follow‐up in any patient.Conclusions: These findings suggest that TTE may be an effective imaging tool for precardioversion screening in young patients with AFF.
Endothelial dysfunction in patients with exaggerated blood pressure response during treadmill test
Authors: Chang Hyuk‐Jae , Chung Jaehoon , Choi So‐Yeon , Yoon Myeong‐Ho , Hwang Gyo‐Seung , Shin Joon‐Han , Tahk Seung‐Jea , Choi Byung‐Il William 
Published: June 2007

AbstractBackground: The diagnostic and prognostic importance of exaggerated blood pressure response to exercise is controversial. Endothelial dysfunction has been demonstrated in patients with atherosclerosis and risk factors for coronary artery disease, but there is a paucity of information on patients with exercise‐induced hypertension.Hypothesis: We designed the study to evaluate endothelial function in patients with exaggerated blood pressure response during exercise.Methods: Exercise‐induced hypertension was defined as systolic blood pressure ≥ 210 mmHg in men and ≥ 190 mmHg in women during the treadmill test. Using a high‐resolution ultrasound technique, endothelial function of the brachial artery in patients with exercise‐induced hypertension (n = 25) and control subjects (n= 25) was investigated.Results: Endothelium‐dependent vasodilation was impaired in patients with exercise‐induced hypertension compared with controls (7.77 ± 5.14 vs. 2.81 ± 2.29%, p < 0.05). Onunivariate analysis, the extent of vasodilation correlated negatively with age (r = ‐0.43, p<0.05) and Δ systolic blood pressure (r = ‐0.39, p < 0.05). Even after adjustment for factors known to affect endothelial function, endothelium‐dependent vasodilation was decreased in patients with exercise‐induced hypertension (β = 5.375, p = 0.02).Conclusion: Patients with exercise‐induced hypertension have impaired endothelium‐dependent vasodilation. This study also supports the concept that endothelial dysfunction may play an important role in exercise‐induced hypertension.
Thrombus aspiration prior to primary angioplasty in acute myocardial infarction: Estimation of rescued myocardial tissue by return of ST‐segment elevation
Authors: Hofmann Robert , Kypta Alexander , Kerschner Klaus , Grund Michael , Steinwender Clemens , Leisch Franz 
Published: June 2007

AbstractBackground: The goal of the study was to validate the clinical benefit of adjunctive thrombus aspiration prior to balloon or stent angioplasty in patients with acute myocardial infarction.Hypothesis: Adjunctive thrombus aspiration reduces no‐reflow by eliminating peripheral thromboembolism.Methods: In all, 143 consecutive patients underwent primary angioplasty for acute myocardial infarction in our institution. We excluded patients with subacute stent thrombosis or bundle‐branch pattern of the electrocardiogram (ECG) and divided the remaining 131 into two groups: 62 patients who underwent intervention without a thrombus aspiration device (Group 1) and 69 patients who were treated as soon as a specifically designed thrombus aspiration catheter became available at our institution (Group 2). The intention was to use thrombus aspiration in every suitable case with proximal occlusion of a major vessel. The reduction of the sum of ST‐segment elevation following angioplasty as a marker of rescued myocardial tissue was compared between the two groups.Results: Thrombus aspiration was technically feasible in 23 of 25 attempted cases. The reduction of the sum of ST‐segment elevation following intervention was 0.41 ± 0.39 mV in Group 1 and 0.37 ± 0.42 mV in Group 2 (p > 0.05).Conclusions: Thrombus aspiration may be helpful during primary angioplasty in selected cases but does not improve the general outcome. Other reasons for “no‐reflow,” apart from peripheral thromboembolism, seem to be responsible for the lack of clinical benefit.
Concise review of atrial fibrillation: Treatment update considerations in light of AFFIRM and RACE
Authors: Bloom Heather L. 
Published: June 2007

AbstractAtrial fibrillation (AF) is the most common clinically significant arrhythmia seen by clinicians. Prevalence is as high as 9.0% in patients aged ≥ 80 years, and incidence is projected to be more than 5.6 million patients in the U.S. by 2050. Recently, new trials have challenged the traditional belief that rhythm control is inherently superior to rate control in these patients. This article reviews the basic tenets of treatment for AF and discusses how new trial data integrate into these protocols. A concise treatment algorithm is provided and new and upcoming more aggressive interventional treatment options are discussed. This review is designed to help the general practitioner decide how to treat patients in the outpatient setting, evaluate which patients should be hospitalized for management, and which patients should be referred to a cardiologist.
Peripheral levels of matrix metalloproteinase‐9, interleukin‐6, and C‐reactive protein are elevated in patients with acute coronary syndromes: Correlations with serum troponin I
Authors: Manginas Athanassios , Bei Evgenia , Chaidaroglou Antigoni , Degiannis Dimitrios , Koniavitou Katerina , Voudris Vassilis , Pavlides Gregory , Panagiotakos Demosthenis , Cokkinos Dennis V. 
Published: June 2007

AbstractBackground: Acute coronary syndromes (ACS) are characterized by activation of systemic and local inflammatory mediators. The interrelation between these soluble inflammatory markers and their association with markers of myocardial necrosis have not been extensively studied.Hypothesis: The study was undertaken to evaluate the association of the systemic levels of matrix metalloproteinase‐9 (MMP‐9) and the tissue inhibitor of metalloproteinase‐1 (TIMP‐1), with C‐reactive protein (CRP), interleukin‐6 (IL‐6), and serum troponin‐I in patients admitted with ACS.Methods: Analysis of serum concentrations of the above inflammatory markers was performed in 53 patients with unstable angina (UA) and in 15 with non‐ST‐segment elevation myocardial infarction (NSTEMI) within 48 h of admission, and 34 patients with stable coronary artery disease.Results: Compared with patients with stable angina, those with ACS had elevated admission levels of MMP‐9 (p = 0.04), CRP (p< 0.001), and IL‐6 (p = 0.001), but not TIMP‐1 (p = 0.55). Compared with patients with UA, those with NSTEMI also had higher levels of IL‐6 (p< 0.001), CRP (p = 0.002), and MMP‐9 (p = 0.05).Conclusions: In patients with ACS, the admission levels of inflammatory mediators, including MMP‐9, CRP, and IL‐6 are significantly elevated, specifically in association with serum troponin I. Systemic and local markers of inflammatory activity may be directly associated with myocardial injury.
Combination niacin and statin therapy in primary and secondary prevention of cardiovascular disease
Authors: Levy Deborah R. , Pearson Thomas A. 
Published: June 2007

AbstractStatin monotherapy may not be sufficient to reach serum lipid goals in many patients, especially in those with combined lipid abnormalities. Statins cause only a modest increase in high‐density lipoprotein cholesterol (HDL)—an established independent protective factor for coronary heart disease (CHD)—and a modest decrease in triglycerides (TG). Niacin is an effective pharmacologic agent for increasing HDL, as well as lowering TG. Used in combination with a statin, niacin provides an option to help patients attain their low‐density lipoprotein cholesterol (LDL‐C) goals, non‐HDL goals, and HDL goals. Based on the National Health and Nutrition Examination Survey, 1999 to 2000, only 12% of the surveyed adult population were under treatment for diagnosed hypercholesterolemia. Furthermore, only 5.4% of the surveyed population had attained goal total cholesterol levels of <5.2 mmol/l (< 200 mg/dl). Combination therapy offers a means to get more people to goal. This paper reviews the impact of lipid‐modifying combination therapy with niacin plus a statin on lipid profile outcomes.
The significance of elevated troponin T in patients with nondialysis‐dependent renal insufficiency: A validation with coronary angiography
Authors: Heitner John F. , Curtis Jeptha P. , Haq Salman A. , Corey G. Ralph , Newby L. Kristin , Jollis James G. 
Published: June 2007

AbstractBackground: Patients with elevated troponin are at high risk of adverse outcomes, future cardiac events, and are more likely to have hemodynamically significant coronary artery stenoses. Elevated troponin T (cTnT) in patients with poor renal function portends a poor prognosis; however, findings of significant coronary artery disease (CAD) by coronary angiography have not been demonstrated in patients with poor renal function and elevated cTnT.Hypothesis: The purpose of this study was to correlate the angiographic findings of patients with elevated cTnT with respect to renal function in patients with nondialysis‐dependent renal insufficiency.Methods: We retrospectively identified 342 patients with elevated cTnT who underwent coronary angiography in the setting of acute coronary syndrome. Patients were divided into poor (< 40 ml/min) and normal (> 40 ml/min) renal function by measuring their glomerular filtration rate. Our primary outcome was CAD stenosis, defined as epicardial stenosis ≥ 70%. Secondary outcomes were rates of contrast nephropathy, initiation of hemodialysis, revascularization, length of stay (LOS), and in‐hospital mortality.Results: There was no significant difference in the prevalence of CAD between patients who had positive cTnT with poor renal function versus patients with positive cTnT and normal renal function (87.1 vs. 89.7%, p = 0.54). This finding persisted after stratifying by age. Patients with impaired renal function had a higher mortality, longer LOS, and a higher rate contrast nephropathy requiring hemodialysis.Conclusion: The association between elevated cTnT and significant CAD stenosis does not vary with renal function.
Peripheral edema due to heart disease: Diagnosis and outcome
Authors: Shah Maulik G. , Cho Shaun , Atwood J. Edwin , Heidenreich Paul A. 
Published: June 2007

AbstractBackground: The purpose of this study was to determine whether baseline physical examination and history are useful in identifying patients with cardiac edema as defined by echocardiography, and to compare survival for patients with cardiac and noncardiac causes of edema.Hypothesis: Physical examination and history data can help to identify patients with edema who have significant cardiac disease.Methods: We reviewed the medical records of 278 consecutive patients undergoing echocardiography for evaluation of peripheral edema. We classified cardiac edema as the presence of any of the following: left ventricular ejection fraction <45%, systolic pulmonary artery pressure >45 mmHg, reduced right ventricular function, enlarged right ventricle, and a dilated inferior vena cava.Results: The mean age of the 243 included patients was 67 ±12 years and 92% were male. A cardiac cause of edema was found in 56 (23%). Independent predictors of a cardiac cause of edema included chronic obstructive pulmonary disease (COPD, odds ratio [OR] 1.74, 95% confidence interval [CI] 1.14–2.60) and crackles (OR 1.98, 95% CI 1.26–3.10). The specificity for a cardiac cause of edema was high (91% for COPD, 93% for crackles); however, the sensitivity was quite low (27% for COPD, for 24% crackles). Compared with patients without a cardiac cause of edema, those with a cardiac cause had increased mortality (25 vs. 8% at 2 years, p < 0.01), even after adjustment for other characteristics (hazard ratio 1.55, 95% CI 1.08–2.24).Conclusions: A cardiac cause of edema is difficult to predict based on history and examination and is associated with high mortality.
Aspirin resistance, an emerging, often overlooked, factor in the management of patients with coronary artery disease
Authors: Makaryus Amgad N. 
Published: June 2007

AbstractAspirin is the most widely used medication in patients with cardiovascular disease. It has had a greater effect on patients with cardiovascular disease than any other drug. With the importance of aspirin now known for decades, it is recently becoming clearer that some patients do not derive as great a benefit from this “wonder drug” secondary to their resistance to its effects. Aspirin resistance, its prevalence, its identification, and how to overcome or avert it with other medications then becomes a central topic of discussion as important, if not more so, than the importance of aspirin itself as a cornerstone in the treatment of patients with cardiovascular disease. This review explores the current understanding of the mechanism of aspirin resistance with regard to its prevalence and the magnitude of its clinical significance. It also examines the therapeutic implications of a diagnosis of aspirin resistance.
The cardiovascular patient's perceptions of complementary and alternative medicine
Authors: Krasuski Richard A. , Michaelis Kyle , Eckart Robert E. 
Published: June 2007

AbstractBackground: Complementary and alternative medicine (CAM) use is common among patients with cardiovascular disorders and is generally underrecognized by physicians. The attitudes of these patients regarding these therapies and their perceptions of safety and efficacy have not been well defined.Methods: A written survey was received from a cohort of outpatients seen at a large outpatient cardiovascular clinic in Texas. Over 75% of patients responded, with more than 90% of returned surveys adequate for analysis.Results: Of the 210 respondents 113 admitted to CAM use, with Vitamins E and C being the most frequently utilized agents. Women were significantly more likely to take CAM than men (69 vs. 46%, p = 0.002), particularly those taking hormone replacement therapy. Over half of patients surveyed stated their cardiologist was unaware of their use of CAM. Only 15% of patients felt that CAM was more efficacious than their traditional medications, but almost half felt it was significantly safer. A similar number were unaware of any interactions between CAM and their other medications.Conclusions: Use of CAM is common in cardiology outpatients, and many patients remain unaware of potential health risks. Physicians should routinely question patients about use of CAM and attempt to educate users regarding potential health risks.