bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain Ischemia Following Bilateral Carotid Occlusion During Development of Hypertension in Young Spontaneously Hypertensive Rats—Importance of Morphologic Changes of the Arteries of the Circle of Willis
Authors: Kusuda Kenji , Ibayashi Setsuro , Sadoshima Seizo , Ishitsuka Takao , Fujishima Masatoshi 
Published: July 2008

The present study was designed to examine the effect of morphologic changes of the arteries of the circle of Willis on cerebral blood flow (CBF) and metabolism in young spontaneously hypertensive rats (SHR). CBF in the parietal cortex was measured by the hydrogen clearance method before and during a one-hour bilateral carotid artery occlusion (BCO), and supratentorial brain metabolites were determined by standard enzymatic methods at a one-hour BCO. The internal diameters of the main arteries of the circle of Willis were estimated morphologically. With increase in age, systemic arterial pressure at rest was significantly raised, while cortical CBF tended to decrease and calculated cerebral vascular resistance increased. During BCO, CBF and supratentorial metabolism (adenosine triphosphate and lactate/pyruvate ratio) tended to be better preserved in two-month-old rats as compared with those in one- or three-month-old rats. The internal diameter of the posterior commu nicating artery (PcomA) was significantly smaller in the one-month-old group than in the other groups, while the diameter of the internal carotid artery was significantly smaller in rats aged three months than those in rats aged one or two months. It is indicated that cortical CBF reduction and impairment of supratentorial metabo lism following occlusion of carotid arteries, at least in part, depend on the morphologic changes of the arteries of the circle of Willis associated with age and development of hypertension in young SHR.
Prevalence and Correlates of Symptomatic Peripheral Atherosclerosis in Individuals with Coronary Heart Disease and Cholesterol Levels Less Than 240 mg/dL: Baseline Results from the Cholesterol And Recurrent Events (CARE) Study
Authors: Wilt Timothy J. , Davis Barry R. , Meyers David G. , Rouleau Jean-Lucien , Sacks Frank M. 
Published: July 2008

Purpose: To determine the prevalence and correlates of symptomatic peripheral athero sclerosis in individuals with a history of myocardial infarction (MI) and cholesterol levels lower than 240 mg/dL. Materials and Methods: A cross-sectional analysis was conducted at baseline of 4159 participants in the Cholesterol and Recurrent Events (CARE) Study. Symptomatic diffuse atherosclerosis was defined as a history of MI plus lower extremity or cerebrovascular atherosclerosis or claudication by Rose questionnaire. Results: The prevalence of symptomatic diffuse atherosclerosis was 12.9%; 353 partici pants (8.5%) had lower extremity disease and 219 (5.3%) had cerebrovascular disease. After controlling for other variables, diffuse atherosclerosis was associated with age (Odds Ratio [OR] = 1.44 per ten-year increase), systolic blood pressure (OR=1.13 per 10 mm Hg increase), a history of multiple myocardial infarctions (OR= 1.76), diabetes (OR=1.76), hypertension (OR=1.38), reduced exercise performance (OR=1.55), current smoking status (OR=2.87), and lower alcohol intake (OR=0.97 per drink per week). There was no association with race, gender, or lipid levels. Conclusions: The presence of clinically evident diffuse atherosclerosis is common and is associated with several modifiable risk factors. Early identification of these individuals could affect treatment and clinical outcomes.
Effects of Verapamil and Magnesium Sulfate on Electrophysiologic Changes During Acute Myocardial Ischemia and Following Reperfusion in Dogs: Comparative Effects of Administration by Intravenous and Coronary Sinus Retroperfusion Routes
Authors: Yamamoto Katsuhito , Bando Shigenobu 
Published: July 2008

The authors evaluated the effects of verapamil (Ve) and magnesium sulfate (Mg) on the electrophysiologic changes induced in dogs during acute myocardial ischemia and following reperfusion. The effects of their intravenous (IV) administration and adminis tration by coronary sinus retroperfusion (CSR) were also compared. Sixty-five dogs were divided into five groups : Ve-IV: 9 dogs, 0.1 mg/kg; Ve-CS: 9 dogs, 0.05 mg/kg; Mg-IV: 12 dogs, 20 mg/kg; Mg-CS: 11 dogs, 10 mg/kg, control: 24 dogs. The left anterior descending coronary artery was ligated for ten minutes, then quickly reopened. The changes in ventricular effective refractory period (ERP) and intramyocardial conduction time (ICT) were determined during ischemia and following reperfusion. The authors observed a shortening of the ERP and a prolongation of the ICT in the control group versus an attenuation of those effects in all other groups. The ERP was shortened to a lesser extent in the Mg-IV group than in the Ve-IV group. Drug adminis tration by CSR inhibited the changes in ERP and ICT to a greater extent than IV admin istration, even though the dose given by CSR was one-half the IV dose. Ventricular fibril lation (Vf) occurred in 12 of 24 dogs (50%) in the control group during ischemia, and in 5 of 12 dogs (41.7%) following reperfusion. Vf occurred during ischemia and following reperfusion, respectively, in 22.2% and 0% in the Ve-IV and Ve-CS groups, in 25% and 22.2% in the Mg-IV group, and in 9.1% and 10% in the Mg-CS group. Thus, verapamil and magnesium sulfate inhibited the electrophysiologic changes and prevented ventric ular arrhythmias during myocardial ischemia and following reperfusion. Administering the antiarrhythmic agent by coronary sinus retroperfusion may be useful for treating patients with acute myocardial infarction with intractable arrhyth mias, according to these experimental results.
White-Coat Normotension and Blood Pressure Variability
Authors: Prattichizzo Fernando Antonio , Galetta Fabio 
Published: July 2008

The objective of this study was to assess blood pressure variability in patients with clinical normotension and ambulatory hypertension (the so-called white-coat normotension). In 58 white-coat normotensives (mean age 64.2 ± 14.9 years; male/female ratio = 1.5:1) the authors evaluated blood pressure variability using the twenty-four-hour coef ficient of variability. Fifty-eight essential hypertensives with the same age and sex distri bution were recruited as a control group. The coefficient of variability in white-coat normotension was greater than in the control group (14.8/16.1 ± 4.2/3.8% vs 13.5/15.1 ± 3.3/3.1%), but this difference was not statistically significant. These findings suggest that white-coat normotension is the result of a specific relaxing response to medical visits and not the expression of an elevated blood pressure variability. It is probably due to the reverse of the alerting response, which causes white- coat hypertension.
Impairment of the Postural Venoarteriolar Response in Young Type 1 Diabetic Patients
Authors: Yosipovitch Gil , Schneiderman Jacob , van Dyk David J. , Chetrit Angella , Milo Guy , Boner Geoffrey 
Published: July 2008

The skin blood flow and venoarteriolar response (VAR) in the feet of young type 1 diabetic patients were studied with laser Doppler flowmetry. The findings were correlated with diabetic microangiopathy in 24 young patients without neuropathy—14 with diabetic microangiopathy, 10 without—and 10 healthy controls. In type 1 diabetic patients the skin blood flow, after lowering of the leg, was significantly higher in the microangiopathic patients than in the healthy controls, 5.3 ± 1.4 vs 3 ± 1.5, (P < 0.01). The VAR index was significantly lower in both groups of diabetics as compared with controls. In conclusion laser Doppler flowmetry is an easy and reliable noninvasive technique to evaluate skin blood flow abnormalities in the feet of young type 1 diabetic patients, including those without neuropathy. The VAR has been found abnormal in the feet of young diabetic patients with and without microangiopathy, regardless of the presence of peripheral neuropathy.
Acute Myocardial Infarction During Pregnancy and Puerperium Review
Authors: Badui Elias , Enciso Roberto 
Published: July 2008

The purpose of this review is to analyze the possible parameters that lead to the devel opment of what is a rare event—acute myocardial infarction (AMI) during pregnancy and puerperium. Through the Index Médicus, 109 publications on the subject were obtained. Since the first well-documented case by Katz in 1922, 136 patients have been reported, and from these reports the following data have been gathered: the average age was 32.1 years. This event is more frequent during the third trimester and puerperium of the first and second pregnancies. In 42.6% of the patients no coronary risk factors were observed, but when present, hypertension and cigarette smoking were the most common. The anterior wall along or in combination with any other anatomic area was affected in 73% of cases. Coronary angiograms, when taken, appeared normal in 47%. The maternal mortality rate was 26/136 (19.1%) and was higher during the third trimester, labor, and puerperium. Eight patients (8/26) (30.7%) had sudden death. In 5 of these, (62.5%) coronary thrombosis was found. In 18/26 deaths, an autopsy was performed; 9/18 (50%) had coronary thrombus formation and in 7/18 (39%) variable degrees of atherosclerosis were detected. On the other hand, the fetal mortality rate was 16.9%; however, in only 52% was death coincidental with that of the mother. Coronary artery spasm associated with a probable hypercoagulability state was the most likely mechanism in the majority of these patients, followed by atherosclerotic heart disease and coronary dissection—the last being secondary most likely to hormonal changes. During the AMI these patients should be studied by a medical team composed of a cardiologist, gynecologist, and anesthesiologist. A complete cardiologic work-up should be made to decide individually about further pregnancies.
Wine Consumption and Other Dietary Variables in Males Under 60 Before and After Acute Myocardial Infarction
Authors: Cleophas Ton J. M. , Tuinenberg Ellen , van der Meulen Jan , Zwinderman Koos H. 
Published: July 2008

In France there are few cardiac deaths in spite of high animal fat intake. France and Italy have the highest overall intake of alcohol in the world. Obviously, there is an inverse association between coronary heart disease (CHD) and alcohol intake in these countries. Although in the past decade several-large scale population studies have confirmed the beneficial effect of alcohol on CHD, these studies may not have been sensitive to control all the confounding variables. No one so far has explored the possibility that the French may be protected by their low level of life stress. In 1993 we conducted a case-control study (n = 118) to examine psychological variables in a group of Dutch males under sixty years of age, before and after acute myocardial infarction (MI). After adjustment for total cholesterol, blood pressure, and smoking, a number of psychological factors appeared to be independently associated with an increased risk of MI. For the present study the same group of patients was assessed for consumption of different types of alcoholic beverages, coffee, sugar, high-fat diet, and vegetables. In the univariate analysis patients appeared to have consumed more red wine (odds ratio [OR] 0.2, P = 0.03) and controls more spirits (OR 4.0, P = 0.005). After adjustment for total cholesterol, blood pressure, and smoking as well as the independent psycholog ical factors, red wine lost its significance (OR 0.4, P = 0.17) whereas the OR for spirits even rose (OR 6.0, P = 0.01). The beneficial effect of wine may be an expression of a relatively low level of life stress. Alcohol itself is not protective but rather a strong risk factor of MI.
Assessing the Independent Effect of Dietary Counseling and Hypolipidemic Medications on Serum Lipids
Authors: Fleming Richard M. , Ketchum Kristy , Fleming Diane M. , Gaede Ruth 
Published: July 2008

Determination of changes in total cholesterol (TC) and triglyceride (TG) levels has focused primarily on hypolipidemic drug effects. Changes resulting from dietary effect alone versus diet and drug effect have not yet been fully established. Seventy subjects were enrolled into four treatment groups to determine the impact of diet and drug effect upon TC and TG. Group 1 (n = 28) served as the control group and received no dietary counseling or drug therapy. Group 2 (n = 22) received dietary coun seling. Group 3 (n = 7) underwent dietary counseling for six months and drug therapy for eighteen months. Subjects in groups 1-3 were monitored for eighteen months. Patients in group 4 (n = 13) were followed up for thirty-six months. No intervention occurred during the first eighteen months, and hypolipidemic medications were used during the second eighteen-month period. Subjects in groups 1 and 4 received no specific dietary counseling and demonstrated no significant improvement over the course of the study. Patients in groups 2 and 3 showed significant reductions in both TC and TG. The improvement in TC seen for patients in group 3 was reduced after dietary counseling ceased. Dietary intervention is necessary if patients are to statistically significantly reduce TC and TG levels. Drug therapy demonstrated the expected reductions in both TC and TG but did not statistically significantly lower lipid levels without concomitant dietary coun seling. When dietary counseling and hypolipidemic medications are used together, reduc tions in TC and TG values are even greater than those seen with dietary effect alone. Diet control alone appears to significantly reduce TC and TG levels, resulting in reduced need for antianginal medications.
A Noninjury, Diet-Induced Swine Model of Atherosclerosis for Cardiovascular-Interventional Research
Authors: Thorpe Patricia E. , Hunter William J. , Xiao Xing Zhan  , Dovgan Peter S. , Agrawal Devendra K. 
Published: July 2008

To investigate whether atherosclerotic vascular disease in the microswine model can be induced by atherogenic diet alone and does not require balloon injury or endothelial denudation as widely stated in the literature, 28 female Yucatan microswine were fed a high-fat, high-cholesterol diet, including 2% sodium cholate, for an average of 310 ± 13 days. Four control swine were placed on a regular diet for an average of 287.2 ± 7.8 days. Selective coronary arteriography and morphologic and histologic studies were performed at the end of this period. Coronary arteries were fixed in vivo by pressure perfusion of formalin. Angiograms and sequential histologic sections were reviewed by a double-blind team. The angiography did not show apparent disease in all vessels but generally revealed mild irregularity. Quantitatively, there was a 30.5 ± 3.5% stenosis (mean ± standard error, P < 0.05 vs. control) in left anterior descending (LAD), 40.7 ± 4.5% of stenosis in right coronary artery (RCA) (P < 0.01 vs. control), and 24.8 ± 3.7% of stenosis in left circumflex artery (LCX). The lesions were eccentric in 95% of LCA, 95.8% of RCA, and 75% of LCX, and the remainder were concentric lesions. Typical lesions were characterized by significant intimal proliferation, cholesterol clefts, necrotic cores, heavy extracellular fat deposition, and calcification. Control animals had only occasional, minimal intimal lipid deposition in coronary arteries. These findings suggest that the Yucatan microswine is an ideal coronary atherosclerosis animal model for vascular research. Lesions can be induced by atherogenic diet alone. Cholesterol uptake is increased by adding sodium cholate to the feed. Moreover, balloon injury of the intima or media is not required to induce significant atherosclerotic lesions in coronary arteries.
Hemorheologic Effects of Vasodilation in Essential Hypertension
Authors: Wysocki Marian , Andersson Ove K. , Persson Bengt , Bagge Ulf , Braide Magnus 
Published: July 2008

Arterial hypertension is often associated with plasma volume contraction and hemocon centration, which negatively affect the vascular flow resistance and microcirculation. Since some antihypertensive drugs can affect blood rheology, the purpose of this study was to evaluate whether acute and long-term arterial vasodilation with cadralazine influ ences rheologic parameters in essential hypertension. Twelve patients with unsatisfacto rily controlled essential hypertension were studied. In the acute double-blind phase of the study the patients were allocated to treatment with either cadralazine or placebo. Intraarterial blood pressure, cardiac output (dye dilution), and blood rheology (viscosity, hematocrit) were registered before and after the first dose of cadralazine. Then 9 patients (3 dropouts) were treated with cadralazine and placebo during two four-week crossover periods and continued with cadralazine medication during the eight-week open phase of the study. Blood pressure and blood hemoglobin were followed during long-term treatment. A single oral dose of cadralazine caused vasodilation (total peripheral resistance index decreased from 45 to 33 U × m2, P < 0.05), which was accompanied by hemodi lution (hematocrit declined from 46.9% to 42.5%, P < 0.05) and a blood viscosity reduction of more than 10%. Viscosity of 45% suspension of erythrocytes in plasma was also reduced, suggesting a possible modification of the microrheologic factors. The changes in total peripheral resistance correlated negatively with the changes in hemat ocrit. An antihypertensive effect of cadralazine was still observed during the chronic phase of the study, which was not accompanied by hemodilution. It is concluded that arterial vasodilation with cadralazine reduces flow resistance in the circulatory system in hypertension and has acute rheologic effects that disappear during chronic medication.
Comparison of whole-Body Thallium Imaging with Transcutaneous PO2 in Studying Regional Blood Supply in Patients with Peripheral Arterial Occlusive Disease
Authors: Yuefei Liu  , Steinacker Jürgen M. , Opitz-Gress Alexandra , Clausen Malte , Stauch Martin 
Published: July 2008

Quantitatively estimating functional reserve of blood supply to the legs in patients with peripheral arterial occlusive disease (PAOD) remains a clinical issue. This study was designed to investigate the regional blood supply to the legs in PAOD patients during exercise by use of thallium 201 (201Tl) whole-body imaging in comparison with transcu taneous PO2 (tcPO2) measurement. Thirty-three patients with PAOD and 10 subjects without PAOD (control) performed an incremental cycle ergometry (CE), while tcPO2 was continuously registered on the involved calf. In the last minute of exercise, 2 mCi of 201Tl was injected intravenously and the 201Tl whole-body images were taken immediately (stress) and four hours (redistrib ution) following stress with a dual-head camera system. Regional blood supply (RBS) (%) was calculated from the geometric mean counts of the region of interest divided by the total counts of the whole body. The performance of PAOD patients was reduced in doing CE, and tcPO2 fell distinctly in PAOD patients (from 51 to 19 mmHg) whereas it increased in controls (from 57 to 67 mmHg). The RBS in PAOD patients was obviously reduced in comparison with that of controls. While in controls the RBS of the calf (3.1%) at stress did not differ from that at redistribution (3.4%), in PAOD patients the redistribution RBS (2.8%) increased as compared with that of stress (1.5%). There was a hyperbolic relationship between stress RBS of the calf and the velocity of tcPO2 fall in PAOD patients during exercise test (velocity of tcPO2 fall = -0.032 + 0.39/RBS, r2 = 0.54, P < 0.05). In conclusion, the RBS determined by 201Tl whole-body imaging is comparable to the tcPO 2 measurement in differentiating patients with PAOD from subjects without PAOD during exercise. Regional 201Tl uptake reflects regional blood supply in PAOD patients. There is a hyperbolic relationship between the RBS derived from 201Tl whole-body imaging and tcPO2 in PAOD patients during exercise, implying that in a critical ischemia the lower the RBS is, the more steeply the tcPO2 decreases.
Effect of Spirapril and Hydrochlorothiazide on Platelet Function and Euglobulin Clot Lysis Time in Patients with Mild Hypertension
Authors: Gleerup G. , Petersen J. Roland , Mehlsen J. , Winther K. 
Published: July 2008

Thirteen patients with mild hypertension (untreated diastolic blood pressure of 95 to 114 mmHg) received, in random order, three successive treatments of four weeks with placebo, spirapril (6 mg daily), or hydrochlorothiazide (HCT2) (24 mg daily). At the end of each treatment, blood samples for assessment of platelet aggregation and platelet release of platelet factor 4 (PF4) and for assessment of fibrinolysis, estimated by tissue plasminogen activator (t-PA), plasminogen activator inhibitor-type 1 (PAI-1), and euglob ulin clot lysis time (ECLT), were taken, first at rest, then immediately after five to ten minutes of vigorous exercise, and finally after the subsequent hour of recovery rest. Platelet aggregation induced in vitro by adrenaline significantly decreased during treatment with HCT2, the threshold rising to 10 μM as compared with 1.0 with placebo (P < 0.05) at rest, and the threshold for adenosine diphosphate (ADP) aggregation also rose, from 2 μM to 4 (NS). The resting plasma PF4 value fell, although not significantly, during HCT2 treatment from the placebo value of 3.28 to 2.56 ng/mL. During spirapril treatment there was no change in the threshold of either adrenaline or ADP for aggregation of platelets sampled at rest, and the PF4 plasma levels showed no significant reductions at rest. However, during exercise PF4 showed an approximate doubling of the resting value irrespective of therapy. This exercise-induced increase in PF4 was significantly reduced by spirapril as compared with placebo (P < 0.05). ECLT and t-PA did not shift significantly from the placebo level during either therapy. PAI-1 did not change during spirapril therapy, but during HCT2 treatment it fell, although not significantly, to 9.36 IU/mL from 15.91 with placebo (NS). Spirapril and HCT2 did not produce any unwanted side effect on platelet function or fibrinolysis. HCT2 seems to decrease platelet activity at rest, whereas spirapril seems to some extent to decrease platelet activity at exercise.