Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Nov 2012
Comparative StudyThe importance of training in echocardiography: a validation study using pocket echocardiography.
To investigate the training effect in echocardiography by using recent hand-held ultrasound scanners (HANDs). ⋯ Well-grounded training in echocardiography leads to a rapid improvement in image acquisition and interpretation over a period of a few weeks. Basic diagnostic findings could be interpreted with high accuracy after short training. Interpretation of complex findings remained difficult. The time needed to carry out an examination using pocket echocardiography could not be reduced to less than 3-4 min per patient. New educational concepts are warranted.
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J Cardiovasc Med (Hagerstown) · Nov 2012
Clinical characteristics and risk assessment of ST-segment elevation myocardial infarction patients of an Iranian referral center.
Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality all over the world. Acute myocardial infarction (AMI) is the leading cause of death and disability in the Iranian population. This prospective comprehensive study aimed to assess the clinical characteristics and in-hospital outcomes with possible correlations between them in patients with AMI. ⋯ Our results provide emphasis on prevention of cardiovascular risk factors and further support to decrease patients' prehospital delay and accelerate in-hospital interventions for patients with AMI.
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J Cardiovasc Med (Hagerstown) · Nov 2012
α-tocopherol and ascorbic acid in early postoperative period of cardiopulmonary bypass.
To investigate whether α-tocopherol and ascorbic acid have effect on the suppression of inflammation in the early postoperative period after open heart surgery. ⋯ Suppression of the systemic inflammatory response to CPB is a double-edged sword and whether this suppression aids in the attenuation of morbidity and mortality is obscure. In this respect, ascorbic acid and α-tocopherol seem to display some anti-inflammatory effect, but further studies are necessary to reveal the actual therapeutic potential and the complex mechanism related to biochemical and inflammatory parameters.
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J Cardiovasc Med (Hagerstown) · Oct 2012
ReviewPathology of plaque haemorrhage and neovascularization of coronary artery.
Intraplaque haemorrhage (IPH) is thought to play crucial roles in plaque progression and plaque rupture, resulting in acute coronary syndromes, which are the leading causes of morbidity and mortality in the developed countries. IPH is a common finding in atherosclerotic plaques. In the past decade, the use of anti-Glycophorin A antibodies that specifically and uniquely label membranes of the red cells triggered a cascade of pathologic and experimental studies concordantly documenting not only the presence but also the major role of IPH in plaque progression and complications. ⋯ Although the mechanisms by which IPH impacts plaque progression and plaque rupture gradually become clear, several questions such as causes of angioneogenesis, identification and treatment of plaques with angioneogenesis are still unanswered. Further studies are needed to resolve these issues; however, the investigation of IPH without a histopathological approach is unconceivable. This review will focus on the pathology of IPH and plaque neovascularization, pathophysiology and potential clinical impact.
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J Cardiovasc Med (Hagerstown) · Oct 2012
ReviewFrom intraplaque haemorrhages to plaque vulnerability: biological consequences of intraplaque haemorrhages.
Intraplaque hemorrhages are mainly related to inward neoangiogenesis, initiated from the adventitia by lipid-dependent outwardly convected signals, and by the immaturity of these neovessels, allowing leaks and hemorrhages. Repeated intraplaque hemorrhages play a major role in the evolution of thrombotic occlusive disease, similar to the role of intraluminal thrombus in the progression of abdominal aortic aneurysm toward rupture. Red blood cells (RBCs) are an important source of unesterified cholesterol, because their membranes are particularly cholesterol rich. ⋯ These proteases concentrate in the hemorrhagic/necrotic core rendered plaque highly vulnerable. An adaptive immune response takes place in the adventitia, in regard of hemorrhagic plaques, in relation to outwardly convected oxidized or proteolyzed neoantigens, and chemokinic signals. Finally, intraplaque hemorrhages and thrombi are the site of weak pathogen entrapment, which promote all these oxydative and proteolytic phenomenons.