International journal of cardiology
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The purpose of this study was to test whether the insulin sensitivity, lipid metabolism and the susceptibility of the heart to ischemia/reperfusion injury are modulated by the chronic estrogen status. Rats were ovariectomized (OVX), not ovariectomized (sham) or ovariectomized and treated with subcutaneous 17 -estradiol (30 mug/kg/day, OVX+E2) (n=14-17 per group). Within 3 months after operation, body weight, the serum levels of estrogen, glucose, insulin, total cholesterol (T-chol), HDL-chol, LDL-cholesterol (LDL-chol), triglycerides (TG) and lipoprotein a (Lp(a)) were monitored. ⋯ In conclusion, chronic E2 treatment has some beneficial effects on cardiovascular disease (CVD), which come from the results of improvement of insulin sensitivity and post-ischemia cardiac function. However, the mechanism did not include changes in lipids and lipoproteins. The change in Lp(a) level shows that estrogen does not confer cardiovascular protection and may increase the risk of stroke.
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Increasingly, patients and clinicians are being confronted with congestive heart failure (CHF) as a late complication of congenital heart disease. However, medical management of heart failure in this patient group represents a challenge because of complex hemodynamics and a lack of evidence from large randomized controlled trials to guide therapy. ⋯ Some recommendations for use of angiotensin converting enzyme inhibitors and beta-blockers in heart failure due various congenital heart lesions are offered. Well-designed clinical trials are urgently needed to extend the impressive reductions in morbidity and mortality achieved with neurohormonal blockade in left ventricular (LV) heart failure to adults with congenital heart disease.
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Review
Idiopathic pulmonary arterial hypertension: current state of play and new treatment modalities.
Research in pulmonary hypertension has led to exciting advances over the last decade, both in terms of understanding aetiology and expanding treatment options. This review highlights the current approach to classification and disease management. In particular, we review the significant data and recommendations on the use of prostacyclin analogues, endothelin receptor antagonists, phosphodiesterase inhibitors and drug combinations.
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Epidemiological estimates of left ventricular mass are based on echocardiographic imaging from the parasternal view, which is often unavailable in subjects with obesity or lung disease. This study was undertaken to assess whether the subcostal view is a valid alternative to estimate left ventricular mass in an unselected older population. ⋯ In unselected older persons, the subcostal view does not improve the accuracy of echocardiographic estimation of left ventricular mass, which remains biased in epidemiological studies.