TABLE OF CONTENT: Cardiovascular Journal of Africa, Vol 14, Issue 2, Mar / Apr 2003

1. Title: CVJSA e-journal publication : editorial
   Authors: Brink, A.J.
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.57-58
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2. Title: Abnormal serum lipoprotein levels as a risk factor for the development of human lenticular opacities : cardiovascular topics
   Authors: Meyer, D.; Parkin, D.; Maritz, F.J.; Liebenberg, P.H.
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.60-64
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   Abstract: Aim : To determine whether an association exists between the different plasma lipoprotein constituents and the prevalence of lenticular opacities in dyslipidaemic subjects.
   Methods : Adult patients (n = 115) of both genders were included if their fasting total serum cholesterol concentrations exceeded the 95th percentile of normal or their serum low-density lipoprotein (LDL) : high-density lipoprotein (HDL) ratios exceeded 5. Patients were excluded if they suffered from any condition known to cause, or predispose them to, elevated lipoprotein levels or lenticular opacification. Lenticular changes were assessed by means of a slit-lamp through the fully dilated pupil.
   Results : An extremely strong association (p < 0.0001) was found to exist between HDL cholesterol levels and the development of lens opacities. Below an HDL-C level of 1.5 mmol / l subjects had a seven-fold higher calculated probability of falling in the lens opacity subgroup than those with HDL-C levels above 1.5 mmol / l [odds ratio = 7.33 (95% CI = 2.06-26.10; p = 0.001)]. An equally strong association was found between high (> 5) LDL : HDL ratios and the development of lens opacities (p < 0.0003). The risk of falling into the cataract subgroup if the individual's LDL : HDL ratio exceeded 5 was 2.35 (95% CI = 1.09-5.04; p = 0.014).
   Conclusions : This study strongly suggests that an association exists between low levels of HDL cholesterol and high LDL : HDL ratios on one hand and the development of adult lens opacification on the other.
    
3. Title: Long-term follow-up of single-lead VDD pacing : cardiovascular topics
   Authors: Munclinger, Miroslav J.; Thornton, Andrew S.; Dateling, Freddie
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.66-72
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   Abstract: Long-term outcomes of single-lead VDD pacing were studied retrospectively and partly prospectively. Records were analysed of 81 patients out of 133 in whom a single-lead VDD pacemaker was implanted between January 1993 and December 1997 and who attended a follow-up clinic more than two years after the implant. Forty-eight of them attended a prospective follow-up 54 ± 15 months after the implant.
   Sinus rhythm was present in 91.5% of the patients and atrial fibrillation in the remaining 8.5%. A-V synchronous pacing was documented in 91.9 to 94.9% at different follow-up periods; however, an intermittent asynchronous ventricular (VVI) pacing of more than 10% occurred intermittently in 19.1% of the patients. Chronic sensed P-wave amplitude was significantly lower than the implant P-wave amplitude (by 70%) and did not correlate with the implant amplitude. Postural changes (supine, sitting, standing, with normal breathing and during deep inspiration) did not have a significant impact on sensed P-wave amplitude more than four years after the implant. Rate histograms were remarkably stable over the years, with dominant heart rate 70 to 79 beats per minute observed for 25 to 30% of the monitored periods.
   Single-lead VDD pacing was found to be a reliable method of long-term physiological pacing in patients with heart block who returned for follow-up. Routine testing more than four years after the implant does not require postural manoeuvres.
    
4. Title: Mechanisms of opioid delta (d) and kappa (k) receptors' cardioprotection in ischaemic preconditioning in a rat model of myocardial infarction : cardiovascular topics
   Authors: Valtchanova-Matchouganska, A.; Ojewole, J.A.O.
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.73-80
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   Abstract: It has been demonstrated that brief periods of coronary artery occlusion before a prolonged period of sustained occlusion paradoxically protect the myocardium against infarction. The mechanisms involved in this phenomenon, termed 'ischaemic preconditioning' (IPC) are still not clear, although it has been established that opioid receptors are involved. The aim of this study was to probe some of the plausible mechanisms involved in the phenomenon by using an in vivo model of myocardial infarction in intact rat, a model that allows electrocardiographic and enzymatic in addition to morphometric evaluation of the development of 24-hour myocardial infarction. Selective opioid d-receptor agonist (DADLE) and antagonist (natrindole), and opioid k-receptor agonist (U-50488H) and antagonist (nor-BNI) were used. To clarify some of the mechanisms of IPC, we used selective inhibitors of the anticipated cellular systems involved. Pertussis toxin (inhibitor of adenylate cyclase Gi / o protein), glibenclamide (inhibitor of KATP channel) and chelerythrine (inhibitor of PKC) were used. Results obtained showed that :
   
   * Both opioid d- and k-receptors were involved in the beneficial effect of IPC, although we were unable to differentiate between opioid receptor subtypes (d1, d2 and k1, k2).
   * Opioid d- and k-receptors displayed different effects in IPC. After 30 minutes of left coronary occlusion and 2-hour reperfusion, opioid d-receptor agonist DADLE significantly decreased (p < 0.05) the infarct size (by 66% - from % IS / AAR 59.80 in the control, untreated infarcted rats to % 20.40), without a significant effect (p > 0.05) on the occurrence of early arrhythmias. Opioid k-receptor agonist U-50488H produced mainly antiarrhythmic effects. It decreased % IS / AAR by 44%, reduced the occurrence of early arrhythmias by 77%, and decreased ventricular ectopic beats by 80%. Both opioid d- and k-receptor agonists significantly reduced (p < 0.05) early (2- hour) mortality by 22% and 19% respectively. The above opioid d- and k-receptor cardiac effects were abolished by the use of respective specific opioid d- and k-receptor antagonists.
   * The beneficial effects of opioid d- and k-receptor agonists persisted for at least 24 hours post-infarction.
   * It is most likely that both opioid d- and k-receptors act via common cellular mechanisms involving :
   
   - activation of ATP-sensitive (sarcolemmal or mitochondrial) K+ channel via Gi / o proteins (based on the results of our experiments with KATP channel antagonist, glibenclamide);
   - phosphatidylinositol pathway via activation of protein kinase C (judging from the results of our experiments with the inhibitor of PKC, chelerythrine);
   - the recently proposed 'cross talk' between b1-adrenergic and opioid receptors in cardiac myocytes (involving inhibition of adenylate cyclase by Gi / o proteins). Exploring the possibility of this signaling pathway will be the next step in our experimental studies.
    
5. Title: Dietary markers of hypertension associated with pulse pressure and arterial compliance in black South African children : the THUSA Bana study : cardiovascular topics
   Authors: Schutte, A.E.; Van Rooyen, J.M.; Huisman, H.W.; Kruger, H.S.; Malan, N.T.; De Ridder, J.H.
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.81-89
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   Abstract: Aims : The aim of the study was to determine which dietary factors contribute to the impairment of arterial compliance, stroke volume, total peripheral resistance and pulse pressure, and could thereby be identified as risk markers in the development of hypertension in black children.
   Methods : Children aged 10 to 15 years were recruited from 30 schools in the North West Province over two years (2000 to 2001). These children comprised 321 black males and 373 females from rural to urbanised communities and 40 male and 79 female subjects with identified high-normal to hypertensive blood pressure. Blood pressure was measured by means of a Finapres apparatus. Through analysis with the Fast Modelflo software program, systemic arterial compliance, pulse pressure, total peripheral resistance and stroke volume were obtained. A 24-hour dietary recall questionnaire and weight and height measurements were taken. Results : In a stepwise regression analysis the following nutrients were significantly associated (p ≤ 0.05) with cardiovascular parameters of hypertensive subjects : protein, carbohydrates, total fat, polyunsaturated fat, mono-unsaturated fat, saturated fat, fibre, vitamin A, nicotinic acid, biotin, vitamin B12, ascorbic acid, vitamin E, magnesium, manganese, phosphorus and iron. No significant dietary markers were indicated for the normotensive groups. Dietary intakes of most of these nutrients were below the dietary reference intakes for all groups.
   Conclusions : The results indicate strong associations of protein, polyunsaturated fats, fibre, vitamin A, vitamin C, vitamin E, nicotinic acid, vitamin B12, biotin and phosphorus with the rate of hypertension in black South African children.
    
6. Title: The William Nelson ECG quiz
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.89, 94
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7. Title: 'Low pressure' left ventricular tamponade in a patient with rheumatic mitral stenosis and HIV-related acute pericarditis : case report
   Authors: Goldberg, L.; Hagios, P.; Grigorov, V.; Mekel, J.
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.91-94
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   Abstract: A case report of isolated left ventricular tamponade in a patient with rheumatic mitral stenosis and effusive pericarditis is presented. The haemodynamics and management of this under-diagnosed pathology is discussed.
    
8. Title: Letters to the editor
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.97-98
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9. Title: Enoxaparin reduced DVT risks in patients with acute medical illness : drug trends in cardiology
   From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
   Published: 2003
   Pages: p.99-100
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10. Title: Policosanol - effective in lowering cholesterol in type 2 diabetes : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
    Published: 2003
    Pages: p.100
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11. Title: Carvedilol gets a nod for post-AMI use : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
    Published: 2003
    Pages: p.100-102
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12. Title: Ramipril benefits over other ACE inhibitors in the treatment of ST-elevation AMI
    From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
    Published: 2003
    Pages: p.102
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13. Title: Report on the SA Hypertension Congress (7-9 March 2003) : successful combination of CME and new research : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
    Published: 2003
    Pages: p.103-106
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14. Title: Cardio news
    From: Cardiovascular Journal of South Africa, Vol 14, Issue 2, Mar / Apr
    Published: 2003
    Pages: p.107-108
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