TABLE OF CONTENT: Cardiovascular Journal of Africa, Vol 15, Issue 2, Mar / Apr 2004

1. Title: The South African Lipid Guidelines : is there a need for an update? : editorial
   Authors: Raal, F.J.; Schamroth, C.; Klug, E.; Mills, P.
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.53-54
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2. Title: New developments in pharmacotherapy : editorial
   Authors: Thompson, Gilbert R.
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.56-58
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3. Title: Letter to the editor
   Authors: Bertrand, Edmond
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.58
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4. Title: Facets of the metabolic syndrome in Dahl hypertensive rats : cardiovascular topics
   Authors: Channa, M.L.; Somova, L.; Nadar, A.
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.61-63
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   Abstract: We recently established that the Dahl salt-sensitive rat, a model for genetic salt-sensitive hypertension, was insulin resistant. This study was undertaken to evaluate whether other features of the metabolic syndrome developed in this animal model.
   Two groups of 16 Dahl salt-sensitive (DSS) rats and their controls, Dahl salt-resistant (DSR) rats were used. For eight weeks, half of each group was fed a standard diet with low sodium content (85 mmol Na/kg diet) while the remainder was fed a high-sodium diet (340 mmol Na/kg diet). Weekly systolic and diastolic blood pressures were measured for all animals. At the end of eight weeks, the urinary Na+/K+ ratio, fasting blood glucose, plasma uric acid and blood lipids were determined for all animals. The same parameters were measured in two additional matched weanling DSS and DSR groups of eight animals each.
   Adult DSS rats became hypertensive, with the DSS high-salt group exhibiting both genetic hypertension and the pressor effects of a high-salt diet. The DSS highsalt and weanling groups exhibited a lowered urinary Na+/K+ ratio, indicative of greater sodium retention, when compared to their respective DSR groups (p < 0.05). No strain differences were observed in the uric acid levels. However a high-salt diet in both DSS and DSR groups elevated uric acid levels. Weanling and DSS high-salt groups showed increased total plasma cholesterol when compared to their corresponding DSR groups (p < 0.05). In addition, the DSS high-salt group also had both increased total plasma cholesterol and high-density lipoprotein (HDL) cholesterol when compared to the DSS low-salt group (p < 0.05). No significant differences in blood glucose and plasma insulin were observed in the adult groups. The weanling DSS group showed a marked hyperinsulinaemia, suggesting that DSS rats were possibly insulin resistant even before hypertension was fully established. This could indicate that insulin resistance and hypertension may be inherited as separate traits that develop in a parallel but independent manner.
    
5. Title: Supraventricular tachycardia in children : cardiovascular topics
   Authors: Van der Merwe, D.M.; Van der Merwe, P.L.
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.64-69
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   Abstract: The mechanisms causing different supraventricular tachycardias can be identified with the aid of the 12-lead ECG using Tipple's approach. The main aims of this retrospective study were to use the 12-lead ECG to determine the underlying mechanisms of supraventricular arrhythmias and to evaluate the effectiveness of the treatment modalities used.
   Forty-one patients were included in the study. The main findings were: nine of the 41 patients had atrial tachycardias while junctional tachycardia occurred in 32/41 of our patients. The underlying mechanisms causing the junctional tachycardias were: AVNRT (n = 21), AVRT (n = 10) and JET (n = 1). Of the 10 patients presenting with AVRT, eight were less than one year old. AVNRT occurred more often in the older age group (>1 year of age). Fifteen of the 41 patients had spontaneous cessation of their supraventricular tachycardia.
   The drug most commonly used during the acute and long-term phases was digoxin. Amiodarone was used in six patients with an 80% success rate. In the early 80s verapamil was used in five patients with a 100% success rate. It is important to note that verapamil is no longer used in children due to its side effects. Lately, adenosine phosphate is the drug of choice in most supraventricular tachycardias.
   The management of supraventricular tachycardias in paediatric practice is mainly based on clinical studies and individual experience. Care must therefore be taken to choose medication regimens that are likely to be effective with the minimum risk of potentiating abnormal haemodynamics or conduction.
    
6. Title: High-dose atorvastatin therapy is required for significant improvement of endothelial function in heterozygous familial hypercholesterolaemic patients : cardiovascular topics
   Authors: Susan L. Brown,; Raal, Frederick J.; Panz, Vanessa R.; Stevens, Belinda A.; Veller, Martin G.
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.70-75
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   Abstract: This study evaluated endothelial dysfunction (ED) by measuring flow-mediated vasodilation (FMD) and for six months documented changes in ED, LDL-C levels and serum concentrations of inflammatory markers with high- and low-dose atorvastatin therapy. In 23 heterozygous familial hypercholesterolaemic (FH) patients, FMD, LDL-C and inflammatory markers (sVCAM-1, sICAM-1, E-selectin and highly sensitive C-reactive protein) were measured at baseline (untreated) and on atorvastatin 20 and 80 mg/day. In untreated patients, FMD was significantly reduced (mean + SD = 3.09 + 0.91%) compared with 10 normocholesterolaemic controls (8.71 + 2.41%; p < 0.01). FMD improved non-significantly with atorvastatin 20 mg/day (5.60 + 1.17%), but showed a significant improvement (8.54 + 1.11%; p < 0.01) with atorvastatin 80 mg/day. LDL-C decreased markedly (-42.4%; p < 0.0001) on 20 mg/day and decreased further (-48.6%; p < 0.05) on 80 mg/day. FMD improvement, however, did not correlate with LDL-C reduction. No significant changes occurred in any inflammatory markers. We concluded that ED was present in untreated FH patients and improved significantly on high-dose atorvastatin. There was no correlation between the changes in FMD and LDL-C, suggesting either a LDLC- independent effect on ED, or that a marked reduction in LDL-C is required to normalise ED in FH.
    
7. Title: The William Nelson ECG Quiz
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.75, 80
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8. Title: Effectiveness of single detachable COOK(R) coils in closure of the patent ductus arteriosus : cardiovascular topics
   Authors: Brown, Stephen; Bruwer, Andre; Al-Zaghal, Ahmed; Claassens, Antoinette
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.76-80
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   Abstract: Objective: To assess the efficacy and safety of single detachable coils in the closure of PDAs.
   Methods: Review of cases in which a single detachable coil was implanted. The diameter of the ampulla was used to select coil size. Diameters of the PDA, ampulla and residual shunts were measured.
   Results: There were 36 patients with a mean minimal ductal diameter of 2.2 + 0.6 mm. Immediately after implantation, 46% of the patients had residual shunts and after 24 hours, only 28%. A final spontaneous closure rate of 94% was observed after 21 months. There was a significant (p < 0.01) difference when minimal PDA diameter of those who had complete closure within 24 hours (median: 2 mm, interquartile range: 1.7-2.3 mm) was compared to those with a residual shunt (median: 2.5 mm, interquartile range: 2.3-3.2 mm). Negligible complications were experienced.
   Conclusion: Single Cook detachable coils are effective for PDA closure with a low complication rate if properly selected. There is a high rate of spontaneous closure of trivial residual shunts. In patients with a minimal ductal diameter > 2 mm and a residual shunt, more coils may be considered.
    
9. Title: Transoesophageal atrial pacing stress echocardiography in coronary artery disease : role, principles and methodology : review article
   Authors: Goldberg, L.; Hagies, P.; Grigorov, V.
   From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
   Published: 2004
   Pages: p.81-87
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   Abstract: This article reviews the physiology and methodology of transoesophageal atrial pacing stress echocardiography (TAPSE) and clarifies its place among the other stress modalities.
   TAPSE correlates well with myocardial perfusion stress scintigraphy and coronary angiography and is a simple and safe diagnostic option for patients with suspected or known CAD, including those with recent myocardial infarction. Furthermore, the results of TAPSE have prognostic significance in patients with uncomplicated MI.
   Although, it is a highly feasible and safe technique, the cardiologist should be directly involved in the procedure and the personnel must be well trained in a large number of tests, as for any other stress echocardiographic modalities.
    
10. Title: Individualising heart failure patients to b-blocker therapy : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.88, 91
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11. Title: Eprosartan dual action offers clinical benefit for elderly and overweight hypertensives : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.91-92
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12. Title: Lipitor stops progression of plaque build-up in arteries : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.92
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13. Title: Policosanol versus atorvastatin effective in cholesterol lowering and increased HDL-C levels : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.94
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14. Title: CHARM shows improvement in NYHA functional class with candesartan : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.96-97
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15. Title: Perindopril protects diabetics with coronary disease from cardiovascular death and heart attacks : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.98
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16. Title: Cardio news
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 2, Mar / Apr
    Published: 2004
    Pages: p.99-100
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