TABLE OF CONTENT: Cardiovascular Journal of Africa, Vol 17, Issue 2, Mar / Apr 2006

1. Title: Meeting the challenges of hypertension in sub-Saharan Africa : editorial
   Authors: Seedat, Y.K.; Rosenthal, Talma
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.47-48
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2. Title: Metabolic syndrome, undiagnosed diabetes mellitus and insulin resistance are highly prevalent in urbanised South African blacks with coronary artery disease : cardiovascular topic
   Authors: Ntyintyane, Lucas M.; Panz, Vanessa R.; Raal, Frederick J.; Gill, Geoffrey V.
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.50-55
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   Abstract: Background: The prevalence of coronary artery disease (CAD) is low in South African blacks, despite increasing westernisation and the accompanying rise in risk factors that are common to CAD and the metabolic syndrome (MS).
   Aim: To assess the prevalence of the MS and abnormal glucose regulation in black patients with established CAD, who had no previously known diabetes mellitus (DM).
   Methods: In 40 patients, anthropometric and biochemical variables were measured by standard methods. MS risk factors were analysed according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. Glucose regulation was assessed by the oral glucose tolerance test, and insulin resistance was evaluated using the hyperinsulinaemic euglycaemic clamp technique (M-value).
   Results: MS was present in 24 patients (60%) and absent in 16 patients (40%). Abdominal obesity, measured as increased waist circumference (WC), was the risk factor that differentiated the two groups and, together with hypertension and elevated glucose, formed the most frequent risk-factor combination. No significant differences were found in the proportions of males or females above and below the various cut-off points for gender-associated risk factors (WC and HDL cholesterol). There was a significant correlation between WC and M-value (r = -0.3595; p = 0.02). Half the patients had abnormal glucose regulation, comprising impaired glucose tolerance (IGT) in 30% and DM in 20% of the patient cohort.
   Conclusions: MS was highly prevalent in our black patients with CAD. Increased WC was the most important risk factor and, together with hypertension and elevated glucose, formed the most frequent risk-factor combination. Abdominal obesity was significantly related to insulin resistance. Previously undiagnosed impaired glucose tolerance (IGT) and DM were common abnormalities.
    
3. Title: NT-proBNP measurements in high-risk diabetic patients - a case series from Mamelodi (Gauteng) : cardiovascular topic
   Authors: Deffur, A.; Ker, J.A.; Rheeder, P.; Van Niekerk, M.M.; Quinton, S.J.
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.56-59
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   Abstract: The prevalence of raised BNP values is unknown in South African urban black populations at risk for heart failure. This study determined the frequency of raised NT-proBNP and the correlates of NT-proBNP in a high-risk diabetic population.
   Methods: A cross-sectional convenience sample of diabetic patients at the Mamelodi Hospital diabetes clinic was examined. Data on clinical, biometric, biochemical and a sixminute walk test were collected.
   Results: Sixty patients (38 female) were examined. The frequency of elevated NT-proBNP was 22% (95% CI; 12-34%). Univariate analysis found systolic blood pressure (BP) (p = 0.007) and duration of diabetes (p = 0.005) to be predictive of an elevated NT-proBNP.
    
4. Title: Prognostic value of N-terminal-pro-brain natriuretic peptide measurements in patients with acute coronary syndromes : cardiovascular topic
   Authors: Ranjith, N.; Pegoraro, R.J.; Naidoo, D.P.; Esterhuizen, T.M.
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.60-66
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   Abstract: Background: The aim of this study was to examine the prognostic value of admission N-terminal-pro-brain natriuretic peptide (NT-proBNP) measurements for the outcome of adverse events, and to compare it with that of cardiac troponin T in the assessment of risk in patients with acute coronary syndrome (ACS) during the hospital stay and at six months following hospital discharge.
   Methods: The study population consisted of 200 Asian Indian patients admitted with a diagnosis of ACS to the Coronary Care Unit at RK Khan Hospital, Durban, South Africa. A reference group comprising 100 healthy Indian individuals drawn from the same community and who did not suffer from cardiovascular disease was also analysed.
   Results: The majority of patients presented with ST segment elevation myocardial infarction (STEMI) (71%), whereas 14.5% had non-ST segment elevation MI (NSTEMI), and the remaining 14.5% had unstable angina. Patients had multiple risk factors for coronary heart disease (CHD) including hypertension (59%), hypercholesterolaemia (59%), smoking (57%), diabetes mellitus (51%), obesity (46%), and a strong family history of CHD (55%). NT-proBNP levels were significantly increased in patients with STEMI (p = 0.005) and NSTEMI (p = 0.002) who developed adverse events during their hospital stay, compared with those who did not. At the six-month followup, although NT-proBNP levels were higher in patients with STEMI and NSTEMI who developed adverse events, these differences were not statistically significant. No differences in troponin T levels were detected in patients with STEMI and NSTEMI who developed adverse events, compared to those who did not, either during the hospital stay, or at six months after release. At hospital admission, 24% of patients with unstable angina who had elevated NT-proBNP levels and normal troponin T concentrations developed adverse events, compared to 38% at six months. NT-proBNP levels in the reference group were comparable with those reported in other populations.
   Conclusion: This study demonstrated that elevation in admission NT-proBNP levels is an important determinant of acute and intermediate cardiac risk in patients with ACS. NT-proBNP concentrations were superior to those of troponin T as prognostic markers in both STEMI and NSTEMI. In a low-risk group of patients with unstable angina and negative troponin T concentrations, elevated NT-proBNP levels constituted a risk for the development of adverse cardiovascular events. Therefore, NT-proBNP should be included in the risk assessment of ACS to provide guidance for further therapeutic strategies.
    
5. Title: The William Nelson ECG quiz
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.66, 72
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6. Title: Hypoglycaemic and hypotensive effects of Harpephyllum caffrum Bernh ex CF Krauss (Anacardiaceae) stem-bark aqueous extract in rats : cardiovascular topic
   Authors: Ojewole, John A.O.
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.67-72
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   Abstract: The stem bark of Harpephyllum caffrum Bernh ex CF Krauss (family: Anacardiaceae) is used traditionally in African folk medicine to manage, control and/or treat an array of human ailments, including diabetes mellitus and hypertension. In order to scientifically appraise some of the anecdotal, folkloric and ethnomedical uses of Harpephyllum caffrum, this study was undertaken to examine the hypoglycaemic and hypotensive effects of Harpephyllum caffrum stem bark aqueous extract (HCE) in rat experimental paradigms. The hypoglycaemic effect of the plant extract (HCE) was examined in normal and diabetic rats, using a streptozotocin (STZ)-induced diabetes mellitus model.
   Hypertensive, Dahl salt-sensitive rats were used to investigate the hypotensive (antihypertensive) effect of the plant extract. Chlorpropamide (250 mg/kg po) was used as the reference hypoglycaemic agent for comparison. Acute oral administrations of the plant extract (HCE, 50-800 mg/kg po) caused dose-related, significant (p < 0.05- 0.001) hypoglycaemia in normal (normoglycaemic) and STZ-treated diabetic rats. Furthermore, acute intravenous administrations of the plant extract (HCE, 25-400 mg/kg iv) produced dose-dependent, significant reductions (p < 0.05-0.001) in systemic arterial blood pressures and heart rates of the hypertensive, Dahl salt-sensitive rats used.
   Although the exact mechanisms of action of the plant extract still remain obscure at the moment, it is unlikely that the plant causes hypotension in the mammalian experimental animal model used, via the cholinergic mechanism, since its hypotensive effect was resistant to atropine pretreatment. The numerous polyphenolic compounds and flavonoids present in the plant are speculated to account for the observed hypoglycaemic and hypotensive effects of the extract. However, the findings of this experimental animal study indicate that the stem-bark aqueous extract of H caffrum possesses hypoglycaemic and hypotensive properties, and thus lend pharmacological support to the suggested folkloric, anecdotal and ethnomedical uses of the plant in the management and/or control of adult-onset type 2 diabetes mellitus and hypertension in some rural communities of southern African.
    
7. Title: Imaging of a coronary artery bypass graft during coronary sinus venography : case report
   Authors: Thornton, Andrew S.; Scholten, Marcoen F.; Jordaens, Luc J.
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.73-74
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   Abstract: Retrograde coronary sinus perfusion to maintain viability during cardiac surgery means that a connection via the capillary system to the coronary arteries, and potentially bypass grafts, may be possible. Coronary sinus (CS) venography prior to resynchronisation therapy in this patient with previous bypass grafting was associated with visualisation of these grafts.
    
8. Title: American Heart Association Congress, 13-16 November 2005 : meeting report
   Authors: Moodley, R.
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.75-80
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9. Title: First Pan-African Congress on Hypertension, Yaondé, Cameroun, 8 - 12 December 2005 : abstracts
   From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
   Published: 2006
   Pages: p.81-89
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10. Title: ACTIVE-W : warfarin beats clopidogrel / aspirin in atrial fibrillation : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.91
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11. Title: Rimonabant study shows cardiometabolic risk factors improve : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.91
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12. Title: New policosanol product combines natural cholesterol lowering with omega-3 fatty acids to lower CV risk
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.92
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13. Title: Review of CHARM shows benefit of candesartan on nonfatal MI and CV death in patients with heart failure : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.95
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14. Title: Joint World Congress on Stroke : International Stroke Society, Mediterranean Stroke Society and Southern African Stroke Foundation, Cape Town, South Africa, 26-29 October 2006
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.95
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15. Title: Benefit of aspirin not surpassed by combining clopidogrel with aspirin in dual anti-platelet prevention of atherothrombotic events in high-risk patients : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.96, 98
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16. Title: Clopidogrel in patients with established atherosclerotic vascular disease : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.99
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17. Title: Cell receptors regulate cholesterol : ezetimibe blocks cholesterol absorption : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.101
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18. Title: SENIORS study using nebivolol provides best evidence of effective treatment for heart failure in the elderly : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.102
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19. Title: Low-molecular weight heparin shows considerable benefits in ST-elevation acute myocardial infarction : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.104
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20. Title: Cardio news
    From: Cardiovascular Journal of South Africa, Vol 17, Issue 2, Mar / Apr
    Published: 2006
    Pages: p.104
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