TABLE OF CONTENT: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / June 2010

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1. Title: Lessons from the first report of the Arrhythmogenic Right Ventricular Cardiomyopathy Registry of South Africa : editorial
   Authors: Hendricks, Neil; Watkins, David A.; Mayosi, Bongani M.
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: The Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Registry of South Africa was established in 2004, under the auspices of the Cardiac Arrhythmia Society of Southern Africa (CASSA). In the November 2009 supplement of Heart Rhythm, the Registry investigators published the first large, multicentre series of patients with ARVC in South Africa. The report, which is based on the first 50 participants with a confirmed diagnosis of ARVC, has practical implications for the clinical profile, diagnosis and management of patients with ARVC in South Africa.
    
   
2. Title: Involvement of pharmaceutical companies at scientific meetings : from the editor's desk
   Authors: Brink, Andries
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: South Africa not infrequently hosts high-level cardiology meetings outside the auspices of South African professional medical societies and associations. Well-known cardiologists, particularly from the USA and Europe are invited to make presentations, which bring the best and most-recent advances in the field to this country. This is of course of great value to the selected group of delegates who are invited to attend. Large sums of money are involved because all the presenters and many of those attending receive full financial support for their participation.
    
   
3. Title: Watch these dates
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: Watch these dates
    
   
4. Title: Dual effect of quercetin on rat isolated portal vein smooth muscle contractility : cardiovascular topics
   Authors: Chiwororo, Witness D.H.; Ojewole, John A.O.
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: This study examined the effects of quercetin on spontaneously contracting portal veins isolated from healthy young adult male and female Wistar rats (250-300 g). Quercetin (10-7-10-4 M) always produced significant biphasic effects, comprising an initial brief stimulant effect (rise in basal tone), followed by a sustained, longer-lasting secondary relaxant (inhibitory) effect on the venous tissues. The initial brief contractions of the venous muscle preparations were not modified by preincubation of the tissues with prazosin (10-6 M), suggesting that the initial upsurge in basal tone and increases in contractile frequencies of the venous tissues were probably not mediated via alpha1-adrenoceptor stimulation. However, preincubation of the tissues with nifedipine (10-7 M) significantly suppressed (p < 0.05) or attenuated the initial stimulant effect of quercetin, suggesting that the flavonoid might be activating L-type voltage-dependent calcium channels. The vasorelaxant effect of quercetin was partially but not significantly (p > 0.05) inhibited by L-NAME (100 µM) or indomethacin (10 µM), suggesting that the vasorelaxant effect of the flavonoid was unlikely to be mediated via endothelium-dependent relaxing factor (EDRF), or through prostacyclin (PGI2) pathways. N-p-tosyl-l-phenylalanine-chloromethyl-ketone (TPCK, 3 µM) significantly (p < 0.01) antagonised quercetin-induced relaxations, suggesting that cAMP-dependent protein kinases might have contributed, at least in part, towards the vasorelaxant effect of quercetin on rat isolated portal veins.
    
   
5. Title: Midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in persistent atrial fibrillation : cardiovascular topics
   Authors: Tekumit, Hayrrettin; Uzun, Kemal; Cenal, Ali Riza; Tataroglu, Cenk; Polat, Adil; Akinci, Esat
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: Introduction : The aim of the study was to assess the midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial fibrillation.
   Methods : Between October 2006 and July 2009, 95 patients with mitral valve disease and persistent atrial fibrillation underwent a mitral valve procedure and left atrial bipolar radiofrequency ablation. The postoperative data of the combined procedure were collected at the time of discharge and at one, three, six and 12 months after the operation.
   Results : Hospital mortality rate was 6.3% (six patients). Normal sinus rhythm was achieved in 77.2% of patients during the early postoperative period in hospital, and in 73.3, 72.0 and 75% of patients at three, six and 12 months postoperatively, respectively. Patients were followed up for a mean duration of 14.02 ± 5.71 months (range: 6-19 months). During this midterm follow-up period, nine patients had late recurrence of atrial fibrillation. No risk factor was identified for late recurrence of atrial fibrillation.
   Conclusion : Our midterm follow-up results suggest that the addition of left atrial bipolar radiofrequency ablation to mitral valve surgery is an effective and safe procedure to restore sinus rhythm in patients with chronic atrial fibrillation.
    
   
6. Title: Erythromycin as an alternative to reduce interfering extra-cardiac activity in myocardial perfusion imaging : cardiovascular topics
   Authors: Vorster, Mariza; Sathekge, M.M.; Rheeder, P.
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: Objectives : We sought to determine whether taking oral erythromycin prior to SPECT myocardial perfusion imaging with Tc99m-sestamibi would reduce the amount of interfering extra-cardiac activity and improve the image quality.
   Methods : A total of 96 patients who were routinely referred for myocardial perfusion imaging were randomly assigned to one of two groups. Patients in group A received 500 mg of non-enterically coated erythromycin orally one hour prior to image acquisition (45 patients). Patients in group B received diluted lemon juice which comprises the current standard of care in our department (51 patients). A two-day protocol was followed and study participants received the same intervention on both days. Planar images of both the stress and rest images were assessed visually by three experienced nuclear medicine physicians for the presence of interfering extra-cardiac activity. Physicians were blinded to the detail of the protocol and independently assessed the images.
   Results : The qualitative results favoured lemon juice in reducing the amount of interfering extra-cardiac activity. The overall incidence of interfering extra-cardiac activity was 46.15% in the lemon juice group vs 55.56% in the erythromycin group. However, this difference was not found to be statistically significant (p = 0.36). The use of a MYO:EXT ratio similar to the one described by Peace and Lloyd, appeared promising in quantifying interfering extra-cardiac activity.
   Conclusion : The difference between the effect of erythromycin and lemon juice on interfering extra-cardiac activity appears statistically insignificant and erythromycin could therefore be considered as a suitable alternative to lemon juice.
    
   
7. Title: The association between anthropometric parameters, the metabolic syndrome and microalbuminuria in black Africans : the SABPA study : cardiovascular topics
   Authors: Hoebel, S.; De Ridder, J.H.; Malan, L.
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: We aimed to determine which surface anthropometric and metabolic syndrome (MS) markers could be associated with the development of microalbuminuria (MA), and assessed 200 urban Africans (25-60 years) stratified into low (≤ 0.90 and ≤ 0.85) and high (> 0.90 and > 0.85) waist-to-hip ratio (WHR) groups from the North-West province. Anthropometric and fasting MS markers, such as systolic and diastolic blood pressure (BP), and glucose, triglyceride (TG) and high-density lipoprotein (HDL) levels, as well as MA markers were measured.
   Males revealed higher lifestyle risk factors (body mass index, smoking, alcohol consumption, low physical activity), anthropometric and MS markers compared to the females. The same overall trend was seen for high-WHR males but not for high-WHR females compared to their low-WHR counterparts. Both high-WHR groups revealed increased glucose values (males, 6.34 mmol/l; females, 6.13 mmol/l). Multiple linear regression analysis, independent of confounders, showed positive associations between diastolic blood pressure (DBP) (high WHR and all males), TG, waist circumference (WC) and development of MA in all males. In high-WHR females, positive associations existed only between WC and the development of MA, while neck circumference (NC) was associated with MA development in all females. To conclude, vascular BP, TG and WC were associated with risk of renal impairment in males, while in females, NC and WC circumferences were associated with this risk.
    
   
8. Title: A South African national database in cardiothoracic surgery : cardiovascular topics
   Authors: Linegar, Anthony; Smit, Francis; Stroebel, Andrie; Schaafsma, Elizabeth
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: This article aims to update South African cardiothoracic surgeons on the developmental progress of the national database in cardiac and thoracic surgery and to encourage participation in this most important endeavour
    
   
9. Title: Cerebral embolism following thrombolytic therapy for acute myocardial infarction : the second reported case : case report
   Authors: Bostan, Mehmet; Kanat, Ayhan; Sen, Murat; Kazdal, Hizir; Bostan, Habib
   From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
   Published: 2010
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   Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
   Abstract: ST-elevation myocardial infarction (STEMI), caused by acute occlusion of the infarct-related coronary artery, is an emergency condition. The primary therapy is restoration of full antegrade flow by either percutaneus coronary intervention (PCI) or thrombolytic therapy (TT). Although primary PCI is superior to TT in patients with STEMI, there are many limitations in clinical practice. TT decreases mortality in STEMI patients, but as experience with thrombolytic agents grows, the potential risks of serious side effects become more apparent. The major complications are bleeding, hypotension and skin rash.
   We report on a case of cerebrovascular accident (CVA) caused by cerebral emboli following TT. We concluded that the fact that the patient was in arterial fibrillation (AF) was a major contributing factor to her CVA. This is an extremely rare condition, and our case appears to be the second one reported on in the literature.
    
   
10. Title: Reconciling Q waves and late gadolinium enhancement with no angiographic evidence of coronary disease : cardiac sarcoidosis presenting as decompensated heart failure : case report
    Authors: Morrissey, Ryan P.; Philip, Kiran J.; Schwarz, Ernst R.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: Cardiac sarcoidosis is rare and subclinical involvement is four to five times more common than clinical involvement. Cardiac sarcoidosis is associated with a poor prognosis. ECG abnormalities are the most common presentation. However, as this case illustrates, it can also present as acute decompensated heart failure. Screening with cardiac positron emission tomography (PET) or magnetic resonance imaging (MRI) is highly suggested in patients with suspected disease. Diagnosis allows for early initiation of corticosteroids. Cardiac sarcoidosis is more common than previously thought. However, with treatment, survival may also be better than previously reported.
     
    
11. Title: Soweto Cardiovascular Research Unit : patients with heart disease encouraged to live and eat healthily
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: The Soweto Cardiovascular Research Unit partners with Adcock Ingram, through its generics portfolio team, to host workshops on disease management and cooking demonstrations on healthy eating for heart disease patients at Chris Hani Baragwanath Hospital.
     
    
12. Title: Persistent left superior vena cava with absent right superior vena cava : a case report and review of the literature : case report
    Authors: Ucar, Ozgul; Pasaoglu, Lale; Cicekcioglu, Hulya; Vural, Murat; Kocaoglu, Ibrahim; Aydogdu, Sinan
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: We report on a rare case of persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC), an anomaly that is also known as isolated PLSVC. This venous malformation was identified incidentally in a 30-year-old woman during thoracic multi-detector computed tomography (MDCT), which was performed with the suspicion of intra-thoracic malignancy.
    On thoracic MDCT, the RSVC was absent. A bridging vein drained the right jugular and right subclavian veins and joined the left brachiocephalic vein in order to form the PLSVC, which descended on the left side of the mediastinum and drained into the right atrium (RA) via a dilated coronary sinus (CS). The patient was referred to the cardiology department for further evaluation. Transthoracic echocardiography revealed a dilated CS, and agitated saline injected from the left or right arms revealed opacification of the CS before the RA. The patient had no additional cardiac abnormality.
    Isolated PLSVC is usually asymptomatic but it can pose difficulties with central venous access, pacemaker implantation and cardiothoracic surgery. This condition is also associated with an increased incidence of congenital heart disease, arrhythmias and conduction disturbances. A wide spectrum of clinicians should be aware of this anomaly, its variations and possible complications.
     
    
13. Title: Point of view on concomitant coronary and lower-limb surgical revascularisation : letter to the editor
    Authors: Lentini, Salvatore; Benedetto, Filippo; Carmignani, Amedeo; Gaeta, Roberto
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: We read with interest the recent paper from Prof Suzer and co-workers on concomitant coronary artery bypass grafting and descending aorta-to-bifemoral artery bypass via sternotomy. The authors are to be commended for their work.
     
    
14. Title: Sunshine and the cardiovascular benefits - a dose of sunshine! : your life and your heart
    Authors: Straughan, John L.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: Without sunlight, there would be no life as we know it. Early human societies rightly paid homage to the sun. Many millennia later, and for a host of different reasons, we are again regarding our sun with special interest. That exposure to sunlight is capable of generating a variety of beneficial effects in our skin is an area of exciting discovery - not least for the cardiovascular practitioner.
     
    
15. Title: CLARIFY registry launched in South Africa : drug trends in cardiology
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: The CLARIFY registry (ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is the first and largest international registry designed to increase knowledge and understanding of stable coronary artery disease (CAD).
     
    
16. Title: Boehringer launches first direct thrombin inhibitor : dabigatran (Pradaxa®) : drug trends in cardiology
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: Dabigatran, an oral reversible direct thrombin inhibitor, already available in Europe and the United Kingdom, has been licensed for anti-coagulant use in orthopaedic hip and knee surgery in South Africa. At the launch of this novel anticoagulant, Prof Simon Frostick, professor of orthopaedics at Liverpool University pointed out that experience from clinical trials and in-practice experience has shown dabigatran to be a safe and effective agent in deep-vein thrombosis (DVT) prophylaxis.
     
    
17. Title: Fibrates consistently lower risk of cardiovascular events across high-risk groups : drug trends in cardiology
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: A recent meta-analysis of published clinical trials conducted over the past 50 years has confirmed that the administration of fibrates to a broad range of high-risk patients lowers the risk of cardiovascular events.
     
    
18. Title: Tirofiban shows better platelet inhibition in diabetic patients during PCI procedures : drug trends in cardiology
    Authors: Aalbers, J.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: The extent of platelet aggregation and levels of C-reactive protein (CRP) released during actual percutaneous coronary intervention (PCI) procedures have not been well studied.
     
    
19. Title: Aspirin in primary prevention : USPSTF recommendations : drug trends in cardiology
    Authors: Aalbers, J.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: Recent clinical studies such as the Japanese Primary Prevention trial (JPAD) and the Aspirin for Asymptomatic Atherosclerosis study (AAA) have resulted in considerable debate on when and for whom aspirin should be given as primary prevention for vascular events.
     
    
20. Title: Boehringer Ingelheim launches a more affordable Micardis®
    Trimega provides essential fatty acids - cardiovascular care products : advertorial
    From: Cardiovascular Journal of Africa, Vol 21, Issue 3, May / Jun
    Published: 2010
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    Notes: Previously published as Cardiovascular Journal of South Africa until Volume 18, Issue 2, Mar/Apr 2007, ISSN 16800745. First volume of Cardiovascular Journal of Africa published as Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: Boehringer Ingelheim launches a more affordable Micardis®
    Trimega provides essential fatty acids - cardiovascular care products

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