Background: Cardiovascular events, the leading cause of death among diabetic patients, are usually under-diagnosed due to subclinical presentation. Methods: We conducted a cross-sectional study from March-2019 to Sept...Background: Cardiovascular events, the leading cause of death among diabetic patients, are usually under-diagnosed due to subclinical presentation. Methods: We conducted a cross-sectional study from March-2019 to September-2020, in two reference hospitals in Yaoundé, Cameroon, to assess the prevalence of asymptomatic Left Ventricular Diastolic Dysfunction (LVDD) and Silent Myocardial Infarction (SMI) and potentially associated factors. Results: Out of 95 participants (mean age ± SD: 43 ± 7 years;M/F sex-ratio 1.6), 22 (23.1%;95% CI: 15.8% - 32.6%) had LVDD and fewer (n = 13, 13.6%;95% CI: 8.2% - 22.0%) had SMI, p = 0.86. Though not statistically significant, patients with ≥5 years diabetes duration, as well as patients with HbA1C ≥ 7.5% had two-fold increased risk of LVDD (p = 0.22 and p = 0.15 respectively). LVDD was significantly higher in patients with SMI (29% vs 6.3%, p Conclusion: The significant presence of asymptomatic cardiovascular manifestations in this population entails mandatory preventive screening, especially, in patients with long standing diabetes and poor glycemic control, to allow timely detection and management.展开更多
Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left ... Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left intraventricular pressure (LVP), the maximum rise rate of intraventricular pressure (LVP dp/dtmax), the area of cardiac force loop (ACFL), and the maximum shortening velocity of myocardial contractile element (Vmax) were observed. As a result, there were significant differences in the improvement of LVP, LVP dp/dtmax, ACFL and Vmax between EA at HM and LM. The regulatory action of EA at HM on the myocardial contractile function was significantly better than that of EA at LM, indicating that HM has a close relationship with the myocardial contractile function.……展开更多
Left bundle branch block （ LBBB ）, traditionally viewed as an electrophysiologic abnormality, is increasingly recognized for its effects on hemodynamics and patient＇s prognosis^[1]. Exercise nuclear studies frequen...Left bundle branch block （ LBBB ）, traditionally viewed as an electrophysiologic abnormality, is increasingly recognized for its effects on hemodynamics and patient＇s prognosis^[1]. Exercise nuclear studies frequently show reversible perfusion defects in the absence of obstructive coronary artery disease^[2] and some patients with intermittent LBBB develop angina coincident with the onset of LBBB^[3]. We report a case of intermittent LBBB with abnormal stress technetium 99m TC single-photon emission computed tomography （SPECT） study and normal coronary artery angiography.展开更多
Objective To study the relationship between isometric exercise and myocardial ischemia in patients with coronary artery disease (CAD) Methods Twenty CAD patients and 10 normal subjects were included in our study ...Objective To study the relationship between isometric exercise and myocardial ischemia in patients with coronary artery disease (CAD) Methods Twenty CAD patients and 10 normal subjects were included in our study All subjects performed maximal brief isometric exercise (BIE), maximal sustained isometric exercise (SIE) and dynamic exercise (DE) Hemodynamic parameters and cardiac function were measured by Echo Doppler technique To avoid influence of different baseline values, increment (Δ%) of exercise response was used as parameter for significant analysis: Δ%=(exercise values-baseline values)/baseline values×100% Results Positive exercise testing (PET) showed no evidence of myocardial ischemia during BIE and SIE even though their rates of perceived exertion (RPE) were similar to DE Δ% heart rate (HR) and Δ% rate pressure product (RPP) were higher during DE than during SIE and BIE in negative exercise testing (NET) and normal controls (NOR) ( P <0 01), except PET during DE and SIE; Δ% systolic blood pressure (SBP) was higher during DE than during BIE in NOR ( P <0 01) Δ% SBP in NOR and NET during SIE was higher than during BIE ( P <0 05) Δ% diastolic blood pressure (DBP) was the highest during SIE among exercises in all groups ( P <0 05) There were no significant inter group differences of Δ% HR, Δ% SBP, Δ% DBP and Δ% RPP during SIE, BIE and DE, except that Δ% SBP during SIE was higher in NET than in NOR and PET ( P <0 05) In NOR, Δ% ejection fraction (EF), Δ% fractional shortening of the minor semi axis (SF), Δ% cardiac output (CO), Δ% E/A was higher during DE than during SIE and BIE ( P <0 01) Δ% stroke volume (SV) was similar during DE, SIE and BIE There were no significant differences in Δ% EF, Δ% SF, Δ% CO, Δ% SV and Δ% E/A during DE, SIE and BIE in both NET and PET, except lower Δ% CO in NET during SIE and BIE than DE ( P <0 01) There were no inter group differences in Δ% EF, Δ% SF, Δ% CO and Δ% E/A, except that Δ% E/A was higher during SIE in NET than PET ( P <0 01) During DE, NOR and NET had higher Δ% SV, Δ% SF, Δ% CO and Δ% E/A than PET ( P <0 05) Conclusions The incidence of myocardial ischemia in CAD patients was lower during isometric exercise than dynamic exercise at similar perceived exertion levels Isometric exercise might protect the myocardium from ischemia through high coronary artery perfusion pressure and long perfusion duration We suggest that application of isometric exercise in a cardiac rehabilitation program may have reasonable physiological background展开更多
文摘Background: Cardiovascular events, the leading cause of death among diabetic patients, are usually under-diagnosed due to subclinical presentation. Methods: We conducted a cross-sectional study from March-2019 to September-2020, in two reference hospitals in Yaoundé, Cameroon, to assess the prevalence of asymptomatic Left Ventricular Diastolic Dysfunction (LVDD) and Silent Myocardial Infarction (SMI) and potentially associated factors. Results: Out of 95 participants (mean age ± SD: 43 ± 7 years;M/F sex-ratio 1.6), 22 (23.1%;95% CI: 15.8% - 32.6%) had LVDD and fewer (n = 13, 13.6%;95% CI: 8.2% - 22.0%) had SMI, p = 0.86. Though not statistically significant, patients with ≥5 years diabetes duration, as well as patients with HbA1C ≥ 7.5% had two-fold increased risk of LVDD (p = 0.22 and p = 0.15 respectively). LVDD was significantly higher in patients with SMI (29% vs 6.3%, p Conclusion: The significant presence of asymptomatic cardiovascular manifestations in this population entails mandatory preventive screening, especially, in patients with long standing diabetes and poor glycemic control, to allow timely detection and management.
文摘 Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left intraventricular pressure (LVP), the maximum rise rate of intraventricular pressure (LVP dp/dtmax), the area of cardiac force loop (ACFL), and the maximum shortening velocity of myocardial contractile element (Vmax) were observed. As a result, there were significant differences in the improvement of LVP, LVP dp/dtmax, ACFL and Vmax between EA at HM and LM. The regulatory action of EA at HM on the myocardial contractile function was significantly better than that of EA at LM, indicating that HM has a close relationship with the myocardial contractile function.……
文摘Left bundle branch block （ LBBB ）, traditionally viewed as an electrophysiologic abnormality, is increasingly recognized for its effects on hemodynamics and patient＇s prognosis^[1]. Exercise nuclear studies frequently show reversible perfusion defects in the absence of obstructive coronary artery disease^[2] and some patients with intermittent LBBB develop angina coincident with the onset of LBBB^[3]. We report a case of intermittent LBBB with abnormal stress technetium 99m TC single-photon emission computed tomography （SPECT） study and normal coronary artery angiography.
文摘Objective To study the relationship between isometric exercise and myocardial ischemia in patients with coronary artery disease (CAD) Methods Twenty CAD patients and 10 normal subjects were included in our study All subjects performed maximal brief isometric exercise (BIE), maximal sustained isometric exercise (SIE) and dynamic exercise (DE) Hemodynamic parameters and cardiac function were measured by Echo Doppler technique To avoid influence of different baseline values, increment (Δ%) of exercise response was used as parameter for significant analysis: Δ%=(exercise values-baseline values)/baseline values×100% Results Positive exercise testing (PET) showed no evidence of myocardial ischemia during BIE and SIE even though their rates of perceived exertion (RPE) were similar to DE Δ% heart rate (HR) and Δ% rate pressure product (RPP) were higher during DE than during SIE and BIE in negative exercise testing (NET) and normal controls (NOR) ( P <0 01), except PET during DE and SIE; Δ% systolic blood pressure (SBP) was higher during DE than during BIE in NOR ( P <0 01) Δ% SBP in NOR and NET during SIE was higher than during BIE ( P <0 05) Δ% diastolic blood pressure (DBP) was the highest during SIE among exercises in all groups ( P <0 05) There were no significant inter group differences of Δ% HR, Δ% SBP, Δ% DBP and Δ% RPP during SIE, BIE and DE, except that Δ% SBP during SIE was higher in NET than in NOR and PET ( P <0 05) In NOR, Δ% ejection fraction (EF), Δ% fractional shortening of the minor semi axis (SF), Δ% cardiac output (CO), Δ% E/A was higher during DE than during SIE and BIE ( P <0 01) Δ% stroke volume (SV) was similar during DE, SIE and BIE There were no significant differences in Δ% EF, Δ% SF, Δ% CO, Δ% SV and Δ% E/A during DE, SIE and BIE in both NET and PET, except lower Δ% CO in NET during SIE and BIE than DE ( P <0 01) There were no inter group differences in Δ% EF, Δ% SF, Δ% CO and Δ% E/A, except that Δ% E/A was higher during SIE in NET than PET ( P <0 01) During DE, NOR and NET had higher Δ% SV, Δ% SF, Δ% CO and Δ% E/A than PET ( P <0 05) Conclusions The incidence of myocardial ischemia in CAD patients was lower during isometric exercise than dynamic exercise at similar perceived exertion levels Isometric exercise might protect the myocardium from ischemia through high coronary artery perfusion pressure and long perfusion duration We suggest that application of isometric exercise in a cardiac rehabilitation program may have reasonable physiological background
