Current Issue : July - September Volume : 2018 Issue Number : 3 Articles : 5 Articles
Atrial fibrillation (AF) is an important public health problem that is increasing at an alarming rate, worldwide. The most common\ntype is permanent AF followed by the paroxysmal and persistent AF. Purpose. This study was aimed at exploring anxiety and\ndepression and the associated factors in patients with permanent AF. Materials and Methods.The sample of the study included 170\nAF patients. Data collection was performed by the method of interview using the ââ?¬Å?Hospital Anxiety and Depression Scaleââ?¬Â\n(HADS) to assess anxiety and depression and a questionnaire including patientsââ?¬â?¢ characteristics. Results. 70% of the participants\nwere men, and 32.4% were above 70 years old. Furthermore, 34.9% of the patients had high levels of anxiety, and 20.2% had high\nlevels of depression. Anxiety levels were statistically significantly associated with gender (p 0.022), age (p 0.022), educational\nlevel (p 0.025), years having the disease (p 0.005), and relations with nursing staff (p 0.040). Depression levels were\nstatistically significantly associated with age (p 0.037), degree of information of the state of health (p<0.001), years having the\ndisease (p<0.001), and relations with medical staff (p 0.041). Conclusions. Patientsââ?¬â?¢ characteristics are associated with anxiety\nand depression and need to be evaluated when treating this frequently encountered arrhythmia....
Essential hypertension, fast heart rate, low heart rate variability, sympathetic nervous\nsystem dominance over parasympathetic, arterial stiffness, endothelial dysfunction and poor\nflow-mediated arterial dilatation are all associated with cardiovascular mortality and morbidity.\nThis review of randomised controlled trials and other studies demonstrates that caloric restriction\n(CR) is capable of significantly improving all these parameters, normalising blood pressure (BP) and\nallowing patients to discontinue antihypertensive medication, while never becoming hypotensive.\nCR appears to be effective regardless of age, gender, ethnicity, weight, body mass index (BMI) or a\ndiagnosis of metabolic syndrome or type 2 diabetes, but the greatest benefit is usually observed in\nthe sickest subjects and BP may continue to improve during the refeeding period. Exercise enhances\nthe effects of CR only in hypertensive subjects. There is as yet no consensus on the mechanism of\neffect of CR and it may be multifactorial. Several studies have suggested that improvement in BP is\nrelated to improvement in insulin sensitivity, as well as increased nitric oxide production through\nimproved endothelial function. In addition, CR is known to induce SIRT1, a nutrient sensor, which is\nlinked to a number of beneficial effects in the body....
Objectives. Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular morbidity and mortality. The\naim of this study was to assess whether the 10-year risk for cardiovascular disease in newly diagnosed patients with OSAS is\nincreased. Materials and Methods. Recently diagnosed, with polysomnography, consecutive OSAS patients were included. The\nSystematic Coronary Risk Evaluation (SCORE) and the Framingham Risk Score (FRS) were used to estimate the 10-year risk for\ncardiovascular disease. Results. Totally, 393 individuals (73.3% males), scheduled to undergo a polysomnographic study with\nsymptoms indicative of OSAS, were enrolled. According to apnea-hypopnea index (AHI), subjects were divided in four groups:\nmild OSAS (AHI 5ââ?¬â??14.9/h) was diagnosed in 91 patients (23.2%), moderate OSAS (AHI 15ââ?¬â??29.9/h) in 58 patients (14.8%), severe\nOSAS (AHI > 30/h) in 167 patients (42.5%), while 77 individuals (19.6%) had an AHI < 5/h and served as controls. Increased\nseverity of OSAS was associated with increased SCORE (p<0.001) and FRS values (p<0.001). More specifically, a significant\ncorrelation was observed both between AHI and SCORE (r 0.251, p<0.001) and AHI and FRS values (r 0.291, p<0.001).\nFurthermore, a negative correlation was observed between FRS values and sleep efficiency (r âË?â?? 0.224, p 0.006). Conclusions.\nThe 10-year risk for cardiovascular morbidity and mortality seems to increase with severity of OSAS. Physicians should bear this\nfinding in mind, in order to seek for and consecutively eliminate risk factors for cardiovascular disease and to prevent future\ncardiovascular events in OSAS patients....
Cardiovascular disease (CVD) still remains the main cause of morbidity and mortality and consequently early diagnosis is of\nparamount importance.Working conditions can be regarded as an additional risk factor for CVD. Since different aspects of the job\nmay affect vascular health differently, it is important to consider occupation frommultiple perspectives to better assess occupational\nimpacts on health. Standard echocardiography has several targets in the cardiac population, as the assessment of myocardial\nperformance, valvular and/or congenital heart disease, and hemodynamics. Three-dimensional echocardiography gained attention\nrecently as a viable clinical tool in assessing left ventricular (LV) and right ventricular (RV) function, volume, and shape. Twodimensional\n(2DSTE) and, more recently, three-dimensional speckle tracking echocardiography (3DSTE) have also emerged as\nmethods for detection of global and regionalmyocardial dysfunction in various cardiovascular diseases and applied to the diagnosis\nof subtle LV and RV dysfunction. Although these novel echocardiographic imaging modalities have advanced our understanding\nof LV and RV mechanics, overlapping patterns often show challenges that limit their clinical utility. This review will describe the\ncurrent state of standard and advanced echocardiography in early detection (secondary prevention) of CVD and address future\ndirections for this potentially important diagnostic strategy...
The left and right ventricles of the four-chambered heart have distinct developmental\norigins and functions. Chamber-specific developmental programming underlies the differential gene\nexpression of ion channel subunits regulating cardiac electrophysiology that persists into adulthood.\nHere, we discuss regional specific electrical responses to genetic mutations and cardiac stressors,\ntheir clinical correlations, and describe many of the multi-scale techniques commonly used to analyze\nelectrophysiological regional heterogeneity...
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