107 research outputs found
Optimized Ventriculo-Arterial Optimized Ventriculo-Arterial Interaction Explains Better Longitudinal Function in Endurance-Trained Athletes by Comparison with Strength-Trained Athletes
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Better longitudinal function in endurance-trained athletes in comparison with strength-trained athletes, related to optimized ventriculo-arterial interaction.
No full text"Supranormal" Cardiac Function in Athletes Related to Better Arterial and Endothelial Function
No full textObjective: Athlete’s heart is associated with left ventricular (LV) hypertrophy (LVH), and “supranormal”
cardiac function, suggesting that this is a physiological process. Hypertrophy alone cannot explain
increase in cardiac function, therefore, other mechanisms, such as better ventriculo-arterial coupling
might be involved. Methods: We studied 60 male (21 ± 3 years) subjects: 27 endurance athletes,
and a control group of 33 age-matched sedentary subjects. We assessed global systolic and diastolic LV
function, short- and long-axismyocardial velocities, arterial structure and function and ventriculo-arterial
coupling, endothelial function by flow-mediated dilatation, and amino-terminal pro-brain natriuretic
peptide (NT-proBNP) and biological markers of myocardial fibrosis and of oxidative stress. Results:
Athletes had “supranormal” LV longitudinal function (12.4 ± 1.0 vs 10.1 ± 1.4 cm/s for longitudinal
systolic velocity, and 17.4 ± 2.6 vs 15.1 ± 2.4 cm/s for longitudinal early diastolic velocity, both P <
0.01), whereas ejection fraction and short-axis function were similar to controls. Meanwhile, they had
better endothelial function (16.7 ± 7.0 vs 13.3 ± 5.3%, P < 0.05) and lower arterial stiffness (pulse
wave velocity 7.1 ± 0.6 vs 8.8 ± 1.1 m/s, P = 0.0001), related to lower oxidative stress (0.259 ± 0.71
vs 0.428 ± 0.88 nmol/mL, P = 0.0001), with improved ventriculo-arterial coupling (37.1 ± 21.5 vs
15.5 ± 13.4 mmHg.m/s3 × 103, P = 0.0001). NT-proBNP and markers of myocardial fibrosis were not
different from controls. LV longitudinal function was directly related to ventriculo-arterial coupling, and
inversely related to arterial stiffness and to oxidative stress. Conclusions: “Supranormal” cardiac function
in athletes is due to better endothelial and arterial function, related to lower oxidative stress, with
optimized ventriculo-arterial coupling; athlete’s heart is purely a physiological phenomenon, associated
with “supranormal” cardiac function, and there are nomarkers of myocardial fibrosis
Enoxaparin in patients not undergoing reperfusion for ST-elevation myocardial infarction.
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Enoxaparin verus unfractionated heparin in patients with heart failure post ST-elevation myocardial infarction
No full textIn-hospital case fatality rates for acute myocardial infarction in Romania
No full textBackground: We describe the clinical characteristics, treatments and in-hospital case-fatality rates in an unselected population of patients admitted for acute myocardial infarction.
Methods: From January 2000 to June 2007, we tracked consecutive patients who were admitted to 7 tertiary referral and 21 county hospitals in Romania for medical treatment of ST-segment elevation acute myocardial infarction. These patients were enrolled in the Romanian Registry for ST-segment Elevation Myocardial Infarction. For this prospective study, we collected data on demographic characteristics, cardiovascular risk factors, various aspects of treatment for myocardial infarction, and in-hospital death.
Results: The 9186 patients in the study group had a mean age of 63.8 years. The median time from onset of symptoms to thrombolysis was 230 (interquartile range 120-510) minutes. Of the 9186 patients, 4986 (54.3%) had hypertension, 1974 (21.5%) had diabetes mellitus, 3545 (38.6%) had lipid disorders and 4653 (50.7%) were smokers. The in-hospital mortality rate was 12.7% (1170 deaths). The study group consisted of 2893 women and 6293 men. The women were older than the men and had higher rates of hypertension and diabetes mellitus but were less likely to be smokers. A smaller proportion of women than men presented within 2 hours after onset of symptoms (23.1% v. 34.4%, p < 0.001). Smaller proportions of women received thrombolytics (40.8% v. 53.5%, p < 0.001), anticoagulants (93.4% v. 95.2%; p = 0.001), antiplatelet agents (88.3% v. 91.2%, p < 0.001) and primary percutaneous coronary interventions (1.5% v. 2.2%, p = 0.030). The risk of in-hospital death was greater for women, even after adjustment for confounders (odds ratio 1.33, 95% confidence interval 1.13-1.56; p < 0.001).
Interpretation: The rates of reperfusion therapy for patients with acute myocardial infarction were low, and in-hospital case-fatality rates were high in this study. Excess in-hospital mortality was more pronounced among women
Exploring sex differences in case fatality rates of acute myocardial infarction in Romania
No full textGender disparities in medical treatment contribute to the excess in-hospital mortality rates in Romanian women.
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