Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Cardiovascular disease wikipedia , lookup
Remote ischemic conditioning wikipedia , lookup
Heart failure wikipedia , lookup
Cardiac contractility modulation wikipedia , lookup
Electrocardiography wikipedia , lookup
Hypertrophic cardiomyopathy wikipedia , lookup
Cardiac surgery wikipedia , lookup
Management of acute coronary syndrome wikipedia , lookup
Coronary artery disease wikipedia , lookup
Ventricular fibrillation wikipedia , lookup
Quantium Medical Cardiac Output wikipedia , lookup
Arrhythmogenic right ventricular dysplasia wikipedia , lookup
8P Medical Research Society that this shortening of ED was due to shortening of mid systole (controls = 109 ms versus CHF = 67 ms;Pd.001)and explicable by early wave reflection. Vitamin C increased ED from 284 f 5 ms to 298 f 6 ms (P<O.001) but there was no change following normal saline (from 274 f 8 ms to 275 f 8 ms; P=NS). Time sequence analysis revealed that this prolongation was almost exclusively due to a prolongation of mid systole (increase from 66ms to 76 ms;P=O.OI) and entirely explicable by a delay in wave reflection. Conclusions - Early wave reflection contributes to shortened ED in CHF. Vitamin C increases ED, which appears, at least in part a consequenceof delayed wave reflection. 25 MEN WITH LOW LEVELS OF ANDROGENS HAVE WORSE LEFT VENTRICULAR FUNCTION FOLLOWING ACUTE MYOCARDIAL INFARCTION PJ PUGH, KM ENGLISH, TH JONES and KS CHANNER Department of Cardiology, Royal Hallamshire Hospital, Sheffield, Department of Human Metabolism and Clinical Biochemistry, University of Sheffield Background: Low androgen levels in men are associated with risk factors for acute myocardial infarction (AMI). The fall in testosterone following AMI may themfore be associated with poorer outcome. We examined the relation of androgens with infarct size and cardiac function in men with AMI. Methods: 22 male patients with AMI were recruited. Blood was taken at presentation (day 1) and on days 2, 3 and 6 following admission. Levels of total (TT), free (FT) and bio-available (BT) testosterone and DHEAS were measured. Peak creatine kinase (CK) was determined. The development of left ventricular failure (LVF) during admission and the subsequent finding of left ventricular dysfunction (LVD) at echo or cardiac catheter were recorded. Results: Baseline androgens did not predict the peak CK. TT on day 3 correlated inversely with peak CK (I=-0.43, e.047). Baseline DHEAS correlated with admission diastolic blood pressure. (14.53, p==O.Oll).Subjects who developed LVF had lower baseline levels of FT (35.9pM v 49.8pM, @.025). Those who developed LVD had higher peak CK (1979UL v 766UL, ~ 4 . 0 3 7 )and lower baseline TT (10.4nM v 14.6nM, e . 0 3 9 ) ; they also had a greater fall in DHEAS level during their hospital stay (-0.95pM v +0.53pM, p=O.043). The development of Q waves was associated with a higher peak CK (2389UL v 836UL. p4.001) and greater fall in BT (-l.OnM v -O.lnM, ~ 4 . 0 1 6 ) . Conclusion: Bigger infarct size and poorer cardiac function are associated with lower androgen levels in men with AMI. These findings may suggest a possible protective role of androgens in limiting myocardial damage. function (n=8) and Group C had normal LV function with normal valves and coronary arteries (n=8). Blood was taken between 0800 and 0900hours. Levels of total (TT) and bio-available (BT) testosterone were measured. Results: Age and body mass index did not differ significantly between groups. TT and BT levels in Group C were 19.6nMf3.0 and 5 . 7 m 1 . 3 respectively. Subjects in Group A had significantly lower levels of both TT (14.3nMf2.9, p4.003) and BT (4.lnMf1.0, fl.017). Subjects in Group B also had lower levels but not significantly (TT=l8.7*6.9, ~ 4 . 7 4 0 BT=S.OnMkl ; .O, ~ 4 . 2 4 2 ) . The difference in hormone levels between Groups A and B was not significant for TT (p4.121) or BT @=O.llI). Conclusion: Men with heart failure due to LVD have lower testosterone levels than men with normal left ventricular function. However, in men with heart failure from VHD who have preserved ventricular function, testosterone levels are not significantly altered, suggesting that the reduced androgen level is associated with myocardial disease rather than systemic abnormalities. Low androgen levels could contribute to altered vascular tone and the muscle wasting and fatigue seen in patients with heart failure. 27 NON-ACE MEDIATED pRoDucIlON ANGXOTENSIN II 26 MEN WITH POOR LEFT VENTRICULAR FUNCTION HAVE LOWER LEVELS OF TESTOSTERONE THAN MEN WITH NORMAL LEFT VENTRICULAR FUNCTION PJ PUGH, KM ENGLISH, TH JONES and KS CHANNER Department of Cardiology, Royal Hallamshire Hospital, Shefield, Department of Human Metabolism and Clinical Biochemisw, University of Sheffield Background Testosterone is an anabolic hormone which has been shown to act as a vasodilator in men.Patients with heart failure have abnormal vascular tone and excess catabolism. We examined testosterone levels in men with heart failure due to either left ventricular dysfunction (LVD) or valvular heart disease (VHD). Methods: Male patients undergoing elective cardiac catheterisation were recruited. Group A consisted of men with LVD due to coronary disease (n=8), Group B had significant VHD but normal LV systolic 28 CAROTID DISEASE IN A LOCAL POPULATION: THE EFFICACY OF AN OPEN ACCESS CAROTID DUPLEX SERVICE CWh4 CHAN, AR BRADWELL*, AD WRIGHT* and CHE IMRAY Vascular Investigation Unit, Walsgrave Hospital, Coventry CV2 2DX Duplex scanning is well established in identifying high grade carotid stenosis suitable for surgery. Whilst differing carotid surgery rates within the United Kingdom may, in part, be due to population differences, local practice and referral patterns may play a more insidious role in the identification of the population at risk.