Background In patients with coronary artery disease CAD , atherosclerotic changes of carotid arteries CA often coexist with CAD itself. If the degree of carotid atherosclerosis can be estimated, it would be very helpful in the management of patients with CAD. Methods CA intima-media thickness IMT was evaluated by ultrasonography at 12 segments both proximal, middle, distal common CA, bifurcation, internal and external CA-of the extracranial CA on the 182 subjects whom underwent coronary angiograms. The subjects were divided into 4 groups according to the severity of CAD; control C, n 23 , single vessel disease , n 64 , two vessel disease , n 44 , three vessel disease , n 51. Results The means SD of maximal IMT, chosen from the 12 segments, of each group were 1.4 0.7mm C , 2.1 1.4mm , 2.2 1.2mm , and 2.9 1.7mm. The 4 groups showed significant differences between each other. The only conparison to yield unsignificant differences was between group I and group p 0.02 for C and , p 0.001 for C and , p 0.001 for C and , p 0.01 for and , p 0.04 for and. When multivariate analysis was used to assess which major risk factors for CAD age, male sex, smoking, hypertension, diabetes, cholesterol, triglycerides-and CAD groups affected CA IMT , group and increasing age were the most significant variables p 0.0001 and 0.0035, respectively. Conclusion It is necessary to evaluate the status of the extracranial carotid arterial system with
Background and ObjectiveThe aging process affects the responsiveness and other functions of endothelium and vascular smooth muscle cells, predisposing the old vessels to the development of atherosclerotic lesions. Endothelial nitric oxide synthase ecNOS gene polymorphism was shown to affect the occurrence of acute myocardial infarction AMI . We hypothesized that aging may affect the association between the ecNOS gene polymorphism and AMI. Methods We investigated the age-related distribution of the ecNOS gene a/b polymorphism in 121 male AMI patients and 206 age-matched healthy male controls. As a control, we also genotyped b-fibrinogen gene H1/H2 polymorphism in the same population. Results The aa, ab, and bb genotypes were found in 1, 49 and 156 cases among the control subjects and 5, 23 and 93 cases among the AMI patients, respectively. There was a significant association between the ecNOS polymorphism and AMI p 0.045 . When the correlation was analyzed by age, the significance remained only in the group below the age of 51 p 0.009 . The distribution of the b-fibrinogen gene H1/H2 alleles, however, was not found to be associated with development of AMI in both young p 0.7400 and old p 0.2160 population. Conclusion Our results provide the first evidence that links ecNOS polymorphism to the risk of AMI in relation to age. Young persons who smoke or have ecNOS aa genotype may have an increased risk of developing AMI. The functional as well as structural changes associated with aging in the vascular endothelium may mask the effect of the ecNOS polymorphism in the development of AMI in old people.
Background Since the 1980s, early ambulation and cardiac rehabilitation have been emphasized in clinical practice after myocardial infarction. This is based on the belief that cardiac rehabilitation can reduce cardiovascular mortality, improve functional capacity and reduce the risk of further coronary events. In this study, we investigate the effect of aerobic exercise-based cardiac rehabilitation on functional capacity and cardiopulmonary responses in patients with myocardial infarction.Methods 19 patients were divided into two groups 9 patients for training group and 10 patients for control group at 4 6 weeks after acute myocardial infarction. Training group performed aerobic exercise for 8 weeks 3 sessions per week, mean 53mins per session at 40 60% of heart rate HR reserve, while control group did not. Before and after 8 weeks, all patients performed symptomlimited exercise test using modified Bruce protocol. Also, breath by breath respiratory gas analysis was carried out throughout exercise test.Results For body composition, body weight 2.7%, p 0.001 , body mass index 2.5%, p 0.001 and %body fat 2.6%, p 0.05 were decreased significantly in training group after 8 week cardiac rehabilitation. Resting HR 13%, p 0.05 was reduced significantly in training group, but no significant change occurred in resting blood pressure between the two groups. Maximal oxygen uptake 18%, p 0.01 and anaerobic threshold 21%, p 0.05 were increased significantly in training group after 8 week cardiac rehabilitation as compared with the control group. There was no significant change in maximal O 2 pulse between the two groups. Submaximal rate-pressure product 17%,
Background and Objectives:There are several reports of cardiac rehabilitation (CR) having beneficial effects on the reduction of cardiovascular mortality and in the prevention of recurrent coronary events in patient with myocardial infarction (MI). An 8-week CR program was investigated to see if it affected the prognostic factors, such as inflammatory markers, after acute MI. Subjects and Methods:33 male and 5 female patients, with a mean age of 55±10 yrs, were consecutively assigned to the CR (n=19) and the control (n=19) groups three weeks after acute MI. The 8-week CR program consisted of life style modification and aerobic exercise training. At the baseline, and after 8 weeks, the symptom limited exercise test and peripheral blood sampling were performed to measure the physiologic capacity, the serum levels of high sensitive C-reactive protein (hs-CRP) and the plasma levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α. The interval changes of each parameter were compared between the two groups. Results:The interval increments of the maximal oxygen uptake (14.3% vs. 10.6%, CR vs. control group, p=0.014), anaerobic threshold (18.8% vs. 7.0%, CR vs. control group, p=0.044) and exercise duration (9.4% vs. 3.1%, CR vs. control group, p=0.009) were larger in the CR than in the control group. The magnitudes of the interval changes in hs-CRP, IL-6 and TNF-α, as inflammatory markers, did not differ between the two groups (p>0.05). Conclusion:This 8-week CR program demonstrated an improved exercise capacity for MI patients, but a larger clinical trial, with modified exercise intensity and duration, will be necessary to detect any possible effect on the inflammatory markers. (Korean
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