动脉粥样硬化多种族研究（MESA)：开创亚临床动脉粥样硬化无创评估新时代

动脉粥样硬化多种族研究（MESA）是美国国家心肺和血液研究所赞助的前瞻性研究,旨在研究性别均衡、多民族、社区居住的美国人群亚临床心血管病的患病率、进展、决定因素和预后意义。MESA开创了无创性评估亚临床动脉粥样硬化及其进展的时代,评估了动脉粥样硬化性心血管病的风险,超越了传统风险因素模型单独预测的能力。MESA的主要研究成果为全球心血管病病人管理指南提供了信息,为有效指导公共卫生政策、人群筛查和临床决策提供了新工具。就MESA的由来、研究目的、研究设计、对心血管医学的贡献以及MESA未来的发展方向予以介绍。     

《心血管病磁共振诊断学》——磁共振著作领域的一朵新葩

中国每年心血管病死亡300万人,平均每10.5秒就有1人死于心血管病,总死亡每3人中就有1人是心血管病。中国每年用于心血管病的直接医疗费用高达1300亿元。可见,心血管病不仅是危害人类健康的头号杀手,也是我国重大公共卫生问题。因此,对心血管病的诊断和治疗,特别是早期诊断及治疗随访尤为重要。近年来,心血管影像学技术的迅速发展和临床广泛应用,提高了心血管病的诊治水平。心血管病的影像学技术包括心血管超声、心血管造影、CT、MRI、PET等。其中,MRI以无电离辐射、软组织分辨率高以及任意平面成像等特点,可对心脏的解剖     

进一步拓展医学影像学研究

进一步拓展医学影像学研究刘玉清心血管病是危害人民健康的重要疾病。近年来，由于心血管影像诊断新技术和介入治疗的开发、应用及其所取得的进展。心血管影像学在心血管病防治工作中的重要作用，愈来愈受到人们的普遍重视。本期作为心血管病尤其缺血性心脏病的重点号，刊...     

高血压及其血管病变进展学习班通知

高血压是当今世界最常见的心血管病,又是动脉粥样硬化、冠心病、脑卒中和心肾功能衰竭的最重要的危险因素。研究证实,动脉功能和结构损害是包括高血压在内的许多心血管危险因素导致的早期血管改变,其与预后的确切关系已引起学术界的高度重视。最新国内外研究发现,血管壁结构和功能的异常是心脑血管疾病及急性心脑血管事件发病的根本原因,早期发现和干预亚临床血管病变的进展是延缓和控制心血管事件的根本措施。心血管病的诊断和治疗技术日新月异,治疗药物层出不穷,给心血管大夫提供了很好的诊疗手段,同时也带来挑战,若应用不当,将会增加医疗…     

急性ST段抬高性心肌梗死患者对相关知识的了解和需求分析

心血管病是危害人们身体健康的主要疾病之一,患者重视对心血管病危险因素的了解以及对心血管病的预防、急救等相关知识的掌握可以改善患者的疾病发生、发展,提高其生活质量。为了对心血管病患者健康教育可行、实效、针对进行,我们对2006年1～12月收治的167例急性ST段抬高性心肌梗死患者进行健康相关知识调查,旨在探讨切合实际的健康对策,现报道如下。     

检测血管炎症血清标志物预测心血管疾病危险性及其意义

在全世界每年死于动脉粥样硬化所致心血管病的人数约〉1900万。最近几年,早期检测动脉粥样硬化的血清标志物,以预测心血管病的危险性,已成为一个热门研究课题。1动脉粥样硬化的炎性发病机制动脉粥样硬化作为慢性炎性疾病,随血管壁的损伤而发展,其特征是血液单核细胞浸润进入内膜、血管平滑肌细胞增殖,以及细胞外基质进行性沉淀。内皮功能紊乱在动脉粥样硬化中是第一步,其原因包括高胆固醇血症、高血压、糖尿病、吸烟、血浆同型半胱氨酸浓度升高,以及这些因素与其他因素的联合。内皮功能紊乱的特征是内皮的作用朝向降低血管舒张,以及炎症前和血栓形成前状态。     

把握心血管病研究前沿,提高武警部队心血管病专业诊治水平

随着心血管流行病学的发展、分子生物学研究方法的广泛应用及以多中心协作大规模临床试验为标志的循证医学深入开展 ,国内外心血管疾病防治领域都得到了飞速的发展。把握住心血管病研究前沿 ,就获得了心血管病研究发展的主动权 ,在欧美发达国家 ,已使心血管病发病率及死亡率明显下降 ,如美国 30ａ来死亡率下降了 5 0 % ;但我国心脑血管病发病率逐年上升 ,占我国死亡原因的第 1位 ,这些已引起心血管临床医生的广泛关注。冠心病是危害我国人民健康的主要疾病之一 ,如 1984～ 1993年 10ａ间 ,北京地区发病率男性增高 36 % ,女性增高 6 6 % ;死…     

北京国际心血管病论坛2006暨中国医学科学院阜外心血管病医院建院50周年学术大会会议征文通知

由卫生部心血管病防治研究中心主办,中国医学科学院、中国协和医科大学阜外心血管病医院、美国 Duke 大学医学中心承办的“北京国际心血管病论坛2006暨中国医学科学院阜外心血管病医院建院50周年学术大会”将于2006年8月19～21日在北京国际会议中心举行。“北京国际心血管病论坛”的主题是:继续关注心血管病学的最新进展,特别是心内科、心外科、心血管影像学、心血管检验医学、心血管护理学、介入心脏病学、预防心脏病学及基础医学。论文投稿要求中英文摘要各1份,请寄北京国际心血管病论坛组委会北京阜外医院收,邮编:100037,或 Email 至 forum2006@fuwaihospital.org。截稿日期为2006年6月15日,请上网下载论文摘要表并查询有关详细信息(www.ihfbeijing.org)。     

动脉粥样硬化的一级预防研究进展

动脉粥样硬化早期干预研究和动物实验证实,在症状出现前的早期病理阶段有效控制致病因素,将延缓或阻止无症状动脉粥样硬化发展成临床疾病。有研究结果显示,70％的心血管事件、80％的冠心病事件、90％的新发糖尿病与不健康生活方式直接相关。不健康生活方式不仅是超重及肥胖、高血压、糖尿病、高胆固醇血症等慢性病的重要危险因素,而且可直接引起血管内皮功能损伤、炎症和氧化应激加强、促进血栓形成等。改善不健康的生活方式是降低动脉粥样硬化疾病发病率的“基石”。     

年大飞行员颈动脉超声的研究（摘要）

目的通过颈动脉超声观察飞行员颈动脉形态功能变化,为飞行员心血管系统健康鉴定提供依据。方法参照ARIC方案,对27名飞行员（组A）和30名非飞行健康人（组B）做颈动脉超声检查,采用高分辨率彩色多普勒超声仪,选用线阵探头,频率为5—10MHz。测量双侧颈总动脉近端、远端和窦部的内中膜厚度（IMT）、收缩与舒张内径并测算动脉紧张度为（收缩期内径-舒张期内径）×100／舒张期内径。     

Prevalence and anatomic characteristics of infarct-like lesions on MR images of middle-aged adults: the atherosclerosis risk in communities study.

BACKGROUND AND PURPOSE: MR imaging has revealed putative evidence of subclinical cerebrovascular disease (CVD) as reflected by white matter signal changes and infarct-like lesions (ILLs). Nonetheless, the prevalence of this condition in the general population has been defined only to a limited extent. We herein report the prevalence and anatomic characteristics of ILLs seen on cranial MR images obtained as part of a population-based study of cardiovascular disease in middle-aged adults. These results are contrasted to those of previous similar studies, particularly those of an elderly population in the Cardiovascular Health Study (CHS). METHODS: This Atherosclerosis Risk in Communities (ARIC) cohort consists of a probability sample of community-living persons who were 55 to 72 years old at the time of MR examination. MR imaging of 1890 participants was performed at two ARIC field centers, based on a common protocol. MR studies were evaluated by trained readers at the MR Reading Center using original digital data displayed on a high-resolution workstation. The measures of lesion size, anatomic location, and signal intensity were collected. The definition for an ILL was a non-mass, hyperintense region with an arterial vascular distribution on spin-density and T2-weighted images. RESULTS: Two hundred ninety participants had ILLs, for an overall prevalence of 15.3%. Eighty-two percent of participants with ILLs had lesions that were 3 mm or larger in maximal dimension, although 87% of these lesions were 20 mm or smaller in maximal dimension. The prevalence of ILLs increased with age, from 7.9% in the 55- to 59-year-old age group to 22.9% in the 65- to 72-year-old age group (P < .001). Lesion prevalence was greater in black (20.7%) than in white persons (10.2% [P < .0001]), but did not differ significantly between male and female participants. The basal ganglia and thalamic region was the most commonly affected anatomic site, accounting for 78.9% of the lesions. CONCLUSION: Considering that the prevalence of self-reported stroke or transient ischemic attack in ARIC participants is 1.5%, these results suggest that there is significantly more subclinical than clinical CVD in the general population. Furthermore, the prevalence of this subclinical disease increases with age, and is greater in black persons. ILLs are dominated by "lacunae" in the basal ganglia and thalamus. These results are, in general, similar to those of a comparable study of elderly participants in the CHS, except for a 60% lower prevalence of ILLs in this younger population.     

Health benefits of tennis

The aim of the study was to explore the role of tennis in the promotion of health and prevention of disease. The focus was on risk factors and diseases related to a sedentary lifestyle, including low fitness levels, obesity, hyperlipidaemia, hypertension, diabetes mellitus, cardiovascular disease, and osteoporosis. A literature search was undertaken to retrieve relevant articles. Structured computer searches of PubMed, Embase, and CINAHL were undertaken, along with hand searching of key journals and reference lists to locate relevant studies published up to March 2007. These had to be cohort studies (of either cross sectional or longitudinal design), case-control studies, or experimental studies. Twenty four studies were identified that dealt with physical fitness of tennis players, including 17 on intensity of play and 16 on maximum oxygen uptake; 17 investigated the relation between tennis and (risk factors for) cardiovascular disease; and 22 examined the effect of tennis on bone health. People who choose to play tennis appear to have significant health benefits, including improved aerobic fitness, a lower body fat percentage, a more favourable lipid profile, reduced risk for developing cardiovascular disease, and improved bone health.     

Contributions of epidemiology to exercise science and cardiovascular health

Much important information about the cardiovascular benefits and hazards of exercise requires the methods of epidemiology, i.e., the study in human populations of frequencies and distributions of disease in terms of time, place, and personal characteristics. The key techniques are comparison and contrast, but epidemiological analyses of physical activity and cardiovascular health often must rely on circumstantial evidence to assess cause-and-effect relationships. The study procedures must be designed to meet rigorous epidemiological principles: statistical association, temporal sequence, consistency, persistence, independence, dose-response relationship, specificity, alterability, repeatability, and confirmation of findings. Through measurement and contrast, study procedures aim to determine whether physically active persons experience a lower incidence of cardiovascular disease than do persons more sedentary. Based on these principles, current evidence indicates that exercise induces protective benefits against coronary heart disease that enable most persons to approach their potential longevity.     

美军健康相关状况及干预措施研究的系统评价

目的：系统评价美军健康相关状况及干预措施,为我军健康促进策略的制定提供借鉴。方法计算机检索PubMed、Medline、Springer、Elservier、HighWire和CNKI等数据库,利用设定的检索策略检索1997年1月～2015年12月发表的关于美军健康相关状况及干预策略或措施的文献。结果经筛选后最终纳入25篇文献,包含训练伤、腰腿痛、创伤后应激障碍、抑郁症、心血管疾病等方面。结论美军主要的健康问题及其所关注的干预策略或措施包括训练伤、腰腿痛、心理疾病和心血管疾病等4个方面,对军人的健康保障正在从单一的疾病预防走向多元化的全面维护,以实现新时期部队的整体强健。     

Cardiovascular risks in a military health care beneficiary population with high blood pressure

Prevention strategies for coronary artery disease among hypertensive patients require assessment of other modifiable risk factors in the target population. In this article, we describe the prevalence of other cardiovascular risk factors in military beneficiaries with high blood pressure (HBP). Baseline data from an ongoing randomized clinical trial designed to test effectiveness of a comprehensive HBP intervention are used in the analysis. A total of 147 beneficiaries from a military health system participated in this study. Findings indicate that the rate of HBP control in this sample was suboptimal (32%: blood pressure < 140/90). Other prevalent cardiovascular risk factors include high cholesterol, obesity, and diabetes. Many of these patients (31.3%) are also in the moderate-to-high danger level of developing coronary artery disease in the near future. These findings warrant a regular assessment of cardiovascular risk factors and rigorous behavioral interventions for all beneficiaries of the military health care system.     

MR imaging evaluation of cardiovascular risk in metabolic syndrome

Metabolic syndrome has become an important public health problem and has reached epidemic proportions globally. Metabolic syndrome is characterized by a cluster of metabolic abnormalities in an individual, with insulin resistance as the main characteristic. The major adverse consequence of metabolic syndrome is cardiovascular disease, which is often already present without clinical signs or symptoms. In this early stage of disease, interventions (eg, lifestyle intervention, medication) can be used to prevent further cardiovascular deterioration or even to reverse cardiovascular disease. Therefore, risk stratification on an individual basis and early detection of cardiovascular disease are essential. Magnetic resonance (MR) imaging is a powerful tool for demonstrating cardiovascular risk factors in metabolic syndrome, such as increased fat depots and arterial stiffening. Furthermore, MR imaging is an established modality for the assessment of myocardial function. This review provides a summary of the current MR applications in metabolic syndrome and discusses how these MR techniques can be used to identify subclinical cardiovascular damage.     

Health benefits of cycling: a systematic review

The purpose of this study was to update the evidence on the health benefits of cycling. A systematic review of the literature resulted in 16 cycling-specific studies. Cross-sectional and longitudinal studies showed a clear positive relationship between cycling and cardiorespiratory fitness in youths. Prospective observational studies demonstrated a strong inverse relationship between commuter cycling and all-cause mortality, cancer mortality, and cancer morbidity among middle-aged to elderly subjects. Intervention studies among working-age adults indicated consistent improvements in cardiovascular fitness and some improvements in cardiovascular risk factors due to commuting cycling. Six studies showed a consistent positive dose-response gradient between the amount of cycling and the health benefits. Systematic assessment of the quality of the studies showed most of them to be of moderate to high quality. According to standard criteria used primarily for the assessment of clinical studies, the strength of this evidence was strong for fitness benefits, moderate for benefits in cardiovascular risk factors, and inconclusive for all-cause mortality, coronary heart disease morbidity and mortality, cancer risk, and overweight and obesity. While more intervention research is needed to build a solid knowledge base of the health benefits of cycling, the existing evidence reinforces the current efforts to promote cycling as an important contributor for better population health.     

苏格兰心脏CT研究的进展和展望

苏格兰心脏CT研究（SCOT-HEART）是一项开放标签、多中心、随机对照试验,旨在评估冠状动脉CT血管成像（CCTA）是否影响胸痛病人的诊断、治疗及预后。这是首次在对常规临床诊疗过程分析中加入CCTA对病人结局影响的实验,并证实了CCTA在冠心病诊断、诊疗决策优化以及改善病人预后等方面的价值。此外,还提示高危斑块特征与病人预后的关系以及联合功能和解剖学检查对疑似冠心病心绞痛病人的增量价值等。主要介绍SCOT-HEART研究的背景、目的、设计、对心血管医学的贡献以及未来的发展方向。