Ischemic heart disease induces upregulation of endothelin receptor mRNA in human coronary arteries

Endothelin has been implicated in the pathogenesis of ischemic heart disease and congestive heart failure. The aims were to quantify endothelin type A (ETA) and type B (ETB) receptor mRNA levels in human coronary arteries from patients with ischemic heart disease, congestive heart failure and controls using real-time polymerase chain reaction (real-time PCR). In addition, the suitability of organ culture as a model mimicking endothelin receptor changes in cardiovascular disease was evaluated by in vitro pharmacology and real-time PCR. Endothelin ETA and ETB receptor mRNA levels were significantly higher in arteries from patients with ischemic heart disease (0.23+/-0.04 and 0.35+/-0.06) as compared to congestive heart failure (0.09+/-0.02 and 0.07+/-0.01) and controls (0.08+/-0.02 and 0.08+/-0.01). After organ culture, the endothelin ETB receptor mRNA levels were elevated, and the sarafotoxin 6c-induced vasoconstriction was more efficacious. Increased endothelin receptor activity may contribute to the increased vascular tone and development of atherosclerotic disease in ischemic heart disease in man.     

Ischemic heart disease down-regulates angiotensin type 1 receptor mRNA in human coronary arteries

Angiotensin II is important in the development of cardiovascular disease. In the present study, angiotensin II receptor mRNA levels were quantified by real-time polymerase chain reaction (real-time PCR) in human coronary arteries from patients with ischemic heart disease and controls. Furthermore, the suitability of artery culture for studying angiotensin receptor changes was evaluated by in vitro pharmacology and real-time PCR. The angiotensin type 1 (AT1) receptor mRNA levels were down-regulated in human coronary arteries from patients with ischemic heart disease as compared to controls (P<0.05). Culture of coronary arteries for 48 h induced down-regulation of the angiotensin AT1 and AT2 receptor mRNA levels and also a less efficacious angiotensin II-induced vasoconstriction (Emax=103+/-2% before and 23+/-7% after artery culture, P<0.001). Artery culture may thus be a suitable method for studying angiotensin receptor regulation.     

高原心脏病、肺心病及矽肺肺心病的心血管X线特征

本文对高原心脏病（高心病）、肺心病、矽肺肺心病各40例男性患者的X线胸片进行对照分析。结果表明：高心病的肺动脉段突度、心脏横径二项参数大于肺心病及矽肺肺心病（P＜0．01），而右肺下动脉横径增加改变后者大于前者。另外，高心病心血管改变在现突出，矽肺肺心病则以肺部改变显著，肺心病该改变介于两者之间，但后两者肺功能损害较显著，临床症状亦较严重。     

Scleroderma heart disease

Heart disease is a frequent and often severe feature of systemic sclerosis (scleroderma). Cardiomyopathy, with ventricular diastolic dysfunction and arrhythmias, is the most important form, since it is associated with a very poor prognosis. The current challenge is to define its pattern and identify individuals at risk, but evaluation in vivo may be hard to perform. The aim of this review is to provide an update on the clinical aspects of scleroderma heart disease and the early pivotal role that coronary microcirculation dysfunction plays in its development. A discussion of the diagnostic tools now available for this frequently asymptomatic condition will be provided. Treatment options will be reviewed, even though no cure for systemic sclerosis exists, and the current therapy of diastolic dysfunction remains unsatisfactory.     

Ischemic heart disease mortality reduction in an arseniasis-endemic area in southwestern Taiwan after a switch in the tap-water supply system

Arsenic has been identified as a major contributing risk factor for development of blackfoot disease (BFD), a unique peripheral vascular disease that was endemic to the southwestern coast of Taiwan, where residents imbibed artesian well water continuing high amounts of arsenic for more than 50 yr. Chronic arsenic exposure was found to be associated with ischemic heart disease (CHD) in a dose-dependent manner. A tap-water supply system was implemented in the early 1960s in the BFD-endemic areas. Artesian well water was no longer used for drinking and cooking after the mid-1970s. The objective of this study was to examine whether CHD-related mortality decreased after consumption of high-arsenic-containing artesian well water ceased and, if so, when the reduction occurred. Standardized mortality ratios (SMRs) for CHD were calculated for the BFD endemic area for the years 1971-2000. Cumulative-sum techniques were used to detect the occurrence of changes in the SMRs. Data show that mortality attributed to CHD declined gradually for approximately 17 to 20 yr following cessation of consumption of high-arsenic artesian well water. Based on the reversibility criterion, the association between arsenic exposure an1rd CHD-related mortality is likely to be causal.     

慢性肺源性心脏病并冠心病80例治疗探讨

目的探讨慢性肺源性心脏病并冠心病在临床上的表现及防治措施。方法本文选择80例患有慢性肺源性心脏病并冠心病的患者进行研究,对于处在急性发作期的患者,在进行综合治疗的基础上应用大环内酯类抗生素,再根据患者的具体情况进行抗凝、溶栓以及有创或者是无创机械通气等的处理,对缓解期的患者进行随诊,同时进行长期的家庭氧疗及口服抗血小板凝集药物、无创双管气道正压通气等治疗对患者的心肺功能进行改善;对伴随血脂增高的患者应采用口服降脂药及低脂饮食来进行干预。结果本组患者经过治疗显效26例（32．5％）;有效34（42．5％）;无效20例（25％）,其中死亡10例（12．5％）。结论长期的防治与随诊对于慢性肺源忡心月庠病并冠心病非常首要．而曜持长期的家庭氧疔也可以在一定程度上降低患者再住院率。     

Lyme disease]

After a short historical review of the Lyme disease, the author describes the responsible bacteria, a Spirochete called Borrelia. Epidemiology, physiopathology and clinical manifestations are studied, as well as the different phases of the disease (primary secondary and tertiary) and the various possible symptoms (dermatological, cardiovascular, rheumatical, neurological syndrome). The biological part includes isolation of the Bacteria and detection of antibodies (IFI, ELISA, passive hemagglutination and Western Blot). Prophylaxy and treatments are also presented.