Heart S.O.S. Medical References

References- Heart disease is the leading cause of death in the West. Some easy techniques and tasty dietary changes can greatly decrease your risks from this disease. Here are some medical references to the suggestions presented in this site.

• Cough CPR
• Dietary Heart Health Supplements
• Water Immersion Therapy

Cough CPR

Section of Cardiology, Providence Hospital, Southfield, Michigan 48037, USA. A 54-year-old male developed ventricular fibrillation during right coronary angiography. Cough cardiopulmonary resuscitation was performed for 30 sec allowing the patient to remain alert and hemodynamically stable. Cough cardiopulmonary resuscitation is a simple, often overlooked technique that can be utilized during resuscitation in the cardiac catheterization laboratory.

Department of Emergency Medicine, University of California, San Diego 92103. A case of a patient with an acute anterior myocardial infarction (MI) and ventricular fibrillation is presented. The patient was resuscitated after cough-cardiopulmonary resuscitation (C-CPR) was administered in the emergency department. The patient received thrombolytic therapy without complication. Cough-CPR is a technique not in widespread use. With the advent of thrombolytic therapy for patients with acute myocardial infarctions, a relative contraindication to thrombolytic therapy is present in patients who receive "standard CPR." The use of cough-CPR in witnessed dysrhythmias can alleviate this problem. Cough-CPR can also reduce the morbidity of resuscitations.

In summary, the cough CPR technique uses physiologic principles similar to those that maintain circulation during chest compression with a number of significant advantages over the latter. At the onset of lethal arrhythmias such as asystole, profound bradycardia, VT, and VF, coughing may assist in maintaining consciousness and an optimum systolic blood pressure. It may also generate the mechanism required to convert the arrhythmia. The simplicity and effectiveness of this technique warrants its consideration for greater clinical use by hospital staff in all monitored settings. It has been noted, however, that clinical research is indicated to more closely examine the proposed cause and effect relationship between cough and arrhythmia conversion and to compare the clinical efficacy between the cough CPR technique and chest blow or other clinical practice measures.

III Clinic of Cardiology of Silesian Academy of Medicine, District Outpatient Department of Silesian Center Cardiology, Washington, DC, USA. Sudden cardiac death caused by cardiac arrhythmia's or asystolies in patients with coronary heart disease can often be avoided if resuscitation is administered immediately, preferably before the patient loses consciousness. In cases when rapid help is not available usually death occurs. We have studied a method of cardiopulmonary resuscitation (CPR) which can be self--administered by patients trained in recognizing imminent arrival of life-threatening Morgani Adams Stokes (MAS) events. The recent study comprised the three methods of investigation in three separate groups of patients: the first group underwent invasive procedures (20 pts), the second non invasive Doppler studies (31 pts) and the third in-and outhospital clinical observations (115 pts). The results indicate that evoked coughing can effectively prevent fainting and maintaining consciousness until conventional CPR help becomes available.

Crit Care Med 1980 Mar;8(3):141-6 Cough-CPR: documentation of systemic perfusion in man and in an experimental model: a "window" to the mechanism of blood flow in external CPR. Niemann JT, Rosborough J, Hausknecht M, Brown D, Criley JM

Maintenance of arterial pressure and consciousness by vigorous coughing during ventricular fibrillation has been previously documented. Observations in 4 additional patients with unstable rhythms and in fibrillating dogs confirm that coughing: (1) produces an arterial pulse; (2) produces opening of the aortic valve; (3) generates forward blood flow; and (4) can maintain consciousness during circulatory arrest. The authors speculate that cough-induced systemic perfusion results from compression of the pulmonary vascular beds by a rise in intrathoracic pressure, the left heart acting only as a one-way conduit to the lower pressure extrathoracic vascular outlets. Recent data suggest that conventional CPR likewise produces blood flow by compression of the pulmonary vascular blood pool, and not by cardiac compression as previously thought.

J Nutr Sci Vitaminol (Tokyo) 1998 Apr;44(2):313-21 The antioxidative substances in cacao liquor. Osakabe N, Yamagishi M, Sanbongi C, Natsume M, Takizawa T, Osawa T

Functional Foods Research and Development Laboratories, Meiji Seika Kaisha, Ltd., Sakado, Japan. The antioxidative substances contained in cacao liquor, which is one of the major ingredients of chocolate, were separated by column chromatography and high-performance liquid chromatography. Three major compounds were purified and two of them were identified by 1H, 13C NMR and mass spectra as (-)-epicatechin (EC) and (+)-catechin (CA). Their antioxidative activity was measured by monitoring the peroxide value of linoleic acid and the thiobarbituric acid-reactive substance values of erythrocyte ghost membranes and microsomes. EC and CA had strong antioxidative effects in all three methods, but one unidentified peak was found to be less effective. Additionally, we analyzed the polyphenol concentration of cacao liquor extractions produced in several countries. The total polyphenol concentration was 7.0 to 13.0%, catechin concentration was 0.31 to 0.49%, and epicatechin concentration was 0.35 to 1.68% in the extractions. It is believed that chocolate is stable against oxidative deterioration on account of the presence of these polyphenolic compounds, and it is also expected to have a protective role against lipid peroxidation in living systems.

Istituto Chimico Farmaceutico Tossicologico, University of Milan, Italy. Roberto.MaffeiFacino@unimi.it Aim of this work was to study the efficacy of procyanidins from Vitis vinifera seeds, a standardized mixture of polyphenol antioxidants, on cardiac mechanics following ischemia/reperfusion stunning in the rat, after 3 weeks supplementation. Young and aged male rats were fed a diet enriched with procyanidins complexed (1:3 w/w) with soybean lecithin (2.4%); control animals (CTR-young and CTR-aged) received an equal amount of lecithin and 2 additional groups of animals the standard diet. At the end of the treatment, the total plasma antioxidant defense (TRAP), vitamin E, ascorbic acid and uric acid were determined in plasma and the hearts from all groups of animals subjected to moderate ischemia (flow reduction to 1 ml/min for 20 min) and reperfusion (15 ml/min for 30 min). In both young and aged rats supplemented with procyanidins the recovery of left ventricular developed pressure (LVDP) at the end of reperfusion was 93% (p < 0.01) and 74% (p < 0.01) of the preischemic values and the values of coronary perfusion pressure (CPP) were maintained close to those of the preischemic period. Also creatine kinase (CK) outflow was restrained to baseline levels, while a 2-fold increase in prostacyclin (6-keto-PGF1alpha) in the perfusate from hearts of young and aged rats was elicited during both ischemia and reperfusion. In parallel, procyanidins significantly increased the total antioxidant plasma capacity (by 40% in young and by 30% in aged rats) and the plasma levels of ascorbic acid, while tend to reduce vitamin E levels; no significant differences were observed in uric acid levels. The results of this study demonstrate that procyanidins supplementation in the rat (young and aged) makes the heart less susceptible to ischemia/reperfusion damage and that this is positively associated to an increase in plasma antioxidant activity.

Turmeric

Mol Cell Biochem 1996 Jun 21;159(2):85-93 Protective role of curcumin against isoproterenol induced myocardial infarction in rats. Nirmala C, Puvanakrishnan R

Department of Biotechnology, Central Leather Research Institute, Madras, India. The effect of curcumin on the biochemical changes induced by isoproterenol (ISO) administration in rats was examined. ISO (300 mg Kg-1 administered subcutaneously twice at an interval of 24 h) caused a decrease in body weight and an increase in heart weight, water content as well as in the levels of serum marker enzymes viz creatine kinase (CK), lactate dehydrogenase (LDH) and LDH1 isozyme. It also produced electrocardiographic changes such as increased heart rate, reduced R amplitude and ST elevation. Curcumin at a concentration of 200 mg.Kg-1, when administered orally, showed a decrease in serum enzyme levels and the electrocardiographic changes got restored towards normalcy. Myocardial infarction was accompanied by the disintegration of membrane polyunsaturated fatty acids expressed by increase of thiobarbituric acid reactive substance (TBARS), a measure of lipid peroxides and by the impairment of natural scavenging, characterized by the decrease in the levels of superoxide dismutase, catalase, glutathione peroxidase, ceruloplasmin, alpha tocopherol, reduced glutathione (GSH) and ascorbic acid. The oral pretreatment with curcumin two days before and during ISO administration decreased the effect of lipid peroxidation. It was shown to have a membrane stabilizing action by inhibiting the release of beta-glucuronidase from nuclei, mitochondria, lysosome and microsome. Curcumin pre- and co-treatment decreased the severity of pathological changes and thus, could have a protective effect against the damage caused by myocardial infarction (MI).

Department of Biotechnology, Central Leather Research Institute, Madras, India. The effect of curcumin on lysosomal hydrolases in serum and heart was studied by determining the activities of beta-glucuronidase, beta-N-acetylglucosaminidase, cathepsin B, cathepsin D, and acid phosphatase. Rats treated with isoproterenol (30 mg/100 g body weight) showed a significant increase in serum lysosomal hydrolase activities, which were found to decrease after curcumin treatment. Isoproterenol administration to rats resulted in decreased stability of the membranes, which was reflected by the lowered activity of cathepsin D in mitochondrial, lysosomal, and microsomal fractions. Curcumin treatment returned the activity levels almost to normal, showing that curcumin restored the normal function of the membrane. Histopathological studies of the infarcted rat heart also showed a decreased degree of necrosis after curcumin treatment.

Department of Pharmacology, College of Medicine, National Taiwan University, Taipei. 1. The possible mechanisms of the antiproliferative and apoptotic effects of curcumin (diferuloylmethane), a polyphenol in the spice turmeric, on vascular smooth muscle cells were studied in rat aortic smooth muscle cell line (A7r5). 2. The proliferative response was determined from the uptake of [3H]-thymidine. Curcumin (10(-6)-10(-4) M) inhibited serum-stimulated [3H]-thymidine incorporation of both A7r5 cells and rabbit cultured vascular smooth muscle cells in a concentration-dependent manner. Cell viability, as determined by the trypan blue dye exclusion method, was unaffected by curcumin at the concentration range 10(-6) to 10(-5) M in A7r5 cells. However, the number of viable cells after 10(-4) M curcumin treatment was less than the basal value (2 x 10(5) cells). 3. To analyse the various stages of the cell cycle, [3H]-thymidine incorporation into DNA was determined every 3 h. After stimulation with foetal calf serum, quiescent A7r5 cells started DNA synthesis in 9 to 12 h (G1/S phase), then reached a maximum at 15 to 18 h (S phase). Curcumin (10(-6)-10(-4) M) added during either the G1/S phase or S phase significantly inhibited [3H]-thymidine incorporation. 4. Following curcumin (10(-6)-10(-4) M) treatment, cell cycle analysis utilizing flow cytometry of propidium iodide stained cells revealed a G0/G1 arrest and a reduction in the percentage of cells in S phase. Curcumin at 10(-4) M also induced cell apoptosis. It is suggested that curcumin arrested cell proliferation and induced cell apoptosis, and hence reduced the [3H]-thymidine incorporation. 5. The apoptotic effect of 10(-4) M curcumin was also demonstrated by haematoxylin-eosin staining, TdT-mediated dUTP nick end labelling (TUNEL), and DNA laddering. Curcumin (10(-4) M) induced cell shrinkage, chromatin condensation, and DNA fragmentation. 6. The membranous protein tyrosine kinase activity stimulated by serum in A7r5 cells was significantly reduced by curcumin at the concentration range 10(-5) to 10(-4) M. On the other hand, the cytosolic protein kinase C activity stimulated by phorbol ester was reduced by 10(-4) M curcumin, but unaffected by lower concentrations (10(-6)-10(-5) M). 7. The levels of c-myc, p53 and bcl-2 mRNA were analysed using a reverse transcription-polymerase chain reaction (RT-PCR) technique. The level of c-myc mRNA was significantly reduced by curcumin (10(-5)-10(-4) M) treatment. And, the level of bcl-2 mRNA was significantly reduced by 10(-4) M curcumin. However, the alteration of the p53 mRNA level by curcumin (10(-5)-10(-4) M) treatment did not achieve significance. The effects of curcumin on the levels of c-myc and bcl-2 mRNA were then confirmed by Northern blotting. 8. Our results demonstrate that curcumin inhibited cell proliferation, arrested the cell cycle progression and induced cell apoptosis in vascular smooth muscle cells. Curcumin may be useful as a template for the development of drugs to prevent the pathological changes of atherosclerosis and post-angioplasty restenosis. Our results suggest that the antiproliferative effect of curcumin may partly be mediated through inhibition of protein tyrosine kinase activity and c-myc mRNA expression. And, the apoptotic effect may partly be mediated through inhibition of protein tyrosine kinase activity, protein kinase C activity, c-myc mRNA expression and bcl-2 mRNA expression.

Department of Physiology, University of Granada, Spain. Atherosclerosis is characterized by oxidative damage which affects lipoproteins, the walls of blood vessels and subcellular membranes. This study evaluates the antioxidant capacity of a Curcuma longa extract on the lipid peroxidation of liver mitochondria and microsome membranes in atherosclerotic rabbits. Male rabbits fed a 3% (w/w) lard and 1.3% (w/w) cholesterol diet were randomly assigned to three groups. Two groups were treated with different dosages of a turmeric extract (A and B) and the third group (control) with a curcumin-free solution. Basal and in vitro 2,2'-azobis (2-amidinopropane) dihydrochloride (AAPH)-induced hydroperoxide and TBARS productions in liver mitochondria and microsomes were analyzed. Group A had the lowest concentration of mitochondrial hydroperoxides. In microsomes, the basal hydroperoxide levels were similar in all groups but, after the induction of oxidation, group C registered the highest value; TBARS production followed the same trend in mitochondria. These findings suggest that active compounds in curcuma extract may be protective in preventing lipoperoxidation of subcellular membranes in a dosage-dependent manner.

Phytochemicals: guardians of our health. Craig WJ

Andrews University, Berrien Springs, MI 49104-0210, USA. Consuming a diet rich in plant foods will provide a milieu of phytochemicals, nonnutritive substances in plants that possess health-protective benefits. Nuts, whole grains, fruits, and vegetables contain an abundance of phenolic compounds, terpenoids, pigments, and other natural antioxidants that have been associated with protection from and/or treatment of chronic disease such as heart disease, cancer, diabetes, and hypertension as well as other medical conditions. The foods and herbs with the highest anticancer activity include garlic, soybeans, cabbage, ginger, licorice, and the umbelliferous vegetables. Citrus, in addition to providing an ample supply of vitamin C, folic acid, potassium, and pectin, contains a host of active phytochemicals. The phytochemicals in grains reduce the risk of cardiovascular disease and cancer.

Division of Pharmacology, Hamdard University, New Delhi, India. The effects of ethanolic extract of ginger (200 mg/kg, p.o.) were studied in cholesterol fed rabbits. The marked rise in serum and tissue cholesterol, serum triglycerides, serum lipoproteins and phospholipids that followed 10 weeks of cholesterol feeding, was significantly reduced by the ethanolic ginger extract and results were compared with gemfibrozil, a standard orally effective hypolipidaemic drug. The severity of aortic atherosclerosis as judged by gross grading was more marked in pathogenic, i.e. the hypercholesterolemic group, while animals receiving ginger extract along with cholesterol showed a lower degree of atherosclerosis. The results indicate that ginger is definitely an antihyperlipidaemic agent.

Nagakura Pharmaceutical Company Ltd., Osaka, Japan. We previously reported on the isolation and identification of (E)-8 beta,17-epoxylabd-12-ene-15,16-dial (ZT) from ginger (rhizome of Zingiber officinale Roscoe, Zingiberaceae). In this paper, the pharmacological effects of ZT are reported. The experimental mouse hypercholesterolemia induced by Triton WR-1339 was treated after oral administration of ZT. In homogenated rat liver with ZT, cholesterol biosynthesis was decreased. In addition, the same activity was observed in the homogenated rat liver which was resected after the oral administration of ZT. According to the results of general pharmacological screening, no remarkable activity of ZT was observed except for an inhibitory effect on the cholesterol biosynthesis.

The beneficial effects of a stable prostacyclin analogue (PGI2-A), OP 41483 against myocardial ischemic injury were experimentally and clinically evaluated. In 31P-NMR study, the preischemic treatment with PGI2-A prevented myocardial ATP depletion of rat hearts which were subjected to 20 min global ischemia. In patients with congenital heart disease, the PGI2-A of 300 ng/ml was added to the glucose-insulin-potassium cardioplegia (PGI2-group), and this group was compared to control group without PGI2-A in terms of postoperative maximal leakage of CPK-MB (maxCPK-MB). In patients under 1 yr or patients over 1 yr with aortic cross clamp time exceeded 120 min, the maxCPK-MB was significantly (p < 0.05) reduced as compared to the control. This stable PGI2 analogue has shown significant myocardial protective effects experimentally and also in clinical setting.

Aviat Space Environ Med 1997 Dec;68(12):1109-14 Sympatho-vagal responses in humans to thermoneutral head-out water immersion. Miwa C, Sugiyama Y, Mano T, Iwase S, Matsukawa T

Department of Autonomic Neuroscience, Nagoya University, Japan. To clarify the role of autonomic nervous functions in cardiovascular adaptation to microgravity, heart rate variability (HRV) and blood pressure variability (BPV) were evaluated during thermoneutral head-out water immersion (HOI) of eight healthy young subjects 23 to 31 yr of age. The very low-frequency (VLF; 0.00-0.04 Hz) component of BPV tended to increase during HOI, whereas the low-frequency (LF; 0.04-0.15 Hz) component of BPV and the ratio of LF power to high-frequency (HF; 0.15-0.40 Hz) component (LF/HF ratio) of HRV decreased. The HF component of HRV increased in all the subjects during immersion up to the shoulder. Concomitantly, we found a decrease in heart rate and increases in stroke volume and cardiac output with no significant changes in BP and respiration rate during HOI. These results suggest that both vasomotor and cardiac sympathetic activities are suppressed and that the parasympathetic (vagal) activity is enhanced during HOI.

Boston (Mass) University School of Medicine, USA. Recent experimental data suggest marked similarities between the effects of hypertension and hypercholesterolemia on the arterial intima. Both conditions also seem to exert proinflammatory effects on the artery, resulting in the recruitment of monocytes into the intima. These effects may be due to production of oxygen-free radicals, which in turn may stimulate genes involved in the recruitment of inflammatory cells into the arterial wall. Plaque rupture and acute myocardial infarction are related to local accumulation of inflammatory cells in vulnerable areas of the plaque. Recent clinical trials using cholesterol-lowering or antihypertensive therapies have shown a decrease in cardiovascular events that may have resulted from withdrawal of inflammatory effects on the arterial wall. Angiotensin-converting enzyme inhibitors decrease the rate of myocardial infarction in patients with overt congestive heart failure or left ventricular dysfunction. These drugs probably affect several mechanisms related to the inhibition of angiotensin production and the potentiation of bradykinin and resultant enhancement of nitric oxide and prostacyclin. The mechanisms could include reversing the proinflammatory effects of angiotensin and hypercholesterolemia on the arterial wall. Future therapeutic strategies of vascular protection in hypertension may include direct attacks on proinflammatory or pro-oxidant vascular mechanisms.

Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. Effects of water temperature on diuresis, natriuresis, and associated endocrine responses during head-out immersion were studied in eight men (23.4 +/- 0.3 yr) during four 5-h experimental conditions: air control at 28 degrees C and immersion at 34.5 degrees C [thermoneutral (Tnt)], 36 degrees C [above Tnt (aTnt)], and 32 degrees C [below Tnt (bTnt)]. Esophageal temperature decreased by approximately 0.4 degrees C in bTnt and increased by approximately 0.5 degrees C in aTnt. Cardiac output increased by approximately 80% in aTnt and approximately 40% in bTnt while thoracic impedance, an index of central blood pooling, decreased by 7.5 omega in bTnt (NS vs. Tnt) and 8.8 omega in aTnt (P < 0.05 vs. Tnt and bTnt). Total peripheral resistance decreased at all temperatures (50% in aTnt, 20% in bTnt). Urine flow and Na+ excretion increased by sixfold in bTnt and Tnt but by only threefold in aTnt. Creatinine clearance was unchanged while osmolal clearance (but not free water clearance) increased two-fold with all immersions. Plasma atrial natriuretic peptide (ANP), urinary urodilatin, and urinary guanosine 3',5'-cyclic monophosphate increased while plasma renin activity, aldosterone, and arginine vasopressin (AVP) decreased similarly at all temperatures. bTnt did not potentiate diuresis by selective attenuation of AVP. The overall natriuretic response exhibited a higher correlation with urodilatin (r = 0.45, P < 0.001) than with ANP (r = 0.26, P < 0.01).

Centre de Recherche, Hotel-Dieu de Montreal, Quebec, Canada. Plasma concentrations of atrial natriuretic factor (ANF) have been reported to be unchanged or increased in patients with essential hypertension. Head out of water immersion (HOI) in a thermoneutral bath induces diuresis and natriuresis, an increase in plasma ANF, and reductions in plasma renin activity and aldosterone concentrations. HOI was used in this study to stimulate the secretion of ANF, and compare its release in patients with essential hypertension (EH) (n = 14) and normotensive subjects (n = 13). Renal function changes induced by HOI were also monitored. HOI that lasted 2 h was compared with a control-seated period in each subject. Blood pressure was significantly reduced (P < .05) in normotensive controls from 112 +/- 3/74 +/- 2 to 100 +/- 3/61 +/- 2 mm Hg, and in patients with EH from 137 +/- 4/93 +/- 3 to 123 +/- 3/78 +/- 2 mm Hg. Plasma levels of ANF increased significantly (P < .05) in both groups from 5.9 +/- 1.3 to 16.3 +/- 3 pmol/L in normotensive controls and from 6.0 +/- 0.9 to 13.2 +/- 2.5 pmol/L in patients with EH. Plasma cyclic guanosine monophosphate concentrations increased more (P < .05) in the patients with EH (3.9 +/- 0.4 to 6.1 +/- 0.5 nmol/L) than in controls (3.4 +/- 0.3 to 4.8 +/- 0.4 nmol/L), whereas plasma renin activity levels decreased in controls (2.29 +/- 0.58 to 1.63 +/- 0.55 ng/mL/h) and to a greater degree in patients with EH (1.62 +/- 0.52 to 0.77 +/- 0.19 ng/mL/h, P < .05) by HOI.