Assessment of Cardiopulmonary Responses to Treadmill Walking Following Gastric Bypass Surgery.

Background: Studies that have evaluated cardiopulmonary responses to exercise within the first few months of bariatric surgery have utilized cycle ergometry. However, walking is the most commonly reported mode of both pre- and post-operative PA. The divergent cardiopulmonary responses and metabolic costs of weight-bearing (walking) and non-weight-bearing (cycling) exercises warrant examination of the effects of bariatric surgery on cardiopulmonary responses during walking.

Sympathetic Activity Assessed during Exercise Recovery in Young Obese Females.

Objective: To evaluate differences in sympathetic activity, as assessed by an exercise recovery index (ERI; heart rate/oxygen consumption [VO2] plateau), between black and white obese female adolescents. An additional aim was to determine the association of ERI with insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]), cardiovascular fitness per fat-free mass (VO2 per fat-free mass), systolic blood pressure (SBP), and percent body fat (%FAT) in both black and white obese adolescents.

Study Design: Sixty-one females volunteered to participate in this study.

An unusual presentation of chest pain: needle perforation of the right ventricle.

Foreign bodies in the heart are a rare occurrence and can result from intravenous drug abuse, trauma or iatrogenic causes. There are no current guidelines for the treatment of a cardiac foreign body. We hereby present a brief review of the available literature and report a case of a woman with chest pain subsequently complicated by cardiogenic shock due to tamponade secondary to a needle fragment perforating her right ventricular free wall.

Comparison of frequencies of patent foramen ovale and thoracic aortic atherosclerosis in patients with cryptogenic ischemic stroke undergoing transesophageal echocardiography.

Studies have shown an association between the presence of a patent foramen ovale (PFO) and cryptogenic stroke (CS) in patients aged <55 years. In addition, protruding atheromatous plaques in the ascending aorta and aortic arch are an independent risk factor for ischemic stroke in patients aged ≥55 years. The aim of this study was to determine the association of CS in the 2 age groups with PFO and with atheromatous plaques in the ascending aorta and in the aortic arch.

Effect of combined metformin and oral contraceptive therapy on metabolic factors and endothelial function in overweight and obese women with polycystic ovary syndrome.

In this randomized, double-blind, placebo-controlled study, 19 overweight women with polycystic ovary syndrome were randomized to a 3-month course of either metformin plus combined hormonal oral contraceptive (OC) (n = 9) or OC plus matched placebo (n = 10). After 3 months, both treatments had similar effects on androgen levels, lipid profile, insulin sensitivity, and serum inflammatory markers, but flow-mediated dilatation increased by 69.0% in the metformin plus OC group while it remained unchanged in the OC group.

Relation between the incidence, location, and extent of thoracic aortic atherosclerosis detected by transesophageal echocardiography and the extent of coronary artery disease by angiography.

Atherosclerotic lesions in the thoracic aorta detected by transesophageal echocardiography (TEE) have been correlated with coronary artery disease (CAD). We determined whether simple or complex aortic plaques seen on transesophageal echocardiogram correlated with extent, location, and severity of CAD. The study population consisted of 188 patients who underwent TEE and coronary angiography.

Maximal aerobic capacity and the oxygen uptake efficiency slope as predictors of large artery stiffness in apparently healthy subjects.

Purpose: Large artery stiffness is now recognized as an important marker of cardiovascular health. The purpose of the present investigation was to assess the relationship between large artery stiffness and the oxygen uptake efficiency slope (OUES) and to determine whether the OUES is a viable surrogate for maximal oxygen uptake (VO(2max)) in a multivariate regression analysis developed to estimate large artery stiffness.

Methods: Two hundred seventy-five apparently healthy subjects (149 men; age = 48.

Association of hypertensive diastolic blood pressure with dyslipidemia during exercise in apparently healthy subjects.

Introduction: Diastolic blood pressure (DBP), which is influenced by cardiac output and total peripheral resistance, normally remains stable or decreases during the transition from rest to exercise. Dyslipidemia has been shown to attenuate vasodilation, and may therefore impede the normal reduction in peripheral vascular resistance during exercise. This investigation examines differences in lipid levels between apparently healthy individuals with a normal and hypertensive DBP response to exercise.

High aerobic capacity does not attenuate aortic stiffness in hypertensive subjects.

Background: It is unknown whether increased physical fitness reduces aortic stiffness in hypertensive individuals. The purpose of this cross-sectional study was to examine, in a cohort of community-dwelling subjects with no history of cardiac events, differences in the impact of aerobic capacity on aortic stiffness between normotensive and hypertensive subjects.

Methods: The study sample included 275 subjects representing a large age range (21-85 years).

Anti-cardiolipin and increased serum adhesion molecule levels in patients with aggressive periodontitis.

Background: We observed that a significant proportion of patients with periodontitis have elevated serum levels of beta2-glycoprotein-I-dependent anti-cardiolipin (anti-CL). These prothrombotic autoantibodies, commonly found to be elevated in patients with systemic lupus erythematosus and the antiphospholipid syndrome, are associated with adverse pregnancy outcomes, such as fetal involution, prematurity, and low birth weight, and with cardiovascular sequelae, such as atherosclerosis, stroke, and myocardial infarction. Anti-CL is known to promote vascular inflammation and thrombosis.

Relationship between arterial stiffness and heart rate recovery in apparently healthy adults.

Introduction: Arterial stiffness and heart rate recovery (HRR) following exercise testing have emerged as variables holding significant prognostic value in a number of populations. The purpose of the present study is to examine the relationship between arterial stiffness and HRR in a group of apparently healthy subjects.

Methods: Two hundred and nine apparently healthy subjects underwent maximal exercise testing.

Influence on aerobic fitness on aortic stiffness in apparently healthy Caucasian and African-American subjects.

Background: Previous research suggests that arterial stiffness may be significantly higher in African-Americans compared to Caucasians. However, the influence of aerobic fitness on the putative difference in arterial stiffness between these groups has not been previously investigated.

Methods: Two hundred forty-eight subjects (215 Caucasian, 33 African-American) participated in this study.

The relationship between C-reactive protein and other cardiovascular risk factors in men and women.

Introduction: C-reactive protein (CRP) has emerged as an important indicator of risk for cardiovascular disease. The impact of gender on the relationship between CRP and other cardiovascular risk factors, however, has not been thoroughly investigated.

Methods: Ninety men and 75 women participated in this study.

A new noninvasive method to determine central venous pressure.

Unlabelled: Knowledge of central venous pressure (CVP) is considered valuable in the assessment and treatment of various states of critical illness and injury.

Objectives: We tested a noninvasive means of determining CVP (NICVP), by monitoring forearm volume changes in response to externally applied circumferential pressure to the upper arm veins.

Methods: Sixteen patients who were undergoing CVP monitoring as a part of their care had NICVP determined and compared with CVP.

Comparison of 2-dimensional echocardiography and myocardial perfusion imaging for diagnosing myocardial infarction in emergency department patients.

Background: Both 2-dimensional echocardiography and myocardial perfusion imaging (MPI) with technetium-99m based agents have been used to identify patients in the emergency department with myocardial infarction (MI). However, the inclusion of small numbers of patients in prior studies limits the accurate assessment of sensitivity of the 2 techniques.

Methods: Gated MPI was used as part of the initial triage process in patients initially considered at low to moderate risk for acute coronary syndromes (no ST elevation or depression).

Determination of left ventricular function by emergency physician echocardiography of hypotensive patients.

Objective: To determine whether emergency physicians (EPs) with goal-directed training can use echocardiography to accurately assess left ventricular function (LVF) in hypotensive emergency department (ED) patients.

Methods: Prospective, observational study at an urban teaching ED with >100,000 visits/year. Four EP investigators with prior ultrasound experience underwent focused echocardiography training.