The Relationship of Lifestyle to International Trends in CHD

Three components of lifestyle—nutrition, smoking and alcohol drinking patterns—have been related to rates of decline or increase of coronary heart disease (CHD) mortality in 27 countries during the past 10 to 25 years. In almost all of the countries with major falls or rises in CHD mortality, there are, respectively, corresponding decreases or increases in animal fat consumption, with reciprocal changes in the consumption of vegetable fats. Countries with moderate or small mortality declines show variable patterns of fat consumption. The prevalence of smoking is declining among men and remains unchanged or is increasing slightly among women in most countries, suggesting that differences in the rate of decline between countries or between the sexes are not related to an appreciable degree to differences in the change of smoking habits; however, the mortality changes in any individual country are most probably influenced by smoking. The consumption of alcoholic beverages increases almost everywhere and cannot be related quantitatively to the secular CHD mortality trends. These findings support in general the presently recommended courses of action for the prevention of premature CH

Magnetic resonance imaging of myocardial strain after acute ST-segment-elevation myocardial infarction: a systematic review

The purpose of this systematic review is to provide a clinically relevant, disease-based perspective on myocardial strain imaging in patients with acute myocardial infarction or stable ischemic heart disease. Cardiac magnetic resonance imaging uniquely integrates myocardial function with pathology. Therefore, this review focuses on strain imaging with cardiac magnetic resonance. We have specifically considered the relationships between left ventricular (LV) strain, infarct pathologies, and their associations with prognosis. A comprehensive literature review was conducted in accordance with the PRISMA guidelines. Publications were identified that (1) described the relationship between strain and infarct pathologies, (2) assessed the relationship between strain and subsequent LV outcomes, and (3) assessed the relationship between strain and health outcomes. In patients with acute myocardial infarction, circumferential strain predicts the recovery of LV systolic function in the longer term. The prognostic value of longitudinal strain is less certain. Strain differentiates between infarcted versus noninfarcted myocardium, even in patients with stable ischemic heart disease with preserved LV ejection fraction. Strain recovery is impaired in infarcted segments with intramyocardial hemorrhage or microvascular obstruction. There are practical limitations to measuring strain with cardiac magnetic resonance in the acute setting, and knowledge gaps, including the lack of data showing incremental value in clinical practice. Critically, studies of cardiac magnetic resonance strain imaging in patients with ischemic heart disease have been limited by sample size and design. Strain imaging has potential as a tool to assess for early or subclinical changes in LV function, and strain is now being included as a surrogate measure of outcome in therapeutic trials

POLYUNSATURATED FATTY ACIDS AND MYOCARDIAL INFARCTION

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32797/1/0000170.pd

Introduction to coronary heart disease prevention forum

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34137/1/0000421.pd

CORONARY AND AORTIC ATHEROSCLEROSIS

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32496/1/0000583.pd

Hereditary aspects of coronary heart disease

Currently available data on aggregations of coronary heart disease among relatives have been reviewed, and the interrelation-ships between genetic and environmental factors responsible for familial predispositions toward coronary atherosclerosis have been discussed. Although the evidence suggests a definite but not striking tendency for coronary disease to cluster in families, a quantitative assessment of the relative importance of familial influences in the genesis of these disorders is not possible at the present time. The first step toward the solution of the methodological problems involved lies in the recognition of their nature. It is suggested that the true extent of familial aggregations of coronary heart disease can only be estimated with assurance on the basis of long-term, rather than one-time, studies of families representative of the population at large.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32135/1/0000188.pd

Comparison of SNR efficiencies and strain for cine DENSE using conventional EPI, flyback EPI and spiral k-space trajectories

The original implementation of 2D cine DENSE (displacement encoding with stimulated echoes) employed a conventional EPI k-space trajectory for rapid data sampling. Follow-up studies used flyback EPI to reduce image artifacts. More recently a spiral k-space trajectory was utilized for improved SNR

Coronary heart disease: Risk factors as guides to preventive action

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34138/1/0000422.pd

Mapping right ventricular myocardial mechanics using 3D cine DENSE cardiovascular magnetic resonance

<p>Abstract</p> <p>Background</p> <p>The mechanics of the right ventricle (RV) are not well understood as studies of the RV have been limited. This is, in part, due to the RV's thin wall, asymmetric geometry and irregular motion. However, the RV plays an important role in cardiovascular function. This study aims to describe the complex mechanics of the healthy RV using three dimensional (3D) cine displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance (CMR).</p> <p>Methods</p> <p>Whole heart 3D cine DENSE data were acquired from five healthy volunteers. Tailored post-processing algorithms for RV mid-wall tissue tracking and strain estimation are presented. A method for sub-dividing the RV into four regions according to anatomical land marks is proposed, and the temporal evolution of strain was assessed in these regions.</p> <p>Results</p> <p>The 3D cine DENSE tissue tracking methods successfully capture the motion and deformation of the RV at a high spatial resolution in all volunteers. The regional Lagrangian peak surface strain and time to peak values correspond with previous studies using myocardial tagging, DENSE and strain encoded CMR. The inflow region consistently displays lower peak strains than the apical and outflow regions, and the time to peak strains suggest RV mechanical activation in the following order: inflow, outflow, mid, then apex.</p> <p>Conclusions</p> <p>Model-free techniques have been developed to study the myocardial mechanics of the RV at a high spatial resolution using 3D cine DENSE CMR. The consistency of the regional RV strain patterns across healthy subjects is encouraging and the techniques may have clinical utility in assessing disrupted RV mechanics in the diseased heart.</p