Physical activity for coronary heart disease: cardioprotective mechanisms and effects on prognosis

A sedentary lifestyle is one of the five major risk factors for coronary heart disease (CHD) along with hypertension, abnormal values of blood lipids, smoking and obesity. After an acute myocardial infarction, risk factors continue to contribute synergically to the clinical progression and prognosis of CHD. Regular physical exercise has been shown to improve exercise capacity and quality of life, to reduce symptoms and to decrease the risk of new coronary events in patients with CHD. Regular physical activity with its favourable effects on coronary risk factors, endothelial dysfunction, inflammation, tendency to thrombosis, on autonomic tone and myocardial ischemia, may play a role in reducing the risk of new coronary events and death. In view of the clinical benefits yielded and its well-documented cardioprotective mechanisms, regular physical activity should be regarded, by general practitioners and cardiologists, as a true and effective form of therapy for patients with CHD

Ivabradine, coronary artery disease, and heart failure: beyond rhythm control

Elevated heart rate could negatively influence cardiovascular risk in the general population. It can induce and promote the atherosclerotic process by means of several mechanisms involving endothelial shear stress and biochemical activities. Furthermore, elevated heart rate can directly increase heart ischemic conditions because of its skill in unbalancing demand/supply of oxygen and decreasing the diastolic period. Thus, many pharmacological treatments have been proposed in order to reduce heart rate and ameliorate the cardiovascular risk profile of individuals, especially those suffering from coronary artery diseases (CAD) and chronic heart failure (CHF). Ivabradine is the first pure heart rate reductive drug approved and currently used in humans, created in order to selectively reduce sinus node function and to overcome the many side effects of similar pharmacological tools (ie, β-blockers or calcium channel antagonists). The aim of our review is to evaluate the role and the safety of this molecule on CAD and CHF therapeutic strategies

A micropolar isotropic plasticity formulation for non-associated flow rule and softening featuring multiple classical yield criteria

The Cosserat continuum is very effective in regularizing the ill-posed governing equations of the Cauchy/Maxwell continuum. An elasto-plastic constitutive model for the linear formulation of the Cosserat continuum is here presented, which features non-associated flow, hardening/softening behaviour and multiple yield and plastic potential surfaces, whilst linear hyper-elasticity is adopted to reproduce the recoverable response. For the definition of the yield and plastic potential functions the equivalent von Mises stress is formulated using energy considerations and the theory of representations, the latter being also used to retrieve an expression for the Lode’s angle. The recent Generalized classical criterion is then used to define the yield and plastic potential functions so that Lode’s angle dependent deviatoric sections can be used