[Association between oxidative stress parameters and inflammations markers according to the gravityt of the acute coronary syndrome]

Cardiovascular disease is the consequence of appearance and development of atherosclerosis lesions of associated with a inflammatory complication. To elucidate a possible association between several inflammation and oxidative stress markers according to the severity of coronary artery disease. This study was carried on 93 coronary subjects with: unstable angina [UA; n=42]; stable angina [SA; n=15] and acute myocardial infarction [AMI; n=36] and 140 control subjects to whom lipidic, oxidative and inflammatory parameters were determined. In addition to a moderate hyperhomocysteinemia observed in the coronary artery disease, a significant higher levels of the oxidized LDL [ox-LDL] were found among these patients [p< 0.001]. A positive correlation was found between the markers of the inflammation and the gravity of the acute coronary syndrome. One note a significant increase of the rate of ox-LDL and high sensitive CRP to AMI by reports in UA and SA [p=0.00, and p=0.001 respectively] which is linked to an elevation of the plasmatic concentration of the total homocysteine. This study suggests an association between the markers of the inflammation and oxidative parameters in the acute coronary syndrome

[ comparaison of the effect of the oral captopril and nicardipine in hypertensive crisis]

Hypertensive crisis is defined as a severe elevation in blood pressure [BP] without target organ injury. There are few data about the efficacy and safety of comparative oral antihypertensive drugs. To compare the efficacy and safety of oral captopril [25 mg] and nicardipine [20 mg] in hypertensive crisis. This prospective, randomized study included 50 patients attended at the emergency department with a hypertensive crisis [arterial blood pressure of at least 180/110 mmHg without target organ damage confirmed after 15 min of rest. Systolic [SBP] and diastolic blood pressure [DBP] and heart rate [HR] were assessed at several intervals during 4 h after the drug administration. Therapeutic success was defined by a SBP 70 years was a predictor's factor of therapeutic failure in the captopril group. Heart rate significantly dropped after 30 min in the captopril group [82.3 +/- 11.8 vs 77.6 +/- 12.7 c/min; p=0.037]. This effect was maintained over four hours. There were no side effects in this study. Oral captopril or nicardipine are efficacy and safe in the treatment of hypertensive crisis

[Abnormalities of the interatrial septum associated with cerebral ischemia in young adults: Contribution of trans-oesophageal echocardiography]

About 40% of the mechanism of ischaemic stroke in young adults remains unclear. A paradoxical embolism associated with persistence of a patent foramen ovale and/or the presence of an atrial septal aneurysm are significantly more frequent in patients examined for ischaemic stroke of unknown cause than in control subjects. Was to evaluate the contribution of trans-oesophageal echocardiography to the diagnosis of abnormalities of the interatrial septum and to identify the role played by this condition in unexplained ischemic stroke. In 30 consecutive patients, trans-oesophageal echocardiography recording were made during a saline contrast study. Abnormalities of the interatrial septum was diagnosed in 23.3% cases. The proportion of patent foramen ovale was 10% [3 patients]; atrial septal aneurysm was detected in 6.6%[2 patients]. The prevalence of patent foramen ovale associated with atrial septal aneurysm was 6.6% [2 patients]. Transesophageal echocardiography with contrast appears to be an effective exam in diagnosis of abnormalities of the interatrial septum and our study was suggestive of their embolic nature

[Cardiac amyloidosis revealing multiple myeloma]

Amyloidosis is a rare disease characterized by an extracellular accumulation of a protein polysaccharide complex [Amyloid]. Cardiac involvement is considered as a major prognostic factor. We report the case of two women, hospitalized for heart failure. The diagnosis of cardiac amyloidosis was suggested by echocardiography left ventricular concentric hypertrophy and typical amyeloid infiltration with hyperechoic. shiny and granite-like aspect of the interventricular septum. The histological confirmation was obtained by gastric biopsy in the first case and biopsy of the salivary glands in the second revealing an amyloidosis AL. This cardiac amyloidosis was secondary to multiple myeloma: monoclonal Gammopathy with immunoglobulin Lambda in the first and Kappa in the second, and the presence of a plasmocyte infiltration in the sternal puncture. Amyloidosis is a rare pathology, the cardiac involvement is frequent in the type AL and can occur with or without clinical manifestations. Echocardiography should be systematic in patients with confirmed amyloidosis