Left Main Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement in a Young Male with Rheumatic Heart Disease and Porcelain Aorta.

We highlight the presence of a calcified mass in the left main coronary artery without significant atherosclerosis seen in the other coronary arteries or in the peripheral large arteries. In our view, the calcified character of the obstruction and the calcification of the aortic valve are characteristic of a variant type of coronary artery disease (CAD) not associated with the same risk factors as diffuse coronary atherosclerosis, but, in this case, with rheumatic heart disease. This case report also emphasizes the interventional approach for patients with aortic valve stenosis secondary to rheumatic heart disease.

Objective measures of the frailty syndrome (hand grip strength and gait speed) and cardiovascular mortality: A systematic review.

BACKGROUND: Handgrip strength (HGS) and gait speed (GS) are objective components of the frailty syndrome in the elderly, and are associated with increased all-cause mortality. However, their association with cardiovascular (CVD) mortality is less lucid. The present systematic review aims to summarize the available literature assessing HGS, GS and their association with CVD Mortality. METHODS: Medline and Embase databases were searched systematically using controlled vocabulary and free text terms. A total of 344 results were obtained and scanned for inclusion. Articles were included if they presented results of original research and provided information on HGS or GS and CVD mortality. RESULTS: A total of 19 studies (N=63,396) were included for review. Twelve studies examined hand grip strength with CVD mortality and 7 studies assessed gait speed. Almost all included studies demonstrated an association of HGS/GS with CVD mortality on univariate analyses. Decreased HGS or GS were associated with increased mortality in most studies (8/12 for HGS and 6/7 for GS). In most positive studies, the association of HGS/GS was usually found to be independent of traditional CVD risk factors. CONCLUSION: The present review demonstrates that decreased HGS and GS are associated with CVD mortality, with the association found to be more consistent for GS as compared to HGS. Both of these measures provide valuable prognostic information above and beyond traditional scoring methods and should be considered for implementation in clinical practice.

Effect of Physical activity on Insulin Resistance, Inflammation and Oxidative Stress in Diabetes Mellitus.

Diabetes Mellitus is a growing health concern projected to affect 366 million people worldwide by around 2030. Multiple approaches to address this health concern are documented; amongst which increased the habitual physical activity has been shown to be beneficial. Various mechanisms demonstrated show improvement of cellular insulin sensitivity. The interplay between insulin sensitivity and insulin resistance plays a key role in development and persistence of the diabetic state, which can be directly linked to the levels of physical activity. Regulation of adiponectin and leptin levels are also linked to physical activity via reduction of central obesity. Inflammatory markers, free radical reduction and up-regulation of physiological antioxidant processes are also observed in subjects with increased physical activity schedules, all of which play a significant role in the pathogenesis of Diabetes Mellitus.