Background: Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments. Objective: The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient. Materials and Methods: Consecutive adult cardiac patients attending an outpatient cardiovascular disease clinic accompanied by an adult were enrolled. Patient–spousal pairs independently completed the Cardiac Depression Scale (CDS) on behalf of the patient. Proxies provided demographic and medical history information and also completed the Physical Health Questionnaire. Results: A total of 72 patients (males 75%; mean age = 67.18 ± 11.35 years) and 72 spouses (mean age = 65.19 ± 11.49 years) met enrollment and analysis criteria. Most spouses were female (75%). Proxies rated patients significantly higher on the CDS (mean = 93.14 ± 29.33) than did patients of themselves (mean = 87.93 ± 26.79), t(71) = –2.05, P < 0.05. Patient–spousal concordance was low to moderate on the total CDS (concordance correlation coefficient [CCC] = 0.69) and CDS symptoms including mood (CCC = 0.35), anhedonia (CCC = 0.63), anxiety (CCC = 0.71), irritability (CCC = 0.55), hopelessness (CCC = 0.50), cognitive dysfunction (CCC = 0.41), and sleep disturbance (CCC = 0.64). Conclusions: These results suggest that spouses have limited insight into patient's psychological status, as self-reported by patients. Proxy assessments should be interpreted with caution and, wherever possible, patients should be encouraged to complete depression assessments on their own.

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Periodontal disease (PD) and cardiovascular disease (CVD) are two types of the most prevalent disorders in elderly people, and an increasing number of data have shown a clinically important association between these two diseases. Numerous published studies have revealed a positive association between PD and CVD, such as myocardial infarction, coronary heart disease, peripheral arterial disease, stroke, and hypertension. Besides, periodontal conditions may be an independent predictor of all-cause mortality. Some interventional trials also indicate the effect of periodontal treatment on the CVD. The aim of this paper is to perform a critical review of the observational and interventional studies about this association, and we especially attached importance to the data from systematic reviews and meta-analysis. In addition, several pathogenic mechanisms implicated in the association between these two diseases were also reviewed. We suggest to promote close collaboration between physicians and dentists, thereby contributing to the improvement of prevention and control of cardiovascular conditions. Future researches are warranted to investigate the potential mechanisms.

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Context: Brain metabolite ratios derived from magnetic resonance spectroscopy (MRS) has been used to document changes in neuronal viability, glial activation and inflammation associated with Human Immunodeficiency Virus (HIV) infection and cardiovascular disease. Aims: To determine whether brain metabolite ratios in the left anterioar insula predicts cardio-autonomic regulation indexed by the ratio of low- to high-frequency heart rate varaibility (LF:HF) after accounting for post-menopausal age, HIV and hypertensive (HTN) status. Design: Thirty women, (n=14 HIV+ and n=16 HTN+) with an average age of 54.5 (SD=6.4) years and no history of neurological disease were recruited for the study. Methods: After conventional MR imaging, single-voxel 1H-MRS (TR = 1500 msec; TE = 35 msec) was performed by using a PROBE-SV system implemented on a 3T GE Discovery MR750 scanner. Shift-selective imaging pulses for water suppression were acquired from a voxel placed in the midline of the left anterior insula with an average voxel size of 15×15×15 mm. Heart rate variability was estimated over a 7 minutes resting state scan using an MR-compatible photoplethysmogram. Statistics: A stepwise regression analysis controlling for (1) age, disease status (HIV+ and HTN+) was modelled separately for the ratio of N-acetylaspartate (NAA), Myo-inostol (mI), and Choline (Ch) to Creatine (Cr) ratios to predict LF:HF. Results: Higher ratios of NAA/Cr were associated with lower LF:HF (β= -.393, t(29)= -2.26, p= .033). Ratios of mI:Cr and Cho:Cr did not predict LF:HF. Conclusions: Decreased neuronal viability in the left anterior insula, indexed by lower NAA/Cr metabolite ratios explain a significant proportion of the variance in the skew towards sympathetic overarusal in postmenopausal women at risk for cerebrovacular disease.

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This article reviewed the epidemiology of coronary heart diseases combined with psychological diseases and noted the ubiquitous presence of coronary diseases combined with psychological diseases. This article also highlights the possible mechanisms underlying the induction of myocardial ischemia by mental stress and proposed that cardiac microvascular diseases may be a key connecting myocardial ischemia induced by mental stress. The clinical manifestations of nonobstructive coronary artery diseases and mental stress-induced myocardial ischemia are found to be similar, and the pathogenic mechanisms exhibit certain consistencies; however, studies on the association between these two diseases have not been reported. This article emphasizes a direction for future studies.

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Background: The association between depressive symptoms and adverse outcomes in patients with coronary artery disease (CAD) is well recognized. However, few studies address the patient's perception of his physical and mental condition after a myocardial infarction (MI). The present study was designed to explore the subjective aspects of the psychological conditions in post-MI patients. Method and Results: A subject population of 8 male patients (age 59±5), selected by saturation sampling, with an average of 6 months post-MI, were submitted to an individual semi-structured interview and afterwards participated in 12 psychodynamic group sessions. Conclusion: There was a predominant non-acceptance of MI due to emotional barriers and this attitude has the potential to influence negatively the adherence to a comprehensive cardiovascular treatment, including pharmacological intervention for depression

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We report a case of a 36-year-old male presented with symptoms of chest pain and the electrocardiographic evidence of ST-segment elevation in inferior and anterior leads. An emergent coronary angiogram showed that both the distal right and mid left descending coronary arteries were totally occluded. Both arteries were successfully ballooned and stented. Multiple cases of simultaneous coronary occlusion have been reported, but the mechanism was still not well understood. In this case, the man had neither coronary risk factors nor positive family history. The laboratory studies revealed a decreased serum-free protein S.

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