M Motro

Tel Aviv University, Tel Aviv, Tel Aviv, Israel

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Publications (121)606.71 Total impact

  • Atherosclerosis Supplements - ATHEROSCLER SUPPL. 01/2007; 8(1):135-135.
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    ABSTRACT: Since coronary artery and cerebrovascular diseases are the most common serious complications of long standing hypertension, there is a great potential for combining treatment with aspirin and angiotensin-converting enzyme inhibitors (ACE-I). However, the data regarding interaction of aspirin and ACE-I in relation to blood pressure control and survival benefits are controversial and inconclusive. We presumed that the appearance of dry cough in some of the patients following initiation of ACE-I treatment could be used as a marker for the presence of their influence, whereas ACE-I cough attenuation after addition of aspirin to treatment could be a sign of aspirin and ACE-I interaction on clinical level. The present study was aimed to use ACE-I induced cough as a clinical marker of ACE-I activity to determine whether dose-dependent aspirin and ACE-I interaction does exist. In a cohort of 750 consecutive ACE-I treated hypertensive and postinfarction outpatients we identified 78 (10.4%) non-smoking ACE-I related coughers. Out of them, 31 (21 men, 10 women; mean age 61 +/- 0.9 years) agreed to take part in the study, which was aimed to compare two regimens of combined ACE-I and aspirin treatment (self-matched control data): intermediate (500 mg daily) vs low-dose aspirin (100 mg daily). On each visit the life quality, cough severity (CS, 0-4) and frequency (CF, 0-10) scores were registered. Low doses of aspirin demonstrated an excellent safety profile and did not influence any life quality score and ACE-I induced cough. In contrast, intermediate doses completely abolished cough in 17 patients and reduced coughing in other 11 patients. Cough severity and cough frequency scores decreased, respectively, from 2.7 +/- 1.1 to 0.7 +/- 1.2 (P < 0.001) and from 7.1 +/- 2.3 to 2.0 +/- 2.2 (P < 0.0001). Overall, the cough frequency score method alone could identify a clear modification of cough in 26 (84%) patients, and cough severity score method alone in 24 (77%). Using the combined frequency/severity score method a modification of cough could be identified in 28 (90%) of the patients receiving intermediate dose of aspirin. Aspirin did not influence heart rate and blood pressure control either in hypertensives or in postinfarction patients. We conclude that using ACE-I induced cough as a clinical marker of ACE-I activity demonstrates that an interaction between ACE-I and aspirin at 500 mg/day does exist. We did not find any evidence supporting the presence of a clinically significant interaction between ACE-I and aspirin at 100 mg/day. Thus, combined treatment by low dose aspirin and ACE-I seems to be both safe and useful.
    Journal of Human Hypertension 07/2002; 16(6):379-83. · 2.82 Impact Factor
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    ABSTRACT: Autoantibodies to cardiolipin (aCL) and beta2-glycoprotein-I (beta2GPI) are considered proatherogenic. Elevated levels of both antibodies have been reported in hypertension. Nonetheless, there are no data regarding an association between these autoantibodies and hypertension in coronary artery disease. The levels of aCL and anti-beta2GPI antibodies were measured in patients having coronary artery disease with (n = 82) or without (n = 36) hypertension, in association with other major risk factors for coronary artery disease. The levels of aCL and anti-beta2GPI antibodies were (OD at 405 nm) 0.23 +/- 0.14 and 0.22 +/- 0.12 in the normal blood pressure group, as opposed to 0.24 +/- 0.12 and 0.20 +/- 0.12 in the hypertensive group, respectively (p = 0.67; 0.42). No significant difference in either antibody levels was found between hypertensive patients with normal and abnormal blood pressure measurements. The presence of additional risk factors did not affect antibody levels in normotensive patients. However, in the hypertensive group, the presence of smoking was associated with significantly decreased anti-beta2GPI antibody levels, whereas no change was found in aCL. Further, patients who had hypertension, smoking and hypercholesterolemia, had significantly decreased anti-beta2GPI antibody levels compared with patients without any of these risk factors (0.13 +/- 0.04 versus 0.23 +/- 0.13, respectively; p = 0.02). Hypertension is not associated with modification of aCL and anti-beta2GPI antibody levels in coronary artery disease patients. However, there are elevated anti-beta2GPI antibody levels in patients without conventional risk factors compared with patients with these risk factors.
    Cardiology 02/2002; 97(1):2-5. · 1.52 Impact Factor
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    ABSTRACT: The mechanisms of atherosclerosis development in the thoracic aorta is miscellaneous and still only partially understood. The marked variability of the sites of deposition of atherosclerotic plaques in the aorta could not be clarified based solely on the risk-factors theory of atherosclerosis. The sites of deposition of atherosclerotic plaques are considered to be affected by blood-flow patterns that cause areas of altered shear stress on the aortic wall. Close relations between protruding aortic plaques (PAP), stroke and peripheral emboli were established. The analysis of PAP distribution and motion to characterize atherogenesis in the human thoracic aorta and the pathogeneses of embolic events was performed. We concluded that protruding aortic plaques and markers of relative aortic flow instability (occurrences of vortices) are predominantly noticed in the human arch and in the descending aorta, whereas the ascending aorta showed lesser prevalence of atheromatosis. Reversal and rotational blood-flow in the thoracic aorta most likely exist in all patients with systemic emboli and mobile protruding aortic atheromas. Therefore, retrograde cerebral embolism from distal aortic plaques is conceivable.
    Medical Hypotheses 12/2001; 57(5):642-7. · 1.05 Impact Factor
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    M Motro, J Shemesh, E Grossman
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    ABSTRACT: Calcium antagonists effective in lowering blood pressure are a heterogeneous group including three main classes: phenylalkylamines, benzothiazepines and dihydropyridines. Dihydropyridines have a dual mode of action upon the endothelium contributing to their beneficial antihypertensive effects: (1) direct relaxation by inhibition of smooth muscle L-type calcium current, and (2) indirect relaxation through release of nitric oxide from the vascular endothelium. Calcium antagonists may affect many calcium-dependent events in the formation of atherosclerosis such as the localized accumulation of collagen, elastin, and calcium together with monocyte infiltration and smooth muscle proliferation and migration. In the INSIGHT calcification study, the overall treatment effect of nifedipine demonstrated significant inhibition of coronary calcium progression over a three-year period. Calcium antagonists improve symptoms and reduce ischemia in hypertensive patients with ischemic heart disease. Although in placebo-controlled trials calcium antagonists demonstrated a significant reduction in cardiovascular morbidity and mortality, they may be less effective than other types of antihypertensive drugs in preventing ischemic heart disease.
    Current Opinion in Cardiology 12/2001; 16(6):349-55. · 2.56 Impact Factor
  • The American Journal of Cardiology 10/2001; 88(5):594-8. · 3.21 Impact Factor
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    ABSTRACT: Mitral annular calcification is a common echocardiographic finding. Caseous calcification is a rare variant seen as a large mass with echolucencies that resembles a tumor, occasionally resulting in exploratory cardiotomy. The aim of this study was to assess the prevalence of caseous calcification of the mitral annulus, to evaluate patient characteristics and the echocardiographic variables for diagnosing this entity, and to describe the clinical outcome on follow-up of such patients. Caseous calcification was defined as a large, round, echo-dense mass with smooth borders situated in the periannular region, with no acoustic shadowing artifacts and containing central areas of echolucencies resembling liquefaction. Eighteen patients were diagnosed by 2-dimensional echocardiography as having caseous calcification of the mitral annulus. One had calcification of the tricuspid annulus. Nine patients underwent transesophageal echocardiographic studies. A typical finding of a round, sometimes semilunar, large, echo-dense, soft mass with central echolucencies seen on both transthoracic and in particular transesophageal echocardiography, resembling a periannular mass, was demonstrated. The mass was posteriorly located in all mitral patients. Transesophageal echocardiography added limited information. Three patients underwent mitral valve replacement. The operative findings were a solid mass adherent to the posterior portion of the mitral valve. Sectioning revealed a toothpaste-like, white, caseous material. Sixteen (84%) patients were treated conservatively. On follow-up of 3.8 +/- 2.4 years, 4 patients died of unrelated causes. The characteristic appearance of a large, soft, echo-dense mass containing central areas of echolucencies resembling liquefaction at the posterior periannular region of the mitral valve on 2D echocardiography is compatible with the diagnosis of caseous abscess. Such a finding should not be confused with a tumor. Transesophageal echocardiography does not appear to contribute to the diagnosis. This rather impressive lesion appears to carry a benign prognosis.
    Journal of the American Society of Echocardiography 09/2001; 14(8):825-31. · 4.28 Impact Factor
  • The American Journal of Cardiology 07/2001; 87(12):1395-7. · 3.21 Impact Factor
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    ABSTRACT: Recent studies have suggested that long-term diuretic therapy may be associated with increased risk of renal cell carcinoma. This carcinoma is not a common malignancy, but it shares risk factors with the considerably more widespread colon cancer (CC). However, there are no data whether or not a relationship between long-term diuretic therapy and CC mortality exists. In this study we tested the hypothesis that long-term diuretic therapy may be associated with increased CC mortality over a 5.6-year follow-up period. The study sample comprised 14 166 patients aged 45 to 74 years with a previous myocardial infarction and/or stable anginal syndrome, screened for participation in the bezafibrate infarction prevention (BIP) study. There were 2153 patients receiving diuretics and 12 013 patients receiving no diuretics. During the follow-up 139 (6.5%) new cases of cancer were diagnosed in the diuretic-treated group compared with 622 (5.2%) in the group receiving no diuretics (P = 0.02). Colon cancer mortality was significantly higher in the diuretic-treated patients (0.1 vs 0.5%, P = 0.001), whereas mortality differences for other cancer types were not documented. Multivariate analysis identified diuretics as an independent predictor of increased colon cancer incidence and colon cancer mortality with a hazard ratio (HR) of 2.0 (95% CI 1.2-3.2) for colon cancer incidence and 3.7 (95% CI 1.7-8.3) for mortality. However, the association between diuretic therapy and higher incidence of colon cancer was observed only among non-users of aspirin. A relatively lower colon cancer incidence was observed in the furosemide subgroup, and higher in the small combined amiloride/hydrochlorthiazide subgroup (HR 3.15, 95% CI 1.15-8.65). Long-term exposure to diuretic therapy may be associated with an increased colon cancer-related mortality.
    Journal of Human Hypertension 07/2001; 15(6):373-9. · 2.82 Impact Factor
  • M Motro, J Shemesh
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    ABSTRACT: Calcium controls numerous events within the vessel wall. Permeability of the endothelium is calcium dependent, as are platelet activation and adhesion, vascular smooth muscle proliferation and migration, and synthesis of fibrous connective tissue. Double-helix computerized tomography is a noninvasive technique that can detect, measure, and compare coronary calcification in the coronary arteries. Using this method, our objective was to determine whether administration of nifedipine once daily in lieu of diuretics in high-risk hypertensive patients will arrest or slow down the progression of coronary artery calcification. The study was designed as a side arm of INSIGHT (International Nifedipine Study: Intervention as Goal for Hypertension Therapy), aimed to show the efficacy of nifedipine once daily versus co-amilozide (hydrochlorothiazide 25 mg, amiloride 2.5 mg) in high-risk hypertensive patients. A total of 201 patients with a total calcium score of >/=10 at the onset of study who underwent an annual double-helix computerized tomography for 3 years were analyzed for efficacy. Inhibition of coronary calcium progression was significant in the nifedipine versus the co-amilozide group during the first year (3.18% versus 27%, respectively, P=0.02), not significant during the second year (28.5% versus 47%, respectively, P=0.14), and significant during the third year (40% versus 78%, respectively, P=0.02). The results point to a slower progression of coronary calcification in hypertensive patients on nifedipine once daily versus co-amilozide.
    Hypertension 06/2001; 37(6):1410-3. · 6.87 Impact Factor
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    ABSTRACT: The issue of whether glucose concentrations below the diabetic threshold may be predictive of increased cardiovascular risk has not yet been fully elucidated. The current study evaluates the prognosis of nondiabetic patients with ischemic heart disease (IHD) and impaired fasting glucose (IFG) over a 7.7-year follow-up period. A total of 11,853 patients with documented coronary artery disease aged between 45 and 74 years were examined. Patients were divided into 3 groups on the basis of their fasting blood glucose levels at screening: nondiabetic individuals, patients with IFG, and undiagnosed diabetic patients. Patients who were on any type of pharmacologic antidiabetic treatment were excluded from the study. Mortality rates were assessed separately for each group. The population comprised 9773 nondiabetic patients (82.4%, glucose up to 109 mg/dL), 1258 patients with IFG levels (10.6%, glucose 110-125 mg/dL), and 822 diabetic subjects (7%, glucose > or =126 mg/dL). Patients were followed up from 6.2 to 9.0 years (mean follow-up period 7.7 +/- 1.5 years). Crude mortality was lower in the nondiabetic subjects than in the 2 other groups. All-cause mortality in the nondiabetic group was 14.3% compared to 20.1% in patients with IFG and 24.3% in the undiagnosed (P <.001). Multivariate adjustment showed the lowest mortality in nondiabetic subjects, who exhibited a survival rate of 0.86 at the end of the follow-up, whereas the lowest survival-0.75-was seen among undiagnosed diabetic patients (P =.0001). An intermediate value of 0.78 was documented for patients with IFG (P <.01). After multivariate analysis, with nondiabetic patients as the reference group, IFG was identified as a consistent predictor of increased all-cause and IHD mortality with hazard ratios of 1.39 (95% confidence interval 1.21-1.59) and 1.29 (95% confidence interval 1.01-1.64), respectively. The main finding of this study is the substantially increased mortality rate among nondiabetic coronary patients with IFG, who had fasting glucose levels markedly lower than hitherto acknowledged as defining overt diabetes.
    American Heart Journal 04/2001; 141(3):485-90. · 4.50 Impact Factor
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    ABSTRACT: The significance of antioxidized low-density lipoprotein (oxLDL) antibodies in atherogenesis is not yet clear, and there are conflicting data regarding anti-oxLDL levels in early hypertension. The levels of anti-oxLDL antibodies were studied in coronary artery disease patients with (n = 82) or without (n = 36) hypertension, in association to other risk factors for coronary artery disease. The levels of anti-oxLDL antibodies did not differ significantly between coronary artery disease patients with or without hypertension. (0.132 +/- 0.146 v 0.153 +/- 0.158 optical density at 405 nm, respectively; P = .48). No significant differences in anti-oxLDL antibodies were found between men and women with and without hypertension, between hypertensive patients with normal and abnormal blood pressure measurements, and between medicated and nonmedicated hypertensive patients. The presence of diabetes mellitus, smoking, and hypercholesterolemia, either solely or in combination, did not result in significant differences in antibody levels in the hypertensive or normotensive patients. Although the levels of oxLDL antibodies might be modified in early hypertension, once advanced coronary artery disease has developed the presence of hypertension does not affect anti-oxLDL levels.
    American Journal of Hypertension 03/2001; 14(2):149-54. · 3.67 Impact Factor
  • The American Journal of Medicine 03/2001; 110(2):143-5. · 4.77 Impact Factor
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    ABSTRACT: A sulfonylurea--usually glyburide--plus metformin constitute the most widely used oral antihyperglycemic combination in clinical practice. Both medications present undesirable cardiovascular effects. The issue whether the adverse effects of each of these pharmacologic agents may be additive and detrimental to the prognosis for coronary patients has not yet been specifically addressed. This study was designed to examine the survival in type 2 diabetics with proven coronary artery disease (CAD) receiving a combined glyburide/metformin antihyperglycemic treatment over a long-term follow-up period. The study sample comprised 2,275 diabetic patients, aged 45-74 years, with proven CAD, who were screened but not included in the bezafibrate infarction prevention study. In addition, 9,047 nondiabetic patients with CAD represented a reference group. Diabetics were divided into four groups on the basis of their therapeutic regimen: diet alone (n = 990), glyburide (n = 953), metformin (n = 79), and a combination of the latter two (n = 253). The diabetic groups presented similar clinical characteristics upon recruitment. Crude mortality rate after a 7.7-year follow-up was lower in nondiabetics (14 vs. 31.6%, p<0.001). Among diabetics, 720 patients died: 260 on diet (mortality 26.3%), 324 on glyburide (34%), 25 on metformin alone (31.6%), and 111 patients (43.9%) on combined treatment (p<0.000001). Time-related mortality was almost equal for patients on metformin and on combined therapy over an intermediate follow-up period of 4 years (survival rates 0.80 and 0.79, respectively). The group on combined treatment presented the worst prognosis over the long-term follow-up, with a time-related survival rate of 0.59 after 7 years, versus 0.68 and 0.70 for glyburide and metformin, respectively. After adjustment to variables for prognosis, the use of the combined treatment was associated with an increased hazard ratio (HR) for all-cause mortality of 1.53 (95% confidence interval [CI] 1.20-1.96), whereas glyburide and metformin alone yielded HR 1.22 (95% CI 1.02-1.45) and HR 1.26 (95% CI 0.81-1.96), respectively. Conclusions: We conclude that after a 7.7-year follow-up, monotherapy with either glyburide or metformin in diabetic patients with CAD yielded a similar outcome and was associated with a modest increase in mortality. However, time-related mortality was markedly increased when a combined glyburide/metformin treatment was used.
    Clinical Cardiology 03/2001; 24(2):151-8. · 1.83 Impact Factor
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    ABSTRACT: The prevalence and extent of coronary calcium were retrospectively assessed by spiral computed tomography in 541 patients (mean age 62 +/- 9 years), of whom 101 had typical angina pectoris, 307 had atypical chest pain, and 133 were asymptomatic subjects with prominent atherosclerotic risk factors. The highest prevalence of coronary calcium was in men with angina pectoris (89%), whereas it was not detected in 48% of men and 56% of women with atypical chest pain.
    The American Journal of Cardiology 02/2001; 87(2):226-8, A9. · 3.21 Impact Factor
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    ABSTRACT: The present study was aimed to evaluate the prevalence and prognostic significance of unrecognized and newly defined borderline diabetes (with fasting blood sugar 126 to 139 mg/dl) by the American Diabetes Association criteria in coronary patients over a 7.7-year follow-up. Both undiagnosed and newly diagnosed borderline diabetes were associated with an unfavorable metabolic profile. The mortality of the borderline diabetics tended to be higher than in their nondiabetic counterparts. but this tendency did not reach statistical significance. A significant excess in long-term mortality was observed among the undiagnosed diabetes group.
    The American Journal of Cardiology 01/2001; 86(12):1363-6, A4-5. · 3.21 Impact Factor
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    ABSTRACT: Cough assessment is an important component in the clinical evaluation of patients with respiratory and cardiovascular disorders (asthma, chronic obstructive lung disease, congestive heart failure, etc.). A dry bothersome cough is the most common adverse class effect of all angiotensin-converting enzyme inhibitors (ACE-I). The present study was aimed to determine the feasibility of a new combined frequency/severity cough scoring method in patients with ACE-I induced cough before and after their modification with aspirin addition. The study was designed to compare two different regimens of active treatment: intermediate (500 mg) versus low (100 mg) dose aspirin in ACE-I cough suppression (self-matched control data) and comprised 21 patients (14 men, 7 women; mean age 62 +/- 11 years) on ACE-I treatment. ACE-I treatment was discontinued and the dry cough completely disappeared, but returned in all patients within one week (rechallenge period) after ACE-I reintroducing. Severity of cough was defined as follows: 0--no cough at all; 1--occasional hems; 2--mild, isolated cough, without additional symptoms; 3--moderate, paroxysmal cough, without additional symptoms; 4--severe, strenuous cough, accompanied by chest discomfort. In addition to cough severity score, cough frequency score (0-10) was obtained using a visual analog scale: 0 = I never cough; 10 = I cough all day. Low doses of aspirin were ineffective to suppress ACE-I induced cough. In contrast, intermediate doses completely abolished cough in 14 patients and reduced coughing in all but one patient. Cough severity and cough frequency scores decreased, respectively, from 2.6 +/- 1.1 to 0.7 +/- 1.0 (p<0.001) and from 6.9 +/- 2.2 to 2.1 +/- 2.4 (p<0.0001). Overall, the cough frequency score method alone could identify a beneficial modification of cough in 17 (81%) patients and cough severity score method alone in 17 (76%). Using the combined cough frequency/severity scoring, a beneficial modification of cough could be identified in 20 (95%) of patients. The new combined cough frequency/severity scoring is suitable for clinical practice and can improve the identification of dynamic cough modifications during treatment period as compared with the conventional frequency score method. It may have important implications in the evaluation of patients with respiratory and cardiovascular disorders.
    Journal of medicine 01/2001; 32(3-4):181-7.
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    ABSTRACT: Autoimmune factors have been shown to play a role in atherosclerosis. The aim of this study is to correlate 5 autoantibodies (anticardiolipin, anti-CL, beta2-glycoprotein-I, beta2GPI, phosphatidylcholine, oxidized low-density lipoprotein, oxLDL, endothelial cell) with the presence of coronary heart disease, angiographic findings, and with coronary artery calcification. The levels of the 5 autoantibodies and a control antifibroblast line of 126 coronary heart disease patients and 20 healthy controls were measured. Fifty-one patients underwent coronary angiography, and 98 patients had coronary artery calcium determination using spiral computerized tomography (dual mode). Levels of 3 autoantibodies (anti-CL, beta2GPI, oxLDL) were significantly elevated in coronary heart disease patients compared with controls (p < 0.001, p = 0.001, p < 0.001, respectively). Within the subgroup of patients with significant coronary artery stenosis, anti-CL antibodies were also elevated (p = 0.008). No correlation was found between anti-CL, and anti-beta2GPI autoantibody levels and coronary calcium scores as measured by spiral computerized tomography. However, anti-oxLDL antibodies were raised in patients with no calcification detected by spiral computerized tomography, compared with the patients with any coronary calcification (p = 0.046). Anti-CL, beta2GPI and oxLDL antibodies are elevated in coronary heart disease patients regardless of coronary calcification.
    Cardiology 01/2001; 95(1):20-4. · 1.52 Impact Factor
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    ABSTRACT: Blood flow in the aorta is complex and incompletely characterized. Mobile aortic plaques (MAPs), moving freely with the pulsatile aortic flow, in fact represent natural tracers that reflect the flow pattern itself. Our aim was to use MAP motion on transesophageal echocardiography (TEE) in order to characterize flow patterns in the atheromatous thoracic aorta of patients with systemic emboli. The study group was recruited from 250 patients referred for TEE to evaluate recent embolism. Among them, 22 patients (14 men and 8 women; mean +/- SD age, 66.3 +/- 7.2 years; 16 patients with cerebrovascular and 6 patients with peripheral emboli) with MAPs of > or = 3 mm in length formed the study group. The longest amplitudes of three spatial components of mobile lesion motions were measured: x (antegrade/retrograde [A/R]), y (up/down [U/D], and z (right/left [R/L]). A total of 33 mobile lesions were detected: 3 in the ascending aorta (1 patient), 13 in the arch (10 patients), and 17 in the descending aorta (11 patients). The length of mobile plaque components ranged from 3 to 13 mm; amplitudes of A/R, U/d, R/L, and retrograde flow motions ranged from 3 to 26 mm, from 1 to 16 mm, from 1 to 17 mm, and from 1 to 13 mm, respectively. Systolic rotational motion was clockwise in six patients (27%), counterclockwise in five patients (23%), incomplete (semicircle) in six patients (27%), and alternate clockwise/counterclockwise in five patients (23%). Diastolic rotational motion was clockwise in 5 patients (23%), counterclockwise in 6 patients (27%), and incomplete (semicircle) in 11 patients (50%). There were 18 multiple MAPs in seven patients: in all these cases, simultaneous rotations of MAP in different directions (as a marker for the presence of multiple vortices) were found. In nine patients with cerebral embolism, MAPs on the distal part of aortic arch solely were found; in five of them, all alternative potential sources of stroke were excluded. Therefore, retrograde cerebral embolism from distal aortic plaques in these patients is highly probable. Retrograde and rotational blood flow in the thoracic aorta probably exists in all patients with systemic emboli and mobile protruding aortic atheromas. Therefore, retrograde cerebral embolism from distal aortic plaques is theoretically possible.
    Chest 12/2000; 118(6):1703-8. · 5.85 Impact Factor
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    ABSTRACT: To investigate the accuracy of dual-section spiral computed tomography (CT) in tracking the progression of coronary calcification, as measured during a 3-year follow-up. Two hundred forty-six patients with hypertension (mean age, 66 years +/- 6 [SD]) were preselected in accordance with the International Nifedipine Study Intervention as a Goal for Hypertension Therapy protocol. Subjects had no clinical coronary arterial disease prior to the study and no cardiovascular events during follow-up. All participants underwent baseline CT (3.2-mm section thickness; reconstruction increment, 1.5 mm) and follow-up CT after 3 years. Calcification progression was defined as any increase in total calcification score (TCS) and analyzed in accordance with five baseline TCS categories: 1-9, 10-35, 36-100, 101-250, and greater than 250. At baseline CT, 152 patients had a TCS greater than 0, and 106 (70%) showed progression after 3 years, while 94 had a baseline TCS of 0; of these, 26 (28%) showed progression (P: <.01 between groups). The mean TCS was significantly higher in each baseline TCS category after 3 years. The percentage increase was negatively correlated with baseline TCS (P: <.01) and ranged from 466% in the lowest category to 38% in the highest. Dual-section spiral CT depicts significant change in TCS over time and is useful in tracking calcified coronary atherosclerosis.
    Radiology 11/2000; 217(2):461-5. · 6.34 Impact Factor

Publication Stats

1k Citations
606.71 Total Impact Points


  • 1984–2002
    • Tel Aviv University
      • Department of Internal Medicine
      Tel Aviv, Tel Aviv, Israel
  • 2001
    • Tel Aviv Sourasky Medical Center
      Tell Afif, Tel Aviv, Israel
  • 1980–2001
    • Sheba Medical Center
      • Department of Pathology
      Gan, Tel Aviv, Israel