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  1. Bedside Recognizing CAD Inherited Real Risk and silent CAD with Biophysical Semeiotics.

    Sergio Stagnaro, Biophysical Semeiotics Research Laboratory

    29 May 2008

    Editors,

    nowadays physicians could be able to recognize CLINICALLY, quickly and easily, coronary artery disease, even in earliest stage, i.e., INHERITED Real Risk of CAD, and obviously overt CAD, even silent, by means of Biophysical Semeiotics (1-9) (See www.semeioticabiofisica.it, Practical Applications). , Thanks to a few open-minded, farsighted physicians and "peer-reviewers" , bedside methods reliable in diagnosing CAD real risk is now-a-days an efficacious clinical tool, which proved to be of paramount importance in CAD Primary Prevention (1-9).

    As a matter of facts, not all hypertensive or diabetic or dyslipidaemic patients are neither suffering of ouvert CAD, nor at real risk of CAD (4, 8). A large number of well-known randomized trials report the benefits of both diuretics and exercise training in prehypertensive and hypertensive subjects, without recognizing individuals with CAD INHERITED Real Risk. The same consideration is valid for diabetics, independent from treatment results. To the best of my knowledge, neither the exact effects in healthy subjects at “real risk” for CAD, nor the real action mechanisms in patient involved by CAD are now-a-days completely known, ignoring the vast majority of doctors around the world what does it means such as original medical concept, i.e.,"microvascular remodelling", CAD real risk is based on, characterized principally by INHERITED newborn-pathological, type I, subtype b), CORONARY Endoarteriolar Blocking Devices, I discovered some years ago, identical to those we observe in diabetic pancreas ... since BIRTH, of course(7-9). In fact, as I illustrated in previous papers (1-9), physical training, such as walking, 120 paces/min.for 1 h., brings about three important effects also in “healthy” individual, involved by diabetic and/or hypertensive and/or arteriosclerotic (especially coronary) constitution: first of all, it ameliorates endothelial cells functions (2, 3, 4), improving “gradient shear stress”, and, in turn, causing physiological distribution of endothelial membrane “adhesion points”, which play notoriously a primary role in normal endothelial cell functioning. Moreover, the above-illustrated exercise training stimulates ubidecarenone synthesis, activating CoQ10 mithocondrial cycle, in both endothelial and scheletric muscle cells (5).

    Finally, doctors can bedside evaluate natriuretic peptides at rest as well as immediately after dynamic tests, described also in above-cited website, in Practical Applications, among them hearth preconditoning plays a central role. For further information, please See Bibliography in above website.

    References.

    1) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

    2) Stagnaro S., Diagnosi percusso-ascoltatoria delle alterazioni emoreologiche precoci nelle arteriopatie periferiche clinicamente silenti. I Congr. Naz. Soc. It. di Emoreologia. Atti, pag. 51. 30 Giugno-2 Luglio, 1982, Siena.

    3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 14, 1989.

    4) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997.

    5) Stagnaro Sergio. Biophysical-Semeiotic Bed-Side Detecting CAD,

    even silent, and Coronary Calcification. 4to Congreso International de Cardiologia por Internet, 2005, http://www.fac.org.ar/ccvc/marcoesp/marcos.php.

    6) Stagnaro S.-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617 (Medline)

    7) Stagnaro S. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. http://www.thelancet.com/journals/lancet/article/

    PIIS0140673607603316/comments?totalcomments=1

    8) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php

    9) Stagnaro S. New bedside way in reducing mortality in diabetic men and women. Ann. Int. Med. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1

    Competing interests

    None declared

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