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Encyclopedia of Health and Medicine

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112 The Cardiovascular System<br />

uses a laser to create several dozen tiny channels<br />

through the wall <strong>of</strong> the heart’s left ventricle to<br />

improve the flow <strong>of</strong> BLOOD <strong>and</strong> oxygen to the<br />

MYOCARDIUM (heart MUSCLE). The surgeon makes a<br />

small “window” incision through the ribs to gain<br />

access to the myocardium, <strong>and</strong> the HEART continues<br />

to beat during the surgery. The channels allow<br />

blood to flow directly from the ventricle’s chamber<br />

to the muscle tissue. Researchers do not know<br />

why TMLR relieves angina pectoris, though<br />

believe it allows oxygen to directly enter myocardial<br />

cells <strong>and</strong> also encourages new blood vessels to<br />

grow (collateral circulation). Cardiologists generally<br />

use TMLR only when other treatments for<br />

angina have failed or are not feasible. Most people<br />

stay in the hospital for three to seven days following<br />

surgery <strong>and</strong> are able to return to their regular<br />

activities, including work, in four to eight weeks.<br />

See also CORONARY ARTERY BYPASS GRAFT (CABG);<br />

SURGERY BENEFIT AND RISK ASSESSMENT.<br />

triglycerides blood level The amount <strong>of</strong> the<br />

fatty acid group, triglycerides, that is present in<br />

the BLOOD circulation. Most <strong>of</strong> the body’s fats are<br />

in the chemical form <strong>of</strong> triglycerides, which provide<br />

the body with energy. The cells draw triglycerides<br />

from the blood to meet their immediate<br />

energy needs. The body acquires triglycerides from<br />

dietary sources as well as manufactures them.<br />

During digestion the gastrointestinal tract extracts<br />

triglycerides from dietary saturated fats such as are<br />

abundant in meats. When the level <strong>of</strong> triglycerides<br />

in the blood meets or exceeds the body’s needs,<br />

the LIVER converts excess CALORIES that derive from<br />

any dietary source into triglycerides. The body<br />

stores excess triglycerides in fat cells, drawing<br />

from these stored energy supplies when dem<strong>and</strong>,<br />

such as increased physical activity, exceeds the<br />

triglycerides available in the blood circulation.<br />

In general, blood triglyceride levels rise when<br />

CHOLESTEROL BLOOD LEVELS, <strong>and</strong> particularly lowdensity<br />

lipoprotein cholesterol (LDL-C), are elevated.<br />

Blood triglyceride levels also tend to be<br />

elevated in OBESITY <strong>and</strong> DIABETES. The role elevated<br />

blood triglyceride levels play in CARDIOVASCULAR<br />

DISEASE (CVD) remains unclear. The National Cholesterol<br />

Education Program (NCEP), a consensus<br />

group <strong>of</strong> health experts, has established healthy<br />

<strong>and</strong> unhealthy levels <strong>of</strong> triglycerides in the blood<br />

based on correlations between elevated levels <strong>and</strong><br />

cardiovascular conditions such as ATHEROSCLEROSIS,<br />

CORONARY ARTERY DISEASE, (CAD), <strong>and</strong> PERIPHERAL<br />

VASCULAR DISEASE (PVD), as people who have these<br />

conditions typically have elevated blood triglycerides<br />

as well.<br />

Doctors recommend lifestyle modifications such<br />

as reducing dietary saturated fat <strong>and</strong> ALCOHOL consumption,<br />

increased daily exercise, <strong>and</strong> WEIGHT LOSS<br />

AND WEIGHT MANAGEMENT when triglyceride levels<br />

are slightly elevated (marginal) <strong>and</strong> <strong>of</strong>ten prescribe<br />

lipid-lowering medications when triglyceride levels<br />

are high or very high. Some people have elevated<br />

triglyceride blood levels <strong>and</strong> healthy cholesterol<br />

blood levels. For them, doctors recommend vigilance<br />

to maintain healthy cholesterol blood levels<br />

<strong>and</strong> annual monitoring, along with lifestyle habits<br />

that support overall cardiovascular health.<br />

TRIGLYCERIDE BLOOD LEVELS<br />

(MILLIGRAMS PER DECILITER)<br />

less than 150 mg/dL healthy<br />

150 to 199 mg/dL marginal<br />

200 to 499 mg/dL high<br />

500 mg/dL or higher very high<br />

See also CALORIE; DIET AND CARDIOVASCULAR<br />

HEALTH; DIET AND HEALTH; HYPERLIPIDEMIA; MEDICATIONS<br />

TO TREAT CARDIOVASCULAR DISEASE; NUTRIENTS.

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