MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Heart' source. Wed, 08 Feb 2012 09:32:40 +0100 http://www.medworm.com/index.php?rid=5666897&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F430%3Frss%3D1 Early diagnosis of mi using serial troponin measurements The recent introduction of high sensitivity troponin assays (hsT) has improved the sensitivity of this assay for the detection of myocardial infarction, while simultaneously decreasing specificity. To overcome this problem, the use of troponin kinetics—to identify acute myocardial damage—has been proposed, either alone or in combination with other diagnostic markers of cardiovascular disease. One thousand eight hundred and eighteen patients with suspected acute coronary syndromes were recruited from three German hospitals between 2007 and 2008. Each patient had blood drawn for the detection of 12 biomarkers, including both normal (cTnI) and high sensitivity (hsTnI) troponin, on admission and at 3 and 6 h. The main ou... Heart journals http://www.medworm.com/rss/comments.php?id=5666897 Mon, 06 Feb 2012 05:00:00 +0100 5666897 http://www.medworm.com/index.php?rid=5666896&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F420%3Frss%3D1 The term muscular dystrophy (MD) comprises various neuromuscular disorders that are characterised by progressive muscle weakness affecting certain muscle groups, which are specific for the respective genetic disorder. Muscular dystrophy type Duchenne (DMD) and type Becker (BMD) represent the most common X-linked genetic diseases: DMD is believed to affect one in 3500 male births whereas BMD is less frequent (one in 18 450 male births).w1 w2 However, due to the longer life expectancy of BMD patients, the prevalence of DMD and BMD is rather similar and at least 2.4/100 000.w1 Apart from progressive proximal skeletal muscle weakness and wasting, DMD and BMD are characterised by cardiac muscle involvement. Indeed, progressive cardiomyopathy has become a major cause of morbidity and mortality i... Heart journals http://www.medworm.com/rss/comments.php?id=5666896 Mon, 06 Feb 2012 05:00:00 +0100 5666896 http://www.medworm.com/index.php?rid=5666895&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F414%3Frss%3D1 Conclusion In this large PCI cohort, the in-hospital and longer-term mortality of South Asians appeared no worse than that of Caucasians. South Asians had higher rates of restenosis and CABG during follow-up. Data suggest that the excess coronary mortality for South Asians compared with Caucasians is not explained by differences in case-fatality rates. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666895 Mon, 06 Feb 2012 05:00:00 +0100 5666895 http://www.medworm.com/index.php?rid=5666894&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F408%3Frss%3D1 Conclusion Intravenous infusion of GLP-1 protects the heart from ischaemic LV dysfunction induced by dobutamine stress in patients with CAD. Clinical trial registration URL: http://isrctn.org. Registration number ISRCTN 69686930. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666894 Mon, 06 Feb 2012 05:00:00 +0100 5666894 http://www.medworm.com/index.php?rid=5666893&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F402%3Frss%3D1 Conclusions Although, this study was underpowered by the small number of acute ischaemic events, ICD-based ST monitoring failed to provide a benefit over ICDs without this capability and increased unscheduled evaluations in patients with remote follow-up. The sensitivity and specificity of the algorithm still require validation. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666893 Mon, 06 Feb 2012 05:00:00 +0100 5666893 http://www.medworm.com/index.php?rid=5666892&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F395%3Frss%3D1 Conclusion Low HRV is strongly predictive of angiographic coronary disease regardless of other co-morbidities and is clinically useful as a risk predictor in patients with sinus rhythm. Clinical trial registration information http://clinicaltrials.gov/ct2/show/NCT00403351 www.armcad.com (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666892 Mon, 06 Feb 2012 05:00:00 +0100 5666892 http://www.medworm.com/index.php?rid=5666891&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F389%3Frss%3D1 Conclusions A strategy of serial monitoring of MR-proANP and, of lesser impact, copeptin, combined with cTnT, may be advantageous in detecting and managing the highest-risk outpatients with HF. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666891 Mon, 06 Feb 2012 05:00:00 +0100 5666891 http://www.medworm.com/index.php?rid=5666890&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F384%3Frss%3D1 Conclusions These data indicate that RIPC reduces myocardial injury and improves cardiac function in patients undergoing heart valve surgery. Trial registration number NCT01175681. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666890 Mon, 06 Feb 2012 05:00:00 +0100 5666890 http://www.medworm.com/index.php?rid=5666889&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F377%3Frss%3D1 Conclusion A new seven factor model for risk stratification of patients with mild to moderate asymptomatic AS identified a high risk group for total mortality with good discrimination properties. Trial registration number ClinicalTrials.gov, NCT 00092677. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666889 Mon, 06 Feb 2012 05:00:00 +0100 5666889 http://www.medworm.com/index.php?rid=5666888&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F376%3Frss%3D1 A 59-year-old man underwent dual chamber permanent pacemaker (DDD PPM) implantation for complete heart block following emergency mechanical mitral valve replacement and coronary artery bypass grafting. At routine pacemaker check 5 months after the implant, a painless moderate sized swelling persisted over the box. The patient described several episodes of rigours and sweating in the preceding month. The patient was otherwise systemically well and without fever. Blood tests demonstrated a normal white blood cell count (9.9x109) and erythrocyte sedimentation rate (13 mm/h) and a mildly raised C reactive protein (11 mg/l). Chest radiograph was unremarkable. Blood cultures were negative. A transoesophageal echocardiogram did not show evidence of intracardiac vegetation. He under... Heart journals http://www.medworm.com/rss/comments.php?id=5666888 Mon, 06 Feb 2012 05:00:00 +0100 5666888 http://www.medworm.com/index.php?rid=5666887&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F370%3Frss%3D1 Conclusions TAVI is highly likely to be a cost-effective treatment for patients with severe aortic stenosis who are currently ineligible for SAVR. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666887 Mon, 06 Feb 2012 05:00:00 +0100 5666887 http://www.medworm.com/index.php?rid=5666886&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F360%3Frss%3D1 Conclusion Many cardiovascular risk scores are available that can be applied to patients with type 2 diabetes. A minority of these risk scores has been validated and tested for its predictive accuracy, with only a few showing a discriminative value of ≥0.80. The impact of applying these risk scores in clinical practice is almost completely unknown, but their use is recommended in various national guidelines. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5666886 Mon, 06 Feb 2012 05:00:00 +0100 5666886 http://www.medworm.com/index.php?rid=5666885&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F353%3Frss%3D1 This article describes the technical innovations in scanners, software, imaging protocols and stress regimens and discusses its evolving clinical role. History Planar MPS was introduced in the 1970s. Two decades later, most centres have adopted SPECT with ECG gating for the combined assessment of myocardial perfusion and left ventricular function using thallium-201, technetium-99m-sestamibi or technetium-99m-tetrofosmin. Over the past few years MPS has evolved from a diagnostic test of high accuracy for the detection of coronary artery disease (CAD) (mean sensitivity and specificity 90% and 75%, respectively) to an important tool for risk stratification, for which a large body of evidence exists documenting its clinical value and cost-effectiveness in a broad range of patient... (Source: H... Heart journals http://www.medworm.com/rss/comments.php?id=5666885 Mon, 06 Feb 2012 05:00:00 +0100 5666885 http://www.medworm.com/index.php?rid=5666884&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F350%3Frss%3D1 The development of primary angioplasty (PPCI) programmes for acute ST elevation myocardial infarction (STEMI) following Roger Boyle's report ‘Mending hearts and brains’ in 20061 has led to a marked shift in the role of the coronary care unit (CCU) in the UK. Some units no longer admit STEMI patients, while in PPCI centres the concentrated influx of patients previously treated across a network of hospitals has placed CCU beds and staff under considerable pressure. However, there are other factors changing and increasing the workload of acute cardiology, and the development of PPCI cannot be considered in isolation. In particular, the changing demographics of the population has led to an increasing proportion of elderly patients presenting to hospital with non-ST elevation myocar... Heart journals http://www.medworm.com/rss/comments.php?id=5666884 Mon, 06 Feb 2012 05:00:00 +0100 5666884 http://www.medworm.com/index.php?rid=5666883&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F348%3Frss%3D1 Sudden occlusion of a coronary artery initiates an expanding array of functional, metabolic and structural abnormalities, ultimately leading to myocyte necrosis, which extends from the subendocardial to the subepicardial layers of the perfusion bed—what Reimer called the ‘wavefront phenomenon’.1 In this setting, the myocardial area at risk (AAR) is defined as the myocardial tissue within the vascular territory that is distal to the culprit lesion of the infarct-related artery. If not timely reperfused, this area is at definite risk of ischaemic death. In humans, the portion of the AAR, that is irreversibly injured (ie, infarcted) ranges from 0% (aborted infarction) to as much as 88%.2 The proportion of the AAR that ultimately survives—that is, the salvaged myocardiu... Heart journals http://www.medworm.com/rss/comments.php?id=5666883 Mon, 06 Feb 2012 05:00:00 +0100 5666883 http://www.medworm.com/index.php?rid=5666882&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F5%2F345%3Frss%3D1 Introduction Cardiovascular disease (CVD) and prostate cancer represent major public health problems. In 2009, over 180 000 people died from CVD in the UK (http://www.bhf.org.uk). Over the past 30 years, the incidence of prostate cancer has almost tripled, with much of this increase attributable to increased early detection due to widespread prostate specific antigen (PSA) testing. Although many of these cases are related to localised disease, around one-third of the 37 000 men diagnosed in the UK annually (http://info.cancerresearchuk.org) will have advanced prostate cancer. The mainstay of treatment for such men is androgen suppression therapy (AST). Immediate initiation of AST is well supported by proven clinical benefits for men with symptomatic skeletal metastases,1 establis... Heart journals http://www.medworm.com/rss/comments.php?id=5666882 Mon, 06 Feb 2012 05:00:00 +0100 5666882 http://www.medworm.com/index.php?rid=5619864&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F343-b%3Frss%3D1 We thank Dr Jeong and colleagues for their comments1 regarding the incidence of dual high on-treatment platelet reactivity in patients undergoing elective percutaneous coronary intervention and its impact on clinical outcome.2 They raise several important issues. First, they provide additional information on the optimal cut-off value of the VerifyNow platelet function test to detect high on-aspirin platelet reactivity. Due to a lack of consensus on the optimal method to quantify high on-aspirin platelet reactivity and on the cut-off value associated with clinical risk, the measurement of platelet reactivity has not been widely implemented and included in the guidelines. Furthermore, the correlation between platelet function tests is moderate and the different tests identify other patients... Heart journals http://www.medworm.com/rss/comments.php?id=5619864 Fri, 20 Jan 2012 05:00:00 +0100 5619864 http://www.medworm.com/index.php?rid=5619863&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F343-a%3Frss%3D1 To the Editor The study performed by Breet et al1 supported our previous suggestion that a cut-off of >550 aspirin reaction units (ARU) was too high to identify high on-treatment platelet reactivity (HPR).2 The cut-off defined by the highest quartile (461 ARU) from our study2 is remarkably similar to the 454 ARU cut-off value associated with 1-year outcomes in the Breet et al study.1 Moreover, across ARU quartiles, reactivity to ADP and collagen significantly increased.2 In a new analysis of 558 patients undergoing elective percutaneous coronary intervention during aspirin and clopidogrel treatment, we observed that aggregations induced by 5 μM ADP and 0.5 mg/ml arachidonic acid (AA) correlated well (r=0.625), as measured by light transmittance aggregometry (... Heart journals http://www.medworm.com/rss/comments.php?id=5619863 Fri, 20 Jan 2012 05:00:00 +0100 5619863 http://www.medworm.com/index.php?rid=5619862&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F342%3Frss%3D1 AIM-HIGH fails to fly Despite the efficacy of statins in reducing the risk of cardiovascular disease a substantial number of patients go on to have further events, even when LDL cholesterol targets are achieved. Consequently, interest has grown in combination therapy approaches and the HDL raising treatment niacin—a drug now over 50 years old—has enjoyed something of a renaissance of late in this regard. In the AIM-HIGH study 3414 patients with known atherosclerotic coronary disease who were already receiving simvastatin (40 to 80 mg) were randomised to 1500 to 2000 mg per day of extended-release niacin (n=1718) or placebo (n=1696). The primary end point was the first event of the composite of death from coronary heart disease, nonfatal myocardial infarction, isc... Heart journals http://www.medworm.com/rss/comments.php?id=5619862 Fri, 20 Jan 2012 05:00:00 +0100 5619862 http://www.medworm.com/index.php?rid=5619861&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F335%3Frss%3D1 Prevention of sudden cardiac death (SCD) is an important target for improving survival in various patient groups and many prevention options have been evaluated. In the past decade several trials have documented beneficial effects for implantable cardioverter-defibrillator (ICD) implantation in patients surviving out-of-hospital cardiac arrest (secondary prevention) and in patients with diminished left ventricular function (primary prevention).1 However, within these patient groups a variety of comorbidities is present which might influence the benefit conferred by prophylactic ICD implantation. One of these comorbidities is chronic kidney disease (CKD), a condition that is highly prevalent among patients with a current ICD indication. CKD is of particular interest since this condition is ... Heart journals http://www.medworm.com/rss/comments.php?id=5619861 Fri, 20 Jan 2012 05:00:00 +0100 5619861 http://www.medworm.com/index.php?rid=5619860&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F330%3Frss%3D1 Conclusions Among middle-aged individuals with ECG LVH, the most likely first events are CHD in men and heart failure in women; these results may have implications for preventive approaches. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619860 Fri, 20 Jan 2012 05:00:00 +0100 5619860 http://www.medworm.com/index.php?rid=5619859&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F329%3Frss%3D1 A man in his 60s with no prior cardiac history presented with a non-ST-elevation acute coronary syndrome. Coronary angiography revealed a moderate lesion in mid-left anterior-descending artery (figure 1A) and two muscular bridges visible only in systole (figure 1B). The myocardial fractional flow reserve (FFR), after an intracoronary bolus of 120 μg adenosine with the wire in distal vessel, was 0.74. The fixed stenosis was implanted with a stent (figure 1C). The result was angiographically locally excellent, but the repeat FFR was 0.73 (figure 1D). The proximal bridge was therefore implanted with a stent (figure 1E). The result was also angiographically excellent, but the repeat FFR was 0.77 in distal vessel, 0.83 proximal to the distal bridge and 0.85 proximal to both mid-vessel s... Heart journals http://www.medworm.com/rss/comments.php?id=5619859 Fri, 20 Jan 2012 05:00:00 +0100 5619859 http://www.medworm.com/index.php?rid=5619858&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F325%3Frss%3D1 Conclusions Atorvastatin treatment for 4 weeks in subjects with SCR significantly improved endothelial function and suppressed systemic inflammatory status by decreasing circulating levels of IL-1b and sVCAM-1. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619858 Fri, 20 Jan 2012 05:00:00 +0100 5619858 http://www.medworm.com/index.php?rid=5619857&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F319%3Frss%3D1 Conclusions Cystatin C is an accurate and easy estimate of renal function with prognostic properties superior to serum creatinine and similar to creatinine based formulae in patients with CHF. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619857 Fri, 20 Jan 2012 05:00:00 +0100 5619857 http://www.medworm.com/index.php?rid=5619856&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F312%3Frss%3D1 Conclusion Measurement of cTnI alone is sufficient for diagnosis. Measurement of a marker panel does not facilitate diagnosis. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619856 Fri, 20 Jan 2012 05:00:00 +0100 5619856 http://www.medworm.com/index.php?rid=5619855&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F303%3Frss%3D1 Conclusions This meta-analysis demonstrates a significant reduction in mortality, MACE and major access site complications associated with the transradial access site in STEMI. The meta-analysis supports the preferential use of radial access for STEMI PCI. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619855 Fri, 20 Jan 2012 05:00:00 +0100 5619855 http://www.medworm.com/index.php?rid=5619854&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F297%3Frss%3D1 Conclusions In patients affected by severely symptomatic permanent AF, Ablate and Pace therapy yielded a clinical benefit in 63% of RV-paced patients and 83% of CRT-paced patients. CRT pacing and echo-optimised CRT were the only independent predictor of clinical benefit. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619854 Fri, 20 Jan 2012 05:00:00 +0100 5619854 http://www.medworm.com/index.php?rid=5619853&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F291%3Frss%3D1 Conclusion In patients with a normal initial electrophysiological study, modifications on the resting ECG and/or SA-ECG, on annual check-up, were associated with an alteration of infrahissian conduction. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619853 Fri, 20 Jan 2012 05:00:00 +0100 5619853 http://www.medworm.com/index.php?rid=5619852&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F282%3Frss%3D1 Conclusion In patients with chronic ischaemic heart disease, G-CSF mobilises EPCs but does not improve myocardial perfusion or angina. G-CSF increases plasma levels of adverse prognostic cardiac biomarkers. Clinical trial registration information Australian New Zealand Clinical Trials Registry: http://www.anzctr.org.au. Unique identifier: ACTRN012607000354482. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619852 Fri, 20 Jan 2012 05:00:00 +0100 5619852 http://www.medworm.com/index.php?rid=5619851&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F276%3Frss%3D1 The fast moving field of genomic medicine is already impacting on clinical care and cardiologists are fortunate to be in a position to benefit early from the transformative advances in genomics. However, the challenges associated with genomics in the clinic in general, and with next generation sequencing technologies in particular, are significant and cardiologists need to be prepared if they wish to surf the wave of genomic opportunity. This paper presents an overview of the implications of next generation sequencing for clinical diagnostics and personalised medicine in the cardiology clinic. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5619851 Fri, 20 Jan 2012 05:00:00 +0100 5619851 http://www.medworm.com/index.php?rid=5619850&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F274%3Frss%3D1 Death and disability as a result of cerebrovascular disease are a significant and growing problem in our ageing society. Surgery for significant carotid artery stenosis (>50%) in the form of carotid endarterectomy (CEA) reduces the subsequent risk of ipsilateral stroke. This benefit is particularly evident in recently symptomatic patients with minor stroke or transient ischaemic attack.1 2 Asymptomatic subjects with significant carotid artery stenosis (>70%) also benefit from surgery (stroke risk at 10 years 10.8% vs 16.9% with medical treatment (gain of 6.1%, 95% CI 2.7% to 9.4%)).3 Carotid artery stenting (CAS) is a less invasive alternative to CEA avoiding the morbidity associated with a surgical incision. However, CAS is a technically demanding procedure and some early resul... Heart journals http://www.medworm.com/rss/comments.php?id=5619850 Fri, 20 Jan 2012 05:00:00 +0100 5619850 http://www.medworm.com/index.php?rid=5619849&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F271%3Frss%3D1 Human migration, the movement of people from one place in the world to another, has gone on for time immemorial being one of the earliest social phenomena history records. In animals it is a ubiquitous phenomenon—found in all major animal groups—and triggered most commonly by climate, availability of food, the season of the year or mating reasons. Ultimately, the innate desire to seek pastures new and to better one's lot is a survival instinct and thus is ironic considering how (im)migration is a political football in these times. However, whereas earlier human migrations usually involved moving into areas that were uninhabited, human migrants now tend to move to areas already settled and thus may result in conflict with indigenous people and cultures of that area. Migration st... Heart journals http://www.medworm.com/rss/comments.php?id=5619849 Fri, 20 Jan 2012 05:00:00 +0100 5619849 http://www.medworm.com/index.php?rid=5619848&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F269%3Frss%3D1 In their paper published in Heart, Mamas et al report on a meta-analysis of studies comparing radial with the more traditional femoral access route for primary percutaneous coronary intervention (PCI) in patients presenting with ST elevation myocardial infarction (STEMI)1 (see page 303.). Even though radial access PCI currently appears to be an evolving technique, this approach has in fact been in use for a long time. In the 1940s, the radial approach was used by Radner in Sweden for diagnostic aortographies.2 In 1960, Mason Sones Jr, a paediatric cardiologist at Cleveland Clinic, performed the first coronary angiography via a brachial artery cut-down. This technique was replaced by the femoral artery approach in the 1960s by Melvin Judkins, a radiologist at the University of Oregon in Por... Heart journals http://www.medworm.com/rss/comments.php?id=5619848 Fri, 20 Jan 2012 05:00:00 +0100 5619848 http://www.medworm.com/index.php?rid=5619847&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F4%2F267%3Frss%3D1 Despite improvements in our understanding of the mechanisms underlying atrial fibrillation (AF) and significant advancements in the treatment options available, optimal management and symptom relief remains a challenge in some patients. In patients with medically refractory AF more aggressive measures may be required, including percutaneous catheter ablation (pulmonary vein isolation, with or without additional substrate modification) or atrioventricular (AV) junction ablation with concomitant insertion of a permanent pacemaker. The latter option, widely known as an ‘ablate and pace’ strategy, may be preferable in patients who want a definitive, albeit palliative, treatment of their symptoms and are not willing to take the risks and potential recurrences associated with AF abla... Heart journals http://www.medworm.com/rss/comments.php?id=5619847 Fri, 20 Jan 2012 05:00:00 +0100 5619847 http://www.medworm.com/index.php?rid=5537543&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F265%3Frss%3D1 A 28-year-old man with chronic pulmonary artery hypertension (PAH) underwent a cardiac CT scan for pulmonary artery (PA) and coronary artery (CA) evaluation due to sporadic dyspnoea and atypical chest discomfort. No acute clinical symptoms were present. Multidetector CT (MDCT) scan showed enlargement of the PA with slight displacement of the left main/proximal tract of the anterior descending CA without any coronary compression. However, the most important and unexpected finding was the presence of an extensive intimal flap inside the proximal portion of the right PA (figure 1), with partial thrombosis of the false lumen and peripheral involvement of the interlobar artery and common basal artery up to the posterior-basal branch (figure 2). Figure 1(A–D) Multidetector CT images showin... Heart journals http://www.medworm.com/rss/comments.php?id=5537543 Fri, 23 Dec 2011 05:00:00 +0100 5537543 http://www.medworm.com/index.php?rid=5537542&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F264%3Frss%3D1 A 41-year-old man presented with chest pain and recent flu-like illness. ECG demonstrated inferolateral ST elevation and troponin I level was raised. A diagnosis of myocardial infarction was made and intravenous thrombolysis was administered. Catheter angiography did not demonstrate significant coronary artery disease, so cardiac MRI was performed to clarify the diagnosis. Late gadolinium enhancement (LGE) images revealed multiple discreet band-like regions of enhancement in the mid-myocardial left ventricular wall with sparing of the subendocardial layer, suggestive of myocarditis rather than myocardial infarction (figure 1). Figure 1Cardiac MRI during the acute phase of the illness. The four-chamber late gadolinium enhancement (LGE) image (A) demonstrates mid-myocardial LGE in the left v... Heart journals http://www.medworm.com/rss/comments.php?id=5537542 Fri, 23 Dec 2011 05:00:00 +0100 5537542 http://www.medworm.com/index.php?rid=5537541&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F263-b%3Frss%3D1 We thank Dr Murakami1 for the interesting comments on our paper.2 Unfortunately, we do not have information about either pulmonary arterial systolic pressure in our controls or the ratio of early transmitral flow velocity to early mitral annular tissue in the overall sample. Competing interestsNone. Provenance and peer reviewNot commissioned; internally peer reviewed. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537541 Fri, 23 Dec 2011 05:00:00 +0100 5537541 http://www.medworm.com/index.php?rid=5537540&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F263-a%3Frss%3D1 To the Editor I read with great interest the report by Dr Todiere and colleagues1 which discussed right ventricular hypertrophy in patients with systemic hypertension. Although they reported that there was no difference in systolic pulmonary artery pressure between hypertensive patients with and without left ventricular hypertrophy, Lam and colleagues2 have previously reported age-associated elevation of pulmonary artery systolic pressure, which was related to increasing systemic vascular stiffening, in the general population. Thus, I would like to know the difference in the pulmonary artery pressure between hypertensive patients and controls. Moreover, Lam and colleagues reported that one of the independent predictors of pulmonary artery systolic pressure was the ratio of early transmitra... Heart journals http://www.medworm.com/rss/comments.php?id=5537540 Fri, 23 Dec 2011 05:00:00 +0100 5537540 http://www.medworm.com/index.php?rid=5537539&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F262%3Frss%3D1 Interventional cardiologyGenetic factors related to early stent thrombosis Dual anti-platelet therapy reduces cardiovascular events after percutaneous coronary intervention (PCI) by more than 80%. However, stent thrombosis can occur in 0.5–4% of patients within the first year following PCI, with the majority occurring in the first month. Cayla et al performed a case–control study using a candidate gene approach—looking in particular at genetic variations previously associated with clopidogrel pharmacogenetics and arterial thrombosis—in order to determine their impact on early stent thrombosis, in addition to established clinical and angiographic factors. The study was conducted across 10 centres in France over a 3-year period and involved 123 patients undergoing PCI... Heart journals http://www.medworm.com/rss/comments.php?id=5537539 Fri, 23 Dec 2011 05:00:00 +0100 5537539 http://www.medworm.com/index.php?rid=5537538&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F254%3Frss%3D1 High blood pressure is one of the leading risk factors influencing the global burden of cardiovascular disease, resulting in increased incidence of all-cause and cardiovascular mortality, sudden death, stroke, coronary heart disease, heart failure, atrial fibrillation, peripheral artery disease, and renal insufficiency. Hypertension affects about 25% of adults around the world and is estimated to lead to over seven million deaths each year—that is, about 13% of the total number of deaths worldwide. Lifestyle changes are able to lower blood pressure and prevent the development of hypertension, and antihypertensive drug treatment has been shown to reduce blood pressure and cardiovascular complications in hypertensive patients. Despite current knowledge on the management of hypertension... Heart journals http://www.medworm.com/rss/comments.php?id=5537538 Fri, 23 Dec 2011 05:00:00 +0100 5537538 http://www.medworm.com/index.php?rid=5537537&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F246%3Frss%3D1 This article provides a broad overview of some of the future uses of contrast ultrasound in patients with cardiovascular disease that are on the horizon, including: (1) evaluating vascular anatomy and plaque neovascularisation; (2) detecting abnormal microvascular function; (3) assessing peripheral vascular disease with stress/rest limb perfusion imaging; (4) molecular imaging of cardiovascular disease; (5) site targeted delivery of therapeutic genes or drugs; and (6) ultrasound facilitated thrombolysis. The acoustic bubble Signal enhancement during contrast enhanced ultrasound (CEU) relies... (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537537 Fri, 23 Dec 2011 05:00:00 +0100 5537537 http://www.medworm.com/index.php?rid=5537536&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F244%3Frss%3D1 There are a number of adjunctive pharmacotherapies available for individuals with peripheral arterial disease and intermittent claudication, in whom appropriate risk factor modification and antiplatelet treatment have been initiated. These include cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate, which have vasodilatation among their mechanisms of action and have been the subject of recent technology appraisal guidance offered by the National Institute for Health and Clinical Excellence (NICE).1 The guidance offered was based upon systematic review, meta-analysis and cost-effectiveness analysis and is summarised in box 1. Box 1Summary of NICE guidelines1 For individuals with peripheral arterial disease and intermittent claudication, where vasodilator treatment is c... Heart journals http://www.medworm.com/rss/comments.php?id=5537536 Fri, 23 Dec 2011 05:00:00 +0100 5537536 http://www.medworm.com/index.php?rid=5537535&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F238%3Frss%3D1 Conclusions Right ventriculo-arterial coupling in pulmonary hypertension can be studied with standard RHC and CMR. Arterial load increases with disease severity whereas contractility cannot progress in parallel, leading to severe uncoupling. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537535 Fri, 23 Dec 2011 05:00:00 +0100 5537535 http://www.medworm.com/index.php?rid=5537534&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F232%3Frss%3D1 Conclusions After age and gender stratification, CTA findings were shown to be of limited predictive value in female patients aged <60 years as compared with male patients at any age and female patients aged ≥60 years. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537534 Fri, 23 Dec 2011 05:00:00 +0100 5537534 http://www.medworm.com/index.php?rid=5537533&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F225%3Frss%3D1 Conclusions In patients treated with the 1-stent technique for bifurcation lesions, FKB after main vessel stenting may be harmful mainly due to increased TLR. Trial Registration Number clinicaltrials.gov number: NCT00851526. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537533 Fri, 23 Dec 2011 05:00:00 +0100 5537533 http://www.medworm.com/index.php?rid=5537532&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F219%3Frss%3D1 Conclusion Serum phosphate is independently associated with LVM in patients with CKD. Interventional studies are required to determine whether this association is causative and whether reducing phosphate exposure reduces LVM in this population. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537532 Fri, 23 Dec 2011 05:00:00 +0100 5537532 http://www.medworm.com/index.php?rid=5537531&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F214%3Frss%3D1 Conclusion According to the findings of the present study, in addition to coronary artery disease burden, the sTRAIL concentration is also related to the composition of atheromatous plaques. A significant association is demonstrated between low sTRAIL levels and the presence of TCFA, the IVUS–virtual histology prototype of the vulnerable plaque. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537531 Fri, 23 Dec 2011 05:00:00 +0100 5537531 http://www.medworm.com/index.php?rid=5537530&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F207%3Frss%3D1 Conclusion The current analysis of the FIR dataset shows that the long-term benefit of the routine invasive strategy over the selective invasive strategy is attenuated in younger patients aged <65 years and in women by the increased risk of early events which seem to have no consequences for long-term cardiovascular mortality. No other clinical risk factors were able to identify patients with differential responses to a routine invasive strategy. Trial registration http://www.controlled-trials.com/ISRCTN82153174 (ICTUS), http://www.controlled-trials.com/ISRCTN07752711 (RITA-3). (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537530 Fri, 23 Dec 2011 05:00:00 +0100 5537530 http://www.medworm.com/index.php?rid=5537529&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F202%3Frss%3D1 Conclusions All algorithms were less accurate in our hands than in other authors' own assessment. None performed well in identifying midseptal or right anteroseptal accessory pathway locations. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537529 Fri, 23 Dec 2011 05:00:00 +0100 5537529 http://www.medworm.com/index.php?rid=5537528&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F195%3Frss%3D1 Conclusion AF control is not optimal. Control appears to be associated with fewer symptoms and better QoL, but even patients with controlled AF have frequent symptoms, functional impairment, altered QoL and cardiovascular events. New treatments are needed to improve control and minimise the functional and QoL burden of AF. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537528 Fri, 23 Dec 2011 05:00:00 +0100 5537528 http://www.medworm.com/index.php?rid=5537527&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F185%3Frss%3D1 Conclusions In LMIC, most but not all, CV risk factors are higher or more common in migrants than in rural groups but lower or less common than in urban groups. Such gradients may or may not be associated with differential CV events and long-term evaluations are necessary. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537527 Fri, 23 Dec 2011 05:00:00 +0100 5537527 http://www.medworm.com/index.php?rid=5537526&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F177%3Frss%3D1 Conclusions Published evidence on the added value of atherosclerosis imaging varies across the different markers, with limited evidence for FMD and considerable evidence for CIMT, carotid plaque and CAC. The added predictive value of additional screening may be primarily found in asymptomatic individuals at intermediate cardiovascular risk. Additional research in asymptomatic individuals is needed to quantify the cost effectiveness and impact of imaging for subclinical atherosclerosis on cardiovascular risk factor management and patient outcomes. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5537526 Fri, 23 Dec 2011 05:00:00 +0100 5537526 http://www.medworm.com/index.php?rid=5537525&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F175%3Frss%3D1 This is not a great time for bifurcation stenting trials. All manner of intellectually attractive bifurcation stent strategies have been studied, and all have demonstrated major weaknesses.1–5 Indeed, the simplest strategy of all, in which the side branch is essentially invited to look after itself, has proved the most durable and reproducible.6 This, presumably, is because any technique that takes a geometrically rigid stent design, and tries to deform and then reconfigure it within a coronary bifurcation, is likely to be found wanting in some respects.7 8 As with the branches of a tree, coronary bifurcations obey Murray's law (and some would say Murphy's too). That is to say, the diameter of the proximal parent vessel is two-thirds the sum of the diameters of the daughter vessels. ... Heart journals http://www.medworm.com/rss/comments.php?id=5537525 Fri, 23 Dec 2011 05:00:00 +0100 5537525 http://www.medworm.com/index.php?rid=5537524&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F3%2F173%3Frss%3D1 The role of a routine invasive strategy in patients with non-ST segment elevation acute coronary syndromes remains a subject of debate. Following the results of several randomised trials many clinicians consider that an invasive strategy should be used in most patients but, in real-world practice, many centres tend to use a routine invasive strategy in younger patients, and a more selective approach in older individuals, in whom the presence of comorbidities is often perceived as a limitation to performing coronary angiography.1 The results of the pooled analysis of the Fragmin and Fast Revascularisation during Instability in Coronary Artery Disease (FRISC-II), Invasive Versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) and Randomized Trial of a Conservative Treatment Str... Heart journals http://www.medworm.com/rss/comments.php?id=5537524 Fri, 23 Dec 2011 05:00:00 +0100 5537524 http://www.medworm.com/index.php?rid=5494776&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F172%3Frss%3D1 We describe the case of a 35-year-old woman who presented with combined mitral and aortic stenosis, and a peculiar and unusual finding on Doppler evaluation. A 2D echocardiogram revealed rheumatic mitral stenosis of moderate severity with a mitral valve area of 1.2 cm2 and coexisting severe aortic stenosis with a peak systolic gradient of 68 mm Hg and mean systolic gradient of 42 mm Hg, with a calculated aortic valve area of 0.8 cm2. Continuous wave Doppler interrogation of the mitral inflow revealed an interesting pattern of flow during the isovolumic relaxation (IVR) phase of diastole, leading to a peculiar ‘triphasic’ mitral inflow trace (figure 1). Pulsed wave Doppler interrogation confirmed it to be prominent intraventricular apically directed... Heart journals http://www.medworm.com/rss/comments.php?id=5494776 Mon, 12 Dec 2011 05:00:00 +0100 5494776 http://www.medworm.com/index.php?rid=5494775&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F170-b%3Frss%3D1 The Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial was a pragmatic evaluation comparing a specific point-of-care panel assessment to what is still standard diagnostic assessment for suspected myocardial infarction, a 12-hour laboratory troponin. The studies by Keller et al1 and Reichlin et al2 show that modern high sensitivity troponin assays have better sensitivity than older assays but troponin measurement at presentation is still suboptimal compared with delayed measurement. We are currently undertaking an economic analysis to determine whether delayed troponin measurement is cost effective compared with measurement at presentation.3 Until this analysis is undertaken, delayed troponin measurement cannot even be considered redundant in principle, ... Heart journals http://www.medworm.com/rss/comments.php?id=5494775 Mon, 12 Dec 2011 05:00:00 +0100 5494775 http://www.medworm.com/index.php?rid=5494774&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F170-a%3Frss%3D1 To the Editor Having read the three papers published on the Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial,1–3 I have come to the conclusion that there has been a major miscarriage of justice. That miscarriage of justice relates to diagnostic equipment used in the standard treatment protocols for the hospitals involved in the RATPAC trial (Beckman Access, Centaur CP and Roche E170). The point-of-care testing (POCT) was not convincingly vindicated in this trial but the other equipment and methods were deemed by association of the data to be inadequate. A cursory examination of the papers clearly shows: (1) The main reason for the improvement in patient discharge was the decision to change the time interval for testing cardiac markers from 12&nbs... Heart journals http://www.medworm.com/rss/comments.php?id=5494774 Mon, 12 Dec 2011 05:00:00 +0100 5494774 http://www.medworm.com/index.php?rid=5494773&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F169%3Frss%3D1 General cardiologyAmbulatory BP monitoring cost-effective Affecting a billion people, hypertension is the cardiovascular risk factor associated with the highest mortality worldwide. There are well-documented problems in the detection of hypertension, as it varies throughout the day and in response to various stimuli. Out-of-office options have been developed that monitor blood pressure either at home or while ambulatory, and have been shown to correlate better with cardiovascular prognosis. Lovibond and colleagues used a Markov model-based probabilistic cost-effectiveness analysis to compare out-of-office blood pressure recording (both ambulatory and home systems) against conventional repeat clinic measurement in a hypothetical primary-care population aged over 40 with a raised screening b... Heart journals http://www.medworm.com/rss/comments.php?id=5494773 Mon, 12 Dec 2011 05:00:00 +0100 5494773 http://www.medworm.com/index.php?rid=5494772&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F162%3Frss%3D1 Risk is defined as the probability and severity of loss from exposure to a hazard, and can be assessed in different ways. The application of quantitative or qualitative measures to determine the level of risk associated with a specific hazard defines the process of risk assessment. Qualitative risk assessments (ie, high, intermediate or low risk) are based on the presence or absence of certain characteristics (risk markers or factors). These are easy to use but not accurate as there may be wide variations in individual risk within risk subgroups. Quantitative risk assessments, based on algorithms or mathematical formulae, are more precise but more complicated to use. Risk scores are formula generated numbers used for quantitative risk assessment that rank-order individuals according to the... Heart journals http://www.medworm.com/rss/comments.php?id=5494772 Mon, 12 Dec 2011 05:00:00 +0100 5494772 http://www.medworm.com/index.php?rid=5494771&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F152%3Frss%3D1 Conclusion The findings suggest that most endogenous plasma NT-BNP is glycosylated and therefore undetectable with the current assay system, and that the relative glycosylation level is increased by haemodialysis. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494771 Mon, 12 Dec 2011 05:00:00 +0100 5494771 http://www.medworm.com/index.php?rid=5494770&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F145%3Frss%3D1 Conclusions Maternal CHD is associated with a markedly increased risk of adverse cardiovascular events and death during admission for delivery. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494770 Mon, 12 Dec 2011 05:00:00 +0100 5494770 http://www.medworm.com/index.php?rid=5494769&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F139%3Frss%3D1 Conclusion The CYP2C19*2 genetic variant may be associated with worse outcome in Korean patients treated exclusively with DES and dual-antiplatelet therapy due to a significant increase in cardiac death, myocardial infarction or stent thrombosis. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494769 Mon, 12 Dec 2011 05:00:00 +0100 5494769 http://www.medworm.com/index.php?rid=5494768&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F133%3Frss%3D1 Conclusions Diabetes, HbA1c level and poor glycaemic control are independently associated with an increased risk of AF, but the underlying mechanisms governing the relationship are unknown and warrant further investigation. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494768 Mon, 12 Dec 2011 05:00:00 +0100 5494768 http://www.medworm.com/index.php?rid=5494767&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F126%3Frss%3D1 Conclusion In a heterogeneous population with predominantly functional MR, percutaneous MVR with the Evalve MitraClip system lowers mPCWP, PCWP v-wave and mPAP by 20%, 20% and 8%, respectively, and increases the CI by 32%. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494767 Mon, 12 Dec 2011 05:00:00 +0100 5494767 http://www.medworm.com/index.php?rid=5494766&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F116%3Frss%3D1 Conclusions HCM patients with an ICD have a significant cardiovascular mortality and are exposed to frequent inappropriate shocks and implant complications. These data suggest that new strategies are required to improve patient selection for ICDs and to prevent disease progression in those that receive a device. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494766 Mon, 12 Dec 2011 05:00:00 +0100 5494766 http://www.medworm.com/index.php?rid=5494765&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F109%3Frss%3D1 Conclusions For measuring AAR, cardiovascular magnetic resonance methods are better than angiographic methods, which are better than electrocardiographic methods. Overall, ESA performed best for measuring AAR in vivo. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494765 Mon, 12 Dec 2011 05:00:00 +0100 5494765 http://www.medworm.com/index.php?rid=5494764&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F100%3Frss%3D1 Conclusions Not only CYP2C19 loss-of-function but also gain-of-function alleles should be considered to define the pharmacogenetic response to clopidogrel. The results question the relevance of the CYP2C19 loss-of-function alleles in the prediction of major cardiovascular events beyond stent thrombosis in coronary patients treated with clopidogrel. The gain-of-function variant is associated with a lower risk of cardiovascular events but a higher risk of bleeding. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5494764 Mon, 12 Dec 2011 05:00:00 +0100 5494764 http://www.medworm.com/index.php?rid=5494763&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F99%3Frss%3D1 Sometimes, the critical reader of biomedical journals witnesses a paradigm shift in treatment recommendations. While the 1998 guidelines recommend the use of mechanical, not bioprosthetic, heart valve prostheses in patients with end-stage renal disease (ESRD) requiring dialysis, the 2005 revised guidelines are less prescriptive because of insufficient data, leaving open the question of the optimum choice. The meta-analysis of Chan et al1 published recently in Heart has the potential to complete the paradigm shift by influencing future guideline recommendations to favour bioprosthetic heart valves as the first choice for patients with ESRD. The 5-year mortality rate of patients with ESRD is approximately 65%.1 In addition, the life expectancy of a chronic dialysis patient in the seventh dec... Heart journals http://www.medworm.com/rss/comments.php?id=5494763 Mon, 12 Dec 2011 05:00:00 +0100 5494763 http://www.medworm.com/index.php?rid=5494762&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F97%3Frss%3D1 The sudden and unexpected death of an often young and otherwise healthy person with hypertrophic cardiomyopathy (HCM) due to a ventricular arrhythmia is a tragic but preventable occurrence. Wider availability of the implantable cardioverter defibrillator (ICD), a reliable and effective therapy that can detect and successfully terminate a spontaneous sustained ventricular arrhythmia, remains one of the most important additions to the therapeutic armamentarium of clinicians who care for patients with HCM in the past 25 years or so and is recommended for those individuals deemed at highest risk.1 Although initially thought to be a disease of the young with high mortality, HCM is now widely recognised as having a relatively benign clinical course for the majority of patients, but remains ... Heart journals http://www.medworm.com/rss/comments.php?id=5494762 Mon, 12 Dec 2011 05:00:00 +0100 5494762 http://www.medworm.com/index.php?rid=5494761&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F2%2F95%3Frss%3D1 During the past decade the measurement of B-type natriuretic peptide (BNP) and the N-terminal fragment of proBNP (NT-proBNP) has become a widely used tool for diagnosing heart failure.1 In their paper published in this issue of Heart, Nishikimi and coworkers2 (see page 152), from the group of Kazuwa Nakao, report that most endogenous NT-proBNP found in the circulation is glycosylated and thus undetectable with current assay systems. These findings are both surprising and intriguing and could have substantial clinical implications, in particular if the degree of glycosylation is found to vary according to the severity of disease. BNP was originally discovered in porcine brain and termed ‘brain natriuretic peptide’, but early pioneer work of Saito et al,3 from the group of Nakao ... Heart journals http://www.medworm.com/rss/comments.php?id=5494761 Mon, 12 Dec 2011 05:00:00 +0100 5494761 http://www.medworm.com/index.php?rid=5468585&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F93%3Frss%3D1 A 69-year-old woman developed dyspnoea 1 day after percutaneous pericardiocentesis for idiopathic pericardial effusion. On the exam, she had a pulsus paradoxus of 12 mm Hg and an elevated jugular venous pulse. The chest radiograph showed air separating the pericardium from the heart, indicating pneumopericardium (Panel A, black arrows). An echocardiogram showed moderate amount of pericardial effusion with a number of pericardial air microbubbles (Panel B,C, asterisks, video clips 1 and 2). Echocardiographic signs of tamponade, including early right ventricular diastolic collapse and significant respiratory variation of tricuspid (Panel D) and mitral (Panel E) inflows and superior vena caval flow (Panel F), were clearly evident. Emergent surgical pericardial drainage and biop... Heart journals http://www.medworm.com/rss/comments.php?id=5468585 Fri, 02 Dec 2011 05:00:00 +0100 5468585 http://www.medworm.com/index.php?rid=5468584&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F92-b%3Frss%3D1 Cortigiani L, Rigo F, Galderisi M, et al. Diagnostic and prognostic value of Doppler echocardiographic coronary flow reserve in the left anterior descending artery. Heart 2011;97:1758–1765 Published Online First: 11 August 2011 doi:10.1136/heartjnl-2011-300178. The title of this paper should read ‘Diagnostic and prognostic value of Doppler echocardiographic coronary flow reserve in the left anterior descending artery in hypertensive and normotensive patients’. The journal apologises for this error. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468584 Fri, 02 Dec 2011 05:00:00 +0100 5468584 http://www.medworm.com/index.php?rid=5468583&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F92-a%3Frss%3D1 Sarkola T, Redington AN, Slorach C, et al. Assessment of vascular phenotype using a novel very high resolution ultrasound technique in adolescents after aortic coarctation repair and/or stent implantation: relationship to central haemodynamics and left ventricular mass. Heart 2011;97:1870–5; Published Online First: 13 September 2011; doi:10.1136/heartjnl-2011-300740. This paper has been withdrawn because it was published twice in error. The version of record is Sarkola T, Redington AN, Slorach C, et al. Assessment of vascular phenotype using a novel very high resolution ultrasound technique in adolescents after aortic coarctation repair and/or stent implantation: relationship to central haemodynamics and left ventricular mass. Heart 2011;97:1788–93; Published Online First: 27 J... Heart journals http://www.medworm.com/rss/comments.php?id=5468583 Fri, 02 Dec 2011 05:00:00 +0100 5468583 http://www.medworm.com/index.php?rid=5468582&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F91-b%3Frss%3D1 We appreciate the comments and viewpoints of Dr Basu1 regarding our paper detailing the clinical assessment of patients initially presenting to the emergency department with acute heart failure syndromes (AHFS) through hospitalisation and the early post-discharge period.2 We agree with Dr Basu regarding the important role that blood pressure (BP) plays in the pathophysiology and, consequently, the comprehensive clinical assessment of AHFS.3 The Organised Program to Initiate Lifesaving Treatment in Hospitalised Patients with Heart Failure (OPTIMISE-HF) investigators found that approximately 50% of patients had a systolic BP (SBP) >140 mm Hg at admission and that in-hospital mortality was lowest in the top decile (SBP 189–300 mm Hg).4 As noted in table 1 of our ... Heart journals http://www.medworm.com/rss/comments.php?id=5468582 Fri, 02 Dec 2011 05:00:00 +0100 5468582 http://www.medworm.com/index.php?rid=5468581&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F91-a%3Frss%3D1 To the Editor I read with interest Harinstein et al's review of clinical assessment in acute heart failure syndromes (AHFS).1 Initial assessment of AHFS included evaluation of important prognostic factors that influence treatment such as the presence of atrial fibrillation, acute pulmonary oedema and renal function. This is in accordance with the six-axis model described by Professor Gheorghiade. An important factor in the six-axis model, which has been neglected, is the role of blood pressure in the presentation and evaluation of AHFS. Blood pressure plays a critical role in the prognosis of acute heart failure and should be a central consideration in management decisions. Previous work by Professor Gheorghiade2 describes the central role of blood pressure in acute heart failure. Blood pr... Heart journals http://www.medworm.com/rss/comments.php?id=5468581 Fri, 02 Dec 2011 05:00:00 +0100 5468581 http://www.medworm.com/index.php?rid=5468580&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F89%3Frss%3D1 ElectrophysiologyRocket AF: rivaroxaban shows efficacy While warfarin has served as the oral anticoagulant of choice for some decades, a variety of new agents that hold several advantages (fewer interactions with other drugs, no need for therapeutic drug monitoring and simpler dosing regimen) are now in late-stage development. The latest of these warfarin competitors to complete Phase III trials is the factor Xa inhibitor rivaroxaban. In the double-blind, double-dummy ROCKET AF trial, the investigators randomly assigned 14 264 patients with non-valvular atrial fibrillation—who were at moderate to high risk of stroke—to receive either rivaroxaban (at a daily dose of 20 mg) or dose-adjusted warfarin. Blinding was maintained through encrypted INR monitoring for all participan... Heart journals http://www.medworm.com/rss/comments.php?id=5468580 Fri, 02 Dec 2011 05:00:00 +0100 5468580 http://www.medworm.com/index.php?rid=5468579&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F79%3Frss%3D1 Ultrasound imaging of the human heart has undergone revolutionary changes along with recent strides in computing power. Since the wider acceptance of two dimensional (2D) echocardiography in the 1970s, progress in this field had slowed to some extent. However, the quest for three dimensional (3D) ultrasound imaging of the heart began in the early 1960s when Baum and Greenwood introduced the concept by imaging the orbit using a series of parallel slices.w1 It was not until 1974, when Dekker and colleagues sought to construct a 3D model of the heart using a mechanical spatial locator,1 that the concept became more realistic. Their model was limited to an open chest with fixed point imaging, requiring all the desired images to be obtained from one location—an extremely slow and primitiv... Heart journals http://www.medworm.com/rss/comments.php?id=5468579 Fri, 02 Dec 2011 05:00:00 +0100 5468579 http://www.medworm.com/index.php?rid=5468578&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F69%3Frss%3D1 Owing to its versatile, non-invasive, radiation-free, and low cost nature, Doppler echocardiography is undoubtedly the method of choice to evaluate prosthetic valve function. This evaluation follows the same principles used for the evaluation of native valves, with some important specifics and caveats described in this article. A complete echocardiography includes two dimensional imaging of the prosthetic valve, evaluation of valve leaflet/occluder morphology and mobility, measurement of the transprosthetic gradients and valve effective orifice area (EOA), estimation of the degree of regurgitation, evaluation of left ventricular size and systolic function, and calculation of systolic pulmonary arterial pressure.1 Timing of echocardiographic follow-up Ideally, a baseline postoperative trans... Heart journals http://www.medworm.com/rss/comments.php?id=5468578 Fri, 02 Dec 2011 05:00:00 +0100 5468578 http://www.medworm.com/index.php?rid=5468577&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F65%3Frss%3D1 Interventional Procedure Guidance 394 from NICE concerns external aortic root support.1 The work of NICE is rightly regarded world wide as setting the standard in healthcare evaluation, and is to be welcomed by all who desire their practice to be underpinned by evidence, in the best interests of patients. The guidance sets out the evidence to date, and the steps which ‘clinicians wishing to undertake external aortic root support in Marfan's syndrome should take’ in terms of governance, patient information, audit and clinical review. The ‘external stent’ (the term used in the patients' version ‘Understanding NICE guidance’2) is an alternative to ‘conventional management’ which ‘involves preventive surgery to replace the ascending aorta w... Heart journals http://www.medworm.com/rss/comments.php?id=5468577 Fri, 02 Dec 2011 05:00:00 +0100 5468577 http://www.medworm.com/index.php?rid=5468576&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F60%3Frss%3D1 Conclusions This multi-centre study demonstrates that at a median follow-up of 22 months, EVH was not associated with adverse short-term or midterm clinical outcomes. However, before the safety of EVH can be clearly determined, further analyses of long-term clinical outcomes are required. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468576 Fri, 02 Dec 2011 05:00:00 +0100 5468576 http://www.medworm.com/index.php?rid=5468575&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F54%3Frss%3D1 Conclusions Haemodynamically optimal AV delay shortened progressively with increasing heart rate during exercise, which suggests the need for programming of rate-adaptive AV delay in CRT recipients. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468575 Fri, 02 Dec 2011 05:00:00 +0100 5468575 http://www.medworm.com/index.php?rid=5468574&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F48%3Frss%3D1 Conclusion Restoration of sinus rhythm by catheter ablation of AF is associated with lower rates of stroke and death compared with patients treated medically. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468574 Fri, 02 Dec 2011 05:00:00 +0100 5468574 http://www.medworm.com/index.php?rid=5468573&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F42%3Frss%3D1 Conclusion Mild RI (eGFR=60–89 ml/min/1.73 m2) on admission is strongly predictive of short- and long-term mortality in patients with STEMI admitted to the catheter laboratory. A redefined threshold of clinically significant impairment is now required (GFR<90 ml/min/1.73 m2). (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468573 Fri, 02 Dec 2011 05:00:00 +0100 5468573 http://www.medworm.com/index.php?rid=5468572&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F37%3Frss%3D1 Conclusion 79% of hyperglycaemic patients with ACS were found to have abnormal glucose metabolism. As APG, HbA1c and FPG had a low sensitivity to detect undiagnosed diabetes, an OGTT appears to be the best test to assess the presence of previously undiagnosed diabetes or impaired glucose metabolism in hyperglycaemic patients with ACS. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468572 Fri, 02 Dec 2011 05:00:00 +0100 5468572 http://www.medworm.com/index.php?rid=5468571&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F31%3Frss%3D1 Conclusions In patients with STEMI, circulating levels of MMP-2, measured early and even before reperfusion therapy, are strongly associated with infarct size and LV dysfunction. This provides further evidence for the role of MMP-2 in ischaemia-reperfusion injury. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468571 Fri, 02 Dec 2011 05:00:00 +0100 5468571 http://www.medworm.com/index.php?rid=5468570&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F24%3Frss%3D1 Conclusions These findings support the strategy of correcting mild-to-moderate functional TR at the time of MV replacement to maintain TV function and improve clinical outcomes. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468570 Fri, 02 Dec 2011 05:00:00 +0100 5468570 http://www.medworm.com/index.php?rid=5468569&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F18%3Frss%3D1 Conclusion Multiple small cerebral infarcts occurred in 77% of patients with TAVI. The majority of infarcts were ‘silent’ with clinical stroke being associated with a both higher infarct number and volume. Increased age and the severity of aortic arch atheroma were independent risk factors for the development of new cerebral infarcts. Overall HRQoL improved and there was no association between the number of new cerebral infarcts and altered health status. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468569 Fri, 02 Dec 2011 05:00:00 +0100 5468569 http://www.medworm.com/index.php?rid=5468568&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F15%3Frss%3D1 The prevalence of coronary artery disease and ST-elevation myocardial infarction (STEMI) are increasing in India. Although recent publications have focused on improving preventive measures in developing countries, less attention has been placed on the acute management of STEMI. Recent policy changes in India have provided new opportunities to address existing barriers but require greater investment and support in the coming years. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5468568 Fri, 02 Dec 2011 05:00:00 +0100 5468568 http://www.medworm.com/index.php?rid=5468567&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F11%3Frss%3D1 The latest European Society of Cardiology (ESC) guidelines on myocardial revascularisation are reviewed. The nearly 300 recommendations make it difficult to apply them in their totality. The authors would propose 20–30 recommendations per guideline based on sound clinical evidence. Also, the scope of the current guidelines is very wide as it includes topics already incorporated in other guidelines, such as strategies for pre-intervention diagnosis and imaging as well as on secondary prevention. Some recommendations in the new guidelines are sensible and will not be disputed. In particular, the encouragement of a balanced multidisciplinary decision process (the ‘heart team’) is welcome. Although coronary revascularisation in unstable high risk patients is well accepted, th... Heart journals http://www.medworm.com/rss/comments.php?id=5468567 Fri, 02 Dec 2011 05:00:00 +0100 5468567 http://www.medworm.com/index.php?rid=5468566&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F5%3Frss%3D1 Exercise training fosters the health and performance of the cardiovascular system, and represents nowadays a powerful tool for cardiovascular therapy. Exercise exerts its beneficial effects through reducing cardiovascular risk factors, and directly affecting the cellular and molecular remodelling of the heart. Traditionally, moderate endurance exercise training has been viewed to determine a balanced and revertible physiological growth, through cardiomyocyte hypertrophy accompanied by appropriate neoangiogenesis (the Athlete's Heart). These cellular adaptations are due to the activation of signalling pathways and in particular, the IGF-1/IGF-1R/Akt axis appears to have a major role. Recently, it has been shown that physical exercise determines cardiac growth also through new cardiomyocyte ... Heart journals http://www.medworm.com/rss/comments.php?id=5468566 Fri, 02 Dec 2011 05:00:00 +0100 5468566 http://www.medworm.com/index.php?rid=5468565&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F3%3Frss%3D1 Introduction Diabetes mellitus and cardiovascular disease are two closely related diseases. In patients with both stable and unstable coronary artery disease (CAD), there is a high prevalence of diabetes and increased rates of both undiagnosed diabetes and impaired glucose metabolism such as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).1 2 Patients with known or newly diagnosed diabetes are at particularly elevated risk for both mortality and adverse cardiac events at 1 year of follow-up.2 Cardiovascular disease is currently the leading cause of death worldwide.3 At the same time, there is a worldwide epidemic of diabetes mellitus, with over 280 million (6.4%) of the world's population affected.4 There is therefore a need for a closer working relationship between... Heart journals http://www.medworm.com/rss/comments.php?id=5468565 Fri, 02 Dec 2011 05:00:00 +0100 5468565 http://www.medworm.com/index.php?rid=5468564&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F98%2F1%2F1%3Frss%3D1 In the past three decades, percutaneous coronary intervention has become the standard of treatment in acute coronary syndromes. However, reopening of acutely occluded coronary arteries paradoxically causes reperfusion injury characterised by a localised, acute inflammatory response and myocardial damage. Because of the lack of good plasma biomarkers, reperfusion-induced myocardial damage and its contribution to final infarct size is difficult to evaluate. Biomarkers play an important role in diagnosis, prognosis and risk evaluation in the treatment of cardiovascular diseases. Ideal biomarkers should not only have a good sensitivity and dynamic range, but should also correlate well to the therapeutic response. There is increasing evidence that matrix metalloproteinase 2 (MMP-2) may be such ... Heart journals http://www.medworm.com/rss/comments.php?id=5468564 Fri, 02 Dec 2011 05:00:00 +0100 5468564 http://www.medworm.com/index.php?rid=5440552&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2094%3Frss%3D1 An 80-year-old man underwent permanent dual-chamber pacemaker implantation for his sick sinus syndrome. During the implantation procedure, the patient complained of mild shortness of breath after left subclavian vein puncture. Under fluoroscope, mild left pneumothorax was found. There was an airspace subsequently interposing between the main pulmonary artery and left atrial appendage with mild protrusion of left atrial appendage beyond the left heart border (video 1). Adequate oxygenation status was achieved after high-flow mask treatment. There was neither hypotension nor tachycardia. At the end of the procedure, persistent left pneumothorax and pneumopericardium were noted on fluoroscopy (video 2). An emergent CT scan showed massive left pneumothorax, pneumopericardium (figure 1A) and pa... Heart journals http://www.medworm.com/rss/comments.php?id=5440552 Thu, 24 Nov 2011 05:00:00 +0100 5440552 http://www.medworm.com/index.php?rid=5440551&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2093%3Frss%3D1 A 43-year-old female patient presented with transient right-sided facial numbness and dysarthria. MRI of the brain demonstrated an ischaemic infarct of the right medial occipital lobe. Embolic cerebral infarction was suspected, and transoesophageal echocardiography with injection of agitated saline was undertaken. This revealed microbubbles entering the left atrium (figure 1A,B) from the left upper pulmonary vein. There was no evidence of atrial septal defect or patent foramen ovale. Computed tomographic arteriography confirmed a pulmonary arteriovenous fistula (PAVF) originating from the left superior lingular segmental pulmonary artery and draining into the left upper pulmonary vein (figure 1C). There was no other clinical sign of hereditary haemorrhagic telangiectasia (HHT) and no mutat... Heart journals http://www.medworm.com/rss/comments.php?id=5440551 Thu, 24 Nov 2011 05:00:00 +0100 5440551 http://www.medworm.com/index.php?rid=5440550&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2091%3Frss%3D1 We thank Dr Marshall1 for this opportunity to expand on our conclusions.2 While agreeing with our main findings, his critique of our suggestion about rapid titration has, to an extent, been addressed in the article where we outlined the limitations of our conclusions and suggested that an individual patient data meta-analysis would advance knowledge about blood pressure (BP) responses. We agree that there is variability in office BP measurements due to a number of factors—biological variability, measurement error and random error, making such office-based measurements insufficient for reliable titration. His analysis of the likelihood of detecting a change in BP makes some assumptions. First, the coefficient of variation from the study of Keenan et al3 was calculated from data once ... Heart journals http://www.medworm.com/rss/comments.php?id=5440550 Thu, 24 Nov 2011 05:00:00 +0100 5440550 http://www.medworm.com/index.php?rid=5440549&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2090-c%3Frss%3D1 To the Editor The meta-analysis reported by Lasserson et al provides evidence that half of the effect of antihypertensive treatment on blood pressure takes place within the first week of treatment.1 There is no reason to doubt these findings. However, the analysis does not support the conclusion that ‘estimation of maximal effect could be made between 1 and 2 weeks after initiation of antihypertensive therapy’. Nor does it support the view that ‘this knowledge will guide practitioners in deciding when a newly started antihypertensive agent can be judged to be ineffective’. First, it is not possible to determine whether blood pressure has been reduced by treatment within a week. The authors reached their conclusion after a meta-analysis of measurements in 4168 i... Heart journals http://www.medworm.com/rss/comments.php?id=5440549 Thu, 24 Nov 2011 05:00:00 +0100 5440549 http://www.medworm.com/index.php?rid=5440548&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2090-b%3Frss%3D1 This study extends the findings of Elliott et al,2 who found desmosomal mutations in patients with familial DCM, by including histological assessment of fibrofatty change, the pathological hallmark of ARVC. The authors found no correlation between desmosomal mutations and fibrofatty change in the explants of their patients with DCM, thus challenging the histological criteria for the diagnosis of ARVC.1 We suggest that the causatory link between desmosomal mutations and ARVC also needs to be challenged or at least re-evaluated. The presence of fibrofatty change in DCM has been reported previously.3 Furthermore, we have found lethal desmosomal mutations in sudden death... (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440548 Thu, 24 Nov 2011 05:00:00 +0100 5440548 http://www.medworm.com/index.php?rid=5440547&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2090-a%3Frss%3D1 To the Editor Adielsson and colleagues1 conducted a study of out-of-hospital cardiac arrest (OHCA) to identify the strong predictors of survival among witnessed arrests with shockable arrhythmias of presumed cardiac aetiology. They concluded that female gender, OHCA outside the home, bystander cardiopulmonary resuscitation (CPR) and a shorter delay from collapse to defibrillation were all strongly associated with increased early and late survival. They postulated that when in-home bystanders are men (spouses), chest compressions might be more effective (deep enough) owing to their physical size and ability compared with women. Also, the chance of a successful defibrillation might be increased in women owing to their smaller heart and thoracic volume. However, although this study brings to ... Heart journals http://www.medworm.com/rss/comments.php?id=5440547 Thu, 24 Nov 2011 05:00:00 +0100 5440547 http://www.medworm.com/index.php?rid=5440546&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2088%3Frss%3D1 In this study, the authors retrospectively analysed data from 7839 isolated coronary artery bypass grafting (CABG) operations—297 off-pump CABG and 986 combined CABG and valve procedures—performed at a single centre between 1994 and 2004. The records of patients with signs of neurological complications were reviewed to identify 149 subjects with stroke at extubation (deemed to have ‘early stroke’, 1.6%) versus 99 patients having a symptom-free interval (deemed to have ‘delayed stroke’, 1.1%). Survival data were then assessed, with a median follow-up time of 9.3 years (maximum, 16.3 years). Of note, ‘early’ and ‘delayed’ strokes had different... (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440546 Thu, 24 Nov 2011 05:00:00 +0100 5440546 http://www.medworm.com/index.php?rid=5440545&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2078%3Frss%3D1 Epidemiology Sarcoidosis has been reported to have a particular predilection for adults under the age of 40 years.w1 The incidence of sarcoidosis varies greatly by ethnicity and region, occurring in 3 to 20 per 100 000 for whites and 35.5 to 80 per 100 000 for blacks.1 Scandinavian populations have been reported as having a higher prevalence than other Caucasian regions.w2 The incidence of cardiac sarcoidosis (CS) also varies by the type of study performed, whether clinical or autopsy study, with clinical and autopsy reports ranging from 5–10% up to 27%, respectively.2 w3 Recently, Mehta et al observed almost 40% of patients with sarcoidosis had CS on advanced imaging (cardiac MRI or positron emission tomography (PET)).3 Pathogenesis of cardiac sarcoidosis The aetiology of sarco... Heart journals http://www.medworm.com/rss/comments.php?id=5440545 Thu, 24 Nov 2011 05:00:00 +0100 5440545 http://www.medworm.com/index.php?rid=5440544&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2075%3Frss%3D1 Introduction The limitations of the first directional atherectomy (DA) device introduced in the '80s1 have mostly been overcome by the second-generation SilverHawk (Ev3, Plymouth, Minnesota, USA) device. First of all, this device is easier to use with no further need for concomitant balloon inflation. The newer generation of the DA SilverHawk devices also has a modified assembly and cutting technique and has clearly demonstrated its technical safety and efficiency in single-centre and also in multi-centre performance, clearly overcoming the initial technical limitations. The overall risk of peripheral macro-embolisation is, under angiographic control, around 1.5% without leaving major damage at the end of the procedure. Related to the broad clinical experience gathered over more than 1&nbs... Heart journals http://www.medworm.com/rss/comments.php?id=5440544 Thu, 24 Nov 2011 05:00:00 +0100 5440544 http://www.medworm.com/index.php?rid=5440543&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2069%3Frss%3D1 Conclusions H-OEF patients were hemodynamically poorer and showed a lower exercise-induced MBF increase compared to L-OEF patients, suggesting exercise-induced O2 supply limitation. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440543 Thu, 24 Nov 2011 05:00:00 +0100 5440543 http://www.medworm.com/index.php?rid=5440542&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2063%3Frss%3D1 Conclusions Biventricular ejection fraction was impaired in patients with MFS, and the impairment was independent of aortic elasticity and β-blocker usage. There was also a strong correlation between LVEF and RVEF. Our findings suggest intrinsic myocardial dysfunction in patients with MFS. Clinical trial registration http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1423. Unique Identifier: NTR1423 (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440542 Thu, 24 Nov 2011 05:00:00 +0100 5440542 http://www.medworm.com/index.php?rid=5440541&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2056%3Frss%3D1 Conclusions A high prevalence of cardiac damage in asymptomatic cocaine addicts can be found by CMR examination. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440541 Thu, 24 Nov 2011 05:00:00 +0100 5440541 http://www.medworm.com/index.php?rid=5440540&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2051%3Frss%3D1 Conclusion In children with isolated AV block, permanent ventricular pacing site is an important determinant of LV function, with LVFS being significantly higher with LV pacing than with RV pacing. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440540 Thu, 24 Nov 2011 05:00:00 +0100 5440540 http://www.medworm.com/index.php?rid=5440539&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2046%3Frss%3D1 Conclusions In elderly patients with NVAF and elevated CHADS2 or CHA2DS2-VASC scores, warfarin users exhibited lower rates of cerebrovascular events and mortality. However, warfarin use did not differ across risk strata, another example of the risk–treatment paradox in cardiovascular disease. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440539 Thu, 24 Nov 2011 05:00:00 +0100 5440539 http://www.medworm.com/index.php?rid=5440538&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2038%3Frss%3D1 Conclusions MSI assessed by CMR predicts long-term clinical outcome in acute reperfused STEMI. Therefore, our data support the use of myocardial salvage as an end point for clinical trials investigating novel reperfusion strategies. Trial registration number http://www.ClinicalTrials.gov: NCT00952224. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440538 Thu, 24 Nov 2011 05:00:00 +0100 5440538 http://www.medworm.com/index.php?rid=5440537&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2033%3Frss%3D1 Conclusions A meta-analysis of the published literature demonstrates no survival difference following valve replacement with either bioprostheses or mechanical prosthesis in patients with ESRD on dialysis. Bioprosthetic valve replacement was associated with fewer valve-related complications. Although this meta-analysis cannot discriminate between the sites of valve implant, these data can likely be extended to include at least aortic valve replacement. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440537 Thu, 24 Nov 2011 05:00:00 +0100 5440537 http://www.medworm.com/index.php?rid=5440536&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2029%3Frss%3D1 Conclusions Surgery should always be considered in very severe AS regardless of symptoms, and particular attention needs to be paid to their extremely poor outcomes. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440536 Thu, 24 Nov 2011 05:00:00 +0100 5440536 http://www.medworm.com/index.php?rid=5440535&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2023%3Frss%3D1 Conclusion Patients with advanced AS deficient in vWF HMWM are characterised by enhanced thrombin formation and platelet activation. This observation indicates the ambivalent impact of high shear stress in AS on haemostasis and might help explain two aspects of AS—Heyde syndrome and increased risk of thromboembolism. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440535 Thu, 24 Nov 2011 05:00:00 +0100 5440535 http://www.medworm.com/index.php?rid=5440534&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2018%3Frss%3D1 Conclusions The prevalence of RHD is several fold higher using echocardiographic screening compared with clinical examination. The prevalence is higher among girls and children of lower socioeconomic status. In the majority of cases, subclinical RHD appears to be non-progressive on medium term follow up. Routine echocardiographic screening may be indicated in populations at high risk of RHD. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440534 Thu, 24 Nov 2011 05:00:00 +0100 5440534 http://www.medworm.com/index.php?rid=5440533&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2007%3Frss%3D1 Introduction With an ageing population and improved diagnostic modalities, the number of patients with valvular heart disease is dramatically increasing. Considering projected changes in the age distribution, a further accentuation of this trend can be expected and this may indeed be considered "the next cardiac epidemic".1 Obviously, we are faced with more complex decisions in patients with advanced age and increasing comorbidities. Advances in percutaneous valve interventional techniques have entered into routine practice. At the same time, new data on the natural history of disease and the identification of predictors of outcome permit improvement in the decision-making process and management of patients with valvular heart disease. Aortic stenosisDisease progression In a population-bas... Heart journals http://www.medworm.com/rss/comments.php?id=5440533 Thu, 24 Nov 2011 05:00:00 +0100 5440533 http://www.medworm.com/index.php?rid=5440532&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F2005%3Frss%3D1 Symptomatic bradycardia contributes significantly to mortality and decreased functional status in many low and middle income countries (LMIC). In contrast to the developed world, where bradycardia often results from sinus node dysfunction, patients requiring pacemakers in LMIC more commonly present with complete heart block.1–3 Yet many patients in LMIC have little to no access to electrophysiological therapies, as the cost of one device often exceeds the annual income of the average citizen.4 Several countries—including Sweden, India and Canada—have previously explanted and resterilised pacemakers from deceased donors for reutilisation.5–7 With increasing global disparities in medical care, post mortem explantation and reuse of pacemakers presents a potential means... Heart journals http://www.medworm.com/rss/comments.php?id=5440532 Thu, 24 Nov 2011 05:00:00 +0100 5440532 http://www.medworm.com/index.php?rid=5440531&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F1999%3Frss%3D1 The pervasive public health message is that moderate amounts of endurance exercise help maintain optimal health and reduce cardiovascular risk. While not enough people meet national physical activity guidelines, there are some at the opposite end of the activity spectrum who far exceed the recommended ‘dose’ of exercise. The cardiovascular health consequences of single and/or multiple (lifelong) ‘doses’ of high-volume endurance exercise are currently being debated. Recent commentaries, case reports and case series data have posed the question whether you can ‘overdose on exercise’, and that is the focus of this brief review. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440531 Thu, 24 Nov 2011 05:00:00 +0100 5440531 http://www.medworm.com/index.php?rid=5440530&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F1997%3Frss%3D1 Aortic valve sclerosis-stenosis is the most common valvular pathology in industrialised countries, evolving from aortic valve sclerosis into aortic stenosis (AS). Aortic valve sclerosis is present in 25% and AS in 2% of people aged >65 years. Heyde syndrome is an acquired and intricate pathology encountered in AS and in the obstructive form of hypertrophic cardiomyopathy (HOCM).1–3 In its initial description Heyde syndrome is a syndrome of AS associated with gastrointestinal (GI) bleeding of idiopathic origin, which was subsequently linked to angiodysplasia. Angiodysplasia is predominantly observed in the elderly and is characterised by small vascular dilatations of GI submucosal veins and capillaries, ultimately leading to arteriovenous communications. This vascular malforma... Heart journals http://www.medworm.com/rss/comments.php?id=5440530 Thu, 24 Nov 2011 05:00:00 +0100 5440530 http://www.medworm.com/index.php?rid=5440529&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2F1995%3Frss%3D1 The role of cardiac magnetic resonance (CMR) for detection of myocardial injury in asymptomatic subjects has been tested so far only in selected healthy or unhealthy populations, such as competitive athletes and patients with liver cirrhosis.1 2 Aquaro et al should be congratulated for their original study, which is the first to assess the prevalence of myocardial tissue abnormalities by CMR in asymptomatic cocaine addicts who were studied ≥48 h after drug withdrawal, with no history of cardiac disease.3 Although biohumoral markers of cardiac involvement were negative in all but one and a stress test was always negative for ischaemia, evidence of myocardial damage was found in the majority (83%), including delayed enhancement (DE, 73%) and oedema (47%). According to pathology and c... Heart journals http://www.medworm.com/rss/comments.php?id=5440529 Thu, 24 Nov 2011 05:00:00 +0100 5440529 http://www.medworm.com/index.php?rid=5440528&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-z%3Frss%3D1 Chronic kidney disease leads to cardiac dysfunction and ultimately heart failure, however the cellular mechanisms remain unclear. The aim of this study was to characterise cardiac mitochondrial function in an experimental model of uraemic cardiomyopathy (UCM). UCM was induced in Sprague-Dawley rats via subtotal nephrectomy. Mitochondria were isolated 12 weeks post surgery and respiratory rates determined, and calcium-induced swelling monitored spectrophotmetrically to investigate susceptibility to permeability transition. Mitochondrial complex and aconitase activities were measured in submitochondrial particles. Cardiac expression of uncoupling protein 3 (UCP3) was quantified by immunoblotting. Urinary creatinine clearance was significantly impaired (0.78±0.1 vs 1.31±0.1... Heart journals http://www.medworm.com/rss/comments.php?id=5440528 Thu, 24 Nov 2011 05:00:00 +0100 5440528 http://www.medworm.com/index.php?rid=5440527&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-y%3Frss%3D1 Concerns have been raised regarding the cardiovascular safety of muscarinic receptor antagonists, such as Ipratropium bromide for use in asthmatic patients with underlying heart disease.1 2 The aims of this study were to determine the involvement of Ipratropium at the muscarinic receptor on myocardial ischaemia/reperfusion injury in isolated adult cardiomyocyte cell death and oxidative stress models. The MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay revealed that in isolated cardiomyocytes, under conditions of hypoxia/reoxygenation, Ipratropium (0.1 picoM–10 μM) inhibits cell viability, in a dose responsive manner. Addition of acetylcholine (0.1 μM) was shown to significantly increase cell viability compared with untreated controls (114... Heart journals http://www.medworm.com/rss/comments.php?id=5440527 Thu, 24 Nov 2011 05:00:00 +0100 5440527 http://www.medworm.com/index.php?rid=5440526&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-x%3Frss%3D1 In conclusion, HFD and obesity-related metabolic disorders induce vasculature oxidative stress, which contributes to endothelial dysfunction and high blood pressure. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440526 Thu, 24 Nov 2011 05:00:00 +0100 5440526 http://www.medworm.com/index.php?rid=5440525&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-w%3Frss%3D1 Mitochondrial function is critical for multiple facets of cellular function including ATP production and calcium handling. Subcellular location of the organelle is important for function. In smooth muscle, mitochondria modulate calcium signals arising from inositol- trisphosphate receptors, even localised calcium puffs, revealing a close physical relationship between the sarcoplasmic reticulum and mitochondria. This seems incompatible with the free movement of mitochondria observed in several cell types. Mitochondrial mobility was imaged in intact cerebral resistance arteries at physiological pressure. Arteries were maintained in organ culture for up to 4 days. Protein expression was measured by western blotting and immunocytochemistry in fixed, pressurised arteries. Proliferation was... Heart journals http://www.medworm.com/rss/comments.php?id=5440525 Thu, 24 Nov 2011 05:00:00 +0100 5440525 http://www.medworm.com/index.php?rid=5440524&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-v%3Frss%3D1 In conclusion, there was a significant increase in the levels of ROS production in the vasculature of ageing mice, which might contribute to the age-related endothelial dysfunction and high blood pressure. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440524 Thu, 24 Nov 2011 05:00:00 +0100 5440524 http://www.medworm.com/index.php?rid=5440523&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-u%3Frss%3D1 Cardiac contractility is controlled by key sarcoplasmic reticulum (SR) Ca2+ handling proteins that regulate intracellular Ca2+ homeostasis. Impaired Ca2+ handling has been associated with heart failure, thus emphasising its critical role in cardiac function. During cardiac relaxation, SR Ca2+ uptake is regulated by the activity of the sarco(endo)plasmic reticulum Ca2+ transport ATPase (SERCA2a) and its inhibitor phospholamban (PLN). We have identified HS-1 associated protein X-1 (HAX-1), a ubiquitously expressed mitochondrial protein with anti-apoptotic function, as a novel binding partner of PLN. This association was found to cause a subcellular redistribution of HAX-1 from mitochondria to the ER and enhanced the protective effects of HAX-1 on cell survival. Deletion analysis determined t... Heart journals http://www.medworm.com/rss/comments.php?id=5440523 Thu, 24 Nov 2011 05:00:00 +0100 5440523 http://www.medworm.com/index.php?rid=5440522&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-t%3Frss%3D1 Conclusion Increased activity of mitochondrial complex II in rabbit HF is a major mediator of oxidative stress leading to impairment of Ca2+ handling and contractility. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440522 Thu, 24 Nov 2011 05:00:00 +0100 5440522 http://www.medworm.com/index.php?rid=5440521&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-s%3Frss%3D1 Conclusions Our data show that elevated Ca and P cause mitochondrial damage and increase superoxide production in VSMCs. We hypothesise that impairment of mitochondrial function can dramatically change VSMC metabolism, promote oxidant stress, and, eventually trigger vascular calcification. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440521 Thu, 24 Nov 2011 05:00:00 +0100 5440521 http://www.medworm.com/index.php?rid=5440520&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-r%3Frss%3D1 Little is known about the changes occurring in the heart at birth. Immediately following birth, cardiac output rapidly increases, and to facilitate this, the predominant mode of cardiac energy generation shifts from glycolysis to Î2-oxidation of lipid. This is relevant to adult cardiac failure, as energy metabolism in failing hearts shifts back to glycolysis. Currently, control of cardiac energy substrate selection is incompletely understood. The b-HLH transcription factor Hand1 has been implicated in cardiac development, and levels of Hand1 RNA are altered in several types of cardiac failure associated with metabolic remodelling. Here we show that cardiac Hand1 RNA levels fall rapidly after birth, directly in response to changes in cardiac hypoxia signalling. Prevention of the postn... Heart journals http://www.medworm.com/rss/comments.php?id=5440520 Thu, 24 Nov 2011 05:00:00 +0100 5440520 http://www.medworm.com/index.php?rid=5440519&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-q%3Frss%3D1 This study was designed to investigate whether the antiarrhythmic effects of CBD are modified by co-administration with a CB1 receptor antagonist (AM251). Experimental CAO was induced by ligation of the LAD coronary artery for 30 min; in sodium pentobarbitone anaesthetised male SD rats. Experimental groups included; (i) vehicle, (ii) CBD (50 μg/kg) alone, (iii) AM251 (1 mg/kg) alone, (iv) CBD followed by AM251, and (v) AM251 followed by CBD. CBD or AM251 alone each reduced the incidence of VT and the total number of VEBs compared with the control group, as did AM251 when administered 5 min after CBD. However, in animals treated with AM251 followed by CBD, the antiarrhythmic effect was significantly more pronounced 1274±303 (VT, P<0.01) and 1727±416 (... Heart journals http://www.medworm.com/rss/comments.php?id=5440519 Thu, 24 Nov 2011 05:00:00 +0100 5440519 http://www.medworm.com/index.php?rid=5440518&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-p%3Frss%3D1 While matrix-metalloproteinase (MMP) inhibition protects against myocardial ischaemia/reperfusion injury, the mechanisms are poorly understood. We hypothesised that this cardioprotection is independent of mitochondrial permeability transition pore (mPTP) inhibition, the end-effector of ischaemic postconditioning (iPOC). In ex vivo and in vivo mouse hearts, we investigated whether the MMP inhibitor, ilomostat (0.25 μmol/l), at reperfusion, could engender protection in the absence of cyclophillin-D (CyPD), an initiator of mPTP opening, against injurious ischaemia/reperfusion. Ilomastat attenuated infarct size in wild type (WT) animals (37±2.8 to 22±4.3%, equivalent to iPOC, 27±2.1%, p<0.05). CyPD knockout (KO) hearts had smaller infarcts compared to their WT b... Heart journals http://www.medworm.com/rss/comments.php?id=5440518 Thu, 24 Nov 2011 05:00:00 +0100 5440518 http://www.medworm.com/index.php?rid=5440517&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-o%3Frss%3D1 Chronic inorganic arsenic exposure through consumption of contaminated drinking water promotes atherosclerosis. Although the pathogenesis is unclear, initiation is likely to involve damage to endothelium. Mitochondria are targets for inorganic arsenite in a variety of cell types including endothelial cells. We hypothesise that arsenite alters mitochondrial function leading to altered mitochondrial-mediated signalling and downstream endothelial dysfunction. The aim of this study was to investigate the effects of arsenite on mitochondrial bioenergetics and the subsequent effects on mitochondrial and nuclear DNA damage. Mitochondrial effects of arsenite were investigated in human umbilical vein endothelial cells (HUVECs) using the Seahorse extracellular flux analyser. This showed a dose-depen... Heart journals http://www.medworm.com/rss/comments.php?id=5440517 Thu, 24 Nov 2011 05:00:00 +0100 5440517 http://www.medworm.com/index.php?rid=5440516&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-n%3Frss%3D1 Conclusions Mitochondrial complex I deficiency is an important cause of infantile-onset cardiomyopathy. This disorder is extremely genetically heterogeneous, but identification of the precise genetic defect is important, since this will inform treatment options, provide more accurate information regarding recurrence risks, and allow prevention of further cases by prenatal or preimplantation genetic diagnosis. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440516 Thu, 24 Nov 2011 05:00:00 +0100 5440516 http://www.medworm.com/index.php?rid=5440515&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-m%3Frss%3D1 Conclusions We have identified novel DNA damage signalling genes involved in regulating the DNA damage response, DNA repair, growth arrest and apoptosis in VSMCs exposed to oxidative stress, and in human plaque VSMCs. The overlap between genes expressed in plaque VSMCs and normal VSMCs after oxidative stress implies that their differential expression in plaque VSMCs is due to oxidative DNA damage. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440515 Thu, 24 Nov 2011 05:00:00 +0100 5440515 http://www.medworm.com/index.php?rid=5440514&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-l%3Frss%3D1 In conclusion, TP improved contractile function, Ca2+ handling and delayed MPTP opening. Data are presented as mean and SEM. n=myocytes, animals. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440514 Thu, 24 Nov 2011 05:00:00 +0100 5440514 http://www.medworm.com/index.php?rid=5440513&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-k%3Frss%3D1 This study was conducted to compare the effect of Vastarel 20 mg IR (immediate release) and Vastarel 35 mg MR (modified release), two bioequivalent marketed formulations of TMZ, on cardioprotection during acute ischaemia in pigs. A 4-day oral treatment with Vastarel 20 mg IR (800 mg three time a day) or Vastarel 35 mg MR (1400 mg twice daily) had no effect on ventricular fibrillation threshold (VFT) prior to ischaemia, but significantly prevented the decrease in VFT observed in placebo-treated groups after a 1-min left anterior descending coronary artery occlusion. This effect occurred without modifying cardiac haemodynamic and conduction parameters. In both Vastarel-treated groups, a significant reduction of the ischaemic area as well as a protection of cardi... Heart journals http://www.medworm.com/rss/comments.php?id=5440513 Thu, 24 Nov 2011 05:00:00 +0100 5440513 http://www.medworm.com/index.php?rid=5440512&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-j%3Frss%3D1 Conclusions Our data suggest that renal and circulating Mt/N values are elevated in diabetes and that resulting mitochondrial dysfunction could be contributing to the pathogenesis of diabetic nephropathy through increased oxidative stress. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440512 Thu, 24 Nov 2011 05:00:00 +0100 5440512 http://www.medworm.com/index.php?rid=5440511&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-i%3Frss%3D1 In conclusion, any pathological impairment of energy supply will affect integrated heart energetics response and may be analysed by MoCA. Therefore, we now propose to use MoCA to diagnose heart dysfunctions in humans. We are currently developing the clinical application of MoCA by using non-invasive 31P-NMR spectroscopy and time-resolved 3D MRI techniques to access energetics and contractile activity respectively. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440511 Thu, 24 Nov 2011 05:00:00 +0100 5440511 http://www.medworm.com/index.php?rid=5440510&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-h%3Frss%3D1 Conclusions This study shows for the first time that mitoHK affects cardiac MVO2. In addition, our data suggest that mitoHK may also determine glycolysis-glucose oxidation coupling. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440510 Thu, 24 Nov 2011 05:00:00 +0100 5440510 http://www.medworm.com/index.php?rid=5440509&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-g%3Frss%3D1 Conclusion Acute low-dose dissociation of HKII from mitochondria in heart prevents IPC whereas high-dose HKII dissociation causes cessation of cardiac contraction and tissue disruption, likely through an acute mitochondrial membrane depolarisation mechanism. The results suggest that the association of HKII with mitochondria is essential for IPC protective effects and normal cardiac function through maintenance of mitochondrial potential. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440509 Thu, 24 Nov 2011 05:00:00 +0100 5440509 http://www.medworm.com/index.php?rid=5440508&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-f%3Frss%3D1 The objective of this study was to assess the role of caveolins and PKC in EET mediated cardioprotection. Hearts from sEH null (KO) and littermate control (WT) mice were perfused in Langendorff mode and subjected to 20 min ischaemia followed by 40 min reperfusion. Immunohistochemistry, immunoblot and electron microscopy were performed to study expression and ultrastructure. H9c2 cells were treated with 11,12-EET (1 μM) for 10, 20, 60 and 120 min followed by subcellular fractionation and immunobloting. In WT heart, cav-1 and cav-3 were present in cardiomyocytes and endothelial cells at baseline. Following ischaemia, cav-1 but not cav-3 disappeared; moreover, caveolae were absent in WT hearts. Mitochondria and T-tubules were swollen and cristae of mitochondria were dam... Heart journals http://www.medworm.com/rss/comments.php?id=5440508 Thu, 24 Nov 2011 05:00:00 +0100 5440508 http://www.medworm.com/index.php?rid=5440507&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-e%3Frss%3D1 In conclusion, our results provide evidence that the anti-infarction activity of mildronate is related to decrease in CPT I-dependent fatty acid metabolism. The cardioprotective effect of mildronate could be partially attributed to the maintenance of the integrity of mitochondrial outer membrane. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440507 Thu, 24 Nov 2011 05:00:00 +0100 5440507 http://www.medworm.com/index.php?rid=5440506&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-d%3Frss%3D1 In conclusion, our results demonstrate that mildronate possess anti-infarction activity, but pivalate is devoid of cardioprotective effect due to detrimental effects on mitochondrial energy pathways. The regulation of L-carnitine availability can be used for cardioprotection, but the effects of pharmacological agents on mitochondrial L-carnitine pathways should be carefully monitored. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440506 Thu, 24 Nov 2011 05:00:00 +0100 5440506 http://www.medworm.com/index.php?rid=5440505&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-c%3Frss%3D1 Conclusion Exposure of VV and NVV to hypoxia or DMOG was associated with upregulation of HIF-1α and HIF-2α protein, and HIF target genes. Our data suggest that the HIF pathway may play a role in hypoxia related venous pathology. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440505 Thu, 24 Nov 2011 05:00:00 +0100 5440505 http://www.medworm.com/index.php?rid=5440504&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-b%3Frss%3D1 Conclusions We confirm that mtDNA damage is present in the early stages of atherogenesis and may be contributive to disease. We also identified a respiratory chain defect which may compromise the bioenergetic capacity of the cells, leading to increased plaque vulnerability. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440504 Thu, 24 Nov 2011 05:00:00 +0100 5440504 http://www.medworm.com/index.php?rid=5440503&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-am%3Frss%3D1 There are contradictory data in the literature regarding the susceptibility of the diabetic heart to ischaemia/reperfusion injury and the initiation of cardioprotection by activating endogenous prosurvival mechanisms. We hypothesise that the diabetic heart may be more susceptible to injury but still amenable to protection. Ex vivo hearts from diabetic rats (Goto–Kakizaki), subjected to 35 min ischaemia and 60 min reperfusion (IRI), were randomly assigned to the following groups: (a) control (as above), (b) preconditioned with three cycles of 5 min ischaemia and 10 min reperfusion prior to IRI, (c) subjected to different ischaemic durations (20 or 45 min), or (d) treated with metformin for 4 weeks prior to IRI; (a)–(c) experiments were also performe... Heart journals http://www.medworm.com/rss/comments.php?id=5440503 Thu, 24 Nov 2011 05:00:00 +0100 5440503 http://www.medworm.com/index.php?rid=5440502&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-al%3Frss%3D1 Conclusions EETs slowed the collapse of mitochondrial membrane potential following HR injury, DOX treatment and PD stress. EETs minimised mitochondrial fragmentation induced by DOX and PD treatments by inhibiting DRP1 and preserving OPA1. Together these data suggest that EETs can enhance mitochondrial function against cellular stress and improve their survival. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440502 Thu, 24 Nov 2011 05:00:00 +0100 5440502 http://www.medworm.com/index.php?rid=5440501&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-ak%3Frss%3D1 Conclusion We show a novel role for DJ-1 in the heart. It appears to protect the heart from IRI and this effect is associated with changes in mitochondrial morphology and mPTP inhibition. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440501 Thu, 24 Nov 2011 05:00:00 +0100 5440501 http://www.medworm.com/index.php?rid=5440500&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-aj%3Frss%3D1 Conclusions Myocardial infarct size did not enlarge with increasing duration of reperfusion. Genetic ablation of CypD confers long-term protection against IRI. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440500 Thu, 24 Nov 2011 05:00:00 +0100 5440500 http://www.medworm.com/index.php?rid=5440499&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-ai%3Frss%3D1 Mitochondria can undergo a generalised increase of the permeability of the inner membrane, called mitochondrial permeability transition (MPT), due to the formation of non-specific pores (MPTP), which is an early key event in apoptosis, causing activation of the caspases through release of cytochrome c.1 Calcium overload and oxidative stress combine with other factors to induce the MPT. Inhibition of the MPTP is accepted as a therapeutic approach in pathological situations, namely by attenuation of the reactive species accumulation through antioxidants usage. In particular, MPTP is considered a therapeutic target for cardioprotection, especially in ischaemia/reperfusion primarily to its central role in cell death.2 Considering this we studied the influence of two new synthetic di(hetero)ary... Heart journals http://www.medworm.com/rss/comments.php?id=5440499 Thu, 24 Nov 2011 05:00:00 +0100 5440499 http://www.medworm.com/index.php?rid=5440498&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-ah%3Frss%3D1 Angiotensin II (Ang II) induces stress-induced premature senescence in human vascular smooth muscle cells (hVSMC) via reactive oxygen species (ROS) generation.1 This effect may explain some of the cardiovascular anti-ageing effects of angiotensin receptor blockers. The current study aimed to investigate the source of ROS mediating this premature senescence. Primary hVSMC were obtained from saphenous veins. Following exposure to Ang II (10–100 nM) with or without inhibitors, superoxide production was measured by lucigenin chemiluminescence and cell senescence by senescence-associated β-galactosidase staining, morphology and growth analysis. Ang II (10 nM) induced a twofold increase in premature senescence in hVSMC. Senescence was blocked by co-incubation with inhibitors... Heart journals http://www.medworm.com/rss/comments.php?id=5440498 Thu, 24 Nov 2011 05:00:00 +0100 5440498 http://www.medworm.com/index.php?rid=5440497&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-ag%3Frss%3D1 This study investigated the effects of Salbutamol and Salmeterol on the myocardium subjected to ischaemia-reperfusion (I/R) in Langendorff heart model and adult cardiomyocytes. Perfused hearts were subjected to 35 min ischaemia and 120 min reperfusion. Hearts underwent triphenyl tetrazolium staining for infarct size measurement. Isolated adult cardiomyocytes were loaded with a fluorophore and subjected to laser induced oxidative stress. The onset of depolarisation and hypercontracture were recorded. Treatment groups (n=6) were subjected to control or I/R ± Salbutamol (100 nM) ± CGP-12177 (1.4 nM) (β1 adrenoceptor antagonist) or ICI 118551 (1.2 nM) (β 2 adrenoceptor antagonist). All experiments were repeated in the presence of Salmeterol. In ... Heart journals http://www.medworm.com/rss/comments.php?id=5440497 Thu, 24 Nov 2011 05:00:00 +0100 5440497 http://www.medworm.com/index.php?rid=5440496&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-af%3Frss%3D1 Conclusion This is the first study to show cardiotoxic effects of Doxorubicin in a functional workloop model to determine its effects on muscle mechanics. (Source: Heart) Heart journals http://www.medworm.com/rss/comments.php?id=5440496 Thu, 24 Nov 2011 05:00:00 +0100 5440496 http://www.medworm.com/index.php?rid=5440495&cid=s_29166_7_f&fid=29166&url=http%3A%2F%2Fheart.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F24%2Fe8-ae%3Frss%3D1 Muscarinic receptors (M1-M5) are G-protein coupled receptors found in the plasma membrane. Muscarinic antagonists are selective for smooth muscle muscarinic sites and are widely used in the treatment of various diseases such as asthma and chronic obstructive pulmonary disorders. However, these anti-cholinergics have been associated with various side effects. The aim of the investigation was to determine the effects of individual muscarinic receptor antagonists in the setting of myocardial ischaemia reperfusion injury. A Langendorff perfusion system was used to perfuse isolated hearts which were subjected to 35 min of ischaemia followed by 120 min of reperfusion in the presence and absence of individual muscarinic antagonists Telenzepine (1 nM–1000 nM), AF-DX 116 (... Heart journals http://www.medworm.com/rss/comments.php?id=5440495 Thu, 24 Nov 2011 05:00:00 +0100 5440495