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 'The American Journal of Cardiology' source. Wed, 08 Feb 2012 09:32:59 +0100 http://www.medworm.com/index.php?rid=5647596&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911035740%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647596 Thu, 02 Feb 2012 14:05:53 +0100 5647596 http://www.medworm.com/index.php?rid=5647595&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911035739%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647595 Thu, 02 Feb 2012 14:05:53 +0100 5647595 http://www.medworm.com/index.php?rid=5647594&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911033091%2Fabstract%3Frss%3Dyes We read with great interest the report “Effect of Joint National Committee VII Report on Hospitalizations for Hypertensive Emergencies in the United States” by Deshmukh et al. The investigators provided a comprehensive overview of trends in hospitalizations and inpatient mortality for hypertensive emergencies before and after the publication of the Seventh Joint National Committee report on the prevention, detection, evaluation, and treatment of high blood pressure. They reported an average increase in hospitalizations of 1.11% and a decrease in inpatient mortality from 2.8% to 2.6% (after the publication of the report). (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647594 Thu, 02 Feb 2012 14:05:53 +0100 5647594 http://www.medworm.com/index.php?rid=5647593&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491103308X%2Fabstract%3Frss%3Dyes The United States Department of Health and Human Services recently launched the Million Hearts initiative to prevent 1 million heart attacks and strokes over the next 5 years by implementing proved, effective, and inexpensive interventions. But why stop at a million? We already have all the information we need to eradicate atherosclerotic disease, which is a food-borne illness. Coronary artery disease is virtually nonexistent in large populations of individuals who consume plant-based nutrition. Some of the most renowned cardiovascular pathologists in the world have stated that maintaining a total cholesterol level >150 mg/dl is the true cause of this disease. Plaque regression occurs in >80% of patients who adopt a low-fat vegetarian diet. Cardiac positron emission tomographic scans show ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647593 Thu, 02 Feb 2012 14:05:53 +0100 5647593 http://www.medworm.com/index.php?rid=5647592&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911033054%2Fabstract%3Frss%3Dyes Left ventricular hypertrabeculation/noncompaction (LVHT/NC) is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. Dr. Madias assumes changes in the depth distribution and/or extent of the Purkinje ventricular conduction network in patients with LVHT/NC and altered intraventricular conduction. He asks for data on QRS durations, QT and corrected QT (QTc) intervals, and PR intervals on the electrocardiograms of our patients with LVHT/NC. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647592 Thu, 02 Feb 2012 14:05:53 +0100 5647592 http://www.medworm.com/index.php?rid=5647591&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911033066%2Fabstract%3Frss%3Dyes The report by Stöllberger et al in the October 1, 2011, issue of The American Journal of Cardiology on the frequency of stroke and embolism in 144 patients with left ventricular hypertrabeculation/noncompaction, a cardiac abnormality of unknown origin, was based on a retrograde analysis of baseline clinical, echocardiographic, and electrocardiographic data. In reference to electrocardiographic information, the investigators reported on the prevalence of normal findings, left bundle branch block, pathologic Q waves, and atrial fibrillation. Left ventricular hypertrabeculation/noncompaction is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. One wonders, given these anatomic peculiarities, about possible changes in th... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647591 Thu, 02 Feb 2012 14:05:53 +0100 5647591 http://www.medworm.com/index.php?rid=5647585&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911033959%2Fabstract%3Frss%3Dyes This article is supported by an educational grant from sanofi-aventis U.S., Bridgewater, New Jersey. Readers are requested to go to www.ajconline.org to participate in a survey. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647585 Thu, 02 Feb 2012 14:05:53 +0100 5647585 http://www.medworm.com/index.php?rid=5608488&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911034643%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608488 Fri, 20 Jan 2012 14:08:11 +0100 5608488 http://www.medworm.com/index.php?rid=5608487&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911034631%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608487 Fri, 20 Jan 2012 14:08:11 +0100 5608487 http://www.medworm.com/index.php?rid=5608486&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911031237%2Fabstract%3Frss%3Dyes We read with interest the report by Guetta et al on the development of high-degree atrioventricular block HDAVB and the frequency of permanent pacemaker (PPM) implantation in a series of 70 patients who underwent transcatheter aortic valve implantation (TAVI) with the Medtronic CoreValve ReValving System (Medtronic, Inc., Minneapolis, Minnesota). The findings presented by the investigators stress the importance of identifying predictors of the development of HDAVB in patients who underwent TAVI. The occurrence of new conduction abnormalities and new PPM implantation are not without clinical implication, as they may have potential detrimental effects on the recovery of left ventricular systolic function and the quality of life. After TAVI with the CoreValve system, new-onset HDAVB has been ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608486 Fri, 20 Jan 2012 14:08:11 +0100 5608486 http://www.medworm.com/index.php?rid=5597215&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911034023%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597215 Sun, 15 Jan 2012 05:00:00 +0100 5597215 http://www.medworm.com/index.php?rid=5597214&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911034011%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597214 Sun, 15 Jan 2012 05:00:00 +0100 5597214 http://www.medworm.com/index.php?rid=5597213&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030542%2Fabstract%3Frss%3Dyes We read with interest the report “Comparison of Aerobic Versus Resistance Exercise Training Effects on Metabolic Syndrome (From the Studies of a Targeted Risk Reduction Intervention Through Defined Exercise - STRRIDE-AT/RT)” in the September 15, 2011, issue of The American Journal of Cardiology. As the investigators clearly demonstrated, aerobic training (AT) had a significantly greater effect than resistance training (RT) on the metabolic syndrome score. We agree in general that these findings confirm previous data on AT, but we would point out that they make up only part of the multifaceted picture of correlations between exercise and the metabolic syndrome. In contrast to Bateman et al's findings, other studies suggest that the combined effects of RT and AT may be more beneficial fo... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597213 Sun, 15 Jan 2012 05:00:00 +0100 5597213 http://www.medworm.com/index.php?rid=5597212&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029948%2Fabstract%3Frss%3Dyes I read with interest the report by Patel et al regarding the prevalence of coronary artery disease (CAD) in alcoholic cirrhosis. The investigators reviewed retrospectively 420 subjects with liver failure due to alcoholic cirrhosis and other causes. A 2-group comparison was made regarding the prevalence of angiographic evidence of CAD. The investigators found a lower prevalence of CAD in patients with alcoholic cirrhosis compared to patients with nonalcoholic cirrhosis, which included viral cirrhosis, biliary cirrhosis, cryptogenic cirrhosis, and nonalcoholic steatohepatitis (NASH) in their cohort of patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597212 Sun, 15 Jan 2012 05:00:00 +0100 5597212 http://www.medworm.com/index.php?rid=5597211&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029936%2Fabstract%3Frss%3Dyes We read with interest the recent report by Cheng et al, who observed that the concentration of plasma N-terminal pro–B-type natriuretic peptide (NT-proBNP) was inversely associated with regional adiposity in community-based patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597211 Sun, 15 Jan 2012 05:00:00 +0100 5597211 http://www.medworm.com/index.php?rid=5597192&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027457%2Fabstract%3Frss%3Dyes In conclusion, the current risk model demonstrates for the first time that 8 parameters readily available during the hospitalization of patients with STEMI treated with primary percutaneous coronary intervention can accurately stratify patients at long-term follow-up (≤4 years after the index infarction) into low-, intermediate-, and high-risk categories. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597192 Sun, 15 Jan 2012 05:00:00 +0100 5597192 http://www.medworm.com/index.php?rid=5647570&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030281%2Fabstract%3Frss%3Dyes The no reflow phenomenon is reported to occur in >2% of all percutaneous coronary interventions (PCIs) and portends a poor prognosis. We analyzed data from 5,286 consecutive patients who underwent PCI from the Melbourne Interventional Group (MIG) registry from April 2004 through January 2008 who had 30-day follow-up completed. Patients without no reflow (normal reflow, n = 5,031) were compared to 255 (4.8%) with no reflow (n = 217 for transient no reflow, n = 38 for persistent no reflow). Patients with transient or persistent no reflow were more likely to present with ST-elevation myocardial infarction (MI) or cardiogenic shock (p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647570 Mon, 19 Dec 2011 05:00:00 +0100 5647570 http://www.medworm.com/index.php?rid=5647569&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030293%2Fabstract%3Frss%3Dyes There are few data on the incidence and clinical outcomes of patients with atrial fibrillation (AF) treated in the era of percutaneous coronary intervention (PCI). We analyzed 30-day clinical outcomes in 3,307 consecutive patients with and without AF (sinus rhythm) undergoing PCI from January 2007 through December 2008 enrolled in a multicenter Australian registry. Periprocedural AF was present in 162 patients (4.9%). AF was associated with older age (74.1 ± 8.9 vs 63.9 ± 11.9 years, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647569 Mon, 19 Dec 2011 05:00:00 +0100 5647569 http://www.medworm.com/index.php?rid=5504641&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911032826%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504641 Fri, 16 Dec 2011 02:36:01 +0100 5504641 http://www.medworm.com/index.php?rid=5504640&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911032814%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504640 Fri, 16 Dec 2011 02:36:01 +0100 5504640 http://www.medworm.com/index.php?rid=5504639&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029122%2Fabstract%3Frss%3Dyes The recent report by the esteemed editor of The American Journal of Cardiology and colleagues presents beautiful illustrations of examples of “isolated ventricular noncompaction … in adults.” It disturbed me because it perpetuates an extreme and restrictive view of this entity, while actual experience differs greatly. In a recent commentary, admittedly replete with speculation, I argued (1) for the acceptance of all noncompaction as congenital, whether it be found in an infant or an elderly patient; (2) for the acceptance of noncompaction as an embryonic fault that may be isolated or associated with other developmental anomalies, including genetic cardiomyopathies; and (3) that noncompaction may have a wide spectrum of presentations, from minimal to extreme, from localized to gen... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504639 Fri, 16 Dec 2011 02:36:01 +0100 5504639 http://www.medworm.com/index.php?rid=5647586&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030487%2Fabstract%3Frss%3Dyes Patients with hypertension are advised to lower their blood pressure to (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647586 Mon, 12 Dec 2011 05:00:00 +0100 5647586 http://www.medworm.com/index.php?rid=5647574&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030384%2Fabstract%3Frss%3Dyes To detect a long-term increase in the incidence of acute myocardial infarction (AMI) after Hurricane Katrina and to investigate the pertinent contributing factors, we conducted a single-center retrospective cohort observational study. The patients admitted with AMI to Tulane University Hospital in the 2 years before Katrina and the 3 years after the hospital reopened were identified from the hospital medical records. The pre- and post-Katrina groups were compared for prespecified demographic and clinical data. In the 3-year post-Katrina group, 418 admissions (2.0%) for AMI occurred of a total census of 21,092 patients compared to 150 (0.7%) of a census of 21,079 in the 2-year pre-Katrina group (p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647574 Thu, 08 Dec 2011 05:00:00 +0100 5647574 http://www.medworm.com/index.php?rid=5647575&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030396%2Fabstract%3Frss%3Dyes Anemia is common in hospitalized cardiac patients and is associated with adverse outcomes. The aim of this study was to identify the association of anemia with early and long-term outcomes in patients with acute coronary syndromes (ACSs). Included were 5,304 consecutive patients (73% men, 61 ± 12 years of age) admitted to a coronary care unit from 1985 through 2008 for ACS. According to the World Health Organization, anemia was defined as serum hemoglobin levels (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647575 Wed, 07 Dec 2011 05:00:00 +0100 5647575 http://www.medworm.com/index.php?rid=5647573&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030335%2Fabstract%3Frss%3Dyes Guidelines recommend urgent reperfusion for patients with new left bundle branch block (LBBB), similar to patients with ST-segment elevation myocardial infarction (STEMI). However, there are limited contemporary data comparing these 2 groups of patients. Patients presenting with acute STEMI or presumed new LBBB (nLBBB) enrolled in the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry–Get With the Guidelines (GWTG) from January 2007 to March 2009 were evaluated for clinical characteristics, treatment patterns, and outcomes. Logistic generalized estimating equation modeling was used to examine associated risk-adjusted mortality. Of 46,006 patients with either STEMI or nLBBB, 44,405 (96.5%) had STEMI, and 1,601 (3.5%) had nLBBB. Overall, patients with nLBBB had mo... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647573 Wed, 07 Dec 2011 05:00:00 +0100 5647573 http://www.medworm.com/index.php?rid=5647588&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030517%2Fabstract%3Frss%3Dyes In conclusion, PCI before TAVI appears feasible and safe. Based on these early results revascularization should become an important consideration in patients with coronary artery disease undergoing TAVI. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647588 Fri, 02 Dec 2011 05:00:00 +0100 5647588 http://www.medworm.com/index.php?rid=5647584&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030426%2Fabstract%3Frss%3Dyes In conclusion, despite similarities in electrocardiographic morphology, the extent of LV dyssynchrony were greater in patients with iLBBB, with LV preload and afterload the main determinants. No association was found between the presence of LV dyssynchrony and prognosis. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647584 Fri, 02 Dec 2011 05:00:00 +0100 5647584 http://www.medworm.com/index.php?rid=5647583&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030438%2Fabstract%3Frss%3Dyes In conclusion, both CHA2DS2-VASc and CHADS2 scores are useful for stroke risk stratification in patients with atrial flutter. CHA2DS2-VASc had greater sensitivity for LA thrombus and SEC detection at the cost of reduced specificity. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647583 Fri, 02 Dec 2011 05:00:00 +0100 5647583 http://www.medworm.com/index.php?rid=5647567&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030311%2Fabstract%3Frss%3Dyes This study evaluated the risk factors of postprocedure cardiac troponin I (cTnI) increase and its effects on repeat revascularization and on overall clinical outcomes in patients with angina and normal preprocedural cTnI levels who underwent successful drug-eluting stent implantation. Postprocedure cTnI increase (≥0.5 ng/ml) was observed in 207 of 802 patients (25.8%). Patients with cTnI increase had more extensive coronary disease than patients without cTnI increase, which necessitated for the cTnI group more multilesion interventions and a longer total stent length. In multivariate analysis, total stent length (odds ratio 1.02, 1.01 to 1.03, p = 0.001) and use of glycoprotein IIb/IIIa inhibitors (3.07, 1.54 to 6.11, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647567 Fri, 02 Dec 2011 05:00:00 +0100 5647567 http://www.medworm.com/index.php?rid=5608479&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029444%2Fabstract%3Frss%3Dyes Among the cardiovascular manifestations in the Marfan syndrome (MFS), aortic dissection stands out as a major cause of early mortality. The aim of this study was to test the hypothesis that patients with the MFS who experience aortic dissection differ in clinical features and outcomes from those with aortic dissection not related to the MFS. Data from patients diagnosed with aortic dissection from December 1994 to March 2009 at 1 of the major medical centers in Korea were reviewed. The clinical presentations, dissection characteristics, and outcomes of patients with and those without the MFS in a Korean population were compared. Of 445 patients with aortic dissection, 46 (10%) had the MFS. Compared to non-MFS patients, those with the MFS developed aortic dissection at younger ages (33 ± 1... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608479 Fri, 02 Dec 2011 05:00:00 +0100 5608479 http://www.medworm.com/index.php?rid=5457286&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911031560%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457286 Thu, 01 Dec 2011 02:36:33 +0100 5457286 http://www.medworm.com/index.php?rid=5457285&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911031559%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457285 Thu, 01 Dec 2011 02:36:33 +0100 5457285 http://www.medworm.com/index.php?rid=5457284&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102995X%2Fabstract%3Frss%3Dyes The following information was inadvertently omitted by The American Journal of Cardiology and should have appeared on the first page of the article in keeping with ACCME requirements: (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457284 Thu, 01 Dec 2011 02:36:33 +0100 5457284 http://www.medworm.com/index.php?rid=5457283&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911028050%2Fabstract%3Frss%3Dyes A recent article by Roberts et al presented typical echocardiographic and gross pathology on 3 adults with noncompaction. The investigators raised the question whether isolated ventricular noncompaction was being overdiagnosed. I agree that morphology based only on echocardiography may be subjective. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457283 Thu, 01 Dec 2011 02:36:33 +0100 5457283 http://www.medworm.com/index.php?rid=5457282&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911028049%2Fabstract%3Frss%3Dyes Differential diagnosis between athlete's heart (AH) and hypertrophic cardiomyopathy (HC) remains one of the most challenging territories in the field of sports cardiology. In a recent report, Kansal et al addressed the usefulness of 2-dimensional and speckle-tracking echocardiography in differentiating AH from HC in “gray zone” left ventricular hypertrophy. The investigators state that especially relative wall thickness (measured as the ratio of septal plus posterior wall thickness to left ventricular end-diastolic diameter) and longitudinal endocardial strain by relative wall thickness have shown sufficient accuracy to clinically differentiate physiologic from pathologic hypertrophy in athletes. The study certainly opens new perspectives, but some major concerns are also raised. (Sour... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457282 Thu, 01 Dec 2011 02:36:33 +0100 5457282 http://www.medworm.com/index.php?rid=5457281&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911028013%2Fabstract%3Frss%3Dyes Early repolarization (ER) is a common electrocardiographic pattern, characterized by J point and ST-segment elevation with upper concavity with tall symmetrical notched T waves in ≥2 contiguous leads, more commonly the precordial leads. The prevalence of ER in the general population ranges from 1% to 13%. It is also reported in 10% to 70% of patients with idiopathic ventricular fibrillation (VF). Over the past several decades ER has been considered a benign phenomenon. However, recently there have been several reports demonstrating the potential arrhythmogenicity of ER. Haïssaguerre et al observed that there was a higher incidence of recurrent VF in patients with ER (hazard ratio 2.1, 95% confidence interval 1.2 to 3.5, p = 0.008). More recently, Tikkanen et al reported that ER in the i... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457281 Thu, 01 Dec 2011 02:36:33 +0100 5457281 http://www.medworm.com/index.php?rid=5457280&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027640%2Fabstract%3Frss%3Dyes Before the story of his life started, the patient's father died in an accidental fire, never witnessing the fire burning in his 1-month-old son, an affliction called homozygous familial hypercholesterolemia. Luckily, this hero had a brave mother, who never left her only son despite extreme poverty. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457280 Thu, 01 Dec 2011 02:36:33 +0100 5457280 http://www.medworm.com/index.php?rid=5457279&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027639%2Fabstract%3Frss%3Dyes Berent et al concluded that “there is no difference in antiplatelet response to aspirin 50 versus 100 mg or cardiovascular events (CV) over 5 years in patients with coronary heart disease.” However, there were 50% more patients with diabetes in the 100-mg group compared to the 50-mg group (24% vs 16%, respectively). It has been shown that patients with diabetes have a much higher prevalence of aspirin resistance. Therefore, more patients with diabetes in the 100-mg group biases the results in favor of a null effect between the doses, with respect to both outcomes. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457279 Thu, 01 Dec 2011 02:36:33 +0100 5457279 http://www.medworm.com/index.php?rid=5457278&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911024416%2Fabstract%3Frss%3Dyes In conclusion, early RAS blockade after heart transplantation is safe, well tolerated, and associated with better renal function and hemodynamic profile at 1 year after transplantation. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457278 Thu, 01 Dec 2011 02:36:33 +0100 5457278 http://www.medworm.com/index.php?rid=5647582&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030463%2Fabstract%3Frss%3Dyes In conclusion, elderly patients with AF or AFL undergo frequent hospitalization for CV and non-CV causes. Measures that lower inpatient admission rates, particularly readmission rates, may reduce the increasing cost of treating patients with AF or AFL with Medicare supplemental insurance. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647582 Mon, 28 Nov 2011 05:00:00 +0100 5647582 http://www.medworm.com/index.php?rid=5647568&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491103030X%2Fabstract%3Frss%3Dyes In conclusion, status after CABG rather than PLM location increases the risk of repeat revascularization with PCI in DES-treated patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647568 Mon, 28 Nov 2011 05:00:00 +0100 5647568 http://www.medworm.com/index.php?rid=5647566&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030323%2Fabstract%3Frss%3Dyes HORIZONS-AMI was a prospective dual-arm randomized trial of different antithrombotic regimens and stent types in patients with ST-segment elevation myocardial infarction. A formal intravascular ultrasound (IVUS) substudy enrolled 464 patients with baseline and 13-month follow-up at 36 centers. Of them, 318 patients with 355 lesions were evaluated for this study. Angiographic restenosis occurred in 45 of 355 lesions (12.7%). Bare-metal stent use (45.5% vs 21.2%, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647566 Mon, 28 Nov 2011 05:00:00 +0100 5647566 http://www.medworm.com/index.php?rid=5608471&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029365%2Fabstract%3Frss%3Dyes In conclusion, RecordAF-AP will provide much needed insight into the real-life management of patients with AF in the Asia Pacific region. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608471 Mon, 28 Nov 2011 05:00:00 +0100 5608471 http://www.medworm.com/index.php?rid=5608470&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029377%2Fabstract%3Frss%3Dyes Anticoagulation has been shown to decrease ischemic stroke in atrial fibrillation (AF). However, concerns remain regarding their safety and efficacy in those ≥70 years of age who constitute most patients with AF. Of the 4,060 patients (mean age 65 years, range 49 to 80) in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial, 2,248 (55% of 4,060) were 70 to 80 years of age, 1,901 of whom were receiving warfarin. Propensity score for warfarin use, estimated for each of the 2,248 patients, was used to match 227 of the 347 patients not on warfarin (in 1:1, 1:2, or 1:3 sets) to 616 patients on warfarin who were balanced in 45 baseline characteristics. All-cause mortality occurred in 18% and 33% of matched patients receiving and not receiving warfarin, respectiv... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608470 Mon, 28 Nov 2011 05:00:00 +0100 5608470 http://www.medworm.com/index.php?rid=5647578&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030402%2Fabstract%3Frss%3Dyes In conclusion, participants who report using ERs as their usual sites of care are disproportionately more likely to have histories of poor cardiovascular outcomes and are more likely to be unaware of having hypertension or hypercholesterolemia. As health care reform takes place and millions more begin seeking care, it is imperative to ensure access to longitudinal care sites designed for continuous disease management. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647578 Thu, 24 Nov 2011 05:00:00 +0100 5647578 http://www.medworm.com/index.php?rid=5608472&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029353%2Fabstract%3Frss%3Dyes Heart failure with preserved left ventricular ejection fraction (HFpEF) is implicitly attributed to diastolic dysfunction, often recognized in elderly patients with hypertension, diabetes, and renal dysfunction. In these patients, left ventricular circumferential and longitudinal shortening is often impaired despite normal ejection fraction. The aim of this prospective study was to analyze circumferential and longitudinal shortening and their relations in patients with nonischemic HFpEF. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S′) were measured in 60 patients (mean age 73 ± 13 years) with chronic nonischemic HFpEF in stable New York Heart Association functional class II or III and compared to the values in 120 healthy controls and 120 patie... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608472 Thu, 24 Nov 2011 05:00:00 +0100 5608472 http://www.medworm.com/index.php?rid=5608469&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029328%2Fabstract%3Frss%3Dyes Aggressive low-density lipoprotein (LDL) cholesterol-lowering therapy is important for high-risk patients. However, sparse data exist on the impact of combined aggressive LDL cholesterol-lowering therapy in familial hypercholesterolemia (FH), particularly on side effects to changes in plasma coenzyme Q10 and proprotein convertase subtilisin/kexin type 9 levels. We enrolled 17 Japanese patients with heterozygous FH (12 men, 63.9 ± 7.4 years old) with single LDL receptor gene mutations in a prospective open randomized study. Permitted maximum doses of rosuvastatin (20 mg/day), ezetimibe (10 mg/day), and granulated colestimide (3.62 g/day) were introduced sequentially. Serum levels of LDL cholesterol decreased significantly by −66.4% (p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608469 Thu, 24 Nov 2011 05:00:00 +0100 5608469 http://www.medworm.com/index.php?rid=5608466&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029298%2Fabstract%3Frss%3Dyes Ischemic cardiomyopathy with depressed left ventricular ejection fraction (LVEF) is predictive of death after percutaneous coronary intervention (PCI), but its association with stent thrombosis (ST) and the need for repeat revascularization is less clearly defined. In total 5,377 patients undergoing PCI were retrospectively evaluated. Multivariable Cox proportional hazards regression and competitive outcome analysis were employed. The primary end point was 1-year major adverse cardiac events (all-cause death, Q-wave myocardial infarction, ST, and target lesion revascularization [TLR]). Individual end points of ST and of TLR were also evaluated. Patients with normal LVEF (>50%) were compared to those with mild (41% to 50%), moderate (25% to 40%), and severe ( (Source: The American Journal o... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608466 Thu, 24 Nov 2011 05:00:00 +0100 5608466 http://www.medworm.com/index.php?rid=5647590&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030499%2Fabstract%3Frss%3Dyes The Fick principle (cardiac output [Qc] = oxygen uptake [Vo2]/arteriovenous oxygen difference) can be used to calculate Qc, with VO2 frequently estimated by derived equations. To compare the accuracy of measured versus estimated VO2, data were analyzed from 2 studies in which VO2 at rest was measured using the Douglas bag technique. One study comprised adults with diabetes, and the other was an exercise study of healthy adults. VO2 at rest was estimated as VO2 (ml/min) = 125 ml/min/m2 × body surface area (m2), with sensitivity analyses evaluating 2 other commonly used equations. Mean absolute difference (milliliters per minute) and ordinary least products regression were used to assess agreement between measured and estimated VO2. Overall, mean measured versus estimated VO2 differed signi... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647590 Mon, 21 Nov 2011 05:00:00 +0100 5647590 http://www.medworm.com/index.php?rid=5647589&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030505%2Fabstract%3Frss%3Dyes Left ventricular hypertrophy is 1 of the most frequent cardiac manifestations associated with an unfavorable prognosis. However, many different causes of left ventricular hypertrophy exist. The aim of the present study was to assess the diagnostic value of common electrocardiographic (ECG) parameters to differentiate Fabry disease (FD), amyloidosis, and nonobstructive hypertrophic cardiomyopathy (HC) from hypertensive heart disease (HHD) and aortic stenosis (AS). In 94 patients with newly diagnosed FD (n = 17), HHD (n = 20), amyloidosis (n = 17), AS (n = 20), and HC (n = 20), common ECG parameters were analyzed and tested for their diagnostic value. A stepwise approach including the Sokolow–Lyon index, corrected QT duration, and PQ interval minus P-wave duration in lead II to overcome P-... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647589 Mon, 21 Nov 2011 05:00:00 +0100 5647589 http://www.medworm.com/index.php?rid=5647581&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030414%2Fabstract%3Frss%3Dyes Few prospective studies have explored the association between renal function and risk for incident atrial fibrillation (AF) in apparently healthy populations. A total of 24,746 women participating in the Women's Health Study who were free of cardiovascular disease and AF and provided blood samples at baseline were prospectively followed for incident AF from 1993 to 2010. AF events were confirmed by medical chart review. Estimated glomerular filtration rate (eGFR) was calculated from baseline creatinine using the Chronic Kidney Disease Epidemiology (CKD-EPI) equation. Cox models were used to estimate hazard ratios and 95% confidence intervals (CIs) for incident AF across eGFR categories controlling for AF risk factors. During a median of 15.4 years of follow-up, 786 incident AF events occur... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647581 Mon, 21 Nov 2011 05:00:00 +0100 5647581 http://www.medworm.com/index.php?rid=5647580&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491103044X%2Fabstract%3Frss%3Dyes In conclusion, in our community-based sample, an increased WBC count was associated with incident AF during 5 years of follow-up. Our findings provide additional evidence for the relation between systemic inflammation and AF. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647580 Mon, 21 Nov 2011 05:00:00 +0100 5647580 http://www.medworm.com/index.php?rid=5647579&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030451%2Fabstract%3Frss%3Dyes Subjects at risk of atherosclerosis might have dysfunctional high-density lipoprotein (HDL) despite normal cholesterol content in the plasma. We considered whether the efflux of excess cellular cholesterol to HDL from obese subjects is associated with impaired arterial endothelial function, a biomarker of cardiovascular risk. A total of 54 overweight (body mass index [BMI] 25 to 29.9 kg/m2) or obese (BMI ≥30 kg/m2) women, aged 46 ± 11 years, were enrolled in a worksite wellness program. The HDL cholesterol averaged 57 ± 17 mg/dl and was inversely associated with the BMI (r = −0.419, p = 0.002). Endothelial function was assessed using brachial artery flow-mediated dilation. Cholesterol efflux from 3H-cholesterol–labeled baby hamster kidney cells transfected with the adenosine tripho... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647579 Mon, 21 Nov 2011 05:00:00 +0100 5647579 http://www.medworm.com/index.php?rid=5647577&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030360%2Fabstract%3Frss%3Dyes Atherosclerosis is the main cause of cardiovascular disease, but the extent of atherosclerosis in individual patients is difficult to estimate. A biomarker of the atherosclerotic burden would be very valuable. The aim of the present study was to evaluate the association of plasma osteoprotegerin (OPG) to clinical and subclinical atherosclerotic disease in a large community-based, cross-sectional population study. In the Copenhagen City Heart Study, OPG concentrations were measured in 5,863 men and women. A total of 494 participants had been hospitalized for ischemic heart disease or ischemic stroke, and compared to controls, this group with clinical atherosclerosis had higher mean OPG (1,773 vs 1,337 ng/L, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647577 Mon, 21 Nov 2011 05:00:00 +0100 5647577 http://www.medworm.com/index.php?rid=5647576&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030372%2Fabstract%3Frss%3Dyes Firefighters are known to have an elevated rate of sudden cardiac death compared to the general population. It is unclear whether this finding is related to underlying cardiovascular risk factors or whether firefighting inherently carries additional risk. Our objective was to determine whether Los Angeles county firefighters have higher coronary artery calcium (CAC) scores and increased atherosclerosis as determined using 64-slice cardiac, multidetector computed tomography. A total of 647 asymptomatic firefighters evaluated as a part of a wellness protocol were referred for cardiac multidetector computed tomography to evaluate abnormal exercise treadmill test findings. They were matched by age and cardiovascular risk factors, with 2,533 asymptomatic subjects undergoing cardiac computed tom... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647576 Mon, 21 Nov 2011 05:00:00 +0100 5647576 http://www.medworm.com/index.php?rid=5647572&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030347%2Fabstract%3Frss%3Dyes Substantial evidence points to a protective role of adiponectin against atherosclerosis and cardiovascular (CV) disease. However, in the setting of an acute myocardial infarction (AMI), the role of adiponectin has not previously been studied. Consequently, the aim of this study was to investigate the prognostic role of adiponectin after AMI in a large population of patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A total of 735 consecutive patients with ST-segment elevation myocardial infarction admitted to a single high-volume invasive heart center and treated with primary percutaneous coronary intervention from September 2006 to December 2008 were included. Blood samples were drawn immediately before the invasive procedure.... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647572 Mon, 21 Nov 2011 05:00:00 +0100 5647572 http://www.medworm.com/index.php?rid=5647571&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030359%2Fabstract%3Frss%3Dyes Elevated uric acid (UA) levels have been associated with cardiovascular disease in epidemiologic studies. The relation between UA levels and long-term outcomes in patients with ST-segment elevation myocardial infarction who undergo primary percutaneous coronary intervention is not known. Data from 2,249 consecutive patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were evaluated. Patients were divided into 2 groups with high or low UA using upper limits of normal of 6 mg/dl for women and 7 mg/dl for men. There were 1,643 patients in the low-UA group (mean age 55.9 ± 11.6 years, 85% men) and 606 patients in the high-UA group (mean age 60.5 ± 12.6 years, 76% men). Serum UA levels were 8.0 ± 1.5 mg/dl in the high-UA group and ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647571 Mon, 21 Nov 2011 05:00:00 +0100 5647571 http://www.medworm.com/index.php?rid=5647565&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491103027X%2Fabstract%3Frss%3Dyes Despite reports of patients with resuscitated sudden cardiac arrest (rSCA) receiving acute cardiac catheterization, the efficacy of this strategy is largely unknown. We hypothesized that acute cardiac catheterization of patients with rSCA would improve survival to hospital discharge. A retrospective cohort of 240 patients with out-of-hospital rSCA caused by ventricular tachycardia or fibrillation was identified from 11 institutions in Seattle, Washington from 1999 through 2002. Patients were grouped into those receiving acute catheterization within 6 hours (≤6-hour group, n = 61) and those with deferred catheterization at >6 hours or no catheterization during the index hospitalization (>6-hour group, n = 179). Attention was directed to survival to hospital discharge, neurologic status, e... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647565 Mon, 21 Nov 2011 05:00:00 +0100 5647565 http://www.medworm.com/index.php?rid=5647587&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030475%2Fabstract%3Frss%3Dyes In conclusion, the results of the present study suggest that candesartan-based therapy is not associated with either carcinogenesis or cancer death compared to non-ARB standard therapy. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5647587 Fri, 18 Nov 2011 05:00:00 +0100 5647587 http://www.medworm.com/index.php?rid=5608483&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029468%2Fabstract%3Frss%3Dyes Amerena et al and the sponsor of the report from the Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation Asia Pacific (RecordAF-AP) deserve congratulations for their contribution in this issue of The American Journal of Cardiology. They present data on 2,721 patients with atrial fibrillation recruited from >100 hospital sites in 8 countries across the Asia-Pacific region. Atrial fibrillation is an important clinical entity because of its increasing incidence and prevalence, its association with embolic stroke, and the development of new antithrombotic medications, preventive approaches, and ablation and device therapies. Sixty-two percent of the patients in RecordAF-AP were on a rate-control strategy using primarily β blockers, and of the remainder (rhythm co... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608483 Fri, 18 Nov 2011 05:00:00 +0100 5608483 http://www.medworm.com/index.php?rid=5608474&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029407%2Fabstract%3Frss%3Dyes In conclusion, overall improvement occurred in survival in patients hospitalized with HF in a Middle-Eastern country, regardless of gender. Women hospitalized with HF had mortality rates comparable to those of men. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608474 Fri, 18 Nov 2011 05:00:00 +0100 5608474 http://www.medworm.com/index.php?rid=5608465&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029304%2Fabstract%3Frss%3Dyes In conclusion, painless STEMI was associated with more adverse outcomes than painful STEMI and late detection may have contributed significantly to total ischemic burden. These results warrant more investigations for methodologic development in the diagnosis of silent ischemia and painless STEMI. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608465 Wed, 16 Nov 2011 05:00:00 +0100 5608465 http://www.medworm.com/index.php?rid=5597202&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027573%2Fabstract%3Frss%3Dyes In conclusion, patients with relatively small LV size, preserved LV contraction, and dilated left atrium were at higher risk for RVF after LVAD surgery. In conclusion, LV echocardiographic RVF score provides a novel tool to predict RVF after LVAD surgery, which does not involve invasive or technically complicated procedures. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597202 Wed, 16 Nov 2011 05:00:00 +0100 5597202 http://www.medworm.com/index.php?rid=5608478&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029420%2Fabstract%3Frss%3Dyes Left ventricular (LV) diastolic dysfunction is associated with poor outcomes after tetralogy of Fallot (TOF) repair, although its cause is not known, and its relation to right ventricular (RV) performance has never been examined. The aim of this study was to test the hypothesis that RV dilation leads to LV diastolic dysfunction after TOF repair. Patients with repaired TOF who underwent cardiac catheterization and cardiac magnetic resonance imaging within 6 months from January 2003 and April 2011 were reviewed to assess the relation of LV end-diastolic pressure (LVEDP) and indexed RV end-diastolic volume (RVEDVi). Thirty-eight patients were included at a median age of 10.1 years (range 0.6 to 54.7). There was a significant linear association between RVEDVi and LVEDP (p = 0.05). RV end-diast... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608478 Mon, 14 Nov 2011 05:00:00 +0100 5608478 http://www.medworm.com/index.php?rid=5608477&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029432%2Fabstract%3Frss%3Dyes Cor triatriatum represents 10%, including patients diagnosed before and after cor triatriatum repair) is noteworthy. Abnormalities of the mitral valve and a supravalvar mitral ring were also seen more often than the existing research would suggest, which may be another important consideration in evaluating and following these patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608477 Mon, 14 Nov 2011 05:00:00 +0100 5608477 http://www.medworm.com/index.php?rid=5608475&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029390%2Fabstract%3Frss%3Dyes Although Friedreich ataxia (FA) is associated with cardiomyopathy, the severity and evolution of cardiac disease is poorly understood. To identify factors predicting cardiomyopathy in FA, we assessed echocardiograms from a large heterogenous cohort and their relation to disease traits. The most recent echocardiograms from 173 subjects with FA were analyzed in a core laboratory to determine their relation to disease duration, subject age, age of onset, functional disability score, and GAA repeat length. Mean age of the cohort was 19.7 years, mean age of disease onset was 10.6 years, and mean shorter GAA length was 681 repeats. Echocardiograms collectively illustrated systolic dysfunction, diastolic dysfunction, and hypertrophy. Measurements of hypertrophy correlated moderately with each oth... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608475 Mon, 14 Nov 2011 05:00:00 +0100 5608475 http://www.medworm.com/index.php?rid=5608473&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029419%2Fabstract%3Frss%3Dyes In conclusion, in chronic IC, quantitated myocardial fibrosis is associated with CMR structural and functional LV abnormalities. Elevated BNP levels are related to high-risk structural and functional CMR abnormalities and wall stress and functional status. Myocardial fibrosis appears to be related to plasma BNP through the processes of ventricular remodeling. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608473 Mon, 14 Nov 2011 05:00:00 +0100 5608473 http://www.medworm.com/index.php?rid=5608464&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029316%2Fabstract%3Frss%3Dyes This study assessed the association between chronic use of ACE inhibitors and clinical outcomes in patients with ACS. From 1999 through 2008, 13,632 Canadian patients with ACS were identified in the Global Registry of Acute Coronary Events (GRACE), the expanded GRACE (GRACE2), and the Canadian Registry of Acute Coronary Events (CANRACE). Patients were stratified by previous use of an ACE inhibitor. Clinical characteristics, in-hospital treatment, and outcomes were compared between the 2 groups. Multivariable logistic regression analysis adjusting for GRACE risk score and other clinical factors was performed. Patients receiving an ACE inhibitor before the ACS had a higher prevalence of diabetes (40.6% vs 21.2%, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608464 Mon, 14 Nov 2011 05:00:00 +0100 5608464 http://www.medworm.com/index.php?rid=5608463&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029286%2Fabstract%3Frss%3Dyes Early in the course of ST-segment elevation myocardial infarction (STEMI), therapies that may harm patients who develop left ventricular (LV) dysfunction, such as β-blockers, are often administered. The investigators analyzed the ACTIVATE-SF database, a registry of consecutive STEMI activations presenting to 2 medical centers at the University of California, San Francisco. LV dysfunction was defined as an ejection fraction ≤40% on echocardiography. Of 211 patients included in the analysis, 66 (31%) had LV ejection fractions ≤40%. Patients with LV dysfunction were older (63 ± 15 vs 56 ± 13 years, p = 0.002). In multivariate regression models, decreased renal function (reference group, creatinine 1.5 mg/dl 6.35, 95% confidence interval [CI] 1.66 to 24.31, p = 0.007), a history of coro... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608463 Mon, 14 Nov 2011 05:00:00 +0100 5608463 http://www.medworm.com/index.php?rid=5608462&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029250%2Fabstract%3Frss%3Dyes Gender-related differences in the incidence of bleeding and its relation to subsequent mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolysis are not well understood. We studied patients with STEMI receiving fibrinolysis enrolled in 6 clinical trials. Outcomes included moderate or severe bleeding defined using Global Utilization of Strategies to Open Occluded Arteries (GUSTO) criteria and adjusted 1-year mortality (excluding deaths in first 24 hours). Moderate or severe bleeding was 1.9-fold higher in women compared to men (13.3% vs 7.1%, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608462 Mon, 14 Nov 2011 05:00:00 +0100 5608462 http://www.medworm.com/index.php?rid=5608461&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029262%2Fabstract%3Frss%3Dyes We examined the admission electrocardiograms from 357 patients with a first inferior acute myocardial infarction who had Thrombolysis In Myocardial Infarction 3 flow of the right coronary artery or left circumflex artery within 6 hours after symptom onset. The patients were divided according to the presence (n = 76) or absence (n = 281) of ST↑ >2 mm in leads V5 and V6. Patients with ST↑ in leads V5 and V6 were subdivided into 2 groups according to the degree of ST↑ in leads III and V6: ST↑ in lead III greater than in V6 (n = 53) and ST↑ in lead III equal to or less than in V6 (n = 23). The perfusion territory of the culprit artery was assessed using the angiographic distribution score, and a mega-artery was defined as a score of ≥0.7. ST↑ in leads V5 and V6 with ST↑ in lead... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608461 Mon, 14 Nov 2011 05:00:00 +0100 5608461 http://www.medworm.com/index.php?rid=5400575&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030013%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400575 Sun, 13 Nov 2011 02:35:44 +0100 5400575 http://www.medworm.com/index.php?rid=5400574&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911030001%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400574 Sun, 13 Nov 2011 02:35:44 +0100 5400574 http://www.medworm.com/index.php?rid=5400573&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026907%2Fabstract%3Frss%3Dyes In the study of Chan et al concerning the use of warfarin in outpatients with atrial fibrillation (AF), among the 9,113 outpatients with nonvalvular AF who were at moderate to high risk for stroke and would be optimally treated with warfarin, only 5,018 received warfarin (55.1%). Interestingly, there was substantial variation in treatment, ranging from 25% to 80%. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400573 Sun, 13 Nov 2011 02:35:44 +0100 5400573 http://www.medworm.com/index.php?rid=5400572&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026555%2Fabstract%3Frss%3Dyes It was with great interest that we read the report by Rodés-Cabau et al titled “Importance of Diffuse Atherosclerosis in the Functional Evaluation of Coronary Stenosis in the Proximal-Mid Segment of a Coronary Artery by Myocardial Fractional Flow Reserve Measurements.” The investigators showed how fractional flow reserve (FFR) results can vary according to the location of the distal pressure sensor within the artery. Specifically, for the first time, it was shown that more distal measurements are more likely to be associated with lower FFR values. This finding strengthens the importance of the pressure wire as a functional assessment of disease severity. Its values not only reflect the significance of the visually obvious stenosis but represent the severity of the entire plaque burden... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400572 Sun, 13 Nov 2011 02:35:44 +0100 5400572 http://www.medworm.com/index.php?rid=5400571&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026543%2Fabstract%3Frss%3Dyes In their extensive state-of-art report on the echocardiographic evaluation of systolic and diastolic function in patient with cardiac amyloidosis, Liu et al dedicated much space to tissue Doppler imaging, strain rate imagining, and 2-dimensional speckle-tracking imagining but made no mention of a particular behavior of left ventricular (LV) motion defined as twisting and untwisting. It consists of LV torsional deformation around the longitudinal axis, originating from the dynamic interaction between the systolic clockwise rotation of the base and the counterclockwise rotation of the apex, followed by untwisting during diastole. Porciani et al recently published a comprehensively 2-dimensional strain evaluation of patients with amyloid light chain amyloidosis. They demonstrated that LV long... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400571 Sun, 13 Nov 2011 02:35:44 +0100 5400571 http://www.medworm.com/index.php?rid=5400570&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102618X%2Fabstract%3Frss%3Dyes This study adds further fuel to the continuing debate over the underuse of anticoagulation for atrial fibrillation (AF), as did the previous reports of Ogilvie et al and Brophy et al. The issue actually involves the use of the vitamin K antagonist warfarin as the basis for successful therapy in a usually highly diseased patient population hosting a multitude of co-morbidities. Having been involved in anticoagulation for >4 decades enables one to be in a somewhat unique position for additional commentary and to play the position of devil's advocate with the intent of diminishing the implications these reviews place upon practicing physicians, whether cardiologists or generalists. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400570 Sun, 13 Nov 2011 02:35:44 +0100 5400570 http://www.medworm.com/index.php?rid=5400567&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911023058%2Fabstract%3Frss%3Dyes In conclusion, ischemic ECG changes are common in patients with COPD and associated with poor clinical outcome irrespective of forced expiratory volume in the first second. These results suggest an important role for cardiovascular disease in impaired survival in these patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400567 Sun, 13 Nov 2011 02:35:43 +0100 5400567 http://www.medworm.com/index.php?rid=5400562&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027998%2Fabstract%3Frss%3Dyes In conclusion, most patients (82% in this study) having acute aortic dissection with entrance tears in the ascending aorta have normal numbers or only trace loss of aortic medial elastic fibers. Thus, underlying abnormal ascending aortic structure uncommonly precedes acute dissection. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400562 Sun, 13 Nov 2011 02:35:43 +0100 5400562 http://www.medworm.com/index.php?rid=5400555&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911028001%2Fabstract%3Frss%3Dyes In conclusion, aortic valve structure was interpretable by transthoracic echocardiogram in 86 of 100 patients and accurate in 57 of these 86 patients (66%). (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5400555 Sun, 13 Nov 2011 02:35:42 +0100 5400555 http://www.medworm.com/index.php?rid=5608481&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029481%2Fabstract%3Frss%3Dyes Reflux of contrast medium into the inferior vena cava (IVC) is often detected on computerized tomographic pulmonary angiogram. The potential clinical implications and associated diagnoses of this finding have not been established. We investigated the prevalence and significance of reflux of contrast medium into the IVC in a large cohort of patients evaluated for possible pulmonary embolism (PE) by computerized tomographic pulmonary angiography. We retrospectively reviewed 1,065 consecutive computerized tomographic pulmonary angiographic examinations performed from January 1, 2007 through January 7, 2008 for the presence of reflux. Degree of reflux into the IVC and hepatic veins was graded from 1 (none) to 6 (severe). Patients' charts were reviewed for diagnoses during the index hospitaliza... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608481 Fri, 11 Nov 2011 05:00:00 +0100 5608481 http://www.medworm.com/index.php?rid=5608476&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029389%2Fabstract%3Frss%3Dyes In conclusion, LAMP2 mutation can cause a severe arrhythmogenic phenotype in women that includes a high risk of sudden death. cMRI may be useful in women harboring LAMP2 mutations to permit early detection of cardiac involvement and guide timely considerations of implantable cardioverter–defibrillator therapy. Heart transplantation should be considered at onset of heart failure symptoms owing to rapid progression of the disease. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608476 Fri, 11 Nov 2011 05:00:00 +0100 5608476 http://www.medworm.com/index.php?rid=5608485&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102950X%2Fabstract%3Frss%3Dyes A male who were implanted bare metal stent 11 years ago were admitted for acute coronay syndrome. Optical coherence tomography showed a neointimal disruption and integrated backscatter intravascular ultrasound revealed a lipid pool around the disrupted neointima, suggesting newly formed atherosclerotic neointima developed after bare metal stent implantation. The disruption of atherosclerotic neointima may represent a new potential mechanism of very late stent thrombosis after bare metal stent implantation. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608485 Thu, 10 Nov 2011 05:00:00 +0100 5608485 http://www.medworm.com/index.php?rid=5608484&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029456%2Fabstract%3Frss%3Dyes In conclusion, the patient ultimately underwent cardiac transplantation. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608484 Thu, 10 Nov 2011 05:00:00 +0100 5608484 http://www.medworm.com/index.php?rid=5608482&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102947X%2Fabstract%3Frss%3Dyes In conclusion, we provide preliminary evidence for a strong detrimental association between high serum catalytic iron and CVD even after adjusting for several co-morbid conditions; however, broader prospective studies are needed to confirm these findings, which would support therapeutic trials to assess the beneficial effects of iron chelators on CVD. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608482 Thu, 10 Nov 2011 05:00:00 +0100 5608482 http://www.medworm.com/index.php?rid=5608480&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029493%2Fabstract%3Frss%3Dyes In conclusion, isolated right-sided mechanical alternans is not an uncommon event in patients with PAH. The existence of alternans is associated with the severity of PAH and right ventricular dysfunction and implies a poor prognosis in the short term. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608480 Thu, 10 Nov 2011 05:00:00 +0100 5608480 http://www.medworm.com/index.php?rid=5608468&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102933X%2Fabstract%3Frss%3Dyes We examined the associations between vitamin D deficiency, vitamin D supplementation, and patient outcomes in a large cohort. Serum vitamin D measurements for 5 years and 8 months from a large academic institution were matched to patient demographic, physiologic, and disease variables. The vitamin D levels were analyzed as a continuous variable and as normal (≥30 ng/ml) or deficient ( (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608468 Thu, 10 Nov 2011 05:00:00 +0100 5608468 http://www.medworm.com/index.php?rid=5608467&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029341%2Fabstract%3Frss%3Dyes The left main coronary artery (LMCA) is a particularly important target of atherosclerotic plaque accumulation. The aim of this study was to investigate the connection between subclinical plaque burden in the LMCA measured by intravascular ultrasound and future cardiovascular events. Two hundred eighteen consecutive patients underwent percutaneous coronary intervention for the left anterior descending coronary artery or the left circumflex coronary artery under intravascular ultrasound guidance. Plaque burden in the LMCA was analyzed for these patients, and major adverse cardiac events were also evaluated. Data were analyzed by grouping the patients into tertiles according to plaque burden values; tertile 1, 45% area stenosis. During a 3-year follow-up period (average 16.1 months), 12% of ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608467 Thu, 10 Nov 2011 05:00:00 +0100 5608467 http://www.medworm.com/index.php?rid=5608460&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911029274%2Fabstract%3Frss%3Dyes Risk assessment is central to the management of acute coronary syndromes. Often, however, assessment is not complete until the troponin concentration is available. Using 2 multicenter prospective observational studies (Evaluation of Methods and Management of Acute Coronary Events [EMMACE] 2, test cohort, 1,843 patients; and EMMACE-1, validation cohort, 550 patients) of unselected patients with acute coronary syndromes, a point-of-admission risk stratification tool using frontal QRS-T angle derived from automated measurements and age for the prediction of 30-day and 2-year mortality was evaluated. Two-year mortality was lowest in patients with frontal QRS-T angles 104° (44.7% vs 14.8%, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5608460 Thu, 10 Nov 2011 05:00:00 +0100 5608460 http://www.medworm.com/index.php?rid=5386119&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911028797%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5386119 Thu, 10 Nov 2011 00:17:59 +0100 5386119 http://www.medworm.com/index.php?rid=5386118&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911028785%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5386118 Thu, 10 Nov 2011 00:17:59 +0100 5386118 http://www.medworm.com/index.php?rid=5386117&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025379%2Fabstract%3Frss%3Dyes We read the interesting report by Szwast et al in a recent issue of The American Journal of Cardiology. The investigators analyzed the predictors of survival after biventricular repair in patients with right-dominant unbalanced atrioventricular canal. Regarding the presence of genetic syndromes among 45 patients analyzed in the study, only 6 (13.3%) had trisomy 21, and all underwent successful biventricular repair. These data confirm previous observations on the prevalence of left ventricular hypoplasia in children with non–Down syndrome atrioventricular canal and the general good surgical prognosis in children with atrioventricular canal and Down syndrome. Moreover, Szwast et al showed that the more severe left ventricular hypoplasia was associated with other types of genetic syndrome d... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5386117 Thu, 10 Nov 2011 00:17:58 +0100 5386117 http://www.medworm.com/index.php?rid=5386116&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026919%2Fabstract%3Frss%3Dyes When I became editor of The American Journal of Cardiology in June 1982, I thought that it might be useful for the readers and authors to have some idea of the thoughts of the new editor. The result was the initiation of the “From the Editor” columns beginning in July 1982. During the first 1.5 years, the publisher placed these columns among the advertising pages with an “A” page number, which excluded them from indexing and binding. In 1984, these columns began appearing in the regular editorial pages of the journal. During the first 5 years, the columns appeared in each issue, and during that time, there were 15 issues a year. We now publish 24 issues a year, and the “From the Editor” columns appear about 5 times yearly. Through the years, some colleagues have suggested to me... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5386116 Thu, 10 Nov 2011 00:17:58 +0100 5386116 http://www.medworm.com/index.php?rid=5386106&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911022788%2Fabstract%3Frss%3Dyes Ascending aortic dilation commonly occurs in patients with bicuspid aortic valve (BAV). Statins have been shown to reduce the expression of matrix metalloproteinases and slow the progression of abdominal aortic aneurysms. The role of statins in slowing ascending aortic dilation in patients with BAV is unknown. We sought to compare the ascending aortic dimensions in patients with BAV stenosis treated with versus without a statin. From our catheterization laboratory database, all patients undergoing preoperative coronary angiography before aortic valve with or without ascending aorta replacement for bicuspid aortic stenosis (AS) from 2004 to 2007 were identified. The ascending aortic size was measured on their preoperative transesophageal echocardiogram. Data on statin use were obtained from... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5386106 Thu, 10 Nov 2011 00:17:56 +0100 5386106 http://www.medworm.com/index.php?rid=5386100&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911022685%2Fabstract%3Frss%3Dyes This CME activity is supported by an educational grant from Abbott Vascular, Abbott Park, Illinois. Dr. Friedewald has received honoraria from and is a speaker for Novartis, East Hanover, New Jersey. Dr. Boden has received honoraria from and is a speaker for CV Therapeutics, Palo Alto, California; Sanofi-Aventis, Bridgewater, New Jersey; and Abbott Laboratories, Abbott Park, Illinois. Dr. Stone is a member of the scientific advisory board of and has received honoraria from Abbott Vascular, Santa Clara, California; and Boston Scientific Corporation, Natick, Massachusetts. Dr. Stone is a consultant for The Medicines Company, Parsippany, New Jersey; AstraZeneca, Wilmington, Delaware; Bristol-Meyers Squibb, New York, New York; and Eli Lilly & Company, Indianapolis, Indiana. Dr. Yancy has no r... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5386100 Thu, 10 Nov 2011 00:17:55 +0100 5386100 http://www.medworm.com/index.php?rid=5597208&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027627%2Fabstract%3Frss%3Dyes We measured the serum levels of myoglobin, total creatine kinase (CK), and the CK myocardial (CK-MB), muscle (CK-MM), and brain (CK-BB) isoenzymes in 37 subjects treated with statins and 43 nonstatin-treated controls running the 2011 Boston Marathon. Venous blood samples were obtained the day before (PRE) and within 1 hour (FINISH) and 24 hours after (POST) the race. The hematocrit and hemoglobin values were used to adjust for changes in the plasma volume. The CK distribution was normalized using log transformation before analysis. The exercise-related increase in CK 24 hours after exercise, adjusted for changes in plasma volume, was greater in the statin users (PRE to POST 133 ± 15 to 1,104 ± 150 U/L) than in the controls (PRE to POST 125 ± 12 to 813 ± 137 U/L; p = 0.03 for comparison... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597208 Mon, 31 Oct 2011 04:00:00 +0100 5597208 http://www.medworm.com/index.php?rid=5597207&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027603%2Fabstract%3Frss%3Dyes Isolated left ventricular noncompaction is a rare form of primary cardiomyopathy. Although increasingly diagnosed, data on the outcomes are limited. To define the predictors of adverse outcomes, we performed a retrospective analysis of a prospectively defined cohort of consecutive patients (age >14 years) diagnosed with left ventricular noncompaction at a single center. The baseline characteristics included presentation with a cardiovascular complication (i.e., decompensated heart failure, systemic embolic event, or sustained ventricular arrhythmia). The primary end point was survival free from cardiovascular death or transplantation. The predictors of survival were evaluated using the Kaplan-Meier method and Cox proportional hazards analysis. A total of 115 patients were included, 77% of ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597207 Mon, 31 Oct 2011 04:00:00 +0100 5597207 http://www.medworm.com/index.php?rid=5597206&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027615%2Fabstract%3Frss%3Dyes In conclusion, immunohistochemical analysis for plakoglobin, applied as a diagnostic test for ARVC, seems associated with a relatively high sensitivity, but limited specificity, and although additional validation is required, we advocate caution in basing clinical decision-making on the proposed diagnostic test. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597206 Mon, 31 Oct 2011 04:00:00 +0100 5597206 http://www.medworm.com/index.php?rid=5597210&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027585%2Fabstract%3Frss%3Dyes Atrial fibrillation (AF) is the most common arrhythmia in the athletic community and is more frequently observed in middle-aged than in young athletes. Recent studies have shown that the prevalence of AF is higher in individuals who are involved in intense short-term training and long-term sports participation compared to general population of the same age although clear evidence about the causal relation between these conditions is lacking. Anatomic adaptation, chronic systemic inflammation, and alterations in the autonomic system are all possible explanations for the increased prevalence of AF in athletes. AF associated with sports is usually paroxysmal with occasional crisis. Treatment of AF in this population can be challenging because of a lack of randomized trials and clear guideline... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597210 Mon, 24 Oct 2011 04:00:00 +0100 5597210 http://www.medworm.com/index.php?rid=5597205&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027548%2Fabstract%3Frss%3Dyes In conclusion, various types of mitral dysfunction severe enough to warrant mitral valve replacement occur in patients with bicuspid aortic valves. A proper search for mitral valve dysfunction in patients with bicuspid aortic valves appears warranted. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597205 Mon, 24 Oct 2011 04:00:00 +0100 5597205 http://www.medworm.com/index.php?rid=5597191&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027469%2Fabstract%3Frss%3Dyes This study compared strain values from 2-dimensional (2D) and real-time 3-dimensional (3D) speckle tracking with hyperenhancement transmural extent by magnetic resonance imaging (MRI). The study included 18 control subjects (mean age 51 ± 10 years) and 25 patients (20 men, mean age 62 ± 16 years) with ischemic left ventricular (LV) dysfunction (mean LV ejection fraction 41 ± 9%) referred for viability assessment using MRI. Longitudinal, radial, and circumferential strain values were computed using 2D speckle tracking. From analysis of 3D speckle tracking, conventional strain markers (longitudinal, radial, and circumferential) and 2 new 3D strain indexes (area and 3D strains) were obtained from apical view 3D datasets. A hyperenhancement transmural extent segment (16-segment model) was d... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597191 Mon, 24 Oct 2011 04:00:00 +0100 5597191 http://www.medworm.com/index.php?rid=5597186&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027391%2Fabstract%3Frss%3Dyes In conclusion, in patients with angiographically significant CAD, (1) normal results on stress echocardiography conferred a benign prognosis (event rate 1.0%/year), and (2) stress echocardiographic results (no ischemia vs ischemia) added incremental prognostic value to coronary angiographic results, and (3) stress echocardiography and coronary angiography together provided additive prognostic value, with the highest global chi-square value. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597186 Mon, 24 Oct 2011 04:00:00 +0100 5597186 http://www.medworm.com/index.php?rid=5597209&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027597%2Fabstract%3Frss%3Dyes In conclusion, the data show a correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, high-density lipoprotein increase, change in low-density lipoprotein particle size, increase in tissue plasminogen activator activity, and decrease in coronary artery calcium. Further research is needed to elucidate the effect of physical activity on inflammatory markers and intima-media thickness. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597209 Thu, 20 Oct 2011 04:00:00 +0100 5597209 http://www.medworm.com/index.php?rid=5597197&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027494%2Fabstract%3Frss%3Dyes Several studies have shown that postoperative atrial fibrillation (POAF) is associated with poorer short- and long-term outcomes after isolated coronary artery bypass grafting surgery. Nevertheless, there is considerable debate as to whether this reflects an independent association of POAF with poorer outcomes or confounding by other factors. We sought to investigate this issue. Data obtained from June 2001 through December 2009 by the Australasian Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database Program were retrospectively analyzed. Demographic and operative data were compared between patients who developed POAF and those who did not using chi-square and t tests. The independent impact of POAF on 14 short-term complications and long-term mortality was determined... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597197 Thu, 20 Oct 2011 04:00:00 +0100 5597197 http://www.medworm.com/index.php?rid=5597189&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102741X%2Fabstract%3Frss%3Dyes Several studies have demonstrated the correlation of heart rate (HR) and image quality in coronary computed tomography angiography. Beta-blocker administration is critical because of its negative inotropic effect. Ivabradine is a selective HR-lowering agent that exclusively inhibits the If current in sinoatrial node cells without having any effect on cardiac contractility or atrioventricular conduction. A total of 120 patients were randomized to oral premedication with ivabradine 15 mg or metoprolol 50 mg. HR and blood pressure (BP) were measured before the administration of premedication and immediately before coronary computed tomographic angiography. The mean time between premedication administration and follow-up was 108 ± 21.5 minutes for ivabradine and 110 ± 22.2 minutes for metopr... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597189 Thu, 20 Oct 2011 04:00:00 +0100 5597189 http://www.medworm.com/index.php?rid=5597187&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027408%2Fabstract%3Frss%3Dyes In conclusion, a combination of cardiac medications at the time of ACS discharge is strongly associated with 2-year survival in men and women, suggesting that discharge is an important time to prescribe secondary preventative medications. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597187 Thu, 20 Oct 2011 04:00:00 +0100 5597187 http://www.medworm.com/index.php?rid=5597185&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027378%2Fabstract%3Frss%3Dyes Although moderate alcohol drinkers have lower rates of incident coronary artery disease than abstainers, much less is known about the health effects of different patterns of alcohol use in women with established coronary artery disease. In the Determinants of Myocardial Infarction Onset Study, 1,253 women hospitalized for acute myocardial infarction (MI) at 64 centers nationwide from 1989 to 1996 were followed for mortality through December 31, 2007. Of the women, 761 (61%) reported abstention in the year before their MIs, 280 (22%) reported consumption of (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597185 Thu, 20 Oct 2011 04:00:00 +0100 5597185 http://www.medworm.com/index.php?rid=5323859&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027706%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5323859 Tue, 18 Oct 2011 01:45:35 +0100 5323859 http://www.medworm.com/index.php?rid=5323858&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102769X%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5323858 Tue, 18 Oct 2011 01:45:35 +0100 5323858 http://www.medworm.com/index.php?rid=5323857&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026154%2Fabstract%3Frss%3Dyes Recently, I examined a beautifully excised severely stenotic congenitally bicuspid aortic valve in a 64-year-old man who, at the same operation, had undergone excision of the ascending aorta, which, by preoperative imaging studies, had a maximal diameter of 4.3 cm. Histologically, the wall of the aorta was normal. Although the aortic valve replacement (AVR) was clearly appropriate, was excision of the ascending aorta justified on a prophylactic basis? I would argue that the latter should be reconsidered. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5323857 Tue, 18 Oct 2011 01:45:35 +0100 5323857 http://www.medworm.com/index.php?rid=5323845&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911022363%2Fabstract%3Frss%3Dyes The aims of the present study were to estimate the prevalence of heart failure (HF) with preserved ejection fraction (HF-PEF) in patients with HF and to compare their clinical characteristics with those with reduced ejection fraction in non-Western countries. The left ventricular ejection fraction ≥45% if measured (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5323845 Tue, 18 Oct 2011 01:45:35 +0100 5323845 http://www.medworm.com/index.php?rid=5323838&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911022314%2Fabstract%3Frss%3Dyes In conclusion, compared to IV administration IC administration of GPIs has favorable effects on Thrombolysis In Myocardial Infarction flow, target vessel revascularization, and short-term mortality after PCI, with no difference in rates of bleeding. Data regarding mid-/long-term outcomes were limited and inconclusive. Large RCTs with longer follow-up are required to determine long-term safety and efficacy. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5323838 Tue, 18 Oct 2011 01:45:35 +0100 5323838 http://www.medworm.com/index.php?rid=5597204&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102755X%2Fabstract%3Frss%3Dyes Bioprosthetic valve replacement is the treatment of choice in older patients with symptomatic severe aortic valve disease. Thrombosis of bioprosthetic valves has been considered a rare complication; however, in the presence of valvular obstruction, therapeutic consequences for the individual patient may be dramatic including repeat valve replacement or thrombolysis. We therefore evaluated oral anticoagulation with phenprocoumon as an alternative treatment for obstructive thrombosis of bioprosthetic valves. Six of 470 patients who had received a single stented bioprosthetic aortic valve from January 2007 through December 2008 at our hospital presented with obstructive bioprosthetic valve thrombosis within 14 months postoperatively. All 6 patients (1% of study population) had received a porc... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597204 Mon, 17 Oct 2011 04:00:00 +0100 5597204 http://www.medworm.com/index.php?rid=5597199&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027512%2Fabstract%3Frss%3Dyes In conclusion, SVT is responsible for a significant number of inappropriate ICD therapies. RFA is an effective strategy to substantially decrease subsequent inappropriate ICD therapies. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597199 Mon, 17 Oct 2011 04:00:00 +0100 5597199 http://www.medworm.com/index.php?rid=5597194&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027433%2Fabstract%3Frss%3Dyes In conclusion, our randomized trial showed that preprocedural intracoronary administration of a single high-dose bolus of adenosine does not provide any benefit in terms of periprocedural myonecrosis in patients undergoing elective PCI. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597194 Mon, 17 Oct 2011 04:00:00 +0100 5597194 http://www.medworm.com/index.php?rid=5597193&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027445%2Fabstract%3Frss%3Dyes Limited data exist regarding drug-eluting stent (DES) versus bare metal stent (BMS) use in older patients. From the National Heart, Lung, and Blood Institute Dynamic Registry, 5,089 percutaneous coronary intervention (PCI)-treated patients were studied (October 2001 to August 2006). The differences in 1-year safety (death, myocardial infarction, and their composite) and efficacy (target vessel revascularization [TVR] with PCI and repeat revascularization) outcomes were compared between the patients who received DESs versus BMSs within each age group: (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597193 Mon, 17 Oct 2011 04:00:00 +0100 5597193 http://www.medworm.com/index.php?rid=5597188&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102738X%2Fabstract%3Frss%3Dyes In conclusion, CCTA after equivocal or mild or moderate abnormal MPI findings results in significant cost savings and a robust reduction in the need for cardiac catheterization and excludes obstructive coronary artery disease in almost 75% of patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597188 Mon, 17 Oct 2011 04:00:00 +0100 5597188 http://www.medworm.com/index.php?rid=5597203&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027561%2Fabstract%3Frss%3Dyes Increased parathyroid hormone (PTH) level is associated with all-cause mortality in patients with heart failure (HF). However its role for identifying advanced HF has not been previously studied. We aimed to investigate whether the assessment of serum PTH could enable clinicians to identify patients with advanced HF. One hundred fifty consecutive patients who visited our outpatient clinic with systolic HF were enrolled in the present study. Serum levels of PTH and brain natriuretic peptide (BNP) were measured across all New York Heart Association functional classes. Mean levels of PTH were 43 ± 19, 84 ± 56, 121 ± 47, and 161 ± 60 pg/ml in New York Heart Association functional classes I, II, III, and IV, respectively (p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597203 Fri, 14 Oct 2011 04:00:00 +0100 5597203 http://www.medworm.com/index.php?rid=5597201&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027536%2Fabstract%3Frss%3Dyes Current data suggest that increases in hemoglobin may decrease nitric oxide and adversely affect vascular function. In the preclinical setting, these changes could precipitate the development of heart failure (HF). We hypothesized that higher hematocrit (HCT) would be associated with an increased incidence of new-onset HF in the community. We evaluated 3,523 participants (59% women) from the Framingham Heart Study who were 50 to 65 years old and free of HF. Participants were followed prospectively until an HF event, death, or the end of 20 years of follow up. HCT was subdivided into 4 gender-specific categories (women: HCT 36.0 to 40.0, 40.1 to 42.0, 42.1 to 45.0, >45.0; men: 39.0 to 44.0, 44.1 to 45.0, 45.1 to 49.0, >49.0). Gender-pooled multivariable Cox proportional hazards models were ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597201 Fri, 14 Oct 2011 04:00:00 +0100 5597201 http://www.medworm.com/index.php?rid=5597200&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027524%2Fabstract%3Frss%3Dyes In conclusion, with proper device sterilization and handling protocols, reuse of explanted PPMs in poor patients in developing countries is safe and effective. Implantation of donated PPMs can not only save lives but also improve quality of life of needy poor patients. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597200 Fri, 14 Oct 2011 04:00:00 +0100 5597200 http://www.medworm.com/index.php?rid=5597198&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027482%2Fabstract%3Frss%3Dyes In conclusion, from this cohort of asymptomatic adults, independent of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between 25(OH)D at levels (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597198 Fri, 14 Oct 2011 04:00:00 +0100 5597198 http://www.medworm.com/index.php?rid=5597196&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027500%2Fabstract%3Frss%3Dyes In conclusion, in clinical practice, major and minor bleeding event rates associated with prasugrel therapy are comparable to those reported in controlled randomized trials. The minimal bleeding event rate is higher than reported but does not seem to affect adherence to treatment. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597196 Fri, 14 Oct 2011 04:00:00 +0100 5597196 http://www.medworm.com/index.php?rid=5597195&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027421%2Fabstract%3Frss%3Dyes In conclusion, the presence of CTO in a non-IRA in patients with ST-segment elevation myocardial infarction and multivessel coronary disease is a strong and independent risk factor for greater 5-year mortality. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597195 Fri, 14 Oct 2011 04:00:00 +0100 5597195 http://www.medworm.com/index.php?rid=5597190&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911027470%2Fabstract%3Frss%3Dyes The current exercise tolerance test (ETT) criteria predominantly assess changes in ST-segment deviation (i.e., a systolic component of the cardiac cycle). Because diastolic dysfunction precedes that of systolic dysfunction during myocardial ischemia and most coronary flow is diastolic, the addition of electrocardiographic markers of diastolic time might improve the ETT sensitivity and specificity for detecting significant coronary artery disease. Among consecutive patients who had an ETT and subsequently underwent coronary angiography, we evaluated the diastolic time by assessing the TP and TQ segments and TP/RR and TQ/RR ratios in each ETT stage. Coronary artery disease was defined angiographically as significant (≥70% lumen occlusion), intermediate (>50% but (Source: The American Journ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5597190 Fri, 14 Oct 2011 04:00:00 +0100 5597190 http://www.medworm.com/index.php?rid=5504628&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025525%2Fabstract%3Frss%3Dyes We examined the association of insulin resistance with incident AF using multivariate Cox proportional hazards regression analysis adjusting for the established AF risk factors (i.e., age, gender, systolic blood pressure, hypertension treatment, PR interval, significant heart murmur, heart failure, and body mass index). Of the 3,023 eligible participants (55% women; mean age 59 years) representing 4,583 person-examinations (Framingham Offspring fifth and seventh examination cycles), 279 participants developed AF (9.3%) within ≤10 years of follow-up. With multivariate modeling, insulin resistance was not significantly associated with incident AF (hazard ratio comparing top quartile to other 3 quartiles of homeostatic model assessment index 1.18, 95% confidence interval 0.84 to 1.65, p = 0... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504628 Fri, 14 Oct 2011 04:00:00 +0100 5504628 http://www.medworm.com/index.php?rid=5457266&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS000291491102813X%2Fabstract%3Frss%3Dyes In conclusion, the findings in this study indicate a strong and significant adjusted association between BMI and 30-day and long-term mortality in patients having AVR for AS with or without concomitant coronary artery bypass grafting. Better survival was observed in patients with BMIs in the low 30s compared to patients with BMIs in the mid 20s and >40 kg/m2. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457266 Fri, 14 Oct 2011 04:00:00 +0100 5457266 http://www.medworm.com/index.php?rid=5304290&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026610%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304290 Wed, 12 Oct 2011 01:43:59 +0100 5304290 http://www.medworm.com/index.php?rid=5304289&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911026609%2Fabstract%3Frss%3Dyes (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304289 Wed, 12 Oct 2011 01:43:59 +0100 5304289 http://www.medworm.com/index.php?rid=5304288&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911024180%2Fabstract%3Frss%3Dyes We read with interest the report by Roberts et al regarding 3 explanted hearts that fulfilled anatomically the echocardiographic definition of left ventricular noncompaction/hypertrabeculation (LVHT). Photographs of 18 cases were reviewed, but only 7 were assessed as representing clear examples of LVHT. It was assumed that LVHT is overdiagnosed in the other cases, at least morphologically. We have several concerns and questions: What is the specificity of the anatomic definition of noncompacted portion of left ventricular free walls ≥2 times as thick as the compacted portions of these walls? Magnetic resonance imaging shows that areas of noncompaction are common in healthy volunteers, athletes, patients with hypertrophic or dilated cardiomyopathy, and patients with aortic stenosis. Addit... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304288 Wed, 12 Oct 2011 01:43:59 +0100 5304288 http://www.medworm.com/index.php?rid=5304287&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911024179%2Fabstract%3Frss%3Dyes We read with interest the recent report by Bartolucci et al relating to the use of aspirin for primary prevention of cardiovascular events and wish to submit the following comments relating to the primary prevention of myocardial infarction (MI). The investigators' report is a follow-up to a previous meta-analysis that was based on 6 trials. We have suggested that the original 6 trials had methodologic defects that argued against their inclusion in a single meta-analysis. The investigators contend that 3 recent trials in particular could enhance the possibility of “detecting moderate, but potentially meaningful, differences that individual trials cannot detect” with respect to the prevention of MI. However, meta-analysis “is only properly applicable if the data summarized are homogen... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304287 Wed, 12 Oct 2011 01:43:59 +0100 5304287 http://www.medworm.com/index.php?rid=5304286&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911024052%2Fabstract%3Frss%3Dyes Aerobic exercise capacity is 1 of the strongest predictors of outcomes in apparently healthy subjects as well as virtually all patient populations. A large amount of the data supporting this premise estimate aerobic capacity from treadmill time. Patients who undergo cardiac stress testing frequently undergo exercise tests using the Bruce treadmill protocol, with American College of Sports Medicine equations used to estimate the peak MET level achieved. We have recently demonstrated that this practice is flawed, leading to a significant overestimation of peak METs in most patients with suspected myocardial ischemia who undergo cardiac stress tests. We posited that a significant contributor to this discrepancy was that subjects were allowed to use handrail support during testing, which is co... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304286 Wed, 12 Oct 2011 01:43:59 +0100 5304286 http://www.medworm.com/index.php?rid=5304285&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911023113%2Fabstract%3Frss%3Dyes Meta-analyses consistently demonstrate that the magnitude of risk prediction associated with high-sensitivity C-reactive protein (CRP) is similar to if not greater than that of cholesterol and blood pressure. I leave it up to individual physicians to decide whether a novel risk marker with an effect as large as that of these established risk markers is “major” or not. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304285 Wed, 12 Oct 2011 01:43:59 +0100 5304285 http://www.medworm.com/index.php?rid=5304284&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911023101%2Fabstract%3Frss%3Dyes The remarks of Paul Ridker, MD, in the recent “Editor's Roundtable” require comment. Ridker declares high-sensitivity C-reactive protein (hsCRP) to be a major risk factor for atherothrombotic disease (ATD). Dr. Ridker is in error in this statement. If hsCRP were a major ATD risk factor, then subjects with the highest levels of hsCRP should have the highest risk for ATD, and as Ridker himself has pointed out, natives of sub-Saharan Africa frequently have malaria, and those who do have malaria have extremely high levels of hsCRP but do not have ATD events to any significant degree. This finding is consistent with Dr. Roberts's observation that patients with rheumatoid arthritis and systemic lupus erythematosus have only a slight increase in atherosclerotic plaque. Moreover, it is common ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304284 Wed, 12 Oct 2011 01:43:59 +0100 5304284 http://www.medworm.com/index.php?rid=5304271&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911020005%2Fabstract%3Frss%3Dyes We examined the HDL cholesterol change continuously and by 3 categories: HDL cholesterol increased ≥6.5 mg/dl, decreased ≥6.5 mg/dl, or remained within ±6.4 mg/dl. The Cox regression models were adjusted for the baseline HDL cholesterol and demographic and clinical risk factors. During a mean follow-up of 55.8 ± 23.8 months, 3,023 patients (10.1%) experienced a CVD hospitalization. After multivariate adjustment, each 5 mg/dl of baseline HDL cholesterol was significantly associated with a 6% lower CVD hospitalization risk (hazard ratio 0.94 per 5 mg/dl, 95% confidence interval 0.92 to 0.95, p (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5304271 Wed, 12 Oct 2011 01:43:59 +0100 5304271 http://www.medworm.com/index.php?rid=5504614&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025410%2Fabstract%3Frss%3Dyes In conclusion, although statin use is good, IST use after ACS is suboptimal. Additionally, newly initiated IST demonstrates poor persistence after discharge. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504614 Mon, 10 Oct 2011 04:00:00 +0100 5504614 http://www.medworm.com/index.php?rid=5504617&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025380%2Fabstract%3Frss%3Dyes Patients with end-stage renal disease commonly develop acute coronary syndromes (ACS). Little is known about the natural history of ACS in patients receiving dialysis. We evaluated the presentation, management, and outcomes of patients with ACS who were receiving dialysis before presentation for an ACS and were enrolled in the Global Registry of Acute Coronary Events (GRACE) at 123 hospitals in 14 countries from 1999 to 2007. Of 55,189 patients, 579 were required dialysis at presentation. Non–ST-segment elevation myocardial infarction was the most common ACS presentation in patients receiving dialysis, occurring in 50% (290 of 579) of patients versus 33% (17,955 of 54,610) of those not receiving dialysis. Patients receiving dialysis had greater in-hospital mortality rates (12% vs 4.8%; p... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504617 Wed, 05 Oct 2011 04:00:00 +0100 5504617 http://www.medworm.com/index.php?rid=5504637&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025616%2Fabstract%3Frss%3Dyes In conclusion, the risk of rehospitalization/death was significantly greater among cardiac patients with caregivers and was not fully explained by the presence of traditional co-morbidities. Systematic determination of having a caregiver might be a simple method to identify patients at a heightened risk of poor clinical outcomes. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504637 Mon, 03 Oct 2011 04:00:00 +0100 5504637 http://www.medworm.com/index.php?rid=5504633&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025598%2Fabstract%3Frss%3Dyes Fragmented QRS (fQRS) on 12-lead electrocardiography reflects conduction delay caused by myocardial fibrosis and dysfunction. Ventricular fibrosis detected by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is reportedly correlated with worse clinical outcomes in adults with repaired tetralogy of Fallot (TOF). The aim of this study was to assess whether the presence of fQRS is associated with right ventricular (RV) fibrosis or dysfunction in this patient group. In 37 consecutive patients (median age 30 years, median age at repair 6.6 years), the number of leads showing fQRS, defined as the presence of >2 notches on the R/S wave in ≥2 contiguous leads, was counted. RV systolic function, dilatation, and LGE score were measured using LGE CMR. Ventricular LGE was observed ... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504633 Mon, 03 Oct 2011 04:00:00 +0100 5504633 http://www.medworm.com/index.php?rid=5504630&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025549%2Fabstract%3Frss%3Dyes In conclusion, high levels of hs-CRP constitute an independent marker for the risk of mortality in patients with atrial fibrillation. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504630 Mon, 03 Oct 2011 04:00:00 +0100 5504630 http://www.medworm.com/index.php?rid=5504626&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025513%2Fabstract%3Frss%3Dyes Vascular complications (VCs) occur in 3% to 8% of percutaneous coronary interventions (PCIs). However, only a portion of patients who experience VCs bleed significantly. The aim of this study was to assess the covariates associated with the amount of blood loss in patients experiencing postprocedural VCs as well as the effect of the degree of blood loss on long-term mortality. Overall, 7,718 unselected patients who underwent PCI through femoral access were evaluated. Those experiencing VCs were identified and stratified with regard to the degree of hematocrit (HCT) decrease after the procedure. In total, 444 patients (5.8%) had VCs. Compared to those without VCs, patients with VCs were older and had more extensive co-morbidities. Severe blood loss was most frequent in those who had vascula... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504626 Mon, 03 Oct 2011 04:00:00 +0100 5504626 http://www.medworm.com/index.php?rid=5504624&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025495%2Fabstract%3Frss%3Dyes In conclusion, patients undergoing coronary artery stenting could have LCP extending beyond the intended treatment margins as defined using QCA alone. This could have implications for stent length selection and optimal lesion coverage. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504624 Mon, 03 Oct 2011 04:00:00 +0100 5504624 http://www.medworm.com/index.php?rid=5504622&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025422%2Fabstract%3Frss%3Dyes In conclusion, compared to PCI patients dying in the index admission, patients who died (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504622 Mon, 03 Oct 2011 04:00:00 +0100 5504622 http://www.medworm.com/index.php?rid=5504619&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025434%2Fabstract%3Frss%3Dyes Patients with first acute myocardial infarction (AMI) constitute a demographic that is exposed to significant amounts of low-dose ionizing radiation (LDIR) over a short period. The aim of this study was to describe cardiac LDIR exposure trends among patients with first AMI over a recent approximately 10-year period. Administrative databases were used to identify a cohort of 106,803 patients who had first AMIs in Quebec, Canada, from 1996 to 2004. These patients were followed through 2007, and the use over time of cardiac imaging procedures associated with LDIR was documented using a cumulative exposure variable. Exposure was documented in 2 periods: the acute phase ( (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504619 Mon, 03 Oct 2011 04:00:00 +0100 5504619 http://www.medworm.com/index.php?rid=5504636&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025628%2Fabstract%3Frss%3Dyes Red cell distribution width (RDW) is strongly associated with prognosis in cardiopulmonary disorders such as coronary artery disease, acute myocardial infarction, acute and chronic heart failure, and pulmonary hypertension. However, its prognostic significance in acute pulmonary embolism (PE) is unknown. The aim of this study was to investigate the relation between admission RDW and early mortality in patients with acute PE. One hundred sixty-five patients with confirmed acute PE were included. Patients with previous treatment for anemia, malignancy, or chronic liver disease, those with dialysis treatment for chronic renal failure, and those who received erythrocyte suspension for any reason were excluded. A total of 136 consecutive patients with acute PE were evaluated prospectively. Acco... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504636 Wed, 28 Sep 2011 04:00:00 +0100 5504636 http://www.medworm.com/index.php?rid=5504620&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025458%2Fabstract%3Frss%3Dyes Clinically stable patients with type 2 diabetes mellitus and coronary artery disease are not often thought to present with the symptom of typical angina. The aims of this study were to enumerate the proportion of patients presenting with typical angina or other cardiac symptoms and to elucidate what important clinical variables are associated with the presence of typical angina in patients with type 2 diabetes mellitus and angiographically documented coronary artery disease. Symptoms of angina, anginal equivalents, or an absence of symptoms were obtained using baseline data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial (n = 2,319). A bivariate analysis stratified by the presence or absence of previous revascularization and logistic regression modeli... The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504620 Wed, 28 Sep 2011 04:00:00 +0100 5504620 http://www.medworm.com/index.php?rid=5457269&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911024301%2Fabstract%3Frss%3Dyes In conclusion, the recognition that the onset of LV hypertrophy in HC can be delayed well into adulthood (and even to advanced age) has important implications regarding the clinical screening practices for families, and suggests the potential value of extending prospective serial imaging beyond adolescence in some relatives. Electrocardiographic repolarization abnormalities can predict the future development of apical LV hypertrophy in adults with HC. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5457269 Wed, 28 Sep 2011 04:00:00 +0100 5457269 http://www.medworm.com/index.php?rid=5504638&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025604%2Fabstract%3Frss%3Dyes In conclusion, these results demonstrate reductions in cardiac vagal modulation, as measured by multiple daytime time-domain markers of HRV, in patients with asymptomatic OSA compared to controls. Further prospective outcomes-based studies are needed to evaluate the applicability of these metrics for noninvasive screening of obese patients with asymptomatic OSA, before the onset of overt cardiovascular disease. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504638 Mon, 26 Sep 2011 04:00:00 +0100 5504638 http://www.medworm.com/index.php?rid=5504635&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025562%2Fabstract%3Frss%3Dyes In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). The use of angiotensin-converting enzyme inhibitors did not show association with mortality. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504635 Mon, 26 Sep 2011 04:00:00 +0100 5504635 http://www.medworm.com/index.php?rid=5504634&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025574%2Fabstract%3Frss%3Dyes In conclusion, the z scores of the TAPSV values were calculated, and percentile charts were established to serve as reference data for patients with congenital heart disease. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504634 Mon, 26 Sep 2011 04:00:00 +0100 5504634 http://www.medworm.com/index.php?rid=5504632&cid=s_34383_7_f&fid=34383&url=http%3A%2F%2Fwww.ajconline.org%2Farticle%2FPIIS0002914911025537%2Fabstract%3Frss%3Dyes In conclusion, in this large population-based cohort, the presence of VPCs was associated with incident HF, independent of incident coronary heart disease. (Source: The American Journal of Cardiology) The American Journal of Cardiology journals http://www.medworm.com/rss/comments.php?id=5504632 Mon, 26 Sep 2011 04:00:00 +0100 5504632