Journal of the American College of Cardiology
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Inside This Issue
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1993 Joseph D. Mishkin, Sherry J. Saxonhouse, Gregory W. Woo, Thomas A. Burkart, William M. Miles, Jamie B. Conti, Richard S. Schofield, Samuel F. Sears, Juan M. Aranda, Jr (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Tags: Frontmatter Source Type: journals
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac SurgeryEmail this article to a colleague.
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Kirsten E. Fleischmann, MD, MPH, FACC, Chair Joshua A. Beckman, MD, FACC (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Lee A. Fleisher, Joshua A. Beckman, Kenneth A. Brown, Hugh Calkins, Elliot L. Chaikof, Kirsten E. Fleischmann, William K. Freeman, James B. Froehlich, Edward K. Kasper, Judy R. Kersten, Barbara Riegel, John F. Robb, American College of Cardiology Foundati Tags: ACCF/AHA PRACTICE GUIDELINES: FULL TEXT Source Type: journals
2009 ACCF/AHA Focused Update on Perioperative Beta BlockadeEmail this article to a colleague.
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Lee A. Fleisher, MD, FACC, FAHA, Chair Joshua A. Beckman, MD, FACC (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Kirsten E. Fleischmann, Joshua A. Beckman, Christopher E. Buller, Hugh Calkins, Lee A. Fleisher, William K. Freeman, James B. Froehlich, Edward K. Kasper, Judy R. Kersten, John F. Robb, R. James Valentine, American College of Cardiology Foundation, Americ Tags: ACCF/AHA PRACTICE GUIDELINES: FOCUSED UPDATE Source Type: journals
Coronary Artery Aneurysm Formation Within New-Generation Bare-Metal Stents: Not Just Due to Drug Elution!Email this article to a colleague.
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A 57-year-old woman with chronic stable angina underwent uncomplicated stenting in the left anterior descending artery (LAD) and right coronary artery (RCA) (A) with excellent results in the target vessel. Coronary angiogram repeated for atypical chest pain 6 months later demonstrated coronary artery aneurysm (CAA) (arrowheads) within the segments stented with a bare-metal stent (BMS) in both arteries (B), confirmed on intravascular ultrasound examination (C). Arrows show the extent of the aneurysm as seen on the intravascular ultrasound images. The RCA segment stented with the everolimus-eluting stent Xience (Abbott Labor...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Sudipta Chattopadhyay, Timothy Kinnaird, Richard A. Anderson Tags: IMAGES IN CARDIOLOGY Source Type: journals
Anemia in Adults With Congenital Heart Disease Relates to Adverse OutcomeEmail this article to a colleague.
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Objectives: To assess the relation of anemia in noncyanotic adults with congenital heart disease (ACHD) to functional capacity and mortality.Background: Anemia is common in acquired heart failure and affects prognosis. The presence of anemia and its relation to outcome in ACHD remain unknown.Methods: Data were collected on consecutive noncyanotic ACHD patients attending our tertiary center between 2001 and 2006 in whom hemoglobin concentration was measured. Anemia was defined as hemoglobin concentration (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Konstantinos Dimopoulos, Gerhard-Paul Diller, Georgios Giannakoulas, Ricardo Petraco, Aikaterini Chamaidi, Evaggelia Karaoli, Michael Mullen, Lorna Swan, Massimo F. Piepoli, Philip A. Poole-Wilson, Darrel P. Francis, Michael A. Gatzoulis Tags: CONGENITAL HEART DISEASE Source Type: journals
A Meta-Analysis of the Mechanism of Blood Pressure Change With AgingEmail this article to a colleague.
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Conclusions: These findings challenge the current consensus view that a shift in timing of wave reflection significantly contributes to the changes in the BP waveform with aging. We should re-evaluate the mechanisms of BP elevation in aging. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Arun J. Baksi, Thomas A. Treibel, Justin E. Davies, Nearchos Hadjiloizou, Rodney A. Foale, Kim H. Parker, Darrel P. Francis, Jamil Mayet, Alun D. Hughes Tags: HYPERTENSION Source Type: journals
Sleep Apnea and Atrial Fibrillation: The Autonomic Link⁎Email this article to a colleague.
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The intuitive and postulated links () between the established association of obstructive sleep apnea with atrial fibrillation (AF) are hypertension, diastolic dysfunction, and the resultant long-term atrial remodeling (). However, studies suggest that the relationship between sleep apnea and AF is independent of hypertension, cardiac function, or body mass index. Further, untreated sleep apnea doubles the risk of AF recurrence within 12 months of cardioversion independent of other risk factors (). Thus, is the relationship between sleep apnea and AF an epiphenomenon, or is it truly causative and the linking mechanism is si...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Samuel J. Asirvatham, Suraj Kapa Tags: Editorial Comment Source Type: journals
The Role of Ganglionated Plexi in Apnea-Related Atrial FibrillationEmail this article to a colleague.
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Conclusions: This experimental model of apnea shows a reproducible incidence of AF. After neural ablation of the RPA GP or autonomic blockade, AF inducibility was significantly inhibited. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Muhammad Ghias, Benjamin J. Scherlag, Zhibing Lu, Guodong Niu, Annerie Moers, Warren M. Jackman, Ralph Lazzara, Sunny S. Po Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
The RYR2-Encoded Ryanodine Receptor/Calcium Release Channel in Patients Diagnosed Previously With Either Catecholaminergic Polymorphic Ventricular Tachycardia or Genotype Negative, Exercise-Induced Long QT Syndrome: A Comprehensive Open Reading Frame Mutational AnalysisEmail this article to a colleague.
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This study was undertaken to determine the spectrum and prevalence of mutations in the RYR2-encoded cardiac ryanodine receptor in cases with exertional syncope and normal corrected QT interval (QTc).Background: Mutations in RYR2 cause type 1 catecholaminergic polymorphic ventricular tachycardia (CPVT1), a cardiac channelopathy with increased propensity for lethal ventricular dysrhythmias. Most RYR2 mutational analyses target 3 canonical domains encoded by (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Argelia Medeiros-Domingo, Zahurul A. Bhuiyan, David J. Tester, Nynke Hofman, Hennie Bikker, J. Peter van Tintelen, Marcel M.A.M. Mannens, Arthur A.M. Wilde, Michael J. Ackerman Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
Genotype–Phenotype Relationship in the Long QT Syndrome: Brimming With Knowledge but Thirsting for a Therapeutic Solution⁎Email this article to a colleague.
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Since it was first reported 50 years ago, the long QT syndrome (LQTS) is now recognized as a genetic disease caused by mutations of ion channel genes encoding a cardiac channel essential for the control of ventricular repolarization (). The LQTS is not only the most common and extensively researched genetic cardiac arrhythmia (), it has also attracted premier scientists and scholars in single-cell electrophysiology and molecular genetics. In turn, they have produced seminal discoveries that shaped our understanding of the syndrome. The mutated genes in LQTS patients cause delayed repolarization and, in turn, prolong the QT...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Koonlawee Nademanee Tags: Editorial Comment Source Type: journals
Genotype-Phenotype Aspects of Type 2 Long QT SyndromeEmail this article to a colleague.
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Conclusions: The KCNH2 missense mutations located in the transmembrane S5-loop-S6 region are associated with the greatest risk. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Wataru Shimizu, Arthur J. Moss, Arthur A.M. Wilde, Jeffrey A. Towbin, Michael J. Ackerman, Craig T. January, David J. Tester, Wojciech Zareba, Jennifer L. Robinson, Ming Qi, G. Michael Vincent, Elizabeth S. Kaufman, Nynke Hofman, Takashi Noda, Shiro Kamak Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
Atrial Fibrillation After Major Thoracic Surgery: New Insights Into Underlying Mechanisms⁎Email this article to a colleague.
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Atrial fibrillation (AF) is a common complication in patients undergoing major thoracic surgery (). It is most frequently observed acutely after valve surgery and/or coronary artery bypass graft surgery (CABG), but it can also manifest after lung and heart transplantation procedures (). Although mechanisms underlying this unique form of AF have not been adequately elucidated, it is likely that these involve a combination of pericardial inflammation, myocardial ischemia, catecholamine surge, autonomic imbalance, interstitial fluid mobilization, tissue rejection, and so forth (). It is interesting to note that AF is observed...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Sanjay Dixit Tags: Editorial Comment Source Type: journals
A Comparison of Atrial Arrhythmias After Heart or Double-Lung Transplantation at a Single Center: Insights Into the Mechanism of Post-Operative Atrial FibrillationEmail this article to a colleague.
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Conclusions: In heart transplant recipients, AF is uncommon and occurs in the setting of myocardial dysfunction and graft rejection. In contrast, AF is more common after lung transplantation despite the absence of graft rejection and cardiac dysfunction. Pulmonary vein isolation alone cannot explain the discrepancy in AF incidence between heart transplant recipients and double-lung transplant recipients. Cardiac autonomic denervation may have a protective effect for heart transplant patients in the post-operative setting. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: José Dizon, Kimberly Chen, Matthew Bacchetta, Michael Argenziano, Donna Mancini, Angelo Biviano, Joshua Sonett, Hasan Garan Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
Transesophageal Echocardiography Before Atrial Fibrillation Ablation: Looking Before Cooking⁎Email this article to a colleague.
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In many electrophysiology laboratories, atrial fibrillation (AF) is becoming the most common heart rhythm disorder being treated with catheter ablation. Reasons for this include the large numbers of patients with AF, the poor quality of life commonly associated with AF, the limitations of drug therapy, advances in ablation tools and methods, and the increasing number of electrophysiologists trained in the technique. Catheter ablation is now recognized as a legitimate option for patients with symptomatic AF who have failed antiarrhythmic drug therapy (). (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Bradley P. Knight Tags: Editorial Comment Source Type: journals
Role of the CHADS2 Score in the Evaluation of Thromboembolic Risk in Patients With Atrial Fibrillation Undergoing Transesophageal Echocardiography Before Pulmonary Vein IsolationEmail this article to a colleague.
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Objectives: The goals of this study were to determine: 1) if low-risk patients assessed by a CHADS2 score, a clinical scoring system quantifying a risk of stroke in patients with atrial fibrillation (AF), require a routine screening transesophageal echocardiogram (TEE) before pulmonary vein isolation (PVI); and 2) the relationship of a CHADS2 score with left atrial (LA)/left atrial appendage (LAA) spontaneous echo contrast, sludge, and thrombus.Background: There is no clear consensus of whether a screening TEE before catheter ablation of AF should be performed in every patient.Methods: Initial TEEs for pre-PVI of 1,058 AF ...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Sarinya Puwanant, Brandon C. Varr, Kevin Shrestha, Sarah K. Hussain, W.H. Wilson Tang, Ruvin S. Gabriel, Oussama M. Wazni, Mandeep Bhargava, Walid I. Saliba, James D. Thomas, Bruce D. Lindsay, Allan L. Klein Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
Atrial Fibrillation at Baseline and During Follow-Up in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)Email this article to a colleague.
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Objectives: The ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) determined that treatment with amlodipine, lisinopril, or doxazosin was not superior to thiazide-like diuretic (chlorthalidone) in preventing coronary heart disease (CHD) or other cardiovascular events. This subanalysis examines baseline prevalence and in-trial incidence of new-onset atrial fibrillation (AF) or atrial flutter (AFL) and their influence on clinical outcomes.Background: Limited information is available on whether atrial fibrillation incidence is affected differentially by different classes of antihypertensive ...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: L. Julian Haywood, Charles E. Ford, Richard S. Crow, Barry R. Davis, Barry M. Massie, Paula T. Einhorn, Angela Williard, ALLHAT Collaborative Research Group Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
Transtelephonic Versus Remote Monitoring of Cardiovascular Implantable Electronic Devices: Is One Approach to Be Preferred?⁎Email this article to a colleague.
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Intracardiac pacemaker implantation was first described a half century ago; the same authors first reported on transtelephonic monitoring (TTM) of such devices a dozen years later (). Follow-up of the pacemaker patient was recognized as critical, particularly in view of the uncertain reliability associated with leads and generators. Tracking device longevity and function have remained an important problem (), compounded by the development of more widespread indications for pacemakers (), increasingly complex devices, and mounting advisories that attest to an ever-present threat of premature device failure (). Ironically, t...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Mark H. Schoenfeld Tags: Editorial Comment Source Type: journals
Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted PacemakersEmail this article to a colleague.
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Conclusions: The strategic use of remote pacemaker interrogation follow-up detects actionable events that are potentially important more quickly and more frequently than transtelephonic rhythm strip recordings. The use of transtelephonic rhythm strips for pacemaker follow-up is of little value except for battery status determinations. (PREFER [Pacemaker Remote Follow-up Evaluation and Review]; NCT00294645) (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: George H. Crossley, Jane Chen, Wassim Choucair, Todd J. Cohen, Douglas C. Gohn, W. Ben Johnson, Eleanor E. Kennedy, Luc R. Mongeon, Gerald A. Serwer, Hongyan Qiao, Bruce L. Wilkoff, PREFER Study Investigators Tags: QUARTERLY FOCUS ISSUE: HEART RHYTHM DISORDERS Source Type: journals
Women Have a Lower Prevalence of Structural Heart Disease as a Precursor to Sudden Cardiac Arrest: The Ore-SUDS (Oregon Sudden Unexpected Death Study)Email this article to a colleague.
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Conclusions: Women were significantly less likely than men to have a diagnosis of structural heart disease (LV dysfunction or coronary artery disease) before SCA. These findings suggest that fewer women may be eligible for prophylactic implantable cardioverter-defibrillator placement based on current guidelines and therefore may not have equal opportunity for prevention. Enhancement of SCA risk stratification may have even higher importance for women. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Sumeet S. Chugh, Audrey Uy-Evanado, Carmen Teodorescu, Kyndaron Reinier, Ronald Mariani, Karen Gunson, Jonathan Jui Tags: Clinical Research Source Type: journals
Implantable Cardioverter-Defibrillator Therapy After Acute Myocardial Infarction: The Results Are Not ShockingEmail this article to a colleague.
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The risk of sudden death is highest early after myocardial infarction (MI) and progressively declines over the ensuing 6 to 12 months. Nevertheless, several randomized clinical trials have failed to show a survival benefit for implantable cardioverter-defibrillators when implanted early after MI in high-risk patients. The etiology of this acute MI–sudden cardiac death paradox is unclear, but may be related to the changing nature of the substrate over the several month period after acute MI. Further investigation is needed to delineate the actual causes of death in the early post-MI period and which interventions can be i...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Jeffrey J. Goldberger, Rod Passman Tags: Viewpoint Source Type: journals
Appropriate Evaluation and Treatment of Heart Failure Patients After Implantable Cardioverter-Defibrillator Discharge: Time to Go Beyond the Initial ShockEmail this article to a colleague.
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Multiple clinical trials support the use of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure (HF). Unfortunately, several complicating issues have arisen from the universal use of ICDs in HF patients. An estimated 20% to 35% of HF patients who receive an ICD for primary prevention will experience an appropriate shock within 1 to 3 years of implant, and one-third of patients will experience an inappropriate shock. An ICD shock is associated with a 2- to 5-fold increase in mortality, with the most common cause being progressive HF. The median time from initi...
Source: Journal of the American College of Cardiology - November 19, 2009 Category: Cardiology Authors: Joseph D. Mishkin, Sherry J. Saxonhouse, Gregory W. Woo, Thomas A. Burkart, William M. Miles, Jamie B. Conti, Richard S. Schofield, Samuel F. Sears, Juan M. Aranda Tags: State-of-the-Art Paper Source Type: journals
Inside This IssueEmail this article to a colleague.
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1903 Carole A. Warnes (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Tags: Frontmatter Source Type: journals
What Do You Think About Health Care Reform?Email this article to a colleague.
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We were all seated around the table. Everyone had been brought up to date as to what was new with everyone else, the dinner orders had been taken, and bread and butter were being passed around. As the conversation turned to politics and current events, the dreaded question came: “Tony, you're a doctor, what do you think about this health care reform issue?” (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Anthony N. DeMaria Tags: EDITOR'S PAGE Source Type: journals
Aortopulmonary Artery DissectionEmail this article to a colleague.
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A 71-year-old man was brought to the hospital by ambulance and admitted because of intermittent back pain. Physical examination revealed continuous heart murmur. Chest X-ray showed cardiomegaly and pulmonary congestion. The patient received continuous hydration for renal dysfunction and severe metabolic acidosis (base excess of –16.5 mmol/l and pH of 7.24) and underwent enhanced chest computed tomography. The chest computed tomography showed not only ascending aortic dissection of Stanford type A but also pulmonary artery dissection with an aortopulmonary window (red arrow = aortopulmonary window, T = true lumen, F = fal...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Hideki Itoh, Takashi Yamamoto, Hiroyuki Sugihara, Takao Saotome, Yutaka Eguchi, Tohru Asai, Minoru Horie Tags: IMAGES IN CARDIOLOGY Source Type: journals
The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging: The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) StudyEmail this article to a colleague.
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Conclusions: In the general population, obesity appears to be the most important risk factor for LAE. Given the increasing prevalence of obesity, early interventions, especially in young obese individuals, are essential to prevent premature onset of cardiac remodeling at the atrial level. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Jan Stritzke, Marcello Ricardo Paulista Markus, Stefanie Duderstadt, Wolfgang Lieb, Andreas Luchner, Angela Döring, Ulrich Keil, Hans-Werner Hense, Heribert Schunkert, MONICA/KORA Investigators Tags: Cardiovascular Risk Source Type: journals
Long-Term Ambrisentan Therapy for the Treatment of Pulmonary Arterial HypertensionEmail this article to a colleague.
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Conclusions: Two years of ambrisentan treatment was associated with sustained improvements in exercise capacity and a low risk of clinical worsening and death in patients with PAH. Ambrisentan was generally well tolerated and had a low risk of aminotransferase abnormalities over the 2-year study period. (A Long Term Study of Ambrisentan in Pulmonary Arterial Hypertension Subjects Having Completed AMB-320 or AMB-321; NCT00578786) (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Ronald J. Oudiz, Nazzareno Galiè, Horst Olschewski, Fernando Torres, Adaani Frost, Hossein A. Ghofrani, David B. Badesch, Michael D. McGoon, Vallerie V. McLaughlin, Ellen B. Roecker, Brooke C. Harrison, Darrin Despain, Christopher Dufton, Lewis J. Rubin, Tags: Pulmonary Hypertension Source Type: journals
A New Look to an Old Measurement⁎Email this article to a colleague.
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Valvular heart diseases often require intervention. In industrialized countries, the reduced incidence of rheumatic valve disease and the prolonged life expectancy account for a progressive increase in the incidence of degenerative valve disease. Their management remains difficult, despite the production of guidelines prepared by organizations (). Because randomized clinical trials are particularly scarce in this setting, most recommendations are supported by only a Level of Evidence: C (consensus of opinion of experts established from small and retrospective studies). This can explain in part an inconsistent compliance wi...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Luc A. Pierard, Julien Magne Tags: Valvular Heart Disease: Editorial Comment Source Type: journals
Survival Implication of Left Ventricular End-Systolic Diameter in Mitral Regurgitation Due to Flail Leaflets: A Long-Term Follow-Up Multicenter StudyEmail this article to a colleague.
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Conclusions: In MR due to flail leaflets, LVESD ≥40 mm is independently associated with increased mortality under medical management but also after mitral surgery. These findings support prompt surgical rescue in patients with LVESD ≥40 mm but also suggest that best preservation of survival is achieved in patients operated before LVESD reaches 40 mm. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Christophe Tribouilloy, Francesco Grigioni, Jean François Avierinos, Andrea Barbieri, Dan Rusinaru, Catherine Szymanski, Marinella Ferlito, Laurence Tafanelli, Francesca Bursi, Faouzi Trojette, Angelo Branzi, Gilbert Habib, Maria G. Modena, Maurice Enriq Tags: Valvular Heart Disease Source Type: journals
Stent Gap by 64-Detector Computed Tomographic Angiography: Relationship to In-Stent Restenosis, Fracture, and Overlap FailureEmail this article to a colleague.
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Conclusions: Stent gap by CTA: 1) is associated with 28% of ISR, and ISR is found in 46% of stent gaps; 2) is associated with ≥3-mm stents by univariate (p = 0.002) but not by multivariate analysis; 3) is infrequently noted on catheter angiography; and 4) most likely represents SF in the setting of a single stent, and may represent SF or OF in overlapping stents. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Harvey S. Hecht, Sotir Polena, Vladimir Jelnin, Marcelo Jimenez, Tandeep Bhatti, Manish Parikh, Georgia Panagopoulos, Gary Roubin Tags: Cardiac Imaging and Stent Failure Source Type: journals
Women Are Like Men … Sometimes⁎Email this article to a colleague.
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The impact of sex on the pathophysiology, clinical manifestations, and treatment of cardiovascular disease has been a topic of considerable investigation (). The issue is an important one because more than 41.3 million women are living with cardiovascular disease. Although progress has been made in reducing the morbidity and mortality of heart disease in both women and men, since 1980 the decrease in mortality has been less for women, and disturbingly, mortality has increased in women younger than 55 years of age (). Overall cardiovascular disease remains the primary cause of death in women. (Source: Journal of the America...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: David P. Faxon Tags: Antithrombotic Therapy: Editorial Comment Source Type: journals
The Relative Efficacy and Safety of Clopidogrel in Women and Men: A Sex-Specific Collaborative Meta-AnalysisEmail this article to a colleague.
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Conclusions: Clopidogrel reduces the risk of cardiovascular events in both women and men. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Jeffrey S. Berger, Deepak L. Bhatt, Christopher P. Cannon, Zhengming Chen, Lixin Jiang, James B. Jones, Shamir R. Mehta, Marc S. Sabatine, Steven R. Steinhubl, Eric J. Topol, Peter B. Berger Tags: Antithrombotic Therapy Source Type: journals
Drug-Eluting Stent Fracture: Promise and Performance⁎Email this article to a colleague.
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All promise outruns performance.—Ralph Waldo Emerson () The saga of drug-eluting stents (DES) continues from their hyperbolic introduction into clinical practice in 2003 through a period of scrupulous clinical safety introspection, emerging as the principal device therapy for percutaneous coronary intervention with renewed enthusiasm in today's era of prolonged oral dual antiplatelet therapy. Clinicians, researchers, industry, and regulatory agencies have gained wisdom from the many lessons taught in the global introduction of DES into clinical practice. As clinicians and scientists, we benefit from an organized cogniti...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Andrew J. Carter Tags: Interventional Cardiology: Editorial Comment Source Type: journals
Incidence and Predictors of Drug-Eluting Stent Fracture in Human Coronary Artery: A Pathologic AnalysisEmail this article to a colleague.
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Conclusions: The incidence of stent fracture was 29% lesions at autopsy, which is much higher than clinically reported. A high rate of adverse pathologic findings was observed in lesions with grade V stent fracture, whereas fracture with grade I to IV did not have a significant impact on the pathological outcome. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Gaku Nakazawa, Aloke V. Finn, Marc Vorpahl, Elena Ladich, Robert Kutys, Isidora Balazs, Frank D. Kolodgie, Renu Virmani Tags: Interventional Cardiology Source Type: journals
The Adult After Kawasaki Disease: The Risks for Late Coronary EventsEmail this article to a colleague.
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Under what circumstances should a transient childhood illness be considered a lifelong potential cardiac risk factor? Do all patients who have had Kawasaki disease (KD) require special follow-up, intermittent cardiac testing, and preventive measures beyond the American Heart Association (AHA) recommendations for all Americans? If not, which patients are at significant risk for late coronary events to justify being placed in a high-risk category? These are the questions that must be answered to recommend a careful follow-up régime for those who are at risk and to reassure the others. The impact of carrying a lifetime diagn...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Welton M. Gersony Tags: Commentary Source Type: journals
When Children With Kawasaki Disease Grow Up: Myocardial and Vascular Complications in AdulthoodEmail this article to a colleague.
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Kawasaki disease (KD) is an acute, self-limited vasculitis that typically occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric age group in developed countries. The majority of patients with KD appear to have a benign prognosis, but a subset of patients with coronary artery aneurysms are at risk for ischemic events and require lifelong treatment. In the 4 decades that have passed since the initial recognition of KD, the number of patients reaching...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: John B. Gordon, Andrew M. Kahn, Jane C. Burns Tags: STATE-OF-THE-ART PAPERS Source Type: journals
Adult Congenital Heart Disease: Importance of the Right VentricleEmail this article to a colleague.
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The right ventricle (RV) is of lesser importance in acquired heart disease, but its role is of increasing importance in congenital heart disease. It may function as a subpulmonary ventricle or as a subaortic (systemic) ventricle in transposition complexes. The RV has a remarkable ability to adapt to pressure and volume load, but its size and function are often overlooked. Patients usually develop symptoms only after RV dysfunction has occurred, and in many diverse clinical scenarios, late referral is common. Advanced RV enlargement and dysfunction are responsible for not only impaired functional capacity but also lethal ve...
Source: Journal of the American College of Cardiology - November 12, 2009 Category: Cardiology Authors: Carole A. Warnes Tags: STATE-OF-THE-ART PAPERS Source Type: journals
Inside This IssueEmail this article to a colleague.
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1827 Franz H. Messerli, Gurusher S. Panjrath (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Tags: Frontmatter Source Type: journals
CorrectionEmail this article to a colleague.
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Meyers DG, Neuberger JS, He J. Cardiovascular Effect of Bans on Smoking in Public Places: A Systematic Review and Meta-Analysis. J Am Coll Cardiol 2009;54:1249–55. In this article, the meta-analysis included data from Pueblo, Colorado, which the authors erroneously reported as incidence rate ratio (IRR): 0.30. Actually, the IRR is 0.66 (95% confidence interval [CI]: 0.58 to 0.75). This changes the meta-analysis summary IRR to 0.92 (95% CI: 0.86 to 0.99). The meta-regression of the effect of ban duration also changes. The coefficient of post-ban duration in the meta-regression model is −0.16 (95% CI: −0.20 to −0.11...
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Tags: CORRECTIONS Source Type: journals
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Yang Q, Li K, Liu X, et al. Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0-T: A Comparative Study With X-Ray Angiography in a Single Center. J Am Coll Cardiol 2009;54:69–76. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Tags: CORRECTIONS Source Type: journals
The 5-Year Clinical Outcomes After a Randomized Comparison of Sirolimus-Eluting Versus Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial InfarctionEmail this article to a colleague.
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Because patients with acute ST-segment elevation myocardial infarction (STEMI) were excluded from early randomized trials, only relatively short-term data from large multicenter studies comparing drug-eluting stents (DES) with bare-metal stents (BMS) are currently available. Unambiguous ascertainment of long-term compliance with thienopyridines is problematic in STEMI, which is a matter of serious concern (), and one observational registry suggested higher late (>6 months) unadjusted and adjusted mortality rates in STEMI patients with a DES compared with those with a BMS (). Thus, the use of a DES in STEMI patients still r...
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Matteo Tebaldi, Chiara Arcozzi, Gianluca Campo, Gianfranco Percoco, Roberto Ferrari, Marco Valgimigli, STRATEGY Investigators Tags: Research Correspondence Source Type: journals
Giant True Saphenous Vein Graft AneurysmEmail this article to a colleague.
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A 60-year-old man who had undergone saphenous vein grafting to the left anterior descending artery 23 years ago complained of continuous resting chest pain for the last 48 h. No electrocardiographic changes were observed, and laboratory tests showed normal troponin T and creatine kinase levels on admittance and at 8, 12, and 24 h later. Coronary angiography was performed and showed chronic total occlusion of the left anterior descending artery and a severely degenerated and occluded saphenous vein graft. Contrast-enhanced computed tomography showed an extracardiac mass of 85 × 51 mm compressing the left atrium, correspond...
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Juan Garcia-Lara, Eduardo Pinar-Bermudez, Jose Antonio Hurtado, Mariano Valdez-Chavarri Tags: IMAGES IN CARDIOLOGY Source Type: journals
Substrate-Specific Derangements in Mitochondrial Metabolism and Redox Balance in the Atrium of the Type 2 Diabetic Human HeartEmail this article to a colleague.
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Conclusions: These findings are the first to directly investigate the effects of type 2 diabetes on a panoply of mitochondrial functions in the human myocardium using cellular and molecular approaches, and they show that mitochondria in diabetic human hearts have specific impairments in maximal capacity to oxidize fatty acids and glutamate, yet increased mitochondrial H2O2 emission, providing insight into the role of mitochondrial dysfunction and oxidative stress in the pathogenesis of heart failure in diabetic patients. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Ethan J. Anderson, Alan P. Kypson, Evelio Rodriguez, Curtis A. Anderson, Eric J. Lehr, P. Darrell Neufer Tags: Diabetes and Cardiac Function Source Type: journals
Structural Abnormalities of the Pulmonary Trunk in Tetralogy of Fallot and Potential Clinical Implications: A Morphological StudyEmail this article to a colleague.
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Conclusions: Marked histological abnormalities in the PT of hearts with TOF exist compared with controls. These changes were present from infancy and among patients who had undergone palliative or reparative surgery, although operations in this cohort were performed late. Our data suggest that structural abnormalities of the PT, similar to these recently shown in the aorta, are intrinsic. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Elisabeth Bédard, Karen P. McCarthy, Konstantinos Dimopoulos, Georgios Giannakoulas, Michael A. Gatzoulis, Siew Yen Ho Tags: Congenital Heart Disease Source Type: journals
The Coronary Artery Calcium Score and Stress Myocardial Perfusion Imaging Provide Independent and Complementary Prediction of Cardiac RiskEmail this article to a colleague.
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Conclusions: The CACS and SPECT findings are independent and complementary predictors of short- and long-term cardiac events. Despite a normal SPECT result, a severe CACS identifies subjects at high long-term cardiac risk. After a normal SPECT result, our findings support performing a CACS in patients who are at intermediate or high clinical risk for coronary artery disease to better define those who will have a high long-term risk for adverse cardiac events. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Su Min Chang, Faisal Nabi, Jiaqiong Xu, Leif E. Peterson, Arup Achari, Craig M. Pratt, John J. Mahmarian Tags: Cardiac Imaging Source Type: journals
Current Selection of Optimal Prosthetic Aortic Valve Replacement in Middle-Aged Patients: Still Dealer's Choice⁎Email this article to a colleague.
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Selection of the type of prosthetic aortic valve replacement (AVR) is frequently a difficult judgment decision affecting the majority of patients who require surgical AVR. The choices generally include bioprosthetic valves (stented or stentless porcine bioprosthesis, stented pericardial prosthesis) and mechanical prosthetic valves (bileaflet or monoleaflet) (). Mechanical valves have the advantage of structural stability but the disadvantage of requiring anticoagulation with warfarin, whereas bioprostheses have the advantage of not requiring anticoagulation with warfarin but the disadvantage of being subject to time-relate...
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Peter H. Stone Tags: Valvular Heart Disease: Editorial Comment Source Type: journals
Aortic Valve Replacement: A Prospective Randomized Evaluation of Mechanical Versus Biological Valves in Patients Ages 55 to 70 YearsEmail this article to a colleague.
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Conclusions: At 13 years, patients undergoing aortic valve replacement either with MP or BP valves had a similar survival rate as well the same rate of occurrence of thromboembolism, bleeding, endocarditis, and MAPE, but patients who had undergone aortic valve replacement with BP valves faced a significantly higher risk of valve failure and reoperation. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Paolo Stassano, Luigi Di Tommaso, Mario Monaco, Francesco Iorio, Paolo Pepino, Nicola Spampinato, Carlo Vosa Tags: Valvular Heart Disease Source Type: journals
Can Natriuretic Peptides Help Identify Heart Failure Patients for Whom Statins Are Beneficial?⁎Email this article to a colleague.
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One of the great success stories in cardiology is the ability of statins to improve the prognosis in patients at risk of a first or subsequent cardiovascular event. This benefit has been shown across a wide spectrum of patient profiles. The efficacy of statin therapy has been challenged only in high-risk patients such as those on dialysis (), older patients with systolic heart failure (), and patients with chronic heart failure of any cause (). (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Lori B. Daniels, Elizabeth Barrett-Connor Tags: Heart Failure: Editorial Comment Source Type: journals
Plasma Concentration of Amino-Terminal Pro-Brain Natriuretic Peptide in Chronic Heart Failure: Prediction of Cardiovascular Events and Interaction With the Effects of Rosuvastatin: A Report From CORONA (Controlled Rosuvastatin Multinational Trial in Heart Failure)Email this article to a colleague.
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Conclusions: Patients with heart failure due to ischemic heart disease who have NT-proBNP values (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: John G.F. Cleland, John J.V. McMurray, John Kjekshus, Jan H. Cornel, Peter Dunselman, Cândida Fonseca, Åke Hjalmarson, Jerzy Korewicki, Magnus Lindberg, Naresh Ranjith, Dirk J. van Veldhuisen, Finn Waagstein, Hans Wedel, John Wikstrand, CORONA Study Gro Tags: Heart Failure Source Type: journals
Hypertension and the “J-Curve”Email this article to a colleague.
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Elevated blood pressure (BP) is one of the most common preventable causes of premature death worldwide. Approximately 8 million deaths/year (i.e., 14% of all deaths worldwide) are directly attributable to an elevated BP, and with the worldwide prevalence of hypertension predicted to increase by more than 50% by 2025, the magnitude of BP-related death is set to increase further (). Abundant data from randomized clinical trials have confirmed that the therapeutic lowering of BP in hypertensive people substantially reduces the risk of cardiovascular morbidity and mortality, and as a consequence, the routine treatment of hyper...
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Bryan Williams Tags: VIEWPOINT AND COMMENTARY Source Type: journals
The J-Curve Between Blood Pressure and Coronary Artery Disease or Essential Hypertension: Exactly How Essential?Email this article to a colleague.
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The topic of the J-curve relationship between blood pressure and coronary artery disease (CAD) has been the subject of much controversy for the past decades. An inverse relationship between diastolic pressure and adverse cardiac ischemic events (i.e., the lower the diastolic pressure the greater the risk of coronary heart disease and adverse outcomes) has been observed in numerous studies. This effect is even more pronounced in patients with underlying CAD. Indeed, a J-shaped relationship between diastolic pressure and coronary events was documented in treated patients with CAD in most large trials that scrutinized this re...
Source: Journal of the American College of Cardiology - November 5, 2009 Category: Cardiology Authors: Franz H. Messerli, Gurusher S. Panjrath Tags: VIEWPOINT AND COMMENTARY Source Type: journals
