Heart articles from February 2003

Heart archives from February 2003

Cardiovascular effects of testosterone: implications of the "male menopause"? (Editorial).
February 1, 2003... A relatively low blood concentration of testosterone in the older man may have adverse effects on atherosclerosis, and explain the higher incidence of coronary heart disease in the male. Death from coronary artery disease (CAD) varies by...

Cystic tumour of the atrioventricular node. (Images in Cardiology).(Brief Article)
February 1, 2003... A 45 year old asymptomatic woman was referred to our clinic because of first degree atrioventricular block on EGG. Transthoracic echocardiography revealed a well delineated mass (27 mm x 29 mm) without a stalk at the lower atrial septum,...

Syncope: what is the trigger? (Editorial).
February 1, 2003... Although a syncopal attack is frequently preceded by prodromal symptoms, sometimes the onset can be so abrupt that there is no warning at all. The switch in autonomic responses responsible for such an attack is quite rapid and dramatic, but...

Prophylactic indomethacin can harm very low birthweight babies with severe CHD. (From BMJ Journals).(Brief Article)
February 1, 2003... A 12 year review of very low birthweight babies with severe congenital heart disease (CHD) has discovered that prophylactic indomethacin for patent ductus arteriosus can compromise a poor outcome still further. The risk would be significant...

Exercise blood pressure in congenital heart disease and in patients after coarctation repair. (Editorial).
February 1, 2003... Cardiologists have often described aortic coarctation as "simple" rather than "complex" congenital heart disease; no thing could be further from the truth Systolic blood pressure rises with increased dynamic work load as a result of...

Drug eluting stents: maximising benefit and minimising cost. (Viewpoint).
February 1, 2003... A policy of selective implantation of drug eluting stents, in a minority of lesions most likely to benefit, seems to be a rational way to employ this new and currently costly technology The RAVEL and the SIRIUS studies, using a sirolimus...

A giant thrombus aspirated from a coronary artery. (Images in Cardiology).(Brief Article)
February 1, 2003... A 72 year old woman was admitted to the emergency department with persistent chest pain. The EGG showed ST segment elevations in the inferior leads. She was diagnosed with acute myocardial infarction. Primary percutaneous coronary...

In-stent restenosis and atherosclerosis in a human saphenous vein graft. (Images in Cardiology).
February 1, 2003... A 62 year old man developed recurrent stable angina 16 years after coronary artery bypass grafting (CABG) with saphenous vein grafts to the left anterior descending and right (RCA) coronary arteries. Angiography showed a long critical...

Anomalous right coronary artery originating from the mid left main coronary artery. (Images in Cardiology).(Brief Article)
February 1, 2003... A 60 year old women presented with chest pain to our department. Risk factors for coronary artery disease included hypertension and hypercholesterolaemia. Her coronary angiogram (see panels) showed normal left anterior descending (LAD) and...

Drug eluting stents: are human and animal studies comparable? (Review).
February 1, 2003... Animal models of stenting probably predict human responses as the stages of healing are remarkably similar. What is characteristically different is the temporal response to healing, which is substantially prolonged in humans. The prevention...

Huge mass bordering on left atrium raises coronary artery. (Images in Cardiology).(Brief Article)
February 1, 2003... A 45 year old carpenter with an abnormal chest radiograph was referred to us. Computed tomographic (CT) chest scan showed a round mass, 7.5 cm in diameter, bordering on the left atrium with patchy calcification around it. Density inside was...

Acute left ventricular rupture after myocardial infarction. (Images in Cardiology).(Brief Article)
February 1, 2003... A 71 year old woman with a two hour history of chest pain and ST segment elevation in leads V1-V4 was admitted to our hospital with the diagnosis of acute myocardial infarction and treated with tissue plasminogen activator. Forty eight hours...

Myocardial contrast echocardiography is superior to other known modalities for assessing myocardial reperfusion after acute myocardial infarction. (Cardiovascular Medicine).
February 1, 2003... Background: Angiographic flow measurements do not define perfusion accurately at a microvascular level, so other techniques which assess flow at a tissue level are to be preferred. Objectives: To compare intravenous myocardial contrast...

Assessment of myocardial perfusion abnormalities by intravenous myocardial contrast echocardiography with harmonic power Doppler imaging: comparison with positron emission tomography. (Cardiocascular Medicine).
February 1, 2003... Background: intravenous myocardial contrast echocardiography with harmonic power Doppler imaging (HPDI) enables assessment of myocardial perfusion. Its accuracy in comparison with positron emission tomography (PET), which is one of the most...

Lipoprotein (a) is not part of the acute phase response. (From BMJ Journals).(Brief Article)
February 1, 2003... Lipoprotein (a) is not involved in the acute phase response after intense exercise, and therefore not implicated in increasing the risk of a heart attack, concludes a study of army volunteers. The finding contradicts previous research, but...

NT-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function. (Cardiovascular Medicine).
February 1, 2003... Objective: To evaluate whether measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) can be used to differentiate patients with normal and reduced left ventricular ejection fraction (LVEF) in an unselected consecutive group of...

Comprehensive cardiac rehabilitation programme for implantable cardioverter-defibrillator patients: a randomised controlled trial. (Cardiovascular Medicine).
February 1, 2003... Objective: To investigate the effects of a 12 week comprehensive cardiac rehabilitation (CCR) programme on patients who have undergone implantation of an implantable cardioverter-defibrillator (ICD). Design: Sixteen patients with ICDs (14...

Mitral annular calcification: a marker of severe coronary artery disease in patients under 65 years old. (Cardiovascular Medicine).
February 1, 2003... Background: Mitral annular calcification has been associated with various systemic and cardiac diseases, with a higher prevalence in women and patients over 70. A possible association between mitral annular calcification and coronary artery...

Spontaneous coronary artery dissection: stent it or wait for healing? (Images in Cardiology).
February 1, 2003... Spontaneous coronary artery dissection is an extremely rare cause of unstable angina and acute myocardial infarction or other ischaemic manifestations. It is more prevalent in young women, particularly in the peripartum period. There are a...

Atrial fibrillation: relation between clinical risk factors and transoesophageal echocardiographic risk factors for thromboembolism. (Cardiovascular Medicine).
February 1, 2003... Objective: To correlate clinical risk factors for thromboembolism with transoesophageal echocardiography (TOE) markers of a thrombogenic milieu. Design: Clinical risk factors for thromboembolism and TOE markers of a thrombogenic milieu...

Acute thrombosis of the sinus node artery: arrhythmological implications. (Electronic Pages).(Brief Article)
February 1, 2003... A 53 year old woman was referred for percutaneous coronary intervention because of a recent inferior myocardial infarction. During right coronary artery stent implantation, intermittent occlusion of the coronary side branch for the sinus node...

Abnormal response to sodium channel blockers in patients with Brugada syndrome: augmented localised wall motion abnormalities in the right ventricular outflow tract region detected by electron beam computed tomography. (Cardiovascular Medicine).
February 1, 2003... Objective: To investigate the relation between the wall motion abnormalities and sodium channel abnormalities in cases of the Brugada syndrome. Design: Consecutive prospective case--control study in a single hospital. Setting:...

Rarefaction of skin capillaries in normotensive offspring of individuals with essential hypertension. (Cardiovascular Medicine).
February 1, 2003... Background: Rarefaction of skin capillaries in people with intermittent borderline essential hypertension suggests a primary or an early abnormality that may antedate the onset of sustained hypertension. Objective: To compare skin...

Sudden cardiac death caused by hypertrophic cardiomyopathy associated with midventricular obstruction and apical aneurysm. (Images in Cardiology).
February 1, 2003... A 79 year old woman with a history of good health presented with sudden cardiac arrest caused by ventricular fibrillation. She was successfully resuscitated and admitted into the coronary care unit. An ECG showed sinus rhythm with left...

Myocardial viability, coronary flow reserve, and in-hospital predictors of late recovery of contractility following successful primary stenting for acute myocardial infarction. (Interventional Cardiology and Surgery).
February 1, 2003... Objective: To assess the relation between myocardial viability, coronary flow reserve, and recovery of myocardial contractility after stenting for acute myocardial infarction. Design: Consecutive sample prospective study. Setting:...

Coronary stenting versus coronary bypass surgery in patients with multiple vessel disease and significant proximal LAD stenosis: results from the ERACI II study. (Interventional Cardiology and Surgery).
February 1, 2003... Purpose: To compare percutaneous coronary intervention (PCI) using stent implantation versus coronary artery bypass graft (CABG) in patients with multiple vessel disease with involvement of the proximal left anterior descending coronary...

Exercise systolic blood pressures are of questionable value in the assessment of the adult with a previous coarctation repair. (Congenital Heart Disease).
February 1, 2003... Background: The role of exercise testing in the follow up of adults with a coarctation repair is unclear. Exercise induced systolic hypertension has been advocated as an indication for further investigation; however, the value of exercise...

Fontan conversion to total cavopulmonary connection and arrhythmia ablation: clinical and functional results. (Congenital Heart Disease).
February 1, 2003... Objectives: To assess the early results of conversion from atriopulmonary to total cavopulmonary connection in patients with failing Fontan operation. Design: Early clinical and instrumental evaluation of patients undergoing conversion...

Vasospastic angina. (Images in Cardiology).(Brief Article)
February 1, 2003... A 50 year old woman was admitted with central crushing chest pain. She had a strong family history of ischaemic heart disease (IHD). Her cholesterol was 4.7 mmol/l. There were no other risk factors for IHD. At the time of admission she was...

Experience with transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder: a single centre study in 236 consecutive patients. (Congenital Heart Disease).
February 1, 2003... Aim: To evaluate the safety and efficacy of transcatheter closure of secundum atrial septal defects (ASD) with the Amplatzer septal occluder. Methods: 236 consecutive patients with a significant ASD (age 6 months to 46 years, median 5...

Heart rate variability in children with hypertrophic cardiomyopathy. (Scientific Letter).
February 1, 2003... Hypertrophic cardiomyopathy (HCM) carries an increased risk of sudden death, especially in children and young adults. We investigated heart rate variability (HRV) in children with HCM, in order to evaluate its prognostic value. METHODS...

Decreased serum vascular endothelial growth factor concentrations in patients with congestive heart failure. (Scientific Letter).
February 1, 2003... Growth factors play an important role in the pathogenesis of cardiovascular diseases by regulating cellular proliferation, migration, differentiation, and apoptosis. Vascular endothelial growth factor (VEGF) is a potent mitogen for...

Web top 10.(Directory)
February 1, 2003... www.heartjnl.com These articles scored the most hits on Heart's website during November 2002 1 Doppler echocardiographic assessment of valvar regurgitation J D Thomas December 2002;88:651-7. (Education in Heart) 2 Heart...

Prolonged temporary cardiac pacing using subcutaneous tunnelled active-fixation permanent pacing leads. (Scientific Letter).
February 1, 2003... Temporary transvenous cardiac pacing is occasionally required for prolonged periods, particularly in patients with severe infection and bradyarrhythmias who may need several weeks of antibiotic treatment before a permanent pacemaker can be...

Protein C deficiency manifesting as an acute myocardial infarction and ischaemic stroke. (Electronic Pages).(Brief Article)
February 1, 2003... Protein C deficiency is a disorder in the coagulation cascade that results in predominantly venous thromboembolism. However, recent studies have implicated this disorder as a possible contributor to arterial thrombosis, especially myocardial...

Enhanced endothelin-1 degradation by intravenous morphine in patients with congestive heart failure: role of neutral endopeptidase 24.11. (Scientific Letter).
February 1, 2003... Endothelin-1 (ET-1), as the most potent endothelium dependent vasoconstrictor peptide, contributes to vasoconstriction, decreased ventricular function, and volume retention in congestive heart failure (CHF). Plasma ET-1 concentrations are...

Deletion polymorphism of the angiotensin I converting enzyme gene is a potent risk factor for coronary artery ectasia. (Scientific Letter).
February 1, 2003... Coronary artery ectasia (CAE) is characterised by irregular, diffuse, saccular, or fusiform dilatation of the coronary arteries. Although the underlying mechanisms are not fully understood, CAE is considered an original form of vascular...

Asymptomatic ventricula pre-excitation in children and adolescents: a 15 year follow up study. (Scientific Letter).
February 1, 2003... The term Wolff-Parkinson-White (WPW) syndrome refers to people with a ventricular pre-excitation (VPE) pattern on ECG who experience symptomatic bouts of tachycardia. (1) Asymptomatic patients with VPE are better described as simply having a...

In-stent stenosis: pathology and implications for the development of drug eluting stents. (Coronary Disease).
February 1, 2003... Over 1.5 million percutaneous coronary revascularisation procedures are performed annually world wide, most being intracoronary stenting. Despite enormous advances in devices, the major limitation is in-stent stenosis (ISS) (reviewed by...

Chronic cor pulmonale. (General Cardiology).
February 1, 2003... The term "cor pulmonale" is still very popular in the medical literature, but its definition varies and there is presently no consensual definition. Forty years ago an expert committee of the World Health Organization (1) defined cor...

Clinical assessment of left ventricular diastolic function. (General Cardiology).
February 1, 2003... Diastolic left ventricular disease is being increasingly incriminated as a cause of limitation of exercise tolerance, whether or not ejection fraction is normal, (1,2) though the mechanisms by which it does so are far from clear. Indeed, it...

Ischaemic heart disease.
February 1, 2003... Clopidogrel should be given for one year after stenting Most cardiologists presently prescribe 2-4 weeks of clopidogrel after placing coronary stents. In patients with acute coronary syndromes, the CURE study suggests benefit to nine...

Heart failure.(Brief Article)
February 1, 2003... Digoxin has no role in treating women with heart failure Among the 6800 patients in the digitalis investigation group study, there was an absolute difference of 5.8% (95% CI 0.5% to 11.1%) between men and women in the effect of digoxin on the...

Hypertension.(Brief Article)
February 1, 2003... ACE inhibitors should become first line antihypertensive agents in renal impairment @ Over 1000 African Americans with renal impairment related to hypertension were randomised to either severe (blood pressure 128/78 mm Hg) or moderate blood...

General cardiology.
February 1, 2003... Use of frusemide drive in renal failure has no scientific basis @ It has been clear for some time that dopamine infusions, although often used in acute renal failure to encourage renal recovery, have no evidence of benefit. The same seems to...

Intrastent sonotherapy in pulmonary vein restenosis: a new treatment for a recalcitrant problem. (Electronic Pages).(Brief Article)
February 1, 2003... A 2 year old boy developed recurrent pulmonary vein stenosis after surgical repair of infradiaphragmatic pulmonary venous connection. He had required implantation of stents in the left and right sided pulmonary veins at 7 and 13 months of...

Obstructive intramural coronary amyloidosis and papillary muscle rupture. (Electronic Pages).(Brief Article)
February 1, 2003... Mitral papillary muscle rupture is usually caused by ischaemia as a complication of myocardial infarction. In a 76 year old patient with no significant disease or major cardiovascular risk factors, papillary muscle rupture was caused by...