Heart articles from February 2004

Heart archives from February 2004

New tools for assessing microvascular obstruction in patients with ST elevation myocardial infarction.(Editorial)
February 1, 2004... While early and sustained patency of the infarct related artery is necessary following ST elevation myocardial infarction, tissue and microvascular perfusion must also be restored. Effective tools for assessing microvascular obstruction are...

Methotrexate eluting stents: to modify or cure?(Editorial)
February 1, 2004... Just as a single antibiotic cannot treat all infections, it may be that a variety of agents utilised in drug eluting stents will be necessary to treat restenosis ********** Heart 2004;90:121-122. doi: 10.1136/hrt.2003.019638 ...

Optimal therapeutic strategies in the setting of post-infarct no reflow: the need for a pathogenetic classification.(Editorial)
February 1, 2004... Although no reflow is clearly associated with a poor prognosis, little guidance is available on the treatment of this phenomenon. The ideal therapeutic approach comprises drugs with multiple actions on the microvascular damage produced by...

The paradoxical finding of mitral valve incompetence and cor triatriatum: a mechanism revealed?(Images in Cardiology)
February 1, 2004... Magnetic resonance imaging demonstrated features of cor triatriatum in a 27 year old woman (upper panel). In the absence of associated congenital anomalies, obstructive cor triatriatum due to a small, flow limiting fenestration will present...

The extents of mitral leaflet opening and closure are determined by left ventricular systolic function.(Editorial)
February 1, 2004... The extent of opening of the mitral leaflets in diastole and their degree of closure during systole are mediated either indirectly or directly through the force of left ventricular systole. Therefore measures of incomplete opening or...

Heart online case reports: www.heartjnl.com.(Electronic Pages)
February 1, 2004... The follow electronic only articles are published in conjunction with this issue of Heart. Tachycardiomyopathy: a diagnosis not to be missed N L Walker, S M Cobbe, D H Birnie The prognosis of dilated cardiomyopathy is generally...

Atrial pacing for the prevention of atrial fibrillation after coronary artery bypass graft surgery: a review of the literature.(Review)
February 1, 2004... Atrial fibrillation (AF) occurs in 20-40% of patients after coronary artery bypass graft surgery (CABG) and contributes to increased morbidity and expenditure after CABG. The limited efficacy of pharmacological treatment to prevent post-CABG...

Spontaneous termination of ventricular fibrillation.(Images in Cardiology)
February 1, 2004... A 65 year old woman with hypertension and permanent atrial fibrillation had suffered two brief syncopal episodes. She was on losartan, digoxin, and aspirin. The ECG showed atrial fibrillation and incomplete left bundle branch block; the QT...

Pacing extremely old patients: who decides--the doctor, the patient, or the relatives?(Featured Case Report)
February 1, 2004... Decision making competence is not necessarily present or absent. In many cases it is partial or compromised. This applies especially to those over 80 years old, in whom the prevalence of dementia is high. Three patients who presented with...

Myocardial hibernation and heart failure: introduction.(Mini-symposium)
February 1, 2004... For many years the functional sequelae of chronic coronary artery disease (CAD) were considered essentially irreversible and amenable only to palliative treatment. For example, asynergy on the left ventriculogram implied infarcted myocardium...

Impact of multislice CT on coronary ostial stenosis in Takayasu's arteritis.(Images in Cardiology)
February 1, 2004... A 34 year old man presented with a five month history of exertional chest discomfort on moderate exercise. He had no significant coronary risk factors. A diagnosis of Takayasu's arteritis had been made three years before when he had undergone...

Fundamental concepts in myocardial viability assessment revisited: when knowing how much is "alive" is not enough.(Mini-Symposium)
February 1, 2004... Heart 2004;90:137-140. doi: 10.1136/hrt.2003.023101 In recent years, it has become evident that myocardial dysfunction in ischaemic heart disease is not always a result of infarction and that contractile function can improve significantly...

Heart online case reports: www.heartjnl.com.(Electronic Pages)
February 1, 2004... The follow electronic only articles are published in conjunction with this issue of Heart. Rare case of heart failure caused by compression of the left atrium by a thoracic aortic aneurysm N M Gandhi, M Greaves, N H Brooks A 61...

Hibernation and heart failure.(Mini-Symposium)
February 1, 2004... Heart 2004;90:141-143. doi: 10.1136/hrt.2003.023119 Heart failure accounts for approximately 20% of all hospital admissions among people over 65, and in the past 10 years the hospitalisation rate has increased by almost 160%. (1) Although...

Infectious endocarditis with an abscess around an aortic prosthesis.(Images in Cardiology)
February 1, 2004... A 50 year old man was admitted for deterioration in his general condition, with a temperature of 38.7[degrees]C, shivering and asthenia. His history included idiopathic cirrhosis of the liver with portal hypertension and type 2 diabetes....

Surgery for hibernation.(Mini-Symposium)
February 1, 2004... Heart 2004;90: 144-145. doi: 10.1136/hrt.2003.023127 In the early 1980s Rahimtoola reviewed the results of coronary bypass surgery trials (1) and identified patients with coronary artery disease and chronic left ventricular dysfunction...

New support for clarifying the relation between ST segment resolution and microvascular function: degree of ST segment resolution correlates with the pressure derived collateral flow index.(Cardiovascular Medicine)
February 1, 2004... Objective: To investigate the relation between the degree of ST segment resolution (STR) after thrombolysis and the pressure derived collateral flow index (CFIp), determined using an intracoronary pressure measurement technique in patients...

Combined membrane covered and uncovered stents for coronary arteriovenous fistula associated with atherosclerotic plaque in a patient with acute myocardial infarction.(Images in Cardiology)
February 1, 2004... Stent grafts have recently been applied for various coronary lesions such as coronary perforation, coronary aneurysm, and fistula. We report a case of coronary arteriovenous fistula associated with atherosclerotic plaque successfully treated...

Increased serum concentrations of soluble CD95/Fas and caspase 1/ICE in patients with acute angina.(Cardiovascular Medicine)
February 1, 2004... Objectives: To investigate the expression of death inducing receptors in the sera of patients with stable and unstable angina. Design: 80 consecutive patients with stable (n = 40) or unstable (n = 40) angina pectoris were studied. Serum...

New combined treatments avoided transplantation in a child with severe pulmonary hypertension.(Images in Cardiology)
February 1, 2004... Therapeutic options for the management of pulmonary hypertension have been limited for many years. However, recent progresses in the understanding of its pathology have led to the introduction of new treatments that have changed its...

Hyperuricaemia does not impair cardiovascular function in healthy adults.(Cardiovascular Medicine)
February 1, 2004... Objective: To investigate the possibility that uric acid (UA) can impair endothelial function, an important surrogate for atherosclerosis. Design: UA was administered locally or systemically to healthy adult men and women in a series of...

Catheter based intracoronary brachytherapy leads to increased platelet activation.(Cardiovascular Medicine)
February 1, 2004... Background: Vascular brachytherapy (VBT) after percutaneous coronary intervention (PCI) is associated with a higher risk of stent thrombosis than conventional treatment. Objective: To investigate in vivo periprocedural platelet...

Ruptured plaque or embolised thrombus.(Images in Cardiology)
February 1, 2004... A 38 year old woman with acute chest pain was admitted to the hospital. Positive troponins and electrocardiographic signs of anterior wall myocardial infarction during atrial fibrillation were found. Echocardiography (panel below) showed...

ECGSIM: an interactive tool for studying the genesis of QRST waveforms.(Cardiovascular Medicine)
February 1, 2004... Background: Discussion about the selection of diagnostic features of the ECG and their possible interpretation would benefit from a model of the genesis of these signals that has a sound basis in electrophysiology as well as in physics....

Is Mobitz type I atrioventricular block benign in adults?(Cardiovascular Medicine)
February 1, 2004... Objective: To assess the need for pacing in adults with chronic Mobitz type I second degree atrioventricular block (Mobitz I). Design: Prospective study. Setting: District general hospital. Patients: 147 subjects aged [greater...

Pulsed wave Doppler tissue echocardiography assessment of the long axis function of the right and left ventricles during the early neonatal period.(Cardiovascular Medicine)
February 1, 2004... Objective: To assess the long axis function of both ventricles during the early neonatal period by using pulsed wave Doppler tissue (PWDT) echocardiography. Design: PWDT echocardiography was recorded from the lateral sites of the mitral...

Factors involved in deciding to start preventive treatment: qualitative study of clinicians' and lay people's attitudes.(From BMJ Journals)
February 1, 2004... Objectives: To explore the views of clinicians and lay people about the minimum benefit needed to justify drug treatment to prevent heart attacks, and to explore the rationale behind treatment decisions. Design: Qualitative study using...

Nicorandil versus isosorbide dinitrate as adjunctive treatment to direct balloon angioplasty in acute myocardial infarction.(Interventional Cardiology and Surgery)
February 1, 2004... Objective: To compare the effects of nicorandil (a hybrid ATP sensitive potassium channel ([K.sup.+.sub.ATP] channel) opener/nitric oxide donor) with those of isosorbide dinitrate (ISDN) on myocardial microcirculation and cardiac function in...

Prognosis of angina with and without a diagnosis: 11 year follow up in the Whitehall II prospective cohort study.(From BMJ Journals)
February 1, 2004... Objective: To investigate the prognosis of angina among people with and without diagnosis by a doctor and an abnormal cardiovascular test result. Design: Prospective cohort study with a median follow up of 11 years. Setting: 20...

Percutaneous closure of patent foramen ovale: impact of device design on safety and efficacy.(Congenital Heart Disease)
February 1, 2004... Objective: To compare the safety and efficacy of percutaneous closure of patent foramen ovale (PFO) with the Amplatzer PFO occluder (Amplatzer) or the PFO STAR device (STAR) in patients with presumed paradoxical embolism. Methods:...

Improved early ventricular performance with a right ventricle to pulmonary artery conduit in stage 1 palliation for hypoplastic left heart syndrome: evidence from strain Doppler echocardiography.(Congenital Heart Disease)
February 1, 2004... Objective: To quantify non-invasively right ventricular (RV) performance in infants after stage 1 palliation for hypoplastic left heart syndrome (HLHS). Design: Prospective, observational study with two dimensional and strain Doppler...

Acute aortic dissection induced renovascular hypertension.(Images in Cardiology)
February 1, 2004... Although percutaneous renal angioplasty has been extensively used for fibromuscular or atherosclerotic renovascular hypertension, few cases have been reported in patients with aortic dissection. We describe stent angioplasty for severe...

Methotrexate loaded SAE coated coronary stents reduce neointimal hyperplasia in a porcine coronary model.(Basic Research)
February 1, 2004... Objective: To evaluate the effect of stent based methotrexate delivery on neointimal hyperplasia. Methods: Stainless steel coronary stents and biological polymer coated (SAE) stents were randomly implanted in coronary arteries of pigs...

The forces generated within the musculature of the left ventricular wall.(Basic Research)
February 1, 2004... Objectives: To test the hypothesis that two populations of myocardial fibres--fibres aligned parallel to the surfaces of the wall and an additional population of fibres that extend obliquely through the wall--when working in concert produce a...

Catheter induced multiple spasms in the right iliac artery during a percutaneous coronary intervention.(Images in Cardiology)
February 1, 2004... Catheter induced vasospasm of small calibre arteries, such as coronary, radial, or brachial arteries, is frequently observed during cardiac catheterisation, but the phenomenon in large calibre arteries has rarely been reported. We report a...

Obtaining informed consent from patients in the early phase of acute myocardial infarction: physicians' experiences and attitudes.(Scientific Letter)
February 1, 2004... Heart 2004;90:208-210. doi: 10.1136/hrt.2003.021501 It is possible to question whether patients suffering from the early phase of an acute myocardial infarction (AMI) are able to give free and informed consent and whether or not it is...

Novel imaging techniques for the differentiation of a left ventricular mass.(Images in Cardiology)
February 1, 2004... A 39 year old man presented with a right popliteal artery embolism and was successfully treated with open embolectomy. He was a heavy smoker but had no history of thrombosis, peripheral vascular disease, arrhythmias, ischaemic heart disease,...

Altered short term heart rate variability with spinal cord stimulation in chronic refractory angina: evidence for the presence of procedure related cardiac sympathetic blockade.(Scientific Letter)
February 1, 2004... Heart 2004;90:211-212. doi: 10.1136/hrt.2002.002998 The first spinal cord stimulator was implanted for intractable angina in 1987. Following this innovation there followed extensive scrutiny of neurostimulation in patients suffering from...

Carer knowledge of children's medical problems in a paediatric cardiology outpatient setting.(Scientific Letter)
February 1, 2004... Heart 2004;90:213-214. doi: 10.1136/hrt.2003.004895 In a world with increasingly mobile populations, children often attend emergency departments or primary care surgeries where no documentation about existing medical problems is held....

Ventilatory response to exercise in patients after correction of cyanotic congenital heart disease: relation with clinical outcome after surgery.(Scientific Letter)
February 1, 2004... Heart 2004;90:215-216. doi: 10.1136/hrt.2002.005918 Patients with congenital heart disease can usually perform low intensity exercise as well as healthy peers, but often have difficulty in reaching maximal exercise intensity. However,...

Assessment of depression following acute myocardial infarction using the Beck depression inventory.(Scientific Letter)
February 1, 2004... Heart 2004;90:217-218. doi: 10.1136/hrt.2003.013904 Survivors of myocardial infarction (MI) who are depressed are at increased risk of cardiac death and morbidity than those who are not depressed. (1) This adverse effect is independent of...

Secretion of atrial natriuretic peptide in idiopathic giant atrium.(Images in Cardiology)
February 1, 2004... A case of idiopathic giant atrium is described. The patient died of cardiac cachexia at the age of 80 years. Although she was diagnosed as having atrial fibrillation and cardiomegaly at the age of 40 years, she had not complained of any...

Indications for the closure of patent foramen ovale.(Congenital Heart Disease)
February 1, 2004... Heart 2004;90:219-224. doi: 10.1136/hrt.2003.019315 The foramen ovale, while vital to our formative development, assumes mischievous potential if it persists post-utero. Similar to other vestigial structures, presence of a patent foramen...

Chronic therapeutically refractory angina pectoris.(Coronary Disease)
February 1, 2004... Heart 2004;90:225-230. doi: 10.1136/hrt.2003.025031 In contrast to the tremendous increase in practical opportunities and theoretical knowledge in the western world, resulting in a doubling of our average life expectancy, the number of...

Implantable cardioverter-defibrillator treatment and resynchronisation in heart failure.(Electrophysiology)
February 1, 2004... Heart 2004;90:231-234. doi: 10.1136/hrt.2003.019695 Patients with severe heart failure in New York Heart Association (NYHA) functional class III-IV, low left ventricular ejection fraction, and broad QRS have been shown to benefit from...

Ischaemic heart disease.(Journal Scan)
February 1, 2004... How long to wait before a plane journey after AMI * Aircrafts are pressurised to achieve cabin pressures equivalent to 5000-8000 feet altitude. At this cabin pressure, Pl[O.sub.2] falls from 150 to 107 mm Hg and Pa[O.sub.2] falls from 98 to...

Ischaemic heart disease.(Journal Scan)
February 1, 2004... Atorvastatin induced neuropathy * A case report of a 57 year old man in good health, excluding hyperlipidaemia, with progressive numbness and burning in both feet, particularly the dorsal aspect, for six months is described. His medications...

Ischaemic heart disease.(Journal Scan)
February 1, 2004... When to start statins * Should statins be started predischarge after acute coronary syndrome (ACS)? There are no conclusive data to suggest mortality advantage over later initiation, but in a busy world, "later" may mean "never". Using data...

Ischaemic heart disease.(Journal Scan)(Brief Article)
February 1, 2004... There is a point to stopping smoking even after you have developed IHD * A study population of 3122 patients with a previous myocardial infarction or stable angina participated in the bezafibrate infarction prevention trial. Patients were...

Ischaemic heart disease.(Journal Scan)(Brief Article)
February 1, 2004... What is the risk of AMI from combination antiretroviral therapy? * In this prospective observational study, 23 468 patients from 11 previously established cohorts were enrolled. Data were collected on infection with the human immunodeficiency...

Ischaemic heart disease.(Journal Scan)
February 1, 2004... No advantage to adding valsartan to captopril post-AMI * In a double blind trial, the effect of the angiotensin receptor blocker valsartan, the angiotensin converting enzyme (ACE) inhibitor captopril, and combination of the two, on mortality...

Hypertension.(Journal Scan)
February 1, 2004... Which antihypertensive drug to use? * The benefits of reducing blood pressure on the risks of major cardiovascular disease are well established, but uncertainty remains about the comparative effects of different blood pressure lowering...

General cardiology.(Journal Scan)
February 1, 2004... How to detect insulin resistance * Although obese individuals tend to be insulin resistant, hyperinsulinaemic, glucose intolerant, and dyslipidaemic, not all overweight or obese individuals are insulin resistant. The adult treatment panel III...

General cardiology.(JournalScan)
February 1, 2004... PFO closure for paradoxical emboli * Ten studies of transcatheter closure (1355 patients) and six studies of medical treatment (895 patients) for patent foramen ovale (PFO) were included. Overall, the one year rate of recurrent neurologic...

General cardiology.(JournalScan)
February 1, 2004... Treating high INR * Treatment of patients with excessive anticoagulation is routinely done by intravenous phytonadione (vitamin [K.sub.1]). Oral administration of phytonadione has been shown to be an effective alternative to the intravenous...

General cardiology.(JournalScan)
February 1, 2004... Progressive carotid stenosis is a risk factor for CVA * The progression of carotid stenosis may be a better predictor of adverse neurological outcomes than a single measurement of stenosis in asymptomatic patients. A total of 1701 carotid...

General cardiology.(JournalScan)
February 1, 2004... Risks of spironolactone * In 125 patients with poor left ventricular function started on spironolactone, the level of side effects was assessed. Taking spironolactone is associated with considerably more frequent side effects than previously...

General cardiology.(JournalScan)(Brief Article)
February 1, 2004... Preventing contrast nephropathy * N-acetyl cysteine given orally or intravenously before contrast may reduce contrast nephropathy. Prehydration is also important. Fenoldopam has also been suggested. Between March 2001 and July 2002, 315...

General cardiology.(JournalScan)(Brief Article)
February 1, 2004... Ximelagatran for atrial fibrillation * In 3410 patients with non-valvar atrial fibrillation, ximelagatran 36 mg twice daily in an open label design proved not to be inferior to warfarin (INR maintained at 2-3) in the prevention of strokes....

Journals scanned.(JournalScan)
February 1, 2004... American Journal of Medicine; American Journal of Physiology: Heart and Circulatory Physiology; Annals of Emergency Medicine; Annals of Thoracic Surgery; Archives of Internal Medicine; BMJ; Chest; European Journal of Cardiothoracic Surgery;...