International journal of cardiology
-
Letter Comparative Study
Valsalva maneuver to predict dynamic intraventricular obstruction during dobutamine stress echocardiography in patients with hypertension.
We were to evaluate the effect of Valsalva maneuver with comparison to preload reduction by nitroglycerin (NTG) to predict intraventricular obstruction (IVO) during dobutamine stress echocardiography (DSE) in patients with hypertension. ⋯ Simple and safe Valsalva maneuver plays an effective role to predict dynamic IVO in patients with hypertension who might be good candidate for beta-blocker therapy and is even more sensitive than preload reduction by NTG.
-
Comment Letter
Is warfarin still underused in patients with atrial fibrillation? A major threat to treatment benefit.
Atrial fibrillation may cause thromboembolic events and the risk of thromboembolic events increase with the number of clinical and echocardiographic risk factors. Although the benefit of anticoagulant therapy in preventing thromboembolic events was clearly shown, a significant number of patients with atrial fibrillation were not under anticoagulant therapy. However, whatever the patient's reason for warfarin underutilisation, probably it is the main obstacle for reducing stroke risk in atrial fibrillation. Consequently, it makes the use of any risk factor calculation useless.
-
Comment Letter
Coronary allograft vasculopathy and coronary vasospasm in heart transplant recipients: a manifestation of Kounis syndrome?
The pathophysiology of vasculopathy of cardiac allografts is still unknown. Coronary vasospasm and thrombosis are some rare manifestations accompanying this entity. Hypersensitivity processes and the hypersensitivity coronary syndrome (Kounis syndrome) may be associated with this potentially fatal complication. Research efforts towards this direction may shed light for prevention and treatment of this disease.
-
Cardiac cachexia as a terminal stage of chronic heart failure carries a devastating prognosis. This article focuses on novel insights into the pathophysiology and on new treatment approaches to cardiac cachexia. Drugs that have been used in preclinical and clinical studies that may also confer beneficial effects in cardiac cachexia include but are not limited to the type 4 melanocortin receptor antagonist SNT 207979, the appetite promoting synthetic ghrelin SUN11031, the soluble myostatin decoy receptor ActRIIB-Fc, the fast skeletal muscle troponin activating substance CK-2017357, the anti-catabolic/anabolic transforming agent MT-102, the anti-inflammatory agent celecoxib, and testosterone supplementation.
-
Letter Clinical Trial
Usefulness of left atrial volume for the diagnosis of diastolic heart failure: an echocardiographic-catheterization study.
The present study attempted to determine the accuracy of left atrial volume (LAVi) by transthoracic echocardiography in the diagnosis of diastolic heart failure (DHF) in patients presenting with chronic, isolated dyspnea. We included 28 consecutive patients with a left ventricular ejection fraction >50% without prior history of heart failure. ⋯ LAVi>38 ml/m(2) was a useful predictor of DHF (area under the ROC curve of 0.84 [0.65-0.95], p<0.001, sensitivity 60%, specificity 100%). The standard cut-off value of 34 ml/m(2) was 70% sensitive and 88% specific.