Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2013
Paradoxical response to exercise in asymptomatic hypertrophic cardiomyopathy: a new description of outflow tract obstruction dynamics.
The purpose of this study was to analyze left ventricular obstruction in patients with hypertrophic cardiomyopathy (HCM) during exercise echocardiography. ⋯ Our study reports a subgroup of HCM patients, designated PRE based on a decreased intraventricular gradient during exercise. The reduced exertional obstruction may account for the better functional class and trend toward fewer clinical events in PRE patients.
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J. Am. Coll. Cardiol. · Aug 2013
Higher natriuretic peptide levels associate with a favorable adipose tissue distribution profile.
The goal of this study was to investigate the association between natriuretic peptides and body fat distribution in a multiethnic cohort. ⋯ Higher natriuretic peptide levels were independently associated with a favorable adiposity profile, characterized by decreased visceral and liver fat and increased lower body fat, suggesting a link between the heart and adipose tissue distribution mediated through natriuretic peptides.
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J. Am. Coll. Cardiol. · Aug 2013
Randomized Controlled Trial Comparative StudyEffect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.
The study sought to evaluate the effects of endurance exercise training (ET) on endothelial-dependent flow-mediated arterial dilation (FMD) and carotid artery stiffness, and their potential contributions to the training-related increase in peak exercise oxygen consumption (Vo2) in older patients with heart failure with preserved ejection fraction (HFPEF). ⋯ In elderly HFPEF patients, 16 weeks of ET improved peak Vo2 without altering endothelial function or arterial stiffness. This suggests that other mechanisms, such as enhanced skeletal muscle perfusion and/or oxygen utilization, may be responsible for the ET-mediated increase in peak Vo2 in older HFPEF patients. (Prospective Aerobic Reconditioning Intervention Study [PARIS]; NCT01113840).
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J. Am. Coll. Cardiol. · Aug 2013
Comparative StudyObstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults.
This study sought to identify the risk of sudden cardiac death (SCD) associated with obstructive sleep apnea (OSA). ⋯ In a population of 10,701 adults referred for polysomnography, OSA predicted incident SCD, and the magnitude of risk was predicted by multiple parameters characterizing OSA severity. Nocturnal hypoxemia, an important pathophysiological feature of OSA, strongly predicted SCD independently of well-established risk factors. These findings implicate OSA, a prevalent condition, as a novel risk factor for SCD.
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J. Am. Coll. Cardiol. · Aug 2013
Comparative StudyRisk-standardizing survival for in-hospital cardiac arrest to facilitate hospital comparisons.
The purpose of this study is to develop a method for risk-standardizing hospital survival after cardiac arrest. ⋯ We have derived and validated a model to risk-standardize hospital rates of survival for in-hospital cardiac arrest. Use of this model can support efforts to compare hospitals in resuscitation outcomes as a foundation for quality assessment and improvement.