American heart journal
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American heart journal · Oct 2009
Comparative StudyDifferential effects of afterload on left ventricular long- and short-axis function: insights from a clinical model of patients with aortic valve stenosis undergoing aortic valve replacement.
The effects of left ventricular (LV) afterload on longitudinal versus circumferential ventricular mechanics are largely unknown. Our objective was to examine changes in LV deformation before and early after aortic valve replacement (AVR) in patients with severe aortic valve stenosis (AS). ⋯ Aortic valve stenosis causes differential changes in longitudinal and circumferential mechanics that partially normalize after AVR. These findings provide new insights into the mechanical adaptation of the LV to chronic afterload elevation and its response to unloading.
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American heart journal · Oct 2009
Multicenter Study Comparative StudyPrevalence and prognostic significance of incidental cardiac troponin T elevation in ambulatory patients with stable coronary artery disease: data from the Heart and Soul study.
The significance of troponin elevation and clinical utility of troponin testing in ambulatory patients with coronary artery disease (CAD) have not been examined. We sought to investigate the prevalence and prognostic value of cardiac troponin T (cTnT) elevation in a population with stable CAD. ⋯ In ambulatory patients with stable CAD, the prevalence of cTnT elevation was 6.2%. Cardiac troponin T elevation detected using the conventional troponin assay was associated with increased risk of adverse cardiovascular outcomes, but its prognostic value was not incremental over N-terminal pro-B-type natriuretic peptide and echocardiographic evidence of cardiac abnormalities.
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American heart journal · Oct 2009
Comparative StudyCardiac amyloidosis in African Americans: comparison of clinical and laboratory features of transthyretin V122I amyloidosis and immunoglobulin light chain amyloidosis.
Transthyretin (TTR) mutations known to cause cardiac amyloidosis include V122I, found almost exclusively in African Americans at a prevalence of 3-3.9%. This retrospective study describes TTR V122I-associated cardiac amyloid disease (ATTR) in a major amyloid referral clinic population. ⋯ ATTR V122I and AL are equally prevalent as the cause of cardiomyopathy in African Americans referred for a diagnosis of amyloidosis. Available therapy for AL underscores the need for early and accurate determination of amyloid type.