This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content

(Circulation. 2005;112:2887.)
© 2005 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	REVERSE REMODELING OF THE LEFT CARDIAC CHAMBERS AFTER CATHETER ABLATION AFTER 1 YEAR IN A SERIES OF PATIENTS WITH ISOLATED ATRIAL FIBRILLATION, by Reant et al.

 
In patients with atrial fibrillation and no specific associated heart disease, there are identifiable abnormalities in structure and function, including left atrial dilation and abnormalities in diastolic ventricular function. An intriguing issue has been whether diastolic abnormalities are cause or consequence; are filling abnormalities related to the abnormal atrial dynamics, or might diastolic dysfunction (and consequent left atrial dilation) represent a driver of atrial fibrillation onset and maintenance? In this issue of Circulation, Reant and colleagues begin to dissect this issue by studying patients with isolated atrial fibrillation with echocardiography before and then 5 times during the year after radiofrequency ablation back to sinus rhythm. Left atrial size decreased, ventricular diastolic parameters improved, and ejection fraction increased. These data suggest that atrial fibrillation results in reversible structural and functional atrial and ventricular abnormalities in the absence of other specific pathologies. Diastolic abnormalities appear in large part a consequence rather than a cause of atrial fibrillation. See p 2896.

	MINERALOCORTICOID RECEPTOR ANTAGONISM AMELIORATES LEFT VENTRICULAR DIASTOLIC DYSFUNCTION AND MYOCARDIAL FIBROSIS IN MILDLY SYMPTOMATIC PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY: A PILOT STUDY, by Izawa et al.

 
Landmark clinical trials have previously demonstrated the benefits of mineralocorticoid receptor antagonism in patients with symptomatic congestive heart failure. In fact, the Randomized Aldactone Evaluation Study (RALES) found that the addition of spironolactone to standard therapy reduced mortality by 30% in patients with NYHA class III or IV congestive heart failure. On the basis of these results, mineralocorticoid receptor antagonists have become widely accepted as part of the standard therapeutic regimen for patients with advanced symptoms due to congestive heart failure. It has been suggested that one mechanism by which . . . [Full Text of this Article]