Circulation. 2006;113:2675
(Circulation. 2006;113:2675.)
© 2006 American Heart Association, Inc.
Issue Highlights
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SINGLE-GENE MUTATIONS AND INCREASED LEFT VENTRICULAR WALL THICKNESS IN THE COMMUNITY: THE FRAMINGHAM HEART STUDY, by Morita et al.
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Left ventricular hypertrophy (LVH) is associated with stroke,
coronary heart disease, heart failure, and cardiovascular and
all-cause mortality. LVH results from increases in LV wall thickness
(LVWT), LV mass, and LV volume. Unexplained increases in LVWT
(LVWT 13mm) contribute to LVH in 3% of the general population
over the age of 45. Mutations in sarcomere protein,
PRKAG2,
LAMP2,
-galactosidase A (
GLA), and several mitochondrial genes
are associated with rare familial cardiomyopathies; their contribution
to LVH in the community is unknown, however. Morita et al identified
the prevalence and clinical features of single-gene mutations
in adults in the community with increased LVWT in the absence
of obvious secondary forms of hypertrophy. Among 1862 Framingham
Heart Study participants, 50 had unexplained increased LVWT.
Eight subjects (16%) had sarcomere protein gene mutations and
one (2%) had a
GLA mutation. Therefore, approximately 0.5% of
the general population over age 45 has increased unexplained
LVWT and a single-gene mutation that probably accounts for their
hypertrophy. Increased LVWT in the community is a heterogeneous
condition, and additional investigation of the prevalence and
clinical features of single-gene mutations in other community-based
cohorts will help improve our understanding of the broad spectrum
of genetic causes of increased LVWT. See p
2697.
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AEROBIC CAPACITY IN PATIENTS ENTERING CARDIAC REHABILITATION, by Ades et al.
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Exercise training is a key component of comprehensive cardiac
rehabilitation/secondary prevention programs and generally yields
marked improvements in exercise capacity, particularly among
those with the lowest initial fitness levels. In this issue
of
Circulation, Ades et al provide normative values for exercise
capacity relative to age, gender, and diagnosis among patients
entering cardiac rehabilitation that are derived from 2896 patients.
The nomograms provided in this paper will serve to assist the
clinician in comparing patient status relative to program peers
and established norms, motivating the patient, and setting exercise
training goals. Incorporation of this important information
into the initial patient assessment should serve to enhance
the treatment of patients as they enter cardiac rehabilitation
programs. See p
2706.
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HEMOGLOBIN LEVEL, CHRONIC KIDNEY DISEASE, AND THE RISKS OF DEATH AND HOSPITALIZATION IN ADULTS WITH CHRONIC HEART FAILURE: THE ANEMIA IN CHRONIC HEART FAILURE: OUTCOMES AND RESOURCE UTILIZATION (ANCHOR) STUDY, by Go et al.
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Although several retrospective studies have suggested a link
between anemia and adverse events in patients with heart failure,
the roles of renal insufficiency, treatment differences, and
comorbidities in leading to this relationship have not been
clear. Go et al examined longitudinal outpatient hemoglobin
and creatinine levels in 59 722 adults with heart failure in
an integrated healthcare system. Decreasing hemoglobin and calculated
glomerular filtration rate were both associated with increased
mortality, and these associations were independent of whether
heart failure was due to systolic or diastolic ventricular dysfunction.
These results from a large outpatient population support the
thesis that anemia and renal dysfunction are independent predictors
of adverse outcomes in patients with heart failure. See p
2713.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Large Renal Artery Aneurysm Treated With Stent Graft. See p
e848.
Severe Endothelial Dysfunction After Sirolimus-Eluting Stent Implantation. See p e850.
A 54-Year-Old Female With Chest Pain, Dyspnea, and Inferior Injury on Electrocardiography. See p e852.
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Book Review
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Molecular Mechanisms of Cardiac Hypertrophy and Failure. See
p
e853.
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Correspondence
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See p
e854.
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Circulation 2006 113: 2713-2723.
[Abstract]
[Full Text]
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Single-Gene Mutations and Increased Left Ventricular Wall Thickness in the Community: The Framingham Heart Study
- Hiroyuki Morita, Martin G. Larson, Scott C. Barr, Ramachandran S. Vasan, Christopher J. O’Donnell, Joel N. Hirschhorn, Daniel Levy, Diane Corey, Christine E. Seidman, J.G. Seidman, and Emelia J. Benjamin
Circulation 2006 113: 2697-2705.
[Abstract]
[Full Text]
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Aerobic Capacity in Patients Entering Cardiac Rehabilitation
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Circulation 2006 113: 2706-2712.
[Abstract]
[Full Text]
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