Circulation. 2006;114:2429
(Circulation. 2006;114:2429.)
© 2006 American Heart Association, Inc.
Issue Highlights
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ISCHEMIC HEART DISEASE EVENTS TRIGGERED BY SHORT-TERM EXPOSURE TO FINE PARTICULATE AIR POLLUTION, by Pope et al.
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Long-term exposure to particulate matter has been linked to
chronic lung injury, vascular inflammation, and atherosclerosis
in animals and increased risk of pulmonary disease, ischemic
heart disease, and death in humans. Short-term exposure to particulate
matter has been reported to alter vascular and cardiac function
and to trigger myocardial infarction and stroke in humans. The
study by Pope et al, reported in this issue of
Circulation,
took advantage of an almost 13 000 patient catheterization registry
and daily community-based monitoring of particulate matter concentrations.
The investigators observed that ambient fine particulate pollution
was associated with a 45% increased risk of acute coronary syndromes.
Furthermore, they report that individuals with catheterization-documented
coronary artery disease were particularly vulnerable to pollution.
Because exposure to pollution is common in metropolitan settings,
these findings may have important implications for public health
and public policy debates about acceptable pollution levels.
See p
2443.
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EXTENDING THE HORIZON IN CHRONIC HEART FAILURE: EFFECTS OF MULTIDISCIPLINARY, HOME-BASED INTERVENTION RELATIVE TO USUAL CARE, by Inglis et al.
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Disease management programs are increasing in popularity, but
little is known about their long-term impact on patient outcomes.
Australian investigators previously conducted a randomized trial
of a nurse-led, multidisciplinary, home-based intervention for
elderly patients with heart failure and found that the intervention
improved survival and reduced hospital admissions. The intervention
consisted of no more than 6 months of support. Now Inglis and
colleagues have examined the outcomes of these patients 7.5
to 10 years after first entering the study. Their question is
whether the relatively brief intervention was able to change
the trajectory of the disease in the participants over the following
decade. They examined all-cause mortality, event-free survival,
hospitalizations, and costs. See p
2466.
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PREVENTION OF HIGH-DOSE CHEMOTHERAPY–INDUCED CARDIOTOXICITY IN HIGH-RISK PATIENTS BY ANGIOTENSIN-CONVERTING ENZYME INHIBITION, by Cardinale et al.
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Cardiac toxicity remains a major limitation for administering
anticancer chemotherapy, particularly with the use of higher
doses of anthracyclines. An increase in proponent shortly after
chemotherapy has been shown to be a strong predictor of the
development of left ventricular dysfunction. In this issue of
Circulation, Cardinale et al report on their randomized trial
of 114 chemotherapy patients with elevated troponins to receive
or not receive the angiotensin-converting enzyme inhibitor enalapril.
The prespecified echocardiographic end points of the deterioration
of left ventricular function were strikingly reduced in the
angiotensin-converting enzyme inhibitor–treated patients.
See p
2474.
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Images in Cardiovascular Medicine
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Reverse Bernheim Phenomenon as a Cause of Exercise-Induced Syncope.
See p
e618.
Computed Tomography–Guided Biopsy of an Epicardial Mass. See p e621.
Right Ventricular Acupuncture Needle Embolism Detected on Coronary Computed Tomography Angiography. See p e623.
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Correspondence
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See p
e627.
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