Circulation. 2007;115:3039
doi: 10.1161/CIRCULATIONAHA.107.183532
(Circulation. 2007;115:3039.)
© 2007 American Heart Association, Inc.
Issue Highlights
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LONG-TERM PROGNOSTIC VALUE OF NEOPTERIN: A NOVEL MARKER OF MONOCYTE ACTIVATION IN PATIENTS WITH ACUTE CORONARY SYNDROME, by Ray et al.
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Inflammatory processes are major contributors to atherothrombosis.
As such, investigators have maintained intense interest in identifying
noninvasive tools to detect underlying inflammation that may
(1) enhance risk assessment, (2) direct specific interventions
to modify risk, and (3) provide a means by which to monitor
the response to therapy. Neopterin, a soluble biomarker produced
by activated monocytes, has shown promise as a prognostic indicator
in small clinical studies of patients with acute coronary syndromes.
Ray and colleagues assessed the association between neopterin
and clinical outcomes in

4000 patients with ACS and showed an
adjusted 86% higher relative risk of death in patients with
a neopterin concentration in the highest quartile (

12.11 nmol/L).
Intensive statin therapy significantly attenuated the risk associated
with an elevated baseline concentration of neopterin. These
findings support continued investigation of neopterin as a potential
tool to target and monitor the success of preventive therapies
with antiinflammatory actions. See p
3071.
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SUPERIOR CARDIOVASCULAR EFFECT OF AEROBIC INTERVAL TRAINING VERSUS MODERATE CONTINUOUS TRAINING IN HEART FAILURE PATIENTS: A RANDOMIZED STUDY, by Wisløff et al.
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and
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EXERCISE TRAINING NORMALIZES SYMPATHETIC OUTFLOW BY CENTRAL ANTIOXIDANT MECHANISMS IN RABBITS WITH PACING-INDUCED CHRONIC HEART FAILURE, by Gao et al.
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Exercise training among patients with heart failure has been
shown to have beneficial effects beyond improvements in exercise
capacity. The mechanisms by which these favorable effects occur
are not yet fully understood, and the optimal training regimen
that should be prescribed to attain these benefits is not known.
In this issue of
Circulation, 2 related papers are presented.
Gao and colleagues report interesting findings from study of
a rabbit model used to evaluate whether the observed favorable
alterations in sympathoexcitation are attributable to antioxidative
changes that occur in the central nervous system. In a clinical
study of patients with heart failure, Wisløff et al evaluated
whether differences in exercise training intensity (high-intensity
interval exercise versus moderate-intensity continuous exercise)
yield discrete changes in antioxidant status, left ventricular
remodeling, and vascular function. The provocative findings
of these important studies are discussed in an accompanying
editorial by Belardinelli. See pp 3086 and 3095 (editorial p
3042).
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RANDOMIZED TRIAL OF ACUPUNCTURE TO LOWER BLOOD PRESSURE, by Flachskampf et al.
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East meets West in this single blinded trial of 160 patients
with hypertension randomized to active or sham acupuncture treatments.
The treatments were conducted by highly trained Chinese physicians
in 22 sessions over a 6-week period. At the first follow-up
visit, the group allocated to the active arm had lower 24-hour
ambulatory blood pressure relative to the sham treatment group.
This difference in blood pressure was not sustained, however,
at subsequent evaluations. Although this trial cannot be considered
as definitive, it represents a strong attempt to use modern
clinical trial methodology to probe ancient medicine. See p
3121 (editorial p
3048).
Visit http://circ.ahajournals.org:
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Cardiology Patient Page
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Testing in the Noninvasive Vascular Laboratory. See p
e624.
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Images in Cardiovascular Medicine
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Diagnostic Utility of Cardiac Magnetic Resonance Imaging in
Monozygotic Twins With Hypertrophic Cardiomyopathy and Identical
Pattern of Left Ventricular Hypertrophy. See p
e627.
Percutaneous Retrieval of a Lost Guidewire That Caused Cardiac Tamponade. See p e629.
Pulmonary Artery Thrombosis and Hemoptysis in Eisenmenger Syndrome. See p e632.
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Book Review
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Heart Valve Disease: A Guide to Patient Management After Surgery.
See p
e635.
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Correspondence
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See p
e637.