Circulation. 2007;115:287
(Circulation. 2007;115:287.)
© 2007 American Heart Association, Inc.
Issue Highlights
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EARLY OUTCOMES OF TRICUSPID VALVE REPLACEMENT IN YOUNG CHILDREN, by Bartlett et al.
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Few data on the outcome of tricuspid valve replacement in young
children are available to guide decisions. Bartlett and colleagues
reviewed the results of tricuspid valve replacement in 97 children
younger than age 6 years using the database of the Pediatric
Cardiac Care Consortium of 45 centers between 1984 and 2002.
The primary outcome was survival to discharge. The most frequent
cardiac diagnoses were Ebstein’s anomaly (40%), pulmonary
atresia (11%), and tetralogy of Fallot (8%). In-hospital mortality
was 26% overall and was highest among infants (64%). Valve thrombosis
and heart block requiring a pacemaker were common complications.
The high morbidity and mortality of tricuspid valve replacement
in young children and especially infants suggests that other
surgical options should be considered. See p
319.
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MYOCARDIAL ISCHEMIC MEMORY IMAGING WITH MOLECULAR ECHOCARDIOGRAPHY, by Villanueva et al.
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Myocardial ischemia that does not result in necrosis may be
difficult to diagnose after resolution of the ischemia. Such
episodes are associated with endothelial upregulation of leukocyte
adhesion molecules. In this issue, Villanueva et al describe
the potential of myocardial ischemic memory using contrast echocardiography.
Lipid microbubbles were designed to adhere to selectins, and
this was tested in a model of inflamed rat cremaster muscle
and in a rat model. Twelve rats underwent 15 minutes of left
anterior descending coronary artery occlusion and then at 15
minutes and 1 hour following reperfusion, there was greater
opacification of the ischemic bed using microbubbles with the
selectin ligand. Immunostaining confirmed endothelial P-selectin
expression. Although preliminary, the present study raises the
potential that this technique may allow the identification of
recent myocardial ischemia in patients and facilitate the triage
of patients with chest pain. See p
345.
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PREVALENCE OF LONG-QT SYNDROME GENE VARIANTS IN SUDDEN INFANT DEATH SYNDROME, by Arnestad et al.
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and
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CARDIAC SODIUM CHANNEL DYSFUNCTION IN SUDDEN INFANT DEATH SYNDROME, by Wang et al.
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Sudden infant death syndrome is unexplained, unexpected death
in the first year of life and has multifactorial etiologies.
One important cause relates to the genes responsible for congenital
long-QT syndrome. In companion manuscripts in this issue of
Circulation, Arnestad and colleagues report their molecular
autopsy findings of genetic screening for 7 known long-QT syndrome—associated
genes in 201 Norwegian victims of sudden infant death syndrome.
They identified mutations or rare genetic variants in 10% of
cases, of which half were in the sodium channel
SCN5A gene.
Wang and colleagues then performed biophysical in vitro functional
experiments on the
SCN5A mutations in transiently transfected
cells. They found defects in the voltage dependence of inactivation
and kinetics, including increased persistent sodium currents,
similar to the biophysical changes seen in
SCN5A mutations causing
long-QT syndrome. Taken together, these investigations conclude
that neonatal electrocardiographic screening may identify QT
prolongation prior to sudden infant death syndrome, potentially
affecting outcome. These studies further our understanding of
the relationship between sudden infant death syndrome and genes
causing long-QT syndrome. See pp
361 and
368.
Visit http://circ.ahajournals.org:
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Clinician Update
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Metabolic Syndrome. See p
e32.
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Images in Cardiovascular Medicine
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Double-Outlet Left Ventricle. See p
e36.
Serial Images Demonstrating Proximal Extension of an Aortic Intramural Hematoma. See p e38.
Lost P’s, but Not Yet Forgotten. See p e41.
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Book Review
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Pediatric Prevention of Atherosclerotic Cardiovascular Disease.
See p
e43.
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Correspondence
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See p
e45.
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Metabolic Syndrome
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Circulation 2007 115: e32-e35.
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Double-Outlet Left Ventricle
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Circulation 2007 115: e36-e37.
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Serial Images Demonstrating Proximal Extension of an Aortic Intramural Hematoma
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Circulation 2007 115: e38-e40.
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Lost P’s, but Not Yet Forgotten
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Circulation 2007 115: e41-e42.
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Pediatric Prevention of Atherosclerotic Cardiovascular Disease
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Circulation 2007 115: e43-e44.
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Letter by Kronish et al Regarding Article, "Residual Arachidonic Acid–Induced Platelet Activation via an Adenosine Diphosphate–Dependent but Cyclooxygenase-1– and Cyclooxygenase-2–Independent Pathway: A 700-Patient Study of Aspirin Resistance"
- Ian M. Kronish, Nina Rieckmann, Daichi Shimbo, and Karina W. Davidson
Circulation 2007 115: e45.
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Early Outcomes of Tricuspid Valve Replacement in Young Children
- Heather L. Bartlett, Dianne L. Atkins, Trudy L. Burns, Kelly J. Engelkes, Sarah J. Powell, Christine B. Hills, and James H. Moller
Circulation 2007 115: 319-325.
[Abstract]
[Full Text]
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Myocardial Ischemic Memory Imaging With Molecular Echocardiography
- Flordeliza S. Villanueva, Erxiong Lu, Shivani Bowry, Sevgi Kilic, Eric Tom, Jianjun Wang, Joan Gretton, John J. Pacella, and William R. Wagner
Circulation 2007 115: 345-352.
[Abstract]
[Full Text]
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Cardiac Sodium Channel Dysfunction in Sudden Infant Death Syndrome
- Dao W. Wang, Reshma R. Desai, Lia Crotti, Marianne Arnestad, Roberto Insolia, Matteo Pedrazzini, Chiara Ferrandi, Ashild Vege, Torleiv Rognum, Peter J. Schwartz, and Alfred L. George, Jr
Circulation 2007 115: 368-376.
[Abstract]
[Full Text]
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Prevalence of Long-QT Syndrome Gene Variants in Sudden Infant Death Syndrome
- Marianne Arnestad, Lia Crotti, Torleiv O. Rognum, Roberto Insolia, Matteo Pedrazzini, Chiara Ferrandi, Ashild Vege, Dao W. Wang, Troy E. Rhodes, Alfred L. George, Jr, and Peter J. Schwartz
Circulation 2007 115: 361-367.
[Abstract]
[Full Text]
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