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(Circulation. 2004;110:1177.)
© 2004 American Heart Association, Inc.
Issue Highlights |
PREVALENT LOW-FREQUENCY OSCILLATION OF HEART RATE: NOVEL PREDICTOR OF MORTALITY AFTER MYOCARDIAL INFARCTION, by Wichterle et al.
Risk stratification after myocardial infarction is of interest to guide the use of effective but costly additional therapy. Noninvasive markers, including diminished heart rate variability (HRV), have limited predictive accuracy and have not been widely adopted. This study reports a novel HRV analysis that defines the prevalent low-frequency oscillation (PLF) in the low-frequency (0.05 to 0.15 Hz) range. Tested retrospectively in two large, independent multicenter trials, PLF in the high end of this spectral range was associated with a >4-fold increase in mortality. PLF was not correlated with several other HRV measures, which suggests that it may reflect different phenomena than those reflected in available tests. These methods offer potential insight into noninvasive risk stratification after myocardial infarction. See p 1183.
IMPACT OF THE METABOLIC SYNDROME ON MORTALITY FROM CORONARY HEART DISEASE, CARDIOVASCULAR DISEASE, AND ALL CAUSES IN UNITED STATES ADULTS, by Malik et al.
It is estimated that 24% of the US population has the metabolic syndrome. Whereas the high mortality rate associated with diabetes itself is established, the mortality rate associated with the metabolic syndrome has been less well understood. The investigators examined data from the US Second National Health and Nutrition Examination Survey and noted that the metabolic syndrome was associated with a doubling in coronary heart disease mortality. Compared with individuals who had neither the metabolic syndrome nor prior cardiovascular disease, those with the metabolic syndrome had a 40% increased risk of dying. Moreover, the investigators noted that the metabolic syndrome more strongly predicted coronary heart, cardiovascular, and total mortality than its individual components. In that the obesity epidemic in the United States has led to a rise in metabolic syndrome prevalence, the significantly increased risk of dying portends a burgeoning public health issue. See p 1245.
SIMVASTATIN INDUCES HEME OXYGENASE-1: A NOVEL MECHANISM OF VESSEL PROTECTION, by Lee et al.
The effectiveness of HMG CoA–reductase inhibitors (statins) in reducing the morbidity and mortality from cardiovascular disease is evident in high-risk patients regardless of their LDL cholesterol levels. As a consequence, there has been considerable interest in delineating vascular effects of statins that are independent of LDL cholesterol. Lee and colleagues found that simvastatin administration led to an increase in the vascular smooth muscle cell content of heme oxygenase-1, an enzyme in the heme degradation pathway that is also important to cellular stress adaptation. This increase in heme oxygenase-1 was responsible for many of the antiinflammatory effects of simvastatin. These findings may explain, in part, why statins have demonstrated such potent antiinflammatory activity in clinical trials. See p 1296.
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Images in Cardiovascular Medicine
Multiple Radial Artery Plaques. See p e293. 
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Multimodality Imaging of Hemangiectasia Hypertrophicans (Klippel-Trenaunay-Parkes-Weber Syndrome). See p e295.
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Related Articles:
Circulation 2004 110: 1245-1250.
Circulation 2004 110: 1296-1302.
Circulation 2004 110: 1183-1190.
Circulation 2004 110: e293-e294.
Circulation 2004 110: e295.
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