Circulation. 2006;113:919
(Circulation. 2006;113:919.)
© 2006 American Heart Association, Inc.
Issue Highlights
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DETECTION OF DIVERSE BACTERIAL SIGNATURES IN ATHEROSCLEROTIC LESIONS OF PATIENTS WITH CORONARY HEART DISEASE, by Ott et al.
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In this issue of
Circulation, Ott and colleagues systematically
evaluated the presence and spectrum of bacteria in coronary
atherosclerotic lesions based on their molecular phylogeny signatures.
A high overall bacterial diversity of more than 50 different
species was detected in catheter-based atherectomy tissues from
38 patients, indicating diverse bacterial colonization of arterial
lesions. The findings of this study have important implications
for the infection hypothesis in the pathophysiology of coronary
atherosclerosis—namely, diverse bacterial colonization
may be more important than a single pathogen. Although large
randomized trials have failed to show a benefit for specific
antibiotics in the treatment of coronary heart disease, this
study suggests the possibility of a far more complex biology
in which diverse bacterial agents colonizing atheromatous lesions
are in a position to act as additional factors modulating disease
progression. See p
929.
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NOVEL SPECKLE-TRACKING RADIAL STRAIN FROM ROUTINE BLACK-AND-WHITE ECHOCARDIOGRAPHIC IMAGES TO QUANTIFY DYSSYNCHRONY AND PREDICT RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY, by Suffoletto et al.
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Mechanical dyssynchrony is increasingly being recognized as
an important contributor to left ventricular (LV) dysfunction
in patients with depressed LV systolic function. Quantification
of dyssynchrony has potential diagnostic, therapeutic, and prognostic
importance. In this issue of
Circulation, Suffoletto and colleagues
describe a novel technique in which radial strain at several
points of the LV is measured using speckle tracking. Dyssynchrony
by this technique correlates with tissue Doppler, is less angle
dependent than the Doppler approach, and correlates well with
the acute hemodynamic and chronic response. Lead placement that
was found to be concordant with the site of the latest mechanical
activation by speckle tracking was associated with greater improvement
in ejection fraction. This study helps to further clarify quantification
of LV dyssynchrony and brings us closer to identifying optimal
candidates for resynchronization and perhaps to directed placement
of the left ventricular lead where anatomically feasible. See
p
960.
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EFFECT OF POSTEROLATERAL SCAR TISSUE ON CLINICAL AND ECHOCARDIOGRAPHIC IMPROVEMENT AFTER CARDIAC RESYNCHRONIZATION THERAPY, by Bleeker et al.
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One cause of a poor response to cardiac resynchronization therapy
(CRT) may be scarring of the posterolateral segments of the
LV, resulting in ineffective resynchronization. Bleeker et al
evaluated 40 consecutive patients with chronic coronary artery
disease and conventional indications for CRT: NYHA class IV
symptoms of heart failure, LV ejection fraction 120 ms, and
left bundle-branch block. Contrast-enhanced magnetic resonance
imaging identified 14 patients with a transmural posterolateral
scar. In contrast to patients without a posterolateral scar,
these patients did not improve clinically or with regard to
echocardiographic measures of LV function or dyssynchrony. These
results suggest that contrast-enhanced MRI can be used to identify
patients with transmural posterolateral scar who will not respond
to CRT. See p
969.
Visit http://circ.ahajournals.org:
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Clinician Update
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Inflammatory Biomarkers in Acute Coronary Syndrome: Part II:
Acute-Phase Reactants and Biomarkers of Endothelial Cell Activation.
See p
e152.
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Images in Cardiovascular Medicine
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Bidirectional Ventricular Tachycardia Caused by Digitalis Toxicity.
See p
e156.
Hibernating Myocardium Identified by Cardiovascular Magnetic Resonance and Positron Emission Tomography. See p e158.
Carcinoid Heart Disease. See p e160.
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Book Review
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A Change of Heart. See p
e162.
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Correspondence
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See p
e164.
Related Articles:
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Detection of Diverse Bacterial Signatures in Atherosclerotic Lesions of Patients With Coronary Heart Disease
- Stephan J. Ott, Nour Eddine El Mokhtari, Meike Musfeldt, Stephan Hellmig, Sandra Freitag, Ateequr Rehman, Tanja Kühbacher, S. Nikolaus, Pawel Namsolleck, Michael Blaut, Jochen Hampe, Hany Sahly, Alexander Reinecke, Nils Haake, Rainer Günther, Dietmar Krüger, Markus Lins, Gunhild Herrmann, Ulrich R. Fölsch, Rüdiger Simon, and Stefan Schreiber
Circulation 2006 113: 929-937.
[Abstract]
[Full Text]
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Inflammatory Biomarkers in Acute Coronary Syndromes: Part II: Acute-Phase Reactants and Biomarkers of Endothelial Cell Activation
- Ehrin J. Armstrong, David A. Morrow, and Marc S. Sabatine
Circulation 2006 113: e152-e155.
[Full Text]
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Bidirectional Ventricular Tachycardia Caused by Digitalis Toxicity
- Joseph L. Kummer, Rajiv Nair, and Subramaniam C. Krishnan
Circulation 2006 113: e156-e157.
[Full Text]
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Hibernating Myocardium Identified by Cardiovascular Magnetic Resonance and Positron Emission Tomography
- Eiji Tadamura, Masaki Yamamuro, Shigeto Kubo, Shotaro Kanao, Masaki Harada, Kazuwa Nakao, Masashi Komeda, and Kaori Togashi
Circulation 2006 113: e158-e159.
[Full Text]
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Carcinoid Heart Disease
- Wissam A. Jaber and Kyle W. Klarich
Circulation 2006 113: e160-e161.
[Full Text]
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A Change of Heart
- W. Virgil Brown
Circulation 2006 113: e162-e163.
[Full Text]
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Letter Regarding Article by Law et al, "Headaches and the Treatment of Blood Pressure: Results From a Meta-Analysis of 94 Randomized Placebo-Controlled Trials With 24 000 Participants" • Disclosures
- Luciano F. Drager, Paulo A. Lotufo, Isabela M. Bensenor, and Vinod Kumar Gupta
Circulation 2006 113: e164-e165.
[Full Text]
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Effect of Posterolateral Scar Tissue on Clinical and Echocardiographic Improvement After Cardiac Resynchronization Therapy
- Gabe B. Bleeker, Theodorus A.M. Kaandorp, Hildo J. Lamb, Eric Boersma, Paul Steendijk, Albert de Roos, Ernst E. van der Wall, Martin J. Schalij, and Jeroen J. Bax
Circulation 2006 113: 969-976.
[Abstract]
[Full Text]
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Novel Speckle-Tracking Radial Strain From Routine Black-and-White Echocardiographic Images to Quantify Dyssynchrony and Predict Response to Cardiac Resynchronization Therapy
- Matthew S. Suffoletto, Kaoru Dohi, Maxime Cannesson, Samir Saba, and John Gorcsan, III
Circulation 2006 113: 960-968.
[Abstract]
[Full Text]
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DETECTION OF DIVERSE BACTERIAL...
NOVEL SPECKLE-TRACKING RADIAL...