Circulation. 2006;114:529
(Circulation. 2006;114:529.)
© 2006 American Heart Association, Inc.
Issue Highlights
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PERFORMANCE OF TOP-RANKED HEART CARE HOSPITALS ON EVIDENCE-BASED PROCESS MEASURES, by Williams et al.
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The
US News & World Report annual publication of "America’s
Best Hospitals" attracts considerable attention each year, but
the validity of the ranking is not known. Investigators from
the Joint Commission on Accreditation of Healthcare Organizations
sought to determine how ranked and unranked hospitals compared
on the publicly reported quality-of-care measures for patients
admitted with acute myocardial infarction and heart failure.
Williams and colleagues compare 41 ranked hospitals and 733
unranked hospitals with respect to their performance on 6 acute
myocardial infarction and 4 heart failure process measures.
The study determined if the ranked hospitals, in aggregate,
performed better and then investigated how well the ranking
discriminated between hospitals by their performance. The results
provide important information about the value of this popular
system. See p
558.
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INHIBITION OF UROKINASE-TYPE PLASMINOGEN ACTIVATOR OR MATRIX METALLOPROTEINASES PREVENTS CARDIAC INJURY AND DYSFUNCTION DURING VIRAL MYOCARDITIS, by Heymans et al.
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The mechanisms by which viral myocarditis leads to cardiac injury
and failure are not fully understood. In this issue of
Circulation,
Heymans et al examined the role of the proteinases urokinase-type
plasminogen activator (uPA) and matrix metalloproteinases (MMPs)
in mediating cardiac inflammation, injury, and subsequent failure
during coxsackievirus-B3 induced myocarditis. The expression
and activity of uPA and MMP-9 was increased in mice 7 days after
infection with coxsackievirus-B3. In mice with deletion of uPA
or inhibition of MMPs by adenoviral gene overexpression of tissue
inhibitor of metalloproteinases-1, there was decreased cardiac
inflammation and reduced myocardial necrosis, decreased cardiac
fibrosis at 35 days, and prevention of cardiac dilatation and
dysfunction. These data implicate these proteinases in the pathogenesis
of viral myocarditis and thereby raise the possibility of new
therapeutic interventions. See p
565.
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TRANSAPICAL TRANSCATHETER AORTIC VALVE IMPLANTATION IN HUMANS: INITIAL CLINICAL EXPERIENCE, by Lichtenstein et al.
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Surgical aortic valve replacement has been the standard of care
for symptomatic patients with severe aortic stenosis. Recently,
percutaneous transfemoral aortic valve replacement has been
proposed. In this study by Lichtenstein et al, a new technique
is reported, in which surgical exposure of the left ventricular
apex allows aortic valve replacement of a pericardial valve
prosthesis via a direct left ventricular apical puncture. The
initial experience in 7 patients is described. All patients
were considered too high risk for conventional surgery. The
procedure was successful in all with an increase in aortic valve
area from 0.7±0.1 cm
2 to 1.8±0.8 cm
2. At an average
of 87 days follow-up, all patients were alive and doing well.
This initial experience suggests that aortic valve replacement
via direct left ventricular access without cardiopulmonary bypass
is feasible. See p
591.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Percutaneous Transluminal Angioplasty for Treatment of Critical
Hand Ischemia. See p
e232.
Gastroesophageal Reflux Facilitates Esophageal Imaging During Pulmonary Vein Ablation. See p e235.
Hybrid Cardiac Single Photon Emission Computed Tomography/Computed Tomography Imaging With Myocardial Perfusion Single Photon Emission Computed Tomography and Multidetector Computed Tomography Coronary Angiography for the Assessment of Unstable Angina Pectoris After Coronary Artery Bypass Grafting. See p e237.
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Correspondence
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See p
e240.
This article has been cited by other articles:
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F. Roshanali, M. H. Mandegar, M. A. Yousefnia, H. Rayatzadeh, and F. Alaeddini
A Prospective Study of Predicting Factors in Ischemic Mitral Regurgitation Recurrence After Ring Annuloplasty
Ann. Thorac. Surg.,
September 1, 2007;
84(3):
745 - 749.
[Abstract]
[Full Text]
[PDF]
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PERFORMANCE OF TOP-RANKED HEART...
INHIBITION OF UROKINASE-TYPE...