Circulation. 2007;115:427
(Circulation. 2007;115:427.)
© 2007 American Heart Association, Inc.
Issue Highlights
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LOSS-OF-FUNCTION MUTATIONS IN THE CARDIAC CALCIUM CHANNEL UNDERLIE A NEW CLINICAL ENTITY CHARACTERIZED BY ST-SEGMENT ELEVATION, SHORT QT INTERVALS, AND SUDDEN CARDIAC DEATH, by Antzelevitch et al.
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There are multiple causes of inherited arrhythmia syndromes,
many due to ion channelopathies. Mutations in ion channel encoding
genes lead to clinical phenotypes of arrhythmias, conduction
abnormalities, and vulnerability to sudden death. Recently,
rather than typical long- or short-QT syndrome, Brugada syndrome,
or conduction defects, reports of several overlapping clinical
features bridge the spectrum of inherited arrhythmias. In this
issue of
Circulation, Antzelevitch and colleagues report finding
mutations in L-type calcium channel encoding genes in 7/82 Brugada
syndrome patients without SCN5A sodium channel or known long-QT
syndrome mutations. Of these, 3 had an interesting clinical
constellation of right precordial ST-segment elevation (resembling
Brugada syndrome), short QT intervals (resembling short-QT syndrome),
and sudden cardiac death. They characterize the clinical, genetic,
and family histories and perform detailed
in vitro biophysical
functional analysis of the resultant calcium channel mutations,
demonstrating loss of function deficits in this hybrid inherited
arrhythmia disorder. See p
442.
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TRIGLYCERIDES AND THE RISK OF CORONARY HEART DISEASE: 10 158 INCIDENT CASES AMONG 262 525 PARTICIPANTS IN 29 WESTERN PROSPECTIVE STUDIES, by Sarwar et al.
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Although there have been many previous reports on the importance
of serum triglyceride concentrations and the risk of coronary
heart disease, the strength of the association and the existence
of sex differences have remained controversial. Sarwar and colleagues
report on case-control studies from Reykjavik and EPIC-Norfolk
studies and present an updated meta-analysis in almost 300 000
participants in 29 Western prospective studies. They observed
that the long-term stability of triglyceride measurements over
time was similar to blood pressure and cholesterol values, and
they account for regression dilution bias in their analysis.
The authors observed that the top third of log-triglyceride
values was associated with a 50% increased risk of coronary
heart disease compared with the lower third. They also noted
no major differences in risk by sex or in studies conducted
among fasting versus nonfasting participants. The investigators
note, however, that their data cannot resolve whether triglycerides
per se are causally responsible for the excess coronary heart
disease risk. See p
450.
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PROGNOSTIC VALUE OF HEART RATE INCREASE AT ONSET OF EXERCISE TESTING, by Leeper et al.
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Non–ST segment variables derived from the exercise ECG
test have recently been shown to provide important prognostic
information and, accordingly, have been the focus of much attention.
Peak exercise capacity, the difference in heart rate from rest
to peak exercise, and the fall in heart rate during early recovery
can be easily measured during routine exercise testing and thus
can be readily applied in clinical practice. In this issue,
Leeper et al evaluate the prognostic value of heart rate responses
at the start of exercise in 1959 patients referred for clinical
treadmill testing and compare it to that provided by other variables
derived from the same test. In an accompanying editorial, Bernard
Chaitman offers important and practical insights regarding these
interesting findings. See p 468 (editorial on p
430).
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Cardiac Leiomyosarcoma. See p
e47.
Kussmaul’s Sign in Right Ventricular Dysfunction. See p e49.
Hemodynamic Consequences of Massive Coronary Air Embolism. See p e51.
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Correspondence
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See p
e54.
Related Articles:
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Should Early Acceleration of Heart Rate During Exercise Be Used to Risk Stratify Patients With Suspected or Established Coronary Artery Disease?
- Bernard R. Chaitman
Circulation 2007 115: 430-431.
[Full Text]
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Cardiac Leiomyosarcoma
- Seth Goldbarg, Naveenta Kumar, and Samin Sharma
Circulation 2007 115: e47-e48.
[Full Text]
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Kussmaul’s Sign in Right Ventricular Dysfunction
- Alex John-Patrick Rosenberg and Duwarakan K. Satchithananda
Circulation 2007 115: e49-e50.
[Full Text]
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Hemodynamic Consequences of Massive Coronary Air Embolism
- Anand Prasad, Subhash Banerjee, and Emmanouil S. Brilakis
Circulation 2007 115: e51-e53.
[Full Text]
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Letter by Guazzi and Reina Regarding Article, "Aspirin Use and Outcomes in a Community-Based Cohort of 7352 Patients Discharged After First Hospitalization for Heart Failure"
- Marco Guazzi and Giuseppe Reina
Circulation 2007 115: e54.
[Full Text]
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Triglycerides and the Risk of Coronary Heart Disease: 10 158 Incident Cases Among 262 525 Participants in 29 Western Prospective Studies
- Nadeem Sarwar, John Danesh, Gudny Eiriksdottir, Gunnar Sigurdsson, Nick Wareham, Sheila Bingham, S. Matthijs Boekholdt, Kay-Tee Khaw, and Vilmundur Gudnason
Circulation 2007 115: 450-458.
[Abstract]
[Full Text]
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Loss-of-Function Mutations in the Cardiac Calcium Channel Underlie a New Clinical Entity Characterized by ST-Segment Elevation, Short QT Intervals, and Sudden Cardiac Death
- Charles Antzelevitch, Guido D. Pollevick, Jonathan M. Cordeiro, Oscar Casis, Michael C. Sanguinetti, Yoshiyasu Aizawa, Alejandra Guerchicoff, Ryan Pfeiffer, Antonio Oliva, Bernd Wollnik, Philip Gelber, Elias P. Bonaros, Jr, Elena Burashnikov, Yuesheng Wu, John D. Sargent, Stefan Schickel, Ralf Oberheiden, Atul Bhatia, Li-Fern Hsu, Michel Haïssaguerre, Rainer Schimpf, Martin Borggrefe, and Christian Wolpert
Circulation 2007 115: 442-449.
[Abstract]
[Full Text]
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