Circulation. 2007;115:547
(Circulation. 2007;115:547.)
© 2007 American Heart Association, Inc.
Issue Highlights
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ASSOCIATIONS OF GESTATIONAL AGE AND INTRAUTERINE GROWTH WITH SYSTOLIC BLOOD PRESSURE IN A FAMILY-BASED STUDY OF 386 485 MEN IN 331 089 FAMILIES, by Lawlor et al.
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Many previous studies have provided support for the fetal origins
of disease. Investigators have hypothesized that fetal undernutrition
contributes to poor growth and programs individuals for hypertension
in later life. Skeptics have raised concerns, however, that
studies supporting the developmental origins hypothesis may
reflect residual confounding by socioeconomic factors. Lawlor
and colleagues took advantage of Swedish birth and military
service registries of 386 485 singleton-born men from 331 089
families to study the associations of birth weight and gestational
age with subsequent systolic blood pressure at age 17 to 19
years. The investigators report that birth weight was inversely
associated with systolic blood pressure; per 1-SD difference
in birth weight, there was a –0.21 mm Hg difference in
siblings, whereas nonsiblings had –0.12 mm Hg lower systolic
blood pressure. They also observed that increasing gestational
age was inversely associated with young adult systolic blood
pressure. By taking advantage of a large unique sibling data
set, the Lawlor et al study suggests that the link between gestational
age, lower birth weight, and adult blood pressure does not merely
reflect confounding by socioeconomic status. See p
562.
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EFFECTS OF NORMAL BLOOD PRESSURE, PREHYPERTENSION, AND HYPERTENSION ON CORONARY MICROVASCULAR FUNCTION, by Erdogan et al.
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Coronary flow reserve (CFR) has been shown to be impaired in
patients with hypertension. Left ventricular hypertrophy contributes,
but other mechanisms likely contribute as well. Prehypertension
is also associated with an increased cardiovascular morbidity
and mortality. Whether prehypertension is associated with impaired
CFR is less well studied. The study by Erdogan et al in this
issue of
Circulation evaluated CFR using transthoracic Doppler
echocardiography before and after intravenous dipyridamole infusion.
CFR was significantly lower in hypertensive patients than in
prehypertensive and normal patients, but prehypertension was
also lower than in normal patients. Both hypertension and prehypertension
were significant predictors of a lower CFR in a multivariable
model. Other factors included systolic and diastolic blood pressure,
high-sensitivity C-reactive protein levels, left atrial diameter
mitral E deceleration time, and mitral A velocity. These findings
are consistent with the concept that mildly elevated blood pressure
is associated with abnormal coronary flow response, although
the degree of impairment is less than in hypertension. See p
593.
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DETECTION OF CORONARY MICROEMBOLIZATION BY DOPPLER ULTRASOUND IN PATIENTS WITH STABLE ANGINA PECTORIS UNDERGOING ELECTIVE PERCUTANEOUS CORONARY INTERVENTIONS, by Bahrmann et al.
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During percutaneous coronary intervention, mechanical disruption
of the atherosclerotic plaque by balloon inflation may result
in embolization of particles to the microvasculature, resulting
in increased postprocedural troponin and high-sensitivity C-reactive
protein levels. Mechanistic studies have found that once coronary
microvascular occlusion occurs, this leads to ventricular contractile
dysfunction. Interestingly, this phenomenon was attributed to
an inflammatory reaction and not a decrease in blood flow. Previous
studies have shown that an intracoronary Doppler guide wire
is able to detect, and quantify, in real time, microemboli that
are released by percutaneous coronary intervention. In this
issue of
Circulation, Bahrmann et al extend these findings to
demonstrate the relationship between percutaneous coronary intervention–induced
coronary microembolization and postprocedural increases in myocardial
necrosis and inflammation. See p
600.
Visit http://circ.ahajournals.org:
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Clinician Update
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Apical Ballooning Syndrome: An Important Differential Diagnosis
of Acute Myocardial Infarction. See p
e56.
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Images in Cardiovascular Medicine
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Left Ventricular Aneurysm Associated With Mucopolysaccharidosis
Type VI Syndrome (Maroteaux–Lamy Syndrome). See p
e60.
Tricyclic Cardiotoxicity Treated With Sodium Bicarbonate. See p e63.
An Unusual Cause of Hand Cellulitis. See p e65.
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Correspondence
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See p
e67.
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Effects of Normal Blood Pressure, Prehypertension, and Hypertension on Coronary Microvascular Function
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Circulation 2007 115: 593-599.
[Abstract]
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Apical Ballooning Syndrome: An Important Differential Diagnosis of Acute Myocardial Infarction
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Tricyclic Cardiotoxicity Treated With Sodium Bicarbonate
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Associations of Gestational Age and Intrauterine Growth With Systolic Blood Pressure in a Family-Based Study of 386 485 Men in 331 089 Families
- Debbie A. Lawlor, Anna Hübinette, Per Tynelius, David A. Leon, George Davey Smith, and Finn Rasmussen
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[Abstract]
[Full Text]
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Detection of Coronary Microembolization by Doppler Ultrasound in Patients With Stable Angina Pectoris Undergoing Elective Percutaneous Coronary Interventions
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ASSOCIATIONS OF GESTATIONAL AGE...
EFFECTS OF NORMAL BLOOD...