This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Related Articles

INSIDE THIS ISSUE OF JACC

Inside This Issue of JACC

	State-of-the-Art Paper

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

	Special Correspondence

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
A Patient's Journey Through Cardiology From 1969 to 2008.  
Hecht and Colmer review some of the major breakthroughs in cardiology from the perspective of a single patient who underwent his first angiogram in 1969 by Dr. Mason Sones. This was followed with a double mammary direct myocardial implantation (the Vineburg procedure). He subsequently required echocardiography, nuclear perfusion imaging, and implantable cardioverter-defibrillator insertion. This was then followed by multidetector computed tomography and placement of a drug-eluting stent. This single patient experienced first hand many of the technological revolutions in cardiology. See page 1366. See figure.

	Atherosclerosis

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
IL-5 May Be Protective Against Atherosclerosis.   Sämpi and colleagues have earlier demonstrated in mice that antibodies to oxidized low-density lipoprotein (OxLDL) are atheroprotective. In this study, they measured levels of interleukin (IL)-5 and antibodies to OxLDL in a cohort of Finnish men who also underwent carotid intima-medial thickness (IMT) measurement. There was a strong association between IL-5 and antibodies to OxLDL. Plasma IL-5 levels were also inversely associated with IMT, even after adjusting for traditional cardiac risk factors. These results suggest that IL-5 may be atheroprotective by increasing the generation of antibodies to OxLDL; the antibody–OxLDL complex is presumably less likely to transit the endothelium. See pages 1370 and 1379.

	Atherosclerosis

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
β2AR Ile164 Polymorphism May Predispose to CAD.  
The beta₂-adrenergic receptor (β2AR) is a polymorphic gene with approximately 4% of individuals expressing the Ile164Thr variant. This variant has been shown to be hypofunctional with in vitro assays. Piscione and colleagues genotyped 330 patients undergoing percutaneous coronary intervention (PCI) and 100 matched controls. The Ile164 variant was found 4 times more frequently in the PCI patients than in controls. Compared to other PCI patients, those with the polymorphism had more severe coronary artery disease (CAD), and higher incidences of new acute myocardial infarction or cardiac death at follow-up. This study suggests that the β2AR Ile164 variant predisposes to CAD and adversely affects prognosis. See pages 1381 and 1389. See figure.

	Heart Failure

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
Decreased Capillary Density Impairs CFR in IDC.   Several mechanisms have been proposed to explain the decreased coronary flow reserve (CFR) seen in some patients with idiopathic dilated cardiomyopathies (IDC). Tsagalou and colleagues performed CFR measurements in patients with IDC and then measured myocardial capillary density (MCD) from endomyocardial biopsy samples. There was a linear relationship between CFR and MCD. This study shows that some patients with IDC have a reduction in the density of capillaries that leads to reduced CFR; further studies will elucidate the etiology of the reduced MCD. See pages 1391 and 1399.

	Cardiac Resynchronization Therapy

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
CRT Is More Effective When the Lead Is Positioned in an Area of Latest Mechanical Activation.  
Ypenburg and colleagues used speckle tracking imaging with strain analysis to manufacture time-strain curves for patients undergoing cardiac resynchronization therapy (CRT). The left ventricular (LV) segment with the latest mechanical activation (LMA) was identified. The position of the LV lead was then assessed using chest X-ray and patients followed for at least 6 months. In patients whose LV lead was in the segment with the LMA, there were significant reductions in LV end-systolic volume but not in those whose lead was suboptimally placed. This study shows that radial strain analysis can be used to identify the segment with the LMA which defines the optimal site for LV pacing. See pages 1402 and 1410. See figure.

	Heart Rhythm Disorders

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
AF Triggers Often Begin in the Carina Region Between the PVs.  
It is still unknown what anatomic features of the pulmonary veins (PVs) serve as a nidus for the initiation of atrial fibrillation (AF). Valles and colleagues mapped the location of spontaneous or isoproterenol-induced AF triggers in patients undergoing PV isolation procedures. Most of the early depolarizations that triggered AF originated from the "carina zone" which they defined as the area between the ipsilateral PVs. The authors conclude that the carina zone between the PVs is an important source of AF triggers. See page 1413. See figure.

	Lipid Reduction in Adolescents

Top State-of-the-Art Paper Special Correspondence Atherosclerosis Atherosclerosis Heart Failure Cardiac Resynchronization... Heart Rhythm Disorders Lipid Reduction in Adolescents

 
Ezetimibe Improves LDL Reduction in Adolescents With HeFH.  
A low-density lipoprotein cholesterol (LDL-C) level of <110 mg/dl is considered ideal for children with hereditary familial hypercholesterolemia (HeFH). Some patients will not achieve this level with simvastatin alone. van der Graaff and colleagues performed a placebo-controlled 1-year trial of ezetimibe in conjunction with simvastatin in 248 subjects age 10 to 17 years with HeFH. The combination reduced LDL by approximately 16% compared to simvastatin monotherapy. The rate of adverse events was similar for ezetimibe and placebo. Coadministration of ezetimibe with simvastatin appears to be safe, well tolerated, and effective for lowering LDL-C in adolescents with HeFH. See page 1421. See figure.

Related Articles

Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use: International Society for Holter and Noninvasive Electrophysiology Consensus

Axel Bauer, Marek Malik, Georg Schmidt, Petra Barthel, Hendrik Bonnemeier, Iwona Cygankiewicz, Przemyslaw Guzik, Federico Lombardi, Alexander Müller, Ali Oto, Raphael Schneider, Mari Watanabe, Dan Wichterle, and Wojciech Zareba
J. Am. Coll. Cardiol. 2008 52: 1353-1365. [Abstract] [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Related Articles