INSIDE THIS ISSUE OF JACC
Inside This Issue of JACC
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Atherosclerosis
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Marine-Derived n-3 FAs Protect Against Atherosclerosis.
Sekikawa and colleagues performed electron beam computed tomography and carotid intima-media thickness measurements on men age 40 to 49 years who were Japanese, white Americans, and Japanese Americans. The findings were then compared with traditional cardiac risk factors as well as with serum levels of marine-derived n-3 fatty acids (FAs). Japanese men had the lowest levels of atherosclerosis as well as the highest levels of FAs. The differences in severity of atherosclerosis between groups became nonsignificant after adjusting for the level of FAs. These data suggest that high serum levels of marine-derived n-3 FAs have antiatherogenic properties. See pages 417 and
425.
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Heart Failure
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Hospitalizations for HF Doubled Over the Past 25 Years.
Fang and colleagues used the National Hospital Discharge Survey data to study trends in hospitalizations for heart failure (HF) in the U.S. over the past 26 years. The overall number of hospitalizations with HF listed as the primary or a contributing diagnosis tripled over this period, which amounts to a doubling when corrected for the increased population. There were especially significant increases in the number of hospitalizations for patients age >85 years and in the frequency with which patients were discharged to long-term care facilities. These findings highlight the increasing prevalence of HF and its role as a source of increased financial demands for Medicare. See pages 428 and
435. See figure.
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Heart Failure
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Identifying Factors That Affect Mortality in Candidates for CRT.
Cleland and colleagues analyzed both baseline variables and early response markers to identify which would better predict the impact of cardiac resynchronization therapy (CRT) on long-term mortality. The strongest predictors of mortality were serum levels of amino terminal pro-brain natriuretic peptide (NT-proBNP) and the severity of mitral regurgitation at 3 months, regardless of assignation to CRT or control. Patients who have refractory mitral regurgitation or elevated NT-proBNP despite treatments for heart failure, including CRT, have higher mortality. However, the effect of CRT on mortality cannot be predicted from these baseline or early response markers. See page 438.
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Biomarkers
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Troponin and NT-proBNP Levels Predict Mortality in Older Adults.
Daniels and colleagues investigated the prognostic value of cardiac troponin T (TnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in a population of community-dwelling, older (mean age 77 years) adults who were followed for up to 9 years. The 4% of participants with detectable TnT ( 0.01 ng/ml) were approximately twice as likely to die. Elevated NT-proBNP (>450 pg/ml) was found in approximately 20% of subjects and also predicted increased mortality. The levels of TnT and NT-proBNP were influenced by several comorbidities including age and renal function, but remained significant in multivariable models. Older adults with detectable TnT or elevated NT-proBNP levels are at increased risk of death. See page 450. See figure.
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Congenital Heart Disease
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Functional Status After Operation for Ebstein Anomaly.
Ebstein anomaly is a spectrum of tricuspid valvular and right ventricular dysplasias with variable severity. Brown and colleagues contacted almost 300 patients who had undergone surgical repair for an Ebstein anomaly over the past 30 years. Eighty-three percent of patients who were alive were in New York Heart Association functional class I or II and 34% were taking no cardiac medications. Thirty-six percent had experienced an atrial arrhythmia. Patients have good long-term survival and functional outcomes after operation for Ebstein anomaly; techniques to reduce the frequency of atrial arrhythmias should be considered. See pages 460 and
467.
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Preclinical Research
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New MRI Method Can Image Macrophages in Atherosclerotic Plaque.
The purpose of this study was to use magnetic resonance imaging (MRI) to identify macrophage-rich atherosclerotic plaque noninvasively. Hyperlipidemic rabbits were injected with iron oxide nanoparticles and then imaged using a positive contrast off-resonance imaging sequence. After administration of the particles, signal enhancement was found only in hyperlipidemic rabbits, and the magnitude of the enhancement correlated with the number of macrophages determined by histology. An accompanying editorial explains how this technique improves on previous MRI and notes that the iron particles are commercially available and appear to be safe in humans. See pages 483 and
492. See figure.
Related Articles
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Marine-Derived n-3 Fatty Acids and Atherosclerosis in Japanese, Japanese-American, and White Men: A Cross-Sectional Study
- Akira Sekikawa, J. David Curb, Hirotsugu Ueshima, Aiman El-Saed, Takashi Kadowaki, Robert D. Abbott, Rhobert W. Evans, Beatriz L. Rodriguez, Tomonori Okamura, Kim Sutton-Tyrrell, Yasuyuki Nakamura, Kamal Masaki, Daniel Edmundowicz, Atsunori Kashiwagi, Bradley J. Willcox, Tomoko Takamiya, Ken-ichi Mitsunami, Todd B. Seto, Kiyoshi Murata, Roger L. White, Lewis H. Kuller for the ERA JUMP (Electron-Beam Tomography, Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort) Study Group
J. Am. Coll. Cardiol. 2008 52: 417-424.
[Abstract]
[Full Text]
[PDF]
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Omega-3 Fatty Acids: The "Japanese" Factor?
- William Harris
J. Am. Coll. Cardiol. 2008 52: 425-427.
[Full Text]
[PDF]
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Heart Failure-Related Hospitalization in the U.S., 1979 to 2004
- Jing Fang, George A. Mensah, Janet B. Croft, and Nora L. Keenan
J. Am. Coll. Cardiol. 2008 52: 428-434.
[Abstract]
[Full Text]
[PDF]
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Worsening Heart Failure Hospitalization Epidemic: We Do Not Know How to Prevent and We Do Not Know How to Treat!
- Javed Butler and Andreas Kalogeropoulos
J. Am. Coll. Cardiol. 2008 52: 435-437.
[Full Text]
[PDF]
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Predicting the Long-Term Effects of Cardiac Resynchronization Therapy on Mortality From Baseline Variables and the Early Response: A Report From the CARE-HF (Cardiac Resynchronization in Heart Failure) Trial
- John Cleland, Nick Freemantle, Stefano Ghio, Friedrich Fruhwald, Aparna Shankar, Monique Marijanowski, Yves Verboven, and Luigi Tavazzi
J. Am. Coll. Cardiol. 2008 52: 438-445.
[Abstract]
[Full Text]
[PDF]
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Minimally Elevated Cardiac Troponin T and Elevated N-Terminal Pro-B-Type Natriuretic Peptide Predict Mortality in Older Adults: Results From the Rancho Bernardo Study
- Lori B. Daniels, Gail A. Laughlin, Paul Clopton, Alan S. Maisel, and Elizabeth Barrett-Connor
J. Am. Coll. Cardiol. 2008 52: 450-459.
[Abstract]
[Full Text]
[PDF]
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Functional Status After Operation for Ebstein Anomaly: The Mayo Clinic Experience
- Morgan L. Brown, Joseph A. Dearani, Gordon K. Danielson, Frank Cetta, Heidi M. Connolly, Carole A. Warnes, Zhuo Li, David O. Hodge, and David J. Driscoll
J. Am. Coll. Cardiol. 2008 52: 460-466.
[Abstract]
[Full Text]
[PDF]
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Can We Modify Late Functional Outcome in Ebstein Anomaly by Altering Surgical Strategy?
- Glen Van Arsdell
J. Am. Coll. Cardiol. 2008 52: 467-469.
[Full Text]
[PDF]
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Noninvasive Detection of Macrophage-Rich Atherosclerotic Plaque in Hyperlipidemic Rabbits Using "Positive Contrast" Magnetic Resonance Imaging
- Grigorios Korosoglou, Robert G. Weiss, Dorota A. Kedziorek, Piotr Walczak, Wesley D. Gilson, Michael Schär, David E. Sosnovik, Dara L. Kraitchman, Raymond C. Boston, Jeff W.M. Bulte, Ralph Weissleder, and Matthias Stuber
J. Am. Coll. Cardiol. 2008 52: 483-491.
[Abstract]
[Full Text]
[PDF]
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"Positive Contrast" Inversion-Recovery With Oxide Nanoparticles-Resonant Water Suppression Magnetic Resonance Imaging: A Change for the Better?
- Michael J. Lipinski, Karen C. Briley-Saebo, Venkatesh Mani, and Zahi A. Fayad
J. Am. Coll. Cardiol. 2008 52: 492-494.
[Full Text]
[PDF]
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Atherosclerosis
Heart Failure
