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Welcome May 30, 2012
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 N E W S C E N T E R
Updated:  May 30, 2012
AusDiab study: Combined impact of diabetes and impaired Health-Related Functioning on CVD mortality
Among those with diabetes, impaired HRF is likely to be important in the identification of individuals at increased risk of CVD mortality  
Rapid aspirin desensitization protocol consisting of 1mg starting dose within 15 mins and 80mg target dose within 30 minutes interval is safe and effective in aspirin-allergic coronary artery disease patients requiring a dual anti-platelet therapy
Among 13 patients desensitized by a protocol using dosing interval of 30 minutes, 1 patient tolerated a repeated desensitization protocol after receiving 80mg oral prednisolone two days later while another discontinued aspirin due to complications. No occurrence of any adverse events was reported.
An analysis of TOPP registry: Difficulty in clinical classification of congenital heart disease associated pulmonary hypertension with the current absolute defect size for those described by the investigator or with moderate defects or considered too young to develop disease
The sub-classification seemed feasible only for following pediatric patients; patients with a large unrestrictive shunt defect with significant cyanosis <90%, those with >90% significant cyanosis + an indexed pulmonary vascular resistance >3 WU*m² and in those with pulmonary arterial hypertension after complete repair.
Effects of diabetes and glycaemic control on peripheral artery disease in patients with end-stage renal disease
Diabetes is a strong predictor of PAD after initiation of haemodialysis therapy, among patients with ESRD
The National Health and Nutrition Examination Survey: Association between Diabetes, Metabolic Syndrome and Platelet Activity
Mean platelet volume strongly and independently co-relate with the presence and severity of diabetes
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Reduced platelet reactivity achieved by an intensive glycemic control than with a conventional glycemic control in hyperglucemic type 2 diabetics suffering an acute coronary syndrome and carriers of the allele C of the rs956115 marker of Insulin Receptor Sustrate-1 gene
Reduced ADP20µM, ADP5µM, collagen, epinephrine, TRAP, IRP, GPIIb/IIIa, P-selectin are reported by type 2 diabetics who were carriers of the C allele assigned to intensive glycemic control in comparison to those assigned to conventional glycemic control.
Effect of Statins on Late Target Lesion Revascularization After Sirolimus-Eluting Stent Implantation
Risk for late TLR significantly favored statin use in patients implanted with sirolimus-eluting stents
Association of arterial stiffness with low-grade inflammation in type 1 diabetics without clinical cardiovascular disease
Particularly in men with type 1 diabetes, low-grade inflammation is independently associated with arterial stiffness
An Isomaltulose diet than a sucrose diet lowers triglyceride levels but did not influence glycemic control in type 2 diabetes patients
Significantly lower triglycerides were reported in the isomaltulose at 12 weeks when compared with the sucrose group. However, HbA1c at 12 weeks was significantly unaffected by isomaltulose.
Effect of antioxidant consumption on endothelial dysfunction in the elderly
antioxidant, endothelial dysfunction, elderly
The Honolulu Asia Aging Study: Joint association of midlife BP and β-Amyloid levels with the risk for late-life Alzheimer disease and vascular dementia
Elevated BP may compromise vascular integrity leading to cerebral amyloid angiopathy and impaired Aβ clearance from the brain
Analysis of the SOS Xience V Study: Use of Xience V Everolimus-eluting stent in saphenous vein grafts effectively suppresses neointima formation
No thrombus was detected in the stented areas. The mean difference between the stent area and the lumen area was 0.36 ± 1.6 mm².
A risk factor for early death in children who undergo mitral valve replacement are low mitral valve annulus size and prosthesis/annulus mismatch
Children aged < 18 yrs of age and with <10 kg weight required earlier re- mitral valve replacement since significantly better early freedom from re- mitral valve replacement (<6 years) was reported in those with >10 kg of weight.
Positive correlation between chylomicron lipopolysaccharide levels and the triglyceride increase after fat overload but not to degree of insulin resistance in morbidly obese patients
A higher increase in lipopolysaccharide levels in serum and the chylomicron fraction after the fat overload were reported in the morbidly obese patients with the highest postprandial hypertriglyceridemia.
Relation between blood pressure and dementia in women followed for 37 years
Association between blood pressure and dementia is complex and is influenced by antihypertensive treatment
Effect of fructose in isocaloric exchange for other carbohydrates on blood pressure
There were no adverse effects of isocaloric substitution of fructose for other carbohydrates on blood pressure in humans
Safety of a percutaneous stent implantation demonstrated in most of the patients with coarctation by reducing the need for multiple anti-hypertensive drugs
Notably, final stent diameter correlated with body surface area in medication free patients. Higher percentage of patients with transverse aorta/aorta diaphragm level >0.8 remained medication free than compared to those with < 0.8.
Contact impedance mapping using the Carto system helps differentiate focal from reentrant arrhythmias in patients undergoing electrophysiologic testing for long RP Supra-ventricular Tachycardias or SVT with variable AV conduction
25 patients diagnosed with macro reentrant atrial arrhythmias showed uniform impedance without a focal low area. It was also found that the focal area of low impedance either encompassed the site of successful focal ablation or was within 1.4±0.8 cm from atrial surface area.
Upper normal blood pressures can predict incident atrial fibrillation in healthy middle-aged men
Sustained upper normal systolic BP is a significant predictor of subsequent AF.
Candesartan antihypertensive treatment influences the correlations in-between inflammatory markers that lead to low grade chronic inflammation and also improves antihypertensive capacity in type 2 diabetes patients
Before candesartan administration, significant positive correlations were found between hs-CRP and MCP-1, IL-6 and MCP-1 and TTR and MCP-1 but these correlations were not found at the end of candesartan administration.
The EVOLVO Study: Remote monitoring as compared to standard follow-up with in-office visits and audible ICD alerts has an increased efficiency for an improved quality of care and reduces cardiac or device related events
23% reduction in rates of all hospital admissions for cardiac/ device-related events was reported in the remote arm vs. standardized patients' management arm. A more favorable change in Minnesota Living with Hearth Failure Questionnaire was observed in the remote arm till the 16-month.
Post hoc analysis of TRINITY study: Triple therapy of Olmesartan + Amlodipine and Hydrochlorothiazide is effective than the dual combination therapy for hypertensive patients with diabetes
Greater mean reductions in systolic BP were achieved with triple therapy consisting of 40 mg Olmesartan + 10mg Amlodipine and 25 mg HCTZ than compared to the dual-combinations for both diabetes and non-diabetes patients with severe hypertension
LV muscarinic receptor density in remote and damaged regions of patients after myocardial infarction
Higher Bmax / LV muscarinic receptor density was reported in the remote regions of all patients after myocardial infarction than in the normal regions of controls. However, a reduced Bmax was reported in the damaged regions, of both patient groups.
Transient dilation of the left ventricle on adenosine myocardial perfusion imaging is not related to chamber enlargement and myocardial stunning but is more likely a function of subendocardial hypoperfusion and impaired coronary flow reserve
On myocardial perfusion imaging in the transient ischemic dilation group, a significant drop in LVEF, and an increase in both LVESV and LVEDV were observed between rest and early stress in patients undergoing single-day Tc-99m adenosine sestamibi myocardial perfusion imaging.
QUARTO Study: Best cardiac output obtained during pacing from a non-traditional vector unique to the quadripolar lead is greater than that obtained from a traditional vector
Association of Bi-V pacing using vectors (only available with a quadripolar lead) with improved cardiac output was reported in 53% of patients.
Multi-scale entropy is a useful tool for heart failure detection and management in patients with systolic heart failure
Significant correlation was shown by serum matrix metalloproteinase 2 levels with multi-scale entropy parameters such as Slope5, Area1-5, and Area6-15. Additionally, a strong and significant correlation existed especially between MMP-2 and Area6-15.
A feasible supraventricular tachyarrhythmias directed therapy like ventricular tachyarrhythmia's zone programming above 170/min can reduce inappropriate anti-tachycardia pacing and/or inappropriate shocks
It was found that inappropriate therapies were triggered by atrial fibrillation with rapid ventricular response, non-atrial fibrillation supraventricular tachyarrhythmia's, abnormal sensing and sinus tachycardia.
Additional measurement of adiponectin level but not Brain natriuretic peptide levels are useful as a marker of heart failure in senile patients with body fat percent more than 40% or in between 40% to 50 %
Heart failure presence was strongly correlated with an integral marker that was an increase of brain natriuretic peptide and adiponectin levels corrected by body fat percent levels. Patients with body fat percent in range 40-50% showed maximal strength of correlation.
Notch pathway dysregulation is underlying mechanism of dysfunction shown by the lipoaspirate mesenchymal stem cells from stromo-vascular fraction of the adipose tissue in heart failure patients
Severe heart failure negatively affected the levels of senescence, stemness and differentiation capability of mesenchymal stem cells isolated from lipoaspirate.
Integrated effects of cardiovascular risk factors and left ventricular systolic dysfunction on myocardial blood flow and flow reserve in patients with angina-like chest pain and without significant coronary artery disease
The only independent predictors of reduced myocardial flow reserve were the left ventricular ejection fraction and insulin resistance.
The moderate association between E/E'septal and pulmonary capillary wedge pressure in modern heart transplant recipients cautions the need for careful interpretation of an echocardiogram for the prediction of left ventricular filling pressure in modern heart transplant recipients with atrial anastomoses
E/E' septal at a cut-off value of 22 could moderately identify a PCWP > 12 mm Hg in heart transplant patients with a sensitivity of 77 % and a specificity of 90 %.
Anterior myocardial infarction is an important risk factor influencing the global left ventricular contractility and the occurrence of heart failure in patients with coronary disease scheduled for elective coronary artery by-pass graft surgery
Other than previous myocardial infarction (MI), similar results were observed between patients who did not have heart failure due to CAD and who had heart failure due to CAD for the preoperative therapy used, age, and the presence of risk factors for coronary disease.
An early detection of diastolic dysfunction in diabetics with subclinical diastolic dysfunction is possible with use of classic cardiovascular risk scores
A Framingham>20% (62.5% sensitivity/SE, 76.9% specificity/SP) and a SCORE>2% (86.7%SE, 64%SP) is the best threshold for identifying diastolic dysfunction.
A lower blood pressure or SBP <90 mmHg leads to their worst prognosis only in heart failure patients with previous history of hypertension
An occurrence of heart failure related mortality was reportedly associated with a crude hazard ratio of 2.208 [1.063-4.586] in those who had systolic blood pressure below 90 mmHg, when compared to the group that had SBP above 90 mmHg.
The Hepcidine link: Hepcidine levels in heart failure patients are related to inflammation and renal function
Pearson correlation in iron deficiency subgroup could only demonstrate the correlation of hepcidine with M-Iron, LVEDV and creatinine. The only predictor for hepcidine levels was M-Iron.
• AusDiab study: Combined impact of diabetes and impaired Health-Related Functioning on CVD mortality   • An 8-year follow-up of the Hoorn Study: Both glucose status and arterial distensibility are independently associated with more severe and deteriorated left ventricular diastolic dysfunction in subjects with preserved LV systolic/ diastolic function and type 2 diabetes   • Analysis of VOYAGER: Greater percentage of patients on rosuvastatin achieved the LDL-C goal < 70mg/dL or >50% when compared with equal or double milligram doses of atorvastatin or simvastatin   • Metabolic status should be monitored with 2 hrs OGTT and not by fasting glucose   • Approximate Entropy is a new clinical tool for the complexity measurement of human persistent atrial fibrillation electrograms   • Retrospective analysis of the St. Jude Medical ACT ICD registry: Single coil ICD leads are equivalent to dual coil ICD leads with regards to the clinical first shock efficacy of rescue ventricular tachycardia/ventricular fibrillation in modern high voltage ICD systems   
 REVIEWS
 
Heart Failure Management
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Clinical assessment and improvement in Diastolic Dysfunction
Therapeutic Options in AMI: Emphasis on DES
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 INDUSTRY NEWS

Qnexa, the new obesity drug to be reviewed for cardiovascular risks by FDA

ICON's Nuloy, an extremely thin strut coronary stent system gets CE mark approval

Sanofi in agreement with Pluromed to buy its U.S. medical device used in surgery
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 INTERESTING  CASES
 
A 56-year-old male with acute coronary syndrome shows the LCX originating from proximal RCA as the culprit artery
Using the knuckle push technique, safe and elegant positioning of the guiding catheter at the origin of the anomalous LCX was achieved by wiring the RCA first and using this guidewire to control the guiding catheter
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 UPCOMING   EVENTS
 
European Society of Cardiology (ESC Congress 2012)
August 25, 2012 - August 29, 2012
Munich - Germany

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