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(Circulation. 2005;111:2711.)
© 2005 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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RHO-KINASE INHIBITOR IMPROVES INCREASED VASCULAR RESISTANCE AND IMPAIRED VASODILATION OF THE FOREARM IN PATIENTS WITH HEART FAILURE, by Kishi et al. |
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Although increased vascular tone is a well-recognized feature in heart failure, the mechanisms responsible are incompletely understood. When activated by the small GTPase Rho, Rho-kinase inhibits the activity of myosin light chain phosphatase, thereby increasing vascular smooth muscle contraction. A Rho-kinase inhibitor, fasudil, was administered via the brachial artery to 26 patients with NYHA functional class II and III heart failure and to 26 control subjects, and forearm vascular resistance was determined by using plethesmography. Fasudil caused vasodilation and improved the vasodilation induced by reactive hyperemia in the patients with heart failure but not in the control subjects. By comparison, nitroprusside caused vasodilation in both groups. These observations suggest the involvement of Rho-kinase in mediating increased vascular tone in heart failure and raise the possibility of a new therapeutic approach. See p 2741.
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PRESENCE OF INTRAPLAQUE HEMORRHAGE STIMULATES PROGRESSION OF CAROTID ATHEROSCLEROTIC PLAQUES: A HIGH-RESOLUTION MAGNETIC RESONANCE IMAGING STUDY, by Takaya et al. |
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Hemorrhage into atherosclerotic plaques has been recently reported in histopathologic studies, associated with larger plaque necrotic cores, as well as greater lipid content and macrophage infiltration. Whether intraplaque hemorrhage is simply associated with larger or more complex plaques or indeed stimulates plaque progression has not been clarified. In this issue, Takaya and colleagues use serial cardiovascular magnetic resonance imaging studies of the carotid arteries over 18 months in patients with carotid atherosclerosis to demonstrate that the presence of intraplaque hemorrhage on the initial examination was associated with greater progression of plaque atherosclerosis. Those with hemorrhage at baseline had greater progression of lipid-rich necrotic core volume as well as wall volume, independent of the volume of hemorrhage
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