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(Circulation. 2005;112:935.)
© 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.

	REAL-TIME THREE-DIMENSIONAL ECHOCARDIOGRAPHY: A NOVEL TECHNIQUE TO QUANTIFY GLOBAL LEFT VENTRICULAR MECHANICAL DYSSYNCHRONY, by Kapetanakis et al.

 
Left ventricular (LV) dyssynchrony is recognized as being an important contributor to LV dysfunction in patients with wide QRS complexes. Optimal evaluation of patients with dyssynchrony is uncertain, and various techniques have been described to identify appropriate candidates for cardiac resynchronization therapy (CRT) and to optimize settings after implantation. Kapetanakis et al describe a real-time 3-dimensional echocardiography technique in which global and regional volume and function are assessed in 89 healthy volunteers and 174 patients with and without LV dysfunction. A dyssynchrony index of the entire LV is derived that increases with worsening LV function irrespective of QRS duration. In 26 patients treated with CRT, the dyssynchrony index improves, and this correlates with reverse remodeling. This real-time, 3-dimensional, echo technique may help to quantify objectively the degree of dyssynchrony, direct CRT settings, and identify a larger group of patients with dyssynchrony in the absence of increased QRS duration. See p 992.

	CONTRIBUTION OF CYCLOOXYGENASE-2 TO ELEVATED BIOSYNTHESIS OF THROMBOXANE A2 AND PROSTACYCLIN IN CIGARETTE SMOKERS, by McAdam et al.

 
In recent months, we have experienced an intense and fierce debate about the cardiovascular safety of COX-2 inhibitors. One of the issues in this context is their effects on the biosynthesis of prostaglandins. In this issue of Circulation, McAdam et al report on the effects of rofecoxib at a high dose on the biosynthesis of thromboxane A₂ and prostacyclin in smokers and nonsmokers. Prostacyclin metabolites were increased in smokers and were reduced by rofecoxib; this also occurred to some degree in nonsmokers. Furthermore, the metabolites of thromboxane were increased in smokers and reduced by rofecoxib in smokers . . . [Full Text of this Article]

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