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(Circulation. 2007;115:2903.)
© 2007 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.

	EARLY METOPROLOL ADMINISTRATION BEFORE CORONARY REPERFUSION RESULTS IN INCREASED MYOCARDIAL SALVAGE: ANALYSIS OF ISCHEMIC MYOCARDIUM AT RISK USING CARDIAC MAGNETIC RESONANCE, by Ibanez et al.

 
The use of early β-blockade in the setting of acute myocardial infarction is recommended by guidelines (oral, class I and intravenous, class IIA) and is widely practiced. Nonetheless, the underlying mechanism of effect has not been firmly established, particularly for early intravenous therapy. Translational models have reported inconsistent results on infarct size, perhaps partly because infarct size has been measured indirectly using enzymatic release. In this issue of Circulation, Ibanez and colleagues use a porcine occlusion/reperfusion model and cardiac magnetic resonance imaging to examine the effect of intravenous metoprolol given during coronary occlusion on infarct size in a randomized, placebo-controlled format. Using recently validated cardiac magnetic resonance techniques, they show that given a similar volume of myocardium at risk, metoprolol was associated with greater myocardial salvage and smaller initial infarct size, as well as greater recovery of left ventricular function over 3 weeks. These interesting data shed light on at least one of the potential underlying mechanisms of effect of early β-blockade on infarct size using contemporary methodology. In an accompanying editorial, Bates examines these data within the perspective of the evolution of the use of β-blockade early in the course of acute myocardial infarction, with focus on contemporary trials and guidelines. See p 2909 (editorial p 2904).

	HERITABILITY, LINKAGE, AND GENETIC ASSOCIATIONS OF EXERCISE TREADMILL TEST RESPONSES, by Ingelsson et al.

 
The exercise treadmill test (ETT) is a standardized test used routinely for detecting ischemic responses to a graded exercise protocol. Several ETT measures are of prognostic importance, including the blood pressure and heart rate responses during exercise and recovery. In . . . [Full Text of this Article]

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