(Circulation. 2004;110:1337.)
© 2004 American Heart Association, Inc.
Issue Highlights |
IN VIVO MAGNETIC RESONANCE IMAGING OF CORONARY THROMBOSIS USING A FIBRIN-BINDING MOLECULAR MAGNETIC RESONANCE CONTRAST AGENT, by Botnar et al.
Most acute coronary syndromes are caused by thrombosis at the site of a rupture plaque. New methods are being developed to allow for direct noninvasive imaging of coronary thrombus. Botnar and colleagues demonstrate the feasibility of using fibrin-binding molecular magnetic resonance (MR) contrast agents with coronary MR imaging. They show that, in an animal model, in-stent thrombosis can be observed with this technique of MR imaging. These recent advances in MR technology coupled with the use of novel clot-binding compounds could have promise in visualizing the formation of thrombus in patients with unstable coronary syndromes. See p 1463.
ACUTE IMPROVEMENT IN GLOBAL AND REGIONAL LEFT VENTRICULAR SYSTOLIC FUNCTION AFTER PERCUTANEOUS HEART VALVE IMPLANTATION IN PATIENTS WITH SYMPTOMATIC AORTIC STENOSIS, by Bauer et al.
Patients with severe aortic stenosis and normal ejection fractions may have subtle systolic dysfunction as measured by tissue Doppler imaging. These changes often are underestimated and yet may contribute importantly to symptoms. It has been thought that progressive interstitial fibrosis contributes largely to this dysfunction. In 8 patients who had percutaneous aortic valve implantation after having surgery declined as a result of hemodynamic instability and/or severe comorbidity, reduction in aortic gradient, as measured at 24 hours compared with baseline, was accompanied by an improvement in ejection fraction and in regional systolic function as measured by tissue Doppler imaging. This immediate improvement occurred even in patients with low ejection fractions. These findings suggest that the major influence on the immediate improvement in regional systolic function is the reduction of afterload. Further immediate improvement is limited by other factors, such as myocardial fibrosis. Future larger studies with evaluations at different time points may clarify the relationship of these important findings to patient outcomes and aid determination as to the appropriate timing of aortic valve surgery. See p 1473.
IMPROVED VASCULAR GENE TRANSFER WITH A HELPER-DEPENDENT ADENOVIRAL VECTOR, by Wen et al.
Vascular gene transfer traditionally has been accomplished with first-generation adenoviral vectors; however, this methodology is limited by brief transgene expression and a significant host inflammatory response in the vessel wall. To overcome these limitations, modified second-generation and third-generation, or "helper-dependent," adenoviral vectors have been constructed. These vectors offer stable and prolonged transgene expression with minimal associated inflammation. In this study, Wen et al utilize helper-dependent adenoviral vectors to demonstrate stable vascular gene transfer of urokinase plasminogen activator for at least 56 days with a minimal inflammatory response in a rabbit carotid artery model. This study highlights how recent advances in vector technology enhance transgene expression in the vessel wall and will facilitate more durable manipulation of gene expression in future studies of vascular disease. See p 1484.
Visit www.circ.ahajournals.org:
Cardiology Patient Page
Measurement of Cholesterol: A Patient Perspective. See p e296.
Images in Cardiovascular Medicine
Ventricular Tachycardia Late After Cardiac Transplantation. See p e298.
Multislice Computed Tomography in Complex Pulmonary Atresia After Stent Implantation. See p e299.
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Book Review
Metabolic Cardiomyopathy, 2nd ed. See p e301.
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