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(Circulation. 2004;110:3399.)
© 2004 American Heart Association, Inc.
Issue Highlights |
SHORT-TERM EFFECTS OF RIGHT-LEFT HEART SEQUENTIAL CARDIAC RESYNCHRONIZATION IN PATIENTS WITH HEART FAILURE, CHRONIC ATRIAL FIBRILLATION, AND ATRIOVENTRICULAR NODAL BLOCK, by Hay et al.
Although the hemodynamic and clinical benefits of biventricular pacing have been demonstrated in patients with heart failure, it has not been clear whether there is additional benefit from sequential pacing of the ventricles. Prior studies of this issue may have been confounded by the effects of concomitant supraventricular activation and atrial contraction. Hay and colleagues avoided this problem by studying the acute hemodynamic effects of right ventricular, left ventricular, and biventricular pacing with simultaneous or sequential activation in 9 patients with atrial fibrillation and high-grade atrioventricular nodal blockade. They found that biventricular pacing was superior to pacing either the left ventricle or right ventricle alone and that simultaneous activation of the right ventricle and left ventricle resulted in the optimal improvement in systolic and diastolic function. See p 3404.
ONE-YEAR CORONARY BYPASS GRAFT PATENCY: A RANDOMIZED COMPARISON BETWEEN OFF-PUMP AND ON-PUMP SURGERY: ANGIOGRAPHIC RESULTS OF THE PRAGUE-4 TRIAL, by Widimsky et al.
The controversy about whether off-pump coronary artery bypass surgery (CABG) is superior to on-pump CABG continues to be evaluated. In the report by Widimsky et al, a cohort of patients from a randomized trial (PRAGUE-4) of off-pump CABG versus on-pump CABG underwent cardiac catherization at one year. Patency of arterial grafts (left internal mammary artery to the left anterior descending) was excellent and similar in both groups, but fewer saphenous vein grafts per patient were patent in the off-pump group. This study raises the concern that the perceived benefits of off-pump CABG may lead to poor late outcomes because of a reduction in graft patency. See p 3418.
CHILDHOOD ADIPOSITY AS A PREDICTOR OF CARDIAC MASS IN ADULTHOOD: THE BOGALUSA HEART STUDY, by Li et al.
Li and colleagues examined the association of left ventricular mass in young adults with longitudinal measurements of risk factors from childhood, with an average follow-up period of 21.5 years. Adiposity (measured as body mass index) in childhood, in adulthood, or as a cumulative burden since childhood was the most consistent predictor of left ventricular mass (indexed to height2.7) in young adults. In addition, systolic blood pressure measured in adulthood or as a cumulative burden since childhood was also an independent predictor. These findings underscore the importance of obesity beginning in childhood in the development of left ventricular hypertrophy, as well as the need for early intervention. See p 3488.
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Images in Cardiovascular Medicine
Giant Unruptured Noncoronary Sinus of Valsalva Aneurysm. See p e515.
Percutaneous Replacement of the Pulmonary Valve in a 12-Year-Old Child. See p e516.
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Related Articles:
Circulation 2004 110: 3418-3423.
Circulation 2004 110: 3404-3410.
Circulation 2004 110: 3488-3492.
Circulation 2004 110: e515.
Circulation 2004 110: e516.
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