Circulation. 2005;111:2413
(Circulation. 2005;111:2413.)
© 2005 American Heart Association, Inc.
Issue Highlights
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POSTINFARCTION GENE THERAPY AGAINST TRANSFORMING GROWTH FACTOR-ß SIGNAL MODULATES INFARCT TISSUE DYNAMICS AND ATTENUATES LEFT VENTRICULAR REMODELING AND HEART FAILURE, by Okada et al.
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REGENERATION OF INFARCTED MYOCARDIUM BY INTRAMYOCARDIAL IMPLANTATION OF EX VIVO TRANSFORMING GROWTH FACTOR-ß–PREPROGRAMMED BONE MARROW STEM CELLS, by Li et al.
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The clinical benefit of limiting ventricular remodeling after
myocardial infarction is clear, though the pharmacological tools
we have available are only moderately successful. Future therapies
targeting the underlying biology of the remodeling process appear
promising, although as 2 articles in this week’s
Circulation illustrate, ‘the devil is in the details.’ Tissue
growth factor ß (TGF ß) promotes fibroblast
proliferation and scar formation, and a study by Okada et al
suggests that blocking its action in the heart will improve
outcome after infarction. On the other hand, Li et al demonstrate
that the same growth factor has a beneficial effect on bone
marrow stem cells, improving their ability to differentiate
into myocytes and repair the wounded heart. Careful evaluation
of these and other biologically based therapeutic strategies
have the potential to lead us to the next era in management
of the postinfarction patient. See pp
2430 and
2438.
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LOWER SERUM SODIUM IS ASSOCIATED WITH INCREASED SHORT-TERM MORTALITY IN HOSPITALIZED PATIENTS WITH WORSENING HEART FAILURE: RESULTS FROM THE OUTCOMES OF A PROSPECTIVE TRIAL OF INTRAVENOUS MILRINONE FOR EXACERBATIONS OF CHRONIC HEART FAILURE (OPTIME-CHF) STUDY, by Klein et al.
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Hyponatremia was identified years ago as a powerful predictor
of an unfavorable prognosis in patients with heart failure,
originally in patients with severe reduction in serum sodium.
In this issue of
Circulation, a retrospective analysis of 949
patients admitted to hospital with decompensated heart failure
in the OPTIME-CHF trial by Klein and colleagues demonstrates
that even modest degrees of reduction in serum sodium were associated
with a significantly elevated risk of unfavorable outcomes,
including number of days in hospital within 60 days of randomization,
as well as in-hospital and 60-day mortality. Moreover, the results
were seen in the setting of substantial use of angiotensin-converting
enzyme inhibition or angiotensin receptor blockers. These data
suggest that a simple clinical measurement can identify a group
with very high short-term risk among patients admitted to hospital
with heart failure in the contemporary treatment era. See p
2454.
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LONG-TERM RESULTS OF MITRAL VALVE REPAIR IN ACTIVE ENDOCARDITIS, by Zegdi et al.
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Mitral valve endocarditis requiring surgical therapy can be
treated by valve replacement or mitral valve repair. A variety
of repair techniques can be used to reconstruct the valve tissue
and remove the site of active infection. In their article, Dr
Alain Carpentier’s group in Paris reported having 37 patients
undergo a mitral valve repair for active endocarditis. During
a 5-year period, these repair patients represented 75% of the
total mitral valve operations performed for active endocarditis,
demonstrating a high degree of repair feasibility. The operative
mortality was low (3%), and the 10-year survival rate was 96%,
with 92% having trivial to no mitral regurgitation on echocardiography.
Freedom from mitral valve reoperation at 10 years was 91%, and
recurrence of endocarditis was 3%. These excellent results should
allow clinicians to consider mitral valve repairs as an alternative
to replacement for mitral valve endocarditis. See p
2532.
Visit www.circ.ahajournals.org:
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Cardiology Patient Page
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Homocysteine and MTHFR Mutations: Relation to Thrombosis and
Coronary Artery Disease. See p
e289.
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Images in Cardiovascular Medicine
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Continuous Cardiac Magnetic Resonance Imaging During Untreated
Ventricular Fibrillation. See p
e294.
ST-Segment Elevation Due to Hyperkalemia. See p e295.
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Correspondence
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See p
e297.
Related Articles:
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Lower Serum Sodium Is Associated With Increased Short-Term Mortality in Hospitalized Patients With Worsening Heart Failure: Results From the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Study
- Liviu Klein, Christopher M. O’Connor, Jeffrey D. Leimberger, Wendy Gattis-Stough, Ileana L. Piña, G. Michael Felker, Kirkwood F. Adams, Jr, Robert M. Califf, Mihai Gheorghiade for the OPTIME-CHF Investigators
Circulation 2005 111: 2454-2460.
[Abstract]
[Full Text]
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Postinfarction Gene Therapy Against Transforming Growth Factor-ß Signal Modulates Infarct Tissue Dynamics and Attenuates Left Ventricular Remodeling and Heart Failure
- Hideshi Okada, Genzou Takemura, Ken-ichiro Kosai, Yiwen Li, Tomoyuki Takahashi, Masayasu Esaki, Kentaro Yuge, Shusaku Miyata, Rumi Maruyama, Atsushi Mikami, Shinya Minatoguchi, Takako Fujiwara, and Hisayoshi Fujiwara
Circulation 2005 111: 2430-2437.
[Abstract]
[Full Text]
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Long-Term Results of Mitral Valve Repair in Active Endocarditis
- Rachid Zegdi, Mohamed Debièche, Christian Latrémouille, Djoulène Lebied, Catherine Chardigny, Jean-Michel Grinda, Sylvain Chauvaud, Alain Deloche, Alain Carpentier, and Jean-Noël Fabiani
Circulation 2005 111: 2532-2536.
[Abstract]
[Full Text]
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Regeneration of Infarcted Myocardium by Intramyocardial Implantation of Ex Vivo Transforming Growth Factor-ß–Preprogrammed Bone Marrow Stem Cells
- Tao-Sheng Li, Masanori Hayashi, Hiroshi Ito, Akira Furutani, Tomoaki Murata, Masunori Matsuzaki, and Kimikazu Hamano
Circulation 2005 111: 2438-2445.
[Abstract]
[Full Text]
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Homocysteine and MTHFR Mutations: Relation to Thrombosis and Coronary Artery Disease
- Elizabeth A. Varga, Amy C. Sturm, Caron P. Misita, and Stephan Moll
Circulation 2005 111: e289-e293.
[Extract]
[Full Text]
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Continuous Cardiac Magnetic Resonance Imaging During Untreated Ventricular Fibrillation
- Vincent L. Sorrell, Maria I. Altbach, Karl B. Kern, Scott Squire, Ronald W. Hilwig, Melinda M. Hayes, Gordon A. Ewy, and Robert A. Berg
Circulation 2005 111: e294.
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[Full Text]
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ST-Segment Elevation Resulting From Hyperkalemia
- Daniel B. Sims and Laurence S. Sperling
Circulation 2005 111: e295-e296.
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Letter Regarding Article by Shyu et al, "Functional Recovery of Stroke Rats Induced by Granulocyte Colony-Stimulating Factor–Stimulated Stem Cells" • Response
- Ivo R. Buschmann, Konstantin-Alexander Hossmann, Woei-Cherng Shyu, Shinn-Zong Lin, Hui-I Yang, Cheng-Yoong Pang, Pao-Sheng Yen, Yi-Shiuan Tzeng, and Hung Li
Circulation 2005 111: e297-e298.
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POSTINFARCTION GENE THERAPY...
REGENERATION OF INFARCTED...