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Circulation. 2005;112:1519

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(Circulation. 2005;112:1519.)
© 2005 American Heart Association, Inc.

Issue Highlights


*    UNMASKING OF BRUGADA SYNDROME BY LITHIUM, by Darbar et al.
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*UNMASKING OF BRUGADA SYNDROME...
down arrowLEFT VENTRICULAR REVERSE...
down arrowMOLECULAR PROFILING OF HEART...
down arrowImages in Cardiovascular...
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Antiarrhythmic drugs and agents from many other classes, including some used for psychiatric illness, can cause marked QT prolongation and torsades de pointes. Similarly, the distinctive Brugada syndrome ECG pattern (and occasionally ventricular fibrillation) can be provoked by sodium channel–blocking antiarrhythmic drugs like flecainide, procainamide, and ajmaline. Unlike in the long-QT syndrome, however, only a few nonantiarrhythmic drugs, notably tricyclic antidepressants and possibly cocaine, are known to block sodium channels and precipitate the Brugada syndrome ECG. The present report adds the widely used agent lithium to that list. Pharmacoepidemiological studies have suggested that drugs used in psychiatric therapy can increase risk for sudden death, and this study thus suggests that Brugada syndrome–related ventricular fibrillation may contribute. Practical mechanisms to identify patients at risk in psychiatric or other settings are not well established. Notably, both patients in this study reported a personal history of syncope as well as sudden death in young family members. See p 1527.


*    LEFT VENTRICULAR REVERSE REMODELING BUT NOT CLINICAL IMPROVEMENT PREDICTS LONG-TERM SURVIVAL AFTER CARDIAC RESYNCHRONIZATION THERAPY, by Yu et al.
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up arrowUNMASKING OF BRUGADA SYNDROME...
*LEFT VENTRICULAR REVERSE...
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Unfavorable left ventricular remodeling is considered an important pathophysiological factor of the heart failure syndrome and has been used as a surrogate end point in early studies of new heart failure therapies. This concept is based in large part on substudies of selected patients from larger clinical trials. In this issue of Circulation, Yu and colleagues report on a group of patients with advanced heart failure who had evaluations of left ventricular volumes before and serially after pacemaker resynchronization therapy. In a Cox regression analysis model, the change in end-systolic volume was the most important predictor of all-cause and cardiovascular mortality as well as heart failure events. This is one of the first studies in which the remodeling process in a group of heart failure patients was directly associated with outcomes, and it has implications for research on new therapeutics. See p 1580.


*    MOLECULAR PROFILING OF HEART ENDOTHELIAL CELLS, by Zhang et al.
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up arrowUNMASKING OF BRUGADA SYNDROME...
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The identification of ligands that specifically target receptors in the heart will aid in the discovery of new diagnostic and therapeutic agents. Zhang et al combine 2 procedures to identify novel heart-homing peptides and the receptors that bind to these peptides. The first step involves screening a phage-display peptide library for phage particles that specifically accumulate in mouse heart. The second step uses these heart-homing peptides as "bait" in a bacterial 2-hybridization procedure to identify their binding partners. These procedures have led to the identification of 5 heart-homing peptides and their corresponding receptors. Independent methods confirmed that 4 of the receptors are preferentially expressed in the heart vasculature. These heart-homing peptides may have utility for the selective delivery of drugs or diagnostic agents to the heart, and the receptors for these peptides may become useful targets for drug discovery. See p 1601.

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*    Images in Cardiovascular Medicine
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up arrowUNMASKING OF BRUGADA SYNDROME...
up arrowLEFT VENTRICULAR REVERSE...
up arrowMOLECULAR PROFILING OF HEART...
*Images in Cardiovascular...
down arrowCorrespondence
 
Constrictive Pericarditis From a Severely Calcified Pericardium. See p e137.

Myocardial Infarction as a Rare Consequence of a Snakebite: Diagnosis With Novel Echocardiographic Tissue Doppler Techniques. See p e140.

Continuous Thrombus in the Right and Left Atria Penetrating the Patent Foramen Ovalis. See p e143.



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*    Correspondence
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up arrowUNMASKING OF BRUGADA SYNDROME...
up arrowLEFT VENTRICULAR REVERSE...
up arrowMOLECULAR PROFILING OF HEART...
up arrowImages in Cardiovascular...
*Correspondence
 
See p e145.


Related Articles:

Constrictive Pericarditis From a Severely Calcified Pericardium
Jeffrey J. Cavendish and Peter E. Linz
Circulation 2005 112: e137-e139. [Extract] [Full Text]

Myocardial Infarction as a Rare Consequence of a Snakebite: Diagnosis With Novel Echocardiographic Tissue Doppler Techniques
Mohsen Gaballa, Taha Taher, Lars Ake Brodin, Jan van der Linden, Ken O’Reilly, W. Hui, Neil Brass, P.K. Cheung, and Lars Grip
Circulation 2005 112: e140-e142. [Extract] [Full Text]

Continuous Thrombus in the Right and Left Atria Penetrating the Patent Foramen Ovalis
Atsushi Fukumoto, Hitoshi Yaku, Kiyoshi Doi, Hirotoshi Ito, Satoshi Numata, Kyoko Hayashida, Tomoya Inoue, Satoshi Akabame, Youhei Oda, Hiroaki Matsubara, and Tsunehiko Nishimura
Circulation 2005 112: e143-e144. [Extract] [Full Text]

Letter Regarding Article by Tschöpe et al, "High Prevalence of Cardiac Parvovirus B19 Infection in Patients With Isolated Left Ventricular Diastolic Dysfunction" Response
Umesh C. Sharma, Saraswati Pokharel, Jos G. Maessen, C. Tschöpe, M. Kasner, M. Noutsias, D. Westermann, P.-L. Schwimmbeck, M. Pauschinger, W.-C. Poller, U. Kühl, H.-P. Schultheiss, C.-T. Bock, and R. Kandolf
Circulation 2005 112: e145. [Extract] [Full Text]

Molecular Profiling of Heart Endothelial Cells
Lianglin Zhang, Jason A. Hoffman, and Erkki Ruoslahti
Circulation 2005 112: 1601-1611. [Abstract] [Full Text]

Left Ventricular Reverse Remodeling but Not Clinical Improvement Predicts Long-Term Survival After Cardiac Resynchronization Therapy
Cheuk-Man Yu, Gabe B. Bleeker, Jeffrey Wing-Hong Fung, Martin J. Schalij, Qing Zhang, Ernst E. van der Wall, Yat-Sun Chan, Shun-Ling Kong, and Jeroen J. Bax
Circulation 2005 112: 1580-1586. [Abstract] [Full Text]

Unmasking of Brugada Syndrome by Lithium
Dawood Darbar, Tao Yang, Keith Churchwell, Arthur A.M. Wilde, and Dan M. Roden
Circulation 2005 112: 1527-1531. [Abstract] [Full Text]




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