Circulation. 2005;112:449
(Circulation. 2005;112:449.)
© 2005 American Heart Association, Inc.
Issue Highlights
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PERCUTANEOUS VERSUS SURGICAL TREATMENT FOR PATIENTS WITH HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY AND ENLARGED ANTERIOR MITRAL VALVE LEAFLETS, by van der Lee et al.
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Surgical myectomy is an accepted therapy for patients with symptomatic
hypertrophic obstructive cardiomyopathy (HOCM). When this condition
is accompanied by enlargement of the anterior mitral valve leaflet,
combining myectomy with mitral leaflet extension reduces the
postoperative aortic outflow gradient and mitral regurgitation.
Percutaneous transluminal septal myocardial ablation by alcohol
injection into the septal coronary arteries is emerging as an
alternative treatment for HOCM. In this issue of
Circulation,
van der Lee and colleagues compared outcome after percutaneous
ablation in 43 patients with HOCM and enlargement of the anterior
mitral valve leaflet to the outcomes of 29 historical control
patients who were treated surgically. The authors report that
percutaneous treatment is associated with more periprocedural
complications and greater need for a second intervention, providing
evidence that the surgical approach might be preferred in such
patients. See p
482.
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ELEVATED HIGH-DENSITY LIPOPROTEIN CHOLESTEROL LEVELS ARE PROTECTIVE AGAINST PLAQUE PROGRESSION: A FOLLOW-UP STUDY OF 1952 PERSONS WITH CAROTID ATHEROSCLEROSIS: THE TROMSØ STUDY, by Johnson et al.
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Carotid intimal medial thickness and carotid plaques are important
markers of subclinical atherosclerosis. Whereas studies have
evaluated cross-sectional relations of carotid plaques, data
on correlates of plaque progression/growth are lacking. In this
issue of
Circulation, Johnsen and colleagues performed serial
carotid ultrasonography on participants in the community-based
Tromso Study. The investigators evaluated determinants of change
in the size (area) and echogenicity of carotid plaques prospectively.
Higher age, systolic blood pressure, and smoking and lower high-density
lipoprotein (HDL) cholesterol were key correlates of plaque
growth. Additionally, greater plaque echogenicity at baseline
was associated with less growth over time. Thus, the study demonstrates
the feasibility of assessing carotid plaque growth and changes
in plaque echogenicity longitudinally. The findings are consistent
with the notion that higher HDL cholesterol levels are associated
with reduced plaque growth. See p
498.
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CARDIORESPIRATORY FITNESS IS INVERSELY ASSOCIATED WITH THE INCIDENCE OF METABOLIC SYNDROME: A PROSPECTIVE STUDY OF MEN AND WOMEN, by LaMonte et al.
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Higher levels of cardiorespiratory fitness are associated with
a lower risk of death and coronary heart disease (CHD) events.
Conversely, the presence of the metabolic syndrome is linked
with higher rates of CHD events. Although cross-sectional studies
have demonstrated a lower prevalence of CHD risk factors among
those with higher levels of fitness, in this issue of
Circulation,
LaMonte et al present the first prospective study to evaluate
whether baseline levels of fitness are associated with the development
of the metabolic syndrome among 9007 men and 1491 women followed
up for nearly 6 years. This association was also evaluated in
this large series of subjects when stratified into categories
of age, body mass index, and number of baseline metabolic risk
factors. The results of this study have important implications
for clinicians, particularly when treating patients who have
already begun to demonstrate components of the metabolic syndrome.
See p
505.
Visit http://www.circ.ahajournals.org:
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Clinician Update
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Coagulation Assays. See p
e53.
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Images in Cardiovascular Medicine
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Detection of Cardiac Metastasis by Positron-Emission Tomography–Computed
Tomography. See p
e61.
Early Tissue Distribution of Bone Marrow Mononuclear Cells After Transcoronary Transplantation in a Patient With Acute Myocardial Infarction. See p e63.
Giant Aneurysm of the Right Coronary Artery Compressing the Right Heart. See p e66.
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Correspondence
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See p
e68.
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