26 marzo 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Artery Disease. Association of Body Mass Index With Major Cardiovascular Events and With Mortality After Percutaneous Coronary Intervention

Duk-Woo Park, MD, Young-Hak Kim, MD, Sung-Cheol Yun, PhD, Jung-Min Ahn, MD, Jong-Young Lee, MD, Won-Jang Kim, MD, Soo-Jin Kang, MD, Seung-Whan Lee, MD, Cheol Whan Lee, MD, Seong-Wook Park, MD and Seung-Jung Park, MD

Background: Conflicting data exist regarding the relation between body mass index (BMI) and cardiovascular events and mortality after percutaneous coronary intervention.

09 abril 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Artery Disease. Impact of Residual Chronic Total Occlusion of Right Coronary Artery on the Long-term Outcome in Patients Treated for Unprotected Left Main Disease. The Milan and New-Tokyo Registry

Kensuke Takagi, MD, Alfonso Ielasi, MD, Alaide Chieffo, MD, Sandeep Basavarajaiah, MD, Azeem Latib, MD, Matteo Montorfano, MD, Mauro Carlino, MD, Hiroyuki Mizuno, MD, Tasuku Hasegawa, MD, Cosmo Godino, MD, Filippo Figini, MD, Joanne Shannon, MD, Ahmed Rezq, MD, Santo Ferrarello, MD, Chiara Bernelli, MD, Toru Naganuma, MD, Yusuke Fujino, MD, Sunao Nakamura, MD and Antonio Colombo, MD

Background: The presence of chronic total occlusion of the right coronary artery (CTO-RCA) in patients undergoing percutaneous interventions for unprotected left main (ULM) disease may affect the prognosis. In this study, we evaluated the immediate results and follow-up of patients with ULM-percutaneous interventions and with or without associated CTO-RCA.

02 abril 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Artery Disease. Fractional Flow Reserve Assessment of Left Main Stenosis in the Presence of Downstream Coronary Stenoses

Andy S.C. Yong, MBBS, PhD*, David Daniels, MD*, Bernard De Bruyne, MD, PhD, Hyun-Sook Kim, MD, Fumiaki Ikeno, MD, Jennifer Lyons, RVT, Nico H.J. Pijls, MD, PhD and William F. Fearon, MD

Background: Several studies have shown that fractional flow reserve (FFR) measurement can aid in the assessment of left main coronary stenosis. However, the impact of downstream epicardial stenosis on left main FFR assessment with the pressure wire in the nonstenosed downstream vessel remains unknown.

02 abril 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Artery Disease. Stroke After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction. Timing, Characteristics, and Clinical Outcomes

Jeffrey T. Guptill, MD, MA, Rajendra H. Mehta, MD, MS, Paul W. Armstrong, MD, John Horton, MS, Daniel Laskowitz, MD, MHS, Stefan James, MD, PhD, Christopher B. Granger, MD and Renato D. Lopes, MD, PhD

Background: Stroke is a rare but potentially devastating complication of acute myocardial infarction. Little is known about stroke timing, characteristics, and clinical outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI).

01 mayo 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Tips and Tricks for MR Angiography of Pediatric and Adult Congenital Cardiovascular Diseases

Phillip M. Young, Kiaran P. McGee, Matthew S. Pieper, Larry A. Binkovitz, Jane M. Matsumoto, Amy B. Kolbe, Thomas A. Foley and Paul R. Julsrud

OBJECTIVE. The use of contrast-enhanced MR angiography (MRA) as an alternative to CT angiography or conventional angiography to assess pediatric and adult patients with cardiovascular diseases has the potential to significantly reduce patients lifetime exposure to ionizing radiation. However, imaging this group of patients can be challenging because of a number of factors, including small size, difficulty timing the contrast bolus to the territory of interest, and the presence of metallic susceptibility artifact resulting from stents or clips.

01 marzo 2013

JACC. Transluminal Attenuation Gradient in Coronary Computed Tomography Angiography Is a Novel Noninvasive Approach to the Identification of Functionally Significant Coronary Artery Stenosis

Dennis T.L. Wong, MBBS (Hons)⁎; Brian S. Ko, MBBS (Hons)⁎; James D. Cameron, MBBS, MD⁎; Nitesh Nerlekar, MBBS⁎; Michael C.H. Leung, MBBS (Hons), PhD⁎; Yuvaraj Malaiapan, MBBS⁎; Marcus Crossett, Ba App Sc‡; Darryl P. Leong, MBBS (Hons), MPH, PhD†; Stephen G. Worthley, MBBS, PhD†; John Troupis, MBBS‡; Ian T. Meredith, MBBS (Hons), PhD⁎; Sujith K. Seneviratne, MBBS⁎

Objective: The purpose of this study was to assess the diagnostic accuracy of TAG320 in predicting functional stenosis severity evaluated by fractional flow reserve (FFR).

01 marzo 2013

JACC. The Year in Valvular Heart Disease

Shahbudin H. Rahimtoola, MB, FRCP, DSc(Hon)

A total of 143 patients, 68 ± 14 years of age who underwent cardiovascular magnetic resonance with administration of gadolinium contrast were enrolled into a study; 67.8% were males. Late gadolinium enhancement (LGE) was assessed by independent blinded observers who categorized the patients into 3 subgroups: no LGE (n = 49), mid-wall (MW) LGE (n = 54), and infarct LGE (n = 40) (2). Histological confirmation of fibrosis in the region of LGE was obtained from biopsy specimens obtained at the time of surgical aortic valve replacement (SAVR). Aortic valve replacement (AVR) was performed in 55% of those with no LGE, in 46% who had MW-LGE, and 53% who had infarct LGE. Follow-up was for 2.0 ± 1.4 years. Both all-cause mortality and cardiac-cause mortality were greater in those with infarct LGE and MW-LGE than in those with no LGE, and there was no significant difference between infarct LGE and MW-LGE. On multivariate analysis, left ventricular (LV) ejection fraction (LVEF) (hazard ratio [HR]: 0.96; 95% confidence interval [CI]: 0.94 to 0.99; p = 0.009) and MW-LGE (HR: 5.35; 95% CI: 1.16 to 24.56; p = 0.0034) were identified as independent predictors of subsequent all-cause mortality.

01 marzo 2013

JACC. Paravalvular Leak After Transcatheter Aortic Valve Replacement. The New Achilles´ Heel? A Comprehensive Review of the Literature

Philippe Généreux, MD⁎; Stuart J. Head, MSc§; Rebecca Hahn, MD⁎; Benoit Daneault, MD⁎; Susheel Kodali, MD⁎; Mathew R. Williams, MD⁎; Nicolas M. van Mieghem, MD∥; Maria C. Alu, MM⁎; Patrick W. Serruys, MD, PhD∥; A. Pieter Kappetein, MD, PhD§; Martin B. Leon, MD⁎

Paravalvular leak (PVL) is a frequent complication of transcatheter aortic valve replacement (TAVR) and is seen at a much higher rate after TAVR than after conventional surgical aortic valve replacement. Recent reports indicating that PVL may be correlated with increased late mortality have raised concerns. However, the heterogeneity of methods for assessing and quantifying PVL, and lack of consistency in the timing of such assessments, is a hindrance to understanding its true prevalence, severity, and effect. This literature review is an effort to consolidate current knowledge in this area to better understand the prevalence, progression, and impact of post-TAVR PVL and to help direct future efforts regarding the assessment, prevention, and treatment of this troublesome complication.

01 marzo 2013

JACC. Histopathologic Characteristics of Atherosclerotic Coronary Disease and Implications of the Findings for the Invasive and Noninvasive Detection of Vulnerable Plaques

Jagat Narula, MD, PhD⁎; Masataka Nakano, MD, PhD†; Renu Virmani, MD†; Frank D. Kolodgie, PhD†; Rita Petersen, MS‡; Robert Newcomb, PhD‡; Shaista Malik, MD, PhD‡; Valentin Fuster, MD, PhD⁎; Aloke V. Finn, MD∥

Objectives: The goal of this study was to identify histomorphologic characteristics of atherosclerotic plaques and to determine the amenability of some of these components to be used as markers for invasive and noninvasive imaging.

01 marzo 2013

JACC. Direct Comparison of Cardiac Magnetic Resonance and Multidetector Computed Tomography Stress-Rest Perfusion Imaging for Detection of Coronary Artery Disease

Nuno Bettencourt, MD⁎; Amedeo Chiribiri, MD, PhD†; Andreas Schuster, MD, PhD†; Nuno Ferreira, MD⁎; Francisco Sampaio, MD⁎; Gustavo Pires-Morais, MD⁎; Lino Santos, MD⁎; Bruno Melica, MD⁎; Alberto Rodrigues, MD⁎; Pedro Braga, MD⁎; Luís Azevedo, MD‡; Madalena Teixeira, MD⁎; Adelino Leite-Moreira, MD, PhD‡; José Silva-Cardoso, MD, PhD‡; Eike Nagel, MD, PhD†; Vasco Gama, MD⁎

Objectives: This study sought to compare the diagnostic performance of a multidetector computed tomography (MDCT) integrated protocol (IP) including coronary angiography (CTA) and stress-rest perfusion (CTP) with cardiac magnetic resonance myocardial perfusion imaging (CMR-Perf) for detection of functionally significant coronary artery disease (CAD).

01 marzo 2013

JACC. Aortic Annular Sizing for Transcatheter Aortic Valve Replacement Using Cross-Sectional 3-Dimensional Transesophageal Echocardiography

Hasan Jilaihawi, MD; Niraj Doctor, MBBS; Mohammad Kashif, MD; Tarun Chakravarty, MD; Asim Rafique, MD; Moody Makar, MD; Azusa Furugen, MD, PhD; Mamoo Nakamura, MD; James Mirocha, MS; Mitch Gheorghiu, MD; Jasminka Stegic, MS, ANP-BC, CCRN, ACNP; Kazuaki Okuyama, MD; Daniel J. Sullivan, MD; Robert Siegel, MD; James K. Min, MD; Swaminatha V. Gurudevan, MD; Gregory P. Fontana, MD; Wen Cheng, MD; Gerald Friede, BS, MS; Takahiro Shiota, MD; Raj R. Makkar, MD

Objectives: This study compared cross-sectional three-dimensional (3D) transesophageal echocardiography (TEE) to two-dimensional (2D) TEE as methods for predicting aortic regurgitation after transcatheter aortic valve replacement (TAVR).

01 marzo 2013

JACC. FIRST: Fractional Flow Reserve and Intravascular Ultrasound Relationship Study

Ron Waksman, MD⁎; Jacek Legutko, MD†; Jasvindar Singh, MD‡; Quentin Orlando, DO§; Steven Marso, MD∥; Timothy Schloss, MD¶; John Tugaoen, MD#; James DeVries, MD⁎⁎; Nicholas Palmer, MD††; Michael Haude, MD‡‡; Stacy Swymelar, BS⁎; Rebecca Torguson, MPH⁎

Objectives: FIRST (Fractional Flow Reserve and Intravascular Ultrasound Relationship Study) aimed to determine the optimal minimum lumen area (MLA) by intravascular ultrasound (IVUS) that correlates with fractional flow reserve (FFR) and to assess the correlation between virtual histology IVUS and FFR for intermediate coronary lesions.

01 marzo 2013

JACC. Intravascular Ultrasound and Fractional Flow Reserve in Assessment of the Intermediate Coronary Stenosis

Goran Stankovic, MD, PhD; Milan Dobric, MD

Fractional flow reserve (FFR) may be regarded as a gold standard for the evaluation of the physiological significance of coronary stenosis in the catheterization laboratory with extensive validation in randomized, controlled trials (1). The beauty of FFR lies in its consistent ischemic threshold value that is valid for varying complexities of geometry and hemodynamics and provides us with the highly reproducible index on which we could base our clinical decisions

01 marzo 2013

JACC. The Influence of Left Ventricular Ejection Fraction on the Effectiveness of Cardiac Resynchronization Therapy. MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy)

Valentina Kutyifa, MD⁎; Axel Kloppe, MD‡; Wojciech Zareba, MD, PhD⁎; Scott D. Solomon, MD§; Scott McNitt, MS⁎; Slava Polonsky, MS⁎; Alon Barsheshet, MD⁎; Bela Merkely, MD, PhD†; Bernd Lemke, MD‡; Vivien Klaudia Nagy, MD†; Arthur J. Moss, MD⁎; Ilan Goldenberg, MD⁎

Objectives: The goal of this study was to evaluate the influence of left ventricular (LV) lead position on the risk of ventricular tachyarrhythmia in patients undergoing cardiac resynchronization therapy (CRT).

01 marzo 2013

JACC. Metformin Impairs Vascular Endothelial Recovery After Stent Placement in the Setting of Locally Eluted Mammalian Target of Rapamycin Inhibitors Via S6 Kinase-Dependent Inhibition of Cell Proliferation

Anwer Habib, MD⁎; Vinit Karmali, MA⁎; Rohini Polavarapu, BA⁎; Hirokuni Akahori, MD, PhD⁎; Masataka Nakano, MD†; Saami Yazdani, PhD†; Fumiyuki Otsuka, MD†; Kim Pachura, BS⁎; Talina Davis⁎; Jagat Narula, MD, PhD‡; Frank D. Kolodgie, PhD†; Renu Virmani, MD†; Aloke V. Finn, MD⁎

Objectives: This study sought to examine the effect of oral metformin (Mf) therapy on endothelialization in the setting of drug-eluting stents (DES).