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Recent items - Journal of the American College of Cardiology

D-Transposition of the Great Arteries The Current Era of the Arterial Switch Operation
28/07/2014 23:16
This paper aims to update clinicians on “hot topics” in the management of patients with D-loop transposition of the great arteries (D-TGA) in the current surgical era. The arterial switch operation (ASO) has replaced atrial switch procedure [...]
Effect of Human Donor Cell Source on Differentiation and Function of Cardiac Induced Pluripotent Stem Cells
28/07/2014 23:16
BackgroundHuman-induced pluripotent stem cells (iPSCs) are a potentially unlimited source for generation of cardiomyocytes (iPSC-CMs). However, current protocols for iPSC-CM derivation face several challenges, including variability in somat [...]
Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk
28/07/2014 23:16
BackgroundAlthough running is a popular leisure-time physical activity, little is known about the long-term effects of running on mortality. The dose-response relations between running, as well as the change in running behaviors over time, [...]
Minimal Amount of Exercise to Prolong Life To Walk, to Run, or Just Mix It Up? ∗
28/07/2014 23:16
In order for man to succeed in life, God provided two means, education and physical activity. Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise can save it and preserve it.—Pl [...]
Neither Too Fast Nor Too Hot Keeping Marathoners’ Hearts Alive During the Race ∗
28/07/2014 23:16
When I (David S. Cannom) began long-distance running 40 years ago, there were very few runners and little information about the cardiac effects of long-distance running. One of the members of our Sunday morning running group, a cardiologist [...]
Finding ECG Readers in Clinical Practice Is It Time to Change the Paradigm?
28/07/2014 23:16
The standard 12-lead electrocardiogram (ECG) is the most commonly performed cardiac diagnostic test because it provides vital information about cardiac rhythm, acute myocardial injury, and a host of other abnormalities while also being simp [...]
Prognostic Value of Site SYNTAX Score and Rationale for Combining Anatomic and Clinical Factors in Decision Making Insights From the SYNTAX Trial
28/07/2014 23:16
BackgroundThe results of SYNTAX trial have been reported based on “corelab” calculated SS (cSS). It has been shown that reproducibility of SS is better among the core laboratory technicians than interventional cardiologists. Thus, the progn [...
Effect of Spironolactone in CV Mortality in Hemodialysis Patients
28/07/2014 23:16
Matsumoto et al. (1) have investigated the role of spironolactone in hemodialysis patients. The investigators have noted that spironolactone reduced the risk of both cardiovascular morbidity and mortality in hemodialysis patients. It would [...]
The Best Treatment Approach to Pre-Clinical Diastolic Dysfunction? Think About Exercise Training!
28/07/2014 23:16
In their state-of-the-art paper, Wan et al. (1) provide a comprehensive overview of the assessment, pathophysiology, and management of pre-clinical diastolic dysfunction (PDD). This condition has been shown to represent an early stage in th [...]
Reply The Best Treatment Approach to Pre-Clinical Diastolic Dysfunction?: Think About Exercise Training!
28/07/2014 23:16
We thank Dr. Pressler and colleagues for their interest in our paper (1). The progression of pre-clinical diastolic dysfunction (PDD) to symptomatic heart failure with preserved ejection fraction (HFpEF) is dependent on a variety of comorbi [...]
Calculating Risks and Benefits to Help Guide Revascularization Decisions Turning All Available Data Into Useful Information ∗
28/07/2014 23:16
We are in the era of “big data” in cardiovascular medicine (1). This brings both excitement and challenges to the clinician who is making dozens, if not hundreds, of clinical decisions every day in the care of individual patients. Enormous [...]
Global Burden of Cardiovascular Disease Time to Implement Feasible Strategies and to Monitor Results
28/07/2014 23:16
Modeling CVD in Human Pluripotent Cells by Genome Editing ∗
28/07/2014 23:16
The use of various animal models for cardiovascular diseases has significantly advanced our understanding of the pathophysiology of these diseases. In addition, these animal models have been quite useful in testing novel treatment strategie [...]
Epigenetic Memory and Cardiac Cell Therapy ∗
28/07/2014 23:16
Cardiovascular diseases, including myocardial infarction and heart failure, remain the leading causes of morbidity and mortality in the developed world. Because the loss of cardiac myocytes contributes to most types of heart failure, strate [...]
Genome Editing of Isogenic Human Induced Pluripotent Stem Cells Recapitulates Long QT Phenotype for Drug Testing
28/07/2014 23:16
BackgroundHuman induced pluripotent stem cells (iPSCs) play an important role in disease modeling and drug testing. However, the current methods are time-consuming and lack an isogenic control.ObjectivesThis study sought to establish an eff [...]
LDL-Cholesterol Targets After the ACC/AHA 2013 Guidelines ∗ Evidence That Lower Is Better?
28/07/2014 23:16
Approximately 25 years ago, the first Adult Treatment Panel (ATP) guidelines set the stage for low-density lipoprotein cholesterol (LDL-C) as both a risk factor and a target of therapy (1). Since then, ever-accumulating evidence on the role [...]
Very Low Levels of Atherogenic Lipoproteins and the Risk for Cardiovascular Events A Meta-Analysis of Statin Trials
28/07/2014 23:16
BackgroundLevels of atherogenic lipoproteins achieved with statin therapy are highly variable, but the consequence of this variability for cardiovascular disease risk is not well-documented.ObjectivesThe aim of this meta-analysis was to eva [...]
Life-Threatening Events During Endurance Sports Is Heat Stroke More Prevalent Than Arrhythmic Death?
28/07/2014 23:16
BackgroundTwo important causes of sudden death during endurance races are arrhythmic death and heat stroke. However, “arrhythmic death” has caught practically all the attention of the medical community whereas the importance of heat stroke [...]
Induced Pluripotent Stem Cells for the Study of Cardiovascular Disease
28/07/2014 23:16
Groundbreaking advances in stem cell research have led to techniques for the creation of human cardiomyocytes from cells procured from a variety of sources, including a simple skin biopsy. Since the advent of this technology, most research [...]
Innovation in Cardiology Fellowship and Early Careers
28/07/2014 23:16
For many cardiologists-in-training, fellowship can seem to be just another educational stepping stone on the way to becoming the experts we all aspire to be. A primary purpose of this stage in training is, of course, the acquisition of spec [...]
The American College of Cardiology’s Response to the American Board of Internal Medicine’s Maintenance of Certification Requirements
28/07/2014 23:16
Medical Malpractice Litigation A Fellow’s Perspective
22/07/2014 00:32
The historical origin of medical malpractice litigation (MML) in the United States dates back to the first half of the 19th century (1). At that time, most cases were related to poorly repaired fractures or were obstetrics cases. In recent [...]
Intravascular Photoacoustic Tomography of Coronary Atherosclerosis Riding the Waves of Light and Sound ∗
22/07/2014 00:32
The emergence of coronary angiography in the late 1950s enabled an imaging-based understanding of coronary artery disease and led to surgical and intravascular treatment approaches of coronary luminal stenosis. Based on the increasing famil [...]
2014 Hypertension Recommendations From the Eighth Joint National Committee Panel Members Raise Concerns for Elderly Black and Female Populations
22/07/2014 00:32
A report from panel members appointed to the Eighth Joint National Committee titled “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults” has garnered much attention due to its major change in recommendations f [...]
Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
22/07/2014 00:32
BackgroundVarious national campaigns launched in recent years have focused on young women with acute myocardial infarctions (AMIs). Contemporary longitudinal data about sex differences in clinical characteristics, hospitalization rates, len [...]
At the Heart of Global Development
22/07/2014 00:32
The year 2014 is pivotally positioned between 2 years of great significance for global health. In the preceding year, 2013, the World Health Assembly adopted the Global Action Plan for Prevention and Control of Non-Communicable Diseases (NC [...]
Myocardial Damage After TAVR Assessed With CMR A New Piece in a Puzzle? ∗
22/07/2014 00:32
Myocardial damage after transcatheter aortic valve replacement (TAVR) may be common and herald a worse prognosis (1,2). In this issue of the Journal, Kim et al. (3) report on the incidence of new, ischemic-type, myocardial late enhancement [...]
Characterization of Lipid-Rich Aortic Plaques by Intravascular Photoacoustic Tomography Ex Vivo and In Vivo Validation in a Rabbit Atherosclerosis Model With Histologic Correlation
22/07/2014 00:32
BackgroundHistologic studies have demonstrated that lipid content and its spatial distribution is related to plaque vulnerability. However, in vivo imaging is still limited. Photoacoustic imaging may provide novel in vivo insights into thes [...]
Reply In Regard to the TERISA Trial
22/07/2014 00:32
Dr. Golwala raises several questions in regard to the TERISA trial (1). First is whether the patients enrolled in TERISA were truly refractory to maximally titrated baseline antianginal treatment at randomization. The protocol did not requi [...]
Management Practices and Major Infections After Cardiac Surgery
22/07/2014 00:32
BackgroundInfections are the most common noncardiac complication after cardiac surgery, but their incidence across a broad range of operations, as well as the management factors that shape infection risk, remain unknown.ObjectivesThis study [...]
Targeting Priority Populations to Reduce Disparities in Cardiovascular Care Health Equity for All ∗
22/07/2014 00:32
The evolving care paradigm and ensuing implementation of high-quality evidence that defines optimal benefits and risks into daily clinical practice has resulted in dramatic declines in case fatality rates for cardiovascular disease over the [...]
In Regard to the TERISA Trial
22/07/2014 00:32
I read with great interest the paper by Kosiborod et al. (1) showing beneficial effects of ranolazine in patients with type 2 diabetes mellitus, coronary artery disease, and chronic refractory angina taking 2 antianginal agents. The authors [...]
Variability of Individual Platelet Reactivity Over Time in Patients Treated With Clopidogrel Insights From the ELEVATE–TIMI 56 Trial
22/07/2014 00:32
BackgroundThe degree of antiplatelet response to clopidogrel has been associated with clinical outcomes. Studies have investigated whether adjustment of antiplatelet therapies based on a single platelet function test is beneficial.Objective [...]
The Chronovariability of Platelet Reactivity A Hurdle in the Road to Personalized Antiplatelet Therapy? ∗
22/07/2014 00:32
The recognition that platelets play a central role in stent thrombosis and the development of the adenosine diphosphate receptor (e.g., the P2Y12 receptor) antagonists have been instrumental in making coronary stenting a cornerstone in the [...]
Paradoxical Embolism
22/07/2014 00:32
Paradoxical embolism is an important clinical entity among patients with venous thromboembolism in the presence of intracardiac or pulmonary shunts. The clinical presentation is diverse and potentially life-threatening. Although the serious [...]
Detection of Myocardial Injury by CMR After Transcatheter Aortic Valve Replacement
22/07/2014 00:32
BackgroundMyocardial injury after transcatheter aortic valve replacement (TAVR) is common, but its cause and relationship to the extent of myocardial tissue loss remain unclear.ObjectivesThis study sought to examine the incidence and degree [...]
Resting Heart Rate An Independent Predictor of Congestive Heart Failure
22/07/2014 00:32
Opdahl et al. (1) recently reported some interesting findings from the MESA (Multi-Ethnic Study of Atherosclerosis) trial showing that elevated resting heart rate (HR) was associated with increased risk for incident heart failure (HF) durin [...]
Reply Resting Heart Rate: An Independent Predictor of Congestive Heart Failure
22/07/2014 00:32
We thank Drs. Palatini and Julius for their interest in our recent work (1). Indeed, in the MESA (Multi-Ethnic Study of Atherosclerosis) study, with participants without cardiovascular disease (CV) at enrollment, we found an increased risk [...]
Infections Post-Cardiac Surgery New Information During Challenging Times ∗
22/07/2014 00:32
Surgical site infections (SSIs) are one of the most challenging complications of surgery, for patients and surgeons alike. For that reason, it is interesting to note that in this recent experience, reported by Gelijns et al. (1) in this iss [...]
Alcohol Consumption and Risk of Atrial Fibrillation A Prospective Study and Dose-Response Meta-Analysis
14/07/2014 23:51
BackgroundAlthough high alcohol consumption has been associated with increased risk of atrial fibrillation (AF), the role of light to moderate drinking remains unclear.ObjectivesThe study sought to investigate the association between alcoho [...]
A Functional Variant in APOA5/A4/C3/A1 Gene Cluster Contributes to Elevated Triglycerides and Severity of CAD by Interfering With MicroRNA 3201 Binding Efficiency
14/07/2014 23:51
BackgroundRecent genome-wide association studies identified the APOA5/A4/C3/A1 gene cluster polymorphisms influencing triglyceride level and risk of coronary artery disease (CAD).ObjectivesThe purposes of this study were to fine-map triglyc [...]
Assessing Risk of Inadequate Defibrillation Safety Margin The Strengths and Limitations of the NCDR ICD Registry ∗
14/07/2014 23:51
From the time of the initial clinical report in 1980 (1), implantable cardioverter-defibrillators (ICDs) have undergone testing to confirm that the devices can detect and terminate ventricular fibrillation (VF). The initial devices were imp [...]
Single Nucleotide Variances Can Account for Loss of microRNA Function The Emerging Cross Talk Between Genetics and Epigenetics ∗
14/07/2014 23:51
Cardiovascular disease is the leading cause of death worldwide, and accumulating evidence has demonstrated that mutations in the gene cluster APOA5/A4/C3/A1 are associated with hypertriglyceridemia, which may predispose to atherosclerosis a [...]
Notice
14/07/2014 23:51
In the JACC ACC.13, Abstract Supplement (61/10 Suppl A), for abstract E112, one of the authors names was printed incorrectly.
Alcohol Consumption and Risk of Atrial Fibrillation How Much Is Too Much? ∗
14/07/2014 23:51
Atrial fibrillation (AF) is the most common arrhythmia and a strong predictor of major cardiovascular complications and death (1,2). Unfortunately, few interventions have been shown to improve hard clinical outcomes in the growing populatio [...]
Yield of Serial Evaluation in At-Risk Family Members of Patients With ARVD/C
14/07/2014 23:51
BackgroundIncomplete penetrance and variable expressivity of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) complicate family screening.ObjectivesThe objective of the present study was to determine the optimal approach t [...]
Family Members of Patients With ARVC Who Is at Risk? At What Age? When and How Often Should We Evaluate to Determine Risk? ∗
14/07/2014 23:51
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is being recognized with increasing frequency as physicians have become more aware of this entity. Some estimate that ARVC may be present in 1 in 5,000 people. The disease is primarily [...]
The MOGE(S) Classification of Cardiomyopathy for Clinicians
14/07/2014 23:51
Most cardiomyopathies are familial diseases. Cascade family screening identifies asymptomatic patients and family members with early traits of disease. The inheritance is autosomal dominant in a majority of cases, and recessive, X-linked, o [...]
Aspirin Therapy in Primary Cardiovascular Disease Prevention A Position Paper of the European Society of Cardiology Working Group on Thrombosis
14/07/2014 23:51
Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a sourc [...]
7 Lessons From Fellowship
14/07/2014 23:51
In my office at the University of Michigan Cardiovascular Center is a plaque—one accorded to me at the end of my cardiology fellowship. At the very bottom is inscribed “June 20, 2012.” As on numerous occasions since then, I now close my eye [..
Intravenous Hydration (With or Without Rosuvastatin) Should Remain the Cornerstone of the Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease
14/07/2014 23:51
In a recent randomized, controlled, multicenter trial, Han et al. (1) showed that rosuvastatin, compared with “standard of care,” significantly reduced the risk of contrast-induced acute kidney injury (AKI) in diabetic patients with chronic [...
Reply Intravenous Hydration (With or Without Rosuvastatin) Should Remain the Cornerstone of the Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease
14/07/2014 23:51
We thank Dr. Cecere and colleagues for their interest in and comments on our study (1). They raise a very important question of whether rosuvastatin was consistently effective among various subgroups, especially the subgroup of patients wit [...]
The Importance of Genotype Variation Beyond Different Antiplatelet Therapy in Nonresponder Patients
14/07/2014 23:51
We read with great interest the recently published paper on prasugrel or high-dose clopidogrel for high platelet reactivity (HPR) in the Journal(1). Using the Multiplate analyzer (Roche Diagnostics, Mannheim, Germany), the authors described [...]
Reply The Importance of Genotype Variation Beyond Different Antiplatelet Therapy in Nonresponder Patients
14/07/2014 23:51
We thank Drs. Sardella and Calcagno for their interest in our paper (1). Following their prior publication (2), they emphasize the importance of genotyping for the CYP2C19*2 allele to define the pharmacodynamic benefit from prasugrel or dou [...]