Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 2007
Multicenter Study Clinical TrialChronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID Trial.
This study evaluated the impact of left ventricular assist device (LVAD) support on survival and quality of life in inotrope-dependent heart failure patients ineligible for cardiac transplantation. ⋯ Inotrope-dependent heart failure patients who are ineligible for transplantation have a high short-term mortality rate and derive a significant survival advantage from "destination" mechanical circulatory support.
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J. Am. Coll. Cardiol. · Aug 2007
Long-term predictors of descending aorta aneurysmal change in patients with aortic dissection.
We sought to demonstrate the long-term natural course of descending aorta dilation after acute aortic dissection (AD) and identify early predictors for late aneurysmal change. ⋯ The UT is the major site of late aneurysmal dilation. A large UT false lumen diameter on the initial CT portends late aneurysm and adverse outcome warranting early intervention.
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J. Am. Coll. Cardiol. · Aug 2007
ReviewCardiovascular protection using beta-blockers: a critical review of the evidence.
For more than 3 decades, beta-blockers have been widely used in the treatment of hypertension and are still recommended as first-line agents by national and international guidelines. Recent meta-analyses indicate that, in patients with uncomplicated hypertension, compared with other antihypertensive agents, first-line therapy with beta-blockers was associated with an increased risk of stroke, especially in the elderly cohort with no benefit for the end points of all-cause mortality, cardiovascular morbidity, and mortality. ⋯ Given the increased risk of stroke, their "pseudo-antihypertensive" efficacy (failure to lower central aortic pressure), lack of effect on regression of target end organ effects like left ventricular hypertrophy and endothelial dysfunction, and numerous adverse effects, the risk benefit ratio for beta-blockers is not acceptable for this indication. However, beta-blockers remain very efficacious agents for the treatment of heart failure, certain types of arrhythmia, hypertropic obstructive cardiomyopathy, and in patients with prior myocardial infarction.
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J. Am. Coll. Cardiol. · Aug 2007
Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study.
The aim of this study was to examine the value of measurement of the interleukin-1 receptor family member ST2 in patients with dyspnea. ⋯ Among dyspneic patients with and without acute HF, ST2 concentrations are strongly predictive of mortality at 1 year and might be useful for prognostication when used alone or together with NT-proBNP.
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The present study evaluated the effect of phosphorylcholine (PC) immunization on the extent of experimental atherosclerosis. ⋯ Phosphorylcholine immunization drives a specific humoral immune response that reduces foam cell formation in vitro and is atheroprotective in vivo.