Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Jul 2012
Assessment of pulmonary endothelial function during invasive testing in children and adolescents with idiopathic pulmonary arterial hypertension.
The purpose of our study was to assess pulmonary endothelial function by vasodilator response to acetylcholine (Ach) administered in segmental pulmonary arteries in children with idiopathic pulmonary arterial hypertension (IPAH). We hypothesized that there was a relationship among pulmonary endothelial response to Ach, severity of the disease, and clinical outcome. ⋯ Our study demonstrates a strong relationship between pulmonary endothelial response to Ach and prognosis of children with IPAH. As an adjunct to the usual testing protocol, this method provides additional information for therapeutic guidance.
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Pharmacogenetics primarily uses genetic variation to identify subgroups of patients who may respond differently to a certain medication. Since its first description, the field of pharmacogenetics has expanded to study a broad range of cardiovascular drugs and has become a mainstream research discipline. Three principle classes of pharmacogenetic markers have emerged: 1) pharmacokinetic; 2) pharmacodynamic; and 3) underlying disease mechanism. ⋯ In addition, we highlight which variants and in which contexts pharmacogenetic testing can be implemented by practicing clinicians. The pace of genetic discovery has outstripped the generation of the evidence justifying its clinical adoption. Until the evidentiary gaps are filled, however, clinicians may choose to target therapeutics to individual patients whose genetic background indicates that they stand to benefit the most from pharmacogenetic testing.
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J. Am. Coll. Cardiol. · Jul 2012
Long-term prognosis following resuscitation from out of hospital cardiac arrest: role of percutaneous coronary intervention and therapeutic hypothermia.
The aim of the study was to assess the influence of percutaneous coronary intervention (PCI) and therapeutic hypothermia (TH) on long-term prognosis. ⋯ The findings suggested that effects of acute hospital interventions for post-resuscitation treatment extend beyond hospital survival and can positively influence prognosis following the arrest hospitalization.
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J. Am. Coll. Cardiol. · Jul 2012
Randomized Controlled Trial Multicenter StudyRadial artery and saphenous vein patency more than 5 years after coronary artery bypass surgery: results from RAPS (Radial Artery Patency Study).
The purpose of this study was to present radial and saphenous vein graft (SVG) occlusion results more than 5 years following coronary artery bypass surgery. ⋯ Radial arteries are associated with reduced rates of functional and complete graft occlusion compared with SVGs more than 5 years following surgery. (Multicentre Radial Artery Patency Study: 5 Year Results; NCT00187356).
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J. Am. Coll. Cardiol. · Jul 2012
Acute and chronic effects of dysfunction of right ventricular outflow tract components on right ventricular performance in a porcine model: implications for primary repair of tetralogy of fallot.
This study investigates the contribution of infundibular versus pulmonary valve (PV) dysfunction on right ventricular (RV) function in a porcine model. ⋯ Surgical RVOT dysfunction, whether it includes the infundibulum and/or the PV, has an immediate effect on RV performance. Although impaired RV contractility is due to intrinsic myocardial damage by infundibular distortion, it is chronically furthered by PI-related RV dilation. These findings support the adoption of a RVOT-sparing strategy to treat tetralogy of Fallot.