Cardiovascular Medicine

5 pages, 110 KB

Open AccessCommunication

Jahresbericht 2006 der Schweizerischen Gesellschaft für Kardiologie

by Andres Jaussi

Cardiovasc. Med. 2007, 10(9), 301; https://doi.org/10.4414/cvm.2007.01266 - 28 Sep 2007

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Ich habe das Vergnügen, Ihnen im folgenden die Arbeit des Vorstandes und des Präsidenten in der Zeitspanne zwischen dem 7. Juni 2006 und dem 13. Juni 2007 zusammenzufassen [...] Full article

3 pages, 207 KB

Open AccessInteresting Images

Six Simultaneously Employed Methods to Gauge the Coronary Collateral Flow of the Decade

by Steffen Gloekler, Tobias Rutz and Christian Seiler

Cardiovasc. Med. 2007, 10(9), 298; https://doi.org/10.4414/cvm.2007.01264 - 28 Sep 2007

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Abstract

Case report. A 59-year-old woman with bronchial asthma and obesity underwent coronary angiography because of exertional dyspnea and atypical chest pain both at rest and sometimes during exertion[...] Full article

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2 pages, 516 KB

Open AccessInteresting Images

Jugendlicher Mit Einer Breitkomplextachykardie

by David Altmann, Marion Bötschi and Peter Ammann

Cardiovasc. Med. 2007, 10(9), 296; https://doi.org/10.4414/cvm.2007.01263 - 28 Sep 2007

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Abstract

Ein 16jähriger Jugendlicher stellt sich wegen erstmalig aufgetretenen tachykarden Palpitationen, begleitet von einem leichten thorakalen Druckgefühl und Schwindel, bei seinem Hausarzt vor [...] Full article

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11 pages, 248 KB

Open AccessEditorial

CETP-Inhibitoren (Torcetrapib und JTT-705)

by Walter F. Riesen

Cardiovasc. Med. 2007, 10(9), 285; https://doi.org/10.4414/cvm.2007.01265 - 28 Sep 2007

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Abstract

Although results from clinical outcome studies and from studies on atherosclerosis progression have convincingly demonstrated that LDL-cholesterol lowering by statins may significantly reduce the incidence of cardiovas-cular events, these studies have also indicated that LDL lowering alone with standard statin doses leaves a considerable residual cardiovas-cular risk. Apart from LDL, HDL has been recognized as an important independent risk factor for coronary heart disease and HDL raising has been associated with coronary heart disease reduction, probably by its anti-athe-roclerotic properties (HDL-mediated reverse cholesterol transport, anti-inflammatory and anti oxidant properties). Therapies to raise HDL are therefore of major scientific importance. The most important increase in HDL-cholesterol is presently achieved by inhibition of the cholesterol ester transport protein (CETP), a protein which mediates the transfer of cholesterol esters from HDL to VLDL/LDL and of trigylcerides from VLDL/IDL to HDL. At the present time two inhibitors of CETP are under clinical investigation, Torcetrapib and JTT-705. These drugs increase HDL cholesterol by 30 to 100%. They moderately lower VLDL/LDL-cholesterol and they normalize small dense LDL. Raising HDL by CETP inhibition in combination with a statin could prove to be en efficient new approach against athe-rosclerosis. Full article

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6 pages, 171 KB

Open AccessArticle

Acute Myocardial Infarction and Associated Deaths in Switzerland—An Approach to Estimating Incidence

by Katharina Meyer, Anja Simmet and Christoph Junker

Cardiovasc. Med. 2007, 10(9), 279; https://doi.org/10.4414/cvm.2007.01262 - 28 Sep 2007

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Abstract

Background and question under study: In Switzerland, there is a lack of populationbased data on the event rate of acute myocardial infarction (AMI) and case fatality. The aim of this study was to estimate theAMI incidence rate in Switzerland and case fatality for both in-hospital and out-of-hospital deaths due to AMI. Methods: All data were taken from the Swiss Hospital Statistics (HOST) and Cause of Death Statistics (CoD) databases 2004. Data were coded according to ICD 10. In order to estimate AMI event rate, we considered (1.) all cases with hospital discharge diagnosis “AMI” (I 21; I 22; HOST) and (2.) all cases with AMI as underlying cause of death (I 21; I 22; CoD). Results: In the HOST, the rate for age-standardised hospital discharges was 118/100 000 overall (60/100 000 for women; 183/100 000 for men). The age-standardised AMI incidence rate was 131/100 000 overall (for women 68/100 000; for men 202/100 000).Age-standardised out-of-hospital case fatality (5.0% for women, 5.3% for men) was higher than agestandardised in-hospital case fatality (2.3% for women, 2.4% for men). In both sexes, on average, six out of ten deaths due to AMI occurred outside the hospital. Conclusion: To our knowledge, this was the first estimation of AMI incidence and case fatality for Switzerland. Data from the HOST database revealed only 11514 AMI cases (3799 women; 7735 men). By using both, HOST and CoD database estimated incidence could be increased to 13007 AMI cases (4414 women, 8593 men). Nevertheless, the estimated AMI incidence rate still does not represent the actual AMI incidence rate for Switzerland since an uncertain proportion of AMI cases and AMI deaths might be unrecognised due to methodological limitations. Full article

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8 pages, 666 KB

Open AccessReview

Chronic Ischaemic Mitral Regurgitation: A Diagnostic and Therapeutic Challenge

by Pascal A. Berdat

Cardiovasc. Med. 2007, 10(9), 271; https://doi.org/10.4414/cvm.2007.01267 - 28 Sep 2007

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Abstract

Ischaemic mitral regurgitation (IMR) is defined as functional MR with systolic restriction of leaflet motion, apical and lateral displacement of the subvalvular apparatus, and annular dilatation in the presence of a morphologically normal mitral valve. IMR is usually caused by LV dilatation in the setting of ischaemic or idiopathic dilated cardiomyopathy (CMP). Left ventricular dilatation leads to dilatation of the mitral annulus and to apical and lateral displacement of one or both papillary muscles with tethering of the valve leaflets and consecutive IMR. Therefore, IMR begets IMR with a vicious cycle of increased volume load leading to ventricular dilatation, leading to more IMR etc. Although MR is thought to unload the LV, wall stress is increased due to LV dilatation according to Laplace’s law. IMR is therefore thought to be primarily a ventricular and not a valvular problem. IMR is known to be prognostically important irrespective of LV function and of IMR severity at rest, because it is very dynamic and sensitive to loading conditions. IMR may frequently be severe during daily activity inducing LV failure on the long term. Therefore, dynamic testing is becoming the method of choice for assessment of these patients. Medical therapy has been shown to be inferior to surgery in the setting of IMR. Although still controversial with regard to what surgical method may be best not only to correct IMR, but also to induce a change in LV size and shape-the so-called reverse remodeling-surgical treatment is indicated with a documented effective regurgitant orifice area (EROA) > 20 mm² and a regurgitant volume (Rvol) > 30 mL by transthoracic echocardiography (TTE) at rest or with an increase of EROA > 13 mm² in exercise TTE. Furthermore, intraoperative provocative testing may help identify significant IMR. Correction of IMR is usually done by restrictive annuloplasty with aggressive undersizing of a conventional closed and semirigid annuloplasty ring. Improved LV function and a decreased need for cardiac transplantation has been seen in published series. With the advent of new rings and devices specifically designed for correction of IMR, results may further improve. Modern specific annuloplasty rings are designed to correct the down- and outward displacement of the subvalvular apparatus by inducing an acute valvular and ventricular reshaping. With the choice of various models, IMR may be corrected more precisely by selecting a type of ring according to the geometry of the regurgitant jet and the distortion of the valve leaflets. In case of ischaemic CMP, not only complete revascularisation, but also resection of aneurysmatic myocardial scar tissue and surgical LV remodeling is usually performed. With the help of new devices such as the ACORN CorCap® device further dilatation may effectively be prevented and may even improve LV function in selected patients. Alternatively, cardiac transplantation, implantation of an assist device for destination therapy in patients not qualifying for cardiac transplantation or resynchronisation therapy may be evaluated in very advanced cases. Full article

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Cardiovasc. Med., Volume 10, Issue 9 (09 2007) – 6 articles

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