Cardiovascular Medicine

2 pages, 539 KB

Open AccessEditorial

High-Density Lipoprotein Dysfunction as a New Therapeutic Target

by Ulf Landmesser, Michaela Keel and Thomas F. Lüscher

Cardiovasc. Med. 2011, 14(2), 71; https://doi.org/10.4414/cvm.2011.01566 - 23 Feb 2011

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Atherosclerosis remains the leading cause of morbidity and mortality in Switzerland and worldwide despite improvements in its management. Epidemiological data and experimental as well as translational studies indicate that high-density lipoprotein (HDL) can exert anti-atherosclerotic effects. However, recent studies showed that these vasoprotective [...] Read more.

Atherosclerosis remains the leading cause of morbidity and mortality in Switzerland and worldwide despite improvements in its management. Epidemiological data and experimental as well as translational studies indicate that high-density lipoprotein (HDL) can exert anti-atherosclerotic effects. However, recent studies showed that these vasoprotective effects of HDL are impaired in patients with cardiovascular disease and this has been termed “HDL dysfunction”. The French Fondation Leducq awarded a grant to develop a transatlantic network of excellence to uncover the mechanisms of HDL dysfunction and its clinical implications. This knowledge is necessary in order to truly understand the impact of HDL-targeted therapies on the cardiovascular system. Full article

2 pages, 515 KB

Open AccessInteresting Images

A Giant Saphenous Vein Graft Aneurysm Compressing the Right Cavities

by Stéphane Chevallier, Etienne Monnard and Jean-Jacques Goy

Cardiovasc. Med. 2011, 14(2), 69; https://doi.org/10.4414/cvm.2011.01567 - 23 Feb 2011

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Abstract

A 86-year-old man was hospitalised because of a cerebral vascular attack [...] Full article

2 pages, 495 KB

Open AccessCase Report

Cornstarch for Fibrofatty Coronaries

by Stéphane Cook, Lorenz Räber, Peter Wenaweser and Stephan Windecker

Cardiovasc. Med. 2011, 14(2), 67; https://doi.org/10.4414/cvm.2011.01570 - 23 Feb 2011

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Abstract

Metallic coronary stents have been developed to overcome acute complications after percutaneous coronary intervention. However, this durable implant is associated with complications in the long-term, such as stent fracture, re-stenosis and thrombosis. Hence, a coronary implant that will provide temporary support before being [...] Read more.

Metallic coronary stents have been developed to overcome acute complications after percutaneous coronary intervention. However, this durable implant is associated with complications in the long-term, such as stent fracture, re-stenosis and thrombosis. Hence, a coronary implant that will provide temporary support before being resorbed has been proposed as a valuable alternative and is currently under investigation. In this article, we report the one-year clinical outcome after implantation of the first bio-resorbable everolimuseluting vascular scaffold (BVS) performed at our institution. Full article

6 pages, 121 KB

Open AccessGuidelines

Recommandations 2011 sur les Bonnes Pratiques dans le Diagnostic et le Traitement des Arythmies par Stimulation Cardiaque et Ablation Percutanée par Cathéter

by Jürg Schläpfer, Istvan Babotai, Urs Bauersfeld, Haran Burri, Jürg Fuhrer, Hans Gloor, Christian Sticherling and Peter Zwicky

Cardiovasc. Med. 2011, 14(2), 61; https://doi.org/10.4414/cvm.2011.01568 - 23 Feb 2011

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Abstract

Guidelines 2011 on the treatment by cardiac pacing, defibrillation and percutaneous catheter ablation. In 2000 the Working Group on Cardiac Pacing and Electrophysiology of the Swiss Society of Cardiology published guidelines on the diagnosis and treatment of arrhythmias by cardiac pacing, internal [...] Read more.

Guidelines 2011 on the treatment by cardiac pacing, defibrillation and percutaneous catheter ablation. In 2000 the Working Group on Cardiac Pacing and Electrophysiology of the Swiss Society of Cardiology published guidelines on the diagnosis and treatment of arrhythmias by cardiac pacing, internal defibrillation and catheter ablation. These fields have evolved significantly in the last few years, and new recommendations on the proficiency of physicians involved in this domain have been published by European and North American societies. For these reasons, and with a view to maintaining quality of care, the recommendations are updated in the present document. Full article

3 pages, 92 KB

Open AccessGuidelines

Recommandations Pour la Télésurveillance des Implants à Buts Diagnostiques et Thérapeutiques Lors D’arythmies et D’insuffisance Cardiaque

by Jürg Fuhrer, Istvan Babotai, Urs Bauersfeld, Haran Burri, Hans Gloor, Jürg Schläpfer, Christian Sticherling and Peter Zwicky

Cardiovasc. Med. 2011, 14(2), 58; https://doi.org/10.4414/cvm.2011.01569 - 23 Feb 2011

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Abstract

Guidelines for remote monitoring of implanted devices for diagnosis and treatment of arrhythmias and heart failure. Implanted devices for diagnosis and treatment of arrhythmias and heart failure comprise event recorders, pacemakers, automatic defibrillators (ICD) and biventricular stimulating devices for the treatment of [...] Read more.

Guidelines for remote monitoring of implanted devices for diagnosis and treatment of arrhythmias and heart failure. Implanted devices for diagnosis and treatment of arrhythmias and heart failure comprise event recorders, pacemakers, automatic defibrillators (ICD) and biventricular stimulating devices for the treatment of severe heart failure (cardiac resynchronisation pacemakers [CRT-P] and resynchronisation ICDs [CRT-D]). Telecommunications open up entirely new potential for remote monitoring of such devices. The article aims to assist doctors using this monitoring equipment. Full article

5 pages, 318 KB

Open AccessArticle

Posterior Probabilities in Sequential Testing Improve Clinical Cardiovascular Risk Prediction Using Carotid Total Plaque Area and C-Statistics

by Michel Romanens, Franz Ackermann, Matthias Schwenkglenks, Thomas Szucs and J. David Spence

Cardiovasc. Med. 2011, 14(2), 53; https://doi.org/10.4414/cvm.2011.01565 - 23 Feb 2011

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Abstract

Background: Risk prediction for myocardial infarction currently uses global risk assessment tools (PROCAM, SCORE or NCEP III). Their sensitivity is however low (about 33%). Emerging risk assessment tools are increasingly applied, but the incremental value is debated. Aims: To develop a [...] Read more.

Background: Risk prediction for myocardial infarction currently uses global risk assessment tools (PROCAM, SCORE or NCEP III). Their sensitivity is however low (about 33%). Emerging risk assessment tools are increasingly applied, but the incremental value is debated. Aims: To develop a risk prediction model based on posterior test probabilities (PTP) and to determine the statistical significance of the incremental gain using Receiver Operating Characteristic (ROC) curve comparison in combination with the Bayes theorem. Methods: In a primary care cohort, both NCEP III and total carotid plaque area (TPA) were used to calculate 10-year risk, and combined posttest risk probabilities for myocardial infarction (TPA-PTP) were combined by using Bayes theorem. ROC curves were compared for NCEP III, TPA, and TPA-PTP. Results: A total of 684 subjects with a mean age of 50 years were followed for 3.3 ± 1.8 years. Thirteen myocardial infarctions occurred. Sensitivity was 31% for NCEP III and 62% for TPA >0.55 cm2 and 39% for TPAPTP; specificity was 89%, 75% and 79% respectively (all p = NS). AUC was 0.68 for NCEP III and 0.75 for TPA-PTP (p = 0.0034). Net reclassification improvement analysis yielded a result of +18.25%. Conclusions: ROC curve comparison is a conservative approach to estimating the value of emerging risk assessment tools in the primary prevention of myocardial infarction. Despite a limited number of individuals and few myocardial infarctions that occurred during follow-up, TPA-PTP yielded a statistically significant incremental value over NCEP III. This was due to the integration of posttest risk calculation into risk prediction. PTP risk estimates using published sensitivities and specificities of an emerging test may be used to compare ROC curves and improve the assessment of the clinical utility of new emerging risk assessment tools. Full article

7 pages, 510 KB

Open AccessReview

Do Stem Cells Contribute to Heart Regeneration or Rather to Pathological Remodelling in Inflammatory Cardiomyopathy?

by Gabriela Kania

Cardiovasc. Med. 2011, 14(2), 46; https://doi.org/10.4414/cvm.2011.01571 - 23 Feb 2011

Cited by 1 | Viewed by 12

Abstract

Understanding the pathways that chauffeur pathological remodelling in the failing heart still remains challenging. Myocardial inflammation is a common cause of pathological tissue remodelling in the heart promoting development of heart failures, often with the phenotype of inflammatory dilated cardiomyopathy. Pathological remodelling is [...] Read more.

Understanding the pathways that chauffeur pathological remodelling in the failing heart still remains challenging. Myocardial inflammation is a common cause of pathological tissue remodelling in the heart promoting development of heart failures, often with the phenotype of inflammatory dilated cardiomyopathy. Pathological remodelling is associated with replacement of native cells by fibrotic tissue that reflects poor clinical prognosis and a stage of irreversibility. Substantial efforts have been attempted to develop therapeutic strategies aiming to regenerate the injured heart with stem cells. There is, however, increasing evidence that stem cells modulate inflammatory processes in damaged hearts acting in a paracrine fashion rather than directly regenerating cardiac tissue. The recent findings suggest that the poor effectiveness of stem-cellbased therapies in heart diseases is a result of the nonphysiological microenvironment of the affected cardiac tissue. In particular, the inflamed myocardium inhibits the cardio-regenerative capacity of transplanted stem cells, and instead promotes the pro-fibrotic processes. A growing body of evidence suggests that the specific signalling milieu of the affected heart is a key determinant of the fate and function of stem cells in the myocardium. Therefore, coupling the modulation of the myocardial microenvironment with patient-specific stem cells must be considered to achieve successful stemcell-based therapy in heart disorders. This review shortly summarises the current knowledge about the role of stem and progenitor cells in inflammatory cardiomyopathy and their potential use in stem-cell-based therapies. Full article

5 pages, 110 KB

Open AccessEditorial

Die Geschichte der Gesundheitsvorsorge

by Philipp Sarasin

Cardiovasc. Med. 2011, 14(2), 41; https://doi.org/10.4414/cvm.2011.01564 - 23 Feb 2011

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Abstract

Ein historischer Rückblick bis zurück an die Schwelle zum 18 [...] Full article

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Cardiovasc. Med., Volume 14, Issue 2 (02 2011) – 8 articles

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