European National Society Cardiovascular Journals - Background, rationale and mission statement of the “Editors´ Club"

Cardiovascular scientific production in Europe is growing both in quantity and in quality. Promoting high-quality research is a major goal of the European Society of Cardiology (ESC). The ESC has two highly respected official general journals, namely the European Heart Journal and Cardiovascular Research, devoted to clinical and basic research respectively. The ESC also publishes several sub-speciality official journals covering the full spectrum of cardiovascular diseases and related techniques. Most European countries, however, also have their own cardiovascular journals. National Society Cardiovascular Journals (NSCJ) are time-honoured and classically disseminate high-quality scientific research mainly originating from each particular European country. They also play a major role in education and harmonisation of clinical practice. Most NSCJ are published in local languages but many of them also incorporate English editions. Altogether, NSCJ provide a highly effective means to disseminate cardiovascular research produced in Europe. Scientific knowledge, however, has no barriers and many of these journals have gained an undisputed international profile. Some NSCJ, however, are just emerging and would benefit from networking support. It became clear that enhancing collaboration among NSCJ Editors would facilitate advancement in knowledge and further diffusion of scientific and educative contents.Developing a “Constitution Document” and “Mission Statement” was considered desirable to set the basis of future collaboration among NSCJ Editors. We assumed this responsibility in recognising the crucial role of NSCJ in Europe. Our target was to produce and issue a core document with fundamental principles upon which all NSCJ Editors would agree. Common goals will be identified and agreed-on measures will be pursued. The constitution document presented herein was therefore developed to formalise the NSCJ Editors´ Club Task Force

Time Course of Diastolic and Systolic Function Improvement After Pulmonary Valve Replacement in Adult Patients With Tetralogy of Fallot

ObjectivesThe aim of this research was to assess right ventricular diastolic and systolic function before and after pulmonary valve replacement (PVR) in adult patients after repair of tetralogy of Fallot.BackgroundPulmonary valve replacement (PVR) in adult patients late after repair of tetralogy of Fallot leads to rapid improvement of right ventricular (RV) systolic function.MethodsA total of 16 patients and 8 healthy subjects were included. Median age at initial repair was 4.9 (0.9 to 13.1) years, and mean age at PVR was 28.7 (19.5 to 45.6) years. Cardiac magnetic resonance imaging was performed before and 8 and 22 months after PVR. Right ventricular volumes and function as well as RV in- and outflow patterns were assessed.ResultsThe volume of the early filling of the RV (Evol) increased from 49.8 ± 14.7 ml to 53.8 ± 19.3 ml (not significant) and 62.0 ± 18.9 ml, respectively (p < 0.05), whereas the volume of the atrial contraction (Avol) remained unchanged. Consequently, the Evol/Avol ratio increased from 1.4 ± 0.7 before PVR to 1.6 ± 0.7 at 8 months (not significant) and 2.3 ± 1.2 at 22 months (p < 0.01). The Evol/Avol ratio was not significantly different from the healthy subjects at 22 months, indicating late recovery of diastolic function. Systolic function improved rapidly after PVR; the indexed RV end-systolic volume decreased from 93.7 ± 33.0 ml/m2to 60.9 ± 18.4 ml/m2(p < 0.01) and 54.8 ± 21.0 ml/m2(p < 0.01).ConclusionsIn adult patients late after total repair of Fallot, PVR leads to late improvement of diastolic function. We speculate that the rapid volume unloading after PVR increases systolic performance, whereas improvement in diastolic function requires long-term remodeling

Noninvasive Evaluation With Multislice Computed Tomography in Suspected Acute Coronary Syndrome Plaque Morphology on Multislice Computed Tomography Versus Coronary Calcium Score

ObjectivesOur aim was to evaluate the atherosclerotic plaque burden and morphology as determined by 64-slice multislice computed tomography (MSCT) coronary angiography in relation to the calcium score in patients presenting with suspected acute coronary syndrome (ACS).BackgroundThe absence of coronary calcium during coronary calcium scoring has been proposed to rule out significant coronary artery disease (CAD). However, data in patients presenting with suspected ACS are scarce.MethodsIn 40 patients (age 57 ± 11 years, 26 men) presenting with suspected ACS, MSCT coronary angiography in combination with coronary calcium scoring was performed before conventional coronary angiography. MSCT angiograms were evaluated for the presence or absence of coronary atherosclerotic plaque and the presence or absence of obstructive (≥50% luminal narrowing) CAD. In addition, plaque type was determined, and findings were related to the calcium score.ResultsCoronary artery disease was observed in 38 patients, of whom 10 patients had nonobstructive and 28 patients had obstructive CAD, confirmed by conventional coronary angiography in all patients. In patients with CAD, plaques were distributed as follows: 39% noncalcified plaques, 47% mixed plaques, and 14% calcified plaques. Coronary calcium was detected in 27 patients, of whom 10 had a score >400. In 13 (33%) patients, no coronary calcium was observed, but in 11 (85%), atherosclerotic plaques were detected on MSCT angiography.ConclusionsIn patients presenting with suspected ACS, noncalcified plaques are highly prevalent and the absence of coronary calcium does not reliably exclude the presence of (significant) atherosclerosis. This information may be of value to improve our understanding of the potential role of MSCT in this patient population

AGREEMENT BETWEEN CLINICAL, ECHOCARDIOGRAPHY AND NEUROHORMONAL RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY

Cardiolog

Regional myocardial blood flow reserve impairment and metabolic changes suggesting myocardial ischemia in patients with idiopathic dilated cardiomyopathy

AbstractOBJECTIVESWe performed positron emission tomography (PET) to evaluate myocardial ischemia in patients with idiopathic dilated cardiomyopathy (IDC).BACKGROUNDPatients with IDC have anatomically normal coronary arteries, and it has been assumed that myocardial ischemia does not occur.METHODSWe studied 22 patients with IDC and 22 control subjects using PET with nitrogen-13 ammonia to measure myocardial blood flow (MBF) at rest and during dipyridamole-induced hyperemia. To investigate glucose metabolism, fluorine-18 deoxyglucose (18FDG) was used. For imaging of oxygen consumption, carbon-11 acetate clearance rate constants (kmono) were assessed at rest and during submaximal dobutamine infusion (20 μg/kg body weight per min).RESULTSGlobal MBF reserve (dipyridamole-induced) was impaired in patients with IDC versus control subjects (1.7 ± 0.21 vs. 2.7 ± 0.10, p < 0.05). In patients with IDC, MBF reserve correlated with left ventricular (LV) systolic wall stress (r = −0.61, p = 0.01). Furthermore, in 16 of 22 patients with IDC (derived by dipyridamole perfusion) mismatch (decreased flow/increased 18FDG uptake) was observed in 17 ± 8% of the myocardium. The extent of mismatch correlated with LV systolic wall stress (r = 0.64, p = 0.02). The MBF reserve was lower in the mismatch regions than in the normal regions (1.58 ± 0.13 vs. 1.90 ± 0.18, p < 0.05). During dobutamine infusion kmonowas higher in the mismatch regions than in the normal regions (0.104 ± 0.017 vs. 0.087 ± 0.016 min−1, p < 0.05). In the mismatch regions 18FDG uptake correlated negatively with rest kmono(r = −0.65, p < 0.05), suggesting a switch from aerobic to anaerobic metabolism.CONCLUSIONSPatients with IDC have a decreased MBF reserve. In addition, low MBF reserve was paralleled by high LV systolic wall stress. These global observations were associated with substantial myocardial mismatch areas showing the lowest MBF reserves. In geographically identical regions an abnormal oxygen consumption pattern was seen together with a switch from aerobic to anaerobic metabolism. These data support the notion that regional myocardial ischemia plays a role in IDC

Non-Invasive Visualization of the Cardiac Venous System in Coronary Artery Disease Patients Using 64-Slice Computed Tomography

ObjectivesThis study was designed to evaluate the value of 64-slice computed tomography (CT) to visualize the cardiac veins and evaluate the relation between variations in venous anatomy and history of infarction.BackgroundCardiac resynchronization therapy (CRT) is an attractive treatment for selected heart failure patients. Knowledge of venous anatomy may help in identifying candidates for successful left ventricular lead implantation.MethodsThe 64-slice CT of 100 individuals (age 61 ± 11 years, 68% men) was studied. Subjects were divided into 3 groups: 28 control patients, 38 patients with significant coronary artery disease (CAD), and 34 patients with a history of infarction. Presence of the following coronary sinus (CS) tributaries was evaluated: posterior interventricular vein (PIV), posterior vein of the left ventricle, and left marginal vein (LMV). Vessel diameters were also measured.ResultsCoronary sinus and PIV were identified in all individuals. Posterior vein of the left ventricle was observed in 96% of control patients, 84% of CAD patients, and 82% of infarction patients. In patients with a history of infarction, a LMV was significantly less observed as compared with control patients and CAD patients (27% vs. 71% and 61%, respectively, p < 0.001). None of the patients with lateral infarction and only 22% of patients with anterior infarction had a LMV. Regarding quantitative data, no significant differences were observed between the groups.ConclusionsNon-invasive evaluation of cardiac veins with 64-slice CT is feasible. There is considerable variation in venous anatomy. Patients with a history of infarction were less likely to have a LMV, which may hamper optimal left ventricular lead positioning in CRT implantation

Diagnostic performance of 320-slice multidetector computed tomography coronary angiography in patients after coronary artery bypass grafting

Cardiovascular Aspects of Radiolog