Editor's Message (Sept 2003)


Richard E. Shaw, PhD, FACC

Dear Readers,

This issue of the Journal of Invasive Cardiology, which coincides with the annual Transcatheter Therapeutics meeting, includes original research articles, case reports, reviews, articles from the Journal special sections “Clinical Decision Making”, “The Electrophysiology Corner” and “Clinical Images”, and a Continuing Medical Education offering.

The first research study, submitted by Dr. George Stoupakis and colleagues from the UMDNJ-New Jersey Medical School in Newark, New Jersey, presents their evaluation of preservation of myocardial microcirculation measured by myocardial blush grade during mechanical reperfusion for myocardial ischemia. They demonstrated that abciximab and eptifibatide both had similar beneficial effects on myocardial perfusion and blush scores were inversely correlated with peak troponin levels. Dr. Dean Kereiakes from the Lindner Center for Research and Education in Cincinnati, Ohio, has provided a commentary to accompany the article submitted by Dr. Stoupakis and associates.

The second research article, submitted by Dr. Saleem Sharieff and colleagues from the National Institute of Cardiovascular Disease in Karachi, Pakistan presents short and intermediate-term follow-up results of balloon valvuloplasty in adolescents and young adults with congenital pulmonary valve stenosis. During follow-up (mean 3 years) further improvement was seen in these patients suggesting that pulmonary balloon valvuloplasty is an effective treatment for this condition.

The third research article, from Dr. Chi Hang Lee and associates from the Department of Cardiology at the Erasmus Medical Center Rotterdam in Rotterdam, The Netherlands, describes their study of collateral formation in patients after percutaneous myocardial revascularization. They demonstrated that collateral formation did not appear to be the explanation for improvement in patients.

In the next research article, Dr. Paolo Angelini and associates from the Texas Heart Institute at St. Luke’s Hospital in Houston, Texas present their research in dogs demonstrating that subselective infusion of metabolically supportive solutions during acute myocardial infarction is feasible and may minimize damage to injured tissues.

In the fifth research article, Dr. Jacob Odenstedt and associates from the Cardiovascular Institute at Sahlgrenska Hospital in Gothenburg, Sweden used catheter-based left ventricular electromechanical mapping in the porcine model to distinguish between acute ischemic or infarcted myocardium. They showed that there were differences between baseline and 2-hour studies, but intersegmental baseline variability in unipolar voltage limited the value of this technique.

In the last research article, Dr. Francis Almeda and colleagues from Rush-Presbyterian-St. Luke’s Medical Center in Chicago, Illinois present their research on in-hospital outcomes in patients with acute coronary syndromes. They demonstrated that newer antiplatelet and antithrombotic therapies have led to improved patient outcomes over time in patients with similar TIMI risk.

This issue of the Journal also includes case reports on interesting topics as well as one case report with a brief review of the literature. The first case report, submitted by Drs. Schussler, Phillips and Anwar from the Department of Cardiology at Baylor University Medical Center in Dallas, Texas, presents a patient in whom they demonstrated the importance of evaluating PFO closure patients for other causes of right to left shunting, such as pulmonary arteriovenous malformations. In the second case report, Drs. Hirose, Kobayashi and Moses from the Cardiovascular Research Foundation at the Lenox Hill Heart and Vascular Institute in New York, New York present a patient in which multiple ulcerations in the plaque behind stent struts led to late stent malappostion after gamma brachytherapy for in-stent restenosis. In the last case report, Drs. Rogers, Chang and Lasala from the Division of Cardiovascular Medicine at Barnes-Jewish Hospital and the Mallinckrodt Institute of Radiology at the Washington University School of Medicine in Saint Louis, Missouri describe their use of the covered Jostent in repairing a pseudoaneurysm in a coronary artery bypass graft. There is also a report in this section which is a multiple case report with discussion submitted by Drs Angelini, Velasco and Khoshnevis from the Texas Heart Institute. They describe their use of intravascular ultrasound to document the descriptive features and pathophysiologic mechanisms of patients with anomalous coronary arteries arising from the opposite sinus. Another case which includes a review has been submitted by Dr. Man-Hong Jim and colleagues from Queen Mary Hospital in Hong Kong in which they explore the association of the coronaro-bronchial artery fistula and localized bronchiectasis.

Three of our special clinical sections are featured in this issue. In the Clinical Decision Making section, edited by Dr. Michael Sketch from Duke University Medical Center in Durham, North Carolina, Dr. Alfredo Rodriguez and colleagues from the Cardiac Unit at Otamendi Hospital in Buenos Aires, Argentina present an interesting clinical situation involving a patient presenting with diffuse proliferative in-stent restenosis with a small reference vessel. In the next special section, Clinical Images, Dr. Rizik and his colleagues, Dr. Neil Barman and Andre Bouhasin, have submitted multiple images documenting a remarkable treatment course using endovascular hypothermia to preserve myocardium in a patient presenting in cardiogenic shock.

This issue of the Journal is completed with several special articles. The first special article is a presentation from the CATH (Cardiac Catheterization and Antithrombotic Therapy in the Hospital) Clinical Consensus Panel on the pharmacoinvasive management of acute coronary syndrome in the setting of percutaneous coronary intervention. Dr. Dean Kereiakes and collaborators from nine other prominent institutions have compiled this report which addresses many of the challenges and potential solutions in treating ACS patients. Finally, this issue is completed with a CME offering that has been provided by Drs. Reisman and Gray from the Swedish Medical Center in Seattle, Washington.

It is my hope that all of the articles in this issue provide healthcare professionals with valuable information that is useful in the daily care of patients with cardiovascular disease.

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