Clinical Cardiology Alert – August 1, 2005
August 1, 2005
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Aortic Stenosis — New Insights
By Jonathan Abrams, MD Professor of Medicine, Division of Cardiology, University of New Mexico, Albuquerque Dr. Abrams serves on the speakers bureau for Merck, Pfizer, and Parke-Davis. -
Aortic Valve Prosthesis-Patient Mismatch (Size Doesn’t Make Much Difference)
By Jonathan Abrams, MD Synopsis: A majority of patients report improvement in functional quality of life early after AVR. Similar functional recovery was demonstrated for patients along the full spectrum of valve sizes indexed to body size, even for values considered to represent severe mismatch for patient size. Factors other than prosthesis-patient size influence functional quality of life early after AVR. Source: Koch CG, et al. Impact of Prosthesis-Patient Size on Functional Recovery After Aortic Valve Replacement. Circulation. 2005:111:3221-3229. -
Amiodarone vs Sotalol for Atrial Fibrillation
By John P. DiMarco, MD, PhD Professor of Medicine, Division of Cardiology, University of Virginia, Charlottesville Dr. DiMarco is a consultant for Novartis and does research for Medtronic and Guidant. Synopsis: Amiodarone and sotalol have a similar efficacy for converting atrial fibrillation to sinus rhythm, that the drugs do not significantly impair electrical cardioversion and that amiodarone is superior to sotalol which, in turn, is better than placebo, for maintaining sinus rhythm. Source: Singh BN, et al. Amiodarone Versus Sotalol for Atrial Fibrillation. N Engl J Med. 2005;352:1861-1872. -
Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction or Heart Failure
By John P. DiMarco, MD, PhD Synopsis: The absolute risk for sudden death or cardiac arrest is greatest in the early period after myocardial infarction, and the event rate declines significantly over time. Source: Solomon SD, et al. Sudden Death in Patients With Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both. N Engl J Med. 2005;352:2581-2588. -
Biventricular Pacing ECG
By Michael H. Crawford, MD Synopsis: BiV capture can be accurately detected by observing the R/S ratio in leads V1 and I of the 12-lead ECG. -
BNP for Differentiating Constrictive Pericarditis vs Restrictive Cardiomyopathy
By Michael H. Crawford, MD Synopsis: BNP levels are significantly elevated in RCM patients as compared to CP patients, and should be a useful noninvasive marker to distinguish the 2 conditions. Source: Leya FS, et al. The Efficacy of Brain Natriuretic Peptide Levels in Differentiating Constrictive Pericarditis From Restrictive Cardiomyopathy. J Am Coll Cardiol. 2005;45:1900-1902. -
New POTS Treatment?
By Michael H. Crawford, MD Synopsis: Acute acetylcholinesterase inhibition reduced standing heart rate and symptoms in POTS patients. Source: Raj SR, et al. Acetylcholinesterase Inhibition Improves Tachycardia in Postural Tachycardia Syndrome. Circulation. 2005;111:2734-2740. -
Pharmacology Watch: Antibiotic Treatment of Acute Lower Respiratory Infection
A new study from England defines acute lower respiratory tract infection as an uncomplicated acute illness, with cough as the primary symptom and at least one symptom or sign localized to the lower respiratory tract including sputum, chest pain, dyspnea, or wheeze. -
Clinical Briefs in Primary Care Supplement