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Does Diastolic Heart Failure Really Exist?

An important publication by Zile and colleagues that have been long interested in diastolic properties of the heart, confirms that diastolic heart failure (DHF) is a real entity and is associated with significant abnormalities of active relaxation and passive stiffness in the left ventricle (LV).

Determinants of Survival in Atrial Fibrillation

The AFFIRM study was a randomized comparison of 2 strategies for management of patients with atrial fibrillation. Patients with atrial fibrillation requiring therapy, who also had one or more risk factors for stroke or death, were randomized to either a rate control strategy of cardioversion and treatment with antiarrhythmic drugs or a rate control strategy using atrioventricular (AV) nodal blocking agents to control ventricular response. Results of this study suggest that if an effective method for maintaining sinus rhythm with fewer adverse effects were available, it might improve survival.

Magnetic Remote Catheter Ablation

Ernst and colleagues from St. George Hospital in Hamburg, Germany describe a new technique for positioning and manipulating ablation catheters during electrophysiologic studies. The system is a remote magnetic navigation system, which uses 2 permanent magnets to move a specially designed catheter.

ACE Inhibitors in Aortic Stenosis

Enalapril improves effort tolerance and reduces dyspnea in patients with symptomatic aortic stenosis, but may cause hypotension in those with congestive heart failure, left ventricular dysfunction, or systolic blood pressure < 100 mm Hg.

Radial Artery Coronary Bypass Conduit

Using a radial raft, as opposed to a vein graft as the second bypass in patients receiving a LITA to the LAD, resulted in less late mortality without a lot of quality data to support it.

Diabetes and CABG

Tight glycemic control during surgery and 12 hours after CABG in diabetic patients improves perioperative outcomes and survival, and decreases wound infections and episodes of recurrent ischemia.

Procalcitonin in Infective Endocarditis

The diagnosis of infective endocarditis (IE) remains a challenge. Thus, these investigators from Basel, Switzerland hypothesized that a marker of systemic bacterial infection such as procalcitonin may help. In 67 consecutive patients with clinical suspicion of IE, a multidisciplinary team applied the Duke criteria to make the diagnosis of IE in 21 patients.

Pharmacology Watch: Missing Link Between Vaccines and Diabetes

Breast Cancer and the Use of Statins; Warnings Issued for IBS Drugs; FDA Actions

Clinical Briefs in Primary Care Supplement

Clinical Cardiology Alert – June 1, 2004

June 1, 2004