Issue Highlights

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HomeCirculationVol. 113, No. 7Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published21 Feb 2006https://doi.org/10.1161/circ.113.7.919Circulation. 2006;113:919DETECTION OF DIVERSE BACTERIAL SIGNATURES IN ATHEROSCLEROTIC LESIONS OF PATIENTS WITH CORONARY HEART DISEASE, by Ott et al.In this issue of Circulation, Ott and colleagues systematically evaluated the presence and spectrum of bacteria in coronary atherosclerotic lesions based on their molecular phylogeny signatures. A high overall bacterial diversity of more than 50 different species was detected in catheter-based atherectomy tissues from 38 patients, indicating diverse bacterial colonization of arterial lesions. The findings of this study have important implications for the infection hypothesis in the pathophysiology of coronary atherosclerosis—namely, diverse bacterial colonization may be more important than a single pathogen. Although large randomized trials have failed to show a benefit for specific antibiotics in the treatment of coronary heart disease, this study suggests the possibility of a far more complex biology in which diverse bacterial agents colonizing atheromatous lesions are in a position to act as additional factors modulating disease progression. See p 929.NOVEL SPECKLE-TRACKING RADIAL STRAIN FROM ROUTINE BLACK-AND-WHITE ECHOCARDIOGRAPHIC IMAGES TO QUANTIFY DYSSYNCHRONY AND PREDICT RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY, by Suffoletto et al.Mechanical dyssynchrony is increasingly being recognized as an important contributor to left ventricular (LV) dysfunction in patients with depressed LV systolic function. Quantification of dyssynchrony has potential diagnostic, therapeutic, and prognostic importance. In this issue of Circulation, Suffoletto and colleagues describe a novel technique in which radial strain at several points of the LV is measured using speckle tracking. Dyssynchrony by this technique correlates with tissue Doppler, is less angle dependent than the Doppler approach, and correlates well with the acute hemodynamic and chronic response. Lead placement that was found to be concordant with the site of the latest mechanical activation by speckle tracking was associated with greater improvement in ejection fraction. This study helps to further clarify quantification of LV dyssynchrony and brings us closer to identifying optimal candidates for resynchronization and perhaps to directed placement of the left ventricular lead where anatomically feasible. See p 960.EFFECT OF POSTEROLATERAL SCAR TISSUE ON CLINICAL AND ECHOCARDIOGRAPHIC IMPROVEMENT AFTER CARDIAC RESYNCHRONIZATION THERAPY, by Bleeker et al.One cause of a poor response to cardiac resynchronization therapy (CRT) may be scarring of the posterolateral segments of the LV, resulting in ineffective resynchronization. Bleeker et al evaluated 40 consecutive patients with chronic coronary artery disease and conventional indications for CRT: NYHA class IV symptoms of heart failure, LV ejection fraction 120 ms, and left bundle-branch block. Contrast-enhanced magnetic resonance imaging identified 14 patients with a transmural posterolateral scar. In contrast to patients without a posterolateral scar, these patients did not improve clinically or with regard to echocardiographic measures of LV function or dyssynchrony. These results suggest that contrast-enhanced MRI can be used to identify patients with transmural posterolateral scar who will not respond to CRT. See p 969.Visit http://circ.ahajournals.org:Clinician UpdateInflammatory Biomarkers in Acute Coronary Syndrome: Part II: Acute-Phase Reactants and Biomarkers of Endothelial Cell Activation. See p e152.Images in Cardiovascular MedicineBidirectional Ventricular Tachycardia Caused by Digitalis Toxicity. See p e156.Hibernating Myocardium Identified by Cardiovascular Magnetic Resonance and Positron Emission Tomography. See p e158.Carcinoid Heart Disease. See p e160. Download figureDownload PowerPointBook ReviewA Change of Heart. See p e162.CorrespondenceSee p e164. Previous Back to top Next FiguresReferencesRelatedDetails February 21, 2006Vol 113, Issue 7 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.113.7.919 Originally publishedFebruary 21, 2006 PDF download Advertisement