HomeCirculationVol. 115, No. 3Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published23 Jan 2007https://doi.org/10.1161/circ.115.3.287Circulation. 2007;115:287EARLY OUTCOMES OF TRICUSPID VALVE REPLACEMENT IN YOUNG CHILDREN, by Bartlett et al.Few data on the outcome of tricuspid valve replacement in young children are available to guide decisions. Bartlett and colleagues reviewed the results of tricuspid valve replacement in 97 children younger than age 6 years using the database of the Pediatric Cardiac Care Consortium of 45 centers between 1984 and 2002. The primary outcome was survival to discharge. The most frequent cardiac diagnoses were Ebstein’s anomaly (40%), pulmonary atresia (11%), and tetralogy of Fallot (8%). In-hospital mortality was 26% overall and was highest among infants (64%). Valve thrombosis and heart block requiring a pacemaker were common complications. The high morbidity and mortality of tricuspid valve replacement in young children and especially infants suggests that other surgical options should be considered. See p 319.MYOCARDIAL ISCHEMIC MEMORY IMAGING WITH MOLECULAR ECHOCARDIOGRAPHY, by Villanueva et al.Myocardial ischemia that does not result in necrosis may be difficult to diagnose after resolution of the ischemia. Such episodes are associated with endothelial upregulation of leukocyte adhesion molecules. In this issue, Villanueva et al describe the potential of myocardial ischemic memory using contrast echocardiography. Lipid microbubbles were designed to adhere to selectins, and this was tested in a model of inflamed rat cremaster muscle and in a rat model. Twelve rats underwent 15 minutes of left anterior descending coronary artery occlusion and then at 15 minutes and 1 hour following reperfusion, there was greater opacification of the ischemic bed using microbubbles with the selectin ligand. Immunostaining confirmed endothelial P-selectin expression. Although preliminary, the present study raises the potential that this technique may allow the identification of recent myocardial ischemia in patients and facilitate the triage of patients with chest pain. See p 345.PREVALENCE OF LONG-QT SYNDROME GENE VARIANTS IN SUDDEN INFANT DEATH SYNDROME, by Arnestad et al.andCARDIAC SODIUM CHANNEL DYSFUNCTION IN SUDDEN INFANT DEATH SYNDROME, by Wang et al.Sudden infant death syndrome is unexplained, unexpected death in the first year of life and has multifactorial etiologies. One important cause relates to the genes responsible for congenital long-QT syndrome. In companion manuscripts in this issue of Circulation, Arnestad and colleagues report their molecular autopsy findings of genetic screening for 7 known long-QT syndrome—associated genes in 201 Norwegian victims of sudden infant death syndrome. They identified mutations or rare genetic variants in 10% of cases, of which half were in the sodium channel SCN5A gene. Wang and colleagues then performed biophysical in vitro functional experiments on the SCN5A mutations in transiently transfected cells. They found defects in the voltage dependence of inactivation and kinetics, including increased persistent sodium currents, similar to the biophysical changes seen in SCN5A mutations causing long-QT syndrome. Taken together, these investigations conclude that neonatal electrocardiographic screening may identify QT prolongation prior to sudden infant death syndrome, potentially affecting outcome. These studies further our understanding of the relationship between sudden infant death syndrome and genes causing long-QT syndrome. See pp 361 and 368.Visit http://circ.ahajournals.org:Clinician UpdateMetabolic Syndrome. See p e32.Images in Cardiovascular MedicineDouble-Outlet Left Ventricle. See p e36.Serial Images Demonstrating Proximal Extension of an Aortic Intramural Hematoma. See p e38. Download figureDownload PowerPointLost P’s, but Not Yet Forgotten. See p e41.Book ReviewPediatric Prevention of Atherosclerotic Cardiovascular Disease. See p e43.CorrespondenceSee p e45. Previous Back to top Next FiguresReferencesRelatedDetails January 23, 2007Vol 115, Issue 3 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.115.3.287 Originally publishedJanuary 23, 2007 PDF download Advertisement
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Jan 18, 2010
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