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February 2007

Cardiac resynchronization in a patient with Class IV heart failure and narrow QRS-the role of mechanical dyssynchrony

ByJoseph Dell'Orfano, MD

Cardiac resynchronization treatment (CRT) has moved into the mainstream of patient care after several randomized studies have demonstrated improved quality of life, reversed remodeling, and decreased heart failure hospitalizations. More recently, 2 large studies have demonstrated a mortality benefit of CRT independent of implantable cardioverter defibrillator

Is circulating heat shock protein 60 a marker for susceptibility to cardiovascular disease in patients with diabetes?

ByBrian Henderson, PhD,Jeffrey W. Stevens MD, PhD,Jacqueline A. Cooper, BSc,Andrew Steptoe, DSc,Anthony R.M. Coates, MD,Steve E. Humphries, PhD, FRCPath, MRCP,Alireza Shamaei-Tousi, PhD

The vital cell stress protein, heat shock protein (Hsp)60, has recently been found in the circulation of healthy subjects over an extremely large concentration range. We performed an analysis of subjects with diabetes to determine whether Hsp60 is associated with biochemical markers of cardiovascular disease. Results showed that high circulating levels of Hsp60 are associated with clinically manifest cardiovascular disease. Hsp60 has cytokine-like actions, which may be responsible for this association.

Nonischemic cardiomyopathy and implantable cardioverter-defibrillators

ByElizabeth J. Masterson, MD,Alan H. Kadish, MD

We assessed whether duration of nonischemic cardiomyopathy was related to the degree of benefit from implantable cardioverter-defibrillator (ICD) insertion. Subjects who had a recent diagnosis of nonischemic cardiomyopathy had at least a similar benefit from ICD insertion as did those with a remote diagnosis. These results indicate that ICD therapy should be considered in such patients as soon as they are diagnosed and once reversible causes of left ventricular dysfunction have been excluded.

C-reactive protein and hypertension

BySusan G. Lakoski, MD, MS1,David M. Siscovick, MD, MPH2,David M. Herrington, MD, MHS1

We assessed whether C-reactive protein (CRP) concentrations predicted future risk of hypertension in a cohort of young adults. Results showed that CRP levels do not independently predict risk of incident hypertension after accounting for body mass index. Further research is needed in the area of inflammation and hypertension, with a special focus on the effect of obesity and age-related changes on this process.