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The follow electronic only articles are published in conjunction with this issue of Heart.

Atypical cause of hibernating myocardium due to complex cardiovascular lesions associated with Takayasu’s arteritis

M Nakajima, K Tsuchiya, J Obata

Myocardial hibernation is recognised as chronic hypoperfusion of the myocardium and its functional recovery after surgical revascularisation has been described. A case of surgery for complex lesions including severe aortic valve regurgitation, coronary ostial stenosis, and aortic calcification (porcelain aorta) caused by Takayasu’s arteritis is presented. The onset of left ventricular functional improvement after aortic valve replacement and coronary revascularisation were indicative of preoperative atypical myocardial hibernation caused by aortic valve disease and coronary artery disease associated with Takayasu’s arteritis.

(Heart 2004;90:e43) www.heartjnl.com/cgi/content/full/90/7/e43

Reversible dilated cardiomyopathy associated with glucagonoma

K Chang-Chretien, J T Chew, D P Judge

A case of a 54 year old woman with tachycardia and congestive heart failure is described. Initial evaluation included an echocardiogram, which showed dilated cardiomyopathy with an ejection fraction of 15%. Coronary angiography and endomyocardial biopsy did not identify a secondary cause of her cardiomyopathy. She subsequently developed necrolytic migratory erythema, and imaging of her pancreas identified a pancreatic mass with a major increase of her serum glucagon concentration. Tachycardia persisted despite treatment with β blockers. After resection of the tumour, her heart rate normalised and subsequently her heart returned to normal size and function. Although rare, in the appropriate clinical setting, glucagonoma should be considered in the differential diagnosis for tachycardia and dilated cardiomyopathy.

(Heart 2004;90:e44) www.heartjnl.com/cgi/content/full/90/7/e44

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