eLetters

174 e-Letters

published between 2001 and 2004

  • Oral glucocorticoid treatment, heart failure and atherosclerotic cardiovascular disease
    Paul G Cohen

    Dear Editor,

    The paper by Souverein et al. has identified oral glucocorticoid therapy as a risk factor for the development of heart failure [1]. They noted that the risk was greater in patients with current use and those receiving higher dosage.

    One of the striking findings in their analysis was the greater incidence of heart failure as compared to ischemic heart disease. This suggests the possi...

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  • Effect of Green Tea on Smokers
    Tsung O. Cheng

    Dear Editor,

    Nagaya et al [1] showed that green tea can reverse endothelial dysfunction in smokers. There is another protective property of green tea in smokers that is worthy of additional comment.

    The polyphenolic catechins in green tea, such as (-)-epigallocatechin -3-gallate, have been shown to be potent antioxidants in many chemical and biochemical studies [2,3]. Oxidants, either present in c...

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  • The risk of shooting stressed myocytes with beta blockers, pinacidil and glibenclamide.
    Richard G Fiddian-Green

    Dear Editor,

    It would seem that the K+(atp) channel opener pinacidil and closer glibenclamide might exert their effects by deceasing and increasing respecitively the rates of ATP resynthesis [1,2]. The implication is that the primary determinants of ATP resynthesis, pH, substrate availability for oxidative phosphorylation and body temperature, are important determinants of the degree of H+(atp) channel openess a...

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  • SUD: product of an abnormally increased amplitude of synchronised metabolic variations?
    Richard G Fiddian-Green

    Dear Editor,

    I find this a most interesting study for it gets to the nub, what exactly is it that causes SUD in patients with chronic heart failure.

    "During follow up, nine patients died: five patients had a sudden unexpected death (SUD) and four died of progressive heart failure (PHF). There were significant intraindividual changes in neutrophil counts (p = 0.02), C reactive protein (p = 0.039), and h...

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  • The Correct Performance of Valsalva Maneuver is Essential to the Diagnosis of Patent Foramen Ovale
    Tsung O Cheng

    Dear Editor,

    I wish to echo the excellent points made by Seiler [1] in his editorial on the echocardiographic assessment of patent foramen ovale (PFO).

    First, although contrast transesophageal echocardiogrpahy is said to be the gold standard for diagnosing PFO [1], very often the sedated state of the patient necessary for the transesophageal examination often prevents the patient from performing an effective...

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  • Aldosterone blockade in cardiovascular disease
    S Wamique Yusuf

    Dear Editor,

    In his elegant review of aldosterone blockade (Heart 2004; 90:1229- 1234), Dr. Struthers has failed to mention the diuretic properties of spironolactone.

    Spironolactone in itself may be a weak diuretic but in combination with frusemide it provides excellent diuresis, which improves quality of life and exercise capacity in elderly patients with end stage congestive cardiac failure [1]. Spirono...

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  • It is still not clear whether long-term anticoagulation is effective and safe in clinical practice
    Ayumu Ono

    Dear Editor,

    Yousef et al concluded in a recent publication that long-term anticoagulation in non-valvular atrial fibrillation is effective and safe in general clinical practice as evidenced by comparable rates of stroke and major complications to those obtained from clinical trials. [1]

    However, results are misinterpreted in this study. First, this is not a long-term study, because that 739 pati...

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  • Extrinsic factors such as air pollution may influence sudden cardiac death.
    Helen C Routledge

    Dear Editor,

    We would like to congratulate Struthers and colleagues on their recent paper showing that sudden unexpected death in a small group of patients with heart failure is preceded by changes in both cardiac autonomic nervous control and markers of inflammation. [1]

    Their findings lend support to the hypothesis that changes in inflammatory or autonomic status, might determine on which particular da...

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  • Paradoxic coronary embolism as an alternative explanation for increased cardiac troponin in acute PE
    Tsung O Cheng

    Dear Editor,

    La Vecchia et al [1] considered increased cardiac troponin on admission to be the strongest independent predictor of mortality in acute pulmonary embolism. They attributed the increased troponin to right ventricular involvement, because they excluded patients with known or prior coronary artery disease in their study. The criteria they used for exclusion were documented angina, previous my...

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  • Informed consent in acute myocardial infarction is possible
    Anne Gammelgaard

    Dear Editor,

    In the editorial "Is informed consent possible in acute myocardial infarction?" published in the November issue of Heart, Dr. Foëx argues that clinicians must learn to empower their patients to make autonomous decisions when they can. According to Dr. Foëx, the empirical studies on informed consent in acute myocardial infarction (AMI) that he cites suggest that some patients are competent and consider...

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