145 e-Letters

published between 2011 and 2014

  • Comment on: An epidemiological appraisal of the association between heart rate variability and particulate air pollution: a meta-analysis
    Stephane Buteau

    We believe that we have identified a methodological issue related to the procedure that Pieters et al. [1] used to combine studies using different types of regression models. In some studies heart rate variability parameters were modeled as a linear model but in others they were modeled as log-linear (i.e., where the outcome was log-transformed). To combine effect estimates from these two types of models, the authors co...

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  • Re:Correspondence: sudden death is associated both with epilepsy and with use of antiepileptic medications
    Abdennasser Bardai

    To the Editor,

    We thank the authors for their letter. The question is raised whether our study is able to distinguish between the effect of using antiepileptic medications (AEMs) and epilepsy on SCD risk. We studied SCD risk among AEM users (with and without epilepsy).1 We show in multiple ways that AEM use increases SCD risk, independently from epilepsy and other confounders. Notably, SCD risk in non-epilepsy pa...

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  • Instantaneous Wave-free Ratio: a Word of Caution or Reliable Parameter?
    Changqing Yang
    Changqing Yang Guoxin Fan, Xiaolong Qi, Shisheng He, Tongji Hospital, Tongji University School of Medicine Shanghai China

    TO THE EDITOR: We take great interest in the paper (1) by Nijjer et al with regard to instantaneous wave-free ratio (iFR) assessing improvement in coronary haemodynamics after percutaneous coronary intervention (PCI). However, we have some concerns about the invasive, pressure-only index, iFR.


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  • Does TCPC power loss really affects exercise capacity?
    T-Y Hsia

    We read with interest the article by Khiabani et al.[1], where the authors suggested TCPC power loss could affect exercise performance in Fontan patients. Using indexed Power Loss, "iPL", instead of unadjusted PL, they report higher iPL correlated with worse exercise. We believe that this approach is misleading leading to wrong conclusions.

    iPL was:

    iPL=PL/(pQ^3/BSA^2 )

    where PL, p, Q, and...

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  • Re:Considerations on the poor discriminatory power of the FRANCE-2 risk score
    Bernard Iung

    We thank Diaz and colleagues for their positive comments on the methodology used to develop the France-2 TAVI score. We also share their opinion that its discrimination limits the accurate identification of patients who are likely to die shortly after TAVI. This should, however, be balanced by the good calibration. We agree that "the creation of an efficient and reliable predictive model for TAVI seems to be of the bigg...

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  • "Type 2" myocardial infarction: Evidence-based or guesswork diagnosis
    Shams Y-Hassan

    I read with great interest the recently published article by the authors Baron et al [1] on October 20, 2014 in the journal ahead of print regarding "type 2" myocardial infarction (MI) in clinical practice. One of the important findings in this large study is the outsized variation in the incidence of "type 2" MI between the reporting sites in SWEDEHEART registry. "Type 2" MI was almost nonexistent in some sites (0.2%) and as...

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  • Re:Re:Effect of incomplete revascularization
    Akshay K. Mehta

    Thank you for your response. However, since lesion calcification influenced incomplete revascularization, it would have been interesting to note its effect independant of incomplete revascularization on PCI outcomes.

    Conflict of Interest:

    None declared

  • Mitral regurgitation in Patients with Aortic Stenosis
    Norman Briffa
    There are a number of studies looking at resolution of mitral regurgitation in patients undergoing aortic valve replacement and there is no reason to doubt that these findings will apply to patients undergoing Transcutaneous Aortic Valve Implantation (TAVI) as well. Mitral regurgitation secondary to abnormal leaflets i.e. a degree of Prolapse, in patients with aortic stenosis will NEVER get better with Aortic valve intervention al...
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  • Re:Effect of incomplete revascularization
    Christos Bourantas

    Unfortunately, data with regards the presence of incomplete revascularization was available only in the Syntax study and thus this variable was not inserted in the multivariate model. Besides the aim of this analysis was to assess for clinical and anatomical variables that are available before percutaneous coronary intervention and are independent predictors of worse outcomes, since these variables can be used to stratif...

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  • Re:The role of Left Ventricle in the Autograft Complication after ROSS operation
    Giovanni Battista Luciani

    We thank the Authors for the careful analysis of our work and the kind comments. In general, a distinction needs to be made when analysing clinical outcome after the Ross procedure in paediatric age. Whereas the neonatal and infant population generally presents with either isolated (often recurrent) or complex, multilevel LVOTO, which may be associated with mitral valve disease and varying degrees of LV hypoplasia, the...

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