eLetters

197 e-Letters

published between 2006 and 2009

  • Waist circumference; a waste of time?
    Patricia CE de Groot

    To the editor: With great interest, we read the articles of a recent issue of Heart addressing the important role of abdominal obesity in relation to cardiovascular risk and the metabolic syndrome. [1, 2] The metabolic syndrome, considered the ailment of the 20th century, emerges from clustering and interactions of multiple cardiovascular risk factors affecting a large proportion of the population. The presence of the m...

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  • Idioppathic left ventricular hypertrophy may be innocent bystander in athlete dying of sudden death
    DR ALOK KUMAR SINGH

    Respected sir

    The findings of Noronha et al (1) et al suggest that idiopathic left ventricular hypertrophy ( without myocyte disarray ) is responsible for 31% of sudden deaths in athletes. However, it is well known that left ventricular hypertrophy is physiologically present in athletes, but its contribution to sudden death is not clear. As there is no detail regarding ECG at the time of presentation, one c...

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  • Management of heart failure with preserved ejection fraction: back to the drawing board?
    Jonathan R Dalzell

    We read with interest the editorial on heart failure with preserved ejection fraction (HFPEF) by Yip and colleagues [1]. As they state, there remains a great deal of uncertainty and debate regarding its management.

    There are no agreed universal criteria for the diagnosis of this condition. The current guidelines of the American College of Cardiology/American Heart Association require the presence of symptoms and...

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  • The additive value of biomarkers to clinical risk scores in acute coronary syndrome
    Antonio Tello-Montoliu

    We read with great interest the study by Ang et al1, addressing the value of brain natriuretic peptide (BNP) levels in comparison with the GRACE score for acute coronary syndromes(ACS), and the additional predictive role of BNP on this established risk score. The latter is of great interest for physicians managing ACS patients. Indeed, several new (and sometimes, not-so-new) biomarkers have been studied in relation to their...

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  • Triple Therapie: proof or expert opinion?
    Willem Dewilde

    We read the article by Schömig et al (1) with great interest. We learned when and how physicians should prescribe triple antithrombotic therapy after stent implantation. Schömig states that further prospective clinical trials are needed in order to evaluate the best treatment strategy for patients on oral anticoagulant therapy (OAC) who undergo percutaneous coronary interventions (PCI). Unfortunately, all present recommendati...

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  • Stress cardiomyopathy and pheochromocytoma
    Roberto Barriales-Villa
    We would like to congratulate Dr. Madhavan et al (1) for their excellent paper in the journal. However, we would like to make some comments. Because of the fact that in their cohort of patients with apical ballooning syndrome (ABS) do not find elevated catecholamine and cortisol levels, they affirm in their conclusions that: “routine measurement of catecholamines in clinical practice is unlike to be of diagnostic value among pat...
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  • A "New" ECG Sign of Proximal LAD Occlusion?
    Kjell C. Nikus

    TO THE EDITOR: Verouden et al. incorrectly report (1) the ECG finding of ST-segment depression (measured at the J-point) and tall, positive symmetrical T waves as a "new" sign of proximal LAD occlusion. In 1947, Dressler and Roesler published a case with the aforementioned ECG pattern in the precordial leads (2). Repeat ECGs showed progression to a typical anteroseptal Q-wave myocardial infarction. The ECG pattern of ST-...

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  • Tailoring post PCI antiplatelet therapy to individual patient's coronary anatomy and pathophysiology
    MANJUNATH DESAI
    We complement the authors for their comprehensive review of the dual antiplatelet therapy (DAT) in the setting of the percutaneous intervention.1 The role of aspirin has been universally accepted in primary and secondary prevention of cardiovascular disease. With increasing understanding of the role of platelets in acute coronary syndromes the antiplatelet therapy has been a subject of ongoing research and debate. After ini...
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  • Pre-hospital heparin with thrombolysis
    Sern Lim
    We read the MINAP analysis by Horne et al (1) with great interest. The
 authors speculated that the high rates of re-infarction might be related to
 the administration of the lytic and anti-thrombotic treatment within the
 pre-hospital environment. Data from our local audit of pre-hospital
 tenectaplase (pTNK) and in-hospital tenectaplase (inTNK) are indeed
 consistent with the authors' speculation....
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  • Pragmatic use of angiotensin converting enzyme inhibitors in patients with systemic right ventricles
    Piotr Szymañski

    In the recent paper presenting the latest insights into the therapeutic options for patients with systemic right ventricles, Winter et al., (1) argued that “the pragmatic use of angiotensin converting enzyme inhibitors and beta-blockers in these patients seems appropriate”. However they also concluded that “the evidence- base for the implementation of left ventricular failure treatment regimes in patients with a systemic...

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