eLetters

174 e-Letters

published between 2001 and 2004

  • Reproductability of N-terminal BNP in stable patients with systelic heart failure
    Manuel Jiménez-Navarro MD

    Dear Editor

    We have read with great interest the recent editorial about B type natriuretic peptide (BNP) by MR Cowie [1].

    Treatment monitoring could be an especially interesting role of this peptide. We report our experience about the reproducibility of N terminal proBNP (NT-proBNP) in patients with stable chronic symptomatic heart failure of any aetiology with systolic heart failure.

    We recruited 34...

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  • Heparin and restenosis during percutaneous intervention
    Elijah W Muriithi

    Dear Editor,

    The article by Day et al [1]. raises some issues about platelet activation, heparin therapy and acute restenosis after percutaneous coronary intervention that merit further discussion. When compared to other anticoagulants heparin not only has the disadvantage of providing a variable (and unpredictable) anticoagulant response as Day et al. have stated but also has little or no effect on clot...

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  • A myocyte buddy system in stressed myocardium?
    Richard G Fiddian-Green

    Dear Editor,

    It would seem, from Boron's [1,2] and our [3,4] data, that the ATP - dependent sodium pump located on the baso-lateral border of most cells might be exquisitely sensitive to the appearance of protons in interstitial fluid coming from contiguous cells under reductive stress. They might even respond by pumping protons into their cytosol and increasing their protonmotive force driving ATP resynthesis by...

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  • Might myocardial protection be achieved by advanced perfusion with an anoxic acidic buffer?
    Richard G Fiddian-Green

    Dear Editor,

    These studies do not exclude the possibility that myocardial protection might be induced independently of K+(atp) changes by priming the protonmotive force needed to drive ATP resynthesis by oxidative phosphorylation [1]. It could be an important consideration for the protonmotive force might be more easily and reliably primed in advance of angioplasty by perfusing the occluded vessel being targeted...

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  • Implantable cardioverter defibrillators - are women getting a RAW deal (refused arrhythmic work-up)?
    Lokpal Bhatia

    Dear Editor,

    Staniforth et al provide interesting data relating to a sex bias in favour of men with regard to implantable cardioverter defibrillator (ICD) use,[1] concluding that the reason for this discrepancy is unclear.

    Previous work has suggested that women are less likely to be referred for ICD implantation, even when clinically appropriate.[2] This is surprising given that survival rates in w...

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  • Author's reply
    Axel Urhausen

    Dear Editor,

    We appreciate the comments made by Kasikcioglu and Dickerman concerning our published study. [1] The assumption of “hypertrophic cardiomyopathy”-like myocardial changes and the difficulty of assessment of these changes is also supported by our recent findings pointing to a reduced diastolic function in bodybuilders with anabolic steroid abuse by using cardiac tissue doppler imaging, while conventio...

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  • BNP testing - jumping the gun
    John Robson

    Dear Editor

    The current evidence does not support the recommendation of Prof. Cowie [1]. and NICE [2]. that BNP testing is an acceptable method to rule out heart failure. Cowie takes an even more restrictive view than the NICE guidance and suggests limiting BNP testing to newly presenting patients not yet on treatment, whilst NICE makes no such distinction. Even in this more restricted setting, the New Zealand t...

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  • Is it cost effective?
    Ganesh Nallur Shivu

    Dear Editor

    As mentioned in the editorial, BNP has a very good negative predictive value. This was noted in the North Glasgow study. So patients who present with acute breathing difficulties and have a negative BNP are very unlikely to have ventricular dysfunction.

    Other diagnosis would have to be considered but will this prevent us from performing echocardiograms on this set of patients to definitely ru...

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  • Authors Reply
    Allan S. Jaffe

    Dear Editor

    Dr. O Cheng raises the possibility that some elevations of troponin we attribute to pulmonary emboli [1] may be due to paradoxical coronary emboli [2].

    We cannot, since all of the patients were not cathed acutely, exclude this possibility with data although we did not observe in this series focal ST segment elevation as one might expect from a paradoxical embolism.

    We did angiogram...

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  • Unambiguous Definition of Endothelial Progenitor Cells.
    Gianpaolo Fadini

    Dear Editor

    We read with great interest the scientific letter by Eizawa and colleagues [1] reporting significant reduction of peripheral blood CD34+ cells in patients with stable coronary artery disease.

    They also showed that, among all common risk factors for atherosclerotic disease, diabetes mellitus is the only significant predictor of a reduced CD34+ cell count. However we have some concerns on the...

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