eLetters

218 e-Letters

published between 2003 and 2006

  • Management of atrial fibrillation
    oscar,m jolobe

    Dear Editor,

    Given the fact that trial fibrillation(AF) is not only a risk factor for sytemic embolism but also a potential marker of sinus node disease, patients who present with an irregular pulse in association with syncope/dizziness(1), should, in the event of being diagnosed with AF, also have Holter monitoring, the latter to identify co-existence of sinus node disease. The authors also revisited the convent...

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  • "Myxomatous" mitral stenosis
    K Mahadevan Krishnamoorthy

    Dear Editor,

    Transoesophageal echocardiographic images of a left atrial myxoma was interesting.[1] The patient was in atrial fibrillation. Hence, first heart sound is expected to be variable instead of "loud" as reported. Also, transthoracic echocardiography could have demonstrated the "myxomatous" mitral stenosis.

    References

    1. Atar S, Bloch L, Rosenfeld T. "Myxomatous" mitral stenosis. He...

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  • Thrombus in atrial septal aneurysm
    K Mahadevan Krishnamoorthy

    Dear Editor,

    A 79-year old woman with transient neurological symptoms, right thalamic infarct and significant mitral regurgitation on transthoracic echocardiogram (TTE) presented interesting reading.[1] In this patient, Baguet et al found a patent foramen ovale with an aneurysm of the interatrial septum on transoesophageal echocardiography (TEE). It is interesting to compare a similar aneurysm in another patien...

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  • Risk assessment in the primary prevention of cardiovascular disease
    Matthias Lenz

    Dear Editor,

    Brindle and colleagues explored the external validity of the Framingham prediction rules in the primary prevention of cardiovascular disease, and its impact on clinical outcomes. They systematically reviewed studies that compared the predicted risk of coronary heart disease or cardiovascular disease, with observed 10-year risk. They found substantial under-prediction in high risk populations and ove...

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  • Variables - continuous or all-or-none
    Arun Kalyanasundaram

    Dear Editor,

    Leung and French have stated that changing the goalposts in the definition of peri-procedural MI or bleeding does not necessarily make such events more or less useful in the overall risk assessment of a patient. They have also raised the issue of whether cardiac markers should be treated as continuous rather than as discrete all-or-none variables in data analysis (1).

    The relationship betwee...

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  • Bedside tissue Doppler echocardiography and acute heart failure
    Stephane Arques

    Dear Editor,

    I read with high interest the article by Huang et al which focuses on the clinical usefulness of tissue Doppler echocardiography in the emergency diagnosis of acute heart failure.[1] In their attractive prospective study, the authors conclude that the measurement of the tissue Doppler-derived E/Ea ratio is able to provide accurate diagnostic information in patients presenting with acute dyspnea in...

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  • Diagnosing diastolic heart failure in the community
    Cesare Rusconi

    Dear Editor,

    Among the ambulatory patients presenting with suspected heart failure in the community Thomas et al.(1) investigated the incidence of new cases of diastolic heart failure according to the guidelines established by the European Society of Cardiology (ESC) (2) and to BNP plasma concentrations.

    In this detailed and really assiduous study the authors showed that 19% had systolic heart failure (LVE...

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  • Triggering of acute coronary syndromes
    Viktor Èuliæ

    Dear Editor,

    Strike et al(1) investigated the presence of triggers of acute coronary syndrome. Vigorous physical exertion was reported by 10% and anger by 17.4% of patients during the respective hazardous periods. The high frequency of triggers in comparison to previous studies was attributed by the authors to the relatively small number of patients and inclusion and exclusion criteria of the study. These frequen...

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  • Accuracy of risk assessment in primary prevention of cardiovascular disease.
    Klaus Eichler

    Dear Editor,

    The systematic review by Brindle et al. [1] about the accuracy and impact of the Framingham risk score in the primary prevention of cardiovascular disease (CVD) is an important contribution. It summarizes the evidence about the predictive performance of this score in different populations but has some limitations. We have four observations.

    First, the applied inclusion criteria (for review...

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  • Noncompaction is associated with neuromuscular disorders even in the absence of systematic neurologi
    josef finsterer

    Dear Editor,

    With interest we read the paper by Lofiego et al. on a long-term follow-up of 65 patients with left ventricular hypertrabeculation/noncompaction (LVHT).[1] We want to add some points and raise some concerns: The prevalence of neuromuscular disorders (NMDs) among patients with LVHT has been reported to be up to 82%.[2] The low rate of 9% in the presented study may be attributed to the fact that the pat...

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