145 e-Letters

published between 2011 and 2014

  • The BLOCK HF authors reply to the article: BLOCK HF: a game changer or a step too far?
    Anne B. Curtis

    Dear Editor:

    In response to Dr. Witte's commentary, we want to provide additional information to allay some of his concerns. Our firm opinion is that BLOCK HF will indeed benefit the patient population included in the trial.

    In his editorial, Dr. Witte states that many patients enrolled in BLOCK HF were likely indicated for cardiac resynchronization therapy (CRT) even before enrollment in the trial. On...

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  • Comments on: The infective endocarditis team: recommendations from an international working group
    Alberto San Roman

    Chambers et al1 give some wise recommendations regarding infective endocarditis management. They recognize the grim prognosis of the disease (mortality: 20-64%), the importance of dedicated teams of experts, and the prominent role of early surgery; despite this, they suggest that some patients can be adequately managed in centres without dedicated teams of experts and surgical facilities, and propose nine indications for...

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    Simonetta Genovesi

    It is with interest that we read the paper by Buiten et al. (1) in which the authors, using the implantable cardioverter defibrillator (ICD) remote monitoring function in patients enrolled in the ICD-2 trial, showed that hemodialysis (HD) is a trigger for atrial fibrillation (AF) episodes. The study of Buiten confirms some observations we made in the recent past. Few years ago we studied, by high frequency electrocardiograp...

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  • Decision to intervene in asymptomatic mitral regurgitation - "more art than science"
    Piotr A. Szymanski

    In a recently published Editorial to the new 2014 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease its authors note that "since in asymptomatic patients decisions on timing of intervention is made primarily on the basis of left ventricular size and function and quantitative evaluation of mitral regurgitation severity, accurate measurements of the left ventricular function, as well as the deg...

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  • Statistical significance vs clinical importance
    Greg Atkinson

    The primary finding reported in this study [1] is a correlation coefficient of -0.042 between the inflammatory marker of interleukin IL-6 and the percentage flow-mediated dilation index (FMD%). The difference between this correlation coefficient and zero is statistically significant (P=0.02) for the large sample of participants that was studied (n=3404).

    Here we have a clear illustration of why it is important to...

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  • Considerations on the poor discriminatory power of the FRANCE-2 risk score
    Rocio Diaz

    The developers1 of the first rigorous predictive model for mortality after transcatheter aortic valve implantation (TAVI) have overcome the limitations of the previous surgical scores. While EuroSCORE I is an old and redundant model based on data of 1995 and derived from a highly heterogeneous patient group with different operations, techniques and demographics, this predictive model is based on new results of a remarka...

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  • Does the heart have a mind of its own? Prevent adverse outcome from Takotsubo cardiomyopathy.
    Kan Liu

    We have read Ghadri et al' s article published in the issue of April 7, 2014 (1), which provide a very useful review to help us better understand Takotsubo cardiomyopathy (TTC), a sometimes puzzling disorder. In the "TTC TYPES" section, the authors state that TTC often affect different left ventricular (LV) regions in the recurrent episodes. The similar findings have been reported repetitively by other studies (2, 3) an...

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  • Personalised External Aortic Root Support
    Tom Treasure
    Both valve replacing and valve sparing root replacement were devised on the operating table and evolved by trial and error. Different times set different standards. By contrast, after four years of research collaboration between surgeons, anatomists and engineers (2000-2004) personalised external aortic root support (PEARS) has followed a standard protocol in 42 patients with over 170 patient-years of intention-to-treat analysis a...
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  • Dual atrioventricular nodes
    Robert H. Anderson

    I read with great interest the "challenge" posed by the electrocardiographic recording in issue 7 of Heart for 2014. I also noted with interest that the authors suggest that Monckeberg provided the first account of such dual nodes in 1993 (their reference #1). Since Monckeberg was long since dead by that date, this must be some mistake! I think the appropriate date is 1913. It is certainly the case that Monckeberg was th...

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  • Vitamin D reduces risk of cardiovascular disease
    William B. Grant

    The paper by the JBS3 Board dismisses the role of vitamin D in reducing risk of cardiovascular disease (CVD) since large-scale randomized controlled trials (RCTs) have not demonstrated the benefit [1]. However, a more recent paper from the Women's Health Initiative calcium/vitamin D RCT did report a beneficial effect in significantly lowering low-density lipoprotein cholesterol and raising high-density lipoprotein cholester...

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