eLetters

883 e-Letters

  • Pseudo Brugada or true Brugada revealed by tricyclic agents?
    De Roy

    Dear Editor

    We have read with great interest the short case in cardiology reported by E Zakynthinos et al (1) in the March 2000 edition of Heart. The ECG recordings after acute ingestion of amitriptyline are remarkable, especially the ST segment elevation in the precordial leads V1 - V3, 6 to 100 hours after admission in the intensive care unit.

    The ECG pattern resembles markedly the ones described in...

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  • Management of cardiocutaneous fistulae
    Peter G Danias

    Dear Editor,

    We thank Dr. Pocar and his colleagues for contributing their experience with another case of cardiocutaneous fistula [1], which confirms several points that we and others have previously discussed [2] [3] [4]. The clinical presentation of cardiocutaneous fistula is usually slow and indolent but may rapidly deteriorate. Therefore, when this diagnosis is established elective operation should be perfo...

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  • Pacing for vasovagal syncope
    Adrian Morley-Davies

    Dear Editor

    Kurbaan and Sutton provide a balanced view of the role of pacing in vasovagal syncope[1] - a common but complex and challenging medical condition.

    However, we feel that attention should be drawn to the methodological problems that bedevil interpretation of the North American Vasovagal Pacemaker Study (VPS).[2] This was not a randomised study of cardiac pacing, but rather a randomised trial...

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  • Re: Pacing for vasovagal syncope
    AS Kurbaan

    Dear Editor,

    We share many of the reservations that Morley-Davies and Byrne have regarding the North American Vasovagal Pacemaker Study (VPS).[1] However, this study should be considered in the context of the other available data supporting the role of pacing in selected patients. We also are interested in the study by Di Girolamo et al[2] suggesting a benefit for orthostatic training in those with neurocardio...

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  • Coronary Endothelial Dysfunction after Kawasaki Disease
    Yoshihide Mitani
    Dear Editor

    Iemura et al's hypothesis that endothelial dysfunction is associated with coronary aneurysms which have regressed after Kawasaki disease (KD) is interesting[1]; however, there are two issues with respect to their study design that need to be considered, in addition to the issues reported before.[2, 3]

    (1) Is endothelial dysfunction associated with regressed coronary aneurysms per se late after KD?

    ...
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  • Re: Coronary endothelial dysfunction after Kawasaki disease
    Masahiro Ishii

    Dear Editor:

    We appreciate the kind comments of Dr Mitani regarding our article in the March 2000 issue of Heart and for sharing their experiences with us.[1]

    In group 1 and 2 patients who had regressed coronary aneurysm after Kawasaki disease, there was significantly more vascular constriction with acetylcholine and poorer dilatation with isosorbide dinitrate at the regressed site, than in group 3 patient...

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  • Platypnoea-orthodeoxia syndrome: is it so rare?
    F Godart
    Dear Editor:

    We read with interest the article by Kubler et al[1] concerning 3 patients with platypnoea-orthodeoxia syndrome. As reported, this syndrome is infrequent and the diagnosis can be difficult. It is characterised by dyspnoea and arterial hypoxaemia induced by upright position that resolved by recumbency. This is usually the consequence of right-to-left shunt at the atrial level. Such shunting is frequent in...

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  • Myocardial perfusion defects visualized by MCE in hypertrophic cardiomyopathy
    Gustavo Camarano
    Dear Editor:

    I read with interest this case report from Hirooka and colleagues.[1] Myocardial contrast echocardiography (MCE) allows the assessment of myocardial perfusion, however, several technical issues remain unresolved and artifacts are quite common.

    It is highly debatable whether the perfusion defect shown represents myocardial ischemia due to systolic compression of the LAD septal branches. If that w...

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  • Atrium is not the only location for ANP
    Serdar Kula

    Dear Editor

    Fruhwald FM and their colleagues mentioned about ANP synthesis from the atrium in their lecture. Most of the ANP is synthesized in the myocites of atrium and the synthesis is prominent in the right atrium than the left. Another location of the ANP synthesis is the ventricles. The highest ANP expression is in the intrauterine period, it declines after birth and reaches to the adult levels of 1-2% of atriu...

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  • Survival of patients with a first hospital admission for heart failure
    Kate MacIntyre

    To the Editor;

    Cowie et al(1) reported high case fatality rates in a population-based cohort of patients with incident heart failure between 1995 and 1996. Survival was 81% at one month, 75% at 3 months, 70% at 6 months, 62% at 12 months and 57% at 18 months. There are few population data that describe the contemporary survival of patients with heart failure.

    The Linked Morbidity Record Database con...

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