151 e-Letters

published between 2009 and 2012

  • QRISK2 (2010) - the key issue is ethnicity and extent of reallocation
    Julia Hippisley-Cox

    In their recent paper[1], the authors describe the performance of ASSIGN and Framingham algorithms in comparison to the original QRISK equations.

    Readers may be interested that the QRISK2 algorithm was published in February 2009[2] and made available as free open source software in April 20103. This can be found at http://svn.clinrisk.co.uk/opensource/qrisk2/. The open source is intended to further increase the...

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  • Diagnosis of heart failure in primary care: the syndrome and the spectrum
    Claudia Fotzeu
    To the Editor: I read with great interest the article by Hobbs et al. [1] I commend the authors for their original review of the diagnosis of heart failure in primary care. Heart failure as defined by current guidelines published by professional societies in North America[2] and Europe[3] is a syndrome in which patients must have both typical signs and symptoms of heart failure and objective evidence of structural or functional a...
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  • Short term effects of transcatheter aortic valve implantation
    David Cunningham

    I read with interest the paper by Gotzmann and colleagues [1] demonstrating some very important differences after TAVI, particularly improvements in exercise tolerance and quality of life. I did have some reservations however on the statistical methodology that the group employed. The study involved a cohort of 44 patients, assessed before and after TAVI, so clearly paired statistical tests are appropriate. However, the...

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  • Cardiac Image Training - the 2010 Curriculum
    Jim A Hall

    Having read the appeal for a 'new dawn in imaging training' I suspect that Rajani et al have not read the current UK cardiology training curriculum (www.jrcptb.org.uk/specialties/ST3- SpR/Documents/2010%20Cardiology%20Curriculum.pdf) and appreciated the flexibility and options open to trainees and their trainers It is factually incorrect to state that UK trainees 'only appear to be able to obtain "in-program" experience i...

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  • The dangers of mandating policy in the absence of clear evidence
    Morton Satin

    It is quite incredible how far the notion of a population-wide benefit accruing from salt reduction has gone in view of the contradictory clinical evidence. In the first instance we know that the population response to salt reduction is rather limited (2-6 mm Hg) and heterogeneous, with 30% experiencing a small drop in BP, about 20% experiencing an increase in BP and the residual 50% o the population undergoing no impac...

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  • Clinical applications of two dimensional speckle tracking
    Rhys P Beynon

    Dear Sir,

    I read with interest Blessberger and Binder's article on the clinical applications of two dimensional speckle tracking following their excellent previous article detailing the technique's basic principles[1, 2]. The two articles carry significant detail but fall down in one major regard. Whilst the authors state that the reproducibility of speckle tracking is greater than tissue Doppler imaging (TDI), at...

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  • Is the gender an authentic risk factor for aortic valve replacement in severe aortic stenosis?
    Juan Caballero-Borrego

    We would like to congratulate the authors for the paper about gender differences in aortic valve replacement (AVR) in severe aortic stenosis (SAS)(1). Traditionally there have been mortality perioperatory differences depending of the gender (2), and these differences have been included in operatory risk calculators. In this work, the authors do not find differences in mortality between men and women. Our attention on the...

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  • ECG clues to an unusual diagnosis
    F. Russell Quinn

    To the Editor.

    We read with interest the Image in Cardiology by Brown & Agarwal documenting the phenomenon of T wave memory in a patient with Ebstein's anomaly who presented with tachycardia[1]. We would be interested to know whether any further investigation for her dysrhythmia was performed. The ECGs presented strongly suggest that she may have an atriofascicular bypass tract - an unusual variant of pree...

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  • RE: Large thrombus burden in acute myocardial infarction: successful use of distal protection device following failure of thrombus aspiration
    Adrian Iancu

    We read with great interest the article published by Mathew G.D. Bates in your journal [1]. We congratulate the authors for the original management of this case. In similar cases of large thrombus, we have administered intrathrombus eptifibatide through the 3F Twin Pass catheter (Vascular Solutions, Minnesota 55369 USA), and then performed thrombus aspiration. Finally, conventional stenting was performed. Postprocedural,...

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  • Review protocols should be registered
    Tom Quinn

    Dear Editor

    Heras and her colleagues make a good point.[1] Perhaps those planning systematic reviews should be required by journal editors to register their protocol on a central database, as we currently do for Cochrane reviews? Authors should also perhaps be required to state what they consider their review adds (e.g. that previous reviews were methodologically flawed, reported inadequate information on search strate...

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