147 e-Letters

published between 2010 and 2013

  • COURAGE not to overstate the case for delaying PCI
    Mark Signy


    It seems that every time COURAGE is discussed, its shortcomings fade further into the little-mentioned background. It is vital to recognise the marked limitations of the study before suggesting, as the editorial appears to do, that we use it as a benchmark for our management decsion making in stable angina.

    1) the recruitment in the study was only 2287 out of 35539 screened: astonishingly low, s...

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  • Surgery for rheumatic mitral valve disease and the forgotten role of concomitant organic tricuspid valve impairment.
    Salvatore Lentini

    Dear Editor,

    I read with interest the recent paper by Kim and co-authors on "Mild- to-moderate functional tricuspid regurgitation (TR) in patients undergoing valve replacement for rheumatic mitral valve (MV) disease".1 The authors, reporting on 236 patients divided into two groups, concluded that compared with MV replacement alone, concomitant TV repair was associated with better postoperative TV function that ma...

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  • Visualising the conducting system
    Robert H. Anderson

    Dear Editor,

    I was intrigued to read the editorial of Calum MacRae,1 where he leads with the provocative statement that "The sinoatrial node, atrioventricular (AV) node and proximal His-Purkinje system can each be seen with the naked eye in humans". I am sure that cardiac surgeons worldwide will be delighted at this news. It is, therefore, unfortunate that MacRae does not share with us the means of achieving the v...

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  • Avoiding Embolisation during aspiration
    Timothy J Glenie

    Dear Editor,

    We read with great interest the article titled "Contemporary clot busting in ST-elevation myocardial infarction: beware of the embolus"(1). Since the publication of the TAPAS trial(2) in 2008 thrombus aspiration has become a useful part of the paradigm for treatment of ST elevation myocardial infarction. As demonstrated in the report by Rawlins et al great care needs to be taken during the use of any a...

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  • Peripartum cocaine use and postpartum myocardial infarction
    James Castleman

    Dear Editor

    "Time to act"1 - a message which resonates with the team on our metropolitan Delivery Suite, who this week managed an acute myocardial infarction in a postnatal lady. Our patient has two of the risk factors mentioned in the editorial, her being 36 years old and a smoker. In addition she had an important risk factor which can be missed, as demonstrated by our recent experience. Since most women with acu...

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  • Extrapolation put into perspective
    Dianne de Korte-de Boer

    Dear editor,

    Recently, our article entitled 'Effect of smoke-free legislation on the incidence of sudden circulatory arrest in the Netherlands' was published in Heart, in which we investigated sudden circulatory arrest (SCA) incidence trends before and after introduction of smoke-free legislation (1). We found a significant decrease in incidence trend after introduction of a nationwide workplace smoking ban....

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  • Considering a possible application to prevent or to treat arterial stiffness
    Rainer Spiegel

    I was impressed to read the results of Mulders et al. (1), who provided evidence that first-degree relatives of patients with premature coronary artery disease had increased arterial stiffness (measured by pulse-wave velocity) in the absence of coronary artery disease. The authors also found a relation between arterial stiffness and coronary artery calcification.

    As a physician, I wonder about ways to prevent the devel...

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  • Re: Quantitative myocardial perfusion analysis using multi-row detector CT in acute myocardial infarction
    Aaron So

    Dear Editors:

    We are writing in regards to the paper entitled "Quantitative myocardial perfusion analysis using multi-row detector CT in acute myocardial infarction" that is recently published in the April 2012 issue of Heart. We would like to congratulate the authors for a very interesting study that has used all the advanced techniques available in the GE Healthcare CT Perfusion research version software. We a...

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  • Industry-sponsored cost-effectiveness study of TAVI
    Michale A. Crilly

    The potential cost-effectiveness (CE) of adopting innovative procedures within a publically funded healthcare system is a recurring issue.[1] Trans-catheter aortic valve insertion (TAVI) is not currently provided by the devolved National Health Service (NHS) in Scotland, although a single high quality randomised controlled clinical trial (RCT) has demonstrated that TAVI is a clinically effective intervention for reducin...

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  • A Comparison of ECG scores for Area at Risk
    John F. Beltrame

    Versteylen et al (1) recently evaluated several area at risk (AAR) methods in patients with acute ST elevation myocardial infarction (STEMI) using 4 physiologic principles, and concluded that cardiac magnetic resonance imaging (CMRI) methods out-perform angiographic methods, which are better than electrocardiographic (ECG) methods. However this study utilized the antiquated Aldrich score, rather than the updated ECG inde...

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