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The measurement of natriuretic peptides has emerged as an important tool for the diagnosis and risk stratification of patients with heart failure, but the use of these markers for monitoring treatment remains under question. In this Review, Drs. O'Donoghue and Braunwald explore the evolving role of natriuretic peptides in the guidance of heart failure therapy and appraise data from clinical trials in this field.
Over the past two decades, there has been rapid progress in our understanding of the pleiotropic actions of relaxin in the cardiovascular system. In this Review, Dr. Du and colleagues discuss basic knowledge of relaxin signaling mechanisms, findings from experimental animal models of cardiovascular diseases, and findings from clinical trials on relaxin.
Continuing our series of Reviews on Molecular Imaging, Drs. Dobrucki and Sinusas discuss the applications of PET and single photon emission CT (SPECT) for the evaluation of cardiovascular disease, including myocardial metabolism, neurohumoral activity, atherosclerosis, ventricular remodeling, and angiogenesis.
In this Review, the authors discuss new developments in the understanding of how thoracic aortic aneurysms arise. They describe the developmental origins of the thoracic aorta, mutations in the structural components of the thoracic aorta that are associated with aneurysms, and advances in treatment strategies.
In this Review, the authors discuss the difficulties with assessing the response to cardiac resynchronization therapy in the treatment of advanced heart failure. They discuss the problems with current methods used and the potential benefits of molecular imaging techniques.
The role of endovascular therapy in patients with renal artery stenosis continues to be very controversial. Two reports have added notable findings to the growing body of evidence on this subject. The investigators of these studies aimed to clarify which patients, if any, would benefit from renal artery stent placement.
The results of the CRIB-2 trial, which show that the mineralocorticoid receptor blocker (MRB) spironolactone improves left ventricular mass and aortic stiffness in patients with early stage chronic kidney disease (CKD), provide impetus for large-scale clinical trials to evaluate the effects of this strategy on clinical outcomes. The optimum choice of MRB and its dose, however, remain uncertain given the potential risk of hyperkalemia in patients with CKD.
The diagnosis of unexplained cardiac arrest could soon become obsolete, as so-called molecular autopsy can now be used to identify its underlying causes. The current view of this subject is discussed, and some personal opinions are presented on the assessment of survivors of sudden cardiac arrest and relatives of individuals who do not survive.
Yang and colleagues report on their single-center experience with high-field coronary MRA using a new MR contrast agent. Data on 30 patients were compared with conventional X-ray angiography. Their new coronary MRA approach seems favourable when compared with previous MRA methods.
In this Perspectives article, the authors discuss the need for national policies to add ress the global problem of noncommunicable diseases. They present their views on the benefits of national policies and the processes involved in developing and implementing such policies.
