Table of contents
November 2004 Volume 1 No 1
Editorial
Viewpoint
New strategies to expand the donor pool: are they misguided?
2A shortage of donors limits the use of heart transplantation. Despite various efforts to widen selection criteria and increase availability, the collective epidemiologic impact on donor-organ shortage has been relatively small. Approaches to date and possible ways forward, including a balance between organs and mechanical assistance, are discussed.
Research Highlights
Practice Points
Can cardiac-resynchronization therapy reduce mortality in patients suffering from advanced chronic heart failure?
10Is pulmonary vein antrum isolation safe and effective in valvular heart disease and open heart surgery?
12Can 
-blocker use lower mortality and improve myocardial tissue recovery after acute myocardial infarction?
14Do implantable cardioverter defibrillators lower mortality risk in patients with cardiomyopathy?
16Can pravastatin lower coronary event rate if HDL and LDL cholesterol are at low levels?
18Does carotid endarterectomy prevent disabling and fatal strokes in neurologically asymptomatic subjects?
20Reviews
The role of sodium in hypertension is more complex than simply elevating arterial pressure
24A positive relationship between salt and hypertension is well documented. Salt seems also to adversely affect cardiac structure and function independently from its influence on arterial pressure. This review discusses clinical and experimental evidence for an association between increased sodium consumption and cardiac structural and functional changes and raised cardiovascular risk.
doi:10.1038/ncpcardio0025 | Full Text | PDF (157K)
Therapy Insight: aortic aneurysm and dissection in Marfan's syndrome
31In Marfan's syndrome, connective-tissue alterations promote aortic aneurysm and dissection. Despite advances in understanding the causes, treatments are still based on old protocols. The pathophysiology of aneurysm formation and progression is, however, being elucidated by new genetic data, discussed here, which might aid the advancement of therapy for Marfan-related aneurysm.
Mechanisms of Disease: new mechanisms of antiarrhythmic actions
37The underlying electrophysiological mechanisms of cardiac arrhythmias remain unclear. Consequently, therapy is difficult, and for the worst arrhythmias is frequently ineffective. This review looks at the accumulating evidence for various emerging mechanisms of cardiac arrhythmias, with focus on selected ionic currents, stretch-activated phenomena and connexins.
Mechanisms of Disease: local renin–angiotensin–aldosterone systems and the pathogenesis and treatment of cardiovascular disease
42Interruption or blocking of renin-angiotensin-aldosterone systems can reverse cardiac fibrosis and hypertensive vascular remodeling, and improve hypertensive left-ventricular hypertrophy. Local, possibly cellular, renin-angiotensin-aldosterone systems are thought to participate in the pathogenesis of vascular disease, but their roles are not yet fully explained. This review explores the evidence of such actions.
doi:10.1038/ncpcardio0012 | Full Text | PDF (167K)
Technology Insight: targeting of biological molecules for evaluation of high-risk atherosclerotic plaques with magnetic resonance imaging
48Given the high risk of sudden death or myocardial infarction associated with atherosclerosis, frequently with no previous symptoms, techniques to better identify high-risk plaques might help lower morbidity and mortality. In this review, various biological markers are suggested as targets for imaging to aid risk assessment.
doi:10.1038/ncpcardio0013 | Full Text | PDF (434K)
Case Study
Atrial fibrillation, sleep apnea and obesity
56Relationships between atrial fibrillation and obesity, sleep apnea and C-reactive protein have only recently been recognized. In this case, an obese patient with a history of atrial fibrillation was diagnosed with concomitant sleep apnea and elevated C-reactive protein. Having exhausted various possibilities of cardiological intervention and seemingly destined for catheter-based pulmonary vein isolation, the patient finally achieved rhythm control through weight loss. This study illustrates linkage of these conditions, discussing current therapeutic options and exploring possible pathophysiologic connections.
