Cardiomyopathies: EAM-guided biopsy reveals cause of ventricular arrhythmias | PDF (134 KB)
p323 | doi:10.1038/nrcardio.2009.42
Table of contents
May 2009 Vol 6 No 5
Research Highlights
Pharmacogenetics: Optimizing warfarin therapy | PDF (134 KB)
p324 | doi:10.1038/nrcardio.2009.39
CRT reduces hospitalization rates | PDF (56 KB)
p324 | doi:10.1038/nrcardio.2009.41
Device therapy: Antibiotics prevent cardiac-device-related infections | PDF (55 KB)
p325 | doi:10.1038/nrcardio.2009.37
Angina and coronary artery disease: Life expectancy after CABG | PDF (54 KB)
p325 | doi:10.1038/nrcardio.2009.38
Reducing Radiation in CT Angiography | PDF (53 KB)
p325 | doi:10.1038/nrcardio.2009.40
Is dronedarone a new option for AF patients? | PDF (56 KB)
p326 | doi:10.1038/nrcardio.2009.36
Acute coronary syndromes: Fasting blood glucose in ACS patients | PDF (61 KB)
p326 | doi:10.1038/nrcardio.2009.43
Correction: JUPITER strikes earth | PDF (43 KB)
p326 | doi:10.1038/nrcardio.2009.54
News and Views
Disease Prevention: The moving target of global cardiovascular health
Rajesh Vedanthan & Valentin Fuster
p327 | doi:10.1038/nrcardio.2009.48
The cardiovascular community has witnessed an important transition over the past two decades—from awareness of the global nature of the cardiovascular disease epidemic, to identification of interventions to control it, and now to a resolution that global action is urgently required.
Angina: Ivabradine for treatment of stable angina pectoris
Ranil de Silva & Kim M. Fox
p329 | doi:10.1038/nrcardio.2009.47
The ASSOCIATE study investigators have reported that the If current inhibitor, ivabradine, is safe, improves exercise performance, and delays the development of ischemia in patients with chronic stable angina being treated with atenolol. Ivabradine should be considered in the medical management of symptom-limited patients with angina, when heart rate is suboptimally controlled.
Valve Disease: Asymptomatic mitral regurgitation: does surgery save lives?
David H. Adams & Anelechi C. Anyanwu
p330 | doi:10.1038/nrcardio.2009.50
Management of asymptomatic patients with severe mitral valve regurgitation is controversial—conservative surveillance and early mitral valve repair have both been advocated as reasonable approaches on the basis of divergent data. A new study by Kang et al. fuels this debate. However, careful assessment of the existing literature can provide insight into the optimal care of this population of patients.
Atrial Fibrillation: A4 study: proof of concept?
A. John Camm & Irina Savelieva
p332 | doi:10.1038/nrcardio.2009.49
The A4 and other similar (small) studies strongly support the launch of major trials of left atrial catheter ablation for the maintenance of sinus rhythm, reduction of cardiovascular hospitalizations and improved survival in patients with symptomatic recurrent atrial fibrillation. Will pharmacological therapies continue to have an important place in the management of atrial fibrillation?
Antiplatelet therapy: Personalized medicine for clopidogrel resistance?
Jean-Sébastien Hulot & Valentin Fuster
p334 | doi:10.1038/nrcardio.2009.28
The benefits of clopidogrel in the treatment and prevention of coronary artery disease vary among patients. Studies have identified predictive markers of poor response to clopidogrel that might allow risk stratification of patients. Are we ready to enter the age of personalized medicine?
Reviews
Sodium channel mutations and arrhythmias
Yanfei Ruan, Nian Liu & Silvia G. Priori
p337 | doi:10.1038/nrcardio.2009.44
This Review describes the current understanding of the molecular mechanism of inherited arrhythmias. Focus is placed on arrhythmia-causing mutations in the genes encoding the 
subunit of the cardiac sodium channel (SCN5A) but arrhythmia-causing mutations in the genes encoding the 
subunit and other proteins in the associated macromolecular complex are also discussed.
Phosphodiesterase 5 inhibition in heart failure: mechanisms and clinical implications
Praneet Kumar, Gary S. Francis & W. H. Wilson Tang
p349 | doi:10.1038/nrcardio.2009.32
The use of phosphodiesterase 5 (PDE5) inhibitors for the treatment of heart failure is an emerging field of research. The authors of this timely Review examine the available basic and clinical data on PDE5 inhibition in the context of heart failure, providing a mechanistic overview and discussing the potential clinical implications of this therapy.
Prevention of venous thromboembolism in medical patients and outpatients
Gregg J. Stashenko & Victor F. Tapson
p356 | doi:10.1038/nrcardio.2009.33
In this comprehensive Review, Drs Stashenko and Tapson examine the literature on the use of venous thromboembolism prophylaxis in hospitalized medical patients, and evaluate the available data for the outpatient setting. The authors also discuss the potential strategies for improving venous thromboembolism prophylaxis rates in these groups of patients.
Antiplatelet drug 'resistance'. Part 2: laboratory resistance to antiplatelet drugs—fact or artifact?
Diana A. Gorog, Joseph M. Sweeny & Valentin Fuster
p365 | doi:10.1038/nrcardio.2009.13
In the second part of their Review on resistance to antiplatelet medication, the authors discuss the various laboratory tests of platelet function and highlight the limitations of these methods for determining the true thrombotic status of the patient.
Case Studies
First case of stenting of a vulnerable plaque in the SECRITT I trial—the dawn of a new era?
Steve Ramcharitar, Nieves Gonzalo, Robert Jan van Geuns, Hector M. Garcia-Garcia, Joanna J. Wykrzykowska, Jurgen M. R. Ligthart, Evelyn Regar & Patrick W. Serruys
p374 | doi:10.1038/nrcardio.2009.34
Ramcharitar et al. describe the first case treated in the SECRITT I trial. The 63-year-old man presented with class II anginal symptoms and was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery. The vulnerable plaque was treated with a self-expanding stent tailored to shield this type of plaque.
Ruptured sinus of Valsalva aneurysm presenting as ST-elevation myocardial infarction
Alistair C. Lindsay, Balakrishnan Mahesh, Jullien A. Gaer & Miles C. D. Dalby
p379 | doi:10.1038/nrcardio.2009.45
Lindsay et al. present an interesting case of a patient with a ruptured sinus of Valsalva aneurysm. The authors recommend the early use of imaging modalities for prompt diagnosis, as anticoagulation therapy might have detrimental effects on patient outcome. Reparative surgery is safe and successful in almost all noninfective cases.
