Volume 6 Issue 9, September 2009

Intentional weight loss is associated with many benefits, including reduced mortality and cardiometabolic and inflammatory risk, as well as improved quality of life. Unintentional weight loss, however, is often a harbinger of future ill-health. Separating these types of weight loss in clinical trials is sometimes difficult and in small trials can produce the 'obesity paradox'.

Cappato et al. have reviewed the major causes of death in patients undergoing catheter ablation of atrial fibrillation. Many of these complications could be prevented by careful catheter manipulation, implementing safe energy settings, adequate anticoagulation, and esophageal monitoring. Urgent pericardial drainage is critical in avoiding death related to cardiac tamponade.

Radiation exposure from cardiac CT is currently under a high level of scrutiny, and many patients may be receiving excessive radiation from this test. A study by Raff and colleagues—aimed at reducing this radiation through a statewide initiative—helps define the potential for improving the safety of cardiac CT at community medical centers.

Lipoprotein(a) has been studied as a risk factor for coronary heart disease, but whether a causal relationship exists has been unclear. A study by Kamstrup and colleagues examining genetically mediated increases in lipoprotein(a) concentration now provides evidence that it could indeed represent a causal coronary risk factor.

Unselected bone-marrow-derived mononuclear cells seem to improve left ventricular function and perhaps short-term clinical outcomes for patients with acute myocardial infarction. The REGENT trial aimed to elucidate whether infusion of selected hematopoetic progenitor cells increases this effect in patients with large infarcts and attenuated left ventricular ejection fraction.

Currently available imaging techniques provide anatomical definition and functional information and have limited ability to report on disease processes at the molecular level. Molecular imaging techniques can, however, supply information about specific proteins, biomolecules, biological pathways or cellular processes. Here, Stanley Shaw discusses molecular imaging targets used in cardiovascular research and emerging approaches to the discovery or application of new molecular imaging probes.

Traditional and nontraditional factors increase cardiovascular risk in patients with kidney disease. In this Review, Dr. van der Zee and colleagues highlight important cardiovascular risk factors in patients with varying degrees of kidney function and discuss therapeutic strategies for reducing cardiovascular risk in these patients.

The underlying cause of idiopathic dilated cardiomyopathy remains unknown, although studies have suggested a genetic component or involvement of inflammatory and autoimmune responses. Several studies have also shown that vascular dysfunction is present in idiopathic dilated cardiomyopathy. Roura and Bayes-Genis review these studies and suggest a reinterpretation of the pathophysiology in terms of the vascular changes.

Consumption of fruit and vegetables has been associated with reduced risk of coronary heart disease. This Review discusses epidemiological studies of the association between fruit and vegetable consumption and coronary heart disease, and assesses the significance of the findings.