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In this thought-provoking Viewpoint and accompanying clinical vignettes, Sengupta and colleagues posit that clinicians should be aware of obstructive sleep apnea in patients with hypertrophic obstructive cardiomyopathy. They hypothesize that this sleep disorder could be the reason cardiomyopathy symptoms remain despite therapy and could also contribute to a raised gradient seen in some patients.
Thirteen years after his seminal Review on flow-mediated endothelial mechanotransduction, Peter Davies reviews the complex spatiotemporal shear stress characteristics that can predict atherosclerosis susceptibility. He also examines endothelial flow-induced responses—collectively known as mechanotransduction—and the spatially decentralized mechanism of endothelial mechanotransduction.
Reduced adiponectin levels have been shown to correlate with increased risk of cardiovascular disease in obese individuals and in patients with diabetes and hyperglycemia. In this Review, Drs Goldstein, Scalia and Ma discuss the various signaling pathways that mediate adiponectin's protective effects in the vasculature and the myocardium.
Mills et al. explore the preclinical and clinical evidence and examine the potential pathways through which air pollution—an important and modifiable determinant of cardiovascular disease—mediates adverse cardiovascular effects. Understanding the mediators and mechanisms will enable the development of strategies to reduce the impact of air pollution on cardiovascular disease.
Atrial fibrillation and heart failure share many common risk factors, and are often seen together in an individual patient. Each of these conditions alone can cause the development and worsening of the other. In this article, Morrison et al. discuss the clinical and pathological relationships between these two conditions, review current treatment strategies, and propose areas for future research that will help define the optimal therapeutic approach for patients with concurrent atrial fibrillation and heart failure.
In this month's Case Study, Versaci and colleagues present a case of congenital coronary artery fistula originating from the left anterior coronary artery and draining into right ventricle, in conjunction with an aneurysm of the left anterior descending artery. The high risk of rupture lead the authors to close the fistula surgically using normothermic cardiopulmonary bypass.
Coronary allograft vasculopathy is a severe complication of heart transplantation. In this paper, the authors used virtual histology intravascular ultrasound to characterize plaque burden and tissue composition over time in vessels of heart transplant recipients. Knowledge of the relationship between changes in plaque composition and clinical outcome might facilitate identification of high-risk patients who require more aggressive medical therapy.
Combined intracoronary and intramyocardial administration might improve outcomes for bone-marrow-derived stem cell therapy for acute myocardial infarction. In this paper patients with left ventricular ejection fraction less than 45% after acute myocardial infarction were randomly assigned stem cell delivery via intramyocardial injection and intracoronary infusion 3–6 weeks or 3–4 months after AMI. Their data shows that combined cardiac stem cell delivery induces a moderate but significant improvement in myocardial infarct size and left ventricular function.
