Lause, Mark A

Underdown, Angela

Crommelin, Claude August, 1840-1874

ʻAmr, Sāmī, 1924-1998

Helman, Anat

Mandel, Debra

Aldama, Frederick Luis, 1969-

Teixeira, Joe

Boland, Mary L

Busse, Richard C

Lakes, Richard D

Lahire, Nathalie

International Labour Conference (93rd : 2005 : Geneva, Switzerland)

Springhall, John

Crnobrnja, Mihailo

Anglin, Douglas George

Stahl, Alan M., 1947-

Lam, Harry C. S

Ring, Laura A., 1968-

Callaars, Josephus

Mwanaka, Tendai R

Thompson, Katrina Daly, 1975-

Khan, Shahnaz

This prespecified secondary analysis of the MOMENTUM 3 randomized clinical trial aims to determine whether clinical outcomes of patients with 2 different left ventricular assist devices differed based on preoperative categories of bridge to transplant/bridge to candidacy vs destination therapy.

This cohort study assesses whether long-term variability and rate of change of blood pressure from young adulthood to midlife are associated with cardiovascular disease and all-cause mortality by middle age.

This case report describes bilateral calcified coronary aneurysms with a significant proximal left anterior descending and right coronary artery stenoses immediately distal to the aneurysms.

In this issue of JAMA Cardiology, Lim and colleagues report on cardiovascular functional reserve in people with end-stage renal disease before and after kidney transplant. They performed a 3-arm, prospective, concurrent cohort study to assess change in cardiovascular functional reserve after kidney transplant using state-of-the-art cardiopulmonary exercise testing (CPET). They also assessed left ventricular morphologic findings 1 year after transplant. They enrolled 81 participants with stage 5 chronic kidney disease (CKD) who underwent kidney transplant, 85 wait-listed participants with stage 5 CKD who had not undergone transplant, and 87 controls treated for hypertension only. The authors quantified cardiovascular functional reserve using CPET in parallel with transthoracic echocardiography. One year after transplant, a significant improvement in maximum oxygen consumption was found in the transplant group compared with the nontransplant group. Moreover, left ventricular function improved but not the body mass index.

To the Editor We read the recent article by Klauser et al with great interest. While the potential implications of the findings are exciting, we have several concerns. First, the authors do not explicitly state whether electrocardiogram gating was used in their study. This is an important detail because cardiac motion artifact is a source of artifactual coloration with dual-energy computed tomography (DECT), particularly with dual-source scanners given the approximately 80-millisecond temporal difference between the 2 radiography beams. Furthermore, beam hardening artifact from calcified atheromas and partial volume effect, known sources of artifacts in the 2-material decomposition algorithm of DECT, may largely explain the findings. While patients with gout had higher prevalence of coronary calcification (55 of 59 patients [93%]) and cardiovascular monosodium urate (MSU) deposition (51 of 59 patients [86%]) than controls, the authors do not report whether the 4 patients with gout without coronary calcifications exhibited MSU deposition nor the number of controls or cadaveric hearts with coronary calcification. The images from the article show areas of green pixelization occurring adjacent to calcified plaques on grayscale computed tomography images (eg, Figure 2A and D, left anterior descending artery [yellow arrowhead]), which would favor this artifact hypothesis without additional data.

In Reply We appreciate the valuable comments of Becce et al on our article. We applied prospective electrocardiography gating using a thin-slice cardiac protocol to ensure highest spatial resolution with minimal motion artifact. A noncontrast electrocardiography-gated computed tomography (CT) examination with standardized scan parameters was performed using a 128-slice dual-source CT (SOMATOM Definition Flash; Siemens) with a detector collimation of 2 × 64 × 0.6 mm, rotation time of 0.28 seconds, and prospective electrocardiography triggering for heart rates less than 65 beats per minute (diastolic padding, 70% of RR interval) and more than 65 beats per minute (systolic padding, 40% of RR interval). Axial images were reconstructed with 0.75-mm slice width, increment of 0.5, and a medium-smooth convolution kernel (B26f). When motion artifact was present, it was distinguished by visual analysis of an experienced observer and colorized pixels related to motion were excluded.

This cohort study assesses cardiovascular functional reserve before and after kidney transplant in patients with end-stage renal disease.

This cross-sectional study investigates whether hospital inpatient percutaneous coronary intervention volume is associated with rates of 30-day risk-adjusted mortality and hospital readmission after transcatheter aortic valve replacement and transcatheter mitral valve repair.

Lowering low-density lipoprotein cholesterol (LDL-C) levels remains a mainstay of cardiovascular disease prevention, but gaps in treatment remain, even in persons with hypercholesterolemia and greatly elevated LDL-C levels. Although well-described gene variants in the apolipoprotein B (APOB), low-density lipoprotein receptor (LDLR), and proprotein convertase subtilisin/kexin type 9 (PCSK9) genes explain small but important fractions of monogenic hypercholesterolemia, recent attention has turned to prognostication of cardiovascular disease using polygenic risk scores (PRS) that incorporate common genetic variants derived from large-scale genome-wide association studies of lipid subfractions. Earlier PRS considered only variants with genome-wide significance, and newer studies have focused on methods that better capture the variance conferred by millions of variants, suggesting an ability to identify risk equivalent to monogenic mutations. There remains a gap in evidence from prospective observational studies or treatment trials regarding the appropriate placement of PRS in risk assessment and lipid treatment decisions relative to information on rare monogenic gene variants, particularly in multiethnic populations.

This cohort study uses the UK Biobank cohort data to compare the association of monogenic vs polygenic hypercholesterolemia with the risk of atherosclerotic cardiovascular disease among individuals with comparable levels of low-density lipoprotein cholesterol.

This randomized clinical trial assesses the effectiveness of an implantable loop recorder plus 24-hour Holter electrocardiographic monitoring vs standard 24-hour Holter electrocardiographic monitoring alone for detecting arrhythmias in pregnant women with structural heart disease and/or symptoms suggestive of arrhythmias.

To the Editor We read with interest the study by Sepehrvand et al, which described secular trends in the conduct of pragmatic or explanatory cardiovascular randomized clinical trials over 2 decades. We believe extension of this thoughtful analysis can provide additional insights into pragmatic vs explanatory trials.

In Reply We thank Fernandes et al for their interest in our study and agree that this field requires further exploration. Explanatory trials are primed to maximize the likelihood of finding efficacy of an intervention by testing it in an ideal setting, whereas pragmatic trials aim to test effectiveness of an intervention in a more generalizable setting. Hence, they are expected to generate more generalizable results, with the risk understood that there may be more variation in less tightly controlled environments, which may result in differing results.

This Special Communication analyzes the conclusions drawn from effective regurgitant orifice area analysis and end-diastolic volume analysis from 2 randomized clinical trials to assess disparities in the different clinical outcomes.

This essay describes a physician’s experience of the sudden, unexplained death of her brother and her family’s discovery of the genetic cause.