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Volume 1, No 1 - Summer 2000

Volume 1, No 1 - Summer 2000

Table of Contents

TARGET Trials Previews in Cardiovascular Medicine
Heart Failure: Recent Advances in Prevention and Treatment Treatment Update
The most important advance in heart failure treatment during the past decade has been the recognition that medications inhibiting neurohormonal activation relieve symptoms, reduce hospitalizations, and prolong survival in patients with heart failure from left ventricular systolic dysfunction. Recent trials with angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, aldosterone antagonists, and ß-blockers have provided valuable information regarding the uses, dosing, and extent of therapeutic benefits of neurohormonal inhibition. [Rev Cardiovasc Med. 2000;1(1):25-33, 54]
Noninvasive Assessment of Cardiovascular Risk: From Framingham to the Future Cardiovascular Disease
Risk assessment and risk factor modification have become essential tools in the management of cardiovascular disease. While the risk assessment defined by the Framingham Study researchers was a great leap forward, the search for additional and more precise markers of cardiovascular risk continues. Markers of thrombosis, abnormal endothelial function, plaque formation, and other events in atherosclerosis development are being evaluated. Some of the most promising for population screening are high-sensitivity C-reactive protein tests, degree of arterial stiffness (measured directly or as pulse pressure), and ankle-brachial index. [Rev Cardiovasc Med. 2000;1(1):34-42, 54]
Radiocontrast Nephropathy: The Dye Is Not Cast Coronary Interventions
A significant source of morbidity and inhospital mortality following percutaneous coronary intervention is radiocontrast-induced nephropathy. Newer strategies, such as using low-osmolar nonionic contrast agents and selective dopamine agonists, are making it possible to greatly reduce the incidence of postcatheterization nephropathy. [Rev Cardiovasc Med. 2000;1(1):43-54]
Severe Mitral Regurgitation Secondary to Partial Papillary Muscle Rupture Following Myocardial Infarction Diagnostic Echocardiography
The scenario is not new—elderly patient, myocardial infarction, cardiac shock, new systolic murmur, rising enzymes—but the cause may not be common. Mechanical problems are probably at the root of the complications, but transthoracic echocardiography is not pinpointing the cause. Where to turn next? This patient’s diagnosis of partial papillary muscle rupture is facilitated by multiplane transesophageal echocardiography. [Rev Cardiovasc Med. 2000;1(1):57-60]