Left ventricular systolic dyssynchrony is a predictor of cardiac remodeling after myocardial infarction.

Objectives: We sought to determine whether early assessment of left ventricular (LV) dyssynchrony by tissue Doppler imaging may predict progressive ventricular enlargement and cardiac dysfunction after acute myocardial infarction (MI).

Methods: Forty-seven patients (mean age 59.9 +/- 11.

Aldosterone receptor antagonism induces reverse remodeling when added to angiotensin receptor blockade in chronic heart failure.

Objectives: The objective of this study was to determine if adding spironolactone to an angiotensin II receptor blocker improves left ventricular (LV) function, mass, and volumes in chronic heart failure.

Background: Add-on spironolactone therapy substantially improves clinical outcomes among patients with severe heart failure (HF) on standard therapy. However, the value of combining spironolactone with an angiotensin II receptor blocker on LV reverse remodeling in mild-to-moderate systolic HF is unclear.

Diagnostic dilemma in a middle-aged man with heart failure.

We report a middle-age man presented with shortness of breath. Echocardiography revealed globally hypokinetic LV with poor function. Coronary angiograms showed no obstructive coronary artery lesions but multiple coronary fistulae to pulmonary artery without significant left to right shunt.

Strain rate imaging differentiates transmural from non-transmural myocardial infarction: a validation study using delayed-enhancement magnetic resonance imaging.

Objectives: The aim of this study was to determine if strain rate imaging (SRI) correlates with the transmural extent of myocardial infarction (MI) measured by contrast-enhanced magnetic resonance imaging (Ce-MRI).

Background: Identification of the transmural extent of myocardial necrosis and degree of non-viability after acute MI is clinically important.

Methods: Tissue Doppler echocardiography with SRI and Ce-MRI were performed in 47 consecutive patients with a first acute MI between days 2 and 6 and compared to 60 age-matched healthy volunteers.

Left ventricular systolic asynchrony after acute myocardial infarction in patients with narrow QRS complexes.

Background: The aim of the study was to assess the degree of left ventricular (LV) asynchrony after myocardial infarction (MI) in patients with a narrow QRS complex using tissue Doppler imaging (TDI) and correlate this with the site and extent of the infarction measured by contrast-enhanced magnetic resonance imaging (Ce-MRI).

Methods: Echocardiography with TDI and Ce-MRI was performed within 6 days of acute MI in 47 patients and compared with 69 age-matched healthy volunteers. Regional myocardial velocities were assessed in 12 segments, and the corresponding systolic velocity (Sm), early diastolic velocity (Em), as well as the time to peak Sm (Ts) and time to peak Em (Te) were measured.

Effect of N-acetylcysteine for prevention of contrast nephropathy in patients with moderate to severe renal insufficiency: a randomized trial.

Background: The effect of N-acetylcysteine (NAC) to prevent contrast nephropathy (CN) in patients with moderate to severe renal insufficiency undergoing coronary angiography or interventions is not clear.

Methods: This is a prospective, open-label, randomized, controlled trial. Ninety-one consecutive patients with a serum creatinine level of 1.

Homocysteine, endothelial dysfunction, and coronary artery disease: emerging strategy for secondary prevention.

Atherosclerosis is an important medical problem of the 21st century, but traditional risk factors could only account for 50% of the problem. Hyperhomocysteinemia is emerging as an independent atherosclerosis risk factor, associated with folate deficiency, renal failure, and relative deficiency of MTHFR (C677T polymorphism) or other enzymes depending on gender, age, and smoking status. Hyperhomocysteinemia has been reported to occur in 11-22% of western people, in 3-5% of normal asymptomatic Chinese subjects aged 18-70 years in Hong Kong, Macau, Sydney, and San Francisco, 23-36% of Chinese in Hong Kong with premature coronary artery disease, and 29% of a nonselective series of coronary subjects in Hong Kong.