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Reply Ectopic Fat Deposition and Diabetes Mellitus
We thank Drs. Gaborit and Dutour for their interest in our paper(1). We acknowledge the lack of assessment of epicardial adipose tissue (EAT) volumes in healthy control subjects, which was due to concerns regarding unnecessary ionizing radiation exposure with coronary computed tomographic angiography. We agree that magnetic resonance imaging (MRI) is highly suitable for adipose tissue imaging. Dark blood prepared, T1-weighted, multislice turbo spin-echo pulse sequence with a water suppression pre-pulse is an established MRI technique for reliable volumetric measurement of EAT volumes(2). Fat quantification on the basis of ...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Ectopic Fat Deposition and Diabetes Mellitus
We read with interest the paper by Levelt et  al.(1) in a recent issue of theJournal, which deciphered the parameters that give rise to ectopic fat deposition in insulin-resistant states, such as type 2 diabetes (T2D). One of the strengths of this study is the use of multiparametric cardiovascular and liver magnetic resonance imaging (MRI), and proton and phosphorus magnetic resonance spectroscopy, allowing a comparison of epicardial adipose tissue (EAT), myocardial and hepatic triglyceride content, hepatic fibroinflammatory changes, but also cardiac function and energetics between lean healthy and lean and obese subjects...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Reply Is There a Prevention Effect of Fludrocortisone on Vasovagal Syncope?
We thank Dr. Zhu and colleagues for their kind interest and insightful comments on our paper(1). They first question whether we sought a sex-specific interaction with the investigational treatment. As noted in the legend for Table  2 of our paper(1), sex itself was not a significant, independent variable associated with outcome. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Is There a Prevention Effect of Fludrocortisone on Vasovagal Syncope?
We read with great interest the paper by Sheldon et  al.(1) in a recent issue of theJournal. Although this research did not meet its primary objective of demonstrating that fludrocortisone reduced the likelihood of vasovagal syncope by the specified risk reduction of 40%, this study indicated a prevention effect of fludrocortisone for vasovagal syncope. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Cardiovascular Adverse Events After Aortic Valve Replacement in Mixed Aortic Valve Disease Beyond Ejection Fraction
There are limited data about outcomes after aortic valve replacement (AVR) in patients with mixed aortic valve disease (MAVD)(1). We conducted a retrospective review of all adults with moderate-to-severe MAVD who underwent AVR at Mayo Clinic from January 1, 1994 to December 31, 2014 to determine the occurrence of cardiovascular adverse events (CAE). Moderate-to-severe MAVD was defined as the combination of greater than or moderate aortic stenosis and greater than or moderate aortic regurgitation. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Long Noncoding RNA Meg3 Controls Endothelial Cell Aging and Function Implications for Regenerative Angiogenesis
The majority of transcribed ribonucleic acid (RNA) does not encode proteins, but it may function as regulatory RNA. Long noncoding RNA (lncRNA) have been described as playing an important role in  many biological processes, including epigenetic regulation of gene expression. To determine the expression and functional role of lncRNA in endothelial cells, we recently performed RNA deep sequencing of human umbilical venous endothelial cells (HUVECs)(1). Aging is known to induce endothelial dysfunction(2), and we hypothesized that lncRNA contribute to aging-associated decline in endothelial function. (Source: Journal of t...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

The Effects of Secondary Cardiovascular Prevention on Cancer Risk in Patients With Manifest Vascular  Disease
In this study, we evaluated the effects of meeting cardiovascular treatment goals, as defined in the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for secondary cardiovascular prevention, on cancer risk in patients with manifest vascular disease. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Finding Mentorship Among Your Peers Sharing the Wealth
“If you want to go fast, go alone. If you want to go far, go with others.”—African Proverb (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

MicroRNAs in Cardiovascular Disease
Micro-ribonucleic acids (miRNAs) are in the spotlight as post-transcriptional regulators of gene expression. More than 1,000 miRNAs are encoded in the human genome. In this review, we provide an introduction to miRNA biology and research methodology, and highlight advances in cardiovascular research to date. This includes the potential of miRNAs as therapeutic targets in cardiac and vascular disease, and their use as novel biomarkers. Although some miRNA therapies are already undergoing clinical evaluation, we stress the importance of integrating current knowledge of miRNA biology into a systemic context. Discovery studies...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Alcohol and Atrial Fibrillation A Sobering Review
Alcohol is popular in Western culture, supported by a perception that modest intake is cardioprotective. However, excessive drinking has detrimental implications for cardiovascular disease. Atrial fibrillation (AF) following an alcohol binge or the “holiday heart syndrome” is well characterized. However, more modest levels of alcohol intake on a regular basis may also increase the risk of AF. The pathophysiological mechanisms responsible for the relationship between alcohol and AF may include direct toxicity and alcohol’s contribution t o obesity, sleep-disordered breathing, and hypertension. We aim to provide a co...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

GLA-Ring Opportunities and Challenges for Fabry Disease ∗
(Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Later Onset Fabry Disease, Cardiac Damage Progress in Silence Experience With a Highly Prevalent Mutation
ConclusionsSignificant cardiomyocyte substrate accumulation in IVS4 patients led to severe and irreversible cardiac fibrosis before development of LVH or other significant cardiac manifestations. Thus, it might be too late to start enzyme replacement therapy after the occurrence of LVH or other significant cardiac manifestations in patients with later onset FD. This study also indicated the importance of newborn screening for early detection of the insidious, ongoing, irreversible cardiac damage in patients with later onset FD. (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Further Progress in Predicting Life-Threatening Arrhythmias in Patients  With Arrhythmogenic Right Ventricular Cardiomyopathy ∗
(Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Arrhythmogenic Right Ventricular Cardiomyopathy Clinical Course and Predictors of Arrhythmic Risk
This study sought to describe the clinical course of ARVC and occurrence of life-threatening arrhythmic events (LAE) and cardiovascular mortality; identify risk factors associated with increased LAE risk; and define the response to therapy.MethodsWe determined the clinical course of 301 consecutive patients with ARVC using the Kaplan-Meier method adjusted to avoid the bias of delayed entry. Predictors of LAE over 5.8 years of follow-up were determined with Cox multivariable analysis. Treatment efficacy was assessed comparing LAE rates during matched time intervals.ResultsA first LAE occurred in 1.5 per 100 person-years bet...
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research

Biological Phenotyping of Combined Post-Capillary and Pre-Capillary Pulmonary Hypertension Focus on Pulmonary Vascular Remodeling ∗
(Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - December 5, 2016 Category: Cardiology Source Type: research