Gilead Lancaster

Letter by Lancaster et al Regarding Article, “Tissue Doppler Imaging in the Estimation of Intracardiac Filling Pressure in Decompensated Patients With Advanced Systolic Heart Failure”

To the Editor: The echo Doppler–derived ratio of early transmitral velocity to tissue Doppler mitral annular early diastolic velocity (E/Ea) has recently become an accepted noninvasive method to estimate left ventricular (LV) diastolic pressures for a variety of clinical conditions.1 However, the reliability of this measurement in patients with decompensated heart failure has been questioned in the article by Mullens et al.2 Their study compared pulmonary capillary wedge pressure (PCWP) to E/Ea in consecutive patients with symptomatic heart failure in intensive care and found a poor …

RECOGNIZING MYOCARDIAL INFARCTION IN BI-VENTRICULAR PACING

The ECG recognition of coronary ischemia in the presence of biventricular pacing (BiV-P) has been little studied. We present a patient with chest pain in whom ECG changes seen during BiV-P raised suspicion of MI, which was more obviously unveiled by transient inhibition of pacing. A 54 year-old-man

Previous Aspirin Use in Acute Coronary Syndromes: More Than a Marker?

We read with interest the analysis of the merged Thrombolysis In Myocardial Infarction (TIMI) database showing an increased risk of myocardial infarction (MI) but not death in patients with acute coronary syndromes (ACS) who were previously on aspirin therapy ([1][1]). The authors conclude that