Políticas de conflictos de intereses y requisitos para su declaración en las revistas cardiovasculares nacionales de la Sociedad Europea de Cardiología / Conflict of interest policies and disclosure requirements among european society of cardiology national cardiovascular journals

Las revistas biomédicas utilizan la declaración de posibles conflictos de intereses para garantizar la credibilidad y la transparencia del proceso científico. Sin embargo, las revistas no abordan la declaración de conflictos de intereses de manera sistemática ni uniforme. Recientes esfuerzos editoriales conjuntos han abierto el camino a la aplicación de herramientas uniformes para la declaración de conflictos de intereses. En este artículo se presenta una visión integral sobre cuestiones clásicas relacionadas con los conflictos de intereses desde un punto de vista editorial. Además, a partir de los datos de un estudio transversal basado en el empleo de un cuestionario estandarizado, se comentan nuevas apreciaciones sobre las políticas y los actuales procedimientos editoriales relativos a los conflictos de intereses en las diversas revistas cardiovasculares nacionales de la Sociedad Europea de Cardiología.

Disclosure of potential conflicts of interest is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for conflicts of interest disclosure. This paper provides a comprehensive editorial perspective on classical conflict of interest-related issues. New insights into current conflicts of interest policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardized questionnaire, are discussed.

Myocardial infarction and patent coronary arteries--an uneventful association?

BACKGROUND: Although many studies addressed the issue of the occurrence of acute myocardial infarction (MI) in patients with angiographically patent coronary arteries, controversies exist concerning the pathophysiology and clinical outcome in this syndrome. AIM: To evaluate the clinical course of patients with MI and patent coronary arteries as well as to assess the post-infarction short-term prognosis. METHODS: A retrospective analysis of patients with acute MI admitted to our institution over a period of 8 years (1995-2002) was performed. The study group consisted of 62 patients with MI and angiographically patent coronary arteries, examined within the first 30 days after the infarction, and the age and gender-matched control group of 62 patients with acute MI and significant coronary artery stenoses. RESULTS: Cardiovascular risk factors found in the study group versus the control group were: smoking 47 (66.1%) vs 54 (87.1%) patients (NS); dyslipidemia 18 (29.0%) vs 44 (74.2%) patients (p<0.005), and family history of coronary artery disease 16 (25.8%) vs 37 (61.3%) patients (p<0.05). The post-infarction complications were: ischaemic recurrences in 25 (40.3%) vs 46 (74.2%) patients (p<0.05); heart failure in 11 (17.7%) vs 26 (41.9%) patients (p<0.05); mechanical events in 12 (19.4%) vs 16 (25.8%) patients (NS); arrhythmias in 18 (29.0%) vs 12 (19.4%) patients (NS); peripheral thromboembolic complications in 5 (8.1%) vs 2 (3.2%) patients (NS), respectively. CONCLUSIONS: In the population with MI and patent coronary arteries, smoking was the only well represented risk factor. Although there was a significantly lower incidence of ischaemic events and heart failure after MI in patients with patent rather than stenotic coronary arteries, the mechanical, arrhythmic and thromboembolic complications occurred with the same frequency.

Anterolateral papillary muscle rupture: diagnosis and successful treatment (a case report).

We report the case of a young man presenting with chest pain, dyspnea, and syncope in whom transthoracic and transesophageal echocardiography helped to diagnose anterolateral papillary muscle rupture. After cardiac catheterization (which confirmed the severe mitral regurgitation and showed two vessel coronary disease), mitral valve replacement was performed together with coronary bypass grafting.

The contribution of non-invasive imaging modalities to the diagnosis of left ventricular pseudoaneurysm.

BACKGROUND: Left ventricular pseudoaneurysm (LVPA) is a rare entity characterized by a tendency to spontaneous rupture due to its morphology, a lack of myocardial fibers and fibrous tissue delineating the cavity. An early diagnosis is essential in order to guide appropriate therapy. PURPOSE: To determine the diagnostic accuracy of different imaging techniques, treatment results, and prognosis of patients (pts) with LVPA. METHODS: We evaluated the incidence of LVPA during a five-year period. The initial clinical presentation, the etiology of LVPA, time between symptom onset and diagnosis, and use of various non-invasive techniques were studied. Mean follow-up was 15 months. RESULTS: Of 19113 pts admitted to our Institute in a five-year period, LVPA was diagnosed in 11 pts (0.05%) (mean age 51 +/- 3.9 years, 8 men). The diagnosis of LVPA was confirmed by surgery in 4 pts, and by pathology in 2 pts. LVPA was an incidental finding in one asymptomatic pt, it was diagnosed in 6 pts presenting with an acute myocardial infarction (AMI) and in 4 pts presenting with LV failure. The main etiology was coronary artery disease (CAD) (9 pts), with the remaining 2 cases being post-traumatic (thoracic stab wound, surgery). LVPA location was postero-inferior in 6 patients, infero-lateral in 3 patients, and anterior in 2 patients. ECG, X-ray and TTE were performed in all cases. 6 pts had a radionuclide angiography (RNA), 3 pts had a computed tomography (CT) scan and 2 pts had a magnetic resonance imaging (MRI) study. Two-dimensional transthoracic echocardiography (TTE) provided information regarding LVPA dimensions and LV-LVPA flow. Four pts were operated (one died). Of the seven non-operated pts., 5 died. CONCLUSIONS: The clinical presentation was variable and non-specific. The most frequent cause of LVPA was MI and the most frequent location was inferior. Echocardiography offered the most reliable information when compared to ventriculography. Because clinical examination, ECG, X-ray data are non-specific for the diagnosis of LVPA, an adequate TTE study performed with a high clinical index of suspicion (especially in pts with inferior MI or thoracic trauma) could facilitate the early diagnosis of LVPA and could be relevant to outcome.