Height is not associated with long-term survival after acute myocardial infarction.

BACKGROUND: Studies show an inverse association between height and risk of myocardial infarction. How height affects survival after acute myocardial infarction is uncertain. METHODS: In the Determinants of Myocardial Infarction Onset Study, trained interviewers performed chart reviews and face-to-face interviews with 1935 patients hospitalized with acute myocardial infarction in 45 US medical centers between 1989 and 1993. We excluded 15 patients with missing information on height. After a search of the National Death Index for patients who died before 1996, we analyzed the relationship of height and survival with Cox proportional hazards regression. RESULTS: Of the 1920 eligible patients, 317 (17%) died during a median follow-up of 3.8 years. Height was positively associated with younger age, greater educational attainment, and a lower likelihood of being sedentary among both men and women. Height was not associated with long-term survival among women in unadjusted or adjusted analyses. Among men, height was associated with survival only in unadjusted analyses; adjustment for age eliminated this association. We found no relationship between height and survival in any individual age group among men or women. CONCLUSIONS: Although stature may be associated with the risk of acute myocardial infarction, it is not associated with long-term survival after such an event.

Magnetic resonance coronary angiography in heart transplant recipients.

BACKGROUND: Annual coronary angiography is routinely performed to evaluate cardiac allografts. Recently, magnetic resonance coronary angiography has been used to imagine native coronary arteries, but its use in transplant recipients, with rapid heart rates, metallic sternal sutures, and altered cardiac orientation, has not been described. Our goal was to describe the feasibility of noninvasive magnetic resonance coronary angiography in cardiac allograft recipients, detect flow-limiting focal stenoses, and quantify the altered coronary artery orientation. METHODS AND RESULTS: We performed magnetic resonance coronary angiography is 18 adult heart transplant recipients (15 men and 3 women) with use of a breath-hold ECG-gated segmented k-space technique. Multiple transverse and oblique images were obtained in each subject. A control population of 16 adult patients without transplant and without angiographic evidence of coronary disease provided a reference for the coronary artery length visualized by magnetic resonance coronary angiography. This technique identified the left main coronary artery in 15 of 15 transplant recipients with normal coronary anatomy. Magnetic resonance coronary angiography demonstrated a +25-degree anterior (clockwise) right coronary artery ostial rotation in transplant recipients (p = 0.0001 versus control group) with corresponding realignment of the left main ostium. By magnetic resonance coronary angiography, the mean contiguous length of coronary artery visualized in the transplant recipients was similar to that in the control subjects for all major vessels (p = not significant). Five transplant recipients had nine discrete stenoses (50% or greater luminal diameter) identified by contrast angiography, of which seven stenoses were identified as signal voids by magnetic resonance coronary angiography. coronary stenoses not seen by this technique were located in the distal one third of the artery. CONCLUSIONS: These data confirm and for the first time quantify the previously observed anterior rotation of the coronary ostia, which may be used to guide coronary engagement for subsequent interventions. In addition, these data demonstrate the potential of magnetic resonance coronary angiography to image noninvasively the coronary arteries and identify focal stenoses in cardiac allograft recipients.

Multiplane transesophageal echocardiographic assessment of left atrial appendage anatomy and function.

Anatomic indexes of the LAA are dependent on the plane in which the appendage is viewed. Greater LAA neck width and cross-sectional area are observed at 135 degrees than at 45 degrees or 90 degrees, consistent with the characteristic 3-dimensional ungular shape of this structure. Appendage ejection and inflow velocity measurements are independent of the imaging plane.

Short stature and risk for mortality and cardiovascular disease events. The Framingham Heart Study.

BACKGROUND: Several studies have observed an inverse association between height and risk for coronary disease, but it is unclear whether other traditional coronary disease risk factors may have confounded this association. We examined the original Framingham Heart Study cohort to determine whether short stature is associated with all-cause mortality, cardiovascular disease mortality, and myocardial infarction after adjusting for age and other traditional coronary heart disease risk factors. METHODS AND RESULTS: A total of 2019 men and 2585 women were followed up to 35.6 years. Subjects were stratified by sex and divided into quartiles according to height. Risk ratios were calculated from proportional hazards analyses comparing the first, second, and third quartiles of height to the tallest quartile before and after adjusting for age, hypertension, smoking, serum cholesterol, diabetes, relative weight, and alcohol intake. In both sexes, there were significant differences in the unadjusted event rates between the shortest and the tallest quartile for all-cause mortality, cardiovascular mortality, and myocardial infarction. Once the analyses were age adjusted, differences among height quartiles persisted only for risk of myocardial infarction in women. Further adjustment for other clinical variables had little additional impact on the results. CONCLUSIONS: After considering age and other coronary disease risk factors, short stature was not associated with increased risk for all-cause or cardiovascular mortality in either sex. It was associated with increased risk for myocardial infarction in women but not in men.