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Despite being an increasingly recognized clinical syndrome, the mechanism of stress or 'Takotsubo' cardiomyopathy remains unknown. In this thought-provoking Review, Lyon et al. present their novel hypothesis for the mechanism behind stress cardiomyopathy, and examine what implications this hypothetical pathophysiology could have for the use of drugs or devices in the treatment of patients with this syndrome.
In light of recent studies demonstrating a lack of benefit with late reperfusion, Sammy Elmariah, Sidney Smith and Valentin Fuster review the data for and against late reperfusion for ST-segment elevation myocardial infarction. The effects of current medical therapies, risk-stratification techniques and indications for the use of late reperfusion over medical management are also examined.
Rapidly developing experimental work has provided new insights into atrial fibrillation pathophysiology that will lead to new mechanism-based therapies. Statins and omega-3 polyunsaturated fatty acids have shown antiarrhythmic potential, exceeding any effect related to the treatment of underlying heart disease. Here Irina Savelieva and John Camm provide a contemporary evidence-based insight into how these agents could be exploited to prevent or reverse atrial remodeling in patients with atrial fibrillation.
