In patients with HF and LV systolic dysfunction without clinical suspicion of CAD, LGE-CMR is an excellent tool for classifying patients in relation to the presence or absence of underlying CAD. Thus, CMR might offer a valid alternative to coronary angiography for the detection of CAD in these patients.

in Chile: weaknesses in teaching and future challenges of the education of the teachers of science A educação científica no chile: debilidades do ensino e futuros desafíos da educação dos professores de ciencia hernán cofré

Key PointsQuestionWhat is the prevalence of familial disease among patients with idiopathic dilated cardiomyopathy (DCM) and the lifetime risk of DCM for their first-degree family members by race and ethnicity?FindingsIn this family-based, cross-sectional study of 1220 patients with DCM and their 1693 family members, the estimated familial DCM prevalence was 29.7% and the estimated DCM risk by age 80 years in family members was 19%.MeaningThese findings suggest substantial prevalence of familial DCM among patients and elevated lifetime risk of DCM among their first-degree family members.

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Abstract. Peñ a R, Lahoz C, Mostaza JM, Jiménez J, Subirats E, Pintó X, Taboada M, López-Pastor A, The RAP study group (Hospital Carlos III; Instituto de Salud Carlos III, Madrid; Hospital de Puigcerdá, Gerona; Hospital de Bellvitge, Barcelona; Centro de Salud de Fuencarral; Hospital La Paz, Madrid, Spain). Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting. J Intern Med 2002; 251: 518-525.Background. Considerable variability exists in the plasma lipid and lipoprotein response to statin treatment due, in part, to genetic factors. The gene for apolipoprotein E (ApoE) is polymorphic and the different genotypes modulate baseline lipid levels. The objective of the present study was to evaluate the effect of the apoE genotype on the lipoprotein response to pravastatin treatment in an outpatient population followed-up in several different clinics across Spain. Subjects and methods. Subjects (n ¼ 401; 56% female; mean age 57 years), who were hypercholesterolaemic despite a diet poor in saturated fat and

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Background: Managing disease risk among first-degree relatives of probands diagnosed with a heritable disease is central to precision medicine. A critical component is often clinical screening, which is particularly important for conditions like dilated cardiomyopathy (DCM) that remain asymptomatic until severe disease develops. Nonetheless, probands are frequently ill-equipped to disseminate genetic risk information that motivates at-risk relatives to complete recommended clinical screening. An easily implemented remedy for this key issue has been elusive. Methods: The DCM Precision Medicine Study developed Family Heart Talk , a booklet designed to help probands with DCM communicate genetic risk and the need for cardiovascular screening to their relatives. The effectiveness of the Family Heart Talk booklet in increasing cardiovascular clinical screening uptake among first-degree relatives was assessed in a multicenter, open-label, cluster-randomized, controlled trial. The primary outcome measured in eligible first-degree relatives was completion of screening initiated within 12 months after proband enrollment. Because probands randomized to the intervention received the booklet at the enrollment visit, eligible first-degree relatives were limited to those who were alive the day after proband enrollment and not enrolled on the same day as the proband. Results: Between June 2016 and March 2020, 1241 probands were randomized (1:1) to receive Family Heart Talk (n=621) or not (n=620) within strata defined by site and self-identified race/ethnicity (non-Hispanic Black, non-Hispanic White, or Hispanic). Final analyses included 550 families (n=2230 eligible first-degree relatives) in the Family Heart Talk arm and 561 (n=2416) in the control arm. A higher percentage of eligible first-degree relatives completed screening in the Family Heart Talk arm (19.5% versus 16.0%), and the odds of screening completion among these first-degree relatives were higher in the Family Heart Talk arm after adjustment for proband randomization stratum, sex, and age quartile (odds ratio, 1.30 [1-sided 95% CI, 1.08–∞]). A prespecified subgroup analysis did not find evidence of heterogeneity in the adjusted intervention odds ratio across race/ethnicity strata ( P =0.90). Conclusions: Family Heart Talk , a booklet that can be provided to patients with DCM by clinicians with minimal additional time investment, was effective in increasing cardiovascular clinical screening among first-degree relatives of these patients. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03037632.