Background-Obesity is a risk factor for impaired cardiac performance, particularly in women. Animal studies suggest that alterations in myocardial fatty acid metabolism and efficiency in obesity can cause decreased cardiac performance.In the present study, we tested the hypothesis that myocardial fatty acid metabolism and efficiency are abnormal in obese women. (rϭ0.58, PϽ0.005). A multivariate, stepwise regression analysis showed that BMI was the only independent predictor of MV O 2 and efficiency (Pϭ0.0005 and PϽ0.05, respectively). Glucose AUC was the only independent predictor of MFAUp, MFAU, and MFAO (PϽ0.05, Ͻ0.005, and Ͻ0.005, respectively). Conclusions-In young women, obesity is a significant predictor of increased MV O 2 and decreased efficiency, and insulin resistance is a robust predictor of MFAUp, MFAU, and MFAO. This increase in fatty acid metabolism and decrease in efficiency is concordant with observations made in experimental models of obesity. These metabolic changes may play a role in the pathogenesis of decreased cardiac performance in obese women.

BACKGROUND-Case studies have suggested the efficacy of catheter-free, electrophysiologyguided noninvasive cardiac radioablation for ventricular tachycardia (VT) using stereotactic body radiation therapy (SBRT), though prospective data is lacking. METHODS-We conducted a prospective phase I/II trial of noninvasive cardiac radioablation in adults with treatment-refractory episodes of VT or cardiomyopathy related to premature ventricular contractions (PVCs). Arrhythmogenic scar regions were targeted by combining noninvasive anatomic and electrical cardiac imaging with a standard SBRT workflow followed by delivery of a single fraction of 25 Gray (Gy) to the target. The primary safety endpoint was treatment-related serious adverse events (SAE) in the first 90 days. The primary efficacy endpoint was any reduction in VT episodes (tracked by indwelling ICDs) or any reduction in PVC burden

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Patients with IDCM exhibit alterations in myocardial metabolism characterized by decreased fatty acid metabolism and increased myocardial glucose metabolism, a pattern similar to that shown in animal models of HF. Whether alterations in myocardial metabolism constitute an adaptive response or mediate the development of HF remains to be determined.

Obesity in young otherwise-healthy women is associated with concentric LV remodeling and decreased systolic and diastolic function. These early abnormalities in LV structure and function may have important implications for explaining the myocardial dysfunction that is associated with increased cardiovascular morbidity and mortality caused by obesity.

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Angiographic severity of coronary artery stenosis has historically been the primary guide to revascularization or medical management of coronary artery disease. However, physiologic severity defined by coronary pressure and/or flow has resurged into clinical prominence as a potential, fundamental change from anatomically to physiologically guided management. This review addresses clinical coronary physiology-pressure and flow-as clinical tools for treating patients. We clarify the basic concepts that hold true for whatever technology measures coronary physiology directly and reliably, here focusing on positron emission tomography and its interplay with intracoronary measurements.

Humans with diabetes mellitus exhibit increased MFAU and MFAO and reduced MGU consistent with observations obtained in experimental models of diabetes.