Echocardiography has emerged as a fundamental tool in the evaluation of patients with atrial fibrillation (AF). Transthoracic echocardiography remains a primary tool for the evaluation and management of many patients presenting with their first episode of AF, but it is not adequate for exclusion of atrial thrombi. TEE offers excellent visualization of the atria and accurate identification or exclusion of thrombi. In concert with therapeutic anticoagulation, a TEE-guided approach to early cardioversion appears to have a safety profile similar to that of conventional therapy (1 month of precardioversion warfarin). The TEE-guided approach offers the advantages of simplified anticoagulation management and shorter duration of sustained AF, thereby allowing for a more rapid recovery of atrial mechanical function. Warfarin should be continued for 1 month after cardioversion to allow for more complete recovery of atrial function and for prophylaxis should the patient revert to AF. Cost-effectiveness models demonstrate that TEE-guided cardioversion represents a cost-effective strategy, but only if the transthoracic echocardiogram is omitted. For patients with a thrombus on the initial TEE, follow-up TEE (to document thrombus resolution) is recommended before cardioversion.

Entry into and progression of vascular cells through the cell cycle is considered a key event in vascular proliferative diseases. Multiple growth factors and cytokines have been found to regulate vascular cell proliferation. However, the machinery regulating cell cycle represents the "final common pathway" of these signaling cascades and thus provides an attractive therapeutic target for the prevention of vascular proliferative diseases. This review focuses on the current understanding of the regulation of the cell cycle machinery especially as it relates to vascular cell biology and the feasibility of targeting cell cycle for the prevention of restenosis after balloon angioplasty and bypass vein graft disease.

In the past 10 years, there has been a trend to use more arterial grafts instead of vein grafts for coronary artery bypass graft surgery. Although there are many reports on the short- and mid-term follow-up of patients who underwent arterial revascularization with 1 or 2 arteries, little has been reported on the follow-up of patients with 3-vessel disease who received 3 arteries.

Several large-scale trials have demonstrated improved survival with ACE-inhibitor therapy started during acute myocardial infarction. A systematic overview was conducted to resolve uncertainties regarding time of initiation, time course of effect, and identification of patients in whom the benefits or the risks may be greater.