Cardiac Magnetic Resonance Imaging: What Can It Add to Our Knowledge of the Right Ventricle in Pulmonary Arterial Hypertension?

Pulmonary arterial hypertension (PAH) is a disease of the pulmonary vasculature characterized by vasoconstriction and vascular remodeling leading to a progressive increase in pulmonary vascular resistance (PVR). It is becoming increasingly recognized that it is the response of the right ventricle (RV) to the increased afterload resulting from this increase in PVR that is the most important determinant of patient outcome. A range of hemodynamic, structural, and functional measures associated with the RV have been found to have prognostic importance in PAH and, therefore, have potential value as parameters for the evaluation and follow-up of patients. If such measures are to be used clinically, there is a need for simple, reproducible, accurate, easy-to-use, and noninvasive methods to assess them. Cardiac magnetic resonance imaging (CMRI) is regarded as the "gold standard" method for assessment of the RV, the complex structure of which makes accurate assessment by 2-dimensional methods, such as echocardiography, challenging. However, the majority of data concerning the use of CMRI in PAH have come from studies evaluating a variety of different measures and using different techniques and protocols, and there is a clear need for the development of standardized methodology if CMRI is to be established in the routine assessment of patients with PAH. Should such standards be developed, it seems likely that CMRI will become an important method for the noninvasive assessment and monitoring of patients with PAH. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110[suppl]:25S-31S)

THE HOUSE OF JOANA DARK: DRAMA AND PRODUCTION

While discussing images of Our Lady and of the mothers and women of the Garden of Flowers (or "Devils' Hole"), a peripheral district of a city in the interior of Sao Paulo state, this paper intends to explore the specificity of dramatic aesthetics. Rather than depend upon the aesthetics of social drama, as discussed in the works of Victor Turner, the present paper deals with a concept of montage that is inspired by the cinema of Sergei Eisenstein in order to illuminate a selection of field notes... and, along with Eisenstein, Julia Kristeva, Walter Benjamin, Michael Taussig and Antonin Artaud. Wit regards to those readers interested in hearing what these women may have to say, caution is suggested, for the words of these women may ring in our ears as the sounds of musket shots