Volume 1, Issue 1, January 2008
By Philippe Pibarot, DVM, PhD, FACC, FAHA
Guest Editor


It is a great pleasure and privilege to serve as the Guest Editor of this first issue of the CMReJournal. This issue includes five articles that provide important new insights into the assessment and management of cardiometabolic risk (CMR).

New methods for the prediction and treatment of obesity-related insulin resistance

In his article, Dr. André Marette, a scientist at Hôpital Laval Research Centre, Quebec City, Canada, provides new insights into the potential mechanisms involved in the promotion of obesity-related insulin resistance. This review emphasizes the need to speed up the discovery of new diagnostic tools to predict the development of insulin resistance in obese individuals and to find novel therapeutic targets to improve the pharmacotherapy of obese diabetic subjects when lifestyle modifications fail to achieve the therapeutic goals.

The visceral adipocyte: does it contribute to CMR?

In this issue of the journal, Dr. André Tchernof, a scientist at Centre Hospitalier Universitaire de l'Université Laval (CHUL) Research Centre, Quebec City, Canada, presents an overview of his research efforts to establish the potential mechanisms relating the visceral adipocyte to cardiometabolic risk factors. Dr. Tchernof concludes that the pathogenesis of the metabolic syndrome and its associated CMR involves several mechanisms, including visceral adipose tissue, fatty acid release, reduced peripheral lipid storage, and secreted cytokines.

Overweight people are not all equal in terms of CMR

Because not all overweight individuals are at increased risk of diabetes and cardiovascular disease, the challenge for the clinician is to identify the subgroup of individuals who have "at risk" obesity. Dr. Philip Barter of the Heart Research Institute, Sydney, Australia, presents the key findings of a large epidemiological study that stresses the importance of simple measures such as plasma triglycerides and HDL-C in identifying those overweight people who have the metabolic syndrome and are at high cardiovascular risk.

CMR in cardiac surgery

Dr. Patrick Mathieu, a heart surgeon and clinical scientist at Hôpital Laval, Quebec City, Canada, presents the cardiac surgeon's perspective on CMR. Specifically, he demonstrates based on his recent findings that the metabolic syndrome negatively affects the patient's postoperative outcome following coronary artery bypass graft surgery and aortic valve replacement.

Valvulo-metabolic risk

Finally, I introduce the concept of "valvulo-metabolic risk," which can be defined as the risk of valvular heart disease resulting from the metabolic abnormalities associated with visceral obesity and metabolic syndrome. This is a new emerging field of research that may have important clinical implications given that valvular heart diseases are among the most frequent cardiovascular diseases and are associated with a high risk of morbidity and mortality.

We hope that you will enjoy this first issue of the CMReJournal, and we welcome your comments about the content and format of this issue as well as your suggestions for future issues.