Submited on: 25 Feb 2013 10:38:50 AM GMT
Published on: 25 Feb 2013 01:57:24 PM GMT
 

  • What are the main claims of the paper and how important are they?

    This paper highlights the issue of underlying coronary artery disease in overt hypothyroidism on a single case report.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No. The paper has numerous limitations:

    1. The idea is not original.

    2. Extrapolation of conclusions on a basis of single case.

    3. Other conventional coronary risk factors not described for the patient and discussed which may be responsible for the CAD in first place e.g. 61 yrs of age!.

    4. "The evolving new techniques for coronary artery stenosis visualization and myocardial perfusion disturbances-CT-assisted  coronary arteriography and contrast-enhanced echocardiography could be used as  non-invasive tests for coronary artery status  elucidation in patients with hypothyroidism" - this holds true for any patient irrespective of thyroid status

    5. The discussion is disjointed and requires more input.

    6. The main conclusion of the paper is not justified from the text


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    No.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Not a priority publication


  • Other Comments:

    NA

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Aggarwal A, Aggarwal S, Goel A, Sharma V, Dwivedi S,. A retrospective case-control study of modifiable risk factors and cutaneous markers in Indian patients with young coronary artery disease. J R Soc Med Cardiovasc Dis 2012; 1:1-8

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Aggarwal A .Severe Hypothyroidism, Ccoronary Artery Disease on CT Coronary Angiography and Hypoperfusion on Contrast Echocardiography [Review of the article 'Severe Hypothyroidism, Ccoronary Artery Disease on CT Coronary Angiography and Hypoperfusion on Contrast Echocardiography ' by Kanazirev B].WebmedCentral 2013;4(4):WMCRW002705
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  • What are the main claims of the paper and how important are they?

    The author describes a patient who presented with clinical hypothyroidism and symptoms consistent with angina at low workload. CAD and myocardial perfusion heterogeneity was demonstrated by CTA and contrast Echo respectively.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The association between hypothyroidism and CAD is not novel but this well-written case report demonstrates well a typical case.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    It would be helpful to submit images demonstrating the hyperechoic myocardial texture described. It would also be interesting to include the response of this patient's anginal symptoms to thyroid hormore replacement therapy. 

    On TDI, systolic velocities may be reduced and peak negative diastolic myocardial velocities would also be attenuated in the presence of diastolic dysfunction. Was there any evidence of such impairment in this patient?


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    The case report is well presented and the discussion is relevant and informative.


  • Other Comments:

    There are some minor spelling mistakes as previously noted (e.g. Ccoronary in title)

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    CTA, TDI

  • How to cite:  Kakouros N .Case of Hypothyroidism and Associated Coronary Artery Disease[Review of the article 'Severe Hypothyroidism, Ccoronary Artery Disease on CT Coronary Angiography and Hypoperfusion on Contrast Echocardiography ' by Kanazirev B].WebmedCentral 2013;4(4):WMCRW002698
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Review of
Posted by Dr. Pietro Scicchitano on 25 Feb 2013 03:34:14 PM GMT

  • What are the main claims of the paper and how important are they?

    The hypothiroidism as a cause of ACS is an important issue in cardiovascular risk evaluation.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not appliable


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes


  • Other Comments:

    Bari, December, 12th, 2012

    Title: “Severe Hypothyroidism, Coronary Artery Disease on CT Coronary Angiography and Hypoperfusion on Contrast Echocardiography”.

    Dear Editor,

    We have read through this case report and we think that the authors well-addressed all the main concerns about this case report. Nevertheless, some really minor flaws should be re-evaluated:

    - “Ccoronary” in the title should be changed in “Coronary”
    - “Disscussion” in the main text should be changed in “Discussion”

    Yours sincerely,

    Dr. Pietro Scicchitano

    Address:

    Piazza G. Cesare 11 - 70124 Bari Italy
    Tel +39-3339801846
    e-mail: piero.sc@hotmail.it

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Ciccone MM, De Pergola G, Porcelli MT, Scicchitano P, Caldarola P, Iacoviello M, Pietro G, Giorgino F, Favale S. Increased carotid IMT in overweight and obese women affected by Hashimoto's thyroiditis: an adiposity and autoimmune linkage? BMC Cardiovasc Disord. 2010 May 28;10:22. doi: 10.1186/1471-2261-10-22.

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Scicchitano P .Review of [Review of the article 'Severe Hypothyroidism, Ccoronary Artery Disease on CT Coronary Angiography and Hypoperfusion on Contrast Echocardiography ' by Kanazirev B].WebmedCentral 2013;4(2):WMCRW002537
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