Serial evaluation of left ventricular contraction and relaxation in Takotsubo cardiomyopathy by 2D speckle tracking echocardiography.

A 78-year-old woman was referred to our hospital because of general fatigue. The electrocardiogram showed ST elevation in the I, II, aVL, and V2-V6 leads. Echocardiography showed left ventricular apical akinesis.

Percutaneous transvenous stent implantation to external iliac vein stenosis in a patient with retroperitoneal fibrosis.

A 59-year-old man visited our hospital due to right leg edema and right leg pain. Computed tomography revealed that the circumferential enhancement of bilateral external iliac arteries by soft tissue that had similar density as the adjacent psoas muscle and that the right external iliac vein that was constricted by those tissues. The patient was diagnosed as retroperitoneal fibrosis.

Impact of aortic arch stiffness on recurrence of stroke in patients with acute ischemic stroke.

Background: Aortic arch plaques are associated with increased risk of stroke recurrence. The atherosclerotic process also affects aortic stiffness. The purpose of the present study was to evaluate aortic arch stiffness by transesophageal echocardiography (TEE) and its effect on recurrence of stroke.

Usefulness of intensity variation in the left atrial appendage with contrast echocardiography to predict ischemic stroke recurrence in patients with atrial fibrillation.

The left atrial appendage (LAA) is 1 of the common thromboembolic sources in patients with atrial fibrillation (AF) with stroke. The aim of this study was to examine the usefulness of LAA opacification seen on contrast echocardiography for predicting stroke recurrence in patients with AF. In 192 patients with stroke with AF who underwent transesophageal echocardiography within 7 days after the onset, intracardiac intensity variation at the orifice of the LAA just after intravenous infusion of Levovist (1,500 mg) was measured.

Elevated serum fibrin-monomer levels are associated with high long-term cerebrovascular event rates in acute ischemic stroke patients.

Background: Serum fibrin-monomer (FM) is a precursor of stable fibrin, and is a sensitive marker of a systemic hypercoagulable state. It has been reported that, in patients with acute ischemic stroke, higher levels of serum FM reflect intracardiac thrombus formation.

Methods And Results: Serum coagulation and fibrinolytic activity were measured in 113 patients with acute ischemic stroke within 7 (6+/-1) days after onset.

Ratio of peak early to late diastolic filling velocity of the left ventricular inflow is associated with left atrial appendage thrombus formation in elderly patients with acute ischemic stroke and sinus rhythm.

Objectives: To investigate the useful parameters of transthoracic echocardiography (TTE) for the diagnosis of stroke subtypes in patients with acute cerebral infarction.

Methods: One hundred and one acute ischemic stroke patients met all of the following criteria; > or = 50 years of age, normal sinus rhythm on admission, and transesophageal echocardiography (TEE) within 7 days from the onset. The clinical significance of the TTE parameters on admission was examined for identifying intracardiac thrombus formation as follows: left atrial dimension, left ventricular end-diastolic dimension, percentage fractional shortening, left ventricular mass index, ratio of the transmitral inflow velocities (E/A), and deceleration time of the E wave.

Higher levels of serum fibrin-monomer reflect hypercoagulable state and thrombus formation in the left atrial appendage in patients with acute ischemic stroke.

Background: It is sometimes difficult to make a diagnosis of cardioembolic stroke in the stroke care unit, because of the splashing and vanishing of the intracardiac source of the emboli on transesophageal echocardiography. Serum fibrin-monomer (FM) is a new marker for coagulation activity that is useful for identifying older individuals at increased risk of ischemic stroke.

Methods And Results: Two hundred and four patients with acute ischemic stroke were examined for serum coagulation and fibrinolytic activity on admission, and underwent transesophageal echocardiography within 7 days of onset.

Hyperuricemia associated with high cardiac event rates in the elderly with chronic heart failure.

Objectives: Congestive heart failure (CHF) is the major cause of death and hospitalization in the elderly population. Simple markers that can be measured anywhere at low cost are necessary to identify patients at high risk. Recent studies have reported that hyperuricemia is a prognostic marker for CHF.

Ongoing myocardial damage relates to cardiac sympathetic nervous disintegrity in patients with heart failure.

Unlabelled: Iodine-123-metaiodobenzylguanidine (123I-MIBG) has been used to assess the integrity and function of the cardiac sympathetic nervous system in patients with heart failure. Heart-type fatty acid binding protein (H-FABP) is released into the circulation when the myocardium is injured, and H-FABP has been recently used as a novel marker for the diagnosis of ongoing myocardial damage.

Objective: The aim of the present study was to compare cardiac sympathetic nervous activity assessed by 123I-MIBG imaging with serum levels of H-FABP in patients with heart failure.

Cystatin C, a novel measure of renal function, is an independent predictor of cardiac events in patients with heart failure.

Background: Cystatin C, a novel endogenous marker of glomerular filtration rate, has been reported as more sensitive to detect renal insufficiency than creatinine. The purpose of the present study was to examine the clinical significance of serum cystatin C level in patients with mild to moderate heart failure.

Methods And Results: Serum levels of cystatin C were measured by an enzyme immunoassay in 140 patients with heart failure and 64 control subjects without heart failure.

Serum heart-type fatty acid binding protein predicts cardiac events in elderly patients with chronic heart failure.

Background And Objectives: Heart-type fatty acid binding protein (H-FABP) is released into the circulation from the damaged myocardium of patients with severe chronic heart failure. Chronic heart failure is the most frequent cause of death and disability in the elderly. However, there are no data for the prognostic value of H-FABP in the elderly population.

Combination of heart-type fatty acid binding protein and brain natriuretic peptide can reliably risk stratify patients hospitalized for chronic heart failure.

Background: The aim of the present study was to prospectively study whether a combination of markers for myocardial cell injury and left ventricular overload at admission can reliably risk stratify patients hospitalized for chronic heart failure (CHF).

Methods And Results: Serum concentrations of heart-type fatty acid binding protein (H-FABP) and plasma concentrations of brain natriuretic peptide (BNP) were measured at admission in 186 consecutive patients hospitalized for CHF. During a mean follow-up period of 534+/-350 days, there were 44 cardiac events, including 16 cardiac deaths and 28 readmissions for worsening heart failure.