Clinical effect of long-term administration of tolvaptan in patients with heart failure and chronic kidney disease.

The effectiveness of long-term administration of tolvaptan in heart failure (HF) patients with chronic kidney disease (CKD) has not been fully studied. Hence, in this study, we investigated the effects of chronic administration of tolvaptan on patients with HF and CKD. We consecutively enrolled 31 patients with acute HF syndrome (AHFS) who were administrated tolvaptan as a long-term medication (TLV group).

Early increase in serum fatty acid binding protein 4 levels in patients with acute myocardial infarction.

Background: Acute myocardial infarction (AMI) induces marked activation of the sympathetic nervous system. Fatty acid binding protein 4 (FABP4) is not only an intracellular protein, but also a secreted adipokine that contributes to obesity-related metabolic complications. Here, we examined the role of serum FABP4 as a pathophysiological marker in patients with AMI.

Transesophageal echocardiography for thrombus screening prior to left atrial catheter ablation.

Background: Transesophageal echocardiography (TEE) is useful for detecting left atrial (LA) thrombus prior to percutaneous LA catheter ablation in patients with atrial fibrillation (AF). This study was designed to evaluate clinical predictors of LA thrombus and determine indications for TEE screening prior to LA ablation.

Methods And Results: The study consisted of 446 patients with drug-resistant AF who were scheduled to undergo initial LA ablation (age 59+/-11 years, 312 males, 136 persistent AF).

Infective endocarditis complicated by mycotic aneurysm of a coronary artery with a perforated mitral valvular aneurysm.

Mycotic aneurysms are well-documented complications of infective endocarditis and occur frequently in the intracranial arteries. However, mycotic aneurysms of the coronary arteries are very rare, and there are few reports of the management of these lesions. The authors report the case of a 72-year-old woman with coagulase-negative staphylococcal endocarditis involving a perforated aortic valve, a perforated mitral valve aneurysm, and a large mycotic coronary artery aneurysm.

Right bundle branch block and impaired left ventricular function as evidence of a left ventricular conduction delay.

Background: The indications and efficacy of cardiac resynchronization therapy (CRT) have not been sufficiently clarified in patients with right bundle branch block (RBBB).

Methods And Results: This study included 55 patients with normal QRS morphology and duration (Control-Gr) and 49 patients with complete RBBB (CRBBB-Gr). Using tissue Doppler imaging, the time difference (TD) between the electromechanical delay of the septal wall, left ventricular (LV) lateral wall, and right ventricular free wall were measured.