Atrial natriuretic peptide (ANP) is a circulating hormone released from the atria in response to wall stretch and volume overload in the setting of heart failure. When atrial fibrillation (AF) becomes long-standing persistent, ANP secretion in response to volume overload is impaired due to degenerative changes of the atria. Here, we report a case of heart failure with preserved ejection fraction and impaired ANP secretion due to long-standing AF.
View Article and Find Full Text PDFThiamine deficiency can cause various clinical manifestations. Wet beriberi, a phenotype of thiamine deficiency, is often underdiagnosed in clinical practice due to the nonspecificity of symptoms. An 83-year-old man presented to a primary care clinic with a two-month history of progressing edema in the scrotum and lower extremities.
View Article and Find Full Text PDFRegional wall motion abnormality in the left ventricular (LV) apex detected on transthoracic echocardiography is commonly interpreted as the presence of a distal left anterior descending (LAD) artery lesion in clinical practice. Herein, we reported a rare case of apical acute myocardial infarction (AMI) caused by an occluded posterior descending branch of the right coronary artery (RCA), in which the correspondence between coronary arterial anatomy and supplied LV apex was evaluated by multi-imaging modalities. Despite the presence of regional wall motion abnormality in the LV apex, left coronary angiography showed no significant coronary artery diseases.
View Article and Find Full Text PDFHypertrophic cardiomyopathy (HCM) is a primary myocardial disease that is genetically transmitted as an autosomal dominant trait. Even apical HCM (ApHCM) induces atrial fibrillation (AF) based on underlying left ventricle (LV) diastolic dysfunction, where anticoagulation therapy is recommended. However, anticoagulation for AF in patients at high risk of bleeding is a double-edged sword.
View Article and Find Full Text PDFTakotsubo syndrome is a non-ischemic cardiomyopathy characterized by transient left ventricular (LV) apical ballooning, which typically occurs after exposure to emotional or physical stress in elderly women. An 85-year-old woman with hypertension presented with a recent onset of palpitation and exertional dyspnea. The patient had a long-standing history of alcohol consumption, and transthoracic echocardiography revealed diffuse LV hypokinesia including apical area with an ejection fraction of 30%.
View Article and Find Full Text PDFEvaluation of a myocardial area at risk is clinically important because it contributes to clinical decision-making and management of patients with acute myocardial infarction (AMI). Herein, we reported a case of non-ST-elevation AMI (non-STEMI) without wall motion abnormalities on echocardiography, in which the myocardial area at risk was evaluated by two modalities; cardiac magnetic resonance (CMR) and radionuclide imaging. Coronary angiography revealed significant luminal stenosis in the diagonal branch and the obtuse marginal branch.
View Article and Find Full Text PDFHiatal hernia is one of common conditions in the elderly. Most patients with hiatal hernia are asymptomatic. However, some reports have described cardiac complications such as heart failure or arrhythmias due to cardiac compression.
View Article and Find Full Text PDFA 90-year-old man experienced chest oppressive sensation at 12:30 AM for the first time. Electrocardiography showed a newly developed inversion of the terminal T-wave in the V leads. A left coronary angiogram showed no significant atherosclerotic stenosis.
View Article and Find Full Text PDFFemale sex in patients with atrial fibrillation (AF) is a controversial and paradoxical risk factor for stroke-controversial because it increases the risk of stroke only among older women of some ethnicities and paradoxical because it appears to contradict male predominance in cardiovascular diseases. However, the underlying mechanism remains unclear. We conducted simulations to examine the hypothesis that this sex difference is generated non-causally through left truncation due to competing risks (CR) such as coronary artery diseases, which occur more frequently among men than among women and share common unobserved causes with stroke.
View Article and Find Full Text PDFAim: Blood cholesterol absorption and synthesis biomarkers predict cardiovascular risk. This study aimed to determine the values of serum non-cholesterol sterol markers [lathosterol (Latho), campesterol (Campe), and sitosterol (Sito)] in healthy individuals and factors affecting these markers.
Methods: The CACHE Consortium compiled clinical data, including serum Latho (cholesterol synthesis marker), and Campe and Sito (cholesterol absorption markers), by a gas chromatography method in 2944 individuals.
Aim: Serum levels of cholesterol absorption and synthesis markers are known to be associated with cardiovascular risk. Familial hypercholesterolemia (FH) is a well-known inherited disorder presenting elevated low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels and premature coronary disease. In this study, we aim to examine the differences in terms of serum markers of cholesterol metabolism between FH and non-FH individuals and to examine their associations with serum lipid levels.
View Article and Find Full Text PDFAim: Risk of cardiovascular disease is increased in patients with diabetes mellitus (DM). Cholesterol metabolism (hepatic synthesis and intestinal absorption) is known to be associated with cardiovascular risk. Next, we examined the association of DM with cholesterol absorption/synthesis.
View Article and Find Full Text PDFThe basement membrane (BM) underlying epithelial tissue is a thin layer of extracellular matrix that governs tissue integrity and function. Epithelial BMs are generally assembled using BM components secreted from two origins: epithelium and stroma. Although de novo BM formation involves self-assembly processes of large proteins, it remains unclear how stroma-derived macromolecules are transported and assembled, specifically in the BM region.
View Article and Find Full Text PDFAim: Serum levels of cholesterol absorption and synthesis markers are known to be associated with cardiovascular risk. Individuals with reduced kidney function or chronic kidney disease (CKD) are at an increased risk for cardiovascular disease. Hence, we examined the relationship between estimated glomerular filtration rate (eGFR) and serum markers of cholesterol absorption and synthesis.
View Article and Find Full Text PDFThe monocyte to high-density lipoprotein cholesterol (HDL-C) ratio has been considered to be a prognostic marker. Whether this ratio is associated with left ventricular (LV) diastolic function remains undetermined. We tested the hypothesis that the monocyte to HDL-C ratio is associated with LV diastolic parameters derived from gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with no significant perfusion abnormality.
View Article and Find Full Text PDFElongated tubular endosomes play essential roles in diverse cellular functions. Multiple molecules have been implicated in tubulation of recycling endosomes, but the mechanism of endosomal tubule biogenesis has remained unclear. In this study, we found that JRAB/MICAL-L2 induces endosomal tubulation via activated Rab8A.
View Article and Find Full Text PDFBackground: The frontal QRS-T angle is one of markers of ventricular repolarization. We investigated whether or not the frontal QRS-T angle could predict left ventricular (LV) volume and function derived from ECG-gated SPECT in patients with advanced chronic kidney disease (CKD).
Methods: Two hundred and twelve patients with advanced CKD defined as estimated glomerular filtration rate of < 45 ml min/1.