Usefulness of the Combination of In-Hospital Poor Diuretic Response and Systemic Congestion to Predict Future Cardiac Events in Patients With Acute Decompensated Heart Failure.

We aimed to (1) investigate the relation between diuretic response (DR) with or without systemic congestion and prognosis and (2) explore the potential predictors of poor DR for risk stratification in patients with acute decompensated heart failure (ADHF). We enrolled 186 consecutive patients hospitalized for ADHF. The DR was defined as (body weight at discharge - body weight at admission)/40 mg furosemide or equivalent loop diuretic dose.

Practical approach to evaluate asymptomatic coronary artery disease in end-stage renal disease patients at the initiation of dialysis.

The high prevalence of significant asymptomatic coronary artery disease (CAD) has been reported in patients with end-stage renal disease (ESRD) at the initiation of dialysis. However, the approach to evaluate asymptomatic CAD for these patients has not been established. The aim of this study is to assess the applicability of our practical approach at the initiation of dialysis.

Temporary adjunctive cilostazol vs clopidogrel loading for ST-segment elevation acute myocardial infarction.

Background: Clopidogrel loading is a standard method to achieve rapid platelet inhibition and prevent thrombotic events. At the current time, little information is available to determine the effect of adjunctive cilostazol compared with clopidogrel loading.

Methods: We retrospectively analyzed 212 patients undergoing primary percutaneous coronary intervention with drug-eluting stents for ST-segment elevation acute myocardial infarction.

Influence of the false lumen status on clinical outcomes in patients with acute type B aortic dissection.

Objective: Clinical outcomes in acute type B aortic dissection patients with partial thrombosis of the false lumen have not been clearly elucidated. The purpose of this study was to investigate long-term mortality and incidence of surgical treatment by focusing on the status of the false lumen including partial thrombosis.

Methods: One hundred three patients (69 males, mean age 67 ± 13 years) with acute type B aortic dissection were enrolled.

Evaluation for hypoperfusion distal to arteriovenous vascular access using skin perfusion pressure in fingers.

Purpose: The usefulness of skin perfusion pressure (SPP) measurement in the assessment of critical ischemia of the lower limb has previously been established. This study investigated whether finger SPP measurement is useful to evaluate hypoperfusion distal to arteriovenous vascular access in dialysis patients.

Methods: Seventeen asymptomatic hemodialysis patients with upper extremity arteriovenous access and 17 non-dialysis control patients were prospectively examined.

Coronary subclavian steal from a left internal thoracic artery coronary bypass graft due to ipsilateral subclavian artery stenosis and an arteriovenous graft in a hemodialysis patient with left vertebral artery occlusion.

Coronary subclavian steal syndrome is an unusual cause of myocardial ischemia, secondary to a reversed blood flow in patients with patent internal thoracic artery coronary bypass grafts. The causes of coronary subclavian steal are either ipsilateral subclavian artery stenosis or upper extremity arteriovenous hemodialysis fistula formation or both. This report involves a 68-year-old woman with left vertebral artery occlusion who developed severe coronary steal in the absence of vertebral subclavian steal due to left subclavian artery stenosis and an arteriovenous hemodialysis graft.

Accelerated decline in renal function after acute myocardial infarction in patients with high low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol ratio.

High low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol (L/H) ratio is associated with progressions of coronary arteriosclerosis and chronic kidney disease. On the other hand, renal function markedly declined after acute myocardial infarction (AMI). The aims of the present study were (1) to identify what type of patients with AMI would have high L/H ratio at follow-up and (2) to evaluate whether decline in renal function after AMI had accelerated or not in patients with high L/H ratio.

Comparison of early outcomes after primary stenting in Japanese patients with acute myocardial infarction between clopidogrel and ticlopidine in concomitant use with proton-pump inhibitor.

Background: Recent studies have reported that concomitant use of clopidogrel with proton-pump inhibitors (PPIs) might decrease antiplatelet effects and increase the risk of adverse outcomes after coronary stenting. However, little is known about the difference between clopidogrel and ticlopidine in concomitant use with PPIs, especially within the Asian population.

Methods: We retrospectively analyzed 302 consecutive patients (248 males, mean age 66 ± 12 years) undergoing primary stenting for acute myocardial infarction from July 2006 to June 2010.

Impact of mild to moderate renal dysfunction on left ventricular relaxation function and prognosis in ambulatory patients with nonischemic dilated cardiomyopathy.

The relationship between mild-to-moderate renal dysfunction and cardiac diastolic dysfunction and cardiac events in patients with nonischemic dilated cardiomyopathy (NDCM) has not been fully elucidated. The aim of this study was to investigate the relationship between renal and cardiac function, as well as clinical outcome in patients with NDCM.We measured plasma BNP and eGFR, and performed cardiac catheterization in 135 patients with NDCM.

Association of diabetes mellitus with myocardial collagen accumulation and relaxation impairment in patients with dilated cardiomyopathy.

Aims: To assess the effects of diabetes mellitus (DM) on myocardial collagen accumulation, myocardial relaxation, and prognosis in patients with dilated cardiomyopathy (DCM).

Methods: A total of 102 consecutive DCM patients with a New York Heart Association functional class of I or II were enrolled. Patients were allocated to two groups on the basis of the presence (DCM+DM group, n = 30) or absence (DCM-DM group, n = 72) of DM.