A multicenter randomized comparison of paclitaxel-coated balloon with plain balloon angioplasty in patients with small vessel disease.

Aim: We investigated the efficacy and safety of using paclitaxel-coated balloon (PCB) to treat small vessel disease.

Methods And Results: In this multicenter, prospective, randomized controlled trial, one-hundred and thirty-five patients with native coronary lesions in small vessels were randomized into a PCB group and plain balloon angioplasty (POBA) group at a ratio of 2:1. There were no differences in target vessel failure (TVF) that was defined as cardiac death or target vessel-related myocardial infarction or target lesion revascularization (TLR), between the two groups (3.

Three-year follow-up outcomes of SES and PES in a randomized controlled study stratified by the presence of diabetes mellitus: J-DEsSERT trial.

Background: Three-year clinical follow-up of patients with diabetes mellitus (DM) in the Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT) using 2 different drug eluting stents (DES). A recent study demonstrated that efficacy of sirolimus eluting stents (SES) attenuated over time in diabetic patients.

Methods: In the largest trial of its kind, 1724 DM patients out of 3533 enrolled patients were randomized to either SES or paclitaxel eluting stents (PES).

Non-invasive diagnosis of coronary artery disease by 123I-BMIPP/201TlCl dual myocardial SPECT in patients with heart failure.

Background/objectives: Detecting the presence of coronary artery disease (CAD) is critically important in managing patients with heart failure of uncertain cause. The recently introduced 123I-BMIPP/201TlCl dual myocardial single-photon emission computed tomography (dual SPECT) is potentially a non-invasive diagnostic tool in detecting ischemic heart disease. The aim of our study is to evaluate the efficacy of detecting CAD by dual SPECT in patients with heart failure.

Outcomes of the largest multi-center trial stratified by the presence of diabetes mellitus comparing sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with coronary artery disease. The Japan drug-eluting stents evaluation: a randomized trial (J-DESsERT).

The Japan drug-eluting stents evaluation: a randomized trial (J-DESsERT) was conducted to compare the effectiveness of 2 different drug-eluting stents (DES). It remains uncertain which is more efficacious in diabetic patients, sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES). In this trial, the largest of its kind, 3,533 patients including 1,724 diabetes mellitus (DM) patients were randomized to either SES or PES.

Optimal duration of dual antiplatelet therapy following treatment with the endeavor zotarolimus-eluting stent in real-world Japanese patients with coronary artery disease (OPERA): study design and rationale.

Background: In patients with coronary artery disease (CAD), there is an increasing therapeutic need among interventional cardiologists to conduct dual antiplatelet therapy (DAPT) whose duration is shorter than current guideline-recommended 6-12 months after the implantation of drug-eluting stents. However, no clinical grounds sufficient to rationalize the need are available.

Objectives: To define the optimal duration of DAPT and to examine the safety and efficacy of the Endeavor zotarolimus-eluting stent (E-ZES) in real-world Japanese patients with CAD.

Early and long-term outcomes of coronary artery bypass grafting and percutaneous coronary intervention in patients with left main disease: single-center results of multidisciplinary decision making.

Objective: Coronary artery bypass grafting (CABG) is considered the standard treatment for patients with left main disease (LMD). However, percutaneous coronary intervention (PCI) has recently emerged as a treatment option for selected patients. We assessed early and long-term outcomes of patients with LMD who underwent either CABG or PCI in our institution.

A multicenter randomized comparison of paclitaxel-coated balloon catheter with conventional balloon angioplasty in patients with bare-metal stent restenosis and drug-eluting stent restenosis.

Background: The aim of this study was to investigate the efficacy and safety of paclitaxel-coated balloon (PCB) for the treatment of the bare-metal stent restenosis (BMS-ISR) and drug-eluting stent restenosis (DES-ISR).

Methods: This study was a prospective, multicenter, randomized (2:1) trial conducted in 208 patients with 213 in-stent restenosis lesions (BMS-ISR: 123 lesions, DES-ISR: 90 lesions) at 13 centers in Japan. Patients were randomly assigned to a PCB group (137 patients with 142 lesions) or a conventional balloon angioplasty (BA) group (71 patients with 71 lesions).

A case of osteopetrosis with severe aortic stenosis treated by transcatheter aortic valve implantation.

Osteopetrosis is a rare hereditary disease characterized by osteoclast dysfunction and consequently diminished bone resorption and disturbed bone building and remodeling, resulting in abnormally dense and brittle bones. Pathologic fractures are common in patients with osteopetrosis. We report a case of benign adult form of osteopetrosis with severe aortic stenosis (AS) and coronary artery disease (CAD).

Post-exercise diastolic stunning detected by velocity vector imaging is a useful marker for induced ischemia in ischemic heart disease.

Background: Recently, post-exercise diastolic stunning (PES) has been reported as a new clinical marker of induced ischemia. Velocity vector imaging (VVI) has been developed to visualize regional wall motion abnormalities based on vectors detected by the tissue tracking technique, which has the potential to visualize PES. Thus, the aim of this study was to evaluate the usefulness of PES detection by VVI as an objective marker of ischemia compared to stress thallium-201 (Tl-201) single photon emission computed tomography (SPECT).

Angiographic findings of everolimus-eluting as compared to sirolimus-eluting stents: angiographic sub-study from the Randomized Evaluation of Sirolimus-eluting versus Everolimus-eluting stent Trial (RESET).

Several recent randomized trials comparing everolimus-eluting stent (EES) and sirolimus-eluting stent (SES) reported similar clinical outcomes. This study was aimed to clarify the differences in the angiographic findings of EES as compared to SES. Randomized Evaluation of Sirolimus-eluting versus Everolimus-eluting stent Trial is a prospective multicenter randomized open-label trial comparing EES with SES in Japan.

Rotational atherectomy followed by cutting-balloon plaque modification for drug-eluting stent implantation in calcified coronary lesions.

Background: Drug-eluting stent (DES) underexpansion has been reported as an independent factor for restenosis and thrombosis; therefore, adequate plaque modification prior to DES implantation is the key of calcified lesion treatment.

Methods: Consecutive patients with severely calcified lesions undergoing rotational atherectomy (RA) followed by balloon dilatation before DES implantation were analyzed. Patients were divided into two groups based on the balloon type before stent implantation: the cutting balloon (ROTACUT group) and the plain balloon (control group).

Lipid-lowering and anti-inflammatory effect of ezetimibe in hyperlipidemic patients with coronary artery disease.

We evaluated the effects of adding ezetimibe to statin therapy in hypercholesterolemic patients with coronary artery disease (CAD) who could not achieve the target cholesterol levels recommended in the 2007 Japan Atherosclerosis Society Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases on statin monotherapy. Ezetimibe (10 mg) was added to basal statin therapy for 12 weeks in 35 patients with hypercholesterolemia and a history of CAD who had not achieved their target cholesterol level with statin monotherapy. Changes in serum lipids, obesity markers, an oxidative stress marker, inflammatory markers, and laboratory values were investigated.

Excessive axial plaque redistribution during coronary stent implantation confirmed by intravascular ultrasound.

We report a case of excessive axial plaque redistribution leading to luminal narrowing at the reference segment confirmed by serial intravascular ultrasound during coronary stent implantation.

Late stent malapposition with marked positive vascular remodeling observed only at the site of drug-eluting stents after multivessel coronary stenting.

A 74-year-old woman presented with effort-induced chest pain. Diagnostic coronary angiography revealed three-vessel disease. A successful angioplasty was performed with two sirolimus-eluting stents placed in the left anterior descending artery (LAD) and left circumflex artery (LCX).

Delayed enhancement cardiovascular magnetic resonance as a novel technique to predict cardiac events in dilated cardiomyopathy patients.

Purpose: Delayed enhancement cardiovascular magnetic resonance (DE-CMR) can detect cardiac scarring and has the potential to visualize the progression of myocardial remodeling. We determined whether DE-CMR can predict cardiac events in dilated cardiomyopathy patients.

Materials And Methods: Transthoracic echocardiography, coronary arteriography, and DE-CMR studies were performed in 60 consecutive dilated cardiomyopathy (DCM) patients.

Preoperative left atrial emptying fraction is a powerful predictor of successful maze procedure.

Background: The maze procedure for the treatment of atrial fibrillation (AF) is a widely used adjunctive therapy. It is necessary to define the precise indications for the procedure based on preoperative factors, but definitive parameters in terms of atrial function have not been well determined.

Methods And Results: In the present study, 55 consecutive patients undergoing the maze procedure for persistent AF in combination with operations for organic heart diseases were evaluated.

Long-term outcome of first-generation metallic coronary stent implantation in patients with coronary artery disease: observational study over a decade.

Background: In the era of drug-eluting stents, percutaneous coronary intervention (PCI) has been considered an established therapeutic modality for patients with coronary artery disease (CAD). However, little is known about the long-term prognosis.

Methods And Results: Using data obtained from a single-center registry for cases of first-generation bare metallic stent (BMS) implantation, a 10-year follow-up study in patients with CAD was performed.

The echocardiographic determinants of functional mitral regurgitation differ in ischemic and non-ischemic cardiomyopathy.

Background: Functional mitral regurgitation (MR) is one of the common and severe complications in patients with dilated cardiomyopathy. The detailed mechanisms that cause functional MR remain to be elucidated. Using two-dimensional transthoracic echocardiography, we investigated the differences in major determinants of MR severity between ischemic cardiomyopathy (ICM) and non-ICM patients.

Pre-operative atrial fibrillation as the key determinant of outcome of mitral valve repair for degenerative mitral regurgitation.

Aims: To examine the impact of pre-operative atrial fibrillation (AF) on the outcome of mitral valve repair (MVR) for degenerative mitral regurgitation (MR).

Methods And Results: Among 392 patients with moderate to severe MR who underwent MVR between 1991 and 2002, 283 patients with isolated degenerative MR were followed for 4.7+/-3.

Impact of a preoperative mitral regurgitation scoring system on outcome of surgical repair for mitral valve prolapse.

The optimal timing of surgical correction of severe mitral regurgitation (MR) is important for improved morbidity and mortality. We utilized a scoring system to decide the timing of procedures. Based on clinical features and echocardiographic data, we hypothesized that preoperative semi-quantitation of MR using this scoring system may be useful for predicting prognosis after repair.

Echocardiographic prediction of left ventricular dysfunction after mitral valve repair for mitral regurgitation as an indicator to decide the optimal timing of repair.

Objectives: This study sought to determine whether echocardiography before mitral valve repair (MVR) for mitral regurgitation (MR) was predictive of postoperative left ventricular (LV) dysfunction and useful for deciding the optimal timing of repair.

Background: Some reports have shown that the preoperative echocardiographic data of left ventricular ejection fraction (LVEF) and left ventricular end-systolic diameter (LVDs) were good predictors of postoperative LV dysfunction. However, few reports were based on long-term follow-up data of large numbers of patients who underwent MVR in the last decade.

Normalization of left ventricular parameters following combined pimobendan and carvedilol treatment in a case of unclassified cardiomyopathy with longstanding refractory status.

A 58-year-old man with a 64-month history of unclassified cardiomyopathy developed congestive heart failure (CHF) and had been dependent on long-term intravenous positive inotropes. Combined pimobendan and carvedilol administration resulted in marked symptomatic improvement from New York Heart Association functional class IV to I. Echocardiograms showed improvement of left ventricular (LV) ejection fraction from 15 to 48%, and LV end-diastolic diameter from 6.