Cardiac Presynaptic Sympathetic Nervous Function Evaluated by Cardiac PET in Patients with Chronotropic Incompetence Without Heart Failure.

Chronotropic incompetence (CTI), the inability of the heart to increase its rate with increased activity, leads to exercise intolerance and predicts overall mortality. We previously reported that cardiac β-adrenergic receptor downregulation occurs in patients with CTI without heart failure (HF), indicating postsynaptic sympathetic nervous dysfunction. However, cardiac presynaptic sympathetic nervous system function in CTI is not fully understood.

Central blood pressure profile variability and prognostic impact of transcatheter aortic valve implantation.

Transcatheter aortic valve implantation (TAVI) is a proven treatment for severe aortic stenosis (AS); however, the effects of TAVI on central blood pressure (CBP) and clinical outcomes remain unclear. We assessed CBP indices before and after TAVI and their prognostic value. Seventy-six patients with severe AS who underwent TAVI were retrospectively evaluated, and CBP was estimated noninvasively 1 day before and after TAVI.

Clinical characteristics and short-term outcomes in patients with cardiogenic shock undergoing mechanical circulatory support escalation from intra-aortic balloon pump to impella: From the J-PVAD registry.

Background: An escalation strategy from intra-aortic balloon pump (IABP) to Impella (AbioMed, Danvers, MA, USA) is proposed in patients with cardiogenic shock (CS) refractory to IABP therapy, but its clinical data are lacking. This study aimed to elucidate the clinical characteristics and short-term outcomes in patients undergoing IABP-Impella escalation.

Methods And Results: From the Japanese nationwide registry of Impella (J-PVAD), a total of 2578 patients with CS receiving Impella support were classified into the IABP-Impella group (n = 189) or the Primary Impella group (n = 2389).

Resting echocardiographic parameters to detect patients with less symptomatic primary mitral regurgitation who require exercise stress echocardiography.

Objectives: We aimed to identify which resting echocardiographic parameters can detect asymptomatic or mildly symptomatic patients with primary mitral regurgitation (MR) who require exercise stress echocardiography (ESE) to determine their suitability for surgery.

Methods: We examined 56 consecutive patients with primary moderate/severe MR who underwent ergometer-based ESE. Patients who met the surgical indications at rest were excluded.

Association of resting left ventricular global longitudinal strain with myocardial perfusion abnormalities evaluated by N-ammonia positron emission tomography in patients with stable angina pectoris and normal left ventricular ejection fraction.

Aims: Little is known about whether resting left ventricular global longitudinal strain (GLS) impairment is associated with myocardial perfusion abnormalities evaluated using N-ammonia positron emission tomography ( N-NH -PET)-myocardial perfusion imaging (MPI). This study aimed to investigate the correlation between resting GLS and myocardial perfusion parameters in patients with a normal left ventricular ejection fraction (LVEF). We evaluated whether resting GLS can predict myocardial perfusion abnormalities in these patients.

Age-related etiologies of aortic regurgitation with moderate or greater severity and coronary cusp bending: evaluation using transesophageal echocardiography.

Purpose: The prevalence of valvular heart disease has been rising, especially among those ≥ 65 years of age, because of age-related valvular degeneration resulting in an increase in the number of patients diagnosed with aortic regurgitation (AR). We analyzed transesophageal echocardiography (TEE) images in AR patients to identify the etiologies and investigate any differences in them according to age.

Methods: We studied 146 consecutive patients with chronic moderate or severe AR who underwent TEE.

Evaluation of end-tidal CO pressure at the anaerobic threshold for detecting and assessing pulmonary hypertension.

Cardiopulmonary exercise testing (CPET) is useful for the evaluation of patients with suspected or confirmed pulmonary hypertension (PH). End-tidal carbon dioxide pressure (PETCO) during exercise is reduced with elevated pulmonary artery pressure. However, the utility of ventilatory parameters such as CPET for detecting PH remains unclear.

Prognostic Factors for Survival in Pulmonary Hypertension Due to Left Heart Disease.

Background: The epidemiological data of pulmonary hypertension (PH) due to left heart disease (LHD) are limited. This study investigated hemodynamic and clinical factors associated with mortality in patients with PH due to LHD.

Methods And Results: We conducted a retrospective review in 243 patients with PH due to LHD, defined as mean pulmonary arterial pressure ≥25 mmHg and pulmonary wedge pressure >15 mmHg at rest in right heart catheterization.

Clinical value of regression of electrocardiographic left ventricular hypertrophy after aortic valve replacement.

Electrocardiographic left ventricular hypertrophy (ECG-LVH) gradually regressed after aortic valve replacement (AVR) in patients with severe aortic stenosis. Sokolow-Lyon voltage (SV1 + RV5/6) is possibly the most widely used criterion for ECG-LVH. The aim of this study was to determine whether decrease in Sokolow-Lyon voltage reflects left ventricular reverse remodeling detected by echocardiography after AVR.