Association of elevated blood pressure during exercise with cerebral white matter lesions.

Objectives: Cerebral white matter lesions (WMLs) are regarded to be subclinical ischemic changes of the cerebral parenchyma. Many previous studies have shown that baseline blood pressure (BP) is one of the most important factors for WMLs, but the relation between exercise BP and WMLs has not been fully evaluated. So, we sought to investigate the relationships between cerebral WMLs and peak exercise BP.

miRNA polymorphisms (miR‑146a, miR‑149, miR‑196a2 and miR‑499) are associated with the risk of coronary artery disease.

Small non‑coding microRNAs (miRNAs) are not only important for heart and vascular development but are also important in cardiovascular pathophysiology and diseases, such as ischemia and atherosclerosis‑related diseases. However, the effect of miR‑146a, miR‑149, miR‑196a2 and miR‑499 polymorphisms on coronary artery disease (CAD) susceptibility remain unknown. The aim of the present study was to examine the genotype frequencies of miR‑146a, miR‑149, miR‑196a2 and miR‑499 polymorphisms in patients with CAD, and assess their clinical applications for diagnosing and monitoring CAD.

The additive value of multiple biomarkers in prediction of premature coronary artery disease.

Objective: The aim of this study was to determine the value of additional multiple biomarkers in the prediction of premature coronary artery disease (CAD).

Methods And Results: Data from 503 CAD patients and 503 healthy control patients with matching age and sex were collected. The patient group consisted of male (25 to 55 years) and female (30 to 60 years) patients with documented angiographic multi-vessel CAD.

Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study.

Background: There are few studies that investigated the correlation between insulin resistance (IR) and the coronary artery remodeling. The aim of the study is to investigate the association of IR measured by homeostasis model assessment of insulin resistance (HOMA-IR) and coronary artery remodeling evaluated by intravascular ultrasound (IVUS).

Methods: A total of 298 consecutive patients who received percutaneous coronary interventions under IVUS guidance were retrospectively enrolled.

An exaggerated blood pressure response to exercise is associated with subclinical myocardial dysfunction in normotensive individuals.

Objectives: An exaggerated blood pressure (BP) response to exercise is associated with adverse cardiovascular outcomes, even in normotensive individuals. The purpose of this study was to compare myocardial function between normotensive individuals with and without an exaggerated BP response.

Methods: We evaluated global myocardial function using speckle tracking echocardiography in normotensive individuals.

Abolished ischemic tricuspid regurgitation by revascularization of left anterior descending artery: The role of collateral circulation.

A 74-year-old man presented with recent inferior wall myocardial infarction. The right ventricle (RV) was strikingly dilated and akinetic along the free wall compatible with right ventricular infarction. Accordingly, severe functional tricuspid regurgitation (TR) was detected.

Extent of late gadolinium enhancement on cardiovascular magnetic resonance imaging and its relation to left ventricular longitudinal functional reserve during exercise in patients with hypertrophic cardiomyopathy.

Background: The aim of this study was to investigate whether the extent of late gadolinium enhancement (LGE) on cardiovascular magnetic resonance imaging reflecting myocardial fibrosis correlates with left ventricular (LV) longitudinal function during exercise in hypertrophic cardiomyopathy (HCM).

Methods And Results: Mitral annular velocities (E' and S') were measured on echocardiography at rest and during graded bicycle exercise (25 W, 3-min increments) in 46 HCM patients (mean age, 53 years; 32 men). LV longitudinal diastolic and systolic functional reserve indices were calculated as ΔE'×E'base and ΔS'×S'base, where ΔE' and ΔS' are the changes in E' and S' from baseline to 50 W of exercise, respectively.

Fatal delayed coronary artery perforation after coronary stent implantation.

Most type I and II perforations are predominately caused by hydrophilic and stiff wires, often presented in the delayed form, and do not require pericardial drainage or surgical interventions. However, we report a type III delayed coronary artery perforation at the site of stent implantation after intervention without any evidence of immediate perforations. To the best of our knowledge, this is the first case report of angiographic documentation and treatment of delayed coronary perforation at the site of stent, presented as a cardiac arrest.

Comparison of the efficacy and safety of fixed-dose amlodipine/losartan and losartan in hypertensive patients inadequately controlled with losartan: a randomized, double-blind, multicenter study.

Background: Fixed-dose combination drugs may enhance blood pressure (BP) goal attainment through complementary effects and reduced side effects, which leads to better compliance.

Objective: This study aimed to evaluate the efficacy and safety profiles of once-daily combination amlodipine/losartan versus losartan.

Methods: This was an 8-week, double-blind, multicenter, randomized phase III study conducted in outpatient hospital clinics.

Evaluation of the dose-response relationship of amlodipine and losartan combination in patients with essential hypertension: an 8-week, randomized, double-blind, factorial, phase II, multicenter study.

Background: Despite recommendations for more intensive treatment and the availability of several effective treatments, hypertension remains uncontrolled in many patients.

Objective: The aim of this study was to determine the dose-response relationship and assess the efficacy and safety of amlodipine or losartan monotherapy and amlodipine camsylate/losartan combination therapy in patients with essential hypertension.

Methods: This was an 8-week, randomized, double-blind, factorial design, phase II, multicenter study conducted in outpatient hospital clinics among adult patients aged 18-75 years with essential hypertension.

Comparative efficacy and safety profile of amlodipine 5 mg/losartan 50 mg fixed-dose combination and amlodipine 10 mg monotherapy in hypertensive patients who respond poorly to amlodipine 5 mg monotherapy: an 8-week, multicenter, randomized, double-blind phase III noninferiority study.

Background: The number of hypertensive patients achieving treatment targets is not ideal with therapies that engage a single mechanism of action, and combination therapies using different mechanisms of action can increase drug efficacy in a synergistic way.

Objective: This noninferiority study compared the clinical efficacy and safety profile of fixed-dose combination of amlodipine/losartan 5/50 mg and amlodipine 10 mg monotherapy in essential hypertensive patients who respond poorly to amlodipine 5 mg monotherapy.

Methods: This was a double-blind, multicenter, randomized trial of hypertensive patients (N = 185) aged ≥18 years taking amlodipine 5 mg during the run-in treatment period but failed to achieve sitting diastolic blood pressure (DBP) <90 mm Hg.

Comparison of outcomes of patients with painless versus painful ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

There are few data available on the prognosis of painless ST-segment elevation myocardial infarction (STEMI). The aim of this study was to determine the incidence, clinical characteristics, and outcomes of painless STEMI. We analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) study, which enrolled 7,288 patients with STEMI (61.

Clinical and echocardiographic predictors of outcomes in patients with apical hypertrophic cardiomyopathy.

Apical hypertrophic cardiomyopathy (HC) is considered to have a favorable prognosis, but recent observations have suggested less benign clinical courses. We investigated the outcomes in patients with apical HC and evaluated the predictors. All 454 patients with apical HC (316 men, age 61 ± 11 years) were recruited.

Vena contracta width as a predictor of adverse outcomes in patients with severe isolated tricuspid regurgitation.

Background: The clinical outcomes and predictors of outcomes in isolated tricuspid regurgitation (TR) are poorly defined. The aim of this study was to investigate the determinants of outcomes in severe isolated TR.

Methods: Seventy-four patients (mean age, 63 ± 12 years; 34 men) with severe isolated TR who satisfied the criteria of (1) TR jet area > 30% of right atrial area or TR jet area > 10 cm(2) and (2) a plethora of inferior vena cava or systolic flow reversal of the hepatic vein were retrospectively analyzed.

Percutaneous cardiopulmonary support-supported percutaneous coronary intervention: a single center experience.

Background And Objectives: Percutaneous cardiopulmonary support (PCPS) has proven to be a valuable technique in high-risk coronary patients undergoing percutaneous coronary intervention (PCI). However, there have been few studies on PCI associated with PCPS in Korea. We summarized our experience with PCPS-supported PCI.

Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation.

Aims: There is a growing concern about the occurrence of coronary artery aneurysms (CAAs) after drug-eluting stent (DES) implantation and their long-term course. We assessed the occurrence and the factors affecting the long-term outcome of DES-associated CAA.

Methods And Results: We analyzed 3,612 consecutive patients (4,419 lesions) who underwent follow-up angiography after DES implantation.

Dyssynchronous systolic expansion of carotid artery in patients with marfan syndrome.

Background: Marfan syndrome is a multisystemic connective tissue disorder associated with a mutation affecting fibrillin-1, the main component of microfibrils. Fibrillin-1 gene mutations may affect the carotid arterial wall. The aim of this study was to investigate carotid arterial mechanics using Velocity Vector Imaging (VVI) in patients with Marfan syndrome.

Optimal pharmacologic approach to patients with hypertriglyceridemia and low high-density lipoprotein-cholesterol: randomized comparison of fenofibrate 160 mg and niacin 1500 mg.

Objectives: Atherogenic dyslipidemia is emerging as a target of lipid-modifying therapy. However, an optimal pharmacologic approach has not yet been established. The aim of this study is to compare the efficacy and tolerability of the typical doses of fenofibrate and niacin.

What is optimal revascularization strategy in patients with multivessel coronary artery disease in non-ST-elevation myocardial infarction? Multivessel or culprit-only revascularization.

Background: In patients with non-ST-elevation myocardial infarction (NSTEMI), current guidelines did not recommend optimal revascularization management in multivessel coronary artery disease. We compared clinical outcomes between multivessel revascularization and culprit-only revascularization in this setting.

Methods: A total of 1919 patients with multivessel disease (1011 patients; multivessel revascularization group, 908 patients; culprit-only revascularization group) diagnosed as NSTEMI was enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008.

Soluble fms-like tyrosine kinase-1 and the progression of carotid intima-media thickness – 24-month follow-up study –.

Background: The relationship between fms-like tyrosine kinase-1 (sFlt-1), a soluble receptor for vascular endothelial growth factor (VEGF), and vascular disease has not been established, so this study aimed to elucidate the association between sFlt-1 and the progression of carotid intima - media thickness (IMT) in hypertensive patients.

Methods And Results: The 120 hypertensive patients under medical control were enrolled and 112 completed the study (age 59 ± 9 years, 57 females). Plasma VEGF and sFlt-1 levels were measured at enrollment.

Vascular endothelial growth factor, soluble fms-like tyrosine kinase 1, and the severity of coronary artery disease.

Background: The association between vascular endothelial growth factor (VEGF), soluble fms-like tyrosine kinase 1 (sFlt-1), and coronary artery disease (CAD) was investigated.

Methods: We enrolled 112 hypertensive patients with proven CAD and 112 hypertensive controls matched for age and gender. The severity of CAD was assessed by the most severe clinical presentation of CAD in patients' history and by the number of diseased vessels.

Assessment of tissue characteristics of noncalcified coronary plaques by 64-slice computed tomography in comparison with integrated backscatter intravascular ultrasound.

Background: The ability of 64-slice computed tomography (CT) angiography to differentiate plaque types remains unclear. We evaluated whether the density of noncalcified coronary plaques by 64-slice CT angiography correlates with plaque components assessed by integrated backscatter intravascular ultrasound (IB-IVUS).

Methods: Eighty-six patients [stable angina/acute coronary syndrome (ACS) 67/19, mean age 62+/-11 years] who showed significant coronary artery stenosis (> or =50% diameter stenosis) by 64-slice CT angiography underwent coronary angiography and were evaluated using IB-IVUS.

Passive leg-raise is helpful to identify impaired diastolic functional reserve during exercise in patients with abnormal myocardial relaxation.

Background: The aim of this study was to demonstrate the usefulness of leg raise in identifying lower diastolic functional reserve to exercise.

Methods: One hundred fifty-four patients with abnormal left ventricular relaxation on Doppler mitral inflow with preserved left ventricular ejection fractions were enrolled. After resting evaluations, Doppler echocardiographic measurements were repeated during passive leg raise and graded supine bicycle exercise.

Delayed enhancement magnetic resonance imaging is a significant prognostic factor in patients with non-ischemic cardiomyopathy.

Background: Delayed enhancement (DE) on cardiac magnetic resonance imaging (CMR) is a marker of myocardial fibrosis. The absence of DE in CMR is a predictor of left ventricular (LV) functional improvement in patients with non-ischemic cardiomyopathy (NICM), so in the present study it was investigated whether presence of DE has prognostic significance in patients with NICM at long-term follow-up.

Methods And Results: The 79 patients (56.