Left Atrial Velocity Vector Imaging Can Assess Early Diastolic Dysfunction in Left Ventricular Hypertrophy and Hypertrophic Cardiomyopathy.

Background: The function of left atrium (LA) is difficult to assess because of its ventricle-dependent, dynamic movement. The aim of this study was to assess LA function using velocity vector imaging (VVI) and compare LA function in patients with hypertrophic cardiomyopathy (HCMP) and left ventricular hypertrophy (LVH) with normal controls.

Methods: Fourteen patients with HCMP (72% male, mean age of 52.

Vascular Alterations Preceding Arterial Wall Thickening in Overweight and Obese Children.

Background: Childhood obesity is linked to adverse cardiovascular outcomes in adulthood. This study aimed to assess the impact of childhood obesity on the vasculature and to investigate whether vascular alteration precedes arterial wall thickening in childhood.

Methods: A total of 295 overweight (body mass index [BMI] 85th to 95th percentile, = 30) and obese (BMI ≥ 95th percentile, = 234) children aged 7-17 years and 31 normal-weight controls with similar age and gender were prospectively recruited.

Association between 10-Year Atherosclerotic Cardiovascular Disease Risk and Vascular Endothelial Function in Patients with Vasospastic Angina.

Background: Endothelial dysfunction is a predictor of atherosclerotic cardiovascular disease (ASCVD) and plays an important role in vasospastic angina (VA).

Objectives: This study evaluated whether flow-mediated dilation (FMD) is also a good marker of 10-year ASCVD risk (10Y-ASCVDR) in patients with VA.

Methods: Based on their clinical history and coronary artery diameter stenosis (DS), patients were retrospectively enrolled into VA (DS <50% and positive ergonovine provocation), minor coronary artery disease (mCAD, DS <30%), and significant coronary artery disease (sCAD, DS ≥50%) groups.

Predictors of survival following veno-arterial extracorporeal membrane oxygenation in patients with acute myocardial infarction-related refractory cardiogenic shock: clinical and coronary angiographic factors.

Background: This study aimed to identify the determinant factors of survival in patients with acute myocardial infarction (AMI) and refractory cardiogenic shock (RCS) who underwent veno-arterial extracorporeal membrane oxygenation (ECMO).

Methods: Sixty-nine consecutive patients with AMI-related RCS were enrolled in the study. They were treated with ECMO and primary percutaneous coronary intervention (PCI).

Association Between Intra-arterial Invasive Central and Peripheral Blood Pressure and Endothelial Function (Assessed by Flow-Mediated Dilatation) in Stable Coronary Artery Disease.

Background: Endothelial function is an independent predictor of coronary artery disease (CAD) and is regulated by a number of factors, including blood pressure.

Objectives: The current study was designed to test the hypothesis that intra-arterial invasive central blood pressure is strongly associated with endothelial function in patients with CAD.

Methods: In patient with CAD (diameter stenosis ≥30%), invasive central (aortic) and left peripheral (brachial) blood pressures were determined during transradial coronary angiography.

Changes of body composition after valve surgery in patients with mitral valve disease.

Background: Patients with chronic heart failure have alteration in body composition as a reduction in fat mass, lean body mass and bone mass. However, body wasting in valvular heart disease and the impact of corrective valvular surgery on body composition has not been investigated.

Objectives: We hypothesized that body wasting in severe mitral valve (MV) diseases is reversible through MV surgery.

Clinical Meaning of the Ratio of Brachial Pre-Ejection Period to Brachial Ejection Time in Patients with Left Ventricular Systolic Dysfunction.

An increase in the ratio of the brachial pre-ejection period to brachial ejection time [pre-ejection period (PEP)/ET] is correlated with a decrease of left ventricular ejection fraction (LVEF). The current study was designed to test the hypothesis that the change value (Δ) of PEP/ET is a useful indicator of Δ LVEF in patients with left ventricular systolic dysfunction.We consecutively enrolled 104 patients with left ventricular systolic dysfunction (LVEF < 45%).

Long-term outcome of patients with triphasic mitral flow with a mid-diastolic L wave: prognostic role of left atrial volume and N-terminal pro-brain natriuretic peptide.

A mid-diastolic L wave has been recognized as a marker of advanced left ventricular (LV) diastolic dysfunction. However, its prognostic implication is unclear. This study assessed long-term prognosis and independent predictors of adverse outcomes in patients with a mid-diastolic L wave.

Functional recovery of regional myocardial deformation in patients with takotsubo cardiomyopathy.

Background: Takotsubo cardiomyopathy (TC) is acute, but completely reversible in the absence of significant coronary artery disease. This study aims to assess the functional recovery of regional myocardial deformation in patients with TC using 2-dimensional (2D) speckle tracking echocardiography.

Methods: Thirty-three patients diagnosed with TC (mean age 63 years, 26 female) prospectively underwent serial 2D echocardiography on day 1 (initial presentation), day 4 [the middle, interquartile range (IQR), 2-5 days], and day 21 (recovery, IQR 13-32 days).

Alterations of carotid arterial mechanics preceding the wall thickening in patients with hypertension.

Background And Aims: Carotid intima-media thickness (cIMT) is an established surrogate marker of atherosclerosis. However, cIMT may not reflect the whole arterial changes occurring in various pathologic conditions, such as hypertension. The aim of this study was to evaluate whether vascular properties of carotid artery (CA) in patients with hypertension differ from those of patients with diabetes and controls before the progression of cIMT.

Endothelial Function and Cardiovascular Autonomic Activity in Neurally Mediated Syncope.

Objectives: The aim of this study was to investigate endothelial function and cardiovascular autonomic activity in patients with neurally mediated syncope (NMS).

Methods: Patients with a typical history of NMS were divided according to the result of a head-up tilt (HUT) test. There were 25 patients each in the HUT-positive (HUT+), HUT-negative (HUT-) and control groups.

Echocardiographic Predictors of Progression to Persistent or Permanent Atrial Fibrillation in Patients with Paroxysmal Atrial Fibrillation (E6P Study).

Backgrounds: Paroxysmal atrial fibrillation (AF) frequently, but not always, progresses to persistent/permanent AF. The aim of this study was to evaluate the echocardiographic predictors of AF progression in patients with paroxysmal AF.

Methods: A multicenter, prospective, observational study was conducted that included 313 patients with paroxysmal AF who underwent two-dimensional speckle-tracking echocardiography.

Impact of Framingham risk score, flow-mediated dilation, pulse wave velocity, and biomarkers for cardiovascular events in stable angina.

Although the age-adjusted Framingham risk score (AFRS), flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and free fatty acid (FFA) can predict future cardiovascular events (CVEs), a comparison of these risk assessments for patients with stable angina has not been reported. We enrolled 203 patients with stable angina who had been scheduled for coronary angiography (CAG). After CAG, 134 patients showed significant coronary artery disease.

Exercise-Induced Intrapulmonary Arteriovenous Shunt in a Patient Complaining of Dyspnea during Strenuous Exercise.

A 51-year-old highly fit man presented for dyspnea with strenuous aerobic exercise. The patient was asymptomatic and all tests were normal at rest. With increasing exercise intensity, he suddenly complained of dyspnea and showed a severe exercise-induced hypoxemia with an excessive alveolar-arterial oxygen tension difference.

Alpha-lipoic acid for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography: the ALIVE study - a prospective randomized trial.

Objectives: α-Lipoic acid (ALA) is widely used for diabetic neuropathy due to its antioxidant properties. We evaluated its potential for preventing contrast-induced nephropathy (CIN).

Methods: We conducted a prospective randomized controlled trial to evaluate the efficacy of ALA in CIN prevention.

Successfully treated femoral artery thrombosis in a patient with minimal change nephrotic syndrome.

In contrast to widely recognized venous thrombotic complications, peripheral arterial thrombosis as a complication of nephrotic syndrome, especially without preceding iatrogenic venous puncture, corticosteroid treatment, or coagulation factor abnormalities, has rarely been reported in adult female patients. We report the case of a 39-year-old woman who presented with pain in the right lower leg accompanied by minimal change nephrotic syndrome. Lower-extremity angiography showed total occlusion of the right superficial femoral artery.

Evaluation of Short-Term Use of N-Acetylcysteine as a Strategy for Prevention of Anthracycline-Induced Cardiomyopathy: EPOCH Trial - A Prospective Randomized Study.

Background And Objectives: We investigate to determine whether N-acetylcysteine (NAC) can prevent anthracycline-induced cardiotoxicity.

Subjects And Methods: A total of 103 patients were enrolled in this prospective randomized open label controlled trial. They are patients first diagnosed with breast cancer or lymphoma, who require chemotherapy, including anthracycline like adriamycine or epirubicine.

Quantitative assessment of aortic elasticity with aging using velocity-vector imaging and its histologic correlation.

Objective: Velocity-vector imaging (VVI) represents a valuable new method for noninvasive quantification of vascular properties associated with aging. The purpose of this study was to assess the correlations between VVI parameters and histological changes with aging.

Approach And Results: Fourteen mongrel dogs were classified as either young (n=7; age, 1-2 years; female; weighing 22-29 kg) or senescent (n=7; age, 8-12 years; female; weighing 36-45 kg).

Functional changes of the myocardium in survivors of high-voltage electrical injury.

Introduction: There are limited long-term follow-up data on functional changes in the myocardium after high-voltage electrical injury (HVEI).

Methods: Twenty-three patients who had been exposed to HVEI (>20,000 volts) and preserved left ventricular ejection fraction (≥55%) were enrolled in the study. Echocardiographic parameters, including peak systolic strain (S) and strain rate (SR), were evaluated at baseline, six weeks and six months later.

Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation.

Background: Abnormalities in the left atrial (LA) structure and function may develop in patients with paroxysmal atrial fibrillation (AF). We sought to determine the contribution of LA mechanical function, including LA stiffness, to AF by comparing patients with paroxysmal AF with normal control subjects, and to evaluate whether LA mechanical function and stiffness are related with the structural changes of LA.

Methods: Sixty-four paroxysmal AF patients (57 ± 13 years, 59% male) were studied, using a speckle tracking echocardiography, and were compared with 34 age-, gender-, and left ventricular (LV) mass-matched controls (53 ± 14 years, 61% male).

Determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction.

Aims: The reversal of the early diastolic mitral annular velocity (e') to the late diastolic mitral annular velocity (a') ratio (e'/a' <1) develops earlier in the septum than in the lateral mitral annulus on tissue Doppler imaging (TDI). Accordingly, patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' ratio can be divided into two groups depending on the presence of a reversal of lateral e'/a'. The aim of this study was to identify the determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction.

Rationale and design of STOP DVT study: rosuvastatin for the prevention of deep vein thrombosis in patients undergoing total knee replacement arthroplasty--a prospective randomized open-label controlled trial.

Background: Deep vein thrombosis (DVT) frequently occurs in high-risk cardiovascular patients receiving orthopedic surgery, despite prophylactic measures for its prevention. Statins, a class of drugs used to lower cholesterol levels, have been reported to help prevent the development of DVT.

Methods: We will conduct a prospective randomized clinical trial to compare the effects of high-dose rosuvastatin plus a low-molecular-weight heparin (LMWH), enoxaparin, with conventional LMWH therapy in the prevention of DVT.

Impact of left ventricular longitudinal diastolic functional reserve on clinical outcome in patients with type 2 diabetes mellitus.

Background: Left ventricular longitudinal diastolic functional reserve (DFR), as assessed by the change in early diastolic mitral annular velocity (E') during exercise, is abnormal in patients with type 2 diabetes mellitus (DM). However, the impact of left ventricular longitudinal DFR on clinical outcome has not been explored. This study evaluated the incremental prognostic value of left ventricular DFR in patients with type 2 DM without overt heart disease.