Incremental value of early systolic lengthening and postsystolic shortening in detecting left anterior descending artery stenosis using nonstress speckle-tracking echocardiography.

The diagnosis of coronary artery disease (CAD) with nonstress echocardiography remains challenging. Although the assessment of either early systolic lengthening (ESL) or postsystolic shortening (PSS) allows the sensitive detection of CAD, it is unclear whether the integrated analysis of ESL and PSS in addition to the peak systolic strain can improve the diagnostic accuracy. We investigated the incremental value of ESL and PSS in detecting left anterior descending artery (LAD) stenosis using nonstress speckle-tracking echocardiography.

Different implication of elevated B-type natriuretic peptide level in patients with heart failure with preserved ejection fraction and in those with reduced ejection fraction.

Background: There have been no reports that show significant direct relationship between echocardiographic parameters and B-type natriuretic peptide (BNP) level. This could be due to the heterogeneous pathophysiology of heart failure and a lack of appropriate echocardiographic parameters. We sought to determine the best echocardiographic parameter that described elevated BNP level in patients with heart failure with and without systolic dysfunction.

Prothrombin fragment 1+2 as a sensitive marker of intraventricular thrombus formation in a patient with dilated cardiomyopathy: comparison with echocardiography.

A 50-year-old man with dilated cardiomyopathy was admitted to our hospital due to heart failure symptoms. Although prothrombin fragment 1+2 (F1+2) was significantly elevated, there was no thrombus in the left ventricle by echocardiography. However, anticoagulation therapy was started because of a possibility of thrombus formation.

Preoperative heart rate variability predicts atrial fibrillation after coronary bypass grafting.

Background: The purpose of the present study was to investigate the association between preoperative heart rate variability and atrial fibrillation after off-pump coronary artery bypass graft surgery.

Methods: Of 524 consecutive patients undergoing isolated coronary artery bypass surgery, 390 were retrospectively analyzed after excluding the following 134 cases: on-pump surgery (n = 6), emergency (n = 106), chronic atrial fibrillation (n = 17), and pacemaker rhythm (n = 5). The following time-domain factors of heart rate variability were calculated: standard deviation of all normal-to-normal QRS (SDNN) and square root of mean of sum of squares of differences between adjacent normal-to-normal QRS (RMSSD).

Steal from skeletonized internal thoracic artery graft during hemodialysis after coronary artery bypass grafting.

Background: We used transthoracic Doppler echocardiography to evaluate the potential for flow variation in a skeletonized internal thoracic artery (ITA) graftc ipsilateral to an upper-extremity arteriovenous fistula during postoperative hemodialysis.

Methods: Between October 2008 and May 2009, 7 patients in chronic hemodialysis underwent coronary artery bypass grafting. We selected 5 of these patients according to the following inclusion criteria: patients who were undergoing chronic hemodialysis via a left upper-extremity arteriovenous fistula and in whom the skeletonized left ITA was anastomosed to the left anterior descending artery as an in situ graft; the right ITA was not used as a graft; postoperative multidetector computed tomography evaluation of the coronary artery demonstrated patency of the left ITA.