Elongation of the high right atrium to coronary sinus conduction time predicts the recurrence of atrial fibrillation after radiofrequency catheter ablation.

Background: The impact of intra-atrial conduction delay on the recurrence of atrial tachyarrhythmia after radio frequency catheter ablation (RFCA) has not been fully elucidated.

Methods: We retrospectively analyzed 155 AF patients who were sinus rhythm at the start of RFCA. The conduction time from the onset of the earliest atrial electrogram at the high right atrium (HRA) to the end of the latest electrogram at the coronary sinus (CS) during sinus rhythm was defined as HRA-CS conduction time.

Prognostic Implication of Three-Dimensional Mitral Valve Tenting Geometry in Dilated Cardiomyopathy.

Background And Aim Of The Study: Functional mitral regurgitation (FMR) is a clinically important complication of left ventricular (LV) dysfunction, occurring as a result of geometric deformity in the mitral valve (MV) complex. The study aim was to determine whether tenting parameters derived from real-time three-dimensional echocardiography (RT3DE) can predict the long-term prognosis for patients with dilated cardiomyopathy (DCM).

Methods: Mitral valve tenting morphology, LV volume and function, and papillary muscle positions were monitored using transthoracic RT3DE in 75 subjects (66 with DCM, nine controls).

Accuracy and usefulness of noninvasive fractional flow reserve from computed tomographic coronary angiography: comparison with myocardial perfusion imaging, echocardiographic coronary flow reserve, and invasive fractional flow reserve.

We present a case of coronary artery disease with intermediate stenosis in the proximal left anterior descending artery, which was evaluated using multiple functional modalities. FFR demonstrated a significant perfusion abnormality in the LAD, and the value of FFR (0.68) was similar to the value measured by invasive FFR (0.

Clinical features and prognosis of patients with coronary spasm-induced non-ST-segment elevation acute coronary syndrome.

Background: The prevalence, clinical features, and long-term outcome of patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) associated with coronary spasm are not fully investigated.

Methods And Results: This observational multicenter study enrolled 1601 consecutive patients with suspected NSTE-ACS who underwent cardiac catheterization between January 2001 and December 2010. A culprit lesion was found in 1152 (72%) patients.

Clinical manifestation of early phase left ventricular rupture complicating acute myocardial infarction in the primary PCI era.

Objective: Before reperfusion therapy was introduced, the incidence of ventricular septal and left ventricular free wall rupture complicating acute myocardial infarction (AMI) was 1-3%. Primary percutaneous coronary intervention (PCI) was expected to reduce the incidence of such mechanical complications.

Methods: We retrospectively analysed 1290 AMI patients referred to our institute from January 2005 to January 2011.

Inadvertent coronary endarterectomy during aspiration thrombectomy with a Thrombuster III GR catheter in a patient with acute coronary syndrome.

We describe a 41-year-old woman who presented with acute ST-segment elevation myocardial infarction. Emergent percutaneous intervention was performed with aspiration thrombectomy followed by coronary artery stenting. White material was extracted from the aspiration catheter.

Sarcoidosis manifesting as cardiac sarcoidosis and massive splenomegaly.

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. We report an unusual case of sarcoidosis in a woman presenting with cardiac sarcoidosis and massive splenomegaly with a familial history of cardiac sarcoidosis. Cardiac sarcoidosis was diagnosed based on electrocardiogram, echocardiogram, 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG-PET) and skin histological findings.

Clinical features and outcomes of eosinophilic myocarditis patients treated with prednisolone at a single institution over a 27-year period.

Background: Eosinophilic myocarditis is a rare clinical entity characterized by eosinophilia and myocardial inflammation with infiltrating eosinophils. The prognosis of patients with eosinophilic myocarditis is difficult to determine due the disease's rarity and varied causes; consequently, standard treatment has not been established.

Objective: To elucidate the clinical characteristics and treatment outcome of eosinophilic myocarditis, we retrospectively studied 7 patients fulfilling the criteria of the Japanese Circulation Society for eosinophilic myocarditis from among 64 patients admitted to our institution with eosinophilia over a 27-year period.

Multidetector computed tomography evaluation of coronary plaque morphology in patients with stable angina.

The purpose of this study was to evaluate the morphology and composition of atherosclerotic coronary plaques in patients with stable coronary artery disease by 64-row multidetector computed tomography (CT) angiography. A total of 56 patients were divided into an ischemia-related (n = 31) and a nonischemia-related lesion group (n = 25) based on myocardial perfusion scintigraphy, invasive angiography, and 1-year clinical follow-up. The 56 lesions detected by CT imaging were analyzed; the severity of stenosis, the lesion length, CT attenuation value, and calcium deposition of the plaques were evaluated.

An autopsy case of the rupture of a giant aneurysm in a saphenous vein graft: 18 years after CABG.

The saphenous vein is a widely used blood vessel for arterial bypass procedures. Failures of saphenous vein aortocoronary bypass grafts are predominantly the result of subsequent vein graft atherosclerotic disease. Rarely saphenous vein grafts undergo aneurysmal degeneration.

High ratio of myeloid dendritic cells to plasmacytoid dendritic cells in blood of patients with acute coronary syndrome.

Background: Dendritic cells (DCs) stimulate T-cells to participate in the inflammatory processes that promote the destruction of vulnerable plaques. The relationship between circulating levels of myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) in patients with acute coronary syndrome (ACS) was evaluated.

Methods And Results: Blood samples were obtained from 39 patients with ACS, 41 patients with stable angina pectoris (SAP) and 43 controls.

Expression levels of Toll-like receptor genes in coronary atherosclerotic lesions of patients with acute coronary syndrome or stable angina pectoris.

Background: The differences between acute coronary syndrome (ACS) and stable angina pectoris (SAP) in Toll-like receptor (TLR) expression levels in coronary plaques are not well known. TLR gene expression levels were examined, not only in peripheral blood mononuclear cells (PBMCs), but also in coronary plaques in ACS and SAP patients.

Methods And Results: TLR gene expression levels were examined in PBMCs using real-time RT-PCR in 27 ACS patients, 45 SAP patients and 28 control subjects.

Significant association between score of periodontal disease and coronary artery disease.

Recently, several researchers have demonstrated the association between periodontal disease and coronary artery disease (CAD). Therefore, we herein investigate the association between periodontal diseases and the existence of CAD among the study population who received both coronary angiography and dental examination. A total of 174 consecutive patients with dental examination including radiography and coronary angiography in the same hospitalization were recruited (64.

Periodontal status and Prevotella intermedia antibody in acute coronary syndrome.

We performed periodontal examination and measured serum antibody levels against Prevotella intermedia in patients with acute coronary syndrome (ACS). Composite periodontal risk scores were significantly higher in the ACS group than in the coronary artery disease (CAD) group. Serum antibody levels were higher in the ACS group than in the CAD group and those were significantly correlated with the composite periodontal risk scores.

Hypereosinophilic syndrome associated with occlusive coronary thrombosis and right ventricular thrombus.

A 44-year-old man with HES who developed a large thrombus in the right ventricle as well as multiple occlusive coronary thrombi died of cardiac failure. Autopsy showed that a large thrombus in the right ventricle was associated with eosinophilic endocarditis. In addition, an occlusive thrombus formed in the circumflex and right coronary arteries with eosinophilic infiltrate in the walls.

Osteopontin expression of circulating T cells and plasma osteopontin levels are increased in relation to severity of heart failure.

Background: T cells in peripheral blood reflect the systemic inflammatory response in patients with heart failure (HF). In a rat model of HF, osteopontin is dramatically increased in the left ventricular myocardium, so the association between osteopontin and HF was examined in the present study.

Methods And Results: Peripheral blood was collected from 93 patients with heart disease and 38 controls.

Relation between CD4+ T-cell activation and severity of chronic heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.

The percentage of CD4(+) T cells in blood is correlated with left ventricular dysfunction and decreased ejection fraction in heart disease. The aim of this study was to determine the relation between activation of CD4(+) T cells and New York Heart Association functional classes in chronic heart failure (HF) and differences in inflammatory activation between ischemic cardiomyopathy (IC) and idiopathic dilated cardiomyopathy (IDC). Blood samples were obtained from 47 patients with HF and 20 controls.

Expression of interferon-gamma and interleukin-4 production in CD4+ T cells in patients with chronic heart failure.

The prevalence of inflammation is high among patients with chronic heart failure (CHF). Reduced ejection fraction was associated with frequency of CD4(+) T cells of leukocytes. Therefore, we investigated inflammatory cytokines of expression markers in CD4(+) T cells in patients with CHF.

Transition from purkinje fiber-related rapid polymorphic ventricular tachycardia to sustained monomorphic ventricular tachycardia in a patient with a structurally normal heart: a case report.

We describe a 17-year-old woman with a structurally normal heart in which short-sustained rapid polymorphic ventricular tachycardias (VTs) were repetitively provoked by an antiarrhythmic agent, pilsicainide, and spontaneously changed into a sustained monomorphic VT. The latter was terminated by verapamil and was shown to be due to reentry by entrainment. Those two VTs originated from the Purkinje fibers in the left ventricular septum.

Elevated plasma osteopontin levels were associated with osteopontin expression of CD4+ T cells in patients with unstable angina.

Background: Plaque instability in patients with unstable angina (UA) is associated with stimulated CD4+ T cells, so the present study investigated whether there is a relationship among plaque instability, osteopontin and CD4+ T cells.

Methods And Results: Peripheral blood mononuclear cells were collected from 51 consecutive patients with UA, 60 patients with stable angina (SA), and 39 patients with chest pain syndrome (CPS). Osteopontin-producing CD4+ T cells were quantified by flow cytometry.

Acute myocardial infarction induced by cisplatin-based combination chemotherapy for malignant melanoma: a case report.

A 61-year-old woman with stage IV malignant melanoma suffered acute myocardial infarction during the third course of chemotherapy with cisplatin, dacarbazine, nimustine hydrochloride and tamoxifen citrate, despite no serious problem occurring during the first and second courses of chemotherapy. Since this patient, excluding menopause, had no significant risk factor for coronary heart disease before the start of chemotherapy, the infarction was likely to be attributable to the chemotherapy regimen. Chemotherapy should be used cautiously in patients with coronary risk factors before treatment is begun.

A case of reversible posterior leukoencephalopathy syndrome caused by transient hypercoagulable state induced by infection.

We report a normotensive case of reversible posterior leukoencephalopathy syndrome caused by transient hypercoagulable state. Hypertension is the main risk factor for reversible posterior leukoencephalopathy syndrome, which is believed to occur as a result of high blood pressure-related dysfunction of cerebrovascular endothelial cells, because it commonly appears in hypertensive emergency. However, in this completely normotensive case, the typical clinical findings of reversible posterior leukoencephalopathy syndrome were triggered by transient hypercoagulable state without any blood pressure variation.

Platypnea - orthodeoxia syndrome with atrial septal defect.

A 75-year old man was referred to hospital for symptomatic hypoxemia. He did not complain of dyspnea while supine, but while sitting or standing, he experienced dyspnea with severe hypoxemia. He did not have any pulmonary diseases that could cause dyspnea.