Ghrelin and its analogues, BIM-28131 and BIM-28125, improve body weight and regulate the expression of MuRF-1 and MAFbx in a rat heart failure model.

Unlabelled: Cardiac cachexia is a serious complication of chronic heart failure with a prevalence of 10-16% and poor prognosis. There are no current therapy options for cardiac cachexia. Ghrelin is the natural ligand for the GHS-1a-receptor and a potential target for conditions associated with cachexia.

Myocardial washout rate of technetium-99m-sestamibi in the chronic phase predicts myocardial damage in patients with previous myocardial infarction.

Objective: This study aimed to clarify the correlation between the myocardial washout rate (WR) of technetium-99m hexakis 2-methoxy-isobutyl-isonitrile ((99m)Tc-sestamibi) and cardiac enzyme levels in patients with acute myocardial infarction (AMI) 6 months after the onset.

Methods: Sixty-one consecutive AMI patients (mean age, 66.2 ± 9.

Global longitudinal strain by two-dimensional speckle tracking imaging predicts exercise capacity in patients with chronic heart failure.

Background: Left ventricular ejection fraction (LVEF) predicts mortality in patients with chronic heart failure (CHF). However, a weak correlation was found between LVEF and peak oxygen uptake ([Formula: see text]) in CHF patients. Global longitudinal strain measured by two-dimensional (2D) strain is regarded as a more useful predictor of cardiac events than LVEF.

The T wave inversion score is useful for evaluating the time-course of acute pulmonary embolism.

Background: The 12-lead electrocardiogram (ECG) has relatively poor specificity for identifying acute pulmonary embolism (APE). The aim of this study was to investigate ECG abnormalities according to 2 different criteria and their usefulness for assessing changes in APE.

Methods And Results: Fifty-two APE patients underwent ECG examinations in the acute and chronic phases.

Significance of 99mTc-sestamibi myocardial scintigraphy after percutaneous coronary intervention in patients with acute myocardial infarction.

Background: This study was designed to clarify the significance of washout rate (WR) determined from 99mTc-sestamibi myocardial scintigraphic images and the levels of cardiac enzymes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).

Material/methods: A total of 56 consecutive patients with AMI (mean age 65.8 ± 8.

Acute myocardial infarction in a young adult patient with simultaneous total occlusion of double coronary arteries.

We report an otherwise healthy 16-year-old male patient with simultaneous double vessel acute myocardial infarction. Coronary angiography (CAG) showed simultaneous total occlusion of the left anterior descending artery (LAD) and the left circumflex artery (LCX). Emergent percutaneous coronary intervention (PCI) was performed on the diseased lesions.

Changes in mitral regurgitation and left ventricular geometry during exercise affect exercise capacity in patients with systolic heart failure.

Aims: exercise may dramatically change the extent of functional mitral regurgitation (MR) and left ventricular (LV) geometry in patients with chronic heart failure (CHF). We hypothesized that dynamic changes in MR and LV geometry would affect exercise capacity.

Methods And Results: this study included 30 CHF patients with functional MR who underwent symptom-limited bicycle exercise stress echocardiography and cardiopulmonary exercise testing for quantitative assessment of MR (effective regurgitant orifice; ERO), and pulmonary artery systolic pressure (PASP).

Takotsubo cardiomyopathy.

Takotsubo cardiomyopathy was first reported in Japan in 1990. Recently, an increasing number of case reports and reviews of takotsubo cardiomyopathy has been published worldwide, including atypical cases with inverted takotsubo cardiomyopathy or incidental coronary artery disease. To date, there has been no guideline for worldwide consensus on takotsubo cardiomyopathy diagnostic criteria and treatment.

Mechanisms of stress (Takotsubo) cardiomyopathy.

Stress cardiomyopathy, also referred to as Takotsubo cardiomyopathy, transient apical ballooning or broken heart syndrome, is a disorder associated with transient left ventricular dysfunction. Symptoms include acute chest pain and dyspnea accompanied by electrocardiographic changes, such as ST-segment elevation and T-wave inversions, minimal elevation of cardiac enzyme levels and transient wall-motion abnormalities in the absence of substantial coronary artery obstruction. Complete recovery of contractile function has been documented in nearly all cases, but the mechanisms of disease remain unclear and the cause has not been established.

Recurrent takotsubo cardiomyopathy with variant forms of left ventricular dysfunction.

A 78-year-old man presented to our emergency department with dyspnea. The patient was diagnosed as having pneumonia from the chest X-ray which depicted mass-like opacity in the left lower lobe. On the 5th hospital day, electrocardiography showed giant negative T waves in pericardial leads and echocardiography demonstrated left ventricular apical akinesis and basal hyperkinesis.

Relationship between sleep apnea syndrome and sleep blood pressure in patients without hypertension.

Background And Purpose: Ambulatory blood pressure monitoring (ABPM) provides an accurate assessment of blood pressure (BP) and shows non-dipper BP pattern in many sleep apnea syndrome (SAS) patients with hypertension (HTN); however, little information is available on the relationship between the severity of SAS and circadian BP changes in SAS patients without HTN. This study investigated whether SAS patients without HTN would have different BP courses in the severity of SAS.

Methods And Subjects: Seventy-four consecutive outpatients without HTN [systolic BP (BPs) at clinic <140mmHg and/or diastolic BP (BPd) at clinic <90mmHg], who received no antihypertensives, underwent overnight polysomnography (PSG) and ABPM.

Takotsubo cardiomyopathy--the current state of knowledge.

Takotsubo cardiomyopathy is defined as acute chest pain during stressful incidents which is associated with ST-segment abnormalities and/or increased serum troponin levels. There is also regressive systolic dysfunction which is usually localized in the apical and medial left ventricles but there are no significant coronary artery lesions. The ventricular asynergy is also described in the right ventricle but is less common.

Hyperventilation and cold-pressor stress echocardiography combined with automated functional imaging non-invasively detected vasospastic angina.

A 47-year-old male presented with chest discomfort while sleeping. The patient was suspected of having vasospastic angina (VSA) and underwent hyperventilation and cold-pressor stress echocardiography. No chest pain, ECG changes or decreased wall motion was found.

Successful surgical removal of long-term implantable cardioverter defibrillator lead infection caused by methicillin-resistant in patients with dilated cardiomyopathy.

The patient was a 67-year-old male who received implantable cardioverter defibrillator (ICD) due to dilated cardiomyopathy and ventricular tachycardia 10 years previously. In September 2007, he was admitted to our hospital for dilated cardiomyopathy accompanied by congestive heart failure. Since he suffered from pneumonia and respiratory insufficiency, he was treated with steroid, long-term artificial respirator, and central venous catheter placement.

Cystatin C: a better marker to detect coronary artery sclerosis.

Background: Nowadays, early detection and treatment can often keep chronic kidney disease patients from getting worse and prevent the occurrence of cardiovascular disease. Cystatin C (Cys-C) is a new marker for renal dysfunction. This study investigated whether Cys-C played an important role for screening coronary artery disease.

Three-dimensional echocardiographic assessments of exercise-induced changes in left ventricular shape and dyssynchrony in patients with dynamic functional mitral regurgitation.

Aims: Left ventricular (LV) shape and LV dyssynchrony are two cofactors associated with functional mitral regurgitation (MR) in patients with heart failure. Both can be accurately examined by real-time three-dimensional echocardiography (3DE). We examined the relationship between dynamic MR and exercise-induced changes in LV shape and synchronicity using 3DE.

Stress cardiomyopathy.

Recently, an increasing number of cases of stress cardiomyopathy, mainly occurring in elderly women, have been documented in many parts of the world. In Japan, this disease is known as takotsubo cardiomyopathy (named after the fishing pot used for trapping octopus). Symptoms of this condition are akin to those of acute myocardial infarction, but no obstructive lesions are found in the coronary arteries, and left ventricular apical ballooning is present.

Heart-rate response to sympathetic nervous stimulation, exercise, and magnesium concentration in various sleep conditions.

The aim of this study was to clarify the mechanism of impaired exercise tolerance in chronic sleep-restricted conditions by investigating variables related to heart-rate (HR) response to sympathetic nervous stimulation. Sixteen healthy men (mean age 21.5 years) were tested in a control state, acute sleep-loss state, and chronic sleep-restricted state.

Peak time of acute coronary syndrome in patients with sleep disordered breathing.

Background: Recently, sleep disordered breathing (SDB) has gained attention in the field of cardiology. Until now, no study describing the relationship between acute coronary syndrome (ACS) and SDB has been carried out in Japan.

Methods: Among ACS patients admitted to our hospital, 44 patients (mean age 60.

123I-BMIPP delayed scintigraphic imaging in patients with chronic heart failure.

Objective: The objective of the present study was to clarify the ability of 123I-beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) to evaluate the heart-to-mediastinum (H/M) ratio and myocardial global washout rate (WR) in patients with chronic heart failure (CHF).

Methods: The severity of CHF was evaluated on the basis of the New York Heart Association (NYHA) classification. Twenty patients with CHF (13 with idiopathic dilated cardiomyopathy and 7 with ischemic cardiomyopathy) and 11 age-matched controls underwent myocardial radionuclide imaging.

Relationship between sleep-disordered breathing level and acute onset time of congestive heart failure.

Sleep-disordered breathing (SDB) is frequently observed in patients with congestive heart failure. Recent studies have shown that SDB negatively affects the onset of congestive heart failure; however, no studies have addressed the relationship between the level of SDB and the onset time of acute dyspnea. We hypothesized that SDB affects the acute onset time of dyspnea (AOT) and investigated the relationship between SDB and AOT.

No effects of human ghrelin on cardiac function despite profound effects on body composition in a rat model of heart failure.

Background: Ghrelin, was observed to have treatment-potential for severe chronic heart failure (CHF) and cardiac cachexia based on anti-cachectic and cardio-protective effects.

Methods: We performed two studies to assess the effects of human ghrelin on food intake, body weight and body composition, as well as heart function in a rat model of CHF. Study-1 (50 or 500 nmole/kg/d ghrelin by pump infusion) was focused on food intake and body composition, study-2 (50 or 100 nmole/kg/d ghrelin by subcutaneous injection (3-times daily) was focused on heart function due to a lack of cardiac effects observed in study-1.

The exercise training effects of skeletal muscle strength and muscle volume to improve functional capacity in patients with myocardial infarction.

Background: No previous studies have fully investigated the exercise training effect on the skeletal muscle strength and volume to improve the exercise capacity in patients with myocardial infarction (MI). The present study was performed based on a hypothesis that the relationship between exercise capacity, skeletal muscle strength and volume might be changed by the amount of skeletal muscle volume in MI patients up to 3 months after the onset.

Methods: Seventy patients with MI underwent symptom-limited cardiopulmonary exercise testing using a treadmill.