A novel method for precise implantation of tracheal Y-shaped stent.

The tracheal Y-shaped stent is mainly used for the treatment of critical patients with airway stenosis or esophagotracheal fistula near carina. A novel method for precise implantation of Y-shaped tracheal stents was developed using double-lumen endotracheal intubation and flexible bronchoscopy. This approach aims to address the limitations associated with X-ray or rigid bronchoscopy guidance, such as operational difficulties and the risk of inaccurate stent placement leading to implantation failure or suffocation.

Dynamic Transcriptome Profiling Reveals LncRNA-Centred Regulatory Networks in the Modulation of Pluripotency.

Long noncoding RNAs (lncRNAs) have emerged as vital regulators of gene expression during embryonic stem cell (ESC) self-renewal and differentiation. Here, we systemically analyzed the differentially regulated lncRNAs during ESC-derived cardiomyocyte (CM) differentiation. We established a perspicuous profile of lncRNA expression at four critical developmental stages and found that the differentially expressed lncRNAs were grouped into six distinct clusters.

Factors associated with behavior modification for cardiovascular risk factors in patients with coronary artery disease in northern Taiwan.

Background: Studies have demonstrated that improvement in cardiovascular risk factors may contribute to reduced coronary artery disease (CAD) morbidity and mortality, improved patient outcomes, and lower medical costs associated with treating heart disease.

Purpose: The purpose of this study was to understand the coronary risk factor profile, to have the knowledge of risk factors, to understand the modifying behaviors, and to understand the factors associated with modifying behaviors of cardiovascular risk factors among patients with CAD in northern Taiwan.

Methods: A cross-sectional design was used in this study.

Combined use of endothelial function assessed by brachial ultrasound and high-sensitive C-reactive protein in predicting cardiovascular events.

Background: Endothelial function plays a key role in determining the clinical manifestations of atherosclerotic lesions. Elevated high-sensitive C-reactive protein (hsCRP) relates to long-term prognosis of cardiovascular disease.

Hypothesis: We test the hypothesis that combined use of endothelial function and hsCRP could increase predictive value of future cardiovascular events.

Decreased heparin cofactor II activity is associated with impaired endothelial function determined by brachial ultrasonography and predicts cardiovascular events.

Background: Heparin cofactor II (HCII) could inactivate thrombin after binding to dermatan sulfate at injured arterial walls, and has been shown to be a novel and independent antiatherosclerotic factor. However, the relation between plasma HCII activity and peripheral vascular endothelial function remains unclear.

Methods: A total of 199 patients (mean age, 63+/-14 years) were enrolled and followed up for a median period of 24 months.

Effects of fluvastatin, an HMG-CoA reductase inhibitor, on serum levels of interleukin-18 and matrix metalloproteinase-9 in patients with hypercholesterolemia.

Background: Interleukin-18 (IL-18), a novel proinflammatory marker, and matrix metalloproteinase-9 (MMP-9) represent the indices of plaque stability. It is unknown whether hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), which provide anti-inflammatory and endothelium protection effects, have the property of stabilizing plaque in patients with hypercholesterolemia.

Hypothesis: The study was designed to investigate the influence of statin therapy in circulating IL-18, MMP-9, and endothelial function.

Electrophysiological mechanisms and catheter ablation of complex atrial arrhythmias from crista terminalis:

Paroxysmal atrial fibrillation (PAF) can be initiated by ectopic activation from the crista terminalis. The crista terminalis conduction gap is also a critical isthmus in atrial reentrant arrhythmias like upper and lower loop reentry. The aim of this study was to investigate the mechanism and results of catheter ablation for complex atrial arrhythmias originating from the crista terminalis using the noncontact mapping system (NCM).

Effect of rosuvastatin on plasma levels of asymmetric dimethylarginine in patients with hypercholesterolemia.

Elevated plasma levels of asymmetric dimethylarginine (ADMA) have been associated with attenuated endothelium-dependent vasodilation in hypercholesterolemic patients. However, whether lowering of plasma cholesterol concentration by hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) can reduce plasma ADMA levels is still not clear. This study was a multicenter, randomized, double-blind, placebo-controlled design including 46 patients with elevated low-density lipoprotein cholesterol levels.

Predictors of early and late recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation.

Introduction: The outcome of patients with early recurrence of atrial fibrillation (AF) (within one month) after ablation procedure is controversial. Furthermore, the predictors of early and late (up to mean follow-up 30 months) recurrence of AF are not investigated in depth.

Aims Of The Study: The aim of the present study was to investigate the predictors of early and late recurrence of AF after catheter ablation of arrhythmogenic foci initiating AF in patients with paroxysmal AF.

Functional characterization of the crista terminalis in patients with atrial flutter: implications for radiofrequency ablation.

Objectives: The aim of the study was to investigate the conduction properties and anisotropy of the crista terminalis (CT) in patients with atrial flutter (AFL) using non-contact mapping.

Background: The CT is a posterior barrier during typical AFL. However, the CT has transverse conduction capabilities in patients with upper loop re-entry (ULR).

High-resolution mapping around the crista terminalis during typical atrial flutter: new insights into mechanisms.

Introduction: The aim of this study was to delineate activation patterns around the crista terminalis (CT) using high-resolution noncontact mapping.

Methods And Results: Twenty-six patients with typical atrial flutter (20 counterclockwise and 6 clockwise) were enrolled in the study. A noncontact mapping system was used to map atrial flutter.

Focal atrial tachycardia: new insight from noncontact mapping and catheter ablation.

Background: This study investigated the electrophysiologic characteristics, atrial activation pattern, and effects of radiofrequency (RF) catheter ablation guided by noncontact mapping system in patients with focal atrial tachycardia (AT).

Methods And Results: In 13 patients with 14 focal ATs, noncontact mapping system was used to map and guide ablation of AT. AT origins were in the crista terminalis (n=8), right atrial (RA) free wall (n=3), Koch triangle (n=1), anterior portion of RA-inferior vena cava junction (n=1), and superior portion of tricuspid annulus (n=1); breakout sites were in the crista terminalis (n=5), RA free wall (n=5), middle cavotricuspid isthmus (n=2), and RA-superior vena cava junction (n=2).

Spontaneous transition of 2:1 atrioventricular block to 1:1 atrioventricular conduction during atrioventricular nodal reentrant tachycardia: evidence supporting the intra-Hisian or infra-Hisian area as the site of block.

Introduction: The incidence of spontaneous transition of 2:1 AV block to 1:1 AV conduction during AV nodal reentrant tachycardia has not been well reported. Among previous studies, controversy also existed about the site of the 2:1 AV block during AV nodal reentrant tachycardia.

Methods And Results: In patients with 2:1 AV block during AV nodal reentrant tachycardia, the incidence of spontaneous transition of 2:1 AV block to 1:1 AV conduction and change of electrophysiologic properties during spontaneous transition were analyzed.

Conduction properties of the crista terminalis in patients with atrial flutter due to amiodarone therapy for atrial fibrillation.

Some patients with atrial fibrillation (AF) treated by antiarrhythmic drugs (AAD) can develop typical atrial flutter, but the mechanism is not clear. This study included 21 patients with AF. Group I (n = 7) had typical atrial flutter due to amiodarone therapy.

Use of fluoroscopic views for detecting Marshall's vein in patients with cardiac arrhythmias.

Introduction: Recently, several studies showed that focal atrial fibrillation (AF) can be initiated by ectopic beats from the vein of Marshall (VOM). However, the incidence and best fluoroscopic views of VOM have never been reported.

Methods And Results: 106 patients (Non-AF = 52, AF = 54) underwent balloon-occluded coronary sinus angiography using seven fluoroscopic views (PA, Lateral, RAO 30 degrees, RA 30 degrees + Caudal 20 degrees, LAO 30 degrees, LAO 60 degrees, LAO 60 degrees + Cranial 20 degrees ).

Plasma levels of asymmetrical dimethylarginine and adverse cardiovascular events after percutaneous coronary intervention.

Aims: We investigated the predictive value of plasma concentration of asymmetrical dimethylarginine (ADMA) on clinical outcome in patients undergoing percutaneous coronary intervention (PCI).

Methods And Results: One-hundred and fifty-three consecutive patients with stable angina and undergoing PCI were prospectively enrolled for clinical follow-up. Plasma ADMA levels were determined before procedure by high performance liquid chromatography.

Asymmetrical dimethylarginine: a novel risk factor for coronary artery disease.

Background: Asymmetrical dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase and has been associated with systemic atherosclerosis; however, the role of ADMA in patients with coronary artery disease (CAD) has not been investigated.

Hypothesis: The present study was designed to determine whether the plasma ADMA level predicts the presence of CAD independently, and whether the plasma ADMA level correlates with the extent and severity of coronary atherosclerosis.

Methods: In all, 97 consecutive patients with angina and positive exercise stress test were enrolled prospectively for coronary angiography.

Is the fascicle of left bundle branch involved in the reentrant circuit of verapamil-sensitive idiopathic left ventricular tachycardia?

The exact reentrant circuit of the verapamil-sensitive idiopathic left VT with a RBBB configuration remains unclear. Furthermore, if the fascicle of left bundle branch is involved in the reentrant circuit has not been well studied. Forty-nine patients with verapamil-sensitive idiopathic left VT underwent electrophysiological study and RF catheter ablation.

Volume status and blood pressure during long-term hemodialysis: role of ventricular stiffness.

The importance of volume status on blood pressure in hemodialysis patients has long been recognized. We hypothesized that the enhanced volume dependency of blood pressure is partly determined by ventricular stiffness at end systole. A total of 115 long-term hemodialysis patients were invited to receive a comprehensive, noninvasive cardiovascular examination.

Clinical outcome of very late recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation.

Introduction: High recurrence rate is still a major problem associated with ablation of paroxysmal atrial fibrillation (AF). Most of the recurrences occur within 6 months after ablation. The characteristics of very late recurrent AF (>12 months after ablation) have not been reported.

Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy.

Background: Most of the ectopic beats initiating paroxysmal atrial fibrillation (PAF) originate from the pulmonary vein (PV). However, only limited data are available on PAF originating from the non-PV areas.

Methods And Results: Two hundred forty patients with a total of 358 ectopic foci initiating PAF were included.

Novel concept of atrial tachyarrhythmias originating from the superior vena cava: insight from noncontact mapping.

Introduction: Information about the activation patterns inside the superior vena cava (SVC) and entry and exit sites at the SVC-right atrial (RA) junction during SVC tachyarrhythmia is limited.

Methods And Results: A detailed characterization of electrophysiologic mechanisms and ablation strategies was performed using a noncontact three-dimensional mapping system in two cases of SVC tachycardia. The first case demonstrated SVC tachycardia originating from an ectopic focus inside the SVC, with sustained depolarization and conduction to the atrium.