702 results match your criteria: "Tsuchiura Kyodo General Hospital[Affiliation]"

Background: Coronary artery calcium score (CACS) is widely used for risk stratification. However, in patients with established coronary artery disease, its clinical implication and relationship with plaque vulnerability are unclear. We sought to correlate the CACS and plaque vulnerability assessed by optical coherence tomography.

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Background: Accurate discrimination of functionally significant coronary stenosis using intravascular imaging remains uncertain, particularly with regard to vessel size. This meta-analysis evaluates the diagnostic performance of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) for identifying functionally significant coronary stenosis as confirmed by fractional flow reserve (FFR).

Methods: A systematic search of PubMed, Scopus and Google Scholar identified studies that assessed the diagnostic accuracy of IVUS and OCT by minimal luminal area (MLA) with FFR as the reference standard.

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Background: Epicardial stenosis and coronary microvascular dysfunction (CMD) may coexist in patients with chronic coronary syndrome (CCS). Microvascular resistance reserve (MRR) has been demonstrated to be a valid cross-modality metric using continuous saline infusion thermodilution and intracoronary Doppler flow velocity methods. This study aimed to investigate the prevalence and diagnostic concordance of CMD defined by MRR using two methods-stress transthoracic Doppler echocardiography (S-TDE) and the invasive bolus thermodilution method (B-Thermo)-in patients with functionally significant epicardial stenosis.

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The introduction of wire-free microcirculatory resistance index from functional angiography (angio-IMR) promises swift detection of coronary microvascular dysfunction, however it has not been properly validated. We sought to validate angio-IMR against invasive IMR and PET derived microvascular resistance (MVR). Moreover, we studied if angio-IMR could aid in the detection of ischemia with non-obstructive coronary arteries (INOCA).

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Article Synopsis
  • - The study investigated how changes in echo intensity (EI) of the soleus muscle are related to changes in its stiffness (Young's modulus) after ankle fracture surgery in 16 participants, averaging 46.8 years old.
  • - Measurements were taken at three and five months post-surgery, including ankle range of motion, strength, and muscle properties assessed through advanced imaging techniques.
  • - Results showed a significant correlation between changes in EI and both Young's modulus and ankle dorsiflexion range of motion, suggesting that EI may be a useful indicator of muscle stiffness recovery post-surgery.
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Background: Global coronary flow reserve (G-CFR) impairment represents coronary microvascular dysfunction (CMD) and correlates with poor prognosis. Hyperemic coronary flow is reduced in conventional CMD, but normal or mildly reduced with elevated resting flow in endogenous-type CMD (E-CMD). This retrospective study assessed the prognostic value of post-percutaneous coronary intervention (PCI) CMD, focusing on E-CMD.

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Background: Endovascular treatment has become the preferred approach for managing unruptured cerebral aneurysms, with simple and balloon-assisted coil embolization as the standard first-line therapy. However, recanalization after coil embolization remains a major clinical concern. This study aimed to evaluate the predictive factors for recanalization using time-of-flight magnetic resonance (TOF-MR) angiography.

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Background: The latest guidelines on hypersensitivity pneumonitis (HP) categorise the disease as either fibrotic or non-fibrotic because of the greater clinical utility of this stratification. However, the prevalence and incidence of fibrotic and non-fibrotic HP are unknown. This study assessed the exact prevalence and incidence of fibrotic and non-fibrotic HP in Japan in 2021.

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Coronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE). Overall, 148 stable patients underwent STDE of the left anterior descending arteries (LAD), before and after elective PCI.

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Aims: The relationship between coronary artery atherosclerosis and microvascular resistance remains unclear. This study aims to clarify the relationship between total atherosclerotic and vessel-specific atherosclerotic burden and microvascular resistance reserve (MRR).

Methods And Results: In this post-hoc analysis of the PACIFIC 1 trial, symptomatic patients without prior coronary artery disease (CAD) underwent [15O]H2O positron emission tomography, coronary computed tomography angiography (CCTA) and invasive fractional flow reserve (FFR).

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Association of coronary inflammation with plaque vulnerability and fractional flow reserve in coronary artery disease.

J Cardiovasc Comput Tomogr

November 2024

Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea; Institute on Aging, Seoul National University, Seoul, South Korea. Electronic address:

Background: The fat attenuation index (FAI) measured using coronary computed tomography angiography (CCTA) enables the direct evaluation of pericoronary adipose tissue composition and vascular inflammation. We aimed to investigate the association of fractional flow reserve (FFR) and plaque vulnerability with coronary inflammation.

Methods: Patients with suspected coronary artery disease (CAD) who underwent CCTA and invasive FFR measurements within 90-day were included.

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Article Synopsis
  • The study aimed to understand how taking anticoagulants before a traumatic brain injury (TBI) affects blood clotting indicators in the first 24 hours after the injury, hypothesizing that these medications would alter coagulation metrics.
  • Researchers analyzed data from 545 TBI patients aged 65 and older, examining the relationship between preinjury anticoagulation and various coagulation factors like D-dimer and PT-INR over five time periods post-injury.
  • Findings indicated that patients on anticoagulation had worse initial TBI assessments and outcomes yet showed lower D-dimer levels, suggesting that traditional measures of clotting may not accurately reflect the severity of injuries in these patients.
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  • Bow hunter's stroke (BHS) occurs when the vertebral artery gets compressed during head rotation, leading to temporary neurological issues and a risk of stroke.
  • A case study of a 25-year-old woman who developed multiple cerebral infarctions after sleeping with her head rotated showed that her vertebral artery was affected by this position.
  • The treatment involved a surgical procedure to stabilize the cervical vertebrae, which successfully prevented further incidents, highlighting the importance of considering sleep position in similar cases.
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Paroxysmal sympathetic hyperactivity caused by neurosyphilis.

BMJ Neurol Open

October 2024

Department of Neurology, Tsuchiura Kyodo General Hospital, Tsuchiura-shi, Ibaraki, Japan.

Article Synopsis
  • Paroxysmal sympathetic hyperactivity (PSH) is a condition linked to autonomic nervous system dysfunction, often seen in severe brain injuries, but non-traumatic causes like infections can also trigger it.
  • A case study discusses a 30-year-old man diagnosed with neurosyphilis who experienced abnormal symptoms like seizures and agitation, leading to a PSH diagnosis after ruling out other conditions.
  • Treatment with propranolol, gabapentin, and clonidine successfully managed his PSH symptoms, highlighting the importance of recognizing and addressing PSH early in cases of central nervous system infections.
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Objective: Although shear-wave elastography (SWE) can be used to assess muscle stiffness, SWE assessments are expensive. Echo intensity (EI) is an indicator of muscle quality and can potentially be used to assess muscle stiffness. This study aimed to determine the relationship between the EI and Young's modulus of the soleus (SOL) muscle after ankle fracture surgery.

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  • Extracorporeal membrane oxygenation (ECMO) offers temporary support for patients with severe trauma, and this study examines the outcomes of patients treated with veno-arterial ECMO (V-A ECMO) in Japan between 2019 and 2021.
  • Out of 72,439 severe trauma patients, only 51 received V-A ECMO, with a discharge survival rate of 31.3%.
  • The findings suggest that V-A ECMO may be beneficial in severe trauma cases, particularly where traditional interventions aren't effective, but further research is needed to clarify its indications.
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Background: Impaired global coronary flow reserve (G-CFR), evaluated through phase-contrast cine cardiovascular magnetic resonance (PC-CMR), has been linked to worse outcomes in patients with cardiovascular disease. This study aimed to investigate the prognostic value of G-CFR improvement, as evaluated using PC-CMR imaging pre- and post-percutaneous coronary intervention (PCI).

Methods: In this single-center study, 320 patients with chronic coronary syndrome (CCS) who underwent pre- and post-PCI PC-CMR measurements were followed up to determine major adverse cardiac or cerebrovascular events (MACCE) predictors.

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  • Thromboembolism is a critical concern in patients undergoing endovascular treatment for ruptured cerebral aneurysms, and administering antiplatelet agents like aspirin before the procedure may lower this risk.
  • The study, called ASTOP, is a multicenter, randomized, double-blind trial involving 484 patients, comparing the effects of 200 mg of aspirin versus a placebo prior to treatment.
  • Primary outcomes will focus on measuring thromboembolic complications and ischemic lesions during the procedure, while secondary outcomes will assess cerebral ischemic events, bleeding incidents, and patient functional status after 90 days.
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  • This study investigated the differences in total plaque burden between patients experiencing plaque rupture versus plaque erosion during acute coronary syndromes, employing coronary computed tomography angiography (CTA) and optical coherence tomography for analysis.
  • A total of 232 patients were examined, revealing that those with plaque rupture showed significantly greater total plaque, non-calcified plaque, low-density non-calcified plaque, and calcified plaque burdens compared to those with plaque erosion.
  • The findings suggest that plaque rupture is associated with more severe coronary artery disease, indicating a potential need for varied clinical management strategies for patients based on the type of plaque pathology present.
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Background: Polymyxin-B direct hemoperfusion (PMX-DHP) is an endotoxin adsorption column-based blood purification therapy. Since one of the most potent effects of PMX-DHP is blood pressure elevations, it may be the most effective when it is introduced at the time when the need for vasopressors is the greatest, which, in turn, may reduce mortality.

Methods: A multicenter retrospective study was conducted at 24 ICUs in Japan.

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Relationship between plaque burden and plaque vulnerability: Acute coronary syndromes versus chronic coronary syndrome.

J Cardiovasc Comput Tomogr

November 2024

Gill Gray Research Laboratory, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Background: The relationship between plaque burden and microscopic characterization of plaque features as it pertains to clinical presentation has not been fully investigated. The aim of this study was to compare the relationship between plaque burden and plaque vulnerability in patients with acute coronary syndromes (ACS) versus chronic coronary syndrome (CCS).

Methods: Patients who underwent both coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) before coronary intervention were enrolled.

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