著者

Sha Tang Hua Li Lei Song Yucheng Zhou

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.64, no.2, pp.203-212, 2023-03-31 (Released:2023-03-31)

参考文献数

34

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This study aimed to evaluate the changes in the left ventricular (LV) myocardial work (MW) in breast cancer patients following chemotherapy by left ventricular pressure-strain loop (LVPSL).A total of 50 patients with newly breast cancer undergoing postoperative adjuvant chemotherapy containing anthracycline were selected. Echocardiography was performed before the treatment (T0), the second (T2) and fourth (T4) cycles of chemotherapy, and 3 (P3 m) and 6 (P6 m) months after the end of chemotherapy. The standard dynamic images of the required sections were collected. After off-line analysis, the routine, global myocardial strain, and global MW parameters were obtained, and the average regional MW index (RMWI) and regional MW efficiency (RMWE) at three levels of LV were calculated.Compared with those at T0 and T2, the global work index (GWI), global constructive work (GCW), global work efficiency (GWE), and global longitudinal strain (GLS) gradually decreased and global wasted work (GWW) gradually increased at T4, P0, and P6 m. The mean RMWI and RMWE of the three levels of LV exhibited a gradually decreasing trend at T4, P0, and P6 m compared with those at T0 and T2. The GWI, GCW, GWE, mean RMWI, and RMWE (basal, medial, and apical) were negatively correlated with the GLS (r = −0.76, −0.66, −0.67, −0.76, −0.77, −0.66, −0.67, −0.59, and −0.61, respectively), whereas the GWW was positively correlated with the GLS (r = 0.55).The mean RMWI and RMWE are effective parameters to reflect the cardiotoxicity of LV, and LVPSL has certain value in the evaluation of the left ventricular myocardial work (LVMW) during anthracycline treatment and follow-up in breast cancer patients.

著者

Yoshiaki Kaneko Tadashi Nakajima Tadanobu Irie Fumio Suzuki Masaki Ota Takafumi Iijima Mio Tamura Takashi Iizuka Shuntaro Tamura Akihiro Saito Masahiko Kurabayashi

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.55, no.1, pp.84-86, 2014 (Released:2014-02-07)

参考文献数

23

被引用文献数

7 9

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An 81-year-old man with long RP narrow QRS tachycardia underwent catheter ablation. Ventricular pacing reset the atrial cycle over a retrograde slow pathway, followed by termination of the tachycardia without atrial capture, confirming the diagnosis of fast-slow atrioventricular nodal reentrant tachycardia (AVNRT). The earliest atrial activation during tachycardia was found in the noncoronary sinus of Valsalva, where the first delivery of radiofrequency energy terminated and eliminated the inducibility of the tachycardia, by retrograde conduction block over the slow pathway. This is the first report of a fast-slow AVNRT, with successful ablation of the slow pathway from a noncoronary sinus of Valsalva.

著者

Kohei Nozaki Nobuaki Hamazaki Yuki Ikeda Manami Nihei Shuken Kobayashi Kentaro Kamiya Emi Maekawa Atsuhiko Matsunaga Minako Yamaoka-Tojo Junya Ako

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.62, no.3, pp.695-699, 2021-05-29 (Released:2021-05-29)

参考文献数

14

被引用文献数

1

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The Impella 5.0 is a catheter-mounted left ventricular assist device that is inserted through the patient's subclavian artery. This device allows patient mobilization. Early mobility improves outcomes, including physical function and exercise tolerance, in critically ill patients and those with heart failure (HF). However, there have been no studies regarding the safety of early mobilization during the period of Impella 5.0 insertion based on hemodynamic assessment.A 39-year-old man with idiopathic dilated cardiomyopathy and cardiogenic shock was transferred to our hospital for Impella 5.0 insertion. We started neuromuscular electrical stimulation (NMES) and mobilization eight days after Impella 5.0 insertion. The safety of NMES and mobilization was assessed based on mean blood pressure, heart rate (HR), and mean pulmonary artery pressure measurements as hemodynamic indicators. Muscle strength was also assessed using the Medical Research Council (MRC) scale. Throughout the interventions, only the HR increased slightly during mobilization, and there were no hemodynamic abnormalities. Also, the MRC scale score improved as mobilization progressed. The results presented here suggest that NMES and mobilization are safe and feasible in patients with Impella 5.0 insertion, and therefore should be widely adopted.

著者

Hiroyuki Kamada Kazuki Mori Nobuhiko Ueda Akinori Wakamiya Kenzaburo Nakajima Tsukasa Kamakura Mitsuru Wada Kohei Ishibashi Kenichiro Yamagata Yuko Inoue Koji Miyamoto Satoshi Nagase Takashi Noda Chisato Izumi Teruo Noguchi Kengo Kusano Takeshi Aiba

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.5, pp.828-836, 2022-09-30 (Released:2022-09-30)

参考文献数

29

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The efficacy of direct current (DC) cardioversion before catheter ablation (CA) for persistent atrial fibrillation (PerAF) patients remains controversial. We hypothesized that maintenance of sinus rhythm (SR) by pre-ablation DC cardioversion may predict the outcome of CA in patients with PerAF. A total of 383 PerAF patients with no or mild symptoms (EHRA I/II) who had undergone DC cardioversion before CA (301 males, 65 ± 10 years old, mean atrial fibrillation (AF) duration: 25 ± 47 months) were retrospectively enrolled. Whether or not SR was maintained at least 24 hour after DC cardioversion, patients were divided into two groups, namely, the DC-SR group and DC-AF group, and then all were followed until AF recurrence after CA. After DC cardioversion, 281 (73%) patients were categorized into the DC-SR group, and 102 (27%) were categorized into the DC-AF group. A total of 195 patients underwent CA at an average of 83 (54-145) days after DC cardioversion, including 161 (83%) in the DC-SR group and 34 (17%) in the DC-AF group. During follow-up (median: 15 [10-25] months), the number of patients who were free from AF was significantly higher in the DC-SR group compared with the DC-AF group (61.5% versus 38.3%, P < 0.0001). Multivariate analysis revealed that the DC-SR group (hazard ratio [HR]: 0.45, 95% confidence interval [CI]: 0.21-0.99, P = 0.047) and age at first AF diagnosis (HR: 0.95, 95% CI: 0.91-1.00, P = 0.039) were the independent predictors for being AF-free after CA. In conclusion, the 24-hour rhythm outcome of pre-ablation DC cardioversion and age at first AF diagnosis may predict the recurrence of AF after CA in patients with PerAF.

著者

Nicolas Girerd Matthieu Aubry Pierre Lantelme Olivier Huttin Patrick Rossignol

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.62, no.1, pp.193-196, 2021-01-30 (Released:2021-01-30)

参考文献数

9

被引用文献数

3 3

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Intravenous mineralocorticoid receptor antagonists (MRAs) have been used in some centers for decades to reduce the risk of hypokalemia and boost diuresis in acutely decompensated heart failure (ADHF). We report the well-tolerated use of intravenous MRAs as a rescue procedure in 3 patients admitted for ADHF with important diuretic resistance. Undertaking trials evaluating the effect of this therapeutic strategy in ADHF could represent a promising avenue.

著者

Jingying Liu Wenjie Dong Chunmei Gao Ye Meng

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.6, pp.1176-1186, 2022-11-30 (Released:2022-11-30)

参考文献数

31

被引用文献数

5

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Circular RNAs (circRNAs) are a class of powerful regulators of gene expression. This study aimed to determine whether circTRRAP (hsa_circ_0081241) was implicated in the cardioprotective effects of salvianolic acid B (Sal B) against myocardial ischemia/reperfusion (I/R) injury and its associated mechanism.Cell viability was analyzed using Cell Counting Kit-8 (CCK-8), and flow cytometry was conducted to evaluate cell cycle progression and cell apoptosis. The leakage of lactic dehydrogenase (LDH), production of malondialdehyde (MDA), and activity of superoxide dismutase (SOD) were measured using their corresponding commercial kits to analyze cell death and oxidative stress.I/R treatment suppressed viability and cell cycle progression and induced the apoptosis and oxidative stress of AC16 cardiomyocytes, whereas Sal B protected AC16 cardiomyocytes against I/R injury. I/R upregulated circTRRAP expression, whereas Sal B dose-dependently reduced the circTRRAP level in AC16 cardiomyocytes. The protective effects of Sal B in I/R-induced AC16 cardiomyocytes were overturned by the overexpression of circTRRAP. CircTRRAP negatively regulated miR-214-3p expression by binding to it in AC16 cardiomyocytes. The circTRRAP overexpression-mediated effects were reversed by the addition of miR-214-3p mimics in AC16 cardiomyocytes. MiR-214-3p targeted the 3'-untranslated region (3'UTR) of SOX6, and SOX6 was regulated by the circTRRAP/miR-214-3p axis in AC16 cardiomyocytes. SOX6 knockdown overturned the circTRRAP overexpression-induced effects in AC16 cardiomyocytes.In conclusion, the silence of circTRRAP was implicated in Sal B-mediated cardioprotective effects against I/R injury by regulating the miR-214-3p/SOX6 axis.

著者

Taiki Nishikawa Shinya Shimizu Haruo Kamiya Jun Ueyama Sumio Yamada

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.6, pp.1107-1114, 2022-11-30 (Released:2022-11-30)

参考文献数

35

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Oxidative stress plays a crucial role in the progression of heart failure (HF). We surveyed the fraction of human mercaptalbumin [f (HMA) ], an indicator of the redox state of human serum albumin (HSA), in patients with HF and examined whether f (HMA) is associated with the severity of HF.We enrolled consecutive elderly patients hospitalized for acute HF or exacerbation of HF. The redox state of HSA was measured by the high-performance liquid chromatography with postcolumn bromocresol green method using serum samples collected close to discharge. First, the distribution of f (HMA) in HF was compared to that in community-dwelling elderly individuals (n = 125; median age, 80 years) as a control group analyzed in a previous study. Overall, 133 patients (median age, 81 years; 75 men) were included. Patients with HF showed a lower level of f (HMA) than those of the control group (55.0% [IQR 47.7-61.3] versus 66.3% [IQR 62.8-70.0], P < 0.001]. Multiple regression analysis showed a negative correlation between f (HMA) and log-transformed B-type natriuretic peptide (standardized beta = −0.19).Patients with HF showed lower f (HMA) than those in the control group. Additionally, f (HMA) was related to HF independently with log-transformed B-type natriuretic peptide in the multivariate regression analysis, suggesting that f (HMA) is a biomarker that reflects the redox state in HF patients.

著者

Manabu Nitta Makoto Kaneko Sayuri Shimizu Hideaki Kanazawa Yuji Itabashi Kotaro Miura Mike Saji Itaru Takamisawa Morimasa Takayama Shintaro Nakano Saki Hasegawa-Tamba Shinichiro Ueda

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.5, pp.864-873, 2022-09-30 (Released:2022-09-30)

参考文献数

26

被引用文献数

1

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In patients with atrial septal defect (ASD), atrial left-to-right shunting causes left atrial (LA) remodeling and dysfunction, leading to atrial fibrillation (AF). In adults with ASD and concomitant AF, LA function should be evaluated after ASD closure plus AF radiofrequency catheter ablation (RFCA).This multicenter retrospective cohort study included patients who underwent transcatheter ASD closure at one of the four leading hospitals. Patients with a history of AF also underwent preceding RFCA. The association between AF history and LA ejection fraction (EF) (indicating LA global function) at 6-12 months following ASD closure was evaluated. To account for differences in baseline characteristics between patients with and without a history of AF, we conducted the following statistical methods: (1) multivariate regression analysis in the prepropensity score (PS)-matched cohort and (2) univariate comparisons in the PS-matched cohort.Overall, this study included 231 patients (30 with AF history, 201 without). Multiple regression analysis showed that AF history was independently associated with impaired LAEF (β = −10.425, P < 0.001, model created prior to propensity matching). A one-to-one PS matching (25 pairs) showed that the LAEF at 6-12 months following ASD closure was significantly impaired in patients with ASD and AF history compared to that in patients without history of AF (median LAEF, 37.5% (interquartile range [IQR] 29.4%-48.5%) versus 52.3 [IQR 50.0%-56.6%]; P < 0.001).LA function was impaired in patients with ASD and a history of AF at 6-12 months after successful transcatheter ASD closure and on maintenance of sinus rhythm by RFCA.

著者

Shenqiang Gao Guifen Ma Lina Zhou Shanhui Guan Jinjun Zhang

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.5, pp.837-842, 2022-09-30 (Released:2022-09-30)

参考文献数

23

被引用文献数

5

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To compare the effects of dexmedetomidine (DEX) pretreatment, posttreatment, and whole-course pumping on myocardial protection during cardiac valve replacement.One hundred and twenty patients undergoing cardiac valve replacement were randomly divided into the follow groups: DEX pretreatment (D1 group), DEX posttreatment (D2 group), DEX whole-course pumping (D3 group), and Control (C group). The concentrations of cardiac troponin I (cTnI), malondialdehyde (MDA), tumor necrosis factor alpha (TNF-α), rate of spontaneous heart rebound after aortic opening, time to heart rebound, incidence of arrhythmia, and use of sufentanil and vasoactive drugs were recorded.Compared with group C, the concentrations of cTnI, MDA, and TNF-α in the D1, D2, and D3 groups were lower, especially in the latter. The time to heart rebound was prolonged in all three groups (P < 0.05). The rate of automatic rebound was increased (P < 0.05) while the incidence of arrhythmia was decreased (P < 0.05) in all groups compared with group C. Group D3 had the highest rate of automatic rebound and the lowest incidence of arrhythmia. Compared with groups C and D2, the use of sufentanil and dopamine was lower in groups D1 and D3 (P < 0.05), especially in the latter.During cardiac valve replacement, DEX pretreatment, posttreatment, and whole-course pumping could have myocardial protective effects. The latter showed better effects.

著者

Umihiko Kaneko Daisuke Hachinohe Ken Kobayashi Hidemasa Shitan Keijiro Mitsube Azusa Furugen Takeshi Kawamura Ryuji Koshima Tsutomu Fujita

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.61, no.5, pp.1059-1069, 2020-09-29 (Released:2020-09-29)

参考文献数

27

被引用文献数

8 7

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Because of its rigidity and non-steerability, the presence of a horizontal aortic root poses a major anatomical issue during transcatheter aortic valve replacement (TAVR) with Evolut self-expanding valve. Previous studies have elucidated the difficulties of coaxial implantation of the self-expanding valve in patients with horizontal aorta, often resulting in increased complications and a lower device success rate. To date, most patients with extremely horizontal aorta (aortic root angle ≥ 70°) have been excluded from major TAVR clinical trials. Therefore, available data on TAVR with Evolut in this challenging anatomy are limited, and standardized treatment strategies and clinical results remain unknown. Herein, we report a clinical case series of TAVR with Evolut in extremely horizontal aorta. Among seven patients (aged 80-92 years; STS score, 12.6% ± 7.9%) who underwent TAVR with Evolut system, aortic root angle ranged from 71° to 83° (mean, 75.1°± 4.5°). All patients achieved device success with dedicated strategies and were clinically stable at 3-month follow-up. None of the patients had more than mild paravalvular leakage (PVL) at any point during follow-up.Complications in three patients included complete atrioventricular block requiring a permanent pacemaker implantation, cerebral infarction because of atrial fibrillation 3 days after TAVR, and cardiac tamponade requiring pericardiocentesis. In this case series, Evolut self-expanding TAVR in extremely horizontal aorta was effective and feasible with a high device success rate. Based on anatomical features, some dedicated strategies majorly contribute to the success of this procedure. Large-scale multicenter studies are required to confirm our findings.

著者

Xiaopeng Chu Yanli Lu Menghan Mei Peng Peng Yanbo Zhao Guosheng Fu Fuyu Qiu Chongying Jin

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.5, pp.806-813, 2022-09-30 (Released:2022-09-30)

参考文献数

27

被引用文献数

6

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Elevated serum uric acid (sUA) is associated with increasing risk of coronary heart disease (CHD). However, existing research is limited by potential confounders. Herein, our study aims to probe the association between sUA levels and the morphological characteristics of coronary plaque by a propensity score matching (PSM) analysis.All 420 patients with CHD who had undergone optical coherence tomography of culprit lesions were included. Eligible patients were assigned into 2 groups according to sUA level: high-sUA group (sUA ≥ 6.0 mg/dL) and low-sUA group (sUA < 6.0 mg/dL). PSM was applied to control the balance of baseline characteristics.After PSM, a total of 112 patients were included in our study (56 in each group). The high-sUA group showed a higher prevalence of TCFA (35.7% versus 16.1%, P = 0.03) and macrophage infiltration (33.9% versus 14.3%, P = 0.026) compared with the low-sUA group. Plaques in the high-sUA group had a wider maximum lipid arc (166.51° (115.77°, 224.14°) versus 142.29° (93.95°, 169.06°), P = 0.048), longer calcification length (6.77 (3.90, 20.55) mm versus 4.20 (1.95, 7.45) mm, P = 0.040), and thinner minimum fibrous cap thickness (43.81 (28.17, 62.26) μm versus 92.57 (46.25, 135.37) μm, P = 0.003). Correlation analysis indicated that the sUA value was inversely associated with the minimum fibrous cap thickness (r = −0.332, P = 0.015) and positively associated with the maximum lipid arc (r = 0.399, P = 0.003), average lipid arc (r = 0.347, P = 0.011), and calcification length (r = 0.386, P = 0.006).The relationship between high-sUA levels and typical vulnerable features of plaques persisted after balancing the traditional risk factors.

著者

Ping Zhang Jianfang Luo Tianlong Wu Xuan Wang Fan Yang Yanhong Yu Lihe Lu Huimin Yu

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.5, pp.928-938, 2022-09-30 (Released:2022-09-30)

参考文献数

39

被引用文献数

4

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The role of endothelial injury and inflammation in atherosclerosis has been well established. miRNAs have been found to be key regulators in the development of atherosclerosis. Here we investigated whether miR-32-5p and its predicted target gene axin interactor, dorsalization associated (AIDA) are involved in endothelial injury and inflammation. Human umbilical vein endothelial cells (HUVECs) were treated with oxidized low-density lipoprotein (oxLDL) to induce endothelial injury and inflammation. AIDA was predicted to be a target gene of miR-32-5p using TargetScan software. Cell viability, migration, and angiogenesis were evaluated using Cell Counting Kit-8, wound-healing, and tube formation assays, respectively. The expression of inflammatory factors was detected using quantitative PCR, enzyme-linked immunosorbent assay, and western blot. We found that miR-32-5p expression was significantly decreased, whereas AIDA expression was significantly increased in oxLDL-treated HUVECs and the increased AIDA expression was reversed by the up-regulation of miR-32-5p. Moreover, both miR-32-5p mimic and knockdown of AIDA enhanced cell viability, promoted cell migration and angiogenesis and suppressed the expression of inflammatory factors including IL-1β, IL-6, TNF-α, ICAM-1, and VCAM-1 in oxLDL-induced HUVECs. Furthermore, miR-32-5p was verified to directly target AIDA using dual-luciferase reporter assay. Overall, these findings suggest that miR-32-5p/AIDA signal plays an important role in oxLDL-induced endothelial injury and inflammation. This study provides new insights into novel molecular mechanisms of endothelial dysfunction and atherosclerosis.

著者

Yohei Yamamoto Hidetoshi Uchiyama Masahiro Oonuki

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.22-153, (Released:2022-09-14)

参考文献数

6

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Some patients with aortic arch aneurysm are ineligible for open repair because of excessive perioperative risk, and others may not be suited for total endovascular repair due to anatomic constraints. We herein report a case of aortic arch aneurysm in a 94-year-old woman. The patient underwent hybrid aortic arch repair consisting of total arch debranching using bilateral femoral artery inflow and thoracic endovascular aortic repair. The patient was discharged without complications and is in good condition with dependent ambulation at 14 months of follow-up. Although a careful selection of cases is highly recommended, the use of the femoral artery inflow for arch debranching is considered to be a viable rescue option for high-risk patients.

著者

Yan Hao Yu-lin Yang Yong-chao Wang Jian Li

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.22-052, (Released:2022-07-14)

参考文献数

22

被引用文献数

13

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Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors significantly reduce low-density lipoprotein cholesterol (LDL-C) and improve the prognosis of patients with acute coronary syndrome (ACS). However, the feasibility and safety of early application of PCSK9 inhibitors on the basis of statins combined with ezetimibe to strengthen lipid lowering in extremely high-risk coronary heart disease populations are still unknown.This study was a prospective, randomized controlled study. A total of 136 patients with extremely high-risk ACS with LDL-C ≥ 3.0 mmol/L after percutaneous coronary intervention (PCI) treatment were randomly assigned 1:1 to the control group (atorvastatin 40 mg/day and ezetimibe 10 mg/day) or the evolocumab group (evolocumab 140 mg every 2 weeks combined with atorvastatin 40 mg/day and ezetimibe 10 mg/day). We compared the blood lipid profiles, major adverse cardiovascular events (MACEs), and adverse reactions. MACEs included cardiogenic death, nonfatal myocardial infarction, nonfatal stroke, and readmission due to angina. Adverse reactions included allergies, myalgia, poor blood glucose control, and liver damage.Within 1 month, the average level of LDL-C in the evolocumab group decreased from 3.54 to 0.57 mmol/L and that in the control group decreased from 3.52 to 1.26 mmol/L. The LDL-C compliance (< 1.0 mmol/L) rate was significantly increased in the evolocumab group compared with the control group (82.35% versus 22.06%, P < 0.01). The average level of lipoprotein (a) (Lp (a)) in the control group increased by 9.94 ± 51.93% from baseline after treatment, but evolocumab reduced the Lp (a) level (−38.84 ± 32.40%). Additionally, evolocumab further reduced the levels of apolipoprotein B/A1 (−70.56 ± 22.38% versus −51.29 ± 18.14%), cholesterol (−54.76 ± 18.10% versus −41.16 ± 18.14%), and apolipoprotein B (−66.47 ± 26.89% versus −46.78 ± 24.12%) compared with those in the control group, all P < 0.01. The blood lipid levels of both control and evolocumab groups stabilized after 1 month. During the 3-month follow-up, the incidence of MACEs after PCI was lower in the evolocumab group than in the control group (8.82% versus 24.59%, P = 0.015), and evolocumab combined with statins and ezetimibe did not increase the occurrence of adverse reactions (13.24% versus 11.48%, P = 0.762).In patients with extremely high-risk ACS with high levels of LDL-C, adding evolocumab to their treatment regimen as early as possible may enhance lipid lowering, increase the patient's LDL-C compliance rate in the short term, and improve cardiovascular prognosis but will not increase adverse reactions.

著者

Takahiro Motonaga Yuji Ohnishi Seigo Okada Yasuo Suzuki Takashi Furuta Mai Kawamura Naoko Okayama Yutaka Suehiro Shunji Hasegawa

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.21-821, (Released:2022-07-14)

参考文献数

25

被引用文献数

2

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Marfan syndrome is an autosomal dominant genetic disorder of the fibrous connective tissue caused by pathogenic mutations in the fibrillin-1 gene. Neonatal Marfan syndrome is a rare type of Marfan syndrome that is genotypically and phenotypically different from classical Marfan syndrome and has a poor prognosis. Most patients with neonatal Marfan syndrome die during infancy due to severe and rapidly progressive cardiovascular disorders. Here, we present a case of an 11-year-old girl with neonatal Marfan syndrome due to a novel missense mutation in exon 27 of the fibrillin-1 gene. Her condition was critical due to progressive mitral and tricuspid regurgitation. Mitral valve replacement, performed at the age of 6 months, improved her critical condition. Our case suggests that early mitral valve replacement may lead to better outcomes in patients with neonatal Marfan syndrome.

著者

Keigo Iwazaki Toshiya Kojima Takahide Murasawa Jun Yokota Hikaru Tanimoto Jun Matsuda Nobuaki Fukuma Takumi Matsubara Yu Shimizu Gaku Oguri Eriko Hasumi Hitoshi Kubo Kyungho Chang Katsuhito Fujiu Issei Komuro

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.59, no.3, pp.626-629, 2018-05-31 (Released:2018-05-30)

参考文献数

8

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A cardiac resynchronization therapy defibrillator (CRT-D) (Medtronic Inc. Protecta XT) was implanted in a 67-year-old man who had cardiac sarcoidosis with extremely low cardiac function. He had ventricular tachycardia which was controlled by catheter ablation, medication and pacing. The programmed mode was DDI, lower rate was 90 beats/minute, paced AV delay was 150 ms, and the noncompetitive atrial pacing (NCAP) function was programmed as 300 ms.After his admission for pneumonia and heart failure, we changed his DDI mode to a DDD mode because he had atrial tachycardia, which led to inadequate bi-ventricular pacing. After a while, there were cycle lengths which were longer than his device setting and alternately varied. We were able to avoid this phenomenon with AV delay of 120 ms and NCAP of 200 ms.NCAP is an algorithm which creates a gap above a certain period after the detection of an atrial signal during the postventricular atrial refractory period of the pacemaker. This is to prevent atrial tachycardia and repetitive non-reentrant ventriculoatrial (VA) synchrony in the presence of retrograde VA conduction. But in this case, NCAP algorithm induced much lower rate than the programmed basic lower rate. This situation produced some arrhythmias and exacerbated symptoms of heart failure. This had to be paid attention to, especially when the device was programmed at high basic heart rate.

著者

Shingo Kujime Hidehiko Hara Yoshinari Enomoto Keijiro Nakamura Takashi Yoshitama Mahito Noro Masao Moroi Kaoru Sugi Masato Nakamura

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.60, no.6, pp.1444-1447, 2019-11-30 (Released:2019-11-30)

参考文献数

14

被引用文献数

2

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A healthy 73-year-old woman unpredictably developed Takotsubo cardiomyopathy syndrome (TTS) during Holter-electrocardiogram (ECG) recording. Thus, the complete chronological ECG data on the actual onset day of TTS were obtained. Many heart rate variability (HRV) parameters, including the low-frequency components (LF) and the high-frequency components (HF), on the actual onset day and in the healing phase were calculated. The interesting facts on the actual onset day were that the suppression of both LF and HF appeared earlier than the changes of the ECG waveform; and the LF/HF ratio remained within the normal range, although both LF and HF were markedly suppressed. The abnormality on the actual onset day was clear compared with the healing phase. It is noteworthy to obtain the chronological ECG data on the actual onset day of TTS in a healthy patient. The present data are unique in terms of being analyzed on the actual onset day. Although the HRV parameters, including LF and HF, were obviously abnormal, there is some skepticism about using HRV parameters as indices of cardiac autonomic activity. In the present case, it was concluded that the abnormality of cardiac autonomic activity contributed to the onset of TTS. These data are unlikely to ever be replicated, and we hope that this report helps elucidate the TTS mechanism.

著者

Takumi J Matsubara Katsuhito Fujiu Satoshi Kodera Kunihiro Kani Kohsaku Goto Yu Shimizu Gaku Oguri Eriko Hasumi Toshiya Kojima Issei Komuro

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.3, pp.486-491, 2022-05-30 (Released:2022-05-31)

参考文献数

13

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Asymptomatic or silent atrial fibrillation (AF) has long been a clinical problem due to the incidence of ischemic stroke. A method is needed to predict the development of silent AF before the occurrence of ischemic stroke. This study was focused on the symptoms of AF, especially palpitation, in pacemaker patients. We assessed the hypothesis that absence of palpitation during rapid ventricular pacing could be a predictor of future onset AF being asymptomatic.In this study, we assessed the presence of symptoms during RV pacing and AF symptoms on 145 pacemaker patients at the outpatient clinic by VVI pacing at 120 ppm. The relationship between symptoms during RV pacing and symptom during AF was assessed. The predictive value of absence of symptom during RV pacing on AF being asymptomatic was assessed.Of 145 patients, 74 had previous AF episode. Among the AF patients, absence of symptom during VVI pacing was associated with AF being asymptomatic.Of 145 patients, 71 had no previous AF events. There were 14 patients who had new-onset AF or atrial flutter (AFL) after the device implantation. Four of the 14 patients (28.6%) were symptomatic during first AF/AFL episode, and 10 (71.4%) were asymptomatic during first-onset AF. All ten patients who were asymptomatic during cardiac pacing test were asymptomatic during their initial episodes of AF as well.This study showed that absence of symptoms during rapid ventricular pacing was associated with first-onset AF being asymptomatic.

著者

Sherif A. Sakr Tarek M. Abbas Maged Z. Amer Eid M. Dawood Nader El-Shahat Ibraheim A. Abdel Aal Mahmoud M. Ramadan

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.50, no.4, pp.407-419, 2009 (Released:2009-07-16)

参考文献数

38

被引用文献数

14 18

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Microvascular angina is a condition characterized by angina-like chest pain and normal coronary angiography. Endothelial dysfunction and systemic inflammation with elevated serum high-sensitive C-reactive protein (hsCRP) levels play a role in its pathogenesis. This study aimed to explore the possible relation between CRP, brachial flow-mediated dilatation (FMD), and microvascular angina.We included 21 patients with attacks of chest pain diagnosed as microvascular angina (study group) and 10 normal asymptomatic subjects (control group). Patients and controls were thoroughly examined clinically and by echocardiography, electrocardiography, and brachial FMD (using external brachial ultrasonography). Serum hsCRP and uric acid levels were assessed in all subjects.A significantly higher mean hsCRP level was found in the study group compared to controls (11.5 ± 3.8 versus 3.34 ± 1.5 mg/L; P < 0.001). FMD of the brachial artery showed significant impairment in patients with microvascular angina compared to controls (0.16 ± 0.06 versus 0.76 ± 0.09 mm; P < 0.001). There were significantly higher total cholesterol (196.1 ± 44.4 versus 159.8 ± 14.5 mg/dL; P = 0.018) and triglyceride levels (185.0 ± 103.2 versus 113.0 ± 17.6 mg/dL; P = 0.038) in the patients compared to controls; but there was a statistically insignificant difference in mean serum uric acid levels between these two groups. There were no significant correlations between the brachial FMD and any of the clinical variables studied (apart from ankle/brachial index). Microvascular angina may have an inflammatory element (reflected as a higher serum hsCRP level), together with a contribution by endothelial dysfunction (reflected as impaired brachial artery FMD); while serum uric acid is possibly not associated with microvascular angina.

著者

Sowitchaya Panthong Thanrada Vimonsuntirungsri Mananchaya Thapanasuta Chaisiri wanlapakorn Wasan Udayachalerm Aekarach Ariyachaipanich

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.2, pp.388-392, 2022-03-30 (Released:2022-03-30)

参考文献数

14

被引用文献数

6

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CoronaVac is an inactivated coronavirus disease (COVID-19) vaccine that was granted an emergency authorization by the World Health Organization in June 2021. We present the two cases of patients presenting with chest pain, abnormal electrocardiography, and elevated troponin consistent with non-ST-elevation myocardial infarction within 24 hours after receiving the CoronaVac COVID-19 vaccine.