Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Volume 68 , Issue 3
Showing 1-20 articles out of 20 articles from the selected issue
Clinical Investigation
  • Kazuhiko Nishigaki, Tsutomu Yamazaki, Hisayoshi Fujiwara, for the Jap ...
    2004 Volume 68 Issue 3 Pages 181-185
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background The first nationwide survey of the situation in Japan (the 1997 SJ) regarding percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was conducted by the Japanese Coronary Intervention Study (JCIS) group and the results of the second nationwide, continuous survey of Japan in 2000 (the 2000 SJ) are presented here. Methods and Results A questionnaire was collected from 8,268 facilities (99.93%). In the 2000 SJ, the total number of coronary arteriography (CAG) performed was 543,046 (428 CAGs per 105 population). The estimated ratio of CAG to patients with coronary artery disease (CAD) in Japan is approximately 1.4-fold that in the US. Total numbers of PCI and CABG performed were 146,992 and 23,584, and increased to 134% and 130%, respectively, over the 3 years. PCI facilities with an annual number of PCIs performed of more than 100 were 40.2%, and the respective CABG facilities were 8.3%. The ratio of PCI to CABG was 6.23 in the 2000 SJ, and was several times higher than the ratio in Western countries. Conclusion The situation in Japan regarding the number of CAG, PCI, and CABG procedures performed is very different from that in Western countries. This provides important information for diagnosis, treatment and guidelines for Japanese patients with CAD. (Circ J 2004; 68: 181 - 185)
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  • Hiroshi Imamura, Atsushi Izawa, Ryuichi Kai, Osamu Yokoseki, Shin-ichi ...
    2004 Volume 68 Issue 3 Pages 186-191
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background The prevalence, pathogenesis, and clinical background of coronary artery disease (CAD) in patients aged 40 years or less in Japan are not well understood. Methods and Results Temporal trends in the clinical background, including growth from childhood, of young patients with CAD over the last 20 years were examined. The study group comprised 38 patients who were 40 years of age or less (7 patients in 1980-84, phase I; 10 patients in 1985-89, phase II; 10 patients in 1990-94, phase III; 11 patients in 1995-99, phase IV). Among the classic coronary risk factors, obesity significantly increased in prevalence. An increase in patients with multiple risk factors was seen (0, 10%, 20%, and 36% in phases I, II, III, and IV, respectively). There was no significant change in the prevalence of familial hypercholesterolemia, sequelae of Kawasaki disease or vasospastic angina. All phase III and IV patients with multiple risk factors had moderate to severe obesity, and 83% had been overweight since childhood. Conclusions These results suggest that the number of young patients with CAD because of multiple risk factors has been increasing, and most of them have been overweight since childhood. Thus, for primary prevention it is essential to control cardiovascular risk factors in overweight children. (Circ J 2004; 68: 186 - 191)
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  • Mizuo Nameki, Iwao Ishibashi, Yoshiya Miyazaki, Yoshiaki Sakai, Susumu ...
    2004 Volume 68 Issue 3 Pages 192-197
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background It has been reported that both nicorandil and magnesium have a cardioprotective effect in experimental ischemia - reperfusion models. In the present study, the cardioprotective effects of nicorandil and magnesium as an adjunct to reperfusion therapy in patients with acute myocardial infarction (AMI) were compared. Methods and Results Forty consecutive patients with AMI caused by occlusion of anterior descending coronary artery were randomized into 3 groups: (1) Group N: nicorandil was given as 4 mg iv and 4 mg ic before reperfusion, followed by continuous infusion at 4 mg/h for 24 h; (2) Group M: magnesium was administered at 10 mmol iv before reperfusion, followed by continuous infusion at 0.4 mmol/h for 24 h; and (3) Group C: neither nicorandil nor magnesium was given. Left ventriculography was performed immediately after reperfusion and 3 months later. There was no significant change in regional wall motion (RWM) in either Group C or M, whereas that of group N improved significantly. The change in RWM in Group N was significantly greater than in Group C (Group N: 0.92±0.92, Group M: 0.44±0.80, Group C: -0.01±0.65, p<0.05). Conclusions The early administration of nicorandil as an adjunct to reperfusion is useful for cardioprotection in AMI, but magnesium is not. (Circ J 2004; 68: 192 - 197)
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  • Kenji Kajiwara, Hironori Ueda, Hideya Yamamoto, Michinori Imazu, Yasuh ...
    2004 Volume 68 Issue 3 Pages 198-203
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Tenascin-C (TNC) is an extracellular matrix glycoprotein that increases after inflammation and injury. In cultured cells TNC has been reported to markedly induce the expression of matrix metalloproteinase-9, which stimulates collagen degradation in the fibrous cap of human atherosclerotic plaque. Methods and Results Immunohistochemical techniques were used to analyze the expression of TNC protein in 51 coronary atherectomy specimens obtained from patients with stable angina pectoris (SAP, n=23) or acute coronary syndromes (ACS) (n=28; unstable angina pectoris, n=20, acute myocardial infarction, n=8). Immunostaining for α-smooth muscle actin, CD68, CD45, and CD31 was also performed in serial sections to identify the cell types that express TNC protein. The %TNC + area (percentage of the area of immunostaining for TNC protein in the total surface area of the plaque) was larger in coronary samples with the plaque characteristics of thrombus, angiogenesis, intraplaque hemorrhage, and macrophage (CD68+), and lymphocyte (CD45 +) clusters than in coronary samples without them (52±3.4 vs 39±4.8, p<0.05; 57±3.7 vs 36±3.7, p<0.01; 51±3.6 vs 39±4.8, p<0.05; 53±3.4 vs 33±4.5, p<0.01; 56±4.1 vs 37±3.6, p<0.01, respectively). The presence of other components, such as dense fibrous tissue, neointimal hyperplasia, atheromatous gruel and calcification, was not significantly correlated with the %TNC + area. The %TNC + area was larger in coronary samples from patients with ACS than in samples from patients with SAP (56±3.2% vs 34±4.3%, p<0.01). Conclusions The results suggest that TNC may have specific functions in coronary plaque formation and may be involved in the pathogenesis of coronary lesions in ACS. (Circ J 2004; 68: 198 - 203)
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  • Sou Takenaka, Yukiko Nakano, Tetsuji Shingu, Kazuaki Chayama, Katsuhik ...
    2004 Volume 68 Issue 3 Pages 204-207
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Surgical isolation of the left atrial posterior wall (LA-PW isolation) can terminate chronic atrial fibrillation associated with mitral valve disease. However, atrial contraction after LA-PW isolation has not been evaluated. Methods and Results The study group comprised 14 patients (mean age, 63±14 years) with mitral valve disease who recovered and maintained regular sinus rhythm after LA-PW isolation. Before the procedure, and 2-3 weeks and 1 year after the LA-PW isolation, the patients underwent an echocardiographic study. The left atrial (LA) diameter decreased after the LA-PW isolation and the change became significant 1 year later (before: 50.1±5.1 mm, after 2-3 weeks: 46.0±4.9 mm; p<0.05, after 1 year: 44.0±6.1 mm; p<0.05 vs before the operation). The left ventricular (LV) end-diastolic diameter, LV ejection fraction and LV fractional shortening did not change significantly from before the LA-PW isolation and after 1 year. The time - velocity integral of the atrial wave (Ai) and atrial filling fraction significantly increased (Ai: 4.5±2.1 cm vs 5.8±2.3 cm; p<0.05; atrial filling fraction: 15.4±7.7% to 19.2±8.3%; p<0.05) during the follow-up period. Conclusion LA-PW isolation can benefit the restoration of regular sinus rhythm and, furthermore, the recovery of atrial contraction. (Circ J 2004; 68: 204 - 207)
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  • Yoshihisa Shimada, Minoru Yoshiyama, Hidemasa Tanaka, Hiroshi Sato, Ke ...
    2004 Volume 68 Issue 3 Pages 208-213
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Microvascular damage immediately after reperfusion therapy is an independent predictor of left ventricular function in patients with acute myocardial infarction (AMI). However, its recovery may vary among individuals and the relationship between convalescent stage microvasculature and late myocardial morphologic change is unclear. Methods and Results Patients treated with coronary angioplasty within 12 h of their first anterior AMI were enrolled in this study. Coronary flow reserve (CFR) was measured 3 weeks post AMI, in both branches of the left coronary artery: culprit (left anterior descending artery: LAD) and non-culprit (left circumflex artery: LCX). Left ventriculography was performed at 3 weeks and 6 months post AMI and compared. Seventeen patients showed abnormal CFR in the LAD (Group 1: CFR<2), whereas 20 patients showed normal CFR (Group 2: CFR ≥2). Percent changes of end-diastolic volume tended to be higher in Group 1 than in Group 2 (11.8±21.6% vs -1.3±14.4%, p=0.056), and %changes of end-systolic volume was significantly smaller in Group 2 (11.8±22.1% vs -8.7±25.1%, p<0.05). A statistically significant correlation was found between absolute and relative CFR in the LAD and %change of end-systolic volume (r=-0.58: p<0.001, and r=0.40: p<0.05, respectively). Conclusions Microvascular function in the convalescent stage may be related to these favorable changes. (Circ J 2004; 68: 208 - 213)
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  • Shuichi Takagi, Satoru Sakuragi, Takeshi Baba, Hiroshi Takaki, Naohiko ...
    2004 Volume 68 Issue 3 Pages 214-219
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background This study was designed to determine the factors influencing the development of left ventricular (LV) remodeling in patients participating in a comprehensive cardiac rehabilitation (CR) program after acute myocardial infarction (AMI), with special reference to exercise intensity and frequency. Methods and Results A total of 72 patients with AMI participated in CR consisting of exercise training of moderate intensity (heart rate reserve 40-60%) and education for 12 weeks. Plasma concentration of brain natriuretic peptide (BNP) was measured at the beginning and the end of CR. Echocardiography was performed before and 1 year after CR. An increase in LV end-diastolic dimension (delta-LVDd) from baseline was used as an index of remodeling. Delta-LVDd was significantly greater in patients with an anterior AMI than with other infarct locations (p<0.05) and correlated significantly with baseline BNP concentration (p<0.05). Delta-LVDd >5 mm occurred exclusively in patients with baseline BNP >150 pg/ml. Variables representing the intensity and frequency of exercise training did not correlate with delta-LVDd. Conclusion In patients with AMI participating in CR, those having both anterior infarction and baseline BNP concentration >150 pg/ml are at high risk for subsequent LV remodeling, whereas neither exercise intensity nor participation frequency in CR appears to be associated with LV remodeling. (Circ J 2004; 68: 214 - 219)
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  • Osamichi Satake, Kouji Kajinami, Yoshimaro Ishikawa, Tadashi Ueda, Hir ...
    2004 Volume 68 Issue 3 Pages 220-226
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Syndrome X has been recognized as a disease that is primarily reflected in the cardiac microvasculature. Myocardial metabolism in this condition has been studied, but not in relation to small vessel pathology. Methods and Results In order to examine the relationship between myocardial metabolism and small vessel pathology, 24 consecutive patients with syndrome X (7 men, 17 women; mean age 58 years) were evaluated by the thallium exercise stress test, positron emission tomography using F-18 fluoro-deoxyglucose (FDG), and an endomyocardial biopsy. All patients showed either diffuse or focal increase in the myocardial uptake of FDG, but only 17 patients (71%) showed hypoperfused areas with partial or complete redistribution in the thallium study. Quantification of myocardial FDG uptake revealed that the value in syndrome X patients was 10-fold higher than in controls (p<0.0001). Histopathological examination revealed that in syndrome X there is an extensive increase in smooth muscle cells and thickening of the vascular wall, even in capillary vessels, and the small vessel lumen was markedly narrowed. There was a significant inverse correlation between FDG myocardial uptake and the microvessel luminal area. Conclusions In syndrome X patients, myocardial FDG uptake is increased extensively, which is strongly associated with narrowed myocardial microvasculature. (Circ J 2004; 68: 220 - 226)
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  • Katsushi Hashimoto, Kazufumi Nakamura, Hideki Fujio, Katsumasa Miyaji, ...
    2004 Volume 68 Issue 3 Pages 227-231
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Primary pulmonary hypertension (PPH) is a rare disease characterized by progressively increased resistance of the pulmonary arteries associated with vascular remodeling. Infiltration of inflammatory cells in affected vessels is a common pathological finding. Monocyte chemoattractant protein-1 (MCP-1) is recognized as a potent chemotactic and activating factor for monocytes and leukocytes, but its significance in PPH is unclear. Methods and Results Serum MCP-1 concentrations were measured in 16 PPH patients and the results were compared with those in 16 normal controls. MCP-1 concentrations in PPH patients (265.6±29.5 pg/ml) were significantly elevated compared with those in normal controls (119.6±6.9 pg/ml, p<0.0001). In 9 patients (3 men, 6 women; mean age, 29±3 years), repeated MCP-1 and hemodynamic measurements were performed prior to and during intravenous epoprostenol therapy. During a mean follow-up period of 7±1 months, MCP-1 concentrations were significantly reduced (288.8±122.8 to 185.9±117.5 pg/ml, p<0.01). Conclusion Circulating MCP-1 concentrations are increased in PPH patients, but can alleviated by chronic intravenous epoprostenol therapy. The increase in MCP-1 might be one of the important factors responsible for the disease development in patients with PPH. (Circ J 2004; 68: 227 - 231)
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  • Tomohiro Sakamoto, Koichi Kaikita, Shinzo Miyamoto, Sunao Kojima, Seig ...
    2004 Volume 68 Issue 3 Pages 232-235
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Nicorandil is a hybrid-type anti-anginal drug that combines a KATP channel opener and a nitric oxide donor. Recently the IONA study reported that nicorandil improves the prognosis of patients with stable angina pectoris. Methods and Results To examine the effects of nicorandil on endogenous fibrinolysis, plasma concentrations of tissue-type plasminogen activator (t-PA) antigen, type-1 plasminogen activator inhibitor (PAI-1) antigen and PAI activity were measured in consecutive 11 patients (7 men and 4 women, mean age 63 years, ranges 41-84 years) with coronary artery disease. Nicorandil (15 mg/day) was administered orally to each patient for 2 weeks. Venous blood samples were obtained from each patient before and after the administration of the drug in the early morning before eating. There were no significant changes in the plasma concentrations of t-PA (12.4±1.9 to 9.8±1.5) or PAI-1 (26.3±3.9 to 21.5±4.9) antigens (ng/ml, mean ± SEM) before and after nicorandil administration. On the other hand, the plasma activity of PAI (IU/ml, mean ± SEM) decreased significantly after the treatment (12.9±3.2 to 5.6±1.9, p=0.039). Conclusions It is well known that PAI activity determines the whole fibrinolytic capacity and oral administration of nicorandil decreased PAI activity in patients with coronary artery disease. This finding suggests that nicorandil improves the fibrinolytic capacity and may reduce the risk of coronary thrombus formation in such patients. (Circ J 2004; 68: 232 - 235)
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  • Raisuke Iijima, Yuji Ikari, Akiyoshi Miyazawa, Hiroyoshi Nakajima, Kaz ...
    2004 Volume 68 Issue 3 Pages 236-240
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background The results of stent implantation for small coronary disease have been inconclusive. The purpose of the present study was to evaluate the factors in predicting the risk of angiographic restenosis after 2.5-mm stent implantation for small coronary arteries. Methods and Results The study group comprised 134 consecutive patients who had a reference small coronary artery with diameter from 1.8 mm to 2.5 mm on quantitative coronary angiography and who had been successfully treated by stent implantation with a 2.5-mm stent. Of the 134 patients, 55 had angiographic restenosis (41%). The rate of target lesion revascularization was 32%. Diabetes mellitus, acute coronary syndrome, lesion length, bifurcation lesion, lower left ventricular ejection fraction (LVEF), stent strut, stent/artery ratio, and stent length were identified as predictors of restenosis by univariate analysis. Subsequent multivariate analysis revealed that lower LVEF (odds ratio (OR) 3.37, p=0.01), bifurcation lesion (OR 2.47, p=0.04), thicker stent strut (OR 2.30, p=0.04), and longer stent length (OR 1.05, p=0.02) were significant predictors of restenosis. Conclusions Two pre-interventional factors (reduced left ventricular function and bifurcated lesion) and 2 procedure-related factors (thickness of stent strut and total stent length) were identified as predictors of restenosis. These factors should be taken into account when deciding on the percutaneous coronary intervention strategy for small coronary artery disease. (Circ J 2004; 68: 236 - 240)
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Experimental Investigation
  • Masanori Sakaguchi, Toshihiko Shibata, Koji Hattori, Hidekazu Hirai, M ...
    2004 Volume 68 Issue 3 Pages 241-246
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background The present study was designed to investigate whether orally administered benidipine and manidipine protect the myocardium from ischemia - reperfusion injury. Methods and Results Each drug (1, 3 or 10 mg/kg) was administered orally once daily for 1 week. The isolated rat heart model (Langendorff perfusion) was used, and each heart was subjected to global ischemia at 37°C for 40 min followed by reperfusion. Post-ischemic recovery of left ventricular (LV) function (measured as developed pressure (LVDP), dP/dt max and end-diastolic pressure) was compared with a control group. Creatine kinase (CK) leakage was also measured. Post-ischemic recovery of LVDP and LV dP/dt max were significantly increased by 3 mg/kg benidipine (LVDP: 87.5±10.1 vs 64.6±11.9%; LV dP/dt max: 97.8±10.4 vs 70.2±15.7%; p<0.05). CK leakage was significantly lower than in the control group (39.4±7.5 vs 61.1 ±9.8 IU per 15 min per kg; p<0.05). Manidipine produced significant recoveries in LVDP and dP/dt max at a dose of 1 mg/kg (LVDP: 93.7±16.5% vs 53.4±9.5%; dP/dt max: 104.2±21.9% vs 55.5±15.5%; p<0.05). CK leakage was also significantly reduced at the same dose (50.0±18.3 vs 80.1±14.0 IU per 15 min per kg; p<0.05). Conclusions Orally administered benidipine and manidipine exerted significant cardioprotective effects against ischemia - reperfusion injury. (Circ J 2004; 68: 241 - 246)
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  • Seimi Satomi-Kobayashi, Seinosuke Kawashima, Tsuyoshi Sakoda, Tomomi U ...
    2004 Volume 68 Issue 3 Pages 247-253
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Glycogen synthase kinase-3 β (GSK-3β) is involved in many cellular processes, such as metabolism, apoptosis, differentiation and proliferation. Insulin-like growth factor-1 (IGF-1), which is well known to have a hypertrophic effect on cardiomyocytes, inactivates (phosphorylates) GSK-3β in some cell types. The role of GSK-3β in cardiomyocytes as a negative regulator of cardiac hypertrophy has been recently reported and the present study investigated the role of GSK-3β in the cardiac hypertrophy of cultivated neonatal rat cardiomyocytes induced by IGF-1. Methods and Results First, the IGF-1 induced signal transduction leading to GSK-3β in neonatal rat cardiomyocytes was examined. The phosphatidylinositol (PI) 3-kinase/Akt/GSK-3 β signaling induced by IGF-1 was investigated using inhibitors of PI 3-kinase and Ad AktAA, a dominant negative form of Akt. Furthermore, using Ad MEK DN, a dominant negative form of MEK, it was found that MEK negatively regulates Akt phosphorylation upon IGF-1 stimulation. Next, it was examined whether GSK-3β acts as a negative regulator in the cardiac hypertrophy induced by IGF-1. Sustained stimulation by IGF-1 caused cardiac hypertrophy in protein synthesis and cellular morphology, and overexpression of unphosphorylatable GSK-3β (Ad GSK-3β S9A) repressed these hypertrophic effects of IGF-1. Conclusion GSK-3β may play an important role as a negative regulator of cardiac hypertrophy induced by IGF-1. (Circ J 2004; 68: 247 - 253)
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Case Report
  • Kazuya Akiyama, Jun Hirota, Naohito Taniyasu, Kazuma Maisawa, Yutaka K ...
    2004 Volume 68 Issue 3 Pages 254-256
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Spontaneous detachment of the aortic valve commissure (ie, avulsion of a commissure) is a rare cause of acute massive aortic regurgitation that follows a rapidly deteriorating clinical course. The aortic valve commissure between the non-coronary and right coronary cusps detached from the aortic wall in a 79-year old man with ascending aortic aneurysm. Emergency aortic valve replacement and aneurysmoplasty were successfully performed; histopathology of the aorta and aortic valve showed cystic medial necrosis and myxomatous degeneration, respectively. Preoperative transthoracic echocardiography showed an eccentric massive regurgitant jet at the site of the prolapsing cusps with a vegetation-like echodense mass, and transesophageal echocardiography showed the prolapsing non-coronary and right coronary cusps conjoined by the commissural tissue. It was the precise echocardiographic evaluation of the avulsion that enabled sucessful emergency aortic valve surgery. (Circ J 2004; 68: 254 - 256)
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  • Hidetsugu Sakai, Kazushi Urasawa, Naotsugu Oyama, Akira Kitabatake
    2004 Volume 68 Issue 3 Pages 257-262
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    A 74 year-old male with old anterior and inferior myocardial infarctions was treated with staged percutaneous coronary intervention. A chronic total occlusion of the middle segment of the left anterior descending branch was successfully stented during the first stage, and during the second stage, preprocedural intravascular ultrasonography (IVUS) revealed that the proximal segment of the right coronary artery was diffusely stenosed by mixed plaque. Directional coronary atherectomy under IVUS guidance was performed, but coronary slow flow appeared during the procedure. After successfully bailing out with intracoronary nicorandil, percutaneous thrombectomy and manual blood pumping, 2 coronary stents were implanted to fully cover the lesion. Quite contrary to expectation, the no-reflow phenomenon appeared just after post-dilatation and a repeat of the same maneuver could not completely recover coronary flow. Plaque fragility could not be predicted from the IVUS examination. (Circ J 2004; 68: 257 - 262)
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  • Yuichi Sato, Takako Imazeki, Fumio Inoue, Akihiro Yoshimura, Takahiro ...
    2004 Volume 68 Issue 3 Pages 263-266
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Multislice spiral computed tomography (MSCT) is a new non-invasive imaging technique for detecting coronary artery disease. It allows direct visualization of not only the lumen of the coronary arteries, but also plaque within the artery. Identification of soft plaques is of the utmost importance in the therapeutic decision making for patients with acute coronary syndrome (ACS), including acute myocardial infarction and unstable angina pectoris. MSCT detected coronary artery soft plaques in 2 cases of ACS. (Circ J 2004; 68: 263 - 266)
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  • Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji ...
    2004 Volume 68 Issue 3 Pages 267-269
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    A 64-year-old man with a history of previous coronary intervention of the left anterior descending artery was admitted to hospital because of recurrent chest pain at rest. Coronary angiography revealed no significant coronary artery stenosis. During preparation for the second shot of the right coronary artery, chest pain occurred unexpectedly, represented by ST segment elevation in leads II, III and aVF. Immediate right coronary angiography revealed no significant coronary artery stenosis, but markedly delayed contrast medium washout. Intracoronary administration of nicorandil attenuated this phenomenon, and the patient was diagnosed as having angina pectoris caused by microvascular spasm with ST segment elevation. (Circ J 2004; 68: 267 - 269)
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Rapid Communication
  • Jun-ichi Suzuki, Hiroshi Ito, Ryo Gotoh, Ryuichi Morishita, Kensuke Eg ...
    2004 Volume 68 Issue 3 Pages 270-271
    Published: 2004
    Released: February 25, 2004
    JOURNALS FREE ACCESS
    Background Nuclear factor-κB (NF-κB) plays a pivotal role in restenosis after percutaneous coronary intervention (PCI) and the aim of the present clinical trials was to evaluate the effectiveness of a NF-κB decoy for preventing restenosis. Methods and Results The initial case was a patient suffering from effort angina who had stenoses in the proximal and middle portions of the right coronary artery. The patient received 2 stents; the NF-κB decoy was delivered to the distal site, but not the proximal site. Six months after the PCI, the NF-κB decoy had suppressed restenosis in comparison with the no-decoy transfection site. The second case was a patient who underwent single-stent insertion and decoy transfection at the same site, and minimal intimal thickening was observed at 6 month after PCI. No systemic adverse effects were observed in either case. Conclusion These results indicate the clinical usefulness and safety of NF-κB decoy transfection after PCI, but further evaluations are necessary to confirm its clinical effectiveness. (Circ J 2004; 68: 270 - 271)
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