Circulation journal : official journal of the Japanese Circulation Society
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Reperfusion therapy has become an established treatment for ST-segment elevation acute myocardial infarction (STEMI), increasing the need for early diagnosis and early treatment. Despite the development of diagnostic strategies, the electrocardiogram (ECG) plays a central role in the diagnostic pathway for STEMI because it is inexpensive, readily available, and noninvasive. Moreover, in the acute phase of STEMI, the ECG can provide useful information about the extent of area at risk, the degree of myocardial damage, reperfusion injury, and myocardial reperfusion, all of which influence infarct size. This review explores the clinical importance of the ECG for patients with anterior wall STEMI in the current interventional era.
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Clinical Trial
Impact of stress hyperglycemia on myocardial salvage following successfully recanalized primary acute myocardial infarction.
Elevated blood glucose on admission may worsen outcome after acute myocardial infarction (AMI). No relationship has been identified between admission blood glucose level and myocardial salvage in patients with AMI. ⋯ Stress hyperglycemia affects MSI, indicating that the manipulation of glucose levels could be a potential therapeutic target for salvaging ischemic damage.
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Comparative Study
Attitudes to bystander cardiopulmonary resuscitation in Japan in 2010.
Early initiation of bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. The aim of the present study was to identify the attitudes of Japanese subjects toward bystander CPR and to compare them with those observed in previous studies in 1998 and 2006. ⋯ Most participants are unlikely to perform CC plus MMV, especially on a stranger or trauma victim, but are more likely to perform CC alone, as also found in the previous studies.
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Randomized Controlled Trial Multicenter Study
Pulsatile cardiopulmonary bypass with intra-aortic balloon pump improves organ function and reduces endothelial activation.
We aimed to evaluate if the use of an intra-aortic balloon pump (IABP) during cardioplegic arrest improves organ function and reduces endothelial activation in patients undergoing coronary artery bypass graft (CABG). ⋯ Pulsatile flow by IABP improves whole-body perfusion and reduces endothelial activation during CPB.
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Tissue Doppler imaging-obtained isovolumetric myocardial acceleration (IVA) is load independent, reportedly predicts systolic functions, and correlates with exercise capacity in patients with reduced ejection fraction (EF). We hypothesized that IVA correlates with the pulmonary capillary wedge pressure (PCWP) in patients with reduced EF. ⋯ IVA can predict PCWP in patients with reduced EF, and can be considered an alternative to the E/e' ratio for patients with atrial fibrillation or E/e' ratio between 8 and 15.