Circulation journal : official journal of the Japanese Circulation Society
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Macitentan is a novel, dual endothelin receptor antagonist with sustained receptor binding, used for the long-term treatment of pulmonary arterial hypertension (PAH). In the present study, we assessed the efficacy and safety of macitentan in Japanese patients with PAH. ⋯ Macitentan was efficacious and well tolerated and improved the hemodynamic parameters, exercise capacity, symptoms, and clinical biomarkers in Japanese PAH patients. Macitentan can be a valuable therapeutic option for Japanese patients with PAH. (
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There is sparse data regarding the survival and neurological outcome of elderly patients with out-of-hospital cardiac arrest (OHCA). ⋯ The annual 1-month CPC 1-2 rate after OHCA among elderly patients significantly improved, and the resuscitation of elderly patients in a selected population is not futile. (Circ J 2016; 80: 1153-1162).
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Fluid redistribution rather than fluid accumulation plays an important role in the development of acute heart failure (HF) syndrome. Patients with fluid redistribution develop acute HF without prominent volume overload. We investigated volume status by measuring the diameter of the inferior vena cava (IVC) and examining variations in hemoglobin and hematocrit. ⋯ In acute HF syndrome, IVC-CI ≥0.5 on admission suggests a volume shift from the central vein into the pulmonary vasculature. Fluid refill occurs within 24 h after admission. This observation could be helpful in selecting strategies for diuretic use. (Circ J 2016; 80: 1171-1177).
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Catheter ablation of atrial fibrillation (AF) has evolved over the past 20 years from being a novel, unproven procedure to a commonly performed procedure. Triggers are important for the initiation of AF and a suitable substrate is important for perpetuation of AF. Remodeling, including electrical and structural remodeling, is common in patients with persistent AF. ⋯ Rotor ablation is controversial. A combined approach using CFAE, similarity and phase mappings with rotor identification may be helpful in searching for AF sources and subsequent substrate ablation. Nevertheless, more prospective randomized studies are required to validate efficacy and safety.