Circulation journal : official journal of the Japanese Circulation Society
-
Heart failure is a condition in which the heart cannot supply enough blood to the body's organs, and is a final common consequence of various heart diseases. In the past 2 decades, much progress has been made in understanding the molecular and cellular processes that contribute to cardiac hypertrophy and heart failure, leading to the development of effective therapies. ⋯ These factors are closely related, and are considered to contribute to the pathogenesis of contractile dysfunction and heart failure in a cooperative manner. Elucidation of the molecular mechanisms underlying the transition of cardiac hypertrophy to heart failure will lead to the development of novel therapeutic strategies for heart diseases.
-
Two cases of paroxysmal atrial fibrillation (AF) first occurred 15 and 36 years, respectively, after isolated direct suture closure of an atrial septal defect (ASD) and failed to be controlled by antiarrhythmic drug therapy. In these cases, an atrial transseptal procedure was feasible and no residual iatrogenic ASD was observed, even after multiple procedures. Pulmonary vein (PV) isolation was also feasible and safe and could eliminate the AF completely. PV isolation may become an alternative to antiarrhythmic drug therapy in patients with paroxysmal AF occurring late after an isolated direct suture closure of an ASD.
-
Sildenafil citrate (Viagra) is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5, which might enhance the vasorelaxant and natriuretic actions of atrial natriuretic peptide (ANP) in patients with heart failure. The objective of this study was to examine the combined effect of Viagra on hemodynamic changes during infusion of exogenous ANP. ⋯ In normal dogs, sildenafil citrate enhances the vasodilator effect of ANP by increasing the cGMP level, however, the concomitant use of sildenafil citrate with ANP will not induce severe hypotension.
-
In Stanford B acute aortic dissection (AAD), medical treatment is the choice of therapy in the acute phase, however, a portion of patients experience complications caused by serious clinical outcomes including aortic rupture and abdominal visceral ischemia. The objective of this study was to determine the predictors of in-hospital events in an Asian cohort of Stanford type B AAD. ⋯ The results identified a large maximum aortic diameter as the independent predictor of in-hospital events in Stanford type B AAD. The non-thrombosed type might also help differentiate high-risk patients.
-
Because the arterial/alveolar oxygen tension ratio (a/APO2) is relatively constant throughout the entire range of fractional inspired oxygen concentration (FiO2), its use in determining the prognosis of acute pulmonary embolism (APE) was investigated. ⋯ The cut-off value of a/APO2 <0.49 exhibits stability at variable FiO2 values and is a useful prognostic predictor in APE.