Circulation journal : official journal of the Japanese Circulation Society
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Left ventricular end-diastolic pressure (LVEDP) is difficult to measure continuously; therefore, pulmonary capillary wedge pressure (PCWP) is frequently used instead for hemodynamic monitoring in patients with heart failure. However, a discrepancy between LVEDP and mean PCWP is sometimes observed. ⋯ Evaluation of the discrepancy between LVEDP and mean PCWP in patients with heart failure was feasible by separately estimating LVEDP by Deltad and mean PCWP by E/Ea using noninvasive TTDE. Early detection of patients with elevated LVEDP and normal mean PCWP may be useful for preventing acute exacerbation of chronic heart failure.
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The aim of this study was to assess in-hospital mortality and major adverse cardiac events (MACE) during long-term clinical follow-up of patients who developed cardiogenic shock (CS) after acute myocardial infarction (AMI) and who underwent primary percutaneous coronary intervention (PCI). ⋯ Primary PCI achieving TIMI 3 flow reduces in-hospital death in AMI with CS. High concentration of CRP and low TIMI flow are associated with MACE during long-term clinical follow-up.
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In the reperfusion era the clinical characteristics of intermediate QRS prolongation without bundle-branch block (BBB) remain unclear in patients with ST-segment elevation myocardial infarction (STEMI). ⋯ In the reperfusion era, although patients with intermediate QRS prolongation without BBB have more severe coronary disease, 6-month-mortality is similar to those with normal conduction, but lower than those with BBB.
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The relationship between enhanced myocardial oxidative stress and impaired beta-adrenergic signaling remains to be characterized during the development of dilated cardiomyopathy. ⋯ Myocardial oxidative stress is actually enhanced in the initial development of LV dysfunction. Both activation of myocardial oxidative stress and impairment of beta-adrenergic signaling become prominent at the stage of severe LV dysfunction. Myocardial oxidative stress may be involved in the development of beta-adrenergic desensitization.
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There have not been previous reports of patients undergoing percutaneous coronary intervention (PCI) using a gadolinium chelate. ⋯ Gadolinium chelates can be an alternative contrast media during PCI in particular patients with contraindications to iodinated media.