163 research outputs found

    CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018

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    While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI

    Inflammatory biomarkers in ischemic heart disease

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    Ischemic heart disease (IHD) is a major cause of death in the western world. Although the age-standardized mortality rates are decreasing, the burden of the disease remains high and novel therapeutic strategies are still needed to improve clinical outcome. In the past decades, inflammation has been recognized as an important factor throughout all stages of IHD. The increase in understanding the inflammatory mechanisms has uncovered an intriguing diversity of potentially targetable pathways. However, the exact role of inflammation still remains to be further elucidated. This thesis supports the hypothesis that inflammation plays an important role across all stages of IHD, varying from atherosclerosis to myocardial infarction, and eventually ischemic heart failure. Increased inflammation is associated with a decrease in cardiac function after myocardial infarction, but adequate anti-inflammatory therapies that may aid in reducing this decline remain to be developed or to be proven to be effective. It is therefore essential to further unravel the complex pathophysiological inflammatory mechanisms underlying IHD. New techniques such as single cell RNA sequencing, can help us to further study these complex mechanisms. Furthermore, accumulating evidence has suggested that the human gut microbiome may play an important role in the pathophysiology of IHD through the modulation of inflammation related to the event. Although the interplay of inflammation and the human gut microbiome in IHD is a relatively young field of research, a better understanding of these two may aid in the improvement of risk stratification, therapeutic treatment efficacy, and prognosis of IHD

    Echocardiography

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    The book "Echocardiography - New Techniques" brings worldwide contributions from highly acclaimed clinical and imaging science investigators, and representatives from academic medical centers. Each chapter is designed and written to be accessible to those with a basic knowledge of echocardiography. Additionally, the chapters are meant to be stimulating and educational to the experts and investigators in the field of echocardiography. This book is aimed primarily at cardiology fellows on their basic echocardiography rotation, fellows in general internal medicine, radiology and emergency medicine, and experts in the arena of echocardiography. Over the last few decades, the rate of technological advancements has developed dramatically, resulting in new techniques and improved echocardiographic imaging. The authors of this book focused on presenting the most advanced techniques useful in today's research and in daily clinical practice. These advanced techniques are utilized in the detection of different cardiac pathologies in patients, in contributing to their clinical decision, as well as follow-up and outcome predictions. In addition to the advanced techniques covered, this book expounds upon several special pathologies with respect to the functions of echocardiography

    Percutaneous coronary interventions in stable and acute coronary syndromes

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    Percutaneous coronary interventions in stable and acute coronary syndromes

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    CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018

    Get PDF
    While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI
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