A liquid-helium cooled large-area silicon PIN photodiode x-ray detector

An x-ray detector using a liquid-helium cooled large-area silicon PIN photodiode has been developed along with a tailor-made charge sensitive preamplifier whose first-stage JFET has been cooled. The operating temperature of the JFET has been varied separately and optimized. The x- and $\gamma$-ray energy spectra for an \nuc{241}{Am} source have been measured with the photodiode operated at 13 K. An energy resolution of 1.60 keV (FWHM) has been obtained for 60-keV $\gamma$ rays and 1.30 keV (FWHM) for the pulser. The energy threshold could be set as low as 3 keV. It has been shown that a silicon PIN photodiode serves as a low-cost excellent x-ray detector which covers large area at 13 K.Comment: 6 pages, and 3 figures, Elsevier macros elsart.sty and elsart12.sty are neede

Association of the low e’ and high E/e’ with long-term outcomes in patients with normal ejection fraction

Objective We aimed to evaluate the association of the severity of left ventricular (LV) diastolic dysfunction with long-term outcomes in patients with normal ejection fraction. Design Retrospective study. Setting A single centre in Japan. Participants We included 3576 patients who underwent both scheduled transthoracic echocardiography and ECG between 1 January and 31 December 2013, in a hospital-based population after excluding valvular diseases or low ejection fraction (14 (with relaxation disorder and high LV end-diastolic pressure, n=646). Primary and secondary outcome measures The primary outcome measure was a composite of all-cause death and major adverse cardiac events (MACE). The secondary outcome measure were all-cause death and MACE, separately. Results The cumulative 3-year incidences of the primary outcome measures were significantly higher in the e′14 group (23.4%) than those for the e′≥7 group (13.0%; p14 related to e′14 was associated with the long-term prognosis in patients with normal ejection fraction in an incremental fashion

Impact of left ventricular concentricity on long-term mortality in a hospital-based population in Japan

[Background]: The prognostic impact of relative wall thickness (RWT), ventricular concentricity, is controversial. [Methods]: We retrospectively analyzed data obtained from 4444 consecutive patients who had undergone both transthoracic echocardiography and electrocardiography at our hospital in 2013. Those who presented with a history of previous episodes of myocardial infarctions and severe or moderate valvular disease were excluded from the analysis. We calculated RWT as follows: (2 x diastolic posterior wall thickness)/(the diastolic LV dimension). We defined high RWT as a ratio > 0.42. A total of 3654 patients were categorized into two groups: 492 with high RWT, and 3162 with normal RWT. [Results]: The mean ages of those in the normal and high RWT groups were 64.6 (±standard deviation 16.3) and 71.6 (± 12.7) years, respectively (p<0.001). Prevalence of male sex, history of diabetes, hypertension, and chronic kidney disease, and the left atrium volume index was higher for the high RWT group than for the normal RWT group. The median follow-up period was 1274 days (interquartile range, 410–1470). The Kaplan-Meier curves showed a constant increase in all-cause death, with cumulative 3-year incidences of 18.3% and 10.8% for the high RWT and normal RWT groups, respectively (log-rank p<0.001). After adjusting for confounders, the increased mortality risk for those with high RWT relative to normal RWT was significant (hazard ratio, 1.64; 95% confidence interval, 1.27–2.10). This trend was consistent for the composite of deaths and major adverse cardiac events. [Conclusion]: High RWT has a deleterious impact on long-term mortality

Age- and body size- adjusted left ventricular end-diastolic dimension in a Japanese hospital-based population

Background: Using the normal values for the East Asian population, we evaluated age- and body size-adjusted left ventricular end-diastolic dimension (LVEDD) and its prognostic impact in a hospital-based population in Japan. Methods and Results: We retrospectively analyzed data obtained from 4, 444 consecutive patients who had undergone both transthoracic echocardiography and electrocardiography at Kitano Hospital in 2013. Those who presented with a history of previous episodes of myocardial infarction and severe or moderate valvular disease or with low ejection fraction (<50%) were excluded from the analysis. We calculated LVEDD adjusted by age and body surface area. A total of 3, 474 patients were categorized into 3 groups: 401 with large adjusted LVEDD, 2, 829 with normal adjusted LVEDD, and 244 with small adjusted LVEDD. Mean patient age in the large, normal, and small adjusted LVEDD groups was 66.6±18.4, 65.6±15.7, and 62.1±15.5 years, respectively (P<0.001). After adjusting for confounding factors, the excess adjusted 3-year risk of primary outcome of large adjusted LVEDD relative to normal LVEDD was significant (HR, 1.40; 95% CI: 1.08–1.78). The risk for primary outcomes of small adjusted LVEDD relative to normal adjusted LVEDD was significantly lower (HR, 0.55; 95% CI: 0.34–0.85). Conclusions: Adjusted large LVEDD has a deleterious impact on long-term mortality, whereas small LVEDD carried a significantly lower risk