IVUS parameters.

<p>IVUS parameters.</p

Patient characteristics and percent diameter stenosis by QCA analysis.

<p>Patient characteristics and percent diameter stenosis by QCA analysis.</p

Correlation between FFR and step-up IBS.

<p>There was an inverse correlation between FFR and step-up IBS (<i>r</i> = −0.84; <i>R²</i> = 0.71; <i>P</i> < 0.001). FFR, fractional flow reserve; IBS, intensity of blood speckle. </p

Schema of Step-up IBS and Calculation of Step-up IBS.

<p>(Schema of Step-up IBS) Schema of the concepts and methods for measuring step-up IBS. (A) Coronary angiography, showing a discrete moderate stenotic lesion of the LAD with an FFR value of 0.69. (B) Longitudinal IVUS image of the lesion. The proximal IBS value was measured in a segment (proximal segment) 5 mm proximal to the site with the largest lumen proximal to a stenosis but within the target lesion. The distal IBS value was measured in a segment (distal segment) 5 mm distal to the site of the smallest lumen size within the target lesion (C and D) Manually encircled cross-sectional vessel lumens and integrated backscatter values measured in the proximal segment (C) and distal segment (D) using the IB-IVUS imaging system in the end-diastolic frame. The acoustic shadows of the guidewire were manually traced and excluded to minimize acoustic artifacts. The proximal and distal integrated backscatter values were 104.73 and 121.03, respectively. Integrated backscatter values were measured in three cross-sectional slices proximal and distal to the target lesion. The mean integrated backscatter values at the proximal and distal sites were 104.89 and 120.92, respectively, and the step-up IBS value was 16.03. LAD, left anterior descending artery; FFR, fractional flow reserve; IVUS, intravascular ultrasound; IBS, intensity of blood speckle; IB-IVUS, integrated backscatter intravascular ultrasound. </p

Datasheet1_Beat-to-beat alterations of acoustic intensity and frequency at the maximum power of heart sounds are associated with NT-proBNP levels.docx

BackgroundAuscultatory features of heart sounds (HS) in patients with heart failure (HF) have been studied intensively. Recent developments in digital and electrical devices for auscultation provided easy listening chances to recognize peculiar sounds related to diastolic HS such as S3 or S4. This study aimed to quantitatively assess HS by acoustic measures of intensity (dB) and audio frequency (Hz).MethodsForty consecutive patients aged between 46 and 87 years (mean age, 74 years) with chronic cardiovascular disease (CVD) were enrolled in the present study after providing written informed consent during their visits to the Kitasato University Outpatient Clinic. HS were recorded at the fourth intercostal space along the left sternal border using a highly sensitive digital device. Two consecutive heartbeats were quantified on sound intensity (dB) and audio frequency (Hz) at the peak power of each spectrogram of S1–S4 using audio editing and recording application software. The participants were classified into three groups, namely, the absence of HF (n = 27), HF (n = 8), and high-risk HF (n = 5), based on the levels of NT-proBNP ResultsThe intensities of four components of HS (S1–S4) decreased linearly (p 2). Differences in S1 intensity (ΔS1) and its frequency (ΔfS1) between two consecutive beats were non-audible level and were larger in patients with HF than those in patients without HF (ΔS1, r = 0.356, p = 0.024; ΔfS1, r = 0.356, p = 0.024). The cutoff values of ΔS1 and ΔfS1 for discriminating the presence of high-risk HF were 4.0 dB and 5.0 Hz, respectively.ConclusionsDespite significant attenuations of all four components of HS by BMI, beat-to-beat alterations of both intensity and frequency of S1 were associated with the severity of HF. Acoustic quantification of HS enabled analyses of sounds below the audible level, suggesting that sound analysis might provide an early sign of HF.</p

By-Laws of the Cooperative

Additional file 3.  Routine blood and urine examination

MOESM1 of Rationale and design of a multicenter randomized study for evaluating vascular function under uric acid control using the xanthine oxidase inhibitor, febuxostat: the PRIZE study

Additional file 1. Trial organization