Myocardial Impairment Detected by Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy: Comparison with 99mTc-MIBI/Tetrofosmin and 123I-BMIPP SPECT

Purpose: Myocardial fibrosis is considered to be an important factor in myocardial dysfunction and sudden cardiac death in hypertrophic cardiomyopathy (HCM). The purpose of this study was to compare myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI with myocardial perfusion and fatty acid metabolism assessed by single photon emission computed tomography in HCM.Materials and Methods: We retrospectively evaluated 20 consecutive HCM patients (female, 7; mean age, 53.4 years) who underwent LGE, technetium-99m methoxyisobutylisonitrile/tetrofosmin (99mTc-MIBI/tetrofosmin), and iodine-123 beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) imaging. We calculated the myocardium-to-lumen signal ratio (M/L) for LGE in 17 segments based on the American Heart Association statement. Scoring of 99mTc-MIBI/tetrofosmin (PI) and 123I-BMIPP (BM) was performed for each segment using a 5-point scale (0, normal; 4, highly decreased).Results: Nineteen of 20 patients (95%) and 153 of 340 segments (45%) showed LGE. M/Ls were 0.42ｱ・.16, 0.55ｱ・.17, and 0.65ｱ・.24 in PI0/BM0, PI0/BM1-4 and PI1-4/BM1-4, respectively. All M/Ls were significantly higher than that of a normal control (0.34ｱ・.14) (p<0.001).Conclusions: Myocardial fibrosis in HCM can occur despite normal perfusion and fatty acid metabolism, and is more strongly associated with disorders of fatty acid metabolism than with perfusion abnormalities. M/L may be a useful indicator of disease severity

Prognostic impact of chronic total coronary occlusion on long-term outcomes in implantable cardioverter-defibrillator recipients with ischemic heart disease

Aims The prognostic impact of chronic total coronary occlusion (CTO) on implantable cardioverterdefibrillator (ICD) recipients remains unclear. Methods and Results Eighty-four consecutive patients with ischemic heart disease who received ICD therapy for primary or secondary prevention were analyzed. We investigated all-cause mortality and major adverse cardiac events (MACEs) including cardiac death, appropriate device therapy, hospitalization for heart failure, and ventricular assist device implantation. Of the study patients (mean age 70 ± 8 years; 86% men), 34 (40%) had CTO. There were no significant differences in age, left ventricular ejection fraction (LVEF), NYHA functional class III or IV status, and proportion who underwent secondary prevention between patients with CTO (CTO group) and without CTO (non-CTO group). During a median follow-up of 3.8 years (interquartile range 2.7 to 5.4 years), the CTO group tended to have a higher MACE rate (log-rank P=0.054) than the non-CTO group. Within the CTO group, there was no difference in the MACE rate between patients with and without viable myocardium. In patients with ICD for secondary prevention (n=47), 16 patients (34%) with CTO had a higher MACE rate than patients without CTO (logrank P<0.01). Cox proportional hazards regression analysis showed that the presence of CTO, but 3 not LVEF, was associated with a higher MACE rate. Multivariate analysis showed that the presence of CTO was a predictor of MACE (P<0.05). Conclusion In patients with ischemic heart disease receiving ICD implantation, the presence of CTO has an adverse impact on long-term prognosis, especially as secondary prevention

Japanese Guidelines for Cardiac Sarcoidosis.

In recent years, advancements in diagnostic imaging modalities, such as cardiac magnetic resonance (CMR) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET), as well as the accumulation of cases, have allowed a more accurate diagnosis of cardiac sarcoidosis (CS). In addition, emerging cases of “isolated CS” in which no obvious lesions are present in organs other than the heart have been reported, and the clinical importance of CS has become recognized. Many issues including etiology, pathology, diagnosis, and treatment of CS remain to be solved. Considering this situation, guidelines for the diagnosis and treatment of cardiac sarcoidosis were recently updated by the Japanese Circulation Society and were published in February 2017

Controlled production of amyloid beta peptide from a photo-triggered, water-soluble precursor "click peptide"

In biological experiments, poor solubility and uncontrolled assembly of amyloid beta peptide (A beta) 1-42 pose significant obstacles to establish an experiment system that clarifies the function of A beta 1-42 in Alzheimer's disease (AD). Herein, as an experimental tool to overcome these problems, we developed a water-soluble photo-"click peptide" with a coumarin-derived photocleavable protective group that is based on an O-acyl isopeptide method. The click peptide hod nearly 100-fold higher water solubility than A beta 1-42 and did not self-assemble, as the isomerized structure in its peptide backbone drastically changed the conformation that was derived from A beta 1-42. Moreover, the click peptide afforded A beta 1-42 quickly under physiological conditions (pH 7.4, 37 degrees C) by photoirradiation followed by an O-N intramolecular acyl migration. Because the in situ production of intact A beta 1-42 from the click peptide could improve the difficulties in handling A beta 1-42 caused by its poor solubility and highly aggregative nature, this click peptide strategy would provide a reliable experiment system for investigating the pathological function of A beta 1-42 in AD

Recommendations for 18F-fluorodeoxyglucose positron emission tomography imaging for diagnosis of cardiac sarcoidosis—2018 update: Japanese Society of Nuclear Cardiology recommendations

This manuscript was previously published in Shinzo-Kaku-Igaku in Japanese [Shinichiro S, Yoshinaga K, Miyagawa M et al. 心臓サルコイドーシスに対する18F-FDG PET検査の手引き 2018年改訂. Shinzo-Kaku-Igaku 21:22–27. https://doi.org/10.14951/jsnc.21-001]. This manuscript is an English translated version with slight modification