Clinical Significance of Arrhythmogenic Foci in Atrial Fibrillation

Atrial fibrillation (AF) is initiated by pulmonary vein (PV) and non-PV foci, which could be associated with initiating and maintaining AF. The development of the remodeling process and preexistent anatomical structures are likely to relate to the structural and electrophysiological changes in the PVs and non-PV area, which could promote the local conduction abnormalities and cause an increased PV/non-PV arrhythmogenicity. In this section, we assessed the features and relating factors of PV/non-PV arrhythmogenicity in patients with AF and evaluated its clinical implication. As a result, we realized the atrial anatomical features, such as the left atrial roof shape, left lateral ridge, and Marshall vein provided us with an understanding of PV and non-PV arrhythmogenicity in patients with AF. In addition, the presence of residual arrhythmogenic non-PV foci is associated with increased AF recurrence after catheter ablation; therefore, the information of arrhythmogenic foci (AMF) is also useful for determining the appropriate strategy of ablation for AF

An Analysis of Foreign Language Speaking Test Anxiety in Japanese EFL University Classes

The aim of this study is to understand the degree to which different factors contribute to student anxiety in the English conversation classroom in regards to speaking tests in English.Japanese university EFL students (N = 187) were asked to complete a 19-item questionnaire measured on a five-point Likert scale. It found that students have anxieties regarding their own abilities and making mistakes in front of others (dubbed as "the intrapersonal factor") as well as how they are being evaluated by their instructors (dubbed as "the interpersonal factor"). The study found that the intrapersonal factor is higher than the interpersonal factors independent of evaluators. It is plausible that the learners\u27 main concern is their internal matters.Furthermore, the intrapersonal factor does not show a significant difference between evaluators, arising regardless of their identity of the evaluator.On the other hand, the interpersonal factor is higher in the case of Japanese evaluators than in the case of native English speaking evaluators.That means when a Japanese English teacher is an evaluator, learners\u27 anxiety of the evaluators\u27 evaluation for their speaking gets higher

Porphyrin-Tape/C 60 Organic Photodetectors with 6.5% External Quantum Efficiency in the Near Infrared

No AbstractPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/77507/1/2780_ftp.pd

心不全を合併した心房細動患者のカテーテルアブレーション後の長期予後 : 左室駆出率に基づいた心不全のサブタイプ間における比較

Aims: Heart failure (HF) prognosis has been reported similar in patients with preserved vs. reduced left ventricular ejection fraction (LVEF). This study compared the long-term prognosis of HF patients undergoing radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). Methods and results: Among 5010 patients undergoing RFCA in Kansai Plus AF registry, 656 patients (13.1%) with a documented history of HF were enrolled in the study before RFCA. The primary endpoint was a composite of all-cause death, HF hospitalization, and stroke or systemic embolism. Patients with reduced (<40%), mid-range (40-49%), and preserved (≥50%) LVEF were 98 (14.9%), 107 (16.3%), and 451 (68.8%) patients, respectively. The prevalence of ischaemic heart disease and cardiomyopathies was higher among patients with reduced as compared with preserved LVEF (27.6% vs. 10.0%, P < 0.05 and 36.7% vs. 15.3%, P < 0.05, respectively). The median follow-up period was 2.9 years. The 3-year cumulative risk for the primary endpoint was higher in patients with reduced LVEF (32.7%) compared to those with mid-range (11.7%) or preserved (11.6%) LVEF (P < 0.001). Reduced LVEF was the most significant independent risk factor for primary endpoint (hazard ratio, 2.83; 95% confidence interval 1.74-4.61, P < 0.001). The 3-year arrhythmia recurrence rate was similar among the groups (48.2%, 42.8%, and 47.3%, respectively, P = 0.75). Conclusion : This study raises hypothesis that patients with HFrEF and AF had approximately three times higher risk for a composite of all-cause death, HF hospitalization, and stroke or systemic embolism after AF ablation compared with patients with HFmrEF or HFpEF.博士（医学）・甲第802号・令和3年12月21日Copyright: © Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021.This is a pre-copyedited, author-produced version of an article accepted for publication in Europace following peer review. The version of record "Europace Online ahead of print (2021 Aug 31;euab201) is available online at: https://doi.org/10.1093/europace/euab201.発行元が定める登録猶予期間終了の後、本文を登録予定（2022.08

Log-transformed plasma level of brain natriuretic peptide during the acute phase of Kawasaki disease is quantitatively associated with myocardial dysfunction

PurposeBrain natriuretic peptide (BNP) has been considered a biochemical marker for myocarditis in Kawasaki disease. We performed this study to determine its quantitative significance.MethodsWe attempted to correlate log-transformed BNP concentrations (log-BNP) and clinical, laboratory, and echocardiographic variables in 81 children with Kawasaki disease. Stepwise multiple linear regression analysis was used to determine the variables independently associated with log-BNP concentration.ResultsSerum C-reactive protein level (P<0.0001), serum alanine aminotransferase concentration (P=0.0032), white blood cell count (P=0.0030), and left ventricular mass index (P=0.0024) were positively related with log-BNP, and hemoglobin level (P<0.0001), serum albumin level (P<0.0001), Na+ concentrations (P<0.0001), left ventricular fractional shortening (P=0.0080), and peak early diastolic tissue velocity of the left ventricular basal lateral segment (P=0.0045) were negatively related to the log-BNP concentration. Multiple regression analysis showed that serum albumin concentration (R2=0.31, P=0.0098) and left ventricular mass index (R2=0.09, P=0.0004) were significantly associated with the log-BNP concentration.ConclusionElevated BNP levels during the acute phase of Kawasaki disease may be attributable to cardiac dysfunction associated with the increase in left ventricular mass, and log-BNP concentration may be a quantitative biochemical marker of myocarditis in Kawasaki disease