19 research outputs found
A Successful Primary Percutaneous Coronary Intervention Twelve Days After a Cabrol Composite Graft Operation in Marfan Syndrome
The Cabrol procedure is one of several techniques used for re-implantation of a coronary artery. After replacement of the ascending aorta and aortic valve using a composite graft, second Dacron tube grafts are used for anastomosis between the ascending aortic graft and the coronary arteries. Ostial stenosis is one of the complications associated with the Cabrol operation. However, there have been no reported cases of acute thrombosis of a Cabrol graft. Here we report a case with acute ST elevation myocardial infarction due to thrombotic total occlusion of a right Cabrol graft-to-right coronary artery (RCA) twelve days after surgery in a patient with Marfan syndrome. He was successfully treated with primary percutaneous coronary intervention (PCI)
Iatrogenic Left Internal Mammary Artery to Great Cardiac Vein Anastomosis Treated With Coil Embolization
Inadvertent left internal mammary artery (LIMA)-great cardiac vein (GCV) anastomosis is a rare complication of coronary artery bypass graft surgery. Patients with iatrogenic aortocoronary fistula (ACF) were usually treated surgical repair, percutaneous embolic occlusion with coil or balloon. We report a case of iatrogenic LIMA to GCV anastomosis successfully treated with coil embolization and protected left main coronary intervention through the percutaneous transfemoral approach
Tumor Suppressor Serine/Threonine Kinase LKB1 Expression, Not Kinase Activity, Increased in the Vascular Smooth Muscle Cells and Neointima in the Rat Carotid Artery Injury Model
Immunoglobulin G4-Related Myocarditis with Eosinophilic Infiltration: A Case Report
Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a fibroinflammatory disorder that can involve
any organ system; however, myocarditis is extremely rare. A 52-year-old male with dyspnea and chest
discomfort underwent cardiac MRI that revealed edema and nodular, patchy, mesocardial and subendoardial
delayed enhancement of left ventricle, suggesting myocarditis. Laboratory findings revealed
elevated serum IgG4 and eosinophilia. Cardiac biopsy confirmed eosinophilic myocarditis
with IgG4-positive cells. Here, we present an unusual case of IgG4-RD manifesting as eosinophilic
myocarditis
Unexpected development of intraoperative paradoxical air embolism during hysteroscopic myomectomy
Elevation of Serum APE1/Ref-1 in Experimental Murine Myocarditis
Myocarditis is an inflammatory disease of the myocardium that causes cardiogenic shock and death. However, endomyocardial biopsy that is, the gold standard for a diagnosis is limited. Apurinic/apyrimidinic endonuclease 1/redox effector factor-1 (APE1/Ref-1) is a multifunctional protein, which is involved in DNA-based excision repair pathway, and in redox signaling, its changes are observed in various cardiovascular diseases including hypertension and coronary artery disease. We analyzed serum APE1/Ref-1 in experimental murine myocarditis. To induce myocarditis, coxsackievirus B3 was injected intraperitoneally to BALB/c mice. The serum APE1/Ref-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin I were measured. The histology and virus titers measurements were performed. The troponin I and inflammation were significantly elevated at day 3, peaked to day 7 and decreased at day 10. The NT-proBNP and virus titers were significantly peaked at day 3, and dropped at day 7 and 10. The serum APE1/Ref-1 was gradually raised and its elevation is still maintained until a later time, namely day 10. Also, its level was positively correlated with myocardial inflammation, reflecting severity of myocardial injury. We suggest that serum APE1/Ref-1 can be used to assess for myocardial injury in viral myocarditis without endomyocardial biopsy
Adherence to tripleâcomponent antihypertensive regimens is higher with singleâpill than equivalent twoâpill regimens: A randomized controlled trial
Abstract Using a singleâpill combination (SPC) for hypertension (HTN) treatment resulted in better adherence and persistence than a freeâequivalent combination in previous observational studies. The aim of this study is to confirm superior adherence with a tripleâcomponent SPC compared with an equivalent twoâpill regimen in a randomized controlled trial (RCT) using a medication event monitoring system (MEMS). This is a multicenter, openâlabel, RCT. Subjects were persons with HTN whose clinic blood pressure was not adequately controlled (systolic >140Â mmHg or diastolic >90Â mmHg) with a dual combination. Eligible patients were randomized to either the tripleâcomponent SPC (olmesartan/amlodipine/hydrochlorothiazide 20/5/12.5Â mg) group or the equivalent twoâpill (olmesartan/hydrochlorothiazide 20/12.5Â mg + amlodipine 5Â mg) group and maintained for 12Â weeks. Primary outcomes were the difference in percentage of doses taken (PDT) and percentage of days with the prescribed dose taken correctly (PDTc) between the singleâ and twoâpill therapy groups, calculated from MEMS data. From 8 hospitals, 145 patients with HTN were randomized. The singleâpill group had significantly higher PDT and PDTc than the twoâpill group: median (25â75 percentile) PDT 95.1 (86.7â100.0) versus 92.1 (73.0â97.3); and PDTc 91.0 (79.4â96.5) versus 88.6 (69.2â96.3%), PÂ =Â 0.04 for both by the Wilcoxon rank sum test. The singleâpill combination of the tripleâcomponent antihypertensive regimen showed better adherence than the equivalent twoâpill therapy. Reducing pill burden by means of a singleâpill combination is an effective strategy for enhancing adherence to multipleâagent antihypertensive therapy. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC? Previous studies suggested that the use of a singleâpill combination (SPC) in hypertension (HTN) treatment produced better adherence and persistence than a freeâequivalent combination. However, supportive data are confined to dualâcomponent SPC and came from observational studies using medication possession ratio as an outcome. WHAT QUESTION DID THIS STUDY ADDRESS? The objective of this study is to investigate whether a tripleâcomponent SPC improved medication adherence over an equivalent twoâpill combination therapy in a randomized controlled trial using medication event monitoring systems. WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE? Medication adherence in the SPC group was superior to that of twoâpill group, confirming previous findings from observational studies. HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE? This finding strongly supports the current HTN treatment guideline to prefer SPC with a higher level of evidence
Ambulatory blood pressure response to Sâamlodipine in Korean adult patients with uncontrolled essential hypertension: A prospective, observational study
Abstract Although amlodipine is recommended as the firstâline therapy for the treatment of hypertension, its use is limited by its potential side effects. Sâamlodipine is expected to be able to minimize side effects of amlodipine with a similar antihypertensive effect by removing the malicious Râchiral form. However, sustainable blood pressure control with Sâamlodipine has not been well established yet. The purpose of the current study was to evaluate ambulatory blood pressure (ABP) profiles before and after a 12âweek treatment of Sâamlodipine. Patients received onceâdaily Sâamlodipine 2.5 or 5 mg. ABP during 24 hr and office blood pressure were measured at baseline and after the 12âweek treatment. Primary endpoints were changes of systolic and diastolic 24 hr ABP. After 12âweek Sâamlodipine treatment, mean systolic ABP (â15.1 ± 16.2 mmHg, p < .001) and diastolic ABP (â8.9 ± 9.8 mmHg, p < .001) were decreased significantly. Both daytime and nightâtime mean systolic BP and diastolic BP were also significantly decreased after the 12âweek treatment. Global troughâtoâpeak ratio and smoothness index after 12âweek Sâamlodipine treatment were .75 and .79 for SBP and .65 and .61 for DBP, respectively. Age â„65 years (hazard ratio [HR]: 3.13; 95% confidence interval [CI]: 1.67â14.3) and nonalcohol drinking (HR: 3.09; 95% CI: 1.34â7.17) were independent clinical factors for target ABP achievement. Adverse drug reactions (ADR) were developed in 16 (6.4%) patients, including two (.8%) cases of peripheral edema. In conclusion, this study demonstrated the efficacy and safety of Sâamlodipine in patients with uncontrolled essential hypertension