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1.
J Phys Condens Matter ; 32(24): 245601, 2020 Jun 03.
Article in English | MEDLINE | ID: mdl-32189642

ABSTRACT

We report 105Pd nuclear magnetic resonance (NMR) and nuclear quadrupolar resonance (NQR) measurements on a single crystal of Ce3Pd20Si6, where antiferroquadrupolar and antiferromagnetic orders develop at low temperature. From the analysis of NQR and NMR spectra, we have determined the electric field gradient (EFG) tensors and the anisotropic Knight shift (K) components for both inequivalent Pd sites-Pd(32f) and Pd(48h). The observed EFG values are in excellent agreement with our state-of-the-art density functional theory calculations. The principal values of the quadrupolar coupling are [Formula: see text] MHz and [Formula: see text] MHz, for the Pd(32f) and Pd(48h) sites, respectively, which is large compared to the Larmor frequency defined by the gyromagnetic constant [Formula: see text] MHz/T for 105Pd. Therefore, the complete knowledge of K and the EFG tensors is crucial to establish the correspondence between NMR spectra and crystallographic sites, which is needed for a complete analysis of the magnetic structure, static spin susceptibility, and the spin-lattice relaxation rate data and a better understanding of the groundstate of Ce3Pd20Si6.

2.
Nat Commun ; 10(1): 1059, 2019 03 05.
Article in English | MEDLINE | ID: mdl-30837479

ABSTRACT

Manipulating topological spin textures is a key for exploring unprecedented emergent electromagnetic phenomena. Whereas switching control of magnetic skyrmions, e.g., the transitions between a skyrmion-lattice phase and conventional magnetic orders, is intensively studied towards development of future memory device concepts, transitions among spin textures with different topological orders remain largely unexplored. Here we develop a series of chiral magnets MnSi1-xGex, serving as a platform for transitions among skyrmion- and hedgehog-lattice states. By neutron scattering, Lorentz transmission electron microscopy and high-field transport measurements, we observe three different topological spin textures with variation of the lattice constant controlled by Si/Ge substitution: two-dimensional skyrmion lattice in x = 0-0.25 and two distinct three-dimensional hedgehog lattices in x = 0.3-0.6 and x = 0.7-1. The emergence of various topological spin states in the chemical-pressure-controlled materials suggests a new route for direct manipulation of the spin-texture topology by facile mechanical methods.

3.
Nat Commun ; 9(1): 408, 2018 01 29.
Article in English | MEDLINE | ID: mdl-29379016

ABSTRACT

Quantum states characterized by nontrivial topology produce interesting electrodynamics and versatile electronic functionalities. One source for such remarkable phenomena is emergent electromagnetic field, which is the outcome of interplay between topological spin structures with scalar spin chirality and conduction electrons. However, it has scarcely been exploited for emergent function related to heat-electricity conversion. Here we report an unusually enhanced thermopower by application of magnetic field in MnGe hosting topological spin textures. By considering all conceivable origins through quantitative investigations of electronic structures and properties, a possible origin of large magneto-thermopower is assigned to the strong energy dependence of charge-transport lifetime caused by unconventional carrier scattering via the dynamics of emergent magnetic field. Furthermore, high-magnetic-field measurements corroborate the presence of residual magnetic fluctuations even in the nominally ferromagnetic region, leading to a subsisting behavior of field-enhanced thermopower. The present finding may pave a way for thermoelectric function of topological magnets.

4.
J Fish Biol ; 90(6): 2363-2374, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28386984

ABSTRACT

This study identified ventilatory and behavioural responses in the marbled sole Pseudopleuronectes yokohamae under experimentally induced progressive decreases in dissolved oxygen (DO) levels. Ventilation frequency showed an increase with decreasing DO levels from normoxia to 2·75 mg O2 l-1 , followed by a decrease in ventilation frequency at decreased DO levels from 2·00 to 0·75 mg O2 l-1 . At DO levels below 2·00 mg l-1 , behaviours at the bottom were suppressed, whereas avoidance behaviours increased. A decrease in avoidance behaviours was observed from 1·00 to 0·75 mg O2 l-1 . Upside-down reversal and incapacitation at DO levels of 1·00-0·75 mg O2 l-1 suggested that sublethal effects on P. yokohamae were induced. The responses observed before the sublethal DO level could be interpreted as an effort to maintain oxygen uptake, reduce routine activities and facilitate avoidance. The observed DO level thresholds that induce behavioural responses, in addition to sublethal effects, indicate hypoxia-tolerance that is important for understanding the effects of hypoxia on coastal ecosystems.


Subject(s)
Flounder/physiology , Oxygen/analysis , Animals , Behavior, Animal , Hypoxia/veterinary , Respiration , Seawater/chemistry
5.
Phys Rev Lett ; 113(14): 147202, 2014 Oct 03.
Article in English | MEDLINE | ID: mdl-25325654

ABSTRACT

Magnetic field (B) variation of the electrical polarization P(c) (∥c) of the perfect triangular lattice antiferromagnet RbFe(MoO(4))(2) is examined up to the saturation point of the magnetization for B⊥c. P(c) is observed only in phases for which chirality is predicted in the in-plane magnetic structures. No strong anomaly is observed in P(c) at the field at which the spin modulation along the c axis, and hence the spin helicity, exhibits a discontinuity to the commensurate state. These results indicate that the ferroelectricity in this compound originates predominantly from the spin chirality, the explanation of which would require a new mechanism for magnetoferroelectricity. The obtained field-temperature phase diagram of ferroelectricity agree well with those theoretically predicted for the spin chirality of a Heisenberg spin triangular lattice antiferromagnet.

6.
Health Phys ; 104(3): 243-50, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23361418

ABSTRACT

Because of radioactive fallout resulting from the Fukushima Daiichi Nuclear Power Plant (NPP) accident, water discharge from many outdoor swimming pools in Fukushima was suspended out of concern that radiocesium in the pool water would flow into farmlands. The Japan Atomic Energy Agency has reviewed the existing flocculation method for decontaminating pool water and established a practical decontamination method by demonstrating the process at eight pools in Fukushima. In this method, zeolite powder and a flocculant are used for capturing radiocesium present in pool water. The supernatant is discharged if the radiocesium concentration is less than the targeted level. The radioactive residue is collected and stored in a temporary storage space. Radioactivity concentration in water is measured with a NaI(Tl) or Ge detector installed near the pool. The demonstration results showed that the pool water in which the radiocesium concentration was more than a few hundred Bq L was readily purified by the method, and the radiocesium concentration was reduced to less than 100 Bq L. The ambient dose rates around the temporary storage space were slightly elevated; however, the total increase was up to 30% of the background dose rates when the residue was shielded with sandbags.


Subject(s)
Decontamination/methods , Fukushima Nuclear Accident , Schools , Swimming Pools/standards , Aluminum Hydroxide/chemistry , Cesium Radioisotopes/chemistry , Cesium Radioisotopes/isolation & purification , Decontamination/economics , Flocculation , Radiation Protection , Time Factors , Water/chemistry , Zeolites/chemistry
7.
Intern Med J ; 43(6): 663-7, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23279137

ABSTRACT

BACKGROUND: Dietary salt restriction is believed to be a mainstay in the management of patients with heart failure. However, the effect of salt intake on heart failure has not been well evaluated in outpatient medical practice. AIMS: The aim of the present study was to assess the hypothesis that B-type natriuretic peptide (BNP) level, as an objective marker of heart failure, is associated with salt intake in patients with heart failure. METHODS: One hundred and thirteen consecutive patients with mild compensated heart failure (77 ± 10 years old, 51 female) were included. We estimated dietary salt intake by the concentration of sodium and creatinine in spot urine. We measured BNP at the time of urine sampling and assessed the relationship between the % changes in BNP levels (%ΔBNP) and the changes in the estimated daily salt excretion (ΔNaCl) during the follow-up period. RESULTS: The baseline median BNP level was 150 (interquartile range: 83-263) pg/mL and the estimated daily salt excretion was 162 ± 45 mmol/day. There was a positive correlation between %ΔBNP and ΔNaCl (r = 0.61, P < 0.01). Multiple regression analysis revealed that %ΔBNP was associated with ΔNaCl (P < 0.01), but not with changes in systolic blood pressure and bodyweight. CONCLUSIONS: Changes in BNP levels were associated with changes in the estimated daily salt excretion in outpatients with compensated heart failure. Salt restriction may be beneficial for the management of patients with heart failure.


Subject(s)
Heart Failure/diet therapy , Heart Failure/urine , Natriuretic Peptide, Brain/urine , Sodium Chloride, Dietary/administration & dosage , Sodium Chloride, Dietary/urine , Stroke Volume/physiology , Adult , Aged , Aged, 80 and over , Biomarkers/urine , Female , Humans , Male , Middle Aged , Prospective Studies
8.
Phys Rev Lett ; 94(14): 147204, 2005 Apr 15.
Article in English | MEDLINE | ID: mdl-15904102

ABSTRACT

We have observed hysteresis loops and abrupt magnetization steps in the magnetic molecule {V(6)}, where each molecule comprises a pair of identical spin triangles, in the temperature range 1-5 K for external magnetic fields B with sweep rates of several Tesla per millisecond executing a variety of closed cycles. The hysteresis loops are accurately reproduced using a generalization of the Bloch equation based on direct one-phonon transitions between the instantaneous Zeeman-split levels of the ground state (an S=1/2 doublet) of each spin triangle. The magnetization steps occur for B approximately 0, and they are explained in terms of adiabatic Landau-Zener-Stückelberg transitions between the lowest magnetic energy levels as modified by an intertriangle anisotropic exchange of order 0.4 K.

10.
J Cardiovasc Pharmacol ; 38(6): 812-20, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11707684

ABSTRACT

Clinical experience suggests that sodium channel blockers are effective in converting atrial fibrillation of recent onset but not chronic atrial fibrillation. We investigated changes in the electrophysiologic effects of pilsicainide, a pure sodium channel blocker, on the canine atrium during chronic rapid pacing (400/min). Three pairs of bipolar electrodes were sutured to the right atrial appendage in six dogs. Five days later, rapid atrial pacing was started after baseline measurements of the effective refractory period (ERP), the intra-atrial conduction velocity, the atrial wavelength, and the inducibility of atrial fibrillation. These studies were repeated at 2, 7, and 14 days of pacing, both before and after pilsicainide administration. Before pacing, pilsicainide increased ERP more than it decreased conduction velocity, causing an increase of wavelength, particularly at faster rates. However, this use-dependent prolongation of ERP disappeared after 2 days of pacing. Thus, pilsicainide failed to prolong ERP during chronic pacing, allowing progressive shortening of wavelength in the remodeled atrium. The effect of sodium channel blockers on atrial refractoriness may decline as rapid atrial excitation persists, limiting the usefulness of these agents for the treatment of chronic atrial fibrillation.


Subject(s)
Anti-Arrhythmia Agents/pharmacology , Atrial Function/drug effects , Lidocaine/pharmacology , Sodium Channel Blockers/pharmacology , Animals , Atrial Fibrillation/drug therapy , Atrial Fibrillation/physiopathology , Atrial Function/physiology , Cardiac Pacing, Artificial , Chronic Disease , Dogs , Electrodes, Implanted , Female , Lidocaine/analogs & derivatives , Male , Neural Conduction , Refractory Period, Electrophysiological/drug effects , Time Factors
11.
Jpn Circ J ; 65(10): 867-73, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11665790

ABSTRACT

Few previous reports have comprehensively screened all the anti-myocardial autoantibodies (AMCA) in relation to other clinical profiles in patients with idiopathic dilated cardiomyopathy (IDC), so the present study used both immunohistochemistry (FITC) and immunoblotting (IB) for screening patients with IDC in order to characterize the clinical significance of AMCA. Sera were collected from 100 patients with IDC and age-matched 100 healthy control subjects (CTL). For FITC, an unfixed frozen section of human myocardium was used for the standard indirect immunofluorescence; for IB, total cardiac homogenates of the same myocardium were blotted to serum at 2 sets of dilution (1:200 and 1:10,000). The positive rates of AMCA detection for each method were as follows (IDC vs CTL); 39% vs 6% for FITC, 38% vs 4% for IB (1:200), and 10% vs 0% for IB (1:10,000). Fifty-nine patients with IDC and 8 CTL were positive for AMCA by either method, and 18 patients with IDC and 2 CTL were positive for AMCA by both methods. IB-positivity at 1:200 was an independent predictor by multiple logistic regression analysis of non-sustained ventricular tachycardias as well as left ventricular end-diastolic diameter and plasma norepinephrine concentration.


Subject(s)
Autoantibodies/analysis , Cardiomyopathy, Dilated/immunology , Myocardium/immunology , Adult , Aged , Aged, 80 and over , Cardiomyopathy, Dilated/etiology , Case-Control Studies , Female , Humans , Immunoblotting , Immunohistochemistry , Japan , Male , Middle Aged , Odds Ratio , Tachycardia, Ventricular/immunology
12.
J Cardiovasc Electrophysiol ; 12(9): 1080-2, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11573701

ABSTRACT

We report a case of Wolff-Parkinson-White syndrome coexistent with atresia of the coronary sinus (CS) ostium and persistence of the left superior vena cava. The accessory pathway was located at the blind end of the CS, which was bumped with mechanical loss of preexcitation during mapping by a catheter from within the CS. The accessory pathway was successfully ablated with radiofrequency energy applied to this site from the right atrium. This unique combination of anatomically matched anomalies may be important in suggesting a potential embryologic link between the accessory pathway and the coronary vein.


Subject(s)
Coronary Vessel Anomalies/complications , Heart Conduction System/abnormalities , Wolff-Parkinson-White Syndrome/etiology , Cardiac Catheterization , Catheter Ablation , Electrocardiography , Heart Conduction System/surgery , Humans , Male , Middle Aged , Vena Cava, Superior/abnormalities , Wolff-Parkinson-White Syndrome/surgery
13.
Int J Cardiol ; 79(2-3): 183-9, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11461740

ABSTRACT

We investigated the recovery of electrophysiological parameters from electrical remodeling after conversion of chronic lone atrial fibrillation in humans. Clinical studies have shown that the longer atrial fibrillation lasts, the more difficult it becomes to maintain the sinus rhythm after cardioversion. To explore the effects of the duration of atrial fibrillation on changes of electrophysiological parameters after conversion, we determined the atrial effective refractory period and P wave duration during right atrial pacing at 1 and 24 h after electrical cardioversion in 15 patients with chronic lone atrial fibrillation (median duration, 6 months). By 24 h after cardioversion, the effective refractory period at a pacing cycle length of 600 ms increased from 225+/-19 to 254+/-27 ms. However, the P wave duration did not decrease significantly 24 h after conversion. As the duration of atrial fibrillation became longer, the prolongation of effective refractory period was more delayed (P<0. 001, r=0.82), and the shortening of P wave duration was significantly smaller within 24 h after cardioversion (P<0. 001, r=0.67). After cardioversion of chronic lone atrial fibrillation, the recovery of shortened atrial refractoriness and prolonged intraatrial conduction time is dependent on the duration of preexisting atrial fibrillation.


Subject(s)
Atrial Fibrillation/therapy , Electric Countershock , Electrocardiography , Heart Conduction System/physiopathology , Recovery of Function , Atrial Fibrillation/physiopathology , Chronic Disease , Female , Humans , Linear Models , Male , Middle Aged , Time Factors
14.
Heart ; 86(1): E3, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11410580

ABSTRACT

A 62 year old man was admitted for evaluation of recurrent episodes of syncope. A surface ECG showed frequent repetitive premature ventricular complexes of right ventricular outflow tract origin. Ventricular fibrillation was inducible by programmed electrical stimulation but otherwise cardiac evaluation was unremarkable. A diagnosis of idiopathic ventricular fibrillation was made and an implantable cardioverter-defibrillator (ICD) was installed. However, spontaneous ventricular fibrillation recurred, requiring repeated ICD discharges. The ventricular fibrillation was reproducibly triggered by a single premature ventricular complex with a specific QRS morphology. Radiofrequency catheter ablation was carried out to eradicate this complex. No ventricular fibrillation has developed after this procedure, and the patient does not require drug treatment.


Subject(s)
Catheter Ablation , Ventricular Fibrillation/surgery , Defibrillators, Implantable , Humans , Male , Middle Aged , Syncope/etiology , Syncope/surgery , Syncope/therapy , Ventricular Fibrillation/complications , Ventricular Fibrillation/therapy
15.
Ann Nucl Med ; 15(1): 79-83, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11355789

ABSTRACT

The purpose of this study was to compare the clinical utility of two image reconstruction algorithms in myocardial perfusion SPECT (single-photon emission computed tomography): filtered back-projection (FBP) and ordered subset expectation maximization (OSEM). A rest/stress one-day protocol with 99mTc-MIBI or tetrofosmin was performed on 102 consecutive patients who underwent coronary angiography. After SPECT data acquisition, images were reconstructed with FBP and OSEM algorithms. We assessed diagnostic performance (sensitivity, specificity and accuracy) in detecting coronary artery stenosis and evaluated regional tracer uptake with a 4-point scoring system. Although there were no significant differences in diagnostic performance between FBP and OSEM reconstruction, the OSEM method yielded higher uptake in the RCA area than the FBP method by reducing the count-loss artifact due to hepatic uptake of the tracers. In addition, regional uptake in the LCX area was significantly lower in the OSEM image than in the FBP image; this phenomenon was observed mainly in patients with coronary stenosis and/or infarction in the LCX territory. In conclusion, OSEM and FBP offered comparable diagnostic performance in stress myocardial perfusion SPECT. The OSEM method contributed to reduction of the count-loss artifact in inferior and posterior walls and to easy recognition of hypoperfusion in the LCX area.


Subject(s)
Coronary Disease/diagnostic imaging , Heart/diagnostic imaging , Image Processing, Computer-Assisted/methods , Tomography, Emission-Computed, Single-Photon/methods , Algorithms , Chi-Square Distribution , Coronary Angiography , Dipyridamole , Exercise Test , Female , Humans , Male , Middle Aged , Organophosphorus Compounds , Organotechnetium Compounds , Radiopharmaceuticals , Reproducibility of Results , Rest , Sensitivity and Specificity , Technetium Tc 99m Sestamibi
16.
J Am Coll Cardiol ; 37(2): 418-24, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11216956

ABSTRACT

OBJECTIVES: We sought to define the clinical and long-term prognostic implications of autoantibodies that act against the second extracellular loop of beta1-adrenergic receptors (ARs) in patients with idiopathic dilated cardiomyopathy (IDC). BACKGROUND: Although autoantibodies directed against various domains of beta-ARs are found in patients with IDC, only a subgroup against the second extracellular domain of beta1-ARs exerts intrinsic sympathomimetic-like actions on human beta-ARs. It is suggested that the autoantibodies take part in the pathophysiology of IDC and may affect long-term prognosis of patients with this disorder. METHODS: Sera from 104 patients with IDC were screened for autoantibodies that act against the second extracellular loop of beta1-ARs by enzyme-linked immunosorbent assay, using a synthetic peptide corresponding to the domain. Relations of the autoantibodies to clinical variables and long-term prognosis were assessed by multivariate analysis. RESULTS: Autoantibodies were detected in 40 patients (38%). Multifocal ventricular premature contractions (p < 0.01) and ventricular tachycardia (VT; p < 0.01) were more common in autoantibody-positive than in autoantibody-negative patients, although no differences in cardiac function or neurohormonal levels were demonstrated. The presence of autoantibodies (p = 0.001) and a low left ventricular ejection fraction (LVEF <30%; p = 0.02) were independent predictors of VT. Sudden death was independently predicted by the presence of autoantibodies (p = 0.03), as well as by LVEF <30% (p = 0.01), whereas total mortality was predicted only by LVEF <30% (p = 0.001). CONCLUSIONS: Autoantibodies directed against the second extracellular loop of beta1-ARs were closely related to serious ventricular arrhythmias in patients with IDC, and the presence of autoantibodies independently predicted sudden death. These autoantibodies may contribute to electrical instability in patients with IDC.


Subject(s)
Autoantibodies/blood , Cardiomyopathy, Dilated/immunology , Death, Sudden, Cardiac/etiology , Receptors, Adrenergic, beta-1/immunology , Tachycardia, Ventricular/immunology , Adult , Aged , Cardiomyopathy, Dilated/epidemiology , Death, Sudden, Cardiac/epidemiology , Extracellular Matrix/immunology , Female , Heart Ventricles/immunology , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Tachycardia, Ventricular/mortality
17.
J Invasive Cardiol ; 12(12): 625-30, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11103031

ABSTRACT

To re-evaluate outcomes of stenting in small vessels, we studied 176 patients successfully treated with several types of stent by way of intravascular ultrasound (IVUS) and quantitative coronary angiography (QCA). These lesions were divided into 3 subgroups according to reference diameter (RD) by QCA, and vessel diameter (VD) by IVUS (group I: pre-RD 2.5 mm; group II: pre-RD < 2.5 mm and pre-VD 4.0 mm; group III: pre-RD < 2.5 mm and pre-VD < 4.0 mm). Post-procedure percent diameter stenosis (4 +/- 3%), post-procedure percent plaque area (42 +/- 3%), and loss index (39 +/- 11%) in group II were not significantly different from those in group I (7 +/- 2%, 37 +/- 2%, 45 +/- 5%, respectively). The rates of restenosis and target lesion revascularization in group II (24.0% and 16.0%, respectively) were not different from those in group I (25.9% and 21. 2%, respectively), and were significantly favorable compared to group III (66.7% and 39.4%, respectively; p < 0.05). By the use of IVUS, we not only identified those vessels which would normally go unstented when only using QCA, but also documented excellent long-term outcome in these patients.


Subject(s)
Coronary Angiography , Coronary Disease/therapy , Stents , Ultrasonography, Interventional , Aged , Coronary Disease/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Sensitivity and Specificity
18.
J Electrocardiol ; 33(4): 381-6, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11099363

ABSTRACT

Radiofrequency catheter ablation (RFCA) for inappropriate sinus tachycardia (IST) is associated with a high recurrence rate and sometimes requires pacemaker implantation, especially after extensive ablation. We report a patient with drug-refractory IST who was successfully treated by selective RFCA to the 2 earliest activation sites. During tachycardia, the earliest atrial activation preceded the surface P wave by 50 ms or more, whereas it was only 27 ms for the rest of the right atrium after ablation. Our patient had the longest activation period during tachycardia among the reported patients. In IST patients, a longer activation time at the site of the earliest atrial activation may imply that the abnormality is confined to a small area within the sinus node and may predict the efficacy of selective RFCA.


Subject(s)
Catheter Ablation , Electrocardiography , Tachycardia, Sinus/physiopathology , Tachycardia, Sinus/surgery , Adult , Electrocardiography/methods , Electrocardiography, Ambulatory , Female , Heart Rate , Humans , Tachycardia, Sinus/diagnosis
19.
Int J Cardiol ; 75(2-3): 253-60, 2000 Sep 15.
Article in English | MEDLINE | ID: mdl-11077143

ABSTRACT

BACKGROUND: No-reflow phenomenon after primary coronary angioplasty is associated with poorer left ventricular (LV) function and prognosis after acute myocardial infarction (AMI). The purpose of this study was to determine the clinical significance of preinfarction angina in the no-reflow phenomenon. METHODS AND RESULTS: A total of 40 patients with first anterior AMI were examined. All patients underwent primary balloon angioplasty or stenting within 12 h of the onset of AMI. No-reflow, defined as TIMI grade 2 flow or less without residual stenosis after angioplasty, was observed in 15 patients. Patients with no-reflow were older (67+/-9 vs. 58+/-10 years, P=0.006) and had a lower incidence of preinfarction angina (7% vs. 48%, P=0.01) than those without no-reflow. Patients with no-reflow had poorer LV function at predischarge and a higher incidence of pump failure, LV aneurysm, malignant ventricular arrhythmias or cardiac death during the hospital course in association with higher peak serum C-reactive protein levels (12.7+/-8.0 vs. 7.1+/-5.5 mg/dl, P=0.02). Multivariate analysis showed that the absence of preinfarction angina was a major independent determinant of no-reflow (RR=17.1, P=0.02). CONCLUSIONS: The absence of preinfarction angina is more frequently observed in patients with no-reflow. The beneficial effect of preinfarction angina on LV function may be explained, at least in part, by prevention of no-reflow after reperfusion.


Subject(s)
Angina Pectoris/physiopathology , Angioplasty, Balloon, Coronary , Coronary Circulation , Myocardial Infarction/physiopathology , Myocardial Infarction/therapy , Ventricular Function, Left , Adult , Aged , Aged, 80 and over , Coronary Angiography , Humans , Middle Aged , Myocardial Infarction/diagnostic imaging , Prognosis
20.
Coron Artery Dis ; 11(6): 451-7, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10966130

ABSTRACT

BACKGROUND: In-stent restenosis has become a significant clinical problem as use of stents has increased. The optimal strategy for dealing with in-stent restenosis needs to be evaluated. OBJECTIVE: To compare the acute and late results of interventions for in-stent restenosis according to the device used, and to analyze the clinical and procedural variables of the lesions treated and identify the determinants of recurrence of restenosis and target lesion revascularization (TLR). METHODS: Procedural and late outcomes for 58 lesions in 50 patients who underwent repeat intervention for in-stent restenosis were analyzed. The results of interventions according to the device employed were compared. The predictors of recurrence of restenosis and TLR within 6 months were analyzed. The ratio of balloon diameter in repeat intervention to minimal lumen diameter after initial stenting (MLD0) was used as an index of re-expansion of stents. Serial intravascular ultrasound imaging was performed before and after repeat intervention for 33 lesions, and re-expansion of the initial stent was evaluated. RESULTS: Repeat intervention was successful in treating all lesions. Angiographic follow-up was possible for 49 lesions (84%). The overall incidences of recurrence of restenosis and TLR were 40.1 and 27.6%, respectively. Despite the immediate results having been good, the late results of stenting for in-stent restenosis were not favorable. Diffuse-type in-stent restenosis, early in-stent restenosis, and balloon diameter:MLD0 ratio > 1.25 are independent predictors of poor late results. Intravascular ultrasound findings have shown that expansion of the initial stent leads to recurrence of restenosis and TLR. CONCLUSIONS: Re-expansion of the initial stent can cause further vascular injury and there is a risk of recurrence of restenosis. Alternative therapeutic strategies that work without dilating the initial stent may be necessary for treating lesions with high risk of recurrence of restenosis.


Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease/therapy , Stents , Aged , Coronary Angiography , Female , Humans , Male , Multivariate Analysis , Postoperative Period , Prognosis , Recurrence , Reoperation , Risk Factors
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