Nitroglycerin use and adverse clinical outcomes in elderly patients with acute coronary syndrome

Objective The primary care for acute coronary syndrome (ACS) includes the administration of nitroglycerin (GTN). This study aimed to investigate the association between the use of GTN before percutaneous coronary intervention (PCI) for ACS and clinical outcomes. Methods Nine-hundred and forty-seven patients who underwent PCI for ACS were examined and classified into two groups: those who were treated with GTN before PCI (GTN group) and those who were not (non-GTN group). The incidence of major adverse cardiovascular events (MACE), which consist of all-cause mortality, non-fatal myocardial infarction, stroke and rehospitalisation for heart failure at 1 year, was compared between the two groups. Results This study identified 289 patients with ACS who used GTN preceding PCI. Pre-PCI systolic blood pressure was significantly lower in the GTN group than in the non-GTN group (median (IQR); 132.0 (110.0–143.5) mm Hg vs 134.0 (112.0–157.0) mm Hg, respectively, p=0.03). Multivariate Cox regression analysis indicated that GTN use preceding PCI showed an independent association with the incidence of MACE (HR 1.57; 95% CI 1.09–2.28; p=0.016). Overall, the incidence of MACE 1 year after PCI for ACS was significantly higher in the GTN group than in the non-GTN group (log-rank test, p=0.024); however, this trend was consistently found in elderly patients aged ≥75 years (p=0.002) but not in non-elderly patients aged <75 years (p=0.773). Conclusions GTN use preceding PCI for ACS is associated with lower blood pressure and adverse clinical outcomes in elderly patients.Citation: Soichi Komaki, Yunosuke Matsuura, Hiroki Tanaka, Kohei Moribayashi, Yoshimasa Yamamura, Kazumasa Kurogi, Takeshi Ideguchi, Nobuyasu Yamamoto, Michikazu Nakai, Toshihiro Tsuruda, Koichi Kaikita, Nitroglycerin use and adverse clinical outcomes in elderly patients with acute coronary syndrome. Open Heart. 2024-01, 11(1), e002494, https://doi.org/10.1136/openhrt-2023-00249

Basal inferoseptal segment is highly susceptible to deformation in the clinical spectrum of transthyretin-derived amyloid cardiomyopathy

AIMS While the prevalence of transthyretin-derived amyloid cardiomyopathy (ATTR-CM) is on the rise, detailed understanding of its morphological and functional characteristics within the left ventricle (LV) across heart failure (HF) remains limited. METHODS AND RESULTS Utilizing two-dimensional (2D) speckle-tracking echocardiography, we assessed longitudinal strain (LS) in 63 histology-confirmed ATTR-CM patients. Additionally, cardiac magnetic resonance (CMR) images measured native T1 and extracellular volume (ECV), compared with LS across 18 LV segments. Patients were categorized into three groups based on HF status: Group 1 (no HF symptoms), Group 2 (HF with preserved LV ejection fraction), and Group 3 (HF with reduced LV ejection fraction). LS analysis unveiled susceptibility to deformation in the basal inferoseptal segment, persisting even in asymptomatic cases. CMR demonstrated increasing native T1 deviation, particularly evident in segments distant from the inferoseptal region. Contrastingly, maximal ECV was consistently observed in the basal and mid-ventricular inferior-septum, even in asymptomatic individuals. Segmental LS decline correlated with ECV expansion but not with native T1 values. CONCLUSION Our findings suggest that the inferoseptal segment is highly susceptible to amyloid infiltration, and 2D speckle-tracking echocardiography and CMR may serve as a valuable tool for its early detection.Citation: Toshihiro Tsuruda, Hiroshi Nakada, Yoshimasa Yamamura, Yunosuke Matsuura, Miyuki Ogata, Miyo Tanaka, Yosuke Suiko, Soichi Komaki, Hiroki Tanaka, Kohei Moribayashi, Takeshi Ideguchi, Tamasa Terada, Tomomi Ota, Keisuke Yamamoto, Kensaku Nishihira, Yoshisato Shibata, Koichi Kaikita, Basal inferoseptal segment is highly susceptible to deformation in the clinical spectrum of transthyretin-derived amyloid cardiomyopathy, European Heart Journal Open, 4(5), 2024-08-31, https://doi.org/10.1093/ehjopen/oeae07

Observation of the Color-Suppressed Decay B̅ 0→D0π0

journal articl

調査報告 : ロマプリエータ地震による被災構造物の復旧状況

departmental bulletin pape

ボケナイ タメノ シンケイ カガク

video/mp4講演者所属: 大阪大学大学院医学系研究科教授vide

高等学校家庭科におけるゲスト・ティーチャーと協働の意義-味噌作り職人が授業にもたらす効果-

departmental bulletin pape

Plastic Behaviours of Polycrystalline Metals under Multi-axial Cyclic Loading Conditions

application/pdfRecently, the formulation of plasic constitutive equations for polycrystalline metals under multi-axial cyclic loading conditions has been noted from the view points of practical safety design of machines and constructions as well as of interests in the deformation mechanisms of metals. However, the experimental data available are not enough yet when we consider the complexity of plastic behaviours under such conditions. Then, the authors conducted some fundamental multi-axial experiments by applying combined loads of cyclic axial force and steady internal pressure to thin-walled tubular specimens of initially isotropic brass, and discussed the possibility of the formulation of constitutive equations useful in such complex conditions on the bases of the experimental data obtained here, following the crystal plasticity approach.departmental bulletin pape

Nitroglycerin use and adverse clinical outcomes in elderly patients with acute coronary syndrome

Objective The primary care for acute coronary syndrome (ACS) includes the administration of nitroglycerin (GTN). This study aimed to investigate the association between the use of GTN before percutaneous coronary intervention (PCI) for ACS and clinical outcomes. Methods Nine-hundred and forty-seven patients who underwent PCI for ACS were examined and classified into two groups: those who were treated with GTN before PCI (GTN group) and those who were not (non-GTN group). The incidence of major adverse cardiovascular events (MACE), which consist of all-cause mortality, non-fatal myocardial infarction, stroke and rehospitalisation for heart failure at 1 year, was compared between the two groups. Results This study identified 289 patients with ACS who used GTN preceding PCI. Pre-PCI systolic blood pressure was significantly lower in the GTN group than in the non-GTN group (median (IQR); 132.0 (110.0–143.5) mm Hg vs 134.0 (112.0–157.0) mm Hg, respectively, p=0.03). Multivariate Cox regression analysis indicated that GTN use preceding PCI showed an independent association with the incidence of MACE (HR 1.57; 95% CI 1.09–2.28; p=0.016). Overall, the incidence of MACE 1 year after PCI for ACS was significantly higher in the GTN group than in the non-GTN group (log-rank test, p=0.024); however, this trend was consistently found in elderly patients aged ≥75 years (p=0.002) but not in non-elderly patients aged <75 years (p=0.773). Conclusions GTN use preceding PCI for ACS is associated with lower blood pressure and adverse clinical outcomes in elderly patients.Citation: Soichi Komaki, Yunosuke Matsuura, Hiroki Tanaka, Kohei Moribayashi, Yoshimasa Yamamura, Kazumasa Kurogi, Takeshi Ideguchi, Nobuyasu Yamamoto, Michikazu Nakai, Toshihiro Tsuruda, Koichi Kaikita - Nitroglycerin use and adverse clinical outcomes in elderly patients with acute coronary syndrome: Open Heart 2024;11:e002494

Optical coherence tomography imaging of coronary thrombosis developed after rotational atherectomy despite appropriate antithrombotic therapy

Citation: Komaki, S., Moribayashi, K., Matsuura, Y. et al. Optical coherence tomography imaging of coronary thrombosis developed after rotational atherectomy despite appropriate antithrombotic therapy. Cardiovasc Interv and Ther 39, 493–494 (2024). https://doi.org/10.1007/s12928-024-01009-