Neuromuscular electrical stimulation has been used to treat cardiovascular diseases and other types of muscular dysfunction. A novel whole-body neuromuscular electrical stimulation (WB-NMES) wearable device may be beneficial when combined with voluntary exercises. This study aimed to investigate the safety and effects of the WB-NMES on hemodynamics, arrhythmia, and sublingual microcirculation. The study included 19 healthy Japanese volunteers, aged 22–33 years, who were not using any medication. Electrocardiogram (ECG), echocardiography, and blood sampling were conducted before a 20-min WB-NMES session and at 0 and 10 min after termination of WB-NMES. Their tolerable maximum intensity was recorded using numeric rating scale. Arrhythmia was not detected during neuromuscular electrical stimulation or during 10 min of recovery. Blood pressure, heart rate, left ventricular ejection fraction, and diastolic function remained unchanged; however, mild mitral regurgitation was transiently observed during WB-NMES in a single male participant. A decrease in blood glucose and an increase in blood lactate levels were observed, but no changes in blood fluidity, sublingual microcirculation, blood levels of noradrenaline, or oxidative stress were shown. WB-NMES is safe and effective for decreasing blood glucose and increasing blood lactate levels without changing the blood fluidity or microcirculation in healthy people.
Background: Sedentary behavior may be an independent risk factor for cardiovascular events. This study aimed to clarify the effects of extended sedentary time in patients with diabetic kidney disease (DKD) on the risk of all-cause death and new events.
Methods and Results:A prospective cohort study was performed over 39 months. The study included 173 patients with DKD who completed the International Physical Activity Questionnaire (IPAQ) (101 men; mean age, 71±11 years); 37 patients (21.4%) were diagnosed with cardiovascular disease (CVD). New events were defined as all-cause death, cerebral stroke, or CVD requiring hospitalization or commencing hemodialysis (HD). Data were analyzed using a multivariate Cox proportional hazard regression model with variables, including sedentary time. There were 34 cases of new events during the observation period, including 4 cases of stroke, 20 cases of CVD, 4 cases of HD implementation, and 6 cases of death. Hazard ratio (HR) calculations for the new event onset group identified sedentary time as a significant independent variable. The independent variable that was identified as a significant predictor of new events was the sedentary time (60 min/day; HR: 1.23, 95% CI: 1.05-1.45, P=0.012).
Conclusions:Extended sedentary time increased the risk of new cardiovascular or renal events and/or all-cause death in patients with DKD.
Spontaneous coronary artery dissection (SCAD) is a reported rare cause of acute coronary syndrome (ACS) and sudden death among middle-aged women. Some institutes have recently reported fibromuscular dysplasia (FMD) concomitant with SCAD. Therefore, a survey of the presence of comorbid FMD in SCAD patients is important to obtain a definitive diagnosis and for the prediction of possible SCAD recurrence. The optimal treatment of ACS due to SCAD remains undetermined, and technical failures are frequently encountered in primary percutaneous coronary intervention (PCI) owing to the unusual nonatherosclerotic cause of the disease. We report a case of SCAD successfully treated with cutting balloon PCI under intravascular ultrasound guidance without stent implantation, in which FMD was detected in the right external iliac artery through screening by noncoronary angiography, not duplex ultrasound.
A right-sided aortic arch is normally asymptomatic. We report the case of an 84-year-old man with right internal jugular vein thrombosis caused by an aneurysm in a right-sided aortic arch. The patient had undergone open repair of an abdominal aortic aneurysm and had an uneventful postoperative course. However, a routine postoperative contrast-enhanced thoracic and abdominal computed tomography scan showed right internal jugular vein thrombosis. The patient had no history of catheter insertion in the right jugular veins and had no hereditary coagulopathy. It was presumed that the cause of this thrombosis was compression of the right brachiocephalic vein by an aneurysm of the right-sided ascending aorta that was considered too small to require surgical repair. The right internal jugular vein thrombosis was successfully treated with edoxaban.
Patients with coronary spastic angina (CSA) are often younger and exhibit fewer classic cardiovascular risk factors except for smoking [1]. In general, patients with CSA who respond to calcium channel blockers have a good prognosis; consequently, the 5-yearsurvival rate of CSA is more than 90% [2,3]. In a Japanese registry study including 1429 patients with CSA [4], 5.9% reached the primary major adverse cardiovascular event (MACE) combined endpoint [cardiac death, nonfatal myocardial infarction, unstable angina, heart failure, or implantable cardioverter defibrillator (ICD) shock] during a median follow-up of 32 months [4]. Patients with CSA who have obstructive coronary artery disease have a poorer prognosis [4,5]. Here, we present three cases of out-of-hospital cardiac arrest (OHCA) likely due to coronary spasm in the presence of nonobstructive coronary artery disease in men older than 65 years. We consider the prognosis of elderly CSA patients and the association of CSA with OHCA.
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