3.

Plasma BNP increases in proportion to the extent of RV dysfunction in pulmonary hypertension.

Smooth contours and a round shape are most suggestive of type A thymic epithelial tumor, whereas irregular contours are most suggestive of type C tumor. Calcification is suggestive of type B tumors. CT is of limited value, however, in differentiating type AB, B1, B2, and B3 tumors.

The presence of lobulated or irregular contour, areas of low attenuation, and multifocal calcification is suggestive of invasive thymoma.

BackgroundWhen transplanted into failing heart, autologous somatic tissue–derived cells yield functional recovery via paracrine effects that enhance native regeneration. However, the therapeutic effects are modest. We developed a method in which scaffold‐free cell sheets are attached to the epicardial surface to maximize paracrine effects. This Phase I clinical trial tested whether transplanting autologous cell–sheets derived from skeletal muscle is feasible, safe, and effective for treating severe congestive heart failure.Methods and ResultsFifteen ischemic cardiomyopathy patients and 12 patients with dilated cardiomyopathy, who were in New York Heart Association functional class II or III and had been treated with the maximum medical and/or interventional therapies available, were enrolled. Scaffold‐free cell sheets of 3 to 9×108 cells derived from autologous muscle were transplanted over the LV free wall via left thoracotomy, without additional interventional treatments. There were no procedure‐related major complications during follow‐up. The majority of the ischemic cardiomyopathy patients showed marked symptomatic improvement in New York Heart Association classification (pre: 2.9±0.5 versus 6 months: 2.1±0.4, P<0.01; 1 year: 1.9±0.3, P<0.01) and the Six‐Minute Walk Test with significant reduction of serum brain natriuretic peptide level (pre: 308±72 pg/mL versus 6 months: 191±56 versus 1 year: 182±46, P<0.05), pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vein resistance, and left ventricular wall stress after transplantation instead of limited efficacy in dilated cardiomyopathy patients.ConclusionsCell‐sheet transplantation as a sole therapy was feasible for treating cardiomyopathy. Promising results in the safety and functional recovery warrant further clinical follow‐up and larger studies to confirm this treatment's efficacy for severe congestive heart failure.Clinical Trial Registration URL: http://www.umin.ac.jp/english/. Unique identifier: UMIN000003273.

The sites of morphological abnormalities detected by electron beam CT in patients with the Brugada syndrome were related to the origins of premature ventricular contractions recorded only in the acute phase, which may trigger ventricular fibrillation. These morphological abnormalities may be related to arrhythmogenic substrates in patients with the Brugada syndrome.

No abstract

Because of a lack of information about the rates of growth of aortic aneurysms, such rates in thoracic and abdominal aortic aneurysms were determined. One hundred seventy-one patients with atherosclerotic aortic aneurysm managed nonoperatively were followed up for more than 6 months with sequential computed tomography (CT). There were 211 aneurysms (thoracic aortic, 82; abdominal aortic, 129). The growth rates of thoracic and abdominal aortic aneurysms were 0.42 and 0.28 cm/y, respectively. Aneurysms at the aortic arch (n = 34) grew at a faster average rate (0.56 cm/y) than aneurysms arising at other levels, even when the rate was corrected for the initial diameter. It is recommended that thoracic aortic aneurysms, especially aortic arch aneurysms, be followed frequently with CT examination of size.