LV torsion analysis could be a useful non-invasive approach for early detection of subclinical anthracycline cardiotoxicity.

easurements of pulse wave velocity (PWV) are useful for evaluating aortic stiffness, which has been shown to be associated with traditional risk factors. [1][2][3][4][5] Aortic stiffness, but not stiffness of peripheral muscular arteries, also has been noted to predict not only primary coronary events and fatal stroke in a variety of disease conditions, such as end-stage renal disease, 6 hypertension 7 and diabetes, 8 but also cardiovascular mortality in the general population. 9-11 Although conventional techniques for measuring carotid-femoral PWV are non-invasive, sophisticated methods, they are inconvenient, particularly in large clinical trials. Recently, brachial-ankle (ba) PWV has been developed as a more simple, practical, reproducible procedure to assess both the central elastic and peripheral muscular arterial stiffness. 12,13 It has been reported that the baPWV is closely correlated with aortic PWV and leg PWV, 13 is associated with risk factors and organ damage in the presence of cardiovascular diseases, [14][15][16] and has a prognostic value for future cardiovascular events in patients with acute coronary syndrome. 17 Thus, the measurement of baPWV is suitable, especially for screening vascular damage in a large population and when assessing vascular damage in long-term follow-up studies.Recent studies suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (ie, statins) act to exert direct beneficial effects on myocardial ischemia and hypertrophy, coronary vasomotion and vascular smooth muscle cell proliferation, and reduce adverse cardiovascular events in patients at risk through not only the lipid-lowering action but also the lipid-independent anti-atherogenic properties; that is, the so-called pleiotropic effects. Although fluvastatin, but not pravastatin or non-statin antihyperlipidemic agents, has been noted to improve aortic stiffness in association with decreased serum lipid and C-reactive protein (CRP) levels over a treatment period of 12 months, 18 its effect over longer treatment periods has not yet been clarified. Thus, the present study was designed to test the hypothesis that fluvastatin might improve arterial stiffness assessed by PWV in patients with coronary artery disease (CAD) and hyperlipidemia over a much longer treatment period. We also investigated whether arterial stiffness improved in patients whose drugs had been switched from non-statin antihyperlipidemic agents to fluvastatin. Background The present study was designed to test the hypothesis that fluvastatin might improve arterial stiffness, as assessed with pulse wave velocity (PWV), in patients with coronary artery disease (CAD) and hyperlipidemia over the long term. Methods Protocol Methods and ResultsNinety-three patients were randomly assigned to either fluvastatin (group A, n=50) or bezafibrate (group B, n=43) and followed for 5 years. There was no difference in the clinical findings between the 2 groups. In group A, there was a progressive reduction in the brachial-ankle PWV along with a decrease in...

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Background: Evaluation of plasma markers of thrombin activity (thrombin-antithrombin III complex: TAT), active fibrinolysis (plasmin-α 2-plasmin inhibitor complex: PIC), and platelet activity (platelet factor 4: PF4) is useful for identifying patients with various cardiovascular disorders who are at high risk of thromboembolism. In this study, these markers were investigated in the left atria (LA) of patients with paroxysmal atrial fibrillation (pAF) in the non-paroxysmal period. Methods and Results: Patients with pAF (n=10) and chronic AF (cAF) (n=10) were enrolled. TAT, PIC, and PF4 levels were determined in blood samples obtained from the LA of AF patients before radiofrequency catheter ablation. TAT levels were high in both pAF and cAF patients. PF4 levels were slightly elevated in both groups, but there was no significant difference between the groups. On the other hand, PIC levels in both groups were almost within normal limits, again with no significant difference between groups. Conclusions: Coagulation activity is elevated in the LA of patients with pAF, even in the non-paroxysmal period, so these patients are at high risk of thromboembolism and anticoagulant therapy is indicated. (Circ J 2009; 73: 1403 -1407

Background: It has recently become possible to analyze coronary plaque characteristics by using integrated backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to use this modality to evaluate the impact of early intervention with rosuvastatin on both the volume and tissue characteristics of non-culprit plaques in acute coronary syndrome (ACS). Methods and Results:Patients with ACS underwent IB-IVUS after percutaneous coronary intervention procedure and were administered rosuvastatin. Follow-up IB-IVUS was recorded 6 months later. We analyzed the changes in plaque burden and tissue characteristics in these patients. Plaque components were classified as calcified, fibrous, and lipid according IB-IVUS. We comprehensively analyzed 20 ACS patients. The low-density lipoprotein-cholesterol levels decreased significantly from 117±34 mg/dl to 73±19 mg/dl (P<0.001) after statin therapy. Comparing the baseline images with the follow-up ones revealed a significant reduction in the plaque burden from 98.4±42.1 mm 3 /10 mm to 80.2±35.8 mm 3 /10 mm (P<0.001) and in the lipid volume from 44.1±29.6 mm 3 / 10 mm to 28.6±17.8 mm 3 /10 mm (P<0.001). With respect to the % lipid volume, the reduction rate at follow-up showed a significant correlation with its baseline value (r=-0.498, P=0.024). Conclusions:Early intervention with rosuvastatin in ACS patients enabled significant reduction of the non-culprit plaque during 6 months. This regression was mainly due to the decrease in the lipid component of the plaque. (Circ J 2011; 75: 633 - 641)

The phosphodiesterase-5 (PDE-5) inhibitor, sildenafil, has been reported to produce sustained pulmonary vasodilatation in patients with pulmonary hypertension (PH). Recently, vardenafil, a more potent and selective PDE-5 inhibitor than sildenafil, has been approved for the treatment of erectile dysfunction. However, the long-term effects of oral vardenafil in patients with PH are unknown. We studied five consecutive patients with PH; one with primary pulmonary hypertension, two with chronic pulmonary thromboembolism,

This study was carried out to compare concentrations of osteopontin (OPN) and osteoprotegerin (OPG) in peripheral arterial disease (PAD). The study population consisted of 200 consecutive subjects in whom both OPN/OPG and ankle-brachial index were measured. It was found that OPN levels, but not OPG levels, were significantly more increased in patients with PAD than those without PAD. Serum OPN levels were significantly lower in subjects with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers than those without these agents. In this study, it has been demonstrated for the first time that serum OPN levels are related to PAD. Inhibition of renin- angiotensin system could decrease OPN levels and prevent the progression of PAD.