Chronic infection with HP may be involved in the development of the atherosclerosis via endothelial dysfunction and systemic and vascular inflammation.

Bach1 is a transcriptional repressor of heme oxygenase-1 gene ( Hmox-1 ) and β β β β -globin gene. Heme oxygenase (HO)-1 is an inducible cytoprotective enzyme that degrades pro-oxidant heme to carbon monoxide (CO) and biliverdin/bilirubin, which are thought to mediate anti-inflammatory and anti-oxidant actions of HO-1. In the present study, we investigated the role of Bach1 in tissue protection against myocardial ischemia/reperfusion (I/R) injury in vivo using mice lacking the Bach1 gene ( Bach1

Abstract-The aim of this study was to determine the role of the AT2 receptor (AT2R) in left ventricular (LV) remodeling after myocardial infarction (MI). The left anterior descending arteries were ligated in AT2R gene knockout (Agtr2-) and wild-type (Agtr2ϩ) mice. The LV remodeling was evaluated by echocardiography and histology over a period of 2 weeks after MI. The infarct sizes in hearts excised from Agtr2ϩ and Agtr2-mice on day 1 were similar. The mortality rate of Agtr2-mice (62.9%) on day 14 after MI was significantly (PϽ0.05) higher than that of Agtr2ϩ mice (39.7%). Accordingly, LV/body weight ratios (3.7Ϯ0.2 versus 3.0Ϯ0.1 on day 14) and LV end-diastolic (4.8Ϯ0.3 versus 3.9Ϯ0.4 mm on day 7) and end-systolic (4.4Ϯ0.3 versus 3.2Ϯ0.6 mm on day 7) dimensions evaluated by echocardiography were significantly greater in Agtr2-than in Agtr2ϩ mice. The rates of ventricular arrhythmia, rates of cardiac rupture, and blood pressures in the 2 strains were similar after MI. Myocyte cross-sectional areas were increased after MI, but the magnitudes were similar in Agtr2ϩ and Agtr2-mice, indicating the greater increases in LV dimensions and weight in Agtr2-mice are due to elongation of myocyte length and/or an increase in the interstitial weight (including vasculatures, infiltrated cells, and interstitial fluid). Interstitial fibrosis in remote myocardium was not evident in either strain. These results indicate AT2R plays a significant role in the protection against early development of LV dilation, thereby reducing the early mortality rate after MI. Key Words: mice Ⅲ myocardial infarction Ⅲ receptors, angiotensin Ⅲ remodeling M yocardial infarction induces global changes in ventricular architecture, called post-myocardial infarction (MI) left ventricular (LV) remodeling, which involves LV dilation, myocyte hypertrophy, and interstitial fibrosis, leading to a deterioration in LV function that is associated with increased rate of mortality. 1,2 A substantial body of evidence 1,3-5 has suggested that angiotensin II (Ang II) plays a critical role in the development of post-MI LV remodeling. Ang II has 2 major receptor subtypes, AT1 receptor (AT1R) and AT2R, both of which are expressed in the heart. 6 It has been suggested that AT1R signaling mediates vasoconstriction, aldosterone secretion, cardiomyocyte hypertrophy, proliferation of fibroblasts, interstitial collagen deposition, and catecholamine release, all of which are implicated in progression of LV remodeling. 7,8 Harada et al 3 recently reported that AT1R gene-knockout mice had less LV remodeling and improved survival after MI. A deletion of AT1R or a blockade of AT1R with specific antagonists may result in selective binding of Ang II to the AT2R, indicating that the effect of AT1R blockade could be in part mediated by the effect of AT2R. 7 However, little is known about the role played by AT2R in post-MI LV remodeling. The AT2R is thought to have opposite effect to AT1R and has been shown to suppress myocardial hypertrophy, 9 -11 fibroblast proliferation, 10,12 and ...

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Transthoracic echocardiography or transesophageal echocardiography is sometimes useful in intracardiac tumor biopsy. Intracardiac echocardiography was used as an alternative to either of these for performing a biopsy of a right cardiac tumor in a 79-year-old woman. The procedure was well tolerated and no complications occurred. Histopathological findings and immunohistological staining were compatible with the diagnosis of neurogenic sarcoma.

ranscatheter occlusion of a small ductus arteriosus is now commonly performed in children. However, there are only a small number of reports of transcatheter coil embolization of adult patent ductus arteriosus (PDAs). We attempted to occlude large PDAs in 3 adult patients with Cook detachable coils and we report the usefulness and problems of such a procedure. Case Reports Case 1A 58-year-old woman had exertional dyspnea and chest discomfort. On physical examination, she had a bounding peripheral pulse and a grade 2/6 continuous murmur at the left upper sternal border. Conventional 2-dimensional echocardiography demonstrated left ventricular and atrial enlargement, and a left ventricular ejection fraction of 71%. On color Doppler echocardiography, left-to-right PDA shunt flow was visible. On transesophageal echocardiography (TEE) the minimal diameter of the PDA was 5 mm. Informed consent for coil embolization was obtained.Right-and left-heart catheterization was performed and an oxygen step-up of the blood samples was detected at the pulmonary artery level.Aortography in the left anterior oblique projection revealed a funnel-shaped PDA (type A1) with a minimal diameter being 5.2 mm (Fig 1A). Following aortography, a 0.032-inch guidewire was advanced retrogradely from the aorta through the PDA into the pulmonary artery, and another guidewire of the same size was advanced anterogradely from the pulmonary artery through the PDA into the aorta. A 6F multipurpose catheter was advanced anterogradely and the guidewire was then removed. A 5-loop coil of 8 mm in diameter was delivered successfully into the PDA. Next, when another 6-F multipurpose catheter was inserted retrogradely, the prepositioned coil was dislodged into the main pulmonary artery. The coil was then successfully retrieved by a snare. Two multipurpose catheters were once more advanced through the PDA, one retrogradely and the other anterogradely. A 5-loop coil of 8 mm in diameter was delivered into the PDA anterogradely. Without detaching the coil, another 5-loop coil of 5 mm in diameter was sequentially delivered retrogradely. Aortography revealed slight residual flow (Fig 1B). Because of the risk of coil migration and the possibility of spontaneous complete closure of the PDA, no additional coiling was attempted and the 2 coils were then detached.The next day, a slight residual shunt was observed on color Doppler echocardiography. However, the patient's exertional dyspnea and chest discomfort disappeared. During her stay in hospital, her urine was not dark colored, and blood chemistry for hemolysis was not examined. Six months after the first procedure, a hematological examination revealed severe hemolytic anemia (Table 1). Transthoracic echocardiography demonstrated a smaller left ventricle and left atrium than that of 6 months previous (Table 2). On the transthoracic and transesophageal color Doppler echocardiography, a residual left-to-right PDA shunt flow was visible. The hemolysis was thought to be due to the shunt, and the patient underwent a sec...

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