BACKGROUND AND PURPOSE:Four-dimensional contrast-enhanced MR angiography (4D-CE-MRA) at 3T may replace digital subtraction angiography (DSA) for certain diagnostic purposes in patients with intracranial dural arteriovenous fistula (DAVF). The aim of this study was to test the hypothesis that 4D-CE-MRA at 3T enables the same characterization of intracranial DAVFs as DSA.

No abstract

We have reported that the Toll-like receptor 9 (TLR9) signaling pathway plays an important role in the development of pressure overload-induced inflammatory responses and heart failure. However, its role in cardiac remodeling after myocardial infarction has not been elucidated. TLR9-deficient and control C57Bl/6 wild-type mice were subjected to left coronary artery ligation. The survival rate 14 days postoperation was significantly lower in TLR9-deficient mice than that in wild-type mice with evidence of cardiac rupture in all dead mice. Cardiac magnetic resonance imaging showed no difference in infarct size and left ventricular wall thickness and function between TLR9-deficient and wild-type mice. There were no differences in the number of infiltrating inflammatory cells and the levels of inflammatory cytokine mRNA in infarct hearts between TLR9-deficient and wild-type mice. The number of α-smooth muscle actin (αSMA)-positive myofibroblasts and αSMA/Ki67-double-positive proliferative myofibroblasts was increased in the infarct and border areas in infarct hearts compared with those in sham-operated hearts in wild-type mice, but not in TLR9-deficient mice. The class B CpG oligonucleotide increased the phosphorylation level of NF-κB and the number of αSMA-positive and αSMA/Ki67-double-positive cells and these increases were attenuated by BAY1-7082, an NF-κB inhibitor, in cardiac fibroblasts isolated from wild-type hearts. The CpG oligonucleotide showed no effect on NF-κB activation or the number of αSMA-positive and αSMA/Ki67-double-positive cells in cardiac fibroblasts from TLR9-deficient hearts. Although the TLR9 signaling pathway is not involved in the acute inflammatory response in infarct hearts, it ameliorates cardiac rupture possibly by promoting proliferation and differentiation of cardiac fibroblasts.

BackgroundChronic heart failure (CHF) with preserved left ventricular (LV) ejection fraction (HFpEF) is observed in half of all patients with CHF and carries the same poor prognosis as CHF with reduced LV ejection fraction (HFrEF). In contrast to HFrEF, there is no established therapy for HFpEF. Chronic inflammation contributes to cardiac fibrosis, a crucial factor in HFpEF; however, inflammatory mechanisms and mediators involved in the development of HFpEF remain unclear. Therefore, we sought to identify novel inflammatory mediators involved in this process.Methods and ResultsAn analysis by multiplex-bead array assay revealed that serum interleukin-16 (IL-16) levels were specifically elevated in patients with HFpEF compared with HFrEF and controls. This was confirmed by enzyme-linked immunosorbent assay in HFpEF patients and controls, and serum IL-16 levels showed a significant association with indices of LV diastolic dysfunction. Serum IL-16 levels were also elevated in a rat model of HFpEF and positively correlated with LV end-diastolic pressure, lung weight and LV myocardial stiffness constant. The cardiac expression of IL-16 was upregulated in the HFpEF rat model. Enhanced cardiac expression of IL-16 in transgenic mice induced cardiac fibrosis and LV myocardial stiffening accompanied by increased macrophage infiltration. Treatment with anti-IL-16 neutralizing antibody ameliorated cardiac fibrosis in the mouse model of angiotensin II-induced hypertension.ConclusionOur data indicate that IL-16 is a mediator of LV myocardial fibrosis and stiffening in HFpEF, and that the blockade of IL-16 could be a possible therapeutic option for HFpEF.

isruption of vulnerable plaque may cause acute coronary syndrome (ACS) [1][2][3][4] and at present angioscopy 5-9 and intravascular ultrasonography (IVUS) [10][11][12][13][14][15] are the most powerful, though invasive, methods of precisely evaluating vulnerable plaque. An angioscopic study reported that vulnerable plaque development was observed in culprit as well as nonculprit coronary artery segments in patients with myocardial infarction, 5 Yellow plaque detected by angioscopy is reportedly related to ACS 16,17 and the grade of yellow plaque predicts its vulnerability. [5][6][7][8] Hodgson et al reported that soft plaque was detected more often than calcified plaque by IVUS in an ACS patient. 10 Calcified plaque may be involved in cases of sudden death. 18 The feasibility of multi-detector row computed tomography (MDCT) [19][20][21][22] for coronary stenosis, 23,24 detection of soft plaque 25 and measuring the vessel area by manual tracing 26 has been reported. MDCT has undergone development of the number of detectors required to obtain precise images. 27,28 Schroeder et al used the region of interest (ROI) to classify plaque by computed tomography (CT) number 27 and very recently Achenbach et al reported a good correlation of the measurement of the CT image with the IVUS findings in a study of remodeling. 26 However, there is not a comprehensive method for evaluating the gray-scale CT image. ROI method using a circle or rectangle is commonly used to calculate the CT number of the area of concern, but usually a circle or rectangle does not fit the shape of the plaque.We developed the 'Plaque Map' system using the colorbased isometric lines method and Bird's Eye view to calculate the CT number in the image. Tissue characterization of the plaque and quantification of the area of both the plaque and vessel can be done by the 'Plaque Map'. In the present study we compared 'Plaque Map' with IVUS and angioscopy.

Digitalis-like factors and the subsequently activated NCX entry mode may play an important role in the development of hypertensive HFPEF, and the blockade of the NCX entry mode may be a new therapeutic strategy for this phenotype of heart failure.

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This open-label, multicenter, phase 1b/2 study assessed necitumumab plus gemcitabine and cisplatin (GC + N) in patients with previously untreated squamous non-small cell lung cancer in Japan. Materials and methods: The phase 1b part determined the gemcitabine dose for the phase 2 part, in which patients were randomized 1:1 to GC + N or gemcitabine and cisplatin (GC) (gemcitabine 1250 mg/m 2 on days 1 and 8; cisplatin 75 mg/m 2 on day 1 of maximum four 3-week cycles; nectimumab 800 mg on days 1 and 8 of a 3