Search

Heart failure is important in determining the prognosis of cardiomyopathy caused by mitochondrial gene abnormalities. We report herein the case of a patient with pericardial effusion and heart failure in whom mitochondrial cardiomyopathy was definitively diagnosed. A 56-year-old woman consulted her primary physician with exertional dyspnea. Examination revealed edema and pericardial effusion, and diuretics were prescribed. However, after marked left ventricular hypertrophy (LVH) was noted, she was admitted to our hospital for further evaluation. Further examination revealed short stature, ptosis, generalized muscle atrophy, and sensorineural hearing loss. Echocardiography showed LVH, a global decrease in wall motion, and pericardial effusion. Physical and laboratory findings, including glucose intolerance and elevated serum lactate, suggested mitochondrial cardiomyopathy. Genetic testing confirmed cardiomyopathy due to a mitochondrial a3243g mutation. After treatment to improve heart failure, marked washout was shown on (99m)Tc-MIBI (methoxyisobutylisonitrile) myocardial scintigraphy, suggesting a correlation with mitochondrial dysfunction. [ABSTRACT FROM AUTHOR]

Bronchial artery aneurysm (BAA) is a rare condition. Rupture of BAA can cause critical hemorrhage, and intervention for BAA is thus recommended. A 69-year-old woman presented with BAA 70 mm in diameter in the right hilum of the lung. Transcatheter arterial embolization for afferent arteries of the BAA was performed and the BAA has subsequently been shrinking as observed by radiography. We present this case and a brief review of management of BAA based on the literature. [ABSTRACT FROM AUTHOR]

This report describes a case of traumatic incomplete rupture of the ventricular septum, a rare complication caused by blunt chest trauma. Although a serial ECG progressed its course similar to acute anteroseptal myocardial infarction in this case, there was little clinical clue of septal tear. The diagnosis was established by transthoracic echocardiography. The authors chose a conservative line of management rather than surgical repair for incomplete septal rupture because of the patent's stable clinical course and hemodynamic status. A sequence of echocardiography during a 32-day stay in the hospital showed no change in the extent of incomplete septal rupture, septal structure, systolic function, and shape of left ventricle and also obtained no evidence of shunting through the rupture. In conclusion, echocardiography is a useful investigation to make a diagnosis as well as for follow-up in case of incomplete ventricular septal rupture. A close follow-up of incomplete septal rupture with serial echocardiography should be performed, because several cases of delayed ventricular septal rupture following blunt chest trauma have been reported. [ABSTRACT FROM AUTHOR]

Objective: To investigate a novel marker of oxidative stress in patients with congestive heart failure (CHF). Patients: 15 patients with mild CHF, 15 patients with severe CHF with acute exacerbation, and 15 control subjects. Main outcome measures: Measurement of urinary 15-F[sub 2t]-isoprostane, plasma brain natriuretic peptide (BNP), serum interleukin 6 (IL-6), and serum thrombomodulin concentrations. In patients with severe CHF, samples were taken at admission and 4, 7, and 14 days after admission. Results: Urinary 15-F[sub 2t]-isoprostane, plasma BNP, and serum IL-6 concentrations in patients with severe CHF were significantly higher than those in control subjects or in patients with mild CHF. However, concentrations of serum thrombomodulin, a marker of endothelial damage, were not different between patients with CHF and control subjects. In addition, urinary 15-F[sub 2t]-isoprostane, plasma BNP, and serum IL-6 concentrations in patients with severe CHF gradually decreased in proportion to the severity of CHF during hospitalisation. Interestingly, urinary 15-F[sub 2t]-isoprostane concentrations significantly correlated with plasma BNP concentrations and serum IL-6 concentrations, but not with serum thrombomodulin concentrations. Conclusions: Urinary 15-F[sub 2t]-isoprostane concentrations increased in proportion to the severity of CHF in patients. This may be caused by increased 15-F[sub 2t]-isoprostane production. These findings suggest that urinary 15-F[sub 2t]-isoprostane may be a marker of morbidity as well as oxidative stress in patients with CHF. [ABSTRACT FROM AUTHOR]

We have investigated the effect of interleukin-1 (IL-1) on the growth of mesangial cells isolated from rat kidney. Recombinant IL-1α inhibited ³H-thymidine uptake by mesangial cells in a dose-dependent manner in the presence of either 0.5% or 5% fetal bovine serum (FBS). In the presence of high concentration of FBS (10%), the effect of IL-1 was not prominent. The inhibitory effect of IL-1 on the growth of mesangial cells was also confirmed by a change in cell numbers and measurements of protein synthesis with ³H-leucine, IL-1-induced inhibition of mesangial cell growth was not affected by indomethacin, IL-I showed no effects on intracellular Ca-2+ levels in mesangial cells. These observations indicate that IL-1 inhibits the growth of mesangial cells, and thus may play a protective role for mesangial cells from abnormal proliferation in some pathophysiological states. [ABSTRACT FROM AUTHOR]

The authors present a case of a large saccular aneurysm in a coronary artery fistula originating from the proximal left anterior descending coronary artery, draining into the main trunk of the pulmonary artery. The diagnosis was made by 3-dimensional computed tomography and coronary arteriography. Congenital coronary artery fistula is not uncommon. With a saccular aneurysm, however, it is very rare. A ruptured aneurysm will induce sudden death if surgical repair is not done. [ABSTRACT FROM AUTHOR]

The authors report the case of a 57-year-old woman with Ebstein's anomaly and atrial septal defect. She was referred to their hospital for treatment of refractory paroxysmal wide QRS tachycardia. Her 12-leads ECG in sinus rhythm showed ventricular preexcitation of type B Wolff-Parkinson-White syndrome. In a baseline electrophysiological study, a wide QRS tachycardia with right bundle branch block configurations was induced. This tachycardia was orthodromic atrioventricular reciprocating tachycardia with a right inferior accessory pathway. Radiofrequency current was successfully delivered at the inferior site of the atrialized right ventricle. Radiofrequency catheter ablation seems to be useful for supraventricular tachycardia in patients with Ebstein's anomaly and atrial septal defect. [ABSTRACT FROM AUTHOR]

In three patients with cardiac myxoma increased expression of interleukin 6 (IL-6) mRNA was found in the myxoma tissue by polymerase chain reaction (PCR) and in situ hybridisation. These cases suggest that IL-6 is overproduced in the myxoma tissue and secreted into the systemic circulatory system. This might contribute to the systemic inflammatory or autoimmune manifestations seen in cardiac myxoma. This study also showed the usefulness of PCR and in situ hybridisation for the evaluation of mRNA expression in small samples of tissue. [ABSTRACT FROM PUBLISHER]

The bone marrow derived endothelial progenitor cells (EPCs) are considered to originate from haematopoietic stem cells, which are positive for CD34. Human CD34 expressing cells (CD34 cells) injected into nude mice and rats undergoing neovascularisation caused by hindlimb ischaemia are incorporated into the neovasculature and express endothelial antigens. Authors recently reported that transplantation of autologous bone marrow cells, including CD34 cells, improved ischaemia in patients with critical limb ischaemia. Moreover, increased neovascularisation by bone marrow derived CD3C cells was shown to improve cardiac function. Recently, a mobilsation of EPCs into circulation from bone marrow was reported in patients with acute myocardial infarction and acute coronary syndrome, but little is known about the regulation of EPCs mobilisation in patients with stable coronary artery disease (CAD). In the present study, authors investigated the number of circulating CD3C cells in patients with CAD and the influence of atherosclerotic risk factors on this number.