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IntroductionThe rise in water demand and reduction of water quality and soil in irrigating areas, especially in dry and semi-arid areas of the world, have turned into one of the most crucial challenges for water and soil engineering in recent years. This issue leads us toward optimal quantitative and qualitative management of these valuable resources aimed at achieving economic performance and water productivity. The periodic evaporation and transpiration of the plant in the conditions of simultaneous water and salinity stress are known as one of the most important factors in the qualitative and quantitative growth of the plant yield. Applying mathematical models that simulate the relationship between field variables and yield can be seen as a useful tool in water and soil management issues in such a situation, which has the potential to ensure optimal use of the water and soil resources of any country by providing the plant's water needs and preventing its further loss.Materials and MethodsA factorial experiment was performed in 2019 based on completely randomized blocks design with three replications in plots with an area of 9 square meters at the agricultural and animal husbandry farm of Aliabad Fashafuyeh, located in Qom province to examine the simultaneous effect of different levels of water stress and salinity on the periodic evaporation-transpiration and fresh yield of the single cross 704 forage corn cultivar. The applied treatments included the irrigation water salinity at three electrical conductivity levels of 1.8 (S0), 5.2 (S1), and 8.6 (S2) deci Siemens/meter (dS/m), which were prepared by mixing saline well water of the region with fresh (drinking) water and three water stress levels of 100% (W0), 75% (W1), and 50% (W2) of the plant's water requirement. The depth of soil moisture in the corn plant root zone was measured by the TDR device at five depths of 7.5, 12, 20, 40, and 60 cm during different growth stages of the plant using pairs of 7.5, 12, and 20 cm stainless steel electrodes.Results and DiscussionThe simultaneous water and salinity stresses, which led to the reduced amount of periodic evaporation-transpiration of the yield compared to ideal conditions (without stress), were simulated by additive and multiplicative models. The results suggested a decrease in the evaporation and transpiration with the increased simultaneous water and salinity stresses so that the amount of total evaporation-transpiration in different treatments was measured to be between 692.7 and 344.9 mm and the fresh yield was estimated between 50.4 and 3.2 tons per hectare. Also, the highest amount of periodic evaporation and transpiration in all treatments was found to occur in the development and intermediate stages, and the relative fresh yield in the W0S0 to W2S2 treatments was calculated between 66% and 100%. The results of modeling the relative yield of the crop based on the amounts of relative evaporation and transpiration of corn in different growth stages and under the different treatments of water stress and salinity, indicated that Singh's additive model and Rao's multiplicative model were appropriate, while the Minhas model was recognized to be inappropriate in this estimation.ConclusionThe research results suggested the significant impact of water stress and salinity at least at the 95% level on evaporation and transpiration and the corn yield. Moreover, the effect of the sensitivity of different growth stages of the plant on the reduction of evaporation and transpiration of corn varies so that in the three treatment groups W0, W1, and W2, the highest average decrease in slope was related to the final stage (13.6%) followed by the middle stage with an average decrease of 8.4% compared to the control treatment. Therefore, the highest decrease rate in evaporation-transpiration slope has been observed in these two growth stages due to the beginning of flowering, fruit formation, and physiological ripening of seeds. These results come from the lack of sufficient water storage and increased salinity of irrigation water in the soil. Water stresses and salinity will reduce water absorption and evaporation-transpiration, and ultimately, reduce crop production due to the decreased amount and potential of water in the soil. Another finding to be mentioned is the priority of water stress compared to salinity stress in reducing evaporation and transpiration and production yield. Also, by managing water and salinity stresses in the critical stages of plant growth (especially the middle stage), which is the time of flowering and the beginning and completion of the maize production process, a significant reduction in the crop can be somewhat prevented.

Introduction: Gastric cancer in Chile takes the first place as a cause of mortality from malignant tumors, therefore it is relevant to know the demographic description of this disease in the country. Studied years go from 2017-2021 in order to get updated data to the Chilean public health. Methodology: Ecological, observational, cross-sectional and descriptive study on deaths due to gastric cancer in 2017-2021 in Chile, according to sex, age group and regions (n=15350). The death rate was calculated. Data was obtained from the Department of Statistics and Health Information and the National Institute of Statistics. It did not require approval from an ethics committee. Results: During the 2017-2021 period the overall death rate was 21.84, 21,58 for men and 10,68 for women. The highest values were in the 80 and older age group and the lowest values in the 15-19 years age group. The highest death rate overall period was registered in the Metropolitan Region. Discussion: There was a reduction in the hospital death rate between 2017-2021, which could be due to the increase in screening and treatment of Helicobacter pylori. Death rate is higher in men, which could be explained because they are more genetically susceptible to developing cancer. The lowest values for death rate were found in the 15-19 years age group, and the highest values in the 80 years and older group, which is consistent with international literature. Conclusion: More studies are required in Chile to broaden the findings to allow investigation continuity and to determine specific risk factors present in the Chilean population. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic disease with a diversity of skin manifestations, whose etiology is multifactorial and associated with cardiovascular and rheumatological pathologies and that may require hospitalization. The objective of this study was to describe the rate of hospital discharges due to psoriasis between the years 2018-2021 in Chile. Methodology: Observational descriptive study on hospital discharges for psoriasis between 2018-2021 in Chile according to sex and age groups (n=2463).. The data was obtained from the Department of Statistics and Health Information (DEIS). The Hospital Discharge Rate (TEH) was calculated. No ethics committee was required. Results: The year 2020 and 2021 presented the lowest TEH of the study period with 2.8 and 2.09/100,000 habitants respectively. The male sex presented the highest TEH of the period with 4.96, and the age group of 45-64 years presented the highest TEH with 6.97/100,000 habitants. Discussion: In 2020 and 2021, there was a reduction in the hospital discharge rate, which coincides with the declaration of a pandemic in 2020 as a result of the SARS-CoV-2 virus and this may be due to a conversion of beds to respiratory beds. The female sex could present lower TEH because estrogen is reported as a protective factor. The higher TEH in the 45-64 age group can be explained by the fact that this population presents more comorbidities that predispose to psoriasis. Conclusion: More studies are required at a national level to deepen the results found. There is a scarcity of national statistics on the rate of discharge from psoriasis, and it is interesting to increase the period of time studied to deepen the reported findings. [ABSTRACT FROM AUTHOR]

Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR > 0.80) and had intracoronary imaging defined vulnerable plaque. Coronary computed tomography angiography (CTA)-defined high risk plaque (HRP) is known to predict future cardiac events. We hypothesized that CTA defined HRP would identify which FFR-negative patients were at greatest risk of future cardiac events., Methods and Results: We examined 373 consecutive CCS patients undergoing CTA followed not more than 90 days later by invasive FFR. Cardiac events were defined as cardiac death, non-fatal acute coronary syndromes, and ischemia-driven revascularization. Clinical follow-up was performed in all patients at a median of 32 months. Revascularization was performed in 131 of the 373 patients due to an FFR ≤ 0.80 (Treat group), with the remaining 242 having revascularization deferred (Defer group) due to an FFR > 0.80. In the Treat group the cardiac event rates between patients with and without HRP on CTA were similar (9.4 % versus 10.1 %, p = 0.90), whilst in the Defer group they were higher in patients with HRP (21.1 % versus 4.7 %, Log-rank-p < 0.0001). In multivariate Cox hazard analysis the presence of HRP (Hazard-ratio 12.79, 95 %confidence-intervals: 3.57-45.83, p < 0.0001) was an independent predictor for cardiac events in the Defer group., Conclusions: HRP on CTA was associated with future cardiac events in patients in whom revascularization was deferred due to a negative invasive-FFR (UMIN000054067; CAPTURE)., Competing Interests: Declaration of competing interest All authors did not have any conflict of interest (COI) for this study., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

We investigated the prognostic value of cardiac myosin-binding protein C (cMyC), a novel cardiospecific marker, both independently and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP), for predicting 6-month all-cause mortality in patients without acute coronary syndrome (ACS) treated at medical (nonsurgical) cardiac intensive care units (CICUs). Admission levels of cMyC, high-sensitivity cardiac troponin T (hs-cTnT), and NT-proBNP were measured in 1032 consecutive patients (mean age; 70 years) without ACS hospitalized acutely in medical CICUs for the treatment of cardiovascular disease. Serum cMyC was closely correlated with hs-cTnT and moderately with NT-proBNP (r = 0.92 and r = 0.49, respectively, p < 0.0001). During the 6-month follow-up period after admission, there were 109 (10.6%) all-cause deaths, including 72 cardiovascular deaths. Both cMyC and NT-proBNP were independent predictors of 6-month all-cause mortality (all p < 0.05). Combining cMyC and NT-proBNP with a baseline model of established risk factors improved patient classification and discrimination beyond any single biomarker (all p < 0.05) or the baseline model alone (both p < 0.0001). Moreover, patients were divided into nine groups using cMyC and NT-proBNP tertiles, and the adjusted hazard ratio (95% confidence interval) for 6-month all-cause mortality in patients with both biomarkers in the highest vs. lowest tertile was 9.67 (2.65-35.2). When cMyC was replaced with hs-cTnT, similar results were observed for hs-cTnT. In addition, the C-indices for addition of cMyC or hs-cTnT to the baseline model were similar (0.798 vs. 0.800, p = 0.94). In conclusion, similar to hs-cTnT, cMyC at admission may be a potent, independent predictor of 6-month all-cause mortality in patients without ACS treated at medical CICUs, and their prognostic abilities may be comparable. Combining cMyC or hs-cTnT with NT-proBNP may substantially improve early risk stratification of this population., Competing Interests: Declarations. Conflict of interest: Dr Nishimura reports no conflicts. Dr J. Ishii received a research grant from Sysmex Corp. Mr. Takahashi, Mr. Ishihara, Mr. Nakamura, Mr. Kitagawa, and Dr Sakaguchi report no conflicts. Ms. Sasaki is an employee of Sysmex R&D Center Europe GmbH. Dr Kawai, Dr Muramatsu, Dr Harada, Dr Yamada, Dr Tanizawa-Motoyama, Dr Naruse, Dr Sarai, and Dr Yanase report no conflicts. Dr H. Ishii received honoraria from AstraZeneca KK, Bayer Pharmaceutical Co., Ltd., Boehringer Ingelheim Japan, Bristol-Myers Squibb Inc., Daiichi-Sankyo Pharma Inc., Kowa, MSD K. K., Mitsubishi Tanabe Pharma Co., Ltd., Mochida Pharmaceutical Co., Ltd., Novartis Japan, Otsuka Pharmaceutical Co. Ltd., and Pfizer Japan Inc. Dr Watanabe reports no conflicts. Dr Ozaki received research grants from Takeda Pharmaceutical Co. Ltd., Sanofi KK, Mitsubishi Tanabe Pharma Corp., Otsuka Pharmaceutical Co. Ltd., Bayer Yakuhin, Ltd., Daiichi Sankyo Co. Ltd., Sumitomo Dainippon Pharma Co. Ltd., and Public Health Research Foundation. Dr Izawa received research grants from grant support through his institution from Bayer Yakuhin Ltd., Sumitomo Pharma Co. Ltd., PDR Pharma Co. Ltd., Biotronik Japan Co Ltd, Abbott Japan Co. Ltd., Boston Scientific Japan Co. Ltd., Japan Lifeline Co. Ltd., and Medtronic Japan Co. LtD., and honoraria for lectures from Otsuka Pharmaceutical Co. Ltd., Novartis Co. Cool., Eli Lilly Japan Co. Ltd., Bayer Yakuhin, Co. Ltd., Nippon Boehringer Ingelheim Co. Ltd., and Daiichi Sankyo Co. Ltd., (© 2024. Springer Nature Japan KK, part of Springer Nature.)

Background/objectives: The aim of this study is to investigate the association between physical and chemical digestion and nutrition markers (serum albumin (ALB), prealbumin (PAB), and vitamin B 12 (B 12 ) levels)., Methods: During a detailed checkup at Fujita Health University, we examined the associations of physical (occlusal force, masticatory performance, and swallowing ability (via the 10-item Eating Assessment Tool, EAT-10)) and chemical ( Helicobacter pylori (HP) eradication history, HP antibody levels, and oral antacid (proton pump inhibitors) use) digestion parameters with serum ALB, PAB, and B 12 levels in 92 individuals (M:67, F:25)., Results: Forty-eight percent of the participants were older than 65 years of age, 19% had decreased occlusal force, 3.2% had decreased masticatory strength, 3.2% had decreased swallowing function, 24% had a history of HP eradication, 23% were HP antibody positive, and 16% were taking oral antacid medication. Additionally, 14% and 11% of the patients had low serum ALB and PAB levels, respectively, and 14% of the patients had B 12 deficiency. Multivariate analysis adjusted for age, sex, body mass index, and C-reactive protein levels revealed that there were no significant associations between the physical digestion parameters and the serum PAB, ALB, or B 12 levels. On the other hand, there was a significant association between oral antacid use and PAB levels (β = -3.3, p = 0.04). Independent of physical or chemical digestion parameters, serum PAB and B 12 levels were significantly associated with protein and B 12 intake, respectively., Conclusions: Oral antacid use may decrease serum PAB levels, indicating protein synthesis.

Preexisting cardiovascular disease (CVD) is a pivotal risk factor for severe coronavirus disease 2019 (COVID-19). We investigated the longitudinal (over 1 year and 9 months) humoral and cellular responses to primary series and booster doses of mRNA COVID-19 vaccines in patients with CVD. Twenty-six patients with CVD who received monovalent mRNA COVID-19 vaccines were enrolled in this study. Peripheral blood samples were serially drawn nine times from each patient. IgG against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (RBD) was measured using an enzyme-linked immunosorbent assay. The numbers of interferon-γ-releasing cells in response to SARS-CoV-2 peptides were measured using an enzyme-linked immunospot assay. The RBD-IgG titers increased 2 weeks after the primary series and booster vaccination and waned 6 months after vaccination. The S1-specific T cell responses in patients aged < 75 years were favorable before and after booster doses; however, the Omicron BA.1-specific T cell responses were poor. These results suggest that regular vaccination is useful to maintain long-term antibody levels and has implications for booster dose strategies in patients with CVD. Additional booster doses, including Omicron variant-adapted mRNA vaccines, may be recommended for patients with CVD, regardless of age.

The CHA 2 DS 2 -VASc score is a vital clinical tool for evaluating thromboembolic risk in patients with atrial fibrillation (AF). This study investigated the efficacy of the CHA 2 DS 2 -VASc score in a cohort of 737 heterogeneous patients (mean age: 63 years) receiving care in cardiac intensive care units (CICUs), with a creatinine-based estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m 2 upon admission and discharge. Incident chronic kidney disease (CKD) was defined as the emergence of a new-onset eGFR<60 mL/min/1.73 m 2 , accompanied by a decline of >5 mL/min/1.73 m 2 compared to that at discharge. The primary endpoint was the incidence of CKD, and the secondary endpoints included all-cause mortality, cardiovascular events, and progression to end-stage kidney disease. In this cohort, 210 (28 %) patients developed CKD. Multivariate analyses revealed that CHA 2 DS 2 -VASc score was a significant independent predictor of incident CKD, regardless of the presence of AF. Integration of CHA 2 DS 2 -VASc scores with eGFR enhanced the predictive accuracy of incident CKD, as evidenced by the improved C-index, net reclassification improvement, and integrated discrimination improvement values (all p < 0.05). Over the 12-month follow-up period, a composite endpoint was observed in 61 patients (8.3 %), with elevated CHA 2 DS 2 -VASc scores being independently associated with this endpoint. In conclusion, CHA 2 DS 2 -VASc scores have emerged as robust predictors of both CKD incidence and adverse outcomes. Their inclusion substantially refined the 12-month risk stratification of patients with preserved renal function hospitalized in the CICUs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Objectives: Evaluation of in-stent restenosis (ISR), especially for small stents, remains challenging during computed tomography (CT) angiography. We used deep learning reconstruction to quantify stent strut thickness and lumen vessel diameter at the stent and compared it with values obtained using conventional reconstruction strategies., Methods: We examined 166 stents in 85 consecutive patients who underwent CT and invasive coronary angiography (ICA) within 3 months of each other from 2019-2021 after percutaneous coronary intervention with coronary stent placement. The presence of ISR was defined as percent diameter stenosis ≥ 50% on ICA. We compared a super-resolution deep learning reconstruction, Precise IQ Engine (PIQE), and a model-based iterative reconstruction, Forward projected model-based Iterative Reconstruction SoluTion (FIRST). All images were reconstructed using PIQE and FIRST and assessed by two blinded cardiovascular radiographers., Results: PIQE had a larger full width at half maximum of the lumen and smaller strut than FIRST. The image quality score in PIQE was higher than that in FIRST (4.2 ± 1.1 versus 2.7 ± 1.2, p < 0.05). In addition, the specificity and accuracy of ISR detection were better in PIQE than in FIRST (p < 0.05 for both), with particularly pronounced differences for stent diameters < 3.0 mm., Conclusion: PIQE provides superior image quality and diagnostic accuracy for ISR, even with stents measuring < 3.0 mm in diameter., Clinical Relevance Statement: With improvements in the diagnostic accuracy of in-stent stenosis, CT angiography could become a gatekeeper for ICA in post-stenting cases, obviating ICA in many patients after recent stenting with infrequent ISR and allowing non-invasive ISR detection in the late phase., Key Points: • Despite CT technology advancements, evaluating in-stent stenosis severity, especially in small-diameter stents, remains challenging. • Compared with conventional methods, the Precise IQ Engine uses deep learning to improve spatial resolution. • Improved diagnostic accuracy of CT angiography helps avoid invasive coronary angiography after coronary artery stenting., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Background: Coronary computed tomography angiography (CTA) followed by computed tomography angiography-derived fractional flow reserve (FFR CT ) is now commonly used for the management of chronic coronary syndrome (CCS). CTA-verified high-risk plaque (HRP) characteristics have also been reported to be associated with a greater likelihood of adverse cardiac events but have not been used for management decisions., Objectives: The aim of this study was to evaluate clinical outcomes based on a combination of point-of-care computed tomography angiography-derived fractional flow reserve (POC-FFR CT ) and the presence of HRP in CCS patients initially treated medically or with revascularization based on invasive coronary angiography findings., Methods: CTA was performed as the initial test in 5,483 patients presenting with CCS between September 2015 and December 2020 followed by invasive coronary angiography and revascularization as necessary. POC-FFR CT assessment and HRP characterization were obtained subsequently in 745 consecutive patients. We investigated how HRP and POC-FFR CT , which were not available during the original clinical decision making, correlated with the endpoint defined as a composite of cardiac death, acute coronary syndrome, and a need for unplanned revascularization., Results: Cardiac events occurred in 20 patients (2.7%) during a median follow-up of 744 days. The event rate was significantly higher in patients with POC-FFR CT  <0.80 compared with POC-FFR CT  ≥0.8 (5.4 vs 0.5 per 100 vessel years; log-rank P < 0.0001) and in patients with HRP compared to those without HRP (3.6 vs 0.8 per 100 vessel years; log-rank P = 0.0001). POC-FFR CT  <0.80 and the presence of HRP were the independent predictors of cardiac events (HR: 16.67; 95% CI: 2.63-105.39; P = 0.002) compared with POC-FFR CT  ≥0.8 and absent HRP. For the vessels with POC-FFR CT  <0.80 and HRP, a significantly higher rate of adverse events was observed in patients who did not undergo revascularization compared with those revascularized (16.4 vs 1.4 per 100 vessel years; log-rank P = 0.006)., Conclusions: POC-FFR CT  <0.80 and the presence of HRP were the independent predictors of cardiac events, and revascularization of HRP lesions with abnormal POC-FFR CT was associated with a lower event rate., Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

The renal angina index (RAI) is a validated scoring tool for predicting acute kidney injury (AKI). We investigated the efficacy of the RAI in 2436 heterogeneous patients (mean age, 70 years) treated in cardiac intensive care units (CICUs). The RAI was calculated from creatinine and patient condition scores. AKI was diagnosed by the Kidney Disease: Improving Global Outcome criteria. The primary and secondary endpoints were the development of severe AKI and all-cause mortality, respectively. Four hundred thirty-three patients developed AKI, 87 of them severe. In multivariate analyses, the RAI was a significant independent predictor of severe AKI. During the 12-month follow-up period, 210 patients suffered all-cause death. Elevated RAI was independently associated with all-cause mortality, as was NT-proBNP (p < 0.001). The RAI is a potent predictor not only of severe AKI but also of adverse outcomes and substantially improved the 12-month risk stratification of patients hospitalized in CICUs., (© 2024. The Author(s).)

Introduction: Coronary computed tomography angiography (CCTA) is known to have a high negative predictive value (NPV) in identifying coronary artery disease (CAD). This study aimed to examine whether resting echocardiographic parameters could exclude significant CAD on CCTA., Methods: We recruited 142 patients who had undergone both CCTA and echocardiography within a 3-month window. Based on the CCTA findings, patients were divided into two groups: Group A (non-significant CAD, defined as all coronary segments having <50% stenosis) and Group B (significant CAD). Resting echocardiographic parameters were compared between the two groups to identify predictors of non-significant CAD on CCTA., Results: A total 92 patients (mean age, 68 ± 13 years; males, 62%) were eligible for this study; 50 in Group A and 42 in Group B. Among the various echo parameters, left atrial volume index (LAVI) and left ventricular (LV) global longitudinal strain (GLS) were significantly lower in Group A (23.5 ± 7.6 vs. 33.6 ± 7.4 mL/m 2 , p < .001; -20.2 ± 1.8% vs. -16.8 ± 2.0%, p < .001, respectively). Analysis of the receiver operating characteristic curve revealed that the cutoff value to exclude significant CAD on CCTA was 29.0 mL/m 2 for LAVI (NPV 80.8%) and -18.1% for GLS (NPV 80.7%). The NPV increased to 95.0% when these parameters were combined (LAVI < 29.0 mL/m 2 and GLS < -18.1%)., Conclusion: The combination of resting LAVI and GLS was clinically useful in excluding significant CAD via CCTA., (© 2023 The Authors. Echocardiography published by Wiley Periodicals LLC.)

Objectives: Malnutrition is associated with an increased risk of hospital readmission for heart failure in patients with acute decompensated heart failure (ADHF). Therefore, evaluation of the nutritional status in patients with ADHF may be important. The geriatric nutritional risk index (GNRI), the controlling nutritional status (CONUT) score, and the prognostic nutritional index (PNI) are widely used objective indexes for evaluation of the nutritional status. The present study was performed to determine the best nutritional index for predicting the prognosis in older adults with ADHF., Methods: We retrospectively studied 167 older adults (>65 years of age) who were admitted with ADHF from January 2012 to December 2015 and discharged alive. The objective nutritional status was evaluated using the GNRI, CONUT score, and PNI at admission. The endpoint of this study was unplanned hospitalization for worsening heart failure (WHF) within 1 year after discharge., Results: During the follow-up period, 58 patients were readmitted for WHF. In the multivariate Cox analysis, only the GNRI ( p <0.0001) was independently associated with readmission for WHF among the three nutritional indexes. Kaplan-Meier analysis revealed that patients in the low-GNRI group (<90 as determined by receiver operating characteristic curve analysis) had a significantly greater risk of 1-year hospital readmission for WHF ( p <0.0001; hazard ratio, 6.1; 95% confidence interval, 3.5-10.5)., Conclusion: Among the objective nutritional indexes, the GNRI is the best predictor of readmission for WHF within 1 year after discharge in older adults with ADHF.

Aims: This study aimed to determine the new cut-off value of serum angiotensin-converting enzyme (ACE) levels for detecting patients with sarcoidosis and to examine the change in ACE levels after the initiation of immunosuppressive therapy., Methods and Results: We retrospectively examined patients in whom serum ACE levels were measured for suspected sarcoidosis between 2009 and 2020 in our institution. For patients diagnosed with sarcoidosis, changes in ACE levels were also observed. Of the 3781 patients (51.1% men, 60.1 ± 17.0 years old), 477 were excluded for taking ACE inhibitors and/or immunosuppression agents or those with any diseases affecting serum ACE levels. In 3304 patients including 215 with sarcoidosis, serum ACE levels were 19.6 IU/L [interquartile range, 15.1-31.5] in patients with sarcoidosis and 10.7 [8.4-16.5] in those without sarcoidosis (P < 0.01), and the best cut-off value was 14.7 IU/L with 0.865 of the area under the curves. Compared with the current ACE cut-off of 21.4, the sensitivity improved from 42.3 to 78.1 at the new cut-off, although specificity slightly decreased from 98.6 to 81.7. The ACE level significantly decreased more in those with immunosuppression therapy than in those without it (P for interaction <0.01), although it decreased in both groups (P < 0.01)., Conclusions: Because the sensitivity for detecting sarcoidosis is comparatively low at the current standard value, further examinations are needed for patients suspected of sarcoidosis with relatively high ACE levels in the normal range. In patients with sarcoidosis, ACE levels decreased after the initiation of immunosuppression therapy., (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Objective: 18 F-FDG PET can be used to calculate the threshold value of myocardial volume based on the mean standardised uptake value (SUV mean ) of the aorta to detect highly integrated regions of cardiac sarcoidosis. The present study investigated the myocardial volume when the position and number of volumes of interest (VOIs) were changed in the aorta., Methods: The present study examined PET/computed tomography images of 47 consecutive cardiac sarcoidosis cases. VOIs were set at three locations in the myocardium and aorta (descending thoracic aorta, superior hepatic margin and near the pre-branch of the common iliac artery). The volume was calculated for each threshold using 1.1-1.5 times the SUV mean (median of three cross-sections) of the aorta as the threshold to detect high myocardial 18 F-FDG accumulation. The detected volume, correlation coefficient with the visually manually measured volume and the relative error were also calculated., Results: The optimum threshold value for detecting high 18 F-FDG accumulation was 1.4 times that of the single cross-section of the aorta and showed the smallest relative errors of 33.84% and 25.14% and correlation coefficients of 0.974 and 0.987 for single and three cross-sections, respectively., Conclusion: The SUV mean of the descending aorta may be detected in good agreement with the visual high accumulation by multiplying the same threshold constant for both single and multiple cross-sections., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Aims: Little is known about whether resting left ventricular global longitudinal strain (GLS) impairment is associated with myocardial perfusion abnormalities evaluated using 13 N-ammonia positron emission tomography ( 13 N-NH 3 -PET)-myocardial perfusion imaging (MPI). This study aimed to investigate the correlation between resting GLS and myocardial perfusion parameters in patients with a normal left ventricular ejection fraction (LVEF). We evaluated whether resting GLS can predict myocardial perfusion abnormalities in these patients., Methods and Results: We selected 157 patients with suspected stable angina pectoris who underwent both ATP-stress NH 3 -PET-MPI and 2-dimentional speckle tracing echocardiography. All subjects had a preserved LVEF and no known history of myocardial infarction. Patients were stratified into Group N (normal perfusion; summed stress score [SSS], 0-3; n = 101), Group M (mildly to moderately abnormal perfusion; SSS, 4-11; n = 41), or Group S (severely abnormal perfusion; SSS, 12+; n = 15). GLS was more impaired as myocardial perfusion abnormality severity increased (-17.9 ± 2.9% for Group N, -16.8 ± 3.1% for Group M, and -14.2 ± 3.5% for Group S; p < .001). GLS was weakly but significantly correlated with SSS (R = .32, p < .001), summed difference score (R = .32, p < .001), and myocardial blood flow during stress (R = -0.27, p < .001). Multivariate logistic regression analysis showed that male sex, diabetes mellitus, systolic blood pressure, and GLS were independent predictors of myocardial perfusion abnormality defined as Groups M and S. Additionally, the area under the curve for GLS for detecting myocardial perfusion abnormality was .65, and the optimal cutoff value for GLS was -16.5%, with sensitivity and specificity of 59% and 66%, respectively., Conclusion: In patients with suspected angina pectoris, resting GLS impairment despite a normal LVEF might aid the detection of hemodynamically significant coronary artery disease., (© 2022 Wiley Periodicals LLC.)

Mobile food records are currently used to determine the nutrition of healthy subjects. To determine the accuracy of such records, we evaluated the nutritional composition of a test meal (noodles and fruit juice) and a hospital meal (Japanese set meal) using two types of mobile food records. Eighteen healthy subjects (2 males and 16 females) were enrolled. Using these diets and validated nutrient-composition information, we evaluated the accuracy of the dietary assessments made by two dietary-record applications, Asken ® and Calomeal ® , over 5 days. For the test meal, the values provided by the two applications were close to the actual values. In contrast, for the hospital meal, the values provided by the two applications were approximately 1.5 times higher than the actual values. A linear-mixed-model analysis showed that the total energy, carbohydrate, and salt contents were significantly overestimated in the hospital meal. Protein also tended to be overestimated, while the fat content was not significantly overestimated. Furthermore, the total energy and fat contents increased significantly over time. No association with age was observed. A comparison of the coefficients of variation (CVs) for each nutrient in the hospital meal indicated that the fat levels were significantly higher than those in the test meal. In conclusion, the accuracy of mobile food records depends on the type of meal. Our data will provide lessons for the use of meal-recording applications in special cases, such as hospital food.

Background: We aimed to clarify the relationship between epicardial adipose tissue (EAT) volume and the presence of severe stenoses (SS) on coronary computed tomography angiography (CTA) for risk stratification of the patients with carotid artery stenoses., Methods: We prospectively performed CTA for 125 consecutive patients (72.4 ± 8.1 years, 85% men) without a history of coronary artery disease (CAD), who were scheduled for carotid artery revascularization from 2014 to 2020. SS was defined as ≥70% luminal stenosis on CTA. EAT was quantified automatically as the total volume of tissue with -190 to -30 HU., Results: Of 125 patients, 76 had SS. Between the patients with and without SS, there were significant differences in coronary artery calcium score (CACS), left ventricular ejection fraction (LVEF), dyslipidemia, and EAT, despite no differences in carotid echocardiography findings. After adjustment for age, gender, and dyslipidemia, EAT was an independent factor associated with SS (p=0.011), as well as CACS and LVEF. The addition of EAT to a baseline model including age, gender, dyslipidemia, LVEF, and CACS achieved both net reclassification improvement (0.505, p=0.003) and integrated discrimination improvement (0.059, p=0.003)., Conclusions: In patients with carotid stenoses, EAT is associated with CAD and is useful for additional risk stratification. Epicardial fat may have a specific role in the development of CAD in patients with suspected systemic atherosclerosis., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Omega-3 fatty acids have been proposed to be useful in the prevention of cardiac events. High-risk plaque (HRP) and plaque progression on serial coronary computed tomography angiography (CTA) have been suggested to be the predecessor of acute coronary syndrome (ACS). The purpose of this study was to investigate whether addition of omega-3 fatty acids to statin therapy for secondary prevention would lead to change in plaque characteristics detected by using serial CTA., Methods and results: This study enrolled 210 patients with ACS: no eicosapentaenoic acid (EPA)/ docosahexaenoic acid (DHA; EPA/DHA), low-dose EPA+DHA, high-dose EPA+DHA, and high-dose EPA alone. HRP was significantly more frequent in patients with plaque progression (P=0.0001). There was a significant interaction between plaque progression and EPA dose regardless of the DHA dose; 20.3% in EPA-none (no EPA/DHA), 15.7% in EPA-low (low-dose EPA+DHA), and 5.6% in EPA-high (high-dose EPA+DHA and high-dose EPA alone). On multivariate logistic regression analysis, HRP (OR 6.44, P<0.0001), EPA-high (OR 0.13, P=0.0004), and Rosvastatin (OR 0.24, P=0.0079) were the independent predictors for plaque progression. In quantitative analyses (n=563 plaques), the interval change of low attenuation plaque (LAP) volume was significantly different based on EPA dose; LAP was significantly increased in the EPA-none group and significantly decreased in the EPA-high group., Conclusions: In patients with ACS, addition of high-dose EPA (EPA-high) to statin therapy, compared to statin therapy without EPA, was associated with a lower rate of plaque progression.