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Aims Congestive splenomegaly is a classic sign of organ congestion in acute decompensated heart failure (ADHF). Shear wave elastography (SWE) allows the measurement of spleen stiffness (SS). We hypothesized that SS could quantify the severity of splenic congestion and predict adverse events in ADHF. Methods and Results This study included two cohorts: a haemodynamic cohort (62 HF patients) and an outcome cohort (115 ADHF patients). SS was measured by two‐dimensional SWE on the same day of right heart catheterization in the haemodynamic cohort. Right atrial pressure (RAP) independently correlated with SS (β = 0.32, P = 0.002). SS was measured in the outcome cohort before discharge. The 115 patients were divided into three groups on the basis of the tertile value of SS. The third tertile SS group had a higher prevalence of severe tricuspid regurgitation, higher N‐terminal B‐type natriuretic peptide (NT pro‐BNP), and larger right ventricular diastolic diameter, than had the first tertile group and the second tertile group. During a median follow‐up period of 105 (77–135) days, adverse events occurred in 25 patients (one death and 24 rehospitalizations for HF). The third tertile SS group had a significantly higher rate of adverse events (P

Desmin‐related myopathy (DRM) is a rare heritable cardiac and skeletal muscle disease caused by mutations in the desmin gene (DES). DRM is generally characterized by skeletal muscle weakness, conduction disturbance, and dilated cardiomyopathy. However, the clinical cardiac phenotypes of DRM are not yet fully understood. Herein, we report the first case of DRM with the de novo missense DES mutation, R454W, that is characterized by left ventricular non‐compaction cardiomyopathy, progressive cardiac conduction defect, spontaneous coronary artery dissection, and no skeletal muscle weakness. Our case findings suggest that clinicians should genetically test patients who have cardiomyopathy, progressive cardiac conduction defect, and coronary artery dissection, even if the patient has neither family history of DRM nor skeletal muscle symptoms.

Aims The prevalence of heart failure with preserved ejection fraction (HFpEF) has increased in the past two decades, and diabetes mellitus (DM) is frequently associated with HFpEF. Although it has been demonstrated that left ventricular (LV) diastolic and vascular functional abnormalities are generally observed in HFpEF, it remains to be clinically elucidated how an asymptomatic stage progresses to symptomatic HFpEF in DM patients. We aimed to identify risk factors associated with incident HFpEF in DM patients and to evaluate the contribution of LV relaxation and compliance to the development of HFpEF. Methods and results The study included 544 consecutive Japanese DM patients with ejection fraction ≥50%. Patients with coronary artery disease or serum creatinine ≥2.0 mg/dL were excluded. Multiple logistic regression analysis revealed that obesity, female gender, anaemia, and impaired LV compliance were independently associated with the prevalence of HFpEF, and that age, LV mass index, an index of LV relaxation, estimated glomerular filtration rate, and history of hypertension were not. There was no difference in haemoglobin A1c or brachial-ankle pulse wave velocity between the DM patients with and without HFpEF. Conclusions This study suggests that exacerbation of LV compliance impairment, rather than of relaxation abnormality or vascular stiffening, plays a crucial role in the induction of HFpEF in DM patients regardless of the severity of DM and renal dysfunction. Anaemia and obesity may also contribute to the transition from asymptomatic stage to symptomatic HFpEF even without further progression of LV diastolic dysfunction.

Purpose: The utility as a simple ECG test for protecting cardiac event in sports club by means of pocket size trans-telephonic electrocardiogragh (TTECG) was examined. Materials and Method: In 6703 applicants in the sports club, the ECG with the RA-V5 bipolar lead by TTECG (CG2100) was recorded as the screening test. Moreover, the V5R-V5 bipolar lead TTECG (CG6106) was recorded for 124 applicants who were exercising by the ergometer in the sports club. Results: Abnormal ECGs were found in 353/6703 (5.3%) of TTECG (CG2100). As abnormal ECG, LVH with ST depression (5), atrial flutter (2), PSVT (1), SSS (1), OMI (1), WPW (1), LBBB (1), abnormal ST-T (22) and atrial fibrillation (10) by 33 cases (50 abnormal findings) were seen, including dangerous example of 2 suggested by HCM and 1 of ST depression with frequent VPCs. On the other hand, TTECG (CG6106) of 124 people was able to be recorded easily as the exercise tolerance test by the ergometer. In 124 cases, 2 had the significant increasing of ST depression with no symptom. Conclusion: It seems that TTECG is the simple method as the screening and exercise test of the heart and might be useful for the prevention of the heart event in the sports club.

Aim: We examined the possibility of the detection of arrhythmias such as atrial fibrillation (AF) based on the analysis of a measured pulse wave signals recorded by the newly developed “watch type” plethysmograph (HC1). Methods: HC1 and 24-hour Holter ECG were recorded simultaneously for 66 outpatients during 24 hours and the data were analyzed. Frequency domain analysis and time domain analysis were applied for the detection of AF. RR interval, frequency power (0.25–0.5 Hz), and coefficient of variation were measured. The rate of detection of AF and the duration of AF were evaluated based on those parameters. Results: AF was detected in 13 patients among 66 patients by 24-hour Holter ECG. The rate of detection of AF by HC1 was 81.3%. In addition, the difference between both methods for the duration of AF was 10–60 minutes. Most of the reason why AF could not be detected by HC1 caused by the incorrect measurement due to the body movement. Conclusions: AF detection by HC1 could be acceptable in clinical setting. Future clinical application for other arrhythmias by HC1 also can be expected.