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Aim: To investigate the relationship between each CTP parameter and that between CTP parameters and patient characteristics in patients without obstructive coronary artery disease (CAD)., Materials and Methods: Seventy-seven (28 female; 65.0±10.3 years) patients with suspected CAD who underwent coronary CT angiography (CCTA) and dynamic CTP with vasodilator stress were included. Patients with obstructive coronary stenosis (≥50%) on CCTA were excluded. Myocardial blood flow (MBF) and myocardial blood volume (MBV) were calculated using the slope and peak of the time-attenuation curves of the myocardium and blood. Perfused capillary blood volume (PCBV), extravascular extracellular volume (EEV), and flow extraction product (FE) were calculated using the extended Tofts model., Results: MBF, MBV, and PCBV were strongly correlated with each other (all r > 0.80 and all p < 0.001), whereas FE and EEV were strongly correlated with each other (r = 0.88 and p < 0.001). In univariate linear regression analysis, male sex and smoking status were significantly associated with MBF, MBV, and PCBV, while age was significantly associated with FE and EEV (all p < 0.05). In stepwise multivariate analysis, smoking status was independently associated with MBF, MBV. and PCBV, while age was the only factor associated with FE and EEV (all p < 0.05)., Conclusion: FE and EEV may reflect different mechanisms of microvascular dysfunction than MBF, MBV, and PCBV., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Myocardial extracellular volume fraction (ECV) measured via MRI serves as a quantitative indicator of myocardial fibrosis. However, accurate measurement of ECV using MRI in the presence of AF is challenging. Meanwhile, CT could be a promising alternative tool for measuring ECV regardless of sinus rhythm or AF. The purpose of this study was to assess the reliability of estimating ECV using CT in patients with AF by comparing it with MRI-derived ECV. Forty-two patients (n = 42) with AF underwent cardiac CT a median of 12 days before catheter ablation, and cardiac MRI a median of 1 day after catheter ablation. Myocardial ECV measured by CT and MRI was compared. Pre-ablation CT scan was performed in the presence of AF in 25 patients, with the remaining 17 in sinus rhythm (SR). All patients were in SR at the time of MRI post ablation. The average of CT-derived ECVs was 0.277 ± 0.022 and that of MRI-derived ECVs was 0.282 ± 0.019 in patients with AF. The average of CT-derived ECVs was 0.268 ± 0.025 and that of MRI-derived ECVs was 0.278 ± 0.025 in patients with SR at the time of the CT scan. CT and MRI were in good agreement with mean differences of -0.0048 ± 0.027 in AF and - 0.0095 ± 0.0354 in SR. CT-derived ECV in the presence of AF measured before ablation showed good agreement with ECV by MRI in SR after ablation. CT-ECV estimations are reliable and feasible in patients with AF., Competing Interests: Declarations. Conflicts of interest: Dohi Kaoru received honoraria from Novartis Pharma K.K., Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Company Limited, and Bayer Yakuhin, Ltd. Dohi Kaoru received departmental research grant support from Otsuka Pharmaceutical Co.Ltd., Daiichi Sankyo Company Limited, Abbott Medical Japan LLC, Kowa Company, Limited, and Zeon Medical Inc. The Department of Advanced Diagnostic Imaging, which Dr. Kitagawa chairs, is an endowment department supported by Siemens Healthcare K.K. and FUJIFILM Medical Co., Ltd. Hajime Sakuma receives departmental research grant support from Eisai Co., Ltd., Guerbet Japan KK, FUJIFILM Toyama Chemical Co., Ltd., Nihon Medi-Physics Co., Ltd., PDRadiopharma Inc. and GE Healthcare Japan. The other authors declare that they have no conflicts of interest., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Nonspecific viral adsorption by polymer nanoparticles is more economical and superior in terms of operating cost and energy efficiency than viral adsorption using virus-specific antibodies and filtration techniques involving size exclusion in the order of tens of nanometres. In this study, we synthesised four types of polycyclic aromatic polymer (ArP) nanoparticles with different structures and evaluated their virus adsorption capability for infectious particles of the newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ArP nanoparticles with a diameter of approximately 500 nm were prepared by one-pot precipitation polymerisation using structural isomers of bifunctional dihydroxynaphthalene (1,5-dihydroxynaphthalene and 2,6-dihydroxynaphthalene) as phenol monomers, as well as 3-hydroxybenzoic acid and 3-aminophenol as comonomers to introduce carboxylic acid and amino groups, respectively. This wide range of phenolic monomers offers a powerful molecular design capability, enabling the optimisation of surface properties for the adsorption of various infectious virus particles. The virus adsorption capacity of the ArP nanoparticles exceeded 20 000 plaque-forming units and was found to be correlated with the nitrogen (primary and secondary amines) and quinone contents on the ArP nanoparticle surface. Furthermore, a polyvinylidene difluoride membrane filter uniformly coated with the ArP nanoparticles could remove viruses by filtration in a flow system.

Purpose: The purposes of this study were to compare global coronary flow reserve (CFR) between patients with idiopathic dilated cardiomyopathy (DCM) and risk-matched controls using cardiac MRI (CMR), and to evaluate the relationship between global CFR and CMR left ventricular (LV) parameters., Methods: Twenty-six patients with DCM and 26 risk-matched controls who underwent comprehensive CMR examination, including stress-rest coronary sinus flow measurement by phase contrast (PC) cine CMR were retrospectively studied. LV peak global longitudinal, radial, and circumferential strains (GLS, GRS, and GCS) were determined by feature tracking., Results: Patients with DCM had significantly lower global CFR compared with the risk-matched controls (2.87 ± 0.86 vs. 4.03 ± 1.47, P = 0.001). Among the parameters, univariate linear regression analyses revealed significant correlation of global CFR with LV end-diastolic volume index (r = -0.396, P = 0.045), LV mass index (r = -0.461, P = 0.018), GLS (r = -0.558, P = 0.003), and GRS (r = 0.392, P = 0.047). Multiple linear regression analysis revealed GLS as the only independent predictor of global CFR (standardized β = -0.558, P = 0.003)., Conclusion: Global CFR was significantly impaired in patients with idiopathic DCM and independently associated with LV GLS, suggesting that microvascular dysfunction may contribute to deterioration of LV function in patients with idiopathic DCM.

This study aims to develop a computerized classification method for significant coronary artery stenosis on whole-heart coronary magnetic resonance angiography (WHCMRA) images using a 3D convolutional neural network (3D-CNN) with attention mechanisms. The dataset included 951 segments from WHCMRA images of 75 patients who underwent both WHCMRA and invasive coronary angiography (ICA). Forty-two segments with significant stenosis (luminal diameter reduction ≥ 75%) on ICA were annotated on WHCMRA images by an experienced radiologist, whereas 909 segments without it were annotated at representative sites. Volumes of interest (VOIs) of 21 × 21 × 21 voxels centered on annotated points were extracted. The network comprises two feature extractors, two attention mechanisms (for the coronary artery and annotated points), and a classifier. The feature extractors first extracted the feature maps from the VOI. The two attention mechanisms weighted the feature maps of the coronary artery and those the neighborhood of the annotated point, respectively. The classifier finally classified the VOIs into those with and without significant coronary artery stenosis. Using fivefold cross-validation, the classification accuracy, sensitivity, specificity, and AUROC (area under the receiver operating characteristic curve) were 0.875, 0.905, 0.873, and 0.944, respectively. The proposed method showed high classification performance for significant coronary artery stenosis and appears to have a substantial impact on the interpretation of WHCMRA images., Competing Interests: Declarations. Conflict of interest: The authors declare no conflicts of interest. Ethics approval: Ethical approval for the use of cases was obtained from the institutional review boards (IRB) of both authors. Informed consent: The institutional review board approved this retrospective study and waived the requirement for informed consent., (© 2024. The Author(s), under exclusive licence to Japanese Society of Radiological Technology and Japan Society of Medical Physics.)

Purpose: To compare two blind source separation (BSS) techniques to principal component analysis and the electrocardiogram for the identification of cardiac triggers in self-gated free-running 5D whole-heart MRI. To ascertain the precision and robustness of the techniques, they were compared in three different noise and contrast regimes., Methods: The repeated superior-inferior (SI) projections of a 3D radial trajectory were used to extract the physiological signals in three cardiac MRI cohorts: (1) 9 healthy volunteers without contrast agent injection at 1.5T, (2) 30 ferumoxytol-injected congenital heart disease patients at 1.5T, and (3) 12 gadobutrol-injected patients with suspected coronary artery disease at 3T. Self-gated cardiac triggers were extracted with the three algorithms (principal component analysis [PCA], second-order blind identification [SOBI], and independent component analysis [ICA]) and the difference with the electrocardiogram triggers was calculated. PCA and SOBI triggers were retained for image reconstruction. The image sharpness was ascertained on whole-heart 5D images obtained with PCA and SOBI and compared among the three cohorts., Results: SOBI resulted in smaller trigger differences in Cohorts 1 and 3 compared to PCA (p < 0.01) and in all cohorts compared to ICA (p < 0.04). In Cohorts 1 and 3, the sharpness increased significantly in the reconstructed images when using SOBI instead of PCA (p < 0.03), but not in Cohort 2 (p = 0.4)., Conclusion: We have shown that SOBI results in more precisely extracted self-gated triggers than PCA and ICA. The validation across three diverse cohorts demonstrates the robustness of the method against acquisition variability., (© 2024 The Author(s). Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

This paper introduces a novel contactless single-chip detector that utilizes impedance-to-digital conversion technology to measure impedance in the microfluidic channel or capillary format analytical device. The detector is designed to operate similarly to capacitively coupled contactless conductivity detectors for capillary electrophoresis or chromatography but with the added capability of performing frequency sweeps up to 200 kHz. At each recorded data point, impedance and phase-shift data can be extracted, which can be used to generate impedance versus frequency plots, or phase-shift versus frequency plots. Real and imaginary parts can also be calculated from the data, allowing for the generation of Nyquist diagrams. This detector represents the first of its kind in the contactless conductivity class to provide spectrum-type data, as demonstrated in capillary electrophoresis experiments.

Aims: Photon-counting detector computed tomography (PCD-CT), which allows the exclusion of electronic noise, shows promise for significant dose reduction in coronary CT angiography (CCTA). This study aimed to assess the radiation dose and image quality of CCTA using PCD-CT, combined with high-pitch helical scanning and an ultra-low tube potential of 70 kVp, and investigate the effect of a sharp kernel on image quality and stenosis assessment in such an ultra-low-dose CCTA setting., Methods and Results: Forty patients (65% male) with stable heart rates and no prior coronary interventions were included. Data on CT dose index volume (CTDIvol) and dose-length product (DLP) were collected, with effective radiation dose estimated using a conversion factor of 0.014. Images were reconstructed using kernels of Bv64 and Bv40 for image quality and stenosis assessment. The mean CTDIvol, DLP, and effective dose of CCTA were 1.72 ± 0.38 mGy, 29.1 ± 6.8 mGy·cm, and 0.41 ± 0.09 mSv, respectively. Image quality was similar ( P = 0.75) between the two kernels, with over 95% of segments achieving a rating of good image quality for both kernels. The per-segment stenosis score distribution between Bv40 and Bv64 reconstruction images showed significant differences for both non-calcified and calcified plaques ( P < 0.001 for both)., Conclusion: PCD-CT technology with high-pitch helical scanning and the tube potential of 70 kVp can provide CCTA with ultra-low radiation exposure (DLP, 29 mGy·cm). The noise reduction capability of PCD-CT allows the use of a sharp kernel even in this low-dose CCTA setting without compromising image quality, potentially improving the evaluation of coronary artery stenosis., Competing Interests: Conflict of interest: Department of Advanced Diagnostic Imaging, where S.N. and K.K. currently belong to, is an endowment department supported with an unrestricted grant from Siemens Healthcare K.K. H.S. receives departmental research grant support from Eisai Co., Ltd, Guerbet Japan KK, FUJIFILM Toyama Chemical Co., Ltd, Nihon Medi-Physics Co., Ltd, PDRadiopharma Inc., and GE Healthcare Japan. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Purpose: Risk stratification for incidence of major adverse cardiovascular events (MACE) in patients with dialysis-dependent end-stage renal disease (dd-ESRD) is challenging. Moreover, the usefulness of coronary CT angiography (CCTA) is often limited because of high calcification. This study aimed to investigate the prognostic value of comprehensive cardiac CT in patients with dd-ESRD for predicting MACE., Materials and Methods: This retrospective analysis included 92 patients with dd-ESRD who underwent comprehensive cardiac CT. Obstructive coronary artery disease (CAD) was defined by CCTA with > 50% stenosis. Global myocardial blood flow (MBF) and summed stress score (SSS) were obtained through dynamic CTP. Cox regression analysis was used to assess correlation with MACE. Kaplan-Meier curves were used to estimate cumulative event rates, and the global Chi-square test was used to assess the incremental value of dynamic CTP over CCTA., Results: During a median follow-up of 2.3 years, 43 patients experienced MACE. Univariate analysis revealed that presence of obstructive CAD, higher SSS, and lower global MBF were significantly associated with increased risk of MACE. In multivariable analysis, lower global MBF and presence of obstructive CAD were independently associated with MACE (p = 0.02, and p = 0.04, respectively). CCTA and dynamic CTP combination had incremental value over CCTA alone for predicting MACE, respectively (global Chi-square score, 19.3 and 11.7, respectively)., Conclusion: Presence of obstructive CAD on CCTA and lower global MBF on dynamic CTP are independently associated with increased risk of MACE in patients with dd-ESRD. The addition of dynamic CTP to CCTA may improve risk stratification in this population., (© 2024. The Author(s).)

Background: Coronary artery disease (CAD) and coronary microvascular disease (CMD) are significant contributors to angina pectoris, necessitating reliable diagnostic techniques for effective management. While positron emission tomography has been the non-invasive gold standard for myocardial blood flow (MBF) quantification, stress dynamic CT myocardial perfusion imaging (CTMPI) has emerged as a promising alternative. This study aimed to evaluate the test-retest reproducibility of MBF measurements obtained using dynamic CTMPI., Methods: The study retrospectively analyzed MBF values from two dynamic CTMPI examinations conducted in the same patient cohort (n = 30) to examine the consistency of MBF quantification and the ability to visually detect and grade abnormal perfusion suggesting ischemia between the tests. Global and remote MBF were defined as the mean MBF and the maximum MBF of all segments, respectively., Results: MBF quantification revealed strong linear correlations between the tests (r = 0.89 for global MBF, r = 0.88 for remote MBF, and r = 0.82 for all segments), and intraclass correlation coefficients reflected high agreement between the tests (0.94 for global MBF, 0.93 for remote MBF, and 0.90 for all segments). Bland-Altman plots indicated a negligible mean difference with acceptable limits of agreements between the tests for global MBF, remote MBF, and all segments. Visual assessment of the CTMPI maps for abnormal perfusion suggesting ischemia yielded a good inter-test agreement with a weighted kappa value of 0.80., Conclusion: Dynamic CTMPI can consistently reproduce absolute MBF values and reliably detect myocardial perfusion abnormalities, potentially making it a robust diagnostic tool for evaluating the presence and severity of CAD and CMD., 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 The Author(s).)

Hydrogels composed of natural and synthetic polymers have considerable potential for use in diverse areas such as biomedical applications and water purification. This is primarily because of their biocompatibility, biodegradability, and low toxicity. The widespread usage of composite hydrogels is hindered by a lack of simultaneous properties, such as high strength and low swelling rate. Herein, we report the preparation of novel hydrogels composed of polyvinyl alcohol (PVA)-intercalated agar polymer networks physically crosslinked with tannic acid. The hydrogel was subjected to multiple freeze/thaw (F/T) cycles (1, 3, and 5), and it was found to exhibit the highest strength after 5 F/T cycles. After 1 F/T cycle, the tensile strength of the composite hydrogel reached 1.56 MPa with a 1.0 wt% crosslinker, whereas after 5 F/T cycles, it increased to 3.77 MPa with a reduced amount (0.75 wt%) of the crosslinker. In addition, the swelling ability decreased upon increasing the crosslinker content and number of F/T cycles. Furthermore, the hydrogel demonstrated excellent water retention and a strong ability to adhere to different substrates. We have successfully implemented an innovative approach to improve the mechanical properties of PVA-based hydrogels by combining the use of tannic acid as a cross-linking agent and multiple F/T cycles. The developed hydrogels are expected to facilitate new developments in hydrogel technology, thus impacting diverse fields such as biomedical (wound dressing and artificial cartilage).

Unique polymer hydrogels with unusual cross-linking networks and self-healing properties have been recently reported. In this study, we fabricated hybrid hydrogels consisting of a chiral supramolecular one-dimensional assembly of glutamide-derived lipids bearing pyridinium head groups ( G -Py + ) cross-linked with termini-anionised hydrophilic polyethylene glycol polymers (S-PEG n -S). The cationic group-linked G -Py + forms nanotubular aggregates in water. G -Py + /S-PEG n -S aqueous mixtures formed hydrogels at certain concentrations and ambient temperatures. The terminal anionic sulfate groups play a key role in hydrogel formation, as evidenced by the absence of gelation in G -Py + /PEG n . The negative circular dichroism signal observed for pyridinium exhibited a blue shift upon the addition of S-PEG n -S but maintained its signal intensity even with excess S-PEG n -S, suggesting the chiral orientation of the nanofibrous G -Py + self-assembly preserved even complexation with S-PEG n -S in hydrogel. The hybrid hydrogel of sulfated polyethylene glycol with nanofibrous chiral supramolecular assembly exhibited self-healing property at a temperature below the gel-to-liquid crystalline phase transition ( T C ) of G -Py + aggregates, which was evidenced by the inversion fluid method and viscoelastic measurements., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: The purpose of this study was to investigate the usefulness of second-generation intra-cycle motion correction algorithm (SnapShot Freeze 2, GE Healthcare, MC2) in improving the delineation and interpretability of coronary arteries in coronary computed tomography angiography (CCTA) compared to first-generation intra-cycle motion correction algorithm (SnapShot Freeze, GE Healthcare, MC1)., Methods: Fifty consecutive patients with known or suspected coronary artery disease who underwent CCTA on a 256-slice CT scanner were retrospectively studied. CCTA were reconstructed with three different algorithms: no motion correction (NMC), MC1, and MC2. The delineation of coronary arteries on CCTA was qualitatively rated on a 5-point scale from 1 (nondiagnostic) to 5 (excellent) by two radiologists blinded to the reconstruction method and the patient information., Results: On a per-vessel basis, the delineation scores of coronary arteries were significantly higher on MC2 images compared to MC1 images (median [interquartile range], right coronary artery, 5.0 [4.5-5.0] vs 4.5 [4.0-5.0]; left anterior descending artery, 5.0 [4.5-5.0] vs 4.5 [3.5-5.0]; left circumflex artery, 5.0 [4.5-5.0] vs 4.5 [3.9-5.0]; all p ​< ​0.05). On a per-segment basis, for both 2 observers, the delineation scores on segment 1, 2, 8, 9, 10, 12 and 13 on MC2 images were significantly better than those on MC1 images (p ​< ​0.05). The percentage of interpretable segments (rated score 3 or greater) on NMC, MC1, and MC2 images was 90.5-91.9%, 97.4-97.9%, and 100.0%, respectively., Conclusion: Second-generation intra-cycle motion correction algorithm improves the delineation and interpretability of coronary arteries in CCTA compared to first-generation algorithm., Competing Interests: Declaration of competing interest There is no industry support for this research project. The authors declare that they have no financial/personal interests or beliefs that would affect the results of this study., (Copyright © 2024 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Free-running 5D whole-heart coronary MR angiography (MRA) is gaining in popularity because it reduces scanning complexity by removing the need for specific slice orientations, respiratory gating, or cardiac triggering. At 3T, a gradient echo (GRE) sequence is preferred in combination with contrast injection. However, neither the injection scheme of the gadolinium (Gd) contrast medium, the choice of the RF excitation angle, nor the dedicated image reconstruction parameters have been established for 3T GRE free-running 5D whole-heart coronary MRA. In this study, a Gd injection scheme, RF excitation angles of lipid-insensitive binominal off-resonance RF excitation (LIBRE) pulse for valid fat suppression and continuous data acquisition, and compressed-sensing reconstruction regularization parameters were optimized for contrast-enhanced free-running 5D whole-heart coronary MRA using a GRE sequence at 3T. Using this optimized protocol, contrast-enhanced free-running 5D whole-heart coronary MRA using a GRE sequence is feasible with good image quality at 3T.

Epipericardial fat necrosis (EFN) is a rare benign cause of chest pain, that is frequently overlooked. EFN involves the necrosis of fat tissue in the mediastinum, and presents on computed tomography (CT) as an ovoid lesion of fat attenuation surrounded by a rim of soft tissue attenuation. This case report describes a case of a 50-year-old man diagnosed with EFN on cardiac CT, which was incidentally associated with apical hypertrophic myocardiopathy. Notably, the detection of EFN proved difficult on arterial phase images during coronary CT angiography, whereas it was much easier to detect on delayed phase images. EFN should be considered in the differential diagnosis of chest pain, and careful examination of mediastinal fat is crucial for accurate diagnosis., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Enantioselective discrimination of chiral molecules is essential in chemistry, biology, and medical science due to the configuration-dependent activities of enantiomers. Therefore, identifying a specific amino acid and distinguishing it from its enantiomer by using nanomaterials with outstanding performance are of great significance. Herein, blue- and green-emitting chiral silicon nanoparticles named bSiNPs and gSiNPs, respectively, with excellent water solubility, salt resistance, pH stability, photobleaching resistance, biocompatibility, and ability to promote soybean germination, were fabricated in a facile one-step method. Especially, chiral gSiNPs presented excellent fluorescence recognition ability for glutamic acid enantiomers within 1 min, and the enantiomeric recognition difference factor was as high as 9.0. The mechanism for enantiomeric fluorescence recognition was systematically explored by combining the fluorescence spectra with density functional theory (DFT) calculation. Presumably, the different Gibbs free energy and hydrogen-bonding interaction of the chiral recognition module with glutamic acid enantiomers mainly contributed to the difference in the fluorescence signals. Most noteworthy was the fact that the chiral gSiNPs can showcase not only the ability to recognize l- and d-glutamic acids in living cells but also the test strips fabricated by soaking gSiNPs can be applied for d-glutamic acid visual detection. As a result, this study provided insights into the design of multifunctional chiral sensing nanoplatforms for enantiomeric detection and other applications.

Purpose: Pulmonary emphysema may associate with ischemic heart disease through systemic microvascular abnormality as a common pathway. Stress cardiovascular MR (CMR) allows for the assessment of global coronary flow reserve (CFR). The purpose of this study was to evaluate the association between the emphysema severity and the multiple MRI parameters in the emphysema patients with known or suspected coronary artery disease (CAD)., Methods: A total of 210 patients with known or suspected CAD who underwent both 3.0T CMR including cine CMR, stress and rest perfusion CMR, stress and rest phase-contrast (PC) cine CMR of coronary sinus, and late gadolinium enhancement (LGE) CMR, and lung CT within 6 months were studied. Global CFR, volumes and functions of both ventricles and atria, and presence or absence of myocardial ischemia and infarction were evaluated. Emphysema severity was visually determined on lung CT by Goddard method., Result: Seventy nine (71.0 ± 7.9 years, 75 male) of 210 patients with known or suspected CAD had emphysema on lung CT. Goddard score was significantly correlated with CFR (r = -0.246, P = 0.029), left ventricular end-diastolic volume index (LV EDVI) (r = -0.230, P = 0.041), right ventricular systolic volume index (RV SVI) (r = -0.280, P = 0.012), left atrial (LA) total emptying volume index (r = -0.269, P = 0.017), LA passive emptying volume index (r = -0.309, P = 0.006), LA systolic strain (Es) (r = -0.244, P = 0.030), and LA conduit strain (Ee) (r = -0.285, P = 0.011) in the patients with emphysema. Multiple linear regression analysis revealed LA conduit function was independently associated with emphysema severity as determined by Goddard method (beta = -0.361, P = 0.006)., Conclusion: LA conduit function independently associates with emphysema severity in the emphysema patients with known or suspected CAD after adjusting age, sex, smoking, and the CMR indexes including CFR. These findings suggest that impairment of LA function predominantly occurs prior to the reduction of the CFR in the emphysema patients with known or suspected CAD.

Controlled aggregation of dyes is crucial to achieve their desired optical and electronic properties. Here, we report the induction of chiral J-aggregation of carbocyanine dyes by using lysine-derived amphiphile assemblies as scaffolds in water. The molecular structure of the amphiphiles affected the packing of the assembly. The tight packing with some flexibility promoted the formation of J-aggregates of the dyes with strong chiroptical properties.

Purpose: To investigate image noise and edge sharpness of coronary CT angiography (CCTA) with super-resolution deep learning reconstruction (SR-DLR) compared with conventional DLR (C-DLR) and to evaluate agreement in stenosis grading using CCTA with that from invasive coronary angiography (ICA) as the reference standard., Materials and Methods: This retrospective study included 58 patients (mean age, 69.0 years ± 12.8 [SD]; 38 men, 20 women) who underwent CCTA using 320-row CT between April and September 2022. All images were reconstructed with two different algorithms: SR-DLR and C-DLR. Image noise, signal-to-noise ratio, edge sharpness, full width at half maximum (FWHM) of stent, and agreement in stenosis grading with that from ICA were compared. Stenosis was visually graded from 0 to 5, with 5 indicating occlusion., Results: SR-DLR significantly decreased image noise by 31% compared with C-DLR (12.6 HU ± 2.3 vs 18.2 HU ± 1.9; P < .001). Signal-to-noise ratio and edge sharpness were significantly improved by SR-DLR compared with C-DLR (signal-to-noise ratio, 38.7 ± 8.3 vs 26.2 ± 4.6; P < .001; edge sharpness, 560 HU/mm ± 191 vs 463 HU/mm ± 164; P < .001). The FWHM of stent was significantly thinner on SR-DLR (0.72 mm ± 0.22) than on C-DLR (1.01 mm ± 0.21; P < .001). Agreement in stenosis grading between CCTA and ICA was improved on SR-DLR compared with C-DLR (weighted κ = 0.83 vs 0.77)., Conclusion: SR-DLR improved vessel sharpness, image noise, and accuracy of coronary stenosis grading compared with the C-DLR technique. Keywords: CT Angiography, Cardiac, Coronary Arteries Supplemental material is available for this article . © RSNA, 2023., Competing Interests: Disclosures of conflicts of interest: M.T. No relevant relationships. K.K. Honoraria for lectures from Siemens Healthcare Japan, Bayer Yakuhin, and Eisai; endowed chair for Siemens Healthcare Japan and Fuji Film Medical. S.M. No relevant relationships. A.H. No relevant relationships. R.K. No relevant relationships. K. Iio No relevant relationships. K. Ichikawa No relevant relationships. D.I. No relevant relationships. H.S. No relevant relationships., (© 2023 by the Radiological Society of North America, Inc.)

Self-organised helical bilayers of dicationic gemini surfactants confined in helical silica nanospace were transformed in situ to carbon dots (CDots) via pyrolysis. These water-dispersible CDots exhibit electronic absorption spanning the UV and visible range and possess symmetrical circular dichroism (CD) signals, the sign of which depends on the handedness of the helices.

Fluorescent materials with large Stokes shifts have significant potential for use in optical applications. Typically, a synthetic design strategy is utilized for this purpose. In this study, we demonstrated a novel method by binding a chiral template to a nonchiral fluorescent agent without chemical modification. Specifically, α-helical poly(L-lysine) was employed as the chiral template, which interacted with a disulfonic fluorescent dye, such as NK2751. The dye caused excimer luminescence by inducing the formation of a chirally H-aggregated dimer only when poly(L-lysine) was in an α-helical shape. The result was a Stokes shift of 230 nm. Similar effects were not observed when the chiral template was in a random coil condition and the Stokes shift was less than 40 nm. These findings imply that H-aggregated dimerization, which often results in quenching, permits the electronic transitions necessary for fluorescence events by the formation of the chirally twisted state. In addition, we introduce for the first time the generation of circularly polarized luminescence using the chirality induction phenomena in a dye supported by poly(L-lysine)., (© 2023 Wiley Periodicals LLC.)

Purpose: Several effective radiation dose reduction methods have been developed for coronary computed tomography angiography (CTA); however, their use in daily clinical practice remains unknown. We aimed to investigate radiation exposure and the utilization of dose-saving strategies for coronary CTA in hospitals in Mie Prefecture, Japan., Materials and Methods: Image acquisition details and dose reports of 30 consecutive cardiac CT examinations performed in 2021 were obtained from 18 hospitals. The inclusion criteria were patients aged 20-80 years who weighed 50-70 kg and underwent coronary CTA using ≥ 64-row multidetector CT. The doses for the overall cardiac CT examination and coronary CTA were analyzed using the dose-length product (DLP) and CT dose index (CTDIvol), respectively. Multivariate analysis was performed to determine independent predictors that affect the radiation dose in coronary CTA., Results: The median DLP of cardiac CT was 774 (interquartile range [IQR]: 538-1119) mGy*cm, and the median CTDIvol of coronary CTA was 33 (IQR: 25-48) mGy. The 75th percentile values of DLP for cardiac CT and that of CTDIvol for coronary CTA were slightly lower than the values recorded in the Japan Diagnostic Reference Level (DRLs) 2020 report (1285 mGy*cm and 66.4 mGy, respectively) but were substantially higher than those reported in a previous large international dose survey (402 mGy*cm and 24 mGy, respectively). Iterative reconstruction was performed during all examinations. Only six hospitals (33%) used a low tube potential (≤ 100 kVp), and nine hospitals (50%) used electrocardiogram-triggered prospective scanning. Multivariate analysis revealed low heart rate, low tube potential, and use of electrocardiogram-triggered prospective scanning as independent predictors of CTDIvol ≤ 24 mGy (p < 0.001, respectively)., Conclusion: As of 2021, low tube potential and prospective scanning are underutilized, whereas iterative reconstruction is used in every coronary CTA in Mie Prefecture. Further efforts to optimize the radiation exposure from cardiac CT scans are necessary., (© 2022. The Author(s).)

This study describes the fabrication of nanocomposites using electrospinning technique from poly lactic acid (PLA) and nano-hydroxyapatite (n-HAp). The prepared electrospun PLA-nHAP nanocomposite is intended to be used for drug delivery application. A hydrogen bond in between nHAp and PLA was confirmed by Fourier transform infrared (FT-IR) spectroscopy. Degradation study of the prepared electrospun PLA-nHAp nanocomposite was conducted for 30 days both in phosphate buffer solution (PBS) of pH 7.4 and deionized water. The degradation of the nanocomposite occurred faster in PBS in comparison to water. Cytotoxicity analysis was conducted on both Vero cells and BHK-21 cells and the survival percentage of both cells was found to be more than 95%, which indicates that the prepared nanocomposite is non-toxic and biocompatible. Gentamicin was loaded in the nanocomposite via an encapsulation process and the in vitro drug delivery process was investigated in phosphate buffer solution at different pHs. An initial burst release of the drug was observed from the nanocomposite after 1 to 2 weeks for all pH media. After that, a sustained drug release behavior was observed for the nanocomposite for 8 weeks with a release of 80%, 70% and 50% at pHs 5.5, 6.0 and 7.4, respectively. It can be suggested that the electrospun PLA-nHAp nanocomposite can be used as a potential antibacterial drug carrier for sustained drug release in dental and orthopedic sector.

Background: Transcatheter aortic valve implantation (TAVI) improved outcome of patients with severe aortic valve stenosis (AS). Myocardial fibrosis is associated with AS-related pathological left ventricular (LV) remodeling and predicts cardiovascular mortality after TAVI. The present study aimed to investigate the impact of preoperative extracellular volume (ECV) assessed by computed tomography (CT) on left ventricular mass (LVM) regression and clinical outcomes in severe AS patients after TAVI., Methods: We examined 71 consecutive severe AS patients who underwent CT with ECV determination before TAVI. ECV was calculated as the ratio of the change in Hounsfield units in the myocardium and LV blood before and after contrast administration, multiplied by (1-hematocrit). Delayed scan was performed at 5 min after contrast injection. Echocardiography was performed before and 6 months after TAVI. The primary endpoint was heart failure (HF) hospitalization after TAVI. Patients were divided into two subgroups according to the median value of global ECV with 32 % (Low-ECV group: n = 35, and High-ECV group: n = 36)., Results: No significant differences were observed in background characteristics between the 2 groups. However, the preoperative LV ejection fraction and LVM index were similar between the 2 groups, the Low-ECV group had greater LVM index reduction than the High-CV group after 6 months (p < 0.001). Kaplan-Meier curves demonstrated that the High-ECV group had significantly higher rate of HF hospitalization than the Low-ECV group (p = 0.016). In addition, multivariate analyses identified high global ECV as an independent predictor of HF hospitalization (HR 10.8, 95 % confidence interval 1.36 to 84.8, p = 0.024)., Conclusion: The low preoperative ECV assessed by CT is associated with the greater LVM regression, and predict better outcome in AS patients after TAVI., Competing Interests: Declaration of competing interest Kaoru Dohi received departmental research grant support equal to or >1,000,000 yen from Otsuka Pharma in 2020 and 2021, Abbot Medical Japan LLC Inc. in 2020 and 2021, and ZEON MEDICAL INC in 2022, and lecture fees from Otsuka Pharma in 2020 and 2021, and Daiichi Sankyo Company in 2021. Hajime Sakuma received departmental research grant support equal to or >1,000,000 yen from Fuji Pharma Co., Ltd. in 2020, FUJIFILM Toyama Chemical Co., Ltd. in 2020, 2021, and 2022, Guerbet Japan in 2020 and 2021, GE Healthcare Pharma in 2020 and 2021. Kakuya Kitagawa received research grant support equal to or >1,000,000 yen from Pfizer Japan Inc. in 2021. Kakuya Kitagawa is an endowed chair in the Department of Advanced Diagnostic Imaging funded by donations from Siemens Healthcare K·K and FUJIFILM Medical Co.,Ltd. Masaki Ishiyama, Tairo Kurita, Masafumi Takafuji, Kei Sato, Emiyo Sugiura, Shiro Nakamori, and Naoki Fujimoto have no financial conflicts of interest to disclose concerning this study. Kaoru Dohi is a member of the editorial team of the Journal of Cardiology., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

We described two novel zwitterionic polymer-terminated porous silica stationary phases containing the same pyridinium cation and anions of different side chains (carboxylate and phosphonate groups) for use in hydrophilic interaction liquid chromatography (HILIC). These two novel columns were prepared by polymerizing 4-vinylpyridine and grafting it onto a silica surface, followed by quaternization reaction with 3-bromopropionic acid (Sil-VPC 24 ) and (3-bromopropyl) phosphonic acid (Sil-VPP 24 ), which possess positively charged pyridinium groups, and negatively charged carboxylate and phosphonate groups, respectively. The products obtained were verified through relevant characterization techniques such as elemental analysis, Fourier-transform infrared spectroscopy, thermogravimetric analysis, Zeta potential analysis, and Brunauer-Emmett-Teller analysis. The retention properties and mechanisms of different types of compounds (neutral, cationic, and anionic) on the two zwitterionic-modified silica stationary phases were studied by varying the buffer salt concentration and pH of the eluent. The separation of phenol and aromatic acids, disubstituted benzene isomers, sulfonamide drugs, as well as nucleosides/nucleobases were investigated on the two packed novel columns and a commercial zwitterionic column in identical HILIC mode, ensuring a thorough comparison between both novel columns and with a commercial standard. The results illustrated that various compounds could be separated up to various efficiencies based on the mechanism of hydrophilic interaction-based retention between the solutes and the two zwitterionic polymer stationary phases. The Sil-VPP 24 column demonstrated the best separation performance out of the three, as well as flexible selectivity and excellent resolution. Both novel columns exhibited excellent stability and chromatographic repeatability for the separation of seven nucleosides and bases., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2023. Published by Elsevier B.V.)

Background: Phase-contrast cine cardiovascular magnetic resonance (CMR) quantifies global coronary flow reserve (CFR) by measuring blood flow in the coronary sinus (CS), allowing assessment of the entire coronary circulation. However, the complementary prognostic value of stress perfusion CMR and global CFR in long-term follow-up has yet to be investigated. This study aimed to investigate the complementary prognostic value of stress myocardial perfusion imaging and global CFR derived from CMR in patients with suspected or known coronary artery disease (CAD) during long-term follow-up., Methods: Participants comprised 933 patients with suspected or known CAD who underwent comprehensive CMR. Major adverse cardiac events (MACE) comprised cardiac death, non-fatal myocardial infarction, unstable angina, hospitalization for heart failure, stroke, ventricular arrhythmia, and late revascularization., Results: During follow-up (median, 5.3 years), there were 223 MACE. Kaplan-Meier curve analysis revealed a significant difference in event-free survival among tertile groups for global CFR (log-rank, p < 0.001) and between patients with and without ischemia (p < 0.001). The combination of stress perfusion CMR and global CFR enhanced risk stratification (p < 0.001 for overall), and prognoses were comparable between the subgroup with ischemia and no impaired CFR and the subgroup with no ischemia and impaired CFR (p = 0.731). Multivariate Cox proportional hazard regression analysis showed that impaired CFR remained a significant predictor for MACE (hazard ratio, 1.6; p = 0.002) when adjusted for coronary risk factors and CMR predictors, including ischemia. The addition of impaired CFR to coronary risk factors and ischemia significantly increased the global chi-square value from 88 to 109 (p < 0.001). Continuous net reclassification improvement and integrated discrimination with the addition of global CFR to coronary risk factors plus ischemia improved to 0.352 (p < 0.001) and 0.017 (p < 0.001), respectively., Conclusions: During long-term follow-up, stress perfusion CMR and global CFR derived from CS flow measurement provided complementary prognostic value for prediction of cardiovascular events. Microvascular dysfunction or diffuse atherosclerosis as shown by impaired global CFR may play a role as important as that of ischemia due to epicardial coronary stenosis in the risk stratification of CAD patients., (© 2023. The Author(s).)

In view of the limitations of existing berberine solid-phase extraction adsorbents, this paper proposes a novel carbonized π-conjugated polymer-coated porous silica (SiO 2 @C-π-CP) adsorbent with simple process and low cost for efficient extraction of berberine by multiple interactions. Characterization methods, including Brunner-Emmet-Teller measurement, thermogravimetric analysis, X-ray photoelectron spectroscopy, and scanning electron microscopy techniques, were used to verify the successful modification of carbonized π-conjugated polymer on the surface of porous silica. The berberine was selected as target molecule, and the adsorption mechanism and process were investigated through adsorption kinetics, adsorption isotherms, and thermodynamic studies. The fitting results show that the adsorption of berberine by SiO 2 @C-π-CP well conforms to the pseudo-second-order and Langmuir models. By optimizing the main SPE parameters, the SPE method based on SiO 2 @C-π-CP was developed. Excellent results were obtained, including low limit of detection (0.75 ng mL -1 ) and limit of quantification (2 ng mL -1 ), wide linearity (2-13,000 ng mL -1 ), and satisfactory relative standard deviations (RSD) of inter-day (1.5%) and intra-day (6.2%). Finally, the SiO 2 @C-π-CP also has been successfully used to the enrichment of berberine in real urine samples. This research makes clear that SiO 2 @C-π-CP has outstanding potential for trace enrichment of berberine alkaloids., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

A Semi Interpenetrating Polymer Network (semi-IPN) hydrogel was prepared and loaded with an antibiotic drug, gentamicin, to investigate the wound healing activity of this system. The semi-IPN hydrogel was synthesized by combining natural polymer cellulose nanocrystal (CNC) and synthetic polymer polyethylene glycol (PEG) and poly (N,N′-dimethyl acrylamide) (PDMAA), which was initially added as a monomer dimethyl acrylamide (DMAA). CNC was prepared from locally obtained jute fibers, dispersed in a PEG-NaOH solvent system and then mixed with monomer DMAA, where polymerization was initiated by an initiator potassium persulphate (KPS) and cross-linked by N,N′-methylenebisacrylamide (NMBA). The size, morphology, biocompatibility, antimicrobial activity, thermal and swelling properties of the hydrogel were investigated by different characterization techniques. The biocompatibility of the hydrogel was confirmed by cytotoxicity analysis, which showed >95% survival of the BHK-21, Vero cell line. The drug loaded hydrogel showed antimicrobial property by forming 25 and 23 mm zone of inhibition against Staphylococcus aureus (gram-positive) and Escherichia coli (gram-negative) bacteria, respectively, in antimicrobial analysis. At pH 5.5, 76% of the drug was released from the hydrogel within 72 h, as observed in an in vitro drug release profile. In an in vivo test, the healing efficiency of the drug loaded hydrogel was examined on a mice model with dorsal wounds. Complete healing of the wound without any scar formation was achieved in 12 days, which revealed excellent wound healing properties of the prepared drug loaded semi-IPN hydrogel. These results showed the relevance of such a system in the rapid healing of acute wounds.

A chiral supramolecular assembly exhibiting redox-induced changes in its chiroptical properties was prepared using viologen-modified glutamide ( G -V 2+ ) derivatives. Achiral viologen moieties in the G -V 2+ assembly were chirally orientated by glutamide groups, affording a unique orange-colored solution, with a visible absorption band at around 470 nm, having electronic circular dichroism (CD) signals (molar ellipticity [ θ ] = 0.58 × 10 5 deg cm 2 dmol -1 : absorption dissymmetry factors ( g ) = 5.2 × 10 -3 at 512 nm). The G -V 2+ could be reduced to its cation radical ( G -V + ˙) but retains its chiral assembly. After chemical reduction, the color change from orange to blueish violet, indicating an absorption band at approximately 560 nm, and the sign change of the CD signal from positive to negative ([ θ ] = -0.36 × 10 5 deg cm 2 dmol -1 ; g = -2.9 × 10 -3 at 580 nm) were observed in water. Subsequent oxidation re-introduces the G -V 2+ chiroptical behavior before reduction., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: Atrial fibrillation (AF) patients without coronary artery stenosis often show clinical evidence of ischemia. However myocardial perfusion in AF patients has been poorly studied. The purposes of this study were to investigate altered hyperemic myocardial blood flow (MBF) in patients with AF compared with risk-matched controls in sinus rhythm (SR), and to evaluate hyperemic MBF before and after catheter ablation using dynamic CT perfusion., Methods: Hyperemic MBF was quantified in 87 patients with AF (44 paroxysmal, 43 persistent) scheduled for catheter ablation using dynamic CT perfusion, and compared with hyperemic MBF in 87 risk-matched controls in SR. Follow-up CT after ablation was performed in 49 AF patients., Results: Prior to ablation, hyperemic MBF of patients in AF during the CT (1.29 ± 0.34 ml/mg/min) was significantly lower than in patients in SR (1.49 ± 0.26 ml/g/min, p = 0.002) or matched controls (1.65 ± 0.32 ml/g/min, p < 0.001); no significant difference was seen between patients in SR during the CT and matched controls (vs. 1.50 ± 0.31 ml/g/min, p = 0.815). In patients in AF during the pre-ablation CT (n = 24), hyperemic MBF significantly increased after ablation from 1.30 ± 0.35 to 1.53 ± 0.17 ml/g/min (p = 0.004); whereas in patients in SR during the pre-ablation CT (n = 25), hyperemic MBF did not change significantly after ablation (from 1.46 ± 0.26 to 1.49 ± 0.27 ml/g/min, p = 0.499)., Conclusion: In the current study using stress perfusion CT, hyperemic MBF in patients with AF during pre-ablation CT was significantly lower than that in risk-matched controls, and improved significantly after restoration of SR by catheter ablation, indicating that MBF abnormalities in AF patients are caused primarily by AF itself., (© 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Purpose: To determine the fitting equation that can correct for the underestimation of myocardial blood flow (MBF) measurement by using dynamic CT perfusion (CTP) with dual-source CT (MBF CT ), using MBF with oxygen 15-labeled water ( 15 O-water) PET (MBF PET ) as a reference, and to determine the accuracy of corrected MBF CT (MBF CT-corrected ) compared with MBF PET in a separate set of participants., Materials and Methods: In this prospective study (reference no. 2466), 34 participants (mean age, 70 years ± 8 [standard deviation]; 27 men) known or suspected to have coronary artery disease underwent dynamic stress CTP and stress 15 O-water PET between January 2014 and December 2018. The participants were randomly assigned to either a pilot group ( n = 17), to determine the fitting equation on the basis of the generalized Renkin-Crone model that can explain the relation between MBF CT and MBF PET , or to a validation group ( n = 17), to validate MBF CT-corrected compared with MBF PET . The agreement between MBF CT-corrected and MBF PET was evaluated by intraclass correlation and Bland-Altman analysis., Results: In the pilot group, MBF CT was lower than MBF PET (1.24 mL/min/g ± 0.28 vs 2.51 mL/min/g ± 0.89, P < .001) at the segment level. The relationship between MBF CT and MBF CT-corrected was represented as MBF CT = MBF CT-corrected × {1-exp[-(0.11 × MBF CT-corrected + 1.54)/MBF CT-corrected ]}. In the validation group, MBF CT-corrected was 2.66 mL/min/g ± 1.93, and MBF PET was 2.68 mL/min/g ± 1.87 at the vessel level. MBF CT-corrected showed an excellent agreement with MBF PET (intraclass correlation coefficient = 0.93 [95% CI: 0.87, 0.96]). The measurement bias of MBF CT-corrected and MBF PET was -0.02 mL/min/g ± 0.74., Conclusion: Underestimation of MBF by CT was successfully corrected with a correction method that was based on contrast kinetics in the myocardium. Keywords: CT, CT-Perfusion, PET, Cardiac, Heart Supplemental material is available for this article. © RSNA, 2021., Competing Interests: Disclosures of Conflicts of Interest: M.T. No relevant relationships. K.K. Endowed chair of Siemens Healthcare KK and Fujifilm Medical; joint research agreement with Elucid Bioimaging; honoraria for lectures from Siemens Healthcare KK. M.I. No relevant relationships. Y.I. No relevant relationships. S. Nakamura No relevant relationships. S. Nakamori No relevant relationships. T.K. No relevant relationships. K.D. No relevant relationships. H.S. Departmental research grants with Eisai, Fujifilm Holdings, Guerbet., (2021 by the Radiological Society of North America, Inc.)

Chiral glutamide-derived lipids form self-assembled fibrous molecular gels that can be used as HPLC organic phases. In this study, HPLC separation efficiency was improved through the addition of branched amphiphilic glutamide lipids to the side chains of a terminally immobilized flexible polymer backbone. Poly(4-vinylpyridine) with a trimethoxysilyl group at one end was grafted onto the surface of porous silica particles (Sil-VP 15 , polymerization degree = 15), and the pyridyl side chains were quaternized with a glutamide lipid having a bromide group (Br G ). Elemental analysis indicated that the total amount of the organic phase of the prepared stationary phase (Sil-VP G 15 ) was 38.0 wt%, and the quaternization degree of the pyridyl groups was determined to be 32.5%. Differential scanning calorimetric analysis of a methanol suspension of Sil-VP G 15 indicated that the G moieties formed a highly ordered structure below the phase transition temperature even on the silica surface, and the ordered G moieties exhibited a gel-to-liquid crystalline phase transition. Compared with a commercially available octadecylated silica column, the Sil-VP G 15 stationary phase showed high selectivity toward polycyclic aromatic hydrocarbons, and particularly excellent separations were obtained for geometrical and positional isomers. Sil-VP G 15 also showed highly selective separation for phenol derivatives, and bio-related molecules containing phenolic groups such as steroids were successfully separated. These separation abilities are probably due to multiple interactions between the elutes and the highly ordered functional groups, such as the pyridinium and amide groups, on the highly ordered molecular gel having self-assembling G moieties.

A chiral molecular gelation system, as a chiral host, was used to effectively realize enantioselectivity using the simple carboxylic acid functional group. For this purpose, an L-glutamic-acid-based lipidic amphiphile ( G -CA) with a carboxylic head group was selected and its responsiveness to cationic guest molecules was investigated. The dispersion morphology of G -CA in its solution state was examined by confocal and transmission electron microscopies, while interactions between the G -CA, as the host system, and guest molecules were evaluated by UV-visible, circular dichroism, and fluorescence spectroscopies. As a result, enantioselectivity was effectively induced when G -CA formed highly ordered aggregates that provide negatively charged surfaces in which carboxyl groups are assembled in highly ordered states, and when the two cationic groups of the guest molecule are attached to this surface through multiple interactions.

Background: Coronary magnetic resonance angiography (CMRA) allows non-ionizing visualization of luminal narrowing in coronary artery disease (CAD). Although a prior study showed the usefulness of CMRA for risk stratification in short-term follow-up, the long-term prognostic value of CMRA remains unclear. The purpose of this study was to evaluate the long-term prognostic value of CMRA., Methods: A total of 506 patients without history of myocardial infarction or prior coronary artery revascularization underwent free-breathing whole-heart CMRA between 2009 and 2015. Images were acquired using a 1.5 T or 3 T scanner and visually evaluated as the consensus decisions of two observers. Obstructive CAD on CMRA was defined as luminal narrowing of ≥ 50% in at least one coronary artery. Major adverse cardiac events (MACE) comprised cardiac death, nonfatal myocardial infarction, and unstable angina., Results: Obstructive CAD on CMRA was observed in 214 patients (42%). During follow-up (median, 5.6 years), 31 MACE occurred. Kaplan-Meier curve analysis revealed a significant difference in event-free survival between patients with and without obstructive CAD for MACE (log-rank, p = 0.003) and cardiac death (p = 0.012). Annualized event rates for MACE in patients with no obstructive CAD, 1-vessel disease, 2-vessel disease, and left-main or 3-vessel disease were 0.6%, 1.5%, 2.3%, and 3.6%, respectively (log-rank, p = 0.003). Cox proportional hazard regression analysis showed that, among obstructive CAD on CMRA and clinical risk factors (age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of CAD), obstructive CAD and diabetes were significant predictors of MACE (hazard ratios, 2.9 [p = 0.005] and 2.2 [p = 0.034], respectively). In multivariate analysis, obstructive CAD remained an independent predictor (adjusted hazard ratio, 2.6 [p = 0.010]) after adjusting for diabetes. Addition of obstructive CAD to clinical risk factors significantly increased the global chi-square result from 8.3 to 13.8 (p = 0.022)., Conclusions: In long-term follow-up, free breathing whole heart CMRA allows non-invasive risk stratification for MACE and cardiac death and provides incremental prognostic value over conventional risk factors in patients without a history of myocardial infarction or prior coronary artery revascularization. The presence and severity of obstructive CAD detected by CMRA were associated with worse prognosis. Importantly, patients without obstructive CAD on CMRA displayed favorable prognosis.