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Ezetimibe has been reported to provide significant incremental reduction in low-density-lipoprotein cholesterol (LDL-C) when added to a statin; however, its effect on coronary atherosclerosis has not yet been evaluated in detail. The aim of this study was to investigate the add-on effect of ezetimibe to a statin on coronary atherosclerosis evaluated by intravascular ultrasound (IVUS).In this prospective randomized open-label study, a total of 51 patients with stable coronary artery disease (CAD) requiring percutaneous coronary intervention (PCI) were enrolled, and assigned to a combination group (n = 26, rosuvastatin 5 mg/day + ezetimibe 10 mg/day) or a monotherapy group (n = 25, rosuvastatin 5 mg/day). Volumetric IVUS analyses were performed at baseline and 6 months after the treatment for a non-PCI site. LDL-C level was significantly reduced in the combination group (-55.8%) versus that in the monotherapy group (-36.8%; P = 0.004). The percent change in plaque volume (PV), the primary endpoint, appeared to decrease more effectively in the combination group compared with the monotherapy group (-13.2% versus -3.1%, respectively, P = 0.050). Moreover, there was a significant group × time interaction in the effects of the two treatments on PV (P = 0.021), indicating the regressive effect of the combination therapy on PV was greater than that of monotherapy for subtly different values of baseline PV in the two treatment groups. Moreover, percent change in PV showed positive correlations with percent change of LDL-C (r = 0.384, P = 0.015).Intensive lipid-lowering therapy with ezetimibe added to usual-dose statin may provide significant incremental reduction in coronary plaques compared with usual-dose statin monotherapy.

Among the devices used for PCI, balloon catheter for percutaneous transluminal coronary angioplasty (“balloon catheter”) is the most frequently used device. In addition, since balloon catheter may be used multiple times, it is required not only to have crossability for an initial lesion, but

Background: Optimal atrial-ventricular (AV) and intra-ventricular (VV) conduction delay setting is mandatory for maintaining left ventricular pump function in patients who have undergone cardiac resynchronization therapy (CRT). Echocardiography is considered the gold standard of timing optimization but is a time-consuming procedure.Purpose: We report an interesting case of refractory heart failure who were successfully managed by algorithmic AV and VV delay programming using Smart Delay algorithm.Case: A 54-year-old female patient. The patient was diagnosed as NYHA III degree heart failure in September 2008, CRT-D was implanted in October 2008. In late December 2009, the patient was diagnosed as NYHA IV degree heart failure, and the patient was transferred to our hospital for the treatment of arrhythmias and heart failure.Therapy: optimization of the intra-cardiac conduction delays was achieved using Smart Delay algorithm (paced AV 160 to 180 msec, sensed AV 160 to 180 msec, and BIV pacing to LV pacing), which resulted in a prompt increase in her stroke volume from 46 to 80 ml with consequent improvement in heart failure symptoms.Conclusion: We experienced a case of refractory heart failure successfully managed by optimization of the intra-cardiac conduction delays using Smart Delay.

Acute stent recoil has been radial strength hand stiffness are important determinants of the mechanical performance of coronary stents. In this study, we quantitatively evaluated the radial strength hand stiffness of four types of stent. The test involved compression of the expanded stent at a