Journal of cardiology
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Journal of cardiology · Jul 2010
Effectiveness of a portable device and the need for treatment of mild-to-moderate obstructive sleep-disordered breathing in patients with cardiovascular disease.
In Japan, there are two sleep-disordered breathing (SDB)-related problems, which include diagnosing SDB using a portable device (PD) and treating mild-to-moderate SDB (mm-SDB) using continuous positive airway pressure (CPAP) for severe SDB (s-SDB) in obstructive sleep apnea (OSA) patients. Our aims were to evaluate the effectiveness of a PD in diagnosing SDB in patients with cardiovascular disease (CVD), and to assess the difference between mm-SDB [apnea-hypopnea index (AHI): 20-40h(-1)] and s-SDB (AHI: >40h(-1)) using brain natriuretic peptide (BNP) in OSA patients. ⋯ The PD was effective in diagnosing SDB in patients with CVD. The BNP value was higher in the mm-SDB patients. Therefore, they need to be treated with CPAP to treat underlying CVD.
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Journal of cardiology · May 2010
Estimated glomerular filtration rate is an independent predictor for mortality of patients with acute heart failure.
Heart failure is a major public health problem in developed countries including Japan, therefore it is important to estimate the future risk in patients with heart failure. Recently, it has been reported that chronic kidney disease (CKD) is an independent predictor for mortality in chronic heart failure. However, it is unknown whether CKD is an independent predictor for mortality in acute heart failure. We retrospectively investigated the relationship between estimated glomerular filtration rate (eGFR) on admission for acute heart failure and long-term mortality. ⋯ Lower eGFR at the time of admission could be an independent predictor for mortality of acute heart failure.
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Journal of cardiology · May 2010
N-terminal pro-BNP is a novel biomarker for integrated cardio-renal burden and early risk stratification in patients admitted for cardiac emergency.
The expanding role of cardiac markers - cytosolic [heart-type fatty acid-binding protein (H-FABP) and creatine kinase MB (CK-MB)], myofibril [troponin T (TnT)], and cardio-endocrine [N-terminal pro-B-type natriuretic peptide (NT-proBNP)] - has been clarified in patients with acute coronary syndrome and those with heart failure. However, these applications for early risk stratification in the cardiac emergency, and the influence of renal function on these evaluations have not been fully investigated. ⋯ NT-proBNP is a novel biomarker for integrated cardio-renal burden, and extremely useful for early risk stratification in the situation of cardiac emergency.
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Journal of cardiology · Jan 2010
Case ReportsVisualization of traumatic tricuspid insufficiency by three-dimensional echocardiography.
A 19-year-old male was admitted to the emergency room of our hospital after a motor vehicle accident. During his first physical examination, a holosystolic murmur was heard at the fourth left parasternal border. Transthoracic echocardiography showed severe tricuspid insufficiency, but the cause of tricuspid insufficiency was unclear. ⋯ Surgical repair of the tricuspid valve was performed in this patient. After surgery, the signs and symptoms of right ventricular heart failure were relieved. In this case, three-dimensional echocardiography was very useful for the evaluation of spatial destruction of the tricuspid valve and papillary muscle.
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Journal of cardiology · Dec 2009
Case ReportsUsefulness of contrast echocardiography for detecting right-to-left cardiac shunts during the diagnosis of hypoxemia: 2 case reports.
We report two cases in which contrast echocardiography was useful for detecting right-to-left shunt. In case 1, a 53-year-old man was admitted to our hospital after being diagnosed with acute heart failure. Even after improvement of the heart failure, hypoxemia remained. ⋯ A patent foramen ovale (PFO) was proved using the Valsalva maneuver, and the contrast medium drained from right atrium into the left atrium via the PFO. He underwent patch closure of the PFO, and his symptoms disappeared. Contrast echocardiography should be performed for the diagnosis of chronic hypoxemia for which causes are not detected with routine clinical examinations, in order to confirm right-to-left shunt.