Resolution of Severe Thrombocytopenia and Candida parapsilosis Infective Endocarditis With Fourth Open-Heart Surgery.

Background: Surgical treatment for infective endocarditis (IE) with severe thrombocytopenia is considered high risk and is often avoided.

Case Summary: A 67-year-old man with a history of 3 open-heart surgeries presented with fever and severe thrombocytopenia accompanied by a bleeding tendency. Blood cultures and transthoracic echocardiography confirmed IE of the aortic bioprosthetic valve caused by Candida parapsilosis.

Stent thrombosis in acute myocardial infarction in the era of second-generation drug-eluting stent: incidence, prognosis, and historical comparisons with previous stent era.

Background: Stent thrombosis (ST) remains a serious complication after percutaneous coronary intervention, leading to acute myocardial infarction (AMI) in over 70% of cases. And it has been reported that the prognosis for ST is worse than for de-novo AMI. While the use of second-generation drug-eluting stents (G2-DES) has reduced ST incidence, ST remains a concern, and its incidence and prognosis in the G2-DES era have not been well studied.

Pressure-volume loop analysis in heart failure with preserved ejection fraction: Implications for cardiac mechanics, diagnosis, and treatment strategy.

Heart failure with preserved ejection fraction (HFpEF), previously referred to as diastolic heart failure, accounts for more than half of heart failure hospitalizations in patients over 65 years of age. Although the prevalence of heart failure with reduced ejection fraction has declined, HFpEF is increasingly prevalent in Japan and worldwide. Traditionally, HFpEF was primarily thought to be caused by diastolic dysfunction, characterized by impaired left ventricular (LV) relaxation and increased LV stiffness.

ST-Segment Elevation and Recurrent Ventricular Fibrillation: What Is the Diagnosis?

We report the case of a 67-year-old man with no significant medical history who experienced sudden cardiac arrest at home. Emergency medical services performed electrical defibrillation for ventricular fibrillation and restored spontaneous circulation. A postresuscitation 12-lead electrocardiogram showed ST-elevation in the precordial leads and frequent premature ventricular contractions.

Prognostic value of right ventricular ejection fraction using three-dimensional echocardiography in patients with ischemic and dilated cardiomyopathy.

Background: There are few studies reporting the prognostic value of three-dimensional echocardiography (3DE)-derived right ventricular ejection fraction (RVEF) in patients with ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM).

Methods: 120 ICM and 107 DCM patients who underwent 3DE were retrospectively selected and analyzed using 3DE speckle tracking software. The primary endpoint was a composite of cardiac events, including cardiac death, heart failure hospitalization, myocardial infarction, or ventricular tachyarrhythmia.

Differences in risk factors between all-cause and pulmonary embolism-related death in acute pulmonary embolism: insights from the COMMAND VTE registry-2.

Background: Accurate risk prediction of early mortality, particularly pulmonary embolism (PE)-related death, in patients with acute PE has become more important for selecting optimal management strategies.

Objectives: To evaluate the cumulative 30-day incidence of and risk factors for all-cause and PE-related death within 30 days.

Methods: In the COMMAND VTE Registry-2, which enrolled symptomatic patients with venous thromboembolism at 31 centers in Japan, we analyzed 2035 patients with acute PE.

Dotinurad, a novel urate reabsorption inhibitor, prolongs survival in Alport mice.

Background: Hyperuricemia contributes to inflammatory conditions such as gout and is associated with liver dysfunction, cardiovascular disease, and immune cell activation. While the benefits of uric acid-lowering therapy in patients with chronic kidney disease (CKD) remain uncertain, dotinurad, a selective urate transporter 1 (URAT1) inhibitor, may provide renal benefits by reducing excessive uric acid reabsorption. This study investigates the effects of dotinurad on kidney function in a mouse model of Alport syndrome, a genetic model of CKD.

Asymmetric Pulmonary Edema Due to Acute Eccentric Mitral Regurgitation Based on Pulmonary Vein Distribution.

Background: Acute eccentric mitral regurgitation (MR) is known to cause unilateral pulmonary edema.

Case Summary: A 63-year-old previously healthy woman presented with dyspnea and asymmetrical pulmonary infiltrates. Unlike the typical unilateral presentation, these infiltrates showed regional stratification across all 4 lung fields.

Assessing Cardiomyocyte DNA Damage Using Cardiovascular Magnetic Resonance T Mapping: Insights From Comparative Biopsy Analysis.

Background: DNA damage in cardiomyocytes is a key pathological pathway in heart failure progression. It is a reversible process that precedes apoptosis and fibrosis. However, the utility of cardiovascular magnetic resonance T mapping for assessing DNA damage is uncertain.

Pneumonia-Masked Pulmonary Embolism in Nephrotic Syndrome: Diagnostic Value of V/Q Scintigraphy: A Case Report.

Nephrotic syndrome predisposes patients to venous thromboembolism. This case highlights the challenges of diagnosing pulmonary embolism in nephrotic syndrome patients with renal dysfunction, and emphasizes the utility of ventilation-perfusion lung scintigraphy when the contrast is contraindicated. A 52-year-old male presented with fatigue, left back pain, dyspnea, and lower limb edema.

Coronavirus Disease 2019-associated Minimal Change Disease: Transient Improvement Does Not Preclude the Need for Standard Therapy in a Case Report and Review of the Literature.

Minimal change disease can be associated with coronavirus disease 2019 (COVID-19). We herein report a 38-year-old woman who developed biopsy-proven minimal change disease 5 days after COVID-19 infection. Initial observation showed some spontaneous reduction in proteinuria, which later worsened.

Left atrial and ventricular strain and extracellular volume fraction in patients with paroxysmal and persistent atrial fibrillation.

To investigate cardiac MR (CMR) parameters, including left atrial (LA)/left ventricular (LV) volume, function, and extracellular volume fraction (ECV), in persistent and paroxysmal AF after catheter ablation and to evaluate the relationship between ECV and CMR parameters in AF patients. Participants comprised 41 patients with AF (persistent AF, n = 25; paroxysmal AF, n = 16) who underwent CMR study including cine-CMR, late gadolinium enhancement (LGE) CMR, and pre- and post-contrast T1 mapping within a week after restoration of sinus rhythm by catheter ablation and 18 matched controls. LA/LV volume and function and LV-ECV were determined by cine-CMR and T1 mapping, respectively.

Biliary microbiome profiling via 16 S rRNA amplicon sequencing in patients with cholangiocarcinoma, pancreatic carcinoma and choledocholithiasis.

Recent studies have revealed that oral, gut, and intratumoral microbial dysbiosis significantly affects tumor progression, therapy resistance, and prognosis in cholangiocarcinoma (CCA) and pancreatic ductal adenocarcinoma (PDAC) patients. However, the biliary microbiome, which directly interacts with malignant tissues, remains poorly understood. In this study, we analyzed the bile microbiota from 17 CCA, 15 PDAC, and 40 choledocholithiasis (CDL) patients using bacterial 16 S rRNA and fungal ITS sequencing.

Latent Tubulointerstitial Nephritis with IgM-positive Plasma Cells Uncovered in a Case of IgA Nephropathy and Primary Biliary Cholangitis: Clinical and Histological Insights.

Patients with anti-mitochondrial antibody positivity rarely develop tubulointerstitial nephritis with IgM-positive plasma cells (IgMPC-TIN). A previous report observed elevated serum IgM and urinary β2 microglobulin levels in all cases of IgMPC-TIN. This case involved IgA nephropathy with latent coexisting IgMPC-TIN; however, no such changes were observed.

Effects of Sacubitril/Valsartan on Myocardial Tissue in Heart Failure With Left Ventricular Ejection Fraction Below 50.

Background: The effects of sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor [ARNI]) on myocardial tissue in heart failure (HF) with left ventricular ejection fraction (LVEF) <50% remain unclear.

Methods And Results: Sixty-four HF outpatients with LVEF <50% were randomized to ARNI (switching from an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker [ACEi/ARB] to ARNI) or control (continuing with ACEi/ARB). Left ventricular (LV) structure and myocardial tissue, including changes in LV extracellular volume fraction (ECV), were evaluated before and after the 9-month program using cardiac magnetic resonance imaging.

Time Interval From Right Atrium to Coronary Sinus Predicts Postablation Atrial Fibrillation Recurrence in Current Ablation Practice.

Background: Recurrence after ablation for atrial fibrillation (AF) may occur in patients in whom atrial remodeling progresses. Atrial conduction time is a marker of remodeling. This study investigated whether atrial conduction time is related to postoperative recurrence.

Manifest type B Wolff-Parkinson-White syndrome complicated with slow/fast atrioventricular nodal reentrant tachycardia: A case report.

The unstable left-sided AP was a bystander in AVRT via the right-sided AP, and the right-sided AP was a bystander in AVNRT in this case. Interestingly, the right-sided AP was either part of the circuit or a bystander.

Clinical outcomes of cancer-associated isolated distal deep vein thrombosis: a comparison between asymptomatic and symptomatic thrombosis-findings from the ONCO DVT Study.

Background: The risk of recurrent venous thromboembolism (VTE) in patients with isolated distal deep vein thrombosis (IDDVT) is generally low, particularly when IDDVT is asymptomatic. However, cancer patients with IDDVT, even asymptomatic IDDVT, may be at a higher risk of recurrent VTE.

Objectives: To compare the clinical outcomes of cancer patients with asymptomatic and symptomatic IDDVT.

Associations Between Mean Arterial Pressure and Prognosis in Acute Myocardial Infarction Complicated by Cardiogenic Shock Differ Depending on Coma Status.

Background: In acute myocardial infarction complicated by cardiogenic shock (AMI-CS), low mean arterial pressure (MAP) can reduce cerebral perfusion, potentially resulting in coma. While both MAP and coma on admission are critical prognostic factors, the relationship between them and their prognostic significance based on coma status remains unclear.

Methods And Results: A retrospective analysis of 543 AMI-CS patients was conducted.

Cardiovascular magnetic resonance radiologic-pathologic correlation in radiomic analysis of myocardium in non-ischemic dilated cardiomyopathy.

Background: There is a growing interest in cardiovascular magnetic resonance (CMR) radiomic signatures as novel imaging biomarkers of cardiac disease. However, very little is known about pathological correlates of the radiomics signature of myocardium on CMR sequences. In this study, we sought to investigate the association between CMR myocardial radiomic signatures and histological features in patients with non-ischemic dilated cardiomyopathy (DCM).