Nobuyuki Komiyama

Intimal hyperplasia regression from 6 to 12 months after stenting

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Three dimensional segmented myocardial perfusion images by selective intracoronary injection of contrast using 256 slice cone beam computed tomography

Information of the segmented left ventricular (LV) area supplied by every coronary artery is potentially useful for strategy and practice of percutaneous coronary intervention, coronary artery bypass surgery, or percutaneous transluminal septal myocardial ablation (PTSMA).1,2nnMyocardial contrast echocardiography (MCE) with intracoronary contrast injection has been used to evaluate the segmented LV area supplied by a coronary artery but it is invasive and evaluation of myocardial enhancement by ultrasound contrast material may depend upon the skill of the investigator.1nnWith a prototype high speed cone beam computed tomography (CT) apparatus employing 256 detector rows (Athena, Sony-Toshiba), an entire heart can be imaged within a single gantry rotation.3,4 Using this technique, combined with selective intracoronary injection of contrast, we determined the segmented LV area supplied by every coronary artery selectively.nnTwo domestic pigs (20 kg each) were anaesthetised with isoflurane, and catheters positioned in the left anterior descending branch (LAD) of the coronary artery in pig 1 and the left circumflex branch (LCx) in pig 2, via the femoral arteries. The heart rate of pigs ranged between 70–80 beats per minute.nnScan conditions for the 256 slice cone beam CT were: 120 kV, 200 mA, 1.0 second exposure, 1.0 second gantry rotation time, 0.5 mm slice thickness, and 256×0.5 mm slice collimation. For comparison, those for the 16 slice multislice CT scanner routinely used at our institute (SOMATOM Sensation 16, Siemens) were: …

Patency of coronary artery lumen surrounded by metallic stent evaluated by three dimensional volume rendering images using ECG gated multislice computed tomography

A 78 year old man came to our hospital because of chest pain on effort. Conventional coronary angiography revealed high grade stenosis at the proximal portion of the left anterior descending branch (LAD). Therefore, percutaneous transluminal coronary angioplasty with metallic stent implantation was performed. Four months after the stent placement, enhanced multislice …

Fibromuscular dysplasia in renovascular hypertension demonstrated by multislice CT: comparison with conventional angiogram and intravascular ultrasound

A 36 year old woman with a history of a gradual increase in blood pressure presented at our hospital. A renogram was performed and a decreased blood flow in the first and second phases was observed in the right kidney, with a significantly higher activity of serum renin in the right renal …

Feeding Artery of a Left Atrial Myxoma Demonstrated by Three-Dimensional Volume-Rendering Images With Multislice Computed Tomography

An 81-year-old man had a mass in the left atrium (LA) that was detected by transthoracic echocardiography at another hospital. To evaluate the characteristics of the mass, ECG-gated enhanced multislice computed tomography (CT) (Aquilion, Toshiba) was performed with a 1-mm slice thickness and helical pitch of 1.0. After intravenous injection of 100 mL of iodinated contrast material (30%), CT scanning was performed with retrospective ECG-gated reconstruction. After acquisition, volume data were extracted from end-diastole, and volume-rendering images were made on a workstation …

Efficacy of nifekalant hydrochloride on the treatment of life-threatening ventricular tachyarrhythmias during reperfusion for acute myocardial infarction.

Nifekalant hydrochloride, which is formally known as MS-551, is a new class III antiarrhythmic drug. This drug inhibits several cardiac potassium channels and is effective for various experimental arrhythmias. In this case report, we demonstrated the clinical effect of nifekalant hydrochloride on the sustained ventricular tachycardia (VT) due to reperfusion therapy for acute myocardial infarction with severe left ventricular dysfunction.

Patency of the right coronary artery following implantation of metallic stent demonstrated by multislice computed tomography

A 67 year old man presented to our hospital with chest pressure. A conventional angiogram revealed significant stenosis in the proximal portion of the right coronary artery (RCA) and percutaneous transluminal coronary angioplasty was therefore performed with successful stent implantation at the …

Rationale and Design of Low-dose Administration of Carperitide for Acute Heart Failure (LASCAR-AHF)

BackgroundsDespite current therapies, acute heart failure (AHF) remains a major public health burden with high rates of in-hospital and post-discharge morbidity and mortality. Carperitide is a recombinantly produced intravenous formulation of human atrial natriuretic peptide that promotes vasodilation with increased salt and water excretion, which leads to reduction of cardiac filling pressures. A previous open-label randomized controlled study showed that carperitide improved long-term cardiovascular mortality and heart failure (HF) hospitalization for patients with AHF, when adding to standard therapy. However, the study was underpowered to detect a difference in mortality because of the small sample size.MethodsLow-dose Administration of Carperitide for Acute Heart Failure (LASCAR-AHF) is a multicenter, randomized, open-label, controlled study designed to evaluate the efficacy of intravenous carperitide in hospitalized patients with AHF. Patients hospitalized for AHF will be randomly assigned to receive either intravenous carperitide (0.02xa0μg/kg/min) in addition to standard treatment or matching standard treatment for 72xa0h. The primary end point is death or rehospitalization for HF within 2xa0years. A total of 260 patients will be enrolled between 2013 and 2018.ConclusionThe design of LASCAR-AHF will provide data of whether carperitide reduces the risk of mortality and rehospitalization for HF in selected patients with AHF.

Multiple cystic aneurysms in aortitis demonstrated by three dimensional volume rendering images of multislice computed tomography

A 29 year old man presented with slight fever and pulsation at the left neck originating from a gradually expanding palpable mass. Multislice computed tomography (CT) (Aquilion, Toshiba, Tokyo, Japan) was performed with a 1 mm slice thickness, helical pitch 5.5, and 100 ml of iodinated contrast material (300 mg/ml) delivered …