Teruhiko Kumamoto

Diagnostic Use of Serum Deoxyribonuclease I Activity as a Novel Early-Phase Marker in Acute Myocardial Infarction

Background—The delayed release of serum cardiac markers such as creatine kinase isoenzyme MB and equivocal early electrocardiographic changes have hampered a diagnosis of acute myocardial infarction (AMI) in the early phase after its onset. Therefore, a reliable serum biochemical marker for the diagnosis of AMI in the very early phase is desirable. Methods and Results—Serum samples were collected from the patients with AMI, unstable angina pectoris, stable angina pectoris, and other diseases. Levels of serum deoxyribonuclease I (DNase I) activity in the patients were determined. An abrupt elevation of serum DNase I activity was observed within approximately 3 hours of the onset of symptoms in patients with AMI, with significantly higher activity levels (21.7±5.10 U/L) in this group compared with the other groups with unstable angina pectoris (10.4±4.41 U/L), angina pectoris (10.8±3.70 U/L), and other diseases (9.22±4.16 U/L). Levels of the DNase I activity in serum then exhibited a marked time-dependent decline within 12 hours and had returned to basal levels within 24 hours. Conclusions—We suggest that serum DNase I activity could be used as a new diagnostic marker for the early detection of AMI.

Circumferential pulmonary vein ablation of atrial fibrillation via superior vena cava approach in a patient with interruption of the inferior vena cava

Interruption of the inferior vena cava (IVC) is a very rare congenital abnormality. Such patients have many difficulties during ablation procedures. We report a case of successful ablation of paroxysmal atrial fibrillation using the superior vena cava in a patient with interruption of the IVC.