Background-Diffusion tensor magnetic resonance imaging (DT-MRI) provides a means for nondestructive characterization of myocardial architecture. We used DT-MRI to investigate changes in direction-dependent water diffusivity to reflect alterations in tissue integrity (trace apparent diffusion coefficients [ADCs] and fractional anisotropy [FA]), as well as indicators of remodeling of fiber helix angles, in patients after myocardial infarction. Methods and Results-Thirty-seven patients (35 men, 2 women; median age, 59) after acute myocardial infarction (median interval from onset, 26 days) were enrolled. DT-MRI was performed at the midventricular level to measure trace ADC, FA, and helix angles of myofibers. Helix angles were grouped into left-handed helical fibers, circumferential fibers, and right-handed helical fibers. Measurements were correlated with viability and regional wall motion assessed by contrast-delay-enhancement and cine MRI, respectively. The infarct zone showed significantly increased trace ADC and decreased FA than the remote zone.

This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

Prophylactic hemodialysis is effective in improving renal outcome in chronic renal failure patients undergoing coronary angiography.

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp iastolic dysfunction has a significant impact on prognosis in a wide range of cardiac disorders. 1 Noninvasive methods of estimating left ventricular filling pressure (LVFP) are often helpful for diagnosing and treating diastolic heart failure. Some echocardiographic parameters associated with left ventricular (LV) diastolic function, such as mitral inflow velocities, deceleration time, and pulmonary venous flow velocities, are significantly influenced by preload. 2,3 Tissue Doppler imaging (TDI) is relatively preload independent, 4,5 and E/e' (the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity) has been proposed to provide a non-invasive measure of LVFP. 6 However, TDI was developed to assess regional function, 7-12 and its value for estimating global diastolic function in coronary artery disease (CAD) with regional function abnormalities is by implication limited. Thus, the application of E/e' for estimating LVFP might be more appropriate for patients with global LV dysfunction. Our previous report 13 indicated that left atrial (LA) distensibility correlates logarithmically with LVFP in patients with severe mitral regurgitation. It was the first comparative echocardiographic-catheterization study to demonstrate the correlation between a LA volume parameter and LVFP. We hypothesized that LA distensibility could become an indicator of global diastolic function and might be useful for assessing LVFP not only in patients with mitral regurgitation but also in those with stable angina. Thus, we analyzed the relationship between LA volume parameters and LVFP in CAD patients with stable angina and performed a head-to-head comparison of those 2 parameters (E/e' and LA volume parameter) for the accuracy of assessing LVFP Background: Although E/e' (the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity) is widely used to measure left ventricular filling pressure (LVFP), its accuracy is questionable in coronary artery disease patients.

535I n humans, the intake of sugar-sweetened beverages is correlated with the prevalence of type 2 diabetes mellitus and obesity.1 High fructose intake is used as a well-established animal model for insulin resistance.2 Some studies have shown that chronic fructose intake in normal rats induces hypertension in association with insulin resistance.2,3 However, insulin infusion was found to stimulate local vasodilation by enhancing the action of nitric oxide (NO). 4 The effect of insulin on the baroreceptor reflex in nucleus tractus solitarii (NTS) is probably mediated by a change in sympathetic nervous activity. 4,5 Furthermore, sympathectomy can prevent the development of fructose-induced hypertension in rats. 6 Recent studies suggest that fructose consumption increases superoxide generation and attenuates baroreflex response. 7,8 Interestingly, inhibition of superoxide generation in NTS can reduce blood pressure (BP) in stroke-prone hypertensive rats. 9 The NTS is located in the dorsal medulla of the brain stem, which is the primary integrating center for cardiovascular regulation and other autonomic functions of the central nervous system. Furthermore, NO has important modulatory functions in the NTS, including the modulation of arterial BP and sympathetic nerve activity. 10 In previous experiments, we demonstrated that insulin microinjected into the NTS induces a depressor effect and initiates an interaction between insulin and phosphatidylinositol 3-kinase Abstract-Recent clinical studies found that fructose intake leads to insulin resistance and hypertension. Fructose consumption promotes protein fructosylation and formation of superoxide. In a previous study, we revealed that inhibition of superoxide production in the nucleus tractus solitarii (NTS) reduces blood pressure. Caffeine displays significant antioxidant ability in protecting membranes against oxidative damage and can lower the risk of insulin resistance. However, the mechanism through which caffeine improves fructose-induced insulin resistance is unclear. The aim of this study was to investigate whether caffeine consumption can abolish superoxide generation to enhance insulin signaling in the NTS, thereby reducing blood pressure in rats with fructose-induced hypertension. Treatment with caffeine for 4 weeks decreased blood pressure, serum fasting glucose, insulin, homeostatic model assessment-insulin resistance, and triglyceride levels and increased the serum direct high-density lipoprotein level in fructose-fed rats but not in control rats. Caffeine treatment resulted in the recovery of fructose-induced decrease in nitric oxide production in the NTS. Immunoblotting and immunofluorescence analyses further showed that caffeine reduced the fructoseinduced phosphorylation of insulin receptor substrate 1 (IRS1 S307) and reversed Akt S473 and neuronal nitric oxide synthase phosphorylation. Similarly, caffeine was able to improve insulin sensitivity and decrease insulin levels in the NTS evoked by fructose. Caffeine intake also reduced the production o...