Background. This study was designed to examine the hemodynamic, renal, and hormonal effects of brain natriuretic peptide (BNP) infusion in patients with congestive heart failure (CHF) and in control subjects.Methods and Results. We infused synthetic human BNP at a rate of 0.1 ug/kg/min. BNP infusion decreased pulmonary capillary wedge pressure (control, from 5±1 to 2±1 mm Hg, p

Compared with standard statin monotherapy, the combination of statin plus ezetimibe showed greater coronary plaque regression, which might be attributed to cholesterol absorption inhibition-induced aggressive lipid lowering. (Plaque Regression With Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound [PRECISE-IVUS]; NCT01043380).

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To evaluate the effect on image quality of a low contrast and radiation dose protocol for cardiac computed tomography (CT) using a low tube voltage, the hybrid-iterative reconstruction algorithm, and a 256-row CT scanner. Before clinical study, we performed phantom experiments to evaluate the hybrid iterative reconstruction technique. We randomly assigned 68 patients undergoing cardiac CT to one of two protocols; 33 were scanned with our conventional 120 kVp protocol, the contrast material (370 mgI/kg body weight) was delivered over 15 s. The other 35 patients underwent scanning at a tube voltage of 80 kVp; the contrast dose, reduced by 50 % (185 mgI/kg), was delivered at the same fractional dose (24.7 mgI/kg/s). The 80 kVp images were post-processed with the 60 % hybrid-iterative reconstruction technique. We evaluated the effective dose (ED), image noise, mean attenuation, and contrast-to-noise ratio (CNR) of each protocol. The hybrid-iterative reconstruction technique offers almost same spatial resolution and noise-power-spectrum curve as compared with filtered back projection reconstruction. There were no decrease in spatial resolution and no shift of spatial frequency in noise power spectrum. The average ED was 74 % lower with the 80- than the 120 kVp protocol (1.4 vs 5.4 mSv). Dunnett's test showed that there were no significant differences in the image noise, mean attenuation, and CNR between hybrid-iterative-reconstructed 80 kVp scans and 120 kVp scans (28.6 ± 6.5 vs 25.3 ± 4.5, p = 0.18; 475.0 HU ± 87.0 vs 445.3 HU ± 67.7, p = 0.20; 17.1 HU ± 3.5 vs 17.8 HU ± 3.1, p = 0.53). The low kVp scan and hybrid-iterative reconstruction algorithm can dramatically decrease the radiation dose and contrast dose with adequate image quality at cardiac CT of thin adults using a 256-row CT scanner.

To examine the constrictor response of the infarct-related stenotic coronary artery in comparison with that of noninfarct-related stenotic arteries, acetylcholine in maximal doses of 100 micrograms for the left and 50 micrograms for the right coronary artery was injected into the 16 infarct-related coronary arteries of 16 patients with previous myocardial infarction (group 1) and into 19 stenotic coronary arteries of 16 patients with stable angina without myocardial infarction (group 2). Acetylcholine's effects on lumen diameter and area were quantitatively analyzed at the stenotic segment and its proximal segment without significant stenosis. Acetylcholine decreased lumen diameter and area at the stenotic segments from 0.72 +/- 0.18 to 0.18 +/- 0.33 mm and from 0.45 +/- 0.22 to 0.10 +/- 0.22 mm2, respectively, in group 1 (both p less than 0.01) and from 0.75 +/- 0.22 to 0.49 +/- 0.30 mm and 0.48 +/- 0.29 to 0.26 +/- 0.23 mm2, respectively, in group 2 (both p less than 0.01). Acetylcholine decreased the diameter and area at the proximal segment from 2.71 +/- 0.75 to 2.38 +/- 0.6 mm and from 6.18 +/- 3.4 to 4.71 +/- 2.23 mm2, respectively, in group 1 (both p less than 0.01) and from 2.31 +/- 0.67 to 1.95 +/- 0.59 mm and from 4.5 +/- 2.97 to 3.22 +/- 1.96 mm2, respectively, in group 2 (both p less than 0.01). The changes in diameter and area at the stenotic segment in group 1 were significantly greater than those in group 2 (both p less than 0.01); there were no significant differences between groups in the changes at the proximal segment.(ABSTRACT TRUNCATED AT 250 WORDS)