There is little information about coronary artery endothelial dysfunction in patients with sleep apnea. We evaluated relation between severity of sleep apnea and coronary artery endothelial dysfunction. In all, 26 patients without significant coronary stenoses were enrolled. Endothelial function was estimated by measuring coronary vasoreactivity in response to acetylcholine infusion (10(-7) mol/L) into coronary arteries. Vasoconstriction rate was defined as ([lumen diameter after isosorbide dinitrate injection - lumen diameter after acetylcholine injection]/lumen diameter after isosorbide dinitrate injection × 100). Vasoconstriction rate was calculated at each major coronary artery and the highest value was used for that patient. Overnight sleep study was performed and the apnea-hypopnea index (AHI) was calculated as the mean number of apneas and hypopneas per hour of sleep. There was significant correlation between AHI and vasoconstriction rate (P = .04). There is significant correlation between severity of sleep apnea and endothelial function of coronary arteries.

SummaryExcimer laser coronary atherectomy (ELCA) has been used for the treatment of complex percutaneous coronary intervention (PCI) such as in-stent restenosis (ISR). However, little information was provided about the clinical outcomes after treatment with ELCA for ISR of drug-eluting stents (DES). This study aimed to investigate the long-term clinical outcomes after PCI with ELCA for ISR of DES. A total of 81 consecutive patients with 87 lesions who underwent PCI for ISR of DES were included. Patients were classified into a PCI with ELCA group (23 patients with 24 lesions) and a PCI without ELCA group (58 patients with 63 lesions). The major adverse cardiac events (MACE) were evaluated. The mean duration of clinical follow-up was 29.8 ± 11.6 months. The incidences of diffuse restenosis and AHA/ACC type B2 or C lesion in the PCI with ELCA group were higher than in the PCI without ELCA group. Quantitative coronary angiography showed the acute luminal gain in the PCI with ELCA group was greater than in the PCI without ELCA group (1.64 ± 0.48 mm versus 1.26 ± 0.42 mm, P < 0.001). There were no significant differences in all-cause death, myocardial infarction, or target lesion revascularization between the 2 groups. Multivariate analysis due to a Cox proportionalhazards model showed that multivessel disease was an independent predictor of MACE (hazard ratio 3.05, 95% confidence interval 1.22 to 7.61, P = 0.02). ELCA was effective as an atherectomy device for lumen enlargement and optimal lesion preparation. Even though ELCA was used for ISR of DES in significantly more complex lesions, the long-term clinical outcomes were favorable and similar.(Int Heart J 2018; 59: 14-20) Key words: Complex percutaneous coronary intervention, Atherectomy device, Revascularization D rug-eluting stents (DES) dramatically reduced the rate of in-stent restenosis (ISR) compared to bare-metal stents in a randomized trial. 1) Moreover, the clinical outcomes have further improved with the advent of second-generation DES.2) However, with the increasing use of DES and the frequent implantation of a DES into complex lesions, ISR has become a challenging problem in percutaneous coronary intervention (PCI).3) Editorial p.1Excimer laser coronary atherectomy (ELCA) has been effective for PCI of complex lesions, including stent restenosis, calcified lesions, chronic total occlusion, and ostial and long lesions. 4) ELCA has been useful to facilitate stent expansion in balloon-resistant lesions. 5) However, there is little information about the clinical outcomes after treatment with ELCA for ISR. Thus, the present study evaluated the long-term clinical outcomes after PCI with ELCA for ISR of DES. Methods Patients:Between January 2012 and March 2015, a total of 913 consecutive patients with 1024 lesions underwent PCI at the Department of Invasive Cardiology, Englewood Hospital and Medical Center. Of these, 81 consecutive patients (8.9%) with 87 lesions (8.5%) who underwent PCI for ISR of DES were included in this study. According to the use of ELCA,...

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The protein μ1B is a member of the medium chain family of the clathrin-associated adaptor complex and is expressed exclusively in epithelial cells. We determined the genomic structure of previously cloned murine genes for μ1B (Ap1m2) and its closely related homolog, μ1A (Ap1m1). Comparison of their genomic structures revealed that the positions of introns are identical between these two genes, except for the insertion of an additional intron in Ap1m1 (intron 4). By contrast, these structures are different from that of the more distantly related Ap2m1 gene encoding μ2. Taken together with the similarity of amino acid sequences among these genes, the data presented in this study suggest that Ap1m1/2 and Ap2m1 diverged long before the separation of Ap1m1 and Ap1m2, which most likely resulted from a relatively recent gene duplication. We also mapped AP1M2 to human chromosome 19p13.2 and Ap1m2 to the proximal region of mouse chromosome 9. The results are consistent with the fact that these regions are syntenic.