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Transplant-free survival is better for patients with CS than for IGCM diagnosed by EMB. Presentation with heart failure predicted IGCM, and presentation with heart block or more than nine weeks of symptoms predicted CS.

eart failure (HF) is a major and growing public health problem in developed countries. 1 In the United States, approximately 5 million individuals have HF, and more than 550,000 new cases are diagnosed annually. 1 To our knowledge, only a few reports have focused on this issue in Japan. 2,3 The purpose of this study was to estimate the impact of population aging on the number of outpatients with left ventricular dysfunction (LVD) over the next 5 decades in Japan. All study participants provided informed consent and the study design was approved by the ethics review board of Niigata University Graduate School of Medical and Dental sciences.We applied estimated age-, gender-, and conditionspecific prevalences to the projected Japanese population in each age group and gender for the future until 2055, to provide a prospective estimate of the number of these patients. The primary data source was the Sado Heart Failure Study, a hospital-based research project primarily designed to count the number of patients with LVD by total enumeration in all hospitals on the island of Sado. The proportion of echocardiographically diagnosed systolic (SD) and isolated diastolic dysfunction (IDD) patients (together referred to as LVD) in the general population in 2003 4,5 was used as a substitute for the prevalence of LVD in the present study

Abstract-The expression of coxsackievirus and adenovirus receptor (CAR) was dominant in the brains and hearts of mice until the newborn phase. There is no detailed information concerning the relation between the expression of CAR and development of hearts. It is also uncertain whether CAR is able to be induced in adult hearts after cardiac injury. We demonstrated that CAR was abundant in the hearts of newborn rats but was barely detectable in the hearts of adult rats. The expression of CAR in rat hearts with experimental autoimmune myocarditis, which was induced by immunization of purified cardiac myosin, was serially investigated. Active myocarditis was observed from day 15 after immunization. By immunohistochemistry, cardiomyocytes were strongly stained for CAR antibody from days 24 to 42. CAR mRNA was also detected from days 18 to 30 by using reverse transcription-polymerase chain reaction. In the next experiment, the induction of CAR on isolated cardiomyocytes was investigated. CAR was barely detectable in cultured cardiomyocytes by Western blot analysis after isolation. This molecule gradually appeared along with the creation of clusters and beating of cardiomyocytes. Furthermore, the induction of CAR in cultured cardiomyocytes increased after supplement with conditioned medium of rat splenocytes activated by concanavalin A. In conclusion, rat CAR is expressed strongly in the hearts of newborn rats and is suppressed in those of adult rats.

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