A family of Becker's muscular dystrophy with marked cardiomyopathy was studied. The propositus, a 16-year-old boy with marked pseudohypertrophy in calves, showed electrocardiographic abnormalities resembling those in the Duchenne's type. Radionuclide study and endomyocardial biopsy revealed remarkable degeneration of myocardium. His uncle, who also had slight proximal muscular atrophy and weakness, and calves' pseudohypertrophy, died of heart failure at the age of 47, and autopsy showed dystrophic changes in skeletal muscles and extensive myocardial damage. Severe cardiac involvement can occur in Becker's muscular dystrophy which has been known to have an essentially benign clinical course, and radionuclide investigation is useful for the detection of preclinical cardiac lesions in patients with muscular dystrophy.
Urgent angiography in a 76-year-old male with acute coronary syndrome revealed calcified tortuous stenosis in the left anterior descending coronary artery (LAD) ( Panel A ). Coronary perforation occurred at the mid-LAD during rotational atherectomy ( Panel B ). Intravascular ultrasound (IVUS) revealed that rotational atherectomy created a false lumen. For the bailout of perforation, a 2.5 × 28 mm everolimus-eluting stent (EES) (Promus Premier, Boston Scientific, Natick, MA, USA) was deployed in the mid-LAD. However, there …
Arteriosclerosis was induced to rabbits by feeding with 1% cholesterol diet for various terms. After killing the rabbits, the surface of the thoracic aorta was measured and spotaneously released PGI2 from the thoracic aorta during 10 minutes incubation was determined by assay using platelet aggregation, which was demonstrated as pg/cm2/min. Plasma concentration of 6-keto PGF1α thromboxane B2 (TXB2) and TXB2 release from the washed platelets in the aggregatory response were determined by the radioimmunoassay.Arteriosclerotic plaque coverage in thoracic aorta was quantitatively determined by the planimetric procedure and they were divided into three groups, normal group (group A, n=16), arteriosclerotic group with less than 50% changes (group B, n=9) and arteriosclerotic group with more than 80% changes (group C, n=7). The PGI2 production of the aortic wall were 54±21 (A), 46±19 (B) and 41±22 (C)pg/cm2/min in each groups (statistically not significant). The microscopic examination of the aorta revealed preservation of the endothelium even at the site of arteriosclerotic lesion. The amount of released TXB2 from platelets showed no significant differences among three groups.PGI2 production was still preserved in advanced arteriosclerotic aortic wall of rabbits. Since the aortic endothelium is the main layer of the PGI2 production, arteriosclerotic lesion per se might not reduce PGI2 production of the aorta unless endothelium is damaged.
The features of neointima after bare metal stent (BMS) or drug-eluting stent (DES) implantation have not yet been fully characterised. The aim of this study was to investigate in-stent neointima characteristics according to stent type and restenotic phase.The study included 59 consecutive patients undergoing target lesion revascularisation for in-stent restenosis (ISR) evaluated by optical coherence tomography (OCT) during the early phase (≤1 year, n=30) and late phase (>1 year, n=29) after either BMS (n=37) or DES (n=22) implantation. The OCT signal patterns of tissues at the minimal lumen area were categorised into three patterns: (1) homogeneous high-signal band, (2) heterogeneous mixed-signal band, and (3) lipid-laden intima. The predominant OCT pattern was homogeneous high-signal band in the BMS early phase (19/21 [91%]), lipid-laden intima in the BMS late phase (12/16 [76%]), and heterogeneous mixed-signal band in the DES late phase (9/13 [69%]). Heterogeneous mixed-signal band was seen more frequently in the DES early phase compared with BMS early phase (44% vs. 9%, p<0.05).There were differences of neointima according to stent type and restenotic phase, and this may lead to a better understanding of the different mechanisms of ISR.
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