To date, a number of studies have been conducted to examine the relationship between seismic ground motion and coseismic landslides. However, the impacts of seismic ground motion on coseismic ...landslide occurrence are not fully understood owing to the poor spatial resolution of seismic ground motion data. Recently, seismic observation research has expanded with the use of satellite technology, as crustal deformation can be observed using pairs of SAR (synthetic aperture radar) satellite data. With this technique, obtaining information regarding the ground surface displacement induced by earthquakes is possible at a high spatial resolution, without the need for interpolation or extrapolation. In this study, we focus specifically on the interrelated impacts of seismic ground motion and topography on coseismic landslide occurrence, which has previously been difficult to detect. Using high-resolution ground surface displacement from SAR data, we examine these interrelated impacts in detail and assess coseismic landslide occurrence based on seismic ground motion and topography. Results show that the developed formula accurately reproduces coseismic landslide occurrence and that the impact behaviors of the two factors on landslide occurrence are different. Finally, based on the new formula, we suggest two different trends for the attenuation of seismic ground motion and topography related to coseismic landslide occurrence.
Primary cardiac lymphoma is a rare condition with a poor prognosis, and patients are at risk for sudden cardiac death. A prompt diagnosis and early treatment are therefore essential. A 68-year-old ...woman was admitted for shortness of breath and peripheral edema. Echocardiograms showed massive pericardial effusion and a mass on the free wall of the right atrium and ventricle. Subsequent pericardial effusion cytology revealed diffuse large B-cell lymphoma. We started chemotherapy with rituximab and achieved a good clinical course. This case is made unique by the use of pericardial effusion cytology, which allowed us to diagnose primary cardiac lymphoma promptly and safely.
The European Society of Cardiology (ESC) recommends a 0-h/1-h (0/1-h) algorithm to classify patients with suspected non-ST-segment elevation myocardial infarction (NSTEMI). However, reliable evidence ...about patients who present early after the onset of symptoms is limited, likely because high-sensitivity cardiac troponin (hs-cTn) values cannot increase sufficiently within that time. This study aimed to evaluate the outcomes in real-world situations that utilized the 0/1-h algorithm.
In a prospective, international, multicenter cohort study that enrolled 1638 patients presenting with acute chest pain to the emergency department, we assessed the performance of the 0/1-h algorithm using hs-cTnT and the associated 30-day rates of major adverse cardiac events: death and acute myocardial infarction (AMI).
Among 1074 patients, the prevalence of AMI was 16.0%. An approximately 60.1% (n = 645) of patients visited the hospital within 3 h after onset of chest pain (less than 1 h; 18.2% n = 196, less than 2 h; 27.5% n = 295, and less than 3 h; 14.3% n = 154). Moreover, the prevalence rates of AMI were similar at all times (1 h, 16.8%; 1–2 h, 20.7%; 2–3 h, 18.2%; p = .5). According to the ESC 0/1-h algorithm, the distribution patterns of rule-out, observe, and rule-in groups were similar; however, none of the patients was diagnosed with AMI or cardiac death in the rule-out group.
This study revealed the applicability of the 0/1-h algorithm for the management of early presenters.
•None of the 30-day major advanced cardiac events was associated with the 0/1-h algorithm for the management of very early presenters.•A distribution patterns of rule-out, observe, and rule-in groups were similar at 1 h, 1–2 h, and 2–3 h after chest pain onset.•Strategies that incorporate a HEART score with the algorithm can be used for clinical implementation.
Despite its clinical relevance, a subclass of acute decompensated heart failure (ADHF) with elevated blood pressure, known as hypertensive ADHF (HT-ADHF), has been less intensively evaluated. This ...study aimed to characterize the prognostic nature and pathophysiology of HT-ADHF. A total of 509 consecutive patients with first-time ADHF hospitalization were subjects of the study. Participants were divided into two groups: an HT-ADHF group (systolic blood pressure, SBP > 140 mmHg at presentation) and a non-HT-ADHF group (SBP ≤ 140 mmHg). Median follow-up duration measured 253 days. Unadjusted Kaplan-Meier analysis demonstrated both a lower cardiovascular mortality rate in the HT-ADHF group and similar incidences of heart failure rehospitalization in both groups. Adjusted Cox hazard analysis showed an association of elevated SBP at presentation with significantly lower cardiovascular mortality, though no such association was observed with heart failure rehospitalization. Moreover, elevated heart rate in combination with elevated SBP at presentation predicted a significantly lower risk of cardiovascular mortality (Hazard Ratio: 0.32, 95% CI: 0.14-0.77, P = 0.01). Also, significantly lower cardiovascular mortality was observed in this subtype, compared with other types of ADHF.
Based on the actual damage data of 7 routes (total length of about 70km) around the Aso area damaged by the 2016 Kumamoto earthquake, an attempt was made to develop a damage estimation method that ...combines the degree of risk and the degree of impact. The probability of collapse occurrence by risk and seismic intensity was evaluated based on the topographical and geological conditions along the road. In addition, the degree of impact based on the amount of collapsed sediment and the sediment removal time was considered. Then, using Monte Carlo simulation, a model was constructed to probabilistically calculate the location of the collapse, the scale of the collapse, and the sediment removal time (road recovery time). As a result of the verification, the actual damage situation was almost simulated, and it was shown that it is possible to quantitatively evaluate the deterioration of the road network function caused by the slope failure during the earthquake.
Abstract Background Risk scores and cardiac biomarker tests allow clinicians to accurately diagnose acute coronary syndrome (ACS) and perform early risk stratification. However, few investigations ...have evaluated use of these risk scores and biomarkers for predicting risk of cardiovascular events in drug-eluting stent (DES) era. Methods This prospective cohort study included 861 patients with ACS. Three risk scores—Global Registry of Acute Coronary Events (GRACE), Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin, and Thrombolysis In Myocardial Infarction—and levels of four biomarkers—N-terminal pro B-type natriuretic peptide (NT pro BNP), high-sensitivity troponin T, heart-fatty acid binding protein, and high-sensitivity C-reactive protein—were recorded on admission. Major adverse cardiac events (MACE) (death, cardiovascular events) were evaluated at 30-day and 1-year follow-up. Results At 30-day follow-up, there were 23 (3.1%) deaths from cardiovascular events and 4 (0.5%) cerebral accidents. NT pro BNP levels and GRACE score were strong MACE predictors, with adjusted odds ratios (OR) (95% CI) of 2.90 (1.63–5.20) and 1.01 (1.00–1.02), respectively, in logistic model. The C-statistic of NT pro BNP (0.77; 95% CI, 0.67–0.86) was similar to that of GRACE score (0.76; 95% CI, 0.66–0.87); however, the combined C-statistic was higher (0.81), yielding a net reclassification improvement of 13% (p < 0.01). At 1-year follow-up, there were 51 (6.8%) deaths and 10 (1.3%) cerebral accidents. Conclusion In the DES era, GRACE score and biomarkers can still predict major cardiac events in patients with ACS for both acute and long-term prognoses.
A 54-year-old woman was referred to our hospital for symptomatic sinus bradyarrhythmia with a sinus pause of 8 seconds. She was diagnosed with dextrocardia during childhood and discovered to have ...heterotaxy syndrome when she had an appendectomy during her teenager years. Chest and abdominal examinations by computed tomography showed multiple spleens located on the right side and abnormal drainages of the superior and inferior vena cava. Left isomerism was diagnosed by bilaterally bilobed lungs. Because of a patent bilateral superior vena cava, pacemaker leads were implanted using the right cephalic vein approach. Her fainting symptoms disappeared after pacemaker implantation.
Background: A previous study reported that amlodipine retarded coronary plaque progression in patients with coronary artery disease. The goal of this multicenter study was to determine which ...calcium-channel blockers (CCBs) other than amlodipine attenuated the progression of plaque volume (PV) accessed by intravascular ultrasound (IVUS). Methods and Results: ALPS-J was a prospective, randomized open-label study conducted at 5 centers. Patients who had hypertension and were scheduled for coronary intervention were enrolled. Subjects were randomly assigned to receive 16mg/day of azelnidipine or 5mg/day of amlodipine administered for 48 weeks. The primary endpoint was the percent change in coronary PV measured by IVUS. Between 2007 and 2009, 199 patients were enrolled; 115 had evaluable IVUS images at both baseline and after 48 weeks of treatment. Blood pressure significantly reduced to 128/68mmHg at follow-up. The lipid profiles in the 2 groups were comparable (low-density lipoprotein cholesterol: 97mg/dl). The %change in PV showed a significant regression of 4.67 and 4.85% in the azelnidipine and amlodipine groups, respectively. The upper limit of the 95% confidence interval of the mean difference in %change PV between the 2 groups (0.18%, 95% confidence interval 4.62 to 4.98%) did not exceed the pre-defined non-inferiority margin of 6.525%. Conclusions: ALPS-J demonstrated that azelnidipine was not inferior to amlodipine for primary efficacy. In addition to standard medical therapy, dihydropyridine CCBs will retard PV progression in hypertensive patients. (Circ J 2011; 75: 1071-1079)
Background
In pacemaker‐dependent patients, the risk of asystole must be managed during device replacement. This study aimed to examine whether we could predict the indication for temporary pacing ...(TP) during the generator replacement.
Methods
We studied 105 consecutive patients who underwent pacemaker replacement due to battery depletion at Juntendo Nerima Hospital between September 2005 and December 2016. We examined the relationship between the stability of the intrinsic rhythm (IR) during pacemaker replacement and several clinical factors including age, gender, sick sinus syndrome or atrioventricular (AV) block, duration of pacing, structural heart disease, use of anti‐arrhythmic drugs, and the presence/absence of a stable IR (>40 bpm) at the outpatient clinic (OPC) just before pacemaker replacement.
Results
Of the 105 patients, we excluded 1 patient who required TP because of bradycardia‐dependent torsades de points. Therefore, we evaluated 104 patients for the indication for TP. TP was underwent in 19 patients (18%) because of an absence or instability of the IR during pacemaker replacement. The indication for TP was significantly correlated with AV block (84% vs 48%, P = .0044) and the absence of a stable IR at the last OPC visit (89% vs 24%, P < .0001). For predicting the indication for TP, the following values of no stable IR at the last OPC visit were obtained: 89% sensitivity, 77% specificity, 46% positive predictive value, and 97% negative predictive value.
Conclusions
The presence of a stable IR at the last OPC visit was a good predictor (97%) of no indication for TP during pacemaker replacement.
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