Search

Introduction: Despite successful transcatheter aortic valve replacement (TAVR), low flow rate (FR) severe aortic stenosis (AS) patients reportedly experienced poorer clinical outcomes than normal FR AS patients. Left ventricular (LV) diastolic function influences stroke volume, though limited data on TAVR outcomes in patients with severe LV diastolic dysfunction is available. Hypothesis: AS patients with severe LV diastolic dysfunction may develop adverse cardiac events, such as heart failure, even after TAVR. Methods: Consecutive patients with severe AS and preserved LV ejection fraction (> 50%) who underwent hemodynamic assessment of LV function using cardiac catheterization before TAVR were enrolled. The average slope of the end-diastolic pressure-volume relationship was calculated to determine LV diastolic stiffness. Adverse cardiac events were defined as cardiac death or heart failure hospitalization. High LV stiffness (> 190 mmHg/L) patients were compared to normal LV stiffness patients. Results: Of the 78 patients (age 83.2 ± 5.1 years; 21 men), 30 (38.5%) were classified to the high LV stiffness group. Low FR (< 200 mL/s) severe AS was more likely in patients with high LV stiffness than in those with normal LV stiffness (66.7% vs 33.3%, P = 0.004). Adverse cardiac events increased in the high LV stiffness group (Figure, Log rank P = 0.054). Cox regression analysis revealed that LV stiffness was associated with increased adverse cardiac events, after adjusting for age, sex, aortic valve area, and renal function (HR, 1.008; 95%CI, 1.001-1.014; P = 0.026). Conclusion: Increased LV stiffness derived from cardiac catheterization was related to low FR and was also associated with poor clinical outcomes after TAVR.

INTRODUCTION AND OBJECTIVE:Previous studies have shown that Randall's plaques are uniformly present in all renal papillae. However, we experienced cases in which the kidney stone recurrence occurre...

INTRODUCTION AND OBJECTIVE:Brown adipocytes consume energy and are known to improve metabolic syndrome. In previous studies using mice that brown adipocytes could prevent the formation of urinary s...

INTRODUCTION AND OBJECTIVE:Endoscopic combined intrarenal surgery (ECIRS) is a hybrid therapy combining PCNL and retrograde intrarenal surgery using flexible ureteroscope (RIRS). The Galdalao-modif...

INTRODUCTION AND OBJECTIVE:Renal access during PCNL is the most critical step in achieving effective stone clearance and mitigating unfavorable complications. There are two types of renal access ap...

INTRODUCTION AND OBJECTIVE:Ureteral stents are commonly used in endoscopic surgery for urinary calculi but are frequently associated with stent encrustation and stent-related infections. New biomat...

INTRODUCTION AND OBJECTIVE:Kidney stones are associated with metabolic syndrome (MetS). MetS has been shown to create a hypoxic environment in adipose tissue, resulting in inflammation. It has been...

INTRODUCTION AND OBJECTIVE:The pathogenesis of urinary stone formation is a multistep process involving complex interactions between the mineral elements and protein matrix. Topographic relations b...

INTRODUCTION AND OBJECTIVE:Renal calculus is thought to be promoted by inflammation and oxidative stress that occur in renal tubular cells. In this study, we investigated the inhibitory effect of a...

INTRODUCTION AND OBJECTIVE:Renal puncture in endoscopic combined intrarenal surgery (ECIRS) greatly affects success rates and perioperative complications. We developed a method to determine the ide...

INTRODUCTION AND OBJECTIVE:This study aimed to evaluate the effect of surgical hand hygiene on the onset of febrile urinary tract infections (f-UTIs). Endourological surgical procedures performed w...

INTRODUCTION AND OBJECTIVE:We reported earlier that hands-on training (HOT) significantly improved the SWL success rate from 66.3% to 87.2% at the AUA annual meeting 2012. In this study, we tracked...

INTRODUCTION AND OBJECTIVE:In recent years, advancement in endoscopic technology has led to the increase in the number of retrograde intrarenal surgery using a flexible ureteroscope (fURS). The tre...

INTRODUCTION AND OBJECTIVE:Endoscopic combined intrarenal surgery (ECIRS) using retrograde fURS and PCNL was developed as a single-step treatment for removal of renal calculi. Both prone split-leg ...

INTRODUCTION AND OBJECTIVE:Laser incision (laser endoureterotomy: LE) and balloon dilatation (BD) are the treatments for ureteral strictures measuring ≤20 mm; however, these treatments are associat...

INTRODUCTION AND OBJECTIVE:Development of kidney stones has been linked to metabolic syndrome, which is characterized by insulin resistance (IR). In this prospective study, we followed the baseline...

Background Early detection for worsening renal function ( WRF ) is indispensable in patients with acute decompensated heart failure (HF). We tested the hypothesis that the difference in the circulating levels of each B‐type or brain natriuretic peptide ( BNP ) molecular form is associated with the occurrence of WRF . Methods and Results Circulating levels of pro BNP , the NT‐proBNP (N‐terminal pro BNP ), and total BNP (pro BNP +mature BNP ) were prospectively measured in patients with acute decompensated HF using specific and sensitive enzyme immunochemiluminescent assays. An estimated mature BNP (em BNP ) concentration was calculated by subtracting pro BNP levels from total BNP levels. WRF was defined as a >20% decrease in the estimated glomerular filtration rate during the hospitalization. One‐way repeated‐measures ANOVA was used to compare the changes of variables between the patients with and without WRF . In patients with acute decompensated HF (New York Heart Association class III – IV ; 96%) hospitalized for HF , NT ‐pro BNP levels did not differ during the hospitalization between patients with and without WRF (n=42 and 140, respectively). By contrast, em BNP levels were lower in patients with WRF than in those without WRF on day 3 after admission. NT ‐pro BNP /em BNP molar ratios were elevated on day 3 after admission in the patients with WRF , before estimated glomerular filtration rate declined, but were unchanged in patients without WRF . On day 3 after hospital admission, NT ‐pro BNP /em BNP ratios were strongly associated with percentage decreases in estimated glomerular filtration rate. Conclusions These findings suggest that elevation of NT ‐pro BNP /em BNP ratio precedes WRF in patients with acute HF and can be a potentially useful biomarker for risk stratification of cardiorenal syndrome.

INTRODUCTION AND OBJECTIVES:Partial nephrectomy for endophytic tumor is not only difficult to identify the tumor site but also the risk of positivity surgical margin and prolongation of warm ischem...

INTRODUCTION AND OBJECTIVES:We found that cellular damage caused by calcium oxalate (CaOx) was repaired by the induction of autophagy using renal tubule cultured cells and CaOx crystal model mice, ...

INTRODUCTION AND OBJECTIVES:Kidney stone structure may provide clinical information in addition to the stone composition. The morphology and succession of different layers can reliably describe the...

INTRODUCTION AND OBJECTIVES:Kidney stone development has been linked to metabolic syndrome (MetS), which is characterized by insulin resistance. In a previous cross-sectional analysis, we reported ...

INTRODUCTION AND OBJECTIVES:We have demonstrated the control of urinary stone formation using macrophages (Mφ) in basic research. The purpose of this study is to establish a method for analysis of ...

Randall plaques (RPs) can contribute to the formation of idiopathic calcium oxalate (CaOx) kidney stones; however, genes related to RP formation have not been identified. We previously reported the potential therapeutic role of osteopontin (OPN) and macrophages in CaOx kidney stone formation, discovered using genome-recombined mice and genome-wide analyses. Here, to characterize the genetic pathogenesis of RPs, we used microarrays and immunohistology to compare gene expression among renal papillary RP and non-RP tissues of 23 CaOx stone formers (SFs) (age- and sex-matched) and normal papillary tissue of seven controls. Transmission electron microscopy showed OPN and collagen expression inside and around RPs, respectively. Cluster analysis revealed that the papillary gene expression of CaOx SFs differed significantly from that of controls. Disease and function analysis of gene expression revealed activation of cellular hyperpolarization, reproductive development, and molecular transport in papillary tissue from RPs and non-RP regions of CaOx SFs. Compared with non-RP tissue, RP tissue showed upregulation (˃2-fold) of LCN2, IL11, PTGS1, GPX3, and MMD and downregulation (0.5-fold) of SLC12A1 and NALCN (P

INTRODUCTION AND OBJECTIVE:Renal access is the most important step for successful percutaneous nephrolithotomy. Several techniques have been developed to improve the accuracy of renal access; howev...

INTRODUCTION AND OBJECTIVE:The ureteral stent placement before ureteroscopic lithotripsy (URSL) are reported to facilitate ureteroscopic management of urolithiasis. However, there is no report eval...