Analyzing the association between aortic regurgitation and atherosclerosis: is pulse pressure a cause of atherosclerosis?

If pulse pressure, one of the mechanical stresses, is a risk factor for atherosclerotic cardiovascular disease, then atherosclerosis should be progressive in aortic regurgitation which is a representative disease with increased pulse pressure. This cross-sectional study included 1,149 patients. We examined the influence of aortic regurgitation on maximum intima-media thickness or brachial-ankle pulse wave velocity. The degree of aortic regurgitation was classified into 4 grades by color Doppler examination. There were 177 patients with aortic regurgitation. Pulse pressure was significantly higher in patients with aortic regurgitation than in those without it. On multiple regression analysis, aortic regurgitation was not found to be a significant independent variable for maximum intima-media thickness [standard partial regression coefficient: aortic regurgitation = grade 1, 0.011, P = 0.7635; aortic regurgitation ≥ grade 2, -0.034, P = 0.3289] and brachial-ankle pulse wave velocity [standard partial regression coefficient: aortic regurgitation = grade1, -0.043, P = 0.1197; aortic regurgitation ≥ grade2, 0.002, P = 0.9358] after adjusting for age, sex, body mass index, presence or absence of cardiovascular disease, antihypertensive treatment, diabetes, dyslipidemia, and smoking. These results found no causal association between aortic regurgitation and atherosclerosis, and were a contradiction to the opinion that pulse pressure was a risk factor of atherosclerosis.

Unusual Case of Cardiac Amyloidosis Preceded by a Twenty-year History of Dilated Cardiomyopathy and Heart Failure.

Amyloidosis is a well-known but uncommon disease, and the physician must maintain a high index of suspicion in order to make a timely diagnosis. The expected survival of patients with cardiac amyloidosis is generally poor. In particular, survival has been reported to be 4-12 months for patients with amyloid light-chain amyloidosis with congestive heart failure. We herein report a rare case of cardiac amyloidosis in which the patient presented with cardiac hypertrophy after a 20-year history of dilated cardiomyopathy and heart failure.

Fever associated with acute aortic dissection.

BACKGROUND: Although fever is a common accompanying feature of acute aortic dissection, few reports have been published concerning the duration and character of this fever. METHODS AND RESULTS: The mean duration of fever was calculated for a total of 57 patients with acute aortic dissection, who were then divided into 2 groups: those with duration of fever shorter than the mean (Group A) and those with duration of fever equal to or longer than the mean (Group B). The reduction in false lumen size and hematological parameters were compared between groups. The mean duration of fever was 15.9+/-11 days. The false lumen reduction ratio was significantly higher in Group A (18.3+/-5.0%) than in Group B (2.0+/-5.3%). There was a significant negative correlation between the false lumen reduction ratio and duration of fever. Hematological parameters did not differ significantly between the 2 groups except for fibrin degradation product, although the white blood cell count and platelet counts and C-reactive protein concentration tended to be higher in Group B. CONCLUSIONS: Checking for fever is important in assessing the status of individual cases of acute aortic dissection.