Efficacy of 24-Hour Blood Pressure Monitoring in Evaluating Response to Percutaneous Transluminal Renal Angioplasty.

BACKGROUND: Percutaneous transluminal renal angioplasty (PTRA) improves patency in atherosclerotic renal artery stenosis (ARAS), but improvement in clinic blood pressure (BP) is seen in only 20-40% of patients who undergo PTRA. This study investigated the effects of PTRA on BP lowering, assessed on 24-h ambulatory BP monitoring (ABPM), and identified preoperative features predictive of satisfactory BP improvement after PTRA. METHODS AND RESULTS: Of 1,753 consecutive patients undergoing coronary angiography, 31 patients with angiographically significant ARAS and translesional pressure gradient (TLPG) >20 mmHg underwent PTRA. ABPM was performed before, at 1 month and at 1 year after PTRA; patients with average systolic ABPM-BP decrease >10 mmHg at 1 month from baseline were categorized as responders. There was no obvious relationship between clinic BP and ABPM-BP at baseline. ABPM-BP was significantly higher in responders at baseline (SBP: 148 vs. 126 mmHg, P<0.01) and was improved 1 month after PTRA. This difference persisted until 1 year after PTRA. Night-time BP improved more than daytime BP in responders. Patients with higher baseline ABPM-BP achieved a larger decrease in ABPM-BP, but the severity of stenosis reflected by TLPG; renal duplex findings; and neurohumoral parameters other than baseline renal function, did not differ between the groups. CONCLUSIONS: Clinic BP does not represent daily hemodynamic status, whereas high ABPM-BP is a potent predictor of satisfactory BP response to PTRA. (Circ J 2016; 80: 1922-1930).

Spray-coated carbon nanotube thin-film transistors with striped transport channels.

We present results for the transfer characteristics of carbon nanotube thin-film transistors (CNT-TFTs) that utilize single-walled carbon nanotube thin-films prepared by direct spray-coating on the substrate. By varying the number of spray-coatings (N(sp)) and the concentration of nanotubes in solution (C(NT)), it was possible to control the conductivity of the spray-coated nanotube thin-film from 129 to 0.1 kΩ/□. Also, by introducing stripes into the channel of the CNT-TFT, and thereby reducing the number of metallic percolation paths between source and drain, it was possible to enhance the on/off current ratio 1000-fold, from 10 to 10(4), demonstrating that it may be possible to utilize spray-coating as a method to fabricate CNT-TFTs for large area switching array applications.

Fabrication of a flexible and transparent touch sensor using single-walled carbon nanotube thin-films.

Reported herein are the fabrication and demonstration of a flexible and transparent touch sensor using carbon nanotube thin films (CNTFs). The CNTF was fabricated by vacuum filtration and was transferred CNTF to polydimethylsiloxane (PDMS) by water-assisted stamping method. The sheet resistance of the CNTF decreased by approximately 74% after HNO3 treatment. The CNTF touch sensor was fabricated similarly to the conventional four-wire touch screen structures. PDMS was used for the upper plate to absorb the tensile and compressive strain and polyethylene terephthalate (PET) for the lower plate to provide device stability during bending action. The CNTF touch sensor showed high optical transmittance (over 80%) and high sensitivity with the measured touch activation pressure of 23 kPa. Cyclic pressure (38 kPa) was applied at 0.5 Hz and good repeatability was found for several hundred cycles. The results show that the CNTF flexible touch sensor can be applied to future flexible electronic interfaces such as, e-paper and flexible displays.

Intimal disruption affects drug-eluting cobalt-chromium stent expansion: A randomized trial comparing scoring and conventional balloon predilation.

BACKGROUND: Stent expansion remains one of the most important predictors of restenosis and subacute thrombosis, even with the use of drug-eluting stents. This study was designed to clarify the impact of lesion preparation on final stent expansion. METHODS: Sixty-six consecutive patients were included in this trial, and ultimately 52 enrolled non-calcified de novo lesions were randomly assigned to undergo single predilation with either a semi-compliant scoring balloon or a semi-compliant conventional balloon. Lesions were treated with a single 2.5- to 3.0-mm cobalt-chromium everolimus-eluting stent under optical coherence tomography (OCT) guidance without post-stenting dilation. Stent expansion was defined as the ratio of OCT-measured minimum stent area to the predicted stent area. RESULTS: Stent expansion was significantly higher after predilation by a scoring balloon (68.0% vs. 62.1%, p=0.017) with similar stent lumen eccentricity (0.84 vs. 0.80, p=0.18). Intimal disruption was induced significantly more frequently (68.0% vs. 38.4%, p=0.035) and was more extensive in the scoring group (122° vs. 65°, p=0.038). Lesions with intimal disruption after predilation achieved significantly higher stent expansion than that without it (67.7% vs. 61.6%, p=0.023). One case in the conventional group required target lesion revascularization; however, any other adverse clinical events including death, myocardial infarction, and stent thrombosis were not observed up to 9months after PCI in both groups. CONCLUSIONS: In this randomized study, pretreatment with a scoring balloon enhanced stent expansion partly through induction of intimal disruption. CLINICAL TRIAL REGISTRATION: URL: http://www.umin.ac.jp/ctr/index.htm. Unique identifier: UMIN000014176.

Randomized pilot trial comparing tolvaptan with furosemide on renal and neurohumoral effects in acute heart failure.

AIMS: Loop diuretics are first-line medications for congestive heart failure (CHF); however, they are associated with serious adverse effects, including decreased renal function, and sympathetic nervous and renin-angiotensin system activation. We tested whether tolvaptan, a vasopressin V2-receptor antagonist, could reduce unfavourable furosemide-induced effects during CHF treatment. METHODS AND RESULTS: Sixty patients emergently hospitalized owing to CHF-induced dyspnea were randomly assigned to receive either 40 mg intravenous furosemide daily or 7.5 mg oral tolvaptan for 5 days after admission. Both groups also received intravenous carperitide and canrenoate potassium. As results, baseline patient characteristics were similar between the furosemide (n = 30) and the tolvaptan (n = 30) groups, with no significant difference in 5 day urine volume or fluid balance. Brain natriuretic peptide and body weight improvements were similar between groups. However, serum creatinine (Cr) level did not increase, and the incidence of worsening renal function was significantly lower in the tolvaptan group. Consequently, the Cr increase to gain 1000 mL urine was 2.5-fold lower in the tolvaptan group. Furthermore, the blood urea nitrogen (BUN)/Cr ratio significantly decreased in the tolvaptan group, suggesting that renal perfusion was preserved, and urea reuptake and passive water reabsorption were suppressed following tolvaptan treatment. Although catecholamine improvements after treatment were not significantly different, plasma renin activity was enhanced in the furosemide group. CONCLUSIONS: As compared with furosemide, tolvaptan in patients with acute heart failure is associated with comparable decongestion, better preservation of renal function and less activation of renin-angiotensin system. (UMIN 000014134).