Although there are many different types of philosophy, many philosophers agree that the mainstream of Western philosophy (Socrates, Plato, Aristotle, Descartes, Kant, Wittgenstein) developed toward the perfection of Socrates' absolutism. But can the absolutism maintain its central position after analytic philosophy? There are pessimistic views on this problem, such as that of R. Rorty, the standard-bearer of neo-pragmatism. Recently, I proposed quantum language (which is including quantum mechanics, statistics, fuzzy sets, etc.). I think that that this theory is not only one of the most fundamental scientific theories, but also the scientific final destination of Western philosophy. If so, Socrates' dream has come true. The purpose of this paper is to discuss the above and to inform readers that quantum language has the power to create a paradigm shift from the classical mechanical world view to the quantum mechanical worldview.

Recently we proposed the linguistic Copenhagen interpretation (or, quantum language, measurement theory), which has a great power to describe both classical and quantum systems.Thus we think that quantum language can be viewed as the language of science.Further, we showed that certain logic (called quantum fuzzy logic) works in quantum language.In general, it is said that logic and time do not go well together.Then, the purpose of this paper is to show that quantum fuzzy logic works well with time.That is, quantum fuzzy logic has the advantage of being able to clearly distinguish between implication and causality.In fact, we will show the contraposition of the proposition "If no one is scolded, no one will study" (or the negation of "John is always hungry") can be written in quantum fuzzy logic.However, "time" in everyday language has various aspects (e.g., tense, subjective time).Therefore, it is not possible to understand all of the "time" of everyday language by the "time" of quantum language.

Background It is well-known that a neurologically favorable outcome of out-of-hospital cardiac arrest (OHCA) is associated with the presence of bystander-initiated cardiopulmonary resuscitation (bystander CPR) and use of an automated external defibrillator. However, little is known about the effect of the presence of pre-existing conditions, prior activity, and locations on the outcome of pediatric OHCA. Methods We analyzed the data from questionnaires about pediatric patients with OHCA aged from 3 days to 19 years in the Kyushu area in Japan between 2012 and 2016. Results A total of 594 OHCA cases were collected. The numbers of OHCA cases and the rate of 1 month survival with a favorable neurological outcome during sleeping, swimming / bathing, and exercise were 192 (1.0%), 83 (32.5%), and 44 (65.9%), respectively. When an OHCA occurred at school (n = 56), 88% of children / adolescents received bystander CPR, but when it occurred at home (n = 390), 15% received bystander CPR. Cardiovascular (n = 61), suicide (n = 61), and neurological / neuromuscular (n = 44) diseases were three major pre-existing conditions. The OHCA of cardiovascular disease was associated with exercise (24/61) and mainly occurred at school (22/61). The OHCA of neurological / neuromuscular disease was associated with swimming/bathing (15/44) and mainly occurred during bathing at home (12/44). Multivariate regression analysis showed that the presence of bystander CPR (P < 0.001) and occurrence of OHCA at school (P < 0.001) were independently predictive of a favorable outcome in pediatric OHCA. Conclusion The outcome was different among pre-existing conditions, prior activity, and location of OHCA. These findings might be useful for preventing OHCA and improving the outcome of pediatric OHCA.

Recently we proposed the linguistic Copenhagen interpretation of quantum mechanics, which is called quantum language or measurement theory. This theory is valid for both quantum and classical systems. Thus we think that quantum language is one of the most powerful scientific theories, like statistics. In this paper we justify Zadeh’s fuzzy sets theory in quantum language, that is, fuzzy propositions are identified with binary measurements. This implies that the definition of “proposition” is, for the first time, acquired in the field of non-mathematics. Further, we assert that fuzzy logic is more natural than crisp logic in science. And furthermore, we discuss and solve Saussure’s linguistics, Moore’s paradox, Quine’s analytic-synthetic distinction and Lewis Carroll’s logical paradox. Therefore, from the philosophical point of view, our result gives a complete answer to Wittgenstein’s problem: “Why does logic work in our world?” and “What is a scientific proposition?” in his picture theory. That is, we simultaneously justify both Zadeh’s fuzzy sets and Wittgenstein’s picture theory in the quantum mechanical worldview.

Recently we proposed the linguistic Copenhagen interpretation (or, quantum language), which has a great power to describe both classical and quantum systems. Thus we think that quantum language can be viewed as the language of science. Therefore, it makes sense to study, from the quantum linguistic point of view, Wittgenstein’s picture theory, since he must have wanted to create a language of science. In this paper, we show that the proposition that Wittgenstein studied in his book “Tractatus Logico-Philosophicus” can be regarded as a binary projective measurement in classical quantum language. And thus, we conclude that Wittgenstein’s language (i.e., the language that he supposed in his book) is realized by classical quantum language. Hence, now we can fully understand Wittgenstein’s picture theory since the reason his book is incomprehensible is that he did not define his language.

Background: We recently reported a new approach for cardioprotection, postconditioning with lactate-enriched blood (PCLeB), and a patient with ST-segment elevation myocardial infarction (STEMI), in whom muscle squeezing of the culprit coronary artery was observed immediately after reperfusion with PCLeB. In this study, we examined the prevalence of muscle squeezing immediately after reperfusion in patients with anterior STEMI treated using PCLeB. Methods and results: PCLeB is a modified postconditioning protocol that comprises intermittent reperfusion and timely coronary injections of lactated Ringer's solution. We treated 30 consecutive patients with anterior STEMI using PCLeB. Among the 30 patients, 4 patients exhibited muscle squeezing of the left anterior descending artery (LAD) immediately after reperfusion. We performed follow-up coronary angiography in 23 patients and found another patient who exhibited muscle squeezing of the LAD. Thus, of 30 patients, 5 were confirmed to have myocardial bridging and 4 exhibited muscle squeezing immediately after reperfusion with PCLeB. No patient died or experienced re-hospitalization for heart failure or recurrent ischemic events at 6 months except for one patient with malignancy. Conclusion: Muscle squeezing immediately after reperfusion therapy is not a rare phenomenon in patients with anterior STEMI treated using PCLeB. (c) 2018 Elsevier B.V. All rights reserved.

BACKGROUND Liver stiffness on ultrasound shear-wave elastography (SWE) reflects central venous pressure (CVP) in adult patients with heart failure, but the association of liver stiffness on SWE with CVP in pediatric patients is not clear. The present study evaluated whether liver stiffness on SWE is useful as a non-invasive indicator of CVP in pediatric patients.Methods and Results:Liver stiffness was measured using ultrasound SWE in 79 patients aged <20 years with congenital heart diseases. None of the patients was found to have liver disease. Correlations between liver stiffness and other clinical variables, including CVP, were analyzed. CVP was the only factor independently and significantly correlated with liver stiffness in multivariate analysis. However, variables related to hepatic fibrosis did not correlate with liver stiffness. CONCLUSIONS Liver stiffness on ultrasound SWE is useful as a non-invasive indicator of CVP in children with heart diseases.

Objective The purpose of this study was to investigate whether the origins and courses of the coronary arteries could be better assessed using ECG-gated dual-source computed tomography (CT) than with echocardiography in neonates with transposition of the great arteries (TGA). Methods A total of 17 neonates within 14 days old who underwent both echocardiography and retrospective ECG-gated coronary CT angiography were retrospectively reviewed. The patients were sedated and intubated during CT examinations, and CT images were obtained with a breath-hold. CT images were reconstructed by multiple cardiac phases, and the coronary artery assessment was performed in the most static phase. Coronary anomalies were classified by Shaher’s classification and validated by surgical findings. Results CT correctly classified 16 of 17 cases (Shaher type 1: 7, type 2: 4, type 9: 3, type 3: 1, type 4: 2), whereas echocardiography classified only 8 of 17 cases correctly. Dual-source CT had a significantly higher diagnostic ability than echocardiography ( p = 0.0078). Conclusion Dual-source coronary CT angiography has a higher diagnostic ability than echocardiography in the assessment of the origins and courses of the coronary arteries in neonates with TGA.

Remote monitoring by implantable devices substantially improves management of heart failure (HF) patients by providing diagnostic day-to-day data. The use of thoracic impedance (TI) as a surrogate measure of fluid accumulation is still strongly debated. The multicenter HomeCARE-II study evaluated clinically apparent HF events in the context of remote device diagnostics, focusing on the controversial role of TI.We followed 497 patients (66.6 ± 10.1 years, 77% male, QRS 139.8 ± 36.0 ms, ejection fraction 26.8 ± 7.0%) implanted with a CRT-D (67%) or an ICD (33%) for 21.4 ± 8.1 months. An independent event committee confirmed 171 HF events of which 82 were used to develop a TI-based algorithm for the prediction of imminent cardiac decompensation. Highly inter-individual variations in patterns of TI trends were observed. The algorithm resulted in a sensitivity of 41.5% (50.0%) with 0.95 (1.34) false alerts per patient year, and a positive predictive value of 7.9% overall and 27.9% in the HF event group of patients. Averaged ratio statistics showed a significant pre-hospital decrease and a highly significant in-hospital increase in TI after intensified diuresis. Recurrent decompensations turned out to be preceded by a significantly stronger decrease of TI compared to first events with a higher chance for detection (63.6% sensitivity, p < 0.05).Overall performance in predicting imminent decompensation by monitoring TI alone is limited due to its high inter-patient variability. TI stand-alone applications should be redirected towards a target population with more advanced symptoms where post-hospital observation aimed to maintain the patient's discharge status might be the most valuable approach.ClinicalTrials.gov Identifier NCT00711360 (HomeCARE-II) and NCT01221649 (J-HomeCARE-II).

BACKGROUND:Pacemaker implantation in patients with single ventricle is associated with poor outcomes.OBJECTIVE:The purpose of this study was to determine the reasons for the poor outcomes of pacemaker implantation.METHODS:We performed a retrospective chart review of patients with single ventricle who had undergone permanent pacemaker implantation. Patients were categorized into 3 groups based on the site of pacing and the proportion of ventricular pacing (VP) as follows: (1) atrial pacing group with atrial pacing only (n = 11); (2) low VP group with low daily VP proportion (<50%; n = 12); and (3) high VP group with high daily VP proportion (≥50%; n = 15). Pacing leads were placed at the epicardium in all patients.RESULTS:No patients in the atrial pacing or low VP groups died, whereas the survival rate in the high VP group was 58.9% and 39.3% at 10 and 20 years, respectively, after pacemaker implantation. Among the post-Fontan patients, plasma brain natriuretic peptide (BNP) levels significantly increased with the proportion of VP: 11.7, 20.3, and 28.4 pg/mL in the atrial pacing, low VP, and high VP groups, respectively (P = 0.04). In the high VP group, the plasma BNP level was significantly lower in patients with an apical pacing lead than in those with a nonapical pacing lead (27.0 pg/mL vs 82.8 pg/mL, respectively; P = .03).CONCLUSION:A higher proportion of VP was associated with poor outcome and higher plasma BNP levels, probably due to ventricular dyssynchrony. In epicardial ventricular pacing, apical pacing is better to avoid the increase in ventricular stress and plasma BNP level.

Clinical trial data suggest that intravascular ultrasound (IVUS) may improve clinical outcomes after PCI. The aim of this study was to investigate the safety of IVUS in its broader use for percutaneous coronary intervention (PCI). A total of 11,570 consecutive patients undergoing PCI between 2008 and 2014 in Japan were analyzed. Associations between IVUS use, PCI-related complications were assessed with logistic regression and propensity score matching analyses. Subgroup analysis was performed in elective PCI patients. IVUS was used in 84.8% of patients (N = 9814; IVUS group); its use was almost universal in elective PCIs (90.8 vs. 81.7% in urgent/emergent PCIs, P < 0.001). The non-IVUS group were older (68.7 ± 11.4 vs. 67.9 ± 10.8 years, P = 0.004), with more comorbid conditions. The non-IVUS group had smaller stent lumens (2.97 ± 0.42 mm vs. 3.09 ± 0.45 mm, P < 0.001) and a higher proportion of plain old balloon angioplasty. After matching, a lower rate of flow-impairing coronary dissections was observed in the IVUS group, although this was limited only to elective PCIs, not among urgent/emergent PCIs (non-IVUS vs. IVUS; 2.7% vs. 1.0%, P = 0.018, 0.7% vs. 1.2%, P = 0.32, respectively). With a multivariate logistic regression analysis, IVUS use remained an independent predictor to reduce risk of flow impairing severe coronary dissection among elective PCIs (odds ratio 0.38, 95% confidence interval 0.22–0.66: P = 0.001). In this Japanese PCI registry, IVUS was used extensively during the study period, particularly in elective cases. Using IVUS was associated with a lower event rate of flow-impairing coronary dissections that was limited to elective PCIs, not among urgent/emergent PCIs, without increasing PCI-related complications.

The exercise tolerance of Fontan patients is poorer than that of healthy people. Some previous studies reported that exercise tolerance can be improved in this population by cardiac rehabilitation. This study aimed to determine the factors associated with peak oxygen uptake (VO2) and to subsequently clarify the correlation between participation in sports club activities and variables related to exercise tolerance. Cardiopulmonary exercise tests were performed by 115 Fontan patients aged between 6 and 20 years. The patients completed questionnaires on their daily physical activities including participation in extracurricular sports clubs in middle (junior high school) and high school. Peak VO2 had a significant negative correlation with age and a positive correlation with hemoglobin, stroke volume, and resting tidal volume in the entire study group. Additionally, the sports club participants who were middle and high school students had significantly higher peak VO2 and resting tidal volume. Exercise habits including participation in sports club activities may promote exercise tolerance by improving respiratory function in Fontan adolescents.

Recently we proposed "quantum language" (or, "the linguistic Copenhagen interpretation of quantum mechanics"), which was not only characterized as the metaphysical and linguistic turn of quantum mechanics but also the linguistic turn of Descartes = Kant epistemology.We believe that quantum language is not only the scientific final goal of dualistic idealism but also the language in which science is written.Hence there is a reason to want to clarify, from the quantum linguistic point of view, the following problems: "brain in a vat argument", "the Cogito proposition", "five-minute hypothesis", "only the present exists", "Copernican revolution", "McTaggart's paradox", and so on.In this paper, these will be discussed in quantum language.And we clarify that these are not propositions in quantum language.That is, these are metaphysical and not scientific.Also, we emphasize that Leibniz's relationalism in Leibniz-Clarke correspondence should be regarded as one of the most important parts of the linguistic Copenhagen interpretation of quantum mechanics.

Rationale: To detect pulmonary arterial hypertension (PAH) at any early stage is a promising approach to optimize the outcome. Objectives: To investigate the impact of school ECG-based screening on detecting idiopathic or heritable (I/H)-PAH in the general pediatric population. Methods: This was a nationwide survey of patients with I/H-PAH newly diagnosed at 3 months to 18 years of age in Japan during 2005-2012. Measurements and Main Results: Eighty-seven eligible patients (age range, 1-16 yr) were recruited. Among 68 (78%) patients diagnosed at greater than or equal to 6 years of age (the age of the first ECG-based screening), 28 (41%) were detected by the ECG-based screening (screening group) and 40 (59%) were recognized by their symptoms (n = 37) or coincidental occasions (n = 3; nonscreening group). In the screening group, the proportion of patients in World Health Organization functional class I/II at diagnosis was higher (96% vs. 60%; P < 0.001), plasma brain natriuretic peptide level was lower (149 ± 290 vs. 398 ± 559 pg/ml; P = 0.045), and 6-minute-walk distance was longer (420 ± 109 vs. 327 ± 104 m; P < 0.001) than the nonscreening group, despite similar values in mean pulmonary artery pressure (58 ± 17 vs. 61 ± 17 mm Hg; P = 0.42) and pulmonary vascular resistance index (18 ± 8 vs. 21 ± 11 Wood units ⋅ m2; P = 0.24) between groups. The proportion of patients on intravenous epoprostenol at the final visit was lower in the screening group than the nonscreening group (14% vs. 50; P = 0.004). Conclusions: These findings suggest that the ECG-based screening detects a unique subpopulation of pediatric patients with I/H-PAH that is associated with already established pulmonary hypertension but without obvious right heart failure and warrants investigating the prognostic significance of this system.

背景：単心室疾患群では，体肺動脈側副血管（APCA）の増加がFontan術後の合併症につながるため，術前にコイル塞栓を行うことがある．その目標については術後のAPCAの推移も考慮することが必要である．

We examined the adaptive mechanism of the pulmonary ventricle (PV) in response to increased afterload secondary to pulmonary stenosis in tetralogy of Fallot (TOF, n = 47) and congenitally corrected transposition of the great arteries (cCTGA, n = 18), where the PV is morphologically different. We also elucidated the effects of such adaptation on systemic ventricular (SV) function. PV contractility, assessed by dp/dt(max), showed significant positive correlations with PV pressure (r = 0.82, p <0.01 for TOF and r = 0.78, p <0.01 for cCTGA) and pulmonary-to-systemic ventricular pressure ratio (r = 0.70, p <0.01 for TOF and r = 0.76, p <0.01 for cCTGA) in patients with both TOF and cCTGA. Notably, the slopes of these correlations were significantly higher in cCTGA than in TOF (p <0.01), suggesting enhanced contractile responses in cCTGA. Moreover, SV dp/dt(max) showed significant positive correlations with PV dp/dt(max) in patients with both TOF and cCTGA (r = 0.67, p <0.01 and r = 0.61, p <0.01, respectively), indicating positive ventricular ventricular interaction. In this relationship, the slopes of correlations were significantly higher in TOF than in cCTGA (p = 0.024). These results, indicating different behaviors of PV contractile physiology and its interaction with the SV, may have important therapeutic implications when considering medical, catheter, and surgical interventions for pulmonary stenosis in these diseases. The results may also offer the potential for a new approach for improvement of prognosis, especially in cCTGA. (C) 2018 Elsevier Inc. All rights reserved.

Background: Although progress in perioperative management and surgical treatment has improved the survival rate of patients with hypoplastic left heart syndrome (HLHS), the Fontan completion rate remains low and prognosis is poor.Analysis of prognostic factors is challenging because HLHS complicates hemodynamics in patients with typical HLHS without ventricular septal defect and nontypical HLHS.This study aimed to categorize typical HLHS into four groups with combinations of stenosis/atresia of the mitral valve/aortic valve and to investigate survival rates and mortality risk factors to improve Fontan completion and prognosis.Methods: We enrolled 119 patients with HLHS [mitral valve atresia (MA)/aortic valve atresia (AA): 61 patients; MA/aortic valve stenosis (AS): 4; mitral valve stenosis (MS)/AA: 24; and MS/AS: 30)].After excluding the MA/AS group because of a small number of patients, we investigated the survival rate, number of mortalities, and cause of death in the MA/AA, MS/AA, and MS/AS groups by using prenatal diagnosis, MS/AA, low birth weight, atrioventricular valvular insufficiency, noncardiac complications, restricted foramen ovale, and length of intensive care unit stay following initial surgery as variables.Results: The overall 5-year survival rate for typical HLHS was 58％, which significantly varied by subtype (MS/ AS: 72％; MA/AA: 59％; and MS/AA: 33％; p＝0.002).Multivariate analysis identified MS/AA (p＝0.002) and positive prenatal diagnosis (p＝0.03) as significant prognostic risk factors. Conclusion:In typical HLHS, MS/AA was found to be an adverse prognostic factor.Because prognosis after total cavopulmonary connection was similar to those of other groups, preoperative diagnosis and treatment strategies before right heart bypass must be improved.

Pediatrics InternationalVolume 60, Issue 3 p. 294-295 Clinical Notes Prednisolone for pulmonary hemorrhage after Fontan procedure Daisuke Toyomura, Daisuke Toyomura Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this authorYoshihiko Kodama, Corresponding Author Yoshihiko Kodama kodamayoshihiko@gmail.com Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanCorrespondence: Yoshihiko Kodama, MD, Department of Pediatric Cardiology, Fukuoka Children's Hospital, 5-1-1 Kashiiteriha, Higashi-ku, Fukuoka 813-0017, Japan. Email: kodamayoshihiko@gmail.comSearch for more papers by this authorJunichiro Tezuka, Junichiro Tezuka Department of Allergy and Pulmonology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this authorKohichi Sagawa, Kohichi Sagawa Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this authorShiro Ishikawa, Shiro Ishikawa Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this author Daisuke Toyomura, Daisuke Toyomura Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this authorYoshihiko Kodama, Corresponding Author Yoshihiko Kodama kodamayoshihiko@gmail.com Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanCorrespondence: Yoshihiko Kodama, MD, Department of Pediatric Cardiology, Fukuoka Children's Hospital, 5-1-1 Kashiiteriha, Higashi-ku, Fukuoka 813-0017, Japan. Email: kodamayoshihiko@gmail.comSearch for more papers by this authorJunichiro Tezuka, Junichiro Tezuka Department of Allergy and Pulmonology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this authorKohichi Sagawa, Kohichi Sagawa Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this authorShiro Ishikawa, Shiro Ishikawa Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, JapanSearch for more papers by this author First published: 26 February 2018 https://doi.org/10.1111/ped.13503Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume60, Issue3March 2018Pages 294-295 RelatedInformation

Percutaneous coronary intervention for left main trifurcation disease is challenging. Although side branch protection techniques such as the jailed balloon technique and jailed Corsair technique are the established methods for treatment of coronary bifurcation lesions, little is known regarding the application and feasibility of these techniques for left main trifurcation disease. We herein describe a 72-year-old man with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a left main trifurcation lesion. In this case, we performed a novel double side branch protection technique, the simultaneous jailed balloon and jailed Corsair technique, with a single 8 Fr guiding catheter. This is the first case report to highlight the feasibility and efficacy of combined use of the jailed balloon and jailed Corsair techniques during percutaneous coronary intervention for left main trifurcation disease.

BACKGROUND:Limiting the contrast volume to creatinine clearance (V/CrCl) ratio is crucial for preventing contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). However, the incidence of CI-AKI and the distribution of V/CrCl ratios may vary according to patient body habitus. OBJECTIVE:We aimed to identify the clinical factors predicting CI-AKI in patients with different body mass indexes (BMIs). METHODS:We evaluated 8782 consecutive patients undergoing PCI and who were registered in a large Japanese database. CI-AKI was defined as an absolute serum creatinine increase of 0.3 mg/dL or a relative increase of 50%. The effect of the V/CrCl ratio relative to CI-AKI incidence was evaluated within the low- (≤25 kg/m2) and high- (>25 kg/m2) BMI groups, with a V/CrCl ratio > 3 considered to be a risk factor for CI-AKI. RESULTS:A V/CrCl ratio > 3 was predictive of CI-AKI, regardless of BMI (low-BMI group: odds ratio [OR], 1.77 [1.42-2.21]; P < 0.001; high-BMI group: OR, 1.67 [1.22-2.29]; P = 0.001). The relationship between BMI and CI-AKI followed a reverse J-curve relationship, although baseline renal dysfunction (creatinine clearance <60 mL/min, 46.9% vs. 21.5%) and V/CrCl ratio > 3 (37.3% vs. 20.4%) were predominant in the low-BMI group. Indeed, low BMI was a significant predictor of a V/CrCl ratio > 3 (OR per unit decrease in BMI, 1.08 [1.05-1.10]; P < 0.001). CONCLUSIONS:A V/CrCl ratio > 3 was strongly associated with the occurrence of CI-AKI. Importantly, we also identified a tendency for physicians to use higher V/CrCl ratios in lean patients. Thus, recognizing this trend may provide a therapeutic target for reducing the incidence of CI-AKI.