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Kishimoto T, Kinoshita S, Kitazawa M, Hishimoto A, Asami T, Suda A, Bun S, Kikuchi T, Sado M, Takamiya A, Mimura M, Sato Y, Takemura R, Nagashima K, Nakamae T, Abe Y, Kanazawa T, Kawabata Y, Tomita H, Abe K, Hongo S, Kimura H, Sato A, Kida H, Sakuma K, Funayama M, Sugiyama N, Hino K, Amagai T, Takamiya M, Kodama H, Goto K, Fujiwara S, Kaiya H, Nagao K. Live two-way video versus face-to-face treatment for depression, anxiety, and obsessive-compulsive disorder: A 24-week randomized controlled trial. Psychiatry Clin Neurosci 2024; 78:220-228. [PMID: 38102849 DOI: 10.1111/pcn.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/17/2023]
Abstract
AIM Live two-way video, easily accessible from home via smartphones and other devices, is becoming a new way of providing psychiatric treatment. However, lack of evidence for real-world clinical setting effectiveness hampers its approval by medical insurance in some countries. Here, we conducted the first large-scale pragmatic, randomized controlled trial to determine the effectiveness of long-term treatment for multiple psychiatric disorders via two-way video using smartphones and other devices, which are currently the primary means of telecommunication. METHODS This randomized controlled trial compared two-way video versus face-to-face treatment for depressive disorder, anxiety disorder, and obsessive-compulsive disorder in the subacute/maintenance phase during a 24-week period. Adult patients with the above-mentioned disorders were allocated to either a two-way video group (≥50% video sessions) or a face-to-face group (100% in-person sessions) and received standard treatment covered by public medical insurance. The primary outcome was the 36-Item Short-Form Health Survey Mental Component Summary (SF-36 MCS) score. Secondary outcomes included all-cause discontinuation, working alliance, adverse events, and the severity rating scales for each disorder. RESULTS A total of 199 patients participated in this study. After 24 weeks of treatment, two-way video treatment was found to be noninferior to face-to-face treatment regarding SF-36 MCS score (48.50 vs 46.68, respectively; p < 0.001). There were no significant differences between the groups regarding most secondary end points, including all-cause discontinuation, treatment efficacy, and satisfaction. CONCLUSION Two-way video treatment using smartphones and other devices, was noninferior to face-to-face treatment in real-world clinical settings. Modern telemedicine, easily accessible from home, can be used as a form of health care.
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Affiliation(s)
- Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| | - Shotaro Kinoshita
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
- Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan
| | - Momoko Kitazawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Psychiatric Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Sato Hospital, Yamagata, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Akihiro Takamiya
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Akasaka Clinic, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Ryo Takemura
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Kengo Nagashima
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tetsufumi Kanazawa
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yasuo Kawabata
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Abe
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Seiji Hongo
- Himorogi Psychiatric Institute, Tokyo, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Gakuji-kai Kimura Hospital, Chiba, Japan
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Aiko Sato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Hisashi Kida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Asaka Hospital, Fukushima, Japan
| | | | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
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Hattori S, Suda A, Kishida I, Miyauchi M, Shiraishi Y, Noguchi N, Furuno T, Asami T, Fujibayashi M, Tsujita N, Ishii C, Ishii N, Saeki T, Fukushima T, Moritani T, Saigusa Y, Hishimoto A. Differences in autonomic nervous system activity between long-acting injectable aripiprazole and oral aripiprazole in schizophrenia. BMC Psychiatry 2023; 23:135. [PMID: 36869320 PMCID: PMC9983165 DOI: 10.1186/s12888-023-04617-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Distinct oral atypical antipsychotics have different effects on autonomic nervous system (ANS) activity. Among them, oral aripiprazole has been linked to dysfunction of the ANS in schizophrenia. Long-acting injectable aripiprazole is a major treatment option for schizophrenia, but the effect of the aripiprazole formulation on ANS activity remains unclear. In this study, we compared ANS activity between oral aripiprazole and aripiprazole once-monthly (AOM) in schizophrenia. METHODS Of the 122 patients with schizophrenia who participated in this study, 72 received oral aripiprazole and 50 received AOM as monotherapy. We used power spectral analysis of heart rate variability to assess ANS activity. RESULTS Patients who received oral aripiprazole showed significantly diminished sympathetic nervous activity compared with those who received AOM. Multiple regression analysis revealed that the aripiprazole formulation significantly influenced sympathetic nervous activity. CONCLUSION Compared with oral aripiprazole, AOM appears to have fewer adverse effects, such as sympathetic nervous dysfunction.
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Affiliation(s)
- Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan. .,Fujisawa Hospital, 383 Kotsuka Fujisawa, Yokohama, 251-8530, Fujisawa, Japan.
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Ikuko Kishida
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan.,Fujisawa Hospital, 383 Kotsuka Fujisawa, Yokohama, 251-8530, Fujisawa, Japan
| | - Masatoshi Miyauchi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Yohko Shiraishi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Nobuhiko Noguchi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Taku Furuno
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Mami Fujibayashi
- Division of Physical and Health Education, Setsunan University, 17-8 Ikedanakamachi, Neyagawa, 572- 8508, Osaka, Japan
| | - Natsuki Tsujita
- Graduate School of Human and Environmental Studies, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, 606-8316, Japan
| | - Chie Ishii
- Fujisawa Hospital, 383 Kotsuka Fujisawa, Yokohama, 251-8530, Fujisawa, Japan
| | - Norio Ishii
- Fujisawa Hospital, 383 Kotsuka Fujisawa, Yokohama, 251-8530, Fujisawa, Japan
| | - Takashi Saeki
- Asahinooka Hospital, 128-1 Kawaihonchou, Asahi-ku, Yokohama, 251-8530, Kanagawa, Japan
| | - Tadashi Fukushima
- Asahinooka Hospital, 128-1 Kawaihonchou, Asahi-ku, Yokohama, 251-8530, Kanagawa, Japan
| | - Toshio Moritani
- Graduate School of Human and Environmental Studies, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, 606-8316, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan
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Ishimori N, Wakabayashi M, Sakurai K, Suda A, Souri M, Osaki T, Ichinose A. [Autoimmune coagulation factor V/5 deficiency during chronic disseminated intravascular coagulation]. Rinsho Ketsueki 2023; 64:113-118. [PMID: 36990730 DOI: 10.11406/rinketsu.64.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Aortic regurgitation, a thoracoabdominal aortic aneurysm, chronic myeloid leukemia, and chronic kidney disease were all being treated at two hospitals for an 83-year-old man. He was admitted to the Department of Orthopedics at our hospital with a lumbar compression fracture. Later, he experienced melena, for which the Department of Internal Medicine was consulted. Due to the aberrant results of PT-INR (7.1) and a PTT > 200 seconds on a coagulation test, we suspected the presence of an autoimmune coagulation factor deficiency, and prednisolone immunosuppressive therapy medication was started right away. Due to a sharp decline in FV/5 activity, the presence of FV/5 inhibitors, and the presence of anti-FV/5 autoantibodies, a final diagnosis of autoimmune coagulation factor V (FV/5) deficiency was made. After the start of immunosuppressive therapy, the FV/5 inhibitor and anti-FV/5 autoantibodies disappeared, and the FV/5 activity progressively returned to normal. Disseminated intravascular coagulation-which may have been caused by a known aortic aneurysm-worsened while tapering off prednisolone. Due to the patient's advanced age and other problems, the aneurysm was extensive and inappropriate for surgical repair. The coagulation test findings improved gradually upon initiation of warfarin therapy. Herein, the patient had autoimmune FV/5 deficiency, a rare disorder that made diagnosis and therapy difficult because of the patient's several coexisting conditions.
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Affiliation(s)
- Noriko Ishimori
- Department of Internal Medicine, Tsudanuma Central General Hospital
| | | | - Kenji Sakurai
- Department of Internal Medicine, Tsudanuma Central General Hospital
| | - Akira Suda
- Department of Internal Medicine, Tsudanuma Central General Hospital
| | - Masayoshi Souri
- Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine
- Department of Public Health and Hygiene, Yamagata University School of Medicine
| | - Tsukasa Osaki
- Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine
- Department of Public Health and Hygiene, Yamagata University School of Medicine
| | - Akitada Ichinose
- Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine
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Suda A, Takahashi J, Schwidder M, Ong P, Ang D, Berry C, Camici PG, Crea F, Carlos Kaski J, Pepine C, Rimoldi O, Sechtem U, Yasuda S, Beltrame JF, Noel Bairey Merz C, Shimokawa H. Prognostic association of plasma NT-proBNP levels in patients with microvascular angina -A report from the international cohort study by COVADIS. Int J Cardiol Heart Vasc 2022; 43:101139. [PMID: 36338319 PMCID: PMC9626381 DOI: 10.1016/j.ijcha.2022.101139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/27/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
BackgroudThe aim of this study was to assess the prognostic association of plasma levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) with clinical outcomes of patients with microvascular angina (MVA). Methods In this international prospective cohort study of MVA by the Coronary Vasomotor Disorders International Study (COVADIS) group, we examined the association between plasma NT-proBNP levels and the incidence of major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina. Results We examined a total of 226 MVA patients (M/F 66/160, 61.9 ± 10.2 [SD] yrs.) with both plasma NT-proBNP levels and echocardiography data available at the time of enrolment. The median level of NT-proBNP level was 94 pg/ml, while mean left ventricular ejection fraction was 69.2 ± 10.9 % and E/e' 10.7 ± 5.2. During follow-up period of a median of 365 days (IQR 365-482), 29 MACEs occurred. Receiver-operating characteristics curve analysis identified plasma NT-proBNP level of 78 pg/ml as the optimal cut-off value. Multivariable logistic regression analysis revealed that plasma NT-proBNP level ≥ 78 pg/ml significantly correlated with the incidence of MACE (odds ratio (OR) [95 % confidence interval (CI)] 3.11[1.14-8.49], P = 0.001). Accordingly, Kaplan-Meier survival analysis showed a significantly worse prognosis in the group with NT-proBNP ≥ 78 (log-rank test, P < 0.03). Finally, a significant positive correlation was observed between plasma NT-proBNP levels and E/e' (R = 0.445, P < 0.0001). Conclusions These results indicate that plasma NT-proBNP levels may represent a novel prognostic biomarker for MVA patients.
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Affiliation(s)
- Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Maike Schwidder
- Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Peter Ong
- Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Daniel Ang
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Colin Berry
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Paolo G. Camici
- Vita Salute University and San Raffaele Hospital, Milan, Italy
| | - Filippo Crea
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Juan Carlos Kaski
- Cardiovascular and Cell Sciences Res Institute, St George’s, University of London, UK
| | - Carl Pepine
- Division of Cardiovascular Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Ornella Rimoldi
- Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche, Segrate, Italy
| | - Udo Sechtem
- Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - John F. Beltrame
- The Discipline of Medicine, University of Adelaide, Basil Hetzel Institute, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - C. Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- International University of Health and Welfare, Narita, Japan
| | - on behalf of the Coronary Vasomotor Disorders International Study COVADIS Group
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
- Vita Salute University and San Raffaele Hospital, Milan, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- Cardiovascular and Cell Sciences Res Institute, St George’s, University of London, UK
- Division of Cardiovascular Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
- Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche, Segrate, Italy
- The Discipline of Medicine, University of Adelaide, Basil Hetzel Institute, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- International University of Health and Welfare, Narita, Japan
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Toyohara N, Fujita J, Okumura Y, Suda A, Hattori S, Saigusa Y, Aoyama K, Asanuma K, Takahashi Y, Arai T, Hishimoto A. Association between suicidal behaviors and auditory and visual hallucinations in Japanese adolescent psychiatric outpatients at first visit: a cross-sectional study. Child Adolesc Ment Health 2022; 27:335-342. [PMID: 34432369 DOI: 10.1111/camh.12504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide remains one of the leading causes of death among adolescents. Although recent studies have suggested a strong association between auditory hallucinations and suicidal behaviors, little is known regarding the association between suicidal behaviors and visual hallucinations, which are also common among adolescent psychiatric patients. METHOD A cross-sectional study of all first-time patients aged 10-15 years was conducted at three child and adolescent psychiatric outpatient facilities in Kanagawa Prefecture, Japan, from April 2015 to March 2018. Self-reported questionnaires were administered to evaluate auditory and visual hallucinations, suicide planning, and suicide attempts within the two weeks prior to the first visit. Our logistic regression model included three covariates (sex, age, and presence of major depressive episode) for adjustments. Among the 1285 respondents, 37 who had moderate or severe intellectual disability were excluded, leaving 1248 for analysis. RESULTS Among the 1069 patients who completed questionnaire items on hallucinations, 230 (21.5%) experienced auditory or visual hallucinations. After controlling for all confounders, visual hallucinations, but not auditory hallucinations, were significantly associated with increased odds of suicide planning (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.5-4.1). In contrast, auditory hallucinations, but not visual hallucinations, were significantly associated with increased odds of suicide attempts (OR 2.8, 95% CI 1.3-6.1). No interaction effects were observed between suicidal behaviors and auditory or visual hallucinations. CONCLUSIONS Clinicians should consider the prevalence of both auditory and visual hallucinations among young adolescent patients, with emphasis on auditory hallucinations, given their association with suicide attempts.
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Affiliation(s)
- Nao Toyohara
- Department of Child and Adolescent Psychiatry, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.,Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Junichi Fujita
- Department of Child and Adolescent Psychiatry, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.,Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Yasuyuki Okumura
- Department of Prevention, Treatment, and Rehabilitation Promoting Mental Health, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Kumi Aoyama
- Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan.,Psychiatric Center, Yokohama City University Medical Center, Kanagawa, Japan
| | - Kazuya Asanuma
- Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan.,Psychiatric Center, Yokohama City University Medical Center, Kanagawa, Japan
| | - Yuichi Takahashi
- Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan.,Psychiatric Center, Yokohama City University Medical Center, Kanagawa, Japan.,Yokohama East Area Habilitation Center for Children, Kanagawa, Japan
| | - Takashi Arai
- Department of Child and Adolescent Psychiatry, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Akitoyo Hishimoto
- Department of Child and Adolescent Psychiatry, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.,Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan
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6
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Minami K, Asami T, Tsujimura S, Suda A, Ide K, Hishimoto A. Electroconvulsive therapy for severe depressive symptoms in a patient with dementia with Lewy bodies after coil embolisation for a cerebral aneurysm. Psychogeriatrics 2022; 22:886-889. [PMID: 36131597 DOI: 10.1111/psyg.12895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Kiriko Minami
- Department of Psychiatry, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
| | - Satoshi Tsujimura
- Department of Psychiatry, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
| | - Keiko Ide
- Department of Psychiatry, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
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7
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Shimokawa H, Suda A, Takahashi J, Ong P, Ang D, Berry C, Camici P, Crea F, Kaski J, Pepine C, Rimoldi O, Sechtem U, Yasuda S, Beltrame J, Merz C. Prognostic impact of plasma level of NT-pro BNP in patients with microvascular angina – a report from the international cohort study by COVADIS. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
Although the importance of microvascular angina (MVA) has been emerging, prognostic biomarkers for MVA remain to be developed. We thus aimed to examine whether plasma level of N-terminal prohormone of brain natriuretic peptide (NT-pro BNP) could predict the prognosis of MVA patients.
Methods
In the international prospective cohort study of MVA patients by the Coronary Vasomotor Disorders International Study (COVADIS) group, we evaluated the association between plasma level of NT-pro BNP and the incidence of major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina.
Results
We examined a total of 226 MVA patients (M/F 66/160, 61.9±10.2 [SD] years) with both plasma NT-pro BNP levels and echocardiographic data in the COVADIS study. Plasma NT-pro BNP level was elevated (median 94 pg/ml, IQR 45–190) while mean LVEF (69.2±10.9%) and E/e' (10.7±5.2) were almost normal. During follow-up period of a median of 365 days (IQR 365–482), 29 MACEs occurred. ROC curve analysis identified plasma NT-pro BNP level of 78 pg/ml as the optimal cut-off value. Multivariable logistic regression analysis revealed that plasma NT-pro BNP level ≥78 pg/ml significantly correlated with the incidence of MACE (odds ratio (OR) [95% confidence interval (CI)] 3.11 [1.14–8.49], P=0.03). When divided into 2 groups by NT-pro BNP 78 pg/ml, the Kaplan-Meier survival analysis showed a significantly worse prognosis in the group with NT-pro BNP ≥78 (log lank, P=0.03) (Figure).
Conclusions
These results indicate that plasma NT-pro BNP level is a novel prognostic biomarker for MVA patients.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Japan Heart Foundation
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Affiliation(s)
- H Shimokawa
- Tohoku University Graduate School of Medicine , Sendai , Japan
| | - A Suda
- Tohoku University Graduate School of Medicine , Sendai , Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine , Sendai , Japan
| | - P Ong
- Robert Bosch Hospital , Stuttgart , Germany
| | - D Ang
- University of Glasgow , Glasgow , United Kingdom
| | - C Berry
- University of Glasgow , Glasgow , United Kingdom
| | - P Camici
- University Vita-Salute San Raffaele , Milan , Italy
| | - F Crea
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University , Rome , Italy
| | - J Kaski
- St George's University of London , London , United Kingdom
| | - C Pepine
- University of Florida , Gainesville , United States of America
| | - O Rimoldi
- University Vita-Salute San Raffaele , Milan , Italy
| | - U Sechtem
- Robert Bosch Hospital , Stuttgart , Germany
| | - S Yasuda
- Tohoku University Graduate School of Medicine , Sendai , Japan
| | - J Beltrame
- University of Adelaide , Adelaide , Australia
| | - C Merz
- Cedars-Sinai Medical Center , Los Angeles , United States of America
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Tanabe Y, Asami T, Yoshimi A, Abe K, Saigusa Y, Hayakawa M, Fujita J, Ide K, Suda A, Hishimoto A. Effectiveness of anger-focused emotional management training in reducing aggression among nurses. Nurs Open 2022; 10:998-1006. [PMID: 36111753 PMCID: PMC9834502 DOI: 10.1002/nop2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/30/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim of this study was to conduct a 5-h training programme on anger-focused emotional management for nurses and verify its effectiveness. DESIGN The study used a one-group pretest-posttest design. METHODS Participants (N = 283) attended a programme comprising lectures and exercises. The Japanese version of the Buss-Perry Aggression Questionnaire was administered pre-, post- and 3-month posttraining. Regression analyses were used to assess the effects of the programme by gender. RESULTS For the total aggression score, the difference between the pre- and posttraining scores was -2.827 points and remained at -1.602 points 3-month posttraining. Physical aggression scores decreased posttraining, but the scores increased after 3 months. There were statistically significant gender differences in hostility scores; pre-training scores were slightly higher for men than for women and lower for men after 3 months. Total and physical aggression scores were higher for men than for women. The training programme decreased aggression, and the effect persisted after 3 months.
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Affiliation(s)
- Yuriko Tanabe
- Department of PsychiatryYokohama City University Graduate School of MedicineYokohamaJapan,Department of NursingYokohama City University School of MedicineYokohamaJapan
| | - Takeshi Asami
- Department of PsychiatryYokohama City University School of MedicineYokohamaJapan
| | - Asuka Yoshimi
- Department of PsychiatryYokohama City University School of MedicineYokohamaJapan
| | - Kie Abe
- Department of PsychiatryYokohama City University Graduate School of MedicineYokohamaJapan,Tsukuba Psychosomatic ClinicTsuchiuraJapan
| | - Yusuke Saigusa
- Department of BiostatisticsYokohama City University School of MedicineYokohamaJapan
| | - Maya Hayakawa
- Department of PsychiatryYokohama City University Graduate School of MedicineYokohamaJapan
| | - Junichi Fujita
- Department of Child PsychiatryYokohama City University HospitalYokohamaJapan
| | - Keiko Ide
- Department of PsychiatryYokohama City University School of MedicineYokohamaJapan
| | - Akira Suda
- Department of PsychiatryYokohama City University School of MedicineYokohamaJapan
| | - Akitoyo Hishimoto
- Department of PsychiatryYokohama City University School of MedicineYokohamaJapan
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Hao K, Takahashi J, Sato K, Suda A, Sindo T, Godo S, Nishimiya K, Kikuchi Y, Shiroto T, Yasuda S. The influence of COVID-19 pandemic on management of acute myocardial infarction in Japan; Insight from the Miyagi AMI Registry Study. IJC Heart & Vasculature 2022; 43:101116. [PMID: 36127895 PMCID: PMC9477968 DOI: 10.1016/j.ijcha.2022.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/19/2022] [Accepted: 08/30/2022] [Indexed: 12/01/2022]
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Abe K, Chiba Y, Ide K, Yoshimi A, Asami T, Suda A, Odawara T, Hishimoto A. Plasma MMP-9 Levels as the Future Risk of Conversion to Dementia in ApoE4-Positive MCI Patients: Investigation Based on the Alzheimer's Disease Neuroimaging Initiative Database. J Prev Alzheimers Dis 2022; 9:331-337. [PMID: 35543007 DOI: 10.14283/jpad.2022.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Matrix metalloproteinase 9 (MMP-9) has been reported to be correlated with declines in hippocampal volume and cognitive function in ApoE4-positive MCI patients. OBJECTIVES The present study was aimed to investigate the effects of plasma matrix MMP-9 on the conversion risk between mild cognitive impairment (MCI) patients with and without ApoE4. DESIGN AND SETTING Retrospective observational study using the data extracted from the Alzheimer's Disease Neuroimaging Initiative database. PARTICIPANTS We included 211 ApoE4-positive MCI subjects (ApoE4+ MCI) and 184 ApoE4-negative MCI subjects (ApoE4- MCI). MEASUREMENTS We obtained demographic and data including plasma MMP-9 levels at baseline and longitudinal changes in Clinical Dementia Rating (CDR) up to 15 years. We compared conversion rates between ApoE4+ MCI and ApoE4- MCI by the Log-rank test and calculated the hazard ratio (HR) for covariates including age, sex, educational attainment, drinking and smoking histories, medications, and plasma MMP-9 levels using a multiple Cox regression analysis of ApoE4+ MCI and ApoE4- MCI. RESULTS No significant differences were observed in baseline plasma MMP-9 levels between ApoE4+ MCI and ApoE4- MCI. High plasma MMP-9 levels increased the conversion risk significantly more than low plasma MMP-9 levels (HR, 2.46 [95% CI, 1.31-4.48]) and middle plasma MMP-9 levels (HR, 1.67 [95% CI, 1.04-2.65]) in ApoE4+ MCI, but not in ApoE4- MCI. CONCLUSION Plasma MMP-9 would be the risk of the future conversion to dementia in ApoE4+ MCI.
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Affiliation(s)
- K Abe
- Yuhei Chiba, 3-9 Fukuura Kanazawa-Ku Yokohama Kanagawa 236-0004, Japan, Telephone: +81-45-787-2667, FAX: +81-45-783-2540, E-mail:
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11
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Shimokawa H, Suda A, Takahashi J, Berry C, Camici PG, Crea F, Escaned J, Ford T, Yii E, Kaski JC, Kiyooka T, Mehta PK, Ong P, Ozaki Y, Pepine C, Rimoldi O, Safdar B, Sechtem U, Tsujita K, Yasuda S, Beltrame JF, Merz CNB. Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group. Eur Heart J 2021; 42:4592-4600. [PMID: 34038937 PMCID: PMC8633728 DOI: 10.1093/eurheartj/ehab282] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/01/2021] [Accepted: 04/23/2021] [Indexed: 12/30/2022] Open
Abstract
AIMS To provide multi-national, multi-ethnic data on the clinical characteristics and prognosis of patients with microvascular angina (MVA). METHODS AND RESULTS The Coronary Vasomotor Disorders International Study Group proposed the diagnostic criteria for MVA. We prospectively evaluated the clinical characteristics of patients according to these criteria and their prognosis. The primary endpoint was the composite of major cardiovascular events (MACE), verified by institutional investigators, which included cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina. During the period from 1 July 2015 to 31 December 2018, 686 patients with MVA were registered from 14 institutes in 7 countries from 4 continents. Among them, 64% were female and the main ethnic groups were Caucasians (61%) and Asians (29%). During follow-up of a median of 398 days (IQR 365-744), 78 MACE occurred (6.4% in men vs. 8.6% in women, P = 0.19). Multivariable Cox proportional hazard analysis disclosed that hypertension and previous history of coronary artery disease (CAD), including acute coronary syndrome and stable angina pectoris, were independent predictors of MACE. There was no sex or ethnic difference in prognosis, although women had lower Seattle Angina Questionnaire scores than men (P < 0.05). CONCLUSIONS This first international study provides novel evidence that MVA is an important health problem regardless of sex or ethnicity that a diagnosis of MVA portends a substantial risk for MACE associated with hypertension and previous history of CAD, and that women have a lower quality of life than men despite the comparable prognosis.
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Affiliation(s)
- Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Sendai, Japan
- International University of Health and Welfare, Narita, Japan
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Sendai, Japan
| | - Colin Berry
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Paolo G Camici
- Vita Salute University and San Raffaele Hospital, Milan, Italy
| | - Filippo Crea
- Department of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Javier Escaned
- Department of Cardiology, Hospital Clínico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain
| | - Tom Ford
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Eric Yii
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Juan Carlos Kaski
- Department of Cardiovascular Science, Cardiovascular and Cell Sciences Res Institute, St George’s, University of London, UK
| | - Takahiko Kiyooka
- Department of Cardiology, Tokai University Oiso Hospital, Oiso, Japan
| | - Puja K Mehta
- Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Peter Ong
- Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University School of Medicine, Toyonaka, Aichi, Japan
| | - Carl Pepine
- Division of Cardiovascular Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Ornella Rimoldi
- Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche, Segrate, Italy
| | - Basmah Safdar
- Department of Emergency Medicine, Yale University, New Haven, CT, USA
| | - Udo Sechtem
- Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Sendai, Japan
| | - John F Beltrame
- The Discipline of Medicine, University of Adelaide, Basil Hetzel Institute, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - C Noel Bairey Merz
- Department of Cardiology, Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Smidt Heart Institute, Los Angeles, CA, USA
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12
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Kishimoto T, Kinoshita S, Bun S, Sato Y, Kitazawa M, Kikuchi T, Sado M, Takamiya A, Mimura M, Nakamae T, Abe Y, Kanazawa T, Kawabata Y, Tomita H, Abe K, Hishimoto A, Asami T, Suda A, Watanabe Y, Amagai T, Sakuma K, Kida H, Funayama M, Kimura H, Sato A, Fujiwara S, Nagao K, Sugiyama N, Takamiya M, Kodama H, Azekawa T. Japanese project for telepsychiatry evaluation during COVID-19: Treatment comparison trial (J-PROTECT): Rationale, design, and methodology. Contemp Clin Trials 2021; 111:106596. [PMID: 34653648 PMCID: PMC8511868 DOI: 10.1016/j.cct.2021.106596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 12/25/2022]
Abstract
Introduction The COVID-19 pandemic has had a profound impact on the mental health of people around the world. Anxiety related to infection, stress and stigma caused by the forced changes in daily life have reportedly increased the incidence and symptoms of depression, anxiety disorder and obsessive-compulsive disorder. Under such circumstances, telepsychiatry is gaining importance and attracting a great deal of attention. However, few large pragmatic clinical trials on the use of telepsychiatry targeting multiple psychiatric disorders have been conducted to date. Methods The targeted study cohort will consist of adults (>18 years) who meet the DSM-5 diagnostic criteria for either (1) depressive disorders, (2) anxiety disorders, or (3) obsessive-compulsive and related disorders. Patients will be assigned in a 1:1 ratio to either a “telepsychiatry group” (at least 50% of treatments to be conducted using telemedicine, with at least one face-to-face treatment [FTF] within six months) or an “FTF group” (all treatments to be conducted FTF, with no telemedicine). Both groups will receive the usual treatment covered by public medical insurance. The study will utilize a master protocol design in that there will be primary and secondary outcomes for the entire group regardless of diagnosis, as well as the outcomes for each individual disorder group. Discussion This study will be a non-inferiority trial to test that the treatment effect of telepsychiatry is not inferior to that of FTF alone. This study will provide useful insights into the effect of the COVID-19 pandemic on the practice of psychiatry. Trial Registration jRCT1030210037, Japan Registry of Clinical Trials (jRCT).
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Affiliation(s)
- Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, #7F Roppongi Hills, North Tower 6-2-31 Roppongi, Minato-ku, Tokyo 106-0032, Japan.
| | - Shotaro Kinoshita
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, #7F Roppongi Hills, North Tower 6-2-31 Roppongi, Minato-ku, Tokyo 106-0032, Japan; Graduate School of Medicine, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo 107-8402, Japan
| | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Sato Hospital, 948-1 Kunugizuka, Nanyo, Yamagata 999-2221, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Momoko Kitazawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akihiro Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, Kyoto 602-8566, Japan
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, Kyoto 602-8566, Japan
| | - Tetsufumi Kanazawa
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Yasuo Kawabata
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Koichi Abe
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Yoshinori Watanabe
- Himorogi Psychiatric Institute, Ichigaya-Asukara Bldg. 1F2F, 2-31-3 Ichigayatamachi, Shinjuku, Tokyo 162-0843, Japan
| | - Toru Amagai
- Amagai Mental Clinic, Kitami Bldg. 3F, 1-4-20 Kamiooka-nishi, Konan, Yokohama, Kanagawa 233-0002, Japan
| | - Kei Sakuma
- Asaka Hospital, 45 Kyotan, Sasagawa, Asakamachi, Koriyama, Fukushima 963-0198, Japan
| | - Hisashi Kida
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Asaka Hospital, 45 Kyotan, Sasagawa, Asakamachi, Koriyama, Fukushima 963-0198, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi 326-0843, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Gakuji-kai Kimura Hospital, 6-19, Higashi Honcho, Chuo-ku, Chiba, Chiba 260-0004, Japan; Department of Psychiatry, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan
| | - Aiko Sato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan
| | - Shuichiro Fujiwara
- Kanazawabunko Yell Clinic, Kanazawa Bunko Park Homes 102, Kamariyahigashi, Kanazawa, Yokohama, Kanagawa 236-0042, Japan
| | - Kiichiro Nagao
- Neyagawa Sanatoriumu, 2370-6 Neyagawakoen, Neyagawa, Osaka, Osaka 572-0854, Japan
| | - Naoya Sugiyama
- Numazu Chuo Hospital, 24-1 Nakase-cho, Numazu, Shizuoka 410-8575, Japan
| | - Maki Takamiya
- Takamiya Hospital, 1931 Omachikou, Yoshimura, Miyazaki, Miyazaki 880-0841, Japan
| | - Hideyuki Kodama
- Takamiya Hospital, 1931 Omachikou, Yoshimura, Miyazaki, Miyazaki 880-0841, Japan
| | - Takaharu Azekawa
- Shioiri Mental Clinic, 2-7-1 Shioiri, Yokosuka, Kanagawa, 238-0042, Japan
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Takahashi J, Suda A, Nishimiya K, Godo S, Yasuda S, Shimokawa H. Pathophysiology and Diagnosis of Coronary Functional Abnormalities. Eur Cardiol 2021; 16:e30. [PMID: 34603510 PMCID: PMC8478147 DOI: 10.15420/ecr.2021.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/07/2021] [Indexed: 01/17/2023] Open
Abstract
Approximately one-half of patients undergoing diagnostic coronary angiography for angina have no significant coronary atherosclerotic stenosis. This clinical condition has recently been described as ischaemia with non-obstructive coronary arteries (INOCA). Coronary functional abnormalities are central to the pathogenesis of INOCA, including epicardial coronary spasm and coronary microvascular dysfunction composed of a variable combination of increased vasoconstrictive reactivity and/or reduced vasodilator function. During the last decade - in INOCA patients in particular - evidence for the prognostic impact of coronary functional abnormalities has accumulated and various non-invasive and invasive diagnostic techniques have enabled the evaluation of coronary vasomotor function in a comprehensive manner. In this review, the authors briefly summarise the recent advances in the understanding of pathophysiology and diagnosis of epicardial coronary artery spasm and coronary microvascular dysfunction.
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Affiliation(s)
- Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Shigeo Godo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
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Takahashi J, Suda A, Yasuda S, Shimokawa H. Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm. J Vis Exp 2021. [PMID: 34605803 DOI: 10.3791/62558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
In about a quarter of patients with angina and non-obstructive coronary arteries, no epicardial spasm is noted on coronary arteriography during an angina attack. Since the pressure-rate product is almost identical at rest and the onset of attack in those patients, the decrease in coronary blood flow rather than increased myocardial oxygen consumption is likely to explain myocardial ischemia, indicating a substantial involvement with coronary microvascular spasm (MVS). Myocardial lactate production, which could be defined as a negative myocardial lactate extraction ratio (ratio of the coronary arterial-venous difference in lactate concentration to arterial concentration), is considered indicative of objective evidence to support the emerging myocardial ischemia. Thus, monitoring of the myocardial lactate production and the emergence of chest pain and ischemic electrocardiographic changes during acetylcholine (ACh) provocation testing is of significant value for detecting the entity of MVS. Practically, 1 min after incremental doses of ACh (20, 50, and 100 μg) are administered into the left coronary artery (LCA), paired samples of 1 mL of blood are collected from the LCA ostium and coronary sinus for measurement of lactate concentration by a calibrated automatic lactate analyzer. Then, the development of MVS could be confirmed by negative myocardial lactate extraction ratio despite the absence of angiographically demonstrable epicardial coronary spasm or before its occurrence throughout ACh provocation testing. In conclusion, assessment of myocardial lactate production is essential and valuable for the diagnosis of MVS.
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Affiliation(s)
- Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine;
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Kumamoto A, Chiba Y, Suda A, Hishimoto A, Kase A. A Severe Dementia Case in End of Life Care with Psychiatric Symptoms Treated by Perampanel. J Epilepsy Res 2021; 11:93-95. [PMID: 34395228 PMCID: PMC8357559 DOI: 10.14581/jer.21012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 11/21/2022] Open
Abstract
Epilepsy is known to comorbid with Alzheimer’s disease. It can promote cognitive decline, and eventually worsen their prognosis and mortality. It is sometimes difficult to find a suitable drug because of the adverse effects. Perampanel has a unique mechanism of action that antagonizes α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid type glutamate receptor. Here, we report a case of severe dementia due to Alzheimer’s disease with intractable epilepsy, which perampanel effected for controlling seizures with less adverse effects. The subject is an 89-year-old Japanese woman with severe dementia due to Alzheimer’s disease and intractable myoclonic epilepsy. She also had psychiatric symptoms, such as circadian rhythm disorder and irritability. Valproic acid, lacosamide, or carbamazepine were prescribed, but none of them was effective. Shortly after perampanel started, however, myoclonus and these psychiatric symptoms improved. Moreover, it did not cause any obvious adverse effects, which made it possible to continue perampanel until the end of her life. Perampanel may be useful for controlling intractable epilepsy accompanied by Alzheimer’s disease. It may also improve psychiatric symptoms with less adverse effect. Accumulation of studies is necessary to evaluate the effectiveness of perampanel on the epilepsy of Alzheimer’s disease patients and further understand that mechanism.
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Affiliation(s)
- Asaki Kumamoto
- Department of Psychiatry, Sekiaikai Yokohama Maioka Hospital, Yokohama, Japan
| | - Yuhei Chiba
- Department of Psychiatry, Sekiaikai Yokohama Maioka Hospital, Yokohama, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akihiko Kase
- Department of Psychiatry, Sekiaikai Yokohama Maioka Hospital, Yokohama, Japan
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Nishimura K, Fu Y, Suda A, Midorikawa K, Takahashi EJ. Apparatus for generation of nanojoule-class water-window high-order harmonics. Rev Sci Instrum 2021; 92:063001. [PMID: 34243496 DOI: 10.1063/5.0045342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
In our recent study [Fu et al., Commun. Phys. 3(1), 92 (2020)], we have developed an approach for energy-scaling of high-order harmonic generation in the water-window region under a neutral-medium condition. More specifically, we obtained a nanojoule-class water-window soft x-ray harmonic beam under a phase-matching condition. It has been achieved by combining a newly developed terawatt-class mid-infrared femtosecond laser and a loose-focusing geometry for high-order harmonic generation. The generated beam is more than 100 times intense compared to previously reported results. The experimental setup included two key parts: a terawatt mid-infrared femtosecond driving laser [Fu et al., Sci. Rep. 8(1), 7692 (2018)] and a specially designed gas cell. Despite the dramatic drop in the optimal gas pressure for phase-matching due to loose-focusing geometry, it still reached the 1 bar level for helium. Thus, we have designed a double-structured pulsed-gas cell with a differential pumping system, which enabled providing sufficiently high gas pressure. Moreover, it allowed reducing gas consumption significantly. A robust energy-scalable apparatus for high-order harmonic generation developed in this study will enable the generation of over ten-nanojoule water-window attosecond pulses in the near future.
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Affiliation(s)
- Kotaro Nishimura
- Extreme Photonics Research Group, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Yuxi Fu
- Extreme Photonics Research Group, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Akira Suda
- Department of Physics, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
| | - Katsumi Midorikawa
- Extreme Photonics Research Group, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Eiji J Takahashi
- Extreme Photonics Research Group, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Abstract
[Figure: see text].
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Affiliation(s)
- Shigeo Godo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (S.G., A.S., J.T., S.Y., H.S.)
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (S.G., A.S., J.T., S.Y., H.S.)
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (S.G., A.S., J.T., S.Y., H.S.)
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (S.G., A.S., J.T., S.Y., H.S.)
| | - Hiroaki Shimokawa
- Graduate School, International University of Health and Welfare, Narita, Japan (H.S.)
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Nakamura R, Asami T, Yoshimi A, Kato D, Fujita E, Takaishi M, Abe K, Hattori S, Suda A, Shiozaki K, Kase A, Hirayasu Y, Hishimoto A. Illness management and recovery program induced neuroprotective effects on language network in schizophrenia. Schizophr Res 2021; 230:101-103. [PMID: 32950322 DOI: 10.1016/j.schres.2020.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Ryota Nakamura
- Psychiatric Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.
| | - Takeshi Asami
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
| | - Asuka Yoshimi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Daiji Kato
- Totsuka Nishiguchi Rindou Clinic, Totsuka-cho, Totsuka-ku, Yokohama, Kanagawa 244-0003, Japan
| | - Emi Fujita
- Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Masao Takaishi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Kie Abe
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Saki Hattori
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Akira Suda
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Kazumasa Shiozaki
- Yokohama Comprehensive Care Continuum, 1735 Karasuyama-cho, Kouhoku-ku, Yokohama, Kanagawa 222-0035, Japan
| | - Akihiko Kase
- Yokohama Maioka Hospital, 3482 Maioka-cho, Totsuka-ku, Yokohama, Kanagawa 244-0813, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Hirayasu Hospital, 346 Kyouzuka, Urasoe, Okinawa 901-2553, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
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Hao K, Takahashi J, Kikuchi Y, Suda A, Sato K, Sugisawa J, Tsuchiya S, Shindo T, Nishimiya K, Ikeda S, Tsuburaya R, Shiroto T, Matsumoto Y, Miyata S, Sakata Y, Yasuda S, Shimokawa H. Prognostic Impacts of Comorbid Significant Coronary Stenosis and Coronary Artery Spasm in Patients With Stable Coronary Artery Disease. J Am Heart Assoc 2021; 10:e017831. [PMID: 33455423 PMCID: PMC7955295 DOI: 10.1161/jaha.120.017831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/05/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Stable coronary artery disease is caused by a variable combination of organic coronary stenosis and functional coronary abnormalities, such as coronary artery spasm. Thus, we examined the clinical importance of comorbid significant coronary stenosis and coronary spasm. METHODS AND RESULTS We enrolled 236 consecutive patients with suspected angina who underwent acetylcholine provocation testing for coronary spasm and fractional flow reserve (FFR) measurement. Among them, 175 patients were diagnosed as having vasospastic angina (VSA), whereas the remaining 61 had no VSA (non-VSA group). The patients with VSA were further divided into the following 3 groups based on angiography and FFR: no organic stenosis (≤50% luminal stenosis; VSA-alone group, n=110), insignificant stenosis of FFR>0.80 (high-FFR group, n=36), and significant stenosis of FFR≤0.80 (low-FFR group, n=29). The incidence of major adverse cardiovascular events, including cardiovascular death, nonfatal myocardial infarction, urgent percutaneous coronary intervention, and hospitalization attributed to unstable angina was evaluated. All patients with VSA received calcium channel blockers, and 28 patients (95%) in the low-FFR group underwent a planned percutaneous coronary intervention. During a median follow-up period of 656 days, although the incidence of major adverse cardiovascular events was low and comparable among non-VSA, VSA-alone, and high-FFR groups, the low-FFR group had an extremely poor prognosis (non-VSA group, 1.6%; VSA-alone group, 3.6%; high-FFR group, 5.6%; low-FFR group, 27.6%) (P<0.001). Importantly, all 8 patients with major adverse cardiovascular events in the low-FFR group were appropriately treated with percutaneous coronary intervention and calcium channel blockers. CONCLUSIONS These results indicate that patients with VSA with significant coronary stenosis represent a high-risk population despite current guideline-recommended therapies, suggesting the importance of routine coronary functional testing in this population.
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Affiliation(s)
- Kiyotaka Hao
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Jun Takahashi
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yoku Kikuchi
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Akira Suda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Koichi Sato
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Jun Sugisawa
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Tsuchiya
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Tomohiko Shindo
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Kensuke Nishimiya
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Shohei Ikeda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Ryuji Tsuburaya
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Takashi Shiroto
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yasuharu Matsumoto
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Miyata
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yasuhiko Sakata
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Yasuda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Hiroaki Shimokawa
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
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Ide K, Asami T, Suda A, Yoshimi A, Fujita J, Nomoto M, Roppongi T, Hino K, Takahashi Y, Watanabe K, Shimada T, Hamasaki T, Endo E, Kaneko T, Suzuki M, Kubota K, Saigusa Y, Kato H, Odawara T, Nakajima H, Takeuchi I, Goto T, Aihara M, Hishimoto A. The psychological effects of COVID-19 on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. PLoS One 2021; 16:e0245294. [PMID: 33428676 PMCID: PMC7799779 DOI: 10.1371/journal.pone.0245294] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/24/2020] [Indexed: 12/17/2022] Open
Abstract
The aim of the present study was to investigate the psychological effects of the COVID-19 outbreak and associated factors on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. This cross-sectional, survey-based study collected demographic data, mental health measurements, and stress-related questionnaires from workers in 2 hospitals in Yokohama, Japan, from March 23, 2020, to April 6, 2020. The prevalence rates of general psychological distress and event-related distress were assessed using the 12-item General Health Questionnaire (GHQ-12) and the 22-item Impact of Event Scale-Revised (IES-R), respectively. Exploratory factor analysis was conducted on the 26-item stress-related questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes for workers both at high- and low-risk for infection of COVID-19. A questionnaire was distributed to 4133 hospital workers, and 2697 (65.3%) valid questionnaires were used for analyses. Overall, 536 (20.0%) were high-risk workers, 944 (35.0%) of all hospital workers showed general distress, and 189 (7.0%) demonstrated event-related distress. Multivariable logistic regression analyses revealed that 'Feeling of being isolated and discriminated' was associated with both the general and event-related distress for both the high- and low-risk workers. In this survey, not only high-risk workers but also low-risk workers in the hospitals admitting COVID-19 patients reported experiencing psychological distress at the beginning of the outbreak.
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Affiliation(s)
- Keiko Ide
- Department of Psychiatry, Yokohama City University Hospital, Yokohama, Japan
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Health Management Office, Yokohama City University Hospital, Yokohama, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University Hospital, Yokohama, Japan
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University Hospital, Yokohama, Japan
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Yokohama City University Hospital, Yokohama, Japan
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Junichi Fujita
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Department of Child Psychiatry, Yokohama City University Hospital, Yokohama, Japan
| | - Munetaka Nomoto
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Psychiatric Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Tomohide Roppongi
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Psychiatric Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Kousuke Hino
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Advanced Emergency Medical Service Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Yuichi Takahashi
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
- Yokohama East Area Habilitation Center for Children, Yokohama, Japan
| | - Kaori Watanabe
- Nursing Department, Yokohama City University Hospital, Yokohama, Japan
| | - Tomoko Shimada
- Patient Care and Safety Management Department, Yokohama City University Hospital, Yokohama, Japan
| | - Toyoko Hamasaki
- Patient Care and Safety Management Department, Yokohama City University Hospital, Yokohama, Japan
| | - Emi Endo
- Nursing Department, Yokohama City University Medical Center, Yokohama, Japan
| | - Tomoko Kaneko
- Nursing Department, Yokohama City University Medical Center, Yokohama, Japan
| | - Michiko Suzuki
- Nursing Department, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazumi Kubota
- Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Japan
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | | | - Hideaki Nakajima
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Ichiro Takeuchi
- Advanced Emergency Medical Service Center, Yokohama City University Medical Center, Yokohama, Japan
- Advanced Critical Care Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Takahisa Goto
- Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Michiko Aihara
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Hospital, Yokohama, Japan
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
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Abe K, Chiba Y, Katsuse O, Takahashi Y, Suda A, Hattori S, Yoshimi R, Kirino Y, Kunii M, Yoshimi A, Asami T, Hishimoto A. Exploratory investigation on antibodies to GluN1 and cognitive dysfunction in patients with chronic autoimmune psychosis. Neurosci Lett 2020; 743:135588. [PMID: 33359543 DOI: 10.1016/j.neulet.2020.135588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/14/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Mild cognitive dysfunction has been implicated in a number of psychiatric diseases and affects social functioning. Although clinical criteria were recently proposed for autoimmune psychosis (AP), biomarkers have not yet been established for the severity and prognosis of cognitive dysfunction. We herein investigated the relationships between 3 types of serum antibodies and cognitive dysfunction in chronic psychiatric patients suspected of AP. METHODS We included 31 patients suspected of AP and obtained information on their clinical characteristics. Three types of autoantibodies (the anti-N-methyl-D-aspartate receptor (anti-NMDAR Ab), anti-N-terminal of GluN1 (anti-GluN1-NT Ab), and anti-thyroid antibodies) were evaluated in serum. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. We examined the relationships between serum autoantibodies and cognitive dysfunction in patients using multiple regression models. RESULTS Serum titers of anti-GluN1-NT Ab significantly contributed to the estimated score of working memory (B= -55.85, β= -0.46, p= 0.01), while no correlation was observed between the other 2 types of antibodies and cognitive function. CONCLUSIONS The present results indicate the potential of serum anti-GluN1-NT Ab as a biomarker for the severity and prognosis of cognitive dysfunction underlying various psychiatric symptoms in patients with AP. The pathological significance of anti-GluN1-NT Ab needs to be verified in future studies.
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Affiliation(s)
- Kie Abe
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yuhei Chiba
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Omi Katsuse
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan; Yokohama Hoyu Hospital 644 Kanegaya, Asahi-ku, Yokohama, 241-0812, Japan
| | - Yukitoshi Takahashi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders 886 Urushiyama, Aoi-ku, Shizuoka, 420-8688, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Saki Hattori
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Misako Kunii
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Saito T, Chiba Y, Abe K, Hattori S, Katsuse O, Takahashi Y, Suda A. An exploratory investigation of antibodies to NMDA-type glutamate receptor subunits in serum and cerebrospinal fluid among psychiatric patients with anti-thyroid antibodies. Heliyon 2020; 6:e05677. [PMID: 33319115 PMCID: PMC7725722 DOI: 10.1016/j.heliyon.2020.e05677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/16/2020] [Accepted: 12/03/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction Hashimoto's thyroiditis, which is characterized by anti-thyroid antibodies such as the anti-thyroglobulin (Tg) antibody and anti-thyroid peroxidase (TPO) antibody, is one of the autoimmune diseases associated with psychiatric illnesses. We previously reported a high prevalence of antibodies to N-terminals of N-methyl-D-aspartate (NMDA) type glutamate receptor (GluR) subunits (GluN1-NT and GluN2B-NT2) among psychiatric patients with anti-thyroid antibodies. However, it remains unclear whether the presence of anti-thyroid antibodies influences antibodies to GluN1-NT or GluN2B-NT2 among psychiatric patients. The present study aims to examine antibodies to GluN1-NT and GluN2B-NT2 in psychiatric patients with anti-thyroid antibodies (PPATs) and in those without (non-PPATs). Material and methods We recruited psychiatric inpatients aged 20–60 years. Patients were excluded if they had a history of neurological diseases, dementia, developmental disorders, tumors, or autoimmune diseases except autoimmune thyroiditis. The rest of the participants were divided into two groups according to the presence of serum anti-Tg and anti-TPO antibodies. We investigated serum and cerebrospinal fluid (CSF) antibodies to GluN1-NT and GluN2B-NT2 using an enzyme-linked immunosorbent assay (ELISA). Results We initially recruited seventy-three psychiatric inpatients. Forty-six patients were excluded because of the exclusion criteria. Eighteen PPATs and nine non-PPATs were ultimately enrolled. We also collected stored sera of eighteen healthy controls (HCs) who were age- and sex-matched with PPATs. The optical densities (ODs) of serum antibodies to GluN1-NT (p = 0.0020) and GluN2B-NT2 (p = 0.039) were significantly higher in PPATs than in HCs. The ODs of CSF antibodies to GluN1-NT (p = 0.030) and GluN2B-NT2 (p = 0.017) as well as the positive ratios of those antibodies were significantly higher in PPATs than in non-PPATs. Conclusion Our finding indicates that detecting anti-thyroid antibodies in psychiatric patients would be a clue to consider psychiatric conditions related to antibodies to GluN1-NT/GluN2B-NT2. Further studies focusing on the relationship between PPATs and antibodies to GluN1-NT/GluN2B-NT2 are needed.
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Affiliation(s)
- Tomoyuki Saito
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Yuhei Chiba
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Kie Abe
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Omi Katsuse
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Yukitoshi Takahashi
- Department of Pediatrics, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
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23
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Sugisawa J, Matsumoto Y, Takeuchi M, Suda A, Tsuchiya S, Ohyama K, Nishimiya K, Akizuki M, Sato K, Ohura S, Ota H, Ikeda S, Shindo T, Kikuchi Y, Hao K, Shiroto T, Takahashi J, Miyata S, Sakata Y, Takase K, Kohzuki M, Shimokawa H. Beneficial effects of exercise training on physical performance in patients with vasospastic angina. Int J Cardiol 2020; 328:14-21. [PMID: 33309635 DOI: 10.1016/j.ijcard.2020.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/04/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022]
Abstract
AIMS In vasospastic angina (VSA), coronary vasomotion abnormalities could develop not only in epicardial coronary arteries but also in coronary microvessels, where calcium channel blockers (CCBs) have limited efficacy. However, efficacy of exercise training for VSA remains to be elucidated. We thus aimed to examine whether vasodilator capacity of coronary microvessels is impaired in VSA patients, and if so, whether exercise exerts beneficial effects on the top of CCBs. METHODS We performed 2 clinical protocols. In the protocol 1, we measured myocardial blood flow (MBF) using adenosine-stress dynamic computed tomography perfusion (CTP) in 38 consecutive VSA patients and 17 non-VSA controls. In the protocol 2, we conducted randomized controlled trial, where 20 VSA patients were randomly assigned to either 3-month exercise training group (Exercise group) or Non-Exercise group (n= 10 each). RESULTS In the protocol 1, MBF on CTP was significantly decreased in the VSA group compared with the Non-VSA group (138 ± 6 vs 166 ± 10 ml/100 g/min, P = 0.02). In the protocol 2, exercise capacity was significantly increased in the Exercise group than in the Non-Exercise group (11.5 ± 0.5 to 15.4 ± 1.8 vs 12.6 ± 0.7 to 14.0 ± 0.8 ml/min/kg, P < 0.01). MBF was also significantly improved after 3 months only in the Exercise group (Exercise group, 145 ± 12 to 172 ± 8 ml/100 g/min, P < 0.04; Non-Exercise group, 143 ± 14 to 167 ± 8 ml/100 g/min, P = 0.11), although there were no significant between-group differences. CONCLUSIONS These results provide the first evidence that, in VSA patients, exercise training on the top of CCBs treatment may be useful to improve physical performance, although its effect on MBF may be minimal.
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Affiliation(s)
- Jun Sugisawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masashi Takeuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Tsuchiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuma Ohyama
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mina Akizuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shoko Ohura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shohei Ikeda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoku Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Suda A, Takahashi J, Beltrame JF, Berry C, Camici PG, Crea F, Escaned J, Ford T, Carlos Kaski J, Kiyooka T, Metha PK, Ong P, Ozaki Y, Pepine C, Rimoldi O, Safdar B, Sechtem U, Tsujita K, Yii E, Noel Bairey Merz C, Shimokawa H. International prospective cohort study of microvascular angina - Rationale and design. Int J Cardiol Heart Vasc 2020; 31:100630. [PMID: 32984497 PMCID: PMC7494778 DOI: 10.1016/j.ijcha.2020.100630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with signs and symptoms of myocardial ischemia and non-obstructive coronary artery disease (CAD) frequently have coronary functional abnormalities, including coronary microvascular dysfunction. Those with the latter are grouped under the term "microvascular angina" (MVA). Although diagnostic criteria exist for MVA, as recently proposed by our COVADIS (COronary VAsomotor Disorders International Study) group and the condition has been increasingly recognized in clinical practice, the clinical characteristics and long-term prognosis of MVA patients in the current era remain to be fully elucidated. AIMS In the present study, we aimed to prospectively assess the clinical characteristics and long-term prognosis of MVA subjects in the current era in an international, multicenter, observational, and prospective registry study. METHODS A total of 15 medical centers across 7 countries (USA, UK, Germany, Spain, Italy, Australia, and Japan) enrolled subjects fulfilling the COVADIS diagnostic criteria for MVA as follows; (1) signs and/or symptoms of myocardial ischemia, (2) absence of obstructive CAD, and (3) objective evidence of myocardial ischemia and/or coronary microvascular dysfunction. The primary endpoint was the composite of major cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospitalization due to heart failure or unstable angina. Between July 2015 and December 2018, a total of 706 subjects with MVA (M/F 256/450, 61.1 ± 11.8 [SD] yrs.) were registered. Subjects will be followed for at least 1 year. SUMMARY The present study will provide important information regarding the clinical characteristics, management, and long-term prognosis of MVA patients in the current era.
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Affiliation(s)
- Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - John F Beltrame
- The Discipline of Medicine, University of Adelaide, Basil Hetzel Institute, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Colin Berry
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom
| | - Paolo G Camici
- Vita Salute University and San Raffaele Hospital, Milan, Italy
| | - Filippo Crea
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Javier Escaned
- Department of Cardiology, Hospital Clínico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain
| | - Tom Ford
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom
| | - Juan Carlos Kaski
- Cardiovascular and Cell Sciences Research Institute, St George's, University of London, UK
| | - Takahiko Kiyooka
- Department of Cardiology, Tokai University Oiso Hospital, Oiso, Japan
| | - Puja K Metha
- Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Peter Ong
- Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Yukio Ozaki
- Department of Cardiology, Fujita Medical University, Toyonaka, Aichi, Japan
| | - Carl Pepine
- Division of Cardiovascular Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Ornella Rimoldi
- Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche, Segrate, Italy
| | - Basmah Safdar
- Department of Emergency Medicine, Yale University, New Haven, CT, USA
| | - Udo Sechtem
- Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eric Yii
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- International University of Health and Welfare, Narita, Japan
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Abe K, Chiba Y, Hattori S, Ide K, Yoshimi A, Suda A, Hishimoto A. Effect of matrix metalloproteinases on the longitudinal change in Alzheimer’s disease (AD) pathology and cognitive function in patients with mild cognitive impairment due to AD. Alzheimers Dement 2020. [DOI: 10.1002/alz.037123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kie Abe
- Yokohama City University School of Medicine Yokohama Japan
| | - Yuhei Chiba
- Yokohama City University School of Medicine Yokohama Japan
| | - Saki Hattori
- Yokohama City University School of Medicine Yokohama Japan
| | - Keiko Ide
- Yokohama City University School of Medicine Yokohama Japan
| | - Asuka Yoshimi
- Yokohama City University School of Medicine Yokohama Japan
| | - Akira Suda
- Yokohama City University School of Medicine Yokohama Japan
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26
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Nishimiya K, Suda A, Hao K, Takahashi J, Matsumoto Y, Satoh K, Sugisawa J, Shindo T, Godo S, Kikuchi Y, Shiroto T, Shimokawa H. Clinical implications of coronary artery morphology of patients with ischemia and non-obstructive coronary artery disease (INOCA) -An intracoronary OCT study-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Ischemia and non-obstructive coronary artery disease (INOCA), including microvascular spasm (MVS) and epicardial spasm, has recently attracted much attention, for which in vivo imaging evaluation for coronary artery morphology is warranted for better understanding of this disorder. Besides the improved diagnostic accuracy of optical coherence tomography (OCT) for coronary plaques, we have recently demonstrated its capability for in vivo visualization of coronary adventitial vasa vasorum (VV) and the enhanced VV formation in patients with epicardial spasm.
Purpose
We aimed to examine OCT-delineated morphological characteristics in patients with INOCA in vivo.
Methods
A total of 335 consecutive INOCA patients, who underwent pharmacological spasm provocation tests, lactate sampling, and OCT imaging over the entire length of the left anterior descending (LAD) coronary arteries, were enrolled at our institute over 68 months from April 2013. They were classified into 4 groups; control with non-cardiac chest pain, MVS, diffuse spasm (DS), or focal spasm (FS) (Fig. 1A). MVS was diagnosed when negative lactate extraction ratio (coronary orifice < coronary sinus) was detected despite the absence of epicardial spasm during the spasm provocation test. DS was defined as epicardial spasm induced in more than 2 coronary segments in LAD, and FS as epicardial spasm in one segment. Quantitative analyses for adventitial inflammation and atherosclerotic changes were performed by calculating VV density and %area stenosis (AS) on OCT (Fig. 1B, E). Furthermore, index of microcirculatory resistance (IMR), a marker of microvascular disorder with a cut-off value of ≥25, was measured during intravenous infusion of adenosine, which was then correlated with VV densities in the MVS and DS groups. Coronary plaque with a necrotic core was classified as fibroatheroma (FA), and the number of OCT frames with internal VV (IVV) in the atheroma was counted.
Results
VV density was significantly higher in MVS as compared with the controls (Fig. 1B). DS was most prevalent in INOCA (Fig. 1A) with highest VV density (Fig. 1B). Patients with IMR≥25 were predominantly distributed with a gradual increase in the MVS, DS, and FS groups, but none in the controls (Fig. 1C). Importantly, there was a significant positive correlation between VV densities and IMR in the MVS and DS groups (Fig. 1D). In addition, FS had the largest plaque size and showed the highest prevalence of FA and IVV (Fig. 1E–G).
Conclusions
These results indicate that MVS and DS are characterized by vasomotion abnormalities associated with adventitial inflammation and microvascular disorder, while FS by vulnerable atherosclerotic phenotype, suggesting that OCT may be useful for screening high-risk populations in INOCA.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Nishimiya
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Satoh
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Sugisawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Godo
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shiroto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
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Kurimoto R, Sakurai K, Motoori K, Suda A. A case of COVID‐19 with the atypical CT finding. Clin Case Rep 2020; 8:2306-2307. [PMID: 32837725 PMCID: PMC7405142 DOI: 10.1002/ccr3.3115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/20/2020] [Accepted: 06/13/2020] [Indexed: 11/11/2022] Open
Abstract
COVID‐19 usually demonstrates the specific pattern of chest CT findings (GGO, inverted‐halo sign, etc). However, some COVID‐19 cases show atypical CT findings. Physicians should make comprehensive judgments.
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Affiliation(s)
- Ryota Kurimoto
- Department of Systems BioMedicine Tokyo Medical and Dental University (TMDU) Tokyo Japan
- Department of Internal Medicine Tsudanuma Central General Hospital Narashino Japan
| | - Kenji Sakurai
- Department of Internal Medicine Tsudanuma Central General Hospital Narashino Japan
| | - Ken Motoori
- Department of Radiology Tsudanuma Central General Hospital Narashino Japan
| | - Akira Suda
- Department of Internal Medicine Tsudanuma Central General Hospital Narashino Japan
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28
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Abe K, Chiba Y, Hattori S, Tamazawa A, Yoshimi A, Katsuse O, Suda A. Influence of plasma cytokine levels on the conversion risk from MCI to dementia in the Alzheimer's disease neuroimaging initiative database. J Neurol Sci 2020; 414:116829. [PMID: 32289574 DOI: 10.1016/j.jns.2020.116829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 01/29/2023]
Affiliation(s)
- Kie Abe
- Yokohama City University, School of Medicine, Department of Psychiatry, Japan
| | - Yuhei Chiba
- Yokohama City University, School of Medicine, Department of Psychiatry, Japan.
| | - Saki Hattori
- Yokohama City University, School of Medicine, Department of Psychiatry, Japan
| | | | - Asuka Yoshimi
- Yokohama City University, School of Medicine, Department of Psychiatry, Japan
| | - Omi Katsuse
- Yokohama City University, School of Medicine, Department of Psychiatry, Japan
| | - Akira Suda
- Yokohama City University, School of Medicine, Department of Psychiatry, Japan
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29
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Abe K, Chiba Y, Hattori S, Yoshimi A, Asami T, Katsuse O, Suda A, Hishimoto A. Influence of plasma matrix metalloproteinase levels on longitudinal changes in Alzheimer's disease (AD) biomarkers and cognitive function in patients with mild cognitive impairment due to AD registered in the Alzheimer's Disease Neuroimaging Initiative database. J Neurol Sci 2020; 416:116989. [PMID: 32603972 DOI: 10.1016/j.jns.2020.116989] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/25/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The present study investigated the effects of plasma matrix metalloproteinases (MMPs) on longitudinal changes in Alzheimer's disease (AD)-related biomarkers in cerebrospinal fluid (CSF), brain atrophy, and cognitive function in patients with mild cognitive impairment due to AD (MCI-AD). METHODS We used data from the Alzheimer's Disease Neuroimaging Initiative database. We included 95 ApoE4-positive patients with MCI-AD who were confirmed to have low Aβ42 and/or high phosphorylated-tau (p-tau) in CSF. We obtained baseline demographic data, plasma MMP levels, including MMP-1, -2, -7, -9, -10, and tissue inhibitor of MMP-1 (TIMP-1), longitudinal annual data on Aβ42, total tau, and p-tau in CSF, MRI-measured hippocampal volumes, and cognitive function evaluated by the Mini-Mental State Examination (MMSE) and AD Assessment Scale-11 (ADAS-11) over 4 years. We examined the effects of baseline MMP levels on longitudinal changes in CSF AD biomarkers, hippocampal volumes, and cognitive function using a linear mixed regression analysis. RESULTS No significant differences were observed in baseline plasma MMP levels between MCI-AD patients and control subjects, except for MMP-10, which was significantly lower in MCI-AD than in controls. The baseline levels of MMPs did not correlate with longitudinal changes in CSF biomarkers. Declines in hippocampal volumes and cognitive function evaluated by MMSE and ADAS-11 were significantly faster in MCI-AD patients with high-MMP-9 levels at baseline than in those with middle and low MMP-9 levels at baseline. CONCLUSION High plasma MMP-9 levels in MCI-AD patients might enhance neurodegeneration and cognitive decline.
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Affiliation(s)
- Kie Abe
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | - Yuhei Chiba
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan.
| | - Saki Hattori
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | - Omi Katsuse
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
| | -
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan
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30
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Suda A, Takahashi J, Hao K, Kikuchi Y, Shindo T, Ikeda S, Sato K, Sugisawa J, Matsumoto Y, Miyata S, Sakata Y, Shimokawa H. Coronary Functional Abnormalities in Patients With Angina and Nonobstructive Coronary Artery Disease. J Am Coll Cardiol 2020; 74:2350-2360. [PMID: 31699275 DOI: 10.1016/j.jacc.2019.08.1056] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/20/2019] [Accepted: 08/26/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Approximately one-half of patients undergoing diagnostic coronary angiography for angina have no significant coronary stenosis, in whom coronary functional abnormalities could be involved. OBJECTIVES This study examined the significance of coronary functional abnormalities in a comprehensive manner for both epicardial and microvascular coronary arteries in patients with angina and nonobstructive coronary artery disease (CAD). METHODS This study prospectively enrolled 187 consecutive patients (male/female 113/74, 63.2 ± 12.3 years), who underwent acetylcholine provocation test for coronary spasm and measurement of index of microcirculatory resistance (IMR) to evaluate coronary microvascular function, and followed them for a median of 893 days. RESULTS Of all subjects, acetylcholine test identified 128 patients with vasospastic angina (VSA) (68%), and cardiac events occurred in 10 patients (5.3%) during the follow-up. Multivariable analysis revealed that IMR correlated with the incidence of cardiac events (hazard ratio: 1.05; 95% confidence interval: 1.02 to 1.09; p = 0.002) and receiver-operating characteristics (ROC) curve analysis identified IMR of 18.0 as the optimal cut-off value. Among the 4 groups based on the cut-off value of IMR and the presence of VSA, the Kaplan-Meier survival analysis showed a significantly worse prognosis in the group with high IMR (≥18.0) and VSA compared with other groups (log rank, p = 0.002). Importantly, intracoronary administration of fasudil, a Rho-kinase inhibitor, significantly ameliorated IMR in the VSA patients with increased IMR (p < 0.0001). CONCLUSIONS These results indicate that in patients with angina and nonobstructive CAD, coexistence of epicardial coronary spasm and increased microvascular resistance is associated with worse prognosis, for which Rho-kinase activation may be involved.
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Affiliation(s)
- Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoku Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shohei Ikeda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Sugisawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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31
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Xu L, Nishimura K, Suda A, Midorikawa K, Fu Y, Takahashi EJ. Optimization of a multi-TW few-cycle 1.7-µm source based on Type-I BBO dual-chirped optical parametric amplification. Opt Express 2020; 28:15138-15147. [PMID: 32403546 DOI: 10.1364/oe.392045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
This paper presents the optimization of a dual-chirped optical parametric amplification (DC-OPA) scheme for producing an ultrafast intense infrared (IR) pulse. By employing a total energy of 0.77 J Ti:sapphire pump laser and type-I BBO crystals, an IR pulse energy at the center wavelength of 1.7 µm exceeded 0.1 J using the optimized DC-OPA. By adjusting the injected seed spectrum and prism pair compressor with a gross throughput of over 70%, the 1.7-µm pulse was compressed to 31 fs, which resulted in a peak power of up to 2.3 TW. Based on the demonstration of the BBO type-I DC-OPA, we propose a novel OPA scheme called the "dual pump DC-OPA" for producing a high-energy IR pulse with a two-cycle duration.
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32
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Ohura-Kajitani S, Shiroto T, Godo S, Ikumi Y, Ito A, Tanaka S, Sato K, Sugisawa J, Tsuchiya S, Suda A, Shindo T, Ikeda S, Hao K, Kikuchi Y, Nochioka K, Matsumoto Y, Takahashi J, Miyata S, Shimokawa H. Marked Impairment of Endothelium-Dependent Digital Vasodilatations in Patients With Microvascular Angina. Arterioscler Thromb Vasc Biol 2020; 40:1400-1412. [DOI: 10.1161/atvbaha.119.313704] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective:
It remains to be elucidated whether and how endothelial functions are impaired in peripheral circulation of patients with coronary functional disorders, such as vasospastic angina (VSA) and microvascular angina (MVA). We simultaneously examined endothelial functions of peripheral conduit and resistance arteries in patients with coronary functional disorders, with a special reference to NO and endothelium-dependent hyperpolarization factors.
Approach and Results:
Based on the results of invasive coronary acetylcholine testing and coronary physiological measurements, we divided 43 patients into 3 groups; VSA, MVA, and VSA+MVA. Endothelium-dependent vasodilatations of the brachial artery and fingertip arterioles to intra-arterial infusion of bradykinin were simultaneously evaluated by ultrasonography and peripheral arterial tonometry, respectively. To assess NO and endothelium-dependent hyperpolarization factors, measurements were repeated after oral aspirin and intra-arterial infusion of N
G
-monomethyl-L-arginine. Additionally, endothelium-independent vasodilatations to sublingual nitroglycerin and plasma levels of biomarkers for endothelial functions were measured. Surprisingly, digital vasodilatations to bradykinin were almost absent in patients with MVA alone and those with VSA+MVA compared with those with VSA alone. Mechanistically, both NO- and endothelium-dependent hyperpolarization–mediated digital vasodilatations were markedly impaired in patients with MVA alone. In contrast, endothelium-independent vasodilatations to nitroglycerin were comparable among the 3 groups. Plasma levels of soluble VCAM (vascular cell adhesion molecule)-1 were significantly higher in patients with MVA alone compared with those with VSA alone.
Conclusions:
These results provide the first evidence that both NO- and endothelium-dependent hyperpolarization–mediated digital vasodilatations are markedly impaired in MVA patients, suggesting that MVA is a cardiac manifestation of the systemic small artery disease.
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Affiliation(s)
- Shoko Ohura-Kajitani
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shigeo Godo
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yosuke Ikumi
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiyo Ito
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shuhei Tanaka
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Sato
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Sugisawa
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Tsuchiya
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Suda
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shohei Ikeda
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyotaka Hao
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoku Kikuchi
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kotaro Nochioka
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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33
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Xue B, Tamaru Y, Fu Y, Yuan H, Lan P, Mücke OD, Suda A, Midorikawa K, Takahashi EJ. Fully stabilized multi-TW optical waveform synthesizer: Toward gigawatt isolated attosecond pulses. Sci Adv 2020; 6:eaay2802. [PMID: 32494595 PMCID: PMC7164932 DOI: 10.1126/sciadv.aay2802] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 01/22/2020] [Indexed: 05/25/2023]
Abstract
A stable 50-mJ three-channel optical waveform synthesizer is demonstrated and used to reproducibly generate a high-order harmonic supercontinuum in the soft x-ray region. This synthesizer is composed of pump pulses from a 10-Hz repetition-rate Ti:sapphire pump laser and signal and idler pulses from an infrared two-stage optical parametric amplifier driven by this pump laser. With full active stabilization of all relative time delays, relative phases, and the carrier-envelope phase, a shot-to-shot stable intense continuum harmonic spectrum is obtained around 60 eV with pulse energy above 0.24 μJ. The peak power of the soft x-ray continuum is evaluated to be beyond 1 GW with a 170-as transform limit duration. We found a characteristic delay dependence of the multicycle waveform synthesizer and established its control scheme. Compared with the one-color case, we experimentally observe an enhancement of the cutoff spectrum intensity by one to two orders of magnitude using three-color waveform synthesis.
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Affiliation(s)
- Bing Xue
- Attosecond Science Research Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 3510198, Japan
| | - Yuuki Tamaru
- Attosecond Science Research Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 3510198, Japan
- Department of Physics, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
| | - Yuxi Fu
- Attosecond Science Research Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 3510198, Japan
| | - Hua Yuan
- School of Physics and Wuhan National Laboratory of Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Pengfei Lan
- School of Physics and Wuhan National Laboratory of Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Oliver D. Mücke
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, 22607 Hamburg, Germany
| | - Akira Suda
- Department of Physics, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
| | - Katsumi Midorikawa
- Attosecond Science Research Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 3510198, Japan
| | - Eiji J. Takahashi
- Attosecond Science Research Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 3510198, Japan
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Hattori S, Suda A, Miyauchi M, Shiraishi Y, Saeki T, Fukushima T, Fujibayashi M, Tsujita N, Ishii C, Ishii N, Moritani T, Saigusa Y, Kishida I. The association of genetic polymorphisms in CYP1A2, UGT1A4, and ABCB1 with autonomic nervous system dysfunction in schizophrenia patients treated with olanzapine. BMC Psychiatry 2020; 20:72. [PMID: 32070304 PMCID: PMC7027321 DOI: 10.1186/s12888-020-02492-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Use of the antipsychotic drug olanzapine by patients with schizophrenia is associated with autonomic nervous system (ANS) dysfunction. It is presumed that there are interindividual differences in ANS dysfunction that correspond to pharmacogenetics. In this study, we investigated whether genetic polymorphisms in ABCB1, CYP1A2, and UGT1A4 are associated with this observed ANS dysfunction. METHODS A total of 91 schizophrenia patients treated with olanzapine monotherapy participated in this study. A power spectral analysis of heart rate variability was used to assess ANS activity. The TaqMan system was used to genotype seven single nucleotide polymorphisms (SNPs) in CYP1A2 (rs2069514 and rs762551), UGT1A4 (rs2011425), and ABCB1 (rs1045642, rs1128503, rs2032582, rs2235048). RESULTS Sympathetic nervous activity was significantly higher in individuals with the UGT1A4 rs2011425 G allele than in those with the UGT1A4 rs2011425 non-G allele (sympathetic activity, p = .001). Furthermore, sympathetic nervous activity was also significantly associated with UGT1A4 rs2011425 genotype as revealed by multiple regression analysis (sympathetic activity, p = .008). CONCLUSIONS We suggest that the UGT1A4 rs2011425 polymorphism affects olanzapine tolerability because it is associated with the observed side effects of olanzapine in schizophrenia patients, namely sympathetic dysfunction.
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Affiliation(s)
- Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Akira Suda
- grid.268441.d0000 0001 1033 6139Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Masatoshi Miyauchi
- grid.268441.d0000 0001 1033 6139Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Yohko Shiraishi
- grid.268441.d0000 0001 1033 6139Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Takashi Saeki
- grid.268441.d0000 0001 1033 6139Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan ,Asahinooka Hospital, 128-1 Kwaihonchou, Asahi-ku, Yokohama, Kanagawa 251-8530 Japan
| | - Tadashi Fukushima
- Asahinooka Hospital, 128-1 Kwaihonchou, Asahi-ku, Yokohama, Kanagawa 251-8530 Japan
| | - Mami Fujibayashi
- grid.412493.90000 0001 0454 7765Division of Physical and Health Education, Setsunan University, 17-8 Ikedanakamachi, Neyagawa, Osaka, 572-8508 Japan
| | - Natsuki Tsujita
- grid.258799.80000 0004 0372 2033Graduate School of Human and Environmental Studies, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, 606-8316 Japan
| | - Chie Ishii
- Fujisawa Hospital, 383 Kotuka Fujisawa, Kanagawa, 251-8530 Japan
| | - Norio Ishii
- Fujisawa Hospital, 383 Kotuka Fujisawa, Kanagawa, 251-8530 Japan
| | - Tosiho Moritani
- grid.258798.90000 0001 0674 6688Faculty of General Education, Kyoto Sangyo University, Kamo-motoyama, Kita-ku, Kyoto, 606-8555 Japan
| | - Yusuke Saigusa
- grid.268441.d0000 0001 1033 6139Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Ikuko Kishida
- grid.268441.d0000 0001 1033 6139Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan ,Fujisawa Hospital, 383 Kotuka Fujisawa, Kanagawa, 251-8530 Japan
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Kikuchi Y, Takahashi J, Hao K, Sato K, Sugisawa J, Tsuchiya S, Suda A, Shindo T, Ikeda S, Shiroto T, Matsumoto Y, Miyata S, Sakata Y, Shimokawa H. Usefulness of intracoronary administration of fasudil, a selective Rho-kinase inhibitor, for PCI-related refractory myocardial ischemia. Int J Cardiol 2019; 297:8-13. [PMID: 31611086 DOI: 10.1016/j.ijcard.2019.09.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/30/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Intra-procedural myocardial ischemia as an iatrogenic complication still remains a critical issue in contemporary interventional cardiology. The aim of this study was to examine the usefulness of fasudil, a selective Rho-kinase inhibitor, for percutaneous coronary intervention (PCI)-related myocardial ischemia. METHODS Among 448 PCI sessions performed between October 2015 and December 2017, we retrospectively examined 36 patients (69.0 ± 9.1 [SD] yrs., M/F 26/10) who underwent intracoronary administration of fasudil during a procedure to resolve myocardial ischemia that was resistant to intracoronary nitrate administration. RESULTS The refractory myocardial ischemia was caused by distal embolization (69%), enhanced vasoconstriction at distal site of chronic total occlusion (11%), coronary spasm (11%), and coronary dissection (8%), most of which occurred immediately after balloon or stent dilatation. Intracoronary fasudil significantly improved corrected TIMI frame count (from 37 [30-56] to 24 [12-36]) and TIMI flow grade (from 2 [1-2.5] to 3 [2-3]) (both P < 0.001). Finally, 86% of all subjects successfully obtained TIMI flow grade 3 at the end of the procedure. Intracoronary fasudil tended to be more effective in patients with an attenuated plaque detected by intravascular ultrasound. Importantly, among the 19 elective cases, fasudil successfully prevented 17 patients from developing post-procedure myocardial infarction. Although fasudil-induced transient hypotension requiring a vasopressor was noted in 22% of the subjects, no other adverse effects were noted. CONCLUSIONS These results indicate that fasudil is a useful and safe therapeutic option for PCI-related myocardial ischemia refractory intracoronary nitrate.
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Affiliation(s)
- Yoku Kikuchi
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyotaka Hao
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Sato
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Sugisawa
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Tsuchiya
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Suda
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shohei Ikeda
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Evidenced-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Evidenced-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Hao K, Takahashi J, Suda A, Sato K, Sugisawa J, Tsuchiya S, Shindo T, Ikeda S, Kikuchi Y, Shiroto T, Matsumoto Y, Sakata Y, Shimokawa H. P3575Clinical importance of fractional flow reserve in patients with organic coronary stenosis and vasospastic angina. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Vasospastic angina (VSA), which is one of the important functional cardiac disorders, may also play a role in the pathogenesis of atherosclerosis. Conversely, organic coronary stenosis is also known as an independent predictor for poor clinical outcomes in VSA patients. Although VSA patients have a variable degree of organic coronary stenosis in clinical setting, the functional importance of organic stenosis in those patients remains to be elucidated.
Purpose
The aim of this study was to examine the clinical importance and prognostic impact of fractional flow reserve (FFR) in patients with VSA and organic coronary stenosis.
Methods
We enrolled 236 consecutive patients with suspected vasospastic angina who underwent acetylcholine provocation test for coronary spasm (M/F 148/88, 63.6±12.0 [SD] yrs.). Among them, 175 patients (74.1%) were diagnosed as having VSA, while the remaining non-VSA patients were regarded as controls (Group-C, n=61). We divided the VSA patients into 3 groups based on angiographical findings and FFR values; VSA with no organic stenosis (>50% luminal stenosis) (Group-N, n=110), organic stenosis and high FFR (≥0.80) (Group-H, FFR 0.87±0.05, n=36), and organic stenosis and low FFR (<0.80) (Group-L, FFR 0.71±0.07, n=29). We evaluated the incidence of major adverse cardiovascular events (MACE), including cardiovascular death (CVD), non-fatal myocardial infarction (MI), urgent percutaneous coronary intervention (PCI), and hospitalization due to unstable angina pectoris (UAP) during the median follow-up period of 656 days.
Results
The groups with organic stenosis (Groups H and L) were characterized by higher prevalence of diabetes mellitus (Group-C/N/H/L, 23.0/20.9/44.4/34.5%, P=0.03) and dyslipidemia (Group-C/N/H/L, 37.7/39.1/50.0/65.5%, P=0.03) as compared with Group-C. After provocation test, all VSA patients received calcium channel blockers (CCBs). In addition, 20 days (median) after provocation test, 26 patients (92.9%) in Group-L underwent elective PCI with coronary stents, while no patient underwent PCI in Groups N or H. The incidence of MACE during follow-up was significantly higher in Group-L (Group-C/N/H/L; 1.6/3.6/5.6/27.6%, log-rank P<0.001), whereas clinical outcomes were comparable among the remaining 3 groups (Figure). Importantly, all 8 patients with MACE in Group-L had poor outcomes (CVD/MI/urgent PCI/UAP; 2/1/3/2) despite complete revascularization and the prevention of coronary spasm with CCBs, indicating that they might be resistant to standard contemporary therapies. They were characterized by less frequent use of angiotensin convert enzyme inhibitor (0 vs. 47.6%, P=0.02) and higher prevalence of multi-vessel organic lesions (37.5 vs. 4.8%, P=0.052) compared with those without MACE.
Figure 1
Conclusions
These results provide the first evidence that evaluation of coronary functional abnormalities with FFR is useful for making therapeutic strategies in VSA patients with organic coronary stenosis.
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Affiliation(s)
- K Hao
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sato
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Sugisawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Tsuchiya
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Shiroto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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Kajitani S, Shiroto T, Godo S, Ito A, Ikumi Y, Sugisawa J, Suda A, Shindo T, Ikeda S, Hao K, Kikuchi Y, Nochioka K, Matsumoto Y, Takahashi J, Shimokawa H. P4158Marked impairment of endothelium-dependent digital vasodilatations in patients with microvascular angina compared with those with vasospastic angina. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Nitric oxide (NO) and endothelium-dependent hyperpolarization (EDH) factor are the major endothelium-derived relaxing factors. NO plays an important role in conduit arteries, while the importance of EDH factor increases as the vessel size decrease in patients with microvascular angina (MVA) compared with those with vasospastic angina (VSA) remains to be fully elucidated.
Purpose
We evaluated the roles of NO and EDH factor in conduit (brachial) arteries and resistance (digital) arteries of the patients with MVA, VSA and comorbid MVA+VSA patients.
Methods
We enrolled 39 patients who underwent diagnostic cardiac catheterization and divided them into 3 groups based on acetylcholine (ACh) provocation test, index of microcirculation resistance (IMR), and coronary flow reserve (CFR); MVA (N=9, mean age 59.9±3.5 years), VSA (N=12, mean age 61.3±1.8 years), and comorbid MVA+VSA (N=18, mean age 64.0±2.2 years). Endothelium-dependent brachial and digital vasodilatations in response to intra-arterial infusion of bradykinin (BK, 25, 50, and 100 ng/min for 2 min) were simultaneously measured by ultrasonography and peripheral arterial tonometry, respectively. Measurements were repeated after oral administration of aspirin (486 mg) and intra-arterial infusion of NG-monomethyl-L-arginine (L-NMMA, 8μmol/min for 5 min) in order to inhibit the effects of vasodilator prostaglandins and NO, respectively. Finally, endothelium-independent brachial and digital vasodilatations in response to sublingual nitroglycerin (NTG, 0.3 mg) were measured in the same manner.
Results
In the brachial artery, dose-dependent vasodilatations to BK were comparable among the 3 groups, and L-NMMA equally attenuated the responses to BK (Figure 1). Endothelium-independent brachial vasodilatation in response to NTG was also comparable among the 3 groups. Surprisingly, dose-dependent digital vasodilatations to BK were almost absent in MVA patients compared with VSA or comorbid MVA+VSA group (Figure 2). Furthermore, the digital vasodilatations were unaffected by L-NMMA in VSA group, but were significantly reduced in comorbid MVA+VSA group (VSA, 16.8±15.1% vs. MVA+VSA, −0.23±6.2%, P<0.05), suggesting reduced EDH and compensatory role of NO in the latter group. In contrast, endothelium-independent digital vasodilatation in response to NTG was comparable among the 3 groups.
The main results of this study
Conclusions
These results provide the first evidence that endothelium-dependent digital vasodilatations (both NO and EDH factor) are markedly impaired in MVA patients compared with VSA or comorbid MVA+VSA patients, whereas the responses are comparable in the brachial artery among the 3 groups, suggesting the involvement of severe endothelial dysfunction in the pathogenesis of MVA.
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Affiliation(s)
- S Kajitani
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shiroto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Godo
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Ito
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Ikumi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Sugisawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
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Watanabe T, Matsumoto Y, Amamizu H, Morosawa S, Ohyama K, Nishimiya K, Shindo T, Suda A, Ikeda S, Kikuchi Y, Hao K, Shiroto T, Takahashi J, Shimokawa H. 2381Low-intensity pulsed ultrasound ameliorates DES-induced coronary adventitial inflammation and hyperconstricting responses in pigs in vivo - A novel non-invasive therapy for coronary inflammation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
We previously demonstrated that coronary adventitial inflammation plays important roles in the pathogenesis of coronary artery spasm, including drug-eluting stent (DES)-induced coronary hyperconstricting responses, in pigs and humans. Indeed, the coronary adventitia has recently attracted much attention as the important site for vascular inflammation. However, a direct therapeutic approach to the coronary adventitia remains to be developed. We have developed a non-invasive low-intensity pulsed ultrasound (LIPUS) therapy for angina, which exerts anti-inflammatory effects through improved coronary microcirculation.
Purpose
In this study, we aimed to examine whether our LIPUS therapy ameliorates DES-induced coronary hyperconstricting responses in pigs in vivo, and if so, what mechanisms are involved.
Methods
An everolimus-eluting stent (EES) was implanted into the left anterior descending (LAD) coronary artery in normal male pigs. They were randomly assigned to the LIPUS or the sham therapy groups. After EES implantation, in the LIPUS group, LIPUS (32 cycles, 193 mW/cm2) was applied to the heart at 3 different levels (proximal and distal stent edges and middle portion of the stent) through X-ray for 20 min at each level for every other day for 2 weeks (6 days in total) (Figs. 1A, 1B). The sham therapy group was treated in the same manner but without LIPUS. At 4 weeks after the procedure, we performed coronary angiography to examine coronary vasoconstricting responses to intracoronary serotonin in vivo. Finally, stented coronary vessels were harvested for immunohistochemistry of vasa vasorum, lymphatic vessels (LYVE-1), sympathetic nerve fibers (SNF), vascular inflammation (macrophages and IL-1β expression), Rho-kinase expression and activity as evaluated by phosphorylated myosin phosphatase target subunit-1 (pMYPT-1).
Results
Coronary vasoconstricting responses to intracoronary serotonin were significantly enhanced in the sham therapy group but were significantly suppressed in the LIPUS group at the DES edges in the LAD, whereas those responses were comparable at the non-DES implanted segments in the left circumflex (LCx) coronary arteries between the 2 groups. (Figs. 1C, 1D). Furthermore, in vivo lymph transport speed was significantly faster in the LIPUS group than in sham group (Figs. 1E–1G). Histological analysis showed that except vasa vasorum formation, the number of lymphatic vessels, adventitial inflammatory cells infiltration, Rho-kinase expression and activity were all significantly enhanced in the sham therapy group and were significantly suppressed in the LIPUS group (Figs. 1G–1K).
Figure 1
Conclusion
We were able to develop a non-invasive LIPUS therapy for coronary functional abnormalities caused by chronic adventitial inflammation in pigs in vivo, for which multiple beneficial effects appear to be involved (Fig. 1L).
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Affiliation(s)
- T Watanabe
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Amamizu
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Morosawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Ohyama
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Nishimiya
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shiroto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
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Sugisawa J, Matsumoto Y, Suda A, Ota H, Tsuchiya S, Ohyama K, Takeuchi M, Shindo T, Ikeda S, Hao K, Kikuchi Y, Takahashi J, Takase K, Kohzuki M, Shimokawa H. 3332Exercise training ameliorates vasodilator capacity of coronary microvessels in patients with vasospastic angina - A new therapeutic approach for the coronary functional disorder. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
We have recently demonstrated that coronary vasospasm could develop in both epicardial coronary arteries and intramuscular coronary microvessels in patients with vasospastic angina (VSA). However, it remains to be examined whether vasodilator capacity of coronary microvessels is impaired in VSA patients and if so, whether exercise training could ameliorate vasodilator capacity of coronary microvessels on the top of calcium channel blockers. The effectiveness of exercise training is established for organic coronary artery disease but remained to be examined for VSA.
Purpose
We thus examined whether vasodilator capacity of coronary microvessels is impaired in VSA patients without organic coronary stenosis using an adenosine-stress dynamic computed tomography perfusion (CTP) that can measure absolute value of myocardial blood flow (MBF). We also examined whether exercise training ameliorates not only vasodilator capacity of coronary microvessels but also exercise capacity and frequency of angina attack.
Methods
In the first protocol, we measured MBF using CTP in consecutive 32 VSA patients with acetylcholine-induced diffuse coronary spasm in the left anterior descending coronary arteries (LAD) and 12 non-VSA controls. In the second protocol, we conducted a randomized controlled trial (RCT; Exercise VSA trial, UMIN: ehz745.008423996), where 20 VSA patients were randomly assigned to either exercise group (Ex group: supervised exercise training session for 30-min using bicycle ergometer, once/week at the hospital and more than 3 times/week at home) or non-exercise group (Non-Ex group) (n=10 each) (Figure A). Before and 3 months after exercise training, we measured MBF with adenosine-stress dynamic CTP and peak VO2 by cardiopulmonary exercise tests, and also assessed angina attack with Seattle Angina Questionnaire (SAQ).
Results
In the first protocol, CTP showed that adenosine-stress MBF was significantly decreased in the VSA group compared with the non-VSA group (VSA, 137.2±6.6 vs. Non-VSA, 174.4±10.7 ml/100g/min, P<0.01) (Figure B), although patient characteristics were comparable between the 2 groups. In the second protocol, exercise training was performed safely in all patients, and RCT showed that MBF was significantly increased in the Ex group compared with the non-Ex group (Figures C, D), although patient characteristics were also comparable between the 2 groups. Furthermore, peak VO2 was significantly increased in the Ex group compared with the non-Ex group (Figure E), and frequency of angina was significantly decreased in the Ex group compared with the non-Ex group (Figure F). Finally, there was a significant positive correlation between the extents of the changes in peak VO2 and the SAQ score for angina frequency in the Ex group (P<0.01, R=0.67).
Figures
Conclusions
These results provide the first evidence that vasodilator capacity of coronary microvessels is impaired in VSA patients, which can be ameliorated by exercise training.
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Affiliation(s)
- J Sugisawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Ota
- Tohoku University Graduate School of Medicine, Department of Radiology, Sendai, Japan
| | - S Tsuchiya
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Ohyama
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - M Takeuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Takase
- Tohoku University Graduate School of Medicine, Department of Radiology, Sendai, Japan
| | - M Kohzuki
- Tohoku University Graduate School of Medicine, Department of Internal Medicine & Rehabilitation Science, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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40
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Suda A, Takahashi J, Hao K, Kikuchi Y, Shindo T, Ikeda S, Sato K, Sugisawa J, Matsumoto Y, Miyata S, Sakata Y, Shimokawa H. P4156Coexistence and prognostic impacts of epicardial and microvascular coronary dysfunctions in patients with chest pain and unobstructive coronary artery disease - Involvement of Rho-kinase activation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although the importance of coronary functional abnormalities has been emerging, including epicardial coronary spasm (vasospastic angina, VSA) and coronary microvascular dysfunction (CMD), comprehensive evaluation of the abnormalities in the same population remains to be examined.
Purpose
We examined the significance of coronary functional abnormalities in a comprehensive manner for both epicardial and microvascular coronary arteries in patients with chest pain and unobstructive coronary artery disease (CAD) as well as their prognostic impacts.
Methods and results
We prospectively enrolled 187 consecutive patients with suspected angina and unobstructive coronary arteries (M/F 113/74, 63.2±12.3 [SD] yrs.). We performed acetylcholine (ACh) provocation tests for coronary spasm, followed by functional tests for coronary microvascular function, including coronary flow reserve (CFR) and index of microcirculation resistance (IMR) during hyperemic state induced by intravenous adenosine. Among the 187 patients, ACh test identified 128 patients with VSA (68%). There was no significant difference in age, sex, or prevalence of traditional coronary risk factors between the non-VSA and the VSA groups. The median IMR value was significantly higher in the VSA group than in the non-VSA group [17.5 (12.0, 25.3) vs. 14.7 (10.7, 17.8), P=0.02], whereas CFR values were comparable between the 2 groups [2.51 (1.72, 3.35) vs. 2.66 (1.85, 3.64), P=0.34]. During the median follow-up period of 893 days, major adverse cardiac events (MACE), including cardiac death, non-fatal myocardial infarction, and hospitalization due to unstable angina pectoris, occurred in 10 patients (5.3%). Multivariable analysis revealed that IMR correlated with the incidence of MACE [hazard ratio (HR) (95% confidence interval), 1.05 (1.02–1.09), P=0.002] and receiver-operating characteristics curve analysis identified IMR of 18.0 as the optimal cut-off value for the incidence of cardiac events. When we divided the patients into the following 4 groups according to the cut-off value of IMR (>18) and the presence or absence of VSA; G1, IMR <18 without VSA (n=45); G2, IMR ≥18 without VSA (n=14); G3, IMR <18 with VSA (n=67); and G4, IMR ≥18 with VSA (n=61), the Kaplan-Meier survival analysis showed a significantly worse prognosis in G4 compared with other 3 groups (HR [95% CI] 6.23 [1.21–118.46], P=0.002) (Figure 1). Importantly, intracoronary administration of fasudil, a Rho-kinase inhibitor, significantly ameliorated IMR in G4 (P<0.0001) (Figure 2A), and %changes in IMR in response to intracoronary fasudil were more evident in G4 compared with other 3 groups (P<0.0001) (Figure 2B).
Conclusions
These results provide the first evidence that in patients with chest pain and unobstructive CAD, epicardial coronary spasm and increased microvascular resistance are frequently coexisted with worse long-term prognosis, for which Rho-kinase activationmay be involved.
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Affiliation(s)
- A Suda
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - K Sato
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - J Sugisawa
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - S Miyata
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
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Tsuchiya S, Matsumoto Y, Doman T, Fujiya T, Sugisawa J, Suda A, Sato K, Ikeda S, Shindo T, Kikuchi Y, Hao K, Takahashi J, Hatta W, Koike T, Masamune A, Saiki Y, Horiuchi H, Shimokawa H. Disappearance of Angiodysplasia Following Transcatheter Aortic Valve Implantation in a Patient with Heyde's Syndrome: A Case Report and Review of the Literature. J Atheroscler Thromb 2019; 27:271-277. [PMID: 31378751 PMCID: PMC7113142 DOI: 10.5551/jat.49239] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
An 83-year-old woman with severe aortic stenosis was admitted to our hospital due to heart failure with refractory anemia requiring blood transfusions. She had repetitive bleeding episodes from endoscopically proven angiodysplasia in the stomach. Moreover, she repeatedly underwent endoscopic argon plasma coagulation for hemostasis. Importantly, she had a deficiency of the high-molecular-weight (HMW) multimers of von Willebrand factor (VWF), and she was diagnosed with Heyde's syndrome.After she underwent transcatheter aortic valve implantation (TAVI), aortic valve area and mean left ventricular aorta pressure gradient improved. Notably, endoscopy showed cessation of bleeding at 10 days after TAVI and the disappearance of angiodysplasia at 4 months after TAVI. Even at 2 years after TAVI, follow-up endoscopy showed remaining free of angiodysplasia in the stomach. She experienced no episodes of anemia since TAVI procedure. Additionally, analysis of HMW multimers demonstrated immediate and lasting recovery after TAVI.Recovery of HMW multimers of VWF with cessation of gastrointestinal bleeding following aortic valve replacement has been previously reported in a patient diagnosed with Heyde's syndrome. To the best our knowledge, this is the first case to demonstrate that angiodysplasia disappears after TAVI for a long term with endoscopic images in a patient with Heyde's syndrome. Here, we summarized case reports of patients with Heyde's syndrome that required aortic valve intervention. Cessation of gastrointestinal bleeding and anemia after aortic valve intervention for severe aortic stenosis may be attributed not only to recovery of HMW multimers of VWF but also to the disappearance of angiodysplasia.
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Affiliation(s)
- Satoshi Tsuchiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tsuyoshi Doman
- Department of Molecular and Cellular Biology, Institute of Development, Aging, and Cancer, Tohoku University
| | - Taku Fujiya
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Jun Sugisawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Koichi Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Shohei Ikeda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yoku Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Waku Hatta
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Tomoyuki Koike
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Atsushi Masamune
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate school of Medicine
| | - Hisanori Horiuchi
- Department of Molecular and Cellular Biology, Institute of Development, Aging, and Cancer, Tohoku University
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Hattori S, Kishida I, Suda A, Kawanishi C, Miyauchi M, Shiraishi Y, Fujibayashi M, Tsujita N, Ishii C, Moritani T, Saigusa Y, Hirayasu Y. A return to work program improves parasympathetic activity and psychiatric symptoms in workers on sick leave due to depression. Heliyon 2019; 5:e02151. [PMID: 31384687 PMCID: PMC6661392 DOI: 10.1016/j.heliyon.2019.e02151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/21/2019] [Accepted: 07/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background People with depression have autonomic function disturbances. In Japan, workers who take leave due to depression often undergo a work-focused intervention program called the return to work (RTW) program at a mental health hospital during their leave of absence. However, its biological efficacy remains unclear. We investigated the biological efficacy of the RTW program, including changes in autonomic nervous system (ANS) activity, in workers on sick leave due to depression in Japan. Methods The study involved 104 workers on sick leave due to major depressive disorder or bipolar disorder who underwent the RTW program for 3 months in Yokohama City University Hospital. The ANS activity of all patients was evaluated using heart rate variability at the beginning and end of the 3-month RTW program. Psychiatric symptoms were evaluated using the Montgomery-Åsberg Depression Rating Scale-Japanese (MADRS-J) and Social Adaptation Self-evaluation Scale (SASS). We followed up 3 months after the end of the program and investigated the association between the success in returning to work within 3 months after the end of the RTW program and several factors, including ANS activity, depressive symptoms, and demographic factors. Results Parasympathetic activity was significantly higher and depressive symptom severity was significantly lower at program end than at baseline. Logistic regression analysis showed that the change in depressive symptoms was significantly associated with success in returning to work. Conclusion We suggest that the RTW program improves parasympathetic activity as well as psychiatric symptoms. ANS activity was not a predictor of a successful return to work within 3 months after the end of the program in workers on sick leave due to depression, but further studies with a larger sample size are needed.
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Affiliation(s)
- Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Ikuko Kishida
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa, 251-8530, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine, S-1, W-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masatoshi Miyauchi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yohko Shiraishi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Mami Fujibayashi
- Division of Physical and Health Education, Setsunan University, 17-8 Ikedanakamachi, Neyagawa, Osaka, 572-8508, Japan
| | - Natsuki Tsujita
- Graduate School of Human and Environmental Studies, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, 606-8316, Japan
| | - Chie Ishii
- Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa, 251-8530, Japan
| | - Toshio Moritani
- Faculty of General Education, Kyoto Sangyo University, Kamo-motoyama, Kita-ku, Kyoto, 606-8555, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Hirayasu Hospital, 346 Kyozuka, Urasoe, Okinawa, 901-2553, Japan
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Ohyama K, Matsumoto Y, Takanami K, Ota H, Nishimiya K, Sugisawa J, Tsuchiya S, Amamizu H, Uzuka H, Suda A, Shindo T, Kikuchi Y, Hao K, Tsuburaya R, Takahashi J, Miyata S, Sakata Y, Takase K, Shimokawa H. Coronary Adventitial and Perivascular Adipose Tissue Inflammation in Patients With Vasospastic Angina. J Am Coll Cardiol 2019; 71:414-425. [PMID: 29389358 DOI: 10.1016/j.jacc.2017.11.046] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/22/2017] [Accepted: 11/11/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent studies suggested that perivascular components, such as perivascular adipose tissue (PVAT) and adventitial vasa vasorum (VV), play an important role as a source of various inflammatory mediators in cardiovascular disease. OBJECTIVES The authors tested their hypothesis that coronary artery spasm is associated with perivascular inflammation in patients with vasospastic angina (VSA) using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). METHODS This study prospectively examined 27 consecutive VSA patients with acetylcholine-induced diffuse spasm in the left anterior descending artery (LAD) and 13 subjects with suspected angina but without organic coronary lesions or coronary spasm. Using CT coronary angiography and electrocardiogram-gated 18F-FDG PET/CT, coronary PVAT volume and coronary perivascular FDG uptake in the LAD were examined. In addition, adventitial VV formation in the LAD was examined with optical coherence tomography, and Rho-kinase activity was measured in circulating leukocytes. RESULTS Patient characteristics were comparable between the 2 groups. CT coronary angiography and ECG-gated 18F-FDG PET/CT showed that coronary PVAT volume and coronary perivascular FDG uptake significantly increased in the VSA group compared with the non-VSA group. Furthermore, optical coherence tomography showed that adventitial VV formation significantly increased in the VSA group compared with the non-VSA group, as did Rho-kinase activity. Importantly, during the follow-up period with medical treatment, both coronary perivascular FDG uptake and Rho-kinase activity significantly decreased in the VSA group. CONCLUSIONS These results provide the first evidence that coronary spasm is associated with inflammation of coronary adventitia and PVAT, where 18F-FDG PET/CT could be useful for disease activity assessment. (Morphological and Functional Change of Coronary Perivascular Adipose Tissue in Vasospastic Angina [ADIPO-VSA Trial]; UMIN000016675).
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Affiliation(s)
- Kazuma Ohyama
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kentaro Takanami
- Department of Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Ota
- Department of Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Sugisawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Tsuchiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirokazu Amamizu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hironori Uzuka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoku Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryuji Tsuburaya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Department of Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Nishimura K, Fu Y, Suda A, Midorikawa K, Eiji JT. Generation of high-flux soft X-ray high harmonics driven by loosely focused TW-class infrared pulses. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920502012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We develop an experimental strategy for generating high-flux soft x-ray high-order harmonics (HH) driven by loosely focused high-energy infrared femtosecond pulses. Strong soft x-ray HHs are generated in a long Ne medium.
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Fu Y, Nishimura K, Xue B, Suda A, Midorikawa K, Eiji J. T. High-energy mid-infrared femtosecond pulses at 3.3 μm directly generated by dual-chirped optical parametric amplification. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920501008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
By employing a dual-chirped optical parametric amplification (DC-OPA) using MgO:LiNbO3 crystals, we generate 31 mJ mid-infrared (MIR) pulses at 3.3 um with a repetition rate of 10 Hz. After passing through a CaF2 bulk compressor which has 70% throughput efficiency, these MIR pulses are compressed to 70 fs (6.3 optical cycles), which is close to the transform-limited duration of 66 fs. Thus, the peak power is evaluated to be 0.3 TW. Our results present notable progress in the generation of high-energy MIR pulses and prove that DC-OPA is a superior method for efficiently generating MIR pulses with few-cycle duration and TW-class peak power.
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Hattori S, Suda A, Kishida I, Miyauchi M, Shiraishi Y, Fujibayashi M, Tsujita N, Ishii C, Ishii N, Moritani T, Saigusa Y, Hirayasu Y. Association between dysfunction of autonomic nervous system activity and mortality in schizophrenia. Compr Psychiatry 2018; 86:119-122. [PMID: 30118994 DOI: 10.1016/j.comppsych.2018.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/31/2018] [Accepted: 08/07/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Patients with schizophrenia have a higher mortality risk than the general population. Additionally, the autonomic nervous system (ANS) activity of patients with schizophrenia is lower and more dysfunctional than that of the general population. Nonetheless, the association between ANS dysfunction and mortality in schizophrenia is unclear. The aim of this study was to investigate the association between ANS activity and mortality in schizophrenia and to evaluate the predictive values of heart rate variability for long-term survival. METHODS This study involves the 10-year follow-up of a sample population consisting of 59 Japanese inpatients with schizophrenia between 60 and 70 years of age from 2007 to 2016. The ANS activity of all patients was evaluated using heart rate variability in 2007. RESULTS Fifty-three participants could be followed up because they stayed in the hospital during the follow-up period. Of these patients, 11 died during follow-up. Their mean age at death was 70.55 ± 3.45 years. The parasympathetic activity of nonsurvivors was significantly lower than that of survivors, and multiple logistic regression analysis showed a significant association between death and parasympathetic activity. CONCLUSION We suggest that decreased parasympathetic activity could be associated with 10-year all-cause mortality in older schizophrenic patients.
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Affiliation(s)
- Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
| | - Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Ikuko Kishida
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa 251-8530, Japan
| | - Masatoshi Miyauchi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Yohko Shiraishi
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Mami Fujibayashi
- Division of Physical and Health Education, Setsunan University, 17-8 Ikedanakamachi, Neyagawa, Osaka 572-8508, Japan
| | - Natsuki Tsujita
- Graduate School of Human and Environmental Studies, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto 606-8316, Japan
| | - Chie Ishii
- Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa 251-8530, Japan
| | - Norio Ishii
- Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa 251-8530, Japan
| | - Toshio Moritani
- Faculty of General Education, Kyoto Sangyo University, Kamo-motoyama, Kita-ku, Kyoto 606-8555, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Hirayasu Hospital, 346 Kyozuka, Urasoe, Okinawa 901-2553, Japan
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Suda A, Hattori S, Kishida I, Miyauchi M, Shiraishi Y, Fujibayashi M, Tsujita N, Ishii C, Ishii N, Moritani T, Hirayasu Y. Effects of long-acting injectable antipsychotics versus oral antipsychotics on autonomic nervous system activity in schizophrenic patients. Neuropsychiatr Dis Treat 2018; 14:2361-2366. [PMID: 30271152 PMCID: PMC6149934 DOI: 10.2147/ndt.s173617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Long-acting injections (LAIs) of antipsychotics show distinct pharmacokinetic profiles from oral antipsychotics (OAPs). Although there may be differences in adverse event frequency, any differences in their effects on autonomic nervous system (ANS) remain unclear. PATIENTS AND METHODS In total, 270 schizophrenic patients were recruited in this study: 241 received OAPs (risperidone, olanzapine, quetiapine, or aripiprazole) and 29 received LAIs (risperidone LAI, aripiprazole LAI, or paliperidone palmitate) as monotherapy. Heart rate variability was measured as an index of ANS activity, and the low-frequency (0.03-0.15 Hz) component, high-frequency (0.15-0.40 Hz) component, and total power (0.03-0.40 Hz) were calculated. Components were compared between the groups using t-tests. RESULTS A significant difference was detected in the low-frequency component between the OAP and LAI groups (P=0.046). No significant difference was found in total power or the high-frequency component between the two groups. CONCLUSION Compared with OAPs, LAIs have fewer adverse effects on ANS activity, particularly the low-frequency component, as determined using a spectral analysis of heart rate variability.
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Affiliation(s)
- Akira Suda
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama,
| | - Saki Hattori
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama,
| | - Ikuko Kishida
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama,
- Department of Psychiatry, Fujisawa Hospital, Kanagawa
| | - Masatoshi Miyauchi
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama,
| | - Yohko Shiraishi
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama,
| | - Mami Fujibayashi
- Division of Physical and Health Education, Setsunan University, Osaka
| | - Natsuki Tsujita
- Graduate School of Human and Environmental Studies, Kyoto University
| | - Chie Ishii
- Department of Psychiatry, Fujisawa Hospital, Kanagawa
| | - Norio Ishii
- Department of Psychiatry, Fujisawa Hospital, Kanagawa
| | - Toshio Moritani
- Department of Health and Sports Sociology, Faculty of General Education, Kyoto Sangyo University, Kyoto
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama,
- Department of Psychiatry, Hirayasu Hospital, Okinawa, Japan
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48
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Hao K, Takahashi J, Suda A, Sato K, Sugisawa J, Tsuchiya S, Sindo T, Ikeda S, Kikuchi Y, Matsumoto Y, Sakata Y, Shimokawa H. P4628Clinical significance of fractional flow reserve in patients with vasospastic angina and organic coronary stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Hao
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sato
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Sugisawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Tsuchiya
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Sindo
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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Suda A, Takahashi J, Hao K, Kikuchi Y, Shindo T, Sato K, Sugisawa J, Matsumoto Y, Miyata S, Sakata Y, Shimokawa H. 1345Prognostic impacts of impaired coronary vasodilatation and enhanced coronary vasoconstricting responses in patients with angina and unobstructive coronary arteries. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Suda
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - K Sato
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - J Sugisawa
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - S Miyata
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Cardiovascular medicine, Sendai, Japan
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Kikuchi Y, Takahashi J, Sato K, Sugisawa J, Tsuchiya S, Suda A, Shindo T, Ikeda S, Hao K, Shiroto T, Matsumoto Y, Sakata Y, Shimokawa H. P793Usefulness and safety of fasudil, a selective Rho-kinase inhibitor, for PCI-related myocardial ischemia in interventional cardiology. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Sugisawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Tsuchiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Ikeda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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