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Ikeda T, Komiyama H, Miyakuni T, Takano M, Asai K. Exploring Possible Links: Thigh Muscle Mass, Apolipoproteins, and Glucose Metabolism in Peripheral Artery Disease-Insights from a Pilot Sub-Study following Endovascular Treatment. Metabolites 2024; 14:192. [PMID: 38668320 PMCID: PMC11052193 DOI: 10.3390/metabo14040192] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Peripheral artery disease (PAD) compromises walking and physical activity, which results in further loss of skeletal muscle. The cross-sectional area of the thigh muscle has been shown to be correlated with systemic skeletal muscle volume. In our previous pilot study, we observed an increase in thigh muscle mass following endovascular treatment (EVT) in patients with proximal vascular lesions affecting the aortoiliac and femoropopliteal arteries. Considering the potential interactions between skeletal muscle, lipid profile, and glucose metabolism, we aimed to investigate the relationship between thigh muscle mass and apolipoproteins as well as glucose metabolism in PAD patients undergoing EVT. This study is a prespecified sub-study conducted as part of a pilot study. We prospectively enrolled 22 symptomatic patients with peripheral artery disease (PAD) and above-the-knee lesions, specifically involving the blood vessels supplying the thigh muscle. The mid-thigh muscle area was measured with computed tomography before and 6 months after undergoing EVT. Concurrently, we measured levels of apolipoproteins A1 (Apo A1) and B (Apo B), fasting blood glucose, 2 h post-load blood glucose (using a 75 g oral glucose tolerance test), and glycated hemoglobin A1c (HbA1c). Changes in thigh muscle area (delta muscle area: 2.5 ± 8.1 cm2) did not show significant correlations with changes in Apo A1, Apo B, fasting glucose, 2 h post-oral glucose tolerance test blood glucose, HbA1c, or Rutherford classification. However, among patients who experienced an increase in thigh muscle area following EVT (delta muscle area: 8.41 ± 5.93 cm2), there was a significant increase in Apo A1 (pre: 121.8 ± 15.1 mg/dL, 6 months: 136.5 ± 19.5 mg/dL, p < 0.001), while Apo B remained unchanged (pre: 76.4 ± 19.2 mg/dL, 6 months: 80.5 ± 4.9 mg/dL). Additionally, post-oral glucose tolerance test 2 h blood glucose levels showed a decrease (pre: 189.7 ± 67.5 mg/dL, 6 months: 170.6 ± 69.7 mg/dL, p = 0.075). Patients who exhibited an increase in thigh muscle area demonstrated more favorable metabolic changes compared to those with a decrease in thigh muscle area (delta muscle area: -4.67 ± 2.41 cm2). This pilot sub-study provides insights into the effects of EVT on thigh muscle, apolipoproteins, and glucose metabolism in patients with PAD and above-the-knee lesions. Further studies are warranted to validate these findings and establish their clinical significance. The trial was registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000047534).
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Affiliation(s)
- Takeshi Ikeda
- Cardiovascular Medicine, Nippon Medical School, Tokyo 113-8603, Japan; (T.I.); (K.A.)
| | - Hidenori Komiyama
- Cardiovascular Medicine, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan
| | - Tomoyo Miyakuni
- Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba 270-1613, Japan; (T.M.)
| | - Masamichi Takano
- Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba 270-1613, Japan; (T.M.)
| | - Kuniya Asai
- Cardiovascular Medicine, Nippon Medical School, Tokyo 113-8603, Japan; (T.I.); (K.A.)
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Komiyama H, Abe T, Ando T, Ishikawa M, Tanaka S, Ishihara S, Inoue Y, Jujo K, Hamatani T, Matsukage T. Analyzing drilling noise in rotational atherectomy: Improving safety and effectiveness through visualization and anomaly detection using autoencoder-A preclinical study. Health Sci Rep 2023; 6:e1739. [PMID: 38033711 PMCID: PMC10684982 DOI: 10.1002/hsr2.1739] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Background and Aims As the population of aging societies continues to grow, the prevalence of complex coronary artery diseases, including calcification, is expected to increase. Rotational atherectomy (RA) is an essential technique for treating calcified lesions. This study aimed to assess the usefulness of the drilling noise produced during rotablation as a parameter for evaluating the safety and effectiveness of the procedure. Methods A human body model mimicking calcified stenotic coronary lesions was constructed using plastic resin, and burrs of sizes 1.25 and 1.5 mm were utilized. To identify the noise source during rotablation, we activated the ROTAPRO™ rotablator at a rotational speed of 180,000 rpm, recording the noise near the burr (inside the mock model) and advancer (outside). In addition to regular operation, we simulated two major complications: burr entrapment and guidewire transection. The drilling noise recorded in Waveform Audio File Format files was converted into spectrograms for analysis and an autoencoder analyzed the image data for anomalies. Results The drilling noise from both inside and outside the mock model was predominantly within the 3000 Hz frequency domain. During standard operation, intermittent noise within this range was observed. However, during simulated complications, there were noticeable changes: a drop to 2000 Hz during burr entrapment and a distinct squealing noise during guidewire transection. The autoencoder effectively reduced the spectrogram data into a two-dimensional representation suitable for anomaly detection in potential clinical applications. Conclusion By analyzing drilling noise, the evaluation of procedural safety and efficacy during RA can be enhanced.
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Affiliation(s)
- Hidenori Komiyama
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Takuro Abe
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Toshiyuki Ando
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Masahiro Ishikawa
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Shinji Tanaka
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Shiro Ishihara
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Yoshiro Inoue
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | - Kentaro Jujo
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
| | | | - Takashi Matsukage
- Department of Cardiology, Saitama Medical CenterSaitama Medical UniversityKawagoeshiJapan
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Komiyama H, Matsukage T. Debating the State-of-the-Art CTO PCI: Is There Still Room for Discussion? JACC Case Rep 2023; 19:101949. [PMID: 37593591 PMCID: PMC10429723 DOI: 10.1016/j.jaccas.2023.101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Hidenori Komiyama
- Department of Cardiology, Saitama Medical University/Saitama Medical Center, Saitama, Japan
| | - Takashi Matsukage
- Department of Cardiology, Saitama Medical University/Saitama Medical Center, Saitama, Japan
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Fukuizumi I, Tokita Y, Shiomura R, Noma S, Matsuda J, Sangen H, Kubota Y, Komiyama H, Nakata J, Miyachi H, Tara S, Shimizu W, Yamamoto T, Takano H. Angioscopic findings 1 year after percutaneous coronary intervention for chronic total occlusion. J Cardiol 2023; 81:91-96. [PMID: 36057486 DOI: 10.1016/j.jjcc.2022.08.008] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chronic total occlusion (CTO) is a high-risk factor for stent thrombosis, but little is known about the difference in neointimal healing between CTO and non-CTO lesions regarding implanted stents. We investigated factors affecting neointimal healing after stent implantation for CTO and non-CTO lesions using angioscopy. METHODS We retrospectively evaluated 106 stents in 85 consecutive patients between March 2016 and July 2020. Their average age was 68 ± 11 years, and participants (73 male and 12 female) underwent follow-up angiography and angioscopy 1 year after percutaneous coronary intervention (PCI). The stents (n = 106) were divided into three groups according to the lesion status at the previous PCI: CTO (n = 17), acute coronary syndrome (ACS) (n = 35), and stable coronary artery disease without CTO or non-CTO (n = 54). RESULTS The neointimal stent coverage grade was significantly lower in the CTO and ACS groups than in the non-CTO group (0.4 ± 0.5, 0.9 ± 0.8, and 1.4 ± 0.8, respectively, p < 0.001). Thrombi were significantly more frequent in CTO and ACS than in non-CTO (71 %, 51 %, and 15 %, respectively, p < 0.001). The yellow grade in CTO was comparable to that in ACS but significantly higher in CTO than in non-CTO (CTO vs. ACS vs. non-CTO 1.5 ± 0.7, 1.4 ± 0.6, and 0.9 ± 0.7, respectively, p = 0.007). CONCLUSIONS Delayed healing occurs in stents implanted for CTO lesions. Longer dual-antithrombotic therapy may be beneficial.
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Affiliation(s)
- Isamu Fukuizumi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yukichi Tokita
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
| | - Reiko Shiomura
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Satsuki Noma
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Junya Matsuda
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hideto Sangen
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshiaki Kubota
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hidenori Komiyama
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Nakata
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hideki Miyachi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Shuhei Tara
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Takeshi Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hitoshi Takano
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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Watanabe Y, Akutsu K, Yasui D, Sugihara F, Miyachi H, Hayashi H, Oka E, Komiyama H, Kumita SI, Shimizu W. Successful Prophylactic Endovascular Therapy for a Rapidly Expanding Hepatic Arterial Aneurysm in a Patient with Vascular Ehlers-Danlos Syndrome. Ann Vasc Dis 2021; 14:163-167. [PMID: 34239643 PMCID: PMC8241546 DOI: 10.3400/avd.cr.20-00144] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/11/2021] [Indexed: 11/24/2022] Open
Abstract
Vascular Ehlers–Danlos syndrome (vEDS) causes fatal vascular complications due to vascular fragility. However, invasive therapeutic procedures are generally avoided except in emergencies. We report a case of vEDS presenting with rapid expansion of a hepatic arterial aneurysm successfully treated using prophylactic endovascular therapy. A 43-year-old woman with vEDS confirmed by genetic testing was hospitalized for a symptomatic hepatic arterial aneurysm that expanded rapidly within a week. Prophylactic coil embolization was then successfully performed. Although the general applicability of this approach cannot be determined, prophylactic endovascular therapy can clearly be an option for arterial aneurysms at high risk of rupture.
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Affiliation(s)
- Yukihiro Watanabe
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Koichi Akutsu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Hideki Miyachi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Eiichiro Oka
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hidenori Komiyama
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | | | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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Chichareon P, Modolo R, Kerkmeijer L, Tomaniak M, Kogame N, Takahashi K, Chang CC, Komiyama H, Moccetti T, Talwar S, Colombo A, Maillard L, Barlis P, Wykrzykowska J, Piek JJ, Garg S, Hamm C, Steg PG, Jüni P, Valgimigli M, Windecker S, Onuma Y, Mehran R, Serruys PW. Association of Sex With Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the GLOBAL LEADERS Randomized Clinical Trial. JAMA Cardiol 2021; 5:21-29. [PMID: 31693078 DOI: 10.1001/jamacardio.2019.4296] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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: 01/10/2023]
Abstract
Importance Women experience worse ischemic and bleeding outcomes after percutaneous coronary intervention (PCI). Objectives To assess the association of sex with patient outcomes at 2 years after contemporary PCI and with the efficacy and safety of 2 antiplatelet strategies. Design, Setting, and Participants This study is a prespecified subgroup analysis of the investigator-initiated, prospective, randomized GLOBAL LEADERS study evaluating 2 strategies of antiplatelet therapy after PCI in an unselected population including 130 secondary/tertiary care hospitals in different countries. The main study enrolled 15 991 unselected patients undergoing PCI between July 2013 and November 2015. Patients had an outpatient clinic visit at 30 days and 3, 6, 12, 18, and 24 months after the index procedure. Data were analyzed between January 1, 2019, and March 31, 2019. Interventions Eligible patients were randomized to either the experimental or reference antiplatelet strategy. Experimental strategy consisted of 1 month of dual antiplatelet therapy (DAPT) followed by 23 months of ticagrelor monotherapy, while the reference strategy comprised of 12 months of DAPT followed by 12 months of aspirin monotherapy. Main Outcomes and Measures The primary efficacy end point was the composite of all-cause mortality and new Q-wave myocardial infarction at 2 years. The secondary safety end point was Bleeding Academic Research Consortium type 3 or 5 bleeding. Results Of the 15 968 patients included in this study, 3714 (23.3%) were women. The risk of the primary end point at 2 years was similar between women and men (adjusted hazard ratio [HR], 1.00; 95% CI, 0.83-1.20). Compared with men, women had higher risk of Bleeding Academic Research Consortium type 3 or 5 bleeding (adjusted HR, 1.32; 95% CI, 1.04-1.67) and hemorrhagic stroke at 2 years (adjusted HR, 4.76; 95% CI, 1.92-11.81). At 2 years, there was no between-sex difference in the efficacy and safety of the 2 antiplatelet strategies. At 1 year, compared with DAPT, ticagrelor monotherapy was associated with a lower risk of bleeding in men (HR, 0.72; 95% CI, 0.53-0.98) but not in women (HR, 1.23; 95% CI, 0.80-1.89; P for interaction = .045). Conclusions and Relevance Compared with men, women experienced a higher risk of bleeding and hemorrhagic stroke after PCI. The effect of 2 antiplatelet strategies on death and Q-wave myocardial infarction following PCI did not differ between the sexes at 2 years. Trial Registration ClinicalTrials.gov identifier: NCT01813435.
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Affiliation(s)
- Ply Chichareon
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rodrigo Modolo
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Division, Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - Laura Kerkmeijer
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariusz Tomaniak
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.,First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Norihiro Kogame
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Kuniaki Takahashi
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Chun-Chin Chang
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands
| | - Hidenori Komiyama
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tiziano Moccetti
- Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Suneel Talwar
- Royal Bournemouth and Christchurch National Health Services Trust, Bournemouth, England
| | - Antonio Colombo
- Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | | | - Peter Barlis
- St Vincent's and Northern Hospitals, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Joanna Wykrzykowska
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan J Piek
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Scot Garg
- East Lancashire Hospitals National Health Services Trust, Blackburn, Lancashire, England
| | - Christian Hamm
- Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- French Alliance for Cardiovascular Trials; Hôpital Bichat, AP-HP; Université Paris-Diderot; INSERM U-1148; Paris, France.,Royal Brompton Hospital, Imperial College, London, England
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada
| | - Marco Valgimigli
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Yoshinobu Onuma
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.,Cardialysis Clinical Trials Management and Core Laboratories, Westblaak 98, Rotterdam, the Netherlands
| | - Roxana Mehran
- Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Patrick W Serruys
- National Heart and Lung Institute, Imperial College London, London, England
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Miyakuni T, Komiyama H, Takano M, Ikeda T, Matsushita M, Kobayashi N, Otsuka T, Miyauchi Y, Asai K, Seino Y, Shimizu W. A preliminary pilot study investigating the impact of endovascular treatment on leg muscle volume in peripheral artery disease and its relation to baseline glycemic control. Nutr Metab Cardiovasc Dis 2021; 31:269-276. [PMID: 33092977 DOI: 10.1016/j.numecd.2020.09.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Peripheral artery disease (PAD), intermittent claudication, and impaired mobility contribute to the loss of skeletal muscle. This study investigated the impact of endovascular treatment (EVT) in patients suffering from PAD above the knee and its relation to baseline glycemic control. METHODS AND RESULTS Mid-thigh muscle volume was measured before EVT, 3 months after EVT and 6 months after EVT. Mid-thigh muscle volumes of ipsilateral PAD patients with ischemic and non-ischemic legs were compared. Correlations between total thigh muscle volume and clinical characteristics were analyzed using univariable and multivariable analysis. Overall, thigh muscle volume increased after EVT. The mid-thigh muscle volume was significantly lower in patients with ipsilateral lesions and in those with ischemic lower limbs. The thigh muscle volume of those with ischemic lower limbs increased after EVT. Baseline glycated hemoglobin was the only factor that was negatively correlated with changes in the muscle volume after EVT. Muscle volume significantly increased in normoglycemic HbA1c<6.5% (47 mmol/mol) patients. There was no significant alteration in the muscle volume of hyperglycemic HbA1c ≥ 6.5% patients. CONCLUSION Ischemic muscle atrophy was ameliorated after EVT in normoglycemic patients. There is a need for a large-scale trial to investigate whether EVT can protect or delay skeletal muscle loss.
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Affiliation(s)
- Tomoyo Miyakuni
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Hidenori Komiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603, Japan.
| | - Masamichi Takano
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Takeshi Ikeda
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Masato Matsushita
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Nobuaki Kobayashi
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, 113-8602, Japan
| | - Yasushi Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Kuniya Asai
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan.
| | - Yoshihiko Seino
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603, Japan
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Kamiya M, Asai K, Maejima Y, Shirakabe A, Murai K, Noma S, Komiyama H, Sato N, Mizuno K, Shimizu W. β 3-Adrenergic Receptor Agonist Prevents Diastolic Dysfunction in an Angiotensin II-Induced Cardiomyopathy Mouse Model. J Pharmacol Exp Ther 2020; 376:473-481. [PMID: 33318077 DOI: 10.1124/jpet.120.000140] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 11/11/2020] [Indexed: 01/01/2023] Open
Abstract
β3-Adrenergic receptor expression is enhanced in the failing heart, but its functional effects are unclear. We tested the hypothesis that a β3-agonist improves left ventricular (LV) performance in heart failure. We examined the chronic effects of a β3-agonist in the angiotensin II (Ang II)-induced cardiomyopathy mouse model. C57BL/6J mice were treated with Ang II alone or Ang II + BRL 37344 (β3-agonist, BRL) for 4 weeks. Systolic blood pressure in conscious mice was significantly elevated in Ang II and Ang II + BRL mice compared with control mice. Heart rate was not different among the three groups. Systolic performance parameters that were measured by echocardiography and an LV catheter were similar among the groups. LV end-diastolic pressure and end-diastolic pressure-volume relationships were higher in Ang II mice compared with control mice. However, the increase in these parameters was prevented in Ang II + BRL mice, which suggested improvement in myocardial stiffness by BRL. Pathologic analysis showed that LV hypertrophy was induced in Ang II mice and failed to be prevented by BRL. However, increased collagen I/III synthesis, cardiac fibrosis, and lung congestion observed in Ang II mice were inhibited by BRL treatment. The cardioprotective benefits of BRL were associated with downregulation of transforming growth factor-β1 expression and phosphorylated-Smad2/3. Chronic infusion of a β3-agonist has a beneficial effect on LV diastolic function independent of blood pressure in the Ang II-induced cardiomyopathy mouse model. SIGNIFICANCE STATEMENT: Chronic infusion of a β3-adrenergic receptor agonist attenuates cardiac fibrosis and improves diastolic dysfunction independently of blood pressure in an angiotensin II-induced hypertensive mouse model. This drug might be an effective treatment of heart failure with preserved ejection fraction.
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Affiliation(s)
- Masataka Kamiya
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Kuniya Asai
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Akihiro Shirakabe
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Koji Murai
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Satsuki Noma
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Hidenori Komiyama
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Naoki Sato
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Kyoichi Mizuno
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (M.K., K.M., S.N., H.K., N.S., W.S.); Intensive Care Unit, Nippon Medical School Chiba-Hokusou Hospital, Chiba, Japan (K.A., A.S.); and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Y.M.); Mitsukoshi Health and Welfare Foundation, Tokyo, Japan (K.M.)
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9
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Katagiri Y, Andreini D, Miyazaki Y, Takahashi K, Komiyama H, Mushtaq S, Sonck J, Schoors D, Maisano F, Kaufman PA, Leal I, Lindeboom W, Piek JJ, Wykrzykowska JJ, Morel MA, Bartorelli AL, Onuma Y, Serruys PW. Site vs. core laboratory variability in computed tomographic angiography-derived SYNTAX scores in the SYNTAX III trial. Eur Heart J Cardiovasc Imaging 2020; 22:1063-1071. [PMID: 32888011 DOI: 10.1093/ehjci/jeaa172] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/03/2020] [Accepted: 05/28/2020] [Indexed: 01/30/2023] Open
Abstract
AIMS To investigate the variability between site and core laboratory (CL) calculation of the anatomical SYNTAX score (SS) based on coronary computed tomography angiography (CTA) alone and functional SS based on coronary CTA and fractional flow reserve derived from computed tomography (FFRCT) in the SYNTAX III trial. METHODS AND RESULTS The SYNTAX III trial was a multicentre, international study that included 223 patients with three-vessel disease with or without left main involvement. Functional SS was computed by subtracting non-flow limiting stenoses (FFRCT > 0.80) from anatomical SS. SS was combined with clinical information to generate the SYNTAX score II (SS II) that provides treatment recommendations. The mean anatomical SS based on coronary CTA alone was 33.4 ± 12.7 by sites and 37.1 ± 13.4 by CL (P < 0.001). The mean functional SS based on coronary CTA and FFRCT was 30.5 ± 13.0 by sites and 33.3 ± 13.6 by CL (P < 0.001). The intraclass correlation coefficient was 0.49 [95% confidence interval (CI) 0.37-0.59) in anatomical SS and 0.62 (95% CI 0.52-0.70) in functional SS. The Cohen's κ comparing treatment recommendation between sites and CL was 0.68 (95% CI 0.58-0.78) based on anatomical SS and 0.71 (95% CI 0.60-0.82) based on functional SS. CONCLUSION The mean anatomical SS derived from coronary CTA alone and functional SS based on coronary CTA and FFRCT were higher when assessed by the CL than by the sites themselves. However, substantial agreement in treatment recommendation by SS II between sites and CL was demonstrated. CLINICAL TRIALS.GOV IDENTIFIER NCT02385279.
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Affiliation(s)
- Yuki Katagiri
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Daniele Andreini
- Centro Cardiologico Monzino, University of Milano, Via Carlo Parea, 4, 20138 Milano, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via della Commenda 19, 20122 Milano, Italy
| | - Yosuke Miyazaki
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Kuniaki Takahashi
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Hidenori Komiyama
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Saima Mushtaq
- Centro Cardiologico Monzino, University of Milano, Via Carlo Parea, 4, 20138 Milano, Italy
| | - Jeroen Sonck
- Department of Cardiology, Cardiovascular Center Aalst, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium.,Department of Advanced Biomedical Sciences, Federico II University of Naples, Corso Umberto I 40 - 80138 Napoli, Italy
| | - Danny Schoors
- Department of Cardiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Jette, Brussel, Belgium
| | - Francesco Maisano
- Department of Cardiovascular Surgery, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Philipp A Kaufman
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Ingrid Leal
- Cardialysis BV, Westblaak 98, 3012 KM Rotterdam, The Netherlands
| | - Wietze Lindeboom
- Cardialysis BV, Westblaak 98, 3012 KM Rotterdam, The Netherlands
| | - Jan J Piek
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Joanna J Wykrzykowska
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | | | - Antonio L Bartorelli
- Centro Cardiologico Monzino, University of Milano, Via Carlo Parea, 4, 20138 Milano, Italy.,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via Festa del Perdono, 7, 20122 Milano MI, Italy
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway, Ireland H91 TK33
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway, Ireland H91 TK33.,Department of Cardiology, Royal Brompton and Harefield Hospitals, Imperial College of London, Kensington, London SW7 2AZ, UK
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10
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Chang CC, Spitzer E, Chichareon P, Takahashi K, Modolo R, Kogame N, Tomaniak M, Komiyama H, Yap SC, Hoole SP, Gori T, Zaman A, Frey B, Ferreira RC, Bertrand OF, Koh TH, Sousa A, Moschovitis A, van Geuns RJ, Steg PG, Hamm C, Jüni P, Vranckx P, Valgimigli M, Windecker S, Serruys PW, Soliman O, Onuma Y. Ascertainment of Silent Myocardial Infarction in Patients Undergoing Percutaneous Coronary Intervention (from the GLOBAL LEADERS Trial). Am J Cardiol 2019; 124:1833-1840. [PMID: 31648781 DOI: 10.1016/j.amjcard.2019.08.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/30/2019] [Accepted: 08/30/2019] [Indexed: 11/18/2022]
Abstract
Q-wave myocardial infarction (QWMI) comprises 2 entities. First, a clinically evident MI, which can occur spontaneously or be related to a coronary procedure. Second, silent MI which is incidentally detected on serial electrocardiographic (ECG) assessment. The prevalence of silent MI after percutaneous coronary intervention (PCI) in the drug-eluting stent era has not been fully investigated. The GLOBAL LEADERS is an all-comers multicenter trial which randomized 15,991 patients who underwent PCI to 2 antiplatelet treatment strategies. The primary end point was a composite of all-cause death or nonfatal new QWMI at 2-years follow-up. ECGs were collected at discharge, 3-month and 2-year visits, and analyzed by an independent ECG core laboratory following the Minnesota code. All new QWMI were further reviewed by a blinded independent cardiologist to identify a potential clinical correlate by reviewing clinical information. Of 15,968 participants, ECG information was complete in 14,829 (92.9%) at 2 years. A new QWMI was confirmed in 186 (1.16%) patients. Transient new Q-waves were observed in 28.5% (53 of 186) of them during the follow-up. The majority of new QWMI (78%, 146 of 186) were classified as silent MI due to the absence of a clinical correlate. Silent MI accounted for 22.1% (146 of 660) of all MI events. The prevalence of silent MI did not differ significantly between treatment strategies (experimental vs reference: 0.88% vs 0.98%, p = 0.5027). In conclusion, we document the prevalence of silent MI in an all-comers population undergoing PCI in this large-scale randomized trial.
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Affiliation(s)
- Chun Chin Chang
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan
| | - Ernest Spitzer
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; Cardialysis B.V., Rotterdam, the Netherlands
| | - Ply Chichareon
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Kuniaki Takahashi
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Rodrigo Modolo
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Norihiro Kogame
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariusz Tomaniak
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Hidenori Komiyama
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Stephen P Hoole
- Department of Interventional Cardiology, Royal Papworth Hospital, Cambridge, United Kingdom
| | - Tommaso Gori
- Zentrum für Kardiologie, Kardiologie I, University Medical Center, and DZHK Standort Rhein-Main, Mainz, Germany
| | - Azfar Zaman
- Freeman Hospital, Newcastle upon Tyne NHS Hospitals Trust and Institute of Cellular Medicine, Newcastle University, United Kingdom
| | - Bernhard Frey
- Department of Internal Medicine II, Medical University Vienna, Vienna, Austria
| | | | - Olivier F Bertrand
- Quebec Heart-Lung Institute, Laval University, Quebec City, Quebec, Canada
| | | | - Amanda Sousa
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Aris Moschovitis
- Department of Cardiology, University of Bern, Inselspital, Bern, Switzerland
| | - Robert-Jan van Geuns
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Radboud UMC, Nijmegen, the Netherlands
| | - Philippe Gabriel Steg
- Département de Cardiologie, Hôpital Bichat, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Christian Hamm
- Kerckhoff Clinic, Bad Nauheim, Germany; DZHK (German Centre for Cardiovascular Research), Frankfurt, Germany
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Institute of Health Policy, Management and Evaluation University of Toronto, Toronto, Ontario, Canada
| | - Pascal Vranckx
- Jessa Ziekenhuis, Faculty of Medicine and Life Sciences at the Hasselt University, Hasselt, Belgium
| | - Marco Valgimigli
- Department of Cardiology, University of Bern, Inselspital, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, University of Bern, Inselspital, Bern, Switzerland
| | | | - Osama Soliman
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; Cardialysis B.V., Rotterdam, the Netherlands
| | - Yoshinobu Onuma
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; Cardialysis B.V., Rotterdam, the Netherlands
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11
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Kogame N, Modolo R, Chichareon P, Komiyama H, Taggart D, Escaned J, Banning A, Farooq V, Onuma Y, Serruys PW. 121Clinical impact of residual SYNTAX score after physiology guided state-of-art PCI in 3VD: insight from the SYNTAX II trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0037] [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: 11/14/2022] Open
Abstract
Abstract
Background
The clinical implication of residual SYNTAX score in patients treated with state-of- art PCI including hybrid iFR-FFR for three vessel disease is undetermined.
Purpose
The purpose of this study was to investigate the clinical impact of residual SYNTAX Score (rSS) after hybrid iFR-FFR guided state-of-art PCI in patients with three vessel disease (3VD).
Methods
The SYNTAX-II study was a multicentre, single arm study that investigated the impact of the state-of-art PCI strategy on clinical outcomes in 454 patients with de novo 3VD, without left main disease. All the patients treated with the state-of-art PCI in the SYNTAX II trial were retrospectively screened and analysed for rSS. The rSS was defined as the SYNTAX Score (SS) recalculated after PCI. The state-of-art PCI strategy included: heart team decision-making utilizing the SYNTAX score II, hybrid iFR-FFR decision-making strategy, intravascular ultrasound guided stent implantation, contemporary chronic total occlusion revascularization techniques and guideline-directed medical therapy. The primary endpoint of this substudy was major adverse cardiac and cerebrovascular events (MACCE – a composite of all-cause death, any stroke, myocardial infarction, or revascularization) at 2 years. Patients with rSS were stratified according to angiographically complete revascularization (rSS of 0) and previously proposed rSS cut-off value of 8 (>0 to 8, and >8).
Results
A total of 454 patients were screened and rSS were analysable in 441 patients (97.1%). Before PCI, anatomical SS was 20.3±6.4 which was after PCI reduced to 3.9±4.5 (rSS). Only 67 patients (15.2%) had rSS >8 (mean 12.3±4.1). Two-year MACCE occurred in 58 patients (13.2%). Patients with MACCE had similar rSS to those without MACCE (2.0 (IQR: 0.0 to 6.0) vs. 2.0 (IQR: 0.0 to 5.0), p=0.313). Kaplan-Meier analysis showed similar 2- year incidence of MACCE with rSS stratifications (rSS of 0 (n=140): 15.0%, >0 to 8 (n=234): 12.0%, >8 (n=67): 13.4%, log-rank p for overall = 0.703).
Conclusion
After hybrid iFR-FFR guided state-of-art PCI in 3VD, residual SYNTAX Score was very low, suggesting that complete or reasonable incomplete revascularization was achieved in majority of cases. Previously proposed rSS cut-off value of 8 was not associated with a worse clinical outcome.
Acknowledgement/Funding
European Cardiovascular Research Institute (ECRI) with unrestricted research grants from Volcano and Boston Scientific
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Affiliation(s)
- N Kogame
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - H Komiyama
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - D Taggart
- John Radcliffe Hospital, Oxford, United Kingdom
| | - J Escaned
- Hospital Clinic San Carlos, Madrid, Spain
| | - A Banning
- John Radcliffe Hospital, Oxford, United Kingdom
| | - V Farooq
- Newcastle upon Tyne Hospitals NHS foundation trust, Newcastle upon Tyne, United Kingdom
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - P W Serruys
- Imperial College London, London, United Kingdom
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12
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Serruys PW, Takahashi K, Kogame N, Chichareon P, Modolo R, Chang CC, Tomaniak M, Komiyama H, Hamm C, Steg PG, Stoll HP, Onuma Y, Valgimigli M, Windecker S, Vranckx P. P2817Efficacy and safety of ticagrelor monotherapy in patients with complex percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1129] [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/Introduction
Optimal dual antiplatelet therapy (DAPT) in patients with complex percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has not been fully investigated.
Purpose
To evaluate the efficacy and safety of 1-month DAPT followed by 23-month ticagrelor monotherapy in patients who underwent complex PCI.
Methods
The Global Leaders trial recruited 15,991 patients treated by default with a biolimus A9-eluting stent, and randomised in a 1:1 ratio either to the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) or to the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy). Complex PCI includes at least one of the following characteristics; left main and/or multivessel PCI, long stenting (defined as total stent length≥46mm), and bifurcation treatment with two stents. The present sub-analysis of the trial evaluated at two years the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code). In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.
Results
Of 15,450 patients included in the present analysis, 5,188 (26.7%) patients underwent complex PCI. The experimental strategy, when compared with the reference one, had a significantly lower risk of the primary endpoint (3.56% vs. 5.33%, HR: 0.66; 95% CI: 0.51–0.86; p-value= 0.002; p-value for interaction= 0.019) in patients with complex PCI. Similarly, the experimental treatment was associated with a significantly reduced risk of POCE (14.41% vs. 16.88%, HR: 0.84; 95% CI: 0.74–0.97; p=0.016, p-value for interaction= 0.099) and NACE (15.77% vs. 18.37%, HR: 0.85; 95% CI: 0.74–0.97; p=0.014; p-value for interaction= 0.096). The reduction in ischemic events was predominantly observed in patients with 2 or more characteristics of complex PCI (Figure). In contrast, there was no significant difference in the risk of BARC type 3 or 5 bleeding between the two regimens (2.40% vs. 2.38%, HR: 1.01; 95% CI: 0.71–1.44; p-value=0.956; p-value for interaction= 0.935).
Central illustration
Conclusion
Together with other well-established clinical risk factors, the extent and complexity of stenting should be taken into account in tailoring antiplatelet regimens for secondary prevention. The 1-month DAPT followed by 23-month ticagrelor monotherapy reduced the ischemic events without increasing the risk of bleeding in patients who underwent complex PCI, when compared with the conventional DAPT.
Acknowledgement/Funding
The Global Leaders trial was supported by the resource from AstraZeneca, Biosensors, and The Medicines Company.
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Affiliation(s)
- P W Serruys
- Imperial College London, London, United Kingdom
| | - K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - H Komiyama
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
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13
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Komiyama H, Chichareon P, Hamm C, Juni P, Valgimigli M, Vranckx P, Windecker S, Onuma Y, Stegg G, Serruys P. P1952Value of GRACE risk score in risk stratification in acute coronary syndrome patients undergoing PCI in the Global Leaders study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0699] [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
Aims
We sought to evaluate the value of GRACE risk score in stratifying acute coronary syndrome patients undergoing percutaneous coronary intervention in the Global Leaders study.
Methods
Global Leaders study was a prospective, multi-center, open-label, all-comers, randomized controlled trial comparing ticagrelor monotherapy after 1 month of dual antiplatelet therapy (DAPT) as experimental therapy with aspirin monotherapy after 12 months of conventional DAPT (reference therapy) in patients who received PCI with biolimus-A9 eluting stent. We assessed the predictive value of GRACE risk score in ACS patients undergoing PCI in the present analysis. Patients were stratified according to GRACE risk score into low (1–108), moderate (109–140), High (141–372) risk group. Clinical outcomes at 2 years after PCI were assessed and compared among risk groups. Interaction between GRACE risk score and antiplatelet regimen were analyzed by the interaction term in Cox model.
Results
GRACE risk score was calculated from 8 clinical parameters at presentation. Among ACS patients, 1664 patients were categorized in low risk group, 2903 patients were in moderate risk group, and 2028 patients were in high risk group. The rate of all-cause mortality, any stroke, patient-oriented composite endpoint (POCE) were highest in the high-risk group at 2 years (All-cause mortality; low risk 1.4%, moderate risk 2.5%, high risk 6.1%, log rank test p value <0.0001, any stroke; low risk 0.7%, moderate risk 1.0%, high risk 2.0%, log rank test p value 0.001, POCE; low risk 12.4%, moderate risk 11.9%, high risk 16.61%, log rank test p value <0.0001). The rate of myocardial infarction, all revascularization and definite or probable stent thrombosis were not different among three groups. There was no interaction between GRACE risk score and treatment regimen on clinical outcomes at 2 years.
Conclusion
GRACE risk score is valuable in identifying ACS patients with highest risk of all-cause mortality, any stroke and POCE at 2 years after PCI. In ACS, ticagrelor monotherapy did not improve the outcomes at 2 years in the three strata of the GRACE risk score.
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Affiliation(s)
- H Komiyama
- University of Amsterdam, Rotterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Rotterdam, Netherlands (The)
| | - C Hamm
- German Centre for Cardiovascular Research, Frankfurt, Germany
| | - P Juni
- Applied Health Research Centre, Toronto, Canada
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - G Stegg
- Hospital Bichat-Claude Bernard, Paris, France
| | - P Serruys
- Imperial College London, London, United Kingdom
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14
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Kogame N, Takahashi K, Tomaniak M, Chichareon P, Modolo R, Chang CC, Komiyama H, Katagiri Y, Asano T, Stables R, Fath-Ordoubadi F, Walsh S, Sabaté M, Davies JE, Piek J, van Geuns RJ, Reiber JH, Banning AP, Escaned J, Farooq V, Serruys PW, Onuma Y. Clinical Implication of Quantitative Flow Ratio After Percutaneous Coronary Intervention for 3-Vessel Disease. JACC Cardiovasc Interv 2019; 12:2064-2075. [DOI: 10.1016/j.jcin.2019.08.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 10/25/2022]
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15
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Modolo R, Kogame N, Komiyama H, Chichareon P, de Vries T, Tomaniak M, Chang CC, Takahashi K, Walsh S, Lesiak M, Moreno R, Farrooq V, Escaned J, Banning A, Onuma Y, Serruys PW. Two years clinical outcomes with the state-of-the-art PCI for the treatment of bifurcation lesions: A sub-analysis of the SYNTAX II study. Catheter Cardiovasc Interv 2019; 96:10-17. [PMID: 31402574 DOI: 10.1002/ccd.28422] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/20/2019] [Accepted: 07/22/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Bifurcation PCI is associated with a lower rate of procedural success, especially in multivessel disease patients. We aimed to determine the impact of bifurcation treatment on 2-years clinical outcomes when a state-of-the-art PCI strategy (heart team decision-making using the SYNTAX score II, physiology guided coronary stenosis assessment, thin strut bioresorbable polymer drug-eluting stent, and intravascular ultrasound guidance) is followed. METHODS Three-vessel disease patients enrolled in the SYNTAX II trial (n = 454) were categorized in patients with (a) ≥1 treated bifurcation (n = 126), and (b) without bifurcation (n = 281). The primary endpoint was the occurrence of major adverse cardio and cerebrovascular events (MACCE-a composite of all-cause death, stroke, any myocardial infarction, or any revascularization) at 2 years. Secondary endpoints were the occurrence of target lesion failure (TLF) defined as cardiac death, target-vessel myocardial infarction and ischemia-driven target lesion revascularization, and the individual components of the composite primary endpoint, as well as stent thrombosis. RESULTS A total of 145 bifurcation were treated in 126 patients. At 2 years, MACCE occurred in 75/407 patients (20.7% for bifurcation versus 17.5% for nonbifurcation, hazard ratio [HR] of 1.28, CI95% 0.78-2.08, p = .32). TLF presented a trend toward higher occurrence in bifurcation (16.8% vs. 10.8%, HR 1.75, CI95% 0.99-3.09, p = .053). Definite stent thrombosis did not differ at 2-year between groups (0.8% for the bifurcation vs. 0.7% for the nonbifurcation, p = .92). CONCLUSION Bifurcation treatment in patients with three-vessel disease undergoing state-of-the-art PCI had similar event rate of MACCE but was associated with a trend toward higher incidence of TLF compared with nonbifurcation lesions.
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Affiliation(s)
- Rodrigo Modolo
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Division, Department of Internal Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Norihiro Kogame
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Hidenori Komiyama
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ply Chichareon
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Mariusz Tomaniak
- Department of Interventional Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Chun Chin Chang
- Department of Interventional Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kuniaki Takahashi
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Simon Walsh
- Department of Cardiology Belfast Health & Social Care Trust, Belfast, UK
| | - Maciej Lesiak
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | - Raul Moreno
- Department of Cardiology, Hospital Universitario la Paz, Madrid, Spain
| | - Vasim Farrooq
- Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, UK
| | - Javier Escaned
- Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain
| | - Adrian Banning
- Department of Cardiology, John Radcliffe Hospital, Cardiology, Oxford, UK
| | - Yoshinobu Onuma
- Cardialysis BV, Rotterdam, the Netherlands.,Department of Interventional Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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16
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Kogame N, Chichareon P, De Wilder K, Takahashi K, Modolo R, Chang CC, Tomaniak M, Komiyama H, Chieffo A, Colombo A, Garg S, Louvard Y, Jüni P, G. Steg P, Hamm C, Vranckx P, Valgimigli M, Windecker S, Stoll H, Onuma Y, Janssens L, Serruys PW. Clinical relevance of ticagrelor monotherapy following 1‐month dual antiplatelet therapy after bifurcation percutaneous coronary intervention: Insight from GLOBAL LEADERS trial. Catheter Cardiovasc Interv 2019; 96:100-111. [DOI: 10.1002/ccd.28428] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 05/11/2019] [Revised: 07/10/2019] [Accepted: 07/27/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Norihiro Kogame
- Department of CardiologyAmsterdam University Medical Center Amsterdam The Netherlands
- Department of CardiologyToho University medical center Ohashi hospital Tokyo Japan
| | - Ply Chichareon
- Department of CardiologyAmsterdam University Medical Center Amsterdam The Netherlands
- Faculty of Medicine, Division of Cardiology, Department of Internal MedicinePrince of Songkla University Songkhla Thailand
| | | | - Kuniaki Takahashi
- Department of CardiologyAmsterdam University Medical Center Amsterdam The Netherlands
| | - Rodrigo Modolo
- Department of CardiologyAmsterdam University Medical Center Amsterdam The Netherlands
- Cardiology Division, Department of Internal MedicineUniversity of Campinas (UNICAMP) Campinas Brazil
| | - Chun Chin Chang
- Department of Interventional CardiologyThoraxcenter, Erasmus Medical Center Rotterdam The Netherlands
| | - Mariusz Tomaniak
- Department of Interventional CardiologyThoraxcenter, Erasmus Medical Center Rotterdam The Netherlands
| | - Hidenori Komiyama
- Department of CardiologyAmsterdam University Medical Center Amsterdam The Netherlands
| | - Alaide Chieffo
- Interventional Cardiology UnitIRCCS San Raffaele Scientific Institute Milan Italy
| | - Antonio Colombo
- Interventional Cardiology UnitVilla Maria Cecila Hospital GVM Cotignola (RA) Italy
| | - Scot Garg
- Department of CardiologyRoyal Blackburn Hospital Blackburn UK
| | - Yves Louvard
- Department of CardiologyRamsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier Massy France
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital Toronto Ontario Canada
- Department of Medicine and Institute of Health Policy, Management and EvaluationUniversity of Toronto Toronto Ontario Canada
| | - Philippe G. Steg
- French Alliance for Cardiovascular Trials (FACT), Université Paris‐Diderot Paris France
| | - Christian Hamm
- Kerckhoff Heart and Thorax Center, University of Giessen Giessen Germany
| | - Pascal Vranckx
- Faculty of Medicine and Life Sciences, Jessa Ziekenhuis, the Hasselt University Hasselt Belgium
| | - Marco Valgimigli
- Department of CardiologyInselspital, University of Bern Bern Switzerland
| | - Stephan Windecker
- Department of CardiologyInselspital, University of Bern Bern Switzerland
| | | | - Yoshinobu Onuma
- Department of Interventional CardiologyThoraxcenter, Erasmus Medical Center Rotterdam The Netherlands
| | - Luc Janssens
- Heart CentreImelda Hospital Bonheiden Bonheiden Belgium
| | - Patrick W. Serruys
- International Centre for Circulatory Health, Imperial College London London UK
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17
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Serruys PW, Takahashi K, Chichareon P, Kogame N, Tomaniak M, Modolo R, Chang CC, Komiyama H, Soliman O, Wykrzykowska JJ, de Winter RJ, Ferrario M, Dominici M, Buszman P, Bolognese L, Tumscitz C, Benit E, Stoll HP, Hamm C, Steg PG, Onuma Y, Jüni P, Windecker S, Vranckx P, Colombo A, Valgimigli M. Impact of long-term ticagrelor monotherapy following 1-month dual antiplatelet therapy in patients who underwent complex percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 2019; 40:2595-2604. [DOI: 10.1093/eurheartj/ehz453] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [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: 04/05/2019] [Revised: 05/09/2019] [Accepted: 06/07/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
To evaluate the impact of an experimental strategy [23-month ticagrelor monotherapy following 1-month dual antiplatelet therapy (DAPT)] vs. a reference regimen (12-month aspirin monotherapy following 12-month DAPT) after complex percutaneous coronary intervention (PCI).
Methods and results
In the present post hoc analysis of the Global Leaders trial, the primary endpoint [composite of all-cause death or new Q-wave myocardial infarction (MI)] at 2 years was assessed in patients with complex PCI, which includes at least one of the following characteristics: multivessel PCI, ≥3 stents implanted, ≥3 lesions treated, bifurcation PCI with ≥2 stents, or total stent length >60 mm. In addition, patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, or any revascularization) and net adverse clinical events (NACE) [composite of POCE or Bleeding Academic Research Consortium (BARC) Type 3 or 5 bleeding] were explored. Among 15 450 patients included in this analysis, 4570 who underwent complex PCI had a higher risk of ischaemic and bleeding events. In patients with complex PCI, the experimental strategy significantly reduced risks of the primary endpoint [hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.48–0.85] and POCE (HR: 0.80, 95% CI: 0.69–0.93), but not in those with non-complex PCI (Pinteraction = 0.015 and 0.017, respectively). The risk of BARC Type 3 or 5 bleeding was comparable (HR: 0.97, 95% CI: 0.67–1.40), resulting in a significant risk reduction in NACE (HR: 0.80, 95% CI: 0.69–0.92; Pinteraction = 0.011).
Conclusion
Ticagrelor monotherapy following 1-month DAPT could provide a net clinical benefit for patients with complex PCI. However, in view of the overall neutral results of the trial, these findings of a post hoc analysis should be considered as hypothesis generating.
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Affiliation(s)
- Patrick W Serruys
- National Heart and Lung Institute, Imperial College London, Guy Scadding Building, Dovehouse St, Chelsea, London, UK
| | - Kuniaki Takahashi
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
| | - Ply Chichareon
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Kho Hong, Hat Yai, Songkhla, Thailand
| | - Norihiro Kogame
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
| | - Mariusz Tomaniak
- Department of Cardiology, Erasmus Medical University Center, Thorax Centre, Molewaterplein 40, GD Rotterdam, The Netherlands
- First Department of Cardiology, Medical University of Warsaw, Żwirki i Wigury Str. 61, Warsaw, Poland
| | - Rodrigo Modolo
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
- Department of Internal Medicine, Cardiology Division, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas - SP, Brazil
| | - Chun Chin Chang
- Department of Cardiology, Erasmus Medical University Center, Thorax Centre, Molewaterplein 40, GD Rotterdam, The Netherlands
| | - Hidenori Komiyama
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
| | - Osama Soliman
- Department of Cardiology, Erasmus Medical University Center, Thorax Centre, Molewaterplein 40, GD Rotterdam, The Netherlands
- Cardialysis B.V., Westblaak 98, KM Rotterdam, The Netherlands
| | - Joanna J Wykrzykowska
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
| | - Robbert J de Winter
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
| | - Maurizio Ferrario
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, 19, Pavia PV, Italy
| | - Marcello Dominici
- Department of Cardiology, Azienda Ospedaliera S. Maria, Viale Tristano di Joannuccio, Terni TR, Italy
| | - Paweł Buszman
- Center for Cardiovascular Research and Development, American Heart of Poland, Sanatoryjna 1, Ustroń, Poland
- Department of Epidemiology and Statistics, Medical University of Silesia, Poniatowskiego 15, Katowice
| | - Leonardo Bolognese
- Cardiovascular Department, San Donato Hospital, Via Pietro Nenni, 20/22, 52100 Arezzo, Italy
| | - Carlo Tumscitz
- Department of Cardiology, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro, 8, Cona FE, Italy
| | - Edouard Benit
- Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium and Faculty of Medicine and Life Sciences, University of Hasselt, Martelarenlaan 42, Hasselt, Belgium
| | | | - Christian Hamm
- Kerckhoff Clinic and Thoraxcenter of the University of Giessen, Benekestraße 2-8, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- Université Paris-Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, INSERM U-1148, French Alliance for Cardiovascular Trials, Paris, France
| | - Yoshinobu Onuma
- Department of Cardiology, Erasmus Medical University Center, Thorax Centre, Molewaterplein 40, GD Rotterdam, The Netherlands
- Cardialysis B.V., Westblaak 98, KM Rotterdam, The Netherlands
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, 209 Victoria St, Toronto, ON, Canada
| | - Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, Bern, Switzerland
| | - Pascal Vranckx
- Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium and Faculty of Medicine and Life Sciences, University of Hasselt, Martelarenlaan 42, Hasselt, Belgium
| | - Antonio Colombo
- Department of Cardiology, Maria Cecilia Hospital-GVM, Via Madonna di Genova, 1, Cotignola RA, Italy
| | - Marco Valgimigli
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, Bern, Switzerland
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18
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Komiyama H, Modolo R, Chang CC, Chichareon P, Kogame N, Takahashi K, Tomaniak M, Onuma Y, Cuisset T, Fajadet J, Amin H, Al Rashdan I, Serruys PW. Interventional cardiology 2018: the year in review. EUROINTERVENTION 2019; 14:e1861-e1878. [DOI: 10.4244/eij-d-19-00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Asano T, Hytönen J, Chichareon P, Taavitsainen J, Kogame N, Katagiri Y, Miyazaki Y, Takahashi K, Modolo R, Komiyama H, Tenekecioglu E, Sotomi Y, Wykrzykowska JJ, Piek JJ, Martin J, Baumbach A, Mathur A, Onuma Y, Ylä-Herttuala S, Serruys PW. Serial Optical Coherence Tomography at Baseline, 7 Days, and 1, 3, 6 and 12 Months After Bioresorbable Scaffold Implantation in a Growing Porcine Model. Circ J 2019; 83:556-566. [PMID: 30700665 DOI: 10.1253/circj.cj-18-0855] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Little is known about serial changes in lumen and device dimensions after bioresorbable scaffold implantation in a growing animal model. Methods and Results: ABSORB (n=14) or bare metal stents (ICROS amg [Abbott Vascular, Santa Clara, CA, USA], Winsen-Luhe, Germany; n=15) were implanted in the coronary arteries of domestic swine (a hybrid of Finnish-Norwegian Landrace swine) weighing 30-35 kg. Angiography and optical coherence tomography (OCT) were performed immediately after implantation and repeated at 7 days, 1, 3, 6 and 12 months after the index procedure. One month after implantation, mean lumen area decreased relative to baseline in both groups (relative area change from baseline, -41.4±15.6% for ABSORB vs. -20.9±18.6% for ICROS) while mean device area decreased only in the ABSORB group (relative area change: -11.1±9.4% vs. +0.14±7.95%, respectively). At 12 months, mean lumen area increased relative to baseline in both groups (relative area change from baseline, +55.6±22.4% vs. +32.3±83.6%, respectively) in accordance with the swine growth weighing up to 260-300 kg. Mean device area in the ICROS group remained stable whereas that in the ABSORB group began to increase between 3 and 6 months along with the vessel growth (relative area change: +107.8±25.7% vs. +0.14±7.95%). CONCLUSIONS In the growing porcine model, ABSORB was associated with greater extent of recoil 1 month after implantation compared with ICROS but demonstrated substantial adaptability to vessel growth in late phase.
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Affiliation(s)
- Taku Asano
- Department of Cardiology, Academic Medical Center, University of Amsterdam.,Department of Cardiology, St. Luke's International Hospital
| | - Jarkko Hytönen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland
| | - Ply Chichareon
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | - Jouni Taavitsainen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland
| | - Norihiro Kogame
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | - Yuki Katagiri
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | | | - Kuniaki Takahashi
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | - Rodrigo Modolo
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | - Hidenori Komiyama
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | | | - Yohei Sotomi
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | | | - Jan J Piek
- Department of Cardiology, Academic Medical Center, University of Amsterdam
| | - John Martin
- Division of Medicine, University College London
| | - Andreas Baumbach
- Department of Cardiology, Barts Health NHS Trust.,Department of Cardiology, Queen Mary University of London
| | - Anthony Mathur
- Department of Cardiology, Barts Health NHS Trust.,Department of Cardiology, Queen Mary University of London
| | | | - Seppo Ylä-Herttuala
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland
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20
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Matsushita M, Takano M, Munakata R, Sawatani T, Kurihara O, Komiyama H, Murakami D, Shirakabe A, Kobayashi N, Hata N, Miyauchi Y, Seino Y, Shimizu W. Feasibility and safety of non-occlusive coronary angioscopic observation using a 4 Fr guiding catheter. AsiaIntervention 2018; 4:110-116. [PMID: 36483993 PMCID: PMC9706746 DOI: 10.4244/aij-d-18-00003] [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: 12/28/2017] [Accepted: 05/09/2018] [Indexed: 06/17/2023]
Abstract
AIMS Coronary angioscopy (CAS) is a robust imaging methodology for evaluation of vascular healing response after stenting. However, the procedure requires a guiding catheter with a diameter of more than 6 Fr, which is rather invasive at follow-up angiography. Recently, coronary angioscopes of a smaller diameter have been able to pass through a 4 Fr guiding catheter. This study aimed to investigate the feasibility and safety of slender CAS observation using a 4 Fr guiding catheter. METHODS AND RESULTS Thirty-three consecutive patients who underwent follow-up angiography were evaluated. Following usual angiography via the radial artery, the stent segment was observed by non-occlusive CAS through a 4 Fr guiding catheter. Low molecular weight dextran-L (4 mL/sec) was flushed from a guiding catheter to replace coronary blood. The success rate, anatomical or procedural factors related to the success, and incidence of adverse events were examined. The success rate was 84.8% (n=28/33). The luminal diameter at the orifice of the target vessel was larger in the successful than in the failed group (4.03±0.61 mm vs. 3.39±0.61 mm, respectively; p=0.009). The presence of deep engagement of the guiding catheter into the target vessel was a key factor for sufficient observation (100% in the successful group vs. 0% in the failed group; p<0.0001). No adverse events, such as dissection or acute coronary syndrome, were reported. CONCLUSIONS The new method of CAS through a 4 Fr guiding catheter demonstrated high feasibility and safety. This less invasive observation via CAS may be useful for stent follow-up.
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Affiliation(s)
- Masato Matsushita
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Masamichi Takano
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Ryo Munakata
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Tomofumi Sawatani
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Osamu Kurihara
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Hidenori Komiyama
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Daisuke Murakami
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Akihiro Shirakabe
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Nobuaki Kobayashi
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Noritake Hata
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yasushi Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yoshihiko Seino
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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21
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Kurihara O, Takano M, Uchiyama S, Fukuizumi I, Shimura T, Matsushita M, Komiyama H, Inami T, Murakami D, Munakata R, Ohba T, Hata N, Seino Y, Shimizu W. Microvascular resistance in response to iodinated contrast media in normal and functionally impaired kidneys. Clin Exp Pharmacol Physiol 2016; 42:1245-50. [PMID: 26277785 PMCID: PMC5063113 DOI: 10.1111/1440-1681.12479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 04/24/2015] [Revised: 07/27/2015] [Accepted: 08/11/2015] [Indexed: 11/29/2022]
Abstract
Contrast‐induced nephropathy (CIN) is considered to result from intrarenal vasoconstriction, and occurs more frequently in impaired than in normal kidneys. It was hypothesized that iodinated contrast media would markedly change renal blood flow and vascular resistance in functionally impaired kidneys. Thirty‐six patients were enrolled (32 men; mean age, 75.3 ± 7.6 years) undergoing diagnostic coronary angiography and were divided into two groups based on the presence of chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of < 60 mL/min per 1.73 m2 (CKD and non‐CKD groups, n = 18 in both). Average peak velocity (APV) and renal artery resistance index (RI) were measured by Doppler flow wire before and after administration of the iodinated contrast media. The APV and the RI were positively and inversely correlated with the eGFR at baseline, respectively (APV, R = 0.545, P = 0.001; RI, R = −0.627, P < 0.001). Mean RI was significantly higher (P = 0.015) and APV was significantly lower (P = 0.026) in the CKD than in the non‐CKD group. Both APV (P < 0.001) and RI (P = 0.002) were significantly changed following contrast media administration in the non‐CKD group, but not in the CKD group (APV, P = 0.258; RI, P = 0.707). Although renal arterial resistance was higher in patients with CKD, it was not affected by contrast media administration, suggesting that patients with CKD could have an attenuated response to contrast media.
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Affiliation(s)
- Osamu Kurihara
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Masamichi Takano
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Saori Uchiyama
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Isamu Fukuizumi
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Tetsuro Shimura
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Masato Matsushita
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Hidenori Komiyama
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Toru Inami
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Daisuke Murakami
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Ryo Munakata
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Takayoshi Ohba
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Noritake Hata
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yoshihiko Seino
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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22
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Komiyama H, Takano H, Nakamura S, Takano M, Hata N, Yasushi M, Seino Y, Mizuno K, Shimizu W. Geographical predisposition influences on the distribution and tissue characterisation of eccentric coronary plaques in non-branching coronary arteries: cross-sectional study of coronary plaques analysed by intravascular ultrasound. Cardiovasc Ultrasound 2016; 14:47. [PMID: 27876049 PMCID: PMC5120430 DOI: 10.1186/s12947-016-0090-3] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We investigated the influence of geographical predisposition on the spatial distribution and composition of coronary plaques. METHODS Thirty coronary arteries were evaluated. A total of 1441 cross-sections were collected from intravascular ultrasound (IVUS) and radio-frequency signal-based virtual histology (VH-IVUS) imaging. To exclude complex geographical effects of side branches and to localise the plaque distribution, we analysed only eccentric plaques in non-branching regions. The spatial distribution of eccentric plaques in the coronary artery was classified into myocardial, lateral, and epicardial regions. The composition of eccentric plaques was analysed using VH-IVUS. RESULTS The plaque was concentric in 723 sections (50.2%) and eccentric in 718 (49.9%). Eccentric plaques were more frequently distributed towards the myocardial side than towards the epicardial side (46.7 ± 7.5% vs. 12.5 ± 4.2%, p = 0.003). No significant difference was observed between the myocardial and lateral sides (46.7 ± 7.5% vs. 20.8 ± 5.0%) or between the lateral and epicardial sides. Eccentric thin-capped fibroatheromas were more frequently distributed towards the myocardial side than towards the lateral side (p = 0.024) or epicardial side (p = 0.005). CONCLUSION Geographical predisposition is associated with distribution, tissue characterisation, and vulnerability of plaques in non-branching coronary arteries.
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Affiliation(s)
- Hidenori Komiyama
- Cardiovascular Medicine, Nippon Medical School, Tokyo, 113-8603, Japan.,Cardiovascular Centre, Nippon Medical School Chiba Hokusou Hospital, Tokyo, 270-1613, Chiba, Japan
| | - Hitoshi Takano
- Cardiovascular Medicine, Nippon Medical School, Tokyo, 113-8603, Japan.
| | - Shunichi Nakamura
- Cardiovascular Medicine, Nippon Medical School, Tokyo, 113-8603, Japan
| | - Masamichi Takano
- Cardiovascular Centre, Nippon Medical School Chiba Hokusou Hospital, Tokyo, 270-1613, Chiba, Japan
| | - Noritake Hata
- Cardiovascular Centre, Nippon Medical School Chiba Hokusou Hospital, Tokyo, 270-1613, Chiba, Japan
| | - Miyauchi Yasushi
- Cardiovascular Centre, Nippon Medical School Chiba Hokusou Hospital, Tokyo, 270-1613, Chiba, Japan
| | - Yoshihiko Seino
- Cardiovascular Centre, Nippon Medical School Chiba Hokusou Hospital, Tokyo, 270-1613, Chiba, Japan
| | - Kyoichi Mizuno
- Cardiovascular Medicine, Nippon Medical School, Tokyo, 113-8603, Japan
| | - Wataru Shimizu
- Cardiovascular Medicine, Nippon Medical School, Tokyo, 113-8603, Japan
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23
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Kurihara O, Seino Y, Shibata Y, Matsushita M, Komiyama H, Kato K, Murakami D, Munakata R, Takano M, Miyauchi Y, Hata N, Shimizu W. Blunted renal vasoconstriction in patients with subclinical contrast-induced renal injury. Clin Exp Pharmacol Physiol 2016; 43:1148-1150. [PMID: 27558080 DOI: 10.1111/1440-1681.12653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/17/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022]
Abstract
Contrast media are considered to cause acute kidney injury by activating various factors that induce renal vasoconstriction. We analysed the renal microvascular haemodynamic response using the Doppler flow wire method. Then changes in urinary liver-type fatty acid-binding protein levels following contrast medium administration were compared between groups with or without a micro-injury of the kidney. In the group without renal micro-injury, the average peak velocity (APV) decreased significantly, whereas the renal artery resistance index (RI) increased significantly following contrast medium administration. In contrast, there was no significant change in either the APV or RI in the group with a renal micro-injury. A blunted microvascular response was found in the micro-injury group, whereas microvascular resistance increased in the non-micro-injury group.
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Affiliation(s)
- Osamu Kurihara
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
| | - Yoshihiko Seino
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yusaku Shibata
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Masato Matsushita
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Hidenori Komiyama
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Katsuhito Kato
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Daisuke Murakami
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Ryo Munakata
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Masamichi Takano
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yasushi Miyauchi
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Noritake Hata
- Cardiovascular Centre, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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Kurihara O, Takano M, Mizuno K, Shibata Y, Matsushita M, Komiyama H, Yamamoto M, Kato K, Munakata R, Murakami D, Okamatsu K, Hata N, Seino Y, Shimizu W. Impact of Diabetic Retinopathy on Vulnerability of Atherosclerotic Coronary Plaque and Incidence of Acute Coronary Syndrome. Am J Cardiol 2016; 118:944-9. [PMID: 27530826 DOI: 10.1016/j.amjcard.2016.06.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 06/30/2016] [Accepted: 06/30/2016] [Indexed: 10/21/2022]
Abstract
Although an association has been reported between the microvascular complications of diabetic patients and their poor prognosis after cardiovascular events related to advanced atherosclerosis, it is not clear whether there is a relation between diabetic retinopathy (DR) and the severity of plaque vulnerability. Fifty-seven diabetic patients with coronary artery disease, classified as non-DR (n = 42) or DR (n = 15), underwent angioscopic observation of at least 1 entire coronary artery. The number of yellow plaques (NYP) through the observed coronary artery was counted and their color grades, defined as 1 (light yellow), 2 (yellow), or 3 (intense yellow), were evaluated. The NYP per vessel and the maximum yellow grade were determined. The association between the presence of DR and incidences of acute coronary syndrome (ACS) was analyzed during the follow-up period (mean 7.1 ± 3.3 years; range, 0.83 to 11.75 years). Mean NYP per vessel and maximum yellow grade were significantly greater in DR than in non-DR patients (2.08 ± 1.01 vs 1.26 ± 0.77, p = 0.002, and 2.40 ± 0.74 vs 1.90 ± 0.82, p = 0.044, respectively). The cumulative incidences of ACS were higher in the DR group (p = 0.004), and the age-adjusted hazard ratio for ACS was 6.943 (95% CI 1.267 to 38.054; p = 0.026) for DR compared with non-DR patients. Our findings indicate that coronary atherosclerosis and plaque vulnerability are more severe in patients with DR. DR as a microvascular complication may be directly linked with macrovascular plaque vulnerability and fatal cardiovascular events such as ACS.
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Komiyama H, Takano M, Hata N, Seino Y, Shimizu W, Mizuno K. Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis. World J Cardiol 2015; 7:776-783. [PMID: 26635925 PMCID: PMC4660472 DOI: 10.4330/wjc.v7.i11.776] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/21/2015] [Accepted: 09/18/2015] [Indexed: 02/06/2023] Open
Abstract
Chronic inflammation of the native vessel wall with infiltration of lipid-laden foamy macrophages through impaired endothelium results in atherosclerosis. Percutaneous coronary intervention, including metallic stent implantation, is now widely utilized for the treatment of atherosclerotic lesions of the coronary artery. Bare-metal stents and the subsequently developed drug-eluting stents seal the atherosclerosis and resolve lumen stenosis or obstruction of the epicardial coronary artery and myocardial ischemia. After stent implantation, neointima proliferates within the stented segment. Chronic inflammation caused by a foreign body reaction to the implanted stent and subsequent neovascularization, which is characterized by the continuous recruitment of macrophages into the vessel, result in the transformation of the usual neointima into an atheromatous neointima. Neointima with an atherosclerotic appearance, such as that caused by thin-cap fibroatheromas, is now recognized as neoatherosclerosis, which can sometimes cause in-stent restenosis and acute thrombotic occlusion originating from the stent segment following disruption of the atheroma. Neoatherosclerosis is emerging as a new coronary stent-associated problem that has not yet been resolved. In this review article, we will discuss possible mechanisms, clinical challenges, and the future outlook of neoatherosclerosis.
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Shibuya J, Nakamura S, Komiyama H, Kato K, Inami S, Takano H, Mizuno K, Shimizu W. Target lesion evaluation by multiple modalities in vivo: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound, optical coherence tomography, and angioscopy. EUROINTERVENTION 2015; 11:e1. [PMID: 26499047 DOI: 10.4244/eijv11i6a130] [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: 11/23/2022]
Affiliation(s)
- Junsuke Shibuya
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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27
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Shiomura R, Nakamura S, Takano H, Kato K, Inui K, Kubota Y, Komiyama H, Murai K, Asai K, Shimizu W. Reply: To PMID 26059866. Am J Cardiol 2015; 116:1155. [PMID: 26282724 DOI: 10.1016/j.amjcard.2015.07.004] [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: 07/03/2015] [Accepted: 07/09/2015] [Indexed: 11/29/2022]
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Shiomura R, Nakamura S, Takano H, Kato K, Inui K, Kubota Y, Komiyama H, Murai K, Asai K, Shimizu W. Impact of Brain Natriuretic Peptide, Calcium Channel Blockers, and Body Mass Index on Recovery Time from Left Ventricular Systolic Dysfunction in Patients With Takotsubo Cardiomyopathy. Am J Cardiol 2015; 116:515-9. [PMID: 26059866 DOI: 10.1016/j.amjcard.2015.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/07/2015] [Accepted: 05/07/2015] [Indexed: 11/19/2022]
Abstract
Takotsubo cardiomyopathy (TC) is generally recognized to have a good prognosis, but it can be rarely aggravated. We sought to investigate the clinical characteristics of TC and to evaluate the effects of clinical parameters on predicting delayed recovery. We enrolled consecutive patients with TC admitted to our hospital from January 1991 to January 2014. We defined delayed recovery as sustained left ventricular (LV) systolic dysfunction requiring ≥10 days for LV contraction to normalize. We screened 9,630 patients suspected of having acute coronary syndrome, and 60 patients (0.6%; men/women: 20/38; mean age: 69.7 ± 11.9 years) were diagnosed as having TC. With the exception of 2 patients who died before LV systolic function improved, all patients recovered from LV systolic dysfunction within 6 months; the mean recovery period was 9.1 ± 11.5 days. Twenty-eight patients met the criteria for delayed recovery. Univariate logistic regression analyses showed that male gender, LV end-diastolic diameter, brain natriuretic peptide (BNP) level, body mass index (BMI), and nonuse of calcium channel blockers (CCBs) at baseline were associated with delayed recovery. Among these factors, multiple logistic regression analysis identified BNP ≥238 pg/ml (relative risk [RR] 11.6, p = 0.002) and nonuse of CCBs (RR 22.2, p = 0.0014) as independent risk factors for delayed recovery and leptosomic build (BMI <20 kg/m(2)) as an independent predictor of rapid recovery (RR 0.11, p = 0.02). In conclusion, BNP level, BMI, and use of CCBs are associated with recovery speed of LV systolic function in patients with TC.
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Affiliation(s)
- Reiko Shiomura
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Shunichi Nakamura
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
| | - Hitoshi Takano
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Koji Kato
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Keisuke Inui
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshiaki Kubota
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hidenori Komiyama
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Koji Murai
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Kuniya Asai
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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Kamiya M, Asai K, Noma S, Komiyama H, Shirakabe A, Sato N, Mizuno K. Beta-3 adrenergic receptor agonist prevents diastolic dysfunction in angiotensin2-induced cardiomyopathy mouse model. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Komiyama H, Miyake K, Asai K, Mizuno K, Shimada T. Cyclical mechanical stretch enhances degranulation and IL-4 secretion in RBL-2H3 mast cells. Cell Biochem Funct 2013; 32:70-6. [PMID: 23584980 DOI: 10.1002/cbf.2973] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/22/2013] [Accepted: 03/12/2013] [Indexed: 01/03/2023]
Abstract
Mast cells are widely distributed in the body and affect their surrounding environment through degranulation and secretion of cytokines. Conversely, mast cells are influenced by environmental stimuli such as cyclical mechanical stretch (CMS), such as that induced by heartbeat and respiration. Peripherally distributed mast cells are surrounded by extracellular matrix, where they bind IgE on their surface by expressing the high-affinity Fc receptor for IgE (FcεRI), and they release mediators after cross-linking of surface-bound IgE by allergen. To analyse how CMS affects mast cell responses, we examined the effect of applying CMS on the behaviour of IgE-bound mast cells (RBL-2H3 cell line) adhering to fibronectin as a substitute for extracellular matrix. We found that CMS enhanced FcεRI-mediated secretion in the presence of antigen (2,4-dinitrophenol-bovine serum albumin). CMS increased expression of IL-4 mRNA and secretion of IL-4 protein. Western blot analysis showed that CMS changes the signal transduction in mitogen-activated protein kinases and AKT, which in turn alters the regulation of IL-4 and increases the secretion of IL-4. These results suggest that CMS modulates the effect of mast cells on inflammation and resultant tissue remodelling. Understanding how CMS affects mast cell responses is crucial for developing therapies to treat mast cell-related diseases.
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Affiliation(s)
- Hidenori Komiyama
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan; First Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
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Ishiyama S, Tashiro Y, Nagayasu K, Niwa K, Ono S, Sugimoto K, Hata M, Kamiyama H, Komiyama H, Takahashi M, Yaginuma Y, Kojima Y, Goto M, Tanaka M, Sengoku H, Okuzawa A, Tomiki Y, Sakamoto K. Spontaneous disappearance of a giant colonic lipoma after endoscopic biopsy. Endoscopy 2011; 43 Suppl 2 UCTN:E16. [PMID: 21271519 DOI: 10.1055/s-0030-1255826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 12/10/2022]
Affiliation(s)
- S Ishiyama
- Department of Coloproctological Surgery, Juntendo University, Tokyo, Japan.
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Abstract
ABSTRACTFirst observation is reported of the deposition rate dependence of Raman-detected structural disorder in a-Si:H/a-SiNx semiconductor superlattices as well as a-Si/a-SiNx ones. FWHM of TO-like Raman peak of a-Si:H in the multilayer structure rapidly decreases as deposition rate decreases, while that of a- Si decreases more slowly. The results demonstrate that the structural disorder of a-Si:H/a-SiNx decreases as time to grow a monolayer (TGM) increases in a time range of a second, and also suggest that hydrogen covering the growing surface enhances the structural-relaxation velocity of disordered amorphous network.
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Shimogaki Y, Lim SW, Loh EG, Nakano Y, Tada K, Komiyama H. Structire, Properties, and Process Characteristics of Low-K Materials Prepared by PECVD. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-565-255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractLow dielectric constant F-doped silicon oxide films (SiO:F) can be prepared by adding fluorine source, like as CF4 to the conventional PECVD processes. We could obtain SiO:F films with dielectric constant as low as 2.6 from the reaction mixture of SiH4/N2 O/CF4. The structural changes of the oxides were sensitively detected by Raman spectroscopy. The three-fold ring and network structure of the silicon oxides were selectively decreased by adding fluorine into the film. These structural changes contribute to the decrease ionic polarization of the film, but it was not the major factor for the low dielectric constant. The addition of fluorine was very effective to eliminate the Si-OH in the film and the disappearance of the Si-OH was the key factor to obtain low dielectric constant. A kinetic analysis of the process was also performed to investigate the reaction mechanism. We focused on the effect of gas flow rate, i.e. the residence time of the precursors in the reactor, on growth rate and step coverage of SiO:F films. It revealed that there exists two species to form SiO:F films. One is the reactive species which contributes to increase the growth rate and the other one is the less reactive species which contributes to have uniform step coverage. The same approach was made on the PECVD process to produce low-k C:F films from C2F4, and we found ionic species is the main precursor to form C:F films.
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Kajikawa Y, Noda S, Komiyama H. A Simple Index to Restrain Abnormal Protrusions in Films Fabricated Using CVD under Diffusion-Limited Conditions. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/cvde.200306285] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kajikawa Y, Tsuchiya T, Noda S, Komiyama H. Incubation Time during Chemical Vapor Deposition of Si onto SiO2 from Silane. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/cvde.200304165] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Itoh N, Tun KL, Komiyama H, Ueki N, Ogawa K. An ovarian infection in the Iwagaki oyster, Crassostrea nippona, with the protozoan parasite Marteilioides chungmuensis. J Fish Dis 2004; 27:311-314. [PMID: 15139910 DOI: 10.1111/j.1365-2761.2004.00540.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- N Itoh
- Laboratory of Fish Diseases, Department of Aquatic Bioscience, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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Zhou HS, Honma I, Komiyama H, Haus JW. Coated semiconductor nanoparticles; the cadmium sulfide/lead sulfide system's synthesis and properties. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100106a015] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Honma I, Sano T, Komiyama H. Surface-enhanced Raman scattering (SERS) for semiconductor microcrystallites observed in silver-cadmium sulfide hybrid particles. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100127a020] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Liu XD, Funakubo H, Noda S, Komiyama H. Internal Microstructure and Formation Mechanism of Surface Protrusions in Pb-Ti-Nb-O Thin Films Prepared by MOCVD. ACTA ACUST UNITED AC 2001. [DOI: 10.1002/1521-3862(200111)7:6<253::aid-cvde253>3.0.co;2-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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43
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Akiba Y, Sato K, Takahashi K, Matsushita K, Komiyama H, Tsunekawa H, Nagao H. Meat Color Modification in Broiler Chickens by Feeding Yeast Phaffia rhodozyma Containing High Concentrations of Astaxanthin. J APPL POULTRY RES 2001. [DOI: 10.1093/japr/10.2.154] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Zhou HS, Aoki S, Honma I, Hirasawa M, Nagamune T, Komiyama H. Conformational change of protein cytochrome b-562 adsorbed on colloidal gold particles; absorption band shift. Chem Commun (Camb) 1997. [DOI: 10.1039/a607451k] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
The successful treatment of severe left lower limb phantom pain is reported. Hypnosis and antidepressant drugs were the basis for the treatment which controlled the phantom limb pain and an associated post-traumatic stress disorder.
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Affiliation(s)
- M Muraoka
- Department of Psychosomatic Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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46
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Miyahara T, Komiyama H, Miyanishi A, Takata M, Nagai M, Kozuka H, Hayashi T, Yamamoto M, Ito Y, Odake H. Stimulative effects of lead on bone resorption in organ culture. Toxicology 1995; 97:191-7. [PMID: 7716786 DOI: 10.1016/0300-483x(94)02948-t] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To clarify whether hypercalcemia after injection of Pb to rats is due to biological bone resorption or physicochemical mineral dissolution, the effect of lead (Pb) on release of previously incorporated 45Ca in organ culture was investigated. Pb at 50 microM and above stimulated the release of 45Ca and hydroxyproline (Hyp). Pb did not stimulate 45Ca release from the bones inactivated by freezing and thawing. Eel calcitonin (ECT), bafilomycin A1 and scopadulcic acid B (SDB) inhibited Pb-stimulated 45Ca release. These results indicate that Pb-induced 45Ca release is due to osteoclastic bone resorption. Pb-stimulated bone resorption was inhibited by indomethacin and flurbiprofen. Pb stimulated the release of prostaglandin E2 (PGE2) from the bones into the media. There was significantly high correlation between 45Ca and PGE2 release. Pb-induced bone resorption was inferred to be mediated by PGE2. From these results, it was suggested that hypercalcemia after Pb injection might be caused by biological bone resorption.
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Affiliation(s)
- T Miyahara
- Department of Toxicology, Faculty of Pharmaceutical Sciences, Toyama Medical and Pharmaceutical University, Japan
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Yokoyama K, Miyahara T, Matsumoto M, Hashimoto K, Komiyama H, Miyanishi A, Kotera N, Maruyama F, Kozuka H. Bone-resorbing activities of 24-epi-1 alpha-hydroxyvitamin D2 and 24-epi-1 alpha,25-dihydroxyvitamin D2. Calcif Tissue Int 1995; 56:49-53. [PMID: 7796346 DOI: 10.1007/bf00298744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Bone-resorbing activities of 24-epi-1 alpha-hydroxyvitamin D2 [24-epi-1 alpha(OH)D2], 24-epi-1 alpha,25-dihydroxyvitamin D2 [24-epi-1,25(OH)2D2], and 1 alpha,24S,25-trihydroxyvitamin D2 [1,24S,25(OH)3D2], which might be a metabolite of 24-epi-1,25(OH)2D2, were investigated. In an in vitro bone resorption test, the activity of 24-epi-1 alpha(OH)D2 was similar to that of 1 alpha-hydroxyvitamin D3 [1 alpha(OH)D3] at 10(-9) M-10(-6) M. The activity of 24-epi-1,25(OH)2D2 was weaker than that of 1 alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3] at 10(-11) M-10(-8) M. On the other hand, the activity of 1,24S,25(OH)3D2 was similar to that of 24-epi-1,25(OH)2D2 at 10(-11) M-10(-9) M. In the formation assay of osteoclast-like cells, the activity of 24-epi-1 alpha(OH)D2 was weaker than that of 1 alpha(OH)D3 at 10(-7) M. The activity of 24-epi-1,25(OH)2D2 was almost similar to that of 1,25(OH)2D3 at 10(-11) M-10(-7) M. The activity of 1,24S,25(OH)3D2 was significantly weaker than that of 24-epi-1,25(OH)2D2 at 10(-11) M-10(-9) M. In the two experiments, the potencies of 24-epi-1,25(OH)2D2 were about 100 times higher than those of 24-epi-1 alpha(OH)D2. In an in vivo/in vitro bone resorption test, the activity of 24-epi-1 alpha(OH)D2 was almost similar to those of 1 alpha(OH)D3 and 1,25(OH)2D3 and higher than those of 24-epi-1,25(OH)2D2 and 1,24S,25(OH)3D2. 24-epi-1 alpha-(OH)D2 and 1 alpha(OH)D3 were longer lasting than 24-epi-1,25(OH)2D2 and 1,25(OH)2D3 in this experiment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- K Yokoyama
- Department of Toxicology, Hikone Research Laboratories, Maruho Co., Ltd., Shiga, Japan
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48
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Zhou HS, Honma I, Komiyama H, Haus JW. Controlled synthesis and quantum-size effect in gold-coated nanoparticles. Phys Rev B Condens Matter 1994; 50:12052-12056. [PMID: 9975346 DOI: 10.1103/physrevb.50.12052] [Citation(s) in RCA: 204] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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49
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Miyahara T, Harada M, Kondo S, Komiyama H, Matsuda S, Miyanishi A, Matsumoto M, Xue-Ya W, Ikemoto Y, Sugure A. Calcium regulating activity of 26,27-dimethyl analog of 24R,25-dihydroxyvitamin D3. Calcif Tissue Int 1994; 55:190-7. [PMID: 7987732 DOI: 10.1007/bf00425874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To determine the possibility that methyl substitution in 26- and 27-positions of 24R,25-dihydroxyvitamin D3 [24,25(OH)2D3] alters activities of the original compound, the effects of 24,25(OH)2D3 on calcium (Ca) regulating activity were compared with those of its methyl analog [24,25(OH)2(CH3)2D3] in addition to 1 alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3]. 24,25(OH)2D3 at 10(-6) M and 24,25(OH)2(CH3)2D3 at 10(-7) M and above significantly stimulated both bone resorption in neonatal mouse calvaria cultures and formation of osteoclast-like multinucleated cells (MNC) in mouse bone marrow cultures. A stimulative effect of 1,25(OH)2D3 on bone resorption and MNC formation was recognized in very low concentrations (10(-11) M and above). Although a potency of 24,25(OH)2(CH3)2D3 in stimulating bone calcium (Ca) mobilization and intestinal Ca transport was higher than that of 24,25(OH)2D3, the potencies of both compounds were similar to that of 1,25(OH)2D3 unlike in vitro experiments. As 1,24R,25-trihydroxy-26,27-dimethylvitamin D3 showed almost the same effect as 24,25(OH)2(CH3)2D3, the dihydroxy form is suggested to be hydroxylated at 1 alpha position and converted to trihydroxy form in vitamin D-deficient rats. From these results, methyl substitution in 26- and 27-position of 24,25(OH)2D3 was found to elevate Ca regulating activity of the original compound. In addition, it is suggested that the basis for a similarity in potency between 1,25(OH)2D3 and 24,25(OH)2D3 or its dimethyl analog in vitamin D-deficient rats is likely the result of 1 alpha-hydroxylation.
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Affiliation(s)
- T Miyahara
- Department of Toxicology, Faculty of Pharmaceutical Sciences, Toyama Medical and Pharmaceutical University, Japan
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Miyahara T, Komiyama H, Miyanishi A, Matsumoto M, Xue-Ya W, Takata M, Takata S, Nagai M, Kozuka H, Yokoyama K. Effects of lead on osteoclast-like cell formation in mouse bone marrow cell cultures. Calcif Tissue Int 1994; 54:165-9. [PMID: 7516817 DOI: 10.1007/bf00296069] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To examine an effect of lead (Pb) on the process of osteoclast-like cell formation from its progenitors, we used a mouse bone marrow culture system in which osteoclast-like multinucleated cells (MNCs) were formed in response to bone-resorbing agents. In a 9-day culture period, Pb dose-dependently stimulated MNC formation over the concentration range 2-10 microM, whereas at 40 microM Pb, MNC formation declined. In an 11-day culture period, MNC formation reached a maximum at 5 microM Pb and decreased with increasing concentration of Pb at 10-40 microM. Pb-stimulated MNC formation was inhibited by both indomethacin and SC19220, an antagonist of prostaglandin E2 (PGE2) receptor. Pb stimulated the production of PGE2 in marrow cell cultures, suggesting that Pb-stimulated MNC formation is dependent on the production of PGE2. 3-Isobutyl-1-methylxanthine potentiated Pb-stimulated MNC formation and 2',5'-dideoxyadenosine, an inhibitor of adenylate cyclase, inhibited it. A calcium ionophore A23187 increased Pb-induced MNC formation and verapamil, a calcium channel blocker, depressed it. It is possible that a PGE2-induced increase in the levels of cyclic adenosine 3',5'-monophosphate (cAMP) and calcium ions in marrow cells is involved in Pb-induced MNC formation. Pb and parathyroid hormone showed a synergistic stimulation on MNC formation. From these results, Pb is thought to induce osteoclast-like cell formation by a mechanism involving PGE2 which increases the intracellular levels of cAMP and calcium ions.
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Affiliation(s)
- T Miyahara
- Department of Toxicology, Faculty of Pharmaceutical Sciences, Toyama Medical and Pharmaceutical University, Japan
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