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Kario K, Hoshide S, Tomitani N, Nishizawa M, Yoshida T, Kabutoya T, Fujiwara T, Mizuno H, Narita K, Komori T, Ogata Y, Suzuki D, Ogoyama Y, Ono A, Yamagiwa K, Abe Y, Nakazato J, Nakagawa N, Katsuya T, Harada N, Kanegae H. Inconsistent Control Status of Office, Home, and Ambulatory Blood Pressure All Taken Using the Same Device: The HI-JAMP Study Baseline Data. Am J Hypertens 2023; 36:90-101. [PMID: 36053278 DOI: 10.1093/ajh/hpac103] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/16/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inconsistencies between the office and out-of-office blood pressure (BP) values (described as white-coat hypertension or masked hypertension) may be attributable in part to differences in the BP monitoring devices used. METHODS We studied consistency in the classification of BP control (well-controlled BP vs. uncontrolled BP) among office, home, and ambulatory BPs by using a validated "all-in-one" BP monitoring device. In the nationwide, general practitioner-based multicenter HI-JAMP study, 2,322 hypertensive patients treated with antihypertensive drugs underwent office BP measurements and 24-hour ambulatory BP monitoring (ABPM), consecutively followed by 5-day home BP monitoring (HBPM), for a total of seven BP measurement days. RESULTS Using the thresholds of the JSH2019 and ESC2018 guidelines, the patients with consistent classification of well-controlled status in the office (<140 mmHg) and home systolic BP (SBP) (<135 mmHg) (n = 970) also tended to have well-controlled 24-hour SBP (<130 mmHg) (n = 808, 83.3%). The patients with the consistent classification of uncontrolled status in office and home SBP (n = 579) also tended to have uncontrolled 24-hour SBP (n = 444, 80.9%). Among the patients with inconsistent classifications of office and home BP control (n = 803), 46.1% had inconsistent ABPM-vs.-HBPM out-of-office BP control status. When the 2017 ACC/AHA thresholds were applied as an alternative, the results were essentially the same. CONCLUSIONS The combined assessment of the office and home BP is useful in clinical practice. Especially for patients whose office BP classification and home BP classification conflict, the complementary clinical use of both HBPM and ABPM might be recommended.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Naoko Tomitani
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | | | - Tetsuro Yoshida
- Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Takeshi Fujiwara
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Hiroyuki Mizuno
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Takahiro Komori
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yukiyo Ogata
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Daisuke Suzuki
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.,Division of Endocrinology and Metabolism, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yukako Ogoyama
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | | | | | | | | | - Naoki Nakagawa
- Division of Cardiology, Nephrology, Pulmonology, and Neurology, Department of Internal Medicine, Asahikawa Medical University, Hokkaido, Japan
| | | | - Noriko Harada
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Hiroshi Kanegae
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.,Genki Plaza Medical Center for Health Care, Tokyo, Japan
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Tan M, Takahara M, Soga Y, Mori S, Tsuchiya T, Mazaki T, Shintani Y, Noguchi M, Taniguchi M, Kobayashi Y, Nakazato J, Urasawa K. Three-Year Clinical Outcomes Following Implantation of LifeStent Self-Expanding Nitinol Stents in Patients With Femoropopliteal Artery Lesions. Angiology 2021; 73:244-251. [PMID: 34493086 DOI: 10.1177/00033197211042685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The aim of this study was to evaluate midterm clinical outcomes after implantation of LifeStent self-expanding nitinol stents for the treatment of femoropopliteal lesions. This retrospective, multicenter, non-randomized study examined 260 femoropopliteal lesions in 250 consecutive patients with peripheral artery disease implanted with LifeStents from April 2016 to April 2017. The prevalence of chronic total occlusion (CTO), lesion length ≥25 cm, and distal reference vessel diameter (RVD) <5 mm was 58%, 35%, and 50%, respectively. The 3-year restenosis rate in the overall population was estimated to be 72.9% and a major adverse limb event was observed in 36.9%. Multivariate analysis revealed that chronic limb-threatening ischemia (CLTI) (odds ratio [OR]: 8.04; 95% confidence interval [CI]: 1.86-34.7), CTO (OR: 4.87; 95% CI: 1.43-16.6), lesion length ≥25 cm (OR: 5.95; 95% CI: 1.11-32.0), and distal RVD <5 mm (OR: 4.43; 95% CI: 1.34-14.6) were independent risk factors for 3-year restenosis. The present study demonstrated the midterm clinical outcomes and risk factors for restenosis after implantation of the LifeStent in femoropopliteal artery lesions. CLTI, CTO, lesion length ≥25 cm, and distal RVD <5 mm predicted decreased patency after a 3-year follow-up.
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Affiliation(s)
- Michinao Tan
- Cardiovascular Center, Tokeidai Memorial Hospital, Sapporo, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshimitsu Soga
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Taketsugu Tsuchiya
- Department of Transcatheter Cardiovascular Therapeutics, Kanazawa Medical University Hospital, Kahoku-gun, Japan
| | - Toru Mazaki
- Department of Cardiology, Kobe Central Hospital, Kobe, Japan
| | - Yoshiaki Shintani
- Department of Cardiology, Ageo Central General Hospital, Ageo, Saitama, Japan
| | - Masahiko Noguchi
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Uyarasu, Japan
| | | | - Yohei Kobayashi
- Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan
| | - Jun Nakazato
- Division of Cardiovascular Medicine, Okinawa Chubu Hospital, Okinawa, Japan
| | - Kazushi Urasawa
- Cardiovascular Center, Tokeidai Memorial Hospital, Sapporo, Japan
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3
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Nagashima K, Hiro T, Fukamachi D, Okumura Y, Watanabe I, Hirayama A, Tanaka M, Tanaka T, Takamisawa I, Taguchi I, Sato A, Aonuma K, Fukamizu S, Nakada A, Watanabe A, Amioka N, Suzuki Y, Matsumoto N, Koizumi J, Kumagai K, Naya M, Higuchi Y, Naito Y, Masuyama T, Kawamura M, Tsunoda R, Suzuki S, Ishii H, Murohara T, Shimizu T, Takeishi Y, Shiina K, Yamashita J, Imamura T, Sumitomo N, Noguchi T, Aso T, Furukawa K, Yamauchi Y, Okishige K, Sakata K, Yamagishi M, Shimizu S, Ohno M, Sugano T, Matsumura K, Matsumoto K, Ozaki K, Hayashidani S, Meno H, Iwata A, Higuma T, Tomita H, Yoshino H, Taniai S, Shishido K, Murakami M, Negishi K, Nii M, Wakatsuki D, Suzuki H, Motoike Y, Ozaki Y, Nakazato J, Hayashi H, Higuchi S, Shoda M. Anomalous origin of the coronary artery coursing between the great vessels presenting with a cardiovascular event (J-CONOMALY Registry). Eur Heart J Cardiovasc Imaging 2021; 21:222-230. [PMID: 31185091 DOI: 10.1093/ehjci/jez076] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/28/2019] [Indexed: 11/12/2022] Open
Abstract
AIMS Anomalous origin of the coronary artery (AOCA) with an inter-arterial course (IAC) between the great vessels poses a risk for a life-threatening cardiovascular event. We assessed, in a registry-based study, the clinical features, treatment strategies, and prognoses of life-threatening cardiovascular events ensuant to AOCA. METHODS AND RESULTS Included were 65 AOCA patients (48 men/17 women, aged 41 ± 23 years) from 40 clinical centres who had experienced sudden cardiac arrest (SCA) (n = 30), acute myocardial infarction (AMI) (n = 5), angina (n = 23), or syncope (n = 7). The anomalous vessel was the right coronary artery in 72% of patients and left coronary artery in 28%; the ostium was slit-like in 42%. Coronary luminal narrowing ≥75% was absent in patients with SCA or syncope (86% and 57%, respectively), but occlusion or narrowing was seen in those with AMI (100%) or angina (52%). Age ≤40 years, male sex, sporting activity, absence of prodromal symptoms, acutely angled (≤30°) take-off from the aorta, and absence of luminal narrowing of the IAC segment were associated with SCA in this patient group. Coronary vasospasm was inducible in 12 of 17 patients without coronary narrowing. Management included surgical revascularization (n = 26) percutaneous coronary intervention (n = 9), and medical treatment (n = 26). Four SCA patients died while hospitalized; no others died during the median 5.0 (range, 1.8-7.0)-year follow-up period. CONCLUSIONS In patients with AOCA, age ≤40 years, male sex, sporting activity, and an acute take-off angle appear to be risk factors for SCA. Appropriate management can be beneficial. Confirmation in a large-scale study is warranted.
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Affiliation(s)
- Koichi Nagashima
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Daisuke Fukamachi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Ichiro Watanabe
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Atsushi Hirayama
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Masashi Tanaka
- Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Tomofumi Tanaka
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-shi, Tokyo 183-0003, Japan
| | - Itaru Takamisawa
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-shi, Tokyo 183-0003, Japan
| | - Isao Taguchi
- Department of Cardiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 343-8555, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Seiji Fukamizu
- Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan
| | - Akihiro Nakada
- Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan
| | - Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Naofumi Amioka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Yasuyuki Suzuki
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan
| | - Junichi Koizumi
- Department of Cardiovascular Surgery, Memorial Heart Center, Iwate Medical University, 9-1, Uchimaru, Morioka city, Iwate 020-8505, Japan
| | - Kazuya Kumagai
- Department of Cardiovascular Surgery, Memorial Heart Center, Iwate Medical University, 9-1, Uchimaru, Morioka city, Iwate 020-8505, Japan
| | - Masanao Naya
- Department of Cardiovascular Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Yoshiharu Higuchi
- Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan
| | - Yoshiro Naito
- Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tohru Masuyama
- Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Mitsuharu Kawamura
- Division of Cardiology, School of Medicine, Showa University, 1-5-8, Hatanodai Shinagawa, Tokyo 142-8555, Japan
| | - Ryusuke Tsunoda
- Department of Cardiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamine Minami, Higashi-ku, Kumamoto 861-8520, Japan
| | - Susumu Suzuki
- Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Takeshi Shimizu
- Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City 960-1295, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City 960-1295, Japan
| | - Kazuki Shiina
- Department of Cardiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Jun Yamashita
- Department of Cardiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Tomohiko Imamura
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-City, Saitama 350-1298, Japan
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-City, Saitama 350-1298, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Toshihide Aso
- Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan
| | - Kojiro Furukawa
- Department of Cardiovascular Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan
| | - Yasuteru Yamauchi
- Heart Center, Yokohama-City Bay Red Cross Hospital, 3-12-1, Shinnyamashita, Naka-ku, Yokohama-shi, Kanagawa 231-0801, Japan
| | - Kaoru Okishige
- Heart Center, Yokohama-City Bay Red Cross Hospital, 3-12-1, Shinnyamashita, Naka-ku, Yokohama-shi, Kanagawa 231-0801, Japan
| | - Kenji Sakata
- Department of Cardiovascular and Internal Medicine, Graduate School of Medicine, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8640, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular and Internal Medicine, Graduate School of Medicine, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8640, Japan
| | - Shigeo Shimizu
- Department of Cardiology, National Hospital Organization, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo 190-0014, Japan
| | - Masakazu Ohno
- Department of Cardiology, National Hospital Organization, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo 190-0014, Japan
| | - Teruyasu Sugano
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Koichiro Matsumura
- Department of Cardiology, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi 570-8507, Japan
| | - Kensuke Matsumoto
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, 2-5-1, Nakai-cho, Kita-ku, Okayama 700-0804, Japan
| | - Kazuyuki Ozaki
- Department of Cardiovascular Biology and Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan
| | - Shunji Hayashidani
- Division of Cardiology, Fukuoka Red Cross Hospital, 3-1-1 Okusu Minamiku, Fukuoka-shi, Fukuoka 815-8555, Japan
| | - Hiroshi Meno
- Division of Cardiology, Fukuoka Red Cross Hospital, 3-1-1 Okusu Minamiku, Fukuoka-shi, Fukuoka 815-8555, Japan
| | - Atsushi Iwata
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Takumi Higuma
- Department of Cardiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Hirofumi Tomita
- Department of Cardiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Hideaki Yoshino
- Division of Cardiology, Department of Internal Medicine II, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
| | - Seiichi Taniai
- Division of Cardiology, Department of Internal Medicine II, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
| | - Koki Shishido
- Department of Cardiology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura 247-8533, Japan
| | - Masato Murakami
- Department of Cardiology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura 247-8533, Japan
| | - Koji Negishi
- Department of Cardiology, Yokohama Municipal Citizens' Hospital, 56 Okasawa-cho, Hodogaya-ku, Yokohama City, Kanagawa 240-8555, Japan
| | - Masaki Nii
- Shizuoka Children's Hospital, 860 Urusiyama, Aoi-ku, Shizuoka 420-8660, Japan
| | - Daisuke Wakatsuki
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Kanagawa 227-8501, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Kanagawa 227-8501, Japan
| | - Yuji Motoike
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Jun Nakazato
- Department of Cardiovascular Medicine, Okinawa Prefectural Chubu Hospital, 281 Miyazato, Uruma-city, Okinawa 904-2293, Japan
| | - Hidemori Hayashi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Satoshi Higuchi
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Morio Shoda
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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Abstract
A postpartum patient with acute-onset dyspnoea and hypotention, associated with reduced left ventricular function requiring intensive blood pressure control, was initially misdiagnosed as having peripartum cardiomyopathy. Her clinical symptoms rapidly resolved. Echocardiography revealed reversible left ventricular dysfunction with apical ballooning and coronary angiography was normal. Based on these findings, we diagnosed takotsubo syndrome. Over the next two months, the patient experienced repeated bouts of elevated sympathetic activity. On workup, we found an adrenal mass and elevated urine metanephrines. After adrenalectomy, histology confirmed pheochromocytoma. Our patient had the rare diagnosis of postpartum pheochromocytoma-induced takotsubo syndrome.
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Affiliation(s)
| | - Jun Nakazato
- Cardiology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
| | - Mitsuyo Kinjo
- Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
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Miyagi T, Ishimine T, Nakazato J, Taniguchi N, Yagi N, Takahashi T, Tengan T, Wake M. Coronary Artery Embolism Caused by BioGlue Surgical Adhesive After Type A Acute Aortic Dissection Repair. JACC Case Rep 2021; 3:53-57. [PMID: 34317468 PMCID: PMC8305680 DOI: 10.1016/j.jaccas.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/04/2020] [Accepted: 11/13/2020] [Indexed: 11/21/2022]
Abstract
Coronary artery embolism due to BioGlue surgical adhesive after repair of type A acute aortic dissection is a rare condition. We report a case of BioGlue coronary artery embolism after type A acute aortic dissection repair confirmed using intravascular ultrasound imaging and pathological examination. It was successfully treated with percutaneous coronary intervention. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Tadayoshi Miyagi
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Tohru Ishimine
- Division of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Naoki Taniguchi
- Division of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Nobuhito Yagi
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Takanori Takahashi
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Toshiho Tengan
- Division of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Minoru Wake
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
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6
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Kabutoya T, Hoshide S, Fujiwara T, Negishi K, Nishizawa M, Yamamoto M, Yamagiwa K, Kawashima A, Yoshida T, Nakazato J, Matsui Y, Sekizuka H, Abe H, Abe Y, Fujita Y, Sato K, Narita K, Tsuchiya N, Kubota Y, Hashizume T, Kario K. Age-related difference of the association of cardiovascular risk factors with the cardio-ankle vascular index in the Cardiovascular Prognostic Coupling Study in Japan (the Coupling Registry). J Clin Hypertens (Greenwich) 2020; 22:1208-1215. [PMID: 32530542 PMCID: PMC8029963 DOI: 10.1111/jch.13896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 11/28/2022]
Abstract
The value of the cardio-ankle vascular index (CAVI) increases with age. All large-scale studies of the CAVI have investigated patients <80 years old. Thus, the clinical characteristics of high CAVI in patients aged 80 or more remain unclear. Therefore, we investigated (1) the CAVI in very elderly patients and (2) the determinants of a high CAVI in high-risk patients, including very elderly patients. The Cardiovascular Prognostic Coupling Study in Japan (Coupling Registry) is a prospective observational study of Japanese outpatients with any cardiovascular risk factors. We enrolled 5109 patients from 30 institutions (average age 68.7 ± 11.4 years, 52.4% males). We investigated the determinants of the CAVI by separating the patients into three groups: 970 middle-aged (<60 years), 3252 elderly (60-79 years), and 887 very elderly (≥80 years) patients. The CAVI values of the males were significantly higher those of the females in all age groups (<60 years: 7.81 ± 1.11 vs. 7.38 ± 0.99, P < .001; 60-79 years: 9.20 ± 1.29 vs. 8.66 ± 1.07, P < .001; ≥80 years: 10.26 ± 1.39 vs. 9.51 ± 1.12, P < .001). In all age groups, the CAVI of the patients with diabetes/glucose tolerance disorder was higher than that of the patients without diabetes/glucose tolerance disorder (<60 years: 7.82 ± 1.22 vs 7.58 ± 1.03, P = .002; 60-79 years: 9.23 ± 1.20 vs 8.78 ± 1.19, P < .001; ≥80 years: 10.04 ± 1.24 vs 9.75 ± 1.32, P = .002). The determinants of the CAVI in these very elderly patients were age, male sex, low BMI, and mean blood pressure. Diabetes/glucose tolerance disorder and glucose were independently associated with the CAVI in the patients aged <60 years and 60-79 years, but not in those aged ≥80 years after adjusting for other covariates.
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Affiliation(s)
| | - Satoshi Hoshide
- Jichi Medical University School of MedicineShimotsukeJapan
- Washiya HospitalUtsunomiyaJapan
| | - Takeshi Fujiwara
- Jichi Medical University School of MedicineShimotsukeJapan
- Higashiagatsuma Town National Health Insurance ClinicAgatsumagunJapan
| | - Keita Negishi
- Jichi Medical University School of MedicineShimotsukeJapan
- Washiya HospitalUtsunomiyaJapan
- JCHO Utsunomiya HospitalUtsunomiyaJapan
| | | | | | | | | | | | | | | | | | | | | | | | - Kei Sato
- Yatsushiro City Shibaru ClinicYatsushiroJapan
| | | | | | | | | | - Kazuomi Kario
- Jichi Medical University School of MedicineShimotsukeJapan
- Washiya HospitalUtsunomiyaJapan
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Kario K, Kabutoya T, Fujiwara T, Negishi K, Nishizawa M, Yamamoto M, Yamagiwa K, Kawashima A, Yoshida T, Nakazato J, Matsui Y, Sekizuka H, Abe H, Abe Y, Fujita Y, Sato K, Narita K, Tsuchiya N, Kubota Y, Hashizume T, Hoshide S. Rationale, design, and baseline characteristics of the Cardiovascular Prognostic COUPLING Study in Japan (the COUPLING Registry). J Clin Hypertens (Greenwich) 2020; 22:465-474. [PMID: 32092246 DOI: 10.1111/jch.13764] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 01/29/2023]
Abstract
Vascular biomarkers, including the cardio-ankle vascular index (CAVI), are increasingly being recognized as important indicators of cardiovascular risk. CAVI has been shown to have good discriminative ability for detecting new-onset hypertension, but results of studies investigating cardiovascular risk prediction are inconsistent. Furthermore, there is a lack of data on the prognostic value of changes in CAVI over time. The Cardiovascular Prognostic Coupling study was designed to determine the impact of baseline CAVI and changes in CAVI on cardiovascular events in a Japanese cohort. The design of the ongoing, multicenter, prospective, observational registry and baseline characteristics of the enrolled population are reported. Eligible consecutive patients were aged ≥30 years, had ≥1 cardiovascular risk factor, and were being treated according to relevant Japanese guidelines. The primary outcome is time to onset of a major cardiovascular event (a composite of cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage, stroke of unknown etiology, myocardial infarction, cardiovascular intervention for angina pectoris, and sudden death). Screening and enrollment occurred over a period of 3 years, followed by ≥7 years of follow-up, with CAVI determined annually. A total of 5279 patients were registered, of whom 5109 had baseline data available and will be included in future analyses. Mean CAVI at baseline was 8.8 ± 1.4. The proportion of patients with CAVI of <8, 8-10 or >10 was 25.3%, 57.0%, and 17.7%, respectively. Data from this registry should provide information on the significance of baseline CAVI and change in CAVI as indicators of cardiovascular prognosis in a representative patient population.
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Affiliation(s)
- Kazuomi Kario
- Jichi Medical University School of Medicine, Shimotsuke, Japan
| | | | | | - Keita Negishi
- Jichi Medical University School of Medicine, Shimotsuke, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Kei Sato
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Qld, Australia
| | | | | | | | - Toshikazu Hashizume
- National Hospital Organization Minami Wakayama Medical Center, Tanabe, Japan
| | - Satoshi Hoshide
- Jichi Medical University School of Medicine, Shimotsuke, Japan
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Nakazato J, Hoshide S, Wake M, Miura Y, Kuro-o M, Kario K. Association of calciprotein particles measured by a new method with coronary artery plaque in patients with coronary artery disease: A cross-sectional study. J Cardiol 2019; 74:428-435. [DOI: 10.1016/j.jjcc.2019.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/10/2019] [Accepted: 04/18/2019] [Indexed: 01/11/2023]
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Hirata K, Takahashi T, Nakazato J. Chest Pain and Electrocardiographic Changes in a Patient With a VVI Pacemaker. JAMA Intern Med 2019; 179:1419-1421. [PMID: 31479148 DOI: 10.1001/jamainternmed.2019.3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kazuhito Hirata
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa, Japan
| | - Takanori Takahashi
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa, Japan
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Hirata K, Nakazato J, Wake M, Takahashi T. Pseudo-hypotension with acute pulmonary oedema due to simultaneous bilateral subclavian artery stenosis in a patient with coronary artery bypass graft surgery using bilateral internal mammary arteries: a case report. Oxf Med Case Reports 2019; 2019:omz038. [PMID: 31198574 PMCID: PMC6544423 DOI: 10.1093/omcr/omz038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/17/2019] [Accepted: 04/07/2019] [Indexed: 11/25/2022] Open
Abstract
A 75-year-old woman, with a history of bilateral internal mammary artery–coronary artery bypass graft surgery, developed hypotension and pulmonary oedema posing as cardiogenic shock. Severe bilateral subclavian artery stenosis emerged to be the cause of ischaemic myocardial dysfunction and heart failure. An emergency endovascular treatment was successfully performed. The presence of simultaneous bilateral subclavian artery narrowing as the pathophysiologic mechanism of myocardial ischaemia makes this case remarkable.
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Affiliation(s)
- Kazuhito Hirata
- Division of Cardiology, Okinawa Chubu Hospital, Miyazato, Uruma, Okinawa, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Chubu Hospital, Miyazato, Uruma, Okinawa, Japan
| | - Minoru Wake
- Division of Cardiology, Okinawa Chubu Hospital, Miyazato, Uruma, Okinawa, Japan
| | - Takanori Takahashi
- Division of Cardiology, Okinawa Chubu Hospital, Miyazato, Uruma, Okinawa, Japan
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Ishimine T, Tengan T, Nakazato J. Tracheal compression by giant thoracoabdominal aortic dissecting aneurysm. Asian Cardiovasc Thorac Ann 2019; 27:317. [PMID: 30674208 DOI: 10.1177/0218492319827669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tohru Ishimine
- 1 Department of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Okinawa, Japan
| | - Toshiho Tengan
- 1 Department of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Okinawa, Japan
| | - Jun Nakazato
- 2 Department of Cardiology, Okinawa Prefectural Chubu Hospital, Okinawa, Japan
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Hirata K, Wake M, Takahashi T, Yagi N, Nakazato J, Miyagi T, Tomishima Y, Tengan T, Yasumoto H, Nakasu A, Ishimine T, Mototake H. P1597Incidence, clinical pictures and risk factors for bioprosthetic tricuspid valve stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Hirata
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - M Wake
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - T Takahashi
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - N Yagi
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - J Nakazato
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - T Miyagi
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - Y Tomishima
- Okinawa Chubu Hospital, Cardiology, Uruma, Japan
| | - T Tengan
- Okinawa Chubu Hospital, Cardiovascular Surgery, Uruma, Japan
| | - H Yasumoto
- Okinawa Chubu Hospital, Cardiovascular Surgery, Uruma, Japan
| | - A Nakasu
- Okinawa Chubu Hospital, Cardiovascular Surgery, Uruma, Japan
| | - T Ishimine
- Okinawa Chubu Hospital, Cardiovascular Surgery, Uruma, Japan
| | - H Mototake
- Okinawa Chubu Hospital, Cardiovascular Surgery, Uruma, Japan
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Hirata K, Wake M, Takahashi T, Nakazato J, Yagi N, Miyagi T, Shimotakahara J, Mototake H, Tengan T, Takara TR, Yamaguchi Y. Clinical Predictors for Delayed or Inappropriate Initial Diagnosis of Type A Acute Aortic Dissection in the Emergency Room. PLoS One 2015; 10:e0141929. [PMID: 26559676 PMCID: PMC4641684 DOI: 10.1371/journal.pone.0141929] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/14/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Initial diagnosis of acute aortic dissection (AAD) in the emergency room (ER) is sometimes difficult or delayed. The aim of this study is to define clinical predictors related to inappropriate or delayed diagnosis of Stanford type A AAD. METHODS We conducted a retrospective analysis of 127 consecutive patients with type A AAD who presented to the ER within 12 h of symptom onset (age: 69.0 ± 15.4 years, male/female = 49/78). An inappropriate initial diagnosis (IID) was considered if AAD was not included in the differential diagnosis or if chest computed tomography or echocardiography was not performed as initial imaging tests. Clinical variables were compared between IID and appropriate diagnosis group. The time to final diagnosis (TFD) was also evaluated. Delayed diagnosis (DD) was defined as TFD > third quartile. Clinical factors predicting DD were evaluated in comparison with early diagnosis (defined as TFD within the third quartile). In addition, TFD was compared with respect to each clinical variable using a rank sum test. RESULTS An IID was determined for 37% of patients. Walk-in (WI) visit to the ER [odds ratio (OR) 2.6, 95% confidence interval (CI) = 1.01-6.72, P = 0.048] and coronary malperfusion (CM, OR = 6.48, 95% CI = 1.14-36.82, P = 0.035) were predictors for IID. Overall, the median TFD was 1.5 h (first/third quartiles = 0.5/4.0 h). DD (>4.5 h) was observed in 27 cases (21.3%). TFD was significantly longer in WI patients (median and first/third quartiles = 1.0 and 0.5/2.85 h for the ambulance group vs. 3.0 and 1.0/8.0 h for the WI group, respectively; P = 0.003). Multivariate analysis revealed that WI visit was the only predictor for DD (OR = 3.72, 95% CI = 1.39-9.9, P = 0.009). TFD was significantly shorter for appropriate diagnoses than for IIDs (1.0 vs. 6.0 h, respectively; P < 0.0001). CONCLUSIONS WI visit to the ER and CM were predictors for IID, and WI was the only predictor for DD in acute type A AAD in the community hospital.
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Affiliation(s)
- Kazuhito Hirata
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Minoru Wake
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Takanori Takahashi
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Nobuhito Yagi
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Tadayoshi Miyagi
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | | | - Hidemitsu Mototake
- Division of Cardiovascular Surgery, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Toshiho Tengan
- Division of Cardiovascular Surgery, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Tsuyoshi R. Takara
- Division of Emergency Department, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
| | - Yutaka Yamaguchi
- Division of Emergency Department, Okinawa Chubu Hospital, 281 Miyasato, Uruma, Okinawa, Japan
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Hirata K, Wake M, Takahashi T, Nakazato J, Yagi N, Miyagi T, Shimotakahara J, Takara T, Tengan T. CLINICAL PREDICTORS FOR INAPPROPRIATE INITIAL DIAGNOSIS OF ACUTE TYPE A AORTIC DISSECTION IN THE EMERGENCY ROOM. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)62104-0] [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: 10/23/2022]
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Hirata K, Yagi N, Wake M, Takahashi T, Nakazato J, Miyagi T, Shimotakahara J. Coronary steal due to ruptured right coronary aneurysm causing myocardial infarction in a patient with systemic lupus erythematosus. Cardiovasc Diagn Ther 2014; 4:333-6. [PMID: 25276619 DOI: 10.3978/j.issn.2223-3652.2014.07.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 06/24/2014] [Indexed: 11/14/2022]
Abstract
A 34-year-old female with a history of systemic lupus erythematosus (SLE) developed an acute inferior myocardial infarction while hospitalized for methicillin-resistant Staphylococcus Aureus sepsis. An emergent coronary angiography revealed an ectatic proximal left coronary artery and a huge aneurysm (37 mm × 32 mm) in the mid-portion of the right coronary artery, which had ruptured into the right atrium. A "steal phenomenon" due to significant left to right shunt resulting from the ruptured aneurysm was the cause of the myocardial infarction. Infection of the wall of the aneurysm might have contributed to the growth and the rupture in the presence of a pre-existing coronary aneurysm.
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Affiliation(s)
| | - Nobuhito Yagi
- Division of Cardiology Okinawa Chubu Hospital, Uruma, Japan
| | - Minoru Wake
- Division of Cardiology Okinawa Chubu Hospital, Uruma, Japan
| | | | - Jun Nakazato
- Division of Cardiology Okinawa Chubu Hospital, Uruma, Japan
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Nakazato J, Hirata K, Wake M. Coronary spasm as the cause of myocardial ischaemia in a patient with anomalous origin of the left anterior descending artery from the proximal right coronary artery. BMJ Case Rep 2014; 2014:bcr-2014-204408. [PMID: 24920513 DOI: 10.1136/bcr-2014-204408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/03/2022] Open
Abstract
A 49-year-old woman developed angina at rest. A CT of the coronary artery revealed that the left anterior descending artery arose from the right coronary artery, and traversed between the aorta and pulmonary trunk. An exercise stress myocardial scintigraphy did not reproduce myocardial ischaemia or anginal symptoms. A coronary angiography did not show any atherosclerotic changes. Finally, an ergotamine provocation test for vasospasm revealed diffuse severe spasm in the right coronary artery and the left anterior descending artery. Surgical correction of the anomaly was deferred and the patient was managed with medications to control spasm with good clinical outcome.
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Affiliation(s)
- Jun Nakazato
- Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan
| | - Kazuhito Hirata
- Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan
| | - Minoru Wake
- Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan
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Shimotakahara J, Hirata K, Nakazato J, Yagi N, Takahashi T, Wake M, Yasumoto H, Tengan T, Mototake H. Left ventricular pseudoaneurysm as a complication of prosthetic mitral valve infective endocarditis. J Cardiol Cases 2013; 8:e27-e30. [PMID: 30546733 DOI: 10.1016/j.jccase.2013.03.004] [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: 11/28/2012] [Revised: 02/24/2013] [Accepted: 03/08/2013] [Indexed: 10/26/2022] Open
Abstract
We report a case of infective endocarditis complicated with left ventricular pseudoaneurysm originating from the posterior annulus of the prosthetic mitral valve in a 56-year-old woman. Despite prolonged antibiotic treatment, transesophageal echocardiography (TEE) showed partial detachment of the prosthesis from the posterior mitral annulus. Three-dimensional rotational computed tomography clearly demonstrated a pseudoaneurysm toward the posterolateral portion of the mitral prosthetic valve, which was not evident by TEE. Valve replacement and repair of the pseudoaneurysm were performed 83 days after initiation of antibiotic therapy. Left ventricular pseudoaneurysm is a rare but serious complication of mitral prosthetic valve endocarditis. It requires prompt diagnosis and early surgical intervention. <Learning objective: We present a case of infective endocarditis (IE) complicated with left ventricular pseudoaneurysm originating from the prosthetic mitral valve. Repeated transesophageal echocardiography is recommended for all IE patients when perivalvular extension is suspected. Electrocardiography-gated three-dimensional-computed tomography is useful for detection and evaluation of pseudoaneurysm, especially in planning surgical procedures.>.
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Affiliation(s)
- Junichi Shimotakahara
- Division of Cardiology, Okinawa Chubu Hospital, 2-1, Asano 3, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
| | - Kazuhito Hirata
- Division of Cardiology, Okinawa Chubu Hospital, 2-1, Asano 3, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Chubu Hospital, 2-1, Asano 3, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
| | - Nobuhito Yagi
- Division of Cardiology, Okinawa Chubu Hospital, 2-1, Asano 3, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
| | - Takanori Takahashi
- Division of Cardiology, Okinawa Chubu Hospital, 2-1, Asano 3, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
| | - Minoru Wake
- Division of Cardiology, Okinawa Chubu Hospital, 2-1, Asano 3, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan
| | - Hiroshi Yasumoto
- Cardiovascular Surgery, Okinawa Chubu Hospital, Kitakyushu, Fukuoka 802-8555, Japan
| | - Toshiho Tengan
- Cardiovascular Surgery, Okinawa Chubu Hospital, Kitakyushu, Fukuoka 802-8555, Japan
| | - Hidemitsu Mototake
- Cardiovascular Surgery, Okinawa Chubu Hospital, Kitakyushu, Fukuoka 802-8555, Japan
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Hirata K, Wake M, Takahashi T, Nakazato J. ELECTROCARDIOGRAPHIC CHANGES IN PATIENTS WITH ACUTE AORTIC DISSECTION -INCIDENCE, PATTERNS AND UNDERLYING MECHANISMS IN 280 CASES-. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60563-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hattori H, Dakeshita E, Nakazato J, Takahashi T, Wake M, Hirata K, Yasumoto H, Tengan T, Mototake H. Primary chylopericardium treated by surgery: Report of two cases. J Cardiol Cases 2011; 3:e106-e110. [PMID: 30532850 DOI: 10.1016/j.jccase.2010.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 10/25/2010] [Revised: 12/12/2010] [Accepted: 12/14/2010] [Indexed: 11/26/2022] Open
Abstract
Primary chylopericardium is a rare condition. The etiology and the treatment remain unclear. We report two cases of primary chylopericardium successfully treated by surgery. Both cases were asymptomatic young women and were found to have cardiomegaly on chest X-ray at a routine annual health examination. An echocardiography demonstrated massive pericardial effusion and chylous fluid was obtained with pericardiocentesis. Lymphoscintigraphy demonstrated abnormal communication between the pericardial sac and the thoracic duct. Because of reaccumulation of chylous pericardial effusion after conservative treatment, we performed surgical ligation of thoracic duct and partial pericardectomy by video-assisted thoracic surgery (VATS) in one case and by thoracotomy in another case. After surgery, both patients are doing well without recurrence of pericardial effusion. Surgical treatment including VATS is effective and should be performed in case of primary chylopericardium.
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Affiliation(s)
| | - Eijirou Dakeshita
- Division of Thoracic Surgery, Okinawa Chubu Hospital, Okinawa, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Chubu Hospital, Okinawa, Japan
| | | | - Minoru Wake
- Division of Cardiology, Okinawa Chubu Hospital, Okinawa, Japan
| | - Kazuhito Hirata
- Division of Cardiology, Okinawa Chubu Hospital, Okinawa, Japan
| | - Hiroshi Yasumoto
- Division of Cardiovascular Surgery, Okinawa Chubu Hospital, Okinawa, Japan
| | - Toshiho Tengan
- Division of Cardiovascular Surgery, Okinawa Chubu Hospital, Okinawa, Japan
| | - Hidemitsu Mototake
- Division of Cardiovascular Surgery, Okinawa Chubu Hospital, Okinawa, Japan
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Hirata K, Wake M, Kyushima M, Takahashi T, Nakazato J, Mototake H, Tengan T, Yasumoto H, Henzan E, Maeshiro M, Asato H. Electrocardiographic changes in patients with type A acute aortic dissection. Incidence, patterns and underlying mechanisms in 159 cases. J Cardiol 2010; 56:147-53. [PMID: 20434885 DOI: 10.1016/j.jjcc.2010.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [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: 11/25/2009] [Revised: 03/23/2010] [Accepted: 03/26/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Not only symptoms but electrocardiographic (ECG) changes mimicking acute coronary syndrome as well have been known to develop in acute aortic dissection (AAD). However, detailed information is lacking. OBJECTIVE We sought to evaluate incidence, patterns, and underlying mechanisms for acute ECG changes in type A AAD. METHODS Retrospective study in a single tertiary care hospital. A total of 159 cases (mean age 65.1±14.8 years, male/female=67/92) that presented within 12 h from the onset were included. Shift of the ST segment ≥0.1 mV or changes of the T wave were considered acute ECG changes. RESULTS Acute and chronic ECG changes were observed in 49.7% and 36.5% cases, respectively. ECG was normal only in 27.0% cases. ST elevation was observed in 8.2% cases and was closely related to direct coronary involvement. ST depression and T wave changes were observed in 34.0% and 21.4% cases, respectively. Cases with ST depression or T wave changes had higher incidence of shock (65.2% vs. 28.8%, p<0.001) and cardiac tamponade (51.2% vs. 15.0%, p<0.001) compared with those without changes. CONCLUSION Acute ECG changes were common in type A AAD. Physicians taking care of patients with chest pain and acute ECG changes should consider the possibility of AAD before performing thrombolysis or percutaneous catheter intervention.
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Affiliation(s)
- Kazuhito Hirata
- Division of Cardiology, Okinawa Chubu Hospital, 281 Miyasato, Uruma City, Okinawa 904-2293, Japan.
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Abstract
We are studying human and robot interaction based on interpersonal communication, focusing on pointing. Pointing, while useful in communicating with others, is highly context-dependent, making it difficult for robots to interpret accurately. We conducted three experiments on robot behavior, creating basic motion using a virtual robot because using a real robot requires much time. We then had the virtual robot interact with two real robots having different degrees of freedom and ranges of movement.
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Yamazato M, Sakima A, Nakazato J, Sesoko S, Muratani H, Fukiyama K. Hypotensive and sedative effects of clonidine injected into the rostral ventrolateral medulla of conscious rats. Am J Physiol Regul Integr Comp Physiol 2001; 281:R1868-76. [PMID: 11705772 DOI: 10.1152/ajpregu.2001.281.6.r1868] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [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: 11/22/2022]
Abstract
We examined the effects of clonidine injected unilaterally into the rostral ventrolateral medulla (RVLM) of conscious, unrestrained rats. We also examined whether the local alpha(2)-adrenoceptor mechanism contributed to the action of clonidine injected into the RVLM. Injection of clonidine but not vehicle solution significantly decreased the mean arterial pressure (MAP), heart rate (HR), and renal sympathetic nerve activity (RSNA) in conscious, unrestrained rats as well as in propofol-anesthetized rats. The frequency of natural behavior was significantly lower after clonidine injection than after vehicle injection. The depressor and sympathoinhibitory responses were significantly larger in the propofol-anesthetized rats than in the conscious rats. Coinjection of a selective alpha(2)-adrenoceptor antagonist, 2-methoxyidazoxan, with clonidine into the RVLM significantly attenuated the depressor, bradycardiac, sympathoinhibitory, and sedative effects of clonidine injected alone. In conclusion, clonidine injected into the RVLM decreased MAP, HR, and RSNA and caused sedation in conscious, unrestrained rats. The action of clonidine in the RVLM was at least partly mediated by alpha(2)-adrenoceptor mechanisms.
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Affiliation(s)
- M Yamazato
- Third Department of Internal Medicine, University of the Ryukyus School of Medicine, 207 Uehara, Okinawa 903-0215, Japan.
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Abstract
The physical properties of experimental visible light-activated resins containing dyestuff, which could be quickly discolored by irradiation was, evaluated by analyzing light absorbance characteristics and measuring micro Vickers hardness. The experimental resin, which was prepared by mixing equivalent weights of Bis GMA and triethyleneglycol-dimethacrylate, was colored by one of three organic dye stuffs, and camphorquinone and dimethyl-p-toluidine were added to activate polymerization. In the tested materials, the experimental resins containing Methylene blue and Nile blue A were discolored quickly after the start of irradiation, and this was considered to be useful for dental practice because an overfilled margin could be easily identified. The Vickers hardness number of the base resin decreased slightly by a level of 6% by adding the dyestuff.
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Nakazato J, Shimomura H, Toko T, Hisamitsu H, Wakumoto S. [Clinical evaluation of posterior restorative composites. Two year assessment]. Showa Shigakkai Zasshi 1988; 8:77-84. [PMID: 3255143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Suzuki M, Senko H, Nakazato J, Horikoshi R. [Preoperative nursing plans and nursing practice for myocardial infarct patients scheduled for surgery]. Kango Gijutsu 1981; 27:2114-22. [PMID: 6915999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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