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Affiliation(s)
- Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chizuko Kamiya
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Rodríguez-Mañero M, Sacher F, Asmundis CD, Maury P, Lambiase PD, Sarkozy A, Probst V, Gandjbakhch E, Castro-Hevia J, Saenen J, Fukushima Kusano K, Rollin A, Arbelo E, Valderrábano M, Arias MA, Mosquera-Pérez I, Schilling R, Chierchia GB, García-Bolao I, García-Seara J, Hernandez-Ojeda J, Kamakura T, Martínez-Sande L, González-Juanatey JR, Haïssaguerre M, Brugada J, Brugada P. Monomorphic ventricular tachycardia in patients with Brugada syndrome: A multicenter retrospective study. Heart Rhythm 2016; 13:669-82. [DOI: 10.1016/j.hrthm.2015.10.038] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Indexed: 10/22/2022]
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Funasako M, Aiba T, Ishibashi K, Nakajima I, Miyamoto K, Inoue Y, Okamura H, Noda T, Kamakura S, Anzai T, Noguchi T, Yasuda S, Miyamoto Y, Fukushima Kusano K, Ogawa H, Shimizu W. Pronounced Shortening of QT Interval With Mexiletine Infusion Test in Patients With Type 3 Congenital Long QT Syndrome. Circ J 2016; 80:340-5. [DOI: 10.1253/circj.cj-15-0984] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 11/09/2022]
Affiliation(s)
- Moritoshi Funasako
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Ikutaro Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideo Okamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shiro Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School
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Kaneko Y, Kato ‘R, Nakahara S, Tobiume T, Morishima I, Tanaka K, Nakajima T, Irie T, Kusano KF, Kamakura S, Nagase T, Takayanagi K, Matsumoto K, Kurabayashi M. Characteristics and Catheter Ablation of Focal Atrial Tachycardia Originating From the Interatrial Septum. Heart Lung Circ 2015; 24:988-95. [DOI: 10.1016/j.hlc.2015.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/20/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
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Rodríguez-Mañero M, de Asmundis C, Sacher F, Arbelo E, Probst V, Castro-Hevia J, Maury P, Rollin A, Lambiase P, García-Bolao I, Chierchia GB, Fukushima Kusano K, Gourraud JB, Schilling R, Kamakura T, Martínez-Sande JL, Haïssaguerre M, González-Juanatey JR, Brugada J, Brugada P. T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads. Circ Arrhythm Electrophysiol 2015; 8:792-8. [DOI: 10.1161/circep.115.002871] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 02/11/2015] [Accepted: 05/19/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Moisés Rodríguez-Mañero
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Carlo de Asmundis
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Frédéric Sacher
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Elena Arbelo
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Vincent Probst
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Jesús Castro-Hevia
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Philippe Maury
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Anne Rollin
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Pier Lambiase
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Ignacio García-Bolao
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Gian-Battista Chierchia
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Kengo Fukushima Kusano
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Jean-Baptiste Gourraud
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Richard Schilling
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Tsukasa Kamakura
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Jose Luis Martínez-Sande
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Michel Haïssaguerre
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - José Ramón González-Juanatey
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Jose Brugada
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
| | - Pedro Brugada
- From the Hospital Clínico Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Spain (M.R.-M., L.M.-S., J.R.G.-J.); Department of Cardiology, Vrije Universiteit Brussel (VUB), Brussels, Belgium (C.d.A., G.-B.C., P.B.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S., M.H.); Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain (E.A., J.B.); CHU de Nantes, Nantes, France (V.P., J.-B.G.); Instituto de Cardiología y Cirugía
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Nagase S, Banba K, Nishii N, Morita H, Fukushima Kusano K, Ohe T, Ito H. Multiform premature ventricular contractions and polymorphic ventricular tachycardia caused by Purkinje activity with slow conduction in idiopathic ventricular fibrillation. Intern Med 2014; 53:725-8. [PMID: 24694485 DOI: 10.2169/internalmedicine.53.1147] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In several cases with idiopathic ventricular fibrillation (VF), VF was initiated by premature ventricular contractions (PVCs) from the Purkinje system. However, the precise characteristics of the Purkinje activity in patients with idiopathic VF remain unclear. We performed an electrophysiological study in a patient with idiopathic VF and examined the correlation between the Purkinje potential and the incidence of PVCs/polymorphic ventricular tachycardia (PMVT). In this case of idiopathic VF, the Purkinje activity caused multiform PVCs and PMVT. The The Purkinje activity and slow conduction of Purkinje fibers are associated with the occurrence of multiform PVCs and PMVT.
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Affiliation(s)
- Satoshi Nagase
- Departments of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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Fukushima Kusano K. J wave monitoring and drug efficacy in Brugada syndrome. Intern Med 2014; 53:1459-60. [PMID: 25030554 DOI: 10.2169/internalmedicine.53.2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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Fukushima H, Mitsuhashi T, Oto T, Sano Y, Kusano KF, Goto K, Okazaki M, Date H, Kojima Y, Yamagishi H, Takahashi T. Successful lung transplantation in a case with diffuse pulmonary arteriovenous malformations and hereditary hemorrhagic telangiectasia. Am J Transplant 2013; 13:3278-81. [PMID: 24165284 DOI: 10.1111/ajt.12499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/20/2013] [Accepted: 09/07/2013] [Indexed: 01/25/2023]
Abstract
Diffuse pulmonary arteriovenous malformations (AVMs) are associated with a poor prognosis and the therapeutic strategy remains controversial. We describe a pediatric patient with diffuse pulmonary AVMs associated with hereditary hemorrhagic telangiectasia (HHT), who presented with two cerebral AVMs in the parietal and occipital lobes as well. Of note, successful bilateral lung transplantation not only improved the hypoxemia but also resulted in size reduction of the cerebral AVMs. Although it is essential to consider involvements other than pulmonary AVMs, especially brain AVMs, to decide the indication, lung transplantation can be a viable therapeutic option for patients with diffuse pulmonary AVMs and HHT.
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Affiliation(s)
- H Fukushima
- Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan
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Kawata H, Morita H, Yamada Y, Noda T, Satomi K, Aiba T, Isobe M, Nagase S, Nakamura K, Fukushima Kusano K, Ito H, Kamakura S, Shimizu W. Prognostic significance of early repolarization in inferolateral leads in Brugada patients with documented ventricular fibrillation: a novel risk factor for Brugada syndrome with ventricular fibrillation. Heart Rhythm 2013; 10:1161-8. [PMID: 23587501 DOI: 10.1016/j.hrthm.2013.04.009] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is known about the clinical and prognostic impact of early repolarization (ER) on patients with Brugada syndrome (BrS), especially those with documented ventricular fibrillation (VF). OBJECTIVE To investigate the prevalence and prognostic significance of ER in inferolateral leads in patients with BrS and documented VF. METHODS We investigated 10 different 12-lead electrocardiograms (ECGs) recorded on different days to identify the presence of ER, which was defined as J-point elevation ≥0.1 mV in inferior (II, III, aVF) or lateral leads (I, aVL, V₄-V₆), in 49 individuals (46 men; age 46 ± 13 years) with a type 1 ECG of BrS and previous history of VF. RESULTS ER was observed persistently (in all ECGs) in 15 patients (31%; P group), intermittently (in at least one but not in all ECGs) in 16 patients (33%; I group), and not observed in 18 patients (37%; N group), yielding an overall ER incidence of 63% (31/49). During the follow-up period (7.7 years), recurrence of VF was documented in all 15 patients (100%) in the P group, and less in 12 patients (75%) in the I group and in 8 patients (44%) in the N group. The P group showed a worse prognosis than N group (P = .0001) by Kaplan-Meier analysis. Either persistent or intermittent ER in an inferolateral lead was an independent predictor of fatal arrhythmic events (hazard ratio 4.88, 95% confidence interval 2.02-12.7, P = .0004; and hazard ratio 2.50, 95% confidence interval 1.03-6.43, P = .043, respectively). CONCLUSION The prevalence of ER in inferolateral leads was high and an especially persistent form of ER was associated with a worse outcome in BrS patients with documented VF.
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Affiliation(s)
- Hiro Kawata
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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10
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Sumita Yoshikawa W, Nakamura K, Miura D, Shimizu J, Hashimoto K, Kataoka N, Toyota H, Okuyama H, Miyoshi T, Morita H, Fukushima Kusano K, Matsuo T, Takaki M, Kajiya F, Yagi N, Ohe T, Ito H. Increased Passive Stiffness of Cardiomyocytes in the Transverse Direction and Residual Actin and Myosin Cross-Bridge Formation in Hypertrophied Rat Hearts Induced by Chronic β-Adrenergic Stimulation. Circ J 2013; 77:741-8. [DOI: 10.1253/circj.cj-12-0779] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 11/09/2022]
Affiliation(s)
- Wakako Sumita Yoshikawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Daiji Miura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Ken Hashimoto
- Departments of Medical Engineering and Physiology, Kawasaki Medical School
| | - Noriyuki Kataoka
- Departments of Medical Engineering and Physiology, Kawasaki Medical School
| | - Hiroko Toyota
- Departments of Medical Engineering and Physiology, Kawasaki Medical School
| | - Hiroshi Okuyama
- Departments of Medical Engineering and Physiology, Kawasaki Medical School
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Tatsuhito Matsuo
- Research and Utilization Division, Japan Synchrotron Radiation Research Institute, SPring-8
| | - Miyako Takaki
- Department of Physiology II, Nara Medical University
| | - Fumihiko Kajiya
- Departments of Medical Engineering and Physiology, Kawasaki Medical School
| | - Naoto Yagi
- Research and Utilization Division, Japan Synchrotron Radiation Research Institute, SPring-8
| | - Tohru Ohe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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11
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Akagi S, Nakamura K, Matsubara H, Kusano KF, Kataoka N, Oto T, Miyaji K, Miura A, Ogawa A, Yoshida M, Ueda-Ishibashi H, Yutani C, Ito H. Prostaglandin I2 induces apoptosis via upregulation of Fas ligand in pulmonary artery smooth muscle cells from patients with idiopathic pulmonary arterial hypertension. Int J Cardiol 2011; 165:499-505. [PMID: 21955608 DOI: 10.1016/j.ijcard.2011.09.004] [Citation(s) in RCA: 19] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 08/19/2011] [Accepted: 09/05/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pulmonary vascular remodeling with idiopathic pulmonary arterial hypertension (IPAH) is associated with impaired apoptosis of pulmonary artery smooth muscle cells (PASMCs). We have reported that high-dose prostaglandin I2 (PGI2) therapy markedly improved hemodynamics in IPAH patients. The therapy is thought to reverse vascular remodeling, though the mechanism is unclear. The aim of this study is to assess proapoptotic effects of PGI2 on PASMCs obtained from IPAH patients. METHODS We investigated proapoptotic effects of PGI2 in PAH-PASMCs by TUNEL assays, caspase-3,-7 assays and transmission electron microscopy. We examined the expression of Fas ligand (FasL), an apoptosis-inducing member of the TNF cytokine family, in PAH-PASMCs. We measured the serum FasL levels in IPAH patients treated with PGI2. RESULTS TUNEL-positive, caspase-3, 7-active cells and fragmentation of the nucleus were detected in PAH-PASMCs treated with PGI2. The percentage of apoptotic cells induced by PGI2 at a high concentration was higher than that induced by PGI2 at a low concentration. PCR-array analysis revealed that PGI2 upregulated the FasL gene in PAH-PASMCs, and we measured the FasL expression by quantitative RT-PCR and Western blotting. PGI2 significantly increased the mRNA level of FasL by 3.98 fold and the protein level of FasL by 1.70 fold. An IP receptor antagonist inhibited the induction of apoptosis, elevation of cyclic AMP and upregulation of FasL by PGI2. Serum FasL level had a significant positive correlation with PGI2 dose in IPAH patients treated with PGI2. CONCLUSIONS PGI2 has proapoptotic effects on PAH-PASMCs via the IP receptor and upregulation of FasL.
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Affiliation(s)
- Satoshi Akagi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Nakagawa K, Nakamura K, Kusano KF, Nagase S, Tada T, Murakami M, Hata Y, Morita H, Kohno K, Hina K, Ujihira T, Ohe T, Ito H. Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure. Pharmaceuticals (Basel) 2011. [PMCID: PMC4055956 DOI: 10.3390/ph4060794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 11/16/2022] Open
Abstract
Background: Both nifekalant hydrochloride (NIF), a selective IKr blocker, and intravenous amiodarone (AMD), a multi-channel (including IKr blocking) blocker, have been reported to be efficacious for refractory arrhythmias. However, the optimal use of those antiarrhythmic drugs for refractory arrhythmia with severe heart failure has not been established. Intravenous AMD might be effective for arrhythmias refractory to NIF in patients with severe heart failure. Here, we report that intravenous amiodarone was effective in the treatment of nifekalant-resistant in a group of arrhythmia patients with severe heart failure. Methods: Eleven severe heart failure patients who had received intravenous AMD for treatment of NIF-resistant arrhythmias were included in this study, and retrospective analysis was performed. Clinical efficacy (terminative and preventive effects on arrhythmia) of intravenous AMD was evaluated. Results: All cases were emergent cases and had depressed left ventricular ejection fraction (30 ± 13%). Clinical arrhythmias were ventricular fibrillation (VF) in four patients, ventricular tachycardia (VT) in six patients, and atrial fibrillation (AF) in one patient. NIF was administered to all patients by intravenous injection. After administration of NIF, VT/VF/AF was terminated in seven of the 10 patients, but a preventive effect was not obtained in any of the patients (NIF-resistance). Intravenous AMD (maintenance dose: 484 ± 166 mg/day) was effective both in termination (80%) and in prevention (80%) of VT/VF events in those patients. It was also effective in termination (80%) and prevention (60%) of AF events refractory to NIF. During continuous AMD administration, no significant adverse effects or proarrhythmic effects were observed in any of the patients. Five patients died within one month, but there was no arrhythmic deaths. Conclusions: Intravenous AMD was effective in NIF-resistant lethal arrhythmias and was relatively safe in emergent cases with severe heart failure.
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Affiliation(s)
- Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-86-235-7351; Fax: +81-86-235-7353
| | - Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Takeshi Tada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Masato Murakami
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Yoshiki Hata
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
| | - Kunihisa Kohno
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
- Department of Cardiology, National Hospital Organization Iwakuni Medical Center, Iwakuni, 7400304, Japan
| | - Kazumasa Hina
- Department of Cardiology, Okayama Heart Clinic, Okayama, 7008558, Japan
| | - Tohru Ujihira
- Department of Cardiology, Okayama Redcross Hospital, Okayama, 7008558, Japan
| | - Tohru Ohe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
- Department of Cardiology, Cardiovascular Center Sakakibara Hospital, Okayama, 7008558, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan
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Miura R, Nakamura K, Miura D, Miura A, Kajiya M, Hisamatsu K, Nagase S, Morita H, Kusano KF, Matsubara H, Ohe T, Ito H. Cytokine reducing effect of azelnidipine in human peripheral blood mononuclear cells. Biol Pharm Bull 2010; 33:1148-51. [PMID: 20606305 DOI: 10.1248/bpb.33.1148] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Numerous clinical trials have shown that calcium channel blocker (CCB) therapy improves the clinical outcome in patients with cardiovascular diseases. Since the progression of several types of cardiovascular diseases is closely associated with inflammation, alleviation of inflammation may be one potential mechanism of those beneficial effects of CCB therapy. We examined whether a new CCB (azelnidipine) could influence the inflammatory response of human peripheral blood mononuclear cells (PBMCs), which are recruited to inflammatory lesions and modulate inflammation. We investigated whether azelnidipine affected intracellular signaling and cytokine production by phytohemagglutinin (PHA)-stimulated human PBMCs in vitro. PBMCs were obtained from 10 healthy volunteers and stimulated with PHA. Then relative intracellular calcium ion concentration ([Ca(2+)](i)) was assessed by fluorescence microscopy, and the production of monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-alpha) were measured by enzyme-linked immunosorbent assay. Stimulation with PHA significantly raised [Ca(2+)](i) and enhanced the production of MCP-1 and TNF-alpha by human PBMCs. Azelnidipine significantly diminished the PHA-induced rise of [Ca(2+)](i), and the production of MCP-1 and TNF-alpha. These findings indicate that azelnidipine might have an anti-inflammatory influence on human PBMCs, although the mechanisms and the difference from other CCBs still remain unclear and further exploration should be required.
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Affiliation(s)
- Ryuzea Miura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
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Nishii N, Ogawa M, Morita H, Nakamura K, Banba K, Miura D, Kumagai N, Matsunaga A, Kawamura H, Urakawa S, Miyaji K, Nagai M, Satoh K, Nakagawa K, Tanaka M, Hiramatsu S, Tada T, Murakami M, Nagase S, Kohno K, Kusano KF, Saku K, Ohe T, Ito H. SCN5A mutation is associated with early and frequent recurrence of ventricular fibrillation in patients with Brugada syndrome. Circ J 2010; 74:2572-8. [PMID: 21048329 DOI: 10.1253/circj.cj-10-0445] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Mutations in SCN5A are reportedly linked to Brugada syndrome (BS), but recent observations suggest that they are not necessarily associated with ventricular fibrillation (VF) in BS patients. Therefore, the clinical importance of SCN5A mutations in BS patients was examined in the present study. METHODS AND RESULTS The 108 BS patients were examined for SCN5A mutations and various parameters were compared between patients with and without mutations. An implantable cardioverter defibrillator (ICD) was implanted in 49 patients and a predictor of appropriate ICD shock was investigated. The existence of a SCN5A mutation was not associated with initial VF episodes (21.7% vs 20.0%, P=0.373). In the secondary prevention group, appropriate shock-free survival rate was significantly lower in patients with spontaneous type 1 ECG than in those without (41.1% vs 85.7% at 2 years, P=0.014). The appropriate shock-free survival rate was also significantly lower in patients with SCN5A mutations than in those without (28.6% vs 83.3% at 1 year, P=0.040). Appropriate shock was more frequent in patients with SCN5A mutations than in those without (6.6±6.2 vs 1.7±3.0, P=0.007). CONCLUSIONS SCN5A mutations are associated with early and frequent VF recurrence, but not with initial VF episodes. This is the first report on the genotype-phenotype interaction and clinical significance of this mutation.
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Affiliation(s)
- Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
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Akagi S, Nakamura K, Miyaji K, Ogawa A, Kusano KF, Ito H, Matsubara H. Marked hemodynamic improvements by high-dose epoprostenol therapy in patients with idiopathic pulmonary arterial hypertension. Circ J 2010; 74:2200-5. [PMID: 20697180 DOI: 10.1253/circj.cj-10-0190] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [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: 11/09/2022]
Abstract
BACKGROUND The appropriate dose range of epoprostenol is thought to be 25-40 ng · kg(-1) · min(-1) based on the results of previous studies showing that epoprostenol therapy reduced mean pulmonary artery pressure (mPAP) by 12-22% and pulmonary vascular resistance (PVR) by 32-53% compared with baseline values in patients with idiopathic pulmonary arterial hypertension (IPAH). However, the efficacy of treatment of IPAH patients with epoprostenol >40 ng · kg(-1) · min(-1) has not been determined and this was the aim of the present study. METHODS AND RESULTS The study group comprised 16 consecutive patients, none of whom died; 2 dropped out because they could not be titrated up as needed to the highest effective epoprostenol dose. Hemodynamics were evaluated in 14 IPAH patients who received high-dose epoprostenol monotherapy. The mean epoprostenol dosage was 107 ± 40 ng · kg(-1) · min(-1) (range, 54-190 ng · kg(-1) · min(-1)) and the mean duration of high-dose epoprostenol therapy was 1,355 ± 627 days (range, 582-2,410 days). Significant decreases from baseline values were seen in mPAP (from 66 ± 16 to 47 ± 12 mmHg, P<0.001) and PVR (from 21.6 ± 8.3 to 6.9 ± 2.9 Wood units, P<0.001). Compared with the baseline state, high-dose epoprostenol therapy reduced mPAP by 30% and PVR by 68%. CONCLUSIONS The present study suggests high-dose epoprostenol therapy is a new treatment strategy for IPAH.
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Affiliation(s)
- Satoshi Akagi
- Division of Cardiology, National Hospital Organization, Okayama Medical Center, Okayama, Japan.
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16
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Nikaido A, Tada T, Nakamura K, Murakami M, Banba K, Nishii N, Fuke S, Nagase S, Sakuragi S, Morita H, Ohe T, Kusano KF. Clinical features of and effects of angiotensin system antagonists on amiodarone-induced pulmonary toxicity. Int J Cardiol 2010; 140:328-35. [DOI: 10.1016/j.ijcard.2008.11.106] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 11/10/2008] [Accepted: 11/15/2008] [Indexed: 10/21/2022]
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17
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Tanaka M, Nakamura K, Kusano KF, Morita H, Ohta-Ogo K, Miura D, Miura A, Nakagawa K, Tada T, Murakami M, Nishii N, Nagase S, Hata Y, Kohno K, Ouchida M, Shimizu K, Yutani C, Ohe T, Ito H. Elevated oxidative stress is associated with ventricular fibrillation episodes in patients with Brugada-type electrocardiogram without SCN5A mutation. Cardiovasc Pathol 2010; 20:e37-42. [PMID: 20219395 DOI: 10.1016/j.carpath.2010.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 10/21/2009] [Revised: 01/19/2010] [Accepted: 02/06/2010] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Brugada syndrome is a disease known to cause ventricular fibrillation with a structurally normal heart and is linked to SCN5A gene mutation. However, the mechanism by which ventricular fibrillation develops in cases of Brugada-type electrocardiogram without SCN5A mutation has remained unclear. Recently, oxidative stress has been implicated in the pathophysiology of cardiac arrhythmia. We also investigated oxidative stress levels in the myocardia of patients with Brugada-type electrocardiogram. METHODS Endomyocardial biopsy samples were obtained from 68 patients with Brugada-type electrocardiogram (66 males and two females). We performed histological and immunohistochemical analyses for CD45, CD68, and 4-hydroxy-2-nonenal-modified protein, which is a major lipid peroxidation product. RESULTS SCN5A mutation was detected in 14 patients. Ventricular fibrillation was documented in three patients with SCN5A mutation and in 11 without SCN5A mutation. In patients with SCN5A mutation, 4-hydroxy-2-nonenal-modified protein-positive area was not significantly different between the documented ventricular fibrillation (VF) group (VF+ group) and the group without documented VF (VF- group). However, in patients without SCN5A, the area was significantly larger in the VF+ group than that in the VF- group (P<.05). All other parameters (fibrosis area, CD45, and CD68) were not different between the VF+ and VF- group in both SCN5A+ and SCN5A- patients. CONCLUSION Oxidative stress is elevated in the myocardium of patients with Brugada-type electrocardiogram who have VF episodes and do not have SCN5A gene mutations. Oxidative stress may be associated with the occurrence of VF in patients with Brugada-type electrocardiogram without SCN5A mutation.
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Affiliation(s)
- Masamichi Tanaka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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18
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Miyoshi T, Doi M, Hirohata S, Sakane K, Kamikawa S, Kitawaki T, Kaji Y, Kusano KF, Ninomiya Y, Kusachi S. Cardio-ankle vascular index is independently associated with the severity of coronary atherosclerosis and left ventricular function in patients with ischemic heart disease. J Atheroscler Thromb 2010; 17:249-58. [PMID: 20103976 DOI: 10.5551/jat.1636] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The cardio-ankle vascular index (CAVI) has been proposed as a new noninvasive marker of arterial stiffness independent of blood pressure. We investigated the association of the CAVI with coronary atherosclerosis and left ventricular (LV) systolic and diastolic function in patients with ischemic heart disease (IHD). METHODS A total of 206 consecutive subjects undergoing coronary angiography were enrolled. CAVI measurement and echocardiography were performed simultaneously. Patients having significant coronary stenosis were classified into the IHD group. RESULTS CAVI in the IHD group (n=133) was significantly higher than in the non-IHD group(n=73)(9.1+/-1.3 vs. 8.7+/-1.2, p=0.02). In all IHD patients, CAVI was negatively correlated with LV ejection fraction (LVEF)(r=-0.31, p<0.01), LV mass index (r=0.24, p<0.01) and angiographic scores of coronary atherosclerosis. Stepwise regression analysis revealed that CAVI was independently associated with LVEF, along with a history of myocardial infarction, LV mass index, and left atrial diameter in all IHD patients (p<0.01). In the sub-analysis of IHD patients with preserved LVEF, CAVI was correlated with echocardiographic parameters regarding LV diastolic function. Multivariate analysis demonstrated that the increased CAVI was significantly associated with LV diastolic dysfunction in patients with preserved LVEF. CONCLUSION CAVI, a new parameter of aortic stiffness, was independently associated with LV systolic and diastolic function as well as coronary artery disease in IHD patients.
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Affiliation(s)
- Toru Miyoshi
- Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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Nishii N, Nagase S, Morita H, Kusano KF, Namba T, Miura D, Miyaji K, Hiramatsu S, Tada T, Murakami M, Watanabe A, Banba K, Sakai Y, Nakamura K, Oka T, Ohe T. Abnormal restitution property of action potential duration and conduction delay in Brugada syndrome: both repolarization and depolarization abnormalities. Europace 2010; 12:544-52. [PMID: 20083482 DOI: 10.1093/europace/eup432] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
AIMS This study sought to examine the action potential duration restitution (APDR) property and conduction delay in Brugada syndrome (BrS) patients. A steeply sloped APDR curve and conduction delay are known to be important determinants for the occurrence of ventricular fibrillation (VF). METHODS AND RESULTS Endocardial monophasic action potential was obtained from 39 BrS patients and 9 control subjects using the contact electrode method. Maximum slopes of the APDR curve were obtained at both the right ventricular outflow tract (RVOT) and the right ventricular apex (RVA). The onset of activation delay (OAD) after premature stimulation was examined as a marker of conduction delay. Maximum slope of the APDR curve in BrS patients was significantly steeper than that in control subjects at both the RVOT and the RVA (0.77 +/- 0.21 vs. 058 +/- 0.14 at RVOT, P = 0.009; 0.98 +/- 0.23 vs. 0.62 +/- 0.16 at RVA, P = 0.001). The dispersion of maximum slope of the APDR curve between the RVOT and the RVA was also larger in BrS patients than in control subjects. The OAD was significantly longer in BrS patients than in control subjects from the RVOT to RVA and from the RVA to RVOT (from RVOT to RVA: 256 +/- 12 vs. 243 +/- 7 ms, P = 0.003; from RVA to RVOT: 252 +/- 11 vs. 241 +/- 9 ms, P = 0.01). CONCLUSIONS Abnormal APDR properties and conduction delay were observed in BrS patients. Both repolarization and depolarization abnormalities are thought to be related to the development of VF in BrS patients.
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Affiliation(s)
- Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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Hiramatsu S, Tada H, Sakamoto Y, Kaseno K, Sato C, Irie T, Yokokawa M, Nagase S, Naito S, Kusano KF, Yamagishi M, Ohe T, Aonuma K, Oshima S, Taniguchi K. Quantitative analysis and characteristics of the electrograms recorded within the non-coronary aortic sinus of Valsalva. Circ J 2009; 73:838-45. [PMID: 19336923 DOI: 10.1253/circj.cj-08-0866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Some supraventricular tachycardias could be ablated from the non-coronary sinus of Valsalva (NSV). However, the characteristics of the NSV electrograms have not been clarified. METHODS AND RESULTS A quantitative analysis of the NSV electrograms was performed in 5 patients with tachycardias arising from near the atrioventricular node (AVN) and the His-bundle region, and in 20 control subjects. In another 7 control subjects, the NSV electrograms were compared with those recorded at the left and right sinus of Valsalva (LSV and RSV). The NSV electrograms during sinus rhythm had a larger atrial amplitude than ventricular amplitude, and the ratio of the atrial amplitude to the ventricular amplitude was usually >1, which was apparently different from the LSV and RSV electrograms. A tiny but distinct His-bundle deflection was sometimes recorded at the NSV during sinus rhythm while it was not during the tachycardia. The distance to the His-bundle region in the anteroseptal right atrium was shorter from the NSV than from the RSV or LSV. CONCLUSIONS The precise identification of the catheter position at the NSV is possible using the characteristics of the electrograms. Much attention should be paid during ablation to the NSV because of its vicinity to the AVN and His-bundle region.
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Affiliation(s)
- Shigeki Hiramatsu
- Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science, Japan
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Nakamura K, Shimizu J, Kataoka N, Hashimoto K, Ikeda T, Fujio H, Ohta-Ogo K, Ogawa A, Miura A, Mohri S, Nagase S, Morita H, Kusano KF, Date H, Matsubara H, Mochizuki S, Hashimoto K, Kajiya F, Ohe T. Altered nano/micro-order elasticity of pulmonary artery smooth muscle cells of patients with idiopathic pulmonary arterial hypertension. Int J Cardiol 2008; 140:102-7. [PMID: 19073348 DOI: 10.1016/j.ijcard.2008.11.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2008] [Revised: 08/12/2008] [Accepted: 11/01/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Idiopathic pulmonary arterial hypertension (IPAH) is a disease characterized by progressively increased resistance of pulmonary arteries. In this study, we evaluated the mechanical property of single pulmonary artery smooth muscles cells (PASMC) from patients with IPAH and tested whether the PASMC showed abnormal response to a vasodilator by use of an atomic force microscope (AFM). METHODS PASMC were isolated and cultured from explanted lungs of 7 patients with IPAH (IPAH-PASMC). Normal vascular specimens from 3 patients with bronchogenic carcinoma were used as normal controls (normal PASMC). The nano/micro-order elasticity of five to ten living PASMC in each sample was measured by parabolic force curves of cantilever deflection/indentation obtained by using an AFM. The elasticity measurements were performed under control conditions and under condition of nitric oxide (NO) treatment (190 and 380 nmol/L). RESULTS There was no significant difference between nano/micro-order elasticity of normal PASMC and that of IPAH-PASMC under the control conditions. In normal PASMC, NO (190 and 380 nmol/L) significantly reduced (i.e., softened) the nano/micro-order elasticity. However, NO did not reduce elasticity in IPAH-PASMC, indicating higher vasodilator-resistive nano/micro-order rigidity in IPAH-PASMC. CONCLUSION Nano/micro-order elasticity change in PASMC in response to vasodilation induced by NO is reduced in patients with IPAH.
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Affiliation(s)
- Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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Sakuragi S, Maruo T, Taniguchi M, Nagase S, Nakamura K, Kusano KF, Ohe T. Radial augmentation index associated with increase in B-type natriuretic peptide in patients with hypertension. Int J Cardiol 2008; 130:414-9. [DOI: 10.1016/j.ijcard.2007.08.129] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2006] [Revised: 07/23/2007] [Accepted: 08/18/2007] [Indexed: 10/22/2022]
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Akagi S, Kusano KF. [Anticoagulation therapy in pulmonary arterial hypertension]. Nihon Rinsho 2008; 66:2174-2178. [PMID: 19051739] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Vascular thrombosis implicates in the pathogenesis of pulmonary arterial hypertension (PAH). Anticoagulation therapy (warfarin) has been recommended by many experts in the treatment of PAH. However, the long-term effectiveness of anticoagulation therapy remains controversial. Because of the various drugs, such as epoprostenol, bosentan, and sildenafil, for the treatment of PAH recently, warfarin alone is not a realistic therapy for PAH. Accordingly we reviewed the previous manuscript regarding anticoagulation therapy for PAH, and looked at the current role of anticoagulation therapy in Japan.
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Affiliation(s)
- Satoshi Akagi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Kobayashi M, Nakamura K, Kusano KF, Nakamura Y, Ohta-Ogo K, Nagase S, Sakuragi S, Ohe T. Expression of monocyte chemoattractant protein-1 in idiopathic dilated cardiomyopathy. Int J Cardiol 2008; 126:427-9. [PMID: 17467829 DOI: 10.1016/j.ijcard.2007.01.109] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Accepted: 01/03/2007] [Indexed: 11/18/2022]
Abstract
Immunological factors have been involved in the pathogenesis of dilated cardiomyopathy (DCM). The cytotoxic action of macrophages is one of the main factors causing cardiac myocyte damage. Monocyte chemoattractant protein-1 (MCP-1) is a major signal for the accumulation of monocytes/macrophages. We examined whether MCP-1 was expressed in the myocardium of DCM patients and whether the expression level was correlated with the degree of impairment of cardiac function. The expression of MCP-1 in the myocardium was determined by immunohistochemistry in endomyocardial biopsy samples from 13 patients. The expression of MCP-1 was found in all myocardial samples from DCM patients but not in those from control subjects. Positive staining for MCP-1 was distinct in cardiac myocytes, interstitium and infiltrating cells. Semi-quantitative analysis revealed that the expression of MCP-1 was inversely correlated with left ventricular ejection fraction. In conclusion, the expression level of MCP-1 in the myocardium was correlated with the degree of impairment of cardiac function in patients with DCM.
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Nagase S, Kusano KF, Morita H, Nishii N, Banba K, Watanabe A, Hiramatsu S, Nakamura K, Sakuragi S, Ohe T. Longer Repolarization in the Epicardium at the Right Ventricular Outflow Tract Causes Type 1 Electrocardiogram in Patients With Brugada Syndrome. J Am Coll Cardiol 2008; 51:1154-61. [PMID: 18355652 DOI: 10.1016/j.jacc.2007.10.059] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Revised: 09/24/2007] [Accepted: 10/17/2007] [Indexed: 11/19/2022]
Affiliation(s)
- Satoshi Nagase
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
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Enko K, Sakuragi S, Kakishita M, Ohkawa K, Nagase S, Nakamura K, Kusano KF, Ohe T. Arterial Stiffening is Associated with Exercise Intolerance and Hyperventilatory Response in Patients with Coronary Artery Disease. Clin Med Cardiol 2008. [DOI: 10.4137/cmc.s453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kenki Enko
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Satoru Sakuragi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Mikio Kakishita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Keisuke Ohkawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
| | - Tohru Ohe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical sciences, Okayama, Japan
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Toyooka S, Sano Y, Yamane M, Oto T, Okazaki M, Kusano KF, Date H. Long-term follow-up of living-donor single lobe transplantation for idiopathic pulmonary arterial hypertension in a child. J Thorac Cardiovasc Surg 2008; 135:451-2. [DOI: 10.1016/j.jtcvs.2007.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Accepted: 10/02/2007] [Indexed: 10/22/2022]
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Nishii N, Kusano KF, Miyaji K, Hiramatsu S, Tada T, Murakami M, Banba K, Sakai Y, Nagase S, Nakamura K, Sakuragi S, Ohe T. Usefulness of a Long-Straight Sheath for Atrial Lead Insertion at the Right Atrial Septum. Circ J 2008; 72:262-7. [DOI: 10.1253/circj.72.262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 11/09/2022]
Affiliation(s)
- Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Kengo Fukushima Kusano
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Kohei Miyaji
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Shigeki Hiramatsu
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Takeshi Tada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Masato Murakami
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Kimikazu Banba
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Yoshiaki Sakai
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Satoru Sakuragi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Tohru Ohe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Tada T, Kusano KF, Nagase S, Banba K, Miura D, Nishii N, Watanabe A, Nakamura K, Morita H, Ohe T. Clinical significance of macroscopic T-wave alternans after sodium channel blocker administration in patients with Brugada syndrome. J Cardiovasc Electrophysiol 2007; 19:56-61. [PMID: 17916151 DOI: 10.1111/j.1540-8167.2007.00967.x] [Citation(s) in RCA: 25] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Macroscopic T-wave alternans (TWA) is sometimes observed after sodium channel blocker administration in patients with Brugada syndrome (BS), but little is known about the association between occurrence of TWA and clinical characteristics in BS patients. We investigated the association between spontaneous ventricular fibrillation (VF) occurrence and TWA after pilsicainide, a sodium channel blocker administration in BS patients. METHODS AND RESULTS We administered pilsicainide at a dose of 1 mg/kg to 77 BS patients (76 males and one female; mean age, 48.4 years) and examined the association between TWA after pilsicainide administration and clinical characteristics, including age, spontaneous VF, syncope, family history of sudden death, spontaneous coved ST elevation, late potentials (LP), induction of VF by programmed electrical stimulation, and SCN5A mutation. None of the patients had TWA before pilsicainide administration, but TWA became apparent in 17 (22.1%) of the patients after pilsicainide administration. Patients with TWA had a significantly higher incidence of spontaneous VF (52.9% vs 8.3%, P < 0.001) and syncope (58.8% vs 26.7%, P < 0.05) than did patients without TWA. Then, we focused on the association between spontaneous VF and clinical characteristics. Patients with spontaneous VF had a significantly higher incidence of TWA (64.3% vs 12.7%, P < 0.001) and LP positive (92.9% vs 56.5%, P < 0.01) than did patients without spontaneous VF. In multivariate analysis, TWA (P = 0.001) and LP (P = 0.047) appeared as the independent predictor for spontaneous VF. CONCLUSION TWA after pilsicainide administration is associated with a high risk of clinical VF in patients with BS.
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Affiliation(s)
- Takeshi Tada
- Department of Cardiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
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Fuke S, Kusano KF, Enko K, Murakami M, Oka T, Nagase S, Nakamura K, Sakuragi S, Ohe T, Date H, Hanawa H, Fuse I, Aizawa Y. Use of Nitric Oxide Inhalation for the Treatment of Pulmonary Hypertensive Crisis Bridging to Living-donor Lobar Lung Transplantation. J Card Fail 2007. [DOI: 10.1016/j.cardfail.2007.06.234] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Date H, Kusano KF, Matsubara H, Ogawa A, Fujio H, Miyaji K, Okazaki M, Yamane M, Toyooka S, Aoe M, Sano Y, Hanazaki M, Goto K, Kasahara S, Sano S, Ohe T. Living-donor lobar lung transplantation for pulmonary arterial hypertension after failure of epoprostenol therapy. J Am Coll Cardiol 2007; 50:523-7. [PMID: 17678735 DOI: 10.1016/j.jacc.2007.03.054] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [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: 01/02/2007] [Revised: 03/05/2007] [Accepted: 03/15/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the long-term effects of living-donor lobar lung transplantation (LDLLT) for critically ill patients with pulmonary arterial hypertension (PAH) who failed in epoprostenol treatment. BACKGROUND Although continuous epoprostenol infusion has markedly improved survival in patients with PAH, some patients do not benefit from this therapy. METHODS From July 1998 to December 2003, 28 consecutive PAH patients who were treated with epoprostenol and accepted as candidates for lung transplantation were enrolled. All data were prospectively collected. As of July 2006, LDLLT was performed in 11 of those patients whose condition was deteriorating. Cadaveric lung transplantation (CLT) was performed in 2 patients. Medical treatment was continued in 15 patients. RESULTS There was no mortality in patients receiving LDLLT during a follow-up period of 11 to 66 months (average 48 months), and all patients returned to World Health Organization functional class I. Mean pulmonary artery pressure decreased from 62 +/- 4 mm Hg to 15 +/- 2 mm Hg (p < 0.001) at discharge and remained normal at 3 years. One CLT patient died of primary graft failure. Among medically treated patients, 6 patients died of disease progression. The survival rate was 100% at 5 years for patients receiving LDLLT, and 80% at 1 year, 67% at 3 years, and 53% at 5 years for patients medically treated (p = 0.028). All living donors have returned to their previous lifestyles. CONCLUSIONS These follow-up data support the option of LDLLT in patients with PAH who would die soon otherwise.
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Affiliation(s)
- Hiroshi Date
- Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
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Affiliation(s)
- Takeshi Ohgo
- Department of Cardiovascular Medicine, Okayama University, Okayama, Japan.
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Losordo DW, Schatz RA, White CJ, Udelson JE, Veereshwarayya V, Durgin M, Poh KK, Weinstein R, Kearney M, Chaudhry M, Burg A, Eaton L, Heyd L, Thorne T, Shturman L, Hoffmeister P, Story K, Zak V, Dowling D, Traverse JH, Olson RE, Flanagan J, Sodano D, Murayama T, Kawamoto A, Kusano KF, Wollins J, Welt F, Shah P, Soukas P, Asahara T, Henry TD. Intramyocardial Transplantation of Autologous CD34
+
Stem Cells for Intractable Angina. Circulation 2007; 115:3165-72. [PMID: 17562958 DOI: 10.1161/circulationaha.106.687376] [Citation(s) in RCA: 446] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND A growing population of patients with coronary artery disease experiences angina that is not amenable to revascularization and is refractory to medical therapy. Preclinical studies have indicated that human CD34+ stem cells induce neovascularization in ischemic myocardium, which enhances perfusion and function. METHODS AND RESULTS Twenty-four patients (19 men and 5 women aged 48 to 84 years) with Canadian Cardiovascular Society class 3 or 4 angina who were undergoing optimal medical treatment and who were not candidates for mechanical revascularization were enrolled in a double-blind, randomized (3:1), placebo-controlled dose-escalating study. Patients received granulocyte colony-stimulating factor 5 microg x kg(-1) x d(-1) for 5 days with leukapheresis on the fifth day. Selection of CD34+ cells was performed with a Food and Drug Administration-approved device. Electromechanical mapping was performed to identify ischemic but viable regions of myocardium for injection of cells (versus saline). The total dose of cells was distributed in 10 intramyocardial, transendocardial injections. Patients were required to have an implantable cardioverter-defibrillator or to temporarily wear a LifeVest wearable defibrillator. No incidence was observed of myocardial infarction induced by mobilization or intramyocardial injection. The intramyocardial injection of cells or saline did not result in cardiac enzyme elevation, perforation, or pericardial effusion. No incidence of ventricular tachycardia or ventricular fibrillation occurred during the administration of granulocyte colony-stimulating factor or intramyocardial injections. One patient with a history of sudden cardiac death/ventricular tachycardia/ventricular fibrillation had catheter-induced ventricular tachycardia during mapping that required cardioversion. Serious adverse events were evenly distributed. Efficacy parameters including angina frequency, nitroglycerine usage, exercise time, and Canadian Cardiovascular Society class showed trends that favored CD34+ cell-treated patients versus control subjects given placebo. CONCLUSIONS A randomized trial of intramyocardial injection of autologous CD34+ cells in patients with intractable angina was completed that provides evidence for feasibility, safety, and bioactivity. A larger phase IIb study is currently under way to further evaluate this therapy.
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Affiliation(s)
- Douglas W Losordo
- Feinberg Cardiovascular Research Institute, and Department of Medicine, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago, IL 60611, USA.
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Banba K, Kusano KF, Nakamura K, Morita H, Ogawa A, Ohtsuka F, Ogo KO, Nishii N, Watanabe A, Nagase S, Sakuragi S, Ohe T. Relationship between arrhythmogenesis and disease activity in cardiac sarcoidosis. Heart Rhythm 2007; 4:1292-9. [PMID: 17905334 DOI: 10.1016/j.hrthm.2007.06.006] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [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: 02/23/2007] [Accepted: 06/10/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND In patients with cardiac sarcoidosis, ventricular arrhythmias and/or conduction disturbances are frequently observed and sometimes fatal. However, few reports on disease activity and arrhythmic events in cardiac sarcoidosis are available. OBJECTIVE The purpose of this study was to investigate the relationship between disease activity and arrhythmic events in cardiac sarcoidosis and the effect of corticosteroid therapy. METHODS The study population consisted of 15 cardiac sarcoidosis patients with new-onset symptomatic arrhythmia, including eight patients admitted once for complete atrioventricular block (CAVB), five patients admitted once for sustained ventricular tachycardia (VT), and two patients admitted twice for two arrhythmic events (one for CAVB and the other for sustained VT). Disease activity was evaluated by gallium-67 citrate (Ga) scintigraphy. All patients with positive Ga uptake were treated with corticosteroids, and arrhythmic events were evaluated by repeat Holter recordings. RESULTS Positive uptake of Ga was observed in 8 (80%) of the 10 CAVB events and in 1 (14%) of the 7 sustained VT events (80% vs 14%, P = .02). Corticosteroids abolished myocardial Ga uptake in all nine patients with positive Ga uptake. After corticosteroid therapy was started, AV conduction improved in 5 of 9 CAVB patients (including 8 patients with new-onset CAVB and one patient with history of CAVB). However, ventricular arrhythmias were not improved after corticosteroid therapy. CONCLUSION In cardiac sarcoidosis patients, CAVB develops mainly during the active phase of the disease. Early treatment with corticosteroids might improve AV conduction disturbance. However, sustained VT is not closely linked with disease activity and frequently develops in the advanced stage of disease.
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Affiliation(s)
- Kimikazu Banba
- Department of Cardiovascular Medicine, Graduate School of Medicine and Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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Akagi S, Matsubara H, Ogawa A, Kawai Y, Hisamatsu K, Miyaji K, Munemasa M, Fujimoto Y, Kusano KF, Ohe T. Prevention of catheter-related infections using a closed hub system in patients with pulmonary arterial hypertension. Circ J 2007; 71:559-64. [PMID: 17384460 DOI: 10.1253/circj.71.559] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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: 11/09/2022]
Abstract
BACKGROUND Most of the patients with pulmonary arterial hypertension (PAH) receiving intravenous epoprostenol have experienced catheter-related infections during long-term treatment. Catheter hub was reported to be the most important source of catheter-related infections. To prevent the catheter-related infections, we have introduced a closed hub system and compared the incidence of catheter-related infections with that in patients using a non-closed hub system. METHODS AND RESULTS We evaluated the results obtained on 24 occasions in 20 patients with PAH between June 1999 and December 2005. On 11 occasions, a non-closed hub system was used and on 13 cases a closed hub system. We classified the catheter-related infection into a catheter-related bloodstream infection (CRBSI) group or a tunnel infection group based on the pathway of bacteria. The CRBSI rate was 0.89 per 1,000 catheter days in the non-closed hub system group vs 0.10 per 1,000 catheter days in the closed hub system group. Kaplan-Meier analysis showed that the risk of CRBSI significantly decreased in the closed hub system group. None of the patients died as a direct consequence of catheter-related infection during the study period. CONCLUSIONS We successfully prevented CRBSI by using a closed hub system.
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Affiliation(s)
- Satoshi Akagi
- Division of Cardiology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
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Tada T, Kusano KF, Ogawa A, Iwasaki J, Sakuragi S, Kusano I, Takatsu S, Miyazaki M, Ohe T. The predictors of central and obstructive sleep apnoea in haemodialysis patients. Nephrol Dial Transplant 2007; 22:1190-7. [PMID: 17277346 DOI: 10.1093/ndt/gfl748] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [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: 11/13/2022] Open
Abstract
BACKGROUND Sleep apnoea (SA) is often observed in haemodialysis patients, but there have been few studies on types of SA and their predictors. We therefore investigated the prevalence and types of SA and the associations between types of SA and clinical factors in haemodialysis patients. METHODS We initially examined nocturnal oxygen desaturation index (ODI) (desaturation of >4%/events per hour) in 119 haemodialysis patients (68 males, mean age of 61.4 years). Patients with ODI of more than five were diagnosed as having SA. Then, 30 patients underwent polysomnography and we measured Apnoea-hypopnoea index (AHI), which was calculated as the number of apnoeas plus hypopnoeas per hour of sleep. Clinical characteristics were examined in all patients. RESULTS Forty-one (34.5%) of the 119 patients had SA. Twenty-seven (22.7%) of the 119 patients had SA with subjective symptoms such as daytime somnolence and snoring. There was a significant difference between body mass index (BMI) in patients with SA and that in patients without SA (22.5 vs 19.8 kg/m2, P<0.001). There were significantly higher prevalences of hypertension (85.4 vs 66.7%, P<0.05) and diabetes mellitus (36.6 vs 10.3%, P<0.01) in patients with SA than those in patients without SA. Multivariable analysis showed that BMI was independently associated with the occurrence of SA (OR 1.20, 95% CI 1.05-1.38). Mean AHI of 30 patients who underwent polysomnography was 53.2+/-28.9 [central apnoea, 4.1+/-5.6 (8%); obstructive apnoea, 21.7+/-21.5 (42%); mixed apnoea, 4.9+/-8.0 (9%); hypopnoea, 21.4+/-15.5 (41%)]. The number of obstructive apnoea events per hour was significantly correlated with BUN (r=0.490, P<0.01), Cr (r=0.418, P<0.05) and BMI (r=0.489, P<0.01) and was inversely correlated with serum bicarbonate (r=-0.646, P<0.01) and brain natriuretic peptide (BNP) (r=-0.481, P<0.01). The number of central apnoea events per hour was correlated inversely with PaO2 (r=-0.393, P<0.05) and PaCO2 (r=-0.388, P<0.05) and tended to be correlated with cardiothoracic ratio (CTR) (r=0.347, P=0.060). CONCLUSIONS There is a high prevalence of SA in haemodialysis patients. The dominant type of SA in haemodialysis patients is obstructive sleep apnoea (OSA). Uraemia (BUN, Cr), metabolic acidosis (serum bicarbonate) and BMI are good predictors of OSA. PaO2, PaCO2 and CTR are good predictors of central sleep apnoea (CSA). Good management of these factors might improve SA in haemodialysis patients.
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Affiliation(s)
- Takeshi Tada
- Department of Cardiology, Okayama University Graduate School of Medicine, and Fukushima Naika Clinic, Saiwaicho Memorial Hospital, Okayama, Japan.
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Miyaji K, Tada H, Fukushima Kusano K, Hashimoto T, Kaseno K, Hiramatsu S, Tadokoro K, Naito S, Nakamura K, Oshima S, Taniguchi K, Ohe T. Efficacy and Safety of the Additional Bepridil Treatment in Patients With Atrial Fibrillation Refractory to Class I Antiarrhythmic Drugs. Circ J 2007; 71:1250-7. [PMID: 17652890 DOI: 10.1253/circj.71.1250] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [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: 11/09/2022]
Abstract
BACKGROUND Bepridil has multiple ion-channel blocking effects and is expected to be useful for managing atrial fibrillation (AF). The purpose of this study was to clarify the efficacy and safety of additional treatment with bepridil in patients with AF who had been treated with class I antiarrhythmic drugs (AADs). METHODS AND RESULTS Bepridil (50-200 mg/day) was given to 76 patients with either paroxysmal (n=49) or persistent AF (n=27). All patients had been treated with class I AADs (1.9+/-0.9 drugs/patient) that failed to control the AF. With the addition of bepridil, the frequency of symptomatic AF episodes decreased to less than 10% in 38 (78%) patients with paroxysmal AF, and sinus rhythm was restored within 3 months and maintained during the follow-up in 20 (74%) patients with persistent AF. Efficacy was usually obtained with a small to moderate dose (50-150 mg/day) of bepridil. During a mean follow-up period of 27+/-22 months, no potential complications occurred in any of the patients. CONCLUSIONS The addition of bepridil to class I AADs is effective and safe for AF, but careful observation using periodic ECG recordings is essential for avoiding torsades de pointes caused by QT prolongation.
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Affiliation(s)
- Kohei Miyaji
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, and Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science, Japan
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Yoshida M, Inoue I, Kawagoe T, Ishihara M, Shimatani Y, Kurisu S, Kusano KF, Ohe T. Novel percutaneous catheter thrombectomy in acute massive pulmonary embolism: rotational bidirectional thrombectomy (ROBOT). Catheter Cardiovasc Interv 2006; 68:112-7. [PMID: 16755594 DOI: 10.1002/ccd.20747] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 12/25/2022]
Abstract
BACKGROUND Although thrombolysis is a standard therapy in cases of pulmonary embolism (PE), fatal outcome is often observed. We designed and investigated the efficacy of a novel percutaneous catheter therapy, rotational bidirectional thrombectomy (ROBOT), for PE. METHODS AND RESULTS Eighteen patients with acute massive PE (Miller score > or = 20) were included in this study. We separated them into two groups [group A (n = 10), thrombolysis; group B (n = 8): thrombolysis and ROBOT or ROBOT alone]. There was no difference in the hemodynamic indices between the groups at diagnosis. ROBOT was designed to fragment emboli by rotating a regular pigtail catheter. Three deaths occurred in group A because of hemodynamic impairment, but there was no death in group B. One day after treatment, systolic pulmonary artery pressure had decreased from 53 +/- 8 to 30 +/- 8 mm Hg (P < 0.05) in group B and from 54 +/- 5 to 42 +/- 19 mm Hg (NS) in group A. The hospitalization period in group B was shorter than that in group A (17 +/- 6 vs. 27 +/- 10 days, P < 0.05). CONCLUSION ROBOT therapy results in a significant, rapid improvement in the hemodynamic situation and in a better outcome than conventional therapy in patients with acute massive pulmonary embolism.
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Affiliation(s)
- Masashi Yoshida
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan.
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Miura R, Nakamura K, Miura D, Miura A, Hisamatsu K, Kajiya M, Hashimoto K, Nagase S, Morita H, Fukushima Kusano K, Emori T, Ishihara K, Ohe T. Aldosterone synthesis and cytokine production in human peripheral blood mononuclear cells. J Pharmacol Sci 2006; 102:288-95. [PMID: 17072102 DOI: 10.1254/jphs.fp0060801] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 10/23/2022] Open
Abstract
Previously, we reported that spironolactone reduced cytokine production in cultured human peripheral blood mononuclear cells (PBMCs) with angiotensin (Ang) II stimulation. To address the mechanisms underlying this effect, we examined the contribution of aldosterone to cytokine production in cultured human PBMCs with Ang II stimulation. PBMCs expressed the messenger RNA (mRNA) of Ang II type 1 receptor (AT1R) and mineralocorticoid receptor (MR) both spontaneously and after Ang II stimulation, but expressed Ang II type 2 receptor (AT2R) under neither condition. After 24 h of incubation, exogenous Ang II induced the expression of CYP11B2 (a key enzyme of aldosterone synthesis) mRNA and caused aldosterone synthesis. CV-11974 (an AT1R antagonist) reduced Ang II-induced aldosterone synthesis, whereas PD-123319 (an AT2R antagonist) had no effect. The concentration of aldosterone peaked earlier than those of monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-alpha). After 48 h of incubation (under the influence of synthesized aldosterone), CV-11974 and spironolactone significantly reduced the Ang II-enhanced production of MCP-1 and TNF-alpha, whereas PD-123319 also had no effect. In conclusion, Ang II induces aldosterone synthesis through AT1R and enhances cytokine production through an AT1R-dependent mechanism and, at least partly, through a MR-dependent mechanism in human PBMCs.
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Affiliation(s)
- Ryuzea Miura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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42
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Kono Y, Nakamura K, Kimura H, Nishii N, Watanabe A, Banba K, Miura A, Nagase S, Sakuragi S, Kusano KF, Matsubara H, Ohe T. Elevated levels of oxidative DNA damage in serum and myocardium of patients with heart failure. Circ J 2006; 70:1001-5. [PMID: 16864932 DOI: 10.1253/circj.70.1001] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [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: 11/09/2022]
Abstract
BACKGROUND Oxidative stress has been implicated in the pathogenesis of chronic heart failure. The present study investigated whether the levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), a marker of oxidative DNA damage, were elevated in the serum and myocardium of patients with dilated cardiomyopathy (DCM), and furthermore whether carvedilol, a vasodilating beta-blocker with antioxidant activity, could reduce the levels. METHODS AND RESULTS Serum levels of 8-OHdG were measured by enzyme immunoassay in 56 patients with DCM and in 20 control subjects. DCM patients had significantly elevated serum levels of 8-OHdG compared with control subjects. Endomyocardial biopsy samples obtained from 12 DCM patients and 5 control subjects with normal cardiac function were studied immunohistochemically for the expression of 8-OHdG. Positive 8-OHdG staining was found in the nuclei of cardiomyocytes from DCM patients but not in those from control subjects. After treatment with carvedilol, the serum levels of 8-OHdG in DCM patients significantly decreased by 19%, together with amelioration of heart failure. CONCLUSIONS Levels of 8-OHdG are elevated in the serum and myocardium of patients with heart failure. Treatment with carvedilol might be effective for decreasing the oxidative DNA damage.
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Affiliation(s)
- Yasuyuki Kono
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, and Division of Cardiology, National Hospital Organization Okayama-Medical Center, Japan.
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43
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Fujio H, Nakamura K, Matsubara H, Kusano KF, Miyaji K, Nagase S, Ikeda T, Ogawa A, Ohta-Ogo K, Miura D, Miura A, Miyazaki M, Date H, Ohe T. Carvedilol inhibits proliferation of cultured pulmonary artery smooth muscle cells of patients with idiopathic pulmonary arterial hypertension. J Cardiovasc Pharmacol 2006; 47:250-5. [PMID: 16495763 DOI: 10.1097/01.fjc.0000201359.58174.c8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Idiopathic pulmonary arterial hypertension (IPAH) is associated with proliferation of smooth muscle cells (SMCs) in small pulmonary arteries. Inhibition of proliferation of pulmonary artery smooth muscle cells (PASMCs) may be an effective treatment of patients with idiopathic pulmonary arterial hypertension. Recent studies have shown that carvedilol, an alpha- and beta-blocker with antioxidant and calcium channel blocking properties, inhibits the proliferation of cultured normal human pulmonary artery smooth muscle cells. In this study, we tested the hypothesis that carvedilol has antiproliferative effects on pulmonary artery smooth muscle cells of patients with idiopathic pulmonary arterial hypertension. Pulmonary artery smooth muscle cells from six idiopathic pulmonary arterial hypertension patients who had undergone lung transplantation were cultured. To determine cell proliferation, H-thymidine incorporation was measured. Platelet-derived growth factor-induced proliferation of IPAH-PASMCs was significantly greater than that of normal control pulmonary artery smooth muscle cells. Carvedilol (0.1 microM to 10 microM) inhibited the proliferation of idiopathic pulmonary arterial hypertension-pulmonary artery smooth muscle cells in a concentration-dependent manner. Prazosin (an alpha-blocker) and N-acetyl L cysteine (an antioxidant agent) (0.1 microM to 10 microM) did not inhibit their proliferation, but the high concentration of propranolol (a beta-blocker) and nifedipine (a calcium channel blocker) (10 microM) inhibited the proliferation. The combination of propranolol and nifedipine inhibited the proliferation but only at a high concentration (10 microM) combination. Cell cycle analysis revealed that carvedilol (10 microM) significantly decreased the number of cells in S and G2/M phases. These results indicate that carvedilol inhibits the exaggerated proliferation of pulmonary artery smooth muscle cells of patients with idiopathic pulmonary arterial hypertension partially via its beta-blocking [corrected] and calcium channel blocking effects in vitro.
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Affiliation(s)
- Hideki Fujio
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Miura R, Nakamura K, Miura D, Miura A, Hisamatsu K, Kajiya M, Nagase S, Morita H, Fukushima Kusano K, Ohe T, Ishihara K. Anti-inflammatory effect of spironolactone on human peripheral blood mononuclear cells. J Pharmacol Sci 2006; 101:256-9. [PMID: 16837769 DOI: 10.1254/jphs.sc0060049] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 12/15/2022] Open
Abstract
We evaluated the effect of alacepril, CV-11974, and spironolactone on the production of monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-alpha) in cultured human peripheral blood mononuclear cells stimulated with angiotensin (Ang) II. Alacepril, CV-11974, and spironolactone significantly reduced the enhanced production of MCP-1 and TNF-alpha induced by exogenous Ang II. Specifically, 10 muM of spironolactone significantly reduced cytokine production, compared to the same dose of alacepril or CV-11974. These findings indicate that spironolactone may contribute to ameliorate the prognosis of patients with cardiovascular diseases by reducing Ang II-induced inflammation, although further exploration including determining the mechanisms would be required.
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Affiliation(s)
- Ryuzea Miura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
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Watanabe A, Fukushima Kusano K, Morita H, Miura D, Sumida W, Hiramatsu S, Banba K, Nishii N, Nagase S, Nakamura K, Sakuragi S, Ohe T. Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome. Eur Heart J 2006; 27:1579-83. [PMID: 16760208 DOI: 10.1093/eurheartj/ehl060] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [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: 11/14/2022] Open
Abstract
AIMS Arrhythmic storm or repetitive ventricular arrhythmia (VA) has been occasionally observed in Brugada syndrome (BS). A beta-adrenergic stimulator [isoproterenol (ISP)] has been reported to suppress this arrhythmic storm in sporadic cases. Accordingly, we investigated the antiarrhythmic effects of ISP infusion in consecutive BS patients with arrhythmic storm or repetitive VA. METHODS AND RESULTS Seven BS patients with arrhythmic storm were studied. Intravenous ISP was administered as a bolus injection (1-2 microg), followed by continuous infusion (0.15 microg/min). Arrhythmic storm or repetitive VA was suppressed immediately after the bolus administration of ISP, which was followed by continuous infusion of low-dose ISP for 1-3 days. In all patients, ST-elevation decreased in right precordial leads. In six of the seven patients, VA subsided after the discontinuance of ISP. RR interval was shortened and ST-elevation in right precordial leads was decreased after ISP bolus injection. ST-elevation in right precordial leads remained decreased during continuous ISP infusion, whereas the RR interval returned to the control level. CONCLUSION Continuous administration of low-dose ISP may be effective for the suppression of repetitive VA occurrence in patients with BS.
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Affiliation(s)
- Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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Yumoto A, Fukushima Kusano K, Nakamura K, Hashimoto K, Aoki M, Morishita R, Kaneda Y, Ohe T. Hepatocyte growth factor gene therapy reduces ventricular arrhythmia in animal models of myocardial ischemia. Acta Med Okayama 2005; 59:73-8. [PMID: 16049559 DOI: 10.18926/amo/31982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
It was recently reported that gene therapy using hepatocyte growth factor (HGF) has the potential to preserve cardiac function after myocardial ischemia. We speculated that this HGF gene therapy could also prevent ventricular arrhythmia. To investigate this possibility, we examined the antiarrhythmic effect of HGF gene therapy in rat acute and old myocardial infarction models. Myocardial ischemia was induced by ligation of the left descending coronary artery. Hemagglutinating virus of Japan (HVJ)-coated liposome containing HGF genes were injected directly into the myocardium fourteen days before programmed pacing. Ventricular fibrillation (VF)was induced by programmed pacing. The VF duration was reduced and the VF threshold increased after HGF gene therapy ( p< 0.01). Histological analyses revealed that the number of vessels in the ischemic border zone was greatly increased after HGF gene injection. These findings revealed that HGF gene therapy has an anti-arrhythmic effect after myocardial ischemia.
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Affiliation(s)
- Akihisa Yumoto
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan.
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47
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Ogawa A, Nakamura K, Matsubara H, Fujio H, Ikeda T, Kobayashi K, Miyazaki I, Asanuma M, Miyaji K, Miura D, Kusano KF, Date H, Ohe T. Prednisolone inhibits proliferation of cultured pulmonary artery smooth muscle cells of patients with idiopathic pulmonary arterial hypertension. Circulation 2005; 112:1806-12. [PMID: 16157769 DOI: 10.1161/circulationaha.105.536169] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Idiopathic pulmonary arterial hypertension (IPAH) is associated with proliferation of smooth muscle cells (SMCs) in small pulmonary arteries. There is no therapy that specifically inhibits SMC proliferation. Recent studies reported that prednisolone (PSL) inhibits the postangioplasty proliferation of SMCs in atherosclerotic arteries. In this study, we tested the hypothesis that PSL has antiproliferative effects on pulmonary artery SMCs of patients with IPAH. METHODS AND RESULTS Pulmonary artery SMCs were harvested from the pulmonary arteries of 6 patients with IPAH who underwent lung transplantation. Control SMCs were obtained from 5 patients with bronchogenic carcinoma who underwent lung lobectomy. After incubation in the presence of platelet-derived growth factor (PDGF), PSL was added at different concentrations and cell proliferation was assessed by 3H-thymidine incorporation. PSL (2x10(-4) and 2x10(-3) mol/L) significantly inhibited PDGF-stimulated proliferation (P<0.05) of SMCs from patients with IPAH but did not affect cell viability of SMCs, as confirmed by trypan blue staining. In cell cycle analysis using a microscope-based multiparameter laser scanning cytometer, PSL inhibited the progression of SMCs from G(0)/G1 to the S phase. This inhibition was associated with increased p27 expression level. PSL (2x10(-4) mol/L) also inhibited PDGF-induced SMC migration. CONCLUSIONS Our results indicate that PSL has an antiproliferative effect on cultured SMCs of pulmonary arteries from patients with IPAH and suggest that PSL may be potentially useful therapeutically in patients with IPAH.
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Affiliation(s)
- Aiko Ogawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan.
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Nakamura K, Kusano KF, Matsubara H, Nakamura Y, Miura A, Nishii N, Banba K, Nagase S, Miyaji K, Morita H, Saito H, Emori T, Ohe T. Relationship between oxidative stress and systolic dysfunction in patients with hypertrophic cardiomyopathy. J Card Fail 2005; 11:117-23. [PMID: 15732031 DOI: 10.1016/j.cardfail.2004.05.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [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: 11/19/2022]
Abstract
BACKGROUND Progression of hypertrophic cardiomyopathy (HCM) to left ventricular dilatation and systolic dysfunction sometimes occurs. However, the mechanism is not known. We examined whether oxidative stress was elevated in myocardia of HCM patients and whether the levels were correlated with left ventricular dilatation and systolic dysfunction. METHODS AND RESULTS Endomyocardial biopsy samples obtained from the right ventricular side of the septum of 31 patients with HCM, and 10 control subjects were studied immunohistochemically for the expression of 4-hydroxy-2-nonenal (HNE)-modified protein, which is a major lipid peroxidation product. Expression of HNE-modified protein was found in all myocardial biopsy samples from patients with HCM. Expression was distinct in the cytosol of cardiomyocytes. The expression levels in patients with HCM were significantly increased compared with those in control subjects (P = .0005). The expression levels in patients with HCM were correlated with left ventricular end-diastolic diameter (r = 0.483, P = .0053) and end-systolic diameter (r = 0.500, P = .0037) determined by echocardiography. The expression levels were inversely correlated with left ventricular ejection fraction determined by left ventriculography (r = -0.640, P = .0001). CONCLUSION Oxidative stress was elevated in myocardia of HCM patients and the levels were correlated with left ventricular dilatation and systolic dysfunction. Oxidative stress is involved in the pathogenesis of heart failure in patients with HCM.
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Affiliation(s)
- Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
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Watanabe A, Nakamura K, Morita H, Kusano KF, Ohe T. [Long QT syndrome]. Nihon Rinsho 2005; 63:1171-7. [PMID: 16001778] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The long QT syndrome (LQTS) is characterized by prolongation of the QT interval, causing torsade de pointes and sudden cardiac death. This syndrome can be divided into idiopathic (congenital) and acquired forms. The idiopathic form is a familial disorder that can be associated with sensorineural deafness (Jervell and Lange--Nielsen syndrome, autosomal recessive) or normal hearing (Romano--Ward syndrome, autosomal dominant). The acquired form has a long QT interval caused by various drugs such as quinidine sotalol and dofetilide, also by noncardiovascular drugs such as antihistamine, antibiotics, antipsychotics and others. Also, the QT interval is prolonged by electrolyte abnormalities such as hypokalemia and hypomagnesemia, central nervous system lesions, significant bradyarrhythmias, cardiac ganglionitis, mitral valve prolapse and probucol. DNA variants appearing to predispose to drug-associated acquired long QT syndrome have been reported in congenital long QT.
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Affiliation(s)
- Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine
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Watanabe A, Kusano KF, Morita H, Banba K, Nishii N, Nagase S, Nakamura K, Saitoh H, Ohe T. Low dose quinidine test in patients with Brugada syndrome. Heart Rhythm 2005. [DOI: 10.1016/j.hrthm.2005.02.838] [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: 11/15/2022]
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