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Yoshihara F, Imazu M, Sakuma I, Hiroi Y, Hara H, Okazaki O, Ishiguro C, Izumi C, Noguchi T, Shiraiwa T, Nishioka N, Fujii K, Iwakura K, Tomonaga O, Kobayashi K, Takihata M, Yumoto K, Takase H, Himi T, Shimizu I, Murakami T, Wagatsuma K, Sato K, Hiramatsu T, Akabame S, Hata S, Asakura M, Kawabata T, Omae K, Ito S, Kitakaze M. DAPagliflozin for the attenuation of albuminuria in Patients with h Ea Rt failure and type 2 diabetes (DAPPER study): a multicentre, randomised, open-label, parallel-group, standard treatment-controlled trial. EClinicalMedicine 2023; 66:102334. [PMID: 38192595 PMCID: PMC10772256 DOI: 10.1016/j.eclinm.2023.102334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 01/10/2024] Open
Abstract
Background Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the urinary albumin-to-creatinine ratio (UACR) in patients with elevated levels of albuminuria in the presence or absence of heart failure (HF) or type 2 diabetes mellitus (T2D). However, these effects have not yet been reported in the presence of both HF and T2D. This lack of evidence prompted us to conduct a clinical trial on the effects of dapagliflozin on UACR in patients with HF and T2D. Methods DAPPER is a multicentre, randomised, open-labeled, parallel-group, standard treatment-controlled trial that enrolled patients at 18 medical facilities in Japan. Eligible participants with both HF and T2D and aged between 20 and 85 years were randomly assigned to a dapagliflozin or control (anti-diabetic drugs other than SGLT 2 inhibitors) group with a 1:1 allocation. The primary outcome was changes in UACR from baseline after a two-year observation, and secondary endpoints were cardiovascular (CV) events and parameters related to HF. This trial was registered with the UMIN-CTR registry, UMIN000025102 and the Japan Registry of Clinical Trials, jRCTs051180135. Findings Between 12 May 2017 and 31 March 2020, 294 patients were randomly assigned to the dapagliflozin group (n = 146) or control group (n = 148). The mean age of patients was 72.1 years and 29% were female. The mean glycated hemoglobin value was 6.9%, mean NT-proBNP was 429.1 pg/mL, mean estimated GFR was 65.7 mL/min/1.73 m2, and median UACR was 25.0 (8.8-74.6) mg/g Cr in the dapagliflozin group and 25.6 (8.2-95.0) mg/g Cr in the control group. Of the 146 patients in the dapagliflozin group, 122 completed the study, and 107 (87.7%) were taking 5 mg of dapagliflozin daily at the end of the observation period. The primary outcome did not significantly differ between the dapagliflozin and control groups. Among the secondary endpoints, the mean decrease in left ventricular end-diastolic dimensions as one of the echocardiographic parameters was larger in the dapagliflozin group than in the control group. The composite endpoint, defined as CV death or hospitalisation for CV events, hospitalisation for HF events, hospitalisation for all causes, and an additional change in prescriptions for heart failure in a two-year observation, was less frequent in the dapagliflozin group than in the control group. Interpretation Although dapagliflozin at a dose of 5 mg daily did not reduce urinary albumin excretion in patients with HF and T2D from that in the controls, our findings suggest that dapagliflozin decreased CV events and suppressed left ventricular remodeling. Funding AstraZeneca KK, Ono Pharmaceutical Co., Ltd.
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Affiliation(s)
- Fumiki Yoshihara
- Division of Nephrology and Hypertension, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Miki Imazu
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Ichiro Sakuma
- Division of Cardiology/Internal Medicine, Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | - Yukio Hiroi
- Department of Cardiology, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Hisao Hara
- Department of Cardiology, National Centre for Global Health and Medicine, Tokyo, Japan
| | | | | | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Toshihiko Shiraiwa
- General Internal Medicine, Hypertension and Diabetes Centre, Shiraiwa Medical Clinic, Kashiwara, Japan
| | - Norio Nishioka
- General Internal Medicine, Cardiology and Cardiac Rehabilitation Centre, Shiraiwa Medical Clinic, Kashiwara, Japan
| | - Kenshi Fujii
- Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan
| | - Katsuomi Iwakura
- Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan
| | - Osamu Tomonaga
- Diabetes and Lifestyle Centre, Tomonaga Clinic, Tokyo, Japan
| | - Koichi Kobayashi
- Department of Cardiology, TOYOTA Memorial Hospital, Toyota, Japan
| | | | - Kazuhiko Yumoto
- Department of Cardiology, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Hiroyuki Takase
- Department of Internal Medicine, JA Shizuoka Kohseiren Enshu Hospital, Hamamatsu, Shizuoka, Japan
| | | | - Ikki Shimizu
- Department of Diabetes, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kenji Wagatsuma
- Tsukuba Heart Centre, Tsukuba Memorial Hospital, Tsukuba, Ibaragi, Japan
| | - Katsuhiko Sato
- Cardiovascular Medicine, Sapporo Cardio Vascular Clinic, Sapporo, Japan
| | | | - Satoshi Akabame
- Department of Cardiovascular Medicine, Kyoto Okamoto Memorial Hospital, Kyoto, Japan
| | - Shiro Hata
- Clinical Cardiology, Sasebo City General Hospital, Sasebo, Nagasaki, Japan
| | - Masanori Asakura
- Department of Cardiovascular and Renal Medicine, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Takanori Kawabata
- Department of Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Katsuhiro Omae
- Department of Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Shin Ito
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Masafumi Kitakaze
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
- Hanwa Memorial Hospital, Osaka, Japan
- The Osaka Medical Research Foundation for Intractable Diseases, Osaka, Japan
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Okazaki O, Higashino Y, Yokoya K, An Y, Tanizawa K, Imamura Y, Hayashi T, Akao M, Okumura K, Yamashita T. Prognosis of elderly non-valvular atrial fibrillation patients stratified by B-type natriuretic peptide: ELDERCARE-AF subanalysis. Am Heart J 2022; 250:66-75. [PMID: 35568194 DOI: 10.1016/j.ahj.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND B-type natriuretic peptide (BNP) is a risk factor for stroke and cardiac death in patients with atrial fibrillation. We hypothesized the prognostic outcomes of very elderly non-valvular atrial fibrillation patients ineligible for standard anticoagulation treatment would vary according to BNP stratification. METHODS In this subanalysis of the ELDERCARE-AF trial, patients were stratified by BNP levels at enrollment, and clinical outcomes compared among BNP subgroups. Hazard ratios were adjusted for age, atrial fibrillation type, body mass index, creatine clearance, congestive heart failure, and D-dimer. BNP levels were measured using chemiluminescence enzyme immunoassays. RESULTS In total, 984 patients (average age: 86.6 years) not considered eligible for oral anticoagulant therapy at approved doses for stroke prevention were included. The BNP levels at enrollment were <200 (low), 200 to <400 (moderate), and ≥400 (high) pg/mL in 428, 300, and 256 patients, respectively. The number (%) of patients with stroke or systemic embolism (SSE) was 7 (1.2%), 24 (5.9%), and 28 (8.6%) in the low, moderate, and high BNP subgroups, respectively (adjusted hazard ratio 3.82, P = .0025 for low vs moderate BNP and 4.76, P = .0007 for low vs high BNP). There was no significant difference in major bleeding incidence between the BNP subgroups. Edoxaban 15 mg was associated with a consistent reduction in SSE vs placebo in all BNP subgroups. CONCLUSIONS Stratification by BNP level was associated with the incidence of SSE for very elderly non-valvular atrial fibrillation patients ineligible for standard anticoagulation treatment, and the effect of edoxaban 15 mg was consistent across BNP levels.
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Affiliation(s)
- Osamu Okazaki
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Yorihiko Higashino
- Department of Cardiology, Medical Corporation Aishinkai, Higashi Takarazuka Satoh Hospital, Hyogo, Japan
| | - Koichi Yokoya
- Department of Cardiology, National Hospital Organization Toyohashi Medical Center, Aichi, Japan
| | - Yoshimori An
- Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kimihiko Tanizawa
- Clinical Development Department III, Development Function, Research and Development Division, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Yuki Imamura
- Clinical Development Department III, Development Function, Research and Development Division, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Takuya Hayashi
- Data Governance & Data Engineering Group, Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Masaharu Akao
- Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ken Okumura
- Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Takeshi Yamashita
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
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Minamimoto R, Nakajima K, Okazaki O. Proliferation PET tracer 11C-4DST PET/CT depicts hibernating myocardium. J Nucl Cardiol 2021; 28:2379-2383. [PMID: 32424679 DOI: 10.1007/s12350-020-02196-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.
| | - Kazuhiko Nakajima
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan
| | - Osamu Okazaki
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Bekki N, Hayama H, Nagai R, Miyake W, Yamamoto J, Torii S, Kubota S, Nakagawa T, Okazaki T, Yamamoto M, Okazaki O, Hara H, Hiroi Y. CARDIOVASCULAR OUTCOME OF LEFT ATRIAL STRAIN IN HEART FAILURE WITH PRESERVED EJECTION FRACTION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Minamimoto R, Hotta M, Hiroe M, Awaya T, Nakajima K, Okazaki O, Yamashita H, Kaneko H, Hiroi Y. Proliferation imaging with 11C-4DST PET/CT for the evaluation of cardiac sarcoidosis, compared with FDG-PET/CT given a long fasting preparation protocol. J Nucl Cardiol 2021; 28:752-755. [PMID: 32052294 DOI: 10.1007/s12350-020-02069-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.
| | - Masatoshi Hotta
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan
| | - Michiaki Hiroe
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toru Awaya
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Kazuhiko Nakajima
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan
| | - Osamu Okazaki
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Yamashita
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Kaneko
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Bekki N, Hayama H, Nagai R, Miyake W, Yamamoto J, Torii S, Kubota S, Nakagawa T, Okazaki T, Yamamoto M, Okazaki O, Hara H, Hiroi Y. Left atrial strain and outcome in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Left atrial (LA) function is impaired in heart failure with preserved ejection fraction (HFpEF). However, the association between LA longitudinal strain and heart failure (HF) events in patients with HFpEF is still unknown. We evaluated whether LA strain measurements would be useful to predict hospitalizations for worsening HF in this study.
Methods
This study included 121 patients (Male 73, Female 48) with HFpEF who had echocardiogram at our institute (Age = 76 ± 14y, Left ventricular ejection fraction; LVEF = 63 ± 8%). Patients with atrial fibrillation were excluded. LA longitudinal strain was measured by speckle-tracking echocardiography, using TOMTEC imaging system. The endpoints were hospitalizations for worsening HF.
Results
During follow-up period of 319 ± 269 days, 33 patients (27%) experienced hospitalizations for worsening HF. LA strain was markedly lower in patients with HF events at 11.3 ± 5.6, whereas LA strain was higher at 20.3 ± 10.1 in patients without HF events. Kaplan-Meier analysis demonstrated a significant separation of survival curves stratified by median value of LA strain (Figure).
Conclusions
LA dysfunction in HFpEF is associated with a higher risk of HF hospitalization, and LA strain measurements would be useful to predict HF events.
Abstract Figure
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Affiliation(s)
- N Bekki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - H Hayama
- National Center for Global Health and Medicine, Tokyo, Japan
| | - R Nagai
- National Center for Global Health and Medicine, Tokyo, Japan
| | - W Miyake
- National Center for Global Health and Medicine, Tokyo, Japan
| | - J Yamamoto
- National Center for Global Health and Medicine, Tokyo, Japan
| | - S Torii
- National Center for Global Health and Medicine, Tokyo, Japan
| | - S Kubota
- National Center for Global Health and Medicine, Tokyo, Japan
| | - T Nakagawa
- National Center for Global Health and Medicine, Tokyo, Japan
| | - T Okazaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - M Yamamoto
- National Center for Global Health and Medicine, Tokyo, Japan
| | - O Okazaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - H Hara
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Hiroi
- National Center for Global Health and Medicine, Tokyo, Japan
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Kario K, Hoshide S, Mizuno H, Kabutoya T, Nishizawa M, Yoshida T, Abe H, Katsuya T, Fujita Y, Okazaki O, Yano Y, Tomitani N, Kanegae H. Nighttime Blood Pressure Phenotype and Cardiovascular Prognosis: Practitioner-Based Nationwide JAMP Study. Circulation 2020; 142:1810-1820. [PMID: 33131317 PMCID: PMC7643792 DOI: 10.1161/circulationaha.120.049730] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Supplemental Digital Content is available in the text. Ambulatory and home blood pressure (BP) monitoring parameters are better predictors of cardiovascular events than are office BP monitoring parameters, but there is a lack of robust data and little information on heart failure (HF) risk. The JAMP study (Japan Ambulatory Blood Pressure Monitoring Prospective) used the same ambulatory BP monitoring device, measurement schedule, and diary-based approach to data processing across all study centers and determined the association between both nocturnal hypertension and nighttime BP dipping patterns and the occurrence of cardiovascular events, including HF, in patients with hypertension.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Hiroyuki Mizuno
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Masafumi Nishizawa
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Tetsuro Yoshida
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Hideyasu Abe
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Tomohiro Katsuya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Yumiko Fujita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Osamu Okazaki
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Yuichiro Yano
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Naoko Tomitani
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Hiroshi Kanegae
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
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- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., S.H., H.M., T. Kabutoya, M.N., T.Y., N.T., H.K.). Washiya Hospital, Tochigi, Japan (K.K., H.M.). Minamisanriku Hospital, Motoyoshigun, Japan (M.N.). Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan (T.Y.). Abe Internal Medicine Clinic, Kobe, Japan (H.A.). Katsuya Clinic, Hyogo, Japan (T. Katsuya). Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan (T. Katsuya). Fujita Neurosurgical Clinic, Mitoyo, Japan (Y.F.). National Center for Global Health and Medicine, Tokyo, Japan (O.O.). Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.). Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
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Hayama H, Uejima T, Okazaki O, Hara H, Hiroi Y. Impact of pulmonary wave reflection in heart failure: right ventricular-arterial coupling. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Pulmonary wave reflection, an important loading component on RV, would help better describe right ventricular (RV) – arterial uncouplingin type II pulmonary hypertension (PH).
Methods
This study included 105patients with type II PH (age = 72±13 years old, ejection fraction = 47±21%). Pulmonary wave reflection was characterised by estimating pressure and velocity profiles from Doppler measurement and separating pressure waveform into forward (Pf) and backward pressure (Pb) waves based on the concept of wave intensity. The relationship of RV strain against Pb or pulmonary artery systolic pressure (PASP) was compared between patients with and without subsequent event of worsening heart failure, using discriminant analysis.
Results
Sample profiles of pressure waveforms illustrated Pb accounted for a significant proportion of total pressure (figure A). When RV strain was plotted against Pb, the distribution of both group were clearly separated, indicating significant uncoupling in patients with events, whereas when plotted against PASP, the both groups were overlapped (figure B and C).
Conclusions
Pulmonary wave reflection can better describe RV-arterial uncoupling in type II PH.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Hayama
- National Center for Global Health and Medicine, Tokyo, Japan
| | - T Uejima
- Cardiovascular Institute, Tokyo, Japan
| | - O Okazaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - H Hara
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Hiroi
- National Center for Global Health and Medicine, Tokyo, Japan
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Hotta M, Minamimoto R, Awaya T, Hiroe M, Okazaki O, Hiroi Y. Radionuclide Imaging of Cardiac Amyloidosis and Sarcoidosis: Roles and Characteristics of Various Tracers. Radiographics 2020; 40:2029-2041. [DOI: 10.1148/rg.2020200068] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Masatoshi Hotta
- From the Division of Nuclear Medicine, Departments of Radiology (M. Hotta, R.M.) and Cardiovascular Medicine (T.A., M. Hiroe, O.O., Y.H.), National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; and Department of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan (T.A.)
| | - Ryogo Minamimoto
- From the Division of Nuclear Medicine, Departments of Radiology (M. Hotta, R.M.) and Cardiovascular Medicine (T.A., M. Hiroe, O.O., Y.H.), National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; and Department of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan (T.A.)
| | - Toru Awaya
- From the Division of Nuclear Medicine, Departments of Radiology (M. Hotta, R.M.) and Cardiovascular Medicine (T.A., M. Hiroe, O.O., Y.H.), National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; and Department of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan (T.A.)
| | - Michiaki Hiroe
- From the Division of Nuclear Medicine, Departments of Radiology (M. Hotta, R.M.) and Cardiovascular Medicine (T.A., M. Hiroe, O.O., Y.H.), National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; and Department of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan (T.A.)
| | - Osamu Okazaki
- From the Division of Nuclear Medicine, Departments of Radiology (M. Hotta, R.M.) and Cardiovascular Medicine (T.A., M. Hiroe, O.O., Y.H.), National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; and Department of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan (T.A.)
| | - Yukio Hiroi
- From the Division of Nuclear Medicine, Departments of Radiology (M. Hotta, R.M.) and Cardiovascular Medicine (T.A., M. Hiroe, O.O., Y.H.), National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; and Department of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan (T.A.)
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10
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Okumura K, Akao M, Yoshida T, Kawata M, Okazaki O, Akashi S, Eshima K, Tanizawa K, Fukuzawa M, Hayashi T, Akishita M, Lip GYH, Yamashita T. Low-Dose Edoxaban in Very Elderly Patients with Atrial Fibrillation. N Engl J Med 2020; 383:1735-1745. [PMID: 32865374 DOI: 10.1056/nejmoa2012883] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [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: 11/19/2022]
Abstract
BACKGROUND Implementation of appropriate oral anticoagulant treatment for the prevention of stroke in very elderly patients with atrial fibrillation is challenging because of concerns regarding bleeding. METHODS We conducted a phase 3, multicenter, randomized, double-blind, placebo-controlled, event-driven trial to compare a once-daily 15-mg dose of edoxaban with placebo in elderly Japanese patients (≥80 years of age) with nonvalvular atrial fibrillation who were not considered to be appropriate candidates for oral anticoagulant therapy at doses approved for stroke prevention. The primary efficacy end point was the composite of stroke or systemic embolism, and the primary safety end point was major bleeding according to the definition of the International Society on Thrombosis and Haemostasis. RESULTS A total of 984 patients were randomly assigned in a 1:1 ratio to receive a daily dose of 15 mg of edoxaban (492 patients) or placebo (492 patients). A total of 681 patients completed the trial, and 303 discontinued (158 withdrew, 135 died, and 10 had other reasons); the numbers of patients who discontinued the trial were similar in the two groups. The annualized rate of stroke or systemic embolism was 2.3% in the edoxaban group and 6.7% in the placebo group (hazard ratio, 0.34; 95% confidence interval [CI], 0.19 to 0.61; P<0.001), and the annualized rate of major bleeding was 3.3% in the edoxaban group and 1.8% in the placebo group (hazard ratio, 1.87; 95% CI, 0.90 to 3.89; P = 0.09). There were substantially more events of gastrointestinal bleeding in the edoxaban group than in the placebo group. There was no substantial between-group difference in death from any cause (9.9% in the edoxaban group and 10.2% in the placebo group; hazard ratio, 0.97; 95% CI, 0.69 to 1.36). CONCLUSIONS In very elderly Japanese patients with nonvalvular atrial fibrillation who were not appropriate candidates for standard doses of oral anticoagulants, a once-daily 15-mg dose of edoxaban was superior to placebo in preventing stroke or systemic embolism and did not result in a significantly higher incidence of major bleeding than placebo. (Funded by Daiichi Sankyo; ELDERCARE-AF ClinicalTrials.gov number, NCT02801669.).
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Affiliation(s)
- Ken Okumura
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Masaharu Akao
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Tetsuro Yoshida
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Masahito Kawata
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Osamu Okazaki
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Shintaro Akashi
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Kenichi Eshima
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Kimihiko Tanizawa
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Masayuki Fukuzawa
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Takuya Hayashi
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Masahiro Akishita
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Gregory Y H Lip
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
| | - Takeshi Yamashita
- From the Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto (K.O.), the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto (M. Akao), Onga Nakama Medical Association Onga Hospital, Onga (T. Yoshida), the Department of Cardiology, Akashi Medical Center, Akashi (M.K.), the Department of Cardiology, National Center for Global Health and Medicine (O.O.), Clinical Development Department III, Development Function, Research and Development Division (K.T., M.F.), and the Data Intelligence Group, Data Intelligence Department, Digital Transformation Management Division (T.H.), Daiichi Sankyo, the Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo (M. Akishita), and the Cardiovascular Institute (T. Yamashita), Tokyo, the Division of Cardiology, Hamada Medical Center, Hamada (S.A.), and the Department of Cardiology, Saga-Ken Medical Center Koseikan, Saga (K.E.) - all in Japan; the Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
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11
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Tanabe N, Fukuda K, Matsubara H, Nakanishi N, Tahara N, Ikeda S, Kishi T, Satoh T, Hirata KI, Inoue T, Kimura H, Okano Y, Okazaki O, Sata M, Tsujino I, Ueno S, Yamada N, Yao A, Kuriyama T. Selexipag for Chronic Thromboembolic Pulmonary Hypertension in Japanese Patients - A Double-Blind, Randomized, Placebo-Controlled, Multicenter Phase II Study. Circ J 2020; 84:1866-1874. [PMID: 32879152 DOI: 10.1253/circj.cj-20-0438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Selexipag is an oral prostacyclin receptor (IP receptor) agonist with a non-prostanoid structure. This study examined its efficacy and safety in Japanese patients with non-operated or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH).Methods and Results:This Phase II study was a randomized, double-blind, placebo-controlled parallel-group comparison. The primary endpoint was a change in pulmonary vascular resistance (PVR) from baseline to week 17. The main analysis involved a per-protocol set group of 28 subjects. The change in PVR (mean±SD) after 17 weeks of treatment in the selexipag group was -104±191 dyn·s/cm5, whereas that in the placebo group was 26±180 dyn·s/cm5. Thus, the treatment effect after 17 weeks of selexipag treatment was calculated as -130±189 dyn·s/cm5(P=0.1553). Although the primary endpoint was not met, for the group not concomitantly using a pulmonary vasodilator the PVR in the selexipag group was significantly decreased compared with placebo group (P=0.0364). The selexipag group also showed improvement in total pulmonary resistance and cardiac index. CONCLUSIONS Selexipag treatment improved pulmonary hemodynamics in Japanese patients with CTEPH, but PVR did not show a significant difference between the selexipag and placebo groups. (Trial registration: JAPIC Clinical Trials Information [JapicCTI-111667]).
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Affiliation(s)
- Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Hiromi Matsubara
- Director of Entire Medical Departments, National Hospital Organization Okayama Medical Center
| | | | - Nobuhiro Tahara
- Department of Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Takuya Kishi
- Department of Cardiology, Graduate School of Medical Sciences, International University of Health and Welfare
| | - Toru Satoh
- Department of Cardiovascular Medicine, Kyorin University Hospital
| | - Ken-Ichi Hirata
- Cardiovascular Medicine, Kobe University Graduate School of Medicine
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | | | - Yoshiaki Okano
- Department of Intermal Medicine, Hanwa Dai-ni Senboku Hospital
| | - Osamu Okazaki
- Department of Cardiology, National Center for Global Health and Medecine
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Ichizo Tsujino
- The First Department of Medicine, Hokkaido University School of Medicine
| | - Shuichi Ueno
- Department of Internal Medicine Division of Cardiovascular Medicine, Jichi Medical University School of Medicine.,Ueno Clinic
| | | | - Atsushi Yao
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
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Awaya T, Minamimoto R, Iwama K, Kubota S, Hotta M, Hirai R, Yamamoto M, Okazaki O, Hara H, Hiroi Y, Hiroe M, Moroi M. Performance of 99mTc-aprotinin scintigraphy for diagnosing light chain (AL) cardiac amyloidosis confirmed by endomyocardial biopsy. J Nucl Cardiol 2020; 27:1145-1153. [PMID: 31591695 DOI: 10.1007/s12350-019-01868-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 08/06/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Light chain (AL) cardiac amyloidosis is associated with a poor prognosis. Diagnosing at an early stage is critical for treatment and the management of cardiac complication. PURPOSE We aimed to evaluate the diagnostic performance of 99mTc-aprotinin images in patients with AL cardiac amyloidosis. METHODS AND RESULTS 99mTc-aprotinin scintigraphy and endomyocardial biopsy were performed in 10 patients with suspected amyloidosis. Endomyocardial biopsy showed amyloid deposits in 5 of 10 patients. 99mTc-aprotinin (planer image) was positive in 4 of 5 patients who had amyloid deposits in endomyocardial biopsy. On the other hand, all 5 patients without amyloid deposits were negative in planer image. 99mTc-aprotinin (SPECT/CT image) was positive in all 5 patients who had amyloid deposits. CONCLUSIONS 99mTc-aprotinin scintigraphy is valuable for the non-invasive diagnosis of AL cardiac amyloidosis.
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Affiliation(s)
- Toru Awaya
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
- Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan.
| | - Ryogo Minamimoto
- Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kentaro Iwama
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Kubota
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Risen Hirai
- Department of Hematology, Internal medicine Tokyo-Kita Medical Center, Tokyo, Japan
| | - Masaya Yamamoto
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Osamu Okazaki
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hisao Hara
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Michiaki Hiroe
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Moroi
- Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan
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Awaya T, Minamimoto R, Iwama K, Kubota S, Hotta M, Hirai R, Yamamoto M, Okazaki O, Hara H, Hiroi Y, Hiroe M, Moroi M. Correction to: Performance of 99mTc-aprotinin scintigraphy for diagnosing light chain (AL) cardiac amyloidosis confirmed by endomyocardial biopsy. J Nucl Cardiol 2020; 27:1154. [PMID: 32557240 DOI: 10.1007/s12350-020-02229-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This prospective study was conducted according to the principles outlined within the Declaration of Helsinki, and approved by the Ethics Review Board of National Center for Global Health and Medicine (NCGM-G-00839-01, NCGM-G-00839-02).
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Affiliation(s)
- Toru Awaya
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
- Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan.
| | - Ryogo Minamimoto
- Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kentaro Iwama
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Kubota
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Risen Hirai
- Department of Hematology, Internal Medicine, Tokyo-Kita Medical Center, Tokyo, Japan
| | - Masaya Yamamoto
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Osamu Okazaki
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hisao Hara
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Michiaki Hiroe
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Moroi
- Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan
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Minamimoto R, Awaya T, Iwama K, Hotta M, Nakajima K, Hirai R, Okazaki O, Hiroi Y. Significance of 11C-PIB PET/CT in cardiac amyloidosis compared with 99mTc-aprotinin scintigraphy: A pilot study. J Nucl Cardiol 2020; 27:202-209. [PMID: 29589208 DOI: 10.1007/s12350-018-1260-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND This study was to investigate the significance of 11C-Pittsburgh B (PIB) PET/CT in patients with suspected cardiac amyloidosis compared with 99mTc-aprotinin scintigraphy. METHODS Thirteen consecutive patients with suspected cardiac amyloidosis were considered for enrolment in this prospective pilot study. Participants were scheduled to undergo a series of 11C-PIB PET/CT and 99mTc-aprotinin within a 2-month period. Finally, we evaluated nine cases who underwent both imaging modalities, and compared imaging results with clinical and pathological results and prognosis. RESULTS Six of the 9 patients who underwent both imaging modalities were diagnosed with amyloidosis, of whom 3 patients were diagnosed with cardiac amyloidosis from endomyocardial biopsy. These 3 patients with positive 11C-PIB uptake at the left ventricle wall showed worsening of cardiac function progressing in the short term or death caused by acute exacerbation of chronic heart failure. Six of 8 patients with positive uptake on 99mTc-aprotinin presented with amyloid deposition in the left ventricle wall, but symptoms remained stable if results of 11C-PIB were not positive. CONCLUSION In a small sample of subjects, the present study showed that 11C-PIB accumulation in myocardium indicated cardiac amyloidosis with poor prognosis. Uptake of 11C-PIB may be related to progressive amyloid deposition to the heart and can predict patient prognosis.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.
| | - Toru Awaya
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kentaro Iwama
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan
| | - Kazuhiko Nakajima
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan
| | - Risen Hirai
- Division of Hematology, Internal medicine, Tokyo Kita Medical Center, Tokyo, Japan
| | - Osamu Okazaki
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Awaya T, Kodama C, Yamamoto M, Okazaki O, Hara H, Hiroi Y, Moroi M. A case of prominent coronary plaque regression with statin therapy. J Cardiovasc Comput Tomogr 2019; 14:275-276. [PMID: 31080108 DOI: 10.1016/j.jcct.2019.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/07/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Toru Awaya
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan; Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
| | - Chiori Kodama
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaya Yamamoto
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Osamu Okazaki
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hisao Hara
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Moroi
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
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Umei TC, Awaya T, Okazaki O, Hara H, Hiroi Y. Pacemaker malfunction after acute myocardial infarction in a patient with wrap-around left anterior descending artery supplying the right ventricular apex. J Cardiol Cases 2018; 18:9-12. [DOI: 10.1016/j.jccase.2018.03.001] [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] [Received: 09/26/2017] [Revised: 02/13/2018] [Accepted: 03/03/2018] [Indexed: 10/17/2022] Open
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Kurotani K, Karunapema P, Jayaratne K, Sato M, Hayashi T, Kajio H, Fukuda S, Hara H, Okazaki O, Jayatilleke AU, Nonaka D, Noda M, Mizoue T. Circulating odd-chain saturated fatty acids were associated with arteriosclerosis among patients with diabetes, dyslipidemia, or hypertension in Sri Lanka but not Japan. Nutr Res 2018. [DOI: 10.1016/j.nutres.2017.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hayama H, Suzuki M, Hashimoto G, Makino K, Ono T, Iijima R, Hara H, Hara H, Okazaki O, Hiroi Y, Moroi M, Ozaki S, Nakamura M. P2401Leaflet thrombosis after aortic valve reconstruction surgery using autologous pericardium. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tanabe N, Ikeda S, Tahara N, Fukuda K, Hatano M, Ito H, Nakayama T, Anzai T, Hashimoto A, Inoue T, Kajinami K, Kihara Y, Kinoshita H, Kuwahara K, Murohara T, Okazaki O, Sakai S, Satoh T, Takeda Y, Takeishi Y, Taniguchi M, Watanabe H, Yamamoto T, Yamauchi-Takihara K, Yoshioka K, Sasayama S. Efficacy and Safety of an Orally Administered Selective Prostacyclin Receptor Agonist, Selexipag, in Japanese Patients With Pulmonary Arterial Hypertension. Circ J 2017; 81:1360-1367. [DOI: 10.1253/circj.cj-16-1348] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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 Tanabe
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Nobuhiro Tahara
- Department of Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Masaru Hatano
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Hospital
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine
| | | | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University Hospital
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | | | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideyuki Kinoshita
- Department of Community Medicine Supporting System, Kyoto University Graduate School of Medicine
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Osamu Okazaki
- Department of Cardiology, National Center for Global Health and Medicine
| | - Satoshi Sakai
- Cardiovascular Division, Department of Clinical Medicine, Faculty of Medicine, University of Tsukuba
| | - Toru Satoh
- Division of Cardiology Department of Medicine, Kyorin University Hospital
| | - Yutaka Takeda
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences
| | | | - Mitsugu Taniguchi
- Department of Cardiology, Osaka Pref. Saiseikai Tondabayashi Hospital
| | - Hiroshi Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
| | - Takeshi Yamamoto
- Faculty of Health Science, Yamaguchi University Graduate School of Medicine
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Awaya T, Yamamoto M, Okazaki O, Hara H, Hiroi Y, Moroi M. Optimal Positive End-Expiratory Pressure was Different in Each Patient with Heart Failure with Reduced Ejection Fraction Treated with Adaptive-Servo Ventilation. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.259] [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: 11/27/2022]
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Kario K, Hoshide S, Uchiyama K, Yoshida T, Okazaki O, Noshiro T, Aoki H, Mizuno H, Matsumoto Y. Dose Timing of an Angiotensin II Receptor Blocker/Calcium Channel Blocker Combination in Hypertensive Patients With Paroxysmal Atrial Fibrillation. J Clin Hypertens (Greenwich) 2016; 18:1036-1044. [DOI: 10.1111/jch.12814] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/20/2016] [Accepted: 01/27/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine; Department of Medicine and Department of Sleep and Circadian Cardiology; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine; Department of Medicine and Department of Sleep and Circadian Cardiology; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
| | | | - Tetsuro Yoshida
- Onga Nakama Medical Association Onga Hospital; Fukuoka Japan
| | - Osamu Okazaki
- National Center for Global Health and Medicine; Tokyo Japan
| | | | | | - Hiroyuki Mizuno
- Division of Cardiovascular Medicine; Department of Medicine and Department of Sleep and Circadian Cardiology; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
| | - Yuri Matsumoto
- Division of Cardiovascular Medicine; Department of Medicine and Department of Sleep and Circadian Cardiology; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
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Masubuchi N, Nishiya T, Imaoka M, Mizumaki K, Okazaki O. Promising toxicological biomarkers for the diagnosis of liver injury types: Bile acid metabolic profiles and oxidative stress marker as screening tools in drug development. Chem Biol Interact 2015; 255:74-82. [PMID: 26365562 DOI: 10.1016/j.cbi.2015.09.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 05/29/2015] [Revised: 09/01/2015] [Accepted: 09/08/2015] [Indexed: 01/15/2023]
Abstract
Promising biomarkers were identified in adult male Crl:CD (SD) rats for the screening of new chemical entities for their potential to cause liver injury. We examined the serum biochemistry, liver histopathology, and bile acid profiles by LC-MS/MS, and the mRNA expression of transporters and CYPs by an RT-PCR after the following treatments to male Crl:CD (SD) rats: (a) bile duct ligation (BDL); (b) a single oral dose of 150 mg/kg α-naphthylisothiocyanate (ANIT); and (c) repeated oral doses of a novel pyrrolidinecarboxylic acid derivative (abbreviated as PCA) at 30, 300, and 1000 mg/kg. The serum total bile acid levels and bilirubin concentrations were found to be elevated in all of the groups. However, the bile acid component profiles of the PCA group differed significantly from BDL and ANIT models: deoxycholic acid, lithocholic acid, and sulfated bile acids were upregulated in a dose-dependent manner only in the PCA group. In addition, the PCA group demonstrated high levels of hepatic heme oxygenase-1 expression, whereas the profiles of the mRNA levels of the hepatic transporters and CYPs of all groups were found to be similar. The histopathological findings, for both the BDL and ANIT groups, were of bile duct hyperplasia, hepatocyte degeneration and necrosis. In contrast, only bile duct hyperplasia and hepatocyte degeneration were observed in the PCA group, even at a lethal dose. These results indicated that PCA induced a cholestatic condition and the increase of oxidative stress markers implies that this will also lead hepatocellular injury. In conclusion, the serum bile acid components and sulfated bile acid levels, and the expression of oxidative stress markers could provide information that aids in the diagnosis of liver injury type and helps to elucidate the mechanisms of hepatotoxicity. These findings can be extrapolated into our clinical investigation. The analysis of these crucial biomarkers is likely to be a useful screening tool in the lead optimization phase of drug discovery.
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Affiliation(s)
- Noriko Masubuchi
- Drug Metabolism & Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710, Japan.
| | - Takayoshi Nishiya
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13, Kita-Kasai, Edogawa-ku, 134-8630, Tokyo, Japan
| | - Masako Imaoka
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13, Kita-Kasai, Edogawa-ku, 134-8630, Tokyo, Japan
| | - Kiyoko Mizumaki
- Daiichi Sankyo RD Novare, 1-16-13, Kita-Kasai, Edogawa-ku, 134-8630, Tokyo, Japan
| | - Osamu Okazaki
- Drug Metabolism & Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710, Japan
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Morooka M, Moroi M, Uno K, Ito K, Wu J, Nakagawa T, Kubota K, Minamimoto R, Miyata Y, Okasaki M, Okazaki O, Yamada Y, Yamaguchi T, Hiroe M. Long fasting is effective in inhibiting physiological myocardial 18F-FDG uptake and for evaluating active lesions of cardiac sarcoidosis. EJNMMI Res 2014; 4:1. [PMID: 24382020 PMCID: PMC3880002 DOI: 10.1186/2191-219x-4-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 12/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising modality for detecting active lesions of cardiac sarcoidosis (CS). However, determining whether 18F-FDG uptake in the myocardium is physiological is challenging due to metabolic shift in myocardial cells. Although methods for inhibiting physiological myocardial 18F-FDG uptake have been proposed, no standard methods exist. This study therefore aimed to compare the effect of an 18-h fast (long fasting (LF)) with heparin loading plus a 12-h fast (HEP) before 18F-FDG PET scan. METHODS We analyzed the effects of LF and HEP on the inhibition of physiological myocardial 18F-FDG uptake in healthy subjects (18 in HEP and 19 in LF) and in patients with known or suspected CS (96 in HEP and 69 in LF). In CS, the lower uptake of 18F-FDG in the myocardium was evaluated. A visual four-point scale was used to assess myocardial 18F-FDG uptake in comparison with hepatic uptake (1 lower, 2 similar, 3 somewhat higher, 4 noticeably higher). RESULTS Myocardial 18F-FDG uptake was 1.68 ± 1.06 in LF and 3.17 ± 1.16 in HEP in healthy subjects (p < 0.0001), whereas it was 1.48 ± 0.99 in LF and 2.48 ± 1.33 in HEP in CS patients (p < 0.0001). Logistic regression and regression trees revealed the LF was the most effective in inhibiting myocardial 18F-FDG uptake. In addition, serum free fatty acid levels on intravenous 18F-FDG injection were a possible biomarker. CONCLUSIONS LF is effective in inhibiting myocardial 18F-FDG uptake, and consequently, it could be useful for evaluating active lesions of CS in 18F-FDG PET images.
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Affiliation(s)
| | - Masao Moroi
- Department of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
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Ito K, Okazaki O, Morooka M, Kubota K, Minamimoto R, Hiroe M. Visual findings of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with cardiac sarcoidosis. Intern Med 2014; 53:2041-9. [PMID: 25224185 DOI: 10.2169/internalmedicine.53.2491] [Citation(s) in RCA: 11] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the cardiac sarcoidosis (CS) activity according to the classified visual uptake pattern using (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and assess the uptake pattern based on the free fatty acid (FFA) levels. METHODS Nineteen CS subjects who underwent (18)F-FDG PET/CT examinations with heparin loading (HL) were recruited to evaluate their CS activity. The (18)F-FDG uptake in the heart was classified into five categories ("none," "diffuse" and "diffuse at base," regarded as stable CS, and "focal" and "focal on diffuse," regarded as de novo or worsening CS). The subject data were compared with the (18)F-FDG PET/CT findings in 13 healthy volunteers. The FFA serum levels were assessed in 10 patients with CS and all volunteers. RESULTS The sensitivity and specificity of (18)F-FDG PET/CT with HL were 75% (6/8) and 73% (8/11), respectively. The major pattern of cardiac (18)F-FDG uptake was "diffuse at base." Ten of the 32 subjects, including the control group, exhibited this pattern. The FFA serum levels before heparin administration were statistically significantly different between the patients with the "none" pattern and those with the "diffuse" and "diffuse at base" patterns. There were no significant correlations between the FFA serum levels after heparin administration and the (18)F-FDG uptake patterns. CONCLUSION "Diffuse at base" is the major (18)F-FDG uptake pattern associated with inadequate physiologic (18)F-FDG suppression. This pattern should be carefully interpreted when examining the (18)F-FDG PET/CT images of CS patients. Additionally, increased FFAs levels associated with HL may not completely suppress the physiologic myocardial FDG uptake.
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Affiliation(s)
- Kimiteru Ito
- Department of Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Japan
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Jesmin S, Akter S, Akashi H, Al-Mamun A, Rahman MA, Islam MM, Sohael F, Okazaki O, Moroi M, Kawano S, Mizutani T. Screening for gestational diabetes mellitus and its prevalence in Bangladesh. Diabetes Res Clin Pract 2014; 103:57-62. [PMID: 24369985 DOI: 10.1016/j.diabres.2013.11.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 11/29/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND The prevalence of gestational diabetes mellitus (GDM) has important health complications for both mother and child and is increasing all over the world. Although prevalence estimates for GDM are not new in developed and many developing countries, data are lacking for many low-income countries like Bangladesh. OBJECTIVE To evaluate the prevalence of GDM in Bangladesh. RESEARCH DESIGN AND METHODS This cross-sectional study included 3447 women who consecutively visited the antenatal clinics with an average gestation age of 26 weeks. GDM was defined according to WHO criteria (fasting plasma glucose [FPG] ≥7.0 mmol/L or 2-h ≥7.8 mmol/L) and the new ADA criteria (FPG ≥5.3 mmol/L or 2-h ≥8.6 mmol/L OGTT). We also calculated overt diabetes as FPG ≥7.0 mmol/L. RESULTS Prevalence of GDM was 9.7% according to the WHO criteria and 12.9% according to the ADA criteria in this study population. Prevalence of overt diabetes was 1.8%. Women with GDM were older, higher educated, had higher household income, higher parity, parental history of diabetes, and more hypertensive, compared with non-GDM women. CONCLUSION This study demonstrates a high prevalence of GDM in Bangladesh. These estimates for GDM may help to formulate new policies to prevent and manage diabetes.
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Affiliation(s)
- Subrina Jesmin
- Health & Disease Research Center for Rural Peoples (HDRCRP), Ena Arista, Flat # B-3, House # 802, Road # 3, Baitul Aman Housing Society, Adabor, Shamoli, Dhaka 1207, Bangladesh; Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan.
| | - Shamima Akter
- Health & Disease Research Center for Rural Peoples (HDRCRP), Ena Arista, Flat # B-3, House # 802, Road # 3, Baitul Aman Housing Society, Adabor, Shamoli, Dhaka 1207, Bangladesh; National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Hidechika Akashi
- National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Abdullah Al-Mamun
- Health & Disease Research Center for Rural Peoples (HDRCRP), Ena Arista, Flat # B-3, House # 802, Road # 3, Baitul Aman Housing Society, Adabor, Shamoli, Dhaka 1207, Bangladesh; Shahid Ziaur Rahman Medical College, Bogra, Bangladesh
| | - Md Arifur Rahman
- Health & Disease Research Center for Rural Peoples (HDRCRP), Ena Arista, Flat # B-3, House # 802, Road # 3, Baitul Aman Housing Society, Adabor, Shamoli, Dhaka 1207, Bangladesh; Shahid Ziaur Rahman Medical College, Bogra, Bangladesh
| | - Md Majedul Islam
- Health & Disease Research Center for Rural Peoples (HDRCRP), Ena Arista, Flat # B-3, House # 802, Road # 3, Baitul Aman Housing Society, Adabor, Shamoli, Dhaka 1207, Bangladesh; Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Farzana Sohael
- Health & Disease Research Center for Rural Peoples (HDRCRP), Ena Arista, Flat # B-3, House # 802, Road # 3, Baitul Aman Housing Society, Adabor, Shamoli, Dhaka 1207, Bangladesh; Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Osamu Okazaki
- National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masao Moroi
- National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Satoru Kawano
- Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Taro Mizutani
- Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Akter S, Jesmin S, Rahman A, AKM AH, Shimojo N, Islam M, Zaedi S, Yamaguchi N, Moroi M, Kimura S, Okazaki O, Miyauchi T, Kawano S, Akashi H, Mizutani T. Higher circulatory level of endothelin-1 in hypertensive subjects screened through a cross-sectional study in rural Bangladeshi women. Life Sci 2013. [DOI: 10.1016/j.lfs.2014.01.017] [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: 11/26/2022]
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Khatun MT, Jesmin S, Rahman A, AKM Ahsan H, Islam M, Akter S, Shimojo N, Kimura S, Okazaki O, Moroi M, Yamaguchi N, Akashi H, Sohael F, Sultana SN, Zaedi S, Kawano S, Mizutani T, Miyauchi T. Assessment of circulatory endothelin-1 level among pre- and post-menopausal rural women in Bangladesh: Result from a population-based study. Life Sci 2013. [DOI: 10.1016/j.lfs.2014.01.030] [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: 10/25/2022]
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Murakami H, Akashi H, Noda S, Mizoue T, Okazaki O, Ouchi Y, Okaji Y, Kajiwara C, Miyoshi C. A cross-sectional survey of blood pressure of a coastal city's resident victims of the 2011 Tohoku tsunami. Am J Hypertens 2013; 26:799-807. [PMID: 23455946 DOI: 10.1093/ajh/hpt022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Blood pressure (BP) increase as a reaction to major disasters has been well documented; however, the impact has been underdocumented for tsunamis. This study aimed to confirm whether different levels of flooding/inundation and other damage caused by the 2011 Tohoku (northeast Japan) tsunami were associated with BP among resident victims in Higashi-Matsushima, Miyagi. METHODS Cross-sectional household screening was conducted 7-19 weeks after the disaster in administrative areas totally or partially flooded by the tsunami. Systolic and diastolic BP (SBP/DBP) were measured in 4,311 residents. RESULTS There was a degree-dependent association between SBP/DBP and flooding height above sea level among victims not on antihypertensive medication (P < 0.01 for both). Disruption of the gas supply was also significantly associated with SBP/DBP (P < 0.01 for both). Among individuals on antihypertensive medication, the discontinuation of medication was associated with SBP/DBP (P < 0.01 for both). After adjusting for confounding and multiplicity, a matched case-control analysis did not identify any significant associations between the tsunami or lifeline indicators and high BP (SBP ≥160mm Hg or DBP ≥100mm Hg). CONCLUSIONS This study suggests that after a major tsunami, resident victims in areas highly inundated by flood waters and those with disrupted gas supply are more likely to have higher BP and thus might warrant getting BP screening earlier than other residents. Those with hypertension should be given assistance to resume or commence antihypertensive medication as soon as possible to reduce the risk of cardiovascular morbidity and mortality.
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Affiliation(s)
- Hitoshi Murakami
- Bureau of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
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Jesmin S, Islam AMS, Akter S, Islam MM, Sultana SN, Yamaguchi N, Okazaki O, Moroi M, Hiroe M, Kimura S, Watanabe T, Saturo K, Mizutani T. Metabolic syndrome among pre- and post-menopausal rural women in Bangladesh: result from a population-based study. BMC Res Notes 2013; 6:157. [PMID: 23597398 PMCID: PMC3639917 DOI: 10.1186/1756-0500-6-157] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 04/12/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Prevalence of non-communicable diseases are a challenging problems among menopausal women specially in a least developed country like Bangladesh, where majority of women suffering from at least one chronic diseases after menopausal age. So, the main objective of this study was to determine the prevalence of metabolic syndrome and related risk factors in Bangladeshi pre- and post-menopausal women living in the rural setting. METHODS This study is based on a community based cross-sectional survey among 1802 rural women aged ≥15 years. Metabolic syndrome was defined according to the criteria of NCEP-ATP III. Logistic regression was used to estimate the association between menopausal status and metabolic syndrome and its components. RESULTS Metabolic syndrome was presented in 25.6% respondents and it was more prevalent among post-menopausal (39.3%) as compared to pre-menopausal (16.8%) women. Logistic regression analysis reveals that prevalence of metabolic syndrome was 1.78 times higher in post-menopausal women than pre-menopausal women (P = 0.001). Prevalence of high blood pressure, elevated fasting blood glucose, and high triglyceride were significantly higher in post-menopausal women than pre-menopausal women (P < 0.05). However, prevalence of low high-density lipoprotein cholesterol was significantly lower in post-menopausal women than pre-menopausal women (P < 0.001). CONCLUSIONS Metabolic syndrome seems to be a major health problem among post-menopausal women in many developing countries like Bangladesh and proper policy emphasis should be given on its prevention and control.
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Minamimoto R, Kubota K, Ishii K, Morooka M, Okasaki M, Miyata Y, Nakajima K, Sato T, Igari T, Hirai R, Okazaki O. Re-evaluating the potentials and limitations of (99m)Tc-aprotinin scintigraphy for amyloid imaging. Am J Nucl Med Mol Imaging 2013; 3:261-271. [PMID: 23638337 PMCID: PMC3627522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 03/15/2013] [Indexed: 06/02/2023]
Abstract
The definitive diagnosis of amyloidosis is made histologically with Congo red stain. Noninvasive imaging techniques for amyloidosis are beneficial for early and definite diagnosis of amyloid deposition in the body. (99m)Tc-aprotinin has the benefit of detecting amyloid deposits mainly in the heart, but it can also detect a wide range of lesions in other locations. The usefulness and limitations of (99m)Tc-Aprotinin scintigraphy for amyloid imaging were re-evaluated based on results from 25 patients (15 men and 10 women; median age, 62.9 y; range, 34-83 y). In addition, other nuclear tracers for imaging amyloidosis are discussed. Of the 25 patients with suspected amyloidosis, 19 patients were proven to have amyloid deposits by histopathological diagnosis. Major (99m)Tc-aprotinin positive sites were confirmed in the myocardium, thyroid, large joints, vertebrae, colon, and lungs. If (99m)Tc-Aprotinin images showed positive findings, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of existing amyloid deposits were 94.7, 33.3, 81.8, and 66.7%, respectively. For analysis based on biopsy region, the sensitivity, specificity, PPV, and NPV of existing amyloid deposition were 30.6, 82.6, 73.3, and 43.2%, respectively. (99m)Tc-Aprotinin has a high potential for diagnosis of amyloid deposition in body; however, due to its physiological uptake, its potential is limited for detection of amyloid deposits in the liver, kidney, and spleen.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Kazuo Kubota
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Kenji Ishii
- Positron Medical Center, Tokyo Metropolitan Institute of GerontologyTokyo, Japan
| | - Miyako Morooka
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Momoko Okasaki
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Yoko Miyata
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Kazuhiko Nakajima
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Takashi Sato
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and MedicineTokyo, Japan
| | - Toru Igari
- Division of Pathology, Department of Central Laboratory, National Center for Global Health and MedicineTokyo, Japan
| | - Risen Hirai
- Division of Hematology, Internal Medicine, National Center for Global Health and MedicineTokyo, Japan
| | - Osamu Okazaki
- Department of Cardiology, National Center for Global Health and MedicineTokyo, Japan
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Wakiya M, Hara H, Iwano M, Nakagawa T, Kayo T, Kamimura M, Ikeda N, Tamori Y, Yamamoto M, Ito S, Okazaki O, Moroi M. Complete atrioventricular block associated with not apical but midventricular ballooning. J Cardiol Cases 2013; 7:e109-e113. [PMID: 30533137 DOI: 10.1016/j.jccase.2012.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 12/01/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
Abstract
An 86-year-old woman was admitted to hospital with a head injury secondary to an episode of syncope associated with incontinence. Electrocardiography showed complete atrioventricular block, giant negative T waves in the precordial leads, and QT interval prolongation. Emergency coronary angiography showed no significant coronary stenosis, while left ventriculography demonstrated midventricular ballooning. Despite temporary transvenous pacing, her complete atrioventricular block persisted, but worsening of heart failure did not occur. Although left ventricular wall motion improved, complete atrioventricular block remained, so a pacemaker was implanted on day 18 after admission. There have been no previous reports of complete atrioventricular block associated with midventricular ballooning. This case demonstrates that complete atrioventricular block may persist after improvement of left ventricular wall motion in patients with midventricular ballooning and implantation of a pacemaker may be needed. <Learning objective: Some cases describe takotsubo-like cardiomyopathy with not apical but midventricular ballooning. This is the first case of midventricular ballooning and persistence of complete atrioventricular block after improvement of left ventricular wall motion that required implantation of a pacemaker.>.
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Affiliation(s)
- Momoko Wakiya
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Hisao Hara
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Mai Iwano
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Takashi Nakagawa
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tsuyosi Kayo
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Munehiro Kamimura
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Nobutaka Ikeda
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Yuiichi Tamori
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masaya Yamamoto
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Shingo Ito
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Osamu Okazaki
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masao Moroi
- Division of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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Jesmin S, Akter S, Rahman MM, Islam MM, Islam AMS, Sultana SN, Mowa CN, Yamaguchi N, Okazaki O, Satoru K, Kimura S, Hiroe M, Mizutani T, Moroi M. Disruption of components of vascular endothelial growth factor angiogenic signalling system in metabolic syndrome. Findings from a study conducted in rural Bangladeshi women. Thromb Haemost 2013; 109:696-705. [PMID: 23364276 DOI: 10.1160/th12-09-0654] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 01/09/2013] [Indexed: 01/01/2023]
Abstract
Metabolic syndrome (MetS) is associated with impaired angiogenesis, a process that is chiefly regulated by vascular endothelial growth factor (VEGF) upon binding to its specific receptors, VEGF-R1 and VEGF-R2. The purpose of the present study was to assess trends or patterns in plasma levels of VEGF and its soluble receptors in subjects with (MetS) or without (non-MetS) MetS; and further examine their association with clinical or metabolic parameters using a subpopulation of South Asian country. A total of 1,802 rural Bangladeshi women aged ≥15 years were studied using a population-based cross-sectional survey. Plasma levels of VEGF were found to be significantly increased (MetS vs. non-MetS: 483.9 vs. 386.9, p<0.001), whereas, the soluble forms of VEGF receptors, sVEGF-R1 and sVEGF-R2, were significantly decreased in subjects with Mets (sVEGF-R1, MetS vs. non-MetS: 512.5 vs. 631.3, p<0.001; sVEGF-R2, MetS vs. non-MetS: 9,302.8 vs. 9,787.4, p=0.004). After adjustment for age and all potential variables, multiple regression analysis revealed that plasma levels of VEGF had significant positive association with blood glucose (p = 0.019) and body mass index (p = 0.007). We also found that mean plasma levels of VEGF increased in direct proportion to levels of MetS components. The present study is the first ever to demonstrate a positive association between trends in levels of plasma VEGF and MetS using a large sample size from South Asia. The association between plasma VEGF and MetS needs further investigations in order to clearly decipher the clinical predictive value and accuracy of plasma VEGF in MetS.
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Affiliation(s)
- Subrina Jesmin
- Subrina Jesmin, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
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Yukinaga H, Iwabuchi H, Okazaki O, Izumi T. Glutathione S-transferase pi trapping method for generation and characterization of drug–protein adducts in human liver microsomes using liquid chromatography–tandem mass spectrometry. J Pharm Biomed Anal 2012; 67-68:186-92. [DOI: 10.1016/j.jpba.2012.04.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 04/24/2012] [Accepted: 04/25/2012] [Indexed: 11/17/2022]
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Miyaji Y, Kasuya Y, Furuta Y, Kurihara A, Takahashi M, Ogawara KI, Izumi T, Okazaki O, Higaki K. Novel Comb-Shaped PEG Modification Enhances the Osteoclastic Inhibitory Effect and Bone Delivery of Osteoprotegerin After Intravenous Administration in Ovariectomized Rats. Pharm Res 2012; 29:3143-55. [DOI: 10.1007/s11095-012-0807-4] [Citation(s) in RCA: 4] [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: 02/10/2012] [Accepted: 06/08/2012] [Indexed: 01/27/2023]
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Jesmin S, Mia S, Islam AMS, Islam R, Sultana SN, Zaedi S, Yamaguchi N, Okazaki O, Moroi M, Kimura S, Hiroe M. Prevalence of metabolic syndrome among rural Bangladeshi women. Diabetes Res Clin Pract 2012; 95:e7-9. [PMID: 22015482 DOI: 10.1016/j.diabres.2011.09.025] [Citation(s) in RCA: 8] [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] [Received: 03/16/2011] [Revised: 08/29/2011] [Accepted: 09/22/2011] [Indexed: 12/15/2022]
Abstract
We assessed prevalence of metabolic syndrome (MS) in rural women of Bangladesh using 1485 women aged ≥15 years. The prevalence rate of MS was 31.25% (NCEP ATP III modified). And 85.05% population had low HDL values. These findings are important in the development of future health prevention strategies in Bangladesh.
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Affiliation(s)
- Subrina Jesmin
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
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Nakagawa T, Okazaki O, Ishihara S, Hiraishi N, Watanabe R, Kamimura M, Tamori Y, Yamamoto M, Ito S, Tanaka Y, Hara H, Moroi M. RTc dispersion indicate the adaptation for ICD implantation in patients with asymptomatic Brugada syndrome using a vector composition high-resolution mapping system. J Electrocardiol 2011. [DOI: 10.1016/j.jelectrocard.2011.09.019] [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: 11/26/2022]
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Suzuki E, Nakai D, Yamamura N, Kobayashi N, Okazaki O, Izumi T. Inhibition mechanism of carbapenem antibiotics on acylpeptide hydrolase, a key enzyme in the interaction with valproic acid. Xenobiotica 2011; 41:958-63. [DOI: 10.3109/00498254.2011.596582] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Miyaji Y, Walter S, Chen L, Kurihara A, Ishizuka T, Saito M, Kawai K, Okazaki O. Distribution of KAI-9803, a novel δ-protein kinase C inhibitor, after intravenous administration to rats. Drug Metab Dispos 2011; 39:1946-53. [PMID: 21712433 DOI: 10.1124/dmd.111.040725] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [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] Open
Abstract
KAI-9803 is composed of a selective δ-protein kinase C (δPKC) inhibitor peptide derived from the δV1-1 portion of δPKC (termed "cargo peptide"), conjugated reversibly to the cell-penetrating peptide 11-amino acid, arginine-rich sequence of the HIV type 1 transactivator protein (TAT₄₇₋₅₇; termed "carrier peptide") via a disulfide bond. KAI-9803 administration at the end of ischemia has been found to reduce cardiac damage caused by ischemia-reperfusion in a rat model of acute myocardial infarction. In the study presented here, we examined the TAT₄₇₋₅₇-mediated distribution of KAI-9803 in rats after a single intravenous bolus administration (1 mg/kg). ¹⁴C-KAI-9803 was rapidly delivered to many tissues, including the heart (1.21 μg eq/g tissue), while being quickly cleared from the systemic circulation. The microautoradiography analysis showed that ¹⁴C-KAI-9803 was effectively delivered into various cells, including cardiac myocytes and cardiac endothelial cells within 1 min after dosing. The tissue distribution of ¹²⁵I-labeled KAI-9803 was compared to that of ¹²⁵I-labeled cargo peptide; this comparison demonstrated that the distribution of KAI-9803 to tissues such as the liver, kidney, and heart was facilitated by the reversible conjugation to TAT₄₇₋₅₇. In an in vitro cardiomyocyte study, the extent of ¹²⁵I-KAI-9803 internalization was greater at 37°C than that at 4°C, whereas the internalization of the ¹²⁵I-cargo peptide at 37°C was not observed, indicating that the uptake of ¹²⁵I-KAI-9803 into the cardiomyocytes was mediated by the TAT₄₇₋₅₇ carrier. Our studies demonstrated that after a single intravenous administration, KAI-9803 can be delivered into the target cells in the liver, kidney, and heart by a TAT₄₇₋₅₇-mediated mechanism.
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Affiliation(s)
- Yoshihiro Miyaji
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan.
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Minamimoto R, Morooka M, Kubota K, Ito K, Masuda-Miyata Y, Mitsumoto T, Hirai R, Okazaki O, Hiroe M. Value of FDG-PET/CT using unfractionated heparin for managing primary cardiac lymphoma and several key findings. J Nucl Cardiol 2011; 18:516-20. [PMID: 21394554 DOI: 10.1007/s12350-011-9358-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.
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Uchiyama M, Koda H, Fischer T, Mueller J, Yamamura N, Oguchi M, Iwabuchi H, Okazaki O, Izumi T. In Vitro Metabolism of Rivoglitazone, a Novel Peroxisome Proliferator-Activated Receptor γ Agonist, in Rat, Monkey, and Human Liver Microsomes and Freshly Isolated Hepatocytes. Drug Metab Dispos 2011; 39:1311-9. [DOI: 10.1124/dmd.111.038729] [Citation(s) in RCA: 4] [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] [Indexed: 11/22/2022] Open
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Nakayama S, Takakusa H, Watanabe A, Miyaji Y, Suzuki W, Sugiyama D, Shiosakai K, Honda K, Okudaira N, Izumi T, Okazaki O. Combination of GSH Trapping and Time-Dependent Inhibition Assays as a Predictive Method of Drugs Generating Highly Reactive Metabolites. Drug Metab Dispos 2011; 39:1247-54. [DOI: 10.1124/dmd.111.039180] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Deguchi T, Watanabe N, Kurihara A, Igeta K, Ikenaga H, Fusegawa K, Suzuki N, Murata S, Hirouchi M, Furuta Y, Iwasaki M, Okazaki O, Izumi T. Human Pharmacokinetic Prediction of UDP-Glucuronosyltransferase Substrates with an Animal Scale-Up Approach. Drug Metab Dispos 2011; 39:820-9. [DOI: 10.1124/dmd.110.037457] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Zhu X, Okazaki O, Wei D. Body Surface Potential Mapping and Conduction Abnormalities at Right Ventricular Outflow Tract in Brugada Syndrome: A Simulation Study. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.op43_1] [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: 11/11/2022] Open
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Okazaki O, Ikeda N, Kamimura M, Ito S, Yamamoto M, Tamori Y, Hara H, Moroi M. Pulmonary Artery Hypertension on RTc Dispersion Map Indicates the Concentration around Right Ventricular Overload Due to HIV Infection Using a High Resolution Mapping System. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj1_075] [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: 11/11/2022] Open
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Uchiyama M, Iwabuchi H, Tsuruta F, Abe K, Takahashi M, Koda H, Oguchi M, Okazaki O, Izumi T. Pharmacokinetics, Metabolism, and Disposition of Rivoglitazone, a Novel Peroxisome Proliferator-Activated Receptor γ Agonist, in Rats and Monkeys. Drug Metab Dispos 2010; 39:653-66. [DOI: 10.1124/dmd.110.036194] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Yamashita T, Inoue H, Okumura K, Kodama I, Aizawa Y, Atarashi H, Ohe T, Ohtsu H, Kato T, Kamakura S, Kumagai K, Kurachi Y, Koretsune Y, Saikawa T, Sakurai M, Sato T, Sugi K, Nakaya H, Hirai M, Hirayama A, Fukatani M, Mitamura H, Yamazaki T, Watanabe E, Ogawa S, Katoh T, Igawa O, Matsumoto N, Yamashita T, Kaneko Y, Watanabe E, Ogawa S, Osaka T, Fujii E, Niwano S, Yoshioka K, Kato M, Okazaki O, Kusano K, Okuyama Y, Furushima H, Suzuki M, Noda T, Kawara T, Sato T, Kamakura S, Endoh Y, Kumagai K, Hiyoshi Y, Ishiyama T, Ohtsuka T, Matsumoto M, Chishaki A, Shinohara T, Shirayama T, Koretsune Y, Yokoyama E, Ajiki K, Fujio K, Sugi K, Yamakawa T, Yusu S, Inoue H, Kawamura Y, Hayano M, Date T, Mizusawa Y, Kobayashi Y, Satomi K, Imai Y, Atarashi H, Fukunami M, Yokoshiki H, Betsuyaku T, Okumura K, Takeda H, Matsumoto K, Okishige K, Tagawa M, Hirai M, Okazaki H. Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study). Europace 2010; 13:473-9. [DOI: 10.1093/europace/euq439] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Imamura Y, Murayama N, Okudaira N, Kurihara A, Okazaki O, Izumi T, Inoue K, Yuasa H, Kusuhara H, Sugiyama Y. Prediction of fluoroquinolone-induced elevation in serum creatinine levels: a case of drug-endogenous substance interaction involving the inhibition of renal secretion. Clin Pharmacol Ther 2010; 89:81-8. [PMID: 21124314 DOI: 10.1038/clpt.2010.232] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to examine the mechanism underlying the elevation in serum creatinine levels caused by a novel des-fluoro(6)-quinolone antibacterial agent, DX-619, in healthy subjects. hOCT2 showed a prominent uptake of creatinine (K(m) = 56.4 mmol/l) among renal organic ion transporters. DX-619 is a potent inhibitor of hOCT2 (K(i) = 0.94 micromol/l), hMATE1 (0.82 µmol/l), and hMATE2-K (0.10 micromol/l). The pharmacokinetic model involving the inhibition of hOCT2 (model 1), hOCT2, and MATE1 or MATE2-K (model 2) could predict the elevation in serum creatinine levels in individual subjects receiving DX-619. This assumes that a significant contribution of tubular secretion (59, 38, and 31%) and reabsorption ranged from 3-50, 4-30, and 5-21% in model 1, -2a (hOCT2/hMATE1), and -2b (hOCT2/hMATE2-K), respectively, for creatinine. In conclusion, DX-619, at its therapeutic dose, is able to inhibit hOCT2, hMATE1, and hMATE2-K, leading to a significant inhibition of tubular secretion of creatinine and consequently to elevation of serum creatinine levels.
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Affiliation(s)
- Y Imamura
- Drug Metabolism and Pharmacokinetics Research Laboratories, R&D Division, Daiichi Sankyo Co., Ltd., Tokyo, Japan
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Saito-Yabe M, Kasuya Y, Yoshigae Y, Yamamura N, Suzuki Y, Fukuda N, Honma M, Yano K, Mochizuki SI, Okada F, Okada A, Nagayama Y, Tsuda E, Fischer T, Höpner U, Zaja S, Mueller J, Okada J, Kurihara A, Ikeda T, Okazaki O. PEGylation of osteoprotegerin/osteoclastogenesis inhibitory factor (OPG/OCIF) results in decreased uptake into rats and human liver. J Pharm Pharmacol 2010; 62:985-94. [PMID: 20663032 DOI: 10.1111/j.2042-7158.2010.01120.x] [Citation(s) in RCA: 6] [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: 01/30/2023]
Abstract
OBJECTIVES Our aim was to investigate the effect of PEGylation on the uptake of osteoprotegerin/osteoclastogenesis inhibitory factor (OPG/OCIF) into rat liver, kidney and spleen, and human liver. METHODS Copolymer of polyethyleneglycol allylmethylether and maleamic acid sodium salt with OCIF (poly(PEG)-OCIF) (0.5 mg/kg) was administered to rats and the concentrations of poly(PEG)-OCIF in the liver, kidney and spleen at 15 min after administration were measured by ELISA. For human liver uptake, the liver perfusion of OCIF and (3)H-labelled poly(PEG)-OCIF was conducted using fresh human liver block. KEY FINDINGS The tissue uptake of poly(PEG)-OCIF in rats was significantly lower compared with that of OCIF. In fresh human liver perfusion, (3)H-poly(PEG)-OCIF was rarely taken up into the liver. On the other hand, more than 50% of the perfused OCIF was taken up. CONCLUSIONS PEGylation of OCIF using poly(PEG) dramatically suppressed the uptake of OCIF into human liver as well as into rat liver and could be a promising approach for improving the pharmacokinetic and pharmacological effects of OCIF in the clinical setting.
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Affiliation(s)
- Motoko Saito-Yabe
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan.
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Takei M, Ando Y, Saitoh W, Tanimoto T, Kiyosawa N, Manabe S, Sanbuissho A, Okazaki O, Iwabuchi H, Yamoto T, Adam KP, Weiel JE, Ryals JA, Milburn MV, Guo L. Ethylene glycol monomethyl ether-induced toxicity is mediated through the inhibition of flavoprotein dehydrogenase enzyme family. Toxicol Sci 2010; 118:643-52. [PMID: 20616209 PMCID: PMC2984528 DOI: 10.1093/toxsci/kfq211] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [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: 01/04/2023] Open
Abstract
Ethylene glycol monomethyl ether (EGME) is a widely used industrial solvent known to cause adverse effects to human and other mammals. Organs with high metabolism and rapid cell division, such as testes, are especially sensitive to its actions. In order to gain mechanistic understanding of EGME-induced toxicity, an untargeted metabolomic analysis was performed in rats. Male rats were administrated with EGME at 30 and 100 mg/kg/day. At days 1, 4, and 14, serum, urine, liver, and testes were collected for analysis. Testicular injury was observed at day 14 of the 100 mg/kg/day group only. Nearly 1900 metabolites across the four matrices were profiled using liquid chromatography-mass spectrometry/mass spectrometry and gas chromatography-mass spectrometry. Statistical analysis indicated that the most significant metabolic perturbations initiated from the early time points by EGME were the inhibition of choline oxidation, branched-chain amino acid catabolism, and fatty acid β-oxidation pathways, leading to the accumulation of sarcosine, dimethylglycine, and various carnitine- and glycine-conjugated metabolites. Pathway mapping of these altered metabolites revealed that all the disrupted steps were catalyzed by enzymes in the primary flavoprotein dehydrogenase family, suggesting that inhibition of flavoprotein dehydrogenase-catalyzed reactions may represent the mode of action for EGME-induced toxicity. Similar urinary and serum metabolite signatures are known to be the hallmarks of multiple acyl-coenzyme A dehydrogenase deficiency in humans, a genetic disorder because of defects in primary flavoprotein dehydrogenase reactions. We postulate that disruption of key biochemical pathways utilizing flavoprotein dehydrogenases in conjugation with downstream metabolic perturbations collectively result in the EGME-induced tissue damage.
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Affiliation(s)
- Makoto Takei
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi-Sankyo Co., Ltd, Shinagawa-ku, Tokyo 140-8710, Japan
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Sawamura R, Okudaira N, Watanabe K, Murai T, Kobayashi Y, Tachibana M, Ohnuki T, Masuda K, Honma H, Kurihara A, Okazaki O. Predictability of Idiosyncratic Drug Toxicity Risk for Carboxylic Acid-Containing Drugs Based on the Chemical Stability of Acyl Glucuronide. Drug Metab Dispos 2010; 38:1857-64. [DOI: 10.1124/dmd.110.034173] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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