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Nagatomo Y, Takase S, Sakamoto K, Nagata H, Yamamura K, Tsutsui H, Ohga S. Successful mapping and ablation of a pediatric-onset non-reentrant fascicular tachycardia. J Cardiol Cases 2024; 29:165-169. [PMID: 38646079 PMCID: PMC11031658 DOI: 10.1016/j.jccase.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 04/23/2024] Open
Abstract
Non-reentrant fascicular tachycardia (NRFT) developed in a 6-year-old Japanese boy. Because of drug-resistant recurrences, he received catheter mapping and ablation at age 10 years. An electrocardiogram exhibited a superior left-axis deviation, a right bundle branch block-type configuration, and relatively narrow QRS with sharp R wave. It suggested verapamil-sensitive ventricular tachycardia (VT), but showed no sensitivity to verapamil or reentrant characteristics in the electrophysiological study. Detailed VT mapping determined the earliest presystolic Purkinje potential on the left posterior fascicle at the mid-ventricular septum. Radiofrequency current applications to the lesion led to his NRFT-free life without restriction. Learning objectives Purkinje-related idiopathic ventricular tachycardias (VTs) are commonly due to reentrant mechanisms, and non-reentrant fascicular tachycardia (NRFT) is a rare form of idiopathic VT in adults. Although it is crucial to distinguish NRFT from reentrant VTs, there is no information about the electrophysiological studies and the treatment effect in pediatric-onset NRFT.
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Affiliation(s)
- Yusaku Nagatomo
- Department of Pediatrics, Graduate School of Medical Science, Kyushu University Hospital, Fukuoka City, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka City, Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka City, Japan
| | - Hazumu Nagata
- Department of Pediatrics, Graduate School of Medical Science, Kyushu University Hospital, Fukuoka City, Japan
| | - Kenichiro Yamamura
- Department of Pediatrics, Graduate School of Medical Science, Kyushu University Hospital, Fukuoka City, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka City, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Science, Kyushu University Hospital, Fukuoka City, Japan
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Matoba T, Nakano Y, Katsuki S, Ide T, Matsushima S, Fujino T, Hashimoto T, Shinohara K, Abe K, Hosokawa K, Sakamoto T, Sakamoto I, Kakino T, Ishikita A, Nishizaki A, Sakamoto K, Takase S, Nagayama T, Tohyama T, Nagata T, Kinugawa S, Tsutsui H. Overview of the 87 th Annual Scientific Meeting of the Japanese Circulation Society (JCS2023) - New Challenge With Next Generation. Circ J 2024; 88:615-619. [PMID: 38448007 DOI: 10.1253/circj.cj-24-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
The 87thAnnual Meeting of the Japanese Circulation Society (JCS2023) was held in March 2023 in Fukuoka, Japan, marking the first in-person gathering after the COVID-19 pandemic. With the theme of "New Challenge With Next Generation" the conference emphasized the development of future cardiovascular leaders and technologies such as artificial intelligence (AI). Notable sessions included the Mikamo Lecture on heart failure and the Mashimo Lecture on AI in medicine. Various hands-on sessions and participatory events were well received, promoting learning and networking. Post-event surveys showed high satisfaction among participants, with positive feedback on face-to-face interactions and the overall experience. JCS2023, attended by 17,852 participants, concluded successfully, marking a significant milestone in post-pandemic meetings, and advancing cardiovascular medicine.
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Affiliation(s)
- Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kazuya Hosokawa
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takafumi Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takamori Kakino
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Ayako Ishikita
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Akiko Nishizaki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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Sakamoto K, Takase S, Ikeda Y, Sakamoto I. Biventricular activation of right bundle branch block pattern ventricular tachycardia originating from the right ventricle in Ebstein's anomaly. HeartRhythm Case Rep 2024; 10:109-111. [PMID: 38264116 PMCID: PMC10801088 DOI: 10.1016/j.hrcr.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Affiliation(s)
- Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yuki Ikeda
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
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Takase S, Mukai Y, Nagaoka K, Ogawa K, Kawai S, Honda N, Nagayama T, Tohyama T, Inoue S, Sadamatsu K, Tashiro H, Sakamoto K, Matoba T, Chishaki A, Kinugawa S, Tsutsui H. Mapping of Purkinje-related ventricular arrhythmias by a multispline catheter with small and close-paired electrodes: Comparison with conventional catheters. Pacing Clin Electrophysiol 2024; 47:5-18. [PMID: 38112039 DOI: 10.1111/pace.14906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Precise mapping of the Purkinje fiber network is essential in catheter ablation of Purkinje-related ventricular arrhythmias (PrVAs). We sought to evaluate the mapping ability of a multi-spline duodecapolar catheter (PentaRay) for PrVAs. METHODS Mappings of Purkinje fibers by PentaRay catheters were compared with those by conventional mapping catheters in consecutive patients undergoing catheter ablation of PrVAs from 2015 to 2022. RESULTS Sixteen PrVAs (7 premature ventricular contractions or non-reentrant fascicular tachycardias [PVCs/NRFTs] and 9 fascicular ventricular tachycardias [FVTs]) were retrospectively studied. In PVCs/NRFTs, earliest preceding Purkinje potentials (PPs) could be recorded by the PentaRay catheters but not by the mapping and ablation catheters in 5 cases. At the earliest PP sites, the precedence from the QRS onset was greater, and the amplitude of the preceding potentials was higher in the PentaRay catheter compared with those in the mapping and ablation catheter (-62.0 ± 42.8 vs. -29.4 ± 34.2 ms, P = 0.02; 0.45 ± 0.43 vs. 0.09 ± 0.08 mV, P = 0.02). In FVTs, late diastolic potentials (P1) were recorded by the PentaRay catheters but not by the mapping and ablation catheters or the linear duodecapolar catheter in 2 cases. The amplitude of P1 was higher in the PentaRay catheter compared with that in the linear duodecapolar catheter and the mapping and ablation catheters (0.72 ± 0.49 vs. 0.17 ± 0.18 vs. 0.27 ± 0.21 mV, P = 0.0006, P = 0.002). The localized critical PPs, defined as the earliest preceding potentials in PVCs/NRFTs and P1 in FVTs, could be recorded in all the patients by the PentaRay catheter. The mapping ability of critical PPs of PrVAs was better with the PentaRay catheter than with the conventional mapping catheters (16/16 vs. 9/16, P = 0.004 by McNemar exact test). CONCLUSIONS The PentaRay catheter has clinical advantages in mapping of the Purkinje fiber network to reveal critical PPs as ablation targets of PrVAs.
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Affiliation(s)
- Susumu Takase
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Kazuhiro Nagaoka
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
- Division of Cardiology, Fukuoka City Hospital, Fukuoka, Japan
| | - Kiyohiro Ogawa
- Division of Cardiology, Fukuoka City Hospital, Fukuoka, Japan
| | - Shunsuke Kawai
- Division of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Nobuhiro Honda
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Tohyama
- Center for Clinical and Translational Research, Kyushu University, Fukuoka, Japan
| | - Shujiro Inoue
- Division of Cardiology, Iizuka Hospital, Iizuka, Japan
| | | | - Hideki Tashiro
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- School of Medicine and Graduate School, International University of Health and Welfare, Okawa, Japan
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Sakamoto K, Tohyama T, Ide T, Mukai Y, Enzan N, Nagata T, Ikeda M, Takase S, Nagayama T, Fujino T, Matsushima S, Tsutsui H. Efficacy of Early Catheter Ablation for Atrial Fibrillation After Admission for Heart Failure. JACC Clin Electrophysiol 2023; 9:1948-1959. [PMID: 37480855 DOI: 10.1016/j.jacep.2023.05.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Advances in catheter ablation (CA) for atrial fibrillation (AF) have improved the prognosis of patients with heart failure (HF) and AF. However, its optimal timing remains to be fully elucidated. OBJECTIVES The aim of this study was to investigate the prognostic impact of early CA in patients with HF and AF hospitalized for worsening HF. METHODS From JROADHF (Japanese Registry of Acute Decompensated Heart Failure) (n = 13,238), patients with HF and AF who underwent CA within 90 days after admission for HF (early CA; n = 103) and those who did not (control; n = 2,683) were identified. Mortality was compared between these groups in the crude cohort, as well as in the propensity-matched cohort (n = 83 in each group). RESULTS In the crude cohort, all-cause mortality was significantly lower in the early CA group than in the control group (log-rank P < 0.001; HR: 0.38; 95% CI: 0.24-0.60). In the matched cohort, all-cause mortality was likewise significantly lower in the early CA group (log-rank P = 0.014; HR: 0.47; 95% CI: 0.25-0.88). Cardiovascular death and HF mortality were significantly lower in both cohorts (crude: Gray' test: P < 0.001 and P = 0.005; subdistribution HR: 0.28 [95% CI: 0.13-0.63] and HR: 0.31 [95% CI: 0.13-0.75]; matched: Gray's test: P = 0.006 and P = 0.017; subdistribution HR: 0.24 [95% CI: 0.08-0.70] and HR: 0.28 [95% CI: 0.09-0.84], respectively). CONCLUSIONS In a nationwide representative real-world cohort, CA for AF within 90 days after admission for HF was associated with improved long-term outcomes, including cardiovascular and HF death in patients with HF and AF.
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Affiliation(s)
- Kazuo Sakamoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yasushi Mukai
- Division of Cardiology, Japanese Red-Cross Fukuoka Hospital, Fukuoka, Japan
| | - Nobuyuki Enzan
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masataka Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Advanced Cardiopulmonary Failure, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; School of Medicine and Graduate School, International University of Health and Welfare, Otawara, Japan
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Nakano Y, Yamamoto M, Matoba T, Katsuki S, Nakashiro S, Takase S, Akiyama Y, Nagata T, Mukai Y, Inoue S, Oi K, Higo T, Takemoto M, Suematsu N, Eshima K, Miyata K, Usui M, Sadamatsu K, Kadokami T, Hironaga K, Ichi I, Todaka K, Kishimoto J, Tsutsui H. Association between Serum Oxysterols and Coronary Plaque Regression during Lipid-Lowering Therapy with Statin and Ezetimibe: Insights from the CuVIC Trial. J Atheroscler Thromb 2023; 30:907-918. [PMID: 36450458 PMCID: PMC10406650 DOI: 10.5551/jat.63507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/23/2022] [Indexed: 08/04/2023] Open
Abstract
AIM Several clinical trials using intravascular ultrasound (IVUS) evaluation have demonstrated that intensive lipid-lowering therapy by statin or a combination therapy with statin and ezetimibe results in significant regression of coronary plaque volume. However, it remains unclear whether adding ezetimibe to statin therapy affects coronary plaque composition and the molecular mechanisms of plaque regression. We conducted this prospective IVUS analysis in a subgroup from the CuVIC trial. METHODS The CuVIC trial was a prospective randomized, open, blinded-endpoint trial conducted among 11 cardiovascular centers, where 260 patients with coronary artery disease who received coronary stenting were randomly allocated into either the statin group (S) or the combined statin and ezetimibe group (S+E). We enrolled 79 patients (S group, 39 patients; S+E group, 40 patients) in this substudy, for whom serial IVUS images of nonculprit lesion were available at both baseline and after 6-8 months of follow-up. RESULTS After the treatment period, the S+E group had significantly lower level of low-density lipoprotein cholesterol (LDL-C; 80.9±3.7 vs. 67.7±3.8 mg/dL, p=0.0143). Campesterol, a marker of cholesterol absorption, and oxysterols (β-epoxycholesterol, 4β-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in the S+E group. IVUS analyses revealed greater plaque regression in the S+E group than in the S group (-6.14% vs. -1.18% for each group, p=0.042). It was noteworthy that the lowering of campesterol and 27-hydroxycholesterol, but not LDL-C, had a significant positive correlation with plaque regression. CONCLUSIONS Compared with statin monotherapy, ezetimibe in combination with statin achieved significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which resulted in greater coronary plaque regression.
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Affiliation(s)
- Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Mitsutaka Yamamoto
- Department of Cardiovascular Medicine, Harasanshin Hospital, Fukuoka, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Soichi Nakashiro
- Department of Cardiovascular Medicine, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yusuke Akiyama
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine, Aso Iizuka Hospital, Fukuoka, Japan
| | - Keiji Oi
- Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan
| | - Masao Takemoto
- Cardiovascular Center, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - Nobuhiro Suematsu
- Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Kenichi Eshima
- Department of Cardiovascular Medicine, Saga-ken Medical Centre Koseikan, Saga, Japan
| | - Kenji Miyata
- Department of Cardiovascular Medicine, Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan
| | - Makoto Usui
- Department of Cardiovascular Medicine, Hamanomachi Hospital, Fukuoka, Japan
| | - Kenji Sadamatsu
- Department of Cardiovascular Medicine, Omuta City Hospital, Fukuoka, Japan
| | - Toshiaki Kadokami
- Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, Fukuoka, Japan
| | - Kiyoshi Hironaga
- Department of Cardiovascular Medicine, Fukuoka City Hospital, Fukuoka, Japan
| | - Ikuyo Ichi
- Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan
| | - Koji Todaka
- Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Akiyama Y, Katsuki S, Matoba T, Nakano Y, Takase S, Nakashiro S, Yamamoto M, Mukai Y, Inoue S, Oi K, Higo T, Takemoto M, Suematsu N, Eshima K, Miyata K, Usui M, Sadamatsu K, Kadokami T, Hironaga K, Ichi I, Todaka K, Kishimoto J, Tsutsui H. Association of Serum Oxysterols with Cholesterol Metabolism Markers and Clinical Factors in Patients with Coronary Artery Disease: A Covariance Structure Analysis. Nutrients 2023; 15:2997. [PMID: 37447327 DOI: 10.3390/nu15132997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Oxysterols have been implicated in the pathogenesis of cardiovascular diseases. Serum levels of oxysterols could be positively correlated with cholesterol absorption and synthesis. However, physiological regulation of various serum oxysterols is largely unknown. The aim of this study was to investigate the relationship between clinical factors and cholesterol metabolism markers, and identify oxysterols associated with cholesterol absorption and synthesis in patients with coronary artery disease. Subjects (n = 207) who underwent coronary stenting between 2011 and 2013 were studied cross-sectionally. We measured lipid profiles including serum oxysterols. As for the serum biomarkers of cholesterol synthesis and absorption, oxysterol levels were positively correlated with campesterol and lathosterol. Covariance structure analysis revealed that dyslipidemia and statin usage had a positive correlation with "cholesterol absorption". Statin usage also had a positive correlation with "cholesterol synthesis". Several oxysterols associated with cholesterol absorption and/or synthesis. In conclusion, we elucidated the potential clinical factors that may affect cholesterol metabolism, and the associations between various oxysterols with cholesterol absorption and/or synthesis in patients with coronary artery disease.
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Affiliation(s)
- Yusuke Akiyama
- Department of Cardiovascular, Respiratory and Geriatric Medicine, Kyushu University Beppu Hospital, Oita 874-0838, Japan
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Soichi Nakashiro
- Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital, Fukuoka 810-0001, Japan
| | - Mitsutaka Yamamoto
- Department of Cardiovascular Medicine, Harasanshin Hospital, Fukuoka 812-0033, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Fukuoka 815-0082, Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine, National Hospital Organization Kyushu Medical Centre, Fukuoka 810-0065, Japan
| | - Keiji Oi
- Department of Cardiovascular Medicine, Harasanshin Hospital, Fukuoka 812-0033, Japan
| | - Taiki Higo
- Wakaba Heart Clinic, Fukuoka 810-0073, Japan
| | - Masao Takemoto
- Cardiovascular Center, Steel Memorial Yahata Hospital, Fukuoka 805-8508, Japan
| | - Nobuhiro Suematsu
- Department of Cardiovascular Medicine, Harasanshin Hospital, Fukuoka 812-0033, Japan
| | - Kenichi Eshima
- Matsuguchi Internal Medicine and Cardiology Clinic, Fukuoka 814-0133, Japan
| | - Kenji Miyata
- Department of Cardiovascular Medicine, Japan Community Health Care Organization, Kyushu Hospital, Fukuoka 806-8501, Japan
| | - Makoto Usui
- Department of Cardiovascular Medicine, Hamanomachi Hospital, Fukuoka 810-0072, Japan
| | - Kenji Sadamatsu
- Department of Cardiovascular Medicine, Omuta City Hospital, Fukuoka 836-0861, Japan
| | - Toshiaki Kadokami
- Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, Fukuoka 818-8516, Japan
| | - Kiyoshi Hironaga
- Department of Cardiovascular Medicine, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | - Ikuyo Ichi
- Graduate School of Humanities and Science, Ochanomizu University, Tokyo 112-8610, Japan
| | - Koji Todaka
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Hiroyuki Tsutsui
- School of Medicine and Graduate School, International University of Health and Welfare, Fukuoka 831-8501, Japan
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Ikeda S, Sakamoto K, Tokudome D, Kawai S, Ogawa K, Nagaoka K, Takase S, Kowase S, Mukai Y, Nogami A, Tsutsui H. Electrophysiological features of repetitive focal Purkinje ventricular arrhythmias originating from the proximal cardiac conduction system. J Arrhythm 2022; 38:1070-1079. [DOI: 10.1002/joa3.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/25/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Shota Ikeda
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
- Department of Cardiology Yokohama Rosai Hospital Yokohama Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Daigo Tokudome
- Clinical Engineering Department Yokohama Rosai Hospital Yokohama Japan
| | - Shunsuke Kawai
- Department of Cardiology Fukuoka Red Cross Hospital Fukuoka Japan
| | - Kiyohiro Ogawa
- Department of Cardiology Fukuoka City Hospital Fukuoka Japan
| | | | - Susumu Takase
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Shinya Kowase
- Department of Cardiology Yokohama Rosai Hospital Yokohama Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
- Department of Cardiology Fukuoka Red Cross Hospital Fukuoka Japan
| | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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Kawai S, Sakamoto K, Takase S, Noma A, Kisanuki H, Nakashima H, Watanabe T, Sakemi T, Okabe K, Okahara A, Tokutome M, Matsuura H, Matsukawa R, Masuda S, Mukai Y. Prevalence and distribution of non-pulmonary vein atrial fibrillation triggers in real-world clinical settings. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Epidemiology of non-pulmonary vein (PV) triggers of atrial fibrillation (AF) is not fully known.
Purpose
This study aimed to clarify the prevalence and distribution of non-PV triggers in real-world clinical settings of AF catheter ablation.
Methods
One-thousand and twenty patients undergoing AF ablations were retrospectively analyzed (mean age 65 years old, 702 males (69%), 506 paroxysmal and 514 non-paroxysmal). Induction and observation of AF triggers were attempted using intravenous isoproterenol/adenosine triphosphate and repeated direct current cardioversion during AF in each session. Documentable non-PV AF triggers were characterized in the studied population. Premature atrial contractions that did not initiate AF were excluded.
Results
A hundred and twenty-six non-PV triggers were documented in 108 patients (10.6%). Non-PV trigger was documented in 6.3% of 1st session cases, whereas 30.9% of recurrent cases undergoing multiple sessions (p<0.0001). Left atrial (LA) posterior wall was the most prevalent site (N=34), followed by 30 intra-atrial septum (IAS), 29 superior vena cava (SVC), 13 crista terminalis, 7 right atrial (RA) free wall, 6 LA anterior wall, 3 coronary sinus (CS), 3 left atrial appendage, and 1 persistent left superior vena cava (LSVC). We classified those non-PV triggers into 4 groups; 43 LA, 33 thoracic veins (SVC, CS and LSVC), 30 IAS and 20 RA. Thoracic vein/RA origins were more prevalently detected in paroxysmal AF cases (57%) compared to non-paroxysmal AF (28%) (p<0.01). Conversely, LA origin was more prevalently detected in non-paroxysmal AF cases (48%) compared to paroxysmal AF (20%) (p<0.01).
Conclusions
Prevalence of non-PV trigger in cases undergoing multiple sessions is extremely high, suggesting a particular importance of non-PV trigger targeting in patients with recurrent AF undergoing 2nd or 3rd ablation sessions. Progressive nature of AF with newly generated AF triggers should be under consideration. Distributions of non-PV triggers are largely different between paroxysmal and non-paroxysmal AF. These findings may help ablation strategy regarding non-PV trigger targeting in practice.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Kawai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine , Fukuoka , Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine , Fukuoka , Japan
| | - A Noma
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Kisanuki
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Nakashima
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Watanabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Sakemi
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - K Okabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - A Okahara
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Matsuura
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - R Matsukawa
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Masuda
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
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10
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Nakashima R, Takase S, Kai K, Sakamoto K, Tsutsui H. Mexiletine effectively prevented refractory Torsades de Pointes and ventricular fibrillation in a patient with congenital type 2 long QT syndrome. J Cardiovasc Electrophysiol 2022; 33:1592-1595. [PMID: 35488741 DOI: 10.1111/jce.15517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/11/2022] [Accepted: 04/23/2022] [Indexed: 11/30/2022]
Abstract
We report a 28-year-old female patient with congenital type 2 long QT syndrome (LQTS) in which mexiletine shortened QTc and effectively prevented refractory Torsade de Pointes (TdP) and ventricular fibrillation (VF). She developed TdP and VF, and was subsequently diagnosed as congenital type 2 LQTS type 2. She had refractory TdP and VF every day despite medical therapy including β-blocker. They were completely suppressed after the initiation of mexiletine with shorting of QTc interval. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ryosuke Nakashima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiji Kai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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11
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Sakamoto K, Mukai Y, Kawai S, Nagaoka K, Inoue S, Takase S, Yakabe D, Ikeda S, Mannoji H, Nagayama T, Chishaki A, Tsutsui H. Intra-atrial activation pattern is useful to localize the areas of non-pulmonary vein triggers of atrial fibrillation. PLoS One 2022; 17:e0264894. [PMID: 35468171 PMCID: PMC9037930 DOI: 10.1371/journal.pone.0264894] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background Pulmonary vein isolation (PVI) is an established ablation procedure for atrial fibrillation (AF), however, PVI alone is insufficient to suppress AF recurrence. Non-pulmonary vein (non-PV) trigger ablation is one of the promising strategies beyond PVI and has been shown to be effective in refractory/persistent AF cases. To make non-PV trigger ablation more standardized, it is essential to develop a simple method to localize the origin of non-PV triggers. Methods We retrospectively analyzed 37 non-PV triggers in 751 ablation sessions for symptomatic AF from January 2017 to December 2020. Regarding non-PV triggers, intra-atrial activation interval from the earliest in right atrium (RA) to proximal coronary sinus (CS) (RA-CSp) and that from the earliest in RA to distal CS (RA-CSd) obtained by a basically-positioned duodecapolar RA-CS catheter were compared among 3 originating non-PV areas [RA, atrial septum (SEP) and left atrium (LA)]. Results RA-CSp of RA non-PV trigger (56.4 ± 23.4 ms) was significantly longer than that of SEP non-PV (14.8 ± 25.6 ms, p = 0.019) and LA non-PV (-24.9 ± 27.9 ms, p = 0.0004). RA-CSd of RA non-PV (75.9 ± 32.1 ms) was significantly longer than that of SEP non-PV (34.2 ± 32.6 ms, p = 0.040) and LA non-PV (-13.3 ± 41.2 ms, p = 0.0008). RA-CSp and RA-CSd of SEP non-PV were significantly longer than those of LA non-PV (p = 0.022 and p = 0.016, respectively). Sensitivity and specificity of an algorithm to differentiate the area of non-PV trigger using RA-CSp (cut-off value: 50 ms) and RA-CSd (cut-off value: 0 ms) were 88% and 97% for RA non-PV, 81% and 73% for SEP non-PV, 65% and 95% for LA non-PV, respectively. Conclusions The analysis of intra-atrial activation sequences was useful to differentiate non-PV trigger areas. A simple algorithm to localize the area of non-PV trigger would be helpful to identify non-PV trigger sites in AF ablation.
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Affiliation(s)
- Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Okusu, Minami-ku, Fukuoka, Japan
- * E-mail:
| | - Shunsuke Kawai
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Okusu, Minami-ku, Fukuoka, Japan
| | - Kazuhiro Nagaoka
- Department of Cardiology, St. Mary’s Hospital, Tsubuku-honmachi, Kurume, Fukuoka, Japan
| | - Shujiro Inoue
- Department of Cardiology, Aso Iizuka Hospital, Yoshio-machi, Iizuka, Fukuoka, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Daisuke Yakabe
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
- Department of Cardiology, Kyushu Medical Center, Jigyohama, Chuo-ku, Fukuoka, Japan
| | - Shota Ikeda
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Hiroshi Mannoji
- Department of Cardiology, Hamanomachi Hospital, Nagahama, Chuo-ku, Fukuoka, Japan
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Akiko Chishaki
- Division of Cardiology, Fukuoka Dental College Hospital, Tamura, Sawara-ku, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-ku, Fukuoka, Japan
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12
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Kawai S, Mukai Y, Inoue S, Yakabe D, Nagaoka K, Sakamoto K, Takase S, Chishaki A, Tsutsui H. Back Cover Image, Volume 33, Issue 4. J Cardiovasc Electrophysiol 2022. [DOI: 10.1111/jce.15469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shunsuke Kawai
- Department of Cardiovascular Medicine Japanese Red Cross Fukuoka Hospital Fukuoka Japan
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine Japanese Red Cross Fukuoka Hospital Fukuoka Japan
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Daisuke Yakabe
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Kazuhiro Nagaoka
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Akiko Chishaki
- Department of Health Sciences Fukuoka Dental College Fukuoka Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
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13
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Kawai S, Mukai Y, Inoue S, Yakabe D, Nagaoka K, Sakamoto K, Takase S, Chishaki A, Tsutsui H. Location and coupling interval of an ectopic excitation determine the initiation of atrial fibrillation from the pulmonary veins. J Cardiovasc Electrophysiol 2022; 33:629-637. [PMID: 35048463 PMCID: PMC9303182 DOI: 10.1111/jce.15371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/21/2021] [Accepted: 11/18/2021] [Indexed: 12/03/2022]
Abstract
Introduction Ectopic beats originating from the pulmonary vein (PV) trigger atrial fibrillation (AF). The purpose of this study was to clarify the electrophysiological determinant of AF initiation from the PVs. Methods Pacing studies were performed with a single extra stimulus mimicking an ectopic beat in the left superior PVs (LSPVs) in 62 patients undergoing AF ablation. Inducibility of AF, effective refractory period (ERP), and conduction properties within the PVs were analyzed. Results A single extra stimulus in LSPV induced AF in 20 patients (32% of all patients) at the mean coupling interval (CI) of 172 ms. A CI‐dependent anisotropic conduction at the AF onset was visualized in a three‐dimensional mapping. Onset of AF was site‐specific with reproducibility in each individual. Mean ERP in LSPV in the AF‐inducible group was shorter than that in the AF‐noninducible group (182 ± 55 vs. 254 ± 51 ms, p < .0001). LSPV ERP dispersion was greater in the AF‐inducible group than in the AF‐noninducible group (45 ± 28 vs. 27 ± 19 ms, p < .01). Circumferential intra‐PV conduction time (IPVCT) exhibited decremental properties in response to shortening of CI and the prolongation of IPVCT in the AF‐inducible site was greater than that in the AF‐noninducible site (p < .05) in each individual. Conclusions Location and CI of an ectopic excitation ultimately determine the initiation of AF from the PVs. ERP dispersion and circumferential conduction delay may lead to anisotropic conduction and reentry within the PVs that initiate AF.
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Affiliation(s)
- Shunsuke Kawai
- Department of Cardiovascular Medicine Japanese Red Cross Fukuoka Hospital Fukuoka Japan
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine Japanese Red Cross Fukuoka Hospital Fukuoka Japan
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Daisuke Yakabe
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Kazuhiro Nagaoka
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Akiko Chishaki
- Department of Health Sciences Fukuoka Dental College Fukuoka Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan
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14
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Mukai Y, Kawai S, Inoue S, Takase S, Sakamoto K, Nagaoka K, Chishaki A, Tsutsui H. Bigeminal potentials in the pulmonary vein indicate arrhythmogenic trigger of atrial fibrillation. J Arrhythm 2021; 37:331-337. [PMID: 33850574 PMCID: PMC8021992 DOI: 10.1002/joa3.12462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/24/2020] [Accepted: 10/28/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The pulmonary veins (PVs) have unique electrophysiological properties triggering and maintaining atrial fibrillation (AF). Bigeminal PV electrical activity (PV bigeminy) during sinus rhythm has been reported; however, its mechanisms and clinical implication remain unclear. We hypothesized that PV bigeminy indicates arrhythmogenic activities and influences clinical outcome. METHODS AND RESULTS We retrospectively analyzed electrophysiological studies in 465 patients with AF who underwent first session PV isolation (PVI). PV bigeminy was observed in 30 PVs of 23 patients (4.9% of patients). PV bigeminy was observed in left inferior PV (LIPV) in 15 patients, which was the most prevalent, followed by left superior in seven and right superior in seven and right inferior in one. In response to atrial extra stimulus, the second PV potentials (PV2) showed decremental conduction properties, suggesting reentrant mechanisms involved (n = 5). Interestingly, AF was initiated from the 23 PVs with bigeminy in 21 patients (76.7% of 30 PVs with bigeminy), spontaneously or in response to drugs, which was significantly more prevalent from the AF initiation rate from each PV in the control 442 patients (182 firings in 1290 PVs, 14.1%, P < .0001). PVI-based ablation was completed in the 23 patients with PV bigeminy and no recurrence was observed during 1-year follow-up, whereas four patients needed second sessions. CONCLUSIONS PV bigeminy is relatively rare but a unique electrophysiological finding in AF patients, suggesting reentrant substrate within the PV and/or surrounding tissue. PV bigeminy is a strong indicator of arrhythmogenic vein triggering AF, and ensures an excellent clinical outcome after PVI.
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Affiliation(s)
- Yasushi Mukai
- Division of CardiologyJapanese Red‐Dross Fukuoka HospitalFukuokaJapan
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
| | - Shunsuke Kawai
- Division of CardiologyJapanese Red‐Dross Fukuoka HospitalFukuokaJapan
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
| | - Shujiro Inoue
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
- Division of CardiologyAso Iizuka HospitalIizukaJapan
| | - Susumu Takase
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
| | - Kazuo Sakamoto
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
| | - Kazuhiro Nagaoka
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
- Division of CardiologySt. Mary’s HospitalKurumeJapan
| | - Akiko Chishaki
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
- Division of CardiologyFukuoka Dental College HospitalFukuokaJapan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
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15
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Akiyama Y, Matoba T, Katsuki S, Takase S, Nakashiro S, Nakano Y, Noma K, Tsutsui H. Comparison of Endothelial Dysfunction in Coronary Arteries with Bare Metal and 2 nd-Generation Drug-Eluting Stents. J Atheroscler Thromb 2021; 29:379-392. [PMID: 33612554 PMCID: PMC8894115 DOI: 10.5551/jat.61366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Aims:
Previous studies suggested that implantation with a 1st-generation DES was associated with coronary endothelial dysfunction, which was associated with Rho-kinase activation. Second-generation drug-eluting stents (DESs) may preserve coronary endothelial function in stented coronary arteries; however, because of methodological limitations, further study is needed to clarify the association between 2
nd
-generation DESs and coronary endothelial dysfunction.
Methods:
We retrospectively analysed the CuVIC trial database, where we identified 112 patients who underwent coronary stenting in the left coronary arteries with either a bare metal stent (BMS,
n
=53) or 2
nd
-generation DES (
n
=59). We compared vasomotions of target vessels with stents and non-target vessels without stents. Furthermore, we measured the Rho-kinase activation detected in mononucleocytes from aortic and coronary sinus blood.
Results:
ACh-induced vasoconstrictive responses of target vessels were not enhanced with a 2
nd
-generation DES (45±21% vs. 44±20%,
P
=0.56, paired
t
-test), but significantly enhanced in the coronary arteries with a BMS (50±18% vs. 42±20%,
P
=0.002). Rho-kinase activation did not differ between patients with a BMS and 2
nd
-generation DES. In the target vessels with a BMS, large late lumen loss and acute coronary syndrome (ACS) at the index percutaneous coronary intervention (PCI) were associated with ACh-induced enhanced coronary vasoconstrictive responses.
Conclusions:
Evaluation of ACh-induced vasomotion of target vessels comparing with non-target vessels revealed that 2
nd
-generation DESs were not associated with coronary endothelial dysfunction in target vessels, nor activation of Rho-kinase in the coronary sinus blood 6-8 months after stenting.
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Affiliation(s)
- Yusuke Akiyama
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Susumu Takase
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | | | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | | | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
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16
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Kawai S, Nagaoka K, Takase S, Sakamoto K, Ikuta H, Toyohara T, Okahara A, Tokutome M, Kuribayashi Y, Matsura H, Matsukawa R, Masuda S, Chishaki A, Tsutsui H, Mukai Y. Presence of low voltage area predicts atrial tachyarrhythmia inducibility with atrial burst pacing after pulmonary vein isolation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0595] [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
Induction of atrial fibrillation (AF)/atrial tachycardia (AT) by atrial burst pacing following ablation procedure may reflect the presence of residual substrates in the atria that maintain AF. However, the relation between the inducibility and left atrial low voltage area (LVA) has not been established.
Methods
Fifty-nine patients (65 years old, 43 males) with persistent AF who underwent pulmonary vein isolation (PVI)-based ablation were studied. All patients underwent left atrial voltage mapping during sinus rhythm and atrial burst pacing after PVI. Atrial burst pacing was performed with 30-beat at an amplitude of 10V from the ostium of the coronary sinus; increasing from 240 to 320 ppm in steps of 20 ppm or failure to 1:1 atrial capture. Inducibility was defined as AF/AT lasting more than 5 minutes following burst pacing. Left atrial LVA and other co-variates were analyzed with regard to burst pacing positivity.
Results
AF/AT was induced by burst pacing in 23 patients (39%). Univariate analysis revealed that past history of stroke, CHADS2 score and presence of left atrial LVA were significantly associated with the inducibility of AF/AT. Multivariate analysis revealed that only the presence of LVA was associated with the inducibility (OR 1.5: per 10% increase; p=0.04). We focused on the relationship between the extent of LVA and burst positivity. AF/AT inducibility increased as low voltage area increased, and it was as high as 72.7% when low voltage area was more than 20% (P<0.05). Interestingly, induced arrhythmia type was AT rather than AF when low voltage area was more than 20%.
Conclusions
Presence of left atrial LVA is an independent predictor of atrial tachyarrhythmia inducibility after PVI in patients with persistent AF. A large amount of low voltage area is related to AT inducibility rather than AF.
Extent of LVA and burst positivity
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Kawai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - H Ikuta
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - T Toyohara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Okahara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - H Matsura
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - S Masuda
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Hospital, Health Sciences, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
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17
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Yakabe D, Ikeda S, Chishaki A, Tsutsui H. P3764Morphological mechanisms of atrial functional mitral regurgitation in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0615] [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
Atrial functional mitral regurgitation (AFMR) occurs in patients with atrial fibrillation. However, morphological mechanisms of AFMR are poorly understood.
Purpose
The purpose of this study was to examine the morphological characteristics in patients with AFMR.
Methods
Among consecutive 795 patients undergoing initial radiofrequency catheter ablation (RFCA) at our hospital, twenty-five patients with persistent AF accompanied by AFMR (≥ moderate) before RFCA (AFMR group) were studied. Age-matched 25 patients with persistent AF without MR were defined as a control group.
Results
Left ventricular ejection fraction (LVEF) was lower and left atrium volume index was larger in the AFMR group (Table). Mitral valve annulus diameter and length of anterior mitral leaflet (AML) were similar between groups, whereas length of posterior mitral leaflet (PML) was significantly shorter in the AFMR group. Smaller tethering angle of AML (γ in the figure) and shorter tethering height were significantly associated with the occurrence of AFMR, which were different from morphology of functional mitral regurgitation in patients with dilated LV. Multiple regression analysis revealed that less tenting height (p<0.05) and LA dilatation toward the posterior (p<0.01) were significantly related to AFMR.
Echocardiographic parameters AFMR (n=25) Control (n=25) P value Age, y 69±8 66±10 NS Male, n (%) 9 (36) 20 (80) P=0.001 LVEF,% 60±9 67±6 P=0.004 LAD, mm 44±5 41±7 NS LAVI, ml/m2 56±17 41±13 P<0.001 MV diameter, mm 3.9±0.4 3.8±0.5 NS α angle, ° 34±9 35±7 NS β angle, ° 48±9 50±8 NS γ angle, ° 32±5 37±5 P=0.0005 AML length, mm 3.0±0.5 3.0±0.5 NS PML length, mm 2.1±0.1 2.4±0.1 P=0.03 Tenting height, mm 1.5±0.1 1.8±0.1 P=0.02 D, mm 0.8±0.3 0.5±0.3 P=0.001 LVEF: left ventricular ejection fraction; LAD: left atrial diameter; LAVI: left atrial volume index; AML: anterior mitral leaflet; PML: posterior mitral leaftlet.
Conclusions
AFMR occurs in patients with unique morphological features, such as less tethering height and LA dilatation toward the posterior.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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18
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Ikeda S, Chishaki A, Tsutsui H. P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) and clinical outcomes in patients with left ventricular systolic dysfunction (LVSD). However, predictors of the improvement of LV function and clinical outcomes by CA were poorly understood.
Purpose
We examined the efficacy of CA in AF patients with LVSD and predictive factors associated with clinical outcomes.
Method
Among consecutive 795 patients undergone initial RFCA at our hospital, we studied 51 patients with LVSD (LVEF ≤50%). Improved LVEF more then 5% at 1-year after CA was classified as “responder” to CA. We analyzed clinical variables and echocardiographic parameters before and after the CAs.
Results
In the responder group, LVEF was significantly improved 1-year after catheter ablation compared with the non-responder group. (ΔLVEF 22±12% vs. −1±4%, p<0.001). The responder group was significantly younger, had more non-paroxysmal AF, smaller LV systolic diameter and lower plasma BNP level before CA (Table). Late gadolinium enhancement (LGE)-positive rate in cardiovascular magnetic resonance imaging (CMR) before CA was higher in the non-responder group than in the responder group (100% [6/6] vs. 38% [5/13], p<0.005). After CAs of AF, event-free survival from hospitalization for heart failure was significantly higher in the responder group (Figure) with less AF recurrence (27% vs. 47%, p=0.04) than in the non-responder group.
Baseline characteristics Responder (N=35) Non-Responder (N=16) P value Age, y 62±11 69±8 p<0.01 Male, n (%) 26 (74) 13 (76) NS Non-pAF 26 (74) 4 (24) p<0.01 LAD, mm 48±7 48±8 NS LAVI, ml/m2 54±17 58±20 NS LVDd, mm 54±7 58±10 NS LVDs, mm 43±7 48±10 p=0.05 EF, % 37±8 38±8 NS BNP (pg/ml) 278±225 684±848 p<0.05
Conclusion
Younger age, absence of LV dilatation, lower plasma BNP, or absence of LGE may well predict favorable clinical outcomes after CA in patients with LVSD.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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19
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Okishige K, Yamauchi Y, Hanaki Y, Inoue K, Tanaka N, Yamaji H, Murakami T, Manita M, Tabata K, Ooie T, Tatsukawa Y, Sakai H, Yamaki M, Murakami M, Takada T, Osaka Y, Ono Y, Handa K, Sugiyama K, Yoshizawa T, Fukaya H, Tashiro H, Takase S, Harada M, Watanabe E, Yamane T, Yamashita S, Aonuma K. Clinical experience of idarucizumab use in cases of cardiac tamponade under uninterrupted anticoagulation of dabigatran during catheter ablation of atrial fibrillation. J Thromb Thrombolysis 2019; 47:487-494. [DOI: 10.1007/s11239-019-01835-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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Kawai S, Mukai Y, Inoue S, Yakabe D, Nagaoka K, Sakamoto K, Takase S, Chishaki A, Tsutsui H. Predictive value of the induction test with atrial burst pacing with regard to long-term recurrence after ablation in persistent atrial fibrillation. J Arrhythm 2019; 35:223-229. [PMID: 31007786 PMCID: PMC6457478 DOI: 10.1002/joa3.12150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/28/2018] [Accepted: 12/03/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Induction test of atrial fibrillation (AF) is one of endpoint measures in catheter ablation (CA). However, its predictive value in long-term outcome remains controversial. METHODS Ninety-eight patients (61 years, 77 males) with persistent AF who underwent pulmonary vein antrum isolation-based CA were retrospectively analyzed. We determined whether inducibility of AF/atrial tachyarrhythmias (AT) by atrial burst pacing at the end of CA and other characteristics were associated with the recurrence of AF/AT. Atrial burst pacing was performed with 30-beat from the coronary sinus; increasing from 240 to 320 ppm. Inducibility was defined as AF/AT lasting ≥5 minutes following atrial burst pacing. RESULTS AF/AT was induced in 50 patients (51%). During 1 year of follow-up, 71 patients (72.4%) had no recurrence of AF/AT. A logistic regression analysis showed that female gender (OR 3.8; P = 0.02), multiple sessions (OR 3.5; P = 0.02), and early recurrence of AF/AT (OR 5.3; P = 0.004) were associated with clinical recurrence. AF/AT Inducibility was not associated with clinical recurrence (P = 0.65). A subanalysis in patients with enlarged LA (LA diameter ≥45 mm, n = 40) showed that AF/AT inducibility was associated with recurrence (OR 8.1; P = 0.04). The positive and negative predictive values of AF/AT inducibility for AF/AT recurrence were 41 and 89%, respectively. Negative predictive value was increased to 92.3% when the inducibility was defined as AF/AT of ≥30 seconds following atrial burst pacing. CONCLUSIONS AF/AT inducibility cannot predict long-term clinical recurrence in patients with persistent AF. However, it may have a prognostic value especially in patients with enlarged LA.
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Affiliation(s)
- Shunsuke Kawai
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yasushi Mukai
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Shujiro Inoue
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Daisuke Yakabe
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Kazuhiro Nagaoka
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Kazuo Sakamoto
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Susumu Takase
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Akiko Chishaki
- Department of Health SciencesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
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21
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Honda N, Takase S, Tashiro H. Severe coronary artery spasm repeatedly induced after left pulmonary vein isolation in patient with atrial fibrillation. HeartRhythm Case Rep 2018; 4:501-505. [PMID: 30479946 PMCID: PMC6241036 DOI: 10.1016/j.hrcr.2018.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Nobuhiro Honda
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | - Susumu Takase
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | - Hideki Tashiro
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
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22
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Sadamatsu K, Takase S, Sagara S, Ohe K, Nishi JI, Tashiro H, Kosuga T, Yasunaga H. Initial medical management in acute type A aortic dissection patients with a thrombosed false lumen in the ascending aorta combining intramural hematoma and retrograde dissection from the descending to the ascending aorta. Eur Heart J Acute Cardiovasc Care 2018; 9:S13-S20. [PMID: 29781287 DOI: 10.1177/2048872618777724] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The feasibility of medical management for select patients with acute type A aortic dissection has been reported from a few institutions. In this study, we retrospectively investigated the safety and feasibility of our conservative approach for patients with type A aortic dissection in daily practice. METHODS From January 2013 to December 2017, 131 consecutive patients were admitted to our institution for acute aortic dissection, including 58 patients of type A. Initial medical management was attempted in select patients who were clinically stable and had a thrombosed false lumen of the ascending aorta without ulcer-like projections in the ascending aorta. RESULTS Except for nine patients contraindicated for surgery, urgent surgery was performed in 26 patients (SRG group), while 23 patients (MED group) were treated with the initial medical management. The maximum diameter of the ascending aorta was significantly larger in the SRG group than in the MED group. In the MED group, the heart rate and blood pressures were well-controlled at admission to the intensive-care unit, and the systolic blood pressure was further reduced at 24 h after. The in-hospital mortality rates of the MED and SRG groups were 0% and 15%, respectively. During the follow-up period, the survival rate was significantly higher in the MED group than in the SRG group, and the aortic event-free survival at one year was 80%. CONCLUSIONS The initial medical management for select patients with a thrombosed false lumen in the ascending aorta was a safe and feasible strategy in real-world practice.
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Affiliation(s)
- Kenji Sadamatsu
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | - Susumu Takase
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | | | - Kensuke Ohe
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | | | - Hideki Tashiro
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | - Tomokazu Kosuga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
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23
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Niwa A, Ii Y, Shindo A, Matsuo K, Ishikawa H, Tanigushi A, Takase S, Maeda M, Akatsu Y, Hashizume Y, Tomimoto H. Comparative analysis of cortical microinfarcts and microbleeds using 3.0-tesla postmortem magnetic resonance images and histopathology. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2281] [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: 10/18/2022]
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24
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Takase S, Mukai Y, Ohe K, Chishaki A, Tashiro H, Tsutsui H. Usefulness of a multi-spline duodecapolar catheter with smaller electrodes and closer spacings for mapping and ablation of Purkinje-related premature ventricular contraction and triggered ventricular fibrillation. HeartRhythm Case Rep 2017; 3:255-258. [PMID: 28736708 PMCID: PMC5509887 DOI: 10.1016/j.hrcr.2017.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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25
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Takase S, Matoba T. Response by Takase and Matoba to Letter Regarding Article, “Ezetimibe in Combination With Statins Ameliorates Endothelial Dysfunction in Coronary Arteries After Stenting: The CuVIC Trial (Effect of Cholesterol Absorption Inhibitor Usage on Target Vessel Dysfunction After Coronary Stenting), a Multicenter Randomized Controlled Trial”. Arterioscler Thromb Vasc Biol 2017; 37:e54. [DOI: 10.1161/atvbaha.117.309301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Higashi-ku, Fukuoka, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Higashi-ku, Fukuoka, Japan
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26
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Takase S, Matoba T, Nakashiro S, Mukai Y, Inoue S, Oi K, Higo T, Katsuki S, Takemoto M, Suematsu N, Eshima K, Miyata K, Yamamoto M, Usui M, Sadamatsu K, Satoh S, Kadokami T, Hironaga K, Ichi I, Todaka K, Kishimoto J, Egashira K, Sunagawa K. Ezetimibe in Combination With Statins Ameliorates Endothelial Dysfunction in Coronary Arteries After Stenting. Arterioscler Thromb Vasc Biol 2017; 37:350-358. [DOI: 10.1161/atvbaha.116.308388] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/21/2016] [Indexed: 11/16/2022]
Abstract
Objectives—
We sought to investigate whether treatment with ezetimibe in combination with statins improves coronary endothelial function in target vessels in coronary artery disease patients after coronary stenting.
Approach and Results—
We conducted a multicenter, prospective, randomized, open-label, blinded-end point trial among 11 cardiovascular treatment centers. From 2011 to 2013, 260 coronary artery disease patients who underwent coronary stenting were randomly allocated to 2 arms (statin monotherapy, S versus ezetimibe [10 mg/d]+statin combinational therapy, E+S). We defined target vessel dysfunction as the primary composite outcome, which comprised target vessel failure during treatment and at the 6- to 8-month follow-up coronary angiography and coronary endothelial dysfunction determined via intracoronary acetylcholine testing performed in cases without target vessel failure at the follow-up coronary angiography. Coadministration of ezetimibe with statins further lowered low-density lipoprotein cholesterol levels (83±23 mg/dL in S versus 67±23 mg/dL in E+S;
P
<0.0001), with significant decreases in oxidized low-density lipoprotein and oxysterol levels. Among patients without target vessel failure, 46 out of 89 patients (52%) in the S arm and 34 out of 96 patients (35%) in the E+S arm were found to have coronary endothelial dysfunction (
P
=0.0256), and the incidence of target vessel dysfunction at follow-up was significantly decreased in the E+S arm (69/112 (62%) in S versus 47/109 (43%) in E+S;
P
=0.0059). A post hoc analysis of post-treatment low-density lipoprotein cholesterol–matched subgroups revealed that the incidence of both target vessel dysfunction and coronary endothelial dysfunction significantly decreased in the E+S arm, with significant reductions in oxysterol levels.
Conclusions—
The CuVIC trial (Effect of Cholesterol Absorption Inhibitor Usage on Target Vessel Dysfunction after Coronary Stenting) has shown that ezetimibe with statins, compared with statin monotherapy, improves functional prognoses, ameliorating endothelial dysfunction in stented coronary arteries, and was associated with larger decreases in oxysterol levels.
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Affiliation(s)
- Susumu Takase
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Tetsuya Matoba
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Soichi Nakashiro
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Yasushi Mukai
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Shujiro Inoue
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Keiji Oi
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Taiki Higo
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Shunsuke Katsuki
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Masao Takemoto
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Nobuhiro Suematsu
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenichi Eshima
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenji Miyata
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Mitsutaka Yamamoto
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Makoto Usui
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenji Sadamatsu
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Shinji Satoh
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Toshiaki Kadokami
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kiyoshi Hironaga
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Ikuyo Ichi
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Koji Todaka
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Junji Kishimoto
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kensuke Egashira
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenji Sunagawa
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
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Abstract
Objective: To report on the surgical treatment of varicose veins by angioscopic valvuloplasty to preserve the long saphenous vein (LSV) and the efficacy of this method compared with conventional stripping and high ligation. Methods: A total of 306 limbs in 187 patients with reflux at the sapheno-femoral junction to below knee level were operated on using intraoperative angioscopy to diagnose valve insufficiency. Angioscopic external valvuloplasty was attempted for the subterminal valves in the LSV by three techniques: total plication of the dilated annulus by running polypropylene sutures (technique 1), plication by autogenous femorofascial sleeve or Dacron-reinforced silicone (technique 2), and plication of the commissure with shortening of the cusps from outside the vein wall (technique 3). Partial stripping or segmental ligation was performed for varicose veins below knee level and the incompetent perforating veins were treated simultaneously by suprafascial ligation. Results: The subterminal valves were classified as follows: valves with elongated and atrophic cusps – type I, 136 (44%); valves with expanded and depressed commissures with cusp changes – type II, 108 (35%); valves that had cusps with other deformities – type III, 38 (13%); and absence of valves between the saphenofemoral junction and mid-thigh level, 24 limbs (8%). Valvuloplasty of the LSV was successfully performed in 62 limbs (20%). There were two cases with occlusion of the LSV (3%) and four with recurrence of varicose veins (6%) at 2–89 (mean 55, SD 21) months follow-up. Conclusions: Angioscopic external valvuloplasty is effective in the treatment of varicose veins to preserve the LSV. Further data are needed for complete evaluation of this procedure.
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Affiliation(s)
- H. Satokawa
- Department of Cardiovascular Surgery, Fukushima Medical College, Fukushima, Japan
| | - S. Hoshino
- Department of Cardiovascular Surgery, Fukushima Medical College, Fukushima, Japan
| | - T. Igari
- Department of Cardiovascular Surgery, Fukushima Medical College, Fukushima, Japan
| | - S. Takase
- Department of Cardiovascular Surgery, Fukushima Medical College, Fukushima, Japan
| | - T. Ogawa
- Department of Cardiovascular Surgery, Fukushima Medical College, Fukushima, Japan
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Nagayama T, Hirooka Y, Kishi T, Mukai Y, Inoue S, Takase S, Takemoto M, Chishaki A, Sunagawa K. Blockade of brain angiotensin II type 1 receptor inhibits the development of atrial fibrillation in hypertensive rats. Am J Hypertens 2015; 28:444-51. [PMID: 25352232 DOI: 10.1093/ajh/hpu196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hypertension is a powerful risk factor of atrial fibrillation (AF). The pathophysiology of AF with hypertension is associated with sympathoexcitation or the renin-angiotensin system; however, current therapies cannot sufficiently prevent its development. We previously revealed that brain angiotensin II type 1 receptor (AT1R) blockade causes a depressor response via sympathoinhibition. Herein, we evaluated whether brain AT1R contributes to AF development in hypertensive rats. METHODS We divided the stroke-prone spontaneously hypertensive rats (SHRSP) treated with intracerebroventricular (ICV) infusion of vehicle, ICV infusion of losartan (S-LOS), or oral administration of hydralazine (S-HYD); and Wistar Kyoto rats treated with ICV S-VEH. RESULTS Two weeks later, systolic blood pressure was significantly lower in the S-LOS group than in the S-VEH group and was even lower in the S-HYD group. Urinary norepinephrine excretion for 24h, an indirect marker of sympathoexcitation, significantly reduced in the S-LOS group but increased in the S-HYD group despite depressor response. AF was induced by transesophageal burst pacing. AF duration was significantly shorter in the S-LOS group than in the S-VEH group (5.0±0.4 vs. 15.2±3.7 s; n = 8 each; P < 0.05). However, it was significantly longer in the S-HYD group than in the S-VEH group. Interstitial atrial fibrosis and echocardiographic parameters did not differ between the SHRSP groups. CONCLUSIONS Brain AT1R blockade suppresses AF inducibility and maintenance independent of depressor response in hypertensive rats.
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Affiliation(s)
- Tomomi Nagayama
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yoshitaka Hirooka
- Department of Advanced Cardiovascular Regulation and Therapeutics, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan;
| | - Takuya Kishi
- Department of Advanced Therapeutics for Cardiovascular Diseases, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kenji Sunagawa
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Han H, Takase S, Nishino N. Survival of silage lactic acid bacteria in the goat gastrointestinal tract as determined by denaturing gradient gel electrophoresis. Lett Appl Microbiol 2012; 55:384-9. [DOI: 10.1111/j.1472-765x.2012.03305.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Takase S, Yokoyama H. [Cardiac and aortic surgery for patient with malignant tumor]. Kyobu Geka 2012; 65:625-635. [PMID: 22868418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The management for patients concomitant with malignant tumor and cardiovascular disorders( CVD) is an extremely important issue in current era, especially with aging of the population. Once the patient planned surgery for neoplasma is also required the intervention of CVD, the intervention should be considered a less invasive measure as much as possible. Off-pump coronary artery bypass grafting( CABG) is more acceptable for the patient with coronary artery disease in this consideration than on-pump CABG, and in recommended anti-coagulant issue than percutaneous coronary intervention( PCI). Simultaneous surgical measure for both non-cardiovascular and cardiovascular diseases is also considered, if the patient is in well-tolerated condition. Important is to organize a team between related expertise physicians and to decide which way is better for the patient, based on a guideline.
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Affiliation(s)
- S Takase
- Department of the Cardiovascular Surgery, Fukushima Medical University, Japan
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31
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Lee YS, Cho HC, Takase S, Shimizu Y, Baek JT, Song JH. Fabrication of nano-LaCrO3 receptor by polymeric precursor method and its impedancemetric NOx sensing properties. J Nanosci Nanotechnol 2012; 12:1141-1146. [PMID: 22629909 DOI: 10.1166/jnn.2012.4628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
LaCrO3 was prepared by using the polymeric precursor method for use as a receptor material and its NOx sensing characteristics were investigated. Nano-LaCrO3 powders were synthesized at the optimum compositions of the mole ratio of [La-, Cr-source]:[EG]:[AcAc] = [a, a]:[160 a]:[8 a] with 1 wt% polyvinylpyrrolidone (PVP) using ethylene glycol (EG) as a solvent, acetyl acetone (AcAc) as a chelating agent, and PVP as a polymer additive. The thermal decomposition behavior, crystal structure, morphology, and particle sizes of nano powders were characterized by a thermal analysis (TG-DTA), X-ray diffraction (XRD), a field emission scanning electron microscopy (FE-SEM), and a particle size analyzer, respectively LaCrO3 powders were mainly orthorhombic in structure and the primary particle size was 30 nm according to the XRD results. All solid-state compact impedancemetric-type sensor devices composed of Li1.5Al0.5Ti1.5(PO4)3 (LATP) as a transducer and a perovskite-type LaCrO3 nano powder as a receptor, have been investigated for their ability to detect NOx (NO and NO2) in the range of 1-250 ppm at 400 degrees C. The sensor device showed high gas sensitivities at NO gas, but relatively low gas sensitivities for NO2 gas.
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Affiliation(s)
- Young-Sung Lee
- Department of Materials Engineering, Graduate School of PaiChai University, Daejeon 302-735, Korea
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32
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Takase S, Mukai Y, Takemoto M, Inoue S, Chishaki A, Sunagawa K. Catheter Ablation of Idiopathic Left Ventricular Outflow Tract Tachycardia Originating from the Left Sinus of Valsalva Experience of 11 Cases. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.cp2_07] [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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33
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Sato H, Takase S, Ozaki A, Wakayama T. Speed-Up of SAR Image Formation Processing using Graphics Processing Units. Informatics 2010. [DOI: 10.2316/p.2010.724-015] [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: 11/16/2022] Open
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34
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Tsuboi E, Yokoyama H, Satokawa H, Sato Y, Takase S. [Acute coronary syndrome caused by giant right coronary artery aneurysm; report of a case]. Kyobu Geka 2009; 62:921-923. [PMID: 19764502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 52-year-old man suffered from sudden chest pain. After urgent hospitalization, electrocardiogram showed complete atrioventricular (A-V) block. Computed tomography and coronary angiography showed a giant right coronary artery aneusysm. The patient was reffered to our hospital and elective operation was scheduled. The patient was re-attacked by chest pain and A-V block. Emergent coronary angiography showed mural thrombus in the right coronary artery aneurysm, which apparently caused the acute coronary syndrome. Under extracorporeal circulation, ligation of coronary artery aneurysm and coronary artery bypass using radial artery graft was performed. The postoperative course was uneventful. The histological findings revealed atherosclerotic coronary aneurysm.
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Affiliation(s)
- Eitoshi Tsuboi
- Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Japan
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35
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Yokoyama H, Takase S, Misawa Y, Hagiwara K, Tanji M, Takahashi S, Watanabe M, Kondo S. [Integrated coronary artery bypass strategy prevents urgent pump conversion during off-pump coronary artery bypass grafting]. Kyobu Geka 2009; 62:28-33. [PMID: 19195183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Urgent pump conversion during off-pump coronary artery bypass (OPCAB) results in high morbidity and mortality. We retrospectively evaluated if the peri-operative integrated strategy prevents this lethal event in our 400 consecutive OPCAB operations. The patients with preoperative cardiogenic shock and/or ventricular arrhythmias underwent on-pump coronary artery bypass grafting (CABG). All other patients (99% of total CABG) were scheduled to undergo OPCAB (n=400). Prophylactic intraaortic balloon pumping (IABP) was applied to the patients with critical (>95%) left main trunk stenosis or low (<0.35) left ventricular ejection fraction. All the patients received the deep pericardial suture, apex-traction device, suction-type stabilizer, test-clamp of target coronary arteries by micro bulldog clamp, and intra-coronary shunts. Intra-operative IABP was applied in the case of sustained ST-segment change and/or elevated pulmonary artery pressure. Pump conversion was indicated for the patients with ventricular fibrillation and/or cardiogenic shock. Two patients (0.5%) had pump conversion due to ventricular arrhythmia and sustained hypotension, respectively. These pump conversion did not result in hospital mortality. Three hospital deaths (0.7%) occurred due to non-cardiac causes. The integrated strategy using prophylactic or intra-operative IABP in OPCAB produce a low pump conversion rate even during an early period of surgeon's learning curve.
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Affiliation(s)
- H Yokoyama
- Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Japan
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36
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Kamigaki T, Murakami M, Matsumoto I, Toyama H, Fujita T, Takase S, Sakai T, Ajiki T, Ku Y, Hishikawa Y, Kuroda Y. A phase I study of proton beam therapy for locally advanced pancreatic cancer: Analysis of feasibility and anti-tumor effect. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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37
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Sato Y, Satokawa H, Takase S, Misawa Y, Wakamatsu H, Sato Y, Yokoyama H. [Therapeutic strategies for acute type A aortic dissection]. Kyobu Geka 2007; 60:262-6. [PMID: 17416090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We herein present the early and mid-term outcomes of therapeutic strategies for acute type A aortic dissection in our department. Subjects were 75 patients who were admitted to our department from January 2001 to October 2006. A total of 33 patients had thrombosed dissection: emergent surgery was indicated for cases in which the maximal ascending aortic diameter was > or =50 mm or when ulcer-like projection (ULP) was observed in the ascending aorta. Only 1 case of rupture-related death was observed, in a patient who had a maximal ascending aortic diameter of 52 mm and refused surgery. Although 8 patients were converted to surgery during the chronic phase, elective surgery was recommended in all cases. Surgery consisted of entry resection using open distal anastomosis under circulatory arrest at a bladder temperature of 25 degrees C, with antegrade cerebral perfusion into the 3 cervical branches of arch aorta based on bilateral axillary artery. In-hospital mortality of the 62 patients who underwent surgery was low (4.8%) and no dissection-related deaths were reported for the midterm outcomes. In addition, a low rate of cerebral infarction was observed among cases who had residual dissection of the brachiocephalic arteries after surgery. These findings demonstrate the validity of the therapeutic strategies in our department.
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Affiliation(s)
- Yoichi Sato
- Yoichi Sato et al., Department of Cardiovascular Surgery, School of Medicine, Fukushima Medical University, Fukushima, Japan
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Kishi K, Takase S, Goda T. Enhancement of sucrase-isomaltase gene expression induced by luminally administered fructose in rat jejunum. J Nutr Biochem 2005; 10:8-12. [PMID: 15539244 DOI: 10.1016/s0955-2863(98)00071-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/1998] [Accepted: 07/30/1998] [Indexed: 11/28/2022]
Abstract
We have previously shown that feeding a diet containing sucrose to rats causes an elevation of sucrase-isomaltase (SI) mRNA level in the jejunum. In this study, we examined whether the SI mRNA level could be directly elevated by administration of one of the constituting monosaccharides (i.e., glucose and/or fructose). Gastric intubation of a sucrose solution caused increases in both sucrase activity and SI mRNA level in the jejunum. Intrajejunal intubation of fructose, but not glucose, led to an elevation of sucrase activity and SI mRNA level. To examine whether fructose directly affects the gene expression of SI at the segment where the absorption of this sugar takes place or the sugar-induced increase in the gene expression of SI is secondary to any possible changes in the level(s) of certain hormonal factor(s) in the blood stream, a solution containing either fructose or glucose was simultaneously perfused into two consecutive cannulated and irrigated loops of jejunum that were not isolated from blood circulation. Compared with the loop perfused with glucose, the loop perfused with fructose exhibited significantly greater sucrase activity and SI mRNA level as well as the elevated GLUT5 mRNA level. These results suggest that fructose is capable of directly increasing the gene expression of SI and GLUT5 in the confined segment where fructose is absorbed.
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Affiliation(s)
- K Kishi
- Department of Nutrition, School of Food and Nutritional Sciences, The University of Shizuoka, Shizuoka, Japan
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Sasaki H, Ajiki T, Takase S, Fujino Y, Suzuki Y, Tominaga M, Ku Y, Kuroda Y. Images of interest. Hepatobiliary and pancreatic: mature cystic teratoma in the hepatoduodenal ligament. J Gastroenterol Hepatol 2005; 20:317. [PMID: 15683440 DOI: 10.1111/j.1440-1746.2005.03784.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- H Sasaki
- Dept. of Gastroenterological Surgery, Kobe University School of Medical Sciences, Kobe, Japan
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40
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Takase S, Pascarella L, Lerond L, Bergan JJ, Schmid-Schönbein GW. Venous Hypertension, Inflammation and Valve Remodeling. Eur J Vasc Endovasc Surg 2004; 28:484-93. [PMID: 15465369 DOI: 10.1016/j.ejvs.2004.05.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To identify possible mechanisms for destruction of valves in chronic venous hypertension and the results of treatment with an anti-inflammatory micronized purified flavonoid fraction. MATERIAL AND METHODS The saphenous vein valves in a rat model of venous hypertension caused by a femoral arterial-venous fistula were studied. Studies included femoral venous pressure, valve morphology, femoral venous reflux and selected molecular inflammatory markers as examined by immunohistochemistry. The effects of treatment with the anti-inflammatory micronized purified flavonoid fraction (S 5628, Servier, 50 and 100 mg/kg/day) were investigated. RESULTS The femoral venous pressure was elevated close to arterial values for a period of 3 weeks. We then examined the morphology of the veins and selected molecular inflammatory markers were assessed. The results show that in this model venous reflux develops in response to venous hypertension. This can be inhibited by the administration of the anti-inflammatory micronized purified flavonoid fraction (S 5628, Servier, 50 and 100 mg/kg/day). The valve becomes incompetent by a combination of venous dilation and shortening of the valve leaflets. This is not inhibited by treatment with S 5628. The valve leaflets are infiltrated with granulocytes, monocytes and T-lymphocytes, and the endothelial cells express enhanced levels of P-selectin and ICAM-1. Cells in the valves are subject to extensive apoptosis although no enhancement of MMP 2,9 expression could be detected at the three-week time point examined in this study. CONCLUSIONS These results indicate that in this model chronic elevation of venous pressure is associated with an inflammatory reaction in venous valves, a process that may lead to their dysfunction, reflux, and upstream elevation of venous pressure. These effects are mitigated by the anti-inflammatory micronized purified flavonoid fraction in a dose dependent manner.
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Affiliation(s)
- S Takase
- Department of Bioengineering, The Whitaker Institute for Biomedical Engineering, University of California San Diego, La Jolla, CA 92093-0412, USA
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Fujimori J, Nakashima I, Fujihara K, Feng J, Yamamoto M, Yamamoto N, Begum N, Sagara Y, Shiraki H, Shiga Y, Onodera J, Sato S, Takase S, Asano M, Endo M, Itoyama Y. Epitope analysis of the cerebrospinal fluid IgG in HTLV-I associated myelopathy patients using phage display method. J Neuroimmunol 2004; 152:140-6. [PMID: 15223246 DOI: 10.1016/j.jneuroim.2004.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2003] [Revised: 02/23/2004] [Accepted: 03/05/2004] [Indexed: 11/24/2022]
Abstract
We, for the first time, analyzed the binding motifs of immunoglobulin G (IgG) in the cerebrospinal fluid (CSF) of human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients with a phage library displaying 12-mer random peptides. As a result, the sequences highly homologous to HTLV-I gp46 192-199, 237-243 and 255-261 were the common linear epitopes of high affinity- IgG exclusively detected in both CSF and sera of the patients. These IgG responses were confirmed with corresponding HTLV-I peptides and serum antibody titers significantly correlated with disease severity or duration. Gp46 237-243 has not been detected in previous enzyme-linked immunosorbent assay (ELISA) studies using bound longer peptides, suggesting the usefulness of the phage display method.
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Affiliation(s)
- J Fujimori
- Department of Neurology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
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Ohtani M, Takase S, Wijayagunawardane MPB, Tetsuka M, Miyamoto A. Local interaction of prostaglandin F2α with endothelin-1 and tumor necrosis factor-α on the release of progesterone and oxytocin in ovine corpora lutea in vivo: a possible implication for a luteolytic cascade. Reproduction 2004; 127:117-24. [PMID: 15056776 DOI: 10.1530/rep.1.00071] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Endothelin-1 (ET-1) and tumor necrosis factor-α (TNFα) participate in the cascade of luteolysis. Thus, in the present study the interactions of ET-1 and TNFα with prostaglandin F2α (PGF2α) on the release of progesterone and oxytocin (OT) within the corpus luteum (CL) were investigated. A microdialysis system (MDS) was surgically implanted in ovine CL (one MDS line/CL; 5–10 lines/ewe) formed after super-ovulation. A 4-h perfusion with PGF2α (0.01–1 μmol l −1) induced no clear effect on progesterone release, but acutely stimulated OT release in a dose-dependent manner. A perfusion of PGF2α (1 μmol l −1) increased ET-1 release over a period of 12 h. Two perfusions of ET-1 (0.1 μmol l−1) or a perfusion of ET-1 followed by TNFα (200 ng ml−1) decreased progesterone release (56–64% at 36–48 h). When the CL were pre-perfused with PGF2α (1 μmol l−1), two consecutive perfusions of ET-1 decreased progesterone release more rapidly. Similarly, a pre-perfusion with PGF2α followed by consecutive perfusions of ET-1 and then TNFα rapidly decreased progesterone release, with the inhibition most pronounced (35%) at 36–48 h. The simultaneous infusion of ET-1 with PGF2α induced a rapid decrease in progesterone release (36% at 36–48 h). In a further study, the possible second messenger systems involved in PGF2α action on the release of progesterone, OT and ET-1 were investigated. A perfusion with 12-O-tetradecanoyl-phorbol-13-acetate (TPA; 10 μmol l−1), A23187 (10 μmol l−1), or PGF2α + A23187 increased progesterone release during infusion, but decreased it after perfusion. All treatments induced a massive release of OT during infusion, and increased ET-1 release after infusion. These results show that ET-1 is capable of suppressing progesterone release in the PGF2α-primed ovine CL in vivo and thus ET-1 works as a local luteolysin together with PGF2α during the process of functional luteolysis. During structural luteolysis, TNFα may interact with PGF2α and ET-1 to cause a rapid drop in progesterone release and accelerate the process of luteolysis. This result supports the contention that ET-1 and TNFα interact with PGF2α as local luteolytic mediators in the ewe as previously suggested.
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Affiliation(s)
- M Ohtani
- The Field Center of Animal Science and Agriculture, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
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Nakashima I, Fujihara K, Misu T, Fujimori J, Sato S, Takase S, Itoyama Y. A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands. Mult Scler 2002; 8:459-62. [PMID: 12474983 DOI: 10.1191/1352458502ms831oa] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The cerebrospinal fluid oligodonal IgG bands (OB) are less frequently observed in Japanese multiple sclerosis (MS) patients compared with Caucasian patients. We studied 40 consecutive Japanese MS patients to investigate the differences in the clinical and magnetic resonance imaging (MRI) features of MS between OB-positive patients and OB-negative ones. Among the 40 patients, 22 (55%) patients were OB-positive by either agarose gel electrophoresis (AGE) or isoelectric focusing (IEF), and 18 (45%) patients were OB-negative by both AGE and IEF. There were differences between the two groups only in the clincal forms of MS, but not in terms of gender, onset age, disease duration, or disease severity. In the OB-negative group, nine (50%) of the patients had the optic-spinal form of MS (OS-MS), but only one patient (4.5%) in the OB-positive group had OS-MS. Although most OB-positive patients showed brain MRI lesions typical of MS, 13 (72%) of the OB-negative patients showed no or few brain MRI lesions and the rest of the OB-negative patients showed atypical MS lesions, such as diffuse white matter lesions or large ring-enhanced lesions. Our results suggest that the majority of OB-negative Japanese MS patents show either no or few brain MRI lesions or atypical brain MRI lesions.
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Affiliation(s)
- I Nakashima
- Department of Neurology, Tohoku University School of Medicine, Sendai 980-8574, Japan.
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Okumura E, Okuda H, Takase S, Okamoto H, Mizuno K, Horio T, Horiguchi Y. A case of cutaneous-type adult T-cell leukaemia/lymphoma showing granuloma formation under a parapsoriatic eruption. Br J Dermatol 2002; 147:1020-2. [PMID: 12410722 DOI: 10.1046/j.1365-2133.2002.49743.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Igari T, Yokoyama H, Iwaya F, Satokawa H, Watanabe M, Ono T, Takase S. [Eleven cases of surgery for Marfan syndrome]. Kyobu Geka 2002; 55:667-70. [PMID: 12174654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The surgical outcomes in 11 patients with a Marfan syndrome (mean [+/- SD] age, 32 +/- 16: range 0.5 to 60) were evaluated. Echocardiography demonstrated annuloaortic ectasia (AAE) in nine patients, mitral regurgitation (5 months baby: valve replaced) and abdominal aortic aneurysm in one each. Among 9 AAE, root were replaced in 8 patients and aortic valve was preserved only one patient. Our early-time result is encouraging in our valve-sparing operation.
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Affiliation(s)
- T Igari
- Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
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Kikuchi A, Takeda A, Kimpara T, Nakagawa M, Kawashima R, Sugiura M, Kinomura S, Fukuda H, Chida K, Okita N, Takase S, Itoyama Y. Hypoperfusion in the supplementary motor area, dorsolateral prefrontal cortex and insular cortex in Parkinson's disease. J Neurol Sci 2001; 193:29-36. [PMID: 11718747 DOI: 10.1016/s0022-510x(01)00641-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The changes of regional cerebral blood flow (rCBF) in Parkinson's disease (PD) were investigated. Because of individual differences in brain volume and the extent of brain atrophy, previous functional imaging studies involved potential methodological difficulties. In this study, using the statistical parametric mapping technique, 99mTechnetium-labeled hexamethylpropyleneamineoxime brain single-photon emission computed tomography images from 18 patients with PD were transformed into standard brain-based stereotaxic coordinate spaces and then compared with such images for 11 control subjects matched for age and extent of brain atrophy. A rCBF decrement in the supplementary motor area (SMA) and such decrement in the dorsolateral prefrontal cortex (DLPFC) were observed in the summarized PD images as compared with controls (p<0.005). In a subgroup in the Hoehn-Yahr III/IV stage (11 cases), the rCBF decrement was demonstrated not only in the SMA, but also in the DLPFC and insular cortex (p<0.001). There was a correlation between the degree of the rCBF decrement in the DLPFC or the insular cortex and the score of the unified Parkinson's disease rating scale (p<0.05), while the rCBF decrement in the SMA showed no relationship with the severity of disease. The function of the SMA is closely associated with the nigro-striatal pathway and its impairment can explain the basic akinetic symptoms in PD, which are responsive to L-DOPA treatment. On the other hand, the DLPFC and insular cortex may play key roles in specific symptoms of impairment at advanced stages, such as impaired working memory, postural instability and autonomic dysfunction. We hypothesize that the impairment of the DLPFC and insular function is correlated with the progression of the disease and is related to DOPA-refractory symptoms, which are major problems in the care of patients with advanced PD.
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Affiliation(s)
- A Kikuchi
- Department of Neurology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Miyagi, 980-8574, Sendai, Japan
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Abstract
Carbohydrate-deficient transferrin is considered to be the most sensitive and specific biological marker of alcohol abuse. However, in alcohol-dependent individuals, microheterogeneity is also found in other glycoproteins besides transferrin. In this study, we compared the appearance of microheterogeneity in serum transferrin and alpha(1)-acidglycoprotein to clarify whether microheterogeneity of alpha(1)-acidglycoprotein is a marker for alcohol abuse. Serum samples were obtained from alcohol-dependent individuals with and without liver disease (LD) and non-alcohol-dependent patients with LD. Microheterogeneity of serum transferrin and alpha(1)-acidglycoprotein was determined by Western blotting. Microheterogeneity of transferrin and alpha(1)-acidglycoprotein was detected, respectively, in 63.2% and 58.5% of patients with alcoholic LD. Microheterogeneity of transferrin was not detected in alcohol-dependent individuals without LD, whereas microheterogeneity of alpha(1)-acidglycoprotein was detected in 42.9%. In non-alcohol-dependent patients with decompensated cirrhosis, microheterogeneity of transferrin and alpha(1)-acidglycoprotein was detected, respectively, in 68.4% and 15.8%. In conclusion, microheterogeneity of serum alpha(1)-acidglycoprotein may be a useful marker for chronic alcohol drinking.
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Affiliation(s)
- M Tsutsumi
- Division of Gastroenterology, Department of Internal Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
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Abstract
In the parabrachial nucleus (PBN), which has been known to play an important regulating role for various autonomic functions, many projecting nerve fiber terminals containing substance P (SP) from the nucleus of the solitary tract (NTS) and other areas are found and effect a modulatory influence on the transmission in the PBN. Postmortem brains were obtained from four multiple system atrophy (MSA) patients with autonomic failure and four control patients without any nervous disease, and an immunohistochemical staining for SP was performed on serial 10-microm-thick sections from paraffin-embedded pons including the PBN after immersion fixation in 10% formalin. In the PBN of all MSA patients, a marked decrease in SP-like immunoreactive (SPLI) nerve fiber terminals was revealed compared with the controls. In addition, an obvious astrocytosis was found in the PBN by simultaneous histopathological evaluation, for the preservation of neurons themselves. Therefore, the projecting SP pathway to the PBN may also be primarily involved in the pathophysiological mechanism of the autonomic failure of MSA patients.
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Affiliation(s)
- H Nomura
- Department of Neurology, Kohnan Hospital, Sendai, Japan
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Hino M, Fujie A, Iwamoto T, Hori Y, Hashimoto M, Tsurumi Y, Sakamoto K, Takase S, Hashimoto S. Chemical diversity in lipopeptide antifungal antibiotics. J Ind Microbiol Biotechnol 2001; 27:157-62. [PMID: 11780786 DOI: 10.1038/sj.jim.7000091] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the course of screening for antifungal antibiotics, we have discovered a novel series of lipopeptide compounds structurally related to, but highly superior to, echinocandin B in terms of their water solubility due to the presence of a sulfate residue. These compounds, WF11899s, WF738s, WF14573s, WF16616 and WF22210, and their derivatives have diversity in their nuclear structures and acyl side chains. The producing strains were classified into two groups, the Coleomycetes group and the Hyphomycetes group. Compound FK463, a derivative of WF11899A, is currently in Phase 3 clinical development as a novel antifungal antibiotic.
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Affiliation(s)
- M Hino
- Exploratory Research Laboratories, Fujisawa Pharmaceutical Co, Ltd, Tsukuba, Ibaraki, Japan
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Konno H, Takase S, Fukui T. [Neuropathology of longstanding subacute myelo-optico-neuropathy (SMON): an autopsy case of SMON with duration of 28 years]. No To Shinkei 2001; 53:875-80. [PMID: 11596484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The present case, 78-years-old female, had been troubled with SMON during 28 years, and was suddenly died from cerebral hemorrhage. The neuropathology characteristic for SMON could not be revealed in the spinal cord on routine histological preparations. There were decreasing number of immunopositive granules in the nucleus gracilis of medulla oblongata for synaptophysin, and in the marginal zone of the lumbar dorsal horn for substance P. These findings showed the presence of tractus gracilis degeneration and the disappearance of nociceptive fibers from the dorsal roots, respectively. To elucidate the histopathological changes of the spinal cord in long standing cases with SMON, the 11 cases reported were reviewed. The mean duration from the onset to death was 22.8 years(16 to 33 years). The mean age was 76.3 years old(54 to 92), and the 10 cases were female. All cases showed sensory impairment of the lower extremities, while deep tendon reflex exaggerated was seen in 7 cases. There were nine cases involving dorsal funiculi degeneration of the spinal cord, in contrast the lateral funiculi alternation were noticed in only two cases. It was considered that the corticospinal tract alteration becomes undiscernible during the long course, although the dorsal funiculi degeneration remained.
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Affiliation(s)
- H Konno
- Department of Clinical Pathology, Kohnan Hospital, Sendai
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