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Yagi S, Takahashi T, Murakami K, Azuma M, Sugano M, Miyamoto R, Niki M, Yamada H, Kawabata Y, Tani A, Fukuda D, Kadota M, Ise T, Kusunose K, Tobiume T, Matsuura T, Yamaguchi K, Soeki T, Wakatsuki T, Hata H, Sata M. Infective Endocarditis from Furuncle with Meningitis Complication Caused by Methicillin-resistant Staphylococcus aureus. Intern Med 2021; 60:3251-3255. [PMID: 33867390 PMCID: PMC8580777 DOI: 10.2169/internalmedicine.6902-20] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Infective endocarditis (IE) may be acquired in the community as community-acquired (CA) IE or in the healthcare setting. In Japan, cases of CA-methicillin-resistant Staphylococcus aureus (MRSA) infection as skin infection have been increasing. CA-MRSA strains, including the USA300 clone, have higher pathogenicity and are more destructive to tissue than healthcare-associated MRSA strains because of the toxins they produce, including arginine-catabolic mobile element (ACME) and Panton-Valentine leukocidin (PVL). However, only a few IE cases induced by USA300 have been reported. We herein report a 64-year-old man who developed CA-IE from a furuncle caused by USA300 MRSA producing PVL and ACME, which resulted in complications of meningitis.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Japan
- Shikoku Central Hospital, Japan
| | - Tomoko Takahashi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Keiji Murakami
- Infection Control Team, Tokushima University Hospital, Japan
| | - Momoyo Azuma
- Infection Control Team, Tokushima University Hospital, Japan
| | - Mikio Sugano
- Department of Cardiovascular Surgery, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Ryosuke Miyamoto
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Mariko Niki
- Department of Dermatology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Yutaka Kawabata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Akihiro Tani
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Muneyuki Kadota
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Hiroki Hata
- Department of Cardiovascular Surgery, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
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2
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Matsuura T, Soeki T, Fukuda D, Uematsu E, Tobiume T, Hara T, Kusunose K, Ise T, Yamaguchi K, Yagi S, Yamada H, Wakatsuki T, Sata M. Activated Factor X Signaling Pathway via Protease-Activated Receptor 2 Is a Novel Therapeutic Target for Preventing Atrial Fibrillation. Circ J 2021; 85:1383-1391. [PMID: 33746155 DOI: 10.1253/circj.cj-20-1006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Activated factor X (FXa), which contributes to chronic inflammation via protease-activated receptor 2 (PAR2), might play an important role in atrial fibrillation (AF) arrhythmogenesis. This study aimed to assess whether PAR2 signaling contributes to AF arrhythmogenesis and whether rivaroxaban ameliorates atrial inflammation and prevents AF.Methods and Results:In Study 1, PAR2 deficient (PAR2-/-) and wild-type mice were infused with angiotensin II (Ang II) or a vehicle via an osmotic minipump for 2 weeks. In Study 2, spontaneously hypertensive rats (SHRs) were treated with rivaroxaban, warfarin, or vehicle for 2 weeks after 8 h of right atrial rapid pacing. The AF inducibility and atrial remodeling in both studies were examined. Ang II-treated PAR2-/- mice had a lower incidence of AF and less mRNA expression of collagen1 and collagen3 in the atrium compared to wild-type mice treated with Ang II. Rivaroxaban significantly reduced AF inducibility compared with warfarin or vehicle. In SHRs treated with a vehicle, rapid atrial pacing promoted gene expression of inflammatory and fibrosis-related biomarkers in the atrium. Rivaroxaban, but not warfarin, significantly reduced expression levels of these genes. CONCLUSIONS The FXa-PAR2 signaling pathway might contribute to AF arrhythmogenesis associated with atrial inflammation. A direct FXa inhibitor, rivaroxaban, could prevent atrial inflammation and reduce AF inducibility, probably by inhibiting the pro-inflammatory activation.
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Affiliation(s)
- Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences.,Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Etsuko Uematsu
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomoya Hara
- Department of Cardiovascular Medicine, Shikoku Medical Center for Children and Adults
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences.,Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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3
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Matsumoto K, Tobiume T, Matsuura T, Ise T, Kusunose K, Yamaguchi K, Yagi S, Fukuda D, Wakatsuki T, Yamada H, Soeki T, Sata M. Evaluation of the input site and characteristics of the antegrade fast pathway based on three-dimensional bi-atrial stimulus-ventricle mapping. J Interv Card Electrophysiol 2021; 63:417-424. [PMID: 34231099 PMCID: PMC8983517 DOI: 10.1007/s10840-021-01026-7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
Purpose Previous studies examined the right atrial (RA) input site of the antegrade fast pathway (AFp) (AFpI). However, the left atrial (LA) input to the atrioventricular (AV) node has not been extensively evaluated. In this study, we created three-dimensional (3-D) bi-atrial stimulus-ventricle (St-V) maps and analyzed the input site and characteristics of the AFp in both the RA and LA. Methods Forty-four patients diagnosed with atrial fibrillation or WPW syndrome were included in this study. Three-dimensional bi-atrial St-V mapping was performed using an electroanatomical mapping system. Sites exhibiting the minimal St-V interval (MinSt-V) were defined as AFpIs and were classified into seven segments, four in the RA (F, S, M, and I) and three in the LA (M1, M2, and M3). By combining the MinSt-V in the RA and LA, the AFpIs were classified into three types: RA, LA, and bi-atrial (BA) types. The clinical and electrophysiological characteristics were compared. Results AFpIs were most frequently observed at site S in the RA (34%) and M2 in the LA (50%), and the BA type was the most common (57%). AFpIs in the LA were recognized in 75% of the patients. There were no clinical or electrophysiological indicators for predicting AFpI sites. Conclusions Three-dimensional bi-atrial St-V maps could classify AFpIs in both the RA and LA. AFpIs in the LA were frequently recognized. There were no significant clinical or electrophysiological indicators for predicting AFpI sites, and 3-D bi-atrial St-V mapping was the only method to reveal the precise AFp input site.
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Affiliation(s)
- Kazuhisa Matsumoto
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan.
| | - Takeshi Tobiume
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Tomomi Matsuura
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Takayuki Ise
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Kenya Kusunose
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Koji Yamaguchi
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Shusuke Yagi
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Daijyu Fukuda
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Hirotsugu Yamada
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Takeshi Soeki
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
| | - Masataka Sata
- Department of Cardiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8501, Japan
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4
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Okushi Y, Kusunose K, Okayama Y, Zheng R, Nakai M, Sumita Y, Ise T, Tobiume T, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Soeki T, Wakatsuki T, Sata M. Acute Hospital Mortality of Venous Thromboembolism in Patients With Cancer From Registry Data. J Am Heart Assoc 2021; 10:e019373. [PMID: 34027673 PMCID: PMC8483529 DOI: 10.1161/jaha.120.019373] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background The prognosis of patients with cancer-venous thromboembolism (VTE) is not well known because of a lack of registry data. Moreover, there is also no knowledge on how specific types are related to prognosis. We sought to evaluate the clinical characteristics and outcomes of patients with cancer-associated VTE, compared with a matched cohort without cancer using real-world registry data of VTE. Methods and Results This study was based on the Diagnosis Procedure Combination database in the JROAD-DPC (Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination). Of 5 106 151 total patients included in JROAD-DPC, we identified 49 580 patients who were first hospitalized with VTE from April 2012 to March 2017. Propensity score was estimated with a logistic regression model, with cancer as the dependent variable and 18 clinically relevant covariates. After propensity matching, there were 25 148 patients with VTE with or without cancer. On propensity score-matched analysis with 25 148 patients with VTE, patients with cancer had higher total in-hospital mortality within 7 days (1.3% versus 1.1%, odds ratio [OR], 1.66; 95% CI, 1.31-2.11; P<0.0001), 14 days (2.5% versus 1.5%, OR, 2.07; 95% CI, 1.72-2.49; P<0.0001), and 30 days (4.8% versus 2.0%, OR, 2.85; 95% CI, 2.45-3.31; P<0.0001). On analysis for each type of cancer, in-hospital mortality in 11 types of cancer was significantly high, especially pancreas (OR, 12.96; 95% CI, 6.41-26.20), biliary tract (OR, 8.67; 95% CI, 3.00-25.03), and liver (OR, 7.31; 95% CI, 3.05-17.50). Conclusions Patients with cancer had a higher in-hospital acute mortality for VTE than those without cancer, especially in pancreatic, biliary tract, and liver cancers.
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Affiliation(s)
- Yuichiro Okushi
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Yoshihiro Okayama
- Clinical Trial Center for Developmental Therapeutics Tokushima University Hospital Tokushima Japan
| | - Robert Zheng
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information National Cerebral and Cardiovascular Center Osaka Japan
| | - Yoko Sumita
- Center for Cerebral and Cardiovascular Disease Information National Cerebral and Cardiovascular Center Osaka Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Hirotsugu Yamada
- Department of Community Medicine Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan
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5
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Arase M, Kusunose K, Morita S, Yamaguchi N, Hirata Y, Nishio S, Okushi Y, Ise T, Tobiume T, Yamaguchi K, Fukuda D, Yagi S, Yamada H, Soeki T, Wakatsuki T, Sata M. Cardiac reserve by 6-minute walk stress echocardiography in systemic sclerosis. Open Heart 2021; 8:openhrt-2020-001559. [PMID: 33608475 PMCID: PMC7898855 DOI: 10.1136/openhrt-2020-001559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/23/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives There is a high prevalence of left ventricular diastolic dysfunction (LVDD) in systemic sclerosis (SSc) which is associated with high mortality. Thus, early detection of LVDD could be important in management of SSc. We hypothesised that exercise echocardiography in SSc patients with normal resting haemodynamics may expose early phase LVDD, which could affect its prognosis, defined as cardiovascular death and unplanned hospitalisation for heart failure. Methods Between January 2014 and December 2018, we prospectively enrolled 140 patients with SSc who underwent 6-minute walk (6MW) stress echocardiographic studies with normal range of estimated mean pulmonary arterial pressure (mPAP) (<25 mm Hg) and mean pulmonary artery wedge pressure (mPAWP) (<15 mm Hg) at rest. We used ΔmPAP/Δcardiac output (CO) to assess pulmonary vascular reserve and ΔmPAWP/ΔCO to assess LV cardiac reserve between resting and post-6MW. Results During a median period of 3.6 years (IQR 2.0–5.1 years), 25 patients (18%) reached the composite outcome. Both ΔmPAP/ΔCO and ΔmPAWP/ΔCO in patients with events were significantly greater than in those without events (8.9±3.8 mm Hg/L/min vs 3.0±1.7 mm Hg/L/min; p=0.002, and 2.2±0.9 mm Hg/L/min vs 0.9±0.5 mm Hg/L/min; p<0.001, respectively). Patients with both impaired LV cardiac reserve (ΔmPAWP/ΔCO>1.4 mm Hg/L/min) and impaired pulmonary vascular reserve (ΔmPAP/ΔCO>3.0 mm Hg/L/min) had worse outcomes compared with those without these abnormalities (p<0.001). Conclusion The 6MW stress echocardiography revealed impaired LV cardiac reserve in SSc patients with normal resting haemodynamics. Furthermore, LV cardiac reserve independently associates with clinical worsening in SSc, providing incremental prognostic utility, in addition to pulmonary vascular parameters.
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Affiliation(s)
- Miharu Arase
- Department of Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan.,Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Sae Morita
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Natsumi Yamaguchi
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yukina Hirata
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Susumu Nishio
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yuichiro Okushi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Medicine, Tokushima, Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Medicine, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
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6
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Tobiume T, Kato R, Matsuura T, Matsumoto K, Hara M, Takamori N, Taketani Y, Okawa K, Ise T, Kusunose K, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Wakatsuki T, Soeki T, Sata M, Matsumoto K. Antegrade slow pathway mapping of typical atrioventricular nodal reentrant tachycardia based on direct slow pathway capture. J Arrhythm 2021; 37:128-139. [PMID: 33664895 PMCID: PMC7896471 DOI: 10.1002/joa3.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/14/2020] [Accepted: 11/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Radiofrequency (RF) ablation of typical atrioventricular nodal reentrant tachycardia (tAVNRT) is performed without revealing out the location of antegrade slow pathway (ASp). In this study, we studied a new electrophysiological method of identifying the site of ASp. METHODS This study included 19 patients. Repeated series of very high-output single extrastimulations (VhoSESts) were delivered at the anatomical slow pathway region during tAVNRT. Tachycardia cycle length (TCL), coupling interval (CI), and return cycle (RC) were measured and the prematurity of VhoSESts [ΔPM (= TCL - CI)] and the prolongation of RCs [ΔPL (= RC - TCL)] were calculated. Pacing sites were classified into two categories: (i) ASp capture sites [DSPC(+) sites], where two different RCs were shown, and ASp non-capture sites [DSPC(-) sites], where only one RC was shown. RF ablation was performed at DSPC(+) sites and/or sites with catheter-induced mechanical trauma (CIMT) to ASp. RESULTS DSPC(+) sites were shown in 13 patients (68%). RF ablation was successful in all patients without any degree of atrioventricular block nor recurrence. Total number of RF applications was 1.8 ± 1.1. Minimal distance between successful ablation sites and DSPC(+)/CIMT sites and His bundle (HB) electrogram recording sites was 1.9 ± 0.8 mm and 19.8 ± 6.1 mm, respectively. ΔPL of more than 92.5 ms, ΔPL/TCL of more than 0.286, and ΔPL/ΔPM of more than 1.565 could identify ASp with sensitivity of 100%, 91.1%, and 88.9% and specificity of 92.9%, 97.0%, and 97.6%, respectively. CONCLUSIONS Sites with ASp capture and CIMT were close to successful ablation sites and could be useful indicators of tAVNRT ablation.
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Affiliation(s)
- Takeshi Tobiume
- Department of CardiologyTokushima University HospitalTokushimaJapan
- Department of CardiologySaitama Medical University International Medical CenterHidakaJapan
- Department of CardiologyKawashima HospitalTokushimaJapan
- Department of CardiologyShikoku Medical Center for Children and AdultsZentsujiJapan
| | - Ritsushi Kato
- Department of CardiologySaitama Medical University International Medical CenterHidakaJapan
| | - Tomomi Matsuura
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | | | - Motoki Hara
- Hara Clinic Higashi‐HiroshimaHigashi‐HiroshimaJapan
| | | | - Yoshio Taketani
- Department of CardiologyShikoku Medical Center for Children and AdultsZentsujiJapan
| | - Keisuke Okawa
- Department of CardiologyKagawa Prefectural Central HospitalTakamatsuJapan
| | - Takayuki Ise
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Kenya Kusunose
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Koji Yamaguchi
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Shusuke Yagi
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Daijyu Fukuda
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Hirotsugu Yamada
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | | | - Takeshi Soeki
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Masataka Sata
- Department of CardiologyTokushima University HospitalTokushimaJapan
| | - Kazuo Matsumoto
- Department of CardiologySaitama Medical University International Medical CenterHidakaJapan
- Department of Internal MedicineHigashi‐Matsuyama Medical Association HospitalHigashimatsuyamaJapan
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7
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Kusunose K, Okushi Y, Okayama Y, Zheng R, Abe M, Nakai M, Sumita Y, Ise T, Tobiume T, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Soeki T, Wakatsuki T, Sata M. Association between Vitamin D and Heart Failure Mortality in 10,974 Hospitalized Individuals. Nutrients 2021; 13:nu13020335. [PMID: 33498709 PMCID: PMC7911510 DOI: 10.3390/nu13020335] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 01/03/2023] Open
Abstract
A broad range of chronic conditions, including heart failure (HF), have been associated with vitamin D deficiency. Existing clinical trials involving vitamin D supplementation in chronic HF patients have been inconclusive. We sought to evaluate the outcomes of patients with vitamin D supplementation, compared with a matched cohort using real-world big data of HF hospitalization. This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). After exclusion criteria, we identified 93,692 patients who were first hospitalized with HF between April 2012 and March 2017 (mean age was 79 ± 12 years, and 52.2% were male). Propensity score (PS) was estimated with logistic regression model, with vitamin D supplementation as the dependent variable and clinically relevant covariates. On PS-matched analysis with 10,974 patients, patients with vitamin D supplementation had lower total in-hospital mortality (6.5 vs. 9.4%, odds ratio: 0.67, p < 0.001) and in-hospital mortality within 7 days and 30 days (0.9 vs. 2.5%, OR, 0.34, and 3.8 vs. 6.5%, OR: 0.56, both p < 0.001). In the sub-group analysis, mortalities in patients with age < 75, diabetes, dyslipidemia, atrial arrhythmia, cancer, renin-angiotensin system blocker, and β-blocker were not affected by vitamin D supplementation. Patients with vitamin D supplementation had a lower in-hospital mortality for HF than patients without vitamin D supplementation in the propensity matched cohort. The identification of specific clinical characteristics in patients benefitting from vitamin D may be useful for determining targets of future randomized control trials.
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Affiliation(s)
- Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
- Correspondence: ; Tel.: +81-88-633-7851; Fax: +81-88-633-7894
| | - Yuichiro Okushi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Yoshihiro Okayama
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima 770-8503, Japan;
| | - Robert Zheng
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Miho Abe
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan; (M.N.); (Y.S.)
| | - Yoko Sumita
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan; (M.N.); (Y.S.)
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan;
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima 770-8503, Japan; (Y.O.); (R.Z.); (M.A.); (T.I.); (T.T.); (K.Y.); (S.Y.); (D.F.); (T.S.); (T.W.); (M.S.)
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8
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Soeki T, Matsumoto K, Fukuda D, Uematsu E, Matsuura T, Tobiume T, Kusunose K, Ise T, Yamaguchi K, Yagi S, Yamada H, Wakatsuki T, Sata M. Toll-like receptor 9 is a novel therapeutic target to prevent atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0463] [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 fibrillation (AF) is the most common type of arrhythmia seen in clinical practice. Recent studies suggest that inflammation contributes to the pathogenesis of AF. On the other hand, several evidence suggests that toll-like receptor (TLR) 9 recognizes bacterial DNA, activating innate immunity, whereas it also provokes inflammation in response to fragmented DNA released from mammalian cells. Recently, we have reported that TLR 9 plays a pivotal role in the development of vascular inflammation and atherogenesis through proinflammatory activation of macrophages.
Purpose
This study aimed to assess whether TLR9 contributes to the AF arrhythmogenesis.
Methods
TLR9 deficient (TLR9−/−) and wild-type mice were infused with angiotensin II (Ang II) or vehicle via an osmotic minipump for 4 weeks. Blood pressure and body weight were measured serially. Then, we examined AF inducibility by intracardiac electrophysiological study and the inflammation-induced atrial remodeling by biochemical analysis after 4 weeks of Ang II infusion.
Results
There was no significant difference in blood pressure and pulse rate between TLR9−/− and wild-type mice both before and after Ang II infusion. Ang II-treated TLR9−/− mice showed lower incidence of AF compared with wild-type mice treated with Ang II. Genetic deletion of TLR9 significantly reduced the interstitial fibrosis in atrium of Ang II-treated mice. TLR9−/− mice also showed less mRNA expressions of inflammatory and fibrosis-related biomarkers (TNF-α, interleukin-6, TGF-β, collagen-1, collagen-3) in atrium compared with wild-type mice.
Conclusions
TLR9 might contribute to the AF arrhythmogenesis associated with atrial inflammation. TLR9 might serve as a potential therapeutic target for AF.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Soeki
- Tokushima University, Tokushima, Japan
| | | | - D Fukuda
- Tokushima University, Tokushima, Japan
| | - E Uematsu
- Tokushima University, Tokushima, Japan
| | | | - T Tobiume
- Tokushima University, Tokushima, Japan
| | | | - T Ise
- Tokushima University, Tokushima, Japan
| | | | - S Yagi
- Tokushima University, Tokushima, Japan
| | - H Yamada
- Tokushima University, Tokushima, Japan
| | | | - M Sata
- Tokushima University, Tokushima, Japan
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9
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Torii Y, Kusunose K, Zheng R, Yamada H, Amano R, Matsumoto R, Hirata Y, Nishio S, Yamada N, Ise T, Yamaguchi K, Tobiume T, Fukuda D, Yagi S, Soeki T, Wakatsuki T, Okayama Y, Sata M. Association between Sarcopenia/Lower Muscle Mass and Short-Term Regression of Deep Vein Thrombosis Using Direct Oral Anticoagulants. Int Heart J 2020; 61:787-794. [PMID: 32684602 DOI: 10.1536/ihj.20-032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Advanced age, obesity, and muscle weakness are independent factors in the onset of deep vein thrombosis (DVT). Recently, an association between sarcopenia and DVT has been reported. We hypothesized that sarcopenia related factors, observed by ultrasonography, are associated with the regression effect on the thrombus following anticoagulation therapy. The present study focused on gastrocnemius muscle (GCM) thickness and the GCM's internal echogenic brightness. We examined the association with DVT regression following direct oral anticoagulants (DOACs) treatment.The prospective cohort study period was between October 2017 and August 2018. We enrolled 46 patients diagnosed with DVT by ultrasonography, who were aged >60 years old and treated with DOACs. Sarcopenia was evaluated using the Asian Working Group for Sarcopenia flowchart. The average DOACs treatment period was 94 days, and 29 patients exhibited thrombus regression. On univariate logistic regression analysis, sarcopenia, average GCM diameter index, and gastrocnemius integrated backscatter index were significantly associated with thrombus regression. In a multivariate model, only the average GCM diameter index correlated with thrombus regression.The average GCM diameter index is associated with DVT regression treated with DOACs. Considering the GCM diameter during DVT treatment can be a marker to make a decision for the treatment of DVT.
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Affiliation(s)
- Yuta Torii
- Ultrasound Examination Center, Tokushima University Hospital
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Robert Zheng
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences
| | - Rie Amano
- Ultrasound Examination Center, Tokushima University Hospital
| | | | - Yukina Hirata
- Ultrasound Examination Center, Tokushima University Hospital
| | - Susumu Nishio
- Ultrasound Examination Center, Tokushima University Hospital
| | - Nao Yamada
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Yoshihiro Okayama
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital
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10
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Ito H, Wakatsuki T, Yamaguchi K, Fukuda D, Kawabata Y, Matsuura T, Kusunose K, Ise T, Tobiume T, Yagi S, Yamada H, Soeki T, Tsuruo Y, Sata M. Atherosclerotic Coronary Plaque Is Associated With Adventitial Vasa Vasorum and Local Inflammation in Adjacent Epicardial Adipose Tissue in Fresh Cadavers. Circ J 2020; 84:769-775. [PMID: 32281556 DOI: 10.1253/circj.cj-19-0914] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The coronary adventitia has recently attracted attention as a source of inflammation because it harbors nutrient blood vessels, termed the vasa vasorum (VV). This study assessed the link between local inflammation in adjacent epicardial adipose tissue (EAT) and coronary arterial atherosclerosis in fresh cadavers.Methods and Results:Lesion characteristics in the left anterior descending coronary artery of 10 fresh cadaveric hearts were evaluated using integrated backscatter intravascular ultrasound (IB-IVUS), and the density of the VV and levels of inflammatory molecules from the adjacent EAT were measured for each of the assessed lesions. The lesions were divided into lipid-rich, lipid-moderate, and lipid-poor groups according to percentage lipid volume assessed by IB-IVUS. Higher expression of inflammatory molecules (i.e., vascular endothelial growth factor A [VEGFA] andVEGFB) was observed in adjacent EAT of lipid-rich (n=11) than in lipid-poor (n=11) lesions (7.99±3.37 vs. 0.45±0.85 arbitrary units [AU], respectively, forVEGFA; 0.27±0.15 vs. 0.11±0.07 AU, respectively, forVEGFB; P<0.05). The density of adventitial VV was greater in lipid-rich than lipid-poor lesions (1.50±0.58% vs. 0.88±0.23%; P<0.05). CONCLUSIONS Lipid-rich coronary plaques are associated with adventitial VV and local inflammation in adjacent EAT in fresh cadavers. This study suggests that local inflammation of EAT is associated with coronary plaque progression via the VV.
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Affiliation(s)
- Hiroyuki Ito
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Yutaka Kawabata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Yoshihiro Tsuruo
- Department of Anatomy and Cell Biology, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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11
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Yamaguchi K, Wakatsuki T, Ueno R, Kawabata Y, Matsuura T, Ise T, Kusunose K, Tobiume T, Yagi S, Yamada H, Soeki T, Sata M. P2813The improvement of chronic local coagulative response according to the progress of drug eluting stent. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1125] [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
We have previously reported local persistent hypercoagulation after sirolimus-eluting stent (SES) implantation by measuring local plasma prothrombin fragment 1+2 (F1+2) levels. The aim of this study is to examine chronic local coagulative response after each generation- drug eluting stent (DES) implantation.
Methods
Ninety-five patients who were treated about eight months earlier with coronary angioplasty, with no evidence of restenosis, were studied [1stgeneration durable polymer (DP)-DES {SES; Cypher®: 26pts, paclitaxel-eluting stent (PES); Taxus®:16pts}, 2ndgeneration DP-DES {everolimus-eluting stent (EES); Xience®:15pts, zotarolimus-eluting stent (ZES); Endeavor®:15pts}, and 3rdgeneration biodegradable polymer (BP)-DES {BP-biolimus-eluting stent (BES); Nobori®: 11pts and BP-SES; Ultimaster®: 12pts}]. We measured plasma levels of F1+2 sampled in coronary sinus (CS) and sinus of Valsalva (V). The transcardiac gradient (Δ) was defined as CS level minus V level.
Results
No significant differences were observed in the percent diameter stenosis among 1st, 2nd, and 3rd DES groups (12.5±15.5 vs 16.1±12.9 vs 13.1±11.9%). The ΔF1+2 was significantly lower in the 2nd and 3rd DES groups than in the 1st DES group (9.0±15.4 and 10.0±17.4 vs 27.3±23.8pmol/l, p<0.05, respectively). The ΔF1+2 was significantly lower in the BP-DES groups (BP-BES and BP-SES) than in the DP-DES groups (DP-SES, DP-PES, DP-ZES, and DP-EES) (10.0±17.4 vs 18.1±19.5pmol/l, p<0.05). The ΔF1+2 was significantly lower in the thin strut-DES groups (BP-SES, DP-ZES, and DP-EES) than in the thick strut-DES groups (DP-SES, DP-PES, and BP-BES) (8.4±15.4 vs 21.7±18.5pmol/l, p<0.05). In the BP-DES groups, the ΔF1+2 was lower in the BP-SES group than in the BP-BES group (8.0±16.1 vs 12.7±18.1pmol/l, p=0.08).
Conclusions
The improvement of chronic local coagulative response was observed according to the progress of DES. These findings might be associated with lower strut thickness and faster polymer resorption in the newer-generation DES.
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Affiliation(s)
- K Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - T Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - R Ueno
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Y Kawabata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - T Matsuura
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - T Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - K Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - T Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - S Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - H Yamada
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - T Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - M Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
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12
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Soeki T, Matsumoto K, Fukuda D, Uematsu E, Matsuura T, Tobiume T, Kusunose K, Ise T, Yamaguchi K, Yagi S, Yamada H, Wakatsuki T, Sata M. P2867Vildagliptin reduces inducibility of atrial fibrillation in hypertensive rats complicated with diabetes mellitus. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, increasing the incidence of ischemic stroke. Diabetes mellitus (DM) is a predictor of stroke and thromboembolism, and it was reported to be an independent risk factor for AF. A recent study has shown that, in obese mice with diabetes, dipeptidyl peptidase-4 (DPP-4) inhibitor prevents myocardial fibrosis, active oxygen stress, weight loss and improves myocardial hypertrophy. However, the effects of DPP-4 inhibitors on atrial remodeling associated with diabetes and atrial fibrillation have not yet been clarified.
Purpose
This study was performed to assess whether a DPP-4 inhibitor (vildagliptin) ameliorates atrial remodeling in spontaneously hypertensive rats (SHR) with streptozotocin-induced diabetes.
Methods
Rats were divided into 3 groups: SHR without DM, SHR with DM treated with vehicle and SHR-DM treated with vildagliptin (3mg/kg/day; intragastric gavage). For each group, blood pressure, blood glucose level and body weight were measured serially. Cardiac function was also evaluated by echocardiography. Then, we examined AF inducibility by intracardiac electrophysiological study and the inflammation-induced atrial remodeling by biochemical analysis after 4 weeks of treatment.
Results
There was no significant difference in blood pressure and blood gucose level between vehicle and vildagliptin groups. Administration of vildagliptin significantly reduced AF inducibility compared with rats with vehicle. In DM rats treated with vehicle, rapid atrial pacing promoted the gene expression of inflammatory and fibrosis-related biomarkers (TNF-α, MCP-1, collagen-1) in atrium. Vildagliptin reduced these gene expression levels. In addition, administration of vildagliptin significantly reduced the interstitial fibrosis in atrium.
Conclusions
DPP-4 inhibitor, vildagliptin. could prevent atrial inflammation and reduce the AF inducibility in SHR complicated with DM.
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Affiliation(s)
- T Soeki
- Tokushima University, Tokushima, Japan
| | | | - D Fukuda
- Tokushima University, Tokushima, Japan
| | - E Uematsu
- Tokushima University, Tokushima, Japan
| | | | - T Tobiume
- Tokushima University, Tokushima, Japan
| | | | - T Ise
- Tokushima University, Tokushima, Japan
| | | | - S Yagi
- Tokushima University, Tokushima, Japan
| | - H Yamada
- Tokushima University, Tokushima, Japan
| | | | - M Sata
- Tokushima University, Tokushima, Japan
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13
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Yagi S, Ueno R, Sutou K, Wakatsuki T, Yamaguchi K, Saijo Y, Hara T, Ise T, Kusunose K, Bando M, Matsuura T, Tobiume T, Yamada H, Fukuda D, Soeki T, Akaike M, Sata M. Lambda-like J wave due to acute myocardial infarction of the diagonal branch. J Med Invest 2019; 66:185-187. [PMID: 31064936 DOI: 10.2152/jmi.66.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The culprit lesion of acute myocardial infarction could be predicted by electrocardiogram findings. However, we experienced some cases with coronary angiographic finding in the area of ST-T elevation that was different from that predicted. The lambda-like J wave could be caused by ischemia although the mechanism has not been fully elucidated. We report a case of acute myocardial infarction that showed discrepancy between ST-T elevation with lambda-like ischemic J wave in a broad area and coronary angiographical finding of diagonal branch occlusion. J. Med. Invest. 66 : 185-187, February, 2019.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.,Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Tokushima,Japan
| | - Rie Ueno
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kumiko Sutou
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoshihito Saijo
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomoya Hara
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mika Bando
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masashi Akaike
- Department of Medical Education, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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14
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Yagi S, Kondo D, Ise T, Fukuda D, Yamaguchi K, Wakatsuki T, Kawabata Y, Ito H, Saijo Y, Seno H, Sutou K, Ueno R, Todoroki T, Kusunose K, Matsuura T, Tobiume T, Yamada H, Soeki T, Shimabukuro M, Aihara KI, Akaike M, Sata M. Association of Decreased Docosahexaenoic Acid Level After Statin Therapy and Low Eicosapentaenoic Acid Level with In-Stent Restenosis in Patients with Acute Coronary Syndrome. J Atheroscler Thromb 2018; 26:272-281. [PMID: 30135329 PMCID: PMC6402885 DOI: 10.5551/jat.44735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: It is speculated that statin therapy modulates the synthesis of polyunsaturated fatty acids (PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). However, the data available on the effects of statin therapy on the serum levels of PUFA and the subsequent impact on in-stent restenosis (ISR) in patients with acute coronary syndrome (ACS) are limited. Methods: A total of 120 ACS patients who received emergent coronary stent implantation, follow-up coronary angiography to evaluate ISR, and new statin therapy were enrolled. We measured the serum levels of the PUFA and lipids at the onset of ACS and at the follow-up coronary angiography. Results: The follow-up coronary angiography revealed 38 ISR cases. New statin therapy significantly reduced the serum levels of DHA and low-density lipoprotein cholesterol (LDL-C), while it did not affect EPA level. Single regression analysis revealed that a decreased serum level of LDL-C was associated with decreased DHA level. The multiple logistic regression analysis revealed that the decreased DHA level after statin therapy and low serum level of EPA on admission were determinants of prevalence of ISR. Conclusion: Statin therapy decreased the serum level of DHA with a parallel reduction in LDL-C level in patients with ACS. Decreased DHA level after statin therapy and low EPA level on admission are risk factors for ISR, indicating that in patients with ACS, decreased serum levels of DHA may be a residual target for the prevention of ISR.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences.,Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences
| | - Daisuke Kondo
- Student Laboratory, Faculty of Medicine, Tokushima University
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Yutaka Kawabata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hiroyuki Ito
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Yoshihito Saijo
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hiromitsu Seno
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kumiko Sutou
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Rie Ueno
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takafumi Todoroki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences.,Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University
| | - Ken-Ichi Aihara
- Department of Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences
| | - Masashi Akaike
- Department of Medical Education, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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15
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Soeki T, Uematsu E, Matsuura T, Tobiume T, Kusunose K, Ise T, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Wakatsuki T, Sata M. P3732C-type natriuretic peptide improves left ventricular diastolic dysfunction and ischemia/reperfusion injury-associated ventricular arrhythmias. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Soeki
- University of Tokushima, Tokushima, Japan
| | - E Uematsu
- University of Tokushima, Tokushima, Japan
| | - T Matsuura
- University of Tokushima, Tokushima, Japan
| | - T Tobiume
- University of Tokushima, Tokushima, Japan
| | - K Kusunose
- University of Tokushima, Tokushima, Japan
| | - T Ise
- University of Tokushima, Tokushima, Japan
| | | | - S Yagi
- University of Tokushima, Tokushima, Japan
| | - D Fukuda
- University of Tokushima, Tokushima, Japan
| | - H Yamada
- University of Tokushima, Tokushima, Japan
| | | | - M Sata
- University of Tokushima, Tokushima, Japan
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16
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Maimaituxun G, Shimabukuro M, Fukuda D, Yagi S, Hirata Y, Iwase T, Matsuura T, Ise T, Kusunose K, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Sata M. 106Gender disparities of distribution of epicardial adipose tissue and its impact on coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Maimaituxun
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - M Shimabukuro
- Fukushima Medical University, Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima, Japan
| | - D Fukuda
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - S Yagi
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - Y Hirata
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - T Iwase
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - T Matsuura
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - T Ise
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - K Kusunose
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - T Tobiume
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - K Yamaguchi
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - H Yamada
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - T Soeki
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - T Wakatsuki
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
| | - M Sata
- Institute of Biomedical Sciences, Tokushima University Graduate School, Department of Cardiovascular Medicine, Tokushima City, Japan
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17
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Ito H, Wakatsuki T, Yamaguchi K, Fukuda D, Kawabata Y, Todoroki T, Matsuura T, Ise T, Kusunose K, Tobiume T, Yagi S, Yamada H, Soeki T, Sata M. P2768Growth of vasa vasorum is associated with local inflammation around coronary plaque in fresh cadavers. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Ito
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - T Wakatsuki
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - K Yamaguchi
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - D Fukuda
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - Y Kawabata
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - T Todoroki
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - T Matsuura
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - T Ise
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - K Kusunose
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - T Tobiume
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - S Yagi
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - H Yamada
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - T Soeki
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
| | - M Sata
- Tokushima University Hospital, Department of Cardiovascular Medicine, Tokushima, Japan
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18
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Saijo Y, Yamada H, Kusunose K, Bando M, Nishio S, Torii Y, Hirata Y, Seno H, Matsuura T, Ise T, Tobiume T, Yamaguchi K, Yagi S, Soeki T, Wakatsuki T, Sata M. A clinical application of preload stress echocardiography for predicting future hemodynamic worsening in patients with early-stage heart failure. Echocardiography 2018; 35:1587-1595. [PMID: 30005132 DOI: 10.1111/echo.14098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM To improve the prognosis of patients with heart failure, risk stratification in their early stage is important. We assessed whether the change in transmitral flow (TMF) velocity pattern during preload augmentation can predict future hemodynamic worsening in early-stage heart failure patients with impaired relaxation TMF pattern. METHODS We designed a prospective cohort study that included 155 consecutive patients with impaired relaxation (IR) pattern at rest. Preload stress echocardiography was achieved using leg-positive pressure (LPP), and changes in TMF pattern during the LPP was observed during baseline echocardiographic examination. The patients whose TMF pattern developed to pseudonormal (PN) pattern throughout the study period were classified into the change to PN group, and patients whose TMF pattern stayed in IR pattern were classified into the stay in IR group. RESULTS The median follow-up period was 17 months. The average age was 68 ± 11 years old, and 97 patients (63%) were male. Among 155 patients, 27 were classified into the change to PN group. A Cox proportional hazard analysis confirmed that the change in the peak atrial systolic TMF velocity during the LPP (ΔA, hazard ratio = 0.58 per 1SD; 95% CI = 0.39-0.88, P = 0.010) was the powerful independent predictor of change into PN pattern. Kaplan-Meier analysis revealed that the patients with ΔA ≤ -7 cm/s had more likely to develop into PN pattern than patients with ΔA > -7 cm/s (P = 0.001). CONCLUSIONS Evaluation of a response in TMF during the LPP might provide an incremental diagnostic value to detect future overt heart failure in patients with early-stage heart failure.
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Affiliation(s)
- Yoshihito Saijo
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Mika Bando
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Susumu Nishio
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yuta Torii
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yukina Hirata
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Hiromitsu Seno
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
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19
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Soeki T, Matsuura T, Tobiume T, Bando S, Matsumoto K, Nagano H, Uematsu E, Kusunose K, Ise T, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Wakatsuki T, Shimabukuro M, Sata M. Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation. Circ J 2018; 82:2253-2258. [PMID: 29848884 DOI: 10.1253/circj.cj-17-0758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The ability to identify risk markers for new-onset atrial fibrillation (AF) is critical to the development of preventive strategies, but it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predicts the onset of AF. In the present study, we evaluated the predictive value of a combined score that includes these parameters. Methods and Results: We retrospectively studied 1,040 patients without AF who underwent both echocardiography and 24-h Holter electrocardiography between May 2005 and December 2010. During a median follow-up period of 68.4 months (IQR, 49.9-93.3 months), we investigated the incidence of new-onset AF. Of the 1,040 patients, 103 (9.9%) developed AF. Patients who developed AF were older than patients who did not. Total heart beats, premature atrial contraction (PAC) count, maximum RR interval, and frequency of sinus pause quantified on 24-h electrocardiography were associated with new-onset AF. LA diameter (LAD) on echocardiography was also associated with the development of AF. On multivariate Cox analysis, age ≥58 years, PAC count ≥80 beats/day, maximum RR interval ≥1.64 s, and LAD ≥4.5 cm were independently associated with the development of AF. The incidence rate of new-onset AF significantly increased as the combined score (i.e., the sum of the risk score determined using hazard ratios) increased. CONCLUSIONS A combined score that includes age, PAC count, maximum RR interval, and LAD could help characterize the risk of new-onset AF.
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Affiliation(s)
- Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Sachiko Bando
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kazuhisa Matsumoto
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hiromi Nagano
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Etsuko Uematsu
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences.,Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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20
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Maimaituxun G, Shimabukuro M, Fukuda D, Yagi S, Hirata Y, Iwase T, Takao S, Matsuura T, Ise T, Kusunose K, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Harada M, Sata M. Local Thickness of Epicardial Adipose Tissue Surrounding the Left Anterior Descending Artery Is a Simple Predictor of Coronary Artery Disease - New Prediction Model in Combination With Framingham Risk Score. Circ J 2018; 82:1369-1378. [PMID: 29563352 DOI: 10.1253/circj.cj-17-1289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Compared with global cardiac adiposity, the local accumulation of fat surrounding coronary arteries might have a more direct impact on coronary artery disease (CAD). Here, we compared the local epicardial adipose tissue (EAT) thickness and global cardiac adiposity volumes for predicting CAD.Methods and Results:A total of 197 consecutive subjects underwent 320-slice multi-detector computed tomography coronary angiography and were segregated into CAD (≥1 coronary artery branch stenosis ≥50%) and non-CAD groups. EAT thickness was measured at the right coronary artery (EATRCA), the left anterior descending artery (EATLAD), and the left circumflex artery (EATLCX). Although EATRCAand EATLCXwere similar between the 2 groups, EATLADwas larger in the CAD group than in the non-CAD group (5.45±2.16 mm vs. 6.86±2.19 mm, P<0.001). EATLAD, after correcting for confounding factors, was strongly associated with CAD (r=0.276, P<0.001) and Gensini score (r=0.239, P<0.001). On multiple regression analysis, Framingham risk score combined with EATLADwas a strong predictor of CAD (adjusted R2=0.121; P<0.001). CONCLUSIONS The local fat thickness surrounding the LAD is a simple and useful surrogate marker for estimating the presence, severity, and extent of CAD, independent of classical cardiovascular risk factors.
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Affiliation(s)
- Gulinu Maimaituxun
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School.,Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Yukina Hirata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takashi Iwase
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Shoichiro Takao
- Department of Diagnostic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Masafumi Harada
- Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
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21
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Yagi S, Aihara KI, Kondo T, Kurahashi K, Yoshida S, Endo I, Fukuda D, Nakaya Y, Suwaki KI, Takeji T, Wada T, Salim HM, Hama S, Matsuura T, Ise T, Kusunose K, Yamaguchi K, Tobiume T, Yamada H, Soeki T, Wakatsuki T, Matsuhisa M, Shimabukuro M, Akaike M, Sata M. Predictors for the Treatment Effect of Sodium Glucose Co-transporter 2 Inhibitors in Patients with Type 2 Diabetes Mellitus. Adv Ther 2018; 35:124-134. [PMID: 29185199 DOI: 10.1007/s12325-017-0639-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Predictors for the effect of sodium glucose co-transporter 2 (SGLT2) inhibitors at lowering hemoglobin A1c (HbA1c) levels in type 2 diabetes mellitus patients remain unclear. We therefore aimed to elucidate these predictors in type 2 diabetes patients after 3 months of SGLT2 treatment. METHODS A total of 302 consecutive type 2 diabetes patients who had been treated with SGLT2 inhibitors as monotherapy or add-on therapy to existing antidiabetic treatments were enrolled retrospectively. After excluding 27 patients whose HbA1c levels could not be evaluated 3 months after treatment, the glucose-lowering effects of SGLT2 inhibitors were assessed in 275 patients by measuring HbA1c levels before and 3 months after treatment. The predictors for changes in HbA1c levels after 3 months of treatment were evaluated. RESULTS SGLT2 inhibitor treatment for 3 months decreased HbA1c levels from 7.8 ± 1.2% to 7.4 ± 1.0% (p < 0.0001). A multiple regression analysis showed that the independent determinants for SGLT2 inhibitor treatment effect included decreased HbA1c levels after 1 month of treatment, high baseline HbA1c levels, and a high estimated glomerular filtration rate (eGFR). CONCLUSION We show that type 2 diabetes patients who received the greatest glucose-lowering effect with SGLT2 inhibitor treatment were those with preserved renal function (high baseline eGFR) and high baseline HbA1c levels. Moreover, SGLT2 inhibitor treatment efficacy could be predicted by the patients' initial response to treatment.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan.
| | - Ken-Ichi Aihara
- Department of Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Kondo
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kiyoe Kurahashi
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Sumiko Yoshida
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Itsuro Endo
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yutaka Nakaya
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan
| | - Kin-Ichiro Suwaki
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan
| | - Takashi Takeji
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan
| | - Toshihiro Wada
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan
| | - Hotimah Masdan Salim
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Saori Hama
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Munehide Matsuhisa
- Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masashi Akaike
- Department of Medical Education, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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22
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Yamazaki H, Yagi S, Torii Y, Amano R, Oomichi Y, Sangawa T, Fukuda D, Kadota M, Ise T, Ueno R, Hara T, Kusunose K, Matsuura T, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Akaike M, Sata M. Edoxaban improves acute venous thromboembolism while preserving protein C and protein S levels. J Cardiol 2017; 71:305-309. [PMID: 29100817 DOI: 10.1016/j.jjcc.2017.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/18/2017] [Revised: 08/23/2017] [Accepted: 09/06/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND It is well known that warfarin inhibits the synthesis of vitamin K-dependent anticoagulants, including thrombin, protein C and S, and factor Xa, leading, paradoxically, to an initial hypercoagulable state. Edoxaban, a direct inhibitor of activated factor X is widely used for the treatment of acute venous thromboembolism (VTE). However, the effect of edoxaban on circulating coagulation factors, in patients with acute VTE, remains unknown. METHODS AND RESULTS We enrolled 57 patients with acute VTE with/without pulmonary embolism treated with edoxaban (n=37) or warfarin (n=20) in a clinical setting. Before treatment and 2 weeks after treatment, we evaluated thrombotic burden using ultrasound or computed tomography angiography. We also evaluated thrombin generation, represented by prothrombin fragment F1+2; thrombus degradation, represented by D-dimer; and levels of anticoagulants, including protein C, protein S, and antithrombin III. Both edoxaban and warfarin treatment improved thrombotic burden and decreased prothrombin fragment F1+2, and D-dimer. Edoxaban treatment preserved protein C and protein S levels. In contrast, warfarin decreased protein C and protein S levels. Neither treatment affected antithrombin III. CONCLUSIONS Edoxaban improves VTE while preserving protein C and protein S levels, thereby indicating that edoxaban improves thrombotic burden while maintaining levels of anticoagulants.
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Affiliation(s)
- Hiromu Yamazaki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan; Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan; Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo-city, Ehime, Japan.
| | - Yuta Torii
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Rie Amano
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yasuyuki Oomichi
- Department of Orthopedics, Shikoku Central Hospital, Shikokuchuo-city, Ehime, Japan
| | - Teruaki Sangawa
- Department of Orthopedics, Shikoku Central Hospital, Shikokuchuo-city, Ehime, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Muneyuki Kadota
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Rie Ueno
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomoya Hara
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masashi Akaike
- Department of Medical Education, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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23
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Bando S, Soeki T, Matsuura T, Tobiume T, Ise T, Kusunose K, Yamaguchi K, Yagi S, Fukuda D, Iwase T, Yamada H, Wakatsuki T, Shimabukuro M, Muguruma N, Takayama T, Kishimoto I, Kangawa K, Sata M. Plasma brain natriuretic peptide levels are elevated in patients with cancer. PLoS One 2017; 12:e0178607. [PMID: 28570595 PMCID: PMC5453551 DOI: 10.1371/journal.pone.0178607] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 09/16/2016] [Accepted: 05/16/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Natriuretic peptides have been proposed as biomarkers of cardiovascular disease, especially heart failure. Brain natriuretic peptide (BNP) has also been shown to be upregulated at the transcriptional and translational levels by pro-inflammatory cytokines in cardiac myocytes. Although we often measure plasma BNP levels in cancer patients, it remains unknown whether cancer-related inflammation affects the plasma BNP levels. We investigated the relationship between the BNP and human cancers. METHODS We retrospectively studied 2,923 patients in whom the plasma BNP levels and serum C-reactive protein (CRP) were measured and echocardiography was performed. Patients with clinically evident heart failure (NYHA II or higher), heart disease requiring medical treatment or surgery, renal dysfunction, and inflammatory disease were excluded. There were 234 patients in the final analysis. Blood sampling was performed before surgery and chemotherapy. In addition, we evaluated the relationship between the inflammation and plasma BNP levels in mouse models of colon cancer. RESULTS Of the 234 patients, 80 were diagnosed with cancer. Both the plasma BNP and serum CRP levels were significantly higher in cancer patients than those without. There were no significant differences in the echocardiographic parameters. There was a significant positive correlation between the plasma BNP and serum CRP levels in cancer patients (r = 0.360, P<0.01) but not in those without. In cancer patients, only the CRP correlated with the BNP independent of the age, creatinine level, hypertension, and body mass index. In addition, in nude mice with subcutaneous colon cancer, the plasma BNP level was elevated compared with that in non-cancer mice, and there was a significant relationship between the plasma BNP and serum levels of the inflammatory markers. CONCLUSIONS In cancer patients, as well as colon cancer model mice, the plasma BNP levels were elevated, possibly due to cancer-related inflammation. The effect of cancer on the BNP levels should be considered when using BNP as an indicator of heart failure in cancer patients.
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Affiliation(s)
- Sachiko Bando
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
- * E-mail:
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takashi Iwase
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Naoki Muguruma
- Department of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Ichiro Kishimoto
- National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Kenji Kangawa
- National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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24
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Yagi S, Hirata Y, Ise T, Kusunose K, Yamada H, Fukuda D, Salim HM, Maimaituxun G, Nishio S, Takagawa Y, Hama S, Matsuura T, Yamaguchi K, Tobiume T, Soeki T, Wakatsuki T, Aihara KI, Akaike M, Shimabukuro M, Sata M. Canagliflozin reduces epicardial fat in patients with type 2 diabetes mellitus. Diabetol Metab Syndr 2017; 9:78. [PMID: 29034006 PMCID: PMC5628447 DOI: 10.1186/s13098-017-0275-4] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 09/19/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND It is unknown whether canagliflozin, a selective sodium glucose co-transporter 2 inhibitor, reduces epicardial adipose tissue (EAT) thickness, which is associated with insulin resistance and is a risk factor for coronary artery disease. METHODS AND RESULTS We administered 100 mg of canagliflozin for 6 months to 13 patients with type 2 diabetes mellitus. We evaluated glycemic control, visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, and skeletal muscle mass by using impedance methods, and EAT thickness by using echocardiography. Canagliflozin treatment for 6 months decreased hemoglobin A1c level from 7.1 ± 0.5% to 6.7 ± 0.6% (P < 0.05) and decreased EAT thickness from 9.3 ± 2.5 to 7.3 ± 2.0 mm (P < 0.001), along with a trend of decreasing VAT and SAT area. No association was found between any of these changes. CONCLUSION Canagliflozin reduced EAT thickness in patients with type 2 diabetes mellitus independent of its effect on lowering blood glucose, suggesting that canagliflozin may have an effect in preventing cardiovascular events in these patients (UMIN000021327).
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime Japan
| | - Yukina Hirata
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hotimah Masdan Salim
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Gulinu Maimaituxun
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Susumu Nishio
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yuriko Takagawa
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Saori Hama
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
| | - Ken-ichi Aihara
- Department of Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masashi Akaike
- Department of Medical Education, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan
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25
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Yagi S, Soeki T, Aihara KI, Fukuda D, Ise T, Kadota M, Bando S, Matsuura T, Tobiume T, Yamaguchi K, Kusunose K, Yamada H, Wakatsuki T, Shimabukuro M, Akaike M, Sata M. Low Serum Levels of Eicosapentaenoic Acid and Docosahexaenoic Acid are Risk Factors for Cardiogenic Syncope in Patients with Brugada Syndrome. Int Heart J 2017; 58:720-723. [DOI: 10.1536/ihj.16-278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences
- Department of Internal Medicine, Shikoku Central Hospital
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Ken-ichi Aihara
- Department of Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Muneyuki Kadota
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Sachiko Bando
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Masashi Akaike
- Departments of Medical Education, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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26
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Takagawa Y, Yagi S, Ise T, Ishii A, Nishikawa K, Fukuda D, Kusunose K, Matsuura T, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Katoh S, Aihara KI, Akaike M, Sata M. Improved Exercise Capacity After Cardiac Rehabilitation Is Associated with Reduced Visceral Fat in Patients with Chronic Heart Failure. Int Heart J 2017; 58:746-751. [DOI: 10.1536/ihj.16-454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 11/18/2022]
Affiliation(s)
- Yuriko Takagawa
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Ayumi Ishii
- Department of Rehabilitation, Tokushima University Hospital
| | - Koji Nishikawa
- Department of Rehabilitation, Tokushima University Hospital
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
- Departments of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Michio Shimabukuro
- Departments of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shinsuke Katoh
- Department of Rehabilitation, Tokushima University Hospital
| | - Ken-ichi Aihara
- Departments of Medical Education Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences
| | - Masashi Akaike
- Departments of Medical Education, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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27
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Takashima A, Yagi S, Yamaguchi K, Watanabe S, Yamamoto N, Ito H, Kadota M, Hara T, Yamazaki H, Ise T, Kusunose K, Tobiume T, Yamada H, Soeki T, Wakatsuki T, Sata M. Purulent Pericarditis Accompanying Pericardial Abscess Induced by Nocardia in an Immunocompromised Patient. Circ J 2016; 80:2409-2411. [PMID: 27628220 DOI: 10.1253/circj.cj-16-0531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Akira Takashima
- Department of Cardiovascular Medicine, Tokushima University Hospital
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28
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Kusunose K, Torii Y, Yamada H, Nishio S, Hirata Y, Seno H, Saijo Y, Ise T, Yamaguchi K, Tobiume T, Yagi S, Soeki T, Wakatsuki T, Sata M. Clinical Utility of Longitudinal Strain to Predict Functional Recovery in Patients With Tachyarrhythmia and Reduced LVEF. JACC Cardiovasc Imaging 2016; 10:118-126. [PMID: 27665160 DOI: 10.1016/j.jcmg.2016.03.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/21/2016] [Accepted: 03/31/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This study sought to assess the time course of presumptive tachycardia-induced cardiomyopathy and the predictors of left ventricular (LV) functional recovery in such patients. BACKGROUND Tachycardia-induced cardiomyopathy is a potentially reversible cardiomyopathy with effective treatment of the tachyarrhythmia. However, cases without improvement of LV systolic function were found occasionally. The diagnosis of tachycardia-induced cardiomyopathy can be challenging, and the role of echocardiographic imaging in the prediction of LV functional recovery is limited. METHODS LV segmental longitudinal strains (LS) were evaluated by 2-dimensional speckle tracking in 71 consecutive patients (65 ± 16 years; 61% men) with tachyarrhythmia and reduced left ventricular ejection fraction (LVEF) without any other known cardiovascular disease, and 30 age and sex-matched control subjects. Relative apical LS ratio (RALSR) was defined using the equation: average apical LS / (average basal LS + average mid LS) as a marker of strain distribution. RESULTS Compared with control subjects, patients with tachyarrhythmia had significantly lower global LS. Improvement in LVEF within 6 months after treatment of index arrhythmia was observed in 41 patients, and LVEF did not improve in 30 patients. In univariate analysis, lower LVEF at baseline (hazard ratio: 0.59 per 1 SD; p = 0.04) and higher RALSR (hazard ratio: 11.2 per 1 SD; p < 0.001) were associated with no recovery in LVEF during follow-up. In a multivariate logistic regression model, the significant predictor of LV systolic functional recovery was RALSR (hazard ratio: 22.9 per 1 SD; p = 0.001). A RALSR of 0.61 was sensitive (71%) and specific (90%) in differentiating LV systolic functional recovery (area under the curve: 0.88). CONCLUSIONS The RALSR was associated with LV systolic functional recovery. This information might be useful for clinical evaluation and follow-up in patients with reduced LVEF.
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Affiliation(s)
- Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Yuta Torii
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
| | - Susumu Nishio
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Yukina Hirata
- Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan
| | - Hiromitsu Seno
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Yoshihito Saijo
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
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29
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Tobiume T, Kotani Y, Takaya H, Nakai H, Tsuji I, Suzuki A, Mandai M. Determinant factors of postoperative recurrence of endometriosis: difference between endometrioma and pain. Eur J Obstet Gynecol Reprod Biol 2016; 205:54-9. [PMID: 27566223 DOI: 10.1016/j.ejogrb.2016.07.516] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/21/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Although the postoperative use of hormonal treatment for endometriosis is recommended in the European Society of Human Reproduction and Embryology guidelines to prevent the recurrence of endometriosis-associated dysmenorrhoea, hormonal treatment may not be necessary for all patients who undergo surgical treatment for endometriosis. The aim of this study was to clarify the determinant factors that predict the recurrence of endometriosis after surgery in order to develop personalized hormonal treatment recommendations. Factors associated with the recurrence of endometrioma and pain were investigated independently to identify the likelihood of recurrence in each individual patient. STUDY DESIGN Between 2008 and 2013, 352 patients underwent surgery and were diagnosed with endometriosis based on pathological findings at the study hospital. Among these patients, 191 experienced a recurrence of endometrioma in the absence of pre- or postoperative hormonal treatment. Various clinical factors such as pre-operative pain, intra-operative findings and postoperative improvement of pain were compared between patients who experienced recurrence after surgery and those who did not. RESULTS The cumulative 5-year recurrence rate of endometrioma was 28.7% among the 191 patients who did not undergo pre- or postoperative hormonal treatment. Significant differences were detected in maximum tumour diameter, revised American Society for Reproductive Medicine score (r-ASRM score), operative time and operative blood loss between patients in the recurrent endometrioma group and the non-recurrent endometrioma group; only the r-ASRM score was significantly correlated with recurrence of endometrioma in the multivariate analysis. The cumulative 5-year rate of persistent/recurrent pain was 33.4%. There were significant differences in the postoperative improvement of pain between the persistent/recurrent pain group and the non-recurrent pain group according to the univariate and multivariate analyses. CONCLUSION This study suggests that the risk factors for recurrence of endometrioma differ from the risk factors for recurrence of pain. The use of postoperative hormonal treatment should be considered based on the dominant risk factors and needs of each patient.
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Affiliation(s)
- T Tobiume
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan.
| | - Y Kotani
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan
| | - H Takaya
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan
| | - H Nakai
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan
| | - I Tsuji
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan
| | - A Suzuki
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan
| | - M Mandai
- Department of Obstetrics and Gynaecology, Kinki University Faculty of Medicine, Osaka, Japan.
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30
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Takashima A, Yagi S, Yamaguchi K, Takagi E, Kanbara T, Ogawa H, Ise T, Kusunose K, Tobiume T, Yamada H, Soeki T, Wakatsuki T, Kitagawa T, Sata M. Vegetation in the coronary sinus that concealed the presence of a coronary arteriovenous fistula in a patient with infectious endocarditis. Int J Cardiol 2016; 207:266-8. [PMID: 26808990 DOI: 10.1016/j.ijcard.2016.01.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/02/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Akira Takashima
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Eri Takagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tamotsu Kanbara
- Department of Cardiovascular Surgery, Tokushima University Hospital, Tokushima, Japan
| | - Hirohisa Ogawa
- Department of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuya Kitagawa
- Department of Cardiovascular Surgery, Tokushima University Hospital, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
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31
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Yagi S, Aihara KI, Fukuda D, Takashima A, Bando M, Hara T, Nishimoto S, Ise T, Kusunose K, Yamaguchi K, Tobiume T, Iwase T, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Akaike M, Sata M. Erratum to: ‘Reduced ratio of eicosapentaenoic acid and docosahexaenoic acid to arachidonic acid is associated with early onset of acute coronary syndrome’. Nutr J 2015; 14:121. [PMID: 26626412 PMCID: PMC4666085 DOI: 10.1186/s12937-015-0112-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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32
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Bando S, Fukuda D, Soeki T, Nishimoto S, Uematsu E, Matsuura T, Ise T, Tobiume T, Yamaguchi K, Yagi S, Iwase T, Yamada H, Wakatsuki T, Shimabukuro M, Sata M. Corrigendum to “Expression of NLRP3 in subcutaneous adipose tissue is associated with coronary atherosclerosis” [Atherosclerosis 242 (2) (2015) 407–414]. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.10.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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33
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Kaneko Y, Naito S, Okishige K, Morishima I, Tobiume T, Nakajima T, Irie T, Ota M, Iijima T, Iizuka T, Tamura M, Tamura S, Saito A, Igawa O, Kato R, Matsumoto K, Suzuki F, Kurabayashi M. Atypical Fast-Slow Atrioventricular Nodal Reentrant Tachycardia Incorporating a "Superior" Slow Pathway: A Distinct Supraventricular Tachyarrhythmia. Circulation 2015; 133:114-23. [PMID: 26541829 DOI: 10.1161/circulationaha.115.018443] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/29/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The existence of an atypical fast-slow (F/S) atrioventricular nodal reentrant tachycardia (AVNRT) including a superior (sup) pathway with slow conductive properties and an atrial exit near the His bundle has not been confirmed. METHODS AND RESULTS We studied 6 women and 2 men (age, 74 ± 7 years) with sup-F/S-AVNRT who underwent successful radiofrequency ablation near the His bundle. Programmed ventricular stimulation induced retrograde conduction over a superior SP with an earliest atrial activation near the His bundle, a mean shortest spike-atrial interval of 378 ± 119 milliseconds, and decremental properties in all patients. sup-F/S-AVNRT was characterized by a long-RP interval; a retrograde atrial activation sequence during tachycardia identical to that over a sup-SP during ventricular pacing; ventriculoatrial dissociation during ventricular overdrive pacing of the tachycardia in 5 patients or atrioventricular block occurring during tachycardia in 3 patients, excluding atrioventricular reentrant tachycardia; termination of the tachycardia by ATP; and a V-A-V activation sequence immediately after ventricular induction or entrainment of the tachycardia, including dual atrial responses in 2 patients. Elimination or modification of retrograde conduction over the sup-SP by ablation near the right perinodal region or from the noncoronary cusp of Valsalva eliminated and confirmed the diagnosis of AVNRT in 4 patients each. CONCLUSIONS sup-F/S-AVNRT is a distinct supraventricular tachycardia, incorporating an SP located above the Koch triangle as the retrograde limb, that can be eliminated by radiofrequency ablation.
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Affiliation(s)
- Yoshiaki Kaneko
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.).
| | - Shigeto Naito
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Kaoru Okishige
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Itsuro Morishima
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Takeshi Tobiume
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Tadashi Nakajima
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Tadanobu Irie
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Masaki Ota
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Takafumi Iijima
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Takashi Iizuka
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Mio Tamura
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Shuntaro Tamura
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Akihiro Saito
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Osamu Igawa
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Ritsushi Kato
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Kazuo Matsumoto
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Fumio Suzuki
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
| | - Masahiko Kurabayashi
- From Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Japan (Y.K., T.N., T.I., M.O., T.I., T.I., M.T., S.T., A.S., M.K.); Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan (S.N.); Heart Center, Yokohama-City Bay Red Cross Hospital, Japan (K.O.); Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan (I.M.); Department of Cardiology, Tokushima University, Japan (T.T.); Division of Cardiology, International Medical Center, Saitama Medical University, Hidaka, Japan (T.T., R.K., K.M.); Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan (O.I.); and Department of Cardiology, Fukujuji Hospital, Kiyose, Tokyo, Japan (F.S.)
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Yagi S, Aihara KI, Fukuda D, Takashima A, Bando M, Hara T, Nishimoto S, Ise T, Kusunose K, Yamaguchi K, Tobiume T, Iwase T, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Akaike M, Sata M. Reduced ratio of eicosapentaenoic acid and docosahexaenoic acid to arachidonic acid is associated with early onset of acute coronary syndrome. Nutr J 2015; 14:111. [PMID: 26514181 PMCID: PMC4627394 DOI: 10.1186/s12937-015-0102-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 10/12/2015] [Indexed: 11/25/2022] Open
Abstract
Background The hospitalization rate for acute coronary syndrome (ACS) for people aged ≤50 has remained stable over the past decade. Increased serum levels of n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are associated with a decreased incidence of cardiovascular events and mortality in older patients; however, it is currently unknown whether reduced serum levels of n-3 PUFAs is also a risk factor for ACS in patients aged ≤50 years. Methods and results We retrospectively reviewed 102 (male/ female 73/29) Japanese ACS patients whose serum levels of EPA/arachidonic acid (AA) and DHA/AA were evaluated on admission. The EPA/AA ratio was the lowest in patients aged ≤50 compared to patients aged 51–74 and ≥75. Pearson correlation analysis showed that early ACS onset was associated with low EPA/AA and DHA/AA ratios, and multiple regression analysis determined that decreased ratios of EPA/AA and DHA/AA, and male sex, current smoker status, increased body mass index and triglyceride levels, independently correlated with early ACS onset. Conversely, low-density and high-density lipoproteins, glycated hemoglobin, and hypertension did not correlate with early ACS onset. Subgroup analyses of male patients revealed that decreased ratios of EPA/AA and DHA/AA independently correlated with early ACS onset. Conclusion Decreased EPA/AA and DHA/AA ratios may be risk factors for early onset of ACS, suggesting that reduced EPA/AA and DHA/AA may represent targets for preventing ACS in Japanese young people. Electronic supplementary material The online version of this article (doi:10.1186/s12937-015-0102-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Ken-ichi Aihara
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Akira Takashima
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Mika Bando
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Tomoya Hara
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Sachiko Nishimoto
- Department of Nutrition and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Takashi Iwase
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Masashi Akaike
- Department of Medical Education, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
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35
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Kaneko Y, Kato ‘R, Nakahara S, Tobiume T, Morishima I, Tanaka K, Nakajima T, Irie T, Kusano KF, Kamakura S, Nagase T, Takayanagi K, Matsumoto K, Kurabayashi M. Characteristics and Catheter Ablation of Focal Atrial Tachycardia Originating From the Interatrial Septum. Heart Lung Circ 2015; 24:988-95. [DOI: 10.1016/j.hlc.2015.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/20/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
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36
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Bando S, Fukuda D, Soeki T, Nishimoto S, Uematsu E, Matsuura T, Ise T, Tobiume T, Yamaguchi K, Yagi S, Iwase T, Yamada H, Wakatsuki T, Shimabukuro M, Sata M. Expression of NLRP3 in subcutaneous adipose tissue is associated with coronary atherosclerosis. Atherosclerosis 2015; 242:407-14. [DOI: 10.1016/j.atherosclerosis.2015.07.043] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 12/16/2022]
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37
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Kusunose K, Hotchi J, Takagawa Y, Nishio S, Ise T, Tobiume T, Yamaguchi K, Yagi S, Iwase T, Yamada H, Soeki T, Wakatsuki T, Sata M. Serial imaging changes during treatment of immunoglobulin G4-related disease with multiple pseudotumors. Circulation 2015; 131:1882-3. [PMID: 26015466 DOI: 10.1161/circulationaha.115.015638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kenya Kusunose
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
| | - Junko Hotchi
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Yuriko Takagawa
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Susumu Nishio
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takayuki Ise
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Tobiume
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Koji Yamaguchi
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Shusuke Yagi
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takashi Iwase
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Hirotsugu Yamada
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Takeshi Soeki
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Masataka Sata
- From Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
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Yamazaki H, Yamaguchi K, Soeki T, Wakatsuki T, Niki T, Taketani Y, Kitaoka A, Kusunose K, Ise T, Tobiume T, Yagi S, Iwase T, Yamada H, Sata M. Impact of Indoxyl Sulfate, a Uremic Toxin, on Non-Culprit Coronary Plaque Composition Assessed on Integrated Backscatter Intravascular Ultrasound. Circ J 2015; 79:1773-9. [PMID: 25971408 DOI: 10.1253/circj.cj-15-0019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Uremic toxin has emerged as an important determinant of cardiovascular risk. The aim of this study was to examine the relationship between serum uremic toxin and coronary plaque composition on integrated backscatter intravascular ultrasound (IB-IVUS). METHODS AND RESULTS IB-IVUS was performed in 47 patients with planned treatment for angina pectoris. Non-culprit intermediate plaque analyzed in this study had to be >5 mm apart from the intervention site. 3-D IB-IVUS analysis was performed to determine percent lipid volume (LV) and fibrous volume (FV). We also measured serum uremic toxins (indoxyl sulfate [IS], asymmetric dimethylarginine [ADMA], and p-cresol [PC]). Glomerular filtration rate correlated with IS (r=-0.329, P=0.04), but did not correlate with ADMA or PC. Percent LV correlated with IS (r=0.365, P=0.02), but did not correlate with ADMA or PC. Percent FV also correlated with IS (r=-0.356, P=0.03), but did not correlate with ADMA or PC. On multivariate regression, only IS was associated with percent LV (r=0.359, P=0.04) and percent FV (r=-0.305, P=0.04) independently of potentially confounding coronary risk factors. CONCLUSIONS Among the uremic toxins, serum IS might be a novel useful biomarker to detect and monitor lipid-rich coronary plaque on IB imaging.
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Affiliation(s)
- Hiromu Yamazaki
- Department of Cardiovascular Medicine, Tokushima University Hospital
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Yagi S, Takashima A, Mitsugi M, Wada T, Hotchi J, Aihara KI, Hara T, Ishida M, Fukuda D, Ise T, Yamaguchi K, Tobiume T, Iwase T, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Akaike M, Sata M. Effect of combination tablets containing amlodipine 10 mg and irbesartan 100 mg on blood pressure and cardiovascular risk factors in patients with hypertension. Ther Clin Risk Manag 2015; 11:83-8. [PMID: 25624765 PMCID: PMC4296916 DOI: 10.2147/tcrm.s72299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Hypertension is one of the major risk factors for cardiovascular and cerebrovascular disease and mortality. Patients who receive insufficient doses of antihypertensive agents or who are poorly adherent to multidrug treatment regimens often fail to achieve adequate blood pressure (BP) control. The aim of this study was to determine the efficacy of an angiotensin II receptor blocker (ARB) and calcium channel blocker (CCB) combination tablet containing a regular dose of irbesartan (100 mg) and a high dose of amlodipine (10 mg) with regard to lowering BP and other risk factors for cardiovascular disease. Methods We retrospectively evaluated data from 68 patients with essential hypertension whose treatment regimen was changed either from combination treatment with an independent ARB and a low-dose or regular-dose CCB or from a combination tablet of ARB and a low-dose or regular-dose CCB to a combination tablet containing amlodipine 10 mg and irbesartan 100 mg, because of incomplete BP control. Previous treatments did not include irbesartan as the ARB. Results The combination tablet decreased systolic and diastolic BP. In addition, it significantly decreased serum uric acid, low-density lipoprotein cholesterol, and increased high-density lipoprotein cholesterol levels, independent of the BP-lowering effect. Treatment with the combination tablet did not affect serum triglycerides, plasma glucose, glycated hemoglobin, serum potassium or creatinine levels, or the urinary albumin excretion rate. Conclusion The combination tablet containing amlodipine 10 mg and irbesartan 100 mg had a greater BP-lowering effect than an ARB and a low-dose or regular-dose CCB. In addition, the combination tablet had more favorable effects on serum uric acid, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels in patients with hypertension.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Akira Takashima
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Minoru Mitsugi
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Japan
| | - Toshihiro Wada
- Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Japan
| | - Junko Hotchi
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Ken-Ichi Aihara
- Department of Medicine and Bioregulatory Sciences, University of Tokushima, Tokushima, Japan
| | - Tomoya Hara
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Masayoshi Ishida
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, University of Tokushima, Tokushima, Japan
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Takashi Iwase
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, University of Tokushima, Tokushima, Japan
| | - Masashi Akaike
- Department of Medical Education, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Graduate School of Health Biosciences, University of Tokushima, Tokushima, Japan
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Kinoshita H, Tanaka N, Jamal M, Kumihashi M, Takakura A, Tobiume T, Tsutsui K, Ameno K. A fatal case of poisoning with ethanol and psychotropic drugs with putrefactive changes. Soud Lek 2015; 60:25-27. [PMID: 25971230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We present a fatal case involving poisoning with paroxetine, flunitrazepam, and ethanol, with putrefactive changes. Quantitative toxicological analysis showed that the concentrations of paroxetine and 7-aminoflunitrazepam, a metabolite of flunitrazepam, in the femoral blood were 0.28 µg/ml and 0.17 µg/ml, respectively. We also detected an ethanol level of 2.90 mg/ml and an n-propanol level of 0.10 mg/ml. We concluded that the cause of death was due to the interaction of paroxetine, flunitrazepam, and ethanol. The effects of putrefactive changes should be considered during forensic toxicological evaluation.
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Soeki T, Yamaguchi K, Niki T, Uematsu E, Bando S, Matsuura T, Ise T, Kusunose K, Hotchi J, Tobiume T, Yagi S, Fukuda D, Taketani Y, Iwase T, Yamada H, Wakatsuki T, Shimabukuro M, Sata M. Plasma microRNA-100 is associated with coronary plaque vulnerability. Circ J 2014; 79:413-8. [PMID: 25519160 DOI: 10.1253/circj.cj-14-0958] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although numerous studies have reported altered plasma levels of various microRNAs (miRNAs) in patients with cardiovascular disease, there are no data on the relationship between plasma miRNAs and vulnerable coronary plaque. In this study, we investigated whether plasma miRNAs might be a sensitive marker of coronary plaque vulnerability. METHODS AND RESULTS Integrated backscatter intravascular ultrasound (IB-IVUS) was performed in 32 consecutive patients with angina pectoris who underwent percutaneous coronary intervention. Three-dimensional analysis of IB-IVUS was performed to determine the percentage of lipid volume (%LV) and fibrous volume (%FV). Circulating miRNAs were measured in EDTA-plasma simultaneously obtained from the aorta and the coronary sinus (CS). Muscle-enriched (miR-133a, miR-208a, miR-499), vascular-enriched (miR-92a, miR-100, miR-126, miR-127, miR-145), and myeloid cell-enriched miRNAs (miR-155, miR-223) were measured. Plasma miR-100 was higher in the CS than in the aorta, but there were no significant differences in the levels of other miRNAs between the aorta and CS. Plasma miR-100 in the aorta was positively correlated with %LV (r=0.48, P<0.01) and negatively correlated with %FV (r=-0.41, P<0.05). Importantly, transcoronary concentration gradient of circulating miR-100 was more strongly correlated with %LV (r=0.53, P<0.01) and %FV (r=-0.56, P<0.01). CONCLUSIONS miR-100 might be released into the coronary circulation from vulnerable coronary plaques. This study provides insights into the role of miRNAs in coronary atherosclerotic disease.
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Affiliation(s)
- Takeshi Soeki
- Department of Cardiovascular Medicine, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
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Yagi S, Hara T, Ueno R, Aihara KI, Fukuda D, Takashima A, Hotchi J, Ise T, Yamaguchi K, Tobiume T, Iwase T, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Akaike M, Sata M. Serum concentration of eicosapentaenoic acid is associated with cognitive function in patients with coronary artery disease. Nutr J 2014; 13:112. [PMID: 25471307 PMCID: PMC4391466 DOI: 10.1186/1475-2891-13-112] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 11/06/2014] [Indexed: 11/17/2022] Open
Abstract
Background Recent studies have shown that intake of n-3 polyunsaturated fatty acids (PUFAs) is associated with reduced risk of cognitive impairment and coronary artery disease (CAD); however, it is currently unknown whether reduced serum n-3 PUFA is associated with cognitive impairment in patients with CAD. Methods We retrospectively evaluated cognitive function with the mini-mental state examination (MMSE), serum levels of PUFAs (including eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], dihomogammalinolenic acid [DGLA], and arachidonic acid [AA]), cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, cerebrovascular disease, and history of current/previous smoking), and parameters of cardiac function (left ventricular ejection fraction and brain natriuretic peptide levels) in 146 Japanese CAD patients. The associations between the MMSE scores and the other parameters were evaluated. Results Pearson correlation analysis showed that EPA (R = 0.25, P <0.01), EPA/AA ratio (R = 0.22, P = 0.01), and left ventricular ejection fraction (R = 0.15, P = 0.04) were positively associated with MMSE score, and that age (R = −0.20, P <0.01) and brain natriuretic peptide levels (R = −0.28, P <0.01) were inversely associated with MMSE score. Multiple regression analysis showed that age (P <0.05) was negatively associated with MMSE score, while EPA (P <0.01) and EPA/AA ratio (P <0.05) were positively associated with MMSE score; however, sex; body mass index; left ventricular ejection fraction; levels of DHA, AA, and DGLA; DHA/AA ratio; brain natriuretic peptide; and presence of hypertension, dyslipidemia, diabetes mellitus, cerebrovascular disease, and history of current/previous smoking were statistically excluded. Conclusions Serum EPA concentration is associated with cognitive function in patients with CAD, suggesting that a low serum EPA level is a risk factor for cognitive impairment independent of cardiac function, including left ventricular ejection fraction. This correlation potentially lends further support to a role of dietary n-3 PUFAs in preventing the cognitive decline in CAD patients. Electronic supplementary material The online version of this article (doi:10.1186/1475-2891-13-112) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Tomoya Hara
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Rie Ueno
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Ken-ichi Aihara
- Department of Medicine and Bioregulatory Sciences, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Akira Takashima
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Junko Hotchi
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Takayuki Ise
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Takashi Iwase
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Masashi Akaike
- Department of Medical Education, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
| | - Masataka Sata
- Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan.
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Yagi S, Aihara KI, Fukuda D, Takashima A, Hara T, Hotchi J, Ise T, Yamaguchi K, Tobiume T, Iwase T, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Akaike M, Sata M. Effects of docosahexaenoic Acid on the endothelial function in patients with coronary artery disease. J Atheroscler Thromb 2014; 22:447-54. [PMID: 25342567 DOI: 10.5551/jat.26914] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The consumption of n-3 polyunsaturated fatty acids (PUFA), including docosahexaenoic acid DHA), reduces the incidence of cardiovascular events, and reduced serum levels of n-3 PUFA may be associated with an increased risk of cardiovascular events. However, controversy remains regarding which components of PUFA are associated with the endothelial function in patients with coronary artery disease (CAD). We therefore examined the associations between the n-3 and n-6 PUFA levels and CAD. METHODS We retrospectively reviewed 160 consecutive Japanese patients with CAD whose endothelial function was measured according to the percent change in flow-mediated dilation (FMD) and the serum levels of n-3 PUFA, including eicosapentaenoic acid (EPA) and DHA, and n-6 PUFA, including arachidonic acid (AA) and dihomo-gamma-linolenic acid (DHLA). RESULTS A single regression analysis showed no relationships between the FMD and the serum levels of PUFA, including EPA, DHA, AA and DHLA. In contrast, a multiple regression analysis showed that the DHA level was a positive (< 0.01) and age was a negative (P < 0.001) contributor to an increased FMD; however, sex, body mass index, systolic and diastolic blood pressure, current/past smoking and the levels of HbA1c, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, EPA, AA and DHLA did not significantly affect the outcome. CONCLUSIONS The serum level of DHA is associated with the endothelial function evaluated according to the FMD in patients with CAD, thus suggesting that a low serum level of DHA may be a predictive biomarker for endothelial dysfunction.
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Affiliation(s)
- Shusuke Yagi
- Department of Cardiovascular Medicine, University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan
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Shiota M, Kotani Y, Umemoto M, Tobiume T, Hoshiai H. Estimation of preoperative uterine weight in uterine myoma and uterine adenomyosis. Asian J Endosc Surg 2012; 5:123-5. [PMID: 22776415 DOI: 10.1111/j.1758-5910.2011.00130.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 10/19/2011] [Accepted: 12/06/2011] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Uterine myoma and uterine adenomyosis frequently occur in sexually mature women. Total hysterectomy is the treatment of choice when the symptoms are severe. To select an operative procedure from abdominal, vaginal, and laparoscopic methods, precise estimation of the preoperative uterine weight is desired. In this study, we estimated the preoperative uterine weight with preoperative images in cases of uterine myoma and uterine adenomyosis. METHODS We evaluated 403 patients with uterine myoma or uterine adenomyosis (uterus < 1000 g) between 1996 and 2010. All patients underwent a preoperative MRI and received a hysterectomy with the uterine weight recorded. Based on MR images, we measured (in centimeters) the maximum longitudinal diameter in the sagittal section (a), the maximum lateral diameter (b) and the maximum longitudinal diameter in the transverse section (c) of each uterus. A correlation coefficient was calculated between the weight of the removed uterus and the value of a × b × c for each individual uterus. Also, a regression analysis was performed between x (the value of a × b × c) and y (weight of the removed uterus). RESULTS A strong correlation was shown between the weight of the removed uterus and the value of a × b × c (r = 0.81, P < 0.01). As a result of the regression analysis, the regression equation y = 0.35x + 107 (R(2) = 0.66, P < 0.01) was obtained. CONCLUSION In this study, the estimated weight of the uterus was calculated by the formula y = 0.35x + 107 (x = a × b × c), and this could be the determining factor in choosing a surgical method for hysterectomy.
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Affiliation(s)
- M Shiota
- Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osakasayama, Japan.
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Shiota M, Kotani Y, Umemoto M, Tobiume T, Hoshiai H. Incidence of complications in patients with benign gynecological diseases by BMI and level of complexity of laparoscopic surgery. Asian J Endosc Surg 2012; 5:17-20. [PMID: 22776337 DOI: 10.1111/j.1758-5910.2011.00103.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 06/25/2011] [Accepted: 07/07/2011] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Laparoscopic surgery has become a standard surgical method for benign gynecological diseases, but the technique can still be accompanied, albeit infrequently, by intraoperative or postoperative complications. It has been postulated that the frequency of complications differs according to patient body habitus or surgical challenge level. We evaluated the relationship between the complication rate at different levels of surgery and BMI in patients with benign gynecological diseases who have undergone laparoscopic surgery at our hospital. METHODS A total of 3231 patients who underwent laparoscopic surgery between 1989 and 2010 were enrolled in this study retrospectively. They were classified into four groups by surgery level (diagnostic laparoscopy or minor, major, or advanced laparoscopic surgery). At each challenge level, patients were classified into three groups based on BMI (as defined by the WHO): A group (underweight), BMI < 18.5; B group (healthy), BMI ≥ 18.5 and < 25; and C group (overweight), BMI ≥ 25. We compared the complication rates between the groups at each level of surgical challenge. RESULTS There was no difference in the complication rate between groups A, B and C at any of the surgical challenge levels. However, at the higher surgical difficulty levels, a higher incidence of overall complications was observed. CONCLUSION The complication rate differs between surgical levels, and complications can occur in any type of surgery, irrespective of the body habitus of the patient. The complication rate is higher when difficult surgical methods are employed, and extra caution is needed.
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Affiliation(s)
- M Shiota
- Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka, Japan.
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Erdem A, Gölcük E, Küçükdurmaz Z, Kato R, Hara M, Tobiume T, Ishida H, Uenishi M, Ishizuka Y, Komiyama N, Nishimura S, Matsumoto K. Novel method to evaluate the conduction velocity and conducting area during isthmus-dependent atrial flutter. Anadolu Kardiyol Derg 2011; 11:711-6. [PMID: 22088859 DOI: 10.5152/akd.2011.193] [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: 11/22/2022]
Abstract
OBJECTIVE The difference of the conduction velocity (CV) around the tricuspid valve annulus between the counter-clockwise (CCW) atrial flutter and the clockwise (CW) atrial flutter has not been well clarified. This study was undertaken to evaluate the CV and the conducting area (CA) per millisecond around the tricuspid valve annulus using the electroanatomical mapping. METHODS The electroanatomical mapping was performed during the tachycardia for 30 consecutive patients (mean age: 61±16 years) with isthmus-dependent atrial flutter (CCW, 25; CW, 5). We measured the CV and the CA of five divided areas of the right atrium, that is, upper septum (US), lower septum (LS), isthmus (I), upper lateral wall (UL) and lower lateral wall (LL) using the novel measurement method in the isochronal map. Statistical differences of these data between the two groups were assessed by the Student's t-test and one-way analysis of variance methods. RESULTS In total, the CV of the LS was significantly slower than other areas (m/sec: US, 0.57±0.18; LS, 0.43±0.18; UL, 0.60±0.26; LL, 0.53±0.20; I, 0.50±0.17; p<0.05) and the CA of the US and UL were significantly larger than other areas (mm2/sec: US, 34.5±16.2; LS, 16.2±9.5; UL, 40.0±14.1; LL, 27.0±17.0; I, 16.8±8.5; p<0.0001). There was no significant difference between the CCW and the CW atrial flutters in terms of the CV and the CA of equally divided five areas. CONCLUSION In both of the CCW and the CW atrial flutters, the CV of the LS was significantly slower than other areas and the CA of the lower atrium was significantly smaller than the upper atrium.
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Affiliation(s)
- Alim Erdem
- Department of Cardiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Shiota M, Kotani Y, Umemoto M, Tobiume T, Shimaoka M, Hoshiai H. Total abdominal hysterectomy versus laparoscopically-assisted vaginal hysterectomy versus total vaginal hysterectomy. Asian J Endosc Surg 2011; 4:161-5. [PMID: 22776300 DOI: 10.1111/j.1758-5910.2011.00104.x] [Citation(s) in RCA: 11] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION While total abdominal hysterectomy (TAH) and total vaginal hysterectomy (TVH) are conventional procedures, we have actively introduced laparoscopically-assisted vaginal hysterectomy (LAVH) since its advent. This study was the first attempt to retrospectively compare the surgical results, including invasiveness, among the three methods of performing a hysterectomy. METHODS The subjects included 1181 patients who underwent total hysterectomies (TAH, n=465; LAVH, n=629; TVH, n=87) due to uterine fibroids or uterine adenomyosis at our hospital between January 1995 and December 2009. The mean age, parity, weight of the removed uterus, operative time, blood loss, rates of intra- and post-operative complications, length of post-operative hospital stay, leukocyte count, and CRP and hemoglobin levels were compared. RESULTS The operative time was significantly longer in the LAVH group than the other two groups. Blood loss was significantly greater in the TAH group than the LAVH and TVA groups. The rates of intra- and post-operative complications were significantly higher in the TAH group than the LAVH group. The CRP level and leukocyte count were significantly lower in the LAVH group than the TAH and TVH groups. CONCLUSION LAVH can be applied to nulligravidas or patients with relatively large uteri and it is proved less invasive than TAH and TVH in this study. We recommend active application of LAVH.
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Affiliation(s)
- M Shiota
- Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka, Japan.
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Hara M, Matsumoto K, Kato R, Tobiume T, Ishida H, Uenishi M, Sada Y, Jo H, Ono Y, Yanagihara K. Contribution of the Posterior Left Atrium for the Maintenance of Atrial Fibrillation: Lessons from “Figure-of-Eight” Ablation. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.op51_3] [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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Tobiume T, Matsumoto K, Ishida H, Kato R, Nishimura S. New Pacing Method for Estimating the Entrance of the Antegrade Fast Pathway. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.op33_2] [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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Jo H, Hara M, Kato R, Tobiume T, Ishida H, Uenishi M, Sada Y, Ono Y, Yanagihara K, Matsumoto K. Two Different Mechanisms for the Transition from Fast/Slow to Slow/Slow Atrioventricular Nodal Reentrant Tachycardia. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj1_112] [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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