1
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Hirose S, Makiyama T, Melgari D, Yamamoto Y, Wuriyanghai Y, Yokoi F, Nishiuchi S, Harita T, Hayano M, Kohjitani H, Gao J, Kashiwa A, Nishikawa M, Wu J, Yoshimoto J, Chonabayashi K, Ohno S, Yoshida Y, Horie M, Kimura T. Propranolol Attenuates Late Sodium Current in a Long QT Syndrome Type 3-Human Induced Pluripotent Stem Cell Model. Front Cell Dev Biol 2020; 8:761. [PMID: 32903469 PMCID: PMC7438478 DOI: 10.3389/fcell.2020.00761] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/20/2020] [Indexed: 01/28/2023] Open
Abstract
Background Long QT syndrome type 3 (LQT3) is caused by gain-of-function mutations in the SCN5A gene, which encodes the α subunit of the cardiac voltage-gated sodium channel. LQT3 patients present bradycardia and lethal arrhythmias during rest or sleep. Further, the efficacy of β-blockers, the drug used for their treatment, is uncertain. Recently, a large multicenter LQT3 cohort study demonstrated that β-blocker therapy reduced the risk of life-threatening cardiac events in female patients; however, the detailed mechanism of action remains unclear. Objectives This study aimed to establish LQT3-human induced pluripotent stem cells (hiPSCs) and to investigate the effect of propranolol in this model. Method An hiPSCs cell line was established from peripheral blood mononuclear cells of a boy with LQT3 carrying the SCN5A-N1774D mutation. He had suffered from repetitive torsades de pointes (TdPs) with QT prolongation since birth (QTc 680 ms), which were effectively treated with propranolol, as it suppressed lethal arrhythmias. Furthermore, hiPSCs were differentiated into cardiomyocytes (CMs), on which electrophysiological functional assays were performed using the patch-clamp method. Results N1774D-hiPSC-CMs exhibited significantly prolonged action potential durations (APDs) in comparison to those of the control cells (N1774D: 440 ± 37 ms vs. control: 272 ± 22 ms; at 1 Hz pacing; p < 0.01). Furthermore, N1774D-hiPSC-CMs presented gain-of-function features: a hyperpolarized shift of steady-state activation and increased late sodium current compared to those of the control cells. 5 μM propranolol shortened APDs and inhibited late sodium current in N1774D-hiPSC-CMs, but did not significantly affect in the control cells. In addition, even in the presence of intrapipette guanosine diphosphate βs (GDPβs), an inhibitor of G proteins, propranolol reduced late sodium current in N1774D cells. Therefore, these results suggested a unique inhibitory effect of propranolol on late sodium current unrelated to β-adrenergic receptor block in N1774D-hiPSC-CMs. Conclusion We successfully recapitulated the clinical phenotype of LQT3 using patient-derived hiPSC-CMs and determined that the mechanism, by which propranolol inhibited the late sodium current, was independent of β-adrenergic receptor signaling pathway.
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Affiliation(s)
- Sayako Hirose
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Dario Melgari
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.,Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
| | - Yuta Yamamoto
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yimin Wuriyanghai
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumika Yokoi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Suguru Nishiuchi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Harita
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hirohiko Kohjitani
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jingshan Gao
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Asami Kashiwa
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Misato Nishikawa
- Center for iPS Cell Research and Application (CiRA), Institute for Integrated Cell-Material Sciences, Kyoto University, Kyoto, Japan
| | - Jie Wu
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.,Department of Pharmacology, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Jun Yoshimoto
- Department of Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Kazuhisa Chonabayashi
- Center for iPS Cell Research and Application (CiRA), Institute for Integrated Cell-Material Sciences, Kyoto University, Kyoto, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshinori Yoshida
- Center for iPS Cell Research and Application (CiRA), Institute for Integrated Cell-Material Sciences, Kyoto University, Kyoto, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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2
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Sonoda K, Ohno S, Ozawa J, Hayano M, Hattori T, Kobori A, Yahata M, Aburadani I, Watanabe S, Matsumoto Y, Makiyama T, Horie M. Copy number variations of SCN5A in Brugada syndrome. Heart Rhythm 2018; 15:1179-1188. [PMID: 29574140 DOI: 10.1016/j.hrthm.2018.03.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 08/31/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Loss-of-function mutations in SCN5A are associated in ∼20% of Brugada syndrome (BrS) patients. Copy number variations (CNVs) have been shown to be associated with several inherited arrhythmia syndromes. OBJECTIVE The purpose of this study was to investigate SCN5A CNVs among BrS probands. METHODS The study cohort consisted of 151 BrS probands who were symptomatic or had a family history of BrS, sudden death, syncope, or arrhythmic diseases. We performed sequence analysis of SCN5A by the Sanger method. For detecting CNVs in SCN5A, we performed multiplex ligation-dependent probe amplification analysis of the 151 BrS probands. RESULTS We identified pathogenic SCN5A mutations in 20 probands by the Sanger method. In 140 probands in whom multiplex ligation-dependent probe amplification was successfully performed, 4 probands were found to present different CNVs (deletion in 3 and duplication in 1). Three of them had fatal arrhythmia events; the remaining 1 was asymptomatic but had a family history. Mean age at diagnosis was 23 ± 14 years. All of the baseline 12-lead electrocardiograms showed PQ-interval prolongation. The characteristics of these 4 probands with CNVs were similar to those of the probands with mutations leading to premature truncation of the protein or missense mutations causing peak INa reduction >90%. CONCLUSION We identified SCN5A CNVs in 2.9% of BrS probands who were symptomatic or had a family history.
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Affiliation(s)
- Keiko Sonoda
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Department of Molecular Biology, National Cerebral and Cardiovacular Center, Suita, Japan
| | - Seiko Ohno
- Department of Molecular Biology, National Cerebral and Cardiovacular Center, Suita, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Junichi Ozawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tetsuhisa Hattori
- Department of Molecular Biology, National Cerebral and Cardiovacular Center, Suita, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Kobori
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mitsuhiko Yahata
- Department of Cardiovascular Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Isao Aburadani
- Department of Cardiovascular Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Seiichi Watanabe
- Department of Pediatrics, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Yuichi Matsumoto
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
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3
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Nishiuchi S, Makiyama T, Aiba T, Nakajima K, Hirose S, Kohjitani H, Yamamoto Y, Harita T, Hayano M, Wuriyanghai Y, Chen J, Sasaki K, Yagihara N, Ishikawa T, Onoue K, Murakoshi N, Watanabe I, Ohkubo K, Watanabe H, Ohno S, Doi T, Shizuta S, Minamino T, Saito Y, Oginosawa Y, Nogami A, Aonuma K, Kusano K, Makita N, Shimizu W, Horie M, Kimura T. Gene-Based Risk Stratification for Cardiac Disorders in
LMNA
Mutation Carriers. ACTA ACUST UNITED AC 2017; 10:CIRCGENETICS.116.001603. [DOI: 10.1161/circgenetics.116.001603] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/25/2017] [Indexed: 01/01/2023]
Abstract
Background—
Mutations in
LMNA
(
lamin A/C
), which encodes lamin A and C, typically cause age-dependent cardiac phenotypes, including dilated cardiomyopathy, cardiac conduction disturbance, atrial fibrillation, and malignant ventricular arrhythmias. Although the type of
LMNA
mutations have been reported to be associated with susceptibility to malignant ventricular arrhythmias, the gene-based risk stratification for cardiac complications remains unexplored.
Methods and Results—
The multicenter cohort included 77
LMNA
mutation carriers from 45 families; cardiac disorders were retrospectively analyzed. The mean age of patients when they underwent genetic testing was 45±17, and they were followed for a median 49 months. Of the 77 carriers, 71 (92%) were phenotypically affected and showed cardiac conduction disturbance (81%), low left ventricular ejection fraction (<50%; 45%), atrial arrhythmias (58%), and malignant ventricular arrhythmias (26%). During the follow-up period, 9 (12%) died, either from end-stage heart failure (n=7) or suddenly (n=2). Genetic analysis showed truncation mutations in 58 patients from 31 families and missense mutations in 19 patients from 14 families. The onset of cardiac disorders indicated that subjects with truncation mutations had an earlier occurrence of cardiac conduction disturbance and low left ventricular ejection fraction, than those with missense mutations. In addition, the truncation mutation was found to be a risk factor for the early onset of cardiac conduction disturbance and the occurrence of atrial arrhythmias and low left ventricular ejection fraction, as estimated using multivariable analyses.
Conclusions—
The truncation mutations were associated with manifestation of cardiac phenotypes in
LMNA
-related cardiomyopathy, suggesting that genetic analysis might be useful for diagnosis and risk stratification.
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4
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Kawaji T, Shizuta S, Morimoto T, Aizawa T, Yamagami S, Yoshizawa T, Ota C, Onishi N, Sasaki Y, Yahata M, Nakai K, Hayano M, Nakao T, Hanazawa K, Goto K, Doi T, Ono K, Kimura T. Very long-term clinical outcomes after radiofrequency catheter ablation for atrial fibrillation: A large single-center experience. Int J Cardiol 2017; 249:204-213. [DOI: 10.1016/j.ijcard.2017.09.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/18/2017] [Accepted: 09/06/2017] [Indexed: 12/27/2022]
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5
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Yamamoto Y, Makiyama T, Harita T, Sasaki K, Wuriyanghai Y, Hayano M, Nishiuchi S, Kohjitani H, Hirose S, Chen J, Yokoi F, Ishikawa T, Ohno S, Chonabayashi K, Motomura H, Yoshida Y, Horie M, Makita N, Kimura T. Allele-specific ablation rescues electrophysiological abnormalities in a human iPS cell model of long-QT syndrome with a CALM2 mutation. Hum Mol Genet 2017; 26:1670-1677. [PMID: 28335032 DOI: 10.1093/hmg/ddx073] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/22/2017] [Indexed: 12/14/2022] Open
Abstract
Calmodulin is a ubiquitous Ca2+ sensor molecule encoded by three distinct calmodulin genes, CALM1-3. Recently, mutations in CALM1-3 have been reported to be associated with severe early-onset long-QT syndrome (LQTS). However, the underlying mechanism through which heterozygous calmodulin mutations lead to severe LQTS remains unknown, particularly in human cardiomyocytes. We aimed to establish an LQTS disease model associated with a CALM2 mutation (LQT15) using human induced pluripotent stem cells (hiPSCs) and to assess mutant allele-specific ablation by genome editing for the treatment of LQT15. We generated LQT15-hiPSCs from a 12-year-old boy with LQTS carrying a CALM2-N98S mutation and differentiated these hiPSCs into cardiomyocytes (LQT15-hiPSC-CMs). Action potentials (APs) and L-type Ca2+ channel (LTCC) currents in hiPSC-CMs were analyzed by the patch-clamp technique and compared with those of healthy controls. Furthermore, we performed mutant allele-specific knockout using a CRISPR-Cas9 system and analyzed electrophysiological properties. Electrophysiological analyses revealed that LQT15-hiPSC-CMs exhibited significantly lower beating rates, prolonged AP durations, and impaired inactivation of LTCC currents compared with control cells, consistent with clinical phenotypes. Notably, ablation of the mutant allele rescued the electrophysiological abnormalities of LQT15-hiPSC-CMs, indicating that the mutant allele caused dominant-negative suppression of LTCC inactivation, resulting in prolonged AP duration. We successfully recapitulated the disease phenotypes of LQT15 and revealed that inactivation of LTCC currents was impaired in CALM2-N98S hiPSC model. Additionally, allele-specific ablation using the latest genome-editing technology provided important insights into a promising therapeutic approach for inherited cardiac diseases.
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Affiliation(s)
- Yuta Yamamoto
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takeshi Harita
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kenichi Sasaki
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yimin Wuriyanghai
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan.,Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Suguru Nishiuchi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hirohiko Kohjitani
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Sayako Hirose
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Jiarong Chen
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Fumika Yokoi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Taisuke Ishikawa
- Department of Molecular Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Seiko Ohno
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
| | - Kazuhisa Chonabayashi
- Department of Life Science Frontiers, Center for iPS Cell Research and Application, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hideki Motomura
- Department of Pediatrics, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yoshinori Yoshida
- Department of Life Science Frontiers, Center for iPS Cell Research and Application, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
| | - Naomasa Makita
- Department of Molecular Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
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6
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Yokoi F, Makiyama T, Yamamoto Y, Harita T, Hayano M, Nishiuchi S, Wuriyanghai Y, Kohjitani H, Hirose S, Yoshida Y, Toyoda F, Horie M, Kimura T. Abstract 443:
l-cis-
Diltiazem Ameliorates Impaired Calcium Channel Inactivation in a Patient-specific Stem Cell Model of Long-QT Syndrome with a Calmodulin Mutation. Circ Res 2017. [DOI: 10.1161/res.121.suppl_1.443] [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: 11/16/2022]
Abstract
Background:
Calmodulin is a ubiquitous Ca
2+
sensor molecule encoded by three distinct calmodulin genes,
CALM1-3
. Recently, mutations in
CALM1-3
have been reported to be associated with severe early-onset long-QT syndrome (LQT) due to impaired Ca
2+
dependent inactivation of L-type Ca
2+
channel (LTCC). However, pharmacotherapeutic agents for the treatment of CALM-related LQT have not been established.
Objective:
We aimed to assess new pharmacotherapies for the treatment of CALM-related LQT using human induced pluripotent stem cell (hiPSC) model.
Methods and Results:
We used CALM-LQT-hiPSC derived cardiomyocytes (CMs) with a
CALM2-
N98S mutation which exhibited prolonged action potential durations. First, we confirmed impaired LTCC inactivation in the CALM-LQT-hiPSC-CMs: the ratio of current remaining after 100 ms depolarization (r100) of LTCC currents was significantly larger in CALM-LQT-hiPSC-CMs (r100; CALM-LQT: 0.333 ± 0.016, control: 0.181 ± 0.025 at 0 mV; P < 0.05). Next, we assessed candidate drugs,
l-cis-
Diltiazem (the stereoisomer of clinically used
d-cis
-Diltiazem) and Cyclosoprin A, which were reported to enhance voltage-dependent inactivation of LTCC for the treatment of impaired LTCC inactivation. We found that 10 μM
l-cis
-Diltiazem attenuated impaired LTCC inactivation in CALM-LQT-iPSC-CMs (r100; baseline: 0.333 ± 0.016, with l-cis: 0.294 ± 0.013 at 0 mV; P < 0.05; Figure A and B). On the other hand, Cyclosporine A had less effect compared to
l-cis-
Diltiazem (Figure A).
Conclusion:
Using patient-derived hiPSC model, we identified that
l-cis
-Diltiazem is a promising candidate drug for treating CALM-LQT resulting from impaired LTCC inactivation.
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Affiliation(s)
- Fumika Yokoi
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Takeru Makiyama
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Yuta Yamamoto
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Takeshi Harita
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Mamoru Hayano
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Suguru Nishiuchi
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Yimin Wuriyanghai
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Hirohiko Kohjitani
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | - Sayako Hirose
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
| | | | | | - Minoru Horie
- Dept of Cardiovascular and Respiratory Medicine, Shiga Univ of Med Science, Otsu, Japan
| | - Takeshi Kimura
- Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch Kyoto, kyoto, Japan
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7
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Hayano M, Makiyama T, Kamakura T, Watanabe H, Sasaki K, Funakoshi S, Wuriyanghai Y, Nishiuchi S, Harita T, Yamamoto Y, Kohjitani H, Hirose S, Yokoi F, Chen J, Baba O, Horie T, Chonabayashi K, Ohno S, Toyoda F, Yoshida Y, Ono K, Horie M, Kimura T. Development of a Patient-Derived Induced Pluripotent Stem Cell Model for the Investigation of SCN5A-D1275N-Related Cardiac Sodium Channelopathy. Circ J 2017. [PMID: 28637969 DOI: 10.1253/circj.cj-17-0064] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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 TheSCN5Agene encodes the α subunit of the cardiac voltage-gated sodium channel, NaV1.5. The missense mutation, D1275N, has been associated with a range of unusual phenotypes associated with reduced NaV1.5 function, including cardiac conduction disease and dilated cardiomyopathy. Curiously, the reported biophysical properties ofSCN5A-D1275N channels vary with experimental system.Methods and Results:First, using a human embryonic kidney (HEK) 293 cell-based heterologous expression system, theSCN5A-D1275N channels showed similar maximum sodium conductance but a significantly depolarizing shift of activation gate (+10 mV) compared to wild type. Second, we generated human-induced pluripotent stem cells (hiPSCs) from a 24-year-old female who carried heterozygousSCN5A-D1275N and analyzed the differentiated cardiomyocytes (CMs). AlthoughSCN5Atranscript levels were equivalent between D1275N and control hiPSC-CMs, both the total amount of NaV1.5 and the membrane fractions were reduced approximately half in the D1275N cells, which were rescued by the proteasome inhibitor MG132 treatment. Electrophysiological assays revealed that maximum sodium conductance was reduced to approximately half of that in control hiPSC-CMs in the D1275N cells, and maximum upstroke velocity of action potential was lower in D1275N, which was consistent with the reduced protein level of NaV1.5. CONCLUSIONS This study successfully demonstrated diminished sodium currents resulting from lower NaV1.5 protein levels, which is dependent on proteasomal degradation, using a hiPSC-based model forSCN5A-D1275N-related sodium channelopathy.
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Affiliation(s)
- Mamoru Hayano
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Tsukasa Kamakura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hiroshi Watanabe
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kenichi Sasaki
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Yimin Wuriyanghai
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine.,Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
| | - Suguru Nishiuchi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Takeshi Harita
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Yuta Yamamoto
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Hirohiko Kohjitani
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Sayako Hirose
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Fumika Yokoi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Jiarong Chen
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Osamu Baba
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Takahiro Horie
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Seiko Ohno
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
| | - Futoshi Toyoda
- Department of Physiology, Shiga University of Medical Science
| | - Yoshinori Yoshida
- Center for iPS Cell Research and Application (CiRA), Kyoto University
| | - Koh Ono
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
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8
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Sasaki K, Makiyama T, Yoshida Y, Wuriyanghai Y, Kamakura T, Nishiuchi S, Hayano M, Harita T, Yamamoto Y, Kohjitani H, Hirose S, Chen J, Kawamura M, Ohno S, Itoh H, Takeuchi A, Matsuoka S, Miura M, Sumitomo N, Horie M, Yamanaka S, Kimura T. Patient-Specific Human Induced Pluripotent Stem Cell Model Assessed with Electrical Pacing Validates S107 as a Potential Therapeutic Agent for Catecholaminergic Polymorphic Ventricular Tachycardia. PLoS One 2016; 11:e0164795. [PMID: 27764147 PMCID: PMC5072719 DOI: 10.1371/journal.pone.0164795] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 09/30/2016] [Indexed: 12/21/2022] Open
Abstract
Introduction Human induced pluripotent stem cells (hiPSCs) offer a unique opportunity for disease modeling. However, it is not invariably successful to recapitulate the disease phenotype because of the immaturity of hiPSC-derived cardiomyocytes (hiPSC-CMs). The purpose of this study was to establish and analyze iPSC-based model of catecholaminergic polymorphic ventricular tachycardia (CPVT), which is characterized by adrenergically mediated lethal arrhythmias, more precisely using electrical pacing that could promote the development of new pharmacotherapies. Method and Results We generated hiPSCs from a 37-year-old CPVT patient and differentiated them into cardiomyocytes. Under spontaneous beating conditions, no significant difference was found in the timing irregularity of spontaneous Ca2+ transients between control- and CPVT-hiPSC-CMs. Using Ca2+ imaging at 1 Hz electrical field stimulation, isoproterenol induced an abnormal diastolic Ca2+ increase more frequently in CPVT- than in control-hiPSC-CMs (control 12% vs. CPVT 43%, p<0.05). Action potential recordings of spontaneous beating hiPSC-CMs revealed no significant difference in the frequency of delayed afterdepolarizations (DADs) between control and CPVT cells. After isoproterenol application with pacing at 1 Hz, 87.5% of CPVT-hiPSC-CMs developed DADs, compared to 30% of control-hiPSC-CMs (p<0.05). Pre-incubation with 10 μM S107, which stabilizes the closed state of the ryanodine receptor 2, significantly decreased the percentage of CPVT-hiPSC-CMs presenting DADs to 25% (p<0.05). Conclusions We recapitulated the electrophysiological features of CPVT-derived hiPSC-CMs using electrical pacing. The development of DADs in the presence of isoproterenol was significantly suppressed by S107. Our model provides a promising platform to study disease mechanisms and screen drugs.
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MESH Headings
- Action Potentials/drug effects
- Adult
- Animals
- Anti-Asthmatic Agents/chemistry
- Anti-Asthmatic Agents/pharmacology
- Anti-Asthmatic Agents/therapeutic use
- Calcium/metabolism
- Calreticulin/genetics
- Calreticulin/metabolism
- Calsequestrin/genetics
- Calsequestrin/metabolism
- Cell Differentiation/drug effects
- Cells, Cultured
- Electric Stimulation
- Fibroblasts/cytology
- Fibroblasts/metabolism
- Humans
- Induced Pluripotent Stem Cells/cytology
- Induced Pluripotent Stem Cells/metabolism
- Isoproterenol/pharmacology
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Models, Biological
- Myocytes, Cardiac/cytology
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/transplantation
- Ryanodine/pharmacology
- Ryanodine Receptor Calcium Release Channel/chemistry
- Ryanodine Receptor Calcium Release Channel/genetics
- Ryanodine Receptor Calcium Release Channel/metabolism
- Sarcoplasmic Reticulum Calcium-Transporting ATPases/genetics
- Sarcoplasmic Reticulum Calcium-Transporting ATPases/metabolism
- Tachycardia, Ventricular/drug therapy
- Tachycardia, Ventricular/pathology
- Tachycardia, Ventricular/therapy
- Thiazepines/chemistry
- Thiazepines/pharmacology
- Thiazepines/therapeutic use
- Transplantation, Heterologous
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Affiliation(s)
- Kenichi Sasaki
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- * E-mail: (TM); (Y. Yoshida)
| | - Yoshinori Yoshida
- Kyoto University iPS Cell Research and Application, Kyoto, Japan
- * E-mail: (TM); (Y. Yoshida)
| | - Yimin Wuriyanghai
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Suguru Nishiuchi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Harita
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuta Yamamoto
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hirohiko Kohjitani
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sayako Hirose
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jiarong Chen
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mihoko Kawamura
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Seiko Ohno
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Hideki Itoh
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Ayako Takeuchi
- Department of Integrative and Systems Physiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Satoshi Matsuoka
- Department of Integrative and Systems Physiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masaru Miura
- Division of Cardiology, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Shinya Yamanaka
- Kyoto University iPS Cell Research and Application, Kyoto, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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9
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Zhou Z, Yano I, Odaka S, Morita Y, Shizuta S, Hayano M, Kimura T, Akaike A, Inui KI, Matsubara K. Effect of vitamin K2 on the anticoagulant activity of warfarin during the perioperative period of catheter ablation: Population analysis of retrospective clinical data. J Pharm Health Care Sci 2016; 2:17. [PMID: 27493787 PMCID: PMC4972987 DOI: 10.1186/s40780-016-0053-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Catheter ablation is a non-medication therapy for atrial fibrillation, and during the procedure, warfarin is withdrawn in the preoperative period to prevent the risk of bleeding. In case of emergency, vitamin K2 can be intravenously administered to antagonize the anticoagulant activity of warfarin. The aims of this study were to conduct population pharmacokinetic/pharmacodynamic modeling for retrospective clinical data and to investigate the effect of vitamin K2 on the anticoagulant activity of warfarin in the perioperative period of catheter ablation. METHODS A total of 579 international normalized ratio (INR) values of prothrombin time from 100 patients were analyzed using the nonlinear mixed-effects modeling program NONMEM. A 1-compartment model was adapted to the pharmacokinetics of warfarin and vitamin K2, and the indirect response model was used to investigate the relationship between plasma concentration and the pharmacodynamic response of warfarin and vitamin K2. Since no plasma concentration data for warfarin and vitamin K2 were available, 3 literally available pharmacokinetic parameters were used to simultaneously estimate 1 pharmacokinetic parameter and 5 pharmacodynamic parameters. RESULTS The population parameters obtained not only successfully explained the observed INR values, but also indicated an increase in sensitivity to warfarin in patients with reduced renal function. Simulations using these parameters indicated that vitamin K2 administration of more than 20 mg caused a slight dose-dependent decrease in INR on the day of catheter ablation and a delayed INR elevation after warfarin re-initiation. CONCLUSIONS A pharmacokinetic/pharmacodynamic model was successfully built to explain the retrospective INR data during catheter ablation. Simulation studies suggest that vitamin K2 should be administered with care and that more than 20 mg is unnecessary in the preoperative period of catheter ablation.
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Affiliation(s)
- Zhi Zhou
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Japan
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Japan
| | - Ikuko Yano
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Japan
- Department of Clinical Pharmacy and Education, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Kyoto Japan
| | - Sumiko Odaka
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Japan
| | - Yosuke Morita
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Japan
| | - Satoshi Shizuta
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Akinori Akaike
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Japan
| | - Ken-ichi Inui
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Japan
| | - Kazuo Matsubara
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Japan
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10
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Hayano M, Yang WS, Corn CK, Pagano NC, Stockwell BR. Loss of cysteinyl-tRNA synthetase (CARS) induces the transsulfuration pathway and inhibits ferroptosis induced by cystine deprivation. Cell Death Differ 2016; 23:270-8. [PMID: 26184909 PMCID: PMC4716307 DOI: 10.1038/cdd.2015.93] [Citation(s) in RCA: 310] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/21/2015] [Accepted: 06/03/2015] [Indexed: 02/07/2023] Open
Abstract
Ferroptosis is a form of regulated non-apoptotic cell death that has been implicated in several disease contexts. A better understanding of the ferroptotic death mechanism could lead to the development of new therapeutics for degenerative diseases, and a better understanding of how to induce ferroptosis in specific tumor contexts. We performed an unbiased genome-wide siRNA screen to find genetic suppressors of ferroptosis. We determined that loss of CARS, the cysteinyl-tRNA synthetase, suppresses ferroptosis induced by erastin, which inhibits the cystine-glutamate antiporter known as system xc(-). Knockdown of CARS inhibited erastin-induced death by preventing the induction of lipid reactive oxygen species, without altering iron homeostasis. Knockdown of CARS led to the accumulation of cystathionine, a metabolite on the transsulfuration pathway, and upregulated genes associated with serine biosynthesis and transsulfuration. In addition, inhibition of the transsulfuration pathway resensitized cells to erastin, even after CARS knockdown. These studies demonstrate a new mechanism of resistance to ferroptosis and may lead to strategies for inducing and suppressing ferroptosis in diverse contexts.
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Affiliation(s)
- M Hayano
- Department of Pharmacology, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
| | - W S Yang
- Department of Biological Sciences, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
| | - C K Corn
- Department of Biological Sciences, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
| | - N C Pagano
- Department of Biological Sciences, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
| | - B R Stockwell
- Department of Biological Sciences, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
- Department of Chemistry, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
- Howard Hughes Medical Institute, Columbia University, 550 West 120th Street, Northwest Corner Building, MC 4846, New York, NY 10027, USA
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11
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Chen J, Makiyama T, Wuriyanghai Y, Ohno S, Sasaki K, Hayano M, Harita T, Nishiuchi S, Yuta Yamamoto, Ueyama T, Shimizu A, Horie M, Kimura T. Cardiac sodium channel mutation associated with epinephrine-induced QT prolongation and sinus node dysfunction. Heart Rhythm 2016; 13:289-98. [DOI: 10.1016/j.hrthm.2015.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Indexed: 12/19/2022]
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12
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Watanabe H, Shiomi H, Nakatsuma K, Morimoto T, Taniguchi T, Furukawa Y, Nakagawa Y, Horie M, Kimura T, Kimura T, Sakata R, Marui A, Matsuda M, Mitsuoka H, Onoe M, Nakagawa Y, Yamanaka K, Fujiwara H, Takatsu Y, Ohno N, Nohara R, Murakami T, Takeda T, Nobuyoshi M, Iwabuchi M, Hanyu M, Tatami R, Matsushita T, Shirotani M, Nishiwaki N, Kita T, Furukawa Y, Okada Y, Kato H, Eizawa H, Is K, Tanaka M, Nakayama S, Lee JD, Nakano A, Koshiji T, Morioka K, Takizawa A, Shimamoto M, Yamazaki F, Takahashi M, Nishizawa J, Horie M, Takashima H, Tamura T, Aota M, Takahashi M, Tabata T, Tei C, Hamasaki S, Imoto Y, Yamamoto H, Kambara H, Doi O, Matsuda K, Nara M, Mitsudo K, Kadota K, Komiya T, Miki S, Mizoguchi T, Nakajima H, Ogawa H, Sugiyama S, Kawasuji M, Moriyama S, Hattori R, Aoyama T, Araki M, Suwa S, Tanbara K, Kitagawa K, Yamauchi M, Okamoto N, Fujino Y, Tezuka S, Saeki A, Hanazawa M, Sato Y, Hibi C, Sasae H, Takinami E, Uchida Y, Yamamoto Y, Nishida S, Yoshimoto M, Maeda S, Miki I, Minematsu S, Abe M, Shiomi H, Tada T, Tazaki J, Kato Y, Hayano M, Tokushige A, Natsuaki M, Nakajima T. Clinical efficacy of thrombus aspiration on 5-year clinical outcomes in patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention. J Am Heart Assoc 2015; 4:e001962. [PMID: 26077588 PMCID: PMC4599536 DOI: 10.1161/jaha.115.001962] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Adjunctive thrombus aspiration (TA) during primary percutaneous coronary intervention (PCI) was reported to promote better coronary and myocardial reperfusion. However, long-term mortality benefit of TA remains controversial. The objective of this study is to investigate the clinical impact of TA on long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. Methods and Results The CREDO-Kyoto AMI Registry is a large-scale cohort study of acute myocardial infarction patients undergoing coronary revascularization in 2005–2007 at 26 hospitals in Japan. Among 5429 patients enrolled in the registry, the current study population consisted of 3536 patients who arrived at the hospital within 12 hours after the symptom onset and underwent primary PCI. Clinical outcomes were compared between the 2 patient groups with or without TA. During primary PCI procedures, 2239 out of 3536 (63%) patients underwent TA (TA group). The cumulative 5-year incidence of all-cause death was significantly lower in the TA group than in the non-TA group (18.5% versus 23.9%, log-rank P<0.001). After adjusting for confounders, however, the risk for all-cause death in the TA group was not significantly lower than that in the non-TA group (hazard ratio: 0.90, 95% CI: 0.76 to 1.06, P=0.21). The adjusted risks for cardiac death, myocardial infarction, stroke, and target-lesion revascularization were also not significantly different between the 2 groups. Conclusions Adjunctive TA during primary PCI was not associated with better 5-year mortality in STEMI patients.
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Affiliation(s)
- Hiroki Watanabe
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.)
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.)
| | - Kenji Nakatsuma
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.)
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.)
| | - Tomohiko Taniguchi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.)
| | - Yutaka Furukawa
- Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.)
| | | | - Minoru Horie
- Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.)
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Ryuzo Sakata
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Akira Marui
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Mitsuo Matsuda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hirokazu Mitsuoka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masahiko Onoe
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Kazuo Yamanaka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hisayoshi Fujiwara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yoshiki Takatsu
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Nobuhisa Ohno
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Ryuji Nohara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Tomoyuki Murakami
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Teruki Takeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masakiyo Nobuyoshi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masashi Iwabuchi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Michiya Hanyu
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Ryozo Tatami
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Tsutomu Matsushita
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Manabu Shirotani
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Noboru Nishiwaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Toru Kita
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yukikatsu Okada
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hiroshi Kato
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hiroshi Eizawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Katsuhisa Is
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masaru Tanaka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Shogo Nakayama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Jong-Dae Lee
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Akira Nakano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Takaaki Koshiji
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Koichi Morioka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Akinori Takizawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Mitsuomi Shimamoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Fumio Yamazaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masaaki Takahashi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Junichiro Nishizawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Minoru Horie
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hiroyuki Takashima
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Takashi Tamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masaki Aota
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Mamoru Takahashi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Takafumi Tabata
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Chuwa Tei
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Shuichi Hamasaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yutaka Imoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hiroyuki Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hirofumi Kambara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Osamu Doi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Katsuhiko Matsuda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masafumi Nara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Kazuaki Mitsudo
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Kazushige Kadota
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Tatsuhiko Komiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Shinji Miki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Tetsu Mizoguchi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hiroyuki Nakajima
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Seigo Sugiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Michio Kawasuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Syuji Moriyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Ryuichi Hattori
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Takeshi Aoyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Makoto Araki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Satoru Suwa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Keiichi Tanbara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Kumiko Kitagawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Misato Yamauchi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Naoko Okamoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yumika Fujino
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Saori Tezuka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Asuka Saeki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Miya Hanazawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yuki Sato
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Chikako Hibi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hitomi Sasae
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Emi Takinami
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yuriko Uchida
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yuko Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Satoko Nishida
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Mai Yoshimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Sachiko Maeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Izumi Miki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Saeko Minematsu
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Mitsuru Abe
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Tomohisa Tada
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Junichi Tazaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Yoshihiro Kato
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Akihiro Tokushige
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Masahiro Natsuaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
| | - Tetsu Nakajima
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (H.W., H.S., K.N., T.T., T.K.) Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan (T.M.) Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.) Division of Cardiology, Tenri Hospital, Nara, Japan (Y.N.) Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan (M.H.)
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13
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Nishiuchi S, Kaseno K, Naito S, Tsukada N, Sasaki T, Hayano M, Nakamura K, Sato C, Ikeda E, Miki Y, Nakamura K, Kumagai K, Kimura T, Oshima S, Tada H. A potential pitfall of the modified 12 lead electrocardiogram (Mason-Likar modification) in catheter ablation of idiopathic ventricular arrhythmias originating from the outflow tract. Europace 2015; 17:1840-7. [PMID: 26045502 DOI: 10.1093/europace/euu371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/22/2014] [Indexed: 11/15/2022] Open
Abstract
AIMS The Mason-Likar modified electrocardiogram (ML-ECG) can be interchanged with standard 12 lead ECG electrode positions (standard ECG) without affecting the diagnostic interpretation during sinus rhythm, but the morphological differences during ventricular arrhythmias have not been sufficiently evaluated. This study aimed to elucidate the morphological changes in the ML-ECG precordial leads. METHODS AND RESULTS In 53 consecutive patients with premature ventricular contractions predicted to originate from the outflow tract (OT-PVCs), the arrhythmias were analysed by those two ECG methods. The OT-PVC origin sites, which were predicted by currently published criteria with the respective ECG methods prior to catheter ablation, were compared with the successful ablation sites. Compared with the standard-ECG, S-waves in the ML-ECG became shallower in leads V1-4 (P < 0.05 in lead V1; P < 0.001 in leads V2-4), and pseudo-R-waves in lead V1 appeared in seven patients. The precordial leads transition zone shifted counter-clockwise in 18 patients in the ML-ECG. In leads I and aVL, the negative deflection amplitudes of the ML-ECG were greater than those of the standard ECG (P < 0.001), and polarity reversals in lead I appeared in 18 patients. The R-wave amplitudes in all ML-ECG inferior leads were greater than those in the standard-ECG leads (all for P < 0.001). Those changes had an effect on the diagnostic indexes for the localization, and the specificity of the criteria for the ML-ECG was poorer than that for the standard-ECG. CONCLUSION Great differences were found between those two ECG methods. Predicting OT-PVC origins by diagnostic criteria with the ML-ECG might result in a misdiagnosis and inefficient ablation.
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Affiliation(s)
- Suguru Nishiuchi
- Department of Cardiology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Shigeto Naito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Naofumi Tsukada
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Takehito Sasaki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Mamoru Hayano
- Department of Cardiology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Keijiro Nakamura
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Chizuru Sato
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Etsuko Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Yuko Miki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Kohki Nakamura
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Koji Kumagai
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Takeshi Kimura
- Department of Cardiology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Shigeru Oshima
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
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14
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Watanabe H, Morimoto T, Natsuaki M, Furukawa Y, Nakagawa Y, Kadota K, Yamaji K, Ando K, Shizuta S, Shiomi H, Tada T, Tazaki J, Kato Y, Hayano M, Abe M, Tamura T, Shirotani M, Miki S, Matsuda M, Takahashi M, Ishii K, Tanaka M, Aoyama T, Doi O, Hattori R, Kato M, Suwa S, Takizawa A, Takatsu Y, Shinoda E, Eizawa H, Takeda T, Lee JD, Inoko M, Ogawa H, Hamasaki S, Horie M, Nohara R, Kambara H, Fujiwara H, Mitsudo K, Nobuyoshi M, Kita T, Kastrati A, Kimura T. Antiplatelet therapy discontinuation and the risk of serious cardiovascular events after coronary stenting: observations from the CREDO-Kyoto Registry Cohort-2. PLoS One 2015; 10:e0124314. [PMID: 25853836 PMCID: PMC4390156 DOI: 10.1371/journal.pone.0124314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 02/27/2015] [Indexed: 02/02/2023] Open
Abstract
Relation of antiplatelet therapy (APT) discontinuation with the risk of serious cardiovascular events has not been fully addressed yet. This study is aimed to evaluate the risk of ischemic event after APT discontinuation based on long-term APT status of large cohort. In the CREDO-Kyoto Registry Cohort-2 enrolling 15939 consecutive patients undergoing first coronary revascularization, 10470 patients underwent percutaneous coronary intervention either with bare-metal stents (BMS) only (N=5392) or sirolimus-eluting stents (SES) only (N=5078). Proportions of patients taking dual-APT were 67.3% versus 33.4% at 1-year, and 48.7% versus 24.3% at 5-year in the SES and BMS strata, respectively. We evaluated daily APT status (dual-, single- and no-APT) and linked the adverse events to the APT status just 1-day before the events. No-APT as compared with dual- or single-APT was associated with significantly higher risk for stent thrombosis (ST) beyond 1-month after SES implantation (cumulative incidence rates beyond 1-month: 1.23 versus 0.15/0.29, P<0.001/P<0.001), while higher risk of no-APT for ST was evident only until 6-month after BMS implantation (incidence rates between 1- and 6-month: 8.43 versus 0.71/1.20, P<0.001/P<0.001, and cumulative incidence rates beyond 6-month: 0.31 versus 0.11/0.08, P=0.16/P=0.08). No-APT as compared with dual- or single-APT was also associated with significantly higher risk for spontaneous myocardial infarction (MI) and stroke regardless of the types of stents implanted. Single-APT as compared with dual-APT was not associated with higher risk for serious adverse events, except for the marginally higher risk for ST in the SES stratum. In conclusion, discontinuation of both aspirin and thienopyridines was associated with increased risk for serious cardiovascular events including ST, spontaneous MI and stroke beyond 1-month after coronary stenting.
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Affiliation(s)
- Hirotoshi Watanabe
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Morimoto
- Division of Genera Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masahiro Natsuaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Kazushige Kadota
- Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kyohei Yamaji
- Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Kenji Ando
- Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Satoshi Shizuta
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohisa Tada
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junichi Tazaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihiro Kato
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuru Abe
- Division of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takashi Tamura
- Division of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Manabu Shirotani
- Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Nara, Japan
| | - Shinji Miki
- Division of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Mitsuo Matsuda
- Division of Cardiology, Kishiwada City Hospital, Kishiwada, Japan
| | | | - Katsuhisa Ishii
- Division of Cardiology, Kansai Electric Power Hospital, Osaka, Japan
| | - Masaru Tanaka
- Division of Cardiology, Osaka Red Cross Hospital, Osaka, Japan
| | - Takeshi Aoyama
- Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan
| | - Osamu Doi
- Division of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
| | - Ryuichi Hattori
- Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan
| | - Masayuki Kato
- Division of Cardiology, Maizuru Kyosai Hospital, Maizuru, Japan
| | - Satoru Suwa
- Division of Cardiology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Akinori Takizawa
- Division of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Yoshiki Takatsu
- Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Japan
| | - Eiji Shinoda
- Division of Cardiology, Hamamatsu Rosai Hospital, Hamamatsu, Japan
| | - Hiroshi Eizawa
- Division of Cardiology, Nishi-Kobe Medical Center, Kobe, Japan
| | - Teruki Takeda
- Division of Cardiology, Koto Memorial Hospital, Higashioumi, Japan
| | - Jong-Dae Lee
- Division of Cardiology, University of Fukui Hospital, Fukui, Japan
| | - Moriaki Inoko
- Cardiovascular Center, the Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shuichi Hamasaki
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory, Shiga University of Medical Science, Otsu, Japan
| | - Ryuji Nohara
- Division of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan
| | - Hirofumi Kambara
- Division of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
| | - Hisayoshi Fujiwara
- Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Japan
| | - Kazuaki Mitsudo
- Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Toru Kita
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
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15
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Tokushige A, Shiomi H, Morimoto T, Ono K, Furukawa Y, Nakagawa Y, Kadota K, Ando K, Shizuta S, Tada T, Tazaki J, Kato Y, Hayano M, Abe M, Hamasaki S, Ohishi M, Nakashima H, Mitsudo K, Nobuyoshi M, Kita T, Imoto Y, Sakata R, Okabayashi H, Hanyu M, Shimamoto M, Nishiwaki N, Komiya T, Kimura T. Incidence and Outcome of Surgical Procedures After Coronary Artery Bypass Grafting Compared With Those After Percutaneous Coronary Intervention. Circ Cardiovasc Interv 2014; 7:482-91. [DOI: 10.1161/circinterventions.113.001056] [Citation(s) in RCA: 10] [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: 11/16/2022]
Affiliation(s)
- Akihiro Tokushige
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Shiomi
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Morimoto
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koh Ono
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Furukawa
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihisa Nakagawa
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazushige Kadota
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Ando
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Shizuta
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohisa Tada
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junichi Tazaki
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihiro Kato
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mamoru Hayano
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuru Abe
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Hamasaki
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuru Ohishi
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hitoshi Nakashima
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuaki Mitsudo
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masakiyo Nobuyoshi
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toru Kita
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Imoto
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuzo Sakata
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hitoshi Okabayashi
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Michiya Hanyu
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuomi Shimamoto
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noboru Nishiwaki
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuhiko Komiya
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Kimura
- From the Department of Cardiovascular Medicine and Hypertension (A.T., S.H., M.O.), and Cardiovascular and Gastoroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders (Y.I.), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Cardiovascular Medicine (H.S., K.O., S.S., T.T., J.T., Y.K., M. Hayano, T. Kimura), and Department of Cardiovascular Surgery (R.S.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
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16
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Nakamura K, Naito S, Kaseno K, Tsukada N, Sasaki T, Hayano M, Nishiuchi S, Fuke E, Miki Y, Sakamoto T, Nakamura K, Kumagai K, Kataoka A, Takaoka H, Kobayashi Y, Funabashi N, Oshima S. Optimal observation time after completion of circumferential pulmonary vein isolation for atrial fibrillation to prevent chronic pulmonary vein reconnections. Int J Cardiol 2013; 168:5300-10. [DOI: 10.1016/j.ijcard.2013.08.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/03/2013] [Indexed: 11/29/2022]
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17
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Kumagai K, Sakamoto T, Nakamura K, Nishiuchi S, Hayano M, Hayashi T, Sasaki T, Aonuma K, Oshima S. Combined dominant frequency and complex fractionated atrial electrogram ablation after circumferential pulmonary vein isolation of atrial fibrillation. J Cardiovasc Electrophysiol 2013; 24:975-83. [PMID: 23691953 DOI: 10.1111/jce.12166] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Revised: 03/09/2013] [Accepted: 03/29/2013] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Atrial substrates with high-dominant frequency (DF) and complex fractionated atrial electrogram (CFAE) sites have sources maintaining atrial fibrillation (AF) and are potential AF ablation targets. This study aimed to evaluate an approach of circumferential pulmonary vein isolation (PVI) followed by a DF and CFAE site ablation. METHODS AND RESULTS Fifty consecutive AF patients (23 paroxysmal, 9 persistent, and 18 longstanding persistent) underwent ablation, using NavX. When AF continued after circumferential PVI, high-DF sites of ≥ 8 Hz and then continuous left atrial (LA) CFAE sites defined by fractionated intervals (FI) of ≤50 milliseconds including the coronary sinus and right atrium were targeted. A total of 45.1% of high-DF and 48.1% of continuous CFAE sites significantly decreased after PVI (P < 0.001). The mean LA DF and FI significantly decreased and prolonged, respectively, after PVI (P < 0.001). Only 14.1% of all high-DF sites after PVI overlapped with continuous CFAE sites. AF terminated at high-DF sites in 11 (22%) patients and continuous CFAE sites in 1 (2%). AF could be induced in only 8% of patients after the procedure. The mean LA DF value before ablation was significantly lower in those without recurrence (P = 0.003). AF freedom on antiarrhythmic drugs was 96% and 59%, respectively, in the paroxysmal and nonparoxysmal AF patients (89% persistent and 44% longstanding persistent) after 1 procedure over a 12-month follow-up. CONCLUSIONS A combined high-DF and continuous CFAE site ablation in all chambers after circumferential PVI may be effective in the paroxysmal and persistent AF patients.
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Affiliation(s)
- Koji Kumagai
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
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18
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Kumagai K, Sakamoto T, Nakamura K, Hayano M, Yamashita E, Oshima S. Pre-procedural prediction of termination of persistent atrial fibrillation by catheter ablation as an indicator of reverse remodeling of the left atrium. Circ J 2013; 77:1416-23. [PMID: 23428717 DOI: 10.1253/circj.cj-12-0934] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The pre-procedural prediction of atrial fibrillation (AF) termination by catheter ablation in patients with persistent AF has not been evaluated fully. The aim of this study was to evaluate the pre-procedural predictors of persistent AF termination by ablation associated with the possibility of reverse remodeling of the left atrium (LA). METHODS AND RESULTS Seventy consecutive patients (mean age, 62±8 years) with persistent or long-standing persistent AF underwent ablation. They were divided into 2 groups: those with AF terminated by ablation (n=14; group 1) and those with AF terminated by cardioversion after ablation (n=56; group 2). The left atrial appendage (LAA) contraction velocity determined on transesophageal echocardiography was significantly decreased in group 2 as compared to group 1 (P<0.001). Kaplan-Meier analysis showed that the group 1 patients had a higher AF-free survival rate than those in group 2 during 12±4.1 months of follow-up (P=0.048). The LA reverse remodeling ratio, given as the volume difference between before and 3 months after ablation in group 1, was significantly greater after ablation than that in group 2 (25.8±13% vs. 15.0±15%, P=0.015). Multivariate logistic regression analysis indicated that the LAA contraction velocity was an independent predictor of persistent AF termination by ablation (P=0.018). CONCLUSIONS The LAA contraction velocity was the only non-invasive pre-procedural predictor of persistent AF termination by ablation, indicating the possibility of reverse remodeling of the LA.
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Affiliation(s)
- Koji Kumagai
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi 371-0004, Japan.
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19
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Bao B, Ozasa N, Morimoto T, Furukawa Y, Nakagawa Y, Kadota K, Iwabuchi M, Shizuta S, Shiomi H, Tada T, Tazaki J, Kato Y, Hayano M, Natsuaki M, Fujiwara H, Mitsudo K, Nobuyoshi M, Kita T, Kimura T. β-Blocker therapy and cardiovascular outcomes in patients who have undergone percutaneous coronary intervention after ST-elevation myocardial infarction. Cardiovasc Interv Ther 2012; 28:139-47. [PMID: 23054967 DOI: 10.1007/s12928-012-0137-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 09/22/2012] [Indexed: 11/30/2022]
Abstract
The effect of β-blockers in ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI) has not been adequately evaluated. Using a large multi-center registry in Japan, we identified 3,692 patients who underwent PCI within 24 h from onset of STEMI and were discharged alive from 2005 to 2007. Three-year cardiovascular outcomes were compared between the 2 groups of patients with (N = 1,614) or without (N = 2,078) β-blocker prescription at discharge. Compared with patients in the no-β group, patients in the β group were younger, more frequently male, more often had hypertension and atrial fibrillation but less often had chronic obstructive pulmonary disease than in the no-β group. Statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were more frequently prescribed in the β group. Crude incidence of cardiac death and/or recurrent myocardial infarction (cardiac death/MI) tended to be higher in the β group (7.6 vs. 6.2%, log-rank p = 0.1). After adjusting for potential confounders, β-blockers were associated with significantly higher risk for cardiac death/MI (hazard ratio 1.43, 95% CI: 1.06-1.94, p = 0.01). β-Blocker prescription at discharge was not associated with better cardiovascular outcomes in patients who underwent PCI after STEMI. Large-scale randomized controlled trials are needed to evaluate the role of β-blocker therapy in these patients.
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Affiliation(s)
- Bingyuan Bao
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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20
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Shiomi H, Morimoto T, Hayano M, Furukawa Y, Nakagawa Y, Tazaki J, Imai M, Yamaji K, Tada T, Natsuaki M, Saijo S, Funakoshi S, Nagao K, Hanazawa K, Ehara N, Kadota K, Iwabuchi M, Shizuta S, Abe M, Sakata R, Okabayashi H, Hanyu M, Yamazaki F, Shimamoto M, Nishiwaki N, Imoto Y, Komiya T, Horie M, Fujiwara H, Mitsudo K, Nobuyoshi M, Kita T, Kimura T. Comparison of long-term outcome after percutaneous coronary intervention versus coronary artery bypass grafting in patients with unprotected left main coronary artery disease (from the CREDO-Kyoto PCI/CABG Registry Cohort-2). Am J Cardiol 2012; 110:924-32. [PMID: 22721575 DOI: 10.1016/j.amjcard.2012.05.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 05/23/2012] [Accepted: 05/23/2012] [Indexed: 01/30/2023]
Abstract
The long-term outcome of percutaneous coronary intervention (PCI) compared to coronary artery bypass grafting (CABG) for unprotected left main coronary artery disease (ULMCAD) remains to be investigated. We identified 1,005 patients with ULMCAD of 15,939 patients with first coronary revascularization enrolled in the CREDO-Kyoto PCI/CABG Registry Cohort-2. Cumulative 3-year incidence of a composite of death/myocardial infarction (MI)/stroke was significantly higher in the PCI group than in the CABG group (22.7% vs 14.8%, p = 0.0006, log-rank test). However, the adjusted outcome was not different between the PCI and CABG groups (hazard ratio [HR] 1.30, 95% confidence interval [CI] 0.79 to 2.15, p = 0.30). Stratified analysis using the SYNTAX score demonstrated that risk for a composite of death/MI/stroke was not different between the 2 treatment groups in patients with low (<23) and intermediate (23 to 33) SYNTAX scores (adjusted HR 1.70, 95% CI 0.77 to 3.76, p = 0.19; adjusted HR 0.86, 95% CI 0.37 to 1.99, p = 0.72, respectively), whereas in patients with a high SYNTAX score (≥33), it was significantly higher after PCI than after CABG (adjusted HR 2.61, 95% CI 1.32 to 5.16, p = 0.006). In conclusion, risk of PCI for serious adverse events seemed to be comparable to that after CABG in patients with ULMCAD with a low or intermediate SYNTAX score, whereas PCI compared with CABG was associated with a higher risk for serious adverse events in patients with a high SYNTAX score.
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21
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Tokushige A, Shiomi H, Morimoto T, Furukawa Y, Nakagawa Y, Kadota K, Iwabuchi M, Shizuta S, Tada T, Tazaki J, Kato Y, Hayano M, Abe M, Ehara N, Inada T, Kaburagi S, Hamasaki S, Tei C, Nakashima H, Ogawa H, Tatami R, Suwa S, Takizawa A, Nohara R, Fujiwara H, Mitsudo K, Nobuyoshi M, Kita T, Kimura T. Incidence and Outcome of Surgical Procedures After Coronary Bare-Metal and Drug-Eluting Stent Implantation. Circ Cardiovasc Interv 2012; 5:237-46. [DOI: 10.1161/circinterventions.111.963728] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [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: 11/16/2022]
Abstract
Background—
There still remain safety concerns on surgical procedures after coronary drug-eluting stents (DES) implantation, and optimal management of perioperative antiplatelet therapy (APT) has not been yet established.
Methods and Results—
During 3-year follow-up of 12 207 patients (DES=6802 patients and bare-metal stent [BMS] only=5405 patients) who underwent coronary stent implantation in the CREDO-Kyoto registry cohort-2, surgical procedures were performed in 2398 patients (DES=1295 patients and BMS=1103 patients). Surgical procedures (early surgery in particular) were more frequently performed in the BMS group than in the DES group (4.4% versus 1.9% at 42-day and 23% versus 21% at 3-year, log-rank
P
=0.0007). Cumulative incidences of death/myocardial infarction (MI)/stent thrombosis (ST) and bleeding at 30 days after surgery were low, without differences between BMS and DES (3.5% versus 2.9%,
P
=0.4 and 3.2% versus 2.1%,
P
=0.2, respectively). The adjusted risks of DES use relative to BMS use for death/MI/ST and bleeding were not significant (hazard ratio: 1.63, 95% confidence interval: 0.93 to 2.87,
P
=0.09 and hazard ratio: 0.6, 95% confidence interval: 0.34 to 1.06,
P
=0.08, respectively). The risks of perioperative single- and no-APT relative to dual-APT for both death/MI/ST and bleeding were not significant; single-APT as compared with dual-APT tended to be associated with lower risk for death/MI/ST (hazard ratio: 0.4, 95% confidence interval: 0.13 to 1.01,
P
=0.053).
Conclusions—
Surgical procedures were commonly performed after coronary stent implantation, and the risk of ischemic and bleeding complications in surgical procedures was low. In patients selected to receive DES or BMS, there were no differences in outcomes. Perioperative administration of dual-APT was not associated with lower risk for ischemic events.
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Affiliation(s)
- Akihiro Tokushige
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Hiroki Shiomi
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Takeshi Morimoto
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Yutaka Furukawa
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Yoshihisa Nakagawa
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Kazushige Kadota
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Masashi Iwabuchi
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Satoshi Shizuta
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Tomohisa Tada
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Junichi Tazaki
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Yoshihiro Kato
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Mamoru Hayano
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Mitsuru Abe
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Natsuhiko Ehara
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Tsukasa Inada
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Satoshi Kaburagi
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Shuichi Hamasaki
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Chuwa Tei
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Hitoshi Nakashima
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Hisao Ogawa
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Ryozo Tatami
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Satoru Suwa
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Akinori Takizawa
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Ryuji Nohara
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Hisayoshi Fujiwara
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Kazuaki Mitsudo
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Masakiyo Nobuyoshi
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Toru Kita
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
| | - Takeshi Kimura
- From the Department of Cardiovascular Medicine (A.T., H.S., S.S., T.T., J.T., Y.K., M.H., T.K.), Graduate School of Medicine, Kyoto University; Center for Medical Education and Clinical Epidemiology Unit (T.M.), Graduate School of Medicine, Kyoto University, Department of Cardiovascular Medicine (Y.F., N.E., T.K.), Kobe City Medical Center General Hospital; Division of Cardiology (Y.N.), Tenri Hospital; Division of Cardiology (K.K., K.M.), Kurashiki Central Hospital; Division of Cardiology (M.I., M
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Kaseno K, Naito S, Nakamura K, Sakamoto T, Sasaki T, Tsukada N, Hayano M, Nishiuchi S, Fuke E, Miki Y, Nakamura K, Yamashita E, Kumagai K, Oshima S, Tada H. Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation. Circ J 2012; 76:2337-42. [DOI: 10.1253/circj.cj-12-0498] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [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: 11/09/2022]
Affiliation(s)
- Kenichi Kaseno
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Shigeto Naito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Kohki Nakamura
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | | | - Takehito Sasaki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Naofumi Tsukada
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Mamoru Hayano
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | | | - Etsuko Fuke
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Yuko Miki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | | | - Eiji Yamashita
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Koji Kumagai
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Shigeru Oshima
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Hiroshi Tada
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
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Kimura T, Morimoto T, Furukawa Y, Nakagawa Y, Kadota K, Iwabuchi M, Shizuta S, Shiomi H, Tada T, Tazaki J, Kato Y, Hayano M, Abe M, Tamura T, Shirotani M, Miki S, Matsuda M, Takahashi M, Ishii K, Tanaka M, Aoyama T, Doi O, Hattori R, Tatami R, Suwa S, Takizawa A, Takatsu Y, Takahashi M, Kato H, Takeda T, Lee JD, Nohara R, Ogawa H, Tei C, Horie M, Kambara H, Fujiwara H, Mitsudo K, Nobuyoshi M, Kita T. Long-term safety and efficacy of sirolimus-eluting stents versus bare-metal stents in real world clinical practice in Japan. Cardiovasc Interv Ther 2011; 26:234-45. [DOI: 10.1007/s12928-011-0065-0] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 04/05/2011] [Indexed: 11/29/2022]
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Nakamura K, Naito S, Kaseno K, Tsukada N, Hayano M, Nishiuchi S, Fuke E, Miki Y, Sakamoto T, Nakamura K, Kumagai K, Oshima S. Characteristics of Patients with Direct Conversion of Atrial Fibrillation to Sinus Rhythm or Cavotricuspid-Isthmus Dependent Atrial Flutter by Catheter Ablation. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.op08_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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25
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Kaseno K, Naito S, Tsukada N, Hayano M, Nishiuchi S, Fuke E, Miki Y, Sakamoto T, Nakamura K, Nakamura K, Kumagai K, Oshima S. Validation of Irrigated Ablation for Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj2_008] [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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26
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Nishiuchi S, Naito S, Nakamura K, Tsukada N, Hayano M, Fuke E, Miki Y, Sakamoto T, Nakamura K, Kaseno K, Kumagai K, Oshima S. Comparison of Rhythm Maintenance Effect after Catheter Ablation between Bepridil and Amiodarone for Persistent and Long-Standing Persistent Atrial Fibrillation. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj1_030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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27
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Yahata M, Sizuta S, Hayano M, Onishi N, Sasaki Y, Nakai K, Goto K, Makiyama T, Doi T, Kimura T. Radiofrequency Catheter Ablation for Atrial Fibrillation Followed by Cardiac Resynchronization Therapy in a Case of Lamin-Related Cardiomyopathy: A Case Report. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj1_097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Kumagai K, Sakamoto T, Nakamura K, Hayano M, Nakamura K, Kaseno K, Naito S, Oshima S. Evaluation of the Efficacy of an Irrigated Catheter as Compared to Non-Irrigated for AF Ablation. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.op40_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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29
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Sasaki Y, Hayano M, Onishi N, Yahata M, Nakai K, Haraguti A, Gotou K, Doi T, Makiyama T, Shizuta S, Kimura T. Cardiomyopathy Caused by Right Free-Wall Accessory Pathway. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj2_077] [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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Hayano M, Kumagai K, Tsukada N, Nishiuchi S, Nakamura K, Sakamoto T, Fuke E, Miki Y, Nakamura K, Kaseno K, Naitou S, Oshima S. Catheter Ablation for Peri-Mitral Atrial Flutter Post Mitral Valve Replacement. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj1_010] [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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Tsukada N, Naito S, Nakamura K, Hayano M, Nishiuchi S, Fuke E, Miki Y, Sakamoto T, Nakamura K, Kaseno K, Kumagai K, Oshima S. Prevalence and Characteristics of Dual-Loop Reentrant Atrial Flutter of Incisional and Cavotricuspid-Isthmus Dependent Atrial Flutter after Open-Heart Surgery. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj1_031] [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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Yamashita T, Inoue H, Okumura K, Kodama I, Aizawa Y, Atarashi H, Ohe T, Ohtsu H, Kato T, Kamakura S, Kumagai K, Kurachi Y, Koretsune Y, Saikawa T, Sakurai M, Sato T, Sugi K, Nakaya H, Hirai M, Hirayama A, Fukatani M, Mitamura H, Yamazaki T, Watanabe E, Ogawa S, Katoh T, Igawa O, Matsumoto N, Yamashita T, Kaneko Y, Watanabe E, Ogawa S, Osaka T, Fujii E, Niwano S, Yoshioka K, Kato M, Okazaki O, Kusano K, Okuyama Y, Furushima H, Suzuki M, Noda T, Kawara T, Sato T, Kamakura S, Endoh Y, Kumagai K, Hiyoshi Y, Ishiyama T, Ohtsuka T, Matsumoto M, Chishaki A, Shinohara T, Shirayama T, Koretsune Y, Yokoyama E, Ajiki K, Fujio K, Sugi K, Yamakawa T, Yusu S, Inoue H, Kawamura Y, Hayano M, Date T, Mizusawa Y, Kobayashi Y, Satomi K, Imai Y, Atarashi H, Fukunami M, Yokoshiki H, Betsuyaku T, Okumura K, Takeda H, Matsumoto K, Okishige K, Tagawa M, Hirai M, Okazaki H. Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study). Europace 2010; 13:473-9. [DOI: 10.1093/europace/euq439] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hayano M, Shizuta S, Nakao T, Doi T, Kimura T, Andou K, Arita T, Nobuyoshi M, Fujii S, Inoue K, Isshiki T. CARDIAC RESYNCHRONIZATION THERAPY FOR PATIENTS WITH HEART FAILURE AND CHRONIC ATRIAL FIBRILLATION. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)60031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fukuchi H, Nakashima M, Araki R, Komiya N, Hayano M, Yano K, Sasaki H, Yukawa E. Effect of obesity on serum amiodarone concentration in Japanese patients: population pharmacokinetic investigation by multiple trough screen analysis. J Clin Pharm Ther 2009; 34:329-36. [DOI: 10.1111/j.1365-2710.2008.00987.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bereczky S, Dolo A, Maiga B, Hayano M, Granath F, Montgomery SM, Daou M, Arama C, Troye-Blomberg M, Doumbo OK, Färnert A. Spleen enlargement and genetic diversity of Plasmodium falciparum infection in two ethnic groups with different malaria susceptibility in Mali, West Africa. Trans R Soc Trop Med Hyg 2006; 100:248-57. [PMID: 16298405 DOI: 10.1016/j.trstmh.2005.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Revised: 02/22/2005] [Accepted: 03/31/2005] [Indexed: 11/16/2022] Open
Abstract
The high resistance to malaria in the nomadic Fulani population needs further understanding. The ability to cope with multiclonal Plasmodium falciparum infections was assessed in a cross-sectional survey in the Fulani and the Dogon, their sympatric ethnic group in Mali. The Fulani had lower parasite prevalence and densities and more prominent spleen enlargement. Spleen rates in children aged 2-9 years were 75% in the Fulani and 44% in the Dogon (P<0.001). There was no difference in number of P. falciparum genotypes, defined by merozoite surface protein 2 polymorphism, with mean values of 2.25 and 2.11 (P=0.503) in the Dogon and Fulani, respectively. Spleen rate increased with parasite prevalence, density and number of co-infecting clones in asymptomatic Dogon. Moreover, splenomegaly was increased in individuals with clinical malaria in the Dogon, odds ratio 3.67 (95% CI 1.65-8.15, P=0.003), but not found in the Fulani, 1.36 (95% CI 0.53-3.48, P=0.633). The more susceptible Dogon population thus appear to respond with pronounced spleen enlargement to asymptomatic multiclonal infections and acute disease whereas the Fulani have generally enlarged spleens already functional for protection. The results emphasize the importance of spleen function in protective immunity to the polymorphic malaria parasite.
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Affiliation(s)
- S Bereczky
- Infectious Diseases Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
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Suzuki K, Oka K, Yatabe Y, Mori S, Hayano M, Hakozaki H, Nakazato Y. Cerebellar hemangioendothelioma. Clin Neuropathol 2004; 23:154-7. [PMID: 15328879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
We report a 26-year-old woman with cellular hemangioendothelioma that may be the third case diagnosed as cerebellar hemangioendothelioma. The tumor was composed of numerous vascular channels lined by endothelial cells and aggregates of large round endothelial cells. Transitional cells were also present. The large round cells were positive for CD34 and vimentin in their abundant cytoplasm that contained 1 or some red blood cells, revealing intracytoplasmic lumina. The patient remains free of disease over 5 years after tumor resection.
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Affiliation(s)
- K Suzuki
- Department of Neurosurgery, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan
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Baba S, Brodie HJ, Hayano M, Kwass G, Gut M. Stereoselective Saturation of a Carbon-Carbon Double Bond under Wilzbach Conditions1. J Org Chem 2002. [DOI: 10.1021/jo01032a069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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38
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Stone D, Hayano M, Dorfman RI, Hechter O, Robinson CR, Djerassi C. Hydroxylation of Desoxycorticosterone with Neurospora crassa1. J Am Chem Soc 2002. [DOI: 10.1021/ja01619a077] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
We report on a 62-year-old woman without Castleman's syndrome diagnosed with chordoid meningioma. A white, encapsulated brain tumor was located in the parietal lobe of the left hemisphere of the cerebrum, adhered to the dura, and was separated from the cerebrum. The tumor revealed a multilobular arrangement of two types of neoplastic cells, and the surrounding myxoid stroma was separated by incomplete fibrous septa. Neoplastic cells consisted of myxomatous and meningothelial cells. The former made up about four-fifths of the tumor, had a vacuolar cytoplasm, and were arranged in a chordoma-like cord pattern. They were floating in myxoid stroma. The latter had an eosinophilic spindle or epithelioid cytoplasm and were disposed in lobules. Coarse eosinophilic materials positive for periodic acid-Schiff stain were deposited among them. Transitional cells between two types of cells were also observed. Both neoplastic cells were positive for vimentin and Leu-7 (CD57) in their cytoplasm, and were consistently negative for epithelial membrane antigen, S-100 protein, and cytokeratin.
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Affiliation(s)
- S Mori
- Department of Neurosurgery, Mito Saiseikai General Hospital, Ibaraki, Japan
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Ohno-Matsui K, Morita I, Tombran-Tink J, Mrazek D, Onodera M, Uetama T, Hayano M, Murota SI, Mochizuki M. Novel mechanism for age-related macular degeneration: an equilibrium shift between the angiogenesis factors VEGF and PEDF. J Cell Physiol 2001; 189:323-33. [PMID: 11748590 DOI: 10.1002/jcp.10026] [Citation(s) in RCA: 175] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We investigated gene expression profiles of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in differentiated and non-differentiated retinal pigment epithelial (RPE) cells during oxidative stress. Human RPE cells were grown in culture on laminin-coated flasks to obtain differentiated features. Cells cultured on plastic were used as non-differentiated controls. After confluence, hydrogen peroxide (H2O2) was added for 48 h, then, total RNA was extracted and used for RT-PCR and Northern blot analysis. Medium conditioned by RPE was used for ELISA, Western blotting, and in vitro angiogenesis assay. As a result, differentiated RPE cells expressed significantly higher levels of VEGF protein, as compared to their non-differentiated counterparts. The expression pattern remained consistent even after cellular exposure to H2O2. Conversely, while elevated levels of PEDF transcript and protein were seen in differentiated RPE cells, compared to non-differentiated cells, a marked decrease at both PEDF mRNA and protein levels was seen after treatment with H2O2. Moreover, this decrease in PEDF expression was dosage dependent. In in vitro angiogenesis assay, conditioned medium from differentiated human RPE cells after exposure to H2O2 showed a dramatic increase in tubular formation and migratory activity of microvascular endothelial cells. These data suggest that, in physiological conditions, a critical balance between PEDF and VEGF exists, and PEDF may counteract the angiogenic potential of VEGF. Under oxidative stress, PEDF decreases disrupting this balance. This equilibrium shift may be significant in promoting a pathological condition of RPE cells and contributing to choroidal neovascularization in age-related macular degeneration.
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Affiliation(s)
- K Ohno-Matsui
- Department of Ophthalmology and Visual Science, Graduate School, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan.
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Hayano M, Thuy LT. [Hereditary QT prolongation syndrome]. Nihon Rinsho 2001; 59 Suppl 8:812-5. [PMID: 11808313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- M Hayano
- Third Department of Internal Medicine, Nagasaki University School of Medicine
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Matsuo K, Kurita T, Eguchi M, Nakao K, Komiya N, Kawano H, Isomoto S, Toda G, Hayano M, Yano K. The right ventricular outflow tract as an unusual location for an implantable defibrillator electrode in a patient with arrhythmogenic right ventricular dysplasia. Jpn Circ J 2001; 65:994-6. [PMID: 11716254 DOI: 10.1253/jcj.65.994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 41-year-old woman with arrhythmogenic right ventricular dysplasia (ARVD) underwent the implantation of an implantable cardioverter-defibrillator (ICD), in which the defibrillator electrode was unusually located in the right ventricular (RV) outflow tract. Although fractionated electrograms were demonstrated in the RV apex, which is the usual site for ICD electrodes, normal electrograms were recorded in the RV outflow tract during an electrophysiologic study. An electrode with a screw-in tip was used to fix the implant in the RV outflow tract and obtain successful defibrillation. If normal electrograms are recorded in the RV outflow tract, the site may prove to be an alternative location for an ICD electrode even for ARVD patients.
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Affiliation(s)
- K Matsuo
- Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
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Matsuo K, Akahoshi M, Nakashima E, Suyama A, Seto S, Hayano M, Yano K. The prevalence, incidence and prognostic value of the Brugada-type electrocardiogram: a population-based study of four decades. J Am Coll Cardiol 2001; 38:765-70. [PMID: 11527630 DOI: 10.1016/s0735-1097(01)01421-8] [Citation(s) in RCA: 135] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We sought to demonstrate the prevalence, incidence and prognostic value of the Brugada-type electrocardiogram (ECG) in a general population. BACKGROUND The Brugada syndrome is characterized by evidence of right bundle branch block and ST segment elevation in the right precordial leads, as well as sudden death caused by ventricular fibrillation. However, the natural history of the Brugada-type ECG remains unclear. METHODS We investigated 4,788 subjects (1,956 men and 2,832 women) who were <50 years old in 1958 and had undergone biennial health examinations, including electrocardiography, through 1999. The Brugada-type ECG was defined as a terminal r' wave in lead V(1) and ST segment elevation > or =0.1 mV in leads V(1) and V(2). Unexpected death was defined as sudden death or unexplained accidental death. RESULTS There were a total of 32 Brugada-type ECG cases; the prevalence and incidence were 146.2 in 100,000 persons and 14.2 persons per 100,000 person-years, respectively. The incidence was nine times higher among men than women, and the average age at presentation was 45 +/- 10.5 years. The Brugada-type ECG appeared intermittently in most cases and was found in 26% of subjects who died unexpectedly. Cox survival analysis revealed that mortality from unexpected death was significantly higher in subjects with a Brugada-type ECG than in control subjects (p < 0.01). Unexpected deaths were more frequent among subjects with the Brugada-type ECG who had a history of syncope (p < 0.05). CONCLUSIONS The Brugada-type ECG is not a very rare condition in the adult Japanese population. Subjects with a Brugada-type ECG have an increased risk of unexpected death.
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Affiliation(s)
- K Matsuo
- Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
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Soga Y, Oka K, Sato M, Kabata T, Kawasaki T, Kawano H, Hayano M. Cavernous sinus thrombophlebitis caused by sphenoid sinusitis--report of autopsy case. Clin Neuropathol 2001; 20:101-5. [PMID: 11430492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
A 34-year-old man developed fever, headache, nausea, double vision, exophthalmus, ptosis, disturbance of vision and oculomotor nerve palsy. Magnetic resonance imaging and cerebral angiography led to the clinical diagnoses of cavernous sinus thrombophlebitis and suspicion of bacterial aneurysm of the left internal carotid artery, respectively. Peptostreptococcus was detected in blood culture analysis. He died 15 days after admission. Systemic organs showed several septic changes. In particular, the bilateral cavernous sinuses were enlarged and showed severe neutrophilic leukocyte infiltration of the walls and organization, recanalization and abscesses in thrombi. In anterior to the middle cranial fossa, abscess-forming, necrotic, hemorrhagic meningitis, purulent sphenoid sinusitis, pyogenic osteomyelitis of the sphenoid bone, suppurative encephalitis, and inflammatory necrosis of the hypophysis were seen. Based on these findings, we diagnosed the patient with cavernous sinus thrombophlebitis caused by sphenoid sinusitis.
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Affiliation(s)
- Y Soga
- Department of Neurosurgery, Mito Saiseikai General Hospital, Ibaraki, Japan
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Nakao K, Hayano M, Iliev II, Doi Y, Fukae S, Matsuo K, Komiya N, Isomoto S, Yano K. Double ventricular response via dual atrioventricular nodal pathways resulting with nonreentrant supraventricular tachycardia and successfully treated with radiofrequency catheter ablation. J Electrocardiol 2001; 34:59-63. [PMID: 11239373 DOI: 10.1054/jelc.2001.22036] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report a patient with a complex nonreentrant supraventricular tachycardia because of double ventricular response resulting from antegrade dual atrioventricular (AV) nodal pathways. We could induce double ventricular response and confirm dual AV nodal pathways by AV simultaneous pacing during basic stimulation proceeding with programmed atrial single extrastimulation. As far as we know, it is the first report about the application of the AV simultaneous basic stimulation to prove the sustained nonreentrant tachycardia because of simultaneous conduction over dual AV nodal pathways. This was also confirmed by absence of the arrhythmia immediately after the elimination of the slow pathway conduction by radiofrequency ablation.
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Affiliation(s)
- K Nakao
- Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan. nakanaka@net..nakasaki-u.ac.jp
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Tasaki H, Serita T, Irita A, Hano O, Iliev I, Ueyama C, Kitano K, Seto S, Hayano M, Yano K. A 15-year longitudinal follow-up study of heart rate and heart rate variability in healthy elderly persons. J Gerontol A Biol Sci Med Sci 2000; 55:M744-9. [PMID: 11129397 DOI: 10.1093/gerona/55.12.m744] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Few researchers have conducted heart rate (HR) studies in healthy very elderly subjects aged 70 years or older, and there are no longitudinal follow-up studies in this population. The objective of this study was to evaluate long-term changes in HR and heart rate variability (HRV) with aging in healthy elderly persons by means of comparison between two Holter monitor recordings obtained at an interval of 15 years. METHODS The study population consisted of 15 healthy elderly persons (10 women and 5 men) aged 64 to 80 years (mean 70 +/- 4.1) at the first recording, and 79 to 95 years old (mean 85 +/- 4.1 years) at the second recording 15 years later. Nighttime (midnight to 5 AM) and daytime (noon to 5 PM) HR and HRV were obtained, and paired t tests were performed to assess the differences in each parameter of nighttime and daytime HR and HRV between the two (15-year interval) Holter monitor recordings. RESULTS The results of the t-test comparisons were as follows: there was a significant increase in minimal, maximal, and average HRs (nighttime, p < .01; daytime, p < .05, respectively). On the other hand, with regard to HRV, there was a significant nighttime decrease in the SDNN index (mean of standard deviations of normal RR intervals between adjacent QRS complexes resulting from sinus node depolarizations for all 5-minute segments) (p = .0086), and a significant daytime increase in the NN50 (number of adjacent normal RR intervals >50 milliseconds) per hour (p = .0425). Moreover, there was a significant decrease in the low-frequency (LF) component (nighttime, p = .0151; daytime, p = .0032), and a significant decrease in the LF/HF ratio (nighttime, p = .0270; daytime, p = .0371), but there was no significant change in the nighttime or daytime high-frequency (HF) component. CONCLUSIONS HR increased with age over the 15-year period in the healthy elderly persons. As for concurrent changes in HRV, however, the parameters of sympathetic modulation decreased, and the parameters of parasympathetic modulation were unchanged or slightly increased.
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Affiliation(s)
- H Tasaki
- The Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
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Toda G, Iliev II, Kawahara F, Hayano M, Yano K. Left ventricular aneurysm without coronary artery disease, incidence and clinical features: clinical analysis of 11 cases. Intern Med 2000; 39:531-6. [PMID: 10888207 DOI: 10.2169/internalmedicine.39.531] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To examine the incidence, underlying disease and clinical features of left ventricular aneurysm (LVA) not related to coronary artery occlusion. METHODS Retrospective review of consecutive patients who underwent both left ventriculography and coronary angiography. PATIENTS LVA was confirmed in 11 of 2,348 consecutive patients (0.47%). RESULTS The location of LVA was mainly in the apical region (81.8%). In five of the 11 patients (45.5%), the underlying heart disease was hypertrophic cardiomyopathy (HCM), including 4 patients of dilated phase and one patient of midventricular type. The serial ECG changes from left ventricular hypertrophy to abnormal Q wave and endomyocardial biopsy were useful for the differential diagnosis of these cases against myocardial infarction. The underlying disease of the remaining patients was: myocarditis (2 patients), arrhythmogenic right ventricular dysplasia (1 patient), Chagas' disease (1 patient), glycogen storage disease (1 patient), and sarcoidosis (1 patient). Ventricular tachycardia appeared in 9 of 11 cases (81.8%) including 2 patients with sustained ventricular tachycardia. CONCLUSION LVA formation without coronary artery disease was a rare phenomenon. The underlying disease was varied but the incidence of hypertrophic cardiomyopathy in the dilated phase was comparatively high. Ventricular tachycardia was a significant complication in these patients.
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Affiliation(s)
- G Toda
- Third Department of Internal Medicine, Nagasaki University School of Medicine
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Oishi K, Hayano M, Yoshimine H, Tugume SB, Kebba A, Mugerwa R, Mugyenyi P, Kumatori A, Matsushima K, Nagatake T. Expression of chemokine receptors on CD4+ T cells in peripheral blood from HIV-infected individuals in Uganda. J Interferon Cytokine Res 2000; 20:597-602. [PMID: 10888116 DOI: 10.1089/10799900050044796] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
CXCR4, a coreceptor for T cell (T)-tropic HIV-1, is preferentially expressed on naive T cells, whereas CCR5, a coreceptor for macrophage (M)-tropic HIV-1, is preferentially expressed on previously activated memory T cells and the Th1 subset of CD4+ T cells. CCR4 is preferentially expressed on the Th2 subset of CD4+ T cells. A cross-sectional flow cytometry study was conducted to evaluate the expression of CXCR4, CCR5, and CCR4 on the peripheral blood CD4+ T cells from African HIV-1-infected and uninfected Ugandan adults. The plasma viral load in HIV-1-infected individuals was also examined. Upregulation of CCR4 and CCR5 expression but no decrease in CXCR4 expression on CD4+ T cells were obtained in peripheral blood from African adults with progression of the disease. Plasma HIV-1 viremia significantly and inversely correlated with the peripheral CD4+ T cell count but did not correlate with the degree of CCR4 and CCR5 expression on the peripheral CD4+ T cells in HIV-1-infected individuals. Our present data suggest an increase in percentage of activated memory CD4+ T cells in the advanced stage of HIV-1 infection among African adults. There was no evidence of a Th1 to Th2 shift in terms of chemokine receptor expression profile with advancing disease in the peripheral blood of these subjects.
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Affiliation(s)
- K Oishi
- Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, Japan.
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Matsuo K, Doi Y, Fukae S, Nakao K, Iliev I, Komiya N, Isomoto S, Hayano M, Yano K. Radiofrequency catheter ablation of a concealed atrioventricular accessory pathway associated with a coronary sinus diverticulum. Jpn Circ J 2000; 64:393-5. [PMID: 10834458 DOI: 10.1253/jcj.64.393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 31-year-old woman underwent radiofrequency catheter ablation of a concealed left posteroseptal accessory pathway associated with a coronary sinus diverticulum. The patient had previously undergone unsuccessful catheter ablation of the posteroseptal region of the mitral annulus. Coronary sinus venography revealed the presence of the diverticulum near the ostium. An electrogram in the neck of the diverticulum showed the shortest ventriculoatrial conduction time and a large accessory pathway potential during atrioventricular reciprocating tachycardia. The pathway was successfully ablated within the neck of the diverticulum. The findings in this case underscore the importance of coronary sinus venography before ablation.
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Affiliation(s)
- K Matsuo
- Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
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Abstract
BACKGROUND Acquired retinal macroaneurysms are round dilatations of retinal arterioles that occur in the posterior fundus. They tend to rupture before they grow large and cause a visual decrease. The average diameter of macroaneurysms in the previous reports is 281 micrometer. METHODS A 63-year-old man complained of a sudden decrease of visual acuity in the left eye. Fundus examination of his left eye revealed a large protruded mass, 2 disc diameters in size, at the first bifurcation of the inferotemporal retinal artery. Preretinal vitreous bleeding and serous retinal detachment were observed around the lesion. Indocyanine green (ICG) angiography showed this mass to be continuous with the inferotemporal retinal artery and ICG dye leaked from the retinal artery into the lumen of the mass, with pulsation. RESULTS Six months later, the large macroaneurysm underwent spontaneous involution. CONCLUSION As shown in this patient, retinal macroaneurysms may grow extremely large. ICG angiography was useful to diagnose this large retinal arterial macroaneurysm.
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Affiliation(s)
- K Ohno-Matsui
- Department of Ophthalmology, School of Medicine, Tokyo Medical and Dental University, Japan.
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