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Ozaki Y, Kitabata H, Takahata M, Katayama Y, Wada T, Hikida R, Taruya A, Shiono Y, Kuroi A, Yamano T, Tanimoto T, Tanaka A. Intracoronary Near-Infrared Spectroscopy to Predict No-Reflow Phenomenon During Percutaneous Coronary Intervention in Acute Coronary Syndrome. Am J Cardiol 2024; 219:17-24. [PMID: 38490338 DOI: 10.1016/j.amjcard.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024]
Abstract
Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) can identify the lipid-rich lesions, described as high lipid-core burden index (LCBI). The aim of this study was to investigate the relation between lipid-core plaque (LCP) in the infarct-related lesion detected using NIRS-IVUS and no-reflow phenomenon during percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). We investigated 371 patients with ACS who underwent NIRS-IVUS in the infarct-related lesions before PCI. The extent of LCP in the infarct-related lesion was calculated as the maximum LCBI for each of the 4-mm longitudinal segments (maxLCBI4mm) measured by NIRS-IVUS. The patients were divided into 2 groups using a maxLCBI4mm cut-off value of 400. The overall incidence of no-reflow phenomenon was 53 of 371 (14.3%). No-reflow phenomenon more frequently occurred in patients with maxLCBI4mm ≥400 compared with those with maxLCBI4mm<400 (17.5% vs 2.5%, p <0.001). After propensity score matching, multivariable logistic regression analysis demonstrated that maxLCBI4mm (odds ratio: 1.008; 95% confidence interval: 1.005 to 1.012, p <0.001) was independently associated with the no-reflow phenomenon. The maxLCBI4mm of 719 in the infarct-related lesion had the highest combined sensitivity (69.8%) and specificity (72.1%) for the identification of no-reflow phenomenon. In conclusion, in patients with ACS, maxLCBI4mm in the infarct-related lesion assessed by NIRS-IVUS was independently associated with the no-reflow phenomenon during PCI.
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Affiliation(s)
- Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Takahata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Teruaki Wada
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Ryo Hikida
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Yamano
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Yamano T, Thammakumpee K, Nabkasorn C, Ritngam A, Krungkraipetch N, Kaewwilai L, Suwanmanee S, Phosri A, Kaewboonchoo O, Murakami S, Tanaka R, Murata N, Katayama Y, Taruya A, Takahata M, Wada T, Ota S, Satogami K, Ozaki Y, Kashiwagi M, Shiono Y, Kuroi A, Tanimoto T, Kitabata H, Tanaka A. Impact of Climate on the Incidence of Acute Coronary Syndrome - Differences Between Japan and Thailand. Circ Rep 2024; 6:134-141. [PMID: 38606419 PMCID: PMC11004035 DOI: 10.1253/circrep.cr-24-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/10/2024] [Indexed: 04/13/2024] Open
Abstract
Background: Although there are many reports of temperature being associated with the onset of acute coronary syndrome (ACS), few studies have examined differences in ACS due to climatic differences between Japan and Thailand. The aim of this joint Japan-Thailand study was to compare patients with myocardial infarction in Japanese and Thai hospitals in different climates. Methods and Results: We estimated the climate data in 2021 for the Wakayama Prefecture and Chonburi Province, two medium-sized cities in Japan and Thailand, respectively, and ACS patients who were treated at the Wakayama Medical University (WMU) and Burapha University Hospital (BUH), the two main hospitals in these provinces (ACS patient numbers: WMU, n=177; BUH, n=93), respectively. In the Chonburi Province, although the average temperature was above 25℃, the number of ACS cases in BUH varied up to threefold between months (minimum: July, 4 cases; maximum: October, 14 cases). In Japan and Thailand, there was a mild to moderate negative correlation between temperature-atmospheric pressure at the onset of ACS, but different patterns for temperature-humidity (temperature-atmospheric pressure, temperature-humidity, and atmospheric pressure-humidity: correlation index; r=-0.561, 0.196, and -0.296 in WMU vs. r=-0.356, -0.606, and -0.502 in BUH). Conclusions: The present study suggests that other climatic conditions and factors, not just temperature, might be involved in the mechanism of ACS.
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Affiliation(s)
- Takashi Yamano
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | | | | | | | | | | | - San Suwanmanee
- Faculty of Public Health, Mahidol University Bangkok Thailand
| | - Arthit Phosri
- Faculty of Public Health, Mahidol University Bangkok Thailand
| | | | - Shin Murakami
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Rikuya Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Nanami Murata
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Masahiro Takahata
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Teruaki Wada
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University Wakayama Japan
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Yoshino F, Ozaki Y, Shibahara T, Matsuoka M, Tachibana M, Ago T, Kitazono T, Kuroda J, Nakane H. FLAIR hyperintense cortical lesions in anti-myelin oligodendrocyte glycoprotein antibody-associated encephalitis with seizure following SARS-CoV-2 mRNA vaccination. eNeurologicalSci 2024; 34:100492. [PMID: 38469372 PMCID: PMC10926202 DOI: 10.1016/j.ensci.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 03/13/2024] Open
Affiliation(s)
- Fumitaka Yoshino
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Yuichi Ozaki
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Tomoya Shibahara
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Mikiaki Matsuoka
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Masaki Tachibana
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Junya Kuroda
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Hiroshi Nakane
- Department of Neurology, National Hospital Organization Fukuokahigashi Medical Center, Japan
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Ota S, Izumiya Y, Kitada R, Nishi T, Taruya A, Wada T, Takahata M, Ozaki Y, Kashiwagi M, Shiono Y, Kuroi A, Takemoto K, Tanimoto T, Kitabata H, Fukuda D, Tanaka A. Diagnostic significance of paradoxical left ventricular hypertrophy in detecting cardiac amyloidosis. Int J Cardiol Heart Vasc 2023; 49:101279. [PMID: 37859641 PMCID: PMC10582063 DOI: 10.1016/j.ijcha.2023.101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
Background Cardiac amyloidosis (CA) progresses rapidly with a poor prognosis. Therefore, methods for early diagnosis that are easily accessible in any hospital, are required. We hypothesized that based on the pathology of CA, morphological left ventricular hypertrophy (LVH) without electrical augmentation, namely paradoxical LVH, could be used to diagnose CA. This study aimed to investigate whether paradoxical LVH has diagnostic significance in identifying CA in patients with LVH. Methods Patients who presented with left ventricular (LV) wall thickness ≥ 12 mm on cardiac magnetic resonance (CMR) were enrolled from a multicentre CMR registry. Paradoxical LVH was defined as a LV wall thickness ≥ 12 mm on CMR, SV1 + RV5 < 3.5 mV, and a lack of secondary ST-T abnormalities. The diagnostic significance of paradoxical LVH in identifying CA was assessed. Results Of the 110 patients enrolled, 30 (27 %) were diagnosed with CA and 80 (73 %) with a non-CA aetiology. The CA group demonstrated paradoxical LVH more frequently than the non-CA group (80 % vs. 16 %, P < 0.001). It was an independent predictor for detecting CA in patients with LVH (odds ratio: 33.44, 95 % confidence interval: 8.325-134.3, P < 0.001). The sensitivity, specificity, positive predict value, negative predict value and accuracy of paradoxical LVH for CA detection were 80 %, 84 %, 65 %, 92 % and 83 %, respectively. Conclusions Paradoxical LVH can be used for identifying CA in patients with LVH. Our findings could contribute to the early diagnosis of CA, even in non-specialized hospitals.
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Affiliation(s)
- Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ryoko Kitada
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Nishi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Teruaki Wada
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Takahata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazushi Takemoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Satogami K, Katayama Y, Ozaki Y, Taruya A, Taniguchi M, Ota S, Kuroi A, Shiono Y, Tanimoto T, Yamano T, Kitabata H, Ino Y, Tanaka A. Characteristics of Discharged Elderly Patients with Acute Heart Failure Followed by Board-Certified-Cardiologists in a Rural Area of Japan. Int Heart J 2023; 64:1105-1112. [PMID: 37967981 DOI: 10.1536/ihj.23-306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
The worldwide incidence rates of heart failure (HF) are approaching pandemic status due to aging societies. Board-certified cardiologists (BCCs) of the Japanese Circulation Society (JCS) are cardiologists who have completed the respective fellowship program and passed the examination. However, in rural areas, patients have limited access to medical care for social or geographical reasons. The clinical features of the specialist's follow-up for HF patients in rural areas are unclear.This study consists of 205 consecutive discharged elderly patients who were admitted to our hospital due to acute HF (AHF). All patients were recommended for follow-up with BCCs-JCS by the multidisciplinary HF team at the discharge-care planning meeting. The aim of this study was to investigate the clinical features and impact of BCC follow-up for discharged elderly patients with AHF in rural areas.A total of 156 patients chose follow-up with BCCs-JCS (BCC group), and 49 patients chose follow-up with non-BCCs-JCS (non-BCC group). Patients in the BCC group were younger (83 [76-86] versus 89 [75-93] years old, P < 0.001) and had more frequent use of β-blockers (67% versus 39%, P < 0.001). The degree of frailty assessed by the clinical frailty scale was more severe in the non-BCC group than in the BCC group (4 [3-5] versus 6 [4-7], P < 0.001). The non-BCC group lived in nursing homes more frequently than the BCC group (16% versus 5%, P = 0.011).The HF patients followed by BCCS-JCS in rural areas were younger and had less frailty.
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Affiliation(s)
- Keisuke Satogami
- Department of Cardiovascular Medicine, Wakayama Medical University
- Department of Cardiology, Shingu Municipal Medical Center
| | | | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University
- Department of Cardiology, Shingu Municipal Medical Center
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takashi Yamano
- Department of Cardiology, Shingu Municipal Medical Center
| | | | - Yasushi Ino
- Department of Cardiology, Shingu Municipal Medical Center
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University
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Kazeto Y, Ito R, Tanaka T, Suzuki H, Ozaki Y, Okuzawa K, Gen K. Establishment of cell-lines stably expressing recombinant Japanese eel follicle-stimulating hormone and luteinizing hormone using CHO-DG44 cells: fully induced ovarian development at different modes. Front Endocrinol (Lausanne) 2023; 14:1201250. [PMID: 37693354 PMCID: PMC10486264 DOI: 10.3389/fendo.2023.1201250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/24/2023] [Indexed: 09/12/2023] Open
Abstract
The gonadotropins (Gth), follicle-stimulating hormone (Fsh) and luteinizing hormone (Lh), play central roles in gametogenesis in vertebrates. However, available information on their differential actions in teleost, especially in vivo, is insufficient. In this study, we established stable CHO-DG44 cell lines expressing long-lasting recombinant Japanese eel Fsh and Lh with extra O-glycosylation sites (Fsh-hCTP and Lh-hCTP), which were produced in abundance. Immature female eels received weekly intraperitoneal injections of Gths. Fsh-hCTP induced the entire ovarian development by 8 weeks from the beginning of injection; thus, the ovaries of most fish were at the migratory nucleus stage while the same stage was observed in eels after 4 weeks in the Lh-hCTP-treated group. In contrast, all pretreated and saline-injected eels were in the pre-vitellogenic stage. Gonadosomatic indices in the Fsh-hCTP-treated group were significantly higher than those in the Lh-hCTP group at the migratory nucleus stage because of the significantly higher frequency of advanced ovarian follicles. Ovarian mRNA levels of genes related to E2 production (cyp11a1, cyp17a1, cyp19a1, hsd3b, fshr, and lhr) were measured using real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). All genes were induced by both Fsh-hCTP and Lh-hCTP, with a peak at either the mid- or late vitellogenic stages. Transcript abundance of cyp19a1 and fshr in the Lh-hCTP group were significantly higher than those in the Fsh-hCTP group, whereas no difference in the expression of other genes was observed between the groups. Fluctuations in serum levels of sex steroid hormones (estradiol-17β, 11-ketotestosterone, and testosterone) in female eels were comparable in the Fsh-hCTP and Lh-hCTP groups, thus increasing toward the maturational phase. Furthermore, the fecundity of the eels induced to mature by Fsh-hCTP was significantly higher than that induced by Lh-hCTP. These findings indicate that Fsh and Lh can induce ovarian development in distinctively different modes in the Japanese eel.
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Affiliation(s)
- Yukinori Kazeto
- Fisheries Technology Institute, Minamiizu Field Station, Japan Fisheries Research and Education Agency, Minamiizu, Shizuoka, Japan
| | - Risa Ito
- Fisheries Technology Institute, Tamaki Field Station, Japan Fisheries Research and Education Agency, Tamaki, Mie, Japan
| | - Toshiomi Tanaka
- Hamanako Branch, Shizuoka Prefectural Research Institute of Fishery and Ocean, Hamamatsu, Shizuoka, Japan
| | - Hiroshi Suzuki
- Fisheries Technology Institute, Shibushi Field Station, Japan Fisheries Research and Education Agency, Shibushi, Kagoshima, Japan
| | - Yuichi Ozaki
- Fisheries Technology Institute, Tamaki Field Station, Japan Fisheries Research and Education Agency, Tamaki, Mie, Japan
| | - Koichi Okuzawa
- Fisheries Technology Institute, Tamaki Field Station, Japan Fisheries Research and Education Agency, Tamaki, Mie, Japan
| | - Koichiro Gen
- Fisheries Technology Institute, Nagasaki Station, Japan Fisheries Research and Education Agency, Nagasaki, Japan
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Nakai M, Ozaki Y, Kitabata H, Nishimura Y, Tanaka A. Postpartum spontaneous coronary artery dissection recovered by coronary artery bypass grafting supported with Impella device. J Invasive Cardiol 2023; 35:E75-E83. [PMID: 37983096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
A 34-year-old female who had delivered a baby 9 days ago was transferred to our hospital due to sudden dyspnea and cardiogenic shock. Her electrocardiogram showed ST-segment elevation in precordial leads, and left ventricular ejection fraction was 20%.
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Affiliation(s)
- Mai Nakai
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan,
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshiharu Nishimura
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Ozaki Y, Kashiwagi M, Imanishi T, Katayama Y, Taruya A, Nishiguchi T, Shiono Y, Kuroi A, Yamano T, Tanimoto T, Kitabata H, Tanaka A. Prognostic value of Toll-like receptor 4 on human monocyte subsets combined with computed tomography-adapted Leaman score assessing coronary artery disease. Coron Artery Dis 2023; 34:356-363. [PMID: 37222220 PMCID: PMC10309091 DOI: 10.1097/mca.0000000000001250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/21/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Upregulation of Toll-like receptor 4 (TLR-4) is associated with coronary plaque vulnerability assessed by coronary computed tomography angiography (CCTA). Computed tomography-adapted Leaman score (CT-LeSc) is an independent long-term predictor of cardiac events. The relationship between the TLR-4 expression of CD14 ++ CD16 + monocytes and future cardiac events is unknown. We investigated this relationship using CT-LeSc in patients with coronary artery disease (CAD). METHODS We analyzed 61 patients with CAD who underwent CCTA. Three monocyte subsets (CD14 ++ CD16 - , CD14 ++ CD16 + , and CD14 + CD16 + ) and the expression of TLR-4 were measured by flow cytometry. We divided the patients into two groups according to the best cutoff value of the TLR-4 expression on CD14 + CD16 + which could predict future cardiac events. RESULTS CT-LeSc was significantly greater in the high TLR-4 group than the low TLR-4 group [9.61 (6.70-13.67) vs. 6.34 (4.27-9.09), P < 0.01]. The expression of TLR-4 on CD14 ++ CD16 + monocytes was significantly correlated with CT-LeSc ( R2 = 0.13, P < 0.01). The expression of TLR-4 on CD14 ++ CD16 + monocytes was significantly higher in patients who had future cardiac events than in those who did not [6.8 (4.5-9.1) % vs. 4.2 (2.4-7.6) %, P = 0.04]. High TLR-4 expression on CD14 ++ CD16 + monocytes was an independent predictor for future cardiac events ( P = 0.01). CONCLUSION An increase in the TLR-4 expression on CD14 ++ CD16 + monocytes is related to the development of future cardiac events.
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Affiliation(s)
- Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Toshio Imanishi
- Department of Cardiovascular Medicine, Hidaka General Hospital, Gobo
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Tsuyoshi Nishiguchi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Takashi Yamano
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
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Nozawa K, Terada M, Onishi M, Ozaki Y, Takano T, Fakhouri W, Novick D, Haro JM, Faris LH, Kawaguchi T, Tanizawa Y, Tsurutani J. Real-world treatment patterns and outcomes of abemaciclib for the treatment of HR + , HER2- metastatic breast cancer patients in Japan. Breast Cancer 2023:10.1007/s12282-023-01461-6. [PMID: 37217763 DOI: 10.1007/s12282-023-01461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/08/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION This study described, in routine clinical practice in Japan, the patient characteristics, treatment patterns, and outcomes of female patients with HR + /HER2- metastatic breast cancer (MBC) who started abemaciclib treatment. METHODS Clinical charts were reviewed for patients starting abemaciclib in 12/2018-08/2021 with a minimum of 3 months follow-up data post-abemaciclib initiation regardless of abemaciclib discontinuation. Patient characteristics, treatment patterns, and tumor response were descriptively summarized. Kaplan-Meier curves estimated progression-free survival (PFS). RESULTS 200 patients from 14 institutions were included. At abemaciclib initiation, median age was 59 years, and the Eastern Cooperative Oncology Group performance status score was 0/1/2 for 102/68/5 patients (58.3/38.9/2.9%), respectively. Most had an abemaciclib starting dose of 150 mg (92.5%). The percentage of patients receiving abemaciclib as 1st, 2nd, or 3rd line treatment was 31.5%, 25.8%, and 25.2%, respectively. The most frequent endocrine therapy drugs used with abemaciclib were fulvestrant (59%) and aromatase inhibitors (40%). Evaluation of tumor response was available for 171 patients, 30.4% of whom had complete/partial response. Median PFS was 13.0 months (95% CI 10.1-15.8 months). CONCLUSIONS In a routine clinical practice setting in Japan, patients with HR + , HER2- MBC appear to benefit from abemaciclib treatment in terms of treatment response and median PFS, with the results broadly reflecting the evidence demonstrated in clinical trials.
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Affiliation(s)
- K Nozawa
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Terada
- Department of Breast Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - M Onishi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Ozaki
- Department of Breast Medical Oncology, Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Takano
- Department of Breast Medical Oncology, Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - W Fakhouri
- Eli Lilly and Company, Indianapolis, IN, USA
| | - D Novick
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - L H Faris
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - T Kawaguchi
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Y Tanizawa
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan.
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10
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Iesato A, Ueno T, Takahashi Y, Kataoka A, Matsunaga Y, Saeki S, Ozaki Y, Inoue Y, Maeda T, Uehiro N, Kobayashi T, Sakai T, Takano T, Kogawa T, Kitano S, Ono M, Osako T, Ohno S. P145 Postpartum breast cancer diagnosed within 10 years of last childbirth is a prognostic factor for distant metastasis – analysis of lymphovascular invasion relating factors. Breast 2023. [DOI: 10.1016/s0960-9776(23)00262-x] [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: 03/15/2023] Open
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11
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Ozaki Y, Taniguchi M, Katayama Y, Satogami K, Ino Y, Tanaka A. Which is more useful for predicting no-reflow phenomenon? Insights from optical coherence tomography and coronary computed tomography. Cardiovasc Interv Ther 2023; 38:246-247. [PMID: 36404374 DOI: 10.1007/s12928-022-00897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/04/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan.
| | - Motoki Taniguchi
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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12
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Yoshimura A, Nakakami A, Komaki R, Isogai A, Endo Y, Ozaki Y, Nozawa K, Kataoka A, Kotani H, Hattori M, Sawaki M, Iwata H. P289 Retrospective study of pregnancy outcome after breast cancer. Breast 2023. [DOI: 10.1016/s0960-9776(23)00407-1] [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: 03/15/2023] Open
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13
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Endo Y, Kotani H, Nakakami A, Komaki R, Isogai A, Ozaki Y, Nozawa K, Kataoka A, Yoshimura A, Hattori M, Sawaki M, Iwata H. P232 A study to evaluate the safety and utility of targeted axillary dissection using Guiding-Marker System. Breast 2023. [DOI: 10.1016/s0960-9776(23)00350-8] [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: 03/15/2023] Open
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14
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Ozaki Y, Taniguchi M, Katayama Y, Ino Y, Tanaka A. Early Healing of Spontaneous Coronary Artery Dissection Confirmed by Optical Coherence Tomography. J Invasive Cardiol 2023; 35:E154-E155. [PMID: 36884362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Our image series show the use of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in the diag- nosis and treatment of a 52-year-old male who was admitted to our hospital because of inferior ST-segment-elevation myocardial infarction. An emergent coronary angiogram showed the total occlusion at the proximal site of the right coronary artery (RCA). IVUS revealed false lumen and intramural hematoma, as well as intimal tear at the proximal site of RCA, diagnosed as a spontaneous coronary artery dissection (SCAD). A drug-eluting stent was implanted over the intimal tear at the proximal site of the RCA. Twenty-eight days later, OCT demonstrated completely healed SCAD with TIMI 3 flow. OCT can visualize the 3-layered construction of the vessel wall and accurately diagnose SCAD. This image provides a presentation of early healing of acute SCAD confirmed by OCT, and might help in the management of acute SCAD.
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Affiliation(s)
- Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan.
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15
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Satogami K, Katayama Y, Ozaki Y, Taruya A, Taniguchi M, Ota S, Kuroi A, Shiono Y, Tanimoto T, Yamano T, Kitabata H, Ino Y, Tanaka A. Long-term risk stratification for hospitalized patients with acute heart failure at a single rural cardiovascular centre. ESC Heart Fail 2023; 10:1717-1725. [PMID: 36840441 DOI: 10.1002/ehf2.14325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/04/2023] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
AIMS Early risk stratification of patients with acute heart failure (AHF) is critical for appropriate triage and outcome improvement. The serum sodium, blood urea nitrogen, age, serum albumin, systolic blood pressure, and natriuretic peptide level (SOB-ASAP) score can predict in-hospital mortality of AHF. However, the relationship between the SOB-ASAP score and long-term prognosis is unknown. This study investigated the determinants of the long-term prognosis of AHF by evaluating the SOB-ASAP score. METHODS This retrospective cohort study included all patients with acute decompensated heart failure who were admitted to our hospital between April 2017 and March 2018. And those who discharged were analysed retrospectively. The follow-up period was 3 years. Primary end point was all-cause death. RESULTS Total of 140 patients were analysed. The median SOB-ASAP score of entire cohort on admission was 3 points (interquartile range; 1-5). The Kaplan-Meier curve demonstrated that patients in the higher SOB-ASAP group (score ≥3) had a higher incidence of all-cause death (log-rank test; P < 0.001) than those in the lower SOB-ASAP (group score <3). CONCLUSIONS At admission, the SOB-ASAP score may be useful for predicting the long-term prognosis of hospitalized patients with AHF.
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Affiliation(s)
- Keisuke Satogami
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yosuke Katayama
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Motoki Taniguchi
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Yamano
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasushi Ino
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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16
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Taniguchi M, Ozaki Y, Katayama Y, Satogami K, Ino Y, Tanaka A. Impact of upper arm prolonged occlusion on radial artery diameter before coronary angiography in patients with coronary artery disease. Cardiovasc Revasc Med 2023; 51:38-42. [PMID: 36725424 DOI: 10.1016/j.carrev.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/11/2023] [Accepted: 01/24/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND The transradial approach (TRA) for percutaneous coronary angiography and intervention has been increasingly gaining popularity in clinical practice. However, there are cases in which it is difficult to insert a sheath or catheter due to spasm, pulsation loss, and occlusion. It has been reported that flow-mediated dilatation (FMD) contributed to the reduction of complications due to the TRA and the improvement of the number of puncture attempts. We hypothesized that FMD might increase the radial artery diameter and plasma nitric oxide (NO). METHODS AND RESULTS A prospective, single-blind, randomized, parallel-group, single-center study to investigate the effect of FMD on radial artery diameter. Fifty-four patients were enrolled and randomly assigned into the pressure group or non-pressure group. Radial artery diameter pre and post procedure and plasma NO after sheath canulation were analyzed in both groups. We measured the biological NO as its stable metabolic products, nitrite and nitrate, and express the results as total nitrogen oxides (NOx). The diameter of pre-procedural radial artery was similar between the 2 groups. However, in the pressure group, the increase of radial artery diameter between post- and pre-procedure was significantly greater than those in the non-pressure group (pressure group; 0.18 [0.07-0.29] mm vs. non-pressure group; -0.33 [-0.04 to -0.22] mm, p = 0.001). No significant differences were observed in terms of plasma NOx between the 2 groups. CONCLUSIONS It was possible to prove the increase in the radial artery diameter by performing FMD in the clinical practice, and to support the feasibility of FMD.
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Affiliation(s)
- Motoki Taniguchi
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan.
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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17
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Biccire FG, Budassi S, Ozaki Y, Boi A, Romagnoli E, Di Pietro R, Debelak C, Sammartini E, Versaci F, Fabbiocchi F, Burzotta F, Crea F, Arbustini E, Alfonso F, Prati F. Morphological and clinical implications of the optical coherence tomography-derived lipid core burden index. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1205] [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: 11/12/2022] Open
Abstract
Abstract
Background
Intracoronary optical coherence tomography (OCT) is a valuable tool for vulnerable plaque assessment and morphology-guided risk stratification. However the groundbreaking impact of OCT in clinical practice may be offset by its inherent limitation, the subjectivity in plaque interpretation. Recent studies reported a semi-automated method to assess fibrous cap thickness but data regarding an automated assessment of lipid component at OCT, such a lipid core burden index (LCBI), are lacking.
Purpose
The aim of this study was to assess the morphological characteristics and prognostic implications of an OCT-derived LCBI (OCT-LCBI).
Methods
In order to assess OCT-LCBI in 1003 patients with 1-year follow-up from the CLIMA multicenter registry (clinicaltrial.gov identifier NCT02883088) we used a novel previously validated software able to automate obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI4mm). A maxOCT-LCBI4mm cut-off of 400 was used, based on previous literature on this topic. Primary composite clinical endpoint included cardiac death, myocardial infarction and target vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed.
Results
Patients with a maxOCT-LCBI4mm ≥400 showed higher prevalence of fibrous cap thickness <75μm (FCT, odds ratio [OR] 1.43, 95% confidence interval [CI] 1.03–1.99; p=0.034), lipid pool arc >180°(OR 3.93, 95% CI 2.97–5.21; p<0.001), minimum lumen area <3.5 mm2 (OR 1.5, 1.16–1.94; p=0.002), macrophage infiltration (OR 2.38, 95% CI 1.81–3.13; p<0.001) and intra-plaque intimal vasculature (OR 1.34, 95% CI 1.05–1.72, p=0.021). A maxOCT-LCBI4mm ≥400 predicted the primary endpoint (adjusted hazard ratio [HR] 1.86, 95% CI 1.1–3.2; p=0.019) as well as the CLIMA endpoint (HR 2.56, 95% CI 1.24–5.29; p=0.011). Patients with high lipid content and thin FCT <75 μm were at higher risk for adverse events (HR 4.88, 95% CI 2.44–9.72; p<0.001) (Figure 1).
Conclusions
We applied for the first time in a large population with clinical follow-up a software able to automatically obtain a maxOCT-LCBI4mm. A high maxOCT-LCBI4mm was related to vulnerable plaque features and further clinical events. This study represents a step further towards a comprehensive automated assessment of the coronary plaque risk profile.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Supported by a grant from the Centro per la Lotta contro l'Infarto – Fondazione Onlus, Rome, Italy
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Affiliation(s)
| | - S Budassi
- San Giovanni Addolorata Hospital , Rome , Italy
| | - Y Ozaki
- Fujita Health University Hospital , Toyoake , Japan
| | - A Boi
- AO Brotzu Hospital , Cagliari , Italy
| | - E Romagnoli
- Catholic University of the Sacred Heart , Rome , Italy
| | - R Di Pietro
- Santa Maria Goretti Hospital , Latina , Italy
| | | | | | - F Versaci
- Santa Maria Goretti Hospital , Latina , Italy
| | | | - F Burzotta
- Catholic University of the Sacred Heart , Rome , Italy
| | - F Crea
- Catholic University of the Sacred Heart , Rome , Italy
| | - E Arbustini
- Policlinic Foundation San Matteo IRCCS , Pavia , Italy
| | - F Alfonso
- La Princesa University Hospital , Madrid , Spain
| | - F Prati
- UniCamillus - Saint Camillus International University of Health Sciences , Rome , Italy
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18
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Ota S, Taniguchi M, Katayama Y, Ozaki Y, Satogami K, Ino Y, Yamamoto N, Onoda K, Tanaka A. Usefulness of Cardiovascular Magnetic Resonance Imaging in a Patient with Cardiac Involvement of Systemic Sclerosis. Intern Med 2022; 61:1977-1981. [PMID: 34840229 PMCID: PMC9334230 DOI: 10.2169/internalmedicine.8418-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 72-year-old Japanese woman with systemic sclerosis was admitted to our hospital because of symptoms of heart failure. Cardiovascular magnetic resonance (CMR) imaging had shown that extensive myocardial fibrosis secondary to systemic sclerosis was the main cause of heart failure. One month after CMR, she had complete atrioventricular (AV) block. It was suggested that the progression of fibrosis to the AV node caused complete AV block. This case report has clinical implications in highlighting the fact that CMR is useful for not only evaluating the present pathophysiology but also predicting future adverse events in patients with systemic sclerosis.
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Affiliation(s)
- Shingo Ota
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Japan
| | - Motoki Taniguchi
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Japan
| | - Naoki Yamamoto
- Department of Cardiovascular Surgery, Shingu Municipal Medical Center, Japan
| | - Koji Onoda
- Department of Cardiovascular Surgery, Shingu Municipal Medical Center, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Japan
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19
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Ota S, Nishiguchi T, Taruya A, Tanimoto T, Ino Y, Katayama Y, Ozaki Y, Satogami K, Tanaka A. Hyperglycemia and intramyocardial hemorrhage in patients with ST-segment elevation myocardial infarction. J Cardiol 2022; 80:456-461. [PMID: 35750553 DOI: 10.1016/j.jjcc.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/20/2022] [Accepted: 06/03/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hyperglycemia at admission and intramyocardial hemorrhage (IMH) are associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Little is known about the relationship between glucose levels at admission and IMH. The association between matrix metalloproteinase-9 (MMP-9), which plays an important role in the development of IMH, and hyperglycemia is also unknown. This study aimed to investigate the relationship between hyperglycemia at admission and IMH in patients with STEMI. METHODS We enrolled 174 patients with first STEMI who underwent primary percutaneous coronary intervention (PCI) and cardiovascular magnetic resonance (CMR) imaging. T2-weighted imaging and late gadolinium enhancement (LGE)-CMR were performed to detect IMH and microvascular obstruction (MVO), respectively. Two patient groups were created: IMH group and non-IMH group. MMP-9 levels were measured in the culprit coronary arteries of 13 patients. RESULTS Glucose level at admission and the value of glycosylated hemoglobin were higher in the IMH group than in the non-IMH group [IMH group vs. non-IMH group; 208.5 (157.8-300.5) mg/dL vs. 157.0 (128.8-204.3) mg/dL, p < 0.001, and 6.2 (5.7-7.5) % vs. 5.8 (5.4-6.6) %, p = 0.030, respectively]. A multivariable logistic regression analysis revealed that only admission glucose level was an independent predictor of IMH (OR: 1.012; 95 % CI: 1.005-1.020, p = 0.001). The MMP-9 levels in patients with IMH were higher than those in patients without IMH [256.0 (161.0-396.0) ng/mL vs. 73.5 (49.5-131.0) ng/mL, p = 0.040]. There was a moderate positive correlation between glucose levels at admission and MMP-9 levels (r = 0.600, p = 0.030). CONCLUSIONS Hyperglycemia at admission is associated with the occurrence of IMH in patients with STEMI.
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Affiliation(s)
- Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | | | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Wakayama, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Wakayama, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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20
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Katayama Y, Taniguchi M, Ota S, Satogami K, Ozaki Y, Ino Y, Tanaka A. Acute coronary syndrome due to plaque erosion likely triggered by insect bites: a case series of Kounis syndrome. Eur Heart J Case Rep 2022; 6:ytac216. [PMID: 35685029 PMCID: PMC9174552 DOI: 10.1093/ehjcr/ytac216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/21/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022]
Abstract
Background Kounis syndrome is the concurrence of acute coronary syndrome (ACS), including coronary spasm, acute myocardial infarction, and stent thrombosis due to an allergic and/or anaphylactoid insult. Case summary We present two cases of Kounis syndrome likely triggered by insect bites, with plaque erosion demonstrated using optical coherence tomography (OCT). Three common findings were derived from this case series. First, the patients developed a rash after an insect bite followed by ACS. Second, immunoglobulin E levels were increased. Finally, OCT identified the aetiology of ACS in this case series as erosion of the culprit lesions. Discussion Kounis syndrome, which is ACS following allergic reactions due to insect bites, is a rare complication. Kounis syndrome is probably not uncommon, but underdiagnosed. It is important for physicians to consider the treatment of Kounis syndrome in the complex course of ACS associated with allergic reactions. Furthermore, patients with a history of Kounis syndrome should avoid antigen exposure during secondary prophylaxis. In some cases, it may take several days from antigen exposure to the onset of ACS. Considering Kounis syndrome is beneficial for early diagnosis and appropriate treatment.
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Affiliation(s)
- Yosuke Katayama
- Corresponding author. Tel: +81 735 31 3333, Fax: +81 735 31 3337,
| | - Motoki Taniguchi
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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21
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Ino Y, Takahata M, Kubo T, Khalifa AKM, Satogami K, Terada K, Ozaki Y, Katayama Y, Taruya A, Ota S, Wada T, Tanimoto T, Shiono Y, Kashiwagi M, Kuroi A, Tanaka A. Vascular Response After Everolimus-Eluting Stent in Acute Myocardial Infarction Caused by Calcified Nodule. Circ J 2022; 86:1388-1396. [PMID: 35545551 DOI: 10.1253/circj.cj-21-1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients with acute myocardial infarction (AMI) caused by calcified nodules (CN) have worse clinical outcomes following primary percutaneous coronary intervention (PCI). This study investigated the late vascular response after everolimus-eluting stent (EES) implantation assessed by optical coherence tomography (OCT) in patients with AMI caused by CN, by comparing with plaque rupture (PR) and plaque erosion (PE).Methods and Results: Based on the OCT findings in AMI culprit lesions before PCI, a total of 141 patients were categorized into 3 groups (PR, PE, or CN), and the OCT findings immediately and 10 months after PCI were compared. The frequency of PR, PE, and CN was 85 (60%), 45 (32%), and 11 patients (8%), respectively. In the 10-month follow-up OCT, the frequency of lesions with uncovered struts and lesions with malapposed struts were highest in the CN group, followed by the PR and PE groups (82% vs. 52% vs. 40%, P=0.042 and 73% vs. 26% vs. 16%, P<0.001, respectively). The incidence of intra-stent thrombus, re-appearance of CN within the stent, and target lesion revascularization were higher in the CN group compared with the PR and PE groups (36% vs. 9% vs. 7%, P=0.028; 27% vs. 0% vs. 0%, P<0.001; and 18% vs. 2% vs. 2%, P=0.024, respectively). CONCLUSIONS Late arterial healing response at 10 months after EES implantation in the CN was worse compared with PR and PE in patients with AMI.
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Affiliation(s)
- Yasushi Ino
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Amir Kh M Khalifa
- Department of Cardiovascular Medicine, Wakayama Medical University.,Department of Cardiovascular Medicine, Assiut University Hospitals
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Kosei Terada
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Teruaki Wada
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University
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22
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Ozaki Y, Tomoe H, Kuwajima M, Ninomiya N, Sekiguchi Y, Sato Y, Nagao K, Takahashi S. Prevalence of genitourinary syndrome of menopause in Japanese peri- and post-menopausal women: A cross-sectional online survey. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Iwamura H, Yoneyama T, Kodama H, Ozaki K, Ozaki Y, Okita K, Konishi S, Narita T, Fujita N, Kojima Y, Okamoto T, Tobisawa Y, Yamamoto H, Hatakeyama S, Yoneyama T, Hashimoto Y, Ohyama C. Development of a novel diagnostic model for urological cancers using comprehensive N-glycan signatures of serum immunoglobulins with a machine learning approach. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00097-5] [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: 11/29/2022]
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24
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Biccire FG, Budassi S, Isidori F, Lella E, Marco V, Ozaki Y, La Manna A, Bourantas CV, Paoletti G, Fabiocchi F, Gatto L, Burzotta F, Arbustini E, Alfonso F, Prati F. Adoption of a new automated optical coherence tomography software to obtain a lipid plaque spread-out plot. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Near infrared spectroscopy – intravascular ultrasound (NIRS-IVUS) imaging can provide a fully automated estimation of lipid burden, providing a two-dimensional spread-out plot, the Lipid Core Burden Index (LCBI), which has been associated with higher incidence of cardiac events. Optical coherence tomography (OCT) can identify lipid component with high accuracy and it is therefore potentially capable of measuring its longitudinal extension in a dedicated two-dimensional LCBI spread-out plot.
Purpose
The present study has been designed to validate a novel automated approach to assess OCT images, able of providing a dedicated LCBI spread-out plot plus other features of plaque vulnerability.
Methods
We compared the results obtained with a novel automated OCT alghorithm, developed utilising a convolutional neural network, with those obtained with conventional (manual) OCT and with NIRS-IVUS in a consecutive series of 40 patients with coronary artery disease. We tested and validated our new OCT algorithm to calculate the lipid core longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. In each coronary plaque, the following measurements were obtained with NIRS-IVUS: 1) minimum lumen area (MLA), 2) vessel area at MLA site, 3) plaque burden (%) at MLA site, 4) NIRS-defined lipid pool arch and 5) maximum LCBI measurement within a 4 mm length. The following OCT features were obtained: 1) the MLA cross section, 2) the minimum fibrous cap thickness (FCT) in presence of lipid components and measured as the average of three measurements obtained in the same cross-section and 3) maximum LCBI within a 4 mm length.
Results
Three lesions groups were identified according to the studied lesions: 1) culprit lesions in patients with acute coronary syndrome (ACS, n=16), 2) non-culprit lesions in patients with ACS (n=12) and 3) lesions in patients with stable angina (n=12). OCT conventional assessment showed for the culprit ACS plaques a trend for a larger lipid arc and a significant thinner FCT (p=0.028). Consistently, NIRS-IVUS showed for culprit ACS plaques a more complex anatomy. A strong trend for increased maximum LPBI in 4mm segments was found in the culprit ACS group, regardless of the adopted imaging modality, either NIRS-IVUS or automated OCT (p=0.184 and p=0.066, respectively, figure 1). A fair correlation was obtained for the maximum 4 mm LCBI measured by NIRS-IVUS and automated OCT (r=0.75). The sensitivity and specificity of automated OCT to detect significant LCBI, applying a validated 400 cut off were 90.5 and 84.2 respectively.
Conclusions
We developed an automated approach, comparable to NIRS, to assess OCT images that can provide a dedicated lipid plaque spread-out plot to address plaque vulnerability. The automated OCT software can promote and improve OCT clinical applications for the identification of patients at risk of hard events.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): CLI - Centro Lotta all'Infarto Spread-out plot by IVUS-NIRS and OCT
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Affiliation(s)
| | - S Budassi
- San Giovanni Addolorata Hospital, Rome, Italy, Cardiovascular Sciences Department, Rome, Italy
| | - F Isidori
- Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy, Rome, Italy
| | - E Lella
- Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy, Rome, Italy
| | - V Marco
- Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy, Rome, Italy
| | - Y Ozaki
- Fujita Health University Hospital, Toyoake, Japan
| | - A La Manna
- AOU Policlinico - Vittorio Emanuele, Catania, Italy
| | | | - G Paoletti
- 1. Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy, Rome, Italy
| | | | - L Gatto
- San Giovanni Addolorata Hospital, Rome, Italy, Cardiovascular Sciences Department, Rome, Italy
| | - F Burzotta
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - E Arbustini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - F Alfonso
- Hospital Universitario La Princesa, Madrid, Spain
| | - F Prati
- San Giovanni Addolorata Hospital, Rome, Italy, Cardiovascular Sciences Department, Rome, Italy
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Matsumura Y, Inomata S, Yamaguchi H, Mine H, Takagi H, Watanabe M, Ozaki Y, Muto S, Okabe N, Shio Y, Suzuki H. MA09.05 PD1-Positive Tertiary Lymphoid Structure as a Predictive Factor of Durable Clinical Effect in Immunotherapy for NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Satogami K, Ozaki Y, Ota S, Katayama Y, Ino Y, Akasaka T. Supporting evidence for ST-segment elevation myocardial infarction from optical coherence tomography. EUROINTERVENTION 2021; 17:506-507. [PMID: 33196447 PMCID: PMC9725035 DOI: 10.4244/eij-d-20-00985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, 647-0072, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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27
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Taruya A, Tanaka A, Nishiguchi T, Ozaki Y, Kashiwagi M, Yamano T, Matsuo Y, Ino Y, Kitabata H, Takemoto K, Kubo T, Hozumi T, Akasaka T. Lesion characteristics and prognosis of acute coronary syndrome without angiographically significant coronary artery stenosis. Eur Heart J Cardiovasc Imaging 2021; 21:202-209. [PMID: 31056642 DOI: 10.1093/ehjci/jez079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/02/2019] [Indexed: 12/29/2022] Open
Abstract
AIMS While patients with acute coronary syndrome (ACS) presenting with non-obstructive coronary artery disease (CAD) are at high risk for cardiovascular mortality and morbidity, detailed lesion characteristics are unclear. The aim of this study was to investigate the lesion characteristics and prognosis of ACS with non-obstructive CAD. METHODS AND RESULTS This study consisted of 82 consecutive ACS patients without obstructive CAD who underwent optical coherence tomography (OCT). Based on the presence of high-risk lesions (HL) in the culprit artery, we classified the patients into two groups: HL group and non-high-risk lesions (NHL) group. A systematic clinical follow-up was performed at our outpatient clinic for up to 24 months. Our endpoint was recurrence of ACS with obstructive CAD. OCT revealed that 42 (51.2%) of 82 patients had hidden HL in the culprit artery, including ruptured plaque (15.9%), calcified nodule (11.0%), spontaneous coronary artery dissection (8.5%), lone thrombus (8.5%), thin-cap fibroatheroma (6.1%), and plaque erosion (1.2%). During angiography, 5 (11.9%) HL patients complained of chest pain without ST elevation. Patients in the HL group had poorer prognoses than those in the other groups (P = 0.040). CONCLUSION Hidden high-risk lesions accompany ACS patients without obstructive CAD, resulting in poorer outcomes. Vascular injury itself might provoke acute chest pain.
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Affiliation(s)
- Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Tsuyoshi Nishiguchi
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Takashi Yamano
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Yoshiki Matsuo
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Kazushi Takemoto
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Takeshi Hozumi
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan
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28
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Ozaki Y, Garcia-Garcia HM, Melaku GD, Joner M, Galli S, Verheye S, Lee MKY, Waksman R, Haude M. Effect of Procedural Technique on Cardiovascular Outcomes Following Second-Generation Drug-Eluting Resorbable Magnesium Scaffold Implantation. Cardiovasc Revasc Med 2021; 29:1-6. [PMID: 34049817 DOI: 10.1016/j.carrev.2021.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study sought to assess target lesion failure (TLF) and clinically driven target lesion revascularization (CD-TLR) through 1 year following second-generation drug-eluting magnesium scaffold (Magmaris) implantation using a dedicated technique (so-called "4 P's" strategy). METHODS AND RESULTS The 4 P's strategy stands for: correct patient selection, proper scaffold sizing, pre-dilatation (<20% residual stenosis), post-dilatation. All the patient and lesion characteristics, preparation, and sizing of the device were compared in patients with TLF and CD-TLR through 1-year follow-up. We analyzed 315 patients for this study. At 1 year, there were 14 TLFs and 10 CD-TLRs. The TLF rates were 7.7%, 4.9%, and 4.1%; while the CD-TLR rates were 7.7%, 2.5%, and 3.2% in the undersized, properly sized, and oversized vessel groups, correspondingly. Diameter stenosis (DS) after pre-dilatation in patients with TLF and CD-TLR was significantly greater than in those without TLF and CD-TLR. In patients with a properly sized scaffold, DS after pre-dilatation was similar in patients with and without TLF and CD-TLR. However, in patients with non-properly sized scaffolds, greater post-balloon DS was observed in patients with TLF and CD-TLR. CONCLUSIONS Improper sizing and poor lesion preparation before Magmaris implantation appear to be related to TLF during 1-year follow-up.
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Affiliation(s)
- Yuichi Ozaki
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
| | - Gebremedhin D Melaku
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, Washington, DC, USA
| | - Michael Joner
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | | | - Stefan Verheye
- Interventional Cardiology, ZNA Cardiovascular Center Middelheim, Antwerp, Belgium
| | - Michael K Y Lee
- Division of Cardiology, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
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29
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Kazeto Y, Suzuki H, Ozaki Y, Gen K. C-terminal peptide (hCTP) of human chorionic gonadotropin enhances in vivo biological activity of recombinant Japanese eel follicle-stimulating hormone and luteinizing hormone produced in FreeStyle 293-F cell lines. Gen Comp Endocrinol 2021; 306:113731. [PMID: 33539901 DOI: 10.1016/j.ygcen.2021.113731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/15/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
Gonadotropins (Gths), follicle-stimulating hormone (Fsh), and luteinizing hormone (Lh) play central roles in the reproductive biology of vertebrates. In this study, recombinant single-chain Japanese eel Gths (rGth: rFsh and rLh), and recombinant chimeric Gths (rGth-hCTPs: rFsh-hCTP and rLh-hCTP; rGth-eCTPs: rFsh-eCTP and rLh-eCTP) with an extra O-glycosylation site (either a C-terminal peptide of human (hCTP) or equine (eCTP) chorionic gonadotropin), which are known to prolong the half-life of glycoprotein were produced in HEK293 cells and highly purified. Lectin blot analyses demonstrated that all these recombinant Gths contained N-glycans of the high mannose and complex types. In contrast, only rGth-hCTPs and rGth-eCTPs possessed highly sialylated O-linked oligosaccharides. Further analyses of glycans by liquid chromatography-mass spectrometry suggested that the species, amount, and degree of sialylation of N-glycans were comparable among recombinant Fshs and recombinant Lhs, while the amount of O-glycans with sialic acids in rGth-hCTPs was higher than that in the corresponding rGth-eCTPs. The serum levels of recombinant Gths in male eels significantly increased 12-24 h after a single injection of the Gths. The levels of rGth-hCTPs tended to be higher than those of the corresponding rGths and rGth-eCTPs throughout the experimental period, coinciding with the serum fluctuations of 11-ketotestosterone (11KT). The long-term treatment of male eels with these recombinant Gths also revealed the superiority of rGth-hCTPs in assisted reproduction; thus, the serum levels of 11KT and gonadosomatic indices in eels treated with rGth-hCTPs were higher than those in eels treated with the corresponding rGths and rGth-eCTPs. The induction of the entire process of spermatogenesis was only histologically observed in rGth-hCTPs-treated eels. These findings strongly suggest that hCTP enhances the in vivo biological activity of recombinant Japanese eel Gths due to the high abundance of O-linked glycans with sialylated antennae.
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Affiliation(s)
- Yukinori Kazeto
- Tamaki Field Station, Physiological Function Division, Aquaculture Research Department, Fisheries Technology Institute, Japan Fisheries Research and Education Agency, 224-1 Hiruda, Tamaki, Watarai, Mie 519-0423, Japan.
| | - Hiroshi Suzuki
- Tamaki Field Station, Physiological Function Division, Aquaculture Research Department, Fisheries Technology Institute, Japan Fisheries Research and Education Agency, 224-1 Hiruda, Tamaki, Watarai, Mie 519-0423, Japan; Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7 Konan, Minato-ku, Tokyo 108-8477, Japan.
| | - Yuichi Ozaki
- Tamaki Field Station, Physiological Function Division, Aquaculture Research Department, Fisheries Technology Institute, Japan Fisheries Research and Education Agency, 224-1 Hiruda, Tamaki, Watarai, Mie 519-0423, Japan.
| | - Koichiro Gen
- Tuna Aquaculture Division, Aquaculture Research Department, Fisheries Technology Institute, Japan Fisheries Research and Education Agency, 1551-8 Taira-machi, Nagasaki 851-2213, Japan.
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30
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Suzuki H, Ozaki Y, Gen K, Kazeto Y. Japanese eel retinol dehydrogenases 11/12-like are 17-ketosteroid reductases involved in sex steroid synthesis. Gen Comp Endocrinol 2021; 305:113685. [PMID: 33271196 DOI: 10.1016/j.ygcen.2020.113685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 11/16/2020] [Accepted: 11/27/2020] [Indexed: 11/28/2022]
Abstract
The synthesis of 11-ketotestosterone (11KT) and estradiol-17β (E2), which play important roles in the regulation of gametogenesis in teleost fishes, is catalyzed by several steroidogenic enzymes. In particular, 17β-hydroxysteroid dehydrogenases (Hsd17bs) with 17-ketosteroid reducing activity (17KSR activity) are essential enzymes in the formation of these sex steroid hormones in the gonads and other tissues. Retinol dehydrogenase 11 (RDH11) has been suggested to be a novel tentative HSD17B (HSD17B15) in humans for a decade, however no definitive proof has been provided yet. In this study, three cDNAs related to human RDH11 were isolated from Japanese eel testis and characterized. Sequence similarity and phylogenetic analyses revealed their close relationship to human rdh11 and rdh12 gene products and they were designated as rdh11/12-like 1, rdh11/12-like 2, and rdh11/12-like 3. Three recombinant Rdh11/12-like proteins expressed in HEK293T cells catalyzed the transformation of estrone into E2 and androstenedione into testosterone. Only Rdh11/12-like 1 catalyzed the conversion of 11-ketoandrostenedione into 11KT. Tissue-distribution analysis by quantitative real-time polymerase chain reaction revealed, in immature male Japanese eel, that rdh11/12-like 1 and rdh11/12-like 2 are predominantly expressed in testis and brain, while rdh11/12-like 3 is expressed ubiquitously. Moreover, we analyzed the effects of gonadotropins and 11KT on the expression of the three rdh11/12-like mRNAs in the immature testis. In vitro incubation of immature testes with various doses of recombinant Japanese eel follicle stimulating hormone, luteinizing hormone, and 11KT indicated that the expression of rdh11/12-like 1 mRNA, rdh11/12-like 2, and rdh11/12-like 3 did not change. These findings suggest that the three Rdh11/12-like proteins metabolize sex steroids. Rdh11/12-like 1 may be one of the enzymes with 17KSR activity involved in the production of 11KT in the testis.
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Affiliation(s)
- Hiroshi Suzuki
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7 Konan, Minato-ku, Tokyo 108-8477, Japan; National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, 224-1 Hiruda, Tamaki, Watarai, Mie 519-0423, Japan.
| | - Yuichi Ozaki
- National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, 224-1 Hiruda, Tamaki, Watarai, Mie 519-0423, Japan.
| | - Koichiro Gen
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, 1551-8 Taira-machi, Nagasaki 851-2213, Japan.
| | - Yukinori Kazeto
- National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, 224-1 Hiruda, Tamaki, Watarai, Mie 519-0423, Japan.
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Ozaki Y, Kuku KO, Sakellarios A, Haude M, Hideo-Kajita A, Desale S, Siogkas P, Sioros S, Ince H, Abizaid A, Tölg R, Lemos PA, von Birgelen C, Christiansen EH, Wijns W, Escaned J, Michalis L, Fotiadis DI, Djikstra J, Waksman R, Garcia-Garcia HM. Impact of Endothelial Shear Stress on Absorption Process of Resorbable Magnesium Scaffold: A BIOSOLVE-II Substudy. Cardiovasc Revasc Med 2021; 29:9-15. [PMID: 33863661 DOI: 10.1016/j.carrev.2021.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/12/2021] [Accepted: 04/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND/PURPOSE Local hemodynamic forces such as endothelial shear stress (ESS) may have an influence on appropriate neointimal healing, vessel remodeling, and struts' absorption process following second-generation drug-eluting resorbable magnesium scaffold (RMS, Magmaris, Biotronik AG, Buelach, Switzerland) placement. The aim of this study was to investigate the impact of ESS assessed by optical coherence tomography (OCT)-based computational fluid dynamic (CFD) simulations on absorption process and coronary lumen dimension after Magmaris implantation. METHODS AND RESULTS A total of 22 patients who were enrolled in the BIOSOLVE-II trial and underwent serial OCT assessment immediately after Magmaris implantation and at 6- and 12-month follow-up were included. We evaluated qualitative OCT findings frame by frame, and CFD simulations were performed to calculate the ESS at 3-dimensional (3D) reconstructed arteries. For quantitative calculation, the average ESS within each 1-mm section was classified into three groups: low (<1.0 Pa), intermediate (1.0-2.5 Pa), or high (>2.5 Pa). A significant difference of percentage remnants of scaffold was observed among the 3 groups at 12-month follow-up (P = 0.001) but not at 6-month follow-up. Low-ESS segment at baseline resulted in a greater lumen change of -1.857 ± 1.902 mm2 at 1 year compared to -1.277 ± 1.562 mm2 in the intermediate-ESS segment (P = 0.017) and - 0.709 ± 1.213 mm2 in the high-ESS segment (P = 0.001). CONCLUSION After Magmaris implantation, the presence of higher ESS might be associated with slower strut absorption process but less luminal loss.
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Affiliation(s)
- Yuichi Ozaki
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA
| | - Kayode O Kuku
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA
| | - Antonis Sakellarios
- Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
| | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
| | - Alexandre Hideo-Kajita
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA
| | - Sameer Desale
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA
| | - Panagiotis Siogkas
- Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Spyros Sioros
- Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Hüseyin Ince
- Department of Cardiology, Vivantes Klinikum im Friedrichschain and Am Urban, Berlin, Germany
| | | | - Ralph Tölg
- Herzzentrum Segeberger Kliniken GmbH, Bad Segeberg, Germany
| | - Pedro Alves Lemos
- Instituto do Coração - HCFMUSP, University of Sao Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, Netherlands
| | | | - William Wijns
- Cardiology Department, Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium
| | - Javier Escaned
- Hospital Clinico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain
| | - Lampros Michalis
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
| | - Dimitrios I Fotiadis
- Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | | | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA.
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32
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Taruya A, Nakajima Y, Tanaka A, Kashiwagi M, Tanimoto T, Kuroi A, Shiono Y, Shimamura K, Kubo T, Sougawa H, Masuno T, Ozaki Y, Satogami K, Ota S, Katayama Y, Ino Y, Hoshiya H, Akasaka T. Cancer-related vulnerable lesions in patients with stable coronary artery disease. Int J Cardiol 2021; 335:1-6. [PMID: 33781853 DOI: 10.1016/j.ijcard.2021.03.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) has become a major cause of morbidity and mortality in cancer survivors. It is still unclear whether cancer history influences lesion characteristics. The purpose of this study was to investigate cancer-related lesion morphology in patients with CAD. METHODS This study enrolled 400 patients with stable CAD. The patients were classified into a cancer survivor group (n = 69) and a noncancer group (n = 331). We investigated coronary lesion morphology by optical coherence tomography, and we assessed the prognosis in terms of both all-cause mortality and major adverse cardiovascular events (MACE). RESULTS Adenocarcinoma was the most common histopathological diagnosis. Serum C-reactive protein levels were significantly higher in the cancer survivor group than in the noncancer group (cancer survivors 0.12 [0.05-0.42] mg/dL vs. noncancer 0.08 [0.04-0.17] mg/dL, p = 0.019). The cancer survivor group was more likely than the noncancer group to have thrombi (cancer survivors 30.4% vs. noncancer 15.4%, p = 0.004), and layered fibrotic plaques (LFPs; cancer survivors 18.8% vs. noncancer 3.6%, p < 0.0001). Cancer survivors had poorer outcomes than noncancer controls in terms of both all-cause mortality (p = 0.020) and MACE (p = 0.036). CONCLUSIONS Because of underlying inflammation, CAD patients with cancer had more high-risk lesions than those without cancer, which could result in poorer prognosis for the former. This result might inform the management of CAD in cancer patients in terms of secondary prevention.
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Affiliation(s)
- Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yuki Nakajima
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kunihiro Shimamura
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiromichi Sougawa
- Department of Cardiovascular Medicine, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Tomizo Masuno
- Department of Cardiovascular Medicine, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Hironobu Hoshiya
- Department of Cardiovascular Medicine, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Muto S, Inomata S, Yamaguchi H, Mine H, Takagi H, Ozaki Y, Okabe N, Matsumura Y, Shio Y, Suzuki H. P72.09 Study of Relationship Between Proportion of CTLA-4 Positive Tregs in Tumor Infiltrating Lymphocytes and PD-L1 TPS. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Takahata M, Ino Y, Kubo T, Tanimoto T, Taruya A, Terada K, Emori H, Higashioka D, Katayama Y, Khalifa AKM, Wada T, Ozaki Y, Shimamura K, Shiono Y, Kashiwagi M, Kuroi A, Fujita S, Tanaka A, Hozumi T, Akasaka T. Prevalence, Features, and Prognosis of Artery-to-Artery Embolic ST-Segment-Elevation Myocardial Infarction: An Optical Coherence Tomography Study. J Am Heart Assoc 2020; 9:e017661. [PMID: 33251922 PMCID: PMC7955389 DOI: 10.1161/jaha.120.017661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background The major underlying mechanisms contributing to acute coronary syndrome are plaque rupture, plaque erosion, and calcified nodule. Artery-to-artery embolic myocardial infarction (AAEMI) was defined as ST-segment-elevation myocardial infarction caused by migrating thrombus formed at the proximal ruptured plaque. The aim of this study was to investigate the prevalence and clinical features of AAEMI by using optical coherence tomography. Methods and Results This study retrospectively enrolled 297 patients with ST-segment-elevation myocardial infarction who underwent optical coherence tomography before percutaneous coronary intervention. Patients were divided into 4 groups consisting of plaque rupture, plaque erosion, calcified nodule, and AAEMI according to optical coherence tomography findings. The prevalence of AAEMI was 3.4%. The culprit vessel in 60% of patients with AAEMI was right coronary artery. Minimum lumen area at the culprit site was larger in AAEMI compared with plaque rupture, plaque erosion, and calcified nodule (4.0 mm2 [interquartile range (IQR), 2.2-4.9] versus 1.0 mm2 [IQR, 0.8-1.3] versus 1.0 mm2 [IQR, 0.8-1.2] versus 1.1 mm2 [IQR, 0.7-1.6], P<0.001). Lumen area at the rupture site was larger in patients with AAEMI compared with patients with plaque rupture (4.4 mm2 [IQR, 2.5-6.7] versus 1.5 mm2 [IQR, 1.0-2.4], P<0.001). In patients with AAEMI, the median minimum lumen area at the occlusion site was 1.2 mm2 (IQR, 1.0-2.1), 40% of them had nonstent strategy, and the 3-year major adverse cardiac event rate was 0%. Conclusions AAEMI is a rare cause for ST-segment-elevation myocardial infarction and has unique morphological features of plaque including larger lumen area at rupture site and smaller lumen area at the occlusion site.
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Affiliation(s)
- Masahiro Takahata
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Yasushi Ino
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Takashi Kubo
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Takashi Tanimoto
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Akira Taruya
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Kosei Terada
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroki Emori
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Daisuke Higashioka
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Yosuke Katayama
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Amir Kh. M. Khalifa
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Teruaki Wada
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Yuichi Ozaki
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Kunihiro Shimamura
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Yasutsugu Shiono
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Manabu Kashiwagi
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Akio Kuroi
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Suwako Fujita
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Atsushi Tanaka
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Takeshi Hozumi
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
| | - Takashi Akasaka
- Department of Cardiovascular MedicineWakayama Medical UniversityWakayamaJapan
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Katayama Y, Tanaka A, Taruya A, Kashiwagi M, Nishiguchi T, Ozaki Y, Shiono Y, Shimamura K, Kitabata H, Kubo T, Hozumi T, Ishida Y, Kondo T, Akasaka T. Increased plaque rupture forms peak incidence of acute myocardial infarction in winter. Int J Cardiol 2020; 320:18-22. [PMID: 32679138 DOI: 10.1016/j.ijcard.2020.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/12/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND It has been widely documented that circannual variation has an impact on the incidence and prognosis of cardiovascular diseases. It is unclear why cold ambient temperature increase the incidence of acute myocardial infarction (AMI). We investigated the relationship between the ambient temperature at the onset of AMI, the morphology of the culprit lesion in patients with AMI. METHODS We investigated 202 consecutive patients with AMI who underwent optical coherence tomography (OCT). The participants were divided into lower (n = 100) and higher (n = 102) temperature groups based on the ambient temperature. The culprit lesion morphology was compared between the two groups. RESULTS The median temperature at the onset of AMI was 16.6 °C. The prevalence of plaque ruptures was higher at lower temperatures (lower 66% vs. higher 45%, p = .003), whereas OCT-erosion was more frequent in the higher temperature group (lower 13% vs. higher 26%, p = .021). The lower temperature group showed more cholesterol crystals (lower 71% vs. higher 54%, p = .014). CONCLUSION The peak incidence of AMI in the winter is formed by increased plaque rupture, suggesting environmental temperature has an influence on the pathogenesis of AMI.
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Affiliation(s)
- Yosuke Katayama
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Tsuyoshi Nishiguchi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Kunihiro Shimamura
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Takeshi Hozumi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Yuko Ishida
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
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Yacob O, Beyene S, Melaku G, Hideo-Kajita A, Kuku K, Brathwaite E, Wilson V, Ozaki Y, Dan K, Sheikh F, Mohammed S, Garcia-Garcia H. Patterns of coronary vascular involvement in patients with heart failure due to cardiac amyloidosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Amyloidosis is a group of protein-folding disorders characterised by organ deposits, derived from one of several amyloidogenic precursor proteins. The involvement of coronary arteries has been previously described in amyloidosis, however the pattern of the disease in the coronaries is still unknown.
Purpose
The aim of this study is to characterise the pattern and severity of coronary artery lesions in cardiac amyloidosis.
Methods
We retrospectively compared patients with heart failure who tested positive (i.e. biopsy or gene tests – HF/CA+) against those that tested negative (HF/CA−) for cardiac amyloidosis. Groups were compared demographically and angiographically for qualitative and quantitative variables to determine patterns of involvement in the major epicardial coronary vessels.
Results
In total, 110 heart failure patients were included in the study, of whom 55 were HF/CA+ patients (88 lesions) and 55 were HF/CA− patients (66 lesions). Despite the advanced age in the HF/CA+, (74.53±11.02 vs 54.11±15.08; p=0.05), severe calcification was reported in HF/CA− group (4.5% vs to 0.0%; p=0.018). The HF/CA+ group also had fewer ostial lesions (3.4% vs. 15.15%, p=0.0095), reduced TIMI flow grade (83% vs 76%; p=0.21) and a higher TIMI frame count (30±12 Vs 27±11 frames; p=0.06). In the HF/CA+ group, compared to women, men had a significant number of tandem lesions (14.55% vs 0.0%, p=0.02). Men trended to have more ulcerations in comparison to women (9.09% vs 0.0%; p=0.15).
Conclusion
Overall, patients with HF/CA+ were older but found to have lesser calcified lesions, ostial involvement and a reduced anterograde blood flow. This is the first report outlining the coronary lesions in patients with HF/CA+.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- O Yacob
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - S Beyene
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - G Melaku
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - A Hideo-Kajita
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - K Kuku
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - E Brathwaite
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - V Wilson
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - Y Ozaki
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - K Dan
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - F Sheikh
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - S Mohammed
- MedStar Washington Hospital Center, Washington DC, United States of America
| | - H Garcia-Garcia
- MedStar Washington Hospital Center, Washington DC, United States of America
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Abe M, Ozaki Y, Takahashi H, Akao M, Kimura T, Nagai R. Impact of chronic kidney disease on mid-term prognosis of stable angina patients with high-dose or low-dose pitavastatin treatment: REAL-CAD sub-study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
We previously demonstrated that high-dose (4 mg/day) compared with low-dose (1 mg/day) pitavastatin therapy significantly reduced cardiovascular events in Japanese patients with stable coronary artery disease in the Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study. However, little is known about whether the advantage of high-dose statins over low-dose statins is consistent among non-, mild, and moderate to severe chronic kidney disease (CKD) patients.
Purpose
The aim of this study was to clarify the effect of high-dose statins on cardiovascular events in Japanese patients with or without CKD.
Methods
The REAL-CAD study is a prospective, multicenter, randomized, open-label, blinded endpoint, physician-initiated superiority trial. In this sub-analysis of REAL-CAD study, patients were categorized into three groups according to estimated glomerular filtration rate (eGFR). Patients on hemodialysis were excluded in this study. The primary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction (MI), non-fatal ischemic stroke, or unstable angina requiring emergency hospitalization. A secondary composite endpoint was defined as a composite of the primary endpoint event or clinically-indicated coronary revascularization excluding target-lesion revascularization.
Results
The total population of the REAL-CAD study was 12,413 patients. After exclusion of patients lacking eGFR data, the numbers of patients categorized into non-CKD (eGFR ≥60 mL/min/1.73m2), mild CKD (eGFR; 45–60), and moderate to severe CKD (eGFR <45) were 7,778 (64%), 3,176 (26%), and 1,164 (10%), respectively. The median follow-up period was 3.9 years. The baseline characteristics and medications were well balanced between the two groups in each CKD group. While high-dose compared to low-dose pitavastatin significantly reduced the primary endpoint in non-CKD patients, the effect was not observed in mild CKD and moderate to severe CKD patients (Figure 1). High-dose compared with low-dose pitavastatin did not significantly reduce the secondary composite endpoint in both mild and moderate to severe CKD patients as well. High-dose pitavastatin significantly reduced the risks of MI and any coronary revascularization in non-CKD patients, however, the effects were diminished in mild CKD and moderate to severe CKD patients. There was no significant difference between high-dose and low-dose pitavastatin treatment in the risk of all-cause death, cardiovascular death, ischemic stroke, or unstable angina requiring emergency hospitalization in patients with or without CKD.
Conclusion
Although high-dose pitavastatin therapy significantly reduced cardiovascular events in non-CKD patients with stable angina compared to low-dose pitavastatin, such beneficial effects had diminished in Japanese patients with mild or moderate to severe CKD patients.
Figure 1. Kaplan-Meier Curves for Endpoints
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Clinical Research of Lifestyle-Related Disease of the Public Health Research Foundation
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Affiliation(s)
- M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y Ozaki
- Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Fujita Health University School of Medicine, Toyoake, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - R Nagai
- Jichi Medical University, Tochigi, Japan
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Ohtake H, Ishii J, Nishimura H, Kawai H, Muramatsu T, Harada M, Motoyama S, Watanabe E, Ozaki Y, Iwata M. Prospective validation of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I in Japanese patients presenting to emergency department. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The diagnostic performance of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I (hsTnI) for non-ST-segment elevation myocardial infarction (NSTEMI) has not been evaluated in an Asian population.
Purpose
We aimed to prospectively validate the 0-hour/1-hour algorithm using hsTnI in a Japanese population.
Method
We enrolled 754 Japanese patients (mean age of 70 years, 395 men) presenting to our emergency department with symptoms suggestive of NSTEMI. The hsTnI concentration was measured using the Siemens ADVIA Centaur hsTnI assay at presentation and after 1 hour. Patients were divided into three groups according to the algorithm: hsTnI below 3 ng/L (only applicable if chest pain onset >3 hours) or below 6 ng/L and delta 1 hour below 3 ng/L were the “rule-out” group; hsTnI at least 120 ng/L or delta 1 hour at least 12 ng/L were in the “rule-in” group; the remaining patients were classified as the “observe” group. Based on the Fourth Universal Definition of Myocardial Infarction, the final diagnosis was adjudicated by 2 independent cardiologists using all available information, including coronary angiography, coronary computed tomography, and follow-up data. Safety of rule-out was quantified by the negative predictive value (NPV) for NSTEMI, accuracy of rule-in by the positive predictive value (PPV), and overall efficacy by the proportion of patients triaged towards rule-out or rule-in within 1 hour.
Results
Prevalence of NSTEMI was 6.5%. The safety of rule-out (NPV 100%), accuracy of rule-in (PPV 26%), and overall efficacy (54%) were shown in Figure.
Conclusion
The 0-hour/1-hour algorithm using hsTnI is very safe and effective in triaging Japanese patients with suspected NSTEMI.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Ohtake
- Fujita Health University, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Toyoake, Japan
| | | | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - M Harada
- Fujita Health University, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - M Iwata
- Fujita Health University, Toyoake, Japan
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39
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Muramatsu T, Ishikawa M, Nanasato M, Nagasaka R, Takatsu H, Yoshiki Y, Hashimoto Y, Ohota M, Kamiya H, Yoshida Y, Murohara T, Ozaki Y, Izawa H. Comparison between optical frequency domain imaging and intravascular ultrasound in PCI guidance for Biolimus A9 eluting stent implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It has been reported that intravascular ultrasound (IVUS) guided PCI reduced a risk of major adverse cardiac event compared to conventional angiography guided PCI, while comparison between IVUS-guided and optical frequency domain imaging (OFDI)-guided PCI specifically in long-term clinical outcomes (>1 year) has been unexplored.
Purpose
We sought to compare imaging surrogates at 8 months and clinical outcomes beyond 1 year after drug-eluting stent implantation between IVUS and OFDI guidance.
Methods
The MISTIC-1 is a prospective, multi-centre, single-blinded, randomised-controlled, non-inferiority trial comparing OFDI-guided and IVUS-guided PCI using Biolimus A9 eluting Nobori stent. We enrolled patients with stable coronary artery disease who have symptoms or clinically relevant myocardial ischemia. Stent landing zones were selected in the most normal looking sites with largest lumen and without percentage plaque area >50% in IVUS group while without lipidic plaque of >2 quadrants or suggestive thin-cap fibroatheroma in OFDI group. Stent sizing was based on external elastic lamina (EEL) in IVUS group, while by taking 10% or 0.25mm larger than mean lumen diameter at reference sites in OFDI group. Stent optimisation with in-stent minimum lumen area ≥80% of the average lumen area at proximal and distal reference sites was encouraged in both groups. Primary efficacy endpoint is in-segment minimum lumen area (MLA) assessed by OFDI at 8 months. Secondary safety endpoint is a composite of cardiovascular death, target vessel myocardial infarction, or target lesion revascularisation. Based on the assumption that mean in-segment MLA at follow-up was 4.5mm2 with a standard deviation of 2.0mm2 in the control (IVUS) group and a non-inferiority limit of 1.2mm2 for OFDI group, sample size was estimated as 48 cases in each group with 5% type I error and 90% statistical power.
Results
Since June-2014 and August-2016, we prospectively enrolled 109 patients (mean age 70 years, male 78%) with 126 lesions. Baseline patient and lesion characteristics were well balanced and average nominal size and length of stent used did not differ between OFDI-guided and IVUS-guided PCI (3.0 and 19.1mm vs. 3.1 and 19.3mm, respectively). Post-procedural minimum stent area was 6.24mm2 in OFDI group and 6.72mm2 in IVUS group (p=0.20). At 8-month follow-up, in-segment MLA was 4.56mm2 in OFDI group and 4.13mm2 in IVUS group (P for non-inferiority <0.001). During the follow-up (median 4.5 years [1654 days]), incidence rates of major adverse cardiac event were comparable between the two groups (7.4% in OFDI group and 7.3% in IVUS group, hazard ratio 0.96, 95% CI 0.24–3.83, p=0.95). No definite or probable stent thrombosis were documented in both groups.
Conclusion
OFDI-guided PCI demonstrated comparable results in achieving satisfactory imaging surrogates as well as long-term clinical outcomes after newer generation DES implantation as compared to IVUS-guided PCI.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Suzuken Memorial Foundation
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Affiliation(s)
- T Muramatsu
- Fujita Health University Hospital, Cardiovascular Center, Department of Cardiology, Toyoake, Japan
| | - M Ishikawa
- Fujita Health University Hospital, Cardiovascular Center, Department of Cardiology, Toyoake, Japan
| | - M Nanasato
- Sakakibara Heart Institute, Department of Cardiology, Fucyu Tokyo, Japan
| | - R Nagasaka
- Fujita Health University Hospital, Cardiovascular Center, Department of Cardiology, Toyoake, Japan
| | - H Takatsu
- Fujita Health University Hospital, Cardiovascular Center, Department of Cardiology, Toyoake, Japan
| | - Y Yoshiki
- Fujita Health University Okazaki Medical Center, Department of Cardiology, Okazaki, Japan
| | - Y Hashimoto
- Fujita Health University Okazaki Medical Center, Department of Cardiology, Okazaki, Japan
| | - M Ohota
- Fujita Health University Hospital, Cardiovascular Center, Department of Cardiology, Toyoake, Japan
| | - H Kamiya
- Gifu Heart Center, Department of Cardiovascular Medicine, Gifu, Japan
| | - Y Yoshida
- Nagoya Daini Red Cross Hospital, Cardiovascular Center, Nagoya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - Y Ozaki
- Fujita Health University Okazaki Medical Center, Department of Cardiology, Okazaki, Japan
| | - H Izawa
- Fujita Health University Hospital, Cardiovascular Center, Department of Cardiology, Toyoake, Japan
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40
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Ohta M, Ozaki Y, Toriya T, Nagasaya R, Takatsu H, Yoshiki Y, Hashimoto Y, Ishikawa M, Kawai H, Muramatsu T, Naruse H, Takahashi H, Ishii J, Izawa H. Five-year major adverse cardiac and cerebrovascular events of patients with lipid core abutting lumen (LCAL) on integrated-backscatter intravascular ultrasound undergoing PCI with current DES. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous Coronary Intervention (PCI) using the new generation drug-eluting stent (DES) has been extremely reduced target lesion revascularization (TLR) in recent years. However, a high incidence of non-target lesion-related cardiovascular events in patients undergoing PCI is an important problem to be solved. According to the previous findings, patients with vulnerable plaques particularly have a high recurrence of cardiovascular events. Little studies, however, has been done to examine the relationship between plaque characteristics on intravascular imaging in a target lesion and non-target lesion-related cardiovascular events.
Purpose
The main objective of this study is to investigate the five-year major adverse cardiac and cerebrovascular events (MACCE) of patients with lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound (IB-IVUS) in a target lesion undergoing PCI with current DES.
Methods and results
Between February 2010 and September 2013, in total 780 patients with ischemic heart disease undergoing PCI, 166 target lesions in 166 consecutive patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) and stable angina pectoris (SAP) undergoing IVUS-guided PCI were studied.
Plaque characteristics in all target lesions were analyzed by three-dimensional IB-IVUS system using the mechanical IVUS catheter. Our previous study has found that LCAL which is defined as a lipid pool directly in contact with the lumen visualizes the thin fibrous cap of less than 75μm on optical coherence tomography (OCT). On the basis of this data, LCAL at minimal lumen area (MLA) site was identified.
In total, 39 patients had lesions with LCAL at MLA site (LCAL(+)), and 127 patients had those without LCAL (LCAL(−)).
The primary endpoint was defined as MACCE, including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke and non-TLR for the new lesion during a median follow up of five years. The MACCE occurred significantly higher in the LCAL(+) than in the LCAL(−) (38.5% vs. 17.3%; p<0.005). And the Kaplan-Meier estimates have shown that the cumulative incidence of MACCE was significantly higher in the LCAL(+) than in the LCAL(−) (log rank test, p=0.041). Additionally, after adjustment for confounders, gender, prior PCI and LCAL was the independent predictors for the MACCE of patients undergoing PCI with current DES.
Furthermore, after adding LCAL to a baseline model with established factors consisting of age, gender, diabetes mellitus, prior PCI and percentage lipid volume on IB-IVUS, the net reclassification (p<0.002) and integrated discrimination improvement (p<0.004) significantly improved compared to baseline model alone.
Conclusions
In this study, it has become clear that LCAL on IB-IVUS is likely to be a surrogate marker of MACCE in patients undergoing PCI with current DES.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Ohta
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - T Toriya
- Fujita Health University, Toyoake, Japan
| | - R Nagasaya
- Fujita Health University, Toyoake, Japan
| | - H Takatsu
- Fujita Health University, Toyoake, Japan
| | - Y Yoshiki
- Fujita Health University, Toyoake, Japan
| | | | - M Ishikawa
- Sakurabashi-Watanabe Hospital, Cardiology, Osaka, Japan
| | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - H Naruse
- Fujita Health University, Toyoake, Japan
| | | | - J Ishii
- Fujita Health University, Toyoake, Japan
| | - H Izawa
- Fujita Health University Second Hospital, Cardiology, Nagoya, Japan
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Harada M, Nomura Y, Nishimura A, Motoike Y, Koshikawa M, Watanabe E, Izawa H, Ozaki Y. Factors associated with silent cerebral events during catheter ablation for atrial fibrillation in the era of uninterrupted oral anticoagulation therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A silent cerebral event (SCE), detected by brain magnetic resonance imaging (MRI), is defined as an acute new brain lesion without clinically apparent neurological deficit, and is frequently observed after catheter ablation in atrial fibrillation (AF) patients. Although the small number of SCEs does not cause neurocognitive dysfunction, the greater volume and/or larger number of SCE lesions are reportedly related to neuropsychological decline; SCE incidence may be a surrogate marker for the potential thromboembolic risk. Thus, strategies to reduce SCEs would be beneficial. Uninterrupted oral anticoagulation strategy for peri-procedural period reportedly reduced the risk of SCEs, but the incidence hovers at 10% to 30%. We sought factors associated with SCEs during catheter ablation for AF in patients with peri-procedural uninterrupted oral anticoagulation (OAC) therapy.
Methods
AF patients undergoing catheter ablation were eligible (n=255). All patients took non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonist (VKA) for peri-procedural OAC (>4 weeks) without interruption during the procedure. Brain MRI was performed within 2 days after the procedure to detect SCEs. Clinical characteristics and procedure-related parameters were compared between patients with and without SCEs.
Results
SCEs were detected in 59 patients (23%, SCE[+]) but not in 196 patients (77%, SCE[-]). Average age was higher in SCE[+] than SCE[-] (66±10 years vs. 62±12 years, p<0.05). Persistent AF prevalence, CHADS2/CHA2DS2-VASc scores, and serum NT-ProBNP levels increased in SCE[+] vs. SCE[-]. In transthoracic/transesophageal echocardiography, left-atrial dimension (LAD) was larger and AF rhythm/spontaneous echo contrast were more frequently observed in SCE[+] than SCE[-]. SCE[+] had lower initial activated clotting time (ACT) before unfractionated heparin (UFH) injection and longer time to reach optimal ACT (>300 sec) before trans-septal puncture than SCE [-]. In multivariate analysis, LAD, initial ACT before UFH injection, and time to reach optimal ACT were predictors for SCEs.
Conclusions
LAD and intra-procedural ACT kinetics affect SCEs during the procedure in patients with uninterrupted OAC for AF ablation. Shortening time to achieve optimal ACT during the procedure may reduce the risk of SCEs.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | | | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - H Izawa
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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Ishii J, Takahashi H, Nishimura H, Fujiwara W, Ohta M, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Motoyama S, Watanabe E, Izawa H, Ozaki Y. Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.
Objective
We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.
Methods
We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.
Results
During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.
Conclusions
Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.
Presepsin quartiles and mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - W Fujiwara
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - M Ohta
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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Hideo-Kajita A, Garcia-Garcia HM, Rubarth R, Wopperer S, Ozaki Y, Freire AFD, Cavalcante R, Bittencourt M, Dan K, Pinheiro TL, Falcão BAA, Falcao JLA, Soares P, Ribeiro E, Rochitte CE, Lemos PA. Natural History of Adapted Leaman Score Assessing Coronary Artery Disease Progression by Computed Tomography Angiography: A 7-Year Follow-Up Report. Cardiovasc Revasc Med 2020; 27:38-44. [PMID: 33097462 DOI: 10.1016/j.carrev.2020.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/22/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Coronary computed tomographic angiography (CCTA) provides a non-invasive assessment of the coronary artery tree. Computed Tomography - adapted Leaman Score (CT-LeSc) has been shown to be an independent predictor of cardiac events in coronary artery disease (CAD) patients with a score greater than 5 (high). PURPOSE To investigate the relationship between CT-LeSc and the progression of CAD and to provide vessel- and segment-level CAD qualification and quantification at baseline and 7-year follow-up. METHODS Patients with multivessel CAD and CCTA assessments at baseline and follow-up were included. The CT-LeSc analysis was performed in a paired fashion. The patient-level scores and the differences between each phase were assessed by 2 analysts in an independent core laboratory. RESULTS This study analyzed 248 coronary segments from 17 patients with a mean follow-up interval of 7.5 ± 0.6 years. The mean CT-LeSc at baseline and follow-up were 14.6 ± 4.2 and 16.9 ± 1.5, respectively, with an absolute increase of 2.3 ± 1.8. The mean cumulative increase of new lesions was 0.2 ± 0.2 per year. Over time, 14.6% of the non-obstructive lesions became obstructive, and 15.0% of the non-calcified plaques became calcified. There were 29 new lesions found at follow-up, and out of these, 16 were obstructive and 19 were non-calcified. CONCLUSION In patients at high risk for cardiac events, as determined by CT-LeSc, there was an increase in CT-LeSc, obstructive lesions, and calcified plaques over the 7-year follow-up period. Most of the new lesions were obstructive and non-calcified. This is the first report showing long-term serial imaging CCTA changes in a high-risk population.
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Affiliation(s)
| | | | - Rodrigo Rubarth
- Georgetown University School of Medicine, Washington, DC, USA
| | - Samuel Wopperer
- MedStar Washington Hospital Center, Interventional Cardiology Department, USA
| | - Yuichi Ozaki
- MedStar Washington Hospital Center, Interventional Cardiology Department, USA
| | | | - Rafael Cavalcante
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Marcio Bittencourt
- Center for Clinical and Epidemiological Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Kazuhiro Dan
- MedStar Washington Hospital Center, Interventional Cardiology Department, USA
| | - Thais L Pinheiro
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | | | - Paulo Soares
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Expedito Ribeiro
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carlos E Rochitte
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Pedro Alves Lemos
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
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Falahati A, Ozaki Y, Damsteegt EL, Zadmajid V, Freeman KJ, Lokman PM. Spatiotemporal expression of activin receptor-like kinase-5 and bone morphogenetic protein receptor type II in the ovary of shortfinned eel, Anguilla australis. Comp Biochem Physiol B Biochem Mol Biol 2020; 251:110509. [PMID: 33002594 DOI: 10.1016/j.cbpb.2020.110509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 11/30/2022]
Abstract
In the eel ovary, the expression of growth differentiation factor-9 (Gdf9) appears to be largely confined to the germ cell in early stages of oogenesis. However, both the target tissue and the function of Gdf9 in fish remain unknown. This study aimed to describe the abundance and localization of activin receptor-like kinase-5 (Alk5) and bone morphogenetic protein receptor type II (Bmpr2), which together mediate the Gdf9 signal, in the ovary of a basal teleost, the shortfinned eel, Anguilla australis, during early folliculogenesis. The cDNA encoding eel alk5 and bmpr2 genes were cloned, characterized and the transcript abundances of these receptors quantified by quantitative real-time PCR. Ovarian transcript abundance for both receptors, along with that of gdf9 and of its paralogue bmp15, increased from the previtellogenic to early vitellogenic stage. Localization of receptor mRNAs by in situ hybridization revealed that these receptors are located in the somatic cells surrounding the oocyte. Furthermore, tissue distribution analysis showed that the expression of alk5 and bmpr2 were highest in ovary and thyroid, respectively. Unexpectedly, however, bmpr2 mRNA levels were lower in the ovary than in any of the other 17 tissues examined, and indeed, lower than ovarian gdf9 transcript abundance. These findings, together with the ovarian expression pattern of Gdf9, suggest that Gdf9, and conceivably, Bmp15, from the oocyte can signal through receptors that are located on the somatic cells surrounding the oocyte; this, in turn, facilitates elucidation of the function of these growth factors during oogenesis in teleost fish.
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Affiliation(s)
- Ali Falahati
- Department of Zoology, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Yuichi Ozaki
- Department of Zoology, University of Otago, PO Box 56, Dunedin 9054, New Zealand; National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, 224-1 Hiruta, Tamaki, Watarai, Mie 519-0423, Japan
| | - Erin L Damsteegt
- Department of Zoology, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Vahid Zadmajid
- Department of Fisheries Science, Faculty of Natural Resources, University of Kurdistan, Sanandaj, Iran
| | - Kaitlyn J Freeman
- Department of Zoology, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - P Mark Lokman
- Department of Zoology, University of Otago, PO Box 56, Dunedin 9054, New Zealand
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45
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Kuku KO, Singh M, Ozaki Y, Dan K, Chezar-Azerrad C, Waksman R, Garcia-Garcia HM. Near-Infrared Spectroscopy Intravascular Ultrasound Imaging: State of the Art. Front Cardiovasc Med 2020; 7:107. [PMID: 32695796 PMCID: PMC7338425 DOI: 10.3389/fcvm.2020.00107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022] Open
Abstract
Acute coronary syndromes (ACS) secondary to coronary vessel plaques represent a major cause of cardiovascular morbidity and mortality worldwide. Advancements in imaging technology over the last 3 decades have continuously enabled the study of coronary plaques via invasive imaging methods like intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The introduction of near-infrared spectroscopy (NIRS) as a modality that could detect the lipid (cholesterol) content of atherosclerotic plaques in the early nineties, opened the potential of studying “vulnerable” or rupture-prone, lipid-rich coronary plaques in ACS patients. Most recently, the ability of NIRS-IVUS to identify patients at risk of future adverse events was shown in a prospective multicenter trial, the Lipid-Rich-plaque Study. Intracoronary NIRS-IVUS imaging offers a unique method of coronary lipid-plaque characterization and could become a valuable clinical diagnostic and treatment monitoring tool.
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Affiliation(s)
- Kayode O Kuku
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, MedStar Health Research Institute, Washington, DC, United States.,Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Manavotam Singh
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Yuichi Ozaki
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Kazuhiro Dan
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Chava Chezar-Azerrad
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Ron Waksman
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, MedStar Health Research Institute, Washington, DC, United States.,Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Hector M Garcia-Garcia
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, MedStar Health Research Institute, Washington, DC, United States.,Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
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Higuchi K, Kazeto Y, Ozaki Y, Izumida D, Hotta T, Soyano K, Gen K. Insulin-like growth factors 1 and 2 regulate gene expression and enzymatic activity of cyp17a1 in ovarian follicles of the yellowtail, Seriola quinqueradiata. Heliyon 2020; 6:e04181. [PMID: 32566787 PMCID: PMC7298419 DOI: 10.1016/j.heliyon.2020.e04181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 01/16/2023] Open
Abstract
There is accumulating evidence that insulin-like growth factors (IGFs), primary mediators of somatic growth, play an important role in fish reproduction. Previously, we showed that IGF-1 and IGF-2 are expressed in the ovarian follicle cells of the yellowtail (Seriola quinqueradiata) during the vitellogenic phase, suggesting that IGFs may be involved in ovarian steroidogenesis. In this study, we examined the effects of IGF-1 and IGF-2 on gene expression and activity of steroidogenic enzymes in yellowtail ovary in vitro. IGF-1 and IGF-2 had no effect on mRNA levels of several steroidogenesis-related genes (star, cyp11a1, hsd3b, cyp17a2, and cyp19a1). However, both IGFs enhanced the transcription of cyp17a1 in vitellogenic ovaries, although such up-regulation was not found in the ovary at the pre-vitellogenic stage. The stage-dependent effects of IGFs were correlated with changes in ovarian cyp17a1 mRNA levels during the reproductive cycle: transcript abundances increased in conjunction with ovarian development. In addition, IGF-induced cyp17a1 gene expression was significantly inhibited by wortmannin, suggesting that PI3 kinase plays an essential role in IGF-mediated ovarian steroidogenesis. Furthermore, IGF-1 and IGF-2 promoted the conversion of both progesterone and 17α-hydroxyprogesterone to androstenedione in vitellogenic ovaries, suggesting that both IGFs stimulated 17α-hydroxylase and C17-20 lyase activities. Taken together, these findings suggest that IGF-1 and IGF-2 act directly on follicle cells to stimulate steroid production through an increase in gene expression and enzymatic activity of cyp17a1 via induction of PI3 kinase.
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Affiliation(s)
- Kentaro Higuchi
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Taira-machi, Nagasaki 851-2213, Japan
| | - Yukinori Kazeto
- Kamiura Station, National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Kamiura, Saiki, Oita 879-2602, Japan
| | - Yuichi Ozaki
- National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Tamaki, Mie 519-0423, Japan
| | - Daisuke Izumida
- Institute for East China Sea Research, Nagasaki University, Taira-machi, Nagasaki 851-2213, Japan
| | - Takuro Hotta
- Goto Station, Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Tamanoura, Goto, Nagasaki 853-0508, Japan
| | - Kiyoshi Soyano
- Institute for East China Sea Research, Nagasaki University, Taira-machi, Nagasaki 851-2213, Japan
| | - Koichiro Gen
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Taira-machi, Nagasaki 851-2213, Japan
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Higuchi K, Kazeto Y, Ozaki Y, Yamaguchi T, Shimada Y, Ina Y, Soma S, Sakakura Y, Goto R, Matsubara T, Nishiki I, Iwasaki Y, Yasuike M, Nakamura Y, Matsuura A, Masuma S, Sakuma T, Yamamoto T, Masaoka T, Kobayashi T, Fujiwara A, Gen K. Author Correction: Targeted mutagenesis of the ryanodine receptor by Platinum TALENs causes slow swimming behaviour in Pacific bluefin tuna (Thunnus orientalis). Sci Rep 2020; 10:9351. [PMID: 32493909 PMCID: PMC7270151 DOI: 10.1038/s41598-020-65964-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Kentaro Higuchi
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Nagasaki, 851-2213, Japan.
| | - Yukinori Kazeto
- Kamiura Station, National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Saiki, Oita, 879-2602, Japan
| | - Yuichi Ozaki
- National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Watarai, Mie, 519-0423, Japan
| | - Toshiya Yamaguchi
- Kamiura Station, National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Saiki, Oita, 879-2602, Japan
| | - Yukinori Shimada
- Kamiura Station, National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Saiki, Oita, 879-2602, Japan
| | - Yoshiaki Ina
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Nagasaki, 851-2213, Japan
| | - Satoshi Soma
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Nagasaki, 851-2213, Japan
| | - Yoshitaka Sakakura
- Organization for Marine Science and Technology, Graduate School of Fisheries and Environmental Sciences, Nagasaki University, Nagasaki, 852-8521, Japan
| | - Rie Goto
- Nishiura Station, South Ehime Fisheries Research Center, Ehime University, Minamiuwa, Ehime, 798-4206, Japan
| | - Takahiro Matsubara
- Nishiura Station, South Ehime Fisheries Research Center, Ehime University, Minamiuwa, Ehime, 798-4206, Japan
| | - Issei Nishiki
- National Research Institute of Fisheries Science, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 236-8648, Japan
| | - Yuki Iwasaki
- National Research Institute of Fisheries Science, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 236-8648, Japan
| | - Motoshige Yasuike
- National Research Institute of Fisheries Science, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 236-8648, Japan
| | - Yoji Nakamura
- National Research Institute of Fisheries Science, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 236-8648, Japan
| | - Aiko Matsuura
- National Research Institute of Fisheries Science, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 236-8648, Japan
| | - Shukei Masuma
- Aquaculture Research Institute, Kindai University, Nishimuro, Wakayama, 649-2211, Japan
| | - Tetsushi Sakuma
- Department of Mathematical and Life Sciences, Graduate School of Science, Hiroshima University, Higashi-Hiroshima, Hiroshima, 739-8526, Japan
| | - Takashi Yamamoto
- Department of Mathematical and Life Sciences, Graduate School of Science, Hiroshima University, Higashi-Hiroshima, Hiroshima, 739-8526, Japan
| | - Tetsuji Masaoka
- National Research Institute of Aquaculture, Japan Fisheries Research and Education Agency, Watarai, Mie, 519-0423, Japan
| | - Takanori Kobayashi
- Headquarters, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 220-6115, Japan
| | - Atushi Fujiwara
- Headquarters, Japan Fisheries Research and Education Agency, Yokohama, Kanagawa, 220-6115, Japan
| | - Koichiro Gen
- Seikai National Fisheries Research Institute, Japan Fisheries Research and Education Agency, Nagasaki, 851-2213, Japan
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Shigesaka M, Ito T, Inaba M, Azuma Y, Tsujimoto S, Tanaka A, Son Y, Ozaki Y, Nomura S. AB0141 MYCOPHENOLATE MOFETIL, INHIBITOR OF INOSINE-5’-MONOPHOSPHATE DEHYDROGENASE, REGULATES DIFFERENTIATION, MATURATION AND FUNCTION OF HUMAN DENDRITIC CELL SUBSETS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is a heterogeneous disease in which excessive inflammation, autoantibodies, and complement activation lead to multisystem tissue damage. Plasmacytoid dendritc cells (pDCs) play a central role in the pathogenesis of SLE through dysregulated type I IFN production, together with activated myeloid DCs (mDCs), amplifying vicious spiral of autoimmune disorders(1). Therefore, control of the aberrant DC activation may provide an alternative treatment strategy against SLE.Objectives:Mycophenolate mofetil (MMF), which has been used to treat lupus nephritis, specifically blocks proliferation of B and T lymphocytes by inhibition of inosine-5-monophosphate dehydrogenase (IMPDH). In addition, although there is evidence indicating the immunosuppressive effects of MMF on human monocyte-derived dendritic cells(2.3), there are no reports showing its effects on human blood DC subsets. Here we focused on the effects of MMF on the functions of the blood pDCs and mDCs.Methods:We isolated human blood DCs from healthy donors using cell sorting(4) and examined the function of mycophenolic acid (MPA), which is metabolic products of MMF, on DC subsets in response to TLR-ligands and serum from patients with active SLE. Written informed consent was obtained from all healthy adult donors and SLE patients.Results:We found that therapeutic plasma concentration range of MPA down-regulated expression of CD40, CD80 and CD86 dose-dependently on mDCs and pDCs without inducing apoptosis, in response to R848(TLR7/8 agonist) and CpG2216(TLR9 agonist), respectively. Of note, MPA profoundly suppressed IL-12 production and STAT4 expression in the mDCs and IFN-α production and IRF7 expression in the pDCs(Fig 1). We also obserbed inhibition of nuclear translocation of IRF-7 in pDCs treated with MPA by confocal microscopy(Fig 2). Furthermore,we identified that MPA had an inhibitory effect on SLE serum-induced IFN-α production by human PBMCs.Conclusion:Our data suggest that MMF can drive a wedge into the vicious spiral of autoimmune disorders through regulating the function of not only lymphocyte but also DC subsets. Thus, we unveiled a part mechanism of the therapeutic ability of MMF against SLE.References:[1]A Plasmacytoid Dendritic Cells-Type I Interferon Axis is Critically Implicated in the Pathogenesis of Systemic Lupus Erythematosus. Int. J. Mol. Sci. 2015: 16, 14158-14170.[2]Mycophenolate mofetil inhibits differentiation, maturation and allostimulatory function of human monocyte-derived dendritic cells. Clin Exp Immunol. 2003;134:63-69.[3]Mycophenolic acid inhibits maturation and function of human dendritic cells and B cells. Human Immunol. 2009;70: 692–700.[4]Miyamoto et al. Arthritis Research & Therapy 2010, 12:R87.Disclosure of Interests:None declared
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Tsujimoto S, Shigesaka M, Tanaka A, Ozaki Y, Ito T, Inaba M, Nomura S. FRI0550 CAN CYTOKINE GENE POLYMORPHISMS BE USEFUL FOR THE THERAPEUTIC CHOICE IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a common autoimmune disease. It is characterized by systemic synovitis with bone erosion and joint cartilage degradation(1). Production of autoantibody is important for autoimmune disease. Cytokines play crucial roles in its pathogenesis(2). SNP distribution varies between races. Few studies have examined SNP targeted at Japanese patients. The analysis of cytokine gene polymorphisms is important factor of pathophysiology and treatment.Objectives:This analysis was aimed to investigate the association between cytokine gene polymorphisms and autoantibody and therapeutic response in Japanese RA patients.Methods:This study subjects consisted of 100 RA patients and 50 healthy controls. We extracted data on patient sex, age, disease duration, rheumatoid factor (RF), anti cyclic citrullinated peptide (anti-CCP) antibody and therapeutic response including methotrexate (MTX) and biological DMARDs. Genomic DNA was isolated from peripheral blood, these were genotyped for TNFα, TGFβ1, IL-6, IL-10 and IFNγ polymorphisms. We analyzed these data using a chi-square test.Results:IL-10 (-819 C/T and -592 C/A) revealed that there were significant decrease in the frequency of IL-10 (-819) CC genotype and (-592) CC genotype as compared to controls in RA patients. Genotyping of IL-10 showed that there was significant decrease ACC/ACC genotype (Table 1).IFNγ (+874 A/T) revealed that there was significant decrease in the frequency of TT genotype as compared to controls (Table 1).No significant differences in TNFα, TGFβ1and IL-6 genotypes and alleles frequency were observed between RA patients and control.TGFβ1(+869 A/T) in patients with anti-CCP antibody positive revealed that there was significant decrease in the frequency of TT genotype as compared to patients with anti-CCP antibody negative (Table 2).No significant association between RF and any cytokine gene polymorphism.Analyzing cytokine gene polymorphisms could be useful for treatment with MTX and biological DMARDs.Table 1.Table 2.Conclusion:IL-10 (-819 C/T, -592 C/A) and IFNγ (+874 A/T) polymorphism might be related to RA in Japanese population. In addition, TGFβ1(+869 A/T) polymorphism might be associated with the production of anti-CCP antibody. These results suggest that the analyzing cytokine gene polymorphisms may offer promise as useful factors in the choice of treatment for Japanese RA patients.References:[1] Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet. 2010; 376: 1094–108.[2] McInnes IB, Schett G. Cytokines in the pathogenesis of rheumatoid arthritis. Nat Rev Immunol. 2007 Jun;7(6):429-42.Disclosure of Interests:None declared
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Ozaki Y, Garcia-Garcia HM, Mintz GS, Waksman R. Supporting evidence from optical coherence tomography for shortening dual antiplatelet therapy after drug-eluting stents implantation. Expert Rev Cardiovasc Ther 2020; 18:261-267. [PMID: 32321328 DOI: 10.1080/14779072.2020.1759421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Dual antiplatelet therapy (DAPT) is required for coronary artery disease treated with drug-eluting stents (DES) implantation. Shortening DAPT duration would be beneficial for patients with high bleeding risk. AREAS COVERED Early healing patterns, especially stent strut coverage, assessed by optical coherence tomography (OCT) as a surrogate of neointima have been investigated to make decisions on whether short DAPT would be a safe alternative. This review evaluates the OCT evidence (i.e. neointimal coverage of stent struts within 3 months) for shortening DAPT duration after DES implantation. EXPERT COMMENTARY Shortening DAPT (i.e. within 3 months) duration after DES implantation might reduce complications including bleeding without increasing stent thrombosis. However, the optimal duration of DAPT after DES implantation is under discussion. Long-term assessment of short DAPT is required for the decision of the new guidelines regarding the recommended duration of DAPT.
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Affiliation(s)
- Yuichi Ozaki
- Section of Interventional Cardiology, MedStar Washington Hospital Center , Washington, DC, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center , Washington, DC, USA
| | - Gary S Mintz
- Section of Interventional Cardiology, MedStar Washington Hospital Center , Washington, DC, USA.,Clinical Trials Center, Cardiovascular Research Foundation , New York, NY, USA
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center , Washington, DC, USA
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