1
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Sekimoto T, Koba S, Mori H, Sakai R, Arai T, Yokota Y, Sato S, Tanaka H, Masaki R, Oishi Y, Ogura K, Arai K, Nomura K, Kosaki R, Sakai K, Tsujita H, Kondo S, Tsukamoto S, Tsunoda F, Shoji M, Matsumoto H, Hamazaki Y, Shinke T. Small Dense Low-Density Lipoprotein Cholesterol: A Residual Risk for Rapid Progression of Non-Culprit Coronary Lesion in Patients with Acute Coronary Syndrome. J Atheroscler Thromb 2021; 28:1161-1174. [PMID: 33551393 PMCID: PMC8592706 DOI: 10.5551/jat.60152] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim:
This study investigated whether the small dense low-density lipoprotein cholesterol (sd-LDL-c) level is associated with the rapid progression (RP) of non-culprit coronary artery lesions and cardiovascular events (CE) after acute coronary syndrome (ACS).
Methods:
In 142 consecutive patients with ACS who underwent primary percutaneous coronary intervention for the culprit lesion, the sd-LDL-c level was measured using a direct homogeneous assay on admission for ACS and at the 10-month follow-up coronary angiography. RP was defined as a progression of any pre-existing coronary stenosis and/or stenosis development in the initially normal coronary artery. CEs were defined as cardiac death, myocardial infarction, stroke, or coronary revascularization.
Results:
Patients were divided into two groups based on the presence (
n
=29) or absence (
n
=113) of RP after 10 months. The LDL-c and sd-LDL-c levels at baseline were equivalent in both the groups. However, the sd-LDL-c, triglyceride, remnant lipoprotein cholesterol (RL-c), and apoC3 levels at follow-up were significantly higher in the RP group than in the non-RP group. The optimal threshold values of sd-LDL-c, triglyceride, RL-c, and apoC3 for predicting RP according to receiver operating characteristics analysis were 20.9, 113, 5.5, and 9.7 mg/dL, respectively. Only the sd-LDL-c level (≥ 20.9 mg/dL) was significantly associated with incident CEs at 31±17 months (log-rank: 4.123,
p
=0.043).
Conclusions:
The sd-LDL-c level on treatment was significantly associated with RP of non-culprit lesions, resulting in CEs in ACS patients. On-treatment sd-LDL-c is a residual risk and aggressive reduction of sd-LDL-c might be needed to prevent CEs.
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Affiliation(s)
- Teruo Sekimoto
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hiroyoshi Mori
- Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital
| | - Rikuo Sakai
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Taito Arai
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Yuya Yokota
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Shunya Sato
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hideaki Tanaka
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Ryota Masaki
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Yosuke Oishi
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Kunihiro Ogura
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Ken Arai
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Kosuke Nomura
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Ryota Kosaki
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Koshiro Sakai
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hiroaki Tsujita
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Seita Kondo
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Shigeto Tsukamoto
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Fumiyoshi Tsunoda
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Makoto Shoji
- Division of Cardiology, Department of Medicine, Showa University School of Medicine.,Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital
| | - Hidenari Matsumoto
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Yuji Hamazaki
- Division of Cardiology, Department of Medicine, Showa University School of Medicine.,Division of Cardiology, Otakanomori Hospital
| | - Toshiro Shinke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
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2
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Arai K, Koba S, Yokota Y, Tsunoda F, Tsujita H, Kondo S, Tsukamoto S, Shoji M, Shinke T. Relationships of Fatty Acids, Delta-5 Desaturase Activity, and Lipid Profiles in Men with Acute Coronary Syndrome. J Atheroscler Thromb 2020; 27:1216-1229. [PMID: 32595194 PMCID: PMC7803831 DOI: 10.5551/jat.55780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIMS We evaluated the relationship between the ratios of eicosapentaenoic acid and arachidonic acid (EPA/AA), docosahexaenoic acid (DHA)/AA, and delta-5 desaturase activity (D5D) and atherogenic lipid profiles (ALP) and coronary atherosclerosis. METHODS Polyunsaturated fatty acids (PUFA) and ALP were assessed in 436 men with the first episode of acute coronary syndrome (ACS) not take any lipid-lowering drugs. D5D was estimated as the ratio of AA to dihomogamma-linolenic acid (DGLA). These biomarkers were compared between the lower and higher levels of EPA/AA (0.41) or DHA/AA (0.93) according to the levels in Japanese general population. The thrombolysis in myocardial infarction flow (TIMI) grade of the culprit coronary artery was visually estimated during the initial angiography. RESULTS Approximately 70% of patients had low EPA/AA or DHA/AA. Serum levels of LDL-cholesterol, apolipoprotein B (apoB), and remnant lipoprotein cholesterol (RL-C) were significantly higher in the low EPA/AA or DHA/AA groups, while those of triglycerides and malondialdehyde-modified LDL (MDA-LDL) were significantly higher in the low EPA/AA group alone. The levels of EPA, EPA/AA, DHA/AA, and HbA1c increased and those of DGLA and apoA1 decreased with increasing number of stenotic vessels. Patients with three stenotic coronary vessels or TIMI grade ≥ 1 had significantly higher EPA levels compared with the others. The levels of LDL-cholesterol, non-HDL-cholesterol, triglycerides, small dense LDL-cholesterol, RL-C, MDA-LDL, apoB, and apoE decreased progressively and those of EPA, DHA, EPA/AA and HDL-cholesterol increased as D5D increased. CONCLUSIONS The EPA/AA is a superior risk marker than DHA/AA in term of correlation with ALP in ACS patients.
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Affiliation(s)
- Ken Arai
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Yuya Yokota
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Fumiyoshi Tsunoda
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Hiroaki Tsujita
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Seita Kondo
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Shigeto Tsukamoto
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Makoto Shoji
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Toshiro Shinke
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
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3
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Koba S, Takao T, Shimizu F, Ogawa M, Ishii Y, Yokota Y, Furuyama F, Tsunoda F, Shoji M, Harris WS, Takada A. Comparison of plasma levels of different species of trans fatty acids in Japanese male patients with acute coronary syndrome versus healthy men. Atherosclerosis 2019; 284:173-180. [PMID: 30921600 DOI: 10.1016/j.atherosclerosis.2019.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS It remains unclear how trans fatty acid (TFA) at low-level intake affect lipid levels and the development of acute coronary syndrome (ACS). The study aimed to investigate how plasma TFA composition differs between male patients with ACS and healthy men. METHODS Plasma fatty acid (FA) composition (as determined by gas chromatography) was analyzed in ACS patients on hospital admission and compared to that of age-adjusted healthy men. RESULTS Total FA and TFA levels were similar between ACS and control subjects. Palmitelaidic acid, ruminant-derived TFA (R-TFA), levels were lower in ACS patients (0.17 ± 0.06 vs. 0.20 ± 0.06 of total FA, in ACS and control, respectively, p<0.01), and were significantly directly associated with HDL cholesterol (HDL-C) (rho = 0.269) and n-3 polyunsaturated FA (n-3 PUFA) (rho = 0.442). Linoleic trans isomers (total C18:2 TFA), primary industrially-produced TFA (IP-TFAs), were significantly higher in ACS patients (0.68 ± 0.17 vs. 0.60 ± 0.20 of total FA, in ACS and control, respectively). Total trans-C18:1 isomers were comparable between ACS and control. Differences between ACS and controls in C18:1 trans varied by specific C18:1 trans species. Absolute concentrations of trans-C18:2 isomers were significantly directly associated with LDL-C and non-HDL-C in ACS men. The ACS patients showed significantly lower levels of both n-6 and n-3 PUFA (i.e., eicosapentaenoic, docosahexaenoic and arachidonic acids). CONCLUSIONS There were several case-control differences in specific TFA that could potential affect risk for ACS. Japanese ACS patients, especially middle-aged patients, may consume less R-TFA.
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Affiliation(s)
- Shinji Koba
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan.
| | - Tetsuya Takao
- Faculty of Human Life and Environmental Sciences, Showa Women's University, Tokyo, Japan
| | - Fumiko Shimizu
- Faculty of Human Life and Environmental Sciences, Showa Women's University, Tokyo, Japan
| | - Mutsumi Ogawa
- Faculty of Human Life and Environmental Sciences, Showa Women's University, Tokyo, Japan
| | - Yukie Ishii
- Faculty of Human Life and Environmental Sciences, Showa Women's University, Tokyo, Japan
| | - Yuuya Yokota
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Fumiaki Furuyama
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Fumiyoshi Tsunoda
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Makoto Shoji
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - William S Harris
- Department of Medicine, University of South Dakota School of Medicine and Omegaquant LLC, Sioux Falls, SD, USA
| | - Akikazu Takada
- The International Projects on Food and Health (NPO), Tokyo, Japan
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4
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Iso Y, Kitai H, Kyuno E, Tsunoda F, Nishinaka N, Funato M, Nishimura E, Akihiro S, Tanuma H, Yonechi T, Geshi E, Sambe T, Suzuki H. Prevalence and significance of sleep disordered breathing in adolescent athletes. ERJ Open Res 2019; 5:00029-2019. [PMID: 30863771 PMCID: PMC6409079 DOI: 10.1183/23120541.00029-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 11/14/2022] Open
Abstract
Sudden cardiac death in a young athlete is a tragic event, and emerging data suggest that the leading finding associated with sudden cardiac death in athletes is autopsy-negative sudden unexplained death [1]. Sleep disordered breathing (SDB) can be arrhythmogenic and lead to sudden cardiac death [2, 3]. While obstructive sleep apnoea is generally prevalent in obese, inactive and/or aged subjects [4], little is known about its incidence in young athletes and highly active young people. Consequently, the impact of SDB on cardiovascular health of young athletes has not been fully elucidated. Athletes who participate in collision sports such as rugby and American football tend to exhibit risk factors for SDB such as large neck circumference and higher body mass index [5]. In this context, we investigated the prevalence and significance of SDB in young competitive athletes with a view to advancing the research conducted on athlete health. Sleep disordered breathing (SDB) was more prevalent in adolescent athletes than expected, and several potential warning signs related to autonomic nerve activity appeared in SDB athletes. SDB screening may prevent associated downstream risks in the future.http://ow.ly/GQqK30nGm8r
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Affiliation(s)
- Yoshitaka Iso
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan.,Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Hitomi Kitai
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan.,Showa University School of Nursing and Rehabilitation Sciences, Yokohama, Japan
| | - Etsushi Kyuno
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan.,Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Fumiyoshi Tsunoda
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan.,Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Naoya Nishinaka
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
| | - Masahiko Funato
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
| | - Eiichi Nishimura
- Division of Ophthalmology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Shuichi Akihiro
- Athletic Dept, Nippon Sport Science University, Yokohama, Japan
| | - Hiroyuki Tanuma
- Faculty of Sport Science, Nippon Sport Science University, Yokohama, Japan
| | - Toru Yonechi
- Faculty of Sport Science, Nippon Sport Science University, Yokohama, Japan
| | - Eiichi Geshi
- Showa University School of Nursing and Rehabilitation Sciences, Yokohama, Japan
| | - Takeyuki Sambe
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
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5
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Sakai K, Koba S, Nakamura Y, Yokota Y, Tsunoda F, Shoji M, Itoh Y, Hamazaki Y, Kobayashi Y. Small dense low-density lipoprotein cholesterol is a promising biomarker for secondary prevention in older men with stable coronary artery disease. Geriatr Gerontol Int 2018; 18:965-972. [PMID: 29512264 DOI: 10.1111/ggi.13287] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/19/2017] [Accepted: 01/23/2018] [Indexed: 12/18/2022]
Abstract
AIM The study objective was to investigate whether small dense low-density lipoprotein cholesterol (sdLDL-C) is superior to low-density lipoprotein cholesterol (LDL-C) and other biomarkers to predict future cardiovascular events (CE) in secondary prevention. METHODS sdLDL-C measured by a homogeneous assay, remnant lipoprotein cholesterol, LDL particle diameter and other biomarkers were compared in 345 men aged ≥65 years with stable coronary artery disease. Baseline LDL-C was 100.5 ± 30.1 mg/dL. CE including cardiovascular death, onset of acute coronary syndrome, need for arterial revascularization, hospitalization for heart failure, surgery procedure for cardiovascular disease and hospitalization for stroke were monitored for 5 years. RESULTS CE occurred in 96 patients during the study period. LDL-C, sdLDL-C non-high-density lipoprotein cholesterol, apolipoprotein B, remnant lipoprotein cholesterol, glucose, glycated hemoglobin and brain natriuretic peptide were significantly higher; LDL particle diameter and apolipoprotein A-1 were significantly lower in patients with than in those without CE. Age-adjusted Cox regression analysis showed that sdLDL-C per 10 mg/dL, but not LDL-C, was significantly associated with CE (HR 1.206, 95% CI 1.006-1.446). A significant association of sdLDL-C and incident CE was observed in statin users (HR 1.252, 95% CI 1.017-1.540), diabetes patients (HR 1.219, 95% CI 1.018-1.460), patients without diabetes (HR 1.257, 95% CI 1.019-1.551) and patients with hypertriglyceridemia (HR 1. 376, 95% CI 1.070-1.770). CONCLUSIONS sdLDL-C was the most effective predictor of residual risk of future CE in stable coronary artery disease patients using statins and in high-risk coronary artery disease patients with diabetes or hypertriglyceridemia. Geriatr Gerontol Int 2018; 18: 965-972.
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Affiliation(s)
- Koshiro Sakai
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Shinji Koba
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Yuya Nakamura
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Yuya Yokota
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Fumiyoshi Tsunoda
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Makoto Shoji
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Yasuki Itoh
- R&D Center, Denka Seiken Co. Ltd, Tokyo, Japan
| | - Yuji Hamazaki
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Youichi Kobayashi
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
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6
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Iso Y, Suzuki H, Kyuno E, Maeda A, Tsunoda F, Miyazawa R, Kowaita H, Kitai H, Takahashi T, Sambe T. Therapeutic potential of cycling high-intensity interval training in patients with peripheral artery disease: A pilot study. Int J Cardiol Heart Vasc 2018; 18:30-32. [PMID: 29750181 PMCID: PMC5941238 DOI: 10.1016/j.ijcha.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 02/07/2018] [Accepted: 02/12/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Yoshitaka Iso
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Etsushi Kyuno
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Atsuo Maeda
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Fumiyoshi Tsunoda
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Ryo Miyazawa
- Cardiac Rehabilitation, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Hitoshi Kowaita
- Cardiac Rehabilitation, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Hitomi Kitai
- Cardiac Rehabilitation, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan
| | - Tetsuya Takahashi
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Takeyuki Sambe
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
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7
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Furuyama F, Koba S, Yokota Y, Tsunoda F, Shoji M, Kobayashi Y. Effects of Cardiac Rehabilitation on High-Density Lipoprotein-mediated Cholesterol Efflux Capacity and Paraoxonase-1 Activity in Patients with Acute Coronary Syndrome. J Atheroscler Thromb 2017; 25:153-169. [PMID: 28855433 PMCID: PMC5827085 DOI: 10.5551/jat.41095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIMS We evaluated whether exercised-based cardiac rehabilitation (CR) can ameliorate the HDL function, i.e., cholesterol efflux capacity (CEC) and paraoxonase-1 activity in patients with acute coronary syndrome (ACS). METHODS This study is a retrospective analysis of stored serum from patients with ACS following successful percutaneous coronary intervention. The CEC, measured by a cell-based ex vivo assay using apolipoprotein B-depleted serum and 3H-cholesterol labeled macrophages and arylesterase activity (AREA) at the onset or early phase of ACS, and the follow-up periods were compared between 69 patients who completed the five-month outpatient CR program (CR group) and 15 patients who did not participate and/or dropped out from CR program (non-CR group). RESULTS Apolipoprotein A-I (apoA-I) and CEC significantly increased by 4.0% and 9.4%, respectively, in the CR group, whereas HDL-cholesterol and AREA were not changed during the follow-up periods in both groups. Among CR patients, the CEC significantly increased, irrespective of the different statin treatment, while HDL-cholesterol and apoA-I significantly increased in patients treated with rosuvastatin or pitavastatin. Although CEC and AREA were significantly correlated each other, there is a discordance between CEC and AREA for their correlations with other biomarkers. Both CEC and AREA were significantly correlated with apoA-I rather than HDL-cholesterol. Changes in CEC and those in AREA were significantly correlated with those in apoA-I (rho=0.328, p=0.002, and rho=0.428, p<0.0001, respectively) greater than those in HDL-cholesterol (rho=0.312, p= 0.0042,and rho=0.343, p=0.003, respectively). CONCLUSIONS CR can improve HDL function, and it is beneficial for secondary prevention.
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Affiliation(s)
- Fumiaki Furuyama
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Yuya Yokota
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Fumiyoshi Tsunoda
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Makoto Shoji
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Youichi Kobayashi
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
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8
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Koba S, Yokota Y, Sakai K, Nakamura Y, Tsunoda F, Shoji M, Ito Y, Kobayashi Y. Small dense LDL cholesterol as strong predictors for secondary cardiovascular events compared with LDL cholesterol in elderly patients. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Koba S, Ayaori M, Uto-Kondo H, Furuyama F, Yokota Y, Tsunoda F, Shoji M, Ikewaki K, Kobayashi Y. Beneficial Effects of Exercise-Based Cardiac Rehabilitation on High-Density Lipoprotein-Mediated Cholesterol Efflux Capacity in Patients with Acute Coronary Syndrome. J Atheroscler Thromb 2016; 23:865-77. [PMID: 26947596 DOI: 10.5551/jat.34454] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AIM Recent studies reported that low high-density lipoprotein (HDL)-mediated cholesterol efflux capacity rather than low HDL cholesterol (HDL-C) is strongly associated with the increased risk for coronary artery disease. It remains unclear whether exercised-based cardiac rehabilitation (CR) can increase HDL cholesterol efflux capacity. METHOD This study is a retrospective analysis of stored serum from patients with acute coronary syndrome (ACS) who participated in outpatient CR program following successful percutaneous coronary intervention. We employed a cell-based cholesterol efflux system including the incubation of (3)H-cholesterol labeled macrophages with apolipoprotein B-depleted serum at the onset or early phase of ACS and at 6-month follow-up periods in 57 male and 11 female patients with ACS. Cardiopulmonary exercise tests were performed at the beginning and end of CR program. RESULT Fifty-seven patients completed the CR program. Compared with patients who dropped out from CR program (non-CR group), CR participants showed marked amelioration in serum lipid levels, increased efflux capacity, and improved exercise capacity. Spearman's rank correlation coefficient analysis revealed that the percent increases of efflux capacity were significantly associated with the percent increases in HDL-C (ρ=0.598, p<0.0001) and apolipoprotein A1 (ρ=0.508, p<0.0001), whereas no association between increases in efflux capacity and increases in cardiopulmonary fitness was observed. Increases in cholesterol efflux capacity were not seen in patients who continued smoking and those who did not achieve all risk factor targets and higher exercise tolerance. CONCLUSION CR can markedly increase both HDL-C and HDL cholesterol efflux capacity. These results suggest that CR is a very useful therapy for reverse cholesterol transport and secondary prevention.
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Affiliation(s)
- Shinji Koba
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine
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10
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Tsunoda F, Lamon-Fava S, Asztalos BF, Iyer LK, Richardson K, Schaefer EJ. Effects of oral eicosapentaenoic acid versus docosahexaenoic acid on human peripheral blood mononuclear cell gene expression. Atherosclerosis 2015; 241:400-8. [PMID: 26074314 DOI: 10.1016/j.atherosclerosis.2015.05.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 01/30/2015] [Revised: 05/08/2015] [Accepted: 05/12/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have beneficial effects on inflammation and cardiovascular disease (CVD). Our aim was to assess the effect of a six-week supplementation with either olive oil, EPA, or DHA on gene expression in peripheral blood mononuclear cells (PBMC). METHODS Subjects were sampled at baseline and six weeks after receiving either: olive oil 6.0 g/day (n = 16), EPA 1.8 g/day (n = 16), or DHA 1.8 g/day (n = 18). PBMC were subjected to gene expression analysis by microarray with key findings confirmed by quantitative real-time polymerase chain reaction (Q-PCR). RESULTS Plasma phospholipid EPA increased 3 fold in the EPA group, and DHA increased 63% in the DHA group (both p < 0.01), while no effects were observed in the olive oil group. Microarray analysis indicated that EPA but not DHA or olive oil significantly affected the gene expression in the following pathways: 1) interferon signaling, 2) receptor recognition of bacteria and viruses, 3) G protein signaling, glycolysis and glycolytic shunting, 4) S-adenosyl-l-methionine biosynthesis, and 5) cAMP-mediated signaling including cAMP responsive element protein 1 (CREB1), as well as many other individual genes including hypoxia inducible factor 1, α subunit (HIF1A). The findings for CREB1 and HIF1A were confirmed by Q-PCR analysis. CONCLUSIONS Our data indicate that EPA supplementation was associated with significant effects on gene expression involving the interferon pathway as well as down-regulation of CREB1 and HIF1A, which may relate to its beneficial effect on CVD risk reduction.
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Affiliation(s)
- Fumiyoshi Tsunoda
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Stefania Lamon-Fava
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Bela F Asztalos
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Lakshmanan K Iyer
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA; Center for Neuroscience Research, Tufts University School of Medicine, Boston, MA, USA
| | - Kris Richardson
- Nutrition and Genomics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
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Furuyama F, Koba S, Yokota Y, Tsunoda F, Shoji M, Kobayashi Y. AMELIORATION OF CHOLESTEROL EFFLUX CAPACITY BY CARDIAC REHABILITATION IN PATIENTS WITH ACUTE CORONARY SYNDROME. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61379-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Nishikura T, Koba S, Yokota Y, Hirano T, Tsunoda F, Shoji M, Hamazaki Y, Suzuki H, Itoh Y, Katagiri T, Kobayashi Y. Elevated small dense low-density lipoprotein cholesterol as a predictor for future cardiovascular events in patients with stable coronary artery disease. J Atheroscler Thromb 2014; 21:755-67. [PMID: 24717762 DOI: 10.5551/jat.23465] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The aim of the present study was to investigate how small dense low-density lipoprotein cholesterol (sdLDL-C) compared with LDL-C affect the long-term prognosis in patients with stable coronary artery disease (CAD). METHODS sdLDL-C measured by heparin magnesium precipitation and LDL particle size measured by non-denatured gradient-gel electrophoresis were compared in 190 consecutive CAD patients who underwent coronary arteriography between 2003 and 2004 who did or did not develop cardiovascular events during a seven-year follow-up period. Cardiovascular events were death caused by cardiovascular diseases(CVDs), onset of acute coronary syndrome, need for coronary and peripheral arterial revascularization, hospitalization for heart failure, surgical procedure for any CVDs, and/or hospitalization for stroke. RESULTS First-time cardiovascular events were observed in 72 patients. Those who experienced cardiovascular events were older and had higher prevalence rates of hypertension and diabetes; significantly higher Gensini coronary atherosclerotic scores; significantly higher levels of sdLDL-C, sdLDL-C/LDL-C, and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratios; and greater glycated hemoglobin(Hb)A1c and brain natriuretic peptide (BNP) levels. They also had significantly smaller LDL particle sizes, HDL-C, apolipoprotein A-1, and estimated glomerular filtration rate (GFR) compared with patients without cardiovascular events. Conversely, LDL-C, non-HDL-C, apolipoprotein B, remnantlike particle cholesterol, and high-sensitivity C-reactive protein (hs-CRP) levels were similar between the two groups. A Kaplan-Meyer event-free survival curve demonstrated that patients with sdLDL-C≥35 mg/dL (median level) had significantly poorer prognosis compared with those with lower sdLDL-C levels, while patients with LDL-C ≥100 mg/dL had a non-significantly lower survival rate. CONCLUSION These results confirm that sdLDL-C is a very promising biomarker to predict future cardiovascular events in the secondary prevention of stable CAD.
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Affiliation(s)
- Tenjin Nishikura
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine
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Shoji M, Furuyama F, Yokota Y, Omori Y, Sato T, Tsunoda F, Iso Y, Koba S, Geshi E, Katagiri T, Suzuki H, Kobayashi Y. IL-6 mobilizes bone marrow-derived cells to the vascular wall, resulting in neointima formation via inflammatory effects. J Atheroscler Thromb 2013; 21:304-12. [PMID: 24366256 DOI: 10.5551/jat.19414] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Among the many factors related to bone marrow cell mobilization, local inflammation induced by cytokines may drive bone marrow cells to the vascular wall, resulting in a thickened neointima. However, the relationship between inflammatory reactions and bone marrow cell invasion has not yet been fully clarified. METHODS We inserted a large wire into the femoral artery in male balb/c(WT), interleukin (IL)-6-knockout (KO) and bone marrow-transplanted (BMT) mice that had received bone marrow cells from KO mice. Immunohistochemistry was performed to evaluate the degree of intimal hyperplasia and inflammation following vascular injury. RESULTS Three days after the vascular injury, the number of CD34/Sca-1-positive cells in the blood was higher in the KO mice. The numbers of apoptotic cells in the neointima was lower in the KO and BMT mice at two hours after injury. The morphometric analysis performed at one and four weeks after injury showed that the intima/media ratio was significantly lower in the KO and BMT mice, while CD34-positive cells were much more frequent in the WT mice. Furthermore, re-endothelialization appeared earlier in the KO and BMT mice than in the WT mice. No differences in the levels of vascular endothelial growth factor or hepatocyte growth factor were observed in the mice sera between the WT, KO and BMT mice after injury. The in vitro culture of bone marrow cells showed more differentiated smooth muscle-like cells in the WT mice than in the KO mice. CONCLUSIONS IL-6 is involved in neointimal formation following vascular injury, possibly acting through inflammatory effects inducing the production of bone marrow cells.
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Affiliation(s)
- Makoto Shoji
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
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Meguro Y, Ito Y, Koba S, Yokota Y, Hirano T, Ban Y, Tsunoda F, Sato T, Shoji M, Suzuki H, Geshi E, Kobayashi Y, Katagiri T. 515 SMALL DENSE LDL-CHOLESTEROL IS SUPERIOR TO LDL-CHOLESTEROL FOR DETERMINING SEVERE CORONARY ATHEROSCLEROSIS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70516-5] [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: 10/18/2022]
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Ito Y, Koba S, Hirano T, Yokota Y, Tsunoda F, Ban Y, Sato T, Shoji M, Suzuki H, Geshi E, Katagiri T. SIGNIFICANCE OF SMALL DENSE LOW-DENSITY LIPOPROTEINS IN CORONARY HEART DISEASE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70971-1] [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: 10/22/2022]
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16
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Suzuki H, Kusuyama T, Sato R, Yokota Y, Tsunoda F, Sato T, Shoji M, Iso Y, Koba S, Katagiri T. Elevation of matrix metalloproteinases and interleukin-6 in the culprit coronary artery of myocardial infarction. Eur J Clin Invest 2008; 38:166-73. [PMID: 18257779 DOI: 10.1111/j.1365-2362.2007.01919.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Interleukin-6 (IL-6) and metalloproteinases (MMPs) are involved in the instability of vulnerable plaque associated with the induction of acute myocardial infarction (AMI). We examined the regional changes of cytokines, MMPs and adhesion molecules in patients with AMI to elucidate how these factors are involved in the onset of AMI. MATERIALS AND METHODS One hundred and twenty-two patients with AMI were included. Blood was aspirated from the culprit coronary artery with a thrombectomy catheter, and was also sampled from peripheral veins during the coronary intervention. Control samples were obtained from the peripheral blood of age-matched patients. RESULTS The serum levels of IL-6 (P < 0.05), tumour necrosis factor-alpha (P < 0.005), MMP-1 (P < 0.001), MMP-13 (P < 0.001), soluble intercellular adhesion molecule-1 (P < 0.005), and soluble vascular cellular adhesion molecule-1 (P < 0.05) in peripheral blood were significantly higher in the AMI group than in the controls. Aspirated serum contained significantly higher levels of IL-6 (P < 0.001), MMP-1 (P < 0.001), and MMP-13 (P < 0.05) compared to the peripheral blood of AMI. Serum IL-6 levels were significantly higher in the aspirated than in the peripheral blood in the patients hospitalized within 6 h and 6-12 h, but were similar in the aspirated and peripheral blood of the patients hospitalized 12-24 h after the onset of AMI. There were no differences between the aspirated serum and peripheral blood in the levels of interleukin-1beta and MMP-2. CONCLUSIONS The levels of MMP-1, MMP-13 and IL-6 were higher in the culprit coronary artery than in the peripheral blood. These factors appear to be involved in the early stage of AMI.
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Affiliation(s)
- H Suzuki
- Third Department of Internal Medicine, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan.
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Shoji M, Iso Y, Kusuyama T, Omori Y, Soda T, Tsunoda F, Sato T, Koba S, Geshi E, Kobayashi Y, Katagiri T, Suzuki H. High-Dose Granulocyte-Colony Stimulating Factor Promotes Neointimal Hyperplasia in the Early Phase and Inhibits Neointimal Hyperplasia in the Late Phase After Vascular Injury. Circ J 2008; 72:1885-93. [DOI: 10.1253/circj.cj-07-1037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Makoto Shoji
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Yoshitaka Iso
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Taro Kusuyama
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Yasutoshi Omori
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Teruko Soda
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Fumiyoshi Tsunoda
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Takatoshi Sato
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Shinji Koba
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Eiichi Geshi
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Youichi Kobayashi
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Takashi Katagiri
- Third Department of Internal Medicine, Showa University School of Medicine
| | - Hiroshi Suzuki
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital
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Koba S, Yokota Y, Hirano T, Ito Y, Ban Y, Tsunoda F, Sato T, Shoji M, Suzuki H, Geshi E, Kobayashi Y, Katagiri T. Small LDL-Cholesterol is Superior to LDL-Cholesterol for Determining Severe Coronary Atherosclerosis. J Atheroscler Thromb 2008; 15:250-60. [DOI: 10.5551/jat.e572] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Sato T, Suzuki H, Kusuyama T, Omori Y, Soda T, Tsunoda F, Shoji M, Iso Y, Koba S, Geshi E, Katagiri T, Kawachi K, Wakabayashi K, Takeyama Y. G-CSF after myocardial infarction accelerates angiogenesis and reduces fibrosis in swine. Int J Cardiol 2007; 127:166-73. [PMID: 17692407 DOI: 10.1016/j.ijcard.2007.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 04/28/2007] [Accepted: 05/19/2007] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Recent studies have suggested that granulocyte colony-stimulating factor (G-CSF) may improve cardiac function after acute myocardial infarction (AMI) by accelerating angiogenesis or cardiomyogenesis, but negative results and side effect of G-CSF have also been reported. However, no previous studies have used large animal models of ischemia/reperfusion to investigate the effect and side effect of G-CSF after AMI. METHODS The diagonal branch of the left anterior descending coronary artery of swine was balloon-occluded for 1 h and then reperfused. The animals of the G-CSF group were injected with G-CSF subcutaneously (5.0 microg/kg/day) for 6 days after MI and then sacrificed after 4 weeks. The control group received the same volume of saline. RESULTS There were no differences between the groups in the rate of thrombotic obstruction or progression of stenosis lesion in coronary angiography. The ejection fraction and end-diastolic volume in the G-CSF group were not significantly improved over the control values. The fibrotic area was significantly smaller in the G-CSF group than in the controls (P<0.05), and the numbers of vessels counted in anti-von Willebrand factor and anti-alpha-smooth muscle actin-stained sections were significantly larger (P<0.005 and P<0.05, respectively). The expression of collagen III mRNA was significantly lower in the G-CSF group than in the control in the infarct (P<0.0005) and border areas (P<0.005), and TGF-beta mRNA was significantly lower in the G-CSF group in the border area (P<0.05). CONCLUSIONS G-CSF could modify the healing process after AMI by accelerating angiogenesis in a swine ischemia/reperfusion model. At the dose administered, however, G-CSF did not seem to improve the global cardiac function.
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Affiliation(s)
- Takatoshi Sato
- Third Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
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Sato T, Suzuki H, Kusuyama T, Omori Y, Soda T, Tsunoda F, Shoji M, Iso Y, Koba S, Geshi E, Katagiri T, Uyama T, Umezawa A. Bone Marrow Stromal Cells Injection into Heart using the Newly Developed Catheter for Transendocardial Cell Transplantation. J Card Fail 2006. [DOI: 10.1016/j.cardfail.2006.08.113] [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: 10/24/2022]
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Koba S, Hirano T, Ito Y, Tsunoda F, Yokota Y, Ban Y, Iso Y, Suzuki H, Katagiri T. Significance of small dense low-density lipoprotein-cholesterol concentrations in relation to the severity of coronary heart diseases. Atherosclerosis 2006; 189:206-14. [PMID: 16414053 DOI: 10.1016/j.atherosclerosis.2005.12.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Revised: 11/24/2005] [Accepted: 12/03/2005] [Indexed: 11/25/2022]
Abstract
We have investigated the clinical significance of small dense low-density lipoprotein-cholesterol (sd-LDL-C) concentrations in coronary heart disease (CHD). We measured the LDL size by gradient gel electrophoresis and quantified sd-LDL-C concentrations by a newly developed rapid assay using heparin-magnesium precipitation in 225 consecutive CHD patients without any lipid-lowering medication and 142 healthy middle-aged subjects as controls. The LDL size was markedly smaller and sd-LDL-C levels were significantly higher in CHD patients than in controls of both sexes, whereas LDL-C levels were comparable between CHD and controls. The LDL-C levels were significantly higher in a subpopulation of 84 patients with acute coronary syndrome than in other patients groups, while LDL size and high-density lipoprotein-cholesterol (HDL-C) were not found to vary among the patients. The sd-LDL-C increased as the number of diseased vessels or Gensini atherosclerosis score increased. Among the 123 stable CHD patients, multiple logistic regression analysis revealed that sd-LDL-C levels were significantly associated with the clinically severe cases requiring coronary revascularization independently of LDL-C, HDL-C and apolipoprotein B. The sd-LDL mass plays a more important role in the progression of CHD than the LDL size, and the sd-LDL-C concentration serves as a powerful surrogate marker for the prevention of CHD.
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Affiliation(s)
- Shinji Koba
- The Third Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.
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Ban Y, Koba S, Tsunoda F, Yokota Y, Ezumi H, Kondo T, Suzuki H, Katagiri T. Predominance of Small Dense Low-Density Lipoproteins and Abnormal Glucose Regulation in Patients With Acute Coronary Syndrome. Circ J 2006; 70:393-401. [PMID: 16565554 DOI: 10.1253/circj.70.393] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although small dense low-density lipoprotein (sd-LDL) has an established association with diabetic dyslipidemia, previous studies have failed to show an association between sd-LDL and diabetes among coronary heart disease patients. This study investigated the prevalence of sd-LDL and abnormal glucose regulation in acute coronary syndrome (ACS). METHODS AND RESULTS LDL size at the onset of ACS was measured by nondenatured gradient gel electrophoresis in 314 of 429 consecutive patients. Sd-LDL was prevalent in 54% of the patients, irrespective of the presence of previously known diabetes (50% vs 60% in nondiabetes and diabetes, respectively). Diabetes was present in 122 (28%) of the patients, and 110 patients without diabetes underwent an oral glucose tolerance test. Impaired glucose tolerance (IGT) and newly detected diabetes were found in as many as 44% and 22% of the patients tested, even though their hemoglobinA1c levels were in the normal range (5.3+/-0.5%). The prevalence of sd-LDL was significantly higher in patients with glucose intolerance than in those with normal glucose tolerance (61% vs 42%). CONCLUSION IGT and diabetes were far more common than normal glucose regulation in ACS patients, and the abnormal glycometabolism was closely associated with highly atherogenic sd-LDL.
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Affiliation(s)
- Yoshihisa Ban
- Third Department of Internal Medicine, Showa University School of Medicine, Hatanodai, Tokyo, Japan
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Suzuki H, Kusuyama T, Omori Y, Soda T, Tsunoda F, Sato T, Shoji M, Iso Y, Kondo T, Koba S, Geshi E, Katagiri T. Inhibitory Effect of Candesartan Cilexetil on Left Ventricular Remodeling After Myocardial Infarction. Int Heart J 2006; 47:715-25. [PMID: 17106142 DOI: 10.1536/ihj.47.715] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although angiotensin-converting enzyme inhibitors (ACEIs) have been shown to reduce left ventricular remodeling after acute myocardial infarction (AMI), the effects of angiotensin receptor blockers have yet to be established. This study was conducted to examine the effects of candesartan on left ventricular remodeling after AMI. Consecutive AMI patients were assigned to a candesartan group or ACEI group after successful coronary intervention. The patients in the candesartan group (n = 77, mean age, 62.8 +/- 1.3) received candesartan and the patients in the ACEI group (n = 80, mean age, 63.3 +/- 1.2) received lisinopril, enalapril, or trandolapril. Four mg was the most frequent dose in the candesartan group at 6 months. Lisinopril, enalapril, and trandolapril were administered to 52%, 27%, and 21% of the patients in the ACEI group, respectively. No significant differences in the incidences of cardiac death, nonfatal MI, or hospitalization for heart failure (P = NS) were found between the groups. The candesartan group exhibited a somewhat higher percent increase in left ventricular ejection fraction and significantly lower percent increases in left ventricular end-diastolic volume index and left ventricular end-systolic volume index compared to the ACEI group (P < 0.05, P < 0.05, respectively). Candesartan is more effective than ACEI in preventing left ventricular remodeling after AMI.
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Affiliation(s)
- Hiroshi Suzuki
- Third Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
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Sato T, Suzuki H, Kusuyama T, Ohmori Y, Soda T, Tsunoda F, Shoji M, Iso Y, Koba S, Geshi E, Katagiri T, Wakabayashi K, Takeyama Y, Uyama T, Umesawa A. The Effects of Bone Marrow Stromal Cell Infusion after Myocardial Infarction Through Cardiac Vein in Swine. J Card Fail 2005. [DOI: 10.1016/j.cardfail.2005.08.218] [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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Nishio K, Fukui T, Tsunoda F, Kawamura K, Itoh S, Konno N, Ozawa K, Katagiri T. Insulin resistance as a predictor for restenosis after coronary stenting. Int J Cardiol 2005; 103:128-34. [PMID: 16080969 DOI: 10.1016/j.ijcard.2004.08.039] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2004] [Revised: 07/31/2004] [Accepted: 08/07/2004] [Indexed: 11/26/2022]
Abstract
PURPOSE The rationale of this study was to determine whether insulin resistance is an independent risk factor for restenosis after coronary stenting. BACKGROUND Previous studies suggested that hyperinsulinemia may be an important risk factor for ischemic heart disease. Restenosis after coronary stenting is neointimal tissue proliferation and de-novo stenosis is atherosclerosis from the point of view of histology. However, it has not been determined whether insulin resistance is independently related to restenosis after coronary stenting. METHODS Clinical variables of unselected population of 110 patients were analyzed in multivariate logistic regression analyses for both restenosis and de-novo stenosis. Clinical, lesion-related, and procedural variables were analyzed by chi-square analysis, and relative risk. RESULTS Multivariate logistic regression analysis showed that homeostasis model assessment insulin resistance (HOMA-IR) and HbA1c were associated with restenosis after coronary stenting (HOMA-IR; P=0.0447, HbA1c; P=0.0462), and HbA1c and low-density lipoprotein cholesterol (LDL-C) were associated with de-novo stenosis (HbA1c; P=0.0201, LDL-C; P=0.0204). Restenosis was influenced by insulin resistance [Relative Risk (RR) 2.06; 95 percent confidence interval (95%CI) 1.20 to 3.56], diabetes mellitus (DM: RR 1.92; 95%CI 1.25 to 2.95), and final minimal lumen diameter (RR 2.83; 95%CI 1.32 to 6.06). CONCLUSIONS HOMA-IR and DM are the predictors of restenosis after coronary stenting, and HbA1c and LDL-C are the predictors of de-novo stenosis. These results may be reflected in histological differences between neointimal tissue proliferation as restenosis and atherosclerosis as de-novo stenosis.
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Affiliation(s)
- Kazuaki Nishio
- The Third Department of Internal Medicine, School of Medicine Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
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Tsunoda F, Koba S, Hirano T, Ban Y, Iso Y, Suzuki H, Geshi E, Katagiri T. Association between small dense low-density lipoprotein and postprandial accumulation of triglyceride-rich remnant-like particles in normotriglyceridemic patients with myocardial infarction. Circ J 2005; 68:1165-72. [PMID: 15564701 DOI: 10.1253/circj.68.1165] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although the small dense low-density lipoprotein (sd-LDL) is associated with hypertriglyceridemia, more than 60% of myocardial infarction (MI) patients are normotriglyceridemic in the fasting state. This study was aimed to investigate the relationship between the low-density lipoprotein (LDL) phenotype and postprandial hyperlipemia (PPL) in MI patients. METHODS AND RESULTS Oral fat tolerance tests were performed in 71 patients with acute MI and fasting triglyceride concentrations below 200 mg/dl. Postprandial changes in the LDL particle diameter (LDL-PD) and lipids over a 6-h period after a meal were compared among 4 groups of patients classified according to fasting triglyceride levels (A, B as <150, and C, D as > or =150) and postprandial triglyceride levels (A, C as <230 and B, D as > or =230). Although fasting concentrations of triglyceride and remnant-like particle (RLP)-triglyceride were significantly higher in group C than in group B, the areas under the curves of the RLPs were significantly higher in group B. The triglyceride-to-cholesterol ratio in the RLPs was significantly higher in the PPL group than in the nonPPL group postprandially. The prevalence of sd-LDL (LDL-PD < or =25.5 nm) was significantly higher in group D but similar between groups B and C (23%, 42%, 50% and 83% in groups A, B, C and D, respectively). CONCLUSION These results suggest that postprandial accumulation of triglyceride-rich lipoproteins is strongly associated with sd-LDL in MI patients without hypertriglyceridemia.
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Affiliation(s)
- Fumiyoshi Tsunoda
- Third Department of Internal Medicine, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan
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Abstract
BACKGROUND Low-density lipoprotein (LDL) particle size is strongly affected by both fasting and postprandial triglyceride levels. We report here that the LDL phenotype shifts toward the smaller phenotype during oral fat tolerance tests (OFTTs) in some patients with myocardial infarction (MI); a condition closely associated with postprandial increases of triglyceride and remnant-like particles (RLPs). METHODS Oral fat tolerance tests were performed on 63 MI patients with fasting serum triglyceride levels of less than 2.25 mmol L-1 (= 200 mg dL-1). Remnant-like particles and other serum lipids were compared among patients characterized by three LDL phenotypes based on nondenaturing gradient gel electrophoresis: pattern A (large LDLs, peak LDL particle size > or = 260 A), pattern I (intermediate-sized LDLs, LDL size > 255 A, < 260 A), and pattern B (small, dense LDLs, LDL size < or = 255 A). RESULTS The LDL size decreased significantly in patients with the highest tertile of areas under the incremental curves (AUICs) of triglycerides above the fasting levels. The LDL phenotype shifted toward the smaller phenotype after a fat load in three of eight patients with pattern A and in seven of 35 patients with pattern I. The AUICs of triglyceride-rich lipoproteins were significantly higher in these patients than in the patients exhibiting little change in LDL size, whereas the fasting metabolic parameters were similar among the patients of the same LDL phenotype in the fasting state. CONCLUSION These results suggest that alimentary lipaemia plays an important role in the remodeling of LDL particles into the more atherogenic small, dense LDLs in patients with MI.
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Affiliation(s)
- S Koba
- 3rd Department of Emergency Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
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Tsunoda F, Koba S, Hirano T, Ban Y, Iso Y, Suzuki H, Geshi E, Katagiri T. 1P-0026 Association with small dense LDL phenotype on postprandial lipemia in patients with acute myocardial infarction. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)90101-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Miura M, Kudo A, Wakusawa R, Itai K, Kudo H, Tsunoda F. [Serum inorganic fluoride concentrations and their urinary excretion during and after sevoflurane, isoflurane, or enflurane anesthesia in man]. Masui 1993; 42:562-7. [PMID: 8315797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Serum inorganic fluoride concentrations and their urinary excretion were examined during and after sevoflurane, isoflurane, or enflurane anesthesia in man. Duration of anesthesia was 3 hours in sevoflurane and enflurane groups (S3 group: n = 10, E3 group: n = 5), and 3 or 5 hours in isoflurane groups (I3 group: n = 5, I5 group: n = 5). Serum inorganic fluoride concentration of the S3 and E3 groups increased immediately following induction, and reached the maximum concentration of 21.8 +/- 9.3 (M +/- SD) mumol.l-1 (S3), 13.6 +/- 6.2 mumol.l-1 (E3) at 1 hour after anesthesia. Serum inorganic fluoride decreased after the peak concentrations, and returned to the pre-anesthesia level at 96 hours (S3) and 144 hours (E3) after anesthesia. On the other hand, serum inorganic fluoride of the I3 and I5 groups scarcely changed from the pre-anesthesia level, and maximum concentrations of these two groups were one tenth of the S3 group. Urinary excretion of inorganic fluoride of the S3 and E3 group began to increase from 2 hours after anesthesia, and showed plateau of 60-90 mmol.h-1 from 12 hours to 24 hours after anesthesia. The change of serum inorganic fluoride sharply contrasted with urinary excretion. Our results suggest that fluoride excretion is largely carried out by the kidney. Therefore sevoflurane or enflurane anesthesia should be avoided in patients with renal dysfunction.
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Affiliation(s)
- M Miura
- Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka
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Sonoyama T, Terata N, Matsumoto H, Nozaki A, Kimura K, Kurioka H, Hashimoto I, Tsunoda F, Kodama M. [Study on the antitumor effect of an inhibitor against cell surface enzyme (Bestatin)]. Nihon Gan Chiryo Gakkai Shi 1982; 17:1264-9. [PMID: 6984058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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