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Fujiyoshi K, Yamaoka-Tojo M, Fujiyoshi K, Komatsu T, Oikawa J, Kashino K, Tomoike H, Ako J. Beat-to-beat alterations of acoustic intensity and frequency at the maximum power of heart sounds are associated with NT-proBNP levels. Front Cardiovasc Med 2024; 11:1372543. [PMID: 38628311 PMCID: PMC11018890 DOI: 10.3389/fcvm.2024.1372543] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Background Auscultatory features of heart sounds (HS) in patients with heart failure (HF) have been studied intensively. Recent developments in digital and electrical devices for auscultation provided easy listening chances to recognize peculiar sounds related to diastolic HS such as S3 or S4. This study aimed to quantitatively assess HS by acoustic measures of intensity (dB) and audio frequency (Hz). Methods Forty consecutive patients aged between 46 and 87 years (mean age, 74 years) with chronic cardiovascular disease (CVD) were enrolled in the present study after providing written informed consent during their visits to the Kitasato University Outpatient Clinic. HS were recorded at the fourth intercostal space along the left sternal border using a highly sensitive digital device. Two consecutive heartbeats were quantified on sound intensity (dB) and audio frequency (Hz) at the peak power of each spectrogram of S1-S4 using audio editing and recording application software. The participants were classified into three groups, namely, the absence of HF (n = 27), HF (n = 8), and high-risk HF (n = 5), based on the levels of NT-proBNP < 300, ≥300, and ≥900 pg/ml, respectively, and also the levels of ejection fraction (EF), such as preserved EF (n = 22), mildly reduced EF (n = 12), and reduced EF (n = 6). Results The intensities of four components of HS (S1-S4) decreased linearly (p < 0.02-0.001) with levels of body mass index (BMI) (range, 16.2-33.0 kg/m2). Differences in S1 intensity (ΔS1) and its frequency (ΔfS1) between two consecutive beats were non-audible level and were larger in patients with HF than those in patients without HF (ΔS1, r = 0.356, p = 0.024; ΔfS1, r = 0.356, p = 0.024). The cutoff values of ΔS1 and ΔfS1 for discriminating the presence of high-risk HF were 4.0 dB and 5.0 Hz, respectively. Conclusions Despite significant attenuations of all four components of HS by BMI, beat-to-beat alterations of both intensity and frequency of S1 were associated with the severity of HF. Acoustic quantification of HS enabled analyses of sounds below the audible level, suggesting that sound analysis might provide an early sign of HF.
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Affiliation(s)
- Kazuhiro Fujiyoshi
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Kanako Fujiyoshi
- Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Takumi Komatsu
- Department of Functional Restoration Science, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Jun Oikawa
- Department of Kitasato Clinical Research Center, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kunio Kashino
- Bio-Medical Informatics Research Center, NTT Basic Research Laboratories, Atsugi, Japan
| | - Hitonobu Tomoike
- Bio-Medical Informatics Research Center, NTT Basic Research Laboratories, Atsugi, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Suzuki M, Tomoike H, Dai Z, Hosoda T, Sumiyoshi T, Hosoda S, Isobe M. Polyvascular Disease and the Incidence of Cancer in Patients with Coronary Artery Disease. JMA J 2022; 5:498-509. [PMID: 36407071 PMCID: PMC9646297 DOI: 10.31662/jmaj.2022-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/30/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Based on the possible relation of atherosclerotic cardiovascular disease to the development of cancer, we examined whether polyvascular disease, as a surrogate marker of the severity of atherosclerosis, is associated with the incidence of cancer in patients with coronary artery disease (CAD). METHODS A total of 8,856 patients with CAD between January 2009 and July 2014 were eligible for this observational study. Two cohorts were established based on the presence or absence of polyvascular disease (i.e., polyvascular disease and CAD only) and tracked for the incidence of cancer and all causes of death. Polyvascular disease was defined when accompanied by diagnosed aortic and/or peripheral arterial disease or other arterial diseases at enrollment. RESULTS With a median follow-up of 1,095 d, the incidence of cancer was markedly higher in the cohort of 716 patients with polyvascular disease than in the cohort of 8,140 patients with CAD only (8.8% vs. 4.9%, P = 0.0001). A large difference in the incidence of cancer was also found in accordance with a number of the coexisting vascular disease with CAD. With the adjustment of shared common risks, polyvascular disease was an independent contributor to the incidence of cancer (hazard ratio, 1.362; 95% confidence interval [CI], 1.029-1.774). In a total of 548 patients (6.2% of participants) died during follow-up, and all-cause, cardiovascular, and cancer mortalities were all higher in the cohort with polyvascular disease than in the cohort with CAD only. CONCLUSION The presence of polyvascular disease may be associated with the incidence of cancer in patients with CAD, implying a pivotal role of the severity of atherosclerosis in cancer development (ClinicalTrials.gov. number: NCT04198896).
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Affiliation(s)
- Makoto Suzuki
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan,Hoshinooka Cardiovascular Clinic, Ehime, Japan
| | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Zhehao Dai
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Toru Hosoda
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Saichi Hosoda
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Mitsuaki Isobe
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
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Kataoka Y, Tomoike H. Spatial Feature Extraction of Vectorcardiography via Minimum Volume Ellipsoid Enclosure in Classifying Left Ventricular Hypertrophy. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:625-628. [PMID: 34891371 DOI: 10.1109/embc46164.2021.9630932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The voltage criteria used to diagnose left ventricular hypertrophy (LVH) in the chest and limb leads are by no means absolute. In addition to QRS voltages, QRS axis and duration, and P wave characteristics, repolarization (STT) changes have been focused attention due to their representing left ventricular overload. Vectorcardiography (VCG) has been studied specifically on its repolarization abnormality. The present study aims to devise spatial feature extraction of VCG and assess it in the LVH classification task. A minimum volume ellipsoid enclosure was applied to six segments obtained from upstroke and downstroke of each P, QRS, and T loops of a single-beat VCG. For the evaluation, VCG and 12 lead ECG dataset along with LVH labels of 61 subjects were derived from public open data, PTB-XL. These classification performances were compared with the LVH diagnosis criteria in the standard 12 lead ECG. As a result, the Random Forest classifier trained by the proposed spatial VCG feature resulted in accuracy of 0.904 (95% confidence interval: 0.861-0.947) when the classbalanced dataset was evaluated, which slightly exceeded the feature of 12 lead ECG. The feature importance analysis provided the quantitative ranking of the spatial feature of VCG, which were practically similar to those of ECG in the LVH classification task. Since the VCG are spatially comparable with three-dimensional data of CT, MRI, or Echocardiography, VCG will shed light on the spatial behavior of electrical depolarization and repolarization abnormalities in cardiac diseases.
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Fukuda Y, Kataoka Y, Kodama H, Yasuno Y, Tomoike H. Tonometric Condition of Cellular Polypropylene Film Sensors in Measuring Arterial Pressure Waveform. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:7445-7449. [PMID: 34892817 DOI: 10.1109/embc46164.2021.9629747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Tonometric continuous measurement of arterial pressure becomes feasible using a cellular polypropylene (Cellular PP) film sensor. A pulsatile arterial vascular phantom model was used to find the range of optimal tonometric conditions and the responsiveness to dynamic pressure changes. The optimal tonometric condition was assessed by the correlation coefficient between the hydraulic pressure and the Cellular PP output using two different types of tubes (the latex tube and the hydrogel tube) to simulate arteries. With a setting of the normal blood pressure range, the output of Cellular PP correlated strongly with the level of hydraulic pressure, 0.998 and 0.989 in the latex tube and the hydrogel tube, respectively. For maintaining the optimal tonometric condition, the depressed depths of the latex and the hydrogel tube were less than 1.2 and 0.6 mm, respectively. The phantom model also demonstrated that the Cellular PP sensor followed changes in a hydraulic pressure dynamically under the optimal tonometric conditions. The present results demonstrated the Cellular PP film sensor is applicable to the arterial tonometry in measuring the instantaneous blood pressure while the sensor is adjusted to maintain the minimal flatness of the underlying arterial wall.Clinical Relevance- To understand the physiological characteristics of blood pressure and arterial system, the instantaneous measurement of blood pressure is necessary. The present study suggests that Cellular PP films are applicable to peripheral arteries tonometrically to obtain simultaneously the respective blood pressure waveforms.
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Shibue R, Nakano M, Iwata T, Kashino K, Tomoike H. Unsupervised Heart Sound Decomposition and State Estimation with Generative Oscillation Models. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:5481-5487. [PMID: 34892366 DOI: 10.1109/embc46164.2021.9630621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper proposes a new generative probabilistic model for phonocardiograms (PCGs) that can simultaneously capture oscillatory factors and state transitions in cardiac cycles. Conventionally, PCGs have been modeled in two main aspects. One is a state space model that represents recurrent and frequently appearing state transitions. Another is a factor model that expresses the PCG as a non-stationary signal consisting of multiple oscillations. To model these perspectives in a unified framework, we combine an oscillation decomposition with a state space model. The proposed model can decompose the PCG into cardiac state dependent oscillations by reflecting the mechanism of cardiac sounds generation in an unsupervised manner. In the experiments, our model achieved better accuracy in the state estimation task compared to the empirical mode decomposition method. In addition, our model detected S2 onsets more accurately than the supervised segmentation method when distributions among PCG signals were different.
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Kitaoka H, Tsutsui H, Kubo T, Ide T, Chikamori T, Fukuda K, Fujino N, Higo T, Isobe M, Kamiya C, Kato S, Kihara Y, Kinugawa K, Kinugawa S, Kogaki S, Komuro I, Hagiwara N, Ono M, Maekawa Y, Makita S, Matsui Y, Matsushima S, Sakata Y, Sawa Y, Shimizu W, Teraoka K, Tsuchihashi-Makaya M, Ishibashi-Ueda H, Watanabe M, Yoshimura M, Fukusima A, Hida S, Hikoso S, Imamura T, Ishida H, Kawai M, Kitagawa T, Kohno T, Kurisu S, Nagata Y, Nakamura M, Morita H, Takano H, Shiga T, Takei Y, Yuasa S, Yamamoto T, Watanabe T, Akasaka T, Doi Y, Kimura T, Kitakaze M, Kosuge M, Takayama M, Tomoike H. JCS/JHFS 2018 Guideline on the Diagnosis and Treatment of Cardiomyopathies. Circ J 2021; 85:1590-1689. [PMID: 34305070 DOI: 10.1253/circj.cj-20-0910] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | | | - Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Kyushu University
| | | | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Noboru Fujino
- Department of Cardiovascular and Internal Medicine, Kanazawa University, Graduate School of Medical Science
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | | | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Seiya Kato
- Division of Pathology, Saiseikai Fukuoka General Hospital
| | | | | | | | - Shigetoyo Kogaki
- Department of Pediatrics and Neonatology, Osaka General Medical Center
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | | | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | - Yuichiro Maekawa
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Shigeru Makita
- Department of Cardiac Rehabilitation, Saitama International Medical Center, Saitama Medical University
| | - Yoshiro Matsui
- Department of Cardiac Surgery, Hanaoka Seishu Memorial Hospital
| | | | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiki Sawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | | | | | | | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
| | | | - Satoshi Hida
- Department of Cardiovascular Medicine, Tokyo Medical University
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | | | - Makoto Kawai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
| | - Toshiro Kitagawa
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Takashi Kohno
- Department of Cardiovascular Medicine, Kyorin University School of Medicine
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoji Nagata
- Division of Cardiology, Fukui CardioVascular Center
| | - Makiko Nakamura
- Second Department of Internal Medicine, University of Toyama
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Hitoshi Takano
- Department of Cardiovascular Medicine, Nippon Medical School Hospital
| | - Tsuyoshi Shiga
- Department of Clinical Pharmacology and Therapeutics, The Jikei University School of Medicine
| | | | - Shinsuke Yuasa
- Department of Cardiology, Keio University School of Medicine
| | - Teppei Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
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Komuro J, Iguchi N, Utanohara Y, Takayama M, Umemura J, Tomoike H. Prediction of Serious Adverse Events of Patients with Hypertrophic Cardiomyopathy by Magnetic Resonance. Int Heart J 2021; 62:135-141. [PMID: 33518652 DOI: 10.1536/ihj.20-479] [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: 11/18/2022]
Abstract
Although it is well known that patients with hypertrophic cardiomyopathy (HCM) have serious adverse events, such as life-threatening arrhythmia and heart failure, the prediction of such evens is still difficult. Recently, it has been reported that one of the causes of these serious adverse events is microvascular dysfunction, which can be noninvasively evaluated by employing cardiac magnetic resonance (CMR) imaging.We analyzed 32 consecutive HCM patients via CMR imaging and myocardial scintigraphy and divided them into two groups: ventricular tachycardia (VT) group and non-VT group. Myocardial perfusion studies were conducted quantitatively using the QMass® software, and each slice image was divided into six segments. The time-intensity curve derived from the perfusion image by CMR imaging was evaluated, and the time to 50% of the peak intensity (time 50% max) was automatically calculated for each segment.Although no difference was observed in various parameters of myocardial scintigraphy between the two groups, the VT group exhibited a higher mean of time 50% max and wider standard deviation (SD) of time 50% max in each segment than the non-VT group. The cutoff values were obtained by the receiver operating characteristic curves derived from the mean of time 50% max and SD of time 50% max. The two groups divided by the cutoff values exhibited significant differences in the occurrence of serious adverse events.CMR imaging may be useful for predicting serious adverse events of patients with HCM.
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Affiliation(s)
- Jin Komuro
- Department of Cardiology, Keio University School of Medicine.,Department of Cardiology, Sakakibara Heart Institute
| | - Nobuo Iguchi
- Department of Cardiology, Sakakibara Heart Institute
| | | | | | - Jun Umemura
- Department of Cardiology, Sakakibara Heart Institute
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Nakayama A, Nagayama M, Morita H, Tajima M, Mahara K, Uemura Y, Tomoike H, Komuro I, Isobe M. A large-scale cohort study of long-term cardiac rehabilitation: A prospective cross-sectional study. Int J Cardiol 2020; 309:1-7. [DOI: 10.1016/j.ijcard.2020.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022]
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Abstract
Background Virtually no reports on the effects of exercise in patients with a small abdominal aortic aneurysm (AAA) exist. Methods and Results We conducted a retrospective cohort study on 1515 patients with a small AAA before surgery at 2 high‐volume hospitals in Tokyo, Japan, from April 2004 to September 2015. A carefully modified cardiac rehabilitation program without excessive blood pressure elevation during exercise was prescribed to 50 patients with an AAA. Using propensity score matching, mortality and clinical outcomes, including AAA expansion rate, were compared between 2 groups: rehabilitation group and nonrehabilitation group. The background characteristics of the rehabilitation group (n=49) and the nonrehabilitation group (n=163) were almost identical. The risk for AAA repair was much lower in the rehabilitation group after matching (before matching: hazard ratio, 0.43; 95% confidence interval, 0.25–0.72; P=0.001; and after matching: hazard ratio, 0.19; 95% confidence interval, 0.07–0.50; P<0.001). AAA expansion rate was slower in the rehabilitation group (before matching: rehabilitation versus nonrehabilitation group, 2.3±3.7 versus 3.8±3.4 mm/y [P=0.008]; after matching: rehabilitation versus nonrehabilitation group, 2.1±3.0 versus 4.5±4.0 mm/y [P<0.001]). Elevation of blood pressure during exercise was positively correlated with AAA expansion rate after the rehabilitation program (r=0.569, P<0.001). Conclusions Cardiac rehabilitation protects against the expansion of small AAAs and mitigates the risk associated with AAA repair, possibly because of the decreased elevation of blood pressure during exercise. Clinical Trial Registration URL: upload.umin.ac.jp. Unique identifier: UMIN000028237.
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Affiliation(s)
- Atsuko Nakayama
- Department of Cardiovascular Medicine, The University of Tokyo, Japan .,Sakakibara Heart Institute, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo, Japan
| | | | - Katsuyuki Hoshina
- Division of Vascular Surgery, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yukari Uemura
- Department of Biostatistics, Central Coordinating Unit, Clinical Research Support Center, The University of Tokyo, Japan
| | | | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Japan
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Nakao YM, Miyamoto Y, Higashi M, Noguchi T, Ohishi M, Kubota I, Tsutsui H, Kawasaki T, Furukawa Y, Yoshimura M, Morita H, Nishimura K, Kada A, Goto Y, Okamura T, Tei C, Tomoike H, Naito H, Yasuda S. Sex differences in impact of coronary artery calcification to predict coronary artery disease. Heart 2018; 104:1118-1124. [PMID: 29331986 PMCID: PMC6031260 DOI: 10.1136/heartjnl-2017-312151] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/17/2017] [Accepted: 11/28/2017] [Indexed: 01/01/2023] Open
Abstract
Objective To assess sex-specific differences regarding use of conventional risks and coronary artery calcification (CAC) to detect coronary artery disease (CAD) using coronary CT angiography (CCTA). Methods The Nationwide Gender-specific Atherosclerosis Determinants Estimation and Ischemic Cardiovascular Disease Prospective Cohort study is a prospective, multicentre, nationwide cohort study. Candidates with suspected CAD aged 50–74 years enrolled from 2008 to 2012. The outcome was obstructive CAD defined as any stenosis ≥50% by CCTA. We constructed logistic regression models for obstructive CAD adjusted for conventional risks (clinical model) and CAC score. Improvement in discrimination beyond risks was assessed by C-statistic; net reclassification index (NRI) for CAD probability of low (<30%), intermediate (30%–60%) and high (≥60%); and risk stratification capacity. Results Among 991 patients (456 women, 535 men; 65.2 vs 64.4 years old), women had lower CAC scores (median, 4 vs 60) and lower CAD prevalence (21.7% vs 37.0%) than men. CAC significantly improved model discrimination compared with clinical model in both sexes (0.66–0.79 in women vs 0.61–0.83 in men). The NRI for women was 0.33, which was much lower than that for men (0.71). Adding CAC to clinical model had a larger benefit in terms of moving an additional 43.3% of men to the most determinant categories (high or low risk) compared with −1.4% of women. Conclusions The addition of CAC to a prediction model based on conventional variables significantly improved the classification of risk in suspected patients with CAD, with sex differences influencing the predictive ability. Trial registration number UMIN-CTR Clinical Trial: UMIN000001577.
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Affiliation(s)
- Yoko M Nakao
- Department of Preventive Medicine and Epidemiologic informatics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Medicine and Epidemiologic informatics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medicine Kagoshima University, Kagoshima, Japan
| | - Isao Kubota
- Department of Cardiology, Pulmonology and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideaki Morita
- Department of Cardiology, Osaka Medical College, Osaka, Japan
| | - Kunihiro Nishimura
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akiko Kada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yoichi Goto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Chuwa Tei
- Waon Therapy Research Institute, Tokyo, Japan
| | | | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Okamoto A, Morita T, Kokubo Y, Sato K, Okayama A, Tomoike H, Miyata T, Sakata T. Age- and gender-related differences of plasma prothrombin activity levels. Thromb Haemost 2017. [DOI: 10.1160/th07-01-0019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Suzuki M, Tomoike H, Sumiyoshi T, Nagatomo Y, Hosoda T, Nagayama M, Ishikawa Y, Sawa T, Iimuro S, Yoshikawa T, Hosoda S. Incidence of cancers in patients with atherosclerotic cardiovascular diseases. Int J Cardiol Heart Vasc 2017; 17:11-16. [PMID: 28948207 PMCID: PMC5602950 DOI: 10.1016/j.ijcha.2017.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 07/12/2017] [Revised: 08/10/2017] [Accepted: 08/30/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND To address a clinical impact of atherosclerotic cardiovascular diseases (CVD) on cancer developments, we investigated an issue whether any difference in an incidence of cancers is present between patients with atherosclerotic CVD and those with non-atherosclerotic CVD. METHODS Of a total of 32,095 consecutive patients with acquired CVD enrolled in the Sakakibara Health Integrative Profile cohort study, we segregated patients based on a presence of atherosclerotic or non-atherosclerotic CVD to investigate an incidence of cancers and mortality. We also evaluated an incidence of cancers in patients with a singular presence versus a plural presence of atherosclerotic CVD. Atherosclerotic CVD included coronary artery diseases, aortic diseases and peripheral artery diseases. Non-atherosclerotic CVD were any acquired CVD except atherosclerotic CVD. RESULTS During a median follow-up of 1020 days (interquartile range, 665-1340 days), an incidence of cancers (5% vs. 2%, p = 0.0001) and overall mortality (6% vs. 3%, p = 0.0001) were more than two-fold higher in 10,592 patients with atherosclerotic CVD than in 21,503 patients with non-atherosclerotic CVD. A presence of atherosclerotic CVD (hazard ratio 1.372 with 95% confidence interval 1.199-1.569) was independently associated with an incidence of cancers. In patients with atherosclerotic CVD, 61 of 640 patients with a plural presence and 470 of 9932 patients with a singular presence developed cancers (9% vs. 5%, p = 0.0001). An incremental risk of death was found according to a presence of atherosclerotic CVD, cancers, and both of them (all p = 0.0001). CONCLUSIONS A presence of atherosclerotic CVD itself may have a potential risk for cancer developments. TRIAL REGISTRATION ClinicalTrials.gov. number, NCT03005834.
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Affiliation(s)
- Makoto Suzuki
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
- Corresponding author at: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi, Fuchu, Tokyo 183-0003, Japan.Department of CardiologySakakibara Heart Institute3-16-1 AsahiFuchuTokyo183-0003Japan
| | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Yuji Nagatomo
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Toru Hosoda
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Yuichi Ishikawa
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiro Sawa
- Medical Information and System Research Center, Teikyo University, Tokyo, Japan
| | - Satoshi Iimuro
- Teikyo Academic Research Center, Teikyo University, Tokyo, Japan
| | | | - Saichi Hosoda
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
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Affiliation(s)
- Junichi Sadoshima
- From the Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, Newark (J.S.); and Sakakibara Heart Institute, Japan Research Promotion Society for Cardiovascular Diseases, Fuchu Tokyo, Japan (H.T.).
| | - Hitonobu Tomoike
- From the Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, Newark (J.S.); and Sakakibara Heart Institute, Japan Research Promotion Society for Cardiovascular Diseases, Fuchu Tokyo, Japan (H.T.)
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Niki K, Sugawara M, Kayanuma H, Takamisawa I, Watanabe H, Mahara K, Sumiyoshi T, Ida T, Takanashi S, Tomoike H. Associations of increased arterial stiffness with left ventricular ejection performance and right ventricular systolic pressure in mitral regurgitation before and after surgery: Wave intensity analysis. Int J Cardiol Heart Vasc 2017; 16:7-13. [PMID: 29067354 PMCID: PMC5607382 DOI: 10.1016/j.ijcha.2017.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/25/2016] [Revised: 04/18/2017] [Accepted: 06/16/2017] [Indexed: 01/09/2023]
Abstract
Background The effect of increased arterial stiffness on mitral regurgitation (MR) is not clear. Using wave intensity (WI) analysis, which is useful for analyzing ventriculo-arterial interaction, we aimed to elucidate associations of increased arterial stiffness with left ventricular (LV) ejection performance and right ventricular systolic pressure (RVSP) in MR. Methods and Results We noninvasively measured carotid arterial WI and stiffness parameter (β) in 98 patients with non-ischemic chronic MR before and after surgery, and 98 age-and-gender matched healthy subjects by ultrasonography. WI is defined as WI = (dP/dt)(dU/dt) [P: blood pressure, U: velocity, t: time]. The peak value of WI (W1) increases with LV peak dP/dt. The temporal WI index (Q-W1)st, which is the standardized interval between the Q wave of the ECG and W1, is a surrogate for preejection period. Ejection fraction (EF), left atrial volume index (LAVI), effective regurgitant orifice area (ERO), RVSP, and other echocardiographic data were also obtained. W1 was enhanced in the MR group before surgery compared with the normal group (10.7 ± 5.7 vs 8.5 ± 3.6 × 103 mmHg m/s3, p < 0.05). However, the results of two-way ANOVA showed this enhancement of W1 was observed only in the subgroup of MR before surgery with lower arterial stiffness (β < 13, p< 0.0001). ERO, β and LAVI were predictor variables before surgery to determine RVSP. EF and (Q-W1)st before surgery were predictor variables for EF after surgery. Conclusions In the MR group before surgery, increased arterial stiffness suppresses compensatory enhancement of W1, and increases RVSP. Prolonged (Q-W1)st has the potential for predicting low EF after surgery.
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Affiliation(s)
- Kiyomi Niki
- Department of Medical Engineering, Tokyo City University, 1-28-1 Tamazutsumi, Setagaya, Tokyo, Japan
| | - Motoaki Sugawara
- Department of Medical Engineering, Himeji Dokkyo University, 7-2-1 Kamiohno, Himeji, Japan
| | - Hiroshi Kayanuma
- Graduate School of Engineering, Tokyo City University, 1-28-1 Tamazutsumi, Setagaya, Tokyo, Japan
| | - Itaru Takamisawa
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, Tokyo, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, Japan
| | - Keitaro Mahara
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, Tokyo, Japan
| | - Tetsuya Sumiyoshi
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, Tokyo, Japan
| | - Takao Ida
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, Tokyo, Japan
| | - Shuichiro Takanashi
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, Tokyo, Japan
| | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, Tokyo, Japan
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Hosoda T, Iguchi N, Cho Y, Inoue M, Murakami T, Tabata M, Takanashi S, Tomoike H. The proliferative potential of human cardiac stem cells was unaffected after a long-term cryopreservation of tissue blocks. Ann Transl Med 2017; 5:41. [PMID: 28251120 DOI: 10.21037/atm.2017.01.69] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Human c-kit-positive cardiac stem cells (CSCs) have been used to treat patients suffering from ischemic cardiomyopathy. This study aimed to investigate whether a long-term storage of cardiac tissues would influence the growth potential of the subsequently isolated CSCs. METHODS A total of 34 fresh samples were obtained from various cardiac regions [right atrium (RA), left atrium (LA), and/or left ventricle (LV)] of 21 patients. From 12 of these patients, 18 samples kept frozen for ~2 years were employed to prepare and characterize the CSCs. After confirming the specificity of the cell sorting by c-kit immunolabeling, the growth rate (number of doublings per day), BrdU positivity, and colony forming unit (CFU) were measured in each CSC population; the values were compared among distinct cardiac regions as well as between fresh and frozen tissues from which CSCs were derived. RESULTS Among independent measurements indicating growth potential, the growth rate and BrdU positivity remarkably correlated in freshly prepared CSCs. The cells obtained from every examined region displayed a high proliferative capacity with the growth rate of 0.48±0.19 and the BrdU positivity of 15.0%±7.6%. The right atrial CSCs tended to show a greater growth than those in the other two areas. Similarly, the CSCs were isolated from tissue blocks, cryopreserved for ~2 years, and compared with CSCs derived from the fresh specimens of the same patients. Importantly, we were able to obtain and culture CSCs from every frozen material, and their proliferative potential, represented by the growth rate of 0.47±0.22 and the BrdU positivity of 13.7%±7.9%, was not inferior to that of the freshly prepared cells. CONCLUSIONS The long-term cryopreservation of cardiac tissues did not affect the growth potential of the derivative CSCs. Our findings should expand the therapeutic applications of these cells over a longer time span.
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Affiliation(s)
- Toru Hosoda
- Tokai University Institute of Innovative Science and Technology, Kanagawa, Japan;; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Nobuo Iguchi
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Yasunori Cho
- Department of Cardiovascular Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Masaki Inoue
- Tokai University Institute of Innovative Science and Technology, Kanagawa, Japan
| | - Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Shuichiro Takanashi
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
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Suzuki M, Takanashi S, Ohshima Y, Nagatomo Y, Seki A, Takamisawa I, Tobaru T, Naito K, Kin H, Umemura J, Takayama M, Sumiyoshi T, Tomoike H. Critical potential of early cardiac surgery for infective endocarditis with cardio-embolic strokes. Int J Cardiol 2017; 227:222-224. [DOI: 10.1016/j.ijcard.2016.11.143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/06/2016] [Indexed: 02/08/2023]
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Yagawa M, Nagatomo Y, Izumi Y, Mahara K, Tomoike H, Shiraishi Y, Kohno T, Mizuno A, Goda A, Kohsaka S, Yoshikawa T. Effect of Obesity on the Prognostic Impact of Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction. Circ J 2017; 81:966-973. [DOI: 10.1253/circj.cj-16-1130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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)
- Mayuko Yagawa
- Department of Cardiology, Sakakibara Heart Institute
| | - Yuji Nagatomo
- Department of Cardiology, Sakakibara Heart Institute
| | - Yuki Izumi
- Department of Cardiology, Sakakibara Heart Institute
| | | | | | | | - Takashi Kohno
- Department of Cardiology, Keio University School of Medicine
| | - Atsushi Mizuno
- Department of Cardiology, St. Luke’s International Hospital
| | - Ayumi Goda
- Department of Cardiology, Kyorin University School of Medicine
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
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Ota T, Senaratne DNS, Preston NK, Ferrara F, Djikic D, Villemain O, Takahashi L, Niki K, Patrascu N, Benyounes N, Popa E, Diego Bellavia DB, Sundqvist M, Wei-Ting C, Papachristidis A, Djordjevic-Dikic A, Volpi C, Reis L, Nieto Tolosa J, Nishikawa H, D'angelo M, Testuz A, Mo YJ, Hashemi N, Toyota K, Nagamine K, Koide Y, Nomura T, Kurata J, Murakami Y, Kozuka Y, Ohshiro C, Thomas K, Townsend C, Wheeler S, Jacobson I, Elkington A, Balkhausen K, Bull S, Ring L, Gargani L, Carannante L, Russo V, D'alto M, Marra AM, Cittadini A, D'andrea A, Vriz O, Bossone E, Mujovic N, Dejanovic B, Peric V, Marinkovic M, Jankovic N, Orbovic B, Simic D, Sitefane F, Pernot M, Malekzadeh-Milani G, Baranger J, Bonnet D, Boudjemline Y, Uejima T, Nishikawa H, Semba H, Sawada H, Yamashita T, Sugawara M, Kayanuma H, Inoue K, Yagawa M, Takamisawa I, Umemura J, Yoshikawa T, Tomoike H, Mihalcea DJ, Mihaila S, Lungeanu L, Trasca LF, Bruja R, Neagu MS, Albu S, Cirstoiu M, Vinereanu D, Van Der Vynckt C, Gout O, Cohen A, Enache R, Jurcut R, Coman IM, Badea R, Platon P, Calin A, Beladan CC, Rosca M, Ginghina C, Popescu BA, Sonia Dell'oglio SD, Attilio Iacovoni AI, Calogero Falletta CF, Giuseppe Romano GR, Sergio Sciacca SS, Lissa Sugeng LS, Joseph Maalouf JM, Michele Pilato MP, Michele Senni MS, Cesare Scardulla CS, Francesco Clemenza FC, Salman K, Tornvall P, Ugander M, Chen ZC, Wang JJ, Fisch S, Liao RL, Roper D, Casar Demarco D, Papitsas M, Tsironis I, Byrne J, Alfakih K, Monaghan MJ, Boskovic N, Rakocevic I, Giga V, Tesic M, Stepanovic J, Nedeljkovic I, Aleksandric S, Kostic J, Beleslin B, Altman M, Annabi MS, Abouchakra L, Cucchini U, Muraru D, Badano LP, Ernande L, Derumeaux G, Teixeira R, Fernandes A, Almeida I, Dinis P, Madeira M, Ribeiro J, Puga L, Nascimento J, Goncalves L, Cambronero Sanchez FJ, Pinar Bermudez E, Gimeno Blanes JR, De La Morena Valenzuela G, Uejima T, Takahashi L, Semba H, Sawada H, Yamashita T, Lopez Fernandez T, Irazusta Cordoba FJ, Rosillo Rodriguez SO, Dominguez Melcon FJ, Meras Colunga P, Gemma D, Moreno Gomez R, Moreno Yanguela M, Lopez Sendon JL, Nguyen V, Mathieu T, Kerneis C, Cimadevilla C, Kubota N, Codogno I, Tubiana S, Estrellat C, Vahanian A, Messika-Zeitoun D, Ondrus T, Van Camp G, Di Gioia G, Barbato E, Bartunek J, Penicka M, Johnsson J, Gomez A, Alam M, Winter R. Poster Session 3The imaging examination and quality assessmentP626Value of mitral and tricuspid annular displacement to assess the interventricular systolic relationship in severe aortic valve stenosis : a Pilot studyP627Follow-up echocardiography in asymptomatic valve disease: assessing the potential economic impact of the European and American guidelines in a dedicated valve clinic, compared to standard care.P628The tricuspid valve: identification of optimal view for assessing for prolapseP629Right atrial volume by two-dimensional echocardiography in healthy subjectsP630Disturbance of inter and intra atrial conduction assessed by tissue doppler imaging in patients with medicaly controlled hypertension and prehypertension.P631Liver stiffness by shear wave elastography, new noninvasive and quantitative tool for acute variation estimation of central venous pressure in real-time?P632Weak atrial kick contribution is associated with a risk for heart failure decompensationP633Usefulness of wave intensity analysis in predicting the response to cardiac resynchronization therapyP634Early subclinical left ventricular systolic and diastolic dysfunction in gestational hypertension and preeclampsiaP635Clinical comparison of three different echocardiographic methods for left ventricular ejection fraction and LV end diastolic volume measurementP636Assessment of right ventricular-arterial coupling parameters by 3D echocardiography in patients with pulmonary hypertension receiving specific vasodilator therapyP637Prediction of right ventricular failure after left ventricular assist device implant: assessing usefulness of standard and strain echocardiographyP638Kinematic analysis of diastolic function using the novel freely available software Echo E-waves - feasibility and reproducibilityP639Evaluation of coronary flow velocity by Doppler echocardiography in the treatment of hypertension with the ARB: correlation to the histological cardiac fibrosisP640The clinical significance of limited apical ischaemia and the prognostic value of stress echocardiography - A contemporary study from a high volume centerP641Effects of intermediate stenosis of left anterior descending coronary artery on survival in patients with chronic total occlusion of right coronary arteryP642Left ventricular remodeling after a first myocardial infarction in patients with preserved ejection fraction at dischargeP643Left atrial size and acute coronary syndromes. Let is make simple.P644Influence of STEMI reperfusion strategy on systolic and diastolic functionP645Aortic valve resistance risk-stratifies low-gradient severe aortic stenosisP646Does permanent pacemaker implantation complicate the prognosis of patients after transcatheter aortic valve implantation?P647Influence of metabolic syndrome and diabetes on progression of calcific aortic valve stenosis - The COFRASA - GENERAC StudyP648Low referral for aortic valve replacement accounts for worse long-term outcome in low versus high gradient severe aortic stenosis with preserved ejection fractionP649The impact of right ventricular function from aortic valve replacement: A randomised study comparing minimally invasive aortic valve surgery and conventional open heart surgery. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew250] [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: 11/14/2022] Open
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Hattori K, Suzuki M, Seki A, Nagatomo Y, Tobaru T, Komuro J, Mori T, Ieki H, Shimada M, Tomoike H. High-Sensitivity Troponin T and Chance of Survival in Acute Decompensated Heart Failure. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.129] [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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Yamamoto H, Nagatomo Y, Yagawa M, Mahara K, Tomoike H, Kohsaka S, Yoshikawa T. Serum Uric Acid Increase Through the Treatment of ADHF Might Predict Adverse Outcome in Patients With Chronic Heart Failure. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.394] [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: 11/30/2022]
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Ieki H, Nagatomo Y, Yagawa M, Mahara K, Tomoike H, Kohsaka S, Yoshikawa T. The Significance of Serum Phosphorus Level at Admission for Acute Decompensated Heart Failure. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.309] [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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Yoshikawa T, Baba A, Akaishi M, Wakabayashi Y, Monkawa T, Kitakaze M, Izumi T, Tomoike H. Immunoadsorption therapy for dilated cardiomyopathy using tryptophan column-A prospective, multicenter, randomized, within-patient and parallel-group comparative study to evaluate efficacy and safety. J Clin Apher 2016; 31:535-544. [PMID: 26801483 PMCID: PMC5123585 DOI: 10.1002/jca.21446] [Citation(s) in RCA: 14] [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: 05/08/2015] [Accepted: 12/21/2015] [Indexed: 12/03/2022]
Abstract
Over the past few decades, several cardiac autoantibodies have been reported in sera from patients with dilated cardiomyopathy (DCM). Immunoadsorption (IA) therapy is one of the therapeutic tools to remove such autoantibodies. The objective of this study was to investigate functional effects of IA therapy using a tryptophan column in severe DCM patients. Of 49 patients enrolled, 44 were randomized from 10 sites in Japan. IA therapy was conducted in 40 patients with DCM (refractory to standard therapy for heart failure, New York Heart Association [NYHA] class III/IV, left ventricular ejection fraction [LVEF] <30%). Mean echocardiographic LVEF was significantly improved (23.8 ± 1.3% to 25.9 ± 1.3%, P = 0.0015). However, mean radionuclide LVEF over 3 months of IA therapy was not significantly improved (20.8 ± 1.1% to 21.9 ± 1%, P = 0.0605). The cardiothoracic ratio was also significantly decreased (P = 0.0010). NYHA functional class (P < 0.0001), subjective symptoms assessed by a quality of life questionnaire (P = 0.0022), maximum oxygen consumption (P = 0.0074), and 6‐minute walk distance (P = 0.0050) were improved after IA therapy. Subgroup analysis revealed improvement of echocardiographic LVEF in patients with higher baseline autoantibody scores but not in those with lower scores. IA therapy improved subjective symptoms and exercise capacity in patients with refractory heart failure resulting from DCM. Favorable effect on cardiac function was noted in patients with higher autoantibody scores. J. Clin. Apheresis 31:535–544, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Akiyasu Baba
- Department of Cardiology, Kitasato Institute Hospital, Tokyo, Japan
| | - Makoto Akaishi
- Department of Cardiology, Kitasato Institute Hospital, Tokyo, Japan
| | | | - Toshiaki Monkawa
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Masafumi Kitakaze
- Cardiovascular Division of Medicine, National Cardiovascular Research Center, Suita, Japan
| | - Tohru Izumi
- Department of Cardio-Angiology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan
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Higuchi R, Mahara K, Naito K, Takamisawa I, Shimizu J, Iguchi N, Tobaru T, Takanashi S, Takayama M, Tomoike H. Silent coronary obstruction following transcatheter aortic valve implantation: Detection by transesophageal echocardiography. J Cardiol Cases 2015; 13:129-132. [PMID: 30546625 DOI: 10.1016/j.jccase.2015.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 11/18/2015] [Accepted: 11/21/2015] [Indexed: 11/26/2022] Open
Abstract
In several recent guidelines, transcatheter aortic valve implantation (TAVI) has been recommended as a therapeutic option for inoperable or high surgical risk patients with severe aortic stenosis. TAVI has various specific complications that seldom occur in surgical aortic valve replacement. Among them, coronary obstruction (CO) is an infrequent but serious complication. Previous case series have reported symptomatic CO cases diagnosed by hemodynamic instability, electrocardiographic changes, and abnormal findings on aortography. We report a case of silent CO in an 86-year-old female. Monitoring of coronary flow by transesophageal echocardiography led to a diagnosis of CO. Silent CO is probably an underdiagnosed complication of TAVI. <Learning objective: Coronary obstruction is an infrequent but serious complication of transcatheter aortic valve implantation (TAVI). Previous case series have reported only symptomatic coronary obstruction cases diagnosed by hemodynamic instability, electrocardiographic changes, and abnormal findings on aortography. Transesophageal echocardiography monitoring of coronary ostium flow is useful for detecting coronary obstruction. Silent coronary obstruction is probably an underdiagnosed complication of TAVI.>.
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Affiliation(s)
- Ryosuke Higuchi
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Keitaro Mahara
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Kazuhiro Naito
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | - Itaru Takamisawa
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Jun Shimizu
- Department of Anesthesiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Nobuo Iguchi
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Tetsuya Tobaru
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Shuichiro Takanashi
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
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Wakabayashi Y, Baba A, Akaishi M, Yoshikawa T, Tomoike H. Plasmaphérèse d’immuno-adsorption en utilisant une colonne immobilisée par le tryptophane pour la cardiomyopathie dilatée : étude randomisée, prospective et multicentrique pour évaluer son efficacité et sa sécurité. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.405] [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: 10/23/2022]
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Suzuki M, Seki A, Takamisawa I, Tobaru T, Takayama M, Sumiyoshi T, Tomoike H. An inspection of therapeutic hypothermia preceding coronary reperfusion in patients with a cardiogenic shock complicating anterior ST-segment elevation myocardial infarction. IJC Heart & Vasculature 2015; 8:108-113. [PMID: 28785689 PMCID: PMC5497289 DOI: 10.1016/j.ijcha.2015.06.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 06/13/2015] [Indexed: 11/25/2022]
Abstract
Background We retrospectively investigated our hypothesis that pre-percutaneous coronary intervention (PCI) procedural therapeutic hypothermia may have clinical advantages in patients with a profound cardiogenic shock complicating anterior ST-segment elevation myocardial infarction (STEMI). Methods Of 483 consecutive patients treated with PCI for a first anterior STEMI including 31 patients with aborted sudden cardiac arrest between 2009 and 2013, a total of 37 consecutive patients with an anterior STEMI complicated with profound cardiogenic shock defined as the presence of hyperlactic acidemia (serum levels of lactate > 4 mmol/L) with mechanical circulatory support were identified. An impaired myocardial tissue-level reperfusion (angiographic myocardial blush grade 0 or 1) and in-hospital mortality were evaluated in accordance with the presence or absence of pre-PCI procedural therapeutic hypothermia. Results Thirteen patients were treated with pre-PCI procedural therapeutic hypothermia and 24 were not inducted with therapeutic hypothermia. Five patients with and 18 without pre-PCI procedural therapeutic hypothermia impaired myocardial tissue-level reperfusion (38% vs. 75%, p = 0.037). A total of 26 patients with in-hospital death (overall in-hospital mortality 70%) were composed of 6 with and 20 without therapeutic hypothermia (in-hospital mortality 46% vs. 83%, p = 0.028). A multivariate analysis demonstrated a significant association of pre-PCI procedural therapeutic hypothermia (p = 0.021) with in-hospital survival benefit. Adverse events associated with therapeutic hypothermia were not found in 12 patients who completed this treatment. Conclusions The present study may imply a crucial possibility of clinical benefits of pre-PCI procedural therapeutic hypothermia in patients with a cardiogenic shock complicating anterior STEMI.
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Ko T, Higashitani M, Sato A, Uemura Y, Norimatsu T, Mahara K, Takamisawa I, Seki A, Shimizu J, Tobaru T, Aramoto H, Iguchi N, Fukui T, Watanabe M, Nagayama M, Takayama M, Takanashi S, Sumiyoshi T, Komuro I, Tomoike H. Impact of Acute Kidney Injury on Early to Long-Term Outcomes in Patients Who Underwent Surgery for Type A Acute Aortic Dissection. Am J Cardiol 2015; 116:463-8. [PMID: 26026862 DOI: 10.1016/j.amjcard.2015.04.043] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/30/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Abstract
Acute kidney injury (AKI) is relatively common after cardiothoracic surgery for type A acute aortic dissection (TA-AAD) and increases mortality. We investigated the incidence and risk factors for AKI in patients with TA-AAD and its impact on their outcomes. The records of 375 consecutive patients who underwent surgical treatment for TA-AAD from October 2007 to March 2013 were analyzed retrospectively. We defined AKI using the Kidney Disease Improving Global Outcomes criteria, which are based on serum creatinine concentration or glomerular filtration rate. We used Kaplan-Meier methods and multivariate Cox proportional hazards regression to assess the impact of AKI on both mortality and major adverse cardiovascular and cerebrovascular events. We also examined the association between risk factors and AKI using logistic regression modeling. Postoperative AKI was observed in 165 patients (44.0%). The overall 30-day and mid- to long-term mortality was 1.6% and 8.8%, respectively. Mortality and major adverse cardiovascular and cerebrovascular events correlated significantly with the severity of AKI, and multivariate analysis showed that AKI stage 3 (the most sever stage) was an independent risk factor for mortality (hazard ratio 6.83, 95% confidence interval 2.52 to 18.52) after adjustment for important confounding factors. Extracorporeal circulation time, body mass index, perioperative peak serum C-reactive protein concentration, renal malperfusion, and perioperative sepsis were found to be risk factors for AKI. In conclusion, AKI was common in patients who underwent surgery for type A acute aortic dissection. The severity of AKI strongly influences patient outcomes, so it should be recognized promptly and treated aggressively when possible.
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Nakanishi K, Fukuda S, Watanabe H, Seo Y, Mahara K, Hyodo E, Otsuka K, Ishizu T, Shimada K, Sumiyoshi T, Aonuma K, Tomoike H, Yoshikawa J. The utility of fully automated real-time three-dimensional echocardiography in the evaluation of left ventricular diastolic function. J Cardiol 2015; 66:50-6. [DOI: 10.1016/j.jjcc.2014.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 08/01/2014] [Accepted: 08/14/2014] [Indexed: 10/24/2022]
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Tomoike H, Yokoyama H, Sumita Y, Hanai S, Kada A, Okamura T, Yoshikawa J, Doi Y, Hori M, Tei C. Nationwide Distribution of Cardiovascular Practice in Japan – Results of Japanese Circulation Society 2010 Annual Survey –. Circ J 2015; 79:1058-67. [DOI: 10.1253/circj.cj-14-1214] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | | | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University
| | | | | | - Masatsugu Hori
- Osaka Medical Center for Cancer and Cardiovascular Diseases
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Sasaki S, Daimon M, Kawata T, Miyazaki S, Ichikawa R, Maruyama M, Chiang SJ, Mahara K, Watanabe H, Sumiyoshi T, Tomoike H, Daida H. Factors responsible for elevated plasma B-type natriuretic peptide levels in severe aortic stenosis: Comparison between elderly and younger patients. J Cardiol 2014; 64:476-81. [DOI: 10.1016/j.jjcc.2014.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/15/2014] [Accepted: 03/22/2014] [Indexed: 11/28/2022]
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Ando M, Takahashi Y, Park IS, Tomoike H. Aircraft transfer of pediatric patients with intractable cardiac or airway problems – single-institutional experience of a specialty hospital. Circ J 2014; 79:180-4. [PMID: 25399757 DOI: 10.1253/circj.cj-14-0597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is currently a well-established network for the allocation of donor organs for transplantation in Japan, and emergency patients are often transported by the "Doctor Helicopter". However, interhospital transfer of patients, which can require aircraft with specialized equipment, depends on arrangement by each responsible hospital. METHODS AND RESULTS Since 2009 there were 41 interhospital aviation transfers of pediatric patients with intractable cardiac or airway diseases seeking surgical treatment at Sakakibara Heart Institute. Of these, 22 were newborns, 21 were on continuous drip infusion and 14 on mechanical ventilator support. In 15 cases (36.6%), a commercial airliner was used, with the remaining using chartered emergency aircraft (eg, local fire department helicopter, Self-Defense-Forces of Japan and the Doctor Helicopter). The median transfer time was 239 min for commercial airliners, 51 min for chartered aircraft departing directly from the referring hospital and 120.5 min for chartered aircraft departing from a nearby location. The efficiency of the transfer exemplified by the percentage of the time on board the aircraft was significantly lower for commercial airliners compared with chartered emergency aircraft. CONCLUSIONS Further efforts and cooperation with government are required to obtain geographically uniform availability of carriers with optimal medical equipment to improve pediatric patient outcomes.
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Affiliation(s)
- Makoto Ando
- Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute
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Yoshikawa T, Baba A, Tomoike H. Immunomodulatory Therapy for Patients with Refractory Heart Failure due to Dilated Cardiomyopathy. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.041] [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: 11/24/2022]
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Izumi Y, Yagawa M, Mahara K, Tomoike H, Shiraishi Y, Inohara T, Goda A, Kohsaka S, Yoshikawa T. Clinical Scenarios on Admission Predict Different Clinical Outcomes in Relation to Renal Function in Patients with Acutely Decompensated Heart Failure. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.270] [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: 11/26/2022]
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Tamaki T, Izumi Y, Yoshikawa T, Umemura J, Sumiyoshi T, Tomoike H. A Case of Congestive Heart Failure Who Exhibited a Marked Improvement of Persistent Nocturnal Dyspnea Despite of Cardiac Resynchronization Therapy. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.425] [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: 11/28/2022]
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Hasegawa T, Asakura M, Eguchi K, Asanuma H, Ohara T, Kanzaki H, Hashimura K, Tomoike H, Kim J, Kitakaze M. Plasma B-type natriuretic peptide is a useful tool for assessing coronary heart disease risk in a Japanese general population. Hypertens Res 2014; 38:74-9. [PMID: 25119474 DOI: 10.1038/hr.2014.123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 06/08/2014] [Accepted: 06/15/2014] [Indexed: 11/09/2022]
Abstract
B-type natriuretic peptide (BNP) has been reported to be associated with cardiovascular prognosis in a community-based population. In addition, accumulation of individual cardiovascular risk factors is important in predicting an individual's risk of future cardiovascular disease. However, there have been few reports showing that BNP is a comprehensive marker of the accumulation of cardiovascular risk factors. We studied 1530 community-dwelling subjects without obvious heart diseases or renal dysfunction (mean age 62 ± 15 years; 569 men and 961 women) who participated in an annual health checkup in a rural Japanese community. Coronary heart disease (CHD) risk was estimated, and patients were placed into the following three groups based on the Framingham function: low risk, moderate risk and high risk. The prevalence of moderate- and high-risk subjects for CHD rose in both genders with increasing plasma BNP levels. The area under the receiver operating characteristic curve showed a modest ability of plasma BNP levels to detect these subjects (0.755 and 0.700 for men and women, respectively). The optimal thresholds for the identification of subjects with moderate- and high-risk disease were BNP concentrations of 12.0 and 22.0 pg ml(-1), with sensitivities of 70% and 66% and specificities of 71% and 63% for men and women, respectively. In conclusion, subjects with high plasma BNP levels were at higher risk for CHD in a population without obvious heart disease or renal dysfunction.
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Affiliation(s)
- Takuya Hasegawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masanori Asakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuo Eguchi
- Department of Cardiology, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Hiroshi Asanuma
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takahiro Ohara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuhiko Hashimura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hitonobu Tomoike
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Jiyoong Kim
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masafumi Kitakaze
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Shibayama K, Watanabe H, Sasaki S, Mahara K, Tabata M, Fukui T, Takanashi S, Sumiyoshi T, Tomoike H, Shiota T. Impact of regurgitant orifice height for mechanism of aortic regurgitation. JACC Cardiovasc Imaging 2014; 6:1347-9. [PMID: 24332288 DOI: 10.1016/j.jcmg.2013.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/29/2013] [Indexed: 02/06/2023]
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Kamide K, Asayama K, Katsuya T, Ohkubo T, Hirose T, Inoue R, Metoki H, Kikuya M, Obara T, Hanada H, Thijs L, Kuznetsova T, Noguchi Y, Sugimoto K, Ohishi M, Morimoto S, Nakahashi T, Takiuchi S, Ishimitsu T, Tsuchihashi T, Soma M, Higaki J, Matsuura H, Shinagawa T, Sasaguri T, Miki T, Takeda K, Shimamoto K, Ueno M, Hosomi N, Kato J, Komai N, Kojima S, Sase K, Miyata T, Tomoike H, Kawano Y, Ogihara T, Rakugi H, Staessen JA, Imai Y. Genome-wide response to antihypertensive medication using home blood pressure measurements: a pilot study nested within the HOMED-BP study. Pharmacogenomics 2014; 14:1709-21. [PMID: 24192120 DOI: 10.2217/pgs.13.161] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with mild-to-moderate essential hypertension in the HOMED-BP trial were randomly allocated to first-line treatment with a calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB). METHODS We recruited 265 (93 for CCB, 71 for ACEI and 101 for ARB) patients who completed the genomic study. Home blood pressure was measured for 5 days off-treatment before randomization and for 5 days after 2-4 weeks of randomized drug treatment. Genotyping was performed by 500K DNA microarray chips. The blood pressure responses to the three drugs were analyzed separately as a quantitative trait. For replication of SNPs with p < 10(-4), we used the multicenter GEANE study, in which patients were randomized to valsartan or amlodipine. RESULTS SNPs in PICALM, TANC2, NUMA1 and APCDD1 were found to be associated with CCB responses and those in ABCC9 and YIPF1 were found to be associated with ARB response with replication. CONCLUSION Our approach, the first based on high-fidelity phenotyping by home blood pressure measurement, might be a step in moving towards the personalized treatment of hypertension.
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Affiliation(s)
- Kei Kamide
- Department of Geriatric Medicine & Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan and Department of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan and Research Institute, National Cerebro & Cardiovascular Research Center, Osaka, Japan and Studies Coordinating Centre, Research Unit Hypertension & Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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Ishimura M, Takayama M, Saji M, Takamisawa I, Umemura J, Sumiyoshi T, Tomoike H, Kobayashi Y. A case of hypertrophic obstructive cardiomyopathy with aortic stenosis. J Cardiol Cases 2014; 9:129-133. [PMID: 30546782 DOI: 10.1016/j.jccase.2013.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 12/04/2013] [Accepted: 12/09/2013] [Indexed: 10/25/2022] Open
Abstract
A 78-year-old woman complained of experiencing dyspnea (New York Heart Association II) and faintness. Echocardiography revealed she had asymmetric left ventricular hypertrophy, and a dynamic left ventricular outflow tract (LVOT) obstruction due to systolic anterior motion of the mitral valve. It also revealed calcification of the noncoronary cusp and a high-flow velocity in the LVOT (6.3 m/s). The planimetry measurement with transesophageal echocardiography was 0.89 cm2 (aortic valve area/body surface area: 0.69 cm2/m2). Later, she was diagnosed with hypertrophic obstructive cardiomyopathy (HOCM) and aortic stenosis (AS). However, during the catheterization, the transvalvular pressure gradient (PG) was only 25 mmHg. In order to solve this, we performed a percutaneous transluminal septal myocardial ablation. As a result, the PG of the LVOT decreased from 152 mmHg to 25 mmHg. We first thought that the LVOT obstruction had reduced the flow passing through the aortic valve, and restricted the motion of the aortic valve leaflets. We also considered the possibility that the aortic valve area had been underestimated. The hemodynamic study played an important role in the decision for the treatment plan. The present case was a combination of HOCM and "mild" AS. <Learning objective: We know that we can distinguish between a left ventricular outflow tract obstruction and aortic stenosis using continuous-wave Doppler according to the phase of the peak gradient. However, if both are present, it is uncertain whether we can distinguish between them. It is necessary to measure the subaortic pressure and flow passing through the aortic valve accurately by catheterization in order to know which is the chief pathology.>.
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Affiliation(s)
- Masayuki Ishimura
- Department of Cardiovascular Medicine, Chiba University Hospital, Chiba, Japan
| | | | - Mike Saji
- Department of Medicine, Sakakibara Heart Institute, Tokyo, Japan
| | - Itaru Takamisawa
- Department of Medicine, Sakakibara Heart Institute, Tokyo, Japan
| | - Jun Umemura
- Department of Medicine, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Hitonobu Tomoike
- Department of Medicine, Sakakibara Heart Institute, Tokyo, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Hospital, Chiba, Japan
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Miyamoto Y, Morisaki H, Kokubo Y, Yamanaka I, Tomoike H, Okayama A, Yoshimasa Y, Morisaki T. Resistin gene variations are associated with the metabolic syndrome in Japanese men. Obes Res Clin Pract 2013; 3:I-II. [PMID: 24345560 DOI: 10.1016/j.orcp.2008.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 09/16/2008] [Accepted: 11/18/2008] [Indexed: 01/03/2023]
Abstract
SUMMARY OBJECTIVES Metabolic syndrome is defined as a cluster of risk factors for cardiovascular disease and is intimately related to insulin resistance. Resistin, a hormone secreted by adipocytes, may play an important role in communication between adiposity and insulin resistance. We investigated whether variations in the resistin gene associated with metabolic syndrome in a Japanese population. METHOD We analyzed five SNPs, two of which were located in the promoter region (-420C > G, -358G > A), two in intron 2 (+157C > T, +299G > A), and one in the 3'-untranslated region (3'UTR) (+1263G > C) across the resistin gene in 2968 residents from an urban Japanese cohort. The associations of SNPs and haplotypes with metabolic syndrome were analyzed. RESULTS The GAC and CGC haplotypes (comprising -420C > G, -358G > A, and +157C > T) had opposite influences on metabolic syndrome susceptibility in men; the former was associated with an increased risk and the latter with a decreased risk. We also found that the -420G allele was significantly associated with an increased risk of metabolic syndrome and significantly correlated with high diastolic blood pressure, high HOMA-IR values, high serum triglyceride levels, low HDL-cholesterol levels and high serum levels of adiponectin. CONCLUSION We identified a risk-conferring SNP and haplotype of the resistin gene for metabolic syndrome in a Japanese population. Our data suggested that resistin gene is a susceptibility gene for metabolic syndrome in Japanese men.
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Affiliation(s)
- Yoshihiro Miyamoto
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan.
| | - Hiroko Morisaki
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
| | - Yoshihiro Kokubo
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
| | - Itaru Yamanaka
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
| | - Hitonobu Tomoike
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
| | - Akira Okayama
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
| | - Yasunao Yoshimasa
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
| | - Takayuki Morisaki
- Department of Bioscience, National Cardiovascular Center Research Institute, Osaka, Japan
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Higuchi R, Iguchi N, Utanohara Y, Inoue K, Umemura J, Sumiyoshi T, Tomoike H. Detection of myocardial metabolic dysfunction caused by the right ventricular apical pacing using thallium 201/iodine 123-labeled beta-methyl iodophenyl pentadecanoic acid SPECT. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1134] [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: 11/14/2022] Open
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Miyazawa K, Yoshikawa T, Takamisawa I, Mahara K, Inoue K, Iguchi N, Takayama M, Umemura J, Sumiyoshi T, Tomoike H. Presence of ventricular aneurysm predicts poor clinical outcomes in patients with cardiac sarcoidosis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p2955] [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: 11/14/2022] Open
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Sasaki S, Watanabe H, Shibayama K, Mahara K, Tabata M, Fukui T, Tobaru T, Takanashi S, Sumiyoshi T, Tomoike H. Three-Dimensional Transesophageal Echocardiographic Evaluation of Coronary Involvement in Patients with Acute Type A Aortic Dissection. J Am Soc Echocardiogr 2013; 26:837-45. [DOI: 10.1016/j.echo.2013.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Indexed: 11/26/2022]
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Ozawa K, Watanabe H, Asano R, Tobaru T, Takamisawa I, Tabata M, Fukui T, Shimizu J, Takanashi S, Takayama M, Tomoike H. A case of osteopetrosis with severe aortic stenosis treated by transcatheter aortic valve implantation. J Cardiol Cases 2013; 8:113-115. [PMID: 30546758 DOI: 10.1016/j.jccase.2013.05.006] [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: 01/23/2013] [Revised: 03/22/2013] [Accepted: 05/15/2013] [Indexed: 11/25/2022] Open
Abstract
Osteopetrosis is a rare hereditary disease characterized by osteoclast dysfunction and consequently diminished bone resorption and disturbed bone building and remodeling, resulting in abnormally dense and brittle bones. Pathologic fractures are common in patients with osteopetrosis. We report a case of benign adult form of osteopetrosis with severe aortic stenosis (AS) and coronary artery disease (CAD). A 67-year-old female patient presented with long-standing dyspnea and palpitation. She was diagnosed with benign adult form of osteopetrosis in her childhood, upon detailed investigations for a pathologic fracture. Physical examination and imaging studies revealed severe AS and two-vessel CAD. Aortic valve replacement and coronary artery bypass grafting were indicated, but open heart surgery by median sternotomy was high risk because of osteopetrosis. We performed staged percutaneous coronary intervention (PCI) and transcatheter aortic valve implantation (TAVI) as minimally invasive treatment. The postoperative course was uneventful and transthoracic echocardiography showed a properly functioning prosthetic valve and no sign of AS. This is the first case report of successful treatment of severe AS and CAD by combined TAVI and PCI in a patient with osteopetrosis. <Learning objective: Transcatheter aortic valve implantation (TAVI) has become available for the treatment of aortic stenosis (AS). In osteopetrosis patients, protraction of bone healing is expected after open heart surgery. Despite standard risk scoring showing AS to be low risk, osteopetrosis may benefit largely from TAVI.>.
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Affiliation(s)
- Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Ryuta Asano
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Tetsuya Tobaru
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Itaru Takamisawa
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | - Jun Shimizu
- Department of Anesthesiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Shuichiro Takanashi
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Hitonobu Tomoike
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
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Ko T, Mahara K, Ota M, Kato Y, Tobaru T, Takanashi S, Kikuchi K, Umemura J, Sumiyoshi T, Tomoike H. A case of prosthetic valve endocarditis caused by Streptococcus constellatus as a rare agent of endocarditis. Heart Lung 2013; 42:379-81. [PMID: 23831301 DOI: 10.1016/j.hrtlng.2013.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 05/29/2013] [Indexed: 10/26/2022]
Abstract
We present a case of prosthetic valve endocarditis, which was caused by a rare etiological agent, Streptococcus constellatus. In our case, transesophageal echocardiography showed a large and broad abscess formation throughout the patient's aortic prosthetic valve ring and left atrium. Despite specific intravenous antibiotic therapy, the infection was uncontrollable, and the patient underwent surgical treatment. The pathogen rarely causes endocarditis, but it is known to have a strong potential to form abscess, and therefore its infection may be more serious than other Streptococcus species. Our case seems to be the first report of surgical treatment of PVE caused by S. constellatus. As in our case, transesophageal echocardiography is useful for the detection of vegetation and abscess, and early cardiac surgery may be a more appropriate therapeutic approach for endocarditis caused by S. constellatus.
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Affiliation(s)
- Toshiyuki Ko
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
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Saji Makoto Suzuki M, Takamisawa I, Ohta M, Mahara K, Inoue K, Tobaru T, Iguchi N, Takayama M, Tomoike H. PENDING FEATURES OF REFRACTORY HYPERTROPHIC OBSTRUCTS CARDIOMYOPATHY WITH PULMONARY HYPERTENSION. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61225-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Matsuda S, Fukui T, Shimizu J, Takao A, Takanashi S, Tomoike H. Associations Between Preoperative Anemia and Outcomes After Off-Pump Coronary Artery Bypass Grafting. Ann Thorac Surg 2013; 95:854-60. [DOI: 10.1016/j.athoracsur.2012.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 10/01/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
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Yagawa M, Yoshikawa T, Mahara K, Kosaka S, Tomoike H. Comparison Between Heart Failure with Preserved and Reduced Ejection Fraction who are Hospitalized with Acute Decompensated Heart Failure. J Card Fail 2012. [DOI: 10.1016/j.cardfail.2012.08.254] [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: 11/26/2022]
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Sugiyama S, Hirota H, Kimura R, Kokubo Y, Kawasaki T, Suehisa E, Okayama A, Tomoike H, Hayashi T, Nishigami K, Kawase I, Miyata T. Corrigendum to Haplotype of thrombomodulin gene associated with plasma thrombomodulin level and deep vein thrombosis in the Japanese population [Thrombosis Research (2007) 119, 35–43]. Thromb Res 2012. [DOI: 10.1016/j.thromres.2012.05.026] [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: 10/28/2022]
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Furuichi S, Tobaru T, Asano R, Watanabe Y, Takamisawa I, Seki A, Sumiyoshi T, Tomoike H. Rotational atherectomy followed by cutting-balloon plaque modification for drug-eluting stent implantation in calcified coronary lesions. J Invasive Cardiol 2012; 24:191-195. [PMID: 22562910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Drug-eluting stent (DES) underexpansion has been reported as an independent factor for restenosis and thrombosis; therefore, adequate plaque modification prior to DES implantation is the key of calcified lesion treatment. METHODS Consecutive patients with severely calcified lesions undergoing rotational atherectomy (RA) followed by balloon dilatation before DES implantation were analyzed. Patients were divided into two groups based on the balloon type before stent implantation: the cutting balloon (ROTACUT group) and the plain balloon (control group). RESULTS Twenty-five patients with 26 calcified lesions were identified: 10 patients (10 lesions) were included in the ROTACUT group and 15 patients (16 lesions) in the control group. There were statistically no differences in the final burr size (1.65 ± 0.21 mm vs 1.67 ± 0.22 mm; P=.803), the maximum (max) balloon diameter before stent implantation (2.85 ± 0.34 mm vs 2.72 ± 0.42 mm; P=.411), the max final balloon diameter (3.30 ± 0.33 mm vs 3.28 ± 0.44 mm; P=.908), and the max final balloon inflation pressure (15.3 ± 3.0 atm vs 16.4 ± 5.5 atm; P=.501). Final minimum stent cross-sectional area (CSA) was significantly larger in the ROTACUT group compared to the control group (6.80 ± 1.27 mm² vs 5.38 ± 1.89 mm²; P=.048). CONCLUSION RA followed by cutting balloon plaque modification for DES implantation in severely calcified lesions appears to be more efficacious including significantly larger final stent CSA.
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Fumichi S, Tobaru T, Asano R, Watanabe Y, Takamisawa I, Seki A, Sumiyoshi T, Tomoike H. ROTATIONAL ATHERECTOMY FOLLOWED BY CUTTING BALLOON PLAQUE MODIFICATION BEFORE DRUG-ELUTING STENT IMPLANTATION IN CALCIFIED CORONARY LESIONS. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60082-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Yamamoto K, Uchida S, Kitano K, Fukuhara N, Okumura-Kitajima L, Gunji E, Kozakai A, Tomoike H, Kojima N, Asami J, Toyoda H, Arai M, Takahashi T, Takahashi K. TS-071 is a novel, potent and selective renal sodium-glucose cotransporter 2 (SGLT2) inhibitor with anti-hyperglycaemic activity. Br J Pharmacol 2012; 164:181-91. [PMID: 21410690 DOI: 10.1111/j.1476-5381.2011.01340.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND PURPOSE The renal sodium-glucose cotransporter 2 (SGLT2) plays an important role in the reuptake of filtered glucose in the proximal tubule and therefore may be an attractive target for the treatment of diabetes mellitus. This study characterizes the pharmacological profile of TS-071 ((1S)-1,5-anhydro-1-[5-(4-ethoxybenzyl)-2-methoxy-4-methylphenyl]-1-thio-D-glucitol hydrate), a novel SGLT2 inhibitor in vitro and in vivo. EXPERIMENTAL APPROACH Inhibition of glucose uptake by TS-071 was studied in CHO-K1 cells stably expressing either human SGLT1 or SGLT2. Single oral dosing studies were performed in rats, mice and dogs to assess the abilities of TS-071 to increase urinary glucose excretion and to lower plasma glucose levels. KEY RESULTS TS-071 inhibited SGLT2 activity in a concentration-dependent manner and was a potent and highly selective inhibitor of SGLT2. Orally administered TS-071 increased urinary glucose excretion in Zucker fatty rats and beagle dogs at doses of 0.3 and 0.03 mg·kg(-1) respectively. TS-071 improved glucose tolerance in Zucker fatty rats without stimulating insulin secretion and reduced hyperglycaemia in streptozotocin (STZ)-induced diabetic rats and db/db mice at a dose of 0.3 mg·kg(-1). CONCLUSION AND IMPLICATIONS These data indicate that TS-071 is a potent and selective SGLT2 inhibitor that improves glucose levels in rodent models of type 1 and 2 diabetes and may be useful for the treatment for diabetes mellitus.
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Affiliation(s)
- K Yamamoto
- Molecular Function and Pharmacology Laboratories, Taisho Pharmaceutical Co., Ltd, Saitama, Japan.
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