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Kawai A, Nagatomo Y, Yukino-Iwashita M, Nakazawa R, Yumita Y, Taruoka A, Takefuji A, Yasuda R, Toya T, Ikegami Y, Masaki N, Adachi T. Sex Differences in Cardiac and Clinical Phenotypes and Their Relation to Outcomes in Patients with Heart Failure. J Pers Med 2024; 14:201. [PMID: 38392634 PMCID: PMC10890585 DOI: 10.3390/jpm14020201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/22/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024] Open
Abstract
Biological sex is one of the major factors characterizing the heart failure (HF) patient phenotype. Understanding sex-related differences in HF is crucial to implement personalized care for HF patients with various phenotypes. There are sex differences in left ventricular (LV) remodeling patterns in the HF setting, namely, more likely concentric remodeling and diastolic dysfunction in women and eccentric remodeling and systolic dysfunction in men. Recently supra-normal EF (snLVEF) has been recognized as a risk of worse outcome. This pathology might be more relevant in female patients. The possible mechanism may be through coronary microvascular dysfunction and sympathetic nerve overactivation from the findings of previous studies. Further, estrogen deficit might play a significant role in this pathophysiology. The sex difference in body composition may also be related to the difference in LV remodeling and outcome. Lower implementation in guideline-directed medical therapy (GDMT) in female HFrEF patients might also be one of the factors related to sex differences in relation to outcomes. In this review, we will discuss the sex differences in cardiac and clinical phenotypes and their relation to outcomes in HF patients and further discuss how to provide appropriate treatment strategies for female patients.
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Affiliation(s)
- Akane Kawai
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | | | - Ryota Nakazawa
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yusuke Yumita
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Akira Taruoka
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Asako Takefuji
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Risako Yasuda
- Department of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yukinori Ikegami
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
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Matsumoto C, Tomiyama H, Takahashi O, Maruhashi T, Matsuzawa Y, Masaki N, Muraki I, Yano Y, Sugimoto T, Kabutoya T, Sawami K, Tanaka A, Arima H, Sata M, Node K. An evidence review project for food with function claims ~Challenges of the Japan society for vascular failure for the promotion of adequate evidences for food with function claims. Hypertens Res 2024; 47:533-536. [PMID: 37907601 DOI: 10.1038/s41440-023-01485-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Chisa Matsumoto
- Center for Health Surveillance & Preventive Medicine, Tokyo Medical University Hospital, Tokyo, Japan.
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
| | | | - Osamu Takahashi
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Tatsuya Maruhashi
- Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yasushi Matsuzawa
- Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Isao Muraki
- Division of Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuichiro Yano
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Tadafumi Sugimoto
- Department of Cardiology, Nagoya City University Mirai Kousei Hospital, Nagoya, Japan
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kosuke Sawami
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
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Naito A, Nagatomo Y, Kawai A, Yukino-Iwashita M, Nakazawa R, Taruoka A, Takefuji A, Yasuda R, Toya T, Ikegami Y, Masaki N, Ido Y, Adachi T. The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword? J Pers Med 2024; 14:141. [PMID: 38392575 PMCID: PMC10890336 DOI: 10.3390/jpm14020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient's history of diabetes mellitus (DM). SGLT2is suppressed cardiovascular adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced the risk of worsening heart failure (HF) events or cardiovascular death in patients with HF. Along with these research findings, SGLT-2is are recommended for patients with HF in the latest guidelines. Despite these benefits, the concern surrounding the increasing risk of body weight loss and other adverse events has not yet been resolved, especially for patients with sarcopenia or frailty. The DAPA-HF and DELIVER trials consistently showed the efficacy and safety of SGLT-2i for HF patients with frailty. However, the Rockwood frailty index that derived from a cumulative deficit model was employed for frailty assessment in these trials, which might not be suitable for the evaluation of physical frailty or sarcopenia alone. There is no fixed consensus on which evaluation tool to use or its cutoff value for the diagnosis and assessment of frailty in HF patients, or which patients can receive SGLT-2i safely. In this review, we summarize the methodology of frailty assessment and discuss the efficacy and safety of SGLT-2i for HF patients with sarcopenia or frailty.
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Affiliation(s)
- Ayami Naito
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Akane Kawai
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | | | - Ryota Nakazawa
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Akira Taruoka
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Asako Takefuji
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Risako Yasuda
- Department of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yukinori Ikegami
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yasuo Ido
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan
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Takase B, Masaki N, Ikeda T, Shimizu W. Could Brugada Syndrome Be Treated With Percutaneous Coronary Intervention? - Reply. Circ J 2023; 88:178. [PMID: 37989296 DOI: 10.1253/circj.cj-23-0764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College
- Division of Cardiology, Iruma Heart Hospital
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
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5
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Ishinoda Y, Masaki N, Hitomi Y, Taruoka A, Kawai A, Iwashita M, Yumita Y, Kagami K, Yasuda R, Ido Y, Toya T, Ikegami Y, Namba T, Nagatomo Y, Miyazaki K, Takase B, Adachi T. A Low Arginine/Ornithine Ratio is Associated with Long-Term Cardiovascular Mortality. J Atheroscler Thromb 2023; 30:1364-1375. [PMID: 36775332 PMCID: PMC10564648 DOI: 10.5551/jat.63779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/25/2022] [Indexed: 02/13/2023] Open
Abstract
AIMS The long-term prognostic value of the bioavailability of L-arginine, an important source of nitric oxide for the maintenance of vascular endothelial function, has not been investigated fully. We therefore investigated the relationship between amino acid profile and long-term prognosis in patients with a history of standby coronary angiography. METHODS We measured the serum concentrations of L-arginine, L-citrulline, and L-ornithine by high-speed liquid chromatography. We examined the relationship between the L-arginine/L-ornithine ratio and the incidence of all-cause death, cardiovascular death, and major adverse cardiovascular events (MACEs) in 262 patients (202 men and 60 women, age 65±13 years) who underwent coronary angiography over a period of ≤ 10 years. RESULTS During the observation period of 5.5±3.2 years, 31 (12%) patients died, including 20 (8%) of cardiovascular death, while 32 (12%) had MACEs. Cox regression analysis revealed that L-arginine/L-ornithine ratio was associated with an increased risk for all-cause death (unadjusted hazard ratio, 95% confidence interval) (0.940, 0.888-0.995) and cardiovascular death (0.895, 0.821-0.965) (p<0.05 for all). In a model adjusted for age, sex, hypertension, hyperlipidemia, diabetes, current smoking, renal function, and log10-transformed brain natriuretic peptide level, cardiovascular death (0.911, 0.839-0.990, p=0.028) retained an association with a low L-arginine/ L-ornithine ratio. When the patients were grouped according to an L-arginine/L-ornithine ratio of 1.16, the lower L-arginine/L-ornithine ratio group had significantly higher incidence of all-cause death, cardiovascular death, and MACEs. CONCLUSION A low L-arginine/L-ornithine ratio may be associated with increased 10-year cardiac mortality.
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Affiliation(s)
- Yuki Ishinoda
- Department of Endocrinology, National Defense Medical College, Saitama, Japan
| | - Nobuyuki Masaki
- Department o f Intensive Care Medicine, National Defense Medical College, Saitama, Japan
| | - Yasuhiro Hitomi
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Akira Taruoka
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Akane Kawai
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Midori Iwashita
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Yusuke Yumita
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Kazuki Kagami
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Yasuo Ido
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Takumi Toya
- Department o f Intensive Care Medicine, National Defense Medical College, Saitama, Japan
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Yukinori Ikegami
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Koji Miyazaki
- Department of Comprehensive Internal Medicine, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Bonpei Takase
- Department o f Intensive Care Medicine, National Defense Medical College, Saitama, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Saitama, Japan
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Takase B, Ikeda T, Shimizu W, Abe H, Aiba T, Chinushi M, Koba S, Kusano K, Niwano S, Takahashi N, Takatsuki S, Tanno K, Watanabe E, Yoshioka K, Amino M, Fujino T, Iwasaki YK, Kohno R, Kinoshita T, Kurita Y, Masaki N, Murata H, Shinohara T, Yada H, Yodogawa K, Kimura T, Kurita T, Nogami A, Sumitomo N. JCS/JHRS 2022 Guideline on Diagnosis and Risk Assessment of Arrhythmia. Circ J 2023:CJ-22-0827. [PMID: 37690816 DOI: 10.1253/circj.cj-22-0827] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 09/12/2023]
Affiliation(s)
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Haruhiko Abe
- Department of Heart Rhythm Management, University of Occupational and Environmental Health, Japan
| | - Takeshi Aiba
- Department of Clinical Laboratory Medicine and Genetics, National Cerebral and Cardiovascular Center
| | - Masaomi Chinushi
- School of Health Sciences, Niigata University School of Medicine
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shinichi Niwano
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Seiji Takatsuki
- Department of Cardiology, Keio University School of Medicine
| | - Kaoru Tanno
- Cardiology Division, Cardiovascular Center, Showa University Koto-Toyosu Hospital
| | - Eiichi Watanabe
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital
| | | | - Mari Amino
- Department of Cardiology, Tokai University School of Medicine
| | - Tadashi Fujino
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Ritsuko Kohno
- Department of Heart Rhythm Management, University of Occupational and Environmental Health, Japan
| | - Toshio Kinoshita
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Yasuo Kurita
- Cardiovascular Center, International University of Health and Welfare, Mita Hospital
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College
| | | | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hirotaka Yada
- Department of Cardiology, International University of Health and Welfare, Mita Hospital
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Takeshi Kimura
- Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
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Kawai A, Nagatomo Y, Yukino-Iwashita M, Nakazawa R, Taruoka A, Yumita Y, Takefuji A, Yasuda R, Toya T, Ikegami Y, Masaki N, Ido Y, Adachi T. β 1 Adrenergic Receptor Autoantibodies and IgG Subclasses: Current Status and Unsolved Issues. J Cardiovasc Dev Dis 2023; 10:390. [PMID: 37754819 PMCID: PMC10531529 DOI: 10.3390/jcdd10090390] [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: 07/26/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
A wide range of anti-myocardial autoantibodies have been reported since the 1970s. Among them, autoantibodies against the β1-adrenergic receptor (β1AR-AAb) have been the most thoroughly investigated, especially in dilated cardiomyopathy (DCM). Β1AR-Aabs have agonist effects inducing desensitization of β1AR, cardiomyocyte apoptosis, and sustained calcium influx which lead to cardiac dysfunction and arrhythmias. Β1AR-Aab has been reported to be detected in approximately 40% of patients with DCM, and the presence of the antibody has been associated with worse clinical outcomes. The removal of anti-myocardial autoantibodies including β1AR-AAb by immunoadsorption is beneficial for the improvement of cardiac function for DCM patients. However, several studies have suggested that its efficacy depended on the removal of AAbs belonging to the IgG3 subclass, not total IgG. IgG subclasses differ in the structure of the Fc region, suggesting that the mechanism of action of β1AR-AAb differs depending on the IgG subclasses. Our previous clinical research demonstrated that the patients with β1AR-AAb better responded to β-blocker therapy, but the following studies found that its response also differed among IgG subclasses. Further studies are needed to elucidate the possible pathogenic role of IgG subclasses of β1AR-AAbs in DCM, and the broad spectrum of cardiovascular diseases including HF with preserved ejection fraction.
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Affiliation(s)
- Akane Kawai
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Midori Yukino-Iwashita
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Ryota Nakazawa
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Akira Taruoka
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Yusuke Yumita
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Asako Takefuji
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Risako Yasuda
- Department of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Yukinori Ikegami
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Nobuyuki Masaki
- Department of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, Japan
| | - Yasuo Ido
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, Japan; (A.K.)
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Masaki N, Adachi T, Tomiyama H, Kohro T, Suzuki T, Ishizu T, Ueda S, Yamazaki T, Furumoto T, Kario K, Inoue T, Koba S, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Maemura K, Ohya Y, Furukawa T, Ito H, Higashi Y, Yamashina A, Takase B. Reduced reactive hyperemia of the brachial artery in diabetic patients assessed by repeated measurements: The FMD-J B study. Physiol Rep 2023; 11:e15786. [PMID: 37607768 PMCID: PMC10444575 DOI: 10.14814/phy2.15786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/23/2023] [Indexed: 08/24/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a major cause of microvascular dysfunction. However, its effect on blood flow patterns during ischemic demand has not been adequately elucidated. In this study, we investigated the hypothesis that microvascular dysfunction in patients with T2DM manifests as brachial reactive hyperemia (BRH), defined as the ratio of peak blood flow velocities in a brachial artery before and after forearm cuff occlusion. The study enrolled 943 subjects (men, n = 152 [T2DM] and n = 371 [non-T2DM]; women, n = 107 [T2DM] and n = 313 [non-T2DM], respectively) with no history of cardiovascular disease. Semiautomatic measurements were obtained three times at 1.5-year intervals to confirm the reproducibility of factors involved in BRH for each sex. An age-adjusted mixed model demonstrated attenuated BRH in the presence of T2DM in both men (p = 0.022) and women (p = 0.031) throughout the study period. Post hoc analysis showed that the estimated BRH was significantly attenuated in patients with T2DM regardless of sex, except at baseline in women. In multivariate regression analysis, T2DM was a negative predictor of BRH at every measurement in men. For women, BRH was more strongly associated with alcohol consumption. Repeated measurements analysis revealed that T2DM was associated with attenuated postocclusion reactive hyperemia.
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Affiliation(s)
- Nobuyuki Masaki
- Department of Intensive Care MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Takeshi Adachi
- Department of CardiologyNational Defense Medical CollegeTokorozawaJapan
| | | | - Takahide Kohro
- Department of Hospital Planning and Management, Medical InformaticsJichi Medical University School of MedicineTochigiJapan
| | - Toru Suzuki
- Cardiovascular MedicineUniversity of LeicesterLeicesterUK
| | - Tomoko Ishizu
- Cardiovascular DivisionInstitute of Clinical Medicine, University of TsukubaIbarakiJapan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and TherapeuticsUniversity of the Ryukyu School of MedicineOkinawaJapan
| | - Tsutomu Yamazaki
- Department of Clinical Epidemiology and Systems, Faculty of MedicineThe University of TokyoTokyoJapan
| | - Tomoo Furumoto
- Department of Cardiovascular MedicineHokkaido University Graduate School of MedicineSapporoJapan
| | - Kazuomi Kario
- Division of Cardiovascular MedicineJichi Medical University School of MedicineTochigiJapan
| | - Teruo Inoue
- Dokkyo Medical University; Nasu Red Cross HospitalTochigiJapan
| | - Shinji Koba
- Department of Medicine, Division of CardiologyShowa University School of MedicineTokyoJapan
| | - Yasuhiko Takemoto
- Department of Internal Medicine and CardiologyOsaka City University Graduate School of MedicineOsakaJapan
| | - Takuzo Hano
- Department of Medical Education and Population‐based Medicine, Postgraduate School of MedicineWakayama Medical UniversityWakayamaJapan
| | - Masataka Sata
- Department of Cardiovascular MedicineInstitute of Health Biosciences, The University of Tokushima Graduate SchoolTokushimaJapan
| | - Yutaka Ishibashi
- Department of General MedicineShimane University Faculty of MedicineShimaneJapan
| | - Koichi Node
- Department of Cardiovascular MedicineSaga UniversitySagaJapan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical SciencesNagasaki UniversityNagasakiJapan
| | - Yusuke Ohya
- The Third Department of Internal MedicineUniversity of the RyukyusOkinawaJapan
| | - Taiji Furukawa
- Department of Internal MedicineTeikyo University School of MedicineTokyoJapan
| | - Hiroshi Ito
- Department of Cardiovascular MedicineOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayamaJapan
| | - Yukihito Higashi
- Department of Regenerative MedicineResearch Institute for Radiation Biology and Medicine, Hiroshima UniversityHiroshimaJapan
| | | | - Bonpei Takase
- Department of Intensive Care MedicineNational Defense Medical CollegeTokorozawaJapan
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9
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Toya T, Nagatomo Y, Ikegami Y, Masaki N, Adachi T. Coronary microvascular dysfunction in heart failure patients. Front Cardiovasc Med 2023; 10:1153994. [PMID: 37332583 PMCID: PMC10272355 DOI: 10.3389/fcvm.2023.1153994] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023] Open
Abstract
Coronary microcirculation has multiple layers of autoregulatory function to maintain resting flow and augment hyperemic flow in response to myocardial demands. Functional or structural alterations in the coronary microvascular function are frequently observed in patients with heart failure with preserved or reduced ejection fraction, which may lead to myocardial ischemic injury and resultant worsening of clinical outcomes. In this review, we describe our current understanding of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved and reduced ejection fraction.
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10
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Osaki A, Kagami K, Ishinoda Y, Sato A, Kimura T, Horii S, Ito K, Toya T, Ido Y, Namba T, Masaki N, Nagatomo Y, Adachi T. Reactive Oxygen Species in the Aorta and Perivascular Adipose Tissue Precedes Endothelial Dysfunction in the Aorta of Mice with a High-Fat High-Sucrose Diet and Additional Factors. Int J Mol Sci 2023; 24:ijms24076486. [PMID: 37047458 PMCID: PMC10095299 DOI: 10.3390/ijms24076486] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Metabolic syndrome (Mets) is the major contributor to the onset of metabolic complications, such as hypertension, type 2 diabetes mellitus (DM), dyslipidemia, and non-alcoholic fatty liver disease, resulting in cardiovascular diseases. C57BL/6 mice on a high-fat and high-sucrose diet (HFHSD) are a well-established model of Mets but have minor endothelial dysfunction in isolated aortas without perivascular adipose tissue (PVAT). The purpose of this study was to evaluate the effects of additional factors such as DM, dyslipidemia, and steatohepatitis on endothelial dysfunction in aortas without PVAT. Here, we employed eight-week-old male C57BL/6 mice fed with a normal diet (ND), HFHSD, steatohepatitis choline-deficient HFHSD (HFHSD-SH), and HFHSD containing 1% cholesterol and 0.1% deoxycholic acid (HFHSD-Chol) for 16 weeks. At week 20, some HFHSD-fed mice were treated with streptozocin to develop diabetes (HFHSD-DM). In PVAT-free aortas, the endothelial-dependent relaxation (EDR) did not differ between ND and HFHSD (p = 0.25), but in aortas with PVAT, the EDR of HFHSD-fed mice was impaired compared with ND-fed mice (p = 0.005). HFHSD-DM, HFHSD-SH, and HFHSD-Chol impaired the EDR in aortas without PVAT (p < 0.001, p = 0.019, and p = 0.009 vs. ND, respectively). Furthermore, tempol rescued the EDR in those models. In the Mets model, the EDR is compromised by PVAT, but with the addition of DM, dyslipidemia, and SH, the vessels themselves may result in impaired EDR.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Yuji Nagatomo
- Correspondence: (Y.N.); (T.A.); Tel.: +81-4-2995-1597 (T.A.); Fax: +81-4-2996-5200 (T.A.)
| | - Takeshi Adachi
- Correspondence: (Y.N.); (T.A.); Tel.: +81-4-2995-1597 (T.A.); Fax: +81-4-2996-5200 (T.A.)
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11
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Namba T, Masaki N, Hitomi Y, Ishinoda Y, Iwashita M, Yumita Y, Kagami K, Yasuda R, Ikegami Y, Toya T, Nagatomo Y, Takase B, Soejima K, Adachi T. Association of serum nitric oxide metabolite level with mortality in patients undergoing coronary angiography. J Cardiol 2022; 80:578-584. [PMID: 35987881 DOI: 10.1016/j.jjcc.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Nitric oxide (NO) is a relevant molecule for vascular homeostasis. The level of serum NO metabolites (NOx), which consist of nitrite and nitrate, has been investigated as an alternative biomarker of NO production, but its clinical value has not yet been determined. METHODS AND RESULTS 143 patients (66 ± 12 years old) were followed up after coronary catheterization. During a median (inter-quartile range) observation period of 6.13 (3.32-9.21) years, there were 20 (14 %) all-cause deaths, including 11 (8 %) cardiovascular deaths, 17 (12 %) major adverse cardiovascular events, and 17 (12 %) hospital admissions for heart failure. Median NOx level was 34.5 μmol/L (23.9-54.3). NOx was a risk factor for all-cause death [hazard ratio (HR) by unit increase, 1.010, 95 % confidence interval (CI) 1.001-1.018; p = 0.021] and heart failure (HR 1.010, CI 1.001-1.019; p = 0.029). Even after adjustment for age, sex, coronary risk factors, C-reactive protein, log-transformed brain natriuretic peptide, estimated glomerular filtration rate, and nitrate treatment, NOx was a risk factor for all-cause death (HR 1.015, CI 1.004-1.027; p = 0.008) and admission with heart failure (HR 1.018, CI 1.005-1.018, p = 0.007). CONCLUSIONS An increase in serum NOx level does not herald a benign clinical course but is an independent predictor of high risk of any-cause mortality and heart failure.
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Affiliation(s)
- Takayuki Namba
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan; Department of Cardiology, Kyorin University School of Medicine, Mitaka, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Japan.
| | - Yasuhiro Hitomi
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Yuki Ishinoda
- Department of Endocrinology, National Defense Medical College, Tokorozawa, Japan
| | - Midori Iwashita
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Yusuke Yumita
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Kazuki Kagami
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Yukinori Ikegami
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan; Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University School of Medicine, Mitaka, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
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12
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Abstract
Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients. The prevalence of delayed VVR due to COVID-19 vaccination was 0.026%. In addition, no delayed VVR was found among 17,386 patients who received the influenza vaccine. Delayed VVR is likely to be overlooked if medical staff are not aware of this symptom. This report provides significant information regarding effects of COVID-19 vaccination.
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Affiliation(s)
- Bonpei Takase
- Division of Cardiology, Iruma Heart Hospital, Japan
- Department of Intensive Care Medicine, National Defense Medical College, Japan
| | | | - Satoko Takei
- Division of Cardiology, Iruma Heart Hospital, Japan
| | | | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Japan
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13
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Takase B, Hayashi K, Hisada T, Tsuchiya T, Masaki N, Nagata M. Chest Pain with New Abnormal Electrocardiogram Development after Injection of COVID-19 Vaccine Manufactured by Moderna. Intern Med 2022; 61:2089-2090. [PMID: 34866106 PMCID: PMC9334252 DOI: 10.2169/internalmedicine.8711-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College, Japan
- Division of Cardiology, Iruma Heart Hospital, Japan
| | | | | | - Tyouji Tsuchiya
- Department of General Medicine, Sakado Central Hospital, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Japan
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14
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Takase B, Hisada T, Masaki N, Nagata M, Shimizu W. Frequency of vaccine‐associated syncope after
COVID
‐19 vaccination in adolescents. J Arrhythm 2022; 38:448-450. [PMID: 35785378 PMCID: PMC9237291 DOI: 10.1002/joa3.12721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Bonpei Takase
- Department of Intensive Care Medicine National Defense Medical College Tokorozawa Japan
- Division of Cardiology Iruma Heart Hospital Iruma Japan
| | | | - Nobuyuki Masaki
- Department of Intensive Care Medicine National Defense Medical College Tokorozawa Japan
| | | | - Wataru Shimizu
- Department of Cardiovascular Medicine Nippon Medical School Bunkyo‐ku Japan
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15
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Kimura T, Kagami K, Sato A, Osaki A, Ito K, Horii S, Toya T, Masaki N, Yasuda R, Nagatomo Y, Adachi T. Sarco/Endoplasmic Reticulum Ca 2+ ATPase 2 Activator Ameliorates Endothelial Dysfunction; Insulin Resistance in Diabetic Mice. Cells 2022; 11:1488. [PMID: 35563793 PMCID: PMC9099866 DOI: 10.3390/cells11091488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 12/11/2022] Open
Abstract
Background: Sarco/endoplasmic reticulum Ca2+-ATPase2 (SERCA2) is impaired in various organs in animal models of diabetes. The purpose of this study was to test the effects of an allosteric SERCA2 activator (CDN1163) on glucose intolerance, hepatosteatosis, skeletal muscle function, and endothelial dysfunction in diabetic (db/db) mice. Methods: Either CDN1163 or vehicle was injected intraperitoneally into 16-week-old male control and db/db mice for 5 consecutive days. Results: SERCA2 protein expression was decreased in the aorta of db/db mice. In isometric tension measurements of aortic rings from db/db mice treated with CDN1163, acetylcholine (ACh)-induced relaxation was improved. In vivo intraperitoneal administrations of CDN 1163 also increased ACh-induced relaxation. Moreover, CDN1163 significantly decreased blood glucose in db/db mice at 60 and 120 min during a glucose tolerance test; it also decreased serum insulin levels, hepatosteatosis, and oxygen consumption in skeletal muscle during the early period of exercise in db/db mice. Conclusions: CDN1163 directly improved aortic endothelial dysfunction in db/db mice. Moreover, CDN1163 improved hepatosteatosis, skeletal muscle function, and insulin resistance in db/db mice. The activation of SERCA2 might be a strategy for the all the tissue expressed SERCA2a improvement of endothelial dysfunction and the target for the organs related to insulin resistance.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yuji Nagatomo
- Department of Internal Medicine I, Division of Cardiovascular Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Japan; (T.K.); (K.K.); (A.S.); (A.O.); (K.I.); (S.H.); (T.T.); (N.M.); (R.Y.)
| | - Takeshi Adachi
- Department of Internal Medicine I, Division of Cardiovascular Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Japan; (T.K.); (K.K.); (A.S.); (A.O.); (K.I.); (S.H.); (T.T.); (N.M.); (R.Y.)
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16
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Takase B, Kobayashi Y, Sasaki N, Hayashi K, Hisada T, Sakurada M, Masaki N, Nagata M. Vasospasm-induced ST-segment elevation myocardial infarction in a premenopausal woman with endothelial dysfunction. Oxf Med Case Reports 2022; 2022:omac040. [PMID: 35464898 PMCID: PMC9021969 DOI: 10.1093/omcr/omac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 11/14/2022] Open
Abstract
ST-segment elevation myocardial infarction (STEMI) can be caused by coronary artery vasospasm (VSA) due to endothelial dysfunction. However, the clinical role of endothelial function tests in VSA-induced STEMI is not fully understood. We present the case of a 43-year-old woman with atypical chest pain and no coronary risk factors. STEMI caused by VSA was diagnosed. Flow-mediated vasodilatation (FMD) and EndPAT tests were performed; the FMD and reactive hyperaemia index were 3.8% and 1.23, respectively. Endothelial dysfunction is the putative cause of STEMI. FMD and EndPAT tests might be useful for predicting adverse outcomes in young premenopausal women with VSA.
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Affiliation(s)
- Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa city, Saitama, Japan
| | - Yukie Kobayashi
- Division of Cardiology, Iruma Heart Hospital, Iruma city, Saitama, Japan
| | - Natsuko Sasaki
- Division of Cardiology, Iruma Heart Hospital, Iruma city, Saitama, Japan
| | - Katsumi Hayashi
- Division of Cardiology, Iruma Heart Hospital, Iruma city, Saitama, Japan
| | - Tetsuya Hisada
- Division of Cardiology, Iruma Heart Hospital, Iruma city, Saitama, Japan
| | - Masami Sakurada
- Division of Cardiology, Tokorozawa Heart Center, Tokorozawa city, Saitama, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa city, Saitama, Japan
| | - Masayoshi Nagata
- Division of Cardiology, Iruma Heart Hospital, Iruma city, Saitama, Japan
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17
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Okamoto H, Kitamura S, Masaki N. Activation of the root xylem proton pump by hydraulic signals from leaves under suppressed transpiration. J Plant Res 2022; 135:311-322. [PMID: 35075591 DOI: 10.1007/s10265-022-01368-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
Long term field observations have revealed that the inhibition of transpiration by heavy rainfall promotes immediate positive shift in the trans-root electric potential (TRP), indicating activation of the xylem proton pump in the tree root system presumably participating in acropetal water transport. This phenomenon is indicative of signal transmission from the aerial part to the root system via change in the xylem hydraulic pressure. To test this hypothesis, we constructed a new device that enables the simultaneous recording of artificially applied xylem hydraulic pressure and the change in the TRP of tree saplings. With the application of artificial pressure to the xylem vessels (20-62 kPa), TRP shifted towards positive potential by 20-80 mV, which indicates the activation of the proton pump in the root xylem. The reaction was observed in 11 tree species, six deciduous and five evergreen, although only during the resting phase of the xylem proton pump (May to October) when the transpiration rates were high. Contrastingly the application of tension (negative pressure) produced no reaction. Simultaneous determination of the two components of the TRP, i.e. Vps (electric membrane potential difference across root surface cell membrane) and Vpx (electric membrane potential difference between root symplast and xylem vessel), are performed using the intra-cellular micro-electrode technique throughout the four seasons. Application of excess xylem hydraulic pressure had no significant effect on Vps, while it brought about hyper-polarisation of Vpx except during the winter season, most significantly during summer when transpiration is vigorous and the xylem pump is in a resting state. Such effect of excess xylem pressure was, however, not observed under anoxia.
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Affiliation(s)
- Hisashi Okamoto
- Mori Laboratory of Plant Physiology, 443-5 Enden Mori, Shizuoka, 437-0221, Japan.
| | - Sayaka Kitamura
- Mori Laboratory of Plant Physiology, 443-5 Enden Mori, Shizuoka, 437-0221, Japan
| | - Nobuyuki Masaki
- Masaki Laboratory of Arboriculture, 729-2 Higashihara Iwata, Shizuoka, 438-0802, Japan
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18
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Hitomi Y, Masaki N, Ishinoda Y, Ido Y, Iwashita M, Yumita Y, Kagami K, Yasuda R, Ikegami Y, Toya T, Namba T, Nagatomo Y, Takase B, Adachi T. Effectiveness of the d-ROMs oxidative stress test to predict long-term cardiovascular mortality. Int J Cardiol 2022; 354:43-47. [DOI: 10.1016/j.ijcard.2022.03.001] [Citation(s) in RCA: 1] [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: 01/24/2022] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 11/05/2022]
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19
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Takase B, Higashimura Y, Asahina H, Masaki N, Kinoshita M, Sakai H. Intraosseous infusion of liposome-encapsulated hemoglobin (HbV) acutely prevents hemorrhagic anemia-induced lethal arrhythmias and its efficacy persists with preventing proarrhythmic side effects in subacute phase of severe hemodilution model. Artif Organs 2022; 46:1107-1121. [PMID: 35006625 DOI: 10.1111/aor.14170] [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: 10/23/2021] [Revised: 11/25/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Artificial oxygen carriers (HbV) can treat hemorrhagic shock with lethal arrhythmias (VT/VF). No reports exist on subacute HbV's effects. METHODS Acute and subacute resuscitation effects with anti-arrhythmogenesis of HbV were studied in 85% blood exchange rat model (85%-Model). Lethal 85%-Model was created by bone marrow transfusion and femoral artery bleeding in 80 SD rats in HbV-administered group (HbV-group), washed erythrocyte-administered group (wRBC-group), and 5% albumin-administered group (ALB-group). Survival rates, anti-arrhythmic efficacy by optical mapping analysis (OMP) with electrophysiological stimulation (EPS) in Langendorff heart, cardiac autonomic activity by heart rate variability (HRV) and ventricular arrhythmias by 24-hour electrocardiogram telemetry monitoring (24h-ECG) in awake, and left ventricular function by echocardiography (LVEF) were measured. RESULTS All rats in HbV- and wRBC-groups survived for 4 weeks whereas no rats in ALB-group. HbV and wRBC acutely suppressed VT/VF in Langendorff heart through ameliorating action potential duration dispersion (APDd) analyzed by OMP with EPS. For subacute analysis, 50% blood exchange by 5% albumin was utilized (ALB-group 50). Subacute salutary effect on APDd and VT/VF inducibility was confirmed in HbV- and wRBC-groups. 24h-ECG showed that HbV and wRBC suppressed none-sustained VT (NSVT) and sympathetic component of HRV (LF/HF) with preserved LVEF (HbV-group, wRBC-group vs. ALB-group 50;NSVT numbers/days, 0.5±0.3, 0.4±0.3 vs. 3.9±1.2*; LF/HF, 1.1±0.2, 0.8±0.2 vs. 3.5±1.0*;LVEF, 84±5, 83±4, vs. 77±4%*; *p<0.05). CONCLUSIONS Collectively, HbV has sustained antiarrhythmic effect in subacute 85%-Model by ameliorating electrical remodeling and improving arrhythmogenic modifying factors (HRV and LVEF). These findings are useful in now continuing clinical trials of HbV.
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Affiliation(s)
- Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yuko Higashimura
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Haruka Asahina
- Department of Critical Care Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Manabu Kinoshita
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hiromi Sakai
- Department of Chemistry, School of Medicine, Nara Medical University, Kashihara Nara, Japan
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20
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Hitomi Y, Masaki N, Ishinoda Y, Kagami K, Yasuda R, Toya T, Namba T, Nagatomo Y, Takase B, Adachi T. Effectiveness of pulsatility index of carotid Doppler ultrasonography to predict cardiovascular events. J Med Ultrason (2001) 2021; 49:95-103. [PMID: 34778938 DOI: 10.1007/s10396-021-01164-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The pulsatility index (PI) obtained from carotid ultrasonography is considered to be a marker of cerebrovascular resistance. However, the impact of PI on cardiovascular events has yet to be fully addressed. METHOD Fifty-four patients who underwent both carotid ultrasonography and coronary angiography were followed for 5.9 ± 3.2 years. The relationship between the incidence of cardiovascular events and PI was investigated. RESULT There were 10 (19%) deaths, four (7%) cardiovascular deaths, and nine (17%) major adverse cardiovascular events (MACEs). The cardiovascular events-defined as all hospitalization for MACEs plus heart failure, revascularization, and cardiovascular surgery-occurred in 21 patients (39%). The patients were divided into two groups according to each threshold of PI value for common carotid arteries (CCA), internal carotid arteries (ICA), and external carotid arteries (ECA), respectively. The thresholds were calculated based on receiver-operating characteristic curves for cardiovascular events. Log-rank test showed that the groups with CCA-PI ≥ 1.71, ICA-PI ≥ 1.20, and ECA-PI ≥ 2.46 had a higher incidence of cardiovascular events, respectively (p < 0.05). ECA-PI ≥ 2.46 was associated with an increased incidence of MACEs. Multivariate Cox regression analysis adjusting for cardiovascular risk factors showed that high PI of CCA, ICA, or ECA was a risk factor for cardiovascular events, respectively (CCA-PI ≥ 1.71, hazard ratio (HR) 3.242, p = 0.042; ICA-PI ≥ 1.20, HR 3.639, p = 0.012; ECA-PI ≥ 2.46, HR 11.322, p = 0.001). CONCLUSION The results suggested that carotid PIs were independent predictive factors for further cardiovascular events. In particular, high ECA-PI levels may reflect severe arteriosclerosis.
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Affiliation(s)
- Yasuhiro Hitomi
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan.
| | - Yuki Ishinoda
- Department of Endocrinology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Kazuki Kagami
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
- Department of Intensive Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
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21
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Horii S, Yada H, Ito K, Tsujita K, Osaki A, Kagami K, Sato A, Kimura T, Yasuda R, Toya T, Namba T, Nagatomo Y, Ido Y, Miyazaki K, Masaki N, Ishihara M, Takase B, Adachi T. Artificially Created Reentry Circuit by Laser Irradiation Causes Atrial Tachycardia to Persist in Murine Atria. Circ J 2021; 86:319-329. [PMID: 34544960 DOI: 10.1253/circj.cj-20-1286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a gradual progression from paroxysmal to persistent atrial fibrillation (AF) in humans. To elucidate the mechanism involved, the creation of an artificial atrial substrate to persist AF in mice was attempted.Methods and Results:This study used wild type (WT) mice, but it is difficult to induce AF in them. A novel antegrade perfusion method from the left ventricle (LV) to enlarge both atria for artificial atrial modification was proposed in this study. Short duration AF was induced by burst pacing under this method. Optical mapping analysis revealed non-sustained focal type and meandering spiral reentrants after short duration AF. A tiny artificial substrate (~1.2 mm in diameter) was added in by laser irradiation to create a critical atrial arrhythmogenic substrate. Burst pacing was performed in a non-laser group (n=8), a circular-shape laser group (n=8), and a wedge-shaped dent laser group (n=8). We defined AF and atrial tachycardia (AT) as atrial arrhythmia (AA). Long-lasting AA was defined as lasting for ≥30 min. Long-lasting AA was observed in 0/8, 0/8, and 6/8 (75%) mice in each group. Optical mapping analysis revealed that the mechanism was AT with a stationary rotor around the irradiated margin. CONCLUSIONS Regrettably, this study failed to reproduce persistent AF, but succeeded in creating an arrhythmic substrate that causes sustained AT in WT mice.
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Affiliation(s)
- Shunpei Horii
- Department of Cardiology, National Defense Medical College
| | - Hirotaka Yada
- Department of Cardiology, International University of Health and Welfare Mita Hospital
| | - Kei Ito
- Department of Cardiology, National Defense Medical College
| | - Kazuhiro Tsujita
- Department of Medical Engineering, National Defense Medical College
| | - Ayumu Osaki
- Department of Cardiology, National Defense Medical College
| | - Kazuki Kagami
- Department of Cardiology, National Defense Medical College
| | - Atsushi Sato
- Department of Cardiology, National Defense Medical College
| | | | - Risako Yasuda
- Department of Cardiology, National Defense Medical College
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College
| | - Yasuo Ido
- Department of Cardiology, National Defense Medical College
| | - Koji Miyazaki
- Department of Comprehensive Internal Medicine, Tokai University Hachioji Hospital
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College
| | - Miya Ishihara
- Department of Medical Engineering, National Defense Medical College
| | - Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College
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22
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Hitomi Y, Nagatomo Y, Yukino M, Yumita Y, Kagami K, Yasuda R, Toya T, Namba T, Masaki N, Yada H, Adachi T. Characterization of tolvaptan response and its impact on the outcome for patients with heart failure. J Cardiol 2021; 78:285-293. [PMID: 34039465 DOI: 10.1016/j.jjcc.2021.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Conventional diuretic therapy such as loop diuretics is a cornerstone of the treatment for heart failure (HF). Diuretic response is an important factor in determining resistance to HF therapy and has been shown to be associated with subsequent clinical outcome. Tolvaptan (TVP), a vasopressin V2 receptor antagonist, has a favorable profile in terms of rapid fluid removal and less aggravation of renal function. We hypothesized that the response to TVP might be associated with the subsequent clinical outcome. METHOD In this single-center retrospective study, 148 consecutive HF patients who were administered TVP from 2014 through 2018 [age 79 (69-86) years, male 89 (60%)] were included. Ninety-six patients were divided into TVP responder [N = 39 (41%)] and non-responder groups based on the cut-off value of gained urine output (+ 93 ml/mg TVP /day) on the day after TVP was introduced. RESULTS Early TVP introduction (p = 0.012) and lower dose of loop diuretics (p = 0.043) were predictors of TVP responder. For 2 years after discharge, TVP responders showed more favorable outcomes regarding the primary endpoint defined as the composite of all-cause death and HF readmission (p = 0.034, log-rank test) and HF readmission (p = 0.005). A multivariable Cox model analysis revealed that TVP responder was an independent predictor of the primary endpoint (hazard ratio 0.48, p = 0.041). TVP responders had a lower number of HF readmissions over a 1-year period (p = 0.002). TVP response was independently associated with the number of HF readmissions (p = 0.015). The proportion of patients with an extended period between discharge and HF readmission after TVP administration was higher in responders than non-responders (67% vs. 23%, p = 0.006). These associations of TVP response and post-discharge outcomes were more evident in patients who continued TVP after discharge. CONCLUSION TVP response can be indicative of subsequent clinical outcomes and may be informative when considering advanced care planning.
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Affiliation(s)
- Yasuhiro Hitomi
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan.
| | - Midori Yukino
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
| | - Yusuke Yumita
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
| | - Kazuki Kagami
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan; Department of Intensive Care, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
| | - Nobuyuki Masaki
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan; Department of Intensive Care, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hirotaka Yada
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan; Department of Cardiology, International University of Health and Welfare Mita hospital
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan
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23
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Masaki N, Ido Y, Yamada T, Yamashita Y, Toya T, Takase B, Hamburg NM, Adachi T. Endothelial Insulin Resistance of Freshly Isolated Arterial Endothelial Cells From Radial Sheaths in Patients With Suspected Coronary Artery Disease. J Am Heart Assoc 2020; 8:e010816. [PMID: 30885039 PMCID: PMC6475050 DOI: 10.1161/jaha.118.010816] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Endothelial insulin resistance is insulin‐insensitivity in the vascular endothelium and can be observed in experimental models. This study aimed to investigate endothelial insulin resistance in patients with suspected coronary artery disease. To this end, a novel method of obtaining freshly isolated arterial endothelial cells from a radial catheter sheath was developed. Methods and Results Freshly isolated arterial endothelial cells were retrieved from catheter sheaths placed in radial arteries for coronary angiography (n=69, patient age 64±12 years). The endothelial cells were divided into groups for incubation with or without insulin, vascular endothelial growth factor, or acetylcholine. The intensity of phosphorylated endothelial nitric oxide synthase at Ser1177 (p‐eNOS) was quantified by immunofluorescence microscopy. The percentage increase of insulin‐induced phosphorylated endothelial nitric oxide synthase correlated negatively with derivatives of reactive oxygen metabolites, an oxidative stress test (r=−0.348, n=53, P=0.011), E/E′, an index of left ventricular diastolic dysfunction in Doppler echocardiography (ρ=−0.374, n=49, P=0.008), and log‐transformed brain natriuretic peptide (r=−0.266, n=62, P=0.037). Furthermore, percentage increase of insulin‐induced p‐eNOS was an independent factor for the cardio‐ankle vascular index (standardized coefficient β=−0.293, n=42, P=0.021) in the multivariate regression analysis of adaptive least absolute shrinkage and selection operator. Conclusions Our results suggested that endothelial insulin resistance is associated with oxidative stress, left ventricular diastolic dysfunction, heart failure, and arterial stiffness.
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Affiliation(s)
- Nobuyuki Masaki
- 1 Department of Intensive Care Medicine National Defense Medical College Tokorozawa Japan
| | - Yasuo Ido
- 2 Department of Cardiology National Defense Medical College Tokorozawa Japan
| | - Toshiyuki Yamada
- 3 Department of Cardiovascular Surgery Keio University Graduate School of Medicine Tokyo Japan
| | - Youhei Yamashita
- 2 Department of Cardiology National Defense Medical College Tokorozawa Japan
| | - Takumi Toya
- 2 Department of Cardiology National Defense Medical College Tokorozawa Japan
| | - Bonpei Takase
- 1 Department of Intensive Care Medicine National Defense Medical College Tokorozawa Japan
| | - Naomi M Hamburg
- 4 The Whitaker Cardiovascular Institute Department of Medicine Boston University School of Medicine Boston MA
| | - Takeshi Adachi
- 2 Department of Cardiology National Defense Medical College Tokorozawa Japan
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Masaki N, Feng B, Bretón‐Romero R, Inagaki E, Weisbrod RM, Fetterman JL, Hamburg NM. O-GlcNAcylation Mediates Glucose-Induced Alterations in Endothelial Cell Phenotype in Human Diabetes Mellitus. J Am Heart Assoc 2020; 9:e014046. [PMID: 32508185 PMCID: PMC7429031 DOI: 10.1161/jaha.119.014046] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Posttranslational protein modification with O-linked N-acetylglucosamine (O-GlcNAc) is linked to high glucose levels in type 2 diabetes mellitus (T2DM) and may alter cellular function. We sought to elucidate the involvement of O-GlcNAc modification in endothelial dysfunction in patients with T2DM. Methods and Results Freshly isolated endothelial cells obtained by J-wire biopsy from a forearm vein of patients with T2DM (n=18) was compared with controls (n=10). Endothelial O-GlcNAc levels were 1.8-ford higher in T2DM patients than in nondiabetic controls (P=0.003). Higher endothelial O-GlcNAc levels correlated with serum fasting blood glucose level (r=0.433, P=0.024) and hemoglobin A1c (r=0.418, P=0.042). In endothelial cells from patients with T2DM, normal glucose conditions (24 hours at 5 mmol/L) lowered O-GlcNAc levels and restored insulin-mediated activation of endothelial nitric oxide synthase, whereas high glucose conditions (30 mmol/L) maintained both O-GlcNAc levels and impaired insulin action. Treatment of endothelial cells with Thiamet G, an O-GlcNAcase inhibitor, increased O-GlcNAc levels and blunted the improvement of insulin-mediated endothelial nitric oxide synthase phosphorylation by glucose normalization. Conclusions Taken together, our findings indicate a role for O-GlcNAc modification in the dynamic, glucose-induced impairment of endothelial nitric oxide synthase activation in endothelial cells from patients with T2DM. O-GlcNAc protein modification may be a treatment target for vascular dysfunction in T2DM.
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Affiliation(s)
- Nobuyuki Masaki
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
| | - Bihua Feng
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
| | - Rosa Bretón‐Romero
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
| | - Elica Inagaki
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
| | - Robert M. Weisbrod
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
| | - Jessica L. Fetterman
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
| | - Naomi M. Hamburg
- The Whitaker Cardiovascular InstituteDepartment of MedicineBoston University School of MedicineBostonMA
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25
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Yada H, Ito K, Naganuma T, Yumita Y, Kagami K, Osaki A, Yasuda R, Toya T, Namba T, Nagatomo Y, Masaki N, Adachi T. 1320Effectiveness of atrial flutter ablation line selection using SOUNDSTAR catheter. Europace 2020. [DOI: 10.1093/europace/euaa162.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cavotricuspid isthmus (CTI) ablation for atrial flutter (AFL) shows a high success rate and effective for patients. However, operators experience difficulties in CTI ablation in some cases and need additional ablation for repeated recurrence. We investigated whether the SOUNDSTAR® (Biosense. Webster, Diamond Barr, CA, USA) catheter would be effective to select a CTI line of high therapeutic effect.
Methods
We have investigated the anatomy of around CTI by SOUNDSTAR® catheter and decided the CTI line using the anatomical information in AFL ablation (Figure1). We assumed two CTI lines of medial and lateral line. Medial CTI (M-CTI) line was more common and shorter line. Lateral CTI (L-CTI) line was uncommon and slightly longer line. We use 3.5mm tip catheter with NxT steerable introducer. The target Ablation Index (AI) was 400, and the target VisTtag™ interval was 6 mm or less.
Results
A total 30 of AFL ablated cases were investigated retrospectively. We surveyed 15 cases in M-CTI group and 15 cases in L-CTI group. Comparing the length of CTI in all cases, the length of M-CTI line was shorter than L-CTI line (M-CTI 32.1 ± 6.6mm vs. L-CTI 38.4 ± 8.3mm, n = 30, p <0.01). The atrial wall thickness of midsection and tricuspid valve (TV) side were thicker in M-CTI line (Midsection: M-CTI 4.0 ± 1.2mm vs. L-CTI 3.3 ± 0.8mm, n = 30, p <0.05, TV side: M-CTI 5.4 ± 1.4mm vs. L-CTI 4.3 ± 1.1mm, n = 30, p <0.05,). There was no difference in the required number of points to complete initial line (M-CTI 8.4 ± 1.6 vs. L-CTI 8.1 ± 1.7, n = 15, ns). Eustachian ridge in IVC side was thicker and higher in the M-CTI group (3.4 ± 3.3mm vs. 0.9 ± 1.9mm, n =30, p <0.01) and ablation on the Eustachian ridge showed instability of catheter placement. A lot of RF delivery was required on Eustachian ridge in M-CTI (2.6 ± 0.6 vs. 2.1 ± 0.7, n =15, p <0.05) and AI had resulted lower in M-CTI (351 ± 42.8 vs. 381 ± 27.1, n =15, p <0.05). Recurrence is more common in M-CTI group (9/15, 60% vs. 3/15, 20%). Recurrence sites in M-CTI group were distributed ((IVC side 3/9 (33%), midsection 5/9 (56%), TV side 5/9 (56%)) and multiple recurrences occurred in 3/9 (33%). Recurrence sites in L-CTI were only midsection of CTI (3/3, 100%).
Conclusions
CTI ablation at the shorter distance M-CTI, which is commonly selected, resulted in more recurrences due to the unevenness including Eustachian ridge and the myocardium thickness. However, ablation at slightly longer L-CTI line showed lower recurrence and effective for CTI ablation.
Abstract Figure 1
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Affiliation(s)
- H Yada
- National Defense Medical College, Saitama, Japan
| | - K Ito
- National Defense Medical College, Saitama, Japan
| | - T Naganuma
- National Defense Medical College, Saitama, Japan
| | - Y Yumita
- National Defense Medical College, Saitama, Japan
| | - K Kagami
- National Defense Medical College, Saitama, Japan
| | - A Osaki
- National Defense Medical College, Saitama, Japan
| | - R Yasuda
- National Defense Medical College, Saitama, Japan
| | - T Toya
- National Defense Medical College, Saitama, Japan
| | - T Namba
- National Defense Medical College, Saitama, Japan
| | - Y Nagatomo
- National Defense Medical College, Saitama, Japan
| | - N Masaki
- National Defense Medical College, Saitama, Japan
| | - T Adachi
- National Defense Medical College, Saitama, Japan
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26
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Toya T, Ito K, Kagami K, Osaki A, Sato A, Kimura T, Horii S, Yasuda R, Namba T, Ido Y, Nagatomo Y, Hayashi K, Masaki N, Yada H, Adachi T. Impact of oxidative posttranslational modifications of SERCA2 on heart failure exacerbation in young patients with non-ischemic cardiomyopathy: A pilot study. Int J Cardiol Heart Vasc 2019; 26:100437. [PMID: 31763443 PMCID: PMC6864308 DOI: 10.1016/j.ijcha.2019.100437] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/30/2019] [Accepted: 11/02/2019] [Indexed: 01/14/2023]
Abstract
Background Oxidative posttranslational modifications (OPTM) impair the function of Sarcoplasmic/endoplasmic reticulum (SR) calcium (Ca2+) ATPase (SERCA) 2 and trigger cytosolic Ca2+ dysregulation. We investigated the extent of OPTM of SERCA2 in patients with non-ischemic cardiomyopathy (NICM). Methods and results Endomyocardial biopsy (EMB) was obtained in 40 consecutive patients with NICM. Total expression and OPTM of SERCA2, including sulfonylation at cysteine-674 (S-SERCA2) and nitration at tyrosine-294/295 (N-SERCA2), were examined by immunohistochemical analysis. S-SERCA2 increased in the presence of late gadolinium enhancement on cardiac magnetic resonance imaging. S-SERCA2/SERCA2 and N-SERCA2/SERCA2 correlated with cardiac fibrosis evaluated by Masson’s trichrome staining of EMB. SERCA2 expression modestly increased in parallel with an upward trend in OPTM of SERCA2 with aging. This tendency became prominent only in patients aged >65 years. OPTM of SERCA2 positively correlated with brain natriuretic peptide (BNP) values only in patients aged ≤65 years. Composite major adverse cardiac events (MACE) increased more in the high OPTM group of younger patients; however, MACE-free survival was similar irrespective of the extent of OPTM in older patients. Conclusions OPTM of SERCA2 correlate with myocardial fibrosis in NICM. In younger patients, OPTM of SERCA2 correlate with elevated BNP and increased composite MACE.
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Affiliation(s)
- Takumi Toya
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kei Ito
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kazuki Kagami
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Ayumu Osaki
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Atsushi Sato
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Toyokazu Kimura
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Shunpei Horii
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yasuo Ido
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Katsumi Hayashi
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hirotaka Yada
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
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Toya T, Nagatomo Y, Kagami K, Yukino M, Yasuda R, Namba T, Ido Y, Kobayashi S, Masaki N, Yada H, Kimura F, Adachi T. Computed tomography-measured pulmonary artery to aorta ratio and EUTOS score for detecting dasatinib-induced pulmonary arterial hypertension. Int J Cardiovasc Imaging 2019; 35:1435-1442. [DOI: 10.1007/s10554-019-01548-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/24/2019] [Indexed: 01/10/2023]
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28
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Yamada T, Adachi T, Ido Y, Masaki N, Toya T, Uchimuro T, Nishigawa K, Suda H, Osako M, Yamazaki M, Takanashi S, Shimizu H. Preserved Vasoconstriction and Relaxation of Saphenous Vein Grafts Obtained by a No-Touch Technique for Coronary Artery Bypass Grafting. Circ J 2018; 83:232-238. [PMID: 30393270 DOI: 10.1253/circj.cj-18-0714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND To obtain a saphenous vein graft (SVG) for coronary artery bypass grafting (CABG), the benefit of using a no-touch (NT) technique in vascular function has not been fully investigated. Methods and Results: The pathological and physiological functions of human SVGs with a NT technique to preserve the perivascular adipose tissue (PVAT) and ones obtained by using a conventional (CON) technique removing PVAT, were examined. Immunohistochemistry of the section of SVGs showed that the phosphorylation of endothelial nitric oxide synthase in the endothelium of the NT group was more responsive to vascular endothelial growth factor. A myograph of SVGs showed greater contraction with phenylephrine in the NT group. However, the strong contraction was eliminated in SVGs taken by electrocautery. In the 10 patients whose SVGs were taken without electrocautery, endothelial-dependent relaxation with bradykinin was apparently increased in the CON group more than in the NT group. Smooth muscle relaxation with nitroprusside was higher in the CON group at the lower concentrations; however, the relaxation became greater in the NT group at the high concentrations. Therefore, the effect of neutralizing PVAT-released factors in the both groups was further examined. After medium of NT and CON were exchanged in half, relaxation of SVGs was immediately restored in the NT group. CONCLUSIONS The results suggest that the NT technique preserves the functions of vasoconstriction and relaxation. Also, the presence of PVAT-released vasoconstrictive factors was suspected.
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Affiliation(s)
- Toshiyuki Yamada
- Department of Cardiovascular Surgery, Keio University Graduate School of Medicine.,Department of Cardiovascular Surgery, National Hospital Organization Tokyo Medical Center
| | - Takeshi Adachi
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
| | - Yasuo Ido
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
| | - Nobuyuki Masaki
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
| | - Takumi Toya
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
| | - Tomoya Uchimuro
- Department of Cardiovascular Surgery, Sakakibara Heart Institute
| | - Kosaku Nishigawa
- Department of Cardiovascular Surgery, Sakakibara Heart Institute
| | - Hisao Suda
- Department of Cardiovascular Surgery, Nagoya City University
| | - Motohiko Osako
- Department of Cardiovascular Surgery, National Hospital Organization Tokyo Medical Center
| | - Masataka Yamazaki
- Department of Cardiovascular Surgery, Keio University Graduate School of Medicine.,Department of Cardiovascular Surgery, Sakakibara Heart Institute
| | | | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University Graduate School of Medicine
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29
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Ito K, Yada H, Horii S, Osaki A, Sato A, Kimura T, Yasuda R, Toya T, Shiraishi Y, Nanba T, Nagatomo Y, Masaki N, Ido Y, Takase B, Adachi T. P2832SERCA2 C674S heterozygote knock-in mice with angiotensin II infusion leads to QT prolongation and lethal ventricular arrhythmia due to impaired sarcoplasmic reticulum Ca2+ handling. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Ito
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - H Yada
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - S Horii
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - A Osaki
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - A Sato
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - T Kimura
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - R Yasuda
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - T Toya
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - Y Shiraishi
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - T Nanba
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - Y Nagatomo
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - N Masaki
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - Y Ido
- National Defense Medical College, Cardiology, Tokorozawa, Japan
| | - B Takase
- National Defence Medical College, Intensive Care Medicine, Tokorozawa, Japan
| | - T Adachi
- National Defense Medical College, Cardiology, Tokorozawa, Japan
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30
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Masaki N, Iwadoh K, Kondo A, Koyama I, Nakajima I, Fuchinoue S. Causes of Ineligibility for Recipients in Living Kidney Transplantation. Transplant Proc 2018; 50:978-981. [PMID: 29731096 DOI: 10.1016/j.transproceed.2018.02.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/01/2018] [Accepted: 02/22/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Even if a living donor candidate exists, there are some cases that do not result in kidney transplantation (KTx) due to problems on the recipient side. The aim of this study was to clarify causes of ineligibility for KTx in these cases, so as to make RTx more applicable for patients. METHODS We targeted 470 patients with end-stage renal disease who applied for the primary kidney KTx from 2010 to 2012. Then we selected those who were not applicable for KTx and investigated recipient causes of ineligibility for KTx or not receiving KTx. RESULTS The average age of recipients was 47.6 ± 12.9 (7-82) years. A majority of the 470 patients were male (n = 305, 64.9%). Two hundred ninety-seven patients intended to receive a living donor KTx and the others hoped for a deceased donor KTx. Of the 297 patients, 207 (70.0%) underwent KTx and 9 (1.9%) were being prepared for KTx at the time of the survey. Eighty-three patients (27.9%) did not receive a living KTx, with 59 of these due to recipient-related problems and 30 due to donor-related problems. We further classified the reasons for these 59 recipients not undergoing KTx as follows: (1) unclear reasons (35.6%); (2) insufficient intention to receive transplant (13.6%); (3) heart disease (10.2%); (4) malignancy (8.5%); (5) immunologic risks (5.1%); (6) death during the waiting period (5.1%); (7) cerebrovascular events (5.1%); (8) cardiovascular problems (5.1%); (9) psychiatric disorders (3.4%); and (10) infections (3.4%). CONCLUSION Nearly 50% of the reasons for ineligibility as a recipient were related to their intention to receive KTx, with 94.9% of the nontransplanted cases due to nonimmunologic reasons. Thanks to the recent advances in immunosuppressive therapy, there were only 3 patients who could not undergo KTx due to immunologic risks. Based on these results, transplant surgeons should not only emphasize physical evaluation but should also pay careful attention to the recipient's intention to receive KTx.
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Affiliation(s)
- N Masaki
- Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan.
| | - K Iwadoh
- Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan
| | - A Kondo
- Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan
| | - I Koyama
- Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan
| | - I Nakajima
- Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan
| | - S Fuchinoue
- Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan
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31
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Horii S, Yada H, Ito K, Osaki A, Sato A, Kimura T, Yasuda R, Toya T, Namba T, Masaki N, Adachi T. A Rare Case of Rush Progression of Purulent Pericarditis by Escherichia coli in a Patient with Malignant Lymphoma. Int Heart J 2018; 59:655-659. [PMID: 29628470 DOI: 10.1536/ihj.17-238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purulent pericarditis is a rare disease in the antibiotic era. The common pathogens of purulent pericarditis are gram-positive species such as Staphylococcus aureus. Streptococcus pneumoniae, Salmonella, Haemophilus, fungal pathogens/tuberculosis can also result in purulent pericarditis. We report an old male case of purulent pericarditis by Escherichia coli. He came to our hospital suffering from leg edema for 3 months. Echocardiography revealed the large amount of pericardial effusion, and he was admitted to test the cause of pericardial effusion without high fever, tachycardia, and shock vital signs. On the third day, he suddenly presented vital shock. We performed emergency cardiopulmonary resuscitation and pericardiocentesis. Appearance of pericardial effusion was hemorrhagic and purulent. The gram stain revealed remarkable E. coli invasion to pericardial space. Antibiotic therapy was immediately started; however, he died on sixth day with septic shock. The cytological examination of pericardial effusion suggested the invasion of malignant lymphoma to pericardium. This case showed subacute or chronic process of pericarditis without severe clinical and laboratory sings before admission. Nevertheless, bacterial purulent pericarditis usually shows acute clinical manifestation; the first process of this case was very silent. Immunosuppression of malignant lymphoma might make E. coli translocation from gastrointestinal tract to pericardial space, and bacterial pericarditis was progressed to purulent pericarditis. In the latter process, this case showed unexpected rush progression to death by sepsis from purulent pericarditis. Immediate pericardiocentesis should be performed for a prompt diagnosis of purulent pericarditis, and it might have improved the outcome of this case.
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Affiliation(s)
- Shunpei Horii
- Department of Cardiology, National Defense Medical College
| | - Hirotaka Yada
- Department of Cardiology, National Defense Medical College
| | - Kei Ito
- Department of Cardiology, National Defense Medical College
| | - Ayumu Osaki
- Department of Cardiology, National Defense Medical College
| | - Atsushi Sato
- Department of Cardiology, National Defense Medical College
| | | | - Risako Yasuda
- Department of Cardiology, National Defense Medical College
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College
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Yamada T, Adachi T, Ido Y, Masaki N, Toya T, Suda H, Osako M, Uchimuro T, Nishigawa K, Yamazaki M, Takanashi S, Shimizu H. VASODILATORY EFFECT OF PERIVASCULAR FAT ON SAPHENOUS VEIN GRAFT FROM PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32589-0] [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: 11/25/2022]
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Masaki N, Iwadoh K, Kondo A, Koyama I, Nakajima I, Fuchinoue S. Influence of Long-term Dialysis on the Outcome of Kidney Transplantation: A Single-Center Study. Transplant Proc 2017; 49:959-962. [DOI: 10.1016/j.transproceed.2017.03.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Katahira S, Kawamoto S, Masaki N, Hayatsu Y, Matsunaga T, Haga Y, Saiki Y. Monitoring Esophageal Mucosal Blood Flow Changes after TEVAR Using a Novel Sensor: Experimental Studies in a Swine Model. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Katahira
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S. Kawamoto
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - N. Masaki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y. Hayatsu
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T. Matsunaga
- Tohoku University, Micro System Integration Center, Sendai, Japan
| | - Y. Haga
- Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Y. Saiki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Gatate Y, Masaki N, Sato A, Yasuda R, Namba T, Yada H, Kawamura A, Adachi T. Tranexamic Acid Controlled Chronic Disseminated Intravascular Coagulation Associated with Aortic Dissection and Patent False Lumen for Three Years. Intern Med 2017; 56:925-929. [PMID: 28420841 PMCID: PMC5465409 DOI: 10.2169/internalmedicine.56.7499] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The management of chronic disseminated intravascular coagulation (DIC) caused by aortic dissection has not yet been established. Even in cases where surgical correction is performed, therapeutic control of systemic hemorrhaging is still required. We herein report the successful treatment of a case of aortic dissection with a patent false lumen using tranexamic acid for acute exacerbation of chronic DIC. Oral administration of 1,500 mg tranexamic acid per day stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects. Heparin was administered periodically for the management of hemodialysis. This favorable result continued for up to 3 years.
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Affiliation(s)
- Yodo Gatate
- Department of Cardiology, National Defense Medical College, Japan
| | - Nobuyuki Masaki
- Department of Cardiology, National Defense Medical College, Japan
| | - Atsushi Sato
- Department of Cardiology, National Defense Medical College, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College, Japan
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College, Japan
| | - Hirotaka Yada
- Department of Cardiology, National Defense Medical College, Japan
| | - Akio Kawamura
- Department of Cardiology, National Defense Medical College, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Japan
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Namba T, Masaki N, Matsuo Y, Sato A, Kimura T, Horii S, Yasuda R, Yada H, Kawamura A, Takase B, Adachi T. Arterial Stiffness Is Significantly Associated With Left Ventricular Diastolic Dysfunction in Patients With Cardiovascular Disease. Int Heart J 2016; 57:729-735. [PMID: 27829641 DOI: 10.1536/ihj.16-112] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 11/18/2022]
Abstract
Left ventricular (LV) diastolic dysfunction is considered the main cause of heart failure with preserved ejection fraction (HFpEF). There have been few reports on the correlation between LV diastolic dysfunction and arterial stiffness in patients with clinical cardiovascular disease.This cross-sectional study enrolled 100 patients (67 men, 33 women; mean age, 70 years). All participants were diagnosed with cardiovascular disease. A total of 89 (89%) patients had coronary artery disease or HF. Patients with reduced EF and valvular disease were excluded. Arterial stiffness was assessed by the cardio-ankle vascular index (CAVI), and LV diastolic dysfunction was estimated using echocardiography. The patients were divided into two groups based on the median value of CAVI. In all patients the ratio of early diastolic transmitral flow velocity to early diastolic mitral annular velocity (E/e') was significantly higher in the high CAVI group than in the low CAVI group (15.5 ± 6.4 versus 12.5 ± 2.9, P = 0.003). In the HF subgroup, E/e' was also significantly higher in the high CAVI group than in the low CAVI group (17.2 ± 5.9 versus 13.0 ± 3.1, P = 0.026). In univariate regression analysis, CAVI was significantly associated with E/e' in all patients (β = 0.28, P = 0.004) and in HF patients (β = 0.4, P = 0.028). Also in multivariate analysis, CAVI remained as an independent predictive factor of E/e' (β = 0.252, P = 0.037).A high CAVI was independently associated with LV diastolic dysfunction in patients with clinical cardiovascular disease. These results suggested that arterial stiffness contributed to the development of LV diastolic dysfunction.
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Affiliation(s)
- Takayuki Namba
- Department of Cardiology, National Defense Medical College
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Namba T, Kimura T, Horii S, Yasuda R, Toya T, Yada H, Masaki N, Kawamura A, Hakuno D, Adachi T. Significance of Branched-Chain Amino Acids in Lean Patients With Heart Failure. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
In order to determine the value of sonography (US), in staging cancer of the mobile tongue, 57 patients were studied prospectively. Real-time sector scanners (5 and 7.5 MHz) were used with a submental approach. The findings by US were compared with those obtained by inspection and palpation and in 13 operated patients with the surgical results. US failed to visualize the tumor in 3 of the 57 patients (5%); in 30 patients (53%), the tumor was considered to be of nearly the same size by US and by palpation, but in 17 cases (30%), to be larger by US than by palpation, and in the remaining 7 cases (12%), to be smaller by US. Extension across the midline (8/8), and depth of tumor penetration, or extension to adjacent structures (5/5) were more correctly evaluated by US. We conclude that US is useful for staging work-up of tumors of the mobile tongue.
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Masaki N, Sato A, Horii S, Kimura T, Toya T, Yasuda R, Namba T, Yada H, Kawamura A, Adachi T. Usefulness of the d-ROMs test for prediction of cardiovascular events. Int J Cardiol 2016; 222:226-232. [PMID: 27497099 DOI: 10.1016/j.ijcard.2016.07.225] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/29/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND d-ROMs test developed to determine the degree of individual oxidative stress may predict cardiovascular events. METHODS AND RESULTS 265 patients (204 men, 61 women; age, 65±13years) who had been treated for cardiovascular disease were divided evenly by quartile of baseline d-ROMs levels, and were followed up. During the observation periods of 2.66±1.47years, there were 14 (5%) deaths, 8 (3%) cardiovascular deaths, 13 (5%) major adverse cardiovascular events (MACEs), and 51 (19%) all cardiovascular events including heart failure, cardiovascular surgery, and revascularization. Log-rank tests demonstrated that the patients in the 4th quartile (d-ROMs≧395.00U.CARR) had a higher incidence rate of cardiovascular death than those in the 2nd quartile (d-ROMs 286.00-335.00, p=0.022). In multivariate Cox regression analysis, even after adjustment for age, sex, coronary risk factors, C-reactive protein, and renal function, high d-ROMs was a risk factor for all-cause death [adjusted HR of 4th vs. 1st quartile, 10.791 (95% confidence interval 1.032-112.805), p=0.047], and all cardiovascular events [HR of 4th vs. 1st quartile, 2.651 (95% confidence interval 1.138-6.177), p=0.024]. CONCLUSIONS Our results suggest that d-ROMs is a useful oxidative stress marker to assess prognosis and risk of further cardiovascular events.
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Affiliation(s)
- Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa, Japan.
| | - Atsushi Sato
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Syumpei Horii
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Toyokazu Kimura
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Takumi Toya
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Risako Yasuda
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Takayuki Namba
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Hirotaka Yada
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Akio Kawamura
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Takeshi Adachi
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
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Miyawaki S, Imai H, Hayasaka T, Masaki N, Ono H, Ochi T, Ito A, Nakatomi H, Setou M, Saito N. Imaging mass spectrometry detects dynamic changes of phosphatidylcholine in rat hippocampal CA1 after transient global ischemia. Neuroscience 2016; 322:66-77. [DOI: 10.1016/j.neuroscience.2016.02.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 11/16/2022]
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Bretón-Romero R, Feng B, Holbrook M, Farb MG, Fetterman JL, Linder EA, Berk BD, Masaki N, Weisbrod RM, Inagaki E, Gokce N, Fuster JJ, Walsh K, Hamburg NM. Endothelial Dysfunction in Human Diabetes Is Mediated by Wnt5a-JNK Signaling. Arterioscler Thromb Vasc Biol 2016; 36:561-9. [PMID: 26800561 DOI: 10.1161/atvbaha.115.306578] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [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: 09/14/2015] [Accepted: 01/08/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Endothelial dysfunction is linked to insulin resistance, inflammatory activation, and increased cardiovascular risk in diabetes mellitus; however, the mechanisms remain incompletely understood. Recent studies have identified proinflammatory signaling of wingless-type family member (Wnt) 5a through c-jun N-terminal kinase (JNK) as a regulator of metabolic dysfunction with potential relevance to vascular function. We sought to gain evidence that increased activation of Wnt5a-JNK signaling contributes to impaired endothelial function in patients with diabetes mellitus. APPROACH AND RESULTS We measured flow-mediated dilation of the brachial artery and characterized freshly isolated endothelial cells by protein expression, eNOS activation, and nitric oxide production in 85 subjects with type 2 diabetes mellitus (n=42) and age- and sex-matched nondiabetic controls (n=43) and in human aortic endothelial cells treated with Wnt5a. Endothelial cells from patients with diabetes mellitus displayed 1.3-fold higher Wnt5a levels (P=0.01) along with 1.4-fold higher JNK activation (P<0.01) without a difference in total JNK levels. Higher JNK activation was associated with lower flow-mediated dilation, consistent with endothelial dysfunction (r=0.53, P=0.02). Inhibition of Wnt5a and JNK signaling restored insulin and A23187-mediated eNOS activation and improved nitric oxide production in endothelial cells from patients with diabetes mellitus. In endothelial cells from nondiabetic controls, rWnt5a treatment inhibited eNOS activation replicating the diabetic endothelial phenotype. In human aortic endothelial cells, Wnt5a-induced impairment of eNOS activation and nitric oxide production was reversed by Wnt5a and JNK inhibition. CONCLUSIONS Our findings demonstrate that noncanonical Wnt5a signaling and JNK activity contribute to vascular insulin resistance and endothelial dysfunction and may represent a novel therapeutic opportunity to protect the vasculature in patients with diabetes mellitus.
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Affiliation(s)
- Rosa Bretón-Romero
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Bihua Feng
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Monika Holbrook
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Melissa G Farb
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Jessica L Fetterman
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Erika A Linder
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Brittany D Berk
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Nobuyuki Masaki
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Robert M Weisbrod
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Elica Inagaki
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Noyan Gokce
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Jose J Fuster
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Kenneth Walsh
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA
| | - Naomi M Hamburg
- From the Whitaker Cardiovascular Institute, Department of Medicine, Boston University School of Medicine, MA.
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Shiraishi Y, Kujiraoka T, Hakuno D, Masaki N, Tokuno S, Adachi T. Elevation of Derivatives of Reactive Oxygen Metabolites Elevated in Young "Disaster Responders" in Hypertension due to Great East Japan Earthquake. Int Heart J 2016; 57:61-6. [PMID: 26742880 DOI: 10.1536/ihj.15-303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There have been very few studies on serum biomarkers associated with hypertension in disaster situations. We assessed biomarkers associated with disaster-related hypertension (DRH) due to the Great East Japan Earthquake of March 2011.We collected blood samples from members of the Japan Self Defense Forces (JSDF) (n = 77) after completing disaster relief operations. We divided them into two groups based on systolic blood pressure. We defined DRH as either systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg at the time of completing missions.In subjects with DRH, the mean blood pressure was 143.5 ± 5.0/99.5 ± 2.4 mmHg. Height and body weight measurements were slightly greater in the DRH group but the differences were not significant, and age was significantly higher in the DRH group. There were no differences in serum biochemical tests including metabolic markers, sulfur-containing amino acids, and cytokines. Among nitric oxide-related amino acids, asymmetric dimethylarginine (ADMA) was lower in the DRH group than in the normotension group (0.40 ± 0.02 versus 0.31 ± 0.02 μmol/L P = 0.04). The serum oxidative stress metabolite levels (d-ROMs; indicators of active oxygen metabolite products) were significantly higher in the DRH group (273.6 ± 6.08 versus 313.5 ± 13.7 U.CARR P = 0.016). Using multivariable regression analysis, d-ROMs levels were particularly predictive for DRH.Oxidative stress is associated with DRH in responders to the disaster of the Great East Japan Earthquake.
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Affiliation(s)
- Yasunaga Shiraishi
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
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Abstract
Eosinophilic myocarditis may be accompanied by Churg-Strauss syndrome (CSS). We report a case of CSS that was accompanied by myocardial changes in the early stage. A 71-year-old woman complained of mild chest pain at rest, but routine echocardiography did not reveal any endocardial abnormalities. Four months later, the patient was hospitalized due to congestive heart failure with neuropathy of both upper extremities. A diagnosis of eosinophilic myocarditis was made based on the patient's laboratory results and the presence of mural thrombus. This case illustrates that, although early eosinophilic myocarditis is an important differential diagnosis in patients with chest pain, it may be difficult to identify in without an apparent mural thrombus.
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Affiliation(s)
- Nobuyuki Masaki
- Department of Cardiovascular Medicine, National Defense Medical College, Japan
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Hakuno D, Isobe S, Masaki N, Adachi T. Right Ventricular Wall Dissection With Ventricular Septal Rupture Following Myocardial Infarction Visualized on 3-Dimensional Transthoracic Echocardiography. Circ J 2015; 79:2072-4. [PMID: 26041718 DOI: 10.1253/circj.cj-14-1246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Daihiko Hakuno
- Division of Cardiology, Department of First Internal Medicine, National Defense Medical College
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Mishima S, Nozaki Y, Mikami S, Kihira E, Iikura M, Koketsu R, Sugiyama H, Masuda T, Kaname H, Egami Y, Nakayama T, Hasuo K, Nakamura H, Igari T, Watanabe K, Nagata N, Sakurai T, Yokoi C, Kobayakawa M, Kojima Y, Akiyama J, Imamura M, Masaki N, Yanase M. Diffuse Liver Metastasis of Small-Cell Lung Cancer Presenting as Acute Liver Failure and Diagnosed by Transjugular Liver Biopsy: A Rare Case in Whom Nodular Lesions Were Detected by Enhanced CT Examination. Case Rep Gastroenterol 2015; 9:81-7. [PMID: 25969674 PMCID: PMC4427142 DOI: 10.1159/000381140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Small-cell lung cancer (SCLC) is a subgroup of lung cancer with a high frequency of liver metastasis, which is a predictor of poor prognosis. Diffuse liver metastases of SCLC with no visible nodular lesions in the liver when examined using computed tomography (CT) are relatively rare; however, a few cases with rapid progression to acute liver failure that were diagnosed after death have been reported. In this paper, we report a 63-year-old man with diffuse liver metastases of SCLC that were histologically diagnosed using a transjugular liver biopsy while the patient was alive, even though no lesions were visible during a contrast-enhanced CT examination.
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Affiliation(s)
- S Mishima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Nozaki
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Mikami
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - E Kihira
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - R Koketsu
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Masuda
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Kaname
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Egami
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Nakayama
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - K Hasuo
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Nakamura
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Igari
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - K Watanabe
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Nagata
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Sakurai
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - C Yokoi
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Kobayakawa
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - J Akiyama
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Imamura
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Masaki
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Yanase
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
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Namba T, Masaki N, Yada H, Hakuno D, Miyazaki K, Adachi T. Arterial Stiffness is Significantly Associated with Left Ventricular Diastolic Dysfunction in Patients with Clinical Cardiovascular Disease. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.403] [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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Masaki N, Hakuno D, Toya T, Shiraishi Y, Kujiraoka T, Namba T, Yada H, Kimura K, Miyazaki K, Adachi T. Association between brachial-ankle pulse wave velocity and the ratio of l-arginine to asymmetric dimethylarginine in patients undergoing coronary angiography. J Cardiol 2014; 65:311-7. [PMID: 25043133 DOI: 10.1016/j.jjcc.2014.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/27/2014] [Accepted: 06/06/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Endothelial dysfunction causes vasomotor dysregulation and vascular stiffening in addition to structural changes. By influencing NO synthesis, deficiency of l-arginine relative to asymmetric dimethylarginine (ADMA), which is an l-arginine derivative that acts as a competitive NO synthase inhibitor, may lead to the promotion of arterial stiffness. This study investigated the relationship between the l-arginine/ADMA ratio and brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness. METHODS AND RESULTS This cross-sectional study enrolled 74 patients (62 men, 12 women; mean age, 67±10 years) undergoing elective coronary angiography. A total of 54 (73%) patients had coronary artery disease. Serum l-arginine and ADMA were measured by high-performance liquid chromatography with fluorescence detection. The ratio of l-arginine to ADMA and the serum l-arginine level was associated with baPWV in univariate regression analysis (l-arginine/ADMA ratio: β=-0.323, p=0.005; l-arginine: β=-0.247, p=0.034). In addition, baPWV was related to blood hemoglobin concentration, hematocrit, brain natriuretic peptide level, symmetric dimethylarginine, renal function, blood pressure, and heart rate. In multivariate analysis, the l-arginine/ADMA ratio was a significant predictor of baPWV (β=-0.310, p<0.001). In subgroup analyses, the l-arginine/ADMA ratio was associated with baPWV in elderly patients (n=46, β=-0.359, p=0.004), and in younger patients (n=28, β=-0.412, p=0.006). CONCLUSION A low l-arginine/ADMA ratio may be associated with high baPWV in patients undergoing coronary angiography.
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Affiliation(s)
- Nobuyuki Masaki
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
| | - Daihiko Hakuno
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Takumi Toya
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yasunaga Shiraishi
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Takehiko Kujiraoka
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Takayuki Namba
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Hirotaka Yada
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kazuo Kimura
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Koji Miyazaki
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Takeshi Adachi
- Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan
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Arima H, Hanada M, Hayasaka T, Masaki N, Omura T, Xu D, Hasegawa T, Togawa D, Yamato Y, Kobayashi S, Yasuda T, Matsuyama Y, Setou M. Blockade of IL-6 signaling by MR16-1 inhibits reduction of docosahexaenoic acid-containing phosphatidylcholine levels in a mouse model of spinal cord injury. Neuroscience 2014; 269:1-10. [DOI: 10.1016/j.neuroscience.2014.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/08/2014] [Accepted: 03/09/2014] [Indexed: 12/18/2022]
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Masaki N, Shiraishi Y, Nakaya Y, Kujiraoka T, Yada H, Hakuno D, Isoda K, Kimura K, Miyazaki K, Adachi T. Abstract 420: The Ratio of L-arginine to Asymmetric Dimethylarginine is Associated With Brachial-ankle Pulse Wave Velocity in Patients Undergoing Coronary Angiography. Arterioscler Thromb Vasc Biol 2013. [DOI: 10.1161/atvb.33.suppl_1.a420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Endothelial dysfunction decrease vasomotor function and cause vascular stiffening in addition to the structural changes. Relative L-arginine deficiency to ADMA influencing NO synthesis may increase arterial stiffness in elderly individuals. We investigated the relationship between the L-arginine / ADMA ratio and brachial ankle pulse wave velocity (baPWV) of the patients with suspected or already known coronary artery disease (CAD).
Methods and Results
The cross-sectional study enrolled 74 patients (67 ± 10 y/o) undergoing coronary angiography. There were 54 (73%) patients with CAD including 3 of coronary bypass surgery, and 11 of old myocardial infarction. Exclusion criteria were ankle brachial index (ABI) less than 0.9 in both lower extremities and hemodialysis. baPWV and ABI were obtained using an automatic waveform analyzer. Serum L-arginine, ADMA were measured by high-performance liquid chromatography. The ratio of L-arginine to ADMA was associated with baPWV (γ= -0.323, p=0.005) (Figure). Although the value of baPWV was dependent on systolic blood pressure and heart rate at measurement as reported previously, the ratio was a significant predictor of baPWV in multivariate analysis (β= -0.448, p<0.001). Additionally, serum L-arginine, and L-arginine / ADMA ratio were also independent contributing factors to baPWV in the subgroup of 46 elderly patients (>64 y/o).
Conclusion
We observed that many ageing patients with cardiovascular disease had low L-arginine / ADMA ratio accompanied with high baPWV. The findings suggested that correction of serum L-arginine level can be a therapeutic option to recover arterial compliance for the population.
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Affiliation(s)
| | | | - Yuko Nakaya
- Cardiology, National Defense Med College, Tokorozawa, Japan
| | | | - Hirotaka Yada
- Cardiology, National Defense Med College, Tokorozawa, Japan
| | - Daihiko Hakuno
- Cardiology, National Defense Med College, Tokorozawa, Japan
| | - Kikuo Isoda
- Cardiology, National Defense Med College, Tokorozawa, Japan
| | - Kazuo Kimura
- Cardiology, National Defense Med College, Tokorozawa, Japan
| | - Koji Miyazaki
- Cardiology, National Defense Med College, Tokorozawa, Japan
| | - Takeshi Adachi
- Cardiology, National Defense Med College, Tokorozawa, Japan
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50
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Karino Y, Toyota J, Kumada H, Katano Y, Izumi N, Kobashi H, Sata M, Moriyama M, Imazeki F, Kage M, Ishikawa H, Masaki N, Seriu T, Omata M. Erratum to: Efficacy and resistance of entecavir following 3 years of treatment of Japanese patients with lamivudine-refractory chronic hepatitis B. Hepatol Int 2010. [DOI: 10.1007/s12072-010-9224-0] [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: 11/28/2022]
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