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Goriki Y, Yoshioka G, Natsuaki M, Shinzato K, Nishihira K, Kuriyama N, Shimomura M, Inoue Y, Nishikido T, Kaneko T, Yokoi K, Yajima A, Sakamoto Y, Tago M, Kawaguchi A, Yamamoto F, Tanaka A, Yamaguchi T, Shiraki A, Asaka M, Kotooka N, Sonoda S, Hikichi Y, Shibata Y, Node K. Simple risk-score model for in-hospital major bleeding based on multiple blood variables in patients with acute myocardial infarction. Int J Cardiol 2022; 346:1-7. [PMID: 34801614 DOI: 10.1016/j.ijcard.2021.11.046] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/30/2021] [Accepted: 11/16/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND In-hospital bleeding is associated with poor prognosis in patients with acute myocardial infarction (AMI). We sought to investigate whether a combination of pre-procedural blood tests could predict the incidence of in-hospital major bleeding in patients with AMI. METHODS AND RESULTS A total of 1684 consecutive AMI patients who underwent primary percutaneous coronary intervention (PCI) were recruited and randomly divided into derivation (n = 1010) and validation (n = 674) cohorts. A risk-score model was created based on a combination of parameters assessed on routine blood tests on admission. In the derivation cohort, multivariate analysis revealed that the following 5 variables were significantly associated with in-hospital major bleeding: hemoglobin level < 12 g/dL (odds ratio [OR], 3.32), white blood cell count >10,000/μL (OR, 2.58), platelet count <150,000/μL (OR, 2.51), albumin level < 3.8 mg/dL (OR, 2.51), and estimated glomerular filtration rate < 60 mL/min/1.73 m2 (OR, 2.31). Zero to five points were given according to the number of these factors each patient had. Incremental risk scores were significantly associated with a higher incidence of in-hospital major bleeding in both cohorts (P < 0.001). Receiver operating characteristic curve analysis of risk models showed adequate discrimination between patients with and without in-hospital major bleeding (derivation cohort: area under the curve [AUC], 0.807; 95% confidence interval [CI], 0.759-0.848; validation cohort: AUC, 0.793; 95% CI, 0.725-0.847). CONCLUSIONS Our novel laboratory-based bleeding risk model could be useful for simple and objective prediction of in-hospital major bleeding events in patients with AMI.
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Affiliation(s)
- Yuhei Goriki
- Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Saga, Japan; Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Goro Yoshioka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Masahiro Natsuaki
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| | - Kodai Shinzato
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Kensaku Nishihira
- Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan
| | - Nehiro Kuriyama
- Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan
| | - Mitsuhiro Shimomura
- Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Saga, Japan
| | - Yohei Inoue
- Cardiovascular Center, Saga Medical Center, Koseikan, Saga, Japan
| | | | - Tetsuya Kaneko
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Kensuke Yokoi
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Ayumu Yajima
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yoshiko Sakamoto
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Motoko Tago
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Atsushi Kawaguchi
- Center for Comprehensive Community Medicine, Saga University, Saga, Japan
| | - Fumi Yamamoto
- Department of Cardiology, Karatsu Red-cross Hospital, Saga, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | | | - Aya Shiraki
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Machiko Asaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Shinjo Sonoda
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yutaka Hikichi
- Cardiovascular Center, Saga Medical Center, Koseikan, Saga, Japan
| | - Yoshisato Shibata
- Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
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2
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Affiliation(s)
- Kohei Kaneta
- Department of Cardiovascular Medicine, Saga University
| | - Kensuke Yokoi
- Department of Cardiovascular Medicine, Saga University
| | - Kota Jojima
- Department of Cardiovascular Medicine, Saga University
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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3
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Asaka M, Kotooka N, Yajima A, Node K. Advance care planning from the penultimate hospitalization in patients with end-stage heart failure: a single-center, 10-year experience. Heart Vessels 2021; 36:1290-1297. [PMID: 33677617 DOI: 10.1007/s00380-021-01807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
Advance care planning (ACP) is a key element of palliative care even in patients with heart failure (HF); however, the complexity of the clinical trajectory hampers its early introduction. We retrospectively evaluated the state of implementation and the quality of ACP from the penultimate hospitalization in patients with HF who died after repeated hospitalizations. Of the 1117 patients admitted to Saga University Hospital from 2007 to 2016, we excluded 934 patients who survived after discharge or changed hospital, 78 patients who died for a reason other than HF, 42 patients who died during their first HF hospitalization, and 23 patients who died during hospitalization in another hospital. The electronic medical records of the remaining 40 patients were evaluated by three trained physicians on the recently provided 12 recommended elements of ACP, using a 5-point Likert scale (1 = very poor to 5 = excellent). The mean ratings of the 12 ACP elements ranged from 1.0 to 1.9. A do not attempt resuscitation (DNAR) order was issued to 10 patients (25%) just before they died. Of the remaining 30 patients not issued a DNAR order, cardiopulmonary resuscitation was attempted for 23 (76.7%) patients. Among patients with HF who eventually died after repeated hospitalizations, ACP even after the penultimate hospitalization was not evaluated highly. It resulted in a DNAR order in the last few days, a CPR as if their death was sudden and unexpected at the final moment, or CPAOA.
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Affiliation(s)
- Machiko Asaka
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan.
| | - Ayumu Yajima
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan
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4
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Kamiya K, Sato Y, Takahashi T, Tsuchihashi-Makaya M, Kotooka N, Ikegame T, Takura T, Yamamoto T, Nagayama M, Goto Y, Makita S, Isobe M. Multidisciplinary Cardiac Rehabilitation and Long-Term Prognosis in Patients With Heart Failure. Circ Heart Fail 2020; 13:e006798. [DOI: 10.1161/circheartfailure.119.006798] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background:
Exercise-based cardiac rehabilitation (CR) improves health-related quality of life and exercise capacity in patients with heart failure (HF). However, CR efficacy in patients with HF who are elderly, frail, or have HF with preserved ejection fraction remains unclear. We examined whether participation in multidisciplinary outpatient CR is associated with long-term survival and rehospitalization in patients with HF, with subgroup analysis by age, sex, comorbidities, frailty, and HF with preserved ejection fraction.
Methods:
This multicenter retrospective cohort study was performed in patients hospitalized for acute HF at 15 hospitals in Japan, 2007 to 2016. The primary outcome (composite of all-cause mortality and HF rehospitalization after discharge) and secondary outcomes (all-cause mortality and HF rehospitalization) were analyzed in outpatient CR program participants versus nonparticipants.
Results:
Of the 3277 patients, 26% (862) participated in outpatient CR. After propensity matching for potential confounders, 1592 patients were included (n=796 pairs), of which 511 had composite outcomes (223 [14%] all-cause deaths and 392 [25%] HF rehospitalizations, median 2.4-year follow-up). Hazard ratios associated with CR participation were 0.77 (95% CI, 0.65–0.92) for composite outcome, 0.67 (95% CI, 0.51–0.87) for all-cause mortality, and 0.82 (95% CI, 0.67–0.99) for HF-related rehospitalization. CR participation was also associated with numerically lower rates of composite outcome in patients with HF with preserved ejection fraction or frail patients.
Conclusions:
Outpatient CR participation was associated with substantial prognostic benefit in a large HF cohort regardless of age, sex, comorbidities, frailty, and HF with preserved ejection fraction.
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Affiliation(s)
- Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences (K.K.), Kitasato University, Kanagawa, Japan
| | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Japan (Y.S.)
| | - Tetsuya Takahashi
- Department of Physical Therapy, Juntendo University, Tokyo, Japan (T. Takahashi)
| | | | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Japan (N.K.)
| | - Toshimi Ikegame
- Department of Nursing (T.I.), Sakakibara Heart Institute, Tokyo, Japan
| | - Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Japan (T. Takura)
| | - Takanobu Yamamoto
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Japan (T.Y.)
| | - Masatoshi Nagayama
- Department of Cardiovascular Medicine (M.N.), Sakakibara Heart Institute, Tokyo, Japan
| | - Yoichi Goto
- Yoka Municipal Hospital, Hyogo, Japan (Y.G.)
| | - Shigeru Makita
- Department of Cardiac Rehabilitation, Saitama Medical University International Medical Center, Japan (S.M.)
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5
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Nagatomo D, Kotooka N, Yoshioka G, Node K. Strategy for estimating optimal heart rate in refractory heart failure with relative sinus bradycardia: A case report. J Cardiol Cases 2019; 21:153-156. [PMID: 32256865 DOI: 10.1016/j.jccase.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/03/2019] [Revised: 11/22/2019] [Accepted: 11/29/2019] [Indexed: 11/16/2022] Open
Abstract
Relative bradycardia (mild sinus bradycardia) is one of the major barriers for the effective treatment of hemodynamically unstable patients with heart failure and reduced cardiac output. We report a case of a man aged 58 years with an old broad anterior myocardial infarction and relative bradycardia (about 60 bpm) suffering from symptoms of congestive heart failure at rest in spite of optimal medical therapy, including the use of the inotropes. Transvenous atrial pacing during right heart catheterization indicated that an increase in heart rate (up to 80 bpm) improved hemodynamics immediately. Implantation of a pacemaker (atrial pacing of 80 bpm) was effective for stabilizing the heart failure symptoms. Transvenous atrial pacing during right heart catheterization is effective for estimating the optimal heart rate in patients with heart failure and relative bradycardia. <Learning objective: Temporary atrial pacing during right heart catheterization is effective for estimating the optimal heart rate in patients with refractory heart failure and relative bradycardia. We present a case of inotrope-dependent heart failure. Our findings, obtained through echocardiography and right heart catheterization, showed dramatic improvements in hemodynamic parameters following an increase in heart rate via a cardiac pacemaker. This case assesses the impact of optimal heart rate in severe heart failure with relative bradycardia.>.
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Affiliation(s)
- Daisuke Nagatomo
- Department of Cardiovascular Medicine, Saga University Hospital, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University Hospital, Saga, Japan
| | - Goro Yoshioka
- Department of Cardiovascular Medicine, Saga University Hospital, Saga, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University Hospital, Saga, Japan
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6
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Sawami K, Natsuaki M, Hongo H, Kajiwara M, Kaneko T, Inoue Y, Komatsu A, Kotooka N, Hikichi Y, Node K. Spontaneous Internal Mammary Artery Graft Dissection Triggered by Emotional Stress. JACC Case Rep 2019; 1:732-736. [PMID: 34316921 PMCID: PMC8288662 DOI: 10.1016/j.jaccas.2019.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 10/31/2022]
Abstract
Internal mammary artery graft dissection is a rare condition and is usually caused by iatrogenic complications or mechanical stress. We experienced a case of acute myocardial infarction due to spontaneous internal mammary artery graft dissection that was triggered by emotional stress and was successfully treated by percutaneous intervention using drug-eluting stents. (Level of Difficulty: Beginner.).
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Affiliation(s)
- Kosuke Sawami
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | | | - Hiroshi Hongo
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | | | - Tetsuya Kaneko
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yohei Inoue
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Aiko Komatsu
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yutaka Hikichi
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
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7
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Kamiya K, Yamamoto T, Tsuchihashi-Makaya M, Ikegame T, Takahashi T, Sato Y, Kotooka N, Saito Y, Tsutsui H, Miyata H, Isobe M. Nationwide Survey of Multidisciplinary Care and Cardiac Rehabilitation for Patients With Heart Failure in Japan ― An Analysis of the AMED-CHF Study ―. Circ J 2019; 83:1546-1552. [DOI: 10.1253/circj.cj-19-0241] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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)
- Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
| | - Takanobu Yamamoto
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | | | | | | | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | | | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University
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8
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Yamashita S, Tago M, Katsuki NE, Ajimi T, Nagatomo D, Kotooka N, Node K, Yamashita SI. Acute Mitral Regurgitation of Unknown Etiology Associated with Disseminated Intravascular Coagulation Eventually Diagnosed as Enterococcus Faecalis Infective Endocarditis by Mitral Valve Surgery. Am J Case Rep 2018; 19:1467-1473. [PMID: 30531674 PMCID: PMC6298248 DOI: 10.12659/ajcr.912097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Patient: Female, 70 Final Diagnosis: Infective endocarditis Symptoms: Dyspnea Medication: — Clinical Procedure: — Specialty: Cradiology
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Affiliation(s)
- Shun Yamashita
- Department of General Medicine, Saga University Hospital, Saga City, Saga, Japan
| | - Masaki Tago
- Department of General Medicine, Saga University Hospital, Saga City, Saga, Japan
| | - Naoko E Katsuki
- Department of General Medicine, Saga University Hospital, Saga City, Saga, Japan
| | - Tsuneki Ajimi
- Department of Cardiovascular Medicine, Saga University, Saga City, Saga, Japan
| | - Daisuke Nagatomo
- Department of Cardiovascular Medicine, Saga University, Saga City, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Saga City, Saga, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga City, Saga, Japan
| | - Shu-Ichi Yamashita
- Department of General Medicine, Saga University Hospital, Saga City, Saga, Japan
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9
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Kurozumi Y, Oishi S, Sugano Y, Sakashita A, Kotooka N, Suzuki M, Higo T, Yumino D, Takada Y, Maeda S, Yamabe S, Washida K, Takahashi T, Ohtani T, Sakata Y, Sato Y. Possible associations between palliative care conferences and positive outcomes when performing palliative care for patients with end-stage heart failure: a nationwide cross-sectional questionnaire survey. Heart Vessels 2018; 34:452-461. [PMID: 30238352 DOI: 10.1007/s00380-018-1261-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/14/2018] [Indexed: 01/06/2023]
Abstract
Palliative care for end-stage heart failure should be provided by a multidisciplinary team. However, the influence of each occupational category on patients receiving palliative care for end-stage heart failure remains unclear. Thus, this study investigated the relationships between palliative care conferences and positive outcomes of palliative care for end-stage heart failure patients. We sent questionnaires to all cardiology training hospitals authorized by the Japanese Circulation Society (n = 1004); of these, responses from the directors at 554 institutions were analyzed. We divided the responding institutions into two groups according to their implementation of palliative care conferences for patients with end-stage heart failure. The institutions that had held such conferences (n = 223) had a larger number of hospital beds, beds in the cardiovascular department, and patients admitted to the cardiovascular department, compared with institutions that had not held these conferences (n = 321). The usage rates of opioids, non-steroidal anti-inflammatory drugs, and sedatives were significantly higher in institutions that held these conferences. Multivariate analysis revealed that nutritionists and medical social workers had greater involvement in the improvement of mental symptoms and ensuring that patients could stay where they wished, respectively. The presence of palliative care physicians, physical therapists, or pharmacists was associated with multiple positive outcomes. This study indicated that there are possible associations between palliative care conferences and positive outcomes when performing palliative care for patients with end-stage heart failure.
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Affiliation(s)
- Yuma Kurozumi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, 660-8550, Hyogo, Japan.
| | - Shogo Oishi
- Department of Cardiology, Himeji Cardiovascular Center, Himeji, Japan
| | - Yasuo Sugano
- Department of Cardiology, Keiyu Hospital, Yokohama, Japan.,Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akihiro Sakashita
- Department of Palliative Medicine, Kobe University School of Medicine, Kobe, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Makoto Suzuki
- Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Yasuko Takada
- Department of Nursing, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Seiko Maeda
- Department of Nursing, Nagoya Heart Center, Nagoya, Japan
| | - Saori Yamabe
- Department of Nursing, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Koichi Washida
- Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, 660-8550, Hyogo, Japan
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Kotooka N, Kitakaze M, Nagashima K, Asaka M, Kinugasa Y, Nochioka K, Mizuno A, Nagatomo D, Mine D, Yamada Y, Kuratomi A, Okada N, Fujimatsu D, Kuwahata S, Toyoda S, Hirotani SI, Komori T, Eguchi K, Kario K, Inomata T, Sugi K, Yamamoto K, Tsutsui H, Masuyama T, Shimokawa H, Momomura SI, Seino Y, Sato Y, Inoue T, Node K. The first multicenter, randomized, controlled trial of home telemonitoring for Japanese patients with heart failure: home telemonitoring study for patients with heart failure (HOMES-HF). Heart Vessels 2018; 33:866-876. [DOI: 10.1007/s00380-018-1133-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/02/2018] [Indexed: 12/19/2022]
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Kurozumi Y, Oishi S, Sugano Y, Sakashita A, Kotooka N, Suzuki M, Higo T, Yumino D, Takada Y, Maeda S, Yamabe S, Washida K, Takahashi T, Ohtani T, Sakata Y, Sato Y. Design of a nationwide survey on palliative care for end-stage heart failure in Japan. J Cardiol 2018; 71:202-211. [PMID: 28844399 DOI: 10.1016/j.jjcc.2017.06.009] [Citation(s) in RCA: 3] [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: 04/21/2017] [Revised: 06/21/2017] [Accepted: 06/27/2017] [Indexed: 01/19/2023]
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Kuragaichi T, Kurozumi Y, Ohishi S, Sugano Y, Sakashita A, Kotooka N, Suzuki M, Higo T, Yumino D, Takada Y, Maeda S, Yamabe S, Washida K, Takahashi T, Ohtani T, Sakata Y, Sato Y. Nationwide Survey of Palliative Care for Patients With Heart Failure in Japan. Circ J 2018. [DOI: 10.1253/circj.cj-17-1305] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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)
- Takashi Kuragaichi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Yuma Kurozumi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Shogo Ohishi
- Department of Cardiology, Himeji Cardiovascular Center
| | - Yasuo Sugano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akihiro Sakashita
- Department of Palliative Medicine, Kobe University Graduate School of Medicine
| | | | - Makoto Suzuki
- Department of Cardiology, Yokohama Minami Kyosai Hospital
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | | | - Yasuko Takada
- Department of Nursing, National Cerebral and Cardiovascular Center
| | - Seiko Maeda
- Department of Nursing, Toyohashi Heart Center
| | - Saori Yamabe
- Department of Nursing, Mitsubishi Kyoto Hospital
| | | | | | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
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Asaka M, Kotooka N, Kamura A, Kanaida M, Morooka T, Node K. Home Medical Care Support for Patients With Left Ventricular Assist Device Using Social Networking Service. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.368] [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: 11/16/2022]
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Sakuma M, Tanaka A, Kotooka N, Hikichi Y, Toyoda S, Abe S, Taguchi I, Node K, Simon DI, Inoue T. Myeloid-related protein-8/14 in acute coronary syndrome. Int J Cardiol 2017; 249:25-31. [PMID: 28986057 DOI: 10.1016/j.ijcard.2017.09.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/09/2017] [Accepted: 09/07/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The alarmin family member myeloid-related protein (MRP)-14 (S100A9), which has been identified by platelet transcriptional profiling as an acute myocardial infarction gene, regulates vascular inflammation and thrombosis. Elevated plasma levels of MRP-8/14 (S100A8/A9) heterodimer predict first and recurrent cardiovascular events. The aim of this study was to elucidate pathophysiological roles of MRP-8/14 in acute coronary syndrome (ACS). METHODS AND RESULTS In 38 consecutive ACS patients, the MRP-8/14 level in coronary artery blood obtained at thrombus aspiration was higher in 23 patients, in whom aspirated thrombus was confirmed, compared to the 15 patients, in whom it was absent [4.86 (1.95, 8.29) vs 2.94 (1.31, 4.44), P=0.017]. The MRP-8/14 level was correlated with myeloperoxidase (MPO) level (R2=0.52), but not with soluble P-selectin level (R2=0.0002) in the coronary artery blood. Immunohistochemistry of the aspirated thrombus exhibited that expression of MRP8/14 was co-localized with leukocytes positive for activated Mac-1. Finally, in cultured human umbilical vein endothelial cells, MRP-8/14 increased tissue factor expression. CONCLUSIONS Our findings indicate that MRP-8/14 concentration increases in coronary artery blood in association with thrombus formation in ACS, co-localizes with leukocytes, and is associated with leukocyte activation. MRP-8/14 is positioned as a unique biomarker at the interface of inflammation and thrombosis in ACS.
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Affiliation(s)
- Masashi Sakuma
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Faculty of Medicine, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Faculty of Medicine, Saga, Japan
| | - Yutaka Hikichi
- Department of Cardiovascular Medicine, Saga University, Faculty of Medicine, Saga, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Shichiro Abe
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Isao Taguchi
- Department of Cardiology, Koshigaya Hospital, Dokkyo Medical University School of Medicine, Koshigaya, Saitama, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Faculty of Medicine, Saga, Japan
| | - Daniel I Simon
- Division of Cardiovascular Medicine, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
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Tanaka A, Yoshida H, Kawaguchi A, Oyama JI, Kotooka N, Toyoda S, Inoue T, Natsuaki M, Node K. N-terminal pro-brain natriuretic peptide and associated factors in the general working population: a baseline survey of the Uranosaki cohort study. Sci Rep 2017; 7:5810. [PMID: 28724951 PMCID: PMC5517578 DOI: 10.1038/s41598-017-06090-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 01/26/2017] [Accepted: 06/07/2017] [Indexed: 12/16/2022] Open
Abstract
Few data on clinical characteristics associated with N-terminal pro-brain natriuretic peptide (NT-proBNP) or the clinical value of measuring NT-proBNP in the working population are available. The aim of the present study was to investigate the levels of NT-proBNP and their association with clinical variables in the Japanese general working population by using baseline data from the Uranosaki cohort study. In the study, the plasma concentration of NT-proBNP and some biomarkers were measured in addition to the standard health checkups at the workplace. Questionnaires regarding health-related quality of life (HR-QOL) were also completed. A total of 2140 participants were enrolled in the study. Plasma levels of NT-proBNP were positively associated with age, female sex, systolic blood pressure, pulse pressure, prevalent hypertension, smoking habit, high-density lipoprotein cholesterol (HDL-C), and prevalent proteinuria, and negatively associated with body mass index, lipid profiles except HDL-C, uric acid, renal function, and hemoglobin. Both the plasma concentration of high-molecular weight adiponectin and that of high-sensitivity troponin T were positively and independently associated with NT-proBNP. In addition, the HR-QOL score regarding sleep disorder was independently associated with NT-proBNP. Thus, we have obtained evidence that the plasma NT-proBNP is affected by several clinical variables in the general working population.
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Affiliation(s)
- Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| | | | | | - Jun-Ichi Oyama
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Masafumi Natsuaki
- Department of Internal Medicine, Imari Matsuura Hospital, Imari, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
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Suzuki M, Kotooka N, Sakuma M, Nakazono T, Node K, Irie H. Validity and Reliability of Three-chamber-View Three-directional Encoded Phase-contrast Magnetic Resonance Velocity-Vector Mapping for Transmitral Velocity Measurements: Comparison with Doppler Echocardiography and Intra- and Inter-observer Variability. Magn Reson Med Sci 2017; 16:152-158. [PMID: 27599583 PMCID: PMC5600075 DOI: 10.2463/mrms.mp.2015-0172] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose: Three-chamber view (3ch.) three-directional encoded phase-contrast magnetic resonance velocity vector mapping (PCMRVM) has been used for visualization and assessment of intra-cardiac flow. Although transmitral inflow velocity can be determined using this method by tracing mitral tips during the cardiac phase, its feasibility for clinical applications has not been established. Our aim was to investigate the validity and reproducibility of 3ch. PCMRVM for determining transmitral inflow velocity. Methods: We conducted 3ch. PCMRVM for 32 patients and eight healthy volunteers and analyzed the transmitral inflow pattern and early (E) and late (A) diastolic velocity. Nine patients also underwent Doppler echocardiography to evaluate correlations between the methods for E and A velocities and the E/A ratio. Intra- and inter-observer variability were calculated using intraclass correlation coefficients (ICC [1, 1] and ICC [2, 1]) for peak E and A velocities, Spearman’s rank correlation coefficient for the E/A ratio, and Cohen’s kappa coefficient for the inflow pattern. Results: Bland-Altman plots indicated that 3ch. PCMRVM showed systemically lower velocities than Doppler echocardiography for E (3 [25.8] 48.6) and A (−6.28 [21] 48.3); however, a strong correlation was observed (r = 0.81, p < 0.0001). The E/A ratio was not statistically different between the two modalities (p = 0.21). The intra- and inter-observer variabilities for peak E and A velocities and the E/A ratio demonstrated nearly perfect agreement or strong correlations, except for the peak E velocity (ICC [2, 1] = 0.751). Conclusion: Based on these results, 3ch. PCMRVM can be used for both visualization and assessment of intra-cardiac flow and evaluation of the transmitral inflow velocity.
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Shiraki A, Kotooka N, Komoda H, Hirase T, Oyama JI, Node K. Pentraxin-3 regulates the inflammatory activity of macrophages. Biochem Biophys Rep 2016; 5:290-295. [PMID: 28955836 PMCID: PMC5600337 DOI: 10.1016/j.bbrep.2016.01.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/26/2015] [Accepted: 01/12/2016] [Indexed: 12/17/2022] Open
Abstract
Background and aims Pentraxin-3 (PTX3) reportedly has protective roles in atherosclerosis and myocardial infarction, and is a useful biomarker of vascular inflammation. However, the detailed functions of PTX3 in inflammation are yet to be elucidated. This study aimed to investigate the function of PTX3 in macrophages. Methods PMA-treated THP-1 cell line (THP-1 macrophage) and monocyte-derived human primary macrophages were treated with recombinant PTX3. Cytokine and chemokine levels in the THP-1 culture medium were measured as well as monocyte chemoattractant protein (MCP-1) concentrations in the Raw 264.7 cell culture medium. PTX3-silenced apoptotic macrophages (THP-1 cell line) were generated to investigate the roles of PTX3 in phagocytosis. Results In the presence of PTX3, macrophage interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α) and MCP-1 levels were reduced significantly (−39%, P=0.007; −21%, P=0.008; and −67%, P=0.0003, respectively), whilst activated transforming growth factor-β (TGF−β) was detected in the THP-1 macrophages (P=0.0004). Additionally, PTX3 induced Akt phosphorylation and reduced nuclear factor-kappa B (NF-κB) activation by 35% (P=0.002), which was induced by TNF-α in THP-1 macrophages. Furthermore, silencing of PTX3 in apoptotic cells resulted in increased macrophage binding, elevated expression rate of HLA-DR (+30%, P=0.015) and CD86 (+204%, P=0.004) positive cells, and induction of IL-1β (+36%, P=0.024) production. Conversely, adding recombinant PTX3 to macrophages reduced CD86 and HLA-DR expression in a dose-dependent manner. Conclusions We identified PTX3 as a novel regulator of macrophage activity, and this function suggests that PTX3 acts to resolve inflammation. PTX3 reduces pro-inflammatory cytokines from macrophages and induced active TGFβ. PTX3 upregulates Akt phosphorylation in macrophages. PTX3 reduces TNFα induced NFκ-B activation. Silencing PTX3 of apoptotic cells evokes phagocytic activity of macrophages.
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Affiliation(s)
- Aya Shiraki
- Department of Cardiovascular Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Hiroshi Komoda
- Department of Cardiovascular Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Tetsuaki Hirase
- National Cerebral and Cardiovascular Center Research Institute, 5-7-1, Fujishirodai, Suita, Osaka, Japan
| | - Jun-Ichi Oyama
- Department of Cardiovascular Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
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Suzuki M, Nakazono T, Yamaguchi K, Dogomori K, Komori Y, Kotooka N, Node K, Irie H. A qualitative and quantitative assessment of cardiac cine Phase contrast MRI: comparison of image quality between 2D and 3D acquisition. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328844 DOI: 10.1186/1532-429x-17-s1-p54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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19
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Nagatomo D, Kotooka N, Oyama JI, Node K. Mismatch of Bilateral Filling Pressures is Effective for Evaluation of Right Ventricular Dysfunction. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.156] [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: 11/16/2022]
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20
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Kubota A, Takano H, Mizuma H, Kuwabara Y, Sato Y, Kotooka N, Inoue T, Node K, Komuro I, Kobayashi Y. Effects of pitavastatin on Japanese patients with chronic heart failure: a subanalysis of the PEARL. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3301] [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: 11/13/2022] Open
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21
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Asaka M, Kotooka N, Mizuma H, Sato Y, Fujimatsu D, Kuwabara Y, Takano H, Inoue T, Komuro I, Node K. High-sensitivity assay of plasma cardiac troponin T predicts the effects of pitavastatin in patients with chronic heart failure: a sub-group analysis from the pitavastatin heart failure study (PEARL). Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Sakuma M, Kotooka N, Mizuma H, Kuwabara Y, Sato Y, Fujimatsu D, Takano H, Inoue T, Komuro I, Node K. Effectiveness of therapy with pitavastatin is associated with plasma interleukin-8 levels and improved cardiovascular outcomes in patients with chronic heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3298] [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: 11/13/2022] Open
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23
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Kotooka N, Asaka M, Sato Y, Kinugasa Y, Nochioka K, Mizuno A, Nagatomo D, Mine D, Yamada Y, Eguchi K, Hanaoka H, Inomata T, Fukumoto Y, Yamamoto K, Tsutsui H, Masuyama T, Kitakaze M, Inoue T, Shimokawa H, Momomura SI, Seino Y, Node K. Home telemonitoring study for Japanese patients with heart failure (HOMES-HF): protocol for a multicentre randomised controlled trial. BMJ Open 2013; 3:e002972. [PMID: 23794546 PMCID: PMC3669725 DOI: 10.1136/bmjopen-2013-002972] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 04/19/2013] [Accepted: 04/22/2013] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Despite the encouraging results from several randomised controlled trials (RCTs) and meta-analyses, the ability of home telemonitoring for heart failure (HF) to improve patient outcomes remains controversial as a consequence of the two recent large-scale RCTs. However, it has been suggested that there is a subgroup of patients with HF who may benefit from telemonitoring. The aim of the present study was to investigate whether an HF management programme using telemonitoring could improve outcomes in patients with HF under the Japanese healthcare system. METHODS AND ANALYSIS The Home Telemonitoring Study for Japanese Patients with Heart Failure (HOMES-HF) study is a prospective, multicentre RCT to investigate the effectiveness of home telemonitoring on the primary composite endpoint of all-cause death and rehospitalisation due to worsening HF in recently admitted HF patients (aged 20 and older, New York Heart Association classes II-III). The telemonitoring system is an automated physiological monitoring system including body weight, blood pressure and pulse rate by full-time nurses 7 days a week. Additionally, the system was designed to make it a high priority to support patient's self-care instead of an early detection of HF decompensation. A total sample size of 420 patients is planned according to the Schoenfeld and Richter method. Eligible patients are randomly assigned via a website to either the telemonitoring group or the usual care group by using a minimisation method with biased-coin assignment balancing on age, left ventricular ejection fraction and a history of ischaemic heart disease. Participants will be enrolled until August 2013 and followed until August 2014. Time to events will be estimated using the Kaplan-Meier method, and HRs and 95% CIs will be calculated using the Cox proportional hazards models with stratification factors. TRIAL REGISTRATION The study is registered at UMIN Clinical Trials Registry (UMIN000006839).
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Affiliation(s)
- Norihiko Kotooka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Machiko Asaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yasunori Sato
- Chiba University Hospital Clinical Research Center, Chiba University, Chiba, Japan
| | - Yoshiharu Kinugasa
- Division of Cardiolovascular Medicine, Department of Molecular Medicine and Therapeutics, Tottori University, Yonago, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Mizuno
- Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan
| | - Daisuke Nagatomo
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Daigo Mine
- Department of Cardiology, Saga Prefectural Hospital Koseikan, Saga, Japan
| | - Yoko Yamada
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Omiya, Japan
| | - Kazuo Eguchi
- Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Hideki Hanaoka
- Chiba University Hospital Clinical Research Center, Chiba University, Chiba, Japan
| | - Takayuki Inomata
- Department of Cardio-Angiology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuhiro Yamamoto
- Division of Cardiolovascular Medicine, Department of Molecular Medicine and Therapeutics, Tottori University, Yonago, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tohru Masuyama
- Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masafumi Kitakaze
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shin-ichi Momomura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Omiya, Japan
| | - Yoshihiko Seino
- Department of Cardiology, Nippon Medical School Chiba-Hokusoh Hospital, Inzai, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
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Takano H, Mizuma H, Kuwabara Y, Sato Y, Shindo S, Kotooka N, Fujimatsu D, Kobayashi Y, Inoue T, Node K, Komuro I. Effects of Pitavastatin in Japanese Patients With Chronic Heart Failure. Circ J 2013; 77:917-25. [DOI: 10.1253/circj.cj-12-1062] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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)
- Hiroyuki Takano
- Department of Molecular Cardiovascular Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University
| | - Hiroshi Mizuma
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | - Yoichi Kuwabara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | | | - Satoshi Shindo
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | | | | | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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25
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Suzuki M, Sakuma M, Kotooka N, Ueda T, Suito H, Irie H, Node K. Intra- and interobserver variability of left ventricular diastolic inflow parameters measured by three chamber view 2D cine three-directionally encoded (3Ch. 2D-cine-3 dir.) Phase contrast MR velocity vector map. J Cardiovasc Magn Reson 2013. [PMCID: PMC3559664 DOI: 10.1186/1532-429x-15-s1-p127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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26
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Kotooka N, Komatsu A, Takahashi H, Nonaka M, Kawaguchi C, Komoda H, Asaka M, Abe S, Taguchi I, Toyoda S, Nishiyama M, Inoue T, Node K. Predictive value of high-molecular weight adiponectin in subjects with a higher risk of the development of metabolic syndrome: from a population based 5-year follow-up data. Int J Cardiol 2012. [PMID: 23194783 DOI: 10.1016/j.ijcard.2012.10.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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27
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Node K, Kotooka N, Oyama JI. Effect of Eicosapentaic Acid and HMG-CoA Reductase Inhibitor on Chronic Heart Failure. J Card Fail 2012. [DOI: 10.1016/j.cardfail.2012.08.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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28
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Kotooka N. Biomarkers for Early Diagnosis of Heart Failure. J Card Fail 2012. [DOI: 10.1016/j.cardfail.2012.08.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Shiraki A, Oyama JI, Komoda H, Asaka M, Komatsu A, Sakuma M, Kodama K, Sakamoto Y, Kotooka N, Hirase T, Node K. The glucagon-like peptide 1 analog liraglutide reduces TNF-α-induced oxidative stress and inflammation in endothelial cells. Atherosclerosis 2012; 221:375-82. [PMID: 22284365 DOI: 10.1016/j.atherosclerosis.2011.12.039] [Citation(s) in RCA: 186] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 12/23/2011] [Accepted: 12/26/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Glucagon-like peptide 1 (GLP-1), one of the incretin hormones, has been reported to increase positive inotropic activity in cardiac myocytes and protect against myocardial injury. However, the effects upon endothelial cells and the mechanisms involved are not fully understood. We assessed the hypothesis that GLP-1 has protective effects against inflammation and oxidative stress on human endothelial cells. METHODS AND RESULTS The effects of the GLP-1 analog liraglutide upon TNF-α-induced injury of the human umbilical vein endothelial cells (HUVECs) were evaluated. First, ROS induced by TNF-α was measured by staining with CM-H(2)DCFDA. Intracellular ROS production of HUVECs was significantly decreased in a dose-dependent manner until 30 nM while liraglutide inhibited the induction of gp91(phox) and p22(phox), subunit of NADPH oxidase, by TNF-α. In addition, protein levels of SOD-2, catalase and GPx were significantly increased by liraglutide. Second, rapid translocation of PKC-α into the membrane following TNF-α was evident. Liraglutide significantly inhibited this very rapid TNF-α-induced translocation of PKC-α into membrane at 2.5 min. Third, liraglutide significantly inhibited NF-κB activation and upregulated I-κB family while phosphorylation of IKK-α/β, which is upstream of NF-κB signaling, was also downregulated after 15 min of TNF-α treatment. Finally, liraglutide inhibited apoptosis of HUVEC and expression of Pentraxin-3 induced by TNF-α. CONCLUSION Liraglutide exerts marked anti-oxidative and anti-inflammatory effects on endothelial cells with inhibition of PKC-α, NADPH oxidase, NF-κB signaling and upregulation of protective anti-oxidative enzymes.
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Affiliation(s)
- Aya Shiraki
- Saga University Faculty of Medicine Department of Cardiovascular and Renal Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan.
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Konishi-Yakushiji M, Yakushiji Y, Kotooka N, Okajima Y, Noguchi T, Hara H. Sonographic confirmation of the association between calcified cerebral emboli and mitral annular calcification. J Ultrasound Med 2010; 29:1507-1510. [PMID: 20876908 DOI: 10.7863/jum.2010.29.10.1507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Mai Konishi-Yakushiji
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
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Nakamura I, Kotooka N, Komori Y, Node K. Ebstein anomaly by cardiac magnetic resonance imaging. J Am Coll Cardiol 2009; 53:1568. [PMID: 19389570 DOI: 10.1016/j.jacc.2009.01.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Revised: 01/05/2009] [Accepted: 01/06/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Ikuko Nakamura
- Department of Cardiovascular and Renal Medicine, Saga University, Japan
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Fujimatsu D, Kotooka N, Inoue T, Nishiyama M, Node K. Association between High Molecular Weight Adiponectin Levels and Metabolic Parameters. J Atheroscler Thromb 2009; 16:553-9. [DOI: 10.5551/jat.1073] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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33
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Node K, Kotooka N. Prognostic value of pentraxin 3 in patients with chronic heart failure. J Card Fail 2008. [DOI: 10.1016/j.cardfail.2008.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kobayashi H, Kotooka N, Tao T, Kawaura F, Tanaka M, Fukuno Y, Aragane N, Nakahara Y, Hayashi S. [A case of sarcoidosis with severe bronchial stenosis and right ventricular dilatation]. Nihon Kokyuki Gakkai Zasshi 2008; 46:25-30. [PMID: 18260306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A 32-year-old woman visited another hospital complaining of productive cough and fever at the beginning of February 2006. Her symptoms improved after the administration of antibiotics, while infiltration shadows on chest radiographs remained unchanged. Bronchoscopic examination revealed stenosis of the left upper division bronchus, while lung biopsy was negative. She was referred to Saga University Hospital for further examination. Bronchoscopy on August 14th showed severe stenosis of the left upper division and lingular bronchi. Her illness was diagnosed as sarcoidosis on the basis of non-caseating granulomas seen in biopsy specimens from the bronchial wall and the periphery of the left upper division bronchus. Pulmonary function test revealed a marked decrease of vital capacity, while the FEV1.0/FVC ratio was 81%. Arrhythmia on electrocardiogram and marked right ventricular enlargement on cardiography were noted. We diagnosed cardiac sarcoidosis on the basis of gallium scintigraphy, thalium scintigraphy and cardiac MRI findings. We report the rare presentation of sarcoidosis with stenosis of proximal airways and marked dilatation of the right ventricle.
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Affiliation(s)
- Hiromi Kobayashi
- Department of Pulmonary Medicine, Saga University School of Medicine
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Kotooka N, Inoue T, Aoki S, Anan M, Komoda H, Node K. Prognostic value of pentraxin 3 in patients with chronic heart failure. Int J Cardiol 2007; 130:19-22. [PMID: 18045709 DOI: 10.1016/j.ijcard.2007.07.168] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Accepted: 07/07/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND A long pentraxin, PTX3, is produced by vascular cells or inflammatory cells and released into the circulation, possibly reflecting local inflammation in the cardiovascular system. AIM This study was designed to assess the clinical significance of plasma pentraxin 3 (PTX3) levels in chronic heart failure (CHF). METHODS We measured plasma PTX3 levels in 37 patients with non-ischemic CHF (dilated cardiomyopathy) using enzyme-linked immunosorbent assay (ELISA) methods. RESULTS The plasma PTX3 levels were higher in CHF patients than in healthy subjects (P=0.001), and the CHF patients in the highest tertile of plasma PTX3 levels had more cardiac events than the patients in the lowest tertile (42% vs. 0%, P=0.02). Multivariate regression analysis showed that PTX3 was the most significant predictor of cardiac events (hazard ratio 1.912 for each increase in PTX3 of 1 ng/ml, P=0.019, 95% CI 1.114-3.282). In addition, PTX3 was strikingly expressed in human myocardial cells obtained from a biopsy specimen in a patient. CONCLUSION Plasma PTX3 levels might be a potentially useful biomarker to predict prognosis as well as to detect inflammatory status in patients with CHF.
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Affiliation(s)
- Norihiko Kotooka
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Japan
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Inoue T, Kotooka N, Morooka T, Komoda H, Uchida T, Aso Y, Inukai T, Okuno T, Node K. High molecular weight adiponectin as a predictor of long-term clinical outcome in patients with coronary artery disease. Am J Cardiol 2007; 100:569-74. [PMID: 17697807 DOI: 10.1016/j.amjcard.2007.03.062] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Revised: 03/12/2007] [Accepted: 03/12/2007] [Indexed: 11/19/2022]
Abstract
Adiponectin is an adipocyte-specific secretory protein that is highly and specifically expressed in adipose tissue, and low plasma levels of adiponectin are associated with coronary artery disease (CAD). It has been suggested that high molecular weight (HMW) adiponectin is more important for vascular protection than total amount of adiponectin. To establish the clinical relevance of HMW adiponectin, we measured its serum levels in 149 patients with CAD. The levels were lower in vasospastic angina pectoris (3.4 +/- 2.4 microg/ml, p <0.01), stable angina pectoris (3.3 +/- 2.6 microg/ml, p <0.001), and healed myocardial infarction (3.8 +/- 2.9 microg/ml, p <0.01) than chest pain syndrome (controls) (6.6 +/- 5.4 microg/ml). The levels were also lower in multivessel CAD (3.4 +/- 2.4 microg/dl) compared with single vessel CAD (4.2 +/- 2.7 microg/ml, p <0.05) or no organic stenosis (5.1 +/- 3.5 microg/ml, p <0.01). In univariate analysis, diabetes mellitus (p = 0.03), insulin resistance (p = 0.06), high-sensitivity C-reactive protein levels (p = 0.0012), and low HMW adiponectin levels (p = 0.0001) predicted cardiovascular events during 7 years of follow-up. However, multivariate analysis showed that only HMW adiponectin levels were an independent predictor of cardiovascular events (relative risk 2.79, 95% confidence interval 1.49 to 5.24, p = 0.0014). In conclusion, serum HMW adiponectin levels may serve as a predictor of future cardiovascular events in patients with CAD as well as a marker for severity of CAD.
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Affiliation(s)
- Teruo Inoue
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Japan.
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Kotooka N, Inoue T, Fujimatsu D, Morooka T, Hashimoto S, Hikichi Y, Uchida T, Sugiyama A, Node K. Pentraxin3 is a novel marker for stent-induced inflammation and neointimal thickening. Atherosclerosis 2007; 197:368-74. [PMID: 17640648 DOI: 10.1016/j.atherosclerosis.2007.05.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 05/08/2007] [Accepted: 05/30/2007] [Indexed: 11/17/2022]
Abstract
Inflammation in the injured vessel wall plays an essential role in the mechanism of restenosis. Pentraxin3 (PTX3) is synthesized at the inflammatory site in response to primary inflammatory stimuli. To establish the clinical significance of plasma PTX3 levels in the pathophysiology of inflammation in the injured vessels, we serially measured the levels in 20 patients undergoing elective coronary stenting. Plasma PTX3 levels increased 15 min after coronary stenting, and reached a maximum at 24h in the coronary sinus (P<0.001 versus baseline) and peripheral blood (P<0.001 versus baseline). The transcardiac gradient of PTX3 at 15 min after PCI was higher in patients with than those without restenosis (0.40+/-0.64 versus -0.19+/-0.33 ng/ml, P=0.02). Furthermore, the increase in PTX3 at 24h was positively correlated with the increase in activated Mac-1 on the surface of neutrophils at 48 h (r=0.48, p<0.05) in the coronary sinus. Stepwise multiple regression analysis demonstrated that the relative increase in PTX3 at 24h was the most powerful predictor of late lumen loss (r=0.547, P=0.007). Coronary stenting enhanced circulating PTX3 levels in association with an inflammatory response. PTX3 may be a useful marker for evaluation of inflammatory reaction and neointimal thickening after vascular injury.
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Affiliation(s)
- Norihiko Kotooka
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Japan
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Inoue T, Komoda H, Kotooka N, Morooka T, Fujimatsu D, Hikichi Y, Soma R, Uchida T, Node K. Increased circulating platelet-derived microparticles are associated with stent-induced vascular inflammation. Atherosclerosis 2007; 196:469-476. [PMID: 17234194 DOI: 10.1016/j.atherosclerosis.2006.12.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Revised: 10/30/2006] [Accepted: 12/02/2006] [Indexed: 11/30/2022]
Abstract
Inflammation as well as platelet activation at the site of local vessel-wall injury plays an essential role in the mechanism of restenosis after Percutaneous coronary intervention (PCI). Platelet-derived microparticles (PDMPs) released from activated platelets are thought to play a role in the inflammatory process, possibly interacting with leukocyte integrin Mac-1. We serially measured circulating PDMPs, high-sensitive C-reactive protein (hs-CRP) and activated Mac-1 on the surface of neutrophils in 61 patients undergoing coronary stenting. PDMPs, hs-CRP and Mac-1 increased after coronary stenting in a time-dependent manner with the maximum response at 48 h in coronary sinus blood (PDMPs: 10.3+/-8.9-32.8+/-13.8 U/ml; P<0.001, hs-CRP: 0.27+/-0.23-1.46+/-0.99 mg/dl; P<0.001, activated Mac-1, 134+/-19% relative increase, P<0.001). PDMPs were correlated with hs-CRP (R=0.58, P<0.001) and the relative increase in Mac-1 (R=0.69, P<0.001) 48 h after coronary stenting. Multiple regression analysis showed that each of PDMPs (R=0.40, P<0.05), hs-CRP (R=0.33, P<0.05) and Mac-1 (R=0.48, P<0.01) was an independent predictor of the late lumen loss. Coronary stenting enhanced circulating PDMPs in association with an inflammatory response in the injured vessel wall. PDMPs may be a useful marker for evaluation of stent-induced inflammatory status and a powerful predictor of restenosis equivalent to activated Mac-1.
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Affiliation(s)
- Teruo Inoue
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan.
| | - Hiroshi Komoda
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Norihiko Kotooka
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Toshifumi Morooka
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Daisuke Fujimatsu
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Yutaka Hikichi
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Ryoichi Soma
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Toshihiko Uchida
- Department of Cardiology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Japan
| | - Koichi Node
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan
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Murakami T, Hayashi YK, Noguchi S, Ogawa M, Nonaka I, Tanabe Y, Ogino M, Takada F, Eriguchi M, Kotooka N, Campbell KP, Osawa M, Nishino I. Fukutin gene mutations cause dilated cardiomyopathy with minimal muscle weakness. Ann Neurol 2006; 60:597-602. [PMID: 17036286 DOI: 10.1002/ana.20973] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The fukutin gene (FKTN) is the causative gene for Fukuyama-type congenital muscular dystrophy, characterized by rather homogeneous clinical features of severe muscle wasting and hypotonia from early infancy with mental retardation. In contrast with the severe dystrophic involvement of skeletal muscle, cardiac insufficiency is quite rare. Fukuyama-type congenital muscular dystrophy is one of the disorders associated with glycosylation defects of alpha-dystroglycan, an indispensable molecule for intra-extra cell membrane linkage. METHODS Protein and functional analyses of alpha-dystroglycan and mutation screening of FKTN and other associated genes were performed. RESULTS Surprisingly, we identified six patients in four families showing dilated cardiomyopathy with no or minimal limb girdle muscle involvement and normal intelligence, associated with a compound heterozygous FKTN mutation. One patient died by rapid progressive dilated cardiomyopathy at 12 years old, and the other patient received cardiac implantation at 18 years old. Skeletal muscles from the patients showed minimal dystrophic features but have altered glycosylation of alpha-dystroglycan and reduced laminin binding ability. One cardiac muscle that underwent biopsy showed altered glycosylation of alpha-dystroglycan similar to that observed in a Fukuyama-type congenital muscular dystrophy patient. INTERPRETATION FKTN mutations could cause much wider spectrum of clinical features than previously perceived, including familial dilated cardiomyopathy and mildest limb girdle muscular dystrophy.
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Affiliation(s)
- Terumi Murakami
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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Kotooka N, Inoue T, Node K. Plasma High-Molecular Weight Adiponectin Levels in Patients with Congestive Heart Failure. J Card Fail 2006. [DOI: 10.1016/j.cardfail.2006.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Morooka T, Inoue T, Kotooka N, Fujimatsu D, Komatsu A, Uchida F, Yoshida K, Hashimoto S, Hikichi Y, Kato T, Node K. An appropriate indication for the initiation of beta-blocker therapy in dilated cardiomyopathy. Cardiology 2005; 105:61-6. [PMID: 16272814 DOI: 10.1159/000089295] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2005] [Accepted: 08/02/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although long-term treatment with beta-blockers has been shown to improve morbidity and mortality in dilated cardiomyopathy (DCM), patient responses are heterogeneous. METHODS To establish the appropriate indication for the initiation of beta-blocker therapy, we retrospectively analyzed 38 DCM patients treated with beta-blockers (metoprolol or carvedilol) and examined differences in baseline profiles between patients who could continue the therapy (responders) and those who could not (non-responders). RESULTS In 13 non-responders, the duration from onset of symptoms to beta-blocker initiation was longer (p < 0.05), systolic blood pressure was lower (p < 0.001), serum sodium concentration was lower (p < 0.05), left ventricular posterior wall thickness was thinner (p < 0.05), left ventricular end-diastolic pressure was higher (p < 0.05) and left ventricular wall stress was lower (p < 0.05) than in 25 responders. In 19 patients receiving carvedilol, 5 non-responders showed higher levels of human atrial natriuretic peptide (p < 0.05) and brain natriuretic peptide (p < 0.01) than 13 responders. Discriminant analysis with a linear discriminant function showed the following equation predicted response to beta-blocker therapy: h = 0.004 x systolic blood pressure - 0.002 x brain natriuretic peptide + 0.667 (R2 = 0.67, p < 0.001). The probability of predicting the response was 94.1% with h > or = 0.5. CONCLUSION We conclude that h > or = 0.5 is the appropriate indication for the initiation of beta-blocker therapy in DCM.
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Affiliation(s)
- Toshifumi Morooka
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Japan
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Kotooka N, Yamashita Y, Koga S, Otsubo S, Node K. [A 71-year-old man with chest pain]. J Cardiol 2005; 45:225-7. [PMID: 15929391] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Norihiko Kotooka
- DDepartment of Cardiology, School of Medicine, Saga University, Nabeshima 5-1, Saga, Saga 849-8501.
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Watanabe T, Kotooka N, Node K. [Cardio-protective effects of nitric oxide]. Nihon Rinsho 2004; 62 Suppl 9:510-2. [PMID: 15506438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Tohru Watanabe
- Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine
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Kotooka N, Otsuka Y, Yasuda S, Morii I, Kawamura A, Miyazaki S. Three Cases of Acute Myocardial Infarction Due to Coronary Embolism: Treatment Using a Thrombus Aspiration Device. ACTA ACUST UNITED AC 2004; 45:861-6. [PMID: 15557727 DOI: 10.1536/jhj.45.861] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this report, we describe three patients with acute myocardial infarction due to coronary embolism who were successfully treated using a thrombus aspiration device. Thrombus aspiration is shown to be a feasible and effective strategy for the treatment of acute coronary embolism.
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Affiliation(s)
- Norihiko Kotooka
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Osaka 565-8565, Japan
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Aoki S, Kotooka N, Yokoyama M, Ikeda Y, Tomiyoshi Y, Sakemi T, Yonemitsu N. Recurrence of rapidly progressive glomerulonephritis probably associated with two different kinds of drugs. Clin Nephrol 2000; 54:249-51. [PMID: 11020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
We describe a rare case that developed a rapidly progressive glomerulonephritis twice in a 69-year-old man during a course of treatment, first with allopurinol and then with piperacillin. The cessation of each treatment was followed by spontaneous recovery in renal function. A renal biopsy showed crescentic glomerulonephritis with mild tubulointerstitial change and a skin biopsy showed leukocytoclastic vasculitis. This is, to our knowledge, a very rare case of crescentic glomerulonephritis, probably associated with vasculitis during a course of treatment with two different kinds of drugs.
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Affiliation(s)
- S Aoki
- Department of Internal Medicine, Saga Medical School, Japan
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Ryu T, Kotooka N, Yoshida K, Kido K, Yoshida K, Ogata T, Tsuji S, Ohmori K, Utsunomiya T, Matsuo S. Ten years' trend of clinical features in congestive heart failure. J Card Fail 1999. [DOI: 10.1016/s1071-9164(99)91329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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