17 results on '"Ryota Masaki"'
Search Results
2. Impact of small dense low-density lipoprotein cholesterol and triglyceride-rich lipoproteins on plaque rupture with ST-segment elevation myocardial infarction
- Author
-
Taito Arai, Teruo Sekimoto, Shinji Koba, Hiroyoshi Mori, Naoki Matsukawa, Rikuo Sakai, Yuya Yokota, Shunya Sato, Hideaki Tanaka, Ryota Masaki, Yosuke Oishi, Kunihiro Ogura, Ken Arai, Kosuke Nomura, Koshiro Sakai, Hiroaki Tsujita, Seita Kondo, Shigeto Tsukamoto, Hiroshi Suzuki, and Toshiro Shinke
- Subjects
Cholesterol ,Nutrition and Dietetics ,Lipoproteins ,Endocrinology, Diabetes and Metabolism ,Internal Medicine ,Humans ,ST Elevation Myocardial Infarction ,Cholesterol, LDL ,Cardiology and Cardiovascular Medicine ,Plaque, Atherosclerotic ,Triglycerides - Abstract
Plaque rupture (PR), characterized by a disruption of the fibrous cap of lipid-rich plaques, is the major etiology of ST-segment elevation myocardial infarction (STEMI). Dyslipidemia is a well-known risk factor for PR. Nonetheless, the impact of detailed atherogenic lipid profiles, including small dense low-density lipoprotein cholesterol (sd-LDL-C) and triglyceride-rich lipoproteins (TRLs), on PR has not yet been investigated.To elucidate the impact of sd-LDL-C and TRL levels on PR in patients with STEMI using optical coherence tomography (OCT).A total of 106 consecutive statin-naive patients with STEMI were enrolled. The PR in culprit lesions was assessed on pre-intervention OCT images, and serum samples were collected immediately before coronary angiography. Sd-LDL-C was directly measured using a homogeneous assay. TRL-cholesterol (TRL-C) was estimated by subtracting the LDL-C level from the non-high-density lipoprotein cholesterol level. Clinical characteristics and lipid profiles were compared between the PR and intact fibrous cap (IFC).No difference in LDL-C levels was observed between the PR (n=64) and IFC (n=42) groups (120.0 mg/dL vs. 129.5 mg/dL, p=0.97); however, sd-LDL-C levels were significantly higher in the PR group (38.9 mg/dL vs. 32.4 mg/dL, p=0.04). Similarly, the PR group had higher TRL-C (24.0 mg/dL vs. 18.0 mg/dL, p=0.01) and triglyceride (130.0 mg/dL vs. 100.3 mg/dL, p=0.03) levels than the IFC group. Multivariate logistic regression analysis showed that sd-LDL-C was an independent factor determining PR (odds ratio, 1.53 per 10 mg/dL; p=0.04).Only sd-LDL-C levels were significantly associated with PR in culprit lesions in patients with STEMI.
- Published
- 2022
3. Impact of small dense low-density lipoprotein cholesterol on cholesterol crystals in patients with acute coronary syndrome: An optical coherence tomography study
- Author
-
Teruo, Sekimoto, Shinji, Koba, Hiroyoshi, Mori, Taito, Arai, Naoki, Matsukawa, Rikuo, Sakai, Yuya, Yokota, Shunya, Sato, Hideaki, Tanaka, Ryota, Masaki, Yosuke, Oishi, Kunihiro, Ogura, Ken, Arai, Kosuke, Nomura, Koshiro, Sakai, Hiroaki, Tsujita, Seita, Kondo, Shigeto, Tsukamoto, Hidenari, Matsumoto, Hiroshi, Suzuki, and Toshiro, Shinke
- Subjects
Apolipoproteins ,Nutrition and Dietetics ,Endocrinology, Diabetes and Metabolism ,Internal Medicine ,Humans ,Cholesterol, LDL ,Coronary Artery Disease ,Acute Coronary Syndrome ,Cardiology and Cardiovascular Medicine ,Coronary Vessels ,Plaque, Atherosclerotic ,Tomography, Optical Coherence - Abstract
The presence of cholesterol crystals (CCs) is recognized as a component of vulnerable atherosclerotic plaques at risk of rupture. The phagocytosis of atherogenic lipid factors by macrophages precedes and promotes the formation of vulnerable plaques, but it is not clear how these factors affect the formation of CC.This study aimed to evaluate the relationship between lipid biomarkers such as small dense low-density lipoprotein cholesterol (sd-LDL-c) and CC detected by optical coherence tomography (OCT) in patients with acute coronary syndrome (ACS).Serum samples were collected immediately before coronary angiography in consecutive 174 patients with ACS who did not take statins and underwent OCT imaging of the culprit lesion. The sd-LDL-c levels were measured using a direct homogenous assay. CC was defined as a thin linear structure with high reflectivity and low signal attenuation on the OCT images.CC was identified in 85 patients (48.9%). The prevalence of CC was significantly higher in lesions with ruptured plaques and greater macrophage grade. The sd-LDL-c levels were significantly higher in the patients with CC (41.6 vs. 31.2 mg/dL, p = 0.01) although there were no significant differences in the levels of LDL-c and apolipoprotein B. The CC group also had higher levels of apolipoprotein C3 and HbA1c levels. In multiple logistic regression analysis, sd-LDL-c was an independent risk factor of CC (odds ratio, 1.19 per 10 mg/dL; p = 0.03).sd-LDL may play an important role in the presence of CC in patients with ACS.
- Published
- 2022
4. Insufficient adenosine-induced hyperemia is a major determinant of discordance between non-hyperemic pressure ratio and fractional flow reserve
- Author
-
Hidenari Matsumoto, Satoshi Higuchi, Hideaki Tanaka, Ryota Masaki, Seita Kondo, Hiroaki Tsujita, and Toshiro Shinke
- Subjects
Multidisciplinary - Abstract
Adenosine occasionally overestimates fractional flow reserve (FFR) values (i.e., insufficient adenosine-induced hyperemia), leading to low non-hyperemic pressure ratios (NHPR)–high FFR discordance. We investigated the impact of insufficient adenosine-induced hyperemia on NHPR–FFR discordance and the reclassification of functional significance. We measured resting distal-to-aortic pressure ratio (Pd/Pa) and FFR by using adenosine (FFRADN) and papaverine (FFRPAP) in 326 patients (326 vessels). FFRADN overestimation was calculated as FFRADN − FFRPAP. We explored determinants of low Pd/Pa − high FFRADN discordance (Pd/Pa ≤ 0.92 and FFRADN > 0.80) versus high Pd/Pa − low FFRADN discordance (Pd/Pa > 0.92 and FFRADN ≤ 0.80). Reclassification of functional significance was defined as FFRADN > 0.80 and FFRPAP ≤ 0.80. Multivariable analysis identified FFRADN overestimation (p = 0.002) and heart rate at baseline (p = 0.048) as independent determinants of the low Pd/Pa–high FFRADN discordance. In the low Pd/Pa–high FFRADN group (n = 26), papaverine produced a further decline in the FFR value in 21 vessels (81%) compared with FFRADN, and the reclassification was observed in 17 vessels (65%). Insufficient adenosine-induced hyperemia is a major determinant of the low resting Pd/Pa–high FFR discordance. Physicians should bear in mind that the presence of low NHPR–high FFR discordance may indicate a false-negative FFR result.
- Published
- 2023
5. Association between Eicosapentaenoic Acid to Arachidonic Acid Ratio and Characteristics of Plaque Rupture
- Author
-
Teruo Sekimoto, Shinji Koba, Hiroyoshi Mori, Taito Arai, Myong Hwa Yamamoto, Takuya Mizukami, Naoki Matsukawa, Rikuo Sakai, Yuya Yokota, Shunya Sato, Hideaki Tanaka, Ryota Masaki, Yosuke Oishi, Kunihiro Ogura, Ken Arai, Kosuke Nomura, Koshiro Sakai, Hiroaki Tsujita, Seita Kondo, Shigeto Tsukamoto, Hiroshi Suzuki, and Toshiro Shinke
- Subjects
Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
6. Linear concentration-response relationship of serum caffeine with adenosine-induced fractional flow reserve overestimation: a comparison with papaverine
- Author
-
Hidenari Matsumoto, Koshiro Sakai, Masahiro Hosonuma, Arihiro Sumida, Ryota Masaki, Teruo Sekimoto, Haruya Takahashi, Natsumi Okada, Toshiro Shinke, Shigeto Tsukamoto, Kunihiro Ogura, Hiroaki Tsujita, Yosuke Oishi, Seita Kondo, Hideaki Tanaka, Kazuo Inoue, and Shunya Sato
- Subjects
Papaverine ,medicine.medical_specialty ,Percentile ,Concentration Response ,business.industry ,Adenosine stress ,Fractional flow reserve ,Adenosine ,chemistry.chemical_compound ,Linear relationship ,chemistry ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,Caffeine ,business ,medicine.drug - Abstract
Background Caffeine intake from one cup of coffee one hour before adenosine stress tests, corresponding to serum caffeine levels of 3-4 mg/L, is thought to be acceptable for non-invasive imaging. Aims We aimed to elucidate whether serum caffeine is independently associated with adenosine-induced fractional flow reserve (FFR) overestimation and their concentration-response relationship. Methods FFR was measured using adenosine (FFRADN) and papaverine (FFRPAP) in 209 patients. FFRADN overestimation was defined as FFRADN - FFRPAP. The locally weighted scatterplot smoothing (LOWESS) approach was applied to evaluate the relationship between serum caffeine level and FFRADN overestimation. Multiple regression analysis was used to determine independent factors associated with FFRADN overestimation. Results Caffeine was ingested at l12 hours in 85 patients, at 12-24 hours in 35 patients, and at g24 hours in 89 patients. Multiple regression analysis identified serum caffeine level as the strongest factor associated with FFRADN overestimation (pl0.001). The LOWESS curve demonstrated that FFRADN overestimation started from just above the lower detection limit of serum caffeine and increased approximately 0.01 FFR unit per 1 mg/L increase in serum caffeine level with a linear relationship. The 90th percentile of serum caffeine levels for the ≤12-hour, the 12-24-hour, and the g24-hour groups corresponded to FFRADN overestimations by 0.06, 0.03, and 0.02, respectively. Conclusions Serum caffeine overestimates FFRADN values in a linear concentration-response manner. FFRADN overestimation occurs at much lower serum caffeine levels than those that were previously believed. Our results highlight that standardised caffeine control is required for reliable adenosine-induced FFR measurements.
- Published
- 2021
7. Impact of overestimation of fractional flow reserve by adenosine on anatomical–functional mismatch
- Author
-
Hidenari Matsumoto, Ryota Masaki, Satoshi Higuchi, Hideaki Tanaka, Seita Kondo, Hiroaki Tsujita, and Toshiro Shinke
- Subjects
Fractional Flow Reserve, Myocardial ,Cardiac Catheterization ,Adenosine ,Multidisciplinary ,Predictive Value of Tests ,Coronary Stenosis ,Humans ,Coronary Angiography ,Coronary Vessels ,Severity of Illness Index - Abstract
Adenosine occasionally results in overestimation of fractional flow reserve (FFR) values, compared with other hyperemic stimuli. We aimed to elucidate the association of overestimation of FFR by adenosine with anatomically significant but functionally non-significant lesions (anatomical–functional mismatch) and its influence on reclassification of functional significance. Distal-to-aortic pressure ratio (Pd/Pa) was measured using adenosine (Pd/PaADN) and papaverine (Pd/PaPAP) in 326 patients (326 vessels). The overestimation of FFR was calculated as Pd/PaADN–Pd/PaPAP. The anatomical–functional mismatch was defined as diameter stenosis > 50% and Pd/PaADN > 0.80. Reclassification was indicated by Pd/PaADN > 0.80 and Pd/PaPAP ≤ 0.80. The mismatch (n = 72) had a greater overestimation of FFR than the non-mismatch (n = 99): median 0.02 (interquartile range 0.01–0.05) versus 0.01 (0.00–0.04), p = 0.014. Multivariable analysis identified the overestimation of FFR (p = 0.003), minimal luminal diameter (p = 0.001), and non-left anterior descending artery (LAD) location (p p = 0.005). The overestimation of FFR is an independent determinant of anatomical−functional mismatch. Anatomical−functional mismatch, specifically in the LAD, may suggest a false-negative result.
- Published
- 2022
8. Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent
- Author
-
Koshiro Sakai, Ryota Masaki, Myong Hwa Yamamoto, Yosuke Oishi, Shunya Sato, Hiroshi Suzuki, Toshiro Shinke, Ken Arai, Masahiko Ochiai, Rikuo Sakai, Kosuke Nomura, Kohei Wakabayashi, Kunihiro Ogura, Hiroaki Tsujita, Teruo Sekimoto, Ryota Kosaki, Hidenari Matsumoto, Taito Arai, Shigeto Tsukamoto, Naoki Matsukawa, Seita Kondo, Hideaki Tanaka, and Hiroyoshi Mori
- Subjects
business.industry ,medicine.medical_treatment ,Everolimus eluting stent ,Stent ,Percutaneous coronary intervention ,General Medicine ,equipment and supplies ,Vascular healing ,Stent placement ,surgical procedures, operative ,Drug-eluting stent ,Sirolimus ,Conventional PCI ,Medicine ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,medicine.drug - Abstract
A recent thinner strut drug-eluting stent might facilitate early strut coverage after its placement. We aimed to investigate early vascular healing responses after the placement of an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) compared to those with a durable-polymer everolimus-eluting stent (DP-EES) using optical coherence tomography (OCT) imaging.This study included 40 patients with chronic coronary syndrome (CCS) who underwent OCT-guided percutaneous coronary intervention (PCI). Twenty patients each received either BP-SES or DP-EES implantation. OCT was performed immediately after stent placement (baseline) and at 1-month follow-up.At one month, the percentage of uncovered struts reduced significantly in both the BP-SES (80.9 ± 10.3% to 2.9 ± 1.7%; P < 0.001) and DP-EES (81.9 ± 13.0% to 5.7 ± 1.8%; P < 0.001) groups, and the percentage was lower in the BP-SES group than in the DP-EES group (P < 0.001). In the BP-SES group, the percentage of malapposed struts also decreased significantly at 1 month (4.9 ± 3.7% to 2.6 ± 3.0%; P = 0.025), which was comparable to that of the DP-EES group (2.5 ± 2.2%; P = 0.860). The optimal cut-off value of the distance between the strut and vessel surface immediately after the placement to predict resolved malapposed struts was ≤ 160 μm for BP-SES and ≤ 190 μm for DP-EES.Compared to DP-EES, ultrathin-strut BP-SES demonstrated favorable vascular responses at one month, with a lower rate of uncovered struts and a comparable rate of malapposed struts.
- Published
- 2021
9. Clinical features and lipid profiles of plaque erosion over lipid-rich plaque versus fibrous plaque in patients with acute coronary syndrome
- Author
-
Teruo Sekimoto, Hiroyoshi Mori, Shinji Koba, Taito Arai, Naoki Matsukawa, Rikuo Sakai, Yuya Yokota, Shunya Sato, Hideaki Tanaka, Ryota Masaki, Yosuke Oishi, Kunihiro Ogura, Ken Arai, Kosuke Nomura, Koshiro Sakai, Hiroaki Tsujita, Seita Kondo, Shigeto Tsukamoto, Hiroshi Suzuki, and Toshiro Shinke
- Subjects
Rupture, Spontaneous ,Coronary Artery Disease ,Coronary Angiography ,Coronary Vessels ,Fibrosis ,Lipids ,Plaque, Atherosclerotic ,Lipoproteins, LDL ,Treatment Outcome ,Cholesterol ,Humans ,Acute Coronary Syndrome ,Cardiology and Cardiovascular Medicine ,Creatine Kinase ,Tomography, Optical Coherence ,Retrospective Studies - Abstract
Pathological reports have shown that plaque erosion (PE), a common cause of acute coronary syndrome (ACS), can form in both fibrous plaque and lipid-rich plaque (LRP). In plaque rupture (PR), which is the main cause of ACS, the underlying plaque is LRP with a thin fibrous cap. In this study, we aimed to investigate the clinical features and lipid profiles of PE with or without LRP in comparison with those of PR.A total of 166 patients with ACS, who underwent percutaneous coronary intervention using optical coherence tomography (OCT) and met the criteria for PR or PE, were included. LRP was defined as plaque with a maximal lipid arc (180°). Culprit lesions were categorized into PR and PE with/without LRP [PEThe prevalence of PR, PEThe clinical features and lipid profiles are substantially different between PE
- Published
- 2022
10. Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture
- Author
-
Syunya Sato, Koshiro Sakai, Taito Arai, Hiroyoshi Mori, Hidenari Matsumoto, Ryota Masaki, Hiroaki Tsujita, Naoki Matsukawa, Ryota Kosaki, Ken Arai, Kohei Wakabayashi, Kunihiro Ogura, Yosuke Oishi, Shigeto Tsukamoto, Teruo Sekimoto, Hiroshi Suzuki, Toshiro Shinke, Seita Kondo, Hideaki Tanaka, Rikuo Sakai, Masahiko Ochiai, Myong Hwa Yamamoto, and Kosuke Nomura
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Lumen (anatomy) ,Pilot Projects ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Coronary Circulation ,Internal medicine ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Aged ,Sirolimus ,Antibiotics, Antineoplastic ,medicine.diagnostic_test ,business.industry ,Percutaneous coronary intervention ,Stent ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,equipment and supplies ,medicine.disease ,Coronary Vessels ,Apposition ,Treatment Outcome ,surgical procedures, operative ,Angiography ,Conventional PCI ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,Tomography, Optical Coherence - Abstract
Recent clinical studies suggest that newer-generation drug-eluting stents that combine ultrathin struts and nanocoating (biodegradable polymer sirolimus-eluting stents, BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, the early vascular response to BP-SES in these patients has not been investigated so far.We examined this response in 20 patients with STEMI caused by plaque rupture using frequency-domain optical coherence tomography (OCT) to understand the underlying mechanisms. Plaque rupture was diagnosed by OCT before PCI with BP-SES implantation was performed. OCT was again performed before the final angiography (post-PCI) and after 2 weeks (2W-OCT).BP-SES placement caused protrusion of atherothrombotic material into the stent lumen and incomplete stent apposition in all patients. After 2 weeks, incomplete stent apposition was significantly reduced (% malapposed struts: post-PCI 4.7 ± 3.3%; 2W-OCT 0.9 ± 1.2%; P < 0.0001), and the percentage of uncovered struts also significantly decreased (% uncovered struts: post-PCI; 69.8 ± 18.3%: 2W-OCT; 29.6 ± 11.0%, P < 0.0001). The maximum protrusion area of the atherothrombotic burden was significantly reduced (post-PCI 1.36 ± 0.70 mm2; 2W-OCT 0.98 ± 0.55 mm2; P = 0.004).This study on the early vascular responses following BP-SES implantation showed rapid resolution of atherothrombotic material and progression of strut apposition and coverage. (UMIN000041324).
- Published
- 2021
11. Prognostic Impact of the Clinical Frailty Scale After Balloon Aortic Valvuloplasty
- Author
-
Tomoyo Hamana, Wataru Fujimoto, Ryota Masaki, Yuta Fukuishi, Toshiro Shinke, Koji Kuroda, Takatoshi Hayashi, Ken-ichi Hirata, Yutaka Hatani, Tatsuya Kokawa, Susumu Odajima, Takumi Inoue, Masamichi Iwasaki, Masanori Okuda, and Hiroshi Okamoto
- Subjects
medicine.medical_specialty ,Transcatheter aortic ,business.industry ,Aortic stenosis ,medicine.medical_treatment ,Original article ,Hemodynamics ,General Medicine ,Balloon ,medicine.disease ,Aortic valvuloplasty ,Stenosis ,Valve replacement ,Aortic valve replacement ,Valvular Heart Disease ,Internal medicine ,Cohort ,medicine ,Cardiology ,Clinical frailty scale ,business ,Balloon aortic valvuloplasty - Abstract
Background: The clinical frailty scale (CFS) predicts late mortality in patients undergoing transcatheter aortic valve replacement. We evaluated the CFS and other parameters associated with 1-year mortality after balloon aortic valvuloplasty (BAV). Methods and Results: Between January 2013 and May 2018, 148 patients with severe aortic stenosis (AS) who underwent BAV at the present hospital were enrolled. We recorded pre-procedural CFS grade, baseline characteristics, echocardiographic, and hemodynamic parameters. To investigate the potential risk to patients before BAV, we evaluated the Society of Thoracic Surgeons (STS) score. After patients who underwent surgical aortic valve replacement, transcatheter aortic valve replacement or repeat BAV were excluded, we investigated 1-year survival. Of 127 patients, 41 (32.3%) died ≤1 year after BAV, 8 of whom (19.5% of all-cause deaths) had cardiac deaths. Higher grade of CFS and STS score significantly correlated with 1-year mortality. Severe frailty and the high operative risk group (CFS ≥7 and STS score ≥8.7%) had an extremely poor prognosis (1-year mortality, 81.2%). Conclusions: In this BAV cohort, severe frailty was a predictor of 1-year mortality in elderly patients with severe AS.
- Published
- 2020
12. Coronary High-Intensity Plaques at T1-weighted MRI in Stable Coronary Artery Disease: Comparison with Near-Infrared Spectroscopy Intravascular US
- Author
-
Shunya Sato, Hidenari Matsumoto, Debiao Li, Hidefumi Ohya, Hiroyoshi Mori, Koshiro Sakai, Kunihiro Ogura, Yosuke Oishi, Ryota Masaki, Hideaki Tanaka, Seita Kondo, Hiroaki Tsujita, Shigeto Tsukamoto, Koji Isodono, Ryoji Kitamura, Yoshiaki Komori, Nobuyuki Yoshii, Ikumi Sato, Anthony G. Christodoulou, Yibin Xie, and Toshiro Shinke
- Subjects
Male ,Spectroscopy, Near-Infrared ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,Coronary Artery Disease ,Magnetic Resonance Imaging ,Plaque, Atherosclerotic ,Ultrasonography, Interventional ,Aged ,Retrospective Studies - Abstract
Background The histologic nature of coronary high-intensity plaques (HIPs) at T1-weighted MRI in patients with stable coronary artery disease remains to be fully understood. Coronary atherosclerosis T1-weighted characterization (CATCH) enables HIP detection by simultaneously acquiring dark-blood plaque and bright-blood anatomic reference images. Purpose To determine if intraplaque hemorrhage (IPH) or lipid is the predominant substrate of HIPs on T1-weighted images by comparing CATCH MRI scans with findings on near-infrared spectroscopy (NIRS) intravascular US (IVUS) images. Materials and Methods This study retrospectively included consecutive patients who underwent CATCH MRI before NIRS IVUS between December 2019 and February 2021 at two facilities. At MRI, HIP was defined as plaque-to-myocardium signal intensity ratio of at least 1.4. The presence of an echolucent zone at IVUS (reported to represent IPH) was recorded. NIRS was used to determine the lipid component of atherosclerotic plaque. Lipid core burden index (LCBI) was calculated as the fraction of pixels with a probability of lipid-core plaque greater than 0.6 within a region of interest. Plaque with maximum LCBI within any 4-mm-long segment (maxLCBI
- Published
- 2021
13. Skin ulcer due to hemodialysis access-induced distal ischemia treated with arteriovenous fistula banding and endovascular therapy
- Author
-
Tomoyo Hamana, Takumi Inoue, Masamichi Iwasaki, Koji Kuroda, Ryota Masaki, Yutaka Hatani, Wataru Fujimoto, Masanori Okuda, Takatoshi Hayashi, Hiroshi Okamoto, and Susumu Odajima
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Arteriovenous fistula ,030204 cardiovascular system & hematology ,Article ,Pallor ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,cardiovascular diseases ,030212 general & internal medicine ,Radial artery ,integumentary system ,medicine.diagnostic_test ,business.industry ,Skin ulcer ,medicine.disease ,Surgery ,body regions ,Giant cell arteritis ,Angiography ,Cardiology ,Hemodialysis ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
A 58-year-old woman with pallor on her left hand due to chronic hemodialysis presented with a recent intractable skin ulcer on her left 3rd finger; the skin perfusion pressure (SPP) was 19 mmHg. Preoperative angiography revealed an occluded proximal left radial artery, no communication between the ulnar and superficial palmar arteries, several collaterals from the left ulnar to the radial artery, and no visualization of the finger arteries. Successful endovascular therapy to the occluded radial artery increased flow to the arteriovenous fistula (AVF), but not to the fingertips. Slightly compressing the AVF augmented the flow and wound blush at the wound sites on the 3rd fingertip, leading to a diagnosis of hemodialysis access-induced distal ischemia (HAIDI). Surgical AVF banding with intra-operative SPP monitoring improved the SPP to 34 mmHg, leading to complete wound healing over 1 month with a preserved AVF. We performed a bilateral temporal artery biopsy and diagnosed giant cell arteritis. As the angiographic wound blush at wound sites is reportedly an important factor for wound healing, angiography with AVF manual compression is essential to diagnose HAIDI and evaluate the blood flow for wound healing.
- Published
- 2019
14. Small Dense Low-Density Lipoprotein Cholesterol: A Residual Risk for Rapid Progression of Non-Culprit Coronary Lesion in Patients with Acute Coronary Syndrome
- Author
-
Ryota Masaki, Yuya Yokota, Yosuke Oishi, Ryota Kosaki, Taito Arai, Teruo Sekimoto, Koshiro Sakai, Ken Arai, Rikuo Sakai, Shinji Koba, Kosuke Nomura, Yuji Hamazaki, Shunya Sato, Fumiyoshi Tsunoda, Makoto Shoji, Kunihiro Ogura, Seita Kondo, Shigeto Tsukamoto, Hideaki Tanaka, Toshiro Shinke, Hiroaki Tsujita, Hiroyoshi Mori, and Hidenari Matsumoto
- Subjects
Male ,Acute coronary syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Culprit ,Triglyceride ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Myocardial infarction ,Stroke ,Small dense low-density lipoprotein cholesterol ,Aged ,business.industry ,Biochemistry (medical) ,Rapid progression ,Percutaneous coronary intervention ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Prognosis ,Coronary Vessels ,Stenosis ,Cardiology ,Apolipoprotein C3 ,lipids (amino acids, peptides, and proteins) ,Female ,Original Article ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Biomarkers ,Follow-Up Studies - Abstract
Aim: This study investigated whether the small dense low-density lipoprotein cholesterol (sd-LDL-c) level is associated with the rapid progression (RP) of non-culprit coronary artery lesions and cardiovascular events (CE) after acute coronary syndrome (ACS). Methods: In 142 consecutive patients with ACS who underwent primary percutaneous coronary intervention for the culprit lesion, the sd-LDL-c level was measured using a direct homogeneous assay on admission for ACS and at the 10-month follow-up coronary angiography. RP was defined as a progression of any pre-existing coronary stenosis and/or stenosis development in the initially normal coronary artery. CEs were defined as cardiac death, myocardial infarction, stroke, or coronary revascularization. Results: Patients were divided into two groups based on the presence ( n =29) or absence ( n =113) of RP after 10 months. The LDL-c and sd-LDL-c levels at baseline were equivalent in both the groups. However, the sd-LDL-c, triglyceride, remnant lipoprotein cholesterol (RL-c), and apoC3 levels at follow-up were significantly higher in the RP group than in the non-RP group. The optimal threshold values of sd-LDL-c, triglyceride, RL-c, and apoC3 for predicting RP according to receiver operating characteristics analysis were 20.9, 113, 5.5, and 9.7 mg/dL, respectively. Only the sd-LDL-c level (≥ 20.9 mg/dL) was significantly associated with incident CEs at 31±17 months (log-rank: 4.123, p =0.043). Conclusions: The sd-LDL-c level on treatment was significantly associated with RP of non-culprit lesions, resulting in CEs in ACS patients. On-treatment sd-LDL-c is a residual risk and aggressive reduction of sd-LDL-c might be needed to prevent CEs.
- Published
- 2021
15. Early vascular healing following bioresorbable-polymer sirolimus-eluting stent implantation in comparison with durable-polymer everolimus-eluting stent: sequential optical coherence tomography study
- Author
-
Yosuke Oishi, Hiroaki Tsujita, Hidenari Matsumoto, Rikuo Sakai, Ken Arai, Seita Kondo, Toshiro Shinke, Hideaki Tanaka, Ryota Masaki, Hiroyoshi Mori, Teruo Sekimoto, Kunihiro Ogura, Shigeto Tsukamoto, Kosuke Nomura, and Taito Arai
- Subjects
Everolimus ,medicine.diagnostic_test ,business.industry ,Everolimus eluting stent ,Bioresorbable polymers ,Vascular healing ,Optical coherence tomography ,Sirolimus ,Durable polymer ,medicine ,Stent implantation ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug ,Biomedical engineering - Abstract
Background Orsiro ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) might facilitate early vascular healing responses that seems to be associated with improved long-term clinical outcomes. We compared the early vascular healing responses to BP-SES and Xience durable-polymer everolimus-eluting stent (DP-EES) in patients with chronic coronary syndrome (CCS) using optical coherence tomography (OCT). Methods A total of 40 patients with CCS receiving OCT-guided PCI were included. 20 patients were assigned to BP-SES, and 20 to DP-EES. OCT was performed immediately after stent placement (post-procedure) and at 1 month follow-up. Struts were recorded as uncovered if any part was visibly exposed in the lumen or covered if a layer of tissue covered all reflecting surfaces. The incidence of intrastent thrombus (IS-Th) and irregular protrusion (IRP) were also assessed. Results At 1 month, the percentage of uncovered struts was significantly lower in the BP-SES compared with the DP-EES (2.8±1.6% vs. 5.8±1.8%, respectively; p Conclusion Early vascular healing response to Orsiro BP-SES implantation was revealed in CCS patients at 1 month compared with Xience DP-EES. Orsiro BP-SES may have a potential to shorten the dual antiplatelet therapy duration. Funding Acknowledgement Type of funding source: None
- Published
- 2020
16. Early vascular responses to ultrathin biodegradable polymer sirolimus-eluting stent for the treatment of st-elevation myocardial infarction
- Author
-
Kosuke Nomura, Hidenari Matsumoto, Hiroyoshi Mori, Kunihiro Ogura, Yosuke Oishi, Hiroaki Tsujita, Shigeto Tsukamoto, Ken Arai, Koshiro Sakai, Teruo Sekimoto, Ryota Masaki, Seita Kondo, Hideaki Tanaka, Toshiro Shinke, and Ryota Kosaki
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Stent ,medicine.disease ,Biodegradable polymer ,St elevation myocardial infarction ,Internal medicine ,Sirolimus ,medicine ,Cardiology ,Thrombus ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background Recent clinical study suggests newer-generation drug-eluting stents (DES) that combine ultrathin strut and nano-coating with biodegradable polymers sirolimus-eluting stent (BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) over current generation DES. However, safety profiles in very early phase have not been systematically addressed. Objective and method We exploratory investigate early vascular response following BP-SES implantation in patients with STEMI to reveal mechanism of the favorable clinical outcomes in recent studies using frequency domain-optical coherence tomography (FD-OCT). Consecutive twenty patients with STEMI who underwent FD-OCT immediately after primary PCI and were eligible for follow-up FD-OCT at 2 weeks after implantation were enrolled between June 2018 and November 2019. Results Twenty patients (age 62.7±11.3 years, male 85.0%) were enrolled with frequencies of hypertension (45.0%), diabetes mellitus (35.0%), dyslipidemia (55.0%) and smoking (80.0%). Aspiration catheter were used in all patients, and 1.13±0.34 stents were used. Only one patient (5.0%) received chronic antiplatelet therapy with aspirin prior to the onset of STEMI. All patients started to receive prasugrel as thienopyridine from this event and continued dual antiplatelet therapy for 2 weeks. The percentage of uncovered struts significantly decreased from post-procedure to 2W follow-up (69±18% post-procedure versus 30±11% at 2W follow up, p Conclusion(s) This study firstly elucidated very early vascular responses following ultrathin strut BP-SES implantation in STEMI patients, showing early progression of strut coverage and resolution of athero-thrombotic materials. This technology may have a potential to overcome the current generation DESs in this clinical setting. Thrombus, uncovered and malapposed struts Funding Acknowledgement Type of funding source: None
- Published
- 2020
17. Feasibility of intracoronary nicorandil for inducing hyperemia on fractional flow reserve measurement: Comparison with intracoronary papaverine
- Author
-
Natsumi Okada, Hidenari Matsumoto, Kunihiro Ogura, Yosuke Oishi, Ryota Masaki, Taitou Arai, Rikuo Sakai, Mikiko Mikuri, Toshiro Shinke, and Hideaki Tanaka
- Subjects
medicine.medical_specialty ,Vasodilator Agents ,Hyperemia ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Coronary Circulation ,Papaverine ,medicine ,Humans ,030212 general & internal medicine ,Nicorandil ,business.industry ,Coronary Stenosis ,Adenosine ,Fractional Flow Reserve, Myocardial ,chemistry ,cardiovascular system ,Cardiology ,Feasibility Studies ,Cardiology and Cardiovascular Medicine ,business ,Caffeine ,Adenosine triphosphate ,medicine.drug - Abstract
Background Adenosine and adenosine triphosphate (ATP) are widely used to induce hyperemia for fractional flow reserve (FFR) measurements. Caffeine attenuates their hyperemic effects, but not those of nicorandil and papaverine. No studies have systematically compared the hyperemic efficacies of nicorandil, papaverine, and ATP with and without caffeine abstention. Methods FFRs were measured using nicorandil 2 mg (FFRNC2), nicorandil 4 mg (FFRNC4), and papaverine (FFRPAP) in 40 patients (group 1), and using nicorandil 2 mg, ATP (FFRATP), ATP plus nicorandil (FFRATP+NC2), and papaverine in 20 patients with (group 2) and in 20 patients without caffeine abstention (group 3). Results In group 1, FFRNC2 and FFRNC4 did not differ (p = 0.321) and were higher than FFRPAP (p Conclusions Nicorandil 2 mg is a safe and practical alternative for patients who consume caffeine-containing products before the test or have contraindications for adenosine/ATP. Increasing the nicorandil dose to 4 mg or administering adjunctive nicorandil during ATP infusions does not offer any clinical advantages compared with administering nicorandil 2 mg alone.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.