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24. Angiotensin converting enzyme 2 gene expression increased compensatory for left ventricular remodeling in patients with end-stage heart failure

Author

Ohtsuki, Masatsugu, primary, Morimoto, Shin-ichiro, additional, Izawa, Hideo, additional, Ismail, Tevfik F, additional, Ishibashi-Ueda, Hatsue, additional, Kato, Yasuchika, additional, Horii, Taiko, additional, Isomura, Tadashi, additional, Suma, Hisayoshi, additional, Nomura, Masanori, additional, Hishida, Hitoshi, additional, Kurahashi, Hiroki, additional, and Ozaki, Yukio, additional

Published
2010
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26. Positron Emission Tomographic Demonstration of Myocardial Oxidative Metabolism in a Case of Left Ventricular Restoration After Cardiac Resynchronization Therapy

Author

Kitaizumi, Kenji, primary, Yukiiri, Kazushi, additional, Masugata, Hisashi, additional, Shinomiya, Kaori, additional, Ohara, Minako, additional, Takinami, Hiroyuki, additional, Iwado, Yasuyoshi, additional, Yoshida, Junji, additional, Noma, Takahisa, additional, Ohmori, Koji, additional, Yamashita, Yoichi, additional, Horii, Taiko, additional, Senda, Shoich, additional, and Kohno, Masakazu, additional

Published
2008
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38. The ubiquitin-proteasome system is enhanced in degenerating cardiomyocytes of dilated cardiomyopathy

Author

Isomura Tadashi, Terasaki Fumio, Hiroaki Simomura, Kitaura Yasushi, Tsukada Bin, Otsuka Koji, Suma Hisayoshi, and Horii Taiko

Subjects
Programmed cell death, biology, medicine.diagnostic_test, Proteolysis, Dilated cardiomyopathy, Vacuole, medicine.disease, Cell biology, Ubiquitin, Biochemistry, Proteasome, Cytoplasm, medicine, biology.protein, Cardiology and Cardiovascular Medicine, Intracellular
Abstract

To maintain intracellular homeostasis against cellular stresses, proteins are not only synthesized but also degraded by proteolytic mechanisms. The ubiquitin (Ub)-proteasome system is the most important mechanism to select and digest damaged intracellular proteins. However, it is still unclear how the Ub-proteasome system plays a role in the failing heart. To elucidate the expressions of Ub and proteasomes in the myocardium of dilated cardiomyopathy (DCM), myocardial tissue obtained from nineteen DCM patients at the left ventriculoplasty was studied. Four normal autopsied hearts served as control. Immunohistochemistry revealed that both Ub and proteasomes were very weak in controls and in less degenerated cardiomyocytes of DCM hearts. On the other hand, their expressions were markedly enhanced in vesicles accumulated adjacent to nuclei, periphery of large vacuoles, hyaline materials and disorganized cytoplasm of degenerated cardiomyocytes. The quantitative analysis of percent area showed that expression of Ub and proteasome were statistically higher in DCM hearts than in normal controls. We propose that the Ub-proteasome system may be protectively enhanced to disorganize damaged proteins and reduce their toxicity. However, it is also possible that the Ub-proteasome system, when its expression is massive, may associate with cytoplasmic degeneration preceding cell death. In conclusion, proteolysis by the Ub-proteasome system is enhanced under the condition where cardiomyocyte degeneration is processing in DCM hearts.

Published
2004
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47. Residual fibrosis affects a long-term result of left ventricular volume reduction surgery for dilated cardiomyopathy in a rat experimental study

Author

Horii, Taiko, Tambara, Keiichi, Nishimura, Kazunobu, Suma, Hisayoshi, and Komeda, Masashi

Subjects
*CARDIOMYOPATHIES, *CARDIAC surgery, *SURGERY, *RATS
Abstract

Abstract: Objectives: The aim of this study is to evaluate the relationship between left ventricular (LV) wall property and the results of LV volume reduction surgery (LVR) to treat dilated cardiomyopathy (DCM) in an experimental model. Methods: DCM was introduced in 18 Lewis rats by autoimmunization with cardiac myosin. Among them, 12 rats underwent LVR and the rest were served as controls. They were subjected to echocardiography and cardiac catheterization for dimensional and functional measurements. The animals were sacrificed 4 weeks after surgery, and the fraction of myocardial fibrosis was calculated in 4 divided parts of the LV wall. Results: Percent fibrosis varied widely from 4.7 to 45.2%. LV volume reduction surgery improved cardiac function immediately after surgery in all rats (Emax, 0.28±0.14 to 0.48±0.18mmHg/μl; LV end-diastolic pressure, 21.0±6.1 to 13.3±5.1mmHg, P<0.05, respectively). Four weeks later, 6 hearts remained in good shape with smaller LV end-diastolic dimension (Dd) than baseline values (LV Dd, 9.7±0.6mm; fractional area change (FAC), 40.3±8.4%) and the other 6 had more redilation in diameter and more deterioration in function than baseline values (LV Dd, 10.9±0.6mm; FAC, 25.8±6.9%; P<0.05, respectively). Percent fibrosis in the septum differed 11.1±3.4 vs. 27.8±2.8% between the two groups (P<0.01). There was a significant correlation between the ratio of LV redilatation after surgery and percent fibrosis in the septum (r=0.951, P<0.01). Conclusions: Although the initial benefit of LVR was confirmed, the long-term result was affected by the amount of residual fibrosis. This information suggests that surgical site selection is important to achieve a good result of LV restoration surgery for DCM. [Copyright &y& Elsevier]

Published
2004
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49. Efficacy of left ventricular restoration with mitral valve surgery for endstage ischemic cardiomyopathy.

Author

Nomura, Fumikazu, Isomura, Tadashi, Horii, Taiko, Irie, Hiroshi, Hoshino, Joji, Makinae, Haruka, and Suma, Hisayoshi

Abstract

Patients with ischemic cardiomyopathy (ICM) are at an extremely high risk of death and ischemic events. This study aims to evaluate the impact of left ventricular restoration (LVR) and mitral valve surgery on the cardiac and clinical functional status of the patients with ICM. Twenty-six patients (46-80 years, mean: 64 years) with severely dilated heart (left ventricular end-systolic volume index: LVESVI > or = 100 ml/m2) who had coronary artery bypass grafting (2.8+/-1.3), mitral valve surgery, and LVR were enrolled in this study. Left ventricular end-diastolic volume index and LVESVI significantly decreased (from 169+/-44 to 130+/-41 ml/m2, P=0.0005, from 120+/-33 to 89+/-43 ml/m2, P=0.0012). Left ventricular ejection fraction showed no change. MR showed significant improvement (from 2.7+/-0.6 to 1.0+/-0.4, P<0.0001) and NYHA functional class showed improvement (from 3.2+/-0.8 to 1.5+/-0.9, P<0.0001). A 5-year survival rate was 71.2%. In conclusion, this aggressive approach with LVR aiming to treat end-stage ICM by relief of ischemia, reduction of LV wall tension by decreasing LV volume and stopping mitral leak, is effective for LV volume reduction and improvement of clinical functional status.

Published
2006
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50. Septal anterior ventricular exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: treat form not disease

Author

Isomura, Tadashi, Horii, Taiko, Suma, Hisayoshi, and Buckberg, Gerald D.

Subjects
*CARDIOMYOPATHIES, *ISCHEMIA, *OPERATIVE surgery, *SUTURES, *CORONARY artery bypass, *MYOCARDIAL revascularization, *MITRAL valve surgery
Abstract

Abstract: Objective: Restoration of left ventricle size and shape is an effective surgical procedure in patients with dilated cardiomyopathy. This report defines early and intermediate results following the reshaping of the left ventricle from spherical to ellipsoid configuration in patients with ischemic cardiomyopathy, employing a technique for LV restoration (LVR) that uses form rather than disease as the endpoint for oblique patch placement. Methods: Between 1998 and 2004, a cohort of 83 patients with dilated ischemic cardiomyopathy underwent an operation to reshape the left ventricle. In 54 patients the Dor procedure was done, and 29 underwent the septal anterior ventricular exclusion (SAVE) procedure to emphasize the elliptical shape, whereby patch placement followed an oblique trajectory between the LV apex and septum below the aortic valve. Ventricular form, rather than the disease scar marked the suture placement site endpoint to create an ellipse. The mean age was 58±27, but SAVE patients had larger end systolic volume index (135±38 vs 95±25*). Overall preoperative NYHA functional class III was in 69% and IV in 31 patients, but more SAVE patients were in class IV (38% vs 28%*). The procedures were elective in 72 and emergent in 11, with similar entry criteria for each procedure. Results: In combination with LVR operation, mitral surgery was performed in 49/83 and tricuspid annuloplasty in 23/83 patients, but these procedures were more common after SAVE (59% vs 44%* and 45% vs 19%*, respectively), because of larger LV volumes in SAVE patients; 2.8±1.3 coronary artery bypass grafts were used. Perioperative use of IABP or LVAD was 15 and 1, respectively in 83 patients. Hospital death was in 1/11 or 9% after emergent operations and 3/72 or 4% in elective procedures, with no difference between groups. After discharge from the hospital, NYHA class improved to class I or II in 57 patients, class III/IV in 14 patients, with 10 late deaths. The 5-year survival rate after the elective operation was 80.3% in SAVE and with elective operation and 77.4% in the Dor procedure. Conclusion: The SAVE or Pacopexy technique is easy to reshape the dilated left ventricle from spherical to ellipsoid form after the LVR, and the resultant improved configuration may contribute to the overall results for patients with ischemic dilated cardiomyopathy. [Copyright &y& Elsevier]

Published
2006
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