509 results on '"Masaharu, Ishihara"'
Search Results
2. Clinical utility of reticulocyte hemoglobin equivalent in patients with heart failure
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Saki Tahara, Yoshiro Naito, Keisuke Okuno, Seiki Yasumura, Tetsuo Horimatsu, Junichi Ohno, Isamu Sunayama, Yuki Matsumoto, Eri Manabe, Kumiko Masai, Kohei Azuma, Koichi Nishimura, Kyung-Duk Min, Akiko Goda, Masanori Asakura, and Masaharu Ishihara
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Medicine ,Science - Abstract
Abstract Anemia and iron deficiency (ID) are common in patients with heart failure (HF) and intravenous (IV) administration of iron to patients hospitalized for decompensated HF with ID improves outcome. The diagnosis of ID in routine practice is based on serum ferritin and transferrin saturation (TSAT) but both have limitations; alternatives should be considered. Reticulocyte hemoglobin equivalent (Ret-He) reflects iron content in reticulocytes but its clinical utility in patients with HF remains uncertain. We prospectively enrolled 142 patients hospitalized for decompensated HF. Sixty five percent had ID as defined in current international guidelines. Ret-He was directly correlated with serum iron and ferritin concentrations and with TSAT. There was a poor relationship between quartile of Ret-He and HF hospitalization or death but increases or decreases in Ret-He between admission and discharge were associated with a worse outcome. The clinical utility of Ret-He for identifying ID and predicting response to IV iron and prognosis for patients with HF requires further investigation.
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- 2022
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3. Plasma renin activity variation following admission predicts patient outcome in acute decompensated heart failure with reduced and mildly reduced ejection fraction
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Kohei Azuma, Koichi Nishimura, Kyung-Duk Min, Kanae Takahashi, Yuki Matsumoto, Akiyo Eguchi, Yoshitaka Okuhara, Yoshiro Naito, Sinichiro Suna, Masanori Asakura, and Masaharu Ishihara
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Renin ,ADHF ,Prognosis ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Background: Plasma renin activity (PRA) level at admission is reported to be a prognostic predictor of acute decompensated heart failure (ADHF) patients. Although PRA is affected during hospitalization by several factors including fluid volume and drug titration, whether the changes in PRA levels during hospitalization (ΔPRA) are associated with prognosis of ADHF patients are largely unknown. Purpose: Investigate the predictive impact of ΔPRA on the prognosis of ADHF patients with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF). Methods: Retrospectively analyzed consecutive 116 HFrEF and HFmrEF patients admitted for ADHF. PRA measurements were acquired at admission and at discharge. The primary outcome was a composite of cardiovascular death and HF re-hospitalization. Results: Out of 116 patients, 85 had PRA measurements both at admission and at discharge. Compared to admission, PRA level was significantly higher at discharge (0.8 (IQR 0.3–2.2) to 2.8 (IQR 1.0–7.2), p
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- 2023
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4. Juzentaihoto improves adenine-induced chronic renal failure in BALB/c mice via suppression of renal fibrosis and inflammation
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Satoyasu Ito, Eri Manabe, Yi Dai, Masaharu Ishihara, and Takeshi Tsujino
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Chronic kidney disease ,Fibrosis ,Inflammation ,TJ-48 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Renal inflammation and fibrosis are observed in underlying diseases associated with the pathological progression of chronic kidney disease (CKD). The inhibition of renal inflammation and fibrosis is one method to suppress the progression of CKD. Juzentaihoto (TJ-48), a Kampo medicine, effectively relieves chronic wasting diseases and fatigue and has been reported to decrease inflammation. In this study, we investigated whether TJ-48 has a renal protective effect and its underlying mechanism in mice with adenine-induced CKD. BALB/c mice were divided into four groups for examination: (1) control, (2) dietary restriction, (3) adenine, and (4) adenine + TJ-48. Biochemical and histological analyses, gene expression analysis, and complete blood counts were performed. TJ-48 treatment decreased tubular damage and fibrosis. TJ-48 also decreased creatinine levels exacerbated by adenine, suppressed the mRNA expression of tumor necrosis factor-α, chemokine ligand 2, transforming growth factor-β, and kidney injury molecule-1, and decreased the neutrophil/lymphocyte ratio increased by adenine. TJ-48 exerts a renoprotective effect possibly via the suppression of fibrosis and inflammation.
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- 2022
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5. Sleep Apnea and Physical Movement During Sleep, But Not Sleep Duration, Are Independently Associated With Progression of Left Ventricular Diastolic Dysfunction: Prospective Hyogo Sleep Cardio‐Autonomic Atherosclerosis Cohort Study
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Yonekazu Kidawara, Manabu Kadoya, Akiko Morimoto, Takashi Daimon, Miki Kakutani‐Hatayama, Kae Kosaka‐Hamamoto, Akio Miyoshi, Kosuke Konishi, Yoshiki Kusunoki, Takuhito Shoji, Akiko Goda, Masanori Asakura, Masaharu Ishihara, and Hidenori Koyama
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actigraphy ,follow‐up studies ,humans ,Kaplan–Meier estimate ,oxygen saturation ,prospective studies ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Although co‐occurrence of sleep disorder with heart failure is known, it is not clear whether that condition is a cause or consequence of heart failure. The present study was conducted as a longitudinal examination of the predictive value of sleep parameters on progression of left ventricular diastolic dysfunction. Methods and Results Four‐hundred fifty‐two subjects were followed for a mean of 34.7 months. An outcome of diastolic dysfunction was defined as increase in early inflow velocity/early diastolic tissue velocity >14. Sleep apnea‐hypopnea index, minimal oxygen saturation, sleep duration, and activity index (physical movement during sleep time, a potential parameter of poor sleep quality) were determined using apnomonitor and actigraphy findings, while heart rate variability was measured with a 24‐hour active tracer device. Sixty‐six of the patients developed diastolic dysfunction during the follow‐up period, with a median time of 25 months. Kaplan–Meier analysis results revealed that those with sleep apnea classified as moderate (apnea‐hypopnea index 15 to
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- 2022
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6. Reduced lifespan of erythrocytes in Dahl/Salt sensitive rats is the cause of the renal proximal tubule damage
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Eri Manabe, Satoyasu Ito, Yoshiya Ohno, Toshiyuki Tanaka, Yoshiro Naito, Naoko Sasaki, Masanori Asakura, Tohru Masuyama, Masaharu Ishihara, and Takeshi Tsujino
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Medicine ,Science - Abstract
Abstract We studied the mechanisms of anemia and the influence of anemia on renal pathology in Dahl/Salt Sensitive (Dahl/SS) rat, a model of cardio-renal-anemia syndrome. Erythrocyte lifespan was shortened and associated with decreased hemoglobin level in the Dahl/SS rats given high-salt diet. Serum haptoglobin decreased, reticulocytes increased, and erythropoiesis in the bone marrow and extramedullary hematopoiesis in the spleen was markedly stimulated by increased serum erythropoietin in them. As a mechanism of hemolysis, we investigated the incidence of eryptosis, suicidal death of erythrocytes. Eryptosis was increased, and red blood cell-derived microparticles, small particle which are generated in hemolytic disease, were also increased in Dahl/SS rats fed with high-salt diet. Deposition of hemosiderin and mitochondrial morphologic abnormality, a sign of ferroptosis, in proximal renal tubules was associated with intravascular hemolysis. Treatment with deferasirox, an oral iron chelator, reduced the renal proximal tubular injury and the glomerular sclerosis in Dahl/SS rats fed with high-salt diet. In conclusion, reduced half-life of erythrocytes induced by hemolysis is the major cause of anemia in Dahl/SS rat. Iron accumulation induced by hemolysis causes renal proximal tubule injury and accelerates renal damage in this model.
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- 2020
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7. Severe acute heart failure during or following cytokine release syndrome after CAR T-cell therapy
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Kyoko Yoshihara, Yoshiyuki Orihara, Tokiko Hoshiyama, Hiroya Tamaki, Isamu Sunayama, Ikuo Matsuda, Akinori Nishikawa, Tomoko Kumamoto, Mami Samori, Nobuto Utsunomiya, Kyung-Duk Min, Masanori Asakura, Seiichi Hirota, Masaharu Ishihara, Satoshi Higasa, and Satoshi Yoshihara
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Cytokine release syndrome ,Acute heart failure ,CAR T-cell therapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Although cardiac dysfunction after chimeric antigen receptor (CAR) T-cell therapy has been increasingly reported, the underlying dynamics and pathogenesis are not well documented. Herein, we describe the clinical presentation and treatment for two patients who developed severe acute heart failure after CAR T-cell therapy. Both cases shared several common characteristics, including the bone marrow involvement at the time of CAR T-cell therapy and early onset of cytokine release syndrome (CRS) with fever developing on the day of CAR T-cell infusion. Patients with early onset and/or severe CRS should be carefully monitored for the possibility of heart failure.
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- 2022
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8. Shorter door-to-balloon time, better long-term clinical outcomes in ST-segment elevation myocardial infarction patients: J-MINUET substudy
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Ryota Nishio, Manabu Ogita, Satoru Suwa, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Kazuteru Fujimoto, Kazuoki Dai, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Toshiaki Mano, Minoru Wake, Kengo Tanabe, Yoshisato Shibata, Hiroshi Tsutsui, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Shirou Uemura, Tetsuya Toubaru, Keijiro Saku, Shigeru Oshima, Yusuke Yoshikawa, Soshiro Ogata, Kunihiro Nishimura, Yoshihiro Miyamoto, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Published
- 2023
9. Anemia has an impact on prognosis in heart failure with preserved ejection fraction with mild chronic kidney disease
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Keisuke Okuno, Yoshiro Naito, Masanori Asakura, Masataka Sugahara, Tetsuo Horimatsu, Seiki Yasumura, Saki Tahara, Toshiyuki Nagai, Yoshihiko Saito, Tsutomu Yoshikawa, Tohru Masuyama, Masaharu Ishihara, and Toshihisa Anzai
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Anemia ,Chronic kidney disease ,Hemoglobin ,Heart failure with preserved left ventricular ejection fraction ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Anemia and chronic kidney disease (CKD) are common in patients with heart failure with preserved left ventricular fraction (HFpEF). However, it is entirely unknown about the impact of anemia on prognosis in HFpEF patients with CKD. In this study, we investigated the impact of anemia on prognosis and the optimal hemoglobin (Hb) levels to predict prognosis in HFpEF patients with CKD. Methods and Results: We prospectively examined 523 consecutive HFpEF patients enrolled in Japanese heart failure syndrome with preserved ejection fraction registry. CKD was defined as an estimated glomerular filtration rate (eGFR) of
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- 2021
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10. Low Quality of Warfarin Therapy is Associated With Female Gender but Not With Polypharmacy in Patients With Atrial Fibrillation
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Kojiro Takamoto, Jun-ichi Sakamoto, Satoyasu Ito, Takeshi Kimura, Eri Manabe, Toshiyuki Shikata, Masanori Asakura, Masaharu Ishihara, and Takeshi Tsujino
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polypharmacy ,atrial fibrillation ,warfarin ,PINRR ,TTR ,female gender ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: We examined the impact of polypharmacy on the quality of the anticoagulation therapy in patients with atrial fibrillation. We also examined the factors that affect the stability of warfarin therapy.Methods and Results: This retrospective study was conducted using data from 157 consecutive outpatients with atrial fibrillation in a single tertiary referral hospital. Patients who were prescribed warfarin continuously and for whom PT-INR was examined at least three times in a year were included in this study. We examined the quality of warfarin therapy using time in the therapeutic INR range (TTR), percentage of PT-INR determinations in range (PINRR), and the coefficient variation (CV) of PT-INR. We found that the number of prescribed medicines was significantly associated with high BMI and low eGFR, but not with TTR, PINRR, and the coefficient variation of PT-INR in patients with atrial fibrillation. We also found that female gender was independently associated with low PINRR in this study population.Conclusion: Polypharmacy did not deteriorate the quality of warfarin therapy in patients with atrial fibrillation treated in the tertiary referral hospital. Female gender was an independent predictor of the low quality of warfarin therapy.
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- 2021
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11. Hypoxia-inducible factor-prolyl hydroxylase inhibitor Roxadustat (FG-4592) reduces renal fibrosis in Dahl salt-sensitive rats.
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Yoshiro Naito, Seiki Yasumura, Keisuke Okuno, Masanori Asakura, Takeshi Tsujino, Tohru Masuyama, and Masaharu Ishihara
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- 2024
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12. Nocturnal Hypertension and Left Ventricular Diastolic Dysfunction in Patients With Diabetes With the Absence of Heart Failure: Prospective Cohort HSCAA Study.
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Yonekazu Kidawara, Manabu Kadoya, Masataka Igeta, Akiko Morimoto, Akio Miyoshi, Miki Kakutani-Hatayama, Akinori Kanzaki, Kosuke Konishi, Yoshiki Kusunoki, Takashi Daimon, Masanori Asakura, Masaharu Ishihara, and Hidenori Koyama
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BACKGROUND: Diabetes is an important risk factor for heart failure (HF) and is associated with left ventricular (LV) diastolic dysfunction. However, diabetic comorbid conditions, such as nocturnal hypertension, as predictors of diastolic dysfunction are not known in the absence of an HF period. The present study was conducted as the longitudinal examination of the predictive value of nocturnal hypertension profiles on the progression of LV diastolic dysfunction in patients with and without diabetes without HF. METHODS: The subjects (154 diabetes and 268 nondiabetes) in the absence of HF were followed for 36.8±18.2 months. The relationships among the patterns of nocturnal hypertension and the outcome of LV diastolic dysfunction, defined as an increase in E/e'>14, were investigated in the patients with and without diabetes. RESULTS: The interaction effect of the diabetes status and the patterns of nocturnal hypertension on the hazard rate of the occurrence of E/e'>14 was statistically significant (P=0.017). Kaplan-Meier analysis results revealed that patients with diabetes with nondipper (P=0.021 versus dipper) and riser (P=0.006 versus dipper) had a greater risk for a diastolic dysfunction event. Furthermore, multivariable Cox proportional hazards analysis revealed that nondipper (hazard ratio, 4.56 [95% CI, 1.49-13.96]; P=0.007) and riser (hazard ratio, 3.89 [95% CI, 1.31-11.57]; P=0.014) patterns were associated with elevated risk of the outcome of LV diastolic dysfunction. In contrast, no similar significant associations were found in patients without diabetes. CONCLUSIONS: During the absence of HF periods, nocturnal hypertension is an important predictor for the progression of LV diastolic dysfunction in patients with diabetes. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Focus on Cellular Iron Metabolism in Aortic Disease
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Yoshiro Naito and Masaharu Ishihara
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abdominal aortic aneurysm ,atherosclerosis ,hepcidin ,iron ,transferrin receptor 1 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Iron deficiency leads to health problems. Conversely, iron overload induces the generation of reactive oxygen species and health problems. Body iron status contributes to the development of various diseases, including aortic disease. Indeed, several clinical studies have reported that iron status can be linked to the pathogenesis of aortic disease. At the cellular level, iron uptake is regulated by the cellular iron transporter, transferrin receptor 1, while systemic iron homeostasis is regulated by hepcidin. As body iron status is regulated to maintain cellular and systemic iron homeostasis, iron metabolism in aortic disease is puzzling and not well understood. Methods: Perspective and short communication. Conclusions: This review provides an overview of the relevant research investigating the association between cellular iron metabolism and aortic disease.
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- 2022
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14. The differences between conventional lead, thin lead, and leadless pacemakers regarding effects on tricuspid regurgitation in the early phase
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Yoshihiro Ohta, Akiko Goda, Aika Daimon, Eri Manabe, Kumiko Masai, Hideyuki Kishima, Takanao Mine, Masanori Asakura, and Masaharu Ishihara
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Radiology, Nuclear Medicine and imaging ,General Medicine - Abstract
Trans-venous pacemaker leads are associated with worsening of tricuspid regurgitation (TR) after pacemaker implantation (PMI) in some cases. Recently, leadless pacemakers and thin ventricular pacemaker leads without a stylet lumen have become popular. However, the differences in the effects of these leads on TR are unclear. We investigated differences in the changes in TR in the early phase after PMI in patients with conventional leads, thin leads, and leadless pacemakers.We enrolled 65 patients who underwent PMI (32 males, 79 ± 8 years), including 48 with trans-venous PMI (29 with conventional 6.0-Fr leads and 19 with 4.1-Fr thin leads) and 17 with leadless pacemakers. Transthoracic echocardiography was performed before and 1 month after PMI for assessment of conventional echocardiographic parameters and severity of TR by quantitative assessment.Atrial fibrillation was the most frequent indication for PMI in patients with leadless pacemakers (p = 0.015). In the before and 1 month after PMI comparison, left ventricular ejection fraction decreased after PMI only in the conventional lead group (p = 0.022). The TR effective regurgitant orifice area (EROA) decreased post PMI in the leadless (p = 0.002) and thin lead groups (p = 0.001), but not in the conventional lead group (p = 0.596). The change in TR EROA was greater in the leadless and thin lead groups as compared with the conventional lead group (p 0.05).The decrease in TR EROA in the early phase after PMI differed according to the type of pacemaker lead. The thin lead might be beneficial for reduction of TR after PMI.
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- 2022
15. Features and Outcomes of Histologically Proven Myocarditis With Fulminant Presentation
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Koshiro Kanaoka, Kenji Onoue, Satoshi Terasaki, Tomoya Nakano, Michikazu Nakai, Yoko Sumita, Kinta Hatakeyama, Fumio Terasaki, Rika Kawakami, Yoshitaka Iwanaga, Yoshihiro Miyamoto, Yoshihiko Saito, Satoshi Yuda, Masaya Tanno, Toru Takahashi, Hisashi Yokoshiki, Masahiro Toba, Toshihisa Anzai, Toshiyuki Nagai, Takuma Sato, Takashi Takenaka, Seiji Yamazaki, Yuki Katagiri, Toshiharu Takeuchi, Kazuya Sugitatsu, Shigeo Kakinoki, Tomoaki Matsumoto, Kazushi Urasawa, Michinao Tan, Ichizo Tsujino, Mitsunori Kamigaki, Hirofumi Tomita, Kenji Hanada, Motoi Kushibiki, Akihiro Nakamura, Yoshihiro Morino, Takahito Nasu, Satoshi Yasuda, Hideaki Suzuki, Kaoru Iwabuchi, Kanako Tsuji, Shigeto Namiuchi, Tatsuya Komaru, Masahiro Yagi, Shoko Uematsu, Toshiaki Takahashi, Satoru Takeda, Toru Nakanishi, Masafumi Watanabe, Masahiro Wanezaki, Motoyuki Matsui, Shigeo Sugawara, Yasuchika Takeishi, Masayoshi Oikawa, Nobuo Komatsu, Satoshi Suzuki, Hiroshi Okamoto, Noriyuki Takeyasu, Daiki Akiyama, Yutaka Eki, Tsunekazu Kakuta, Tomoyo Sugiyama, Tomomi Koizumi, Koji Ueno, Kazuomi Kario, Mizuri Taki, Yuri Matsumoto, Takanori Yasu, Osamu Nishioka, Shigeto Naito, Makoto Murata, Shoichi Tange, Katsumi Kaneko, Makoto Muto, Hiroshi Inagaki, Shuichi Hasegawa, Eizo Tachibana, Wataru Atsumi, Masahiro Suzuki, Toshihiro Muramatsu, Yoshihiro Yamada, Isao Taguchi, Yoshiaki Fukuda, Akihiro Matsui, Junji Kanda, Koji Hozawa, Akihiko Matsumura, Wataru Shimizu, Takeshi Yamamoto, Issei Komuro, Masaru Hatano, Takanori Ikeda, Shunsuke Kiuchi, Taishiro Chikamori, Yasuyoshi Takei, Kyoko Soejima, Toshinori Minamishima, Hiroyuki Tanaka, Shigeo Shimizu, Masashi Kasao, Tadayuki Kadohira, Tohru Minamino, Kazunori Shimada, Hiroshi Iwata, Yukihiko Momiyama, Takashi Ashikaga, Toshihiro Nozato, Yasumasa Fujiwara, Kenji Inoue, Tetsuo Sasano, Junji Matsuda, Yasuhiro Ishii, Yuichi Ono, Kengo Tanabe, Yu Horiuchi, Toshiro Shinke, Yusuke Kodama, Masao Moroi, Yoshiyuki Yazaki, Taisuke Mizumura, Hiroshi Ohta, Yoshihiro Akashi, Nozomi Kotoku, Yuji Ikari, Mitsunori Maruyama, Yasuhiro Sato, Koichi Tamura, Masaaki Konishi, Hiroshi Suzuki, Mio Ebato, Kazuki Fukui, Kazuhiko Yumoto, Takamasa Iwasawa, Takeshi Kashimura, Kazuyoshi Takahashi, Yoshinobu Okada, Bunji Kaku, Kazuo Usuda, Michiro Maruyama, Tomoki Kameyama, Toshinori Higashikata, Akihiko Hodatsu, Kazuo Osato, Yoji Nagata, Koji Maeno, Kazuo Satake, Takao Sawanobori, Noboru Watanabe, Koichiro Kuwahara, Hirohiko Motoki, Hiroshi Kitabayashi, Kyuhachi Otagiri, Tsunesuke Kono, Daisuke Yamagishi, Yoshikazu Yazaki, Toshiyuki Noda, Itsuro Morishima, Naoki Watanabe, Shinichiro Tanaka, Tomoya Onodera, Ryuzo Nawada, Akinori Watanabe, Masaki Matsunaga, Satoru Suwa, Hiroshi Sakamoto, Hiroki Sakamoto, Takeshi Aoyama, Norio Kanamori, Masahiro Muto, Yuichiro Maekawa, Hayato Ohtani, Yukio Ozaki, Kenshin Naruse, Kenji Takemoto, Haruo Kamiya, Takeshi Suzuki, Yasushi Tomita, Susumu Suzuki, Ryosuke Kametani, Hidekazu Aoyama, Hiroyuki Osanai, Ken Harada, Kenji Kada, Tomoaki Saeki, Koichi Kobayashi, Yasuhiro Ogawa, Akihiro Terasawa, Masanori Shinoda, Mitsutoshi Oguri, Kiyokazu Shimizu, Akinori Sawamura, Atsushi Sugiura, Kosuke Hattori, Shinji Mokuno, Kazuhisa Kondo, Kaoru Dohi, Keishi Moriwaki, Atsunobu Kasai, Tetsuya Nakakuki, Kazuaki Kaitani, Toshikazu Jinnai, Takashi Yamamoto, Hiroyuki Kurata, Atsuyuki Wada, Masaharu Akao, Yasuhiro Hamatani, Kazuya Ishibashi, Yoshiki Akakabe, Yasuhide Asaumi, Hideo Matama, Yasushi Sakata, Hidetaka Kioka, Hiroshi Takaishi, Toru Takase, Mitsuo Matsuda, Fumi Sato, Shinji Hasegawa, Kenichi Ishigami, Minoru Ichikawa, Takashi Takagi, Moriaki Inoko, Masaaki Hoshiga, Shuichi Fujita, Yoshihiro Takeda, Takahiko Kawarabayashi, Hideyuki Takaoka, Kenji Nakajima, Tadashi Yuguchi, Tatsuya Kawasaki, Yukinori Shinoda, Yukihito Sato, Masaharu Ishihara, Yuki Matsumoto, Hiroya Kawai, Tomofumi Takaya, Kouki Matsuo, Toshiaki Mano, Kenichi Hirata, Eriko Hisamatsu, Nobutaka Inoue, Koichi Tamita, Naoki Mukohara, Hisashi Shimoyama, Toru Miyajima, Toshihiro Tamura, Yodo Tamaki, Megumi Suzuki, Ryoji Yokota, Manabu Horii, Kazuo Yamanaka, Hiroyuki Kawata, Yukihiro Hashimoto, Yasuki Nakada, Hitoshi Nakagawa, Tomoya Ueda, Taku Nishida, Ayako Seno, Makoto Watanabe, Takashi Akasaka, Takashi Tanimoto, Mamoru Toyofuku, Kazuhiro Yamamoto, Yoshiharu Kinugasa, Masayuki Hirai, Hiroshi Nasu, Kinya Shirota, Tsuyoshi Oda, Takefumi Oka, Kazushige Kadota, Masanobu Ohya, Hiroshi Ito, Kazufumi Nakamura, Soichiro Ogura, Soichiro Fuke, Shiro Uemura, Hiromi Matsubara, Atsuyuki Watanabe, Nobuyuki Morishima, Yasuki Kihara, Takayuki Hidaka, Hironori Ueda, Yujiro Ono, Yuji Muraoka, Miyo Hatanari, Yoshinori Miyamoto, Keigo Dote, Masaya Kato, Masafumi Yano, Mamoru Mochizuki, Yasuhiro Ikeda, Hiroyuki Fujinaga, Shinobu Hosokawa, Masataka Sata, Koji Yamaguchi, Naoko Aki, Tetsuo Minamino, Yuichi Miyake, Yuichiro Takagi, Masayuki Doi, Yoshio Taketani, Hideki Okayama, Tatsuya Shigematsu, Akinori Higaki, Osamu Yamaguchi, Shinji Inaba, Shuntaro Ikeda, Kazuya Kawai, Hiroaki Kitaoka, Toru Kubo, Kenji Ando, Kaoru Inui, Yoshihiro Fukumoto, Kensuke Hori, Takehiro Homma, Tomohiro Kawasaki, Masahiro Mohri, Masaki Fujiwara, Hiroyuki Tsutsui, Tomomi Ide, Shin-Ichiro Miura, Takashi Kuwano, Hideki Shimomura, Toshiaki Kadokami, Masanao Taba, Katsuhiro Kondou, Toru Kubota, Daisuke Nagatomo, Yasushi Mukai, Ryuichi Matsukawa, Hideki Tashiro, Mitsuhiro Shimomura, Koji Maemura, Hiroaki Kawano, Koji Oku, Toshihiko Yamasa, Yoshihisa Kizaki, Tomohiro Sakamoto, Yudai Tamura, Teruhiko Ito, Kazuteru Fujimoto, Kenichi Tsujita, Seiji Takashio, Hirofumi Kurokawa, Naohiko Takahashi, Shotaro Saito, Masaya Arikawa, Yoshisato Shibata, Kensaku Nishihira, Toshihiro Tsuruda, Masahiro Sonoda, Nobuhiko Atsuchi, Mitsuru Ohishi, Koji Higuchi, Masaaki Miyata, Naoya Oketani, Yoshinori Akimoto, Tomohiro Asahi, and Minoru Wake
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Male ,Myocarditis ,Physiology (medical) ,Humans ,Heart Transplantation ,Female ,Arrhythmias, Cardiac ,Middle Aged ,Prognosis ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
Background: Fulminant myocarditis presentation (FMP) is a rare and severe presentation of myocarditis. The natural history of FMP and its clinical features associated with poor outcomes are incompletely understood because there is a lack of generalizable evidence. Methods: This multicenter retrospective cohort study included patients hospitalized with histologically proven myocarditis who underwent catecholamine or mechanical support from 235 cardiovascular training hospitals across Japan between April 2012 and March 2017. Clinical features and the prognostic predictors of death or heart transplantation within 90 days on the basis of clinical and pathologic findings were determined using the Kaplan-Meier method, log-rank test, and Cox regression analysis. Results: This study included 344 patients with histologically proven FMP (median age, 54 years; 40% female). The median follow-up was 600 days (interquartile range, 36 to 1599 days) and the cumulative risk of death or heart transplantation at 90 days was 29% (n=98). Results from multivariable Cox regression analysis showed that older age, nonsinus rhythm, low left ventricular wall motion ( Conclusions: The results from analyses of data from this multicenter registry demonstrated that patients with FMP are at a higher risk of death or heart transplantation in real-world settings. These observations inform which clinical and pathologic findings may be useful for prognostication in FMP. Registration: URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000039763.
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- 2022
16. Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors on Outcomes After Catheter Ablation for Atrial Fibrillation
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Hideyuki Kishima, Takanao Mine, Eiji Fukuhara, Ryo Kitagaki, Masanori Asakura, and Masaharu Ishihara
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Male ,Glucose ,Diabetes Mellitus, Type 2 ,Atrial Fibrillation ,Sodium ,Catheter Ablation ,Humans ,Stroke Volume ,Prospective Studies ,Middle Aged ,Ventricular Function, Left ,Aged - Abstract
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have recently been a significant focus of attention because of their multiple pleiotropic effects. However, the impact of SGLT2i on atrial fibrillation (AF) remains unclear.The goal of this study was to examine the effects of SGLT2i on AF after catheter ablation (CA).This prospective, randomized controlled study compared the suppressive effect of SGLT2i vs dipeptidyl peptidase-4 inhibitors on AF recurrence after CA. Eighty AF patients with type 2 diabetes mellitus were randomized (by a computer-generated random sequence) to the tofogliflozin group (20 mg/d) or the anagliptin group (200 mg/d) stratified according to left atrial diameter and AF type (paroxysmal AF [PAF] or non-paroxysmal atrial fibrillation [PAF]) at screening. The primary outcome was AF recurrence at 12 months after CA.Seventy patients were analyzed (mean age 70.3 ± 8.1 years; 48 male; 30 with paroxysmal AF; 38 tofogliflozin treated). Recurrent AF was detected in 24 (34.3%) of 70 patients, and the AF recurrence ratio was higher in the anagliptin group than in the tofogliflozin group (15 of 32 patients [47%] vs 9 of 38 patients [24%]; P = 0.0417). Moreover, univariate analysis revealed that compared with the nonrecurrence group (n = 46), the recurrence group (n = 24) had a higher prevalence rate of non-PAF, elevated brain natriuretic peptide, higher urinary albumin-creatinine ratio, lower rate of SGLT2i use, larger left atrial diameter, elevated E wave, lower left ventricular ejection fraction, and lower rate of cryoballoon pulmonary vein isolation.Compared with anagliptin, tofogliflozin achieved greater suppression of AF recurrence after CA in patients with type 2 diabetes mellitus.
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- 2022
17. Effect of ipragliflozin on carotid intima-media thickness in type 2 diabetes patients
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Atsushi, Tanaka, Masataka, Sata, Yosuke, Okada, Hiroki, Teragawa, Kazuo, Eguchi, Michio, Shimabukuro, Isao, Taguchi, Kazuo, Matsunaga, Yumiko, Kanzaki, Hisako, Yoshida, Tomoko, Ishizu, Shinichiro, Ueda, Masafumi, Kitakaze, Toyoaki, Murohara, Koichi, Node, Yoshihiko, Nishio, Mitsuru, Ohishi, Kazuomi, Kario, Wataru, Shimizu, Hideaki, Jinnouchi, Hirofumi, Tomiyama, Koji, Maemura, Makoto, Suzuki, Shinichi, Ando, Haruo, Kamiya, Tomohiro, Sakamoto, Mamoru, Nanasato, Munehide, Matsuhisa, Junya, Ako, Yoshimasa, Aso, Masaharu, Ishihara, Kazuo, Kitagawa, Akira, Yamashina, Yumi, Ikehara, Ayako, Takamori, Miki, Mori, Kaori, Yamaguchi, Machiko, Asaka, Tetsuya, Kaneko, Masashi, Sakuma, Shigeru, Toyoda, Takahisa, Nasuno, Michiya, Kageyama, Jojima, Teruo, Iijima, Toshie, Haruka, Kishi, Hirotsugu, Yamada, Kenya, Kusunose, Daiju, Fukuda, Shusuke, Yagi, Koji, Yamaguchi, Takayuki, Ise, Yutaka, Kawabata, Akio, Kuroda, Yuichi, Akasaki, Mihoko, Kurano, Satoshi, Hoshide, Takahiro, Komori, Tomoyuki, Kabutoya, Yukiyo, Ogata, Yuji, Koide, Hiroaki, Kawano, Satoshi, Ikeda, Satoki, Fukae, Seiji, Koga, Yukihito, Higashi, Shinji, Kishimoto, Masato, Kajikawa, Tatsuya, Maruhashi, Yoshiaki, Kubota, Yoshisato, Shibata, Nehiro, Kuriyama, Ikuko, Nakamura, Kanemitsu, Hironori, Bonpei, Takase, Yuichi, Orita, Chikage, Oshita, Yuko, Uchimura, Ruka, Yoshida, Yukihiko, Yoshida, Hirohiko, Suzuki, Yasuhiro, Ogura, Mayuho, Maeda, Masaki, Takenaka, Takumi, Hayashi, Mirai, Hirose, Itaru, Hisauchi, Toshiaki, Kadokami, Ryo, Nakamura, Junji, Kanda, Masaaki, Hoshiga, Koichi, Sohmiya, Arihiro, Koyosue, Hiroki, Uehara, Naoto, Miyagi, Toshiya, Chinen, Kentaro, Nakamura, Chikashi, Nago, Suguru, Chiba, Sho, Hatano, Yoshikatsu, Gima, Masami, Abe, Masayoshi, Ajioka, Hiroshi, Asano, Yoshihiro, Nakashima, Hiroyuki, Osanai, Takahiro, Kanbara, Yusuke, Sakamoto, Mitsutoshi, Oguri, Shiou, Ohguchi, Kunihiko, Takahara, Kazuhiro, Izumi, Kenichiro, Yasuda, Akihiro, Kudo, Noritaka, Machii, Ryota, Morimoto, Yasuko, Bando, Takahiro, Okumura, Toru, Kondo, Shin-Ichiro, Miura, Yuhei, Shiga, Joji, Mirii, Makoto, Sugihara, Tadaaki, Arimura, Junko, Nakano, Kazuhisa, Kodama, Nobuyuki, Ohte, Tomonori, Sugiura, Kazuaki, Wakami, Yasuhiko, Takemoto, Minoru, Yoshiyama, Taichi, Shuto, Kazuo, Fukumoto, Kenichi, Tanaka, Satomi, Sonoda, Akemi, Tokutsu, Takashi, Otsuka, Fumi, Uemura, Kenji, Koikawa, Megumi, Miyazaki, Maiko, Umikawa, Manabu, Narisawa, Machi, Furuta, Hiroshi, Minami, Masaru, Doi, Kazuhiro, Sugimoto, Susumu, Suzuki, Akira, Kurozumi, and Kosuke, Nishio
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Ipragliflozin ,Type 2 diabetes ,Pharmacology (medical) ,Carotid intima-media thickness ,Atherosclerosis ,Cardiology and Cardiovascular Medicine - Abstract
Aims To examine the effects of a 24-month treatment with ipragliflozin on carotid intima-media thickness (IMT) in type 2 diabetes patients. Methods and results In this multicenter, prospective, randomized, open-label, and blinded-endpoint investigator-initiated clinical trial, adults with type 2 diabetes and haemoglobin A1C (HbA1c) of 6.0–10.0% (42–86 mmol/mol) were randomized equally to ipragliflozin (50 mg daily) and non-sodium-glucose cotransporter-2 (SGLT2) inhibitor use of standard-care (control group) for type 2 diabetes and were followed-up to 24 months. The primary endpoint was the change in mean common carotid artery IMT (CCA-IMT) from baseline to 24 months. A total of 482 patients were equally allocated to the ipragliflozin (N = 241) and control (N = 241) groups, and 464 patients (median age 68 years, female 31.7%, median type 2 diabetes duration 8 years, median HbA1c 7.3%) were included in the analyses. For the primary endpoint, the changes in the mean CCA-IMT from baseline to 24 months were 0.0013 [95% confidence interval (CI), −0.0155–0.0182] mm and 0.0015 (95% CI, −0.0155–0.0184) mm in the ipragliflozin and control groups, respectively, with an estimated group difference (ipragliflozin-control) of −0.0001 mm (95% CI, −0.0191–0.0189; P = 0.989). A group difference in HbA1c change at 24 months was also non-significant between the treatment groups [−0.1% (95% CI, −0.2–0.1); P = 0.359]. Conclusion Twenty-four months of ipragliflozin treatment did not affect carotid IMT status in patients with type 2 diabetes recruited in the PROTECT study, relative to the non-SGLT2 inhibitor-use standard care for type 2 diabetes.
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- 2022
18. Evolocumab for prevention of microvascular dysfunction in patients undergoing percutaneous coronary intervention: the randomised, open-label EVOCATION trial
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Masaharu, Ishihara, Masanori, Asakura, Kiyoshi, Hibi, Kozo, Okada, Wataru, Shimizu, Hitoshi, Takano, Satoru, Suwa, Kenshi, Fujii, Yasuo, Okumura, Toshiaki, Mano, Kenichi, Tsujita, Masataka, Igeta, Rika, Okamoto, and Shinichiro, Suna
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Percutaneous Coronary Intervention ,Treatment Outcome ,Troponin T ,Myocardial Infarction ,Humans ,Cholesterol, LDL ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Antibodies, Monoclonal, Humanized ,Cardiology and Cardiovascular Medicine - Abstract
Statins have been shown to prevent microvascular dysfunction that may cause periprocedural myocardial infarction after percutaneous coronary intervention (PCI). Evolocumab has more potent lipid-lowering properties than statins. Aims: The aims of this study were to investigate whether evolocumab pretreatment on top of statin therapy could prevent periprocedural microvascular dysfunction. Methods: This study included 100 patients with stable coronary artery disease who were scheduled to undergo PCI and had high low-density lipoprotein cholesterol (LDL-C) under statin therapy. Patients were randomised to receive evolocumab 140 mg every 2 weeks for 2 to 6 weeks before PCI (evolocumab group: N=54) or not (control group: N=46). The primary endpoint was the index of microvascular resistance (IMR) after PCI. Troponin T was measured before and 24 hours after PCI. Results: Geometric mean LDL-C was 94.1 (95% confidence interval [CI]: 86.8-102.1) mg/dl and 89.4 (95% CI: 83.5-95.7) mg/dl at baseline, and 25.6 (95% CI: 21.9-30.0) mg/dl and 79.8 (95% CI: 73.9-86.3) mg/dl before PCI, in the evolocumab group and in the control group, respectively. PCI was performed 22.1±8.5 days after allocation. Geometric mean IMR was 20.6 (95% CI: 17.2-24.6) in the evolocumab group and 20.6 (95% CI: 17.0-25.0) in the control group (p=0.98). There was no significant difference in the geometric mean of post-PCI troponin T (0.054, 95% CI: 0.041-0.071 ng/ml vs 0.054, 95% CI: 0.038-0.077 ng/ml; p=0.99) and in the incidence of major periprocedural myocardial infarction between the 2 groups (44.4% vs 44.2%; p=1.00). Conclusions: Evolocumab pretreatment did not prevent periprocedural microvascular dysfunction in patients on modern medical management with statins.
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- 2022
19. Impact of out-stent plaque characteristics on vascular response after second generation drug-eluting stent implantation: iMAP-intravascular ultrasound and angioscopic study
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Kenji Kawai, Minoru Ichikawa, Tohru Masuyama, Masaharu Ishihara, and Yoshiyuki Kijima
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Purpose: The purpose of this study is to elucidate the impact of out-stent plaque characteristics on vascular response after implantation of second generation drug-eluting stent (G2-DES). Methods: Enrolled were 37 patients with 39 coronary artery lesions into which three types of G2-DES were successfully implanted (9 Nobori biolimus-, BES; 15 Xience everolimus-, EES; 15 Resolute zotarolimus-eluting stents; R-ZES). Immediately after (baseline) and one year after the implantation (follow-up), iMAP-intravascular ultrasound (IVUS) was performed to measure out-stent plaque volume (OSPV) and its components. Percent OSPV and vulnerable plaque index (VPI) were defined as percentile of OSPV to vessel volume and as percentile of lipidic plus necrotic volume to OSPV. Coronary angioscopy at follow-up rated the degree of arterial repair by neointimal stent coverage (NSC). Results: Poor NSC was found in approximately 60% of each G2-DES. In BES, % OSPV at baseline was significantly greater in poor NSC than in good NSC (36.2 ± 3.9 vs. 27.3 ± 4.0%, P = 0.01). In EES, %OSPV was significantly greater in poor NSC than in good NSC (41.0 ± 4.1 vs. 32.6 ± 2.7%, P
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- 2018
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20. Twelve‐month safety and effectiveness of TCD‐17187 drug‐coated balloon for the treatment of atherosclerotic lesions in the superficial femoral and proximal popliteal artery
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Osamu, Iida, Yoshimitsu, Soga, Shu-Ichi, Seki, Daizo, Kawasaki, Hitoshi, Anzai, Hiroshi, Ando, Tatsuya, Nakama, Norihiko, Shinozaki, Amane, Kozuki, Masaharu, Ishihara, Kazushi, Urasawa, Satoru, Toi, Hiroaki, Tsujita, Kazuki, Tobita, Kenji, Ogata, Kazunori, Horie, Naoki, Hayakawa, Shinsuke, Mori, Masahiko, Fujihara, Takao, Ohki, Kenichiro, Yuba, Toshiaki, Mano, and Masato, Nakamura
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Aged, 80 and over ,Femoral Artery ,Peripheral Arterial Disease ,Treatment Outcome ,Humans ,Popliteal Artery ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,General Medicine ,Atherosclerosis ,Cardiology and Cardiovascular Medicine ,Aged - Abstract
The aim of this preapproval trial was to evaluate the 12-month safety and effectiveness of the TCD-17187 drug-coated balloon (DCB) for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and/or proximal popliteal artery (PA).This was a prospective, multicenter, core laboratory adjudicated, single-arm trial. From October 2019 to November 2020, a total of 121 symptomatic peripheral artery disease patients with SFA and/or proximal PA lesions were enrolled. The primary effectiveness endpoint was 12-month primary patency defined as freedom from restenosis as determined by duplex ultrasonography in the absence of clinically driven target lesion revascularization (CD-TLR). The safety endpoint was the major adverse event (MAE) rate defined as freedom from a composite of device- and procedure-related death within 30 days, and index limb major amputation and/or CD-TLR through follow-up.Average age was 74.5 ± 7.3 years and the frequency of diabetes mellitus was 67.5%. Average lesion length and vessel diameter were 106.0 ± 52.6 and 5.2 ± 0.8 mm, respectively. The frequency of chronic total occlusion and bilateral calcification was 17.5% and 50.8% of patients, respectively. The 12-month primary patency rate calculated by Kaplan-Meier analysis was 81.1%, while 12-month freedom from CD-TLR was 95.8%. The MAE rate at 30 days was 1.7% and all events comprised CD-TLR. There were no instances of device- or procedure-related deaths, major amputations, or thrombosis throughout the 12-month evaluation period.This preapproval trial confirmed the safety and effectiveness of TCD-17187 DCB in the treatment of atherosclerotic lesions in the SFA and/or proximal PA.
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- 2022
21. Impact of lipoprotein (a) on long-term outcome after percutaneous coronary intervention in the era of new generation drug-eluting stents
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Toshio, Kimura, Hirokuni, Akahori, Takamasa, Tanaka, Koji, Yanaka, Nagataka, Yoshihara, Kojiro, Miki, Takahiro, Imanaka, Masanori, Asakura, and Masaharu, Ishihara
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Percutaneous Coronary Intervention ,Treatment Outcome ,Risk Factors ,Humans ,Drug-Eluting Stents ,Coronary Artery Disease ,Prosthesis Design ,Cardiology and Cardiovascular Medicine ,Lipoprotein(a) - Abstract
High lipoprotein (a) [Lp (a)] levels are associated with worse long-term outcomes in patients undergoing percutaneous coronary intervention (PCI). However, there are limited studies investigating association between Lp (a) levels and long-term outcomes in the era of new generation drug-eluting stents (DES).A total of 495 patients with available data on Lp (a) who underwent PCI for de novo lesions with new generation DES were enrolled between 2013 and 2017. The primary endpoint was the major adverse cardiovascular event (MACE), which was defined as a composite of cardiac death, myocardial infarction, stent thrombosis, clinically driven target lesion revascularization, and revascularization for new lesions during 3 years. Patients were divided into 2 groups according to the Lp (a) level: high Lp (a) group (≥30 mg/dL: n = 109) and low Lp (a) group (30 mg/dL: n = 386). Multivariate Cox regression analysis was performed to identify the predictors for 3-year MACE.The incidence of 3-year MACE was significantly higher in high Lp (a) group than low Lp (a) group (33.0% vs. 15.9%, p 0.001). Multivariable analysis showed that Lp (a) level of ≥30 mg/dL was an independent predictor for 3-year MACE (HR 2.01, 95%CI 1.30-3.11, p = 0.002).High Lp (a) level was associated with worse long-term outcome even in the era of new generation DES.
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- 2022
22. Impact of lipoprotein(a) levels on primary patency after endovascular therapy for femoropopliteal lesions
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Koji Yanaka, Hirokuni Akahori, Takahiro Imanaka, Kojiro Miki, Nagataka Yoshihara, Toshio Kimura, Takamasa Tanaka, Masanori Asakura, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Abstract
Lipoprotein(a) [Lp(a)] is a risk factor for peripheral artery disease (PAD). However, the relationship between Lp(a) levels and clinical events after endovascular therapy (EVT) for the femoropopliteal artery in PAD patients remains unclear. Thus, this study aimed to assess the impact of Lp(a) levels on primary patency after EVT for de novo femoropopliteal lesions in PAD patients. A retrospective analysis was conducted on 109 patients who underwent EVT for de novo femoropopliteal lesions, and Lp(a) levels were measured before EVT between June 2016 and December 2019. Patients were divided into low Lp(a) [Lp(a) 30 mg/dL; 78 patients] and high Lp(a) [Lp(a) ≥ 30 mg/dL; 31 patients] groups. The main outcome was primary patency following EVT. Loss of primary patency was defined as a peak systolic velocity ratio 2.4 on a duplex scan or 50% stenosis on angiography. Cox proportional hazards analysis was performed to determine whether high Lp(a) levels were independently associated with loss of primary patency. The mean follow-up duration was 28 months. The rates of primary patency were 83 and 76% at 1 year and 75 and 58% at 2 years in the low and high Lp(a) groups, respectively (P = 0.02). After multivariate analysis, High Lp(a)[Lp(a) ≥ 30 mg/dL] (hazard ratio 2.44; 95% CI 1.10-5.44; P = 0.03) and female sex (hazard ratio 2.65; 95% CI 1.27-5.51; P 0.01) were independent predictors of loss of primary patency. Lp(a) levels might be associated with primary patency after EVT for de novo femoropopliteal lesions.
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- 2022
23. Mean pulmonary artery pressure estimated by echocardiogram rapidly exceeds 20 mmHg from the normal range in patients with connective tissue disease
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Yoshiyuki Orihara, Masanori Asakura, Kyung-Duk Min, Yuki Matsumoto, Isamu Sunayama, Koichi Nishimura, Akiyo Eguchi, Yoshitaka Okuhara, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Published
- 2023
24. α-Glucosidase inhibitor miglitol attenuates glucose fluctuation, heart rate variability and sympathetic activity in patients with type 2 diabetes and acute coronary syndrome: a multicenter randomized controlled (MACS) study
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Michio Shimabukuro, Atsushi Tanaka, Masataka Sata, Kazuoki Dai, Yoshisato Shibata, Yohei Inoue, Hiroki Ikenaga, Shinji Kishimoto, Kozue Ogasawara, Akira Takashima, Toshiyuki Niki, Osamu Arasaki, Koichi Oshiro, Yutaka Mori, Masaharu Ishihara, Koichi Node, and on behalf of the Collaborators on the Effect of Miglitol on Glucose Metabolism in Acute Coronary Syndrome (MACS) Study
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Acute coronary syndrome ,Glucose fluctuation ,Heart rate variability ,Hypoglycemia ,Miglitol ,Sympathetic nervous system activity ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Little is known about clinical associations between glucose fluctuations including hypoglycemia, heart rate variability (HRV), and the activity of the sympathetic nervous system (SNS) in patients with acute phase of acute coronary syndrome (ACS). This pilot study aimed to evaluate the short-term effects of glucose fluctuations on HRV and SNS activity in type 2 diabetes mellitus (T2DM) patients with recent ACS. We also examined the effect of suppressing glucose fluctuations with miglitol on these variables. Methods This prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group comparative study included 39 T2DM patients with recent ACS, who were randomly assigned to either a miglitol group (n = 19) or a control group (n = 20). After initial 24-h Holter electrocardiogram (ECG) (Day 1), miglitol was commenced and another 24-h Holter ECG (Day 2) was recorded. In addition, continuous glucose monitoring (CGM) was performed throughout the Holter ECG. Results Although frequent episodes of subclinical hypoglycemia (≤4.44 mmo/L) during CGM were observed on Day 1 in the both groups (35% of patients in the control group and 31% in the miglitol group), glucose fluctuations were decreased and the minimum glucose level was increased with substantial reduction in the episodes of subclinical hypoglycemia to 7.7% in the miglitol group on Day 2. Holter ECG showed that the mean and maximum heart rate and mean LF/HF were increased on Day 2 in the control group, and these increases were attenuated by miglitol. When divided 24-h time periods into day-time (0700–1800 h), night-time (1800–0000 h), and bed-time (0000–0700 h), we found increased SNS activity during day-time, increased maximum heart rate during night-time, and glucose fluctuations during bed-time, which were attenuated by miglitol treatment. Conclusions In T2DM patients with recent ACS, glucose fluctuations with subclinical hypoglycemia were associated with alterations of HRV and SNS activity, which were mitigated by miglitol, suggesting that these pathological relationships may be a residual therapeutic target in such patients. Trial registration Unique Trial Number, UMIN000005874 ( https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000006929 )
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- 2017
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25. A case of infective endocarditis diagnosed simultaneously with quadricuspid aortic valve and anomalous origin of coronary artery by transesophageal echocardiography
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Eri MANABE, Kyung-duk MIN, Kohei AZUMA, Masataka SUGAHARA, Masanori ASAKURA, and Masaharu ISHIHARA
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Radiology, Nuclear Medicine and imaging - Published
- 2023
26. In memoriam—Dr. Hikaru Sato: the discoverer of Takotsubo syndrome
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Michiaki Nagai, Keigo Dote, Masaharu Ishihara, and Satoshi Kurisu
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Cardiology and Cardiovascular Medicine - Published
- 2022
27. I. General: Read Treatment Algorism for Heart Failure in the Guideline Focused Update; 1. Heart Failure with Reduced Ejection Fraction (HFrEF)
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Masanori Asakura and Masaharu Ishihara
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General Medicine - Published
- 2022
28. Urine albumin-to-creatinine ratio on admission predicts early rehospitalization in patients with acute decompensated heart failure
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Yuki, Matsumoto, Yoshiyuki, Orihara, Masanori, Asakura, Kyung-Duk, Min, Yoshitaka, Okuhara, Kohei, Azuma, Koichi, Nishimura, Isamu, Sunayama, Kazunori, Kashiwase, Yoshiro, Naito, Akiko, Goda, and Masaharu, Ishihara
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Aged, 80 and over ,Heart Failure ,Male ,Albumins ,Creatinine ,Natriuretic Peptide, Brain ,Humans ,Female ,Prospective Studies ,Urinalysis ,Prognosis ,Cardiology and Cardiovascular Medicine - Abstract
Detecting high-risk patients for early rehospitalization is crucial in heart failure patient care. An association of albuminuria with cardiovascular events is well known. However, its predictive impact on rehospitalization for acute decompensated heart failure (ADHF) remains unknown. In this study, 190 consecutive patients admitted due to ADHF between 2017 and April 2019 who underwent urinalysis were enrolled. Among them, 140 patients from whom urine albumin-to-creatinine ratio (UACR) was measured with spot urine samples on admission were further analyzed. The association between UACR and rehospitalization due to HF during 1 year after discharge was evaluated. The mean age of 140 participants was 77.6 years and 55% were men. Only 18% (n = 25) of patients presented with normoalbuminuria (UACR 30 mg/g∙creatinine), whereas 59% (n = 83) and 23% (n = 32) showed microalbuminuria (UACR 30-300 mg/g·creatinine) and macroalbuminuria (UACR 300 mg/g·creatinine), respectively. The level of UACR on admission was correlated with the risk of subsequent rehospitalization due to HF (p = 0.017). The receiver operating characteristic analysis indicated that the best cut-off values for the UACR and B-type natriuretic peptide (BNP) levels to predict ADHF rehospitalization were 50 mg/g·creatinine and 824 pg/ml, respectively. When the patients were divided into four groups using both cut-off values, the individual predictive impacts of UACR and BNP on rehospitalization were comparable. Patients with both elevated UACR and BNP levels had a higher rate of HF rehospitalization than those with elevated BNP levels alone (p 0.05). The combination of both values enabled more accurate prediction of HF rehospitalization than BNP levels alone. In conclusion, UACR could be a new useful biomarker to predict HF rehospitalization in patients with ADHF, especially in combination with the levels of BNP, and should be further evaluated in a prospective study.
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- 2022
29. Design and rationale of the EVOCATION trial: A prospective, randomized, exploratory study comparing the effect of evolocumab on coronary microvascular function after percutaneous coronary intervention in patients with stable coronary artery disease
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Kenshi Fujii, Masataka Igeta, Kiyoshi Hibi, Masaharu Ishihara, Masanori Asakura, Rika Okamoto, Yasuo Okumura, Toshiaki Mano, Satoru Suwa, and Wataru Shimizu
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medicine.medical_specialty ,Statin ,business.industry ,medicine.drug_class ,Standard treatment ,medicine.medical_treatment ,Percutaneous coronary intervention ,Coronary Artery Disease ,Antibodies, Monoclonal, Humanized ,medicine.disease ,Coronary artery disease ,Evolocumab ,Percutaneous Coronary Intervention ,Treatment Outcome ,Internal medicine ,Conventional PCI ,medicine ,Clinical endpoint ,Cardiology ,Humans ,Prospective Studies ,cardiovascular diseases ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business - Abstract
Percutaneous coronary intervention (PCI) is a standard treatment in patients with stable coronary artery disease (CAD); however, periprocedural myocardial infarction (PMI) remains a common complication of PCI. Aggressive lipid-lowering therapy with statin has shown to reduce the incidence of PMI by preventing coronary microvascular dysfunction. It is unclear whether evolocumab, a potent lipid-lowering agent, could diminish microvascular damage after PCI. The EVOCATION trial (jRCTs051180022) is a multicenter, randomized, open-label, active-controlled, parallel-group, exploratory, investigator-initiated clinical study to evaluate whether pretreatment with evolocumab could decrease the index of microvascular resistance (IMR) after PCI in patients with stable CAD. This study population consists of 100 patients with stable CAD who will undergo PCI and have high low-density lipoprotein cholesterol levels despite administration of maximum tolerated dose of statins for at least 2 weeks. Eligible patients are randomized in a 1:1 ratio to receive either evolocumab 140 mg every 2 weeks in addition to standard of care treatment or standard of care treatment only for 2-6 weeks before PCI. The primary endpoint is IMR after PCI. The EVOCATION trial will evaluate whether pretreatment with evolocumab reduces periprocedural microvascular damage in patients with stable CAD undergoing PCI.
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- 2022
30. Prediction of Long-Term Outcomes in ST-Elevation Myocardial Infarction and Non-ST Elevation Myocardial Infarction with and without Creatinine Kinase Elevation—Post-Hoc Analysis of the J-MINUET Study
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Shigeru Toyoda, Masashi Sakuma, Shichiro Abe, Teruo Inoue, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Atsunori Okamura, Toshiaki Mano, Minoru Wake, Kengo Tanabe, Yoshisato Shibata, Mafumi Owa, Kenichi Tsujita, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Tetsuya Toubaru, Keijirou Saku, Shigeru Ohshima, Yoshihiro Miyamoto, Hisao Ogawa, and Masaharu Ishihara
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myocardial infarction ,cardiac troponin ,creatine kinase ,predictor of prognosis ,risk score ,Medicine - Abstract
Background: A Japanese prospective, nation-wide, multicenter registry (J-MINUET) showed that long-term outcomes were worse in non-ST elevation acute myocardial infarction (NSTEMI), diagnosed by increased cardiac troponin levels, compared to STEMI. This was observed in both non-STEMI with elevated creatine kinase (CK) (NSTEMI+CK) and non-STEMI without elevated CK (NSTEMI-CK). However, predictive factors for long-term outcomes in STEMI, NSTEMI+CK, and NSTEMI-CK have not been elucidated. Methods: Using the Cox proportional hazards model, we determined significant independent predictors of long-term outcomes from a total of 111 parameters evaluated in the J-MINUET study in each of our groups, including STEMI, NSTEMI+CK, and NSTEMI-CK. Then, we calculated the risk score using the regression coefficients for the determined independent predictors for the strict prediction of long-term outcomes. Results: Prognostic factors, as well as composite cardiovascular events and all-cause death, were different between STEMI, NSTEMI+CK, and NSTEMI-CK. Risk scores could effectively and powerfully predict both composite cardiovascular events and all-cause death in each group. Conclusions: The prediction of long-term outcomes using cored parameters of baseline demographics and clinical characteristics is feasible and could prove useful in establishing therapeutic strategies in patients with STEMI, NSTEMI+CK, and NSTEMI-CK.
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- 2020
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31. Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm
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Ryota Sato, Kenji Sakamoto, Koichi Kaikita, Kenichi Tsujita, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Satoshi Yasuda, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Toshiaki Mano, Kazuhito Hirata, Kengo Tanabe, Yoshisato Shibata, Mafumi Owa, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Shirou Uemura, Tetsuya Toubaru, Keijirou Saku, Shigeru Ohshima, Kunihiro Nishimura, Yoshihiro Miyamoto, Hisao Ogawa, and Masaharu Ishihara
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acute myocardial infarction ,clinical outcomes ,coronary vasospasm ,universal definition of myocardial infarction ,Medicine - Abstract
While prognoses in relation to myocardial infarction (MI) type have been elucidated in past reports, the results were not consistent, perhaps due to occurrence of Type 2 MI with CVS and its mortality. The Japanese registry of acute Myocardial Infarction diagnosed by Universal Definition (J-MINUET) is a prospective multicenter registry in Japan. In contrast to thromboembolic event-related Type 1 myocardial infarction (MI), clinical features of Type 2 MI, including coronary vasospasm (CVS), are varied due to the heterogeneous nature of its development. To elucidate the MI type-related all-cause mortality, 2989 consecutive patients with AMI were stratified as Type 1 MI, Type 2 MI with CVS, and Type 2 MI with non-CVS. Most patients (n = 2834; 94.8%) were classified as Type 1 MI and 155 patients (5.2%) were classified as Type 2 MI. Of the Type 2 MI patients, 87 (56% of Type 2 MI) were diagnosed as MI with CVS. Although the 3-year mortality was comparable between Type 1 and Type 2 MI patients, significant differences were observed between Type 2 MI with CVS and with non-CVS (3.4% and 22.1%, p < 0.001). Among Japanese patients with AMI, mortality rates between Type 1 MI and Type 2 MI are comparable, but further stratification of Type 2 MI (with or without CVS) may be useful in predicting the prognosis of patients with Type 2 MI.
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- 2020
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32. Effects of early diuretic response to carperitide in acute decompensated heart failure treatment: A single-center retrospective study.
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Yoshitaka Okuhara, Masanori Asakura, Kohei Azuma, Yoshiyuki Orihara, Koichi Nishimura, Tomotaka Ando, Hideyuki Kondo, Yoshiro Naito, Kazunori Kashiwase, Shinichi Hirotani, Masaharu Ishihara, and Tohru Masuyama
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Medicine ,Science - Abstract
BACKGROUND:Diuretic response is a strong predictor of outcome for admitted patients of acute decompensated heart failure (ADHF). However, little is known about the effects of early diuretic response to carperitide. METHODS:We retrospectively analyzed records of 85 patients hospitalized for ADHF who received carperitide as initial treatment and
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- 2018
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33. Impact of Chronic Kidney Disease on In-Hospital and 3-Year Clinical Outcomes in Patients With Acute Myocardial Infarction Treated by Contemporary Percutaneous Coronary Intervention and Optimal Medical Therapy ― Insights From the J-MINUET Study ―
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Minoru Wake, Shigeru Oshima, Yoshihiko Miyamoto, Y Hashimoto, Tevfik F Ismail, Hiroshi Funayama, Teruo Inoue, Hideo Izawa, Yukio Ozaki, Kenichi Tsujita, Nobuaki Kokubu, Junya Ako, Kengo Tanabe, Toshiaki Mano, Yasuhiro Morita, Satoru Suwa, Atsunori Okamura, Kazuteru Fujimoto, Wataru Shimizu, Atsushi Hirohata, Satoshi Yasuda, Mafumi Owa, Tetsuya Tobaru, Shiro Uemura, Kazuoki Dai, Kazuo Kimura, Kunihiro Nishimura, Masaharu Ishihara, Hiroshi Takahashi, Yoshihiko Saito, Takashi Morita, Teruo Noguchi, Shino Kan, Takashi Muramatsu, Ken Kozuma, Koichi Nakao, Hisao Ogawa, Yoshisato Shibata, and Keijiro Saku
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medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Renal Insufficiency, Chronic ,Stage (cooking) ,Stroke ,business.industry ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Hospitals ,female genital diseases and pregnancy complications ,Treatment Outcome ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Kidney disease - Abstract
BACKGROUND The impact of chronic kidney disease (CKD) on long-term outcomes following acute myocardial infarction (AMI) in the era of modern primary PCI with optimal medical therapy is still in debate.Methods and Results:A total of 3,281 patients with AMI were enrolled in the J-MINUET registry, with primary PCI of 93.1% in STEMI. CKD stage on admission was classified into: no CKD (eGFR ≥60 mL/min/1.73 m2); moderate CKD (60>eGFR≥30 mL/min/1.73 m2); and severe CKD (eGFR
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- 2021
34. Mechanisms of gradual pressure drop in angiographically normal left anterior descending and right coronary artery: Insights from wave intensity analysis
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Kojiro Miki, Masaharu Ishihara, Hiroto Tamaru, Masahiko Shibuya, Machiko Nishimura, Kenji Kawai, Tohru Masuyama, Tetsuo Horimatsu, Masashi Fukunaga, Kenichi Fujii, Takahiro Imanaka, Akinori Sumiyoshi, and Ten Saita
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medicine.medical_specialty ,Suction ,Hyperemia ,Fractional flow reserve ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Coronary circulation ,0302 clinical medicine ,Coronary Circulation ,Internal medicine ,medicine.artery ,Humans ,Medicine ,Arterial Pressure ,cardiovascular diseases ,030212 general & internal medicine ,business.industry ,Mean Aortic Pressure ,Coronary Vessels ,Intensity (physics) ,Coronary arteries ,Ostium ,surgical procedures, operative ,medicine.anatomical_structure ,Right coronary artery ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity - Abstract
Background This study evaluated the mechanism of decline in coronary pressure from the proximal to the distal part of the coronary arteries in the left anterior descending (LAD) versus the right coronary artery (RCA) from the insight of coronary hemodynamics using wave intensity analysis (WIA). Methods Twelve patients with angiographically normal LAD and RCA were prospectively enrolled. Distal coronary pressure, mean aortic pressure, and average peak velocity were measured at 4 different positions: 9, 6, 3, and 0 cm distal from each coronary ostium. Results The distal-to-proximal coronary pressure ratio during maximum hyperemia gradually decreased in proportion to the distance from the ostium (0.92±0.03 and 0.98±0.03 at 9 cm distal to the LAD and RCA ostium). WIA showed the dominant forward-traveling compression wave gradually decreased and the backward-traveling suction wave gradually decreased in proportion to the decrease in coronary pressure through the length of the non-diseased LAD but not the RCA. Conclusions The pushing wave and suction wave intensities on WIA were diminished in proportion to the distance from the ostium of the LAD despite the wave intensity not changing across the length of the RCA, which may lead to gradual intracoronary pressure drop in the angiographically normal LAD.
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- 2021
35. Iron Deficiency Induces Heart Failure With Ectopic Cardiac Calcification in Mice With Metabolic Syndrome
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Yoshiro Naito, Hisashi Sawada, Seiki Yasumura, Tetsuo Horimatsu, Keisuke Okuno, Saki Tahara, Koichi Nishimura, Masanori Asakura, Takeshi Tsujino, Tohru Masuyama, and Masaharu Ishihara
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Heart Failure ,Metabolic Syndrome ,Mice ,Anemia, Iron-Deficiency ,Animals ,Heart ,Iron Deficiencies ,Cardiology and Cardiovascular Medicine - Abstract
Iron deficiency is linked to worse clinical status and outcomes in heart failure. Although metabolic syndrome contributes to the development of heart failure, the impact of iron deficiency in heart failure complicated with metabolic syndrome remains obscure. KKAy mice were used as a model of metabolic syndrome. Four-week-old male C57BL/6J and KKAy mice were fed either a normal diet or iron-restricted (IR) diet for 12 weeks. During the experiment, 40% of mice died due to pulmonary congestion in KKAy mice with IR diet (KKAy-IR), while no mice died in other groups. Necropsy showed the presence of multiple white lesions on the cardiac surface in those KKAy-IR mice. Echocardiography and histological analyses revealed that KKAy-IR mice exhibited cardiac hypertrophy and cardiac dysfunction with cardiac calcification. Cardiac mRNA of ectonucleotide pyrophosphatase/phosphodiesterase-1 (Enpp1), a key enzyme for bone mineralization, was highly abundant in KKAy-IR mice. Of note, iron restriction-induced cardiac calcification and dysfunction were attenuated by etidronate, an inhibitor of bone mineralization, with decreased cardiac Enpp1 mRNA abundance in KKAy-IR mice. In conclusion, iron deficiency leads to ectopic cardiac calcification and dysfunction with the increase of Enpp1 in metabolic syndrome model mice.
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- 2022
36. Relationship Between Lipoprotein(a) and Angiographic Severity of Femoropopliteal Lesions
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Takahiro Imanaka, Nagataka Yoshihara, Masanori Asakura, Kojiro Miki, Toshio Kimura, Koji Yanaka, Hirokuni Akahori, Takamasa Tanaka, and Masaharu Ishihara
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Male ,medicine.medical_specialty ,Arterial disease ,Endovascular therapy ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Gastroenterology ,Femoropopliteal lesion ,Lesion ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Popliteal Artery ,In patient ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,biology ,business.industry ,Endovascular Procedures ,Biochemistry (medical) ,Angiography ,Lipoprotein(a) ,medicine.disease ,Femoral Artery ,biology.protein ,Original Article ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Calcification ,Lipoprotein - Abstract
Aim: High levels of lipoprotein(a) [Lp(a)] are a risk factor for peripheral artery disease (PAD). However, the relationship between Lp(a) levels and the severity of femoropopliteal lesions in patients with PAD has not been systematically studied. This study aimed to assess the impact of Lp(a) levels on angiographic severity of femoropopliteal lesions in patients with PAD. Methods: We retrospectively analyzed a single-center database including 108 patients who underwent endovascular therapy for de novo femoropopliteal lesions and measured the Lp(a) levels before therapy between June 2016 and September 2019. Patients were divided into low Lp(a) [Lp(a) <30 mg/dL; 77 patients] and high Lp(a) [Lp(a) ≥ 30 mg/dL; 31 patients] groups. Trans-Atlantic Inter-Society Consensus (TASC) II classification, calcification [referring to the peripheral arterial calcium scoring system (PACSS) classification], and lesion length were compared between the groups. Results: The prevalence of TASC II class D (13% vs 38%, P <0.01) and severe calcification (PACSS 4) (6% vs 23%, P =0.02) was significantly higher and the lesion length longer (123±88 mm vs 175±102 mm, P <0.01) in the high Lp(a) group than in the low Lp(a) group. In multivariate analysis, Lp(a) ≥ 30 was an independent predictor for the prevalence of TASC II class D (HR=3.67, 95% CI 1.27–10.6, P =0.02) and PACSS 4 (HR=4.97, 95% CI 1.27–19.4, P =0.02). Conclusion: The prevalence of TASC II class D and severe calcification of femoropopliteal lesions was higher in patients with high Lp(a) than those with low Lp(a).
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- 2021
37. Validation of the atherothrombotic risk score for secondary prevention in patients with acute myocardial infarction: the J-MINUET study
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Junya Ako, Toshiaki Mano, Mafumi Owa, Ken Kozuma, Atsunori Okamura, Kazuteru Fujimoto, Yoshihiro Miyamoto, J-Minuet investigators, Teruo Noguchi, Shigeru Oshima, Satoru Suwa, Yoshisato Shibata, Kazuhito Hirata, Teruo Inoue, Yasuharu Nakama, Kazuo Kimura, Kunihiro Nishimura, Kenichi Tsujita, Yoshiyasu Minami, Kengo Tanabe, Masaharu Ishihara, Hisao Ogawa, Yasuhiro Morita, Atsushi Hirohata, Tetsuya Tobaru, Koichi Nakao, Yukio Ozaki, Wataru Shimizu, Takashi Morita, Nobuaki Kokubu, Takuya Hashimoto, Shiro Uemura, Keijiro Saku, Yoshihiko Saito, and Hiroshi Funayama
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medicine.medical_specialty ,Framingham Risk Score ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,Thrombolysis ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Conventional PCI ,Cohort ,medicine ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,Mace - Abstract
Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS2°P) is a contemporary risk scoring system for secondary prevention based on nine clinical factors. However, this scoring system has not been validated in other populations. The aim of this study was to validate the TRS2°P in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI) in a nationwide registry cohort. Among 3283 consecutive patients with AMI enrolled in the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET), a total of 2611 patients who underwent primary PCI were included in this study. The performance of the TRS2°P to predict major adverse cardiovascular events (MACE) composed of all-cause death, non-fatal MI, and non-fatal stroke up to 3 years in the present cohort was evaluated. The TRS2°P had modest discriminative performance in this J-MINUET cohort with a c-statistic of 0.63, similar to that in the derived cohort (TRA2°P-TIMI50, c-statistic 0.67). A strong graded relationship between the TRS2°P and 3-year cardiovascular event rates was also observed in the J-MINUET cohort. Age ≥ 75 years, Killip ≥ 2, prior stroke, peripheral artery disease, anemia, and non-ST-elevation myocardial infarction were identified as independent factors for the incidence of MACE. The TRS2°P modestly predicted secondary cardiovascular events among patients with AMI treated by primary PCI in a nationwide cohort of Japan. Further studies are needed to develop a novel risk score better predicting secondary cardiovascular events.
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- 2021
38. Iron-restricted pair-feeding affects renal damage in rats with chronic kidney disease.
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Yoshiro Naito, Aya Senchi, Hisashi Sawada, Makiko Oboshi, Tetsuo Horimatsu, Keisuke Okuno, Seiki Yasumura, Masaharu Ishihara, and Tohru Masuyama
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Medicine ,Science - Abstract
BACKGROUND:We have previously shown that dietary iron restriction prevents the development of renal damage in a rat model of chronic kidney disease (CKD). However, iron deficiency is associated with appetite loss. In addition, calorie restriction is reported to prevent the development of end-stage renal pathology in CKD rats. Thus, the beneficial effect of iron restriction on renal damage may depend on calorie restriction. Here, we investigate the effect of pair-feeding iron restriction on renal damage in a rat model of CKD. METHODS:First, to determine the amount of food intake, Sprague-Dawley (SD) rats were randomly given an ad libitum normal diet or an iron-restricted diet, and the food intake was measured. Second, CKD was induced by a 5/6 nephrectomy in SD rats, and CKD rats were given either a pair-feeding normal or iron-restricted diet. RESULTS:Food intake was reduced in the iron-restricted diet group compared to the normal diet group of SD rats for 16 weeks (mean food intake; normal diet group and iron-restricted diet group: 25 and 20 g/day, respectively). Based on the initial experiments, CKD rats received either a pair-feeding normal or iron-restricted diet (20 g/day) for 16 weeks. Importantly, pair-feeding iron restriction prevented the development of proteinuria, glomerulosclerosis, and tubulointerstitial damage in CKD rats. Interestingly, pair-feeding iron restriction attenuated renal expression of nuclear mineralocorticoid receptor in CKD rats. CONCLUSIONS:Pair-feeding iron restriction affected renal damage in a rat model of CKD.
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- 2017
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39. Efficacy and safety of novel anticoagulant dabigatran in clinical practice for Japanese patients with non-valvular atrial fibrillation
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Koji Miyamoto, Takeshi Aiba, Ikutaro Nakajima, Yuko Yamada, Hideo Okamura, Takashi Noda, Kazuhiro Satomi, Masaharu Ishihara, Toshihisa Anzai, Satoshi Yasuda, Hisao Ogawa, Shiro Kamakura, and Wataru Shimizu
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Dabigatran ,Atrial fibrillation ,Efficacy ,Safety ,Japanese ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: There is little evidence of the efficacy and safety of dabigatran in Japanese patients with non-valvular atrial fibrillation (NVAF). Methods and Results: We evaluated 300 consecutive patients with NVAF (68±11 years old, 209 men, 180 paroxysmal) who received 220 mg/day (203 patients) or 300 mg/day dabigatran (97 patients) at our hospital. Most patients (84%) had lower CHADS2 (congestive heart failure, hypertension, age>75 years, diabetes, stroke/transient ischemic attack) scores of 0 (n=60), 1 (n=114), or 2 (n=78) and lower HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition) scores of 0 (n=39), 1 (n=114), or 2 (n=103). The estimated creatinine clearance was 77±24 mL/min, which was inversely correlated to age (r2=0.48, p
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- 2014
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40. Impact of Age on Gender Difference in Long-term Outcome of Patients With Acute Myocardial Infarction (from J-MINUET)
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Atsunori Okamura, Satoru Suwa, Kazuteru Fujimoto, Toshio Kimura, Yoshihiko Saito, Wataru Shimizu, Yukio Ozaki, Minoru Wake, Yoshisato Shibata, Tetsuya Toubara, Nobuaki Kokubu, Junya Ako, Takashi Morita, Keijiro Saku, Toshiaki Mano, Masaharu Ishihara, Masanori Asakura, Atsushi Hirohata, Yoshihiro Miyamoto, Hisao Ogawa, Hiroshi Funayama, Mafumi Owa, Ken Kozuma, Shiro Uemura, Koichi Nakao, Teruo Inoue, J-Minuet investigators, Shigeru Oshima, Hirokuni Akahori, Kazuo Kimura, Kunihiro Nishimura, Teruo Noguchi, Kengo Tanabe, Yasuharu Nakama, Kenichi Tsujita, and Yasuhiro Morita
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Male ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Coronary Angiography ,0302 clinical medicine ,Japan ,Recurrence ,Atrial Fibrillation ,Myocardial Revascularization ,Clinical endpoint ,Longitudinal Studies ,Registries ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,Aged, 80 and over ,Age Factors ,Middle Aged ,Prognosis ,Practice Guidelines as Topic ,Cardiology ,Female ,Guideline Adherence ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,Revascularization ,Time-to-Treatment ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Sex Factors ,Internal medicine ,medicine ,Humans ,Angina, Unstable ,cardiovascular diseases ,Mortality ,Renal Insufficiency, Chronic ,Major adverse cardiovascular event ,Aged ,Heart Failure ,Unstable angina ,business.industry ,medicine.disease ,Heart failure ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Platelet Aggregation Inhibitors ,Mace - Abstract
Although gender difference in long-term outcomes after acute myocardial infarction have been shown previously, impact of age on gender difference is still controversial. This study focused on the association between age and gender difference in long-term outcome. We analyzed data from 3,283 consecutive patients who were included in a prospective, nationwide, multicenter registry (Japan Registry of Acute Myocardial Infarction Diagnosed by Universal Definition) from 2012 to 2014. The primary end point was the major adverse cardiovascular event (MACE), which was defined as a composite of death, myocardial infarction, stroke, heart failure, and revascularization for unstable angina during 3 years. Patients were divided into 4 strata according to age: those with age65 years (group 1: n = 1161), 65 to 74 years (group 2: n = 954), 75 to 84 years (group 3: n = 866) and 84years (group 4: n = 302). Although the crude incidence of 3-year MACE was significantly higher in women than men (36.4% vs. 28.5%, p0.001), there was not significant gender difference in each group (group 1, 19.6% vs 19.0%, p = 0.74; group 2, 33.1% vs 28.3%, p = 0.25; group 3, 38.9% vs 39.6%, p = 0.54; and group 4, 54.0% vs 56.8%, p = 0.24). In conclusion, although women had higher crude incidence of 3-year MACE than men, there was no gender difference in each group.
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- 2021
41. Iron and cardiovascular diseases
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Tohru Masuyama, Yoshiro Naito, and Masaharu Ishihara
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medicine.medical_specialty ,Iron Overload ,Iron ,030204 cardiovascular system & hematology ,Bioinformatics ,medicine.disease_cause ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Heart Failure ,Fenton reaction ,business.industry ,Iron Deficiencies ,Iron deficiency ,Atherosclerosis ,medicine.disease ,Oxidative Stress ,Cardiovascular Diseases ,Heart failure ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Oxidative stress - Abstract
Iron is a necessary element for life; however, excess iron leads to oxidative stress by the Fenton reaction. Iron deficiency is prevalent in patients with heart failure, while iron overload is associated in the pathogenesis of atherosclerosis. These findings suggest the "iron paradox" in cardiovascular diseases. Iron metabolism in cardiovascular diseases is complex, and the mechanisms regulating systemic and cellular iron metabolism in cardiovascular diseases remain completely unknown. In this review, we focus on the role of iron in cardiovascular diseases.
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- 2021
42. Clinical characteristics and in-hospital outcomes in patients aged 80 years or over with cardiac troponin-positive acute myocardial infarction -J-MINUET study
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Atsushi Hirohata, Koichi Nakao, Ken Kozuma, Wataru Shimizu, Shigeru Oshima, Takashi Morita, Mafumi Owa, Tsunenari Soeda, Kenichi Tsujita, Hiroyuki Okura, Yoshihiro Miyamoto, Yukio Ozaki, Nobuaki Kokubu, Satoru Suwa, Hisao Ogawa, Teruo Inoue, Kengo Tanabe, Yasuhiro Morita, Shiro Uemura, Yoshisato Shibata, Hiroshi Funayama, Atsunori Okamura, Keijirou Saku, Kazuteru Fujimoto, Yoshihiko Saito, Masaharu Ishihara, Tetsuya Toubaru, Kazuhito Hirata, Kazuo Kimura, Yasuharu Nakama, Teruo Noguchi, Junya Ako, and Toshiaki Mano
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Male ,medicine.medical_specialty ,Myocardial Infarction ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Hospital Mortality ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,Aged ,Aged, 80 and over ,Heart Failure ,business.industry ,Incidence ,Incidence (epidemiology) ,Age Factors ,Atrial fibrillation ,Middle Aged ,Prognosis ,medicine.disease ,Hospitals ,Troponin ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Dyslipidemia ,Kidney disease - Abstract
Background The prevalence of acute myocardial infarction (AMI) in elderly people is increasing worldwide. However, their characteristics and prognosis have been rarely investigated. This study aimed to investigate the characteristics and prognosis in elderly patients with cardiac troponin-positive AMI. Methods Consecutive patients with AMI from the J-MINUET study were divided into the following 3 groups: patients aged less than 65 years, those aged between 65 and 79 years, and those aged 80 years or over. Their characteristics and in-hospital outcomes were compared. Results Patients with AMI aged 80 years or over had the highest incidence of female gender, and the highest incidence of hypertension, chronic kidney disease, and cardiovascular disease, such as peripheral artery disease, atrial fibrillation, and stroke, whereas they had the lowest body mass index, and the lowest incidence of current smoker, diabetes mellitus, and dyslipidemia. Patients with AMI aged 80 years or over had significantly longer onset to door time and longer door to device time, and lower peak creatine kinase (CK). The incidence of ST-segment elevation myocardial infarction (STEMI) was the lowest in the AMI patients aged 80 years or over, but the patients had a higher incidence of in-hospital death and cardiac failure than the other two groups. In addition, the presentation with STEMI and non-ST-segment elevation myocardial infarction with CK elevation among patients aged 80 years or over showed the highest incidence of in-hospital death and cardiac failure. Conclusions J-MINUET showed different clinical characteristics between the aged and younger populations. The incidence of in-hospital death and cardiac failure in patients aged 80 years or over with AMI was poorer than their younger counterparts.
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- 2021
43. Left ventricular stiffness assessed by diastolic Wall strain predicts asymptomatic atrial high-rate episodes in patients with pacemaker implantation
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Eiji Fukuhara, Masaharu Ishihara, Hideyuki Kishima, and Takanao Mine
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Male ,Pacemaker, Artificial ,medicine.medical_specialty ,Heart Ventricles ,Diastole ,Strain (injury) ,030204 cardiovascular system & hematology ,Risk Assessment ,Asymptomatic ,Pacemaker implantation ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Sinus rhythm ,In patient ,Heart Atria ,030212 general & internal medicine ,Aged ,High rate ,Heart Murmurs ,business.industry ,Incidence ,Arrhythmias, Cardiac ,Middle Aged ,medicine.disease ,Echocardiography ,Cardiology ,Ventricular stiffness ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Cardiac implantable electronic device-detected atrial high-rate episodes (AHREs) have been reported to be associated with thromboembolic risks. The present study aimed to investigate the association of echocardiographic and clinical parameters with the occurrence of AHREs in patients with a dual-chamber pacemaker (PMI).One hundred forty-seven patients (76 males, 75.2 ± 8.9 years) who did not show atrial tachyarrhythmia before the implantation of the PMI were studied. Diastolic wall strain (DWS) and other measurements were assessed during sinus rhythm using transthoracic echocardiography before the PMI. DWS was calculated from the M-mode echocardiographic measurement of the left ventricular (LV) posterior wall thickness at end-systole (PWs) and end-diastole (PWd), and DWS was defined as (PWs-PWd) / PWs.AHREs (defined as AHREs duration6 min and atrial rate180 bpm) were detected in 50 / 147 patients during follow up (38.3 ± 13.8 months). Patients in the AHREs group had reduced DWS (0.29 ± 0.07 vs. 0.39 ± 0.06, p 0.0001), larger left atrial volume index, thicker LV posterior diameter, higher rate of patients taking β-blocker / diuretics, and higher prevalence of sinus node dysfunction. On multivariable analysis, only DWS was independently associated with AHREs. Patients with reduced DWS (0.33) had a higher risk of incidences of AHREs.LV stiffness assessed by DWS was associated with AHREs in patients with a PMI.
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- 2021
44. Efficacy of optical frequency domain imaging in detecting peripheral artery disease: the result of a multi-center, open-label, single-arm study
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Yasumasa Kakei, Toshiro Shinke, Takashi Kubo, Takayoshi Toba, Takashi Omori, Amane Kozuki, Akihide Konishi, Hirokuni Akahori, Hiromasa Otake, Ken-ichi Hirata, Junya Shite, Takahiro Yasuda, Isao Nanba, Hiroaki Tsujita, Kosuke Tanimura, Yoshiro Tsukiyama, Shinsuke Nakano, Hiroyuki Kawamori, and Masaharu Ishihara
- Subjects
medicine.medical_specialty ,business.industry ,Lumen (anatomy) ,Disease ,030204 cardiovascular system & hematology ,Vascular surgery ,Cardiac surgery ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Clinical endpoint ,Medicine ,030212 general & internal medicine ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Blood vessel ,Artery - Abstract
Optical frequency domain imaging (OFDI) is a high-resolution intracoronary imaging modality with fast automated longitudinal pullback. We aimed to evaluate the ability of performing OFDI from the superficial femoral artery (SFA) to the below-knee (BK) artery. This clinical trial was a multi-center, single-arm, open-label study. The primary endpoint was to obtain a clear image of the intra-vascular lumen from the SFA to the BK artery, specifically > 270° visualization of the blood vessel lumen with > 16/21 cross sections. The proportion of the clear image (≥ 85%) was regarded as confirmatory of the ability of OFDI to visualize the vessel lumen. Overall, 20 patients were enrolled. The proportion of the primary endpoint was 90% (18/20), and the pre-specified criterion was successfully attained. The proportion of the clear image assessed by the operator was 100% (20/20), and an additional statistical analysis for the proportion of the visualization, > 270°, of the blood vessel lumen revealed a significantly higher cut-off value than that for the pre-specified criterion, 85% (p = 0.0315). There were three adverse events not related to OFDI. OFDI achieved acceptable visualization of the vessel lumen without any adverse event related to it. After regulatory approval based on the present study, OFDI will be available as a new option of endovascular imaging for peripheral artery diseases in daily practice Trial registration: This study was registered in the Japanese Registry of Clinical Trials (jRCT 2052190025, https://jrct.niph.go.jp/latest-detail/jRCT2052190025 ).
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- 2021
45. Effects of Statin Plus Ezetimibe on Coronary Plaques in Acute Coronary Syndrome Patients with Diabetes Mellitus: Sub-Analysis of PRECISE-IVUS Trial
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Hideki Shimomura, Ryusuke Tsunoda, Seiji Hokimoto, Kazuteru Fujimoto, Yasuhiro Morikami, Kenji Sakamoto, Takuro Yamashita, Hisao Ogawa, Koichiro Fujisue, Toshiyuki Matsumura, Naritsugu Sakaino, Yasuhiro Izumiya, Nobuyasu Yamamoto, Suguru Nagamatsu, Takashi Miyazaki, Koushi Matsuyama, Koichi Nakao, Masaharu Ishihara, Kenshi Yamanaga, Shuichi Oshima, Sunao Nakamura, Kenichi Tsujita, Kunihiko Matsui, Shunichi Koide, and Koichi Kaikita
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,Statin ,medicine.drug_class ,medicine.medical_treatment ,Atorvastatin ,Gastroenterology ,Diabetes mellitus ,Ezetimibe ,Internal medicine ,Intravascular ultrasound ,Internal Medicine ,medicine ,Humans ,Cholesterol absorption inhibitor ,Ultrasonography, Interventional ,Aged ,medicine.diagnostic_test ,business.industry ,Anticholesteremic Agents ,Biochemistry (medical) ,Statins ,Percutaneous coronary intervention ,Cholesterol, LDL ,medicine.disease ,Coronary Vessels ,Plaque, Atherosclerotic ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,lipids (amino acids, peptides, and proteins) ,Original Article ,Female ,Drug Monitoring ,Cardiology and Cardiovascular Medicine ,business ,Coronary plaque ,medicine.drug - Abstract
Aim: Coronary plaque regression is weak in acute coronary syndrome (ACS) patients with diabetes mellitus (DM). We evaluated whether dual lipid-lowering therapy (DLLT) with ezetimibe and atorvastatin attenuates coronary plaques in ACS patients with DM. Methods: The prospective, randomized controlled, multicenter PRECISE-IVUS (Plaque Regression with Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound) trial assigned 246 patients undergoing percutaneous coronary intervention to DLLT or atorvastatin monotherapy and evaluated IVUS-derived changes in percent atheroma volume (ΔPAV), at baseline and 9–12-month follow-up, in 126 ACS cases, including 25 DM patients. The atorvastatin dose was up-titrated to achieve low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL. Results: In DM patients, the monotherapy group (n = 13) and the DLLT group (n = 12) showed a similar prevalence of coronary risks and baseline lipid profiles. During the study, the change in LDL-C level was similar between DM and non-DM patients. Compared with non-DM patients, DM patients showed weaker regression of ΔPAV by DLLT than those who underwent monotherapy (DM: −2.77 ± 3.47% vs. −0.77 ± 2.51%, P = 0.11; non-DM: −2.01 ± 3.36% vs. −0.08 ± 2.66%, P = 0.008). The change in LDL-C level was not correlated with ΔPAV in non-DM patients, but there was significant correlation between the change in LDL-C level and ΔPAV in DM patients (r = 0.52, P = 0.008). Conclusions: ACS patients with DM showed weaker coronary plaque regression than their counterparts. A significant correlation between the change in LDL-C level and ΔPAV in DM patients suggested that more intensive lipid-lowering therapy is required in ACS patients with DM.
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- 2021
46. Retracted: Effects of cardiac resynchronization therapy in patients with inotrope‐dependent class IV end‐stage heart failure
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Ikutaro Nakajima, Takashi Noda, Hideaki Kanzaki, Kohei Ishibashi, Koji Miyamoto, Yuko Yamada, Hideo Okamura, Kazuhiro Satomi, Takeshi Aiba, Shiro Kamakura, Toshihisa Anzai, Masaharu Ishihara, Satoshi Yasuda, Hisao Ogawa, and Wataru Shimizu
- Subjects
Cardiac resynchronization therapy ,Inotrope‐dependent heart failure ,Survival ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Cardiac resynchronization therapy (CRT) has been widely used for the treatment of refractory heart failure (HF). However, the efficacy of CRT is not well established in class IV HF patients on inotropic support. Methods Twenty‐six patients (age 55±18 years, 73% men) with inotrope‐dependent HF were reviewed to evaluate the effectiveness of CRT in class IV HF patients on inotropic support. Results Intravenous inotropic therapy was administered for 72±56 days before CRT and consisted of dobutamine (n=24; 3.0±1.2 μg kg−1 min−1), dopamine (n=2; 4.5±2.1 μg kg−1 min−1), and/or milrinone (n=16; 0.12±0.09 μg kg−1 min−1). CRT did not produce significant reverse remodeling in eligible patients (left ventricular ejection fraction 23±7% to 25±9%; p=0.23, left ventricular end‐diastolic diameter 70±9 mm to 68±9 mm; p=0.14). After CRT device implantation, 13 (50%) patients experienced 1 or more episodes of ventricular tachyarrhythmia or sudden cardiac death. Twenty (77%) patients survived to hospital discharge with weaning from inotropic support (70±70 days after CRT implantation). The 1‐year survival rate was 81%. However, data from long‐term follow‐up showed that 68% of the study patients who attained survival discharge had an HF hospitalization event within the follow‐up period. Conclusion CRT did not result in significant reverse remodeling in patients with inotrope‐dependent class IV end‐stage HF. However, it contributed to dramatically improve the cardiovascular outcomes at least in the short‐term period in some patients.
- Published
- 2013
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47. CONDUCTION BLOCK IN THE LEFT ATRIUM CONTRIBUTES TO THE LEFT ATRIAL APPENDAGE THROMBUS IN PATIENTS WITH ATRIAL FIBRILLATION
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Miho Sugitani, Takanao Mine, Ryo Kitagaki, Eiji Fukuhara, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Published
- 2023
48. PLEIOTROPIC EFFECTS OF SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS SUPPRESS RECURRENCE OF ATRIAL FIBRILLATION AFTER CATHETER ABLATION
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Takanao Mine, Hideyuki Kishima, Eiji Fukuhara, Ryo Kitagaki, Takehiro Kogame, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Published
- 2023
49. PRESERVED LEFT ATRIAL BOOSTER FUNCTION IN ADDITION TO LEFT VENTRICULAR DIASTOLIC DYSFUNCTION CONTRIBUTE TO SYMPTOMS IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION
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Eiji Fukuhara, Takanao Mine, Miho Sugitani, Takehiro Kogame, Ryo Kitagaki, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Published
- 2023
50. LEFT VENTRICULAR STIFFNESS ASSESSED BY DIASTOLIC WALL STRAIN PREDICTSLATE RECURRENCE OF ATRIAL FIBRILLATIONAFTER CATHETER ABLATION
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Takehiro Kogame, Takanao Mine, Ryo Kitagaki, Eiji Fukuhara, and Masaharu Ishihara
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Cardiology and Cardiovascular Medicine - Published
- 2023
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