Papers - KAIKITA Koichi
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More haste, less speed: Cardiac perforation by a thoracentesis catheter Reviewed
Sueta D., Hokimoto S., Okamoto K., Yasuda H., Usuku H., Tazume H., Yamamoto E., Sakamoto K., Izumiya Y., Tsujita K., Kaikita K., Sakaguchi H., Fukui T., Ogawa H.
IJC Heart and Vasculature 11 17 - 18 2016.6
Language：English Publishing type：Research paper (scientific journal) Publisher：IJC Heart and Vasculature
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Akasaka T., Hokimoto S., Sueta D., Tabata N., Sakamoto K., Yamamoto E., Yamamuro M., Tsujita K., Kojima S., Kaikita K., Kajiwara A., Morita K., Oniki K., Saruwatari J., Nakagawa K., Ogata Y., Ogawa H.
American Journal of Physiology - Heart and Circulatory Physiology 310 ( 11 ) H1494 - H1500 2016.6
Language：English Publishing type：Research paper (scientific journal) Publisher：American Journal of Physiology - Heart and Circulatory Physiology
Categorization as a cytochrome P-450 (CYP) 2C19 poor metabolizer (PM) is reported to be an independent risk factor for cardiovascular disease. It is correlated with an increase in the circulating levels of high-sense C-reactive protein (hs-CRP) in women only, although its role in coronary microcirculation is unclear. We examined sex differences in the impact of the CYP2C19 genotype and low-grade inflammation on coronary microvascular disorder (CMVD). We examined CYP2C19 genotypes in patients with CMVD (n = 81) and in healthy subjects as control (n = 81). CMVD was defined as the absence of coronary artery stenosis and epicardial spasms, the presence of inverted lactic acid levels between the intracoronary and coronary sinuses, or an adenosine triphosphate-induced coronary flow reserve ratio < 2.5. CYP2C19 PMs have two loss-of-function (LOF) alleles (*2, *3). Extensive metabolizers have no LOF alleles, and intermediate metabolizers have one LOF allele. The ratio of CYP2C19 PM and hs-CRP levels in CMVD was significantly higher than that of controls, especially in women (40.9 vs. 13.8%, P = 0.013; 0.11 ± 0.06 vs. 0.07 ± 0.04 mg/dl, P = 0.001). Moreover, in each CYP2C19 genotype, hs-CRP levels in CMVD in CYP2C19 PMs were significantly higher than those of the controls, especially in women (0.15 ± 0.06 vs. 0.07 ± 0.03, P = 0.004). Multivariate analysis for CMVD indicated that the female sex, current smoking, and hypertension were predictive factors, and that high levels of hs-CRP and CYP2C19 PM were predictive factors in women only (odds ratio 3.5, 95% confidence interval 1.26–9.93, P = 0.033; odds ratio 4.1, 95% confidence interval 1.15–14.1, P = 0.038). CYP2C19 PM genotype may be a new candidate risk factor for CMVD via inflammation exclusively in the female population.
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Yamamura S., Fujisue K., Tsujita K., Sakamoto K., Miyazaki Y., Kaikita K., Hokimoto S., Ogawa H.
BMC Cardiovascular Disorders 16 ( 1 ) 116 2016.5
Language：English Publishing type：Research paper (scientific journal) Publisher：BMC Cardiovascular Disorders
Background: Stent malapposition, stent fracture, and deformity, and inadequate anti-thrombotic therapy are known as the risk of stent thrombosis. We report a case of stent deformation with subsequent thrombus adhesion at the site of a partial stent fracture detected by intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Case presentation: A 61-year-old male patient was diagnosed as effort angina pectoris. Coronary angiography revealed obstructions in the proximal segment of the left anterior descending (LAD) and left circumflex artery (LCx). Elective percutaneous coronary intervention (PCI) was scheduled for these lesions in the prior hospital. First, an everolimus-eluting stent (EES) was implanted in the just proximal LAD slightly protruding into left main trunk. One week later, the treatment to residual obstruction at proximal LCx was attempted. During delivery of the stent to LCx, the proximal edge of the previously-implanted LAD stent got stuck with the newly-deploying stent and deformed into the intravascular lumen when retracting the stent into the guide-catheter. He was immediately transferred to our hospital to repair these procedural problems. Two days later after the index procedure to LCx, intracoronary imaging with an IVUS and OCT were performed, and the IVUS/OCT imaging revealed thrombus adhesion around the deformed struts. The three-dimensional OCT guide also helped the detection of the deformed stent and the repair of deformed struts by additional stenting and kissing balloon technique. Conclusion: The current case suggested that thrombus adhesion can occur at the site of deformed and/or fractured stent at very early phase after stent implantation.
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Tabata N., Hokimoto S., Akasaka T., Sueta D., Arima Y., Sakamoto K., Yamamoto E., Izumiya Y., Yamamuro M., Tsujita K., Kojima S., Kaikita K., Morita K., Oniki K., Saruwatari J., Nakagawa K., Yamabe H., Matsui K., Ogawa H.
Clinical Trials and Regulatory Science in Cardiology 17 9 - 14 2016.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Clinical Trials and Regulatory Science in Cardiology
Background Host genetic factors of interleukin (IL)-1 polymorphisms influence Helicobacter pylori infection pathogenic activity. We examined whether H. pylori-infected patients with IL-1 polymorphisms are associated with myocardial infarction (MI). Materials and methods We recruited 594 consecutive coronary artery disease patients and excluded those who met exclusion criteria. After matching age and sex, 82 cases with MI and 82 controls were enrolled. Immunoglobulin G antibodies against H. pylori and IL-1 polymorphisms (IL-1 beta-511 base pairs and IL-1 receptor antagonist) were analyzed. We assessed high sensitivity C-reactive protein (hs-CRP) level and reactive hyperemia-peripheral arterial tonometry (RH-PAT) index (RHI) using the EndoPAT2000 system. Results The simultaneous prevalence of H. pylori-seropositivity and IL-1 polymorphisms was 45.1% and 19.5% in the cases and controls, respectively (P = 0.001). H. pylori-positive patients with IL-1 polymorphisms showed significantly higher serum levels of natural logarithm of hs-CRP in the cases and controls (- 2.8 ± 1.0 vs. - 3.4 ± 0.6, respectively; P = 0.003 and - 2.8 ± 0.9 vs. - 3.2 ± 0.6, respectively; P = 0.02) and significantly lower levels of natural logarithm of RHI in the cases and controls (0.51 ± 0.13 vs. 0.61 ± 0.23, respectively; P = 0.039 and 0.47 ± 0.13 vs. 0.69 ± 0.23, respectively; P = 0.005). H. pylori-seropositivity with IL-1 polymorphisms was significantly associated with MI by logistic regression analysis (odds ratio, 4.83; 95% confidence interval, 1.99-11.7; P < 0.001). Conclusions H. pylori-positive patients with IL-1 polymorphisms showed higher levels of hs-CRP and lower levels of RHI, and were significantly correlated with the MI.
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Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm Reviewed
Ishii M., Kaikita K., Sato K., Yamanaga K., Miyazaki T., Akasaka T., Tabata N., Arima Y., Sueta D., Sakamoto K., Yamamoto E., Tsujita K., Yamamuro M., Kojima S., Soejima H., Hokimoto S., Matsui K., Ogawa H.
Journal of the American Heart Association 5 ( 5 ) 2016.5
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of the American Heart Association
Background: Statin therapy reduces the risk of cardiovascular events in patients with obstructive coronary artery disease. The aim of the present study was to determine the effects of statins on the prognosis of patients with coronary vasospastic angina (VSA) free of significant atherosclerotic stenosis. Methods and Results: After exclusion of 475 from 1877 consecutive patients who underwent an acetylcholine-provocation test between January 1991 and December 2010, data of 640 VSA patients without significant organic stenosis of the remaining 1402 were analyzed retrospectively. Propensity score matching was performed to reduce the effect of treatment-selection bias and possible confounders. The primary endpoint was major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and unstable angina. Among the study population, dyslipidemia on admission was identified in 160 of 168 (95.2%) patients of the statin group compared with only 125 of 472 (26.5%) of the no-statin group. Of the 640 patients, 24 (3.8%) developed MACE. Multivariate Cox hazard regression analysis identified statin therapy as a significant negative predictor of MACE (hazard ratio, 0.11; 95% CI, 0.02-0.84; P=0.033). In the propensity-score matched cohorts (n=128 each), Kaplan-Meier survival curve showed a better 5-year MACE-free survival rate for patients of the statin group compared to the no-statin group (100% vs 91.7%, respectively; P=0.002). Conclusions: Statin therapy correlated with a lower rate of cardiovascular events in VSA patients free of significant organic stenosis. Statins seems to improve the prognosis of VSA patients free of significant organic stenosis.
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Arima Y., Kaikita K., Ishii M., Ito M., Sueta D., Oimatsu Y., Sakamoto K., Tsujita K., Kojima S., Nakagawa K., Hokimoto S., Ogawa H.
Journal of Thrombosis and Haemostasis 14 ( 4 ) 850 - 859 2016.4
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Thrombosis and Haemostasis
Background: Accurate evaluation of thrombogenicity helps to prevent thrombosis and excessive bleeding. The total thrombus-formation analysis system (T-TAS) was developed for quantitative analysis of platelet thrombus formation by the use of microchips with thrombogenic surfaces (collagen, platelet chip [PL-chip]; collagen plus tissue factor, atherome chip [AR-chip]). We examined the utility of the T-TAS in the assessment of the efficacy of antiplatelet therapy in patients with coronary artery disease (CAD). Methods and Results: In this cross-sectional study, 372 consecutive patients admitted to the cardiovascular department were divided into three groups: patients not receiving any antiplatelet therapy (control, n = 56), patients receiving aspirin only (n = 69), and patients receiving aspirin and clopidogrel (n = 149). Blood samples were used for the T-TAS to measure the platelet thrombus-formation area under the curve (AUC) at various shear rates (1500 s [PL -AUC ] and 2000 s [PL -AUC ] for the PL-chip; 300 s [AR -AUC ] for the AR-chip). The on-clopidogrel platelet aggregation was measured by the use of P2Y12 reaction units (PRUs) with the VerifyNow system. The mean PL -AUC levels were 358 ± 111 (± standard deviation) (95% confidence interval [CI] 328.9-387.1) in the control group, 256 ± 108 (95% CI 230.5-281.5) in the aspirin group, and 113 ± 91 (95% CI 98.4-127.6) in the aspirin/clopidogrel group. In the aspirin/clopidogrel group, the PL -AUC was higher in poor metabolizers (PMs) with cytochrome P450 2C19(CYP2C19) polymorphisms (152 ± 112, 95% CI 103.4-200.6) than in the non-PM group (87 ± 74, 95% CI 73.8-100.2). Conclusions: Our findings suggest that the PL -AUC level measured by the T-TAS is a potentially suitable index for the assessment of antiplatelet therapy in CAD patients. -1 -1 -1 18 10 24 10 10 30 24 10 24 10 24 10
DOI： 10.1111/jth.13256
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Fragmented QRS complex is a diagnostic tool in patients with left ventricular diastolic dysfunction Reviewed
Onoue Y., Izumiya Y., Hanatani S., Kimura Y., Araki S., Sakamoto K., Yamamoto E., Tsujita K., Tanaka T., Yamamuro M., Kojima S., Kaikita K., Hokimoto S., Ogawa H.
Heart and Vessels 31 ( 4 ) 563 - 567 2016.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Heart and Vessels
Fragmented QRS complex (fQRS) on 12-lead ECG is associated with myocardial fibrosis and ischemic scar. Interstitial fibrosis is one of the histological characteristics of left ventricular diastolic dysfunction (LVDD). However, the clinical importance of fQRS in patients with LVDD remains unclear. Here, we assessed the hypothesis that the presence of fQRS is associated with disease severity in patients with LVDD, and could be used as an additional parameter to differentiate patients with heart failure with preserved ejection fraction (HFpEF) from LVDD. We analyzed 12-lead ECG of 239 patients with LVDD. The patients were divided into two groups according to the presence or absence of fQRS; 88 patients had fQRS (fQRS group) and 151 patients did not have fQRS (non-fQRS group). The percentage of patients with heart failure in the fQRS group was significantly higher than that in the non-fQRS group. The levels of B-type natriuretic peptide (BNP) and high-sensitive troponin T were significantly higher in the fQRS group than those in the non-fQRS group. In univariate logistic regression analysis, fQRS was associated with the presence of heart failure in patients with LVDD. Multivariate logistic regression analysis identified fQRS and BNP as independent indicators for HFpEF. In conclusion, the presence of fQRS on the ECG could be used as an additional tool to differentiate HFpEF from LVDD.
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Ogura Y., Tsujita K., Shimomura H., Yamanaga K., Komura N., Miyazaki T., Ishii M., Tabata N., Akasaka T., Arima Y., Sakamoto K., Kojima S., Nakamura S., Kaikita K., Hokimoto S., Ogawa H.
Heart and Vessels 31 ( 3 ) 341 - 350 2016.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Heart and Vessels
Acute coronary syndrome (ACS) is one of the main causes of cardiovascular death. According to rapid aging of society, the peak age of ACS onset has grown older globally. Despite growing recognition of the necessity to build the ACS prevention strategy in the elderly, patients background and culprit lesion morphology of these elderly ACS patients have not been well studied. We sought to assess the clinical characteristics and intravascular ultrasound (IVUS) findings of the culprit lesions in elderly ACS patients. One-hundred and fifty-eight consecutive ACS patients whose culprit lesions imaged by pre-intervention IVUS were divided into two groups based on the age of onset: elderly [E] group (≥75 years, n = 65) and non-elderly [NE] group (<75 years, n = 93). As compared with NE group, hemoglobin (12.7 ± 2.0 g/dL vs. 13.7 ± 1.6 g/dL, p = 0.001), estimated glomerular filtration rate (62.5 ± 22.5 mL/min/1.73 m vs. 75.5 ± 20.5 mL/min/1.73 m , p = 0.0001), and body mass index (22.9 ± 3.4 kg/m vs. 24.5 ± 3.4 kg/m , p = 0.003) were significantly lower, and comorbid malignancy was more common (20.0 vs 6.5 %, p = 0.01) in E group. Although whole culprit segment was not positively remodeled (mean vessel area was 15.2 ± 5.6 mm /mm vs. 16.2 ± 5.1 mm /mm, p = 0.16) in E group, at maximum external elastic membrane site of the culprit lesion, lumen area was smaller (5.5 ± 3.2 mm vs. 6.7 ± 3.5 mm , p = 0.04), and plaque burden tended to be more abundant (70 ± 13 vs. 66 ± 13 %, p = 0.08). Interestingly, echo attenuation arc of culprit attenuated plaque was significantly greater in E group than in NE group (157 ± 83° vs. 118 ± 60°, p = 0.01). In conclusion, extracardiac comorbidity was more common in elderly ACS patients, and their culprit coronary lesions were still rupture prone, and “vulnerable.” 2 2 2 2 3 3 2 2
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New aspects of onco-cardiology Reviewed
Sueta D., Hokimoto S., Utsunomiya D., Tabata N., Akasaka T., Sakamoto K., Tsujita K., Kaikita K., Yamashita Y., Ogawa H.
International Journal of Cardiology 206 68 - 70 2016.3
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cardiology
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Yamamoto E., Hirata Y., Tokitsu T., Kusaka H., Tabata N., Tsujita K., Yamamuro M., Kaikita K., Watanabe H., Hokimoto S., Maruyama T., Ogawa H.
ESC Heart Failure 3 ( 1 ) 53 - 59 2016.3
Language：English Publishing type：Research paper (scientific journal) Publisher：ESC Heart Failure
Aims: Although inflammation plays an important role in the pathogenesis of heart failure (HF), the precise pathophysiological role of inflammation in HF with preserved left ventricular ejection fraction (HFpEF) still remains unclear. Hence, we examined the clinical significance of plasma neopterin, an inflammatory biomarker, in HFpEF patients. Methods and results: In the present study, we recruited consecutive HFpEF patients hospitalized in Kumamoto University Hospital, and further measured plasma neopterin by high-performance liquid chromatography and serum derivatives of reactive oxidative metabolites (DROM), a new biomarker of reactive oxygen species. Compared with risk factors (number of patients, age, sex, and equal incidence of diabetes mellitus, hypertension, and dyslipidemia) -matched non-HF patients (n = 68), plasma neopterin levels, but not serum high-sensitivity C-reactive protein levels, were significantly increased in patients with HFpEF (n = 68) (P < 0.001 and P = 0.15, respectively), accompanied by an elevation in serum DROM levels (P < 0.001). Plasma neopterin levels in New York Heart Association (NYHA) class III/IV HFpEF patients were significantly higher than in NYHA class II patients (P < 0.004). Furthermore, plasma ln-neopterin levels had significant and positive correlation with ln-DROM values (r = 0.57) and parameters of cardiac diastolic dysfunction [the ratio of early transmitral flow velocity to tissue Doppler early diastolic mitral annular velocity (r = 0.34), left atrial volume index (r = 0.17), and B-type natriuretic peptide (r = 0.38)]. Kaplan–Meier analysis showed that the high-neopterin group (>51.5 nM: median value of neopterin in HFpEF patients) had a higher probability of cardiovascular events than the low-neopterin group (log-rank test, P = 0.003). Conclusions: Plasma neopterin levels significantly increased in HFpEF and correlated with the severity of HF. Furthermore, high neopterin were significantly correlated with future cardiovascular events, indicating that measurement of plasma neopterin might provide clinical benefits for risk stratification of HFpEF patients. © 2015 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
DOI： 10.1002/ehf2.12070
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急性冠症候群における凝固・線溶異常と抗血栓療法
海北幸一, 石井正将, 小川久雄
ICUとCCU 集中治療医学 40 ( 3 ) 223 - 229 2016.3
Authorship：Lead author Publishing type：Research paper (scientific journal)
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Kimura Y., Izumiya Y., Hanatani S., Yamamoto E., Kusaka H., Tokitsu T., Takashio S., Sakamoto K., Tsujita K., Tanaka T., Yamamuro M., Kojima S., Tayama S., Kaikita K., Hokimoto S., Ogawa H.
Heart and Vessels 31 ( 1 ) 52 - 59 2016.1
Language：English Publishing type：Research paper (scientific journal) Publisher：Heart and Vessels
Thrombospondin-2 (TSP-2) is highly expressed in hypertensive heart. Interstitial fibrosis is frequently observed in hypertensive heart, and it is a characteristic feature of heart failure with preserved ejection fraction (HFpEF). We tested here the hypothesis that high TSP-2 serum levels reflect disease severity and can predict poor prognosis of patients with HFpEF. Serum TSP-2 levels were measured by ELISA in 150 patients with HFpEF. HFpEF was defined as left ventricular ejection fraction ≥50 %, B-type natriuretic peptide (BNP) ≥100 pg/ml or E/e′ ≥15. The endpoints were mortality rate, HF-related hospitalization, stroke and non-fatal myocardial infarction. The median serum TSP-2 level was 19.2 (14.4–26.0) ng/ml. Serum TSP-2 levels were associated with the New York Heart Association (NYHA) functional class. Circulating levels of BNP and high-sensitivity troponin T were positively correlated with serum TSP-2 levels. Kaplan–Meier survival curve showed high risk of adverse cardiovascular events in the high TSP-2 group (>median value), and that the combination of high TSP-2 and high BNP (≥100 pg/ml) was associated with the worst event-free survival rate. Multivariate Cox proportional hazard analysis identified TSP-2 as independent predictor of risk of death and cardiovascular events. Circulating TSP-2 correlates with disease severity in patients with HFpEF. TSP-2 is a potentially useful predictor of future adverse cardiovascular events in patients with HFpEF.
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Tabata N., Hokimoto S., Akasaka T., Arima Y., Sakamoto K., Yamamoto E., Tsujita K., Izumiya Y., Yamamuro M., Kojima S., Kaikita K., Kumagae N., Morita K., Oniki K., Nakagawa K., Matsui K., Ogawa H.
Journal of Cardiology 67 ( 1 ) 104 - 109 2016.1
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Background: There is some controversy regarding the effect of CYP2C19 polymorphism on clinical outcome in patients receiving dual antiplatelet therapy (DAPT). Peripheral endothelial dysfunction has recently been reported to predict adverse cardiovascular events. We hypothesized that CYP2C19 loss-of-function (LOF) allele carriers with peripheral endothelial dysfunction had worse prognosis. The aim of this study was to evaluate an additive effect of peripheral endothelial dysfunction on clinical outcome following percutaneous coronary intervention (PCI) in patients with a CYP2C19 variant. Methods: We enrolled 434 patients on DAPT following PCI. CYP2C19 genotype was examined, and we divided patients into two groups: carriers, who had at least one CYP2C19 LOF allele, and non-carriers. Peripheral endothelial dysfunction was examined using reactive hyperemia-peripheral arterial tonometry index (RHI), and we divided patients into low and high RHI. Thus, subjects were divided into four groups, and clinical events were followed up. Results: A total of 55 patients had a cardiovascular event. Kaplan-Meier analysis demonstrated a significantly higher probability of cardiovascular events in carriers with low RHI (log-rank test: p = 0.007). Multivariate Cox proportional hazards analysis identified both CYP2C19 LOF allele possession (hazard ratio (HR): 1.94; 95% confidence interval (CI): 1.1-3.69; p = 0.045) and low RHI (HR: 2.15; 95% CI: 1.22-3.78; p = 0.008) as independent and significant predictors of future cardiovascular events. Conclusions: CYP2C19 LOF allele carriers with peripheral endothelial dysfunction were significantly correlated with cardiovascular events. The additional evaluation of peripheral endothelial function along with CYP2C19 polymorphism might improve risk stratification after coronary stent implantation.
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Ito M., Kaikita K., Sueta D., Ishii M., Oimatsu Y., Arima Y., Iwashita S., Takahashi A., Hoshiyama T., Kanazawa H., Sakamoto K., Yamamoto E., Tsujita K., Yamamuro M., Kojima S., Hokimoto S., Yamabe H., Ogawa H.
Journal of the American Heart Association 5 ( 1 ) 2016.1
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of the American Heart Association
Background-Non-vitamin K antagonist oral anticoagulants are used to prevent thromboembolism in patients with atrial fibrillation. The T-TAS "Total Thrombus-formation Analysis System" (Fujimori Kogyo Co Ltd) was developed for quantitative analysis of thrombus formation using microchips with thrombogenic surfaces (collagen, platelet chip [PL] ; collagen plus tissue factor, atheroma chip [AR]). We evaluated the utility of T-TAS in predicting periprocedural bleeding in atrial fibrillation patients undergoing catheter ablation (CA). Methods and Results-After exclusion of 20 from 148 consecutive patients undergoing CA, the remaining 128 patients were divided into 2 treatment groups: the warfarin group (n=30) and the non-vitamin K antagonist oral anticoagulants group (n=98). Blood samples obtained on the day of CA (anticoagulant-free point) and at 3 and 30 days after CA were used in T-TAS to compute the thrombus formation area under the curve (AUC; AUC for the first 10 minutes for PL tested at flow rate of 24 μL/min [PL - AUC ]; AUC for the first 30 minutes for AR tested at flow rate of 10 μL/min [AR -AUC ]). AR -AUC and PL -AUC levels were similar in the 2 groups on the day of CA. Levels of AR -AUC , but not PL -AUC , were significantly lower in the 2 groups at days 3 and 30 after CA. Multiple logistic regression analyses identified the AR -AUC level on the day of CA as a significant predictor of periprocedural bleeding events (odds ratio 5.7; 95% CI 1.54-21.1; P=0.009). Receiver operating characteristic analysis showed that the AR -AUC level on the day of CA significantly predicted periprocedural bleeding events (AUC 0.859, 95% CI 0.766-0.951; P < 0.001). The cutoff AR -AUC level was 1648 for identification of periprocedural bleeding events. Conclusions-These results suggested that the AR -AUC level determined by T-TAS is a potentially useful marker for prediction of bleeding events in atrial fibrillation patients undergoing CA. 24 10 10 30 10 30 24 10 10 30 24 10 10 30 10 30 10 30 10 30
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A destabilized case of stable effort angina pectoris induced by low-dose adenosine triphosphate Reviewed
Sueta D., Kojima S., Izumiya Y., Yamamuro M., Kaikita K., Hokimoto S., Ogawa H.
Internal Medicine 55 ( 22 ) 3291 - 3294 2016
Language：English Publishing type：Research paper (scientific journal) Publisher：Internal Medicine
A 79-year-old man was diagnosed with sudden deafness. He had previously experienced a suspected episode of angina pectoris. At a local hospital, after 500 mg of hydrocortisone and 80 mg adenosine triphosphate (ATP) were administered, he became aware of chest discomfort. An electrocardiogram revealed serious ST-segment depressions. He was diagnosed with a non-ST elevated myocardial infarction (NSTEMI). Emergency coronary angiography revealed triple vessel disease, and the lesion was successfully stented. The mechanisms whereby the stable effort angina pectoris destabilized in this case were thought to include a reduction of the local blood flow because of an ATP product and probable thrombus formation in response to the administered steroids.
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Hokimoto S, Soejima H, Kojima S, Kaikita K, Yamamuro M, Izumiya Y, Tsujita K, Yamamoto E, Tanaka T, Sugamura K, Arima Y, Sakamoto K, Akasaka T, Tabata N, Sueta D, Miyoshi I, Usami M, Ogawa H
Annals of vascular diseases 9 ( 1 ) 22 - 29 2016
Language：English Publishing type：Research paper (scientific journal) Publisher：Annals of Vascular Diseases 編集委員会
<b>Objective:</b> To describe the distribution of ankle-brachial index (ABI) among Japanese cardiovascular inpatients and to explore risk factors of peripheral arterial disease (PAD) associated with ABI ≤0.9.<b>Materials and Methods:</b> This study was a retrospective analysis using clinical record databases of patients with cardiovascular disease admitted to the Department of Cardiovascular Medicine, Kumamoto University Hospital between 2007 and 2014.<b>Results:</b> Of 3639 patients included in the analysis, male patients accounted for 62.1% and the mean age of patients was 66.1 years. Ischemic heart disease (IHD) was observed in 49.1%. ABI ≤0.9 was observed in 11.3% of all patients, 14.1% in the IHD group and 8.5% in the non-IHD group. Age of ≥65 years (odds ratio [OR]: 2.93, 95% confidence interval [CI]: 2.22–3.86), current smoking (OR: 2.28, 95%CI:1.71–3.04), diabetes (OR: 2.15, 95%CI:1.71–2.71), hypertension (OR: 1.42, 95%CI:1.12–1.81) and chronic kidney disease (OR: 2.52, 95%CI:1.82–3.48) were significantly associated factors with ABI ≤0.9.<b>Conclusions:</b> This study suggests that PAD is prevalent even in patients without IHD. Active management of risk factors, early detection of PAD based on ABI, and therapeutic intervention could be effective in preventing future cardiovascular events or death.
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Misumi I., Honda T., Usuku H., Togashi A., Kiyama T., Tsunoda R., Obayashi H., Yasuda H., Kaikita K., Hokimoto S., Ogawa H.
Internal Medicine 55 ( 13 ) 1747 - 1750 2016
Language：English Publishing type：Research paper (scientific journal) Publisher：Internal Medicine
A 63-year-old woman with atrial fibrillation visited our hospital due to decompensated heart failure. Because atrial fibrillation was considered a remarkable precipitating factor for heart failure, cardioversion was performed. After cardioversion, refractory hypotension and cardiopulmonary arrest occurred. An arterial blood gas analysis showed marked lactic acidosis. Chronic kidney disease, heart failure, sedatives, and hypoventilation might have contributed to refractory hypotension due to severe acidosis in this case.
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冠攣縮性狭心症の発症機序
海北幸一、小川久雄
日本臨牀 74 ( 増刊号6 ) 39 - 42 2016
Authorship：Lead author Publishing type：Research paper (scientific journal)
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冠攣縮性狭心症の診断と治療に関するガイドライン（2013年改訂版）
海北幸一、小川久雄
日本臨牀 74 ( 増刊号6 ) 54 - 57 2016
Authorship：Lead author Publishing type：Research paper (scientific journal)
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冠攣縮性狭心症の危険因子・臨床的特徴・予後
石井正将、海北幸一、小川久雄
日本臨牀 74 ( 増刊号6 ) 48 - 53 2016
Publishing type：Research paper (scientific journal)