Papers - KAIKITA Koichi
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Waveform of ophthalmic artery doppler flow predicts the severity of systemic atherosclerosis Reviewed
Maruyoshi H., Kojima S., Kojima S., Nagayoshi Y., Horibata Y., Kaikita K., Sugiyama S., Ogawa H.
Circulation Journal 74 ( 6 ) 1251 - 1256 2010.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Circulation Journal
Background: Doppler imaging of ophthalmic artery (OA), the first major branch of the internal carotid artery, provides anatomical advantages due to the vertical angle to the body surface and absence of ultrasonic obstacles. It was hypothesized that the Doppler waveform indices of OA correlate with severity of systemic atherosclerosis. Methods and Results: The study subjects were 180 patients who underwent cardiac catheterization and OA Doppler imaging (90 patients with coronary artery disease (CAD) and 90 control patients). The ratio of stroke volume to pulse pressure, an index of arterial compliance, was closely associated with the ratio of systolic to diastolic mean velocity (Sm/Dm) in OA. The level of Sm/Dm increased in proportion with the increase in number of stenosed coronary arteries (0-vessel disease 2.1±0.3, 1-vessel disease 2.3±0.3, multi-vessel disease 2.6±0.5, P<0.0001). The Sm/Dm level in OA correlated positively with age, pulse pressure, pulse wave velocity, resistive index and pulsatility index in OA. The best Sm/Dm cut-off to predict CAD was 2.3, and patients with Sm/Dm >2.3 had 8.0-fold risk for CAD. Conclusions: The waveform indices of OA are clinically useful for evaluating the severity of CAD and may help explain the missing link between OA circulation and systemic arterial compliance.
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循環器疾患
三浦光年, 海北幸一, 小川久雄
臨牀と研究 87 ( 6 ) 766 - 770 2010.6
Publishing type：Research paper (scientific journal)
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Digital Assessment of Endothelial Function and Ischemic Heart Disease in Women Reviewed
Matsuzawa Y., Sugiyama S., Sugamura K., Nozaki T., Ohba K., Konishi M., Matsubara J., Sumida H., Kaikita K., Kojima S., Nagayoshi Y., Yamamuro M., Izumiya Y., Iwashita S., Matsui K., Jinnouchi H., Kimura K., Umemura S., Ogawa H.
Journal of the American College of Cardiology 55 ( 16 ) 1688 - 1696 2010.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of the American College of Cardiology
Objectives: We investigated the utility of digital reactive hyperemia peripheral arterial tonometry (RH-PAT) in predicting ischemic heart disease (IHD), including obstructive coronary artery disease (CAD) and nonobstructive coronary artery disease (NOCAD), in women. Background: IHD is the leading cause of mortality, and its pathogenesis is diverse in women. Fingertip RH-PAT is a new device that provides noninvasive, automatic, and quantitative evaluation of endothelial dysfunction. Methods: RH-PAT was measured using Endo-PAT2000 (Itamar Medical, Caesarea, Israel) before cardiac catheterization in 140 stable women scheduled for hospitalization to examine chest pain. NOCAD was diagnosed by angiography with measurement of coronary blood flow and cardiac lactate production during intracoronary acetylcholine provocation test and cardiac scintigraphy with stress tests. Results: Sixty-eight women (49%) had obstructive CAD and 42 women (30%) had NOCAD. RH-PAT indexes were significantly attenuated in both obstructive CAD and NOCAD as compared with non-IHD (n = 30) (obstructive CAD: median 1.57, interquartile range [IQR] 1.42 to 1.76; NOCAD: median 1.58, IQR 1.41 to 1.78; non-IHD: median 2.15, IQR 1.85 to 2.48, p < 0.001). By multivariate logistic regression analysis, only RH-PAT index was significantly associated with IHD, including obstructive CAD and NOCAD (odds ratio 0.51; 95% confidence interval: 0.38 to 0.68; p < 0.001). In receiver-operating characteristic analysis, RH-PAT index was a significant predictor of IHD (area under the curve 0.86; p < 0.001). Furthermore, only RH-PAT was useful for the prediction of NOCAD after excluding obstructive CAD (area under the curve 0.85; p < 0.001; RH-PAT index of <1.82 had 81% sensitivity and 80% specificity). Conclusions: RH-PAT indexes were significantly attenuated in women with IHD. Digital RH-PAT can predict patients with IHD, especially NOCAD before angiography. RH-PAT is potentially useful for identifying high-risk women for IHD. (Endothelial Dysfunction and Coronary Artery Spasm; NCT00619294). © 2010 American College of Cardiology Foundation.
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Miura M., Kaikita K., Matsukawa M., Soejima K., Fuchigami S., Miyazaki Y., Ono T., Uemura T., Tsujita K., Hokimoto S., Sumida H., Sugiyama S., Matsui K., Yamabe H., Ogawa H.
Thrombosis and Haemostasis 103 ( 3 ) 623 - 629 2010.3
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Thrombosis and Haemostasis
High plasma level of von Willebrand factor (VWF) is a marker of future cardiovascular events in patients at high risk of coronary artery disease (CAD). The purpose of this study was to examine the changes and the prognostic value of plasma VWF-cleaving protease (ADAMTS13) levels in patients with CAD. Plasma VWF and ADAMTS13 levels were measured in 225 patients with CAD (152 men and 73 women, age, 70.3 ± 8.9 years, mean ± SD) and 100 patients without CAD who were age-and gender-matched to the CAD patients (60 men and 40 women, age, 68.6 ± 8.9 years). The CAD patients had higher VWF and lower ADAMTS13 antigen levels compared to patients without CAD. During 22.3 ± 10.4 months follow-up period, 20 major adverse cardiac and cerebrovascular events (MACCE) occurred in 222 patients with CAD who could be followed up. Kaplan-Meier analysis demonstrated that CAD patients with high plasma VWF antigen levels were significantly more likely to develop MACCE. Furthermore, eight cardiac and cerebrovascular thrombotic events [acute coronary syndrome (n=4) and cerebral infarction (n=4)] occurred in CAD patients with both high plasma VWF and low ADAMTS13 antigen levels. Multivariate Cox hazards regression analysis identified high plasma VWF and low ADAMTS13 antigen levels as significant and independent predictors of future MACCE and thrombotic events during the follow-up period in CAD patients. Our findings suggest that low plasma ADAMTS13 as well as high VWF level is a useful predictor of cardiac and cerebrovascular events in CAD patients. © Schattauer 2010.
DOI： 10.1160/TH09-08-0568
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Arima Y., Kojima S., Kusuhara K., Nagayoshi Y., Kawano H., Kaikita K., Sugiyama S., Kinoshita Y., Ogawa H.
Journal of Cardiology Cases 1 ( 1 ) e45 - e48 2010.2
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology Cases
A 76-year-old woman with a diagnosis of dilated-phase hypertrophic cardiomyopathy was admitted to our hospital for exacerbation of congestive heart failure. After admission, she developed cardiac arrest and the electrocardiogram showed pulseless electrical activity. Cardiopulmonary resuscitation was started immediately; however, return of spontaneous circulation was achieved 56 min after cardiopulmonary arrest. Therapeutic hypothermia was considered as an adjunct therapy, together with intensive treatment. The target temperature of 33.0 °C was achieved 10 h after cardiopulmonary arrest. Core temperature was maintained between 33.0 and 35.0 °C for 72 h with no cardiac arrhythmia detected during this period. Re-warming was initiated at a rate of 1 °C/day. On day 6, the core temperature returned to 37 °C and recovery of consciousness was achieved on day 9. No impairment of neurological function was noted. She had no heart failure-related symptoms and B-type natriuretic peptide level decreased from 4174 pg/mL on admission to 450 pg/mL at discharge. Therapeutic hypothermia may be a promising post-resuscitation therapy for comatose survivors of in-hospital cardiac arrest with non-ventricular fibrillation leading to improvement in neurological outcome. © 2009 Japanese College of Cardiology.
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Clinical factors affecting serum potassium concentration in cardio-renal decompensation syndrome Reviewed
Ueno H., Yoshimura M., Nakayama M., Yamamuro M., Nishijima T., Kusuhara K., Nagayoshi Y., Kojima S., Kaikita K., Sumida H., Sugiyama S., Ogawa H.
International Journal of Cardiology 138 ( 2 ) 174 - 181 2010.1
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cardiology
Background: Renin-angiotensin-aldosterone system (RAAS) inhibitors are currently indispensable for the treatment of heart failure. It is well known that hyperkalemia is likely to occur in renal failure; however, it has not yet been clarified how the serum potassium concentration changes as heart failure progresses. Currently, the cardio-renal decompensation syndrome holds that the serum potassium concentration is altered similarly by both heart failure and renal failure; however, there are no definitive reports on this. In order to use RAAS inhibitors more safely and effectively in heart failure, it is necessary to understand the factors affecting serum potassium concentration in the clinical setting. Methods and results: We examined the clinical factors affecting serum potassium concentration in 1035 consecutive patients with cardiovascular disease who were hospitalized in our institution. Multiple regression analysis showed that the independent factors associated with an elevated serum potassium concentration were renal insufficiency evaluated by estimated glomerular filtration rate (eGFR) (P < 0.0001), diabetes mellitus evaluated by HbA (P = 0.0005) and the use of RAAS inhibitors (P = 0.0010). The independent factors associated with a decreased serum potassium concentration were mean blood pressure (P < 0.0001), heart failure evaluated by log BNP (P = 0.0164) and the use of diuretics (P = 0.0232). Conclusions: The serum potassium concentration decreases with the severity of heart failure if renal function is preserved. From the perspective of potassium homeostasis, we could use the RAAS inhibitors more aggressively in patients with heart failure who do not have renal failure. © 2008 Elsevier Ireland Ltd. All rights reserved. 1c
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Cannabinoid 1 receptor blockade reduces atherosclerosis with enhances reverse cholesterol transport Reviewed
Sugamura K., Sugiyama S., Fujiwara Y., Matsubara J., Akiyama E., Maeda H., Ohba K., Matsuzawa Y., Konishi M., Nozaki T., Horibata Y., Kaikita K., Sumida H., Takeya M., Ogawa H.
Journal of Atherosclerosis and Thrombosis 17 ( 2 ) 141 - 147 2010
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Atherosclerosis and Thrombosis
Aim: A recent clinical study using coronary intravascular ultrasound showed that rimonabant, a cannabinoid 1 (CB1) receptor antagonist, significantly reduced total atheroma volume, suggesting that CB1 receptor blockade could be beneficial in anti-atherogenic therapy. The reverse cholesterol transport (RCT) system plays important roles in atherogenesis. We investigated whether CB1 receptor blockade could modulate atherogenesis in mice. Methods and Results: Oral administration of rimonabant (8 mg/kg/day) to apolipoprotein E-deficient mice for 3 months significantly reduced the relative area of atherosclerotic lesions in the aorta (vehicle; 12.6 ± 4.0% vs. rimonabant; 9.7 ± 2.3, n = 12 each, p < 0.05) with an increase in serum adiponectin levels (15.6 ± 2.3 μg/mL vs. 12.2 ± 2.1, n = 12 each, p < 0.001), without affecting body weight or serum cholesterol levels. Rimonabant tended to increase serum high-density lipoprotein cholesterol (HDL-C) (p = 0.05). The relative area of atherosclerotic lesions in the aorta correlated inversely with serum HDL-C levels (r = -0.45, n = 24, p < 0.05). Rimonabant upregulated the mRNA expression levels of various components of the RCT system on THP-1 cell-derived macrophages (scavenger receptor B1: 1.15 ± 0.12 fold, n = 6; p < 0.05, ATP-binding cassette [ABC] transporter G1: 1.23 ± 0.11 fold, n = 6; p < 0.01), but not ABCA1 (1.13 ± 0.20 fold, n = 6; p = 0.13). Conclusion: CB1 receptor blockade reduced atherosclerosis in apoE-deficient mice through an increase in serum adiponectin levels and activation of the RCT system. CB1 receptor blockade may be therapeutically beneficial for atherogenesis by increasing the serum adiponectin level and enhancing of the RCT system.
DOI： 10.5551/jat.2865
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Standard-dose statin therapy provides incremental clinical benefits in normocholesterolemic diabetic patients Reviewed
Kojima S＊, Sakamoto T, Ogawa H, Kitagawa A, Matsui K, Shimomura H, Kimura K, Ogata Y, Sakaino N; multicenter study for aggressive lipid-lowering strategy by HMG-CoA reductase inhibitors investigators (including Kaikita K)
Circulation Journal 74 ( 4 ) 779 - 785 2010
Language：English Publishing type：Research paper (scientific journal)
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Nakamura Y., Yamada Y., Shimomura H., Nagayoshi Y., Tsujita K., Yamashita T., Fukuda M., Ohba K., Nako H., Ogura Y., Chitose T., Yamaguchi M., Nagata T., Soejima H., Kaikita K., Sugiyama S., Ogawa H.
Journal of Cardiology 54 ( 3 ) 416 - 424 2009.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Background: Monocyte chemoattractant protein-1 (MCP-1) plays an important role in the pathogenesis of acute coronary syndrome. We have recently demonstrated that the administration of edaravone before reperfusion attenuated reperfusion injury in patients with acute myocardial infarction (AMI). Methods: Plasma MCP-1 levels were measured in 45 consecutive patients with AMI (edaravone group, n = 25; control group, n = 20). In the edaravone group, 30 mg edaravone was intravenously infused just before reperfusion. Plasma samples were obtained before and at 24 h, 3, 5, 7, and 14 days after reperfusion. Cardiovascular events were defined as cardiac death, subacute thrombosis, or fatal arrhythmia. Heart failure requiring rehospitalization was evaluated at 12 months after reperfusion. Results: Plasma MCP-1 levels were not different between the two groups before reperfusion. Compared with the placebo group, the edaravone group had statistically lower maximum creatine kinase-MB levels (218 ± 31 IU/l versus 145 ± 21 IU/l, p < 0.05) and plasma MCP-1 levels on day 3 after reperfusion (873 ± 118 pg/ml versus 516 ± 66 pg/ml, p < 0.05). Heart failure requiring rehospitalization occurred in four patients in the control group, but did not occur in the edaravone group (p < 0.05). At 12 months after reperfusion, left ventricular ejection fraction was statistically higher in the edaravone group than in the control group (62 ± 2% versus 54 ± 3%, p < 0.05). Conclusion: Edaravone suppressed plasma MCP-1, improved left ventricular ejection fraction, and reduced rehospitalization due to heart failure. Suppression of plasma MCP-1 level by edaravone might induce better prognosis for AMI patients. © 2009 Japanese College of Cardiology.
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Nagayoshi Y., Kawano H., Hokamaki J., Uemura T., Soejima H., Kaikita K., Sugiyama S., Yamabe H., Shioji I., Sasaki S., Kuroda Y., Ogawa H.
Free Radical Research 43 ( 12 ) 1159 - 1166 2009.11
Language：English Publishing type：Research paper (scientific journal) Publisher：Free Radical Research
Various oxidative stress markers have been measured to evaluate the status of heart failure (HF). However, the relationships between these markers and the aetiology of HF have not been fully investigated. This study compared 8-hydroxy-2′-deoxyguanosine (8-OHdG) and biopyrrins levels in patients with ischemic and non-ischemic HF. Study subjects were divided into a coronary artery disease (CAD) group (n70), a non-CAD group (n61) and a control group (n33). In the CAD group, 8-OHdG and biopyrrins levels increased with the severity of the New York Heart Association (NYHA) functional class and log BNP levels correlated with 8-OHdG and biopyrrins levels. However, non-CAD patients with NYHA class III/IV had significantly lower 8-OHdG levels than CAD patients with NYHA class III/IV and the levels did not correlate with log BNP levels. In the CAD group, 8-OHdG levels reflected the severity of atherosclerosis. These results indicate that the properties of oxidative stress markers should be carefully taken into consideration for the assessment of HF status.
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Fukunaga T., Soejima H., Irie A., Fukushima R., Oe Y., Kawano H., Sumida H., Kaikita K., Sugiyama S., Nishimura Y., Ogawa H.
Circulation Journal 73 ( 10 ) 1914 - 1919 2009.10
Language：English Publishing type：Research paper (scientific journal) Publisher：Circulation Journal
Background: Dendritic cells (DCs) stimulate T-cells to participate in the inflammatory processes that promote the destruction of vulnerable plaques. The relationship between circulating levels of myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) in patients with acute coronary syndrome (ACS) was evaluated. Methods and Results: Biood samples were obtained from 39 patients with ACS, 41 patients with stable angina pectoris (SAP) and 43 controls. The proportion of mDCs tended to be lower in the ACS group than in the SAP group and controls. Interleukin-12 levels associated with mDCs were significantly higher in the ACS group than in control group. The proportion of pDCs was significantly lower in the ACS groups than in the other two groups. Interferon-α levels secreted by pDCs, however, were not significantly different among the 3 groups. The ratio of mDCs to pDCs ≥4 is an important value for distinguishing ACS from SAP patients and control patients through receiver operating characteristic analysis (sensitivity; 85.0%, specificity; 83.4%). Conclusions: The ratio of mDCs to pDCs may be a useful marker for detecting ACS and the existence of vulnerable plaques.
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Tabata M., Kadomatsu T., Fukuhara S., Miyata K., Ito Y., Endo M., Urano T., Zhu H.J., Tsukano H., Tazume H., Kaikita K., Miyashita K., Iwawaki T., Shimabukuro M., Sakaguchi K., Ito T., Nakagata N., Yamada T., Katagiri H., Kasuga M., Ando Y., Ogawa H., Mochizuki N., Itoh H., Suda T., Oike Y.
Cell Metabolism 10 ( 3 ) 178 - 188 2009.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Cell Metabolism
Recent studies of obesity have provided new insights into the mechanisms underlying insulin resistance and metabolic dysregulation. Numerous efforts have been made to identify key regulators of obesity-linked adipose tissue inflammation and insulin resistance. We found that angiopoietin-like protein 2 (Angptl2) was secreted by adipose tissue and that its circulating level was closely related to adiposity, systemic insulin resistance, and inflammation in both mice and humans. Angptl2 activated an inflammatory cascade in endothelial cells via integrin signaling and induced chemotaxis of monocytes/macrophages. Constitutive Angptl2 activation in vivo induced inflammation of the vasculature characterized by abundant attachment of leukocytes to the vessel walls and increased permeability. Angptl2 deletion ameliorated adipose tissue inflammation and systemic insulin resistance in diet-induced obese mice. Conversely, Angptl2 overexpression in adipose tissue caused local inflammation and systemic insulin resistance in nonobese mice. Thus, Angptl2 is a key adipocyte-derived inflammatory mediator that links obesity to systemic insulin resistance. © 2009 Elsevier Inc. All rights reserved.
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Hokimoto S., Matsui K., Oshima S., Noda K., Kaikita K., Sumida H., Sugiyama S., Ogawa H.
Journal of Cardiology 54 ( 1 ) 71 - 75 2009.8
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Background: The aim of this study was to examine the effects of gastric medicines on gastroduodenal injury during antiplatelet therapy after coronary intervention. Methods: A total of 501 patients were enrolled and as dual antiplatelet therapy, aspirin and thienopyridine were administered. Patients were divided into four groups: histamine H2-receptor antagonists (H2RA); proton pump inhibitors (PPI); other gastromucosal protective agents (GMP); or nothing (None), and follow-up lasted 8-20 months. Results: H2RA were prescribed in 212 cases (42%), PPI in 150 (30%), GMP in 56 (11%), and None in 83 (17%). Significant findings by endoscopy were recognized in 18 cases and upper gastrointestinal bleeding requiring hospitalization occurred in 7 patients (1.4%; H2RA in 4, GMP in 2, and None in 1). There were no gastrointestinal injuries in the PPI group. To minimize the effect of selection bias on gastroduodenal lesions, the propensity score analysis for clinical characteristics was used. The results of propensity score matching showed that administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group. Conclusion: Administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group. © 2009 Japanese College of Cardiology.
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Uemura T., Kaikita K., Yamabe H., Soejima K., Matsukawa M., Fuchigami S., Tanaka Y., Morihisa K., Enomoto K., Sumida H., Sugiyama S., Ogawa H.
Thrombosis Research 124 ( 1 ) 28 - 32 2009.5
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Thrombosis Research
Introduction: Previous studies have shown raised plasma von Willebrand factor (VWF) levels in patients with atrial fibrillation (AF). However, little is known about changes of VWF associated with VWF-cleaving protease (ADAMTS13) in AF. The aim of this study was to examine the relationship between changes in plasma VWF and ADAMTS13 levels, and left atrial remodeling in AF patients. Materials and Methods: We measured plasma VWF and ADAMTS13 antigen levels in 70 paroxysmal AF (PAF) patients, 56 chronic AF (CAF) patients, and 55 control subjects. Results: Plasma VWF levels (mU/ml) were significantly higher in CAF and PAF patients compared with the controls (2103 ± 743, 1930 ± 676, 1532 ± 555, respectively, P < 0.0001 in CAF vs. controls, P = 0.001 in PAF vs. control), while ADAMTS13 levels (mU/ml) were significantly lower in CAF and PAF patients compared with the controls (795 ± 169, 860 ± 221, 932 ± 173, respectively, P = 0.0002 in CAF vs. controls, P = 0.04 in PAF vs. control). The VWF/ADAMTS13 ratio was significantly higher in patients with CAF than PAF or controls (2.81 ± 1.30, 2.34 ± 0.92, 1.73 ± 0.83, respectively; P = 0.01 in CAF vs. PAF, P < 0.0001 in CAF vs. controls). There was a significant correlation between the VWF/ADAMTS13 ratio and left atrial diameter (positive correlation; r = 0.275, P = 0.0002) and left atrial appendage flow velocity (negative correlation; r = - 0.345, P = 0.0018). Conclusions: These findings suggest that the imbalance between plasma VWF and ADAMTS13 levels caused by left atrial remodeling might be closely associated with intra-atrial thrombus formation in AF patients. © 2008 Elsevier Ltd. All rights reserved.
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Morihisa K., Yamabe H., Uemura T., Tanaka Y., Enomoto K., Kawano H., Nagayoshi Y., Kaikita K., Sumida H., Sugiyama S., Ogawa H.
PACE - Pacing and Clinical Electrophysiology 32 ( 4 ) 484 - 493 2009.4
Language：English Publishing type：Research paper (scientific journal) Publisher：PACE - Pacing and Clinical Electrophysiology
Background: The precise nature of the upper turnaround part of atrioventricular nodal reentrant tachycardia (AVNRT) is not entirely understood. Methods: In nine patients with AVNRT accompanied by variable ventriculoatrial (VA) conduction block, we examined the electrophysiologic characteristics of its upper common pathway. Results: Tachycardia was induced by atrial burst and/or extrastimulus followed by atrial-His jump, and the earliest atrial electrogram was observed at the His bundle site in all patients. Twelve incidents of VA block: Wenckebach VA block (n = 7), 2:1 VA block (n = 4), and intermittent (n = 1) were observed. In two of seven Wenckebach VA block, the retrograde earliest atrial activation site shifted from the His bundle site to coronary sinus ostium just before VA block. Prolongation of His-His interval occurred during VA block in 11 of 12 incidents. After isoproterenol administration, 1:1 VA conduction resumed in all patients. Catheter ablation at the right inferoparaseptum eliminated antegrade slow pathway conduction and rendered AVNRT noninducible in all patients. Conclusion: Selective elimination of the slow pathway conduction at the inferoparaseptal right atrium may suggest that the subatrial tissue linking the retrograde fast and antegrade slow pathways forms the upper common pathway in AVNRT with VA block. © 2009 Wiley Periodicals, Inc.
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Smoking cessation is associated with increased plasma adiponectin levels in men Reviewed
Otsuka F., Kojima S., Maruyoshi H., Kojima S., Matsuzawa Y., Funahashi T., Kaikita K., Sugiyama S., Kimura K., Umemura S., Ogawa H.
Journal of Cardiology 53 ( 2 ) 219 - 225 2009.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Objectives: Low levels of adiponectin, an adipocytokine with anti-diabetic and anti-atherogenic properties, are associated with increased risk of future myocardial infarction in men. Previous studies have demonstrated that cigarette smoking is involved in the development of insulin resistance, and current smokers have been shown to have reduced plasma adiponectin levels. However, the influence of smoking cessation on adiponectin levels remains unknown. We sought to assess whether smoking cessation is associated with increased plasma adiponectin levels in men. Methods: The study includes 72 men (47 non-smokers and 25 current smokers at baseline) with stable angina pectoris who underwent percutaneous coronary intervention and follow-up coronary angiography 6 months later. During the 6-month follow-up period, all 47 non-smokers remained non-smokers, while 15 men of the 25 baseline current smokers successfully quit smoking. We evaluated plasma adiponectin levels at coronary intervention and 6 months later. Results: Plasma adiponectin levels at coronary intervention were comparable to those after 6 months in non-smokers (4.22 [3.15-6.43] vs. 4.58 [3.03-6.26] μg/mL, P = 0.124) and in persistent smokers (4.77 [4.25-10.53] vs. 5.16 [4.11-8.10] μg/mL, P = 0.721). Meanwhile, an increase in adiponectin level was observed in patients who quit smoking for 6 months (4.24 [3.30-5.70] vs. 5.50 [4.03-8.00] μg/mL, P = 0.002). Univariate analysis revealed that the percent increase in adiponectin levels correlated positively with smoking cessation (P = 0.003) and negatively with additional use of β-blockers (P = 0.049). In addition, increases in adiponectin levels were closely associated with increase in high-density lipoprotein cholesterol (P = 0.148), decrease in triglycerides (P = 0.140), and additional use of renin-angiotensin system inhibitors (P = 0.069). Multivariate analysis demonstrated that smoking cessation was an independent determinant of the increase in adiponectin (P = 0.036). Conclusions: Smoking cessation is associated with increased plasma adiponectin levels in men with stable angina, suggesting that the significance of smoking cessation may be partly explained by the increase in adiponectin level. © 2008 Japanese College of Cardiology.
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Effects of imidapril therapy on endogenous fibrinolysis in patients with recent myocardial infarction Reviewed
Soejima H, Ogawa H＊, Yasue H, Suefuji H, Kaikita K
Clinical Cardiology 20 ( 5 ) 441 - 445 2009.2
Authorship：Last author Language：English Publishing type：Research paper (scientific journal)
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Sugamura K., Sugiyama S., Nozaki T., Matsuzawa Y., Izumiya Y., Miyata K., Nakayama M., Kaikita K., Obata T., Takeya M., Ogawa H.
Circulation 119 ( 1 ) 28 - 36 2009.1
Language：English Publishing type：Research paper (scientific journal) Publisher：Circulation
Cannabinoid 1 (CB1) receptor blockade with rimonabant represents a clinical therapeutic strategy for obesity. Recently, the role of the endocannabinoid system has been described in peripheral organs. We sought to determine whether the endocannabinoid system could be involved in human atherosclerosis and whether CB1 receptor blockade could modulate proinflammatory activity in macrophages. Methods and Results-mRNA expression levels of CB1 receptor in coronary atherectomy samples were significantly higher in patients with unstable angina than in those with stable angina (3.62±2.96-fold; n=7; P<0.05). Immunoreactive area analysis of the coronary artery showed that CB1 receptor expression was greater in lipid-rich atheromatous plaques than in fibrous plaques, especially in CD68 macrophages (9.5± 1.2% versus 0.6±0.6%; n=5; P<0.01). Levels of blood endocannabinoids were significantly higher in patients with coronary artery disease (n=20) than those without coronary artery disease (n=20) (median [interquartile range]: anandamide, 1.048 pmol/mL [0.687 to 1.387 pmol/mL] versus 0.537 pmol/mL [0.468 to 0.857 pmol/mL], P<0.01; 2-arachidonoyl glycerol, 13.30 pmol/mL [6.65 to 16.21 pmol/mL] versus 7.67 pmol/mL [6.39 to 10.03 pmol/mL], P<0.05). In cultured macrophages, expression of CB1 receptor was significantly increased during monocyte-macrophage differentiation (1.78±0.13-fold; n=6; P<0.01). CB1 receptor blockade in macrophages induced a significant increase in cytosolic cAMP (29.9± 13.0%; n=4; P<0.01), inhibited phosphorylation of c-Jun N-terminal kinase (-19.1±12.6%, n=4; P<0.05), and resulted in a significant decrease in the production of proinflammatory mediators (interleukin-lβ, -28.9± 10.9%; interleukin-6, -24.8±7.6%; interleukin-8, -22.7±5.2%; tumor necrosis factor-α, -13.6±4.8%; matrix metalloproteinase-9, -16.4±3.8%; n=4 to 8; P<0.01). Conclusions-Patients with coronary artery disease demonstrated the activation of the endocannabinoid system with elevated levels of blood endocannabinoids and increased expression of CB1 receptor in coronary atheroma. CB1 receptor blockade exhibited antiinflammatory effects on macrophages, which might provide beneficial effects on atherogenesis. (Circulation. 2009;119:28-36.) © 2009 American Heart Association, Inc.
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Idiopathic left ventricular aneurysm accompanied by lethal arrhythmia:Report of two cases Reviewed
Morihisa Kenji, Sumida Hitoshi, Sugiyama Seigo, Ogawa Hisao, Yamabe Hiroshige, Enomoto Koji, Uemura Takashi, Tanaka Yasuaki, Matsuzawa Yasushi, Nagayoshi Yasuhiro, Kaikita Koichi, Kawano Hiroaki
Shinzo 41 ( 9 ) 1012 - 1017 2009
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Heart Foundation
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Uemura T., Yamabe H., Tanaka Y., Morihisa K., Kawano H., Kaikita K., Sumida H., Sugiyama S., Ogawa H.
Internal Medicine 47 ( 20 ) 1799 - 1802 2008.11
Language：English Publishing type：Research paper (scientific journal) Publisher：Internal Medicine
Ventricular tachycardia originating from the right ventricular outflow tract (RVOT) is considered benign, but sometimes it causes polymorphic ventricular tachycardia and ventricular fibrillation, resulting in sudden cardiac death. A 58-year-old woman without structural heart disease was admitted for evaluation of recurrent episodes of syncope. Surface ECG showed frequent repetitive premature ventricular contraction (PVC) of RVOT origin. Polymorphic ventricular tachycardia triggered by the same PVC was documented by Holter ECG during an episode of syncope. Radiofrequency catheter ablation was performed to eradicate this PVC. No polymorphic ventricular tachycardia has developed after the procedure, and the patient has had no recurrence of syncope. © 2008 The Japanese Society of Internal Medicine.