論文 - 楠瀬　賢也

Impact of Vagal Nerve Stimulation on Left Atrial Structure and Function in a Canine High-Rate Pacing Model

Kenya Kusunose, Youhua Zhang, Todor N. Mazgalev, David R. Van Wagoner, James D. Thomas, Zoran B. Popovic

CIRCULATION-HEART FAILURE ( LIPPINCOTT WILLIAMS & WILKINS )  7 ( 2 ) 320 - 326   2014年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Background- Cervical vagal nerve stimulation (VNS) can improve left ventricular dysfunction in the setting of heart failure (HF). However, little is known about the impact of VNS on left atrial (LA) function. The aim of this study was to compare LA mechanics and histology between control and VNS-treated animals during HF development. Methods and Results- Fifteen mongrel dogs were randomized into control (n=7) and VNS (n=8) groups. All dogs underwent 8 weeks of high-rate ventricular pacing (at 220 beats per minute for the first 4 weeks to develop HF and another 4 weeks at 180 beats per minute to maintain HF). LA contractile function (LA negative peak strain), conduit function (LA positive peak strain), and reservoir function (LA total strain) were measured from speckle tracking in 2 groups. At the end of the terminal study, the LA appendage was obtained. Baseline LA strains were comparable in the control and VNS-treated dogs. At 4 and 8 weeks of ventricular pacing, all LA strains were decreased and LA volumes were increased in the control group compared with the VNS group (P < 0.05). Histological evaluation of the left atrium revealed that percent fibrosis was significantly lower in the VNS versus the control group (8 +/- 1% versus 13 +/- 1%; P < 0.001). Finally, transmitral flow showed decreased atrial contribution to left ventricular filling in the control group (P < 0.05). Conclusions- VNS improved LA function and volumes and suppressed LA fibrosis in the canine high-rate ventricular pacing model. VNS is a novel and potentially useful therapy for improving LA function during HF.

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Effects of Telmisartan on Inflammatory Cytokines and Coronary Plaque Component as Assessed on Integrated Backscatter Intravascular Ultrasound in Hypertensive Patients

Koji Yamaguchi, Tetsuzo Wakatsuki, Takeshi Soeki, Toshiyuki Niki, Yoshio Taketani, Hiroyasu Oeduka, Kenya Kusunose, Takayuki Ise, Takashi Iwase, Hirotsugu Yamada, Masataka Sata

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOC )  78 ( 1 ) 240 - 247   2014年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: Telmisartan has unique pleiotropic effects in addition to renin-angiotensin system (RAS)-inhibition effects. The aim of this study was to evaluate the effects of telmisartan on the coronary plaque component and local inflammatory cytokines. Methods and Results: A total of 50 patients with hypertension were randomized to 2 groups: the telmisartan group (additional treatment with telmisartan 80 mg/day, n=25) or the control group (additional treatment with other anti-hypertensive drugs except RAS blockers, n=25) for 6 months. Tissue characteristics of target coronary plaque were analyzed using integrated backscatter intravascular ultrasound (IB-IVUS) before and after treatment. Plasma levels of inflammatory cytokines sampled in the coronary sinus (CS) and peripheral vein were also measured. Significant increases in fibrous volume (51.2 +/- 10.4 to 58.3 +/- 7.7%, P=0.03) and reductions in lipid volume (38.4 +/- 12.4 to 32.8 +/- 9.7%, P=0.03) were observed on IB in the telmisartan group, while there were no significant changes in the plaque component in the control group. CS levels of inflammatory cytokines (matrix metalloproteinase [MMP]3, tumor necrosis factor-alpha, high-sensitivity C-reactive protein and MMP9) were lower after than before treatment in the only telmisartan group (7.7 +/- 6.1 to 5.5 +/- 4.9 ng/ml, 3.1 +/- 1.9 to 2.3 +/- 2.0 pg/ml, 5.6 +/- 6.0 to 2.2 +/- 2.4 mg/L, 36.1 +/- 39.3 to 19.9 +/- 27.5 ng/ml, P=0.02, P=0.03, P=0.04, P=0.07, respectively). Conclusions: Decreased local inflammatory response and plaque stabilization on IB imaging were observed after 6 months of telmisartan treatment. These findings might be associated with local anti-inflammatory and anti-arteriosclerotic effects of telmisartan.

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Left Main Coronary Artery Compression Syndrome with an Incomplete Atrioventricular Septal Defect Presenting as Angina Induced by Hyperthyroidism

Kenya Kusunose, Noriko Tomita, Susumu Nishio, Mika Bando, Shuji Hayashi, Junko Hotchi, Takashi Iwase, Hirotsugu Yamada, Masataka Sata

INTERNAL MEDICINE ( JAPAN SOC INTERNAL MEDICINE )  53 ( 18 ) 2083 - 2085   2014年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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We herein report the case of a 29-year-old woman who was diagnosed with incomplete atrioventricular septal defect and extrinsic compression of the left main coronary artery (LMCA) with chest pain due to postpartum thyroiditis. She exhibited chest pain with ST elevation, and coronary computed tomography showed that the LMCA was compressed between the dilated pulmonary artery and aorta. After her hyperthyroidism was treated, her chest pain resolved. Surgical repair of endocardiosis and coronary bypass grafting were performed. On the one-year follow-up visit, the dilation of the pulmonary artery and right heart was decreased. It is important to consider the possibility of compression of the LMCA in patients presenting with pulmonary hypertension and chest pain.

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Multimodality imaging of biatrial myxomas in an asymptomatic patient

Susumu Nishio, Kenya Kusunose, Hirotsugu Yamada, Junko Hotchi, Shuji Hayashi, Mika Bando, Yoshihiko Saijo, Yukina Hirata, Miho Abe, Masataka Sata

Journal of Cardiology Cases ( Elsevier Ltd )  10 ( 3 ) 85 - 87   2014年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Myxomas are located in the left atrium in 75-80% of cases and almost always present with signs and symptoms of a thromboembolic event. Biatrial myxomas are rare, and their incidence is generally less than 2.5% of all myxomas. We herein present a case of biatrial myxomas as an incidental finding by echocardiography where the patient underwent surgery. Echocardiography continues to be the initial imaging modality for intracardiac masses. Cardiac magnetic resonance provides superior tissue characterization, particularly important in differentiating a myxoma from a thrombus. Appropriate use of these non-invasive imaging modalities may lead to a correct diagnosis and good outcome.&lt . Learning objective: In this report we present a rare case of cardiac biatrial myxomas. Multimodality imaging, especially delayed enhancement cardiac magnetic resonance imaging, provided specific findings for the diagnosis.&gt . © 2014 Japanese College of Cardiology.

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Local persistent hypercoagulability after sirolimus-eluting stent implantation in patients with stable angina

Koji Yamaguchi, Tetsuzo Wakatsuki, Toshiyuki Niki, Kenya Kusunose, Kunihiko Koshiba, Shusuke Yagi, Yoshio Taketani, Takashi Iwase, Noriko Tomita, Hirotsugu Yamada, Takeshi Soeki, Masashi Akaike, Masataka Sata

INTERNATIONAL JOURNAL OF CARDIOLOGY ( ELSEVIER IRELAND LTD )  153 ( 3 ) 272 - 276   2011年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: Late stent thrombosis (LST) after sirolimus-eluting stent (SES) implantation has been demonstrated previously. Although incomplete neointimal coverage after SES implantation has been reported, local long-term hypercoagulability remains unknown. Methods: We evaluated the local persistent coagulative response in eighty-three consecutive patients with stable angina, treated with either SES (n = 51) or BMS (n = 32) implantation for isolated de novo left anterior descending (LAD) stenosis. We measured prothrombin fragment F1+ 2 (frF1 + 2) and D-dimer levels sampled in the coronary sinus (CS) and sinus of Valsalva (V). The transcardiac gradient (Delta) was defined as the CS level minus V level. Results: The Delta frF1 + 2 and Delta D-dimer were significantly greater in the SES group than in the BMS group (0.50 +/- 0.35 vs -0.14 +/- 0.15 nmol/l, p = 0.009 and 0.24 +/- 0.21 vs -0.05 +/- 0.16 mu g/ml, p = 0.041, respectively). We selected the hypocoagulative [Delta frF1 + 2<0.15 (mean value-SD) nmol/l, n = 21] and hypercoagulative [Delta frF1 + 2>0.85 (mean value + SD) nmol/l, n = 14] groups out of the SES patients. Multivariate analysis was performed to identify independent predictors of local hypercoagulability. Total SES length was the only independent predictor of local hypercoagulability. There was a significant positive correlation between the Delta frF1 + 2 and total stent length in the SES group (r = 0.57, p<0.05). Conclusions: An increased local coagulative response was observed in the convalescent phase after SES implantation as compared to BMS. Careful long-term follow-up of patients after longer SES implantation is recommended in order to avoid LST. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

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Detection of Cardiac Involvement in Patients with Sarcoidosis Using Cardiac Magnetic Resonance

Iwase Takashi, Takao Shoichiro, Akaike Masashi, Ise Takayuki, Niki Toshiyuki, Kusunose Kenya, Sumitomo-Ueda Yuka, Tomita Noriko, Yamaguchi Koji, Taketani Yoshio, Yamada Hirotsugu, Soeki Takeshi, Aihara Ken-ichi, Wakatsuki Tetsuzo, Harada Masafumi, Sata Masataka

CIRCULATION   124 ( 21 )   2011年11月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Ultrasonic Tissue Characterization of Carotid Artery Plaque using High-resolution Integrated Backscatter Imaging: Validation Study with Histological Correlation

Bando Mika, Yamada Hirotsugu, Nishio Susumu, Uematsu Etsuko, Hayashi Shuji, Hotchi Junko, Kusunose Kenya, Tomita Noriko, Tamai Rina, Hirata Yukina, Hirota Daichi, Nakagawa Maya, Niki Toshiyuki, Yamaguchi Koji, Taketani Yoshio, Iwase Takashi, Soeki Takeshi, Wakatsuki Tetsuzo, Shimabukuro Michio, Sata Masataka

CIRCULATION   124 ( 21 )   2011年11月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Single-Beat Assessment of Left Ventricular Systolic and Diastolic Function During Atrial Fibrillation using Myocardial Strain and Strain Rate

Kusunose Kenya, Yamada Hirotsugu, Nishio Susumu, Tomita Noriko, Hayashi Shuji, Hotchi Junko, Tamai Rina, Hirota Daichi, Hirata Yukina, Bando Mika, Ogasawara Kozue, Takashima Akira, Yamazaki Hiromu, Bando Sachiko, Ise Takayuki, Niki Toshiyuki, Yamaguchi Koji, Taketani Yoshio, Iwase Takashi, Soeki Takeshi, Wakatsuki Tetsuzo, Sata Masataka

CIRCULATION   124 ( 21 )   2011年11月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Effects of Telmisartan on Inflammatory Cytokines and Coronary Plaque Component Assessed by Integrated Backscatter Intravascular Ultrasound in Hypertensive Patients

Yamaguchi Koji, Wakatsuki Tetsuzo, Soeki Takeshi, Niki Toshiyuki, Taketani Yoshio, Oezuka Hiroyasu, Bando Sachiko, Tomita Noriko, Kusunose Kenya, Iwase Takashi, Yamada Hirotsugu, Sata Masataka

CIRCULATION   124 ( 21 )   2011年11月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

A patient who developed toe necrosis due to poor blood circulation after an interdigital tick bite

Hiromu Yamazaki, Koji Yamaguchi, Takashi Iwase, Toshiyuki Niki, Kenya Kusunose, Noriko Tomita, Yoshio Taketani, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Yutaka Fukunaga, Hideki Nakanishi, Haruhiko Maruyama, Hiroyuki Matsuoka, Masataka Sata

Journal of Cardiology Cases   4 ( 2 ) e106 - e109   2011年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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A 71-year-old female had worked on a farm in the mountains and noticed itching of the left 3rd toe. She visited a local hospital due to a color change to purple in this area. Attachment of a tick was observed between the left 2nd and 3rd toes, and it was extracted. However, due to persistent pain, she was referred to our department of cardiovascular medicine for close examination and treatment. Lower extremity angiography showed that vascular visualization was poor in the area supplied by the arteries distal to the tick bite site, but the other blood vessels of the toe were clearly visualized. Toe amputation was performed and pathological examination of a surgical specimen revealed that most blood vessels near the necrosis were occluded by thrombi. We speculated that tick bite reactions were associated with thrombogenic vasculopathy. This report shows a patient who developed toe necrosis due to poor blood circulation after an interdigital tick bite. © 2011 Japanese College of Cardiology.

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Elevated concentrations of pentraxin 3 are associated with coronary plaque vulnerability

Takeshi Soeki, Toshiyuki Niki, Kenya Kusunose, Sachiko Bando, Yoichiro Hirata, Noriko Tomita, Koji Yamaguchi, Kunihiko Koshiba, Shusuke Yagi, Yoshio Taketani, Takashi Iwase, Hirotsugu Yamada, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata

JOURNAL OF CARDIOLOGY ( ELSEVIER IRELAND LTD )  58 ( 2 ) 151 - 157   2011年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: Inflammation is a critical contributing factor to the development and progression of atherosclerosis. Pentraxin 3 (PTX3) is produced abundantly in atherosclerotic lesions while C-reactive protein (CRP) is mainly produced in the liver. In this study, we investigated whether plasma levels of PTX3 might be a sensitive marker both for the severity of coronary artery disease and vulnerable plaques. Next, we determined whether assays for inflammatory molecules can be used to monitor the therapeutic effects of telmisartan on stabilization of vulnerable atherosclerotic plaques. Methods and results: We measured PTX3 concentrations in the peripheral and coronary sinus plasma of 40 patients with angina pectoris (AP) and 20 control subjects. Next, in 28 patients with AP, we determined the correlation between levels of inflammatory molecules and the computed tomography (CT) density of plaques as a quantitative index of plaque vulnerability. There was no significant difference in peripheral plasma PTX3 concentrations between patients with AP and control subjects, while coronary sinus plasma PTX3 concentrations were significantly higher in AP patients than control subjects. The concentrations of PTX3 in coronary sinus and peripheral plasma correlated with Gensini scores as an index of severity of coronary atherosclerosis. Interestingly, there was a significantly negative correlation between plasma PTX3 concentrations and CT density (r= 0.67, p < 0.01). On the other hand, CT density did not correlate with the peripheral plasma concentrations of monocyte chemoattractant protein-1 (MCP-1) or high-sensitivity CRP (hsCRP). Furthermore, telmisartan treatment for 6 months decreased plasma concentrations of PTX3 but not those of MCP-1 or hsCRP in 12 patients with essential hypertension. Multivariate regression analysis revealed that changes in PTX3 levels were independent of blood pressure changes. Conclusions: PTX3 is likely more specific than hsCRP as an indicator of coronary plaque vulnerability that could lead to plaque rupture. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

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Comparison of chronic-stage histopathological findings among 3 coronary stents implanted in the same patient

Toshiyuki Niki, Tetsuzo Wakatsuki, Koji Yamaguchi, Kenya Kusunose, Kunihiko Koshiba, Shusuke Yagi, Yoshio Taketani, Takashi Iwase, Noriko Tomita, Hirotsugu Yamada, Takeshi Soeki, Masashi Akaike, Masataka Sata

INTERNATIONAL JOURNAL OF CARDIOLOGY ( ELSEVIER IRELAND LTD )  150 ( 1 ) E25 - E27   2011年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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A 73-year-old woman suffering from anterior thoracic pain on exertion presented to our hospital. We performed coronary angiography and noted three stenotic legions in each coronary artery. For each angiographic finding, we implanted a bare metal stent (BMS), sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) into the right coronary artery, left anterior descending and left circumflex coronary arteries, respectively. Nine months later, she died of lung disease, and we could compare the histopathological findings among the three coronary stents. In the drug-eluting stents, very thin intima, infiltration of inflammatory cells, and fibrin deposition were observed, while thick intima and no inflammatory findings were observed in the BMS. Fibrin deposition was more marked in the PES than in the SES. This report shows marked differences in the subsequent pathological course among three stents in the same patient. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

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Effect of Low-Dose (1 mg/day) Pitavastatin on Left Ventricular Diastolic Function and Albuminuria in Patients With Hyperlipidemia

Shusuke Yagi, Masashi Akaike, Ken-Ichi Aihara, Takashi Iwase, Kazue Ishikawa, Sumiko Yoshida, Yuka Sumitomo-Ueda, Kenya Kusunose, Toshiyuki Niki, Koji Yamaguchi, Kunihiko Koshiba, Yoshio Taketani, Noriko Tomita, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Toshio Matsumoto, Masataka Sata

AMERICAN JOURNAL OF CARDIOLOGY ( EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC )  107 ( 11 ) 1644 - 1649   2011年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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The aim of the present study was to evaluate the factors that modulate the protective action of statins on cardiorenal function, regardless of the lipid-lowering effect. To treat abnormal serum lipid profiles, low-dose pitavastatin (1.0 mg/day) was administered to 65 hyperlipidemic patients. The exclusion criteria included left ventricular ejection fraction <40% and apparent renal disease. Age- and gender-matched patients with hyperlipidemia (n = 40) served as the controls. After 12 to 16 weeks of pitavastatin treatment, pitavastatin had decreased low-density lipoprotein cholesterol (from 143.5 +/- 31.4 to 98.2 +/- 19.4 mg/dl, p <0.01), triglycerides (from 157.7 +/- 57.2 to 140.5 +/- 60.7 mg/dl, p <0.01), E/e' (from 10.8 +/- 6.2 to 9.0 +/- 4.5, p <0.05), a parameter of left ventricular diastolic function, and albuminuria (from 47.6 +/- 55.9 to 28.5 +/- 40.0 mg/g creatinine, p <0.01). Furthermore, pitavastatin decreased serum transforming growth factor-beta 1 (from 709 +/- 242 to 550 +/- 299 pg/ml, p <0.01), urinary 8-hydroxy-2'-deoxyguanosine (from 6.6 +/- 4.1 to 5.0 +/- 3.1 mu g/g creatinine, p <0.01), an oxidative stress marker, and increased urinary nitrate and nitrite (from 22.5 +/- 14.6 to 29.4 +/- 27.6 nmol/g creatinine, p <0.05). No such changes were observed in the controls. Multiple regression analysis in the pitavastatin group revealed the effect of pitavastatin on cardiorenal function was associated with suppression of oxidative stress, but not on low-density lipoprotein cholesterol reduction. In conclusion, pitavastatin decreases E/e' and albuminuria, which is associated with suppression of oxidative stress. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:1644-1649)

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Observation of short-term atorvastatin-induced changes in coronary arterial plaque properties using integrated backscatter intravascular ultrasound in a patient

Koji Yamaguchi, Tetsuzo Wakatsuki, Toshiyuki Niki, Yoshio Taketani, Hiroyasu Oezuka, Kenya Kusunose, Takashi Iwase, Hirotsugu Yamada, Takeshi Soeki, Masataka Sata

Journal of Cardiology Cases   3 ( 3 ) e111 - e114   2011年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Integrated backscatter intravascular ultrasound (IB-IVUS) capable of assessing plaque properties has recently become clinically applicable. We observed short-term atorvastatin-induced changes in coronary arterial plaque properties using IB-IVUS. The patient was a 57-year-old man who underwent coronary angiography when admitted to our hospital for cerebrovascular surgery, and lesions were observed in 2 branches: 99% and 90% stenoses in the proximal anterior descending branch (LAD) and middle region of the circumflex, respectively. Stenting was performed for the LAD on November 4, 2009 and for the circumflex on December 9. Oral atorvastatin administration at 10. mg/day was initiated on November 5 because the LDL-cholesterol level was high (160. mg/dl). A region about 5. mm in length proximal to the stent placed in the LAD was analyzed using IB-IVUS. Atorvastatin lowered the LDL cholesterol level from 160 to 79. mg/dl. On IB image analysis, although the period was as short as about 1 month, a marked decrease in the fatty component (44% → 26%) and an increase in the fibrous component (53% → 66%) were observed in the plaque. It was suggested that atorvastatin changes the tissue properties of coronary arterial plaques from a very early phase. It might be associated with the stabilization of coronary plaque. © 2011 Japanese College of Cardiology.

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Serial imaging changes during treatment of Takayasu arteritis with pulmonary artery stenosis

Kenya Kusunose, Hirotsugu Yamada, Noriko Tomita, Susumu Nishio, Toshiyuki Niki, Koji Yamaguchi, Kunihiko Koshiba, Shusuke Yagi, Yoshio Taketani, Takashi Iwase, Takeshi Soeki, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata

INTERNATIONAL JOURNAL OF CARDIOLOGY ( ELSEVIER IRELAND LTD )  148 ( 3 ) E47 - E50   2011年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Most cases of chronic stenosis or occlusive lesions of the pulmonary arteries are attributed to thromboembolism, and pulmonary arteritis is extremely rare as the primary cause of these entities. We report a case of pulmonary stenosis and occlusion caused by Takayasu arteritis. The patient was a 54-year-old woman who presented with dyspnea. Total occlusion of the left pulmonary artery and significant stenosis of the right pulmonary artery caused by Takayasu arteritis were confirmed by various imaging modalities including pulmonary angiography, 18fluorodeoxyglucose-positron emission tomography, magnetic resonance imaging and real-time three-dimensional transesophageal echocardiography. After 6 weeks of steroid therapy, follow-up imaging studies showed that the stenotic lesion had resolved. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

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RELATIONSHIP BETWEEN CAROTID ARTERY STIFFNESS PARAMETER ? AND BRACHIAL ARTERY FLOW-MEDIATED DILATION IN CORONARY ARTERY DISEASE

Nishio Susumu, Yamada Hirotsugu, Tamai Rina, Endo Keisuke, Hayashi Shuji, Kusunose Kenya, Tomita Noriko, Miki Junko, Bando Sachiko, Hisaoka Sahika, Niki Toshiyuki, Yamaguchi Koji, Taketani Yoshio, Iwase Takashi, Soeki Takeshi, Wakatsuki Tetsuzo, Akaike Masashi, Sata Masataka

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   57 ( 14 ) E1569   2011年04月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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Acute hemodynamic effects of adaptive servo ventilation in patients with pulmonary hypertension

Shusuke Yagi, Masashi Akaike, Takashi Iwase, Kenya Kusunose, Toshiyuki Niki, Koji Yamaguchi, Kunihiko Koshiba, Yoshio Taketani, Noriko Tomita, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

INTERNATIONAL JOURNAL OF CARDIOLOGY ( ELSEVIER IRELAND LTD )  148 ( 1 ) 125 - 127   2011年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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出産後の甲状腺機能亢進症が発見の契機となったLeft Main Coronary Trunk Compression Syndromeの一例

太田 理絵, 冨田 紀子, 楠瀬 賢也, 坂東 左知子, 久岡 白陽花, 林 修司, 竹内 秀和, 仁木 敏之, 山口 浩司, 竹谷 善雄, 岩瀬 俊, 山田 博胤, 添木 武, 若槻 哲三, 赤池 雅史, 佐田 政隆, 木村 建彦, 西内 健, 黒部 裕嗣, 北川 哲也

四国医学雑誌 ( 徳島医学会 )  67 ( 1-2 ) 97 - 98   2011年04月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Effect of low-dose (1 mg/day) pitavastatin on left ventricular diastolic function and albuminuria in patients with hyperlipidemia.

Shusuke Yagi, Masashi Akaike, Ken-ichi Aihara, Takashi Iwase, Kazue Ishikawa, Sumiko Yoshida, Yuka Sumitomo-Ueda, Kenya Kusunose, Toshiyuki Niki, Koji Yamaguchi, Kunihiko Koshiba, Yoshio Taketani, Noriko Tomita, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Toshio Matsumoto, Masataka Sata

The American Journal of Cardiology   Vol.107 ( No.11 ) 1644 - 1649   2011年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

The aim of the present study was to evaluate the factors that modulate the protective action of statins on cardiorenal function, regardless of the lipid-lowering effect. To treat abnormal serum lipid profiles, low-dose pitavastatin (1.0 mg/day) was administered to 65 hyperlipidemic patients. The exclusion criteria included left ventricular ejection fraction <40% and apparent renal disease. Age- and gender-matched patients with hyperlipidemia (n = 40) served as the controls. After 12 to 16 weeks of pitavastatin treatment, pitavastatin had decreased low-density lipoprotein cholesterol (from 143.5 ± 31.4 to 98.2 ± 19.4 mg/dl, p <0.01), triglycerides (from 157.7 ± 57.2 to 140.5 ± 60.7 mg/dl, p <0.01), E/e' (from 10.8 ± 6.2 to 9.0 ± 4.5, p <0.05), a parameter of left ventricular diastolic function, and albuminuria (from 47.6 ± 55.9 to 28.5 ± 40.0 mg/g creatinine, p <0.01). Furthermore, pitavastatin decreased serum transforming growth factor-1 (from 709 ± 242 to 550 ± 299 pg/ml, p <0.01), urinary 8-hydroxy-2'-deoxyguanosine (from 6.6 ± 4.1 to 5.0 ± 3.1 g/g creatinine, p <0.01), an oxidative stress marker, and increased urinary nitrate and nitrite (from 22.5 ± 14.6 to 29.4 ± 27.6 nmol/g creatinine, p <0.05). No such changes were observed in the controls. Multiple regression analysis in the pitavastatin group revealed the effect of pitavastatin on cardiorenal function was associated with suppression of oxidative stress, but not on low-density lipoprotein cholesterol reduction. In conclusion, pitavastatin decreases E/e' and albuminuria, which is associated with suppression of oxidative stress.

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Validation of Longitudinal Peak Systolic Strain by Speckle Tracking Echocardiography With Visual Assessment and Myocardial Perfusion SPECT in Patients With Regional Asynergy

Kenya Kusunose, Hirotsugu Yamada, Susumu Nishio, Yukio Mizuguchi, Masahito Choraku, Yasuhiro Maeda, Shinobu Hosokawa, Nobuo Yamazaki, Noriko Tomita, Toshiyuki Niki, Koji Yamaguchi, Kunihiko Koshiba, Takeshi Soeki, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOC )  75 ( 1 ) 141 - 147   2011年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: Automated function imaging (AFI) is a recently developed method of calculating the longitudinal peak systolic strains (LS) of the regional left ventricular (LV) wall using speckle tracking echocardiography and displaying them on a single bull's-eye map. The feasibility of AFI in patients with regional LV wall motion abnormalities caused by myocardial infarction (MI) was evaluated by comparison with visual assessment and myocardial perfusion single-photon emission computed tomography (SPECT). Methods and Results: Segmental LS was measured by AFI in 60 patients with MI (67 +/- 11 years) and 58 controls (71 +/- 9 years). Wall thickening (WT) was measured by SPECT in 20 patients with MI. There was a strong positive linear relationship between the wall motion score index by expert visual assessment and global LS. The receiver-operating characteristic analysis revealed the best cutoff value of -11% <LS to identify hypokinetic segments. The overall accuracy of wall motion scoring by LS in the 2,006 segments was 96.8% (kappa=0.90) compared with visual assessment. The correlation coefficient between LS and WT was R(2)=0.65 in the 340 segments. Conclusions: Assessment of LV regional asynergy by AFI showed good agreement with visual and SPECT assessments. AFI is clinically useful for quantitative assessment of LV regional wall motion abnormalities. (Circ J 2011;75: 141-147)

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