Kyoichi Mizuno - Academia.edu (original) (raw)

Papers by Kyoichi Mizuno

Research paper thumbnail of Effects of long-term treatment for obstructive sleep apnea on pulse wave velocity

Hypertension Research, 2010

Continuous positive airway pressure (CPAP) treatment improves endothelial function and sympatheti... more Continuous positive airway pressure (CPAP) treatment improves endothelial function and sympathetic activity in patients with obstructive sleep apnea (OSA). However, the long-term effects of CPAP on pulse wave velocity (PWV), which reflects arterial stiffness that is associated with cardiovascular events, have not been evaluated in OSA patients with or without hypertension (HT). In this study, 212 male OSA patients who had been receiving CPAP treatment for 2 years and were divided into two groups, those with HT (n¼114) and those without (n¼98), were studied. In both HT and normotensive (NT) patients, PWV decreased significantly over the first 6 months of treatment (P¼0.005 and 0.010, respectively), before increasing gradually from 6 to 24 months. Body mass index (BMI), body weight, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels decreased significantly in the HT group over the 2 years of CPAP treatment (Po0.001 for all). In contrast, only HR decreased significantly in the NT group over the 2 years of treatment (Po0.001). Multivariate regression analysis revealed that age (P¼0.008), decreases in DBP (Po0.001) and HR (Po0.001) and higher initial levels of serum high-density lipoprotein-cholesterol (P¼0.040) were independent factors related to changes in PWV over the 2 years of CPAP treatment in all patients. In conclusion, we found a significant decrease in PWV in both NT and HT patients after 6 months of CPAP treatment. In HT patients, long-term CPAP treatment significantly decreases blood pressure, which may contribute to explain the PWV improvement.

Research paper thumbnail of PE-281 Relationship between B-type Natriuretic Peptide Response during Exercise and Functional Capacity in Patients with Hypertrophic Obstructive Cardiomyopathy(Cardiomyopathy, basic/clinical(04)(M),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)

Circulation Journal Official Journal of the Japanese Circulation Society, Mar 1, 2008

Research paper thumbnail of S7-4 Percutaneous Alcohol Septal Ablation Results in Excellent Hemodynamic and Clinical Outcome in Medically Refractory Hypertrophic Cardiomyopathy with Left Ventricular Outflow or/and Mid-Cavitary Obstruction

CVD Prevention and Control, 2009

Research paper thumbnail of Impact of Statin Therapy on Renal Function and Long-Term Prognosis in Acute Coronary Syndrome Patients With Chronic Kidney Disease

International Heart Journal, 2010

A recent study showed that statins reduce cardiovascular events in stable coronary artery disease... more A recent study showed that statins reduce cardiovascular events in stable coronary artery disease patients with chronic kidney disease (CKD). However, it remains unclear whether acute coronary syndrome (ACS) patients with CKD benefit from statins. A total of 501 patients with ACS who underwent successful percutaneous coronary intervention were investigated and CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/minute/1.73 m 2 at discharge. Three hundred and twenty-four of 501 patients (64.7%) had CKD and 173 patients (34.5%) received statins. The patients with CKD were older and had higher blood pressure than those without CKD. With a mean follow-up of 5.2 years, irrespective of treatment assignment, 74 patients with CKD experienced cardiac events (22.8%) in comparison to 25 without CKD (14.1%, HR 1.81; 95% CI 1.15-2.84, P = 0.0095). Cardiac events occurred in only 18 of the patients with CKD treated with statins (16.2%) and in 56 of those treated with CKD without statins (26.3%, HR 0.58; 95% CI 0.34-0.98, P = 0.039), whereas, no significant reduction of the events was observed in the patients without CKD treated with statins versus without having statins (P = 0.130). These data indicate that statin therapy reduces cardiac events in ACS patients with CKD.

Research paper thumbnail of Effects of Statin Therapy on the Production of Monocyte Pro-Inflammatory Cytokines, Cardiac Function, and Long-Term Prognosis in Chronic Heart Failure Patients With Dyslipidemia

Circulation Journal, 2012

Background: The effects of statin therapy on the production of monocyte pro-inflammatory cytokine... more Background: The effects of statin therapy on the production of monocyte pro-inflammatory cytokines, cardiac function and the long-term prognosis in chronic heart failure (CHF) patients with dyslipidemia remain unclear. Methods and Results: A total of 146 CHF patients with a mean left ventricular ejection fraction (LVEF) of 26.9±6.6% were divided into 2 groups based on whether or not statins were included in their treatment: a statin group (n=63) and a no statin group (n=83). Only patients with dyslipidemia were treated with statins. Peripheral blood mononuclear cells (PBMCs) were isolated, and the production of monocyte tumor necrosis factor (TNF)-α and interleukin (IL)-6 were measured at baseline and after 6 months of treatment, and the data expressed as mean ± SD (pg • ml-1 • 10-6 PBMCs). The LVEF in the statin group improved, and the monocyte TNF-α and IL-6 production decreased (respectively, P<0.001), but the LVEF and cytokine production remained unchanged in the no statin group. Multivariate Cox hazard analysis showed that statin therapy (hazard ratio, 0.14; 95% confidence interval: 0.02-0.97, P=0.046) was an independent predictor of cardiac events. Conclusions: Statin therapy attenuates the production of monocyte pro-inflammatory cytokines, and ameliorates the cardiac function and may improve long-term prognosis in CHF patients with dyslipidemia.

Research paper thumbnail of Denervated Sympathetic Nerve Distributed to Motor Muscle as a Possible Cause of Enhanced BP Response to Exercise in Patients with Heart Disease

Journal of the Japanese Coronary Association, 2012

Research paper thumbnail of Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation

European Heart Journal, 2006

Aims The neointimal coverage and intracoronary thrombi within stented segments at 6 months after ... more Aims The neointimal coverage and intracoronary thrombi within stented segments at 6 months after implantation between sirolimus-eluting stents (SESs) and bare metal stents (BMSs) were compared by direct visualization using angioscopy. Methods and results Forty-six patients (36 stable angina and 10 acute coronary syndrome) were treated with 33 SESs and 33 BMSs. Immediately after and 6 months after stenting, each of the stented segments, edge body, and overlapping segment were observed by angioscopy and the grade of neointimal coverage over the stents was classified as 0: absent neointima, 1: visible struts through thin neointima, or 2: invisible struts. The existence of thrombi was also evaluated. The average grade of the neointimal coverage at 6 months follow-up was lower in the SES than that in the BMS (edge: 1.4 + 0.7 vs. 1.9 + 0.2, body: 1.0 + 0.5 vs. 1.8 + 0.5, overlapping segment: 0.6 + 0.7 vs. 1.8 + 0.5; P , 0.0001, P , 0.0001, P ¼ 0.0069, respectively). The frequency of persistence of thrombus was significantly higher in the SESs than that in the BMSs (86 vs. 29%, respectively; P ¼ 0.031). Conclusion The present study suggested a delayed neointimal stent coverage and slower thrombus disappearance process in the SESs in comparison to the BMSs.

Research paper thumbnail of Intense yellow culprit plaque coloration is closely associated with troponin-T elevation and flow complications following elective coronary stenting

Journal of atherosclerosis and thrombosis, 2011

The elevation of troponin-T (TnT) and occurrence of transient slow-flow phenomena have been recog... more The elevation of troponin-T (TnT) and occurrence of transient slow-flow phenomena have been recognized as procedure-related myocardial injuries. Little is known about the characteristics of high-risk plaque resulting in myocardial injury after coronary stenting. The culprit plaques in 42 consecutive patients with stable angina undergoing elective coronary stenting were observed by angioscopy. The plaque color upon angioscopic examination was classified as either intense yellow or not yellow. Slow flow was defined as < TIMI grade 3 flow during the procedure. The TnT levels were measured 8, 16, and 24 hours after stenting, and myocardial injury was defined as TnT ≥ 0.03 ng/mL at any time point. Twenty-four patients (57%) had intense yellow plaques and myocardial injury occurred in 22 patients (52%). The frequency of intense yellow plaque was significantly higher in the patients with myocardial injury than in those without myocardial injury (91% vs. 20%, p < 0.001). Transient slo...

Research paper thumbnail of Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

Clinical Research in Cardiology, 2014

Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in pa... more Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in patients with coronary artery disease. We used optical coherence tomography (OCT) to investigate the characteristics of coronary plaques that were associated with derived ChCs. We evaluated 101 subjects with stable coronary artery disease who underwent OCT. We compared the OCT findings of the culprit lesions with ChCs to those without ChCs and investigated the background characteristics. ChCs were observed in culprit lesions of 39 patients. The frequencies of spotty calcification, microchannel structure, and lipid-rich plaque were significantly higher in patients with ChCs than those without ChCs (64.1 vs. 27.4%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; 69.2 vs. 38.7%, p = 0.003; 53.8 vs. 29.0%, p = 0.01, respectively). On the other hand, the frequencies of thrombus, disruption, and thin-cap fibroatheroma did not differ significantly between patients with and without ChCs (15.3 vs. 24.1%, p = 0.3; 33.3 vs. 17.7%, p = 0.07; and 33.3 vs. 24.1 %, p = 0.3, respectively). Among the possible clinical factors, multivariate analysis showed an elevated level of glycated hemoglobin as the sole significant factor associated with ChCs. ChCs are frequently associated with the major findings of vulnerable plaque, and are often seen in poorly controlled diabetic patients. Thus, ChCs might be one of the features of vulnerable plaque.

Research paper thumbnail of Sleep-disordered breathing with nighttime hypocapnia relates to daytime enhanced ventilatory response to exercise in patients with heart disease

Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 2012

Sleep-disordered breathing (SDB) induces nighttime disturbance of arterial gases, such as carbon ... more Sleep-disordered breathing (SDB) induces nighttime disturbance of arterial gases, such as carbon dioxide. However, it is still unclear whether nighttime SDB-related gas abnormality is related to respiratory dysregulation in daytime. Therefore, we examined the relationship between the arterial partial pressure of carbon dioxide (PaCO(2)) at nighttime and the respiratory response to exercise in daytime. Eighteen men (age, mean ± SD; 55 ± 11 years) with heart disease underwent multichannel respiratory monitoring through the night with transdermal measurement of PaCO(2) (PtcCO(2)) reflecting PaCO(2) and a cardiopulmonary exercise test in daytime. The ventilatory equivalent (VE)/carbon dioxide production (VCO(2)) slope as an index of ventilatory response to exercise and peak oxygen consumption (VO(2)) were obtained with a cardiopulmonary exercise test. Of the 18 patients, 10 patients had obstructive SDB, 5 had central SDB, and 3 patients did not have SDB. The mean apnea-hypopnea index wa...

Research paper thumbnail of OE-137 Characteristics of Exercise Induced Abnormal Blood Pressure Response in Patients with Hypertrophic Obstructive Cardiomyopathy(OE23,Heart Failure (Pathophysiology) (M),Oral Presentation (English),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)

Circulation Journal Official Journal of the Japanese Circulation Society, Mar 1, 2009

Research paper thumbnail of Clinical Backgrounds and the Time Course of Sleep-disordered Breathing in Patients after Myocardial Infarction

Journal of Nippon Medical School, 2013

Research paper thumbnail of Inhaled nitric oxide therapy for secondary pulmonary hypertension with hypertrophic obstructive cardiomyopathy and severe kyphoscoliosis

International Journal of Cardiology, 2012

Research paper thumbnail of Sympathetic Excitation during Exercise as a Cause of Attenuated Heart Rate Recovery in Patients with Myocardial Infarction

Journal of Nippon Medical School, 2009

Research paper thumbnail of Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes

The American Journal of Cardiology, 2013

Although attention has recently been focused on the role of psychosocial factors in patients with... more Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). In conclusion, depression in hospitalized patients with CVD is a stronger independent risk factor for adverse cardiac events than either anxiety or anger. Anger may help prevent adverse outcomes. Routine screening for depression should therefore be performed in patients with CVD, and the potential effects of anger in clinical practice should be reconsidered.

Research paper thumbnail of Coronary atherosclerosis and risk of acute coronary syndromes in chronic kidney disease using angioscopy and the kidney disease: Improving Global Outcomes (KDIGO) classification

Atherosclerosis, Jan 24, 2015

This 8-year follow-up cohort study evaluated and compared the degree of coronary atherosclerosis ... more This 8-year follow-up cohort study evaluated and compared the degree of coronary atherosclerosis in chronic kidney disease (CKD) according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification using multivessel angioscopy and investigated the impact of the vulnerability of coronary arteries on the relationship between the classification and risk of acute coronary syndromes (ACS). We studied 89 coronary artery disease patients who underwent angioscopic observation of multiple coronary arteries. The patients were divided into 3 groups: Risk 0, 1, and 2 were equivalent to low risk, moderately high risk, and high and severely high risk, respectively. We examined the frequencies of complex and yellow plaques. Furthermore, we followed all patients for de novo ACS, dividing into two groups according to the existence of vulnerable coronary atherosclerosis (VCA) based on angioscopic findings. The number of yellow plaques per vessel, maximum yellow grade, number of complex p...

Research paper thumbnail of Observation of Bubbles and Detection of Hepatocytes in the Portal Vein During Radiofrequency

Research paper thumbnail of Ultrastructural features of cardiomyocytes in dilated cardiomyopathy with initially decompensated heart failure as a predictor of prognosis

European heart journal, Jan 21, 2015

The aim of the present study was to clarify the significance of myocardial ultrastructural change... more The aim of the present study was to clarify the significance of myocardial ultrastructural changes in patients with dilated cardiomyopathy (DCM). Endomyocardial biopsy of the left ventricle was performed in 250 consecutive DCM patients (54.9 ± 13.9 years, 79% men), presenting initially as decompensated heart failure (HF). Myofilament changes of cardiomyocytes were evaluated by electron microscopy and compared with clinical and morphometric data. Mortality and HF recurrence were evaluated during the follow-up period. During the follow-up period (4.9 ± 3.9 years), 24 patients (10%) died and 67 (27%) were readmitted because of HF recurrence, including those who had died because of HF. Myofilament changes, classified as either focal derangement of myofilaments (sarcomere damage) or diffuse myofilament lysis (disappearance of most sarcomeres in cardiomyocytes), were identified in 164 patients (66%). Multivariate analysis identified a family history of DCM [hazard ratio (HR) 4.763; 95% co...

Research paper thumbnail of Coronary atherosclerosis is already ongoing in pre-diabetic status: Insight from intravascular imaging modalities

World journal of diabetes, Jan 15, 2015

Diabetes mellitus is a powerful risk factor of coronary artery disease (CAD), leading to death an... more Diabetes mellitus is a powerful risk factor of coronary artery disease (CAD), leading to death and disability. In recent years, given the accumulating evidence that prediabetes is also related to increasing risk of CAD including cardiovascular events, a new guideline has been proposed for the treatment of blood cholesterol for primary prevention of cardiovascular events. This guideline recommends aggressive lipid-lowering statin therapy for primary prevention in diabetes and other patients. The ultimate goal of patient management is to inhibit progression of systemic atherosclerosis and prevent fatal cardiovascular events such as acute coronary syndrome (ACS). Because disruption of atherosclerotic coronary plaques is a trigger of ACS, the high-risk atheroma is called a vulnerable plaque. Several types of novel diagnostic imaging technologies have been developed for identifying the characteristics of coronary atherosclerosis before the onset of ACS, especially vulnerable plaques. Acc...

Research paper thumbnail of Heart-type fatty acid-binding protein is a novel prognostic marker in patients with essential hypertension

International journal of cardiology, Jan 20, 2014

Research paper thumbnail of Effects of long-term treatment for obstructive sleep apnea on pulse wave velocity

Hypertension Research, 2010

Continuous positive airway pressure (CPAP) treatment improves endothelial function and sympatheti... more Continuous positive airway pressure (CPAP) treatment improves endothelial function and sympathetic activity in patients with obstructive sleep apnea (OSA). However, the long-term effects of CPAP on pulse wave velocity (PWV), which reflects arterial stiffness that is associated with cardiovascular events, have not been evaluated in OSA patients with or without hypertension (HT). In this study, 212 male OSA patients who had been receiving CPAP treatment for 2 years and were divided into two groups, those with HT (n¼114) and those without (n¼98), were studied. In both HT and normotensive (NT) patients, PWV decreased significantly over the first 6 months of treatment (P¼0.005 and 0.010, respectively), before increasing gradually from 6 to 24 months. Body mass index (BMI), body weight, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels decreased significantly in the HT group over the 2 years of CPAP treatment (Po0.001 for all). In contrast, only HR decreased significantly in the NT group over the 2 years of treatment (Po0.001). Multivariate regression analysis revealed that age (P¼0.008), decreases in DBP (Po0.001) and HR (Po0.001) and higher initial levels of serum high-density lipoprotein-cholesterol (P¼0.040) were independent factors related to changes in PWV over the 2 years of CPAP treatment in all patients. In conclusion, we found a significant decrease in PWV in both NT and HT patients after 6 months of CPAP treatment. In HT patients, long-term CPAP treatment significantly decreases blood pressure, which may contribute to explain the PWV improvement.

Research paper thumbnail of PE-281 Relationship between B-type Natriuretic Peptide Response during Exercise and Functional Capacity in Patients with Hypertrophic Obstructive Cardiomyopathy(Cardiomyopathy, basic/clinical(04)(M),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)

Circulation Journal Official Journal of the Japanese Circulation Society, Mar 1, 2008

Research paper thumbnail of S7-4 Percutaneous Alcohol Septal Ablation Results in Excellent Hemodynamic and Clinical Outcome in Medically Refractory Hypertrophic Cardiomyopathy with Left Ventricular Outflow or/and Mid-Cavitary Obstruction

CVD Prevention and Control, 2009

Research paper thumbnail of Impact of Statin Therapy on Renal Function and Long-Term Prognosis in Acute Coronary Syndrome Patients With Chronic Kidney Disease

International Heart Journal, 2010

A recent study showed that statins reduce cardiovascular events in stable coronary artery disease... more A recent study showed that statins reduce cardiovascular events in stable coronary artery disease patients with chronic kidney disease (CKD). However, it remains unclear whether acute coronary syndrome (ACS) patients with CKD benefit from statins. A total of 501 patients with ACS who underwent successful percutaneous coronary intervention were investigated and CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/minute/1.73 m 2 at discharge. Three hundred and twenty-four of 501 patients (64.7%) had CKD and 173 patients (34.5%) received statins. The patients with CKD were older and had higher blood pressure than those without CKD. With a mean follow-up of 5.2 years, irrespective of treatment assignment, 74 patients with CKD experienced cardiac events (22.8%) in comparison to 25 without CKD (14.1%, HR 1.81; 95% CI 1.15-2.84, P = 0.0095). Cardiac events occurred in only 18 of the patients with CKD treated with statins (16.2%) and in 56 of those treated with CKD without statins (26.3%, HR 0.58; 95% CI 0.34-0.98, P = 0.039), whereas, no significant reduction of the events was observed in the patients without CKD treated with statins versus without having statins (P = 0.130). These data indicate that statin therapy reduces cardiac events in ACS patients with CKD.

Research paper thumbnail of Effects of Statin Therapy on the Production of Monocyte Pro-Inflammatory Cytokines, Cardiac Function, and Long-Term Prognosis in Chronic Heart Failure Patients With Dyslipidemia

Circulation Journal, 2012

Background: The effects of statin therapy on the production of monocyte pro-inflammatory cytokine... more Background: The effects of statin therapy on the production of monocyte pro-inflammatory cytokines, cardiac function and the long-term prognosis in chronic heart failure (CHF) patients with dyslipidemia remain unclear. Methods and Results: A total of 146 CHF patients with a mean left ventricular ejection fraction (LVEF) of 26.9±6.6% were divided into 2 groups based on whether or not statins were included in their treatment: a statin group (n=63) and a no statin group (n=83). Only patients with dyslipidemia were treated with statins. Peripheral blood mononuclear cells (PBMCs) were isolated, and the production of monocyte tumor necrosis factor (TNF)-α and interleukin (IL)-6 were measured at baseline and after 6 months of treatment, and the data expressed as mean ± SD (pg • ml-1 • 10-6 PBMCs). The LVEF in the statin group improved, and the monocyte TNF-α and IL-6 production decreased (respectively, P<0.001), but the LVEF and cytokine production remained unchanged in the no statin group. Multivariate Cox hazard analysis showed that statin therapy (hazard ratio, 0.14; 95% confidence interval: 0.02-0.97, P=0.046) was an independent predictor of cardiac events. Conclusions: Statin therapy attenuates the production of monocyte pro-inflammatory cytokines, and ameliorates the cardiac function and may improve long-term prognosis in CHF patients with dyslipidemia.

Research paper thumbnail of Denervated Sympathetic Nerve Distributed to Motor Muscle as a Possible Cause of Enhanced BP Response to Exercise in Patients with Heart Disease

Journal of the Japanese Coronary Association, 2012

Research paper thumbnail of Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation

European Heart Journal, 2006

Aims The neointimal coverage and intracoronary thrombi within stented segments at 6 months after ... more Aims The neointimal coverage and intracoronary thrombi within stented segments at 6 months after implantation between sirolimus-eluting stents (SESs) and bare metal stents (BMSs) were compared by direct visualization using angioscopy. Methods and results Forty-six patients (36 stable angina and 10 acute coronary syndrome) were treated with 33 SESs and 33 BMSs. Immediately after and 6 months after stenting, each of the stented segments, edge body, and overlapping segment were observed by angioscopy and the grade of neointimal coverage over the stents was classified as 0: absent neointima, 1: visible struts through thin neointima, or 2: invisible struts. The existence of thrombi was also evaluated. The average grade of the neointimal coverage at 6 months follow-up was lower in the SES than that in the BMS (edge: 1.4 + 0.7 vs. 1.9 + 0.2, body: 1.0 + 0.5 vs. 1.8 + 0.5, overlapping segment: 0.6 + 0.7 vs. 1.8 + 0.5; P , 0.0001, P , 0.0001, P ¼ 0.0069, respectively). The frequency of persistence of thrombus was significantly higher in the SESs than that in the BMSs (86 vs. 29%, respectively; P ¼ 0.031). Conclusion The present study suggested a delayed neointimal stent coverage and slower thrombus disappearance process in the SESs in comparison to the BMSs.

Research paper thumbnail of Intense yellow culprit plaque coloration is closely associated with troponin-T elevation and flow complications following elective coronary stenting

Journal of atherosclerosis and thrombosis, 2011

The elevation of troponin-T (TnT) and occurrence of transient slow-flow phenomena have been recog... more The elevation of troponin-T (TnT) and occurrence of transient slow-flow phenomena have been recognized as procedure-related myocardial injuries. Little is known about the characteristics of high-risk plaque resulting in myocardial injury after coronary stenting. The culprit plaques in 42 consecutive patients with stable angina undergoing elective coronary stenting were observed by angioscopy. The plaque color upon angioscopic examination was classified as either intense yellow or not yellow. Slow flow was defined as < TIMI grade 3 flow during the procedure. The TnT levels were measured 8, 16, and 24 hours after stenting, and myocardial injury was defined as TnT ≥ 0.03 ng/mL at any time point. Twenty-four patients (57%) had intense yellow plaques and myocardial injury occurred in 22 patients (52%). The frequency of intense yellow plaque was significantly higher in the patients with myocardial injury than in those without myocardial injury (91% vs. 20%, p < 0.001). Transient slo...

Research paper thumbnail of Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

Clinical Research in Cardiology, 2014

Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in pa... more Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in patients with coronary artery disease. We used optical coherence tomography (OCT) to investigate the characteristics of coronary plaques that were associated with derived ChCs. We evaluated 101 subjects with stable coronary artery disease who underwent OCT. We compared the OCT findings of the culprit lesions with ChCs to those without ChCs and investigated the background characteristics. ChCs were observed in culprit lesions of 39 patients. The frequencies of spotty calcification, microchannel structure, and lipid-rich plaque were significantly higher in patients with ChCs than those without ChCs (64.1 vs. 27.4%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; 69.2 vs. 38.7%, p = 0.003; 53.8 vs. 29.0%, p = 0.01, respectively). On the other hand, the frequencies of thrombus, disruption, and thin-cap fibroatheroma did not differ significantly between patients with and without ChCs (15.3 vs. 24.1%, p = 0.3; 33.3 vs. 17.7%, p = 0.07; and 33.3 vs. 24.1 %, p = 0.3, respectively). Among the possible clinical factors, multivariate analysis showed an elevated level of glycated hemoglobin as the sole significant factor associated with ChCs. ChCs are frequently associated with the major findings of vulnerable plaque, and are often seen in poorly controlled diabetic patients. Thus, ChCs might be one of the features of vulnerable plaque.

Research paper thumbnail of Sleep-disordered breathing with nighttime hypocapnia relates to daytime enhanced ventilatory response to exercise in patients with heart disease

Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 2012

Sleep-disordered breathing (SDB) induces nighttime disturbance of arterial gases, such as carbon ... more Sleep-disordered breathing (SDB) induces nighttime disturbance of arterial gases, such as carbon dioxide. However, it is still unclear whether nighttime SDB-related gas abnormality is related to respiratory dysregulation in daytime. Therefore, we examined the relationship between the arterial partial pressure of carbon dioxide (PaCO(2)) at nighttime and the respiratory response to exercise in daytime. Eighteen men (age, mean ± SD; 55 ± 11 years) with heart disease underwent multichannel respiratory monitoring through the night with transdermal measurement of PaCO(2) (PtcCO(2)) reflecting PaCO(2) and a cardiopulmonary exercise test in daytime. The ventilatory equivalent (VE)/carbon dioxide production (VCO(2)) slope as an index of ventilatory response to exercise and peak oxygen consumption (VO(2)) were obtained with a cardiopulmonary exercise test. Of the 18 patients, 10 patients had obstructive SDB, 5 had central SDB, and 3 patients did not have SDB. The mean apnea-hypopnea index wa...

Research paper thumbnail of OE-137 Characteristics of Exercise Induced Abnormal Blood Pressure Response in Patients with Hypertrophic Obstructive Cardiomyopathy(OE23,Heart Failure (Pathophysiology) (M),Oral Presentation (English),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)

Circulation Journal Official Journal of the Japanese Circulation Society, Mar 1, 2009

Research paper thumbnail of Clinical Backgrounds and the Time Course of Sleep-disordered Breathing in Patients after Myocardial Infarction

Journal of Nippon Medical School, 2013

Research paper thumbnail of Inhaled nitric oxide therapy for secondary pulmonary hypertension with hypertrophic obstructive cardiomyopathy and severe kyphoscoliosis

International Journal of Cardiology, 2012

Research paper thumbnail of Sympathetic Excitation during Exercise as a Cause of Attenuated Heart Rate Recovery in Patients with Myocardial Infarction

Journal of Nippon Medical School, 2009

Research paper thumbnail of Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes

The American Journal of Cardiology, 2013

Although attention has recently been focused on the role of psychosocial factors in patients with... more Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). In conclusion, depression in hospitalized patients with CVD is a stronger independent risk factor for adverse cardiac events than either anxiety or anger. Anger may help prevent adverse outcomes. Routine screening for depression should therefore be performed in patients with CVD, and the potential effects of anger in clinical practice should be reconsidered.

Research paper thumbnail of Coronary atherosclerosis and risk of acute coronary syndromes in chronic kidney disease using angioscopy and the kidney disease: Improving Global Outcomes (KDIGO) classification

Atherosclerosis, Jan 24, 2015

This 8-year follow-up cohort study evaluated and compared the degree of coronary atherosclerosis ... more This 8-year follow-up cohort study evaluated and compared the degree of coronary atherosclerosis in chronic kidney disease (CKD) according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification using multivessel angioscopy and investigated the impact of the vulnerability of coronary arteries on the relationship between the classification and risk of acute coronary syndromes (ACS). We studied 89 coronary artery disease patients who underwent angioscopic observation of multiple coronary arteries. The patients were divided into 3 groups: Risk 0, 1, and 2 were equivalent to low risk, moderately high risk, and high and severely high risk, respectively. We examined the frequencies of complex and yellow plaques. Furthermore, we followed all patients for de novo ACS, dividing into two groups according to the existence of vulnerable coronary atherosclerosis (VCA) based on angioscopic findings. The number of yellow plaques per vessel, maximum yellow grade, number of complex p...

Research paper thumbnail of Observation of Bubbles and Detection of Hepatocytes in the Portal Vein During Radiofrequency

Research paper thumbnail of Ultrastructural features of cardiomyocytes in dilated cardiomyopathy with initially decompensated heart failure as a predictor of prognosis

European heart journal, Jan 21, 2015

The aim of the present study was to clarify the significance of myocardial ultrastructural change... more The aim of the present study was to clarify the significance of myocardial ultrastructural changes in patients with dilated cardiomyopathy (DCM). Endomyocardial biopsy of the left ventricle was performed in 250 consecutive DCM patients (54.9 ± 13.9 years, 79% men), presenting initially as decompensated heart failure (HF). Myofilament changes of cardiomyocytes were evaluated by electron microscopy and compared with clinical and morphometric data. Mortality and HF recurrence were evaluated during the follow-up period. During the follow-up period (4.9 ± 3.9 years), 24 patients (10%) died and 67 (27%) were readmitted because of HF recurrence, including those who had died because of HF. Myofilament changes, classified as either focal derangement of myofilaments (sarcomere damage) or diffuse myofilament lysis (disappearance of most sarcomeres in cardiomyocytes), were identified in 164 patients (66%). Multivariate analysis identified a family history of DCM [hazard ratio (HR) 4.763; 95% co...

Research paper thumbnail of Coronary atherosclerosis is already ongoing in pre-diabetic status: Insight from intravascular imaging modalities

World journal of diabetes, Jan 15, 2015

Diabetes mellitus is a powerful risk factor of coronary artery disease (CAD), leading to death an... more Diabetes mellitus is a powerful risk factor of coronary artery disease (CAD), leading to death and disability. In recent years, given the accumulating evidence that prediabetes is also related to increasing risk of CAD including cardiovascular events, a new guideline has been proposed for the treatment of blood cholesterol for primary prevention of cardiovascular events. This guideline recommends aggressive lipid-lowering statin therapy for primary prevention in diabetes and other patients. The ultimate goal of patient management is to inhibit progression of systemic atherosclerosis and prevent fatal cardiovascular events such as acute coronary syndrome (ACS). Because disruption of atherosclerotic coronary plaques is a trigger of ACS, the high-risk atheroma is called a vulnerable plaque. Several types of novel diagnostic imaging technologies have been developed for identifying the characteristics of coronary atherosclerosis before the onset of ACS, especially vulnerable plaques. Acc...

Research paper thumbnail of Heart-type fatty acid-binding protein is a novel prognostic marker in patients with essential hypertension

International journal of cardiology, Jan 20, 2014