著者

Keiko Sumimoto Hidekazu Tanaka Jun Mukai Kentaro Yamashita Yusuke Tanaka Ayu Shono Makiko Suzuki Shun Yokota Kensuke Matsumoto Yu Taniguchi Noriaki Emoto Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.10, pp.625-629, 2020-10-09 (Released:2020-10-09)

参考文献数

9

被引用文献数

3

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Background:The 6th World Symposium on Pulmonary Hypertension proposed that precapillary pulmonary hypertension (PH) be defined as mean pulmonary arterial pressure (mPAP) >20 mmHg instead of mPAP ≥25 mmHg. Peak tricuspid regurgitation velocity (TRV) >3.4 m/s is widely used to predict PH, but it is unclear whether this value remains reliable for the new definition of PH.Methods and Results:We found that the optimal cut-off value of peak TRV for 511 PH patients was >2.8 m/s, with a sensitivity of 89.5%, specificity of 73.4%, and area under the curve of 0.89 (P<0.001).Conclusions:Based on the new definition of PH, TRV >2.8 m/s can be considered to indicate a high probability of PH.

著者

Naoki Tamada Kazuhiko Nakayama Kenichi Yanaka Hiroyuki Onishi Yuto Shinkura Yu Taniguchi Hiroto Kinutani Yasunori Tsuboi Kazuhiro P. Izawa Seimi Satomi-Kobayashi Hiromasa Otake Hiroshi Tanaka Toshiro Shinke Yutaka Okita Noriaki Emoto Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.5, pp.228-234, 2019-05-10 (Released:2019-05-10)

参考文献数

27

被引用文献数

4

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Background:While hemodynamics and exercise capacity in patients with chronic thromboembolic pulmonary hypertension (CTEPH) can be improved by invasive therapy such as pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA), there has been little data on the health-related quality of life (HRQOL) in such patients.Methods and Results:This single-center and observational study compared the impact of invasive therapy on HRQOL. We utilized the Medical Outcome Study 36-Item Short Health Survey (SF-36) to measure HRQOL and compared HRQOL changes after PEA and BPA. A total of 48 patients were diagnosed with CTEPH. Of these, 39 patients completed questionnaires before and after invasive therapy. The PEA group (n=15) and the BPA group (n=24) had similar improvements in clinical parameters. With regard to HRQOL score, both groups had fairly low scores in physical functioning (PF), role physical (RP), general health (GH), social functioning (SF), role emotional (RE), and physical component summary (PCS) at baseline. PF, GH, vitality (VT), mental health (MH), and PCS had significant improvements in the PEA group while PCS and all subscales except for bodily pain (BP) had significant improvements in the BPA group. Furthermore, changes between baseline and follow-up were not significantly different between the 2 groups.Conclusions:BPA for patients who are ineligible for PEA can recover HRQOL to a similar level to that achieved by PEA.

著者

Tomohiro Hayashi Tomoya Yamashita Hikaru Watanabe Kenjiro Kami Naofumi Yoshida Tokiko Tabata Takuo Emoto Naoto Sasaki Taiji Mizoguchi Yasuhiro Irino Ryuji Toh Masakazu Shinohara Yuko Okada Wataru Ogawa Takuji Yamada Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.1, pp.182-192, 2018-12-25 (Released:2018-12-25)

参考文献数

44

被引用文献数

79

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Background: Gut microbiome composition or circulating microbiome-related metabolites in patients with heart failure (HF) have not been investigated at different time points (i.e., in the decompensated (Decomp) and compensated (Comp) phases). Methods and Results: We prospectively enrolled 22 patients admitted for HF and 11 age-, sex-, and comorbidity-matched hospitalized control subjects without a history of HF. Gut flora and plasma microbiome-related metabolites were evaluated by amplicon sequencing of the bacterial 16S ribosomal RNA gene and capillary electrophoresis time-of-flight mass spectrometry, respectively. HF patients were evaluated in both the Decomp and Comp phases during hospitalization. The phylum Actinobacteria was enriched in HF patients compared with control subjects. At the genus level, Bifiodobacterium was abundant while Megamonas was depleted in HF patients. Meanwhile, plasma concentration of trimethylamine N-oxide (TMAO), a gut microbiome-derived metabolite, was increased in HF patients (Decomp HF vs. control, P=0.003; Comp HF vs. control, P=0.004). A correlation analysis revealed positive correlations between the abundance of the genus Escherichia/Shigella and levels of TMAO and indoxyl sulfate (IS, a microbe-dependent uremic toxin) in Comp HF (TMAO: r=0.62, P=0.002; IS: r=0.63, P=0.002). Escherichia/Shigella was more abundant in Decomp than in Comp HF (P=0.030). Conclusions: Our results suggest that gut microbiome composition and microbiome-related metabolites are altered in HF patients.

著者

Keiko Hatazawa Hidekazu Tanaka Akiko Nonaka Hiroki Takada Fumitaka Soga Yutaka Hatani Hiroki Matsuzoe Hiroyuki Shimoura Junichi Ooka Hiroyuki Sano Yasuhide Mochizuki Kensuke Matsumoto Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.10, pp.2566-2574, 2018-09-25 (Released:2018-09-25)

参考文献数

27

被引用文献数

1 28

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Background: Our aim was to investigate the baseline clinical and echocardiographic parameters for predicting left ventricular (LV) dysfunction after anthracycline chemotherapy and heart failure (HF) hospitalization in a single cancer disease. Methods and Results: We studied 73 patients with malignant lymphoma and preserved LV ejection fraction (LVEF). Echocardiography was performed before and after anthracycline chemotherapy. Global longitudinal strain (GLS) was determined from 3 standard apical views. LV dysfunction after anthracycline chemotherapy was defined according to the current definition of cancer therapeutics-related cardiac dysfunction. Long-term (50-month) unfavorable outcome was prespecified as hospitalization for HF. A total of 10 patients had LV dysfunction after anthracycline chemotherapy. Multivariate logistic regression analysis showed that baseline GLS was the only independent predictor of this dysfunction. Receiver-operating characteristic curve analysis identified the optimal GLS cutoff for predicting LV dysfunction after anthracycline chemotherapy as ≤19% (P=0.008). Furthermore, the Kaplan-Meier curve indicated that fewer patients with GLS >19% were hospitalized for HF than among those with GLS ≤19% (log-rank P=0.02). For sequential logistic models, a model based on baseline clinical variables (χ2=2.9) was improved by the addition of baseline LVEF (χ2=9.0; P=0.01), and further improved by the addition of baseline GLS (χ2=13.1, P=0.04). Conclusions: Watchful observation or early therapeutic intervention with established cardioprotective medications may be necessary for patients with malignant lymphoma and preserved LVEF but with abnormal GLS.

著者

Tomoya Yamashita Tomohiro Hayashi Tokiko Tabata Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.10, pp.2470-2471, 2018-09-25 (Released:2018-09-25)

参考文献数

8

被引用文献数

4

著者

Haruhi Yamada Yukiko Katsumori Miki Kawano Shumpei Mori Ryo Takeshige Jun Mukai Hiroshi Imada Hiroyuki Shimoura Hachidai Takahashi Tadasu Horai Yutaka Okita Ken-ichi Hirata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.12, pp.1763-1767, 2018-06-15 (Released:2018-06-15)

参考文献数

12

被引用文献数

5

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A 73-year-old man, with congestive heart failure due to combined valvar disease, underwent curative surgery. Although the surgery was successful, his clinical course was eventful because of pulmonary complications, and he began to deteriorate mentally. Quetiapine was prescribed, which appeared to effectively settle his mental status. Following the administration of quetiapine, however, he developed acute kidney injury (AKI) that required continuous hemodiafiltration. Subsequent to discontinuation of quetiapine, his renal function gradually improved. Atypical antipsychotic drugs, including quetiapine, are frequently used to treat delirium in elderly patients in the intensive-care setting. This case highlights a potential risk of quetiapine-related AKI.

著者

Tomoya Yamashita Takuo Emoto Naoto Sasaki Ken-ichi Hirata

出版者

一般社団法人 インターナショナル・ハート・ジャーナル刊行会

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.16-414, (Released:2016-11-04)

被引用文献数

52

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Gut microbiota have been attracting increased attention in many fields of medicine recently. We can perform a comprehensive analysis of gut microbiota using next-generation sequencing techniques together with bioinformatics technology, which expands our knowledge of a large ecosystem consisting of a host and gut microbiota. We summarize some reports about the correlations between gut microbiota and metabolic disorders, particularly atherosclerosis, and discuss future directions for the diagnostic or therapeutic potential of gut microbiota. To take simple examples, we demonstrated that the order Lactobacillales was significantly increased; while the phylum Bacteroidetes was significantly decreased in coronary artery disease (CAD) patients compared with controls or healthy volunteers. The characteristics of gut microbiota in type 2 diabetes and dyslipidemia have been reported. However, these studies have limitations, and the biological significance of gut microbiota and the causal relationships are still controversial. We hope the reports listed in this review article might lead to the development of a novel therapy to prevent CAD via modulating gut microbiota or their metabolites.

著者

Ryo Nishio Toshiro Shinke Hiromasa Otake Takahiro Sawada Yoko Haraguchi Masakazu Shinohara Ryuji Toh Tatsuro Ishida Masayuki Nakagawa Ryoji Nagoshi Amane Kozuki Takumi Inoue Hirotoshi Hariki Tsuyoshi Osue Yu Taniguchi Masamichi Iwasaki Noritoshi Hiranuma Akihide Konishi Hiroto Kinutani Junya Shite Ken-ichi Hirata

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.76, no.10, pp.2348-2355, 2012 (Released:2012-09-25)

参考文献数

32

被引用文献数

15 37

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Background: Cytochrome P450 (CYP) 2C19 polymorphism is associated with reduced responsiveness to clopidogrel and poor clinical outcome after drug-eluting stent (DES) implantation, but its contribution to lesion outcome after DES implantation is unclear. Methods and Results: The study included 160 Japanese patients who received clopidogrel and underwent DES implantation with follow-up angiography. Patients were divided into 3 groups by CYP2C19 polymorphism: extensive metabolizers (EM), intermediate metabolizers (IM), and poor metabolizers (PM). The incidence of major adverse cardiac events (MACE) and target lesion revascularization (TLR) were compared among the 3 groups. Optical coherence tomography (OCT) was performed for 120 patients to evaluate the incidence of intra-stent thrombi. Of the 160 patients, the proportion of EM, IM, and PM was 37.5%, 48.1%, and 14.4%, respectively. The incidence of TLR and MACE was more frequent in IM and PM than EM (TLR: 18.2% and 26.1% vs. 3.3%, P=0.008, MACE: 22.1% and 30.4% vs. 5.0%, P=0.005). Among the 120 patients who underwent follow-up OCT, intra-stent thrombi were more frequently detected in IM and PM than in EM (45.6% and 63.2% vs. 20.5%, P=0.005). The incidence of TLR was significantly higher in patients with than in those without intra-stent thrombi (27.7% vs. 6.8%, P=0.003). Conclusions: CYP2C19 loss-of-function polymorphism might be associated with the incidence of MACE and TLR in association with intra-stent thrombi.  (Circ J 2012; 76: 2348–2355)

著者

Tomoya Yamashita Kazuyuki Kasahara Takuo Emoto Takuya Matsumoto Taiji Mizoguchi Naoki Kitano Naoto Sasaki Ken-ichi Hirata

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.9, pp.1882-1890, 2015-08-25 (Released:2015-08-25)

参考文献数

48

被引用文献数

4 49

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Atherosclerosis is considered a chronic inflammatory disease and an intervention targeting the inflammatory process could be a new therapeutic strategy for preventing atherosclerotic cardiovascular diseases (CVD). We hypothesized that the intestine, which is considered the biggest immune organ in the human body, could be a therapeutic target for preventing CVD. We demonstrated that oral administration of anti-CD3 antibody or an active form of vitamin D3reduced atherosclerosis in mice via induction of regulatory T cells and tolerogenic dendritic cells in the gut-associated lymphoid tissues. Similar to regulatory immune responses achieved by oral tolerance, our method had systemic effects that ultimately contributed towards atherosclerosis reduction. Recently, we have been interested in the gut microbiota, which have been reported as highly associated with intestinal immunity and systemic metabolic disorders, including obesity and diabetes. Notably, the guts of obese individuals are predominantly colonized byFirmicutesoverBacteroidetes. The association between atherosclerosis and microbiota has been attracting increased attention, and gut microbiota have been shown to participate in the metabolism of a proatherogenic compound called trimethylamine-N-oxide (TMAO) and aggravate CVD. Our investigation of the relationship between susceptibility to CVD and the gut microbiota revealed a characteristic flora type. Here, we discuss the evidence for the relationship between the gut microbiota and cardiometabolic diseases, and consider the gut microbiota as new potential therapeutic targets for treating CVD. (Circ J 2015; 79: 1882–1890)

著者

Kenta Mori Tatsuro Ishida Tomoyuki Yasuda Minoru Hasokawa Tomoko Monguchi Maki Sasaki Kensuke Kondo Hideto Nakajima Masakazu Shinohara Toshiro Shinke Yasuhiro Irino Ryuji Toh Kunihiro Nishimura Ken-ichi Hirata

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-14-0750, (Released:2015-07-13)

参考文献数

36

被引用文献数

8 39

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Background:Adverse effects of dietary intake of trans-fatty acids (TFA) on the incidence of coronary artery disease (CAD) are well recognized in Western countries. The risk of TFA, however, has not been well clarified in Japan. We investigated the association of serum TFA concentration with serum lipid profile, coronary risk factors, and prevalence of CAD.Methods and Results:A total of 902 patients, who were hospitalized at Kobe University Hospital from July 2008 to March 2012 and gave written informed consent, were enrolled in this study. Among them, 463 patients had CAD, and 318 patients had metabolic syndrome (MetS). Serum TFA, elaidic acid (trans-9-C18:1) and linolelaidic acid (trans-9, 12-C18:2), were measured on gas chromatography/mass spectrometry. Serum TFA level had a positive correlation with body mass index, waist circumference, low-density lipoprotein cholesterol, triglycerides, and apolipoprotein B48, and an inverse correlation with age and high-density lipoprotein cholesterol. Fasting serum TFA, by age quartile in the young generation with CAD and/or MetS, was higher than that in patients without CAD and/or MetS. On multivariate logistic regression, TFA was identified as a CAD risk after adjustment for classical risk factors.Conclusions:Serum TFA concentration was elevated in young patients with CAD and/or MetS. Diet-derived TFA may cause a serious health problem, particularly in the young generation in Japan.

著者

Takuo Emoto Naoto Sasaki Tomoya Yamashita Kazuyuki Kasahara Keiko Yodoi Yoshihiro Sasaki Takuya Matsumoto Taiji Mizoguchi Ken-ichi Hirata

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-14-0644, (Released:2014-10-18)

参考文献数

22

被引用文献数

9 40

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Background:The protective function of regulatory T cells (Treg) has been identified in experimental atherosclerosis, but the contribution of Tregto the pathogenesis of human coronary artery disease (CAD) remains poorly understood. We investigated Tregand regulatory T-cell/effector T-cell (Treg/Teff) ratio in peripheral blood samples from CAD patients using a new strategy for precise identification of Treg.Methods and Results:Peripheral blood samples were collected from 73 stable CAD patients (55 middle-aged CAD patients and 18 old CAD patients) and 64 controls (47 middle-aged controls and 17 young controls). CD3+CD4+FoxP3+T cells were divided into 3 fractions: CD45RA+FoxP3lowresting Treg(Fr1), CD45RA–FoxP3highactivated Treg(Fr2), and CD45RA–FoxP3lownon-Treg(Fr3). CAD patients had lower percentages of Fr1 and Fr2 and higher percentages of Fr3 and CD45RA–Foxp3–Teff(Fr4+5) within the CD3+CD4+T-cell population compared to age-matched controls. Treg/Teffratio (Fr1+2/Fr3+4+5) in CAD patients was also markedly lower than in controls (middle-aged control, 0.17±0.09 vs. middle-aged CAD, 0.10±0.05; P<0.001). The percentage of CD4+CD28nullT cells within the CD4+T-cell population was negatively correlated with Treg/Teffratio, excluding CD4+CD28nullT cells <0.3% (r=–0.27, P<0.05). High-sensitivity C-reactive protein was also negatively correlated with Treg/Teffratio (r=–0.22, P<0.05).Conclusions:CAD patients had reduced Tregand Treg/Teffratio compared to healthy controls. The present findings may be helpful when developing immunotherapy for the prevention of CAD.

著者

Hidekazu Tanaka Kazuhiro Tatsumi Sei Fujiwara Takayuki Tsuji Akihiro Kaneko Keiko Ryo Yuko Fukuda Kensuke Matsumoto Mayumi Shigeru Akihiro Yoshida Hiroya Kawai Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.76, no.2, pp.382-389, 2012 (Released:2012-01-25)

参考文献数

28

被引用文献数

33 38

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Background: Dyssynchrony has various detrimental effects on cardiac function, but its effect on cardiac sympathetic activity is not fully understood. Methods and Results: We studied 50 heart failure patients who underwent cardiac resynchronization therapy (CRT). Cardiac sympathetic activity was assessed by 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy as the delayed heart-to-mediastinum ratio (H/M ratio). Echocardiography was performed before and 7 months after CRT, and response was defined as a ≥15% decrease in end-systolic volume. Dyssynchrony was determined by the time difference between the anteroseptal-to-posterior wall using speckle-tracking radial strain (≥130ms predefined as significant). H/M ratio in patients with dyssynchrony was less than that in patients without dyssynchrony (1.62±0.31 vs. 1.82±0.36, P<0.05), even though ejection fraction was not significantly different (24±6% vs. 25±7%). Patients with dyssynchrony and H/M ratio ≥1.6 had a higher frequency of response to CRT (94%) and favorable long-term outcome over 3.0 years. In contrast, patients without dyssynchrony and H/M ratio <1.6 were more likely to show a lower frequency of response to CRT (0%) and unfavorable long-term outcome after CRT. Conclusions: Dyssynchrony is associated with cardiac sympathetic activity, and 123I-MIBG scintigraphy may be valuable for predicting the response to CRT. (Circ J 2012; 76: 382-389)