- 著者
- Akihito Miyoshi Nobuhiro Nishii Yoji Okamoto Shinpei Fujita Kenji Kawamoto Keisuke Okawa Shigeki Hiramatsu Kazufumi Nakamura Hiroshi Morita Hiroshi Ito
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.84, no.3, pp.456-462, 2020-02-25 (Released:2020-02-25)
- 参考文献数
- 21
- 被引用文献数
- 1 5
Background:In heart failure (HF) patients implanted with high-energy devices, worsening of HF can be diagnosed from intrathoracic impedance (ITI) before symptoms appear. Early therapeutic intervention can prevent HF worsening, but the optimal intervention remains unknown. This study aimed to examine which lifestyle modifications or medications can improve HF indicators in asymptomatic HF patients diagnosed from ITI.Methods and Results:This multicenter, prospective, randomized study included patients with high-energy devices, left ventricular ejection fraction <40%, or with a history of HF hospitalization. After the OptiVol alert was evoked by decreased ITI, patients underwent examinations. If they were diagnosed with HF, they were randomly assigned to 3 groups: lifestyle modification, diuretic, or nitrate. After 1 week, they underwent the same examinations. The primary endpoint was change in ITI and serum B-type natriuretic peptide (BNP). Totally, 57 patients were randomized. In all 3 groups, ITI was significantly increased post-intervention compared with pre-intervention. In the diuretic and nitrate groups, logBNP post-intervention was significantly lower than pre-intervention, but not in the lifestyle modification group.Conclusions:Compared with lifestyle modifications, diuretic and nitrate therapy for 1 week may be more effective management of HF detected by decreased ITI. However, lifestyle modification may have the additional benefits of reducing the workload or cost.
- 著者
- Soichiro Fuke Kiyoaki Maekawa Kenji Kawamoto Hironori Saito Tetsuya Sato Toru Hioka Tohru Ohe
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.71, no.2, pp.220-225, 2007 (Released:2007-01-25)
- 参考文献数
- 28
- 被引用文献数
- 89 93
Background Sirolimus inhibits endothelial cell proliferation in vitro, but although the sirolimus-eluting stent (SES) is widely used because of the very low rates of in-stent restenosis, the influence of SES on coronary endothelial vasomotor function in humans is not well known. Methods and Results The present study included 21 patients treated with SES, and 12 patients treated with conventional bare metal stent (BMS). Endothelium-dependent vasomotor function was evaluated 6 months after stent implantation, using intracoronary acetylcholine infusion. Changes in diameter at the 5-mm proximal and distal edges of the stent, and at the control segment were assessed by quantitative coronary angiography. To evaluate native endothelial function, an intracoronary acetylcholine test was performed before stenting. In the 21 SES patients acetylcholine infusion at 10-8 mol/L and 10-7 mol/L produced significant vasoconstriction in the proximal stent segment (-11.3±10.3%, and -14.1±11.3%, respectively) and the distal stent segment (-13.7±9.3%, and -17.5±12.5%, respectively). In contrast, in the 12 BMS patients, acetylcholine infusion at the same concentrations did not produce a vasoconstrictive response in the proximal stent segment (5.0±8.2% and 4.9±9.1%, respectively) or the distal stent segment (4.2±7.6% and 5.1±7.7%, respectively). Intracoronary nitroglycerin induced a similar grade of vasodilation in the peri-stent area in both groups. Local endothelial function before SES implantation showed no vasoconstrictive response. Conclusions In contrast to vasodilation in BMS patients, SES implantation in the peri-stent area resulted in a vasoconstrictive response to acetylcholine. SES implantation may impair endothelial function in humans. (Circ J 2007; 71: 220 - 225)
- 著者
- Takayuki KAKIMOTO Satoshi MURAI Noboru KUSAKA Fukiko BABA Yohei INOUE Hayato MIYAKE Masato KAWAKAMI Yukei SHINJI Hisakazu ITAMI Shinji OTSUKA Tsukasa NISHIURA Kenji KAWAMOTO Tsuyoshi YAMAMOTO Nobuhiko KIMURA Kotaro OGIHARA
- 出版者
- The Japan Neurosurgical Society
- 雑誌
- NMC Case Report Journal (ISSN:21884226)
- 巻号頁・発行日
- vol.10, pp.21-25, 2023-12-31 (Released:2023-02-23)
- 参考文献数
- 11
A 78-year-old man underwent a tracheostomy after embolization for a dural arteriovenous fistula. Seventy days after tracheostomy, arterial bleeding appeared through the tracheal stoma. The bleeding stopped spontaneously. However, two days later, arterial bleeding reappeared, and he was diagnosed with a tracheo-innominate artery fistula (TIF). He then underwent urgent endovascular covered stent placement. After the procedure, there was no bleeding. TIF can be a fatal complication after tracheostomy and it is generally treated with open chest surgery. However, a successful endovascular treatment for TIF has recently been reported and may yield better results.