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Imizu, Japan

Matsuzaki M.,Yamaguchi University | Hori M.,Japan National Cardiovascular Center Research Institute | Izumi T.,Kitasato University | Asanoi H.,Imizu City Hospital | Tsutamoto T.,Shiga University of Medical Science
Cardiovascular Drugs and Therapy | Year: 2011

Purpose: Tolvaptan may reduce the signs of volume overload in heart failure (HF) patients who experience volume overload despite using conventional diuretics. In this study, we evaluated the dose-response effects of tolvaptan on weight loss, urine volume and electrolyte excretion in furosemide-treated Japanese HF patients exhibiting volume overload. Methods: In the study, 117 HF patients with volume overload on stable doses of furosemide (≥40 mg/day) were treated with tolvaptan (15, 30 or 45 mg) or placebo once-daily for 7 days. Results: The decrease in body weight from baseline to the day after the final dose with 15, 30 or 45 mg tolvaptan (-1.62±1.55, -1.35±1.54 and -1.85±1.10 kg, respectively), was significantly greater compared with that in the placebo group (-0.53±0.96 kg) (p<0.05). However, the decrease in body weight with tolvaptan was not significantly dose-dependent. Signs of volume overload improved at all doses of tolvaptan. Tolvaptan elicited a dose-dependent increase in urine volume and a decrease in urine osmolality, but did not affect urinary sodium or potassium excretion. Adverse reactions associated with diuresis were most frequently observed at the higher doses of tolvaptan. Conclusions: Once-daily tolvaptan (15, 30 or 45 mg) was effective and tolerable as an add-on treatment to furosemide therapy in Japanese HF patients with volume overload. © 2011 Springer Science+Business Media, LLC.

Oda Y.,University of Toyama | Joho S.,University of Toyama | Harada D.,University of Toyama | Hirai T.,University of Toyama | And 2 more authors.
Autonomic Neuroscience: Basic and Clinical | Year: 2010

We investigated whether coexisting renal insufficiency (RI) is associated with elevated sympathetic activity in patients with heart failure (HF). Resting muscle sympathetic nerve activity (MSNA) was determined in 101 patients with HF (ejection fraction < 0.45) and 8 patients with RI but without HF (RI group). Diagnosis of RI was made of glomerular filtration rates < 60 ml/min/1.73 m2 estimated using the simplified Modification of Diet in Renal Disease equation. Of 101 patients, 45 had RI (HFRI group) and 56 did not (HF group). HFRI group was older (p < 0.05) and given loop diuretics more frequently (p < 0.05), and had a lower specific activity scale (p < 0.05) than HF group. HFRI group exhibited significantly greater MSNA indices than either HF group or RI group (burst rate, p < 0.05; burst incidence, p < 0.01). Univariate analysis showed that RI, age, specific activity scale level and dose of furosemide were significant predictors of increased burst incidence of MSNA in patients with HF. Notably, multivariate analysis revealed that RI was the only independent factor for increased MSNA indices. These findings suggest that coexisting RI is associated with elevated sympathetic activity in patients with HF. © 2010 Elsevier B.V. All rights reserved.

Tazawa K.,Itoigawa General Hospital | Tsuchiya Y.,Itoigawa General Hospital | Shinbo M.,Itoigawa General Hospital | Yamagishi F.,Itoigawa General Hospital | And 5 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2011

We report a 50-year-old female with pulmonary metastases from breast cancer who responded to S-1. In September 2003, she underwent surgery for breast cancer. Four years 8 months after the operation, lung relapse was detected. After the treatment failure of FEC60 (5-FU 500 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 500 mg/m2) and taxane antitumor drugs, oral administration of S-1 80 mg/body/day was initiated. At the end of three courses, thoracic CT revealed the disappearance of the lung metastasis. Advanced reactions during the administration period were mild. After 14 courses of S-1 therapy (during 11 months), a complete response was clinically maintained. S-1 showed a good antitumor effect and tolerance, and it might be useful for treating metastatic and recurrent breast cancers.

Ohori T.,University of Toyama | Hirai T.,University of Toyama | Joho S.,University of Toyama | Kameyama T.,University of Toyama | And 3 more authors.
Autonomic Neuroscience: Basic and Clinical | Year: 2011

Cardiovascular events are characterized by circadian periodicity with a peak prevalence during the awakening period, which suggests a morning surge in sympathetic activity. We developed an experimental system to determine circadian changes in heart rate (HR), blood pressure (BP), locomotor activity (Loc), respiratory rate and autonomic function in conscious, unrestrained rats. The effects of amiodarone on circadian variation of these variables were determined in rats with myocardial infarction and subsequent congestive heart failure (CHF). We continuously recorded BP, HR and Loc for 24. h in rats with CHF (n=16) or after a sham operation (Sham; n=7). To determine circadian changes in sympathovagal balance, digitized BP and HR data throughout 24. h were analyzed based on maximum entropy. The study was repeated after 3. weeks of oral amiodarone (50. mg/kg/day) or saline administration. Baseline HR, mean BP, and Loc were higher in the dark period than in the light period (all p<0.05) in both CHF and Sham rats, which is consistent with the circadian periodicity of nocturnal animals. Low-frequency components of diastolic BP variability (LFdp), an index of sympathetic tone, were significantly higher during the awakening period (16:00-20:00) than during the sleeping period (08:00-14:00), a finding analogous to the sympathetic morning surge in men. Amiodarone suppressed this transient increase in LFdp power during the awakening period. Our experimental system could detect sympathetic surge in conscious rats. Amiodarone suppressed the sympathetic surge, which could explain, at least in part, beneficial effects of amiodarone in patients with CHF. © 2010 Elsevier B.V.

Motoi K.,Kanazawa University | Taniguchi S.,Fujimoto Hayasuzu Hospital | Yuji T.,Fujimoto Hayasuzu Hospital | Ogawa M.,Kanazawa University | And 14 more authors.
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS | Year: 2011

The demand for ubiquitous healthcare monitoring has been increasingly raised for prevention of lifestyle-related diseases, acute life support or chronic therapies for inpatients and/or outpatients having chronic disorder and home medical care. From these view points, we developed a non-conscious healthcare monitoring system without any attachment of biological sensors and operations of devices, and an ambulatory postural changes and activities monitoring system. Furthermore in this study, in order to investigate those applicability to the ubiquitous healthcare monitoring, we have developed a new healthcare monitoring system combined with the non-conscious and the ambulatory measurements developed by us. In patients with chronic cardiovascular disease or stroke, the daily health conditions such as pulse, respiration, activities and so on, could be continuously measured in the hospital, the rehabilitation room and subject's own home, using the present system. The results demonstrated that the system appears useful for the ubiquitous healthcare monitoring not only at medical facility, but also during daily living at home. © 2011 IEEE.

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