Imizu City Hospital

Imizu, Japan

Imizu City Hospital

Imizu, Japan
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Tanaka K.,Nippon Medical School | Kato K.,The Cardiovascular Institute Hospital | Takano T.,Nippon Medical School | Katagiri T.,Showa University | And 7 more authors.
Journal of Cardiology | Year: 2010

Background: Nicorandil injection, a potent vasodilator with KATP channel opening action and nitrate-like action, has been used for treatment of unstable angina. In the present investigation, we examined the effect of intravenous nicorandil on hemodynamics in patients with acute decompensated heart failure (ADHF). Methods: ADHF patients admitted to hospital with pulmonary artery wedge pressure (PAWP). ≥ 18. mm. Hg were enrolled. Patients received nicorandil by an intravenous bolus injection of 0.2. mg/kg/5. min followed by continuous infusion at a rate of 0.05, 0.10, or 0.20. mg/kg/h for 6. h. Results: Nicorandil administration caused a significant decrease in PAWP and increase in the cardiac index (CI) that began immediately after the injection and were maintained during the continuous infusion. After 6. h, nicorandil administration at 0.2. mg/kg/5. min followed by 0.20. mg/kg/h resulted in a decrease in PAWP (26.5%, p< 0.01), an increase in CI (15.8%, p< 0.05), and a decrease in total peripheral resistance (13.8%, p< 0.01) in a dose-dependent manner. Nicorandil decreased blood pressure significantly, without an excessive decrease or negative impact even in patients with lower systolic blood pressure. Conclusion: Intravenous administration of nicorandil, by bolus injection followed by continuous infusion, improves PAWP and CI in ADHF patients immediately and continuously as a potent vasodilator with combined preload and afterload reduction. These results demonstrate that nicorandil is a safe and effective new medication for the treatment of ADHF. © 2010 Japanese College of Cardiology.


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.


Wang X.,University of California at San Francisco | Takagawa J.,University of California at San Francisco | Takagawa J.,Imizu City Hospital | Lam V.C.,University of California at San Francisco | And 18 more authors.
Science Translational Medicine | Year: 2011

Delivery of bone marrow cells (BMCs) to the heart has substantially improved cardiac function in most rodent models of myocardial infarction (MI), but clinical trials of BMC therapy have led to only modest improvements. Rodent models typically involve intramyocardial injection of BMCs from distinct donor individuals who are healthy. In contrast, autologous BMCs from individuals after MI are used for clinical trials. Using BMCs from donor mice after MI, we discovered that recent MI impaired BMC therapeutic efficacy. MI led to myocardial inflammation and an increased inflammatory state in the bone marrow, changing the BMC composition and reducing their efficacy. Injection of a general anti-inflammatory drug or a specific interleukin-1 inhibitor to donor mice after MI prevented this impairment. Our findings offer an explanation of why human trials have not matched the success of rodent experiments and suggest potential strategies to improve the success of clinical autologous BMC therapy.


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.


Motoi K.,Kanazawa University | Ogawa M.,Kanazawa University | Ueno H.,Imizu City Hospital | Fukunaga S.,Fujimoto Hayasuzu Hospital | And 6 more authors.
Proceedings of the IEEE/EMBS Region 8 International Conference on Information Technology Applications in Biomedicine, ITAB | Year: 2010

Daily monitoring of health condition at home is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes and cardiovascular diseases. While a number of commercially available devices for home health care monitoring are widely used, those are actually cumbersome in terms of self-attachment of biological sensors and self-operation of them. From this viewpoint, we have been developing a non-conscious physiological monitoring system without attachment of any sensors to the human body as well as any operations for the measurement. We developed some devices installed in a toilet, a bath, and a bed and showed their high measurement precision by comparison with simultaneous recordings of ordinary biological sensors directly attached to the body. In order to investigate those applicability to the health condition monitoring, we developed a monitoring system in combination with all of the monitoring devices at hospital rooms and previously carried out the measurements of patients' health condition. Further in this study, the health conditions were measured in 10 patients with cardiovascular disease or sleep disorder. From these results, the patients' health conditions such as the body and excretion weight in the toilet, the ECG during taking the bath and the pulse and respiration rate during sleeping were successfully monitored in the hospital room, demonstrating its usefulness for monitoring the health condition of the subjects with cardiovascular disease or sleep disorder. © 2010 IEEE.


Harada D.,Imizu City Hospital | Asanoi H.,Imizu City Hospital | Takagawa J.,Imizu City Hospital | Ishise H.,Imizu City Hospital | And 5 more authors.
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2014

Influences of slow and deep respiration on steady-state sympathetic nerve activity remain controversial in humans and could vary depending on disease conditions and basal sympathetic nerve activity. To elucidate the respiratory modulation of steady-state sympathetic nerve activity, we modeled the dynamic nature of the relationship between lung inflation and muscle sympathetic nerve activity (MSNA) in 11 heart failure patients with exaggerated sympathetic outflow at rest. An autoregressive exogenous input model was utilized to simulate entire responses of MSNA to variable respiratory patterns. In another 18 patients, we determined the influence of increasing tidal volume and slowing respiratory frequency on MSNA; 10 patients underwent a 15-min device-guided slow respiration and the remaining 8 had no respiratory modification. The model predicted that a 1-liter, step increase of lung volume decreased MSNA dynamically; its nadir (−33 ± 22%) occurred at 2.4 s; and steady-state decrease (−15 ± 5%), at 6 s. Actually, in patients with the device-guided slow and deep respiration, respiratory frequency effectively fell from 16.4 ± 3.9 to 6.7 ± 2.8/min (P < 0.0001) with a concomitant increase in tidal volume from 499 ± 206 to 1,177 ± 497 ml (P < 0.001). Consequently, steady-state MSNA was decreased by 31% (P < 0.005). In patients without respiratory modulation, there were no significant changes in respiratory frequency, tidal volume, and steady-state MSNA. Thus slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with high levels of resting sympathetic tone as in heart failure. © 2014 the American Physiological Society.


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.


PubMed | University of Toyama and Imizu City Hospital
Type: Journal Article | Journal: American journal of physiology. Heart and circulatory physiology | Year: 2014

Influences of slow and deep respiration on steady-state sympathetic nerve activity remain controversial in humans and could vary depending on disease conditions and basal sympathetic nerve activity. To elucidate the respiratory modulation of steady-state sympathetic nerve activity, we modeled the dynamic nature of the relationship between lung inflation and muscle sympathetic nerve activity (MSNA) in 11 heart failure patients with exaggerated sympathetic outflow at rest. An autoregressive exogenous input model was utilized to simulate entire responses of MSNA to variable respiratory patterns. In another 18 patients, we determined the influence of increasing tidal volume and slowing respiratory frequency on MSNA; 10 patients underwent a 15-min device-guided slow respiration and the remaining 8 had no respiratory modification. The model predicted that a 1-liter, step increase of lung volume decreased MSNA dynamically; its nadir (-33 22%) occurred at 2.4 s; and steady-state decrease (-15 5%), at 6 s. Actually, in patients with the device-guided slow and deep respiration, respiratory frequency effectively fell from 16.4 3.9 to 6.7 2.8/min (P < 0.0001) with a concomitant increase in tidal volume from 499 206 to 1,177 497 ml (P < 0.001). Consequently, steady-state MSNA was decreased by 31% (P < 0.005). In patients without respiratory modulation, there were no significant changes in respiratory frequency, tidal volume, and steady-state MSNA. Thus slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with high levels of resting sympathetic tone as in heart failure.

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