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Nishi-Tokyo-shi, Japan

Hirayama A.,Nihon University | Saito S.,Nihon University | Ueda Y.,Osaka Police Hospital | Takayama T.,Nihon University | And 8 more authors.
Circulation Journal | Year: 2011

Background: The aim of this study was to compare the effect of atorvastatin treatment on high-grade yellow coronary plaques (grade ≥2, group H) vs. low-grade yellow plaques (grade ≤1, group L). Methods and Results: Twenty-nine hypercholesterolemic patients with coronary heart disease were treated with atorvastatin (10-20 mg/day) for 80 weeks and were divided into 2 groups by baseline plaque color grade. The angioscopic plaque grade and the vessel, plaque, and luminal volumes were measured by intravascular ultrasound at baseline and in weeks 28 and 80. The plaque color grade decreased significantly from baseline to weeks 28 and 80 in group H (2.27±0.48, 1.47±0.75, and 1.55±0.86, respectively), but not significantly in group L (0.90±0.31, 0.83±0.61, and 0.89±0.56, respectively). The plaque volume of group HP was greater than that of group LP (respectively 158.0±45.8 vs. 107.5±21.9 mm3 at baseline, 144.5±41.1 vs. 97.5±24.8 mm3 in week 28, and 128.8±31.5 vs. 87.9±31.5 mm3 in week 80 (P<0.001 by ANCOVA between groups). Conclusions: The plaque-stabilizing effect of atorvastatin was stronger for more vulnerable plaques with a higher color grade, although regression of plaque during atorvastatin therapy was noted irrespective of plaque vulnerability. Source

Okada K.,Osaka Police Hospital | Ueda Y.,Osaka Police Hospital | Takayama T.,Nihon University | Honye J.,Fuchu Keijin kai Hospital | And 9 more authors.
Circulation Journal | Year: 2012

Background: Previously the stabilization of coronary plaque with atorvastatin was demonstrated in the TWINS (evaluaTion With simultaneous angIoscopy and iNtravascular ultraSound) study. The influence of the low-density lipoprotein cholesterol (LDL-C) level on plaque stabilization was analyzed. Methods and Results: Patients (n=29) with hypercholesterolemia and coronary artery disease (CAD) were analyzed. They received atorvastatin (10-20 mg/day) for 80 weeks and were divided into low (<91 mg/dl) and high (≥91 mg/dl) LDL-C groups based on their 80-week LDL-C level. Angioscopy was performed before and after treatment. Yellow coronary plaques were classified into six grades (grades 0 to 5) and mean grade was determined for each patient. The LDL-C levels at week 28 and 80 were reduced in both low LDL-C groups (n=14, 140.3 to 77.9 and 75.9 mg/dl; P<0.001 both groups) and high LDL-C groups (n=15, 151.7 to 93.0 and 99.1 mg/dl; P<0.001 both groups). Significant improvement in the mean grade was shown in the low LDL-C groups (1.44 to 1.00 and 1.05; P=0.003 both groups) at week 28 and 80 vs. no significant change in high LDL-C groups (1.43 to 1.23 and 1.28; P=0.032 and P=0.169 respectively). Conclusions: Adequate reduction of LDL-C is important for the stabilization of coronary plaques. Source

Tanaka K.,Nippon Medical School | Kato K.,The Cardiovascular Institute Hospital | Takano T.,Nippon Medical School | Katagiri T.,Showa University | And 6 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. Source

Yoda M.,The Cardiovascular Institute Hospital | Tanabe H.,The Cardiovascular Institute Hospital | Kishi M.,The Cardiovascular Institute | Suma H.,The Cardiovascular Institute Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2011

Transvenous endocardial cardioverter defibrillator lead implantation is contraindicated in patients with prosthetic tricuspid valves (TVs). A 61-year-old male was hospitalized due to right heart failure, severe TV regurgitation, and non-sustained ventricular tachycardia (VT), which required Sotalol. The patient received an implantable cardioverter defibrillator (ICD) using an epicardial cardioverter defibrillation patch during a TV replacement (TVR) for VT and severe TV regurgitation because of arrhythmogenic right ventricular cardiomyopathy. There were no complications and the stimulation thresholds were stable. ICD implantation with the use of an epicardial cardioverter defibrillation patch serves as a safe, easy and effective therapy for patients undergoing TVR complicated with ventricular arrhythmia. © 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved. Source

Funada R.,The Cardiovascular Institute Hospital | Oikawa Y.,The Cardiovascular Institute Hospital | Yajima J.,The Cardiovascular Institute Hospital | Matsuno S.,The Cardiovascular Institute Hospital | And 5 more authors.
Cardiovascular Intervention and Therapeutics | Year: 2011

Although sirolimus-eluting stents (SESs) have shown to significantly reduce the incidence of restenosis, it remains unclear when the follow-up angiography should be performed after SES implantation. A total of 868 patients with 1,574 lesions were treated with SES. Of the 71 patients with 87 lesions were performed serial angiographic and intravascular ultrasound (IVUS) analysis (pre, post, 1st and 2nd-follow-up). The first follow-up period was 7.9 ± 3.5 months and the second follow-up was 18.9 ± 7.7 months. Late restenosis (LR) was defined as diameter stenosis ≥50% at second follow-up, which was <50% at first follow-up. A total of restenosis was documented in 69 patients with 89 lesions (5.7%) overall, 13 lesions (3.2%) led to LR. Angiographic pattern of LR was predominately focal pattern. In LR group, late lumen loss by angiography was increased between 1st-follow-up and 2nd-follow-up (0.69 ± 0.41 mm in first follow-up and 1.98 ± 0.44 mm in second follow-up, p < 0.0001). Minimum lumen area (MLA) by IVUS had slightly decreased already in 1st-follow-up (6.07 ± 2.31 mm 2 in post procedure and 4.71 ± 2.05 mm 2 in 1st-follow-up, p = 0.098) and significantly decreased in 2nd-follow-up (6.07 ± 2. 31 mm 2 in post procedure and 1.71 ± 0.93 mm 2 in 2nd-follow-up, p < 0.0001). However, in each period, there were no significant difference in both late lumen loss and MLA in non-LR group. Neointima growth prolonged gradually over 1 year in LR group. These findings suggest that if neointimal proliferation is recognized in short-term-follow-up period, long-follow-up should be needed. © 2010 Japanese Association of Cardiovascular Intervention and Therapeutics. Source

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