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Biomedical subjects

F Ohsuzu

Publications and source records attributed to F Ohsuzu.

At least 55 records · Page 3Linked to original sources

Morning attenuation of endothelium-dependent, flow-mediated dilation in healthy young men: possible connection to morning peak of cardiac events?

BACKGROUND AND HYPOTHESIS: Brachial artery flow-mediated dilation (FMD), a noninvasive, widely used clinical index of endothelial function and magnitude of FMD, has been reported to be closely related to many coronary risk factors and coronary atherosclerosis. However, there has been no study that examines the diurnal change of FMD. We designed this study to reveal the diurnal variation of FMD in healthy volunteers. METHODS: We examined FMD in response to reactive hyperemia by high resolution ultrasound in 13 healthy young men (age 25-32) at four different times over the course of a day. RESULTS: Mean measures of brachial artery FMD was 4.0% at 8:00, 5.3% at 12:00, 9.7% at 17:00, and 6.9% at 21:00 hours. Flow-mediated dilation at 8:00 and at 12:00 hours was significantly lower than that at 17:00 (p < 0.05). CONCLUSIONS: These results show that endothelial function has diurnal variation and is significantly attenuated in the morning. Morning attenuation of endothelial function should be recognized in clinical research and may play an important role in the circadian variation of the occurrence of acute cardiovascular events.

Adult↗

Maternally transmitted susceptibility to non-insulin-dependent diabetes mellitus and left ventricular hypertrophy.

OBJECTIVES: We studied the association of diabetes transmission with left ventricular hypertrophy (LVH) in patients with non-insulin-dependent diabetes mellitus (NIDDM). BACKGROUND: It is suggested that NIDDM has a strong genetic basis and that maternally transmitted NIDDM is associated with mitochondrial deoxyribonucleic acid (DNA) mutations. However, genetic factors for LVH in NIDDM are unknown. METHODS: We investigated the family history of diabetes and the prevalence of LVH using electrocardiography in 834 patients with NIDDM, of whom 199 also underwent echocardiography. RESULTS: Of the 834 patients, 121 had diabetic mothers, 122 had diabetic fathers and 30 had both. The LVH criterion of S(v1) + R(V5) or R(v6) >35 mm was met in 148 patients. The percentage of patients having diabetic mothers was higher in those with LVH criterion (29%) than without it (16%) (p < 0.001), but the percentage of patients having diabetic fathers was similar in those with LVH (18%) and without it (18%). Compared with the 683 patients with nondiabetic mothers, the 151 patients with diabetic mothers were younger and had earlier onset of diabetes. The percentage of patients having diabetic siblings was also higher in those with diabetic mothers (31%) than in those with nondiabetic mothers (18%) (p < 0.001). On electrocardiograms, the prevalence of LVH was higher in patients with diabetic mothers (28%) than in those with nondiabetic mothers (15%) (p < 0.001). Echocardiograms showed that patients with diabetic mothers had greater left ventricular wall thickness and mass than those with nondiabetic mothers. In multivariate analysis, the family history of diabetes in mothers was an independent factor to LVH, but the family history of diabetes in fathers was not. CONCLUSIONS: Maternal transmission of diabetes was associated with LVH in patients with NIDDM. Some genetic factors of diabetes, such as mitochondrial DNA abnormalities, may contribute to the development of LVH in maternally transmitted NIDDM.

Adult↗

Changes in CD4+ T lymphocyte subsets in circulating blood and synovial fluid following filtration leukocytapheresis therapy in patients with rheumatoid arthritis.

The purpose of this study is to determine the changes in CD4+ T lymphocyte subsets in the circulating blood and synovial fluid following filtration leukocytapheresis (LCP) therapy for patients with rheumatoid arthritis (RA). A Cellsorba column packed with polyester fibers was used for the removal of circulating leukocytes. For patients with RA, filtration LCP or sham procedures were performed 3 times with 1 week intervals between procedures. T lymphocyte surface markers in the peripheral blood and synovial fluid were measured by flow cytometry. The proportions of activated CD4+ T cells (CD4+DR+, CD4+CD25+, and CD4+CD71+) and CD4+CD29+ T cells increased significantly in the peripheral blood, but the counts of these cells were significantly reduced in the synovial fluid after 2 treatment sessions in the LCP group. No significant changes were observed in the proportion of these cells in the control group. Our findings suggest that filtration LCP may cause a redistribution of activated T cells from affected joints into the circulating blood.

Arthritis, Rheumatoid↗

Rapid progression of cardiomyopathy in mitochondrial diabetes.

Cardiac involvement and its clinical course in a diabetic patient with a mitochondrial tRNA(Leu)(UUR) mutation at position 3243 is reported in a 54-year-old man with no history of hypertension. At age 46, an electrocardiogram showed just T wave abnormalities. At age 49, it fulfilled SV1 + RV5 or 6>35 mm with strain pattern. At age 52, echocardiography revealed definite left ventricular (LV) hypertrophy, and abnormally increased mitochondria were shown in biopsied endomyocardial specimens. He was diagnosed as having developed hypertrophic cardiomyopathy associated with the mutation. However, at age 54, SV1 and RV5,6 voltages were decreased, and echocardiography showed diffuse decreased LV wall motion and LV dilatation. Because he had mitochondrial diabetes, the patient's heart rapidly developed hypertrophic cardiomyopathy, and then it seemed to be changing to a dilated LV with systolic dysfunction. Rapid progression of cardiomyopathy can occur in mitochondrial diabetes.

Cardiomyopathy, Dilated↗

Calcinosis cutis and intestinal pseudoobstruction in a patient with adult onset Still's disease associated with recurrent relapses of disordered coagulopathy.

Adult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown origin, characterized by a typical spiking fever, evanescent salmon-colored rash, polyarthralgia, and myalgia. Calcinosis cutis and gastrointestinal involvement have rarely been noted in AOSD. We herein describe a 54-year-old woman who demonstrated repeated disseminated intravascular coagulation (DIC), and adult respiratory distress syndrome (ARDS), associated with AOSD. The patient also revealed a remarkable degree of digital calcinosis cutis and intestinal pseudoobstruction. A connective tissue disease, such as systemic sclerosis, might have been the underlying factor in the latter two symptoms.

Anticoagulants↗

Detection of anti-annexin IV and V antibodies in patients with antiphospholipid syndrome and systemic lupus erythematosus.

OBJECTIVE: Annexins (Anx) are a family of structurally related proteins that bind to phospholipids in a calcium dependent manner. It has been reported that antibodies to Anx V, which acts as an antithrombotic protein, are associated with thrombosis in systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). Homology between the primary structures of Anx IV and Anx V is the highest among members of the Anx family. We investigated whether anti-Anx IV autoantibodies can be detected in the sera of patients with SLE and/or APS. METHODS: Seventy-four patients with SLE/APS were divided into 3 groups: Group A, patients with SLE but no clinical or serological features of APS; Group B, patients with SLE having only serological signs of APS; and Group C, patients with clinical symptoms and serological signs of APS. Anx IV and Anx V were prepared by recombinant technique. Anti-Anx IV, Anx V, cardiolipin (CL), and CL beta2-glycoprotein I were detected by ELISA. RESULTS: Anti-Anx IV was found in 15.4% of Group A, 20.0% of Group B, and 21.7% of Group C. Anti-Anx V was found in 3.8% of Group A, 28.0% of Group B, and 30.4% of Group C. Significant correlations were noted between anti-Anx IV titer and anti-Anx V titer (p<0.001), and between anti-Anx IV titer and aCL titer (p<0.01). CONCLUSION: Anti-Anx IV and V antibodies were characterized in the sera of patients with SLE/APS. Significantly higher frequency of arterial or venous thrombosis was found in patients with anti-Anx V.

Adolescent↗

[Cost-effectiveness of exercise 201Tl myocardial SPECT in patients with chest pain assessed by decision-tree analysis].

To evaluate the potential cost-effectiveness of exercise 201Tl myocardial SPECT in outpatients with angina-like chest pain, we developed a decision-tree model which comprises three 1000-patient groups, i.e., a coronary arteriography (CAG) group, a follow-up group, and a SPECT group, and total cost and cardiac events, including cardiac deaths, were calculated. Variables used for the decision-tree analysis were obtained from references and the data available at our hospital. The sensitivity and specificity of 201Tl SPECT for diagnosing angina pectoris, and its prevalence were assumed to be 95%, 85%, and 33%, respectively. The mean costs were 84.9 x 10(4) yen/patient in the CAG group, 30.2 x 10(4) yen/patient in the follow-up group, and 71.0 x 10(4) yen/patient in the SPECT group. The numbers of cardiac events and cardiac deaths were 56 and 15, respectively in the CAG group, 264 and 81 in the follow-up group, and 65 and 17 in the SPECT group. SPECT increases cardiac events and cardiac deaths by 0.9% and 0.2%, but it reduces the number of CAG studies by 50.3%, and saves 13.8 x 10(4) yen/patient, as compared to the CAG group. In conclusion, the exercise 201Tl myocardial SPECT strategy for patients with chest pain has the potential to reduce health care costs in Japan.

Chest Pain↗

Endothelium-dependent flow-mediated vasodilation in coronary and brachial arteries in suspected coronary artery disease.

Previous studies showed a weak correlation between endothelial function of the coronary arteries as assessed by acetylcholine and brachial artery vasomotion during reactive hyperemia. When the same stimulus was used, we obtained a strong correlation between flow-mediated dilation in the coronary and brachial arteries (r=0.78, p <0.001), so that noninvasive assessment of flow-mediated dilation in the brachial artery could be used as a surrogate measure for coronary artery endothelial function.

Adult↗

Hypertrophic obstructive cardiomyopathy due to a novel T-to-A transition at codon 624 in the beta-myosin heavy chain (beta-MHC) gene possibly related to the sudden death.

Many missense mutations in the beta-myosin heavy chain have been reported in patients with hypertrophic obstructive cardiomyopathy (HOCM). However, the controversy is present whether the mutation accompanying the change of electric charge is related with poorer prognosis. The proband, a 48-year-old female, of the family was diagnosed clinically as HOCM, and a structural analysis of the cardiac beta-MHC gene showed that the proband and her junior daughter had a novel mutation with T to A transition in codon 624 replacing tyrosine with asparagine, which was not present in her husband, elder daughter and son. The proband's husband, son and two daughters were healthy except that the ECG of junior daughter (15-year-old) showed complete right bundle branch block. Proband's mother died suddenly after the delivery of the proband and the proband also collapsed suddenly. The occurrence of sudden death in proband and her mother suggested that HOCM with this novel mutation might be associated with a high risk of sudden death irrespective of the absence of charge alteration.

Amyl Nitrite↗

Age-related effects of norepinephrine on rat ventricular hypertrophy.

Norepinephrine (NE) (2.5 micrograms/kg/min) was administered to 5-week-old male Sprague Dawley rats by subcutaneous osmotic mini pumps for 14 days to generate an in vivo cardiac hypertrophy model and the responses with respect to aging examined. In the model, ventricles were significantly hypertrophied without myocardial necrosis and without significant increases in heart rate or blood pressure; the beta adrenergic system was down-regulated. In 37-week-old rats receiving 1.0 microgram/kg/min NE, there was a tendency towards heart failure, and myocardial necrosis and interstitial fibrosis were revealed by histological examinations. The density of beta adrenergic receptors and adenylyl cyclase activity was lower in the older rats. The excess stimulation of adrenergic receptors caused severe cardiac injury in old rats regardless of down regulation of beta adrenergic receptors.

Aging↗

Cardiac beta-adrenergic signaling pathway alteration in isoproterenol-induced cardiac hypertrophy in male Sprague-Dawley rats.

Isoproterenol was continuously administered to rats at a rate of 2.5 microg/kg/min for 7 days via subcutaneously implanted osmotic minipumps. This treatment induced cardiac hypertrophy with increases in heart rate and systolic blood pressure. Beta-adrenoceptor (beta-AR) density decreased in hypertrophied hearts, but the affinity for 125I-cyanopindolol did not change. The beta-AR density decrease did not accompany the change in expression of beta1-AR mRNA. In hypertrophied hearts, adenylyl cyclase activities in the steady state, and stimulated with isoproterenol, forskolin, and manganese, decreased but there was no change in the expression of adenylyl cyclase type V mRNA. The results suggest that beta-AR downregulation and adenylyl cyclase desensitization in isoproterenol-induced cardiac hypertrophy are caused by post-transcriptional changes.

Adenylyl Cyclases↗

Relation of abdominal and thigh adipose tissue distribution to serum lipids and glucose metabolism in obese males.

Spin-echo magnetic resonance imaging (MRI) and postprocessing for fat quantification were used to examine the relationship of abdominal and thigh adipose-tissue distribution to serum lipids and glucose metabolism in obesity. Thirteen simple obese male patients and 12 non-obese male volunteers were examined by MRI, blood pressure, and fasting blood sample levels of serum lipids, glucose, immunoreactive insulin, c-peptide, HbA1C and hematocrit. Correlations of thigh visceral and subcutaneous fat areas to serum lipid levels were generally similar, but marked differences were found between relationships of thigh versus abdominal fat areas to serum lipid levels. In addition, diastolic blood pressure was significantly correlated with the fat area, especially with the abdominal visceral fat area (r=0.51, p<0.01), but not with abdominal subcutaneous fat area. The thigh muscle area was highly and inversely correlated with c-peptide (r=-0.72, p<0.01) and systolic blood pressure (r=-0.65). Differences in correlations between visceral and subcutaneous fat areas in the abdomen to metabolic parameters were found between abdominal visceral fat areas and HbA1C and between the abdominal subcutaneous fat areas and HbA1C. These findings suggest that the character of regional fat could be heterogeneous with respect to lipid and glucose metabolism and blood pressure levels in obese males.

Abdomen↗

[Prediction of 6-year prognosis for cardiac event by thallium-201 single-photon emission computed tomography (SPECT) with treadmill exercise test].

To examine thallium-201 single-photon emission computed tomography (SPECT) with a treadmill exercise test can predict the long-term prognosis of patients with coronary artery disease, 95 patients (71 men, 24 women) who underwent a treadmill exercise test with thallium-201 SPECT from April to December 1986 were followed for 6 years. Three short-axis slices at the apical, mid- and basal-level were selected, and each slice was divided into eight segments. Each segment count was assigned a score according to the count range in the slice (score 0, count range 76-100%; 1, 51-75%; 2, 26-50%; 3, 1-25%; 4, 0%) by evaluating the mean value of the slice. The total T1 defect score of each segment in 3 slices was summed (sigma T1 defect score). The 'early sigma T1 defect score' was the sigma T1 defect score 5 min after treadmill exercise, and the 'late sigma T1 defect score' was sigma T1 defect score measured 4 h after treadmill exercise. Cardiac events occurred in 27 of the 95 patients: cardiac death 3; myocardial infarction 1; percutaneous transluminal angioplasty 16; coronary artery bypass graft 5; congestive heart failure 3. Univariate analysis showed that previous myocardial infarction (p < 0.01), exercise work load (p < 0.05), early sigma T1 defect score (p < 0.01) and late sigma T1 defect score (p < 0.01) were independent predictors of the prognosis. These results suggest that thallium-201 SPECT with the treadmill exercise test could be applicable and useful to predict long term prognosis.

Coronary Disease↗

Comparative measurement of myocardial ATP and creatine phosphate by two chemical extraction methods and 31P-NMR spectroscopy.

Changes in ATP and creatine phosphate levels during early (up to 150 s) global ischaemia were determined in isolated rat hearts by two chemical extraction methods (a conventional direct perchloric acid extraction and a stepwise extraction using alcohol and perchloric acid solutions) and by qualitative 31P-NMR. No difference in the ATP level hardly changed up to 40 s of ischaemia when measured by the three methods, and slightly decreased at 150 s of ischaemia. In contrast to ATP, creatine phosphate content in the normally perfused tissue was observed to be higher by the stepwise extraction (68-73 nmol/mg protein) than by direct perchloric acid extraction (55 nmol/mg protein). The creatine phosphate rapidly decreased to about 50% of normal value at 40 s of ischaemia, and the difference in the normal creatine phosphate content using the two chemical methods disappeared with the progression of ischaemia. Thus, the creatine phosphate more rapidly decreased when observed by the stepwise method than by the other two methods in this ischaemic condition. These results suggest that (1) creatine phosphate exists in an undetermined chemical state (perhaps neither in simple soluble form nor in so-called "bound" form) in rat cardiac myocytes, and (2) the stepwise extraction method is useful to measure the content of energy metabolites and to examine the intracellular chemical state in cardiac tissues.

Adenosine Triphosphate↗

Reduction of beta-adrenergic receptors in atrial cell membranes of patients following mild to moderate heart failure.

The density of cardiac beta-adrenoceptors (Bmax) was measured in eighteen patients [2 with atrial septal defect (ostium secundum), 4 with aortic valve disease, 3 with mitral valve disease, 1 with aortic and mitral valve disease, 5 with a history of myocardial infarction, and 3 with angina pectoris] following mild to moderate cardiac failure. Measures were obtained by cardiac catheterization prior to cardiac surgery and also during the surgical procedures. On the basis of symptoms immediately preceding surgery, the severity of the condition in each patient was categorized as either Class I (n = 5) or Class II (n = 13) following the New York Heart Association (NYHA) functional classification system. The Bmax was measured using right atrial appendage tissue obtained during cardiac surgery. [125I]-iodocyanopindolol was used for the assay. The Bmax of atrial cell membranes in patients with NYHA class II was significantly lower than that of class I (34.1 +/- 2.5 vs 55.4 +/- 9.3 fmol/mg protein, M +/- SE, p < 0.05). Correlation coefficients between the Bmax and hemodynamic parameters measured just prior to cardiac surgery were examined, but only that between Bmax and the minimum value of the time derivative of left ventricular pressure (max negative dp/dt) was significant (r = -0.552, p < 0.05). Further study is needed to understand and clarify the relationship between Bmax and dp/dt min.

Adult↗