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Biomedical subjects

Jitsuo Higaki

Publications and source records attributed to Jitsuo Higaki.

At least 55 records · Page 3Linked to original sources
PubMed2005

Antiarrhythmic drug cibenzoline attenuates left ventricular pressure gradient and improves transmitral Doppler flow pattern in patients with hypertrophic obstructive cardiomyopathy caused by midventricular obstruction.

BACKGROUND: Recent interventional and surgical therapies to attenuate left ventricular pressure gradient (LVPG) can be difficult to perform in patients with hypertrophic obstructive cardiomyopathy (HOCM) caused by midventricular obstruction (MVO), owing to the risk of inducing or deteriorating mitral regurgitation. METHODS AND RESULTS: The effects of the antiarrhythmic drug, cibenzoline, on LVPG and left ventricular (LV) diastolic function estimated by the change in the transmitral Doppler flow pattern were examined in 23 patients with HOCM and MVO. Hemodynamic changes 2 h after a single dose of 200 mg of cibenzoline and 3 months after oral administration of 300-450 mg of cibenzoline per day were examined. At 2 h after the treatment, LVPG decreased from 79+/-37 mmHg to 24+/-21 mmHg (p < 0.0001). E-wave velocity significantly increased and A-wave velocity significantly decreased, and thus the E/A ratio increased from 0.83+/-0.39 to 1.36+/-0.50 (p < 0.0001). After 3 months of treatment, LVPG remained decreased, and the E-wave and A-wave velocities and the E/A ratio remained improved. CONCLUSIONS: Cibenzoline can attenuate LVPG and ameliorate LV diastolic dysfunction in patients with HOCM caused by MVO, which suggests a new strategy for the management of this condition.

Aged↗
PubMed2005

Sex-related differences in relations of uric acid to left ventricular hypertrophy and remodeling in Japanese hypertensive patients.

Both hyperuricemia and echocardiographically determined left ventricular (LV) mass have a well-determined association with cardiovascular morbidity and mortality. However, whether or not there is a sex difference in the association of serum uric acid level with LV mass has never been systematically explored. We examined the sex-specific relation of serum uric acid level and echocardiographic indexes of LV structure in never-treated patients with essential hypertension. We enrolled 160 never-treated hypertensive patients (89 men and 71 women) to assess the possible relationship between LV mass and serum uric acid levels. LV measurements were performed according to the recommendations of the American Society of Echocardiography and the Penn Convention. LV mass was indexed by height, body surface area and height raised to the 2.7th power. A positive significant correlation between LV geometry (LV mass, indexed LV mass and relative wall thickness) and serum uric acid level was found in male hypertensive patients but not in female hypertensive patients. Independent determinants of serum uric acid levels in male hypertensive patients were LV mass and serum creatinine levels. In addition, male hypertensive patients with concentric hypertrophy showed the highest serum uric acid levels. In comparison, independent determinants of serum uric acid levels in female hypertensive patients were age and serum creatinine levels. In conclusion, these findings indicate a sex difference in the association of uric acid with LV geometry in Japanese hypertensive patients. In addition, the finding that the highest levels of serum uric acid were observed in our male hypertensive patients with concentric hypertrophy confirmed the previous reports that these patients have the highest risk for cardiovascular morbidity and mortality.

Aged↗
PubMed2005

Association between carotid hemodynamics and asymptomatic white and gray matter lesions in patients with essential hypertension.

The aim of this study was to clarify the magnitude of common carotid artery (CCA) structural and hemodynamic parameters on brain white and gray matter lesions in patients with essential hypertension (EHT). The study subjects were 49 EHT patients without a history of previous myocardial infarction, atrial fibrillation, diabetes mellitus, impaired glucose tolerance, chronic renal failure, symptomatic cerebrovascular events, or asymptomatic carotid artery stenosis. All patients underwent brain MRI and ultrasound imaging of the CCA. MRI findings were evaluated by periventricular hyperintensity (PVH), deep and subcortical white matter hyperintensity (DSWMH), and état criblé according to the Japanese Brain dock Guidelines of 2003. Intima media thickness (IMT), and mean diastolic (Vd) and systolic (Vs) velocities were evaluated by carotid ultrasound. The Vd/Vs ratio was further calculated as a relative diastolic flow velocity. The mean IMT and max IMT were positively associated with PVH, DSWMH, and état criblé (mean IMT: rho=0.473, 0.465, 0.494, p=0.0007, 0.0014, 0.0008, respectively; max IMT: rho=0.558, 0.443, 0.514, p=0.0001, 0.0024, 0.0004, respectively). Vd/Vs was negatively associated with état criblé (rho=-0.418, p=0.0038). Carotid structure and hemodynamics are potentially related to asymptomatic lesions in the cerebrum, and might be predictors of future cerebral vascular events in patients with EHT.

Adult↗
PubMed2005

Hemoperitoneum secondary to spontaneous rupture of hepatic metastasis from lung cancer.

We describe a rare case of hemoperitoneum secondary to spontaneous rupture of hepatic metastasis from lung cancer. A 72-year-old man with non-small cell lung cancer was admitted to our hospital with sudden onset of right upper abdominal pain and hypovolemic shock. Laboratory tests showed severe anemia. Abdominal contrast-enhanced computed tomography revealed massive ascites and multiple liver metastases. Rupture of a metastatic liver tumor was suspected. Only palliative therapy was performed. The patient's general condition gradually worsened, and he died 2 months after admission. Autopsy examination revealed hemoperitoneum due to a ruptured metastatic liver tumor originating from pulmonary squamous cell carcinoma.

Aged↗
PubMed2005

Two cases of primary pulmonary osteosarcoma.

Two cases of primary pulmonary osteosarcoma are presented. In both cases, chest computed tomography revealed a calcified pulmonary mass and technetium-99m methylene diphosphonate bone scintigraphy showed intense uptake in the pulmonary mass. Primary pulmonary osteosarcoma was suspected on the basis of these radiographic findings. Microscopic examination of tumor specimens obtained by needle biopsy revealed histologic features of osteosarcoma, and this diagnosis was confirmed by postmortem examination of a second specimen in each case. Radiographic and histopathological findings enabled us to diagnose primary pulmonary osteosarcoma, which is one of the rarest types of cancer.

Aged↗
PubMed2005

[Repeated changes of electrocardiogram caused by Takotsubo-type cardiomyopathy: a case with hypertrophic nonobstructive cardiomyopathy].

A 67-year-old woman had been examined due to abnormalities on electrocardiography (ECG) at a medical checkup three years previously. When a negative T-wave was seen in leads I, aVL, and V1 to V4, but the abnormal findings were improved at consultation. Echocardiography revealed apical hypertrophy and hypertrophic nonobstructive cardiomyopathy was diagnosed. She felt chest discomfort in September, 2003 and an ECG showed a negative T-wave in leads I, II, III aVL, aVF and V2 to V6 and an elongation of QT interval Left ventriculography revealed myocardial hypertrophy at the left ventricular apex and left ventriclar wall motion was normal. Coronary angiography did not show any significant luminal narrowing. I-123 metaiodobenzyl-guanitidine scintigraphy showed marked perfusion defects at the left ventricular apex. After five months, ECG showed an improvement of the QT interval and a decrease in the negative T-wave. We considered that the repeated changes of ECG were caused by Takotsubo-type cardiomyopathy.

Aged↗
PubMed2005

[A 73-year-old man with primary pulmonary hypertension].

A rare case of primary pulmonary hypertension was observed in a 73-year-old man. Angina pectoris was diagnosed at the age of 67 and he received several percutaneous coronary interventions because of refractory restenosis. He also had coronary artery bypass surgery at the age of 69. After 4 years, he again suffered from dyspnea and chest pain upon physical exertion. On admission to our hospital, a chest radiograph showed dilatation of bilateral pulmonary arteries. Moreover, echocardiography showed right ventricular dilatation and tricuspid regurgitation. Continuous wave Doppler imaging revealed a pressure gradient of 82.1 mmHg. Pulmonary capillary wedge pressure was normal, but pulmonary artery pressure was elevated upon cardiac catheterization. Because there was no apparent etiology of pulmonary hypertension, primary pulmonary hypertension was diagnosed and appropriate conventional therapy was started.

Aged↗
PubMed2005

[A case of small cell lung cancer with intramedullary spinal cord metastasis].

An 83-year-old man was admitted with paraplegia and loss of all sensation below the level of umbilicus, with bowel and bladder dysfunction. Stage IV small cell lung cancer had been diagnosed two years ago and had received several courses of chemotherapies. A magnetic resonance imaging revealed an enhanced mass in the intramedullary spinal cord at the level of Th10-L1. Metastatic spinal tumor was diagnosed by clinical and radiological examinations. This is a rare case of small cell lung cancer with intramedullary spinal cord metastasis which caused various neurological symptoms.

Aged↗
PubMed2005

[Atherosclerosis].

Explore the source record for details and available documents.

Angiotensin II↗
PubMed2005

Separate origins of three coronary arteries arising from the right sinus of Valsalva.

A 58-year-old woman underwent coronary angiography because of chest pain on exertion. Her three coronary arteries arose from separate ostia in the right sinus of Valsalva. The left anterior descending coronary artery coursed between the great vessels, and the circumflex coronary artery coursed anterior to the pulmonary artery. Angiographic and clinical data of this rare anomaly are described.

Adrenergic beta-Antagonists↗
PubMed2005

[Future medicine for hypertension in the elderly].

The number of the aged patients with hypertension is now explosively increasing. In near future, progress of new and tailor-made prescribed antihypertensive drugs and curable-gene therapy for hypertension will improve new era of hypertension in the elderly. And finally, resolusion of the aging mechanism and anti-aging medicine may open our future.

Aged↗
PubMed2004

C-reactive protein induces apoptosis in human coronary vascular smooth muscle cells.

BACKGROUND: Accumulating evidence suggests that C-reactive protein (CRP), in addition to being a predictor of coronary events, may have direct actions on the vessel wall in the evolution of atherosclerosis. Although accumulation of vascular smooth muscle cells (VSMCs) in the intima is a key event in the development of arterial lesions, apoptosis of VSMCs also plays an important role in progression of atherosclerotic lesions and contributes to increased plaque vulnerability. METHODS AND RESULTS: In the present study we demonstrate that CRP induces caspase-mediated apoptosis of human coronary VSMCs. DNA microarray analysis was used to identify CRP-regulated genes. The growth arrest- and DNA damage-inducible gene 153 (GADD153) mRNA expression was prominently upregulated by CRP. As confirmed by Northern blot analysis, CRP induced a time- and dose-dependent increase of GADD153 mRNA expression. GADD153, a gene involved in growth arrest and apoptosis in vascular and nonvascular cells, is regulated at both transcriptional and posttranscriptional levels. CRP regulation of GADD153 mRNA expression in VSMCs occurs primarily at the posttranscriptional level by mRNA stabilization. Small interfering RNA (siRNA) specifically targeted to GADD153 reduced CRP-induced apoptosis. GADD153 also specifically colocalized to apoptotic VSMCs in human coronary lesions, further supporting a functional role for GADD153 in CRP-induced cell death. CONCLUSIONS: These results demonstrate that GADD153 is a CRP-regulated gene in human VSMCs and plays a causal role in CRP-induced apoptosis. Pharmacological targeting of CRP expression or action may provide a novel therapy for atherosclerosis.

Apoptosis↗
PubMed2004

Myocardial microvascular abnormalities observed by intravenous myocardial contrast echocardiography in patients with hypertrophic cardiomyopathy.

We tested the hypothesis that myocardial microvascular abnormalities occur and are influenced by clinical features in 30 patients with hypertrophic cardiomyopathy (HC) using intravenous myocardial contrast echocardiography. Patients with HC were subdivided into 3 groups: nonobstructive HC (n = 12), obstructive HC (n = 10), or HC with systolic dysfunction and heart failure (n = 8). In patients with nonobstructive HC and obstructive HC, subendocardial peak myocardial contrast intensity at the mid-septal area was significantly decreased and the transmyocardial difference of peak myocardial contrast intensity between subendocardial and periendocardial regions at the mid-septal area was significantly related to regional wall thickness. Reduced peak myocardial contrast intensities at the mid-septal subendocardial and periendocardial regions were observed in patients with HC and heart failure. Our study indicates that subendocardial microvascular abnormalities during end-systole may be associated with severity of regional myocardial hypertrophy in patients with nonobstructive HC and obstructive HC. In addition, progressive microvascular damage may occur in patients with HC and heart failure.

Aged↗
PubMed2004

Relation of circulating interleukin-6 to left ventricular remodeling in patients with reperfused anterior myocardial infarction.

BACKGROUND: During the remodeling process after myocardial infarction (MI), the expression of proinflammatory cytokines is enhanced in the myocardium. However, only a few clinical studies have been conducted on cytokine involvement in left ventricular (LV) remodeling after MI. HYPOTHESIS: Circulating proinflammatory cytokines may be involved in LV remodeling in patients with reperfused MI. METHODS: We studied 25 patients with acute anterior MI who had undergone coronary reperfusion therapy, and 10 normal control subjects with no cardiac disease. In all patients, LV ejection fraction, end-diastolic volume index (EDVI), and end-systolic volume index (ESVI) were determined using left ventriculography at the acute phase and 6 months after onset. The delta EDVI and delta ESVI were calculated as the value of LV volume reduction, suggesting LV reverse remodeling. Serum levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha were measured using enzyme-linked immunosorbent assay. RESULTS: Serum levels of IL-6 and TNF-alpha at the acute phase were significantly higher in patients with MI than in control subjects (both p < 0.05). The IL-6 levels correlated well negatively with delta EDVI (r = 0.779, p = 0.039), whereas no correlation was found for TNF-alpha. According to multivariate analysis, IL-6 at the acute phase was a significant independent predictor for LV remodeling after reperfused MI (p = 0.007). CONCLUSIONS: Circulating IL-6 levels correlated closely with LV geometric changes during the remodeling process in patients with reperfused MI. Our study addresses the usefulness of another marker for LV remodeling after MI.

Adrenergic beta-Antagonists↗
PubMed2004

Computed tomography assessment of myocardial perfusion, viability, and function.

In addition to coronary artery assessment, contrast-enhanced multidetector spiral computed tomography (CE-MDCT) can provide valuable information about myocardial perfusion. Using CE-MDCT, myocardial perfusion defects are often observed in the early phase of the contrast bolus (early defect (ED)), with residual defects (RDs) and late enhancement (LE) observed in the late phase in myocardial infarction (MI). However, the clinical significance of EDs, RDs, and LE has not yet been fully described. This work reviews myocardial viability and function by CE-MDCT based on our prior data by including contrast-enhanced single-slice (detector) CT (CE-SSCT) and CE-MDCT. Recently, equivalent results were obtained, as seen in CE-SSCT with images by CE-MDCT. In this review, images that were acquired by MDCT will be presented. In this work, the following items will be the focus: myocardial enhancement patterns (EDs, LE, and RDs), early perfusion defects and their relationship to wall thickness (WT) and wall motion, early CT perfusion defects vs. Tl-201 single photon emission CT (SPECT), the protocol for performing dual-phase contrast CT, classification of enhancement patterns, enhancement patterns on dual-phase CE-MDCT vs. left ventricular functional recovery and WT, changes in enhancement patterns in conjunction with healing stage, enhancement patterns on dual-phase CE-MDCT vs. 201Tl/99mTc-pyrophosphate (dual-isotope SPECT), the clinical meaning of each enhancement pattern, pitfalls of enhancement patterns and other diseases, and study limitations and the future of MDCT.

Coronary Circulation↗