Effectiveness of heparin in preventing thrombin generation and thrombin activity in patients undergoing coronary intervention.
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Angioplasty, Balloon, Coronary↗
Biomedical subjects
Y Hojo
Publications and source records attributed to Y Hojo.
Procoagulant and proinflammatory activity in acute coronary syndromes.
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Angina Pectoris↗
Coronary artery disease and endothelial nitric oxide synthase and angiotensin-converting enzyme gene polymorphisms.
Nitric oxide (NO) inhibits platelet aggregation, proliferation of vascular smooth muscle cells, and leukocyte adhesion to endothelial cells. Thus, genetic variation in or near NO synthase may be involved in the pathogenesis of coronary artery disease (CAD). We investigated the association between CAD and endothelial constitutive NO synthase (ecNOS) and angiotensin-converting enzyme (ACE) gene polymorphisms by polymerase chain reaction analysis. These genotypes were examined in consecutive patients with CAD (n = 40) and control subjects (n = 34). The frequency of ecNOS genotypes in the CAD group (4a/a + 4a/b: 48%; 4bb: 52%) did not differ from that in the control group (4a/a + 4a/b: 29%; 4bb: 71%). The allele frequencies of ecNOS4a and ecNOS4b also did not differ between the two groups. On the other hand, the frequency of the ACE DD genotype in the CAD group (DD: 45%; ID: 35%; II: 20%) was significantly higher than that in the control group (DD: 21%; ID: 35%; II: 44%). The frequency of the D allele in patients with CAD (0.63) was also significantly higher than in controls (0.38). Combined analysis showed that the frequency of the ecNOS genotypes in ACE DD genotype subjects (4a/a + 4a/b: 39%; 4b/b: 61%) in the CAD group was not significantly different from that in the control group (4a/a + 4a/b: 29%; 4b/b: 71%). The ACE genotype might be a predictor of CAD, while the ecNOS genotype appeared to confer no appreciable increase in the risk of CAD.
Case-Control Studies↗
Familial isolated noncompaction of the left ventricular myocardium.
Noncompaction of the ventricular myocardium (sometimes referred to as 'spongy myocardium') is believed to represent an arrest in endomyocardial morphogenesis. The gross anatomical appearance is characterized by numerous excessively prominent trabeculations and deep intertrabecular recesses. Distinct morphological features can be diagnosed on two-dimensional echocardiography. We present here a family of isolated noncompaction of the left ventricular myocardium, in which 5 affected individuals suggested the presence of some genetic abnormalities in this disorder.
Biopsy↗
Monocyte-vascular smooth muscle cell interaction enhances nitric oxide production.
OBJECTIVE: The adhesive interaction of monocytes and vascular smooth muscle cells (VSMCs) has been suggested to be a regulatory signal in the cellular activation that is involved in the pathogenesis of atherosclerosis. We investigated the effects of monocyte-VSMC interaction on inducible nitric oxide (NO) synthase expression. METHODS: NO production by the cultured cells was determined by measuring the nitrite content of the culture media using the Griess reagent. The expression of inducible NO synthase protein was assayed by Western blotting. RESULTS: Interleukin-1 beta (IL-1 beta) induced nitrite production by VSMCs in a time-dependent manner. The addition of the mouse monocyte cell line J774 to IL-1 beta-stimulated VSMCs further increased nitrite production in a monocyte number-dependent manner. Enhanced nitrite production by coculture was accompanied by increased inducible NO synthase protein accumulation. Addition of tumor necrosis factor-alpha (TNF-alpha) also enhanced IL-1 beta-induced nitrite production by VSMCs, but TNF-alpha showed no effect in the presence of monocytes. Coculture of monocytes and VSMCs in the presence of IL-1 beta secreted substantial amounts of TNF-alpha. The production of nitrite by coculture was markedly inhibited by an anti-TNF-alpha antibody. CONCLUSIONS: The present study revealed that direct cell-to-cell interaction between monocytes and VSMCs enhances NO production, suggesting an important role for their interaction in the pathogenesis of atherosclerosis.
Animals↗
Coronary embolism in hypertrophic cardiomyopathy.
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Atrial Fibrillation↗
[Role of cytokines in acute coronary syndrome].
Cytokines modulate immunologic processes, inflammation, proliferative responses and apoptosis. Recent studies focused on the role of proinflammatory cytokines in cardiovascular diseases. Proinflammatory cytokines, such as interleukin (IL)-6, IL-8, IL-1 beta and tumor necrosis factor-alpha play important roles in acute coronary syndrome by regulating inflammation, cellular adhesion and production of growth factors and various vasoactive substances. Reperfusion after myocardial infarction and transient myocardial ischemia are supposed to induce these proinflammatory cytokines. We reviewed the mechanisms and clinical significance of proinflammatory cytokine expression in acute coronary syndrome. In addition we recently found out that an interaction between monocytes and vascular endothelial cells induces matrix metallo-proteinase expression by these cytokine-mediated mechanisms.
Acute Disease↗
Diurnal blood pressure rhythm in hypertensives with parental history of stroke.
To investigate whether the lack of nocturnal decline of blood pressure (nondipper) is a primary cause of stroke or a secondary abnormality due to stoke, we examined the relation between the blood pressure variation and parental history of stroke in 110 hypertensive patients. In nondippers (n = 54), the frequency of positive parental history of stroke was significantly higher than in dippers (n = 56) (53.7% v 33.9%, chi2 = 4.37, P = .0366). We observed a significant increase in the incidence of positive parental history of stroke in nondippers, suggesting that some genetic factors may regulate blood pressure profiles before stroke develops.
Aged↗
Angiotensin converting enzyme gene polymorphism in essential hypertension based on ambulatory blood pressure monitoring.
The association of the angiotensin converting enzyme (ACE) gene polymorphism with essential hypertension is still controversial. We studied its polymorphism in 41 patients with hypertension based on ambulatory blood pressure (ABP) and 34 subjects with normal blood pressure. The ACE genotype was not significantly different between hypertensive and normotensive subjects. Casual blood pressure levels, 24 h, and daytime and nighttime ABP levels did not differ among the ACE genotype in patients with hypertension. In conclusion, the ACE genotype is not associated with essential hypertension based on ABP monitoring.
Alleles↗
Autonomic nervous system activity in essential hypertension: a comparison between dippers and non-dippers.
The present study was undertaken to investigate the changes in autonomic nervous system activity in essential hypertension. Fourteen normotensive controls and 33 age-matched untreated hypertensive subjects, diagnosed by ambulatory blood pressure (ABP) measurement (24-h systolic ABP value over 140 mm Hg or 24-h diastolic ABP over 90 mm Hg, or both) were recruited. ABP and 24-h electrocardiogram were monitored simultaneously. Power spectral analysis of the R-R interval was performed by a fast Fourier transformation method and the powers of low frequency (LF; 0.04 to 0.15 Hz) and high frequency (HF; 0.15 to 0.4 Hz) components were obtained. Hypertensive subjects were divided into 'dippers', whose night-time systolic ABP fell by more than 10% of their daytime ABP, and 'non-dippers' in whom this phenomenon was absent. In hypertensive subjects, electrocardiogram monitoring and power spectral analysis were also performed for 5 min before and during 90 degrees tilt. There were no significant differences in the 24-h mean LF/HF power ratio, LF power or HF power between normotensive and hypertensive subjects. A significant negative correlation between the night-time systolic ABP level and the 24-h LF/HF power ratio was found (r= -0.36, P < 0.05) in the hypertensive subjects. A significant positive correlation was found between the 24-h LF/HF power ratio and the percentage nocturnal reduction of the daytime systolic ABP in hypertensive subjects (r = +0.40, P < 0.01). The 24-h LF/HF power ratio was significantly lower in non-dippers than in dippers (2.09 +/- 1.06 vs 3.24 +/- 0.97, P < 0.01). The mean daytime LF/HF power ratio was significantly lower in non-dippers than in dippers (2.50 +/- 1.43 vs 4.08 +/- 1.27, P < 0.01). The night-time LF/HF power ratio was not significantly different between the two groups. The LF/HF power ratio increased significantly in dippers (from 1.32 +/- 1.95 to 4.65 +/- 1.54, P < 0.001) during 90 degrees tilt, but there was no significant change in the LF/HF power ratio in non-dippers during tilt (from 1.13 +/- 0.28 to 1.36 +/- 0.78, NS). The 24-h LF/HF power ratio decreased according as the night-time systolic BP elevated in hypertensive subjects. During ambulatory monitoring, the non-dippers showed a significantly lower LF/HF power ratio than the dippers. The LF/HF power ratio increased significantly in dippers, but not in non-dippers during tilting. These results suggest that impaired cardiovascular reflexes might contribute to the decreased sympathovagal balance in non-dipper type hypertension.
Autonomic Nervous System↗
Thyroid hormone stimulates Na(+)-Ca2+ exchanger expression in rat cardiac myocytes.
We investigated whether thyroid hormone directly affects Na(+)-Ca2+ exchanger expression in cardiac myocytes. Cultured neonatal rat cardiocytes were prepared from 1-day-old Sprague-Dawley rats. Intracellular Na+ concentration ([Na+]i) in cardiocytes was measured by using the Na(+)-sensitive dye sodium-binding benzofran isophthalate (SBFI). Na(+)-Ca2+ exchanger messenger RNA (mRNA) and protein expression were assayed by Northern and Western blotting, respectively. Triiodothyronine (T3; 10(-8) M) showed no effect on [Na+]i in cardiocytes, whereas ouabain (100 microM) caused a significant increase in [Na+]i from 11.3 +/- 5.0 to 21.8 +/- 5.0 mM. Exposure of cardiocytes to ouabain caused a rapid increase in Na(+)-Ca2+ exchanger mRNA accumulation, with a maximal twofold elevation at 12 h. The ouabain-induced Na(+)-Ca2+ exchanger mRNA accumulation was still observed in the Ca(2+)-free culture medium. On the other hand, exposure of cardiocytes to T3 induced a gradual increase in Na+ exchanger mRNA accumulation, with a maximal threefold increase at 24 h. Even in Na(+)-free medium, T3 still induced a twofold increase in Na(+)-Ca2+ exchanger mRNA accumulation in cardiocytes. Exposure of cardiocytes to T3 for 24-48 h also caused a marked increase in Na(+)-Ca2+ exchanger protein accumulation. In conclusion, thyroid hormone directly increases cardiac Na(+)-Ca2+ exchanger expression, independent of alterations in Na+ mobilization. These findings suggest also that thyroid hormone and Na+ regulate Na(+)-Ca2+ exchanger gene expression through distinct molecular regulatory pathways.
Animals↗
Angiotensin-converting enzyme gene polymorphism in hypertensive individuals with parental history of stroke.
BACKGROUND AND PURPOSE: It has been suggested that the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene is an independent risk factor for coronary artery disease, but its relation to stroke has not yet been proven. We investigated an association of ACE gene polymorphism with parental history of stroke (PHS) in patients with hypertension. METHODS: We studied 70 hypertensive patients (ambulatory blood pressure > 140/90 mm Hg; age, 59 +/- 11 years) with (n = 27) or without (n = 43) PHS, defined as either one or both parents having had a stroke before 60 years of age. The ACE genotype was analyzed by polymerase chain reaction. RESULTS: Casual blood pressure and mean ambulatory blood pressure levels were not significantly different between patients with and without PHS. The incidence of left ventricular hypertrophy also did not differ significantly between the two groups. However, the frequency of the D allele was significantly higher in patients with PHS (0.72) than in patients without PHS (0.52) (chi 2 = 5.472, P = .019). The frequency of the DD genotype of the ACE gene was also significantly higher in patients with than in those without PHS (DD, 63.0%; ID, 18.5%; II, 18.5% versus DD, 32.6%; ID, 39.5%; II, 27.9%; chi 2 = 6.395, P = .041). CONCLUSIONS: The DD genotype of the ACE gene is associated with PHS in patients with hypertension, which is independent of blood pressure levels or presence of cardiac hypertrophy.
Aged↗
Prediction of hemodynamic conditions by noninvasive arterial tonometry in mitral stenosis.
To predict the hemodynamic conditions in patients with mitral stenosis (MS), continuous blood pressure responses were monitored noninvasively at the bedside by arterial tonometry during the Valsalva maneuver in 18 MS patients aged 54.2 +/- 9.1 (40 approximately 77) years (6 men, 12 women). Two indices during the Valsalva maneuver (blood pressure decline value at phase III (BPdec) and subsequent blood pressure overshoot value at phase IV (BPov)) were compared with hemodynamic data obtained by the cardiac catheterization method, and the correlations between the changes in these parameters were examined. In these 18 patients, BPdec showed a significant negative correlation with the mean diastolic pressure gradient between the left atrium and left ventricle and showed a significant negative correlation with pulmonary capillary wedge pressure (PCWP) (r = - 0.62, p < 0.01, r = - 0.53, p < 0.05, respectively). Mitral valve area (MVA) showed a significant positive correlation with BPdec (r = + 0.63, p < 0.01). Similarly, BPov showed a significant positive correlation with cardiac output (CO), cardiac index (CI) and MVA (r = + 0.60, p < 0.01, r = + 0.64, p < 0.01, r = + 0.65, p < 0.01, respectively). Thus, continuous monitoring of blood pressure by arterial tonometry during the Valsalva maneuver is useful for predicting the hemodynamic conditions in patients with MS.
Adult↗
[Initial outcome of coronary intervention in elderly patients].
The effect of age on the early results of coronary intervention was examined retrospectively using the initial success rate of coronary angioplasty in 60 patients older than 70 years. Patients were selected from those who underwent coronary angioplasty at the Saiseikai Utsunomiya Hospital from January 1992 to December 1994. There were 267 patients with 350 lesions, 223 men and 44 women, aged from 31 to 79 years (mean age 61.4 +/- 9.8 years). The elderly group consisted of 60 patients (mean age 73.5 +/- 3.0 years) and the control group was 207 patients less than 70 years (mean age 57.9 +/- 8.2 years). Successful coronary dilatation was defined as > 20% reduction of stenosis with residual stenosis < 50%. Body mass index, presence of hypertension or diabetes mellitus and the ratio of smokers were not significantly different between the two groups. The elderly group included more women and patients with hyperlipidemia. Both groups had similar baseline extent of coronary artery disease, distribution of coronary artery stenosis type and left ventricular ejection fraction. The initial success rate for all patients was 93.4%. There was no significant difference in the initial success rate between the elderly and control groups (98.8% and 91.9%, respectively). There was no significant difference in major complication rate between the two groups (6.3% and 11.5%). Multivariate logistic regression analysis showed that only the type of coronary artery stenosis was significantly associated with initial success rate (p < 0.01). These results suggest that coronary intervention can be successfully performed with a low incidence of major complication in elderly patients.
Adult↗
Expression of monocyte chemoattractant protein-1 in vascular tissue.
We investigated monocyte chemoattractant protein-1 (MCP-1) mRNA expression in rat vascular smooth muscle cells (VSMC) and in human atherosclerotic arteries to test the involvement of MCP-1 in the pathogenesis of atherosclerosis. In Northern blot analysis, MCP-1 mRNA expression was not observed in unstimulated cultured rat vascular smooth muscle cells (VSMC), but its expression was clearly observed by exposure to tumour necrosis factor-alpha (100 U/ml) for 2-6 h. Mitogen-activated protein kinase activity in VSMC incubated in serum-free culture medium was increased by exposure to 0.5% fetal bovine serum, while the effect was significantly suppressed in the presence of MCP-1 (100 ng/ml). We then evaluated MCP-1 mRNA expression in atherosclerotic arteries obtained from 12 patients undergoing bypass revascularization through reverse transcription-polymerase chain reaction analysis and observed MCP-1 mRNA expression in all atherosclerotic arteries studied. These results support the premise that MCP-1 is secreted by VSMC in atherosclerotic plaques as well as by endothelial cells and macrophages and contributes to the pathogenesis of atherosclerosis.
Animals↗
Differential effects of an alpha 1-blocker (doxazosin) on diurnal blood pressure variation in dipper and non-dipper type hypertension.
A study was conducted to determine whether sympathetic nerve activity, one of the main regulators of blood pressure, is involved in high blood pressure in the night-time and morning. Twenty-seven untreated hypertensive subjects, in whom hypertension was diagnosed by ambulatory blood pressure (ABP) measurement, who showed a 24 h systolic ABP value over 140 mmHg and/or 24 h diastolic ABP over 90 mmHg were recruited. They also showed a night-time systolic ABP value of over 130 mmHg and/or a night-time diastolic ABP of over 80 mmHg. They were divided into two groups: "dippers (D)" whose night-time ambulatory blood pressure fell by more than 10% of the day-time blood pressure, and "non-dippers (ND)" in whom this phenomenon was absent. We examined the effect of a long-acting alpha 1-blocker (doxazosin) on diurnal blood pressure variation in these subjects with essential hypertension. Baseline casual blood pressure and 24 h systolic ABP were not significantly different between the two groups. However, both night-time and morning ABP in ND were higher than those in D. Administration of doxazosin (mean 73 +/- 13 (SE) d) significantly decreased casual blood pressure, and 24 h, day-time, night-time and morning systolic ABP in the whole cohort. When subjects were divided into D and ND, the day-time and morning systolic ABP decreased significantly after doxazosin treatment in both groups, whereas the night-time systolic ABP decreased significantly only in ND but not in D. These results suggest that sympathetic nerve activity involved in elevating blood pressure during the night may differ between D and ND.
Adrenergic alpha-Antagonists↗
Aneurysmal dilatation of the pulmonary trunk with mild pulmonic stenosis.
We present the unusual case of a 72-year-old woman whose chest X-ray showed an abnormal left hilar shadow. A pulmonary angiogram revealed an aneurysm in the pulmonary artery with a diameter of 55 mm that extended from the main pulmonary trunk to its bifurcation. Mild pulmonic stenosis with a systolic pressure gradient of 18 mmHg across the pulmonic valve was recognized. Mild dilatation of the ascending aorta was also present. The pressure gradient across the pulmonic valve was lower than is typical for an aneurysmal dilatation, suggesting that this patient represented a case of idiopathic pulmonary artery dilatation. We suspected the presence of a congenital structural alteration common to the pulmonary artery and the ascending aorta.
Aged↗
Multicystic aneurysmal dilatation of bilateral coronary artery fistula.
Bilateral coronary artery fistula constitutes an uncommon subgroup of coronary artery fistulas that may have a distinct embryologic origin. Coronary artery fistulas usually show a tortuous arrangement upon coronary angiography, but aneurysmal dilatation is rare. We report here an extremely rare case of coronary artery fistula originating from both coronary arteries, which showed multicystic aneurysmal dilatation.
Aged↗