Asami Suzuki

Tokyo Medical and Dental University, Edo, Tōkyō, Japan

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Publications (4)17.03 Total impact

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    ABSTRACT: The prevalence of subclinical, cardiac troponin I (cTnI) elevation in stable patients undergoing elective percutaneous coronary intervention and its relationship to culprit lesion characteristics assessed by optical coherence tomography (OCT) are unknown. We studied 206 native de novo culprit coronary lesions from 206 patients with stable angina pectoris who underwent OCT before elective percutaneous coronary intervention. Patients were divided into 2 groups according to the presence (cTnI group; n=47; 22.8%) or absence (non-cTnI group; n=159; 77.2%) of cTnI ≥0.03 ng/mL at admission. The clinical and OCT findings were compared between these 2 groups. No significant difference was found in the clinical presentation between the groups except for the serum C-reactive protein levels and presence of multivessel disease. By OCT, cTnI elevation was associated with the presence of thin-cap fibroatheromas, a greater lipid arc, and a longer lipid length. In a multivariable analysis, the presence of positive C-reactive protein levels (odds ratio, 4.38; 95% confidence interval, 1.90-10.08; P=0.001) and OCT-derived thin-cap fibroatheromas (odds ratio, 2.89; 95% confidence interval, 1.22-6.86; P=0.016) were independent predictors of cTnI elevation. Periprocedural myocardial injury, defined as postpercutaneous coronary intervention peak cTnI levels >1.0 ng/mL (5× the upper reference limit), occurred more often in patients with cTnI elevation at admission (cTnI group: 41% versus non-cTnI group: 18%; P=0.001). The presence of subclinical cTnI elevation at admission was not uncommon and was associated with OCT-derived unstable plaque morphology in patients undergoing elective percutaneous coronary intervention, and may help to identify patients with stable angina pectoris at high risk for periprocedural myocardial injury. © 2015 American Heart Association, Inc.
    Circulation Cardiovascular Interventions 04/2015; 8(4). DOI:10.1161/CIRCINTERVENTIONS.114.001727 · 6.98 Impact Factor
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    ABSTRACT: A 68 year-old man who had ischemic cardiomyopathy (ejection fraction 40%), with prior coronary artery bypass graft and ventricular septal perforation (VSP) repair, was admitted due to ventricular tachycardia (VT) with left bundle branch block morphology, and QR pattern in inferior leads. Electro anatomical voltage map (CARTO) during sinus rhythm (SR) demonstrated large low voltage zone (low-VZ) (<0.6 mV on amplitude of bipolar voltages) in posteroseptal (basal and mid levels) left ventricle (LV), but no low-VZ in right ventricle (RV). Optimal pace map during SR was obtained in basal posteroseptal RV, not in LV. And during VT (cycle length 459 ms), RV septal activation was earlier than LV. Delayed potential during SR was recorded at low-VZ in a basal posteroseptal LV, where mid diastolic potential during VT preceding QRS onset by 140 ms was seen. Entrainment pacing showed concealed entrainment with stimulus-QRS interval of 140 ms and post pacing interval identical to VT cycle length. Irrigated radiofrequency application terminated VT in three seconds. VT was considered that its central common pathway located in the basal posteroseptal low-VZ in LV between mitral annulus and VSP patch, with preferential breakout to septal RV.
    Journal of Arrhythmia 01/2011; 27(Supplement):PE4_116. DOI:10.4020/jhrs.27.PE4_116
  • Journal of Cardiac Failure 09/2010; 16(9). DOI:10.1016/j.cardfail.2010.07.219 · 3.07 Impact Factor
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    ABSTRACT: Atherosclerotic plaque that shows echo signal attenuation (EA) without associated bright echoes is sometimes observed by intravascular ultrasound but its clinical significance remains unclear. We investigated the impact of EA on coronary perfusion and evaluated the pathological features of plaque with EA. We studied 687 native coronary lesions in 687 consecutive patients (336 with acute coronary syndrome and 351 with stable angina pectoris) who underwent intravascular ultrasound before percutaneous coronary intervention. By subgroup analysis, 60 lesions (30 lesions with EA) treated with directional coronary atherectomy underwent pathological examination. The Thrombolysis in Myocardial Infarction (TIMI) flow grade and myocardial blush grade after percutaneous coronary intervention were compared between lesions with and without EA in 627 lesions except directional coronary atherectomy subgroup. EA was observed in 245 lesions (35.7%), and coronary flow after percutaneous coronary intervention was worse for lesions with EA than without (final TIMI grade of 0 to 2: 15.4% versus 2.4%, P<0.001; final myocardial blush grade of 0 to 2: 45.6% versus 21.4%, P<0.001). Multivariate analysis revealed a significant association between no reflow (TIMI grade 0 to 2) and EA (odds ratio, 5.59; 95% CI, 2.64 to 11.85; P<0.001), a baseline TIMI grade of 0 to 2 (odds ratio, 5.91; 95% CI, 2.79 to 12.5; P<0.001), and a large reference area (odds ratio, 3.08; 95% CI, 1.40 to 6.76; P=0.005) after controlling for other associated factors. Pathological examination revealed a significantly higher frequency of lipid-rich plaque with microcalcification in lesions with EA. Atherosclerotic plaque with EA showed a significant association with no reflow after percutaneous coronary intervention, suggesting the existence of fragile components susceptible to distal embolization.
    Circulation Cardiovascular Interventions 10/2009; 2(5):444-54. DOI:10.1161/CIRCINTERVENTIONS.108.821124 · 6.98 Impact Factor