Kunihiro Matsuo

St.Mary's Hospital (Fukuoka - Japan), Hukuoka, Fukuoka, Japan

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Publications (44)124.1 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Acute pulmonary thromboembolism (PTE) is a common illness that causes death and disability. Deep vein thrombosis (DVT) is often found in patients with a large myomatous uterus, and can occasionally result in acute PTE. Here, we describe the achievement of a favorable outcome in a case of acute PTE. The patient presented with acute PTE caused by a large uterine leiomyoma, without DVT of the lower extremities. Percutaneous cardiopulmonary support (PCPS) was used as an adjunct to thrombolytic therapy to treat the right ventricular thrombus with acute PTE. According to emergency practice, PCPS was initiated, and the patient was successfully treated with thrombolytic and anticoagulant therapy associated with total abdominal hysterectomy. This case suggests that PCPS can lead to favorable clinical outcomes in patients with large uterine leiomyomata and severe PTE.
    Taiwanese journal of obstetrics & gynecology 12/2012; 51(4):639-42.
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    ABSTRACT: There is some evidence in prospective randomized clinical trials that the administration of adrenaline (AD) before admission for the treatment of out-of-hospital cardiac arrest did not improve survival to hospital discharge. The aim of this study was to evaluate our real-world experience regarding the efficacy of intravenous AD in out-of-hospital cardiac arrest at our university hospital. In this retrospective study, we enrolled and divided 644 patients into AD (AD administration before arrival at the hospital) and non-AD (no AD administration before arrival at the hospital) groups. The patient characteristics including age, sex, percentage of cardiac cause, location of cardiac arrest, and witnessed arrest were similar between the AD and non-AD groups. There were no significant differences between the AD and non-AD groups with regard to return of spontaneous circulation, survival to hospital admission, survival to hospital discharge, or good neurologic recovery at hospital discharge in all patients. In addition, we excluded the data of patients with extrinsic cause. We analyzed whether intravenous AD before arrival in patients with intrinsic cause was effective. The outcomes in the AD group were similar to those in the non-AD group. In conclusion, our study indicated that AD administration before arrival at the hospital for the treatment of out-of-hospital cardiac arrest did not improve the clinical outcome.
    Journal of Cardiology 08/2012; · 2.57 Impact Factor
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    ABSTRACT: Dietary habits are associated with obesity, and both are important contributing factors to lifestyle-related diseases. The STYLIST study examined the effects of dietary counseling by registered dietitians and the delivery of proper calorie-controlled meals (UMIN Registration No: 000006582). Two-hundred adult patients with hypertension and/or diabetes mellitus were randomly divided into 2 groups with/without dietary counseling and consumed an ordinary diet for 4 weeks. Each group was then subdivided into 2 groups with/without dietary counseling and received calorie-controlled lunch and dinner boxes for the next 4 weeks. The calories in the delivered meals were based on the subject's ideal body weight (BW) and physical activity level. BW, waist circumference, blood pressure, and laboratory data, including glycoalbumin, were measured at 0, 4, and 8 weeks. BW and the other parameters were significantly reduced during the study period in patients who received diet counseling in the ordinary diet period and/or delivered meal period but not in patients without dietary counseling, as assessed by linear mixed models for longitudinal data. The combination of dietary counseling by dietitians and delivery of calorie-controlled meals was effective in reducing BW, as well as blood pressure and glycoalbumin, in patients with hypertension and/or diabetes mellitus.
    Circulation Journal 05/2012; 76(6):1335-44. · 3.69 Impact Factor
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    ABSTRACT: Coarctation of the aorta with aortic dissection is sometimes seen in cases of Turner syndrome, and most cases are type A aortic dissection, whereas coarctation of the aorta with type B aortic dissection is unusual. Only two cases of coarctation of the aorta presenting as aortic dissection have been reported in Japan, and only a few cases have been reported worldwide. We report here a case of coarctation of the aorta with some collaterals presenting as aortic dissection (type B) detected by 64-multidetector row computed tomography (MDCT). A 36-year-old man was brought to the emergency room complaining of sudden chest pain and back pain. Since he showed highly developed collaterals, he might never have exhibited symptoms or any limits on movement. Three-dimensional image reconstruction enabled detection of the coarctation of the aorta with some collaterals and aortic dissection in the best projection, and enabled assessment of precise anatomical relationship. In the present case, MDCT gave more useful information than cardiac catheterization for planning the surgical repair of coarctation of the aorta with some collaterals presenting as aortic dissection.
    Journal of Cardiology Cases 02/2012;
  • Internal Medicine 01/2012; 51(23):3301-2. · 0.97 Impact Factor
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    ABSTRACT: A 54-year old man was diagnosed with right lung carcinoma (squamous cell carcinoma, SCC), stage IIIB (c-T2N3M0). Transthoracic echocardiography (TTE) showed a huge 8.9 cm × 1.3 cm tumor in the left atrium (LA) that was invaded by a pulmonary vein, and the tumor moved under the mitral valve at LA systole. After 3 months, he was diagnosed with acute myocardial infarction (AMI) and emergency coronary angiography (CAG) was performed. CAG showed that the distal segment of the right coronary artery was totally occluded. TTE showed that the shape of the mass tip became sharp. He was discharged on hospital day 15. He died 4 months after discharge because of right lung carcinoma with respiratory failure. An autopsy showed that the cause of AMI was tumor embolism. SCC clearly occupied a blood vessel lumen in the distal segment. This is a rare case of AMI due to embolism of lung carcinoma during progression of the disease with direct invasion to the LA. TTE is useful for assessing lung carcinoma invasion.
    Journal of Cardiology Cases 12/2010;
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    ABSTRACT: It has been reported that the overlap of sirolimus-eluting stents (SESs) is associated with greater in-stent late lumen loss and more angiographic restenosis. The purpose of this study was to evaluate whether the site of such overlap shows increased or decreased late lumen loss as assessed by quantitative coronary angiogram. We compared 7-month angiographic late lumen loss at the site of overlap in patients with multiple overlapping stents (overlap SES group, n=48) to that in patients with single stents (single SES group, n=144). With regard to baseline angiographic characteristics and procedural results, there were significant differences between the overlap SES group and the single SES group in lesion complexity, lesion length and reference diameter, minimal lumen diameter, and mean stent length. In-stent late lumen loss at the 7-month follow-up did not differ significantly between the two groups (overlap SES 0.25 ± 0.61 mm vs. single SES 0.10 ± 0.55 mm, p=0.11). Furthermore, the site of overlap in the overlap SES group did not show greater late lumen loss compared to the stented area in the single SES group (0.17 ± 0.55 mm vs. 0.10 ± 0.55 mm, p=0.43). The overlap SES group tended to be associated with an increase in binary restenosis compared with the single SES group (22.8% vs. 12.8%, p=0.08), while this value was 4.2% at the site of overlap. There were no significant differences in death, myocardial infarction, target lesion revascularization, or stent thrombosis between the two groups. In addition, stent length was the most independent factor of late lumen loss in the overlap SES group by multivariate logistic analysis, whereas it was not an independent factor of late lumen loss of the SES overlap segment. The site of overlap of overlapping SES dose not associate with greater late lumen loss or a higher in-stent binary restenosis rate compared to single SES implantation. The overlapping of SES by itself did not increase in-stent late lumen loss.
    Journal of Cardiology 12/2010; 57(2):187-93. · 2.57 Impact Factor
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    ABSTRACT: Introduction: We examined whether the additional use of amiodarone (AMD) under implantable cardioverter-defibrillator (ICD) therapy may have beneficial effects in patients at risk for lethal ventricular arrhythmias with structural heart diseases. Methods: Sixty patients (47 males, mean age, 62 ± 13 years) with structural heart disease who underwent ICD implantation were retrospectively analyzed. There were 2 groups: one group (AMD group) was treated with AMD (n = 33) and the other group (non-AMD group) was treated without AMD (n = 27). We compared the incidence and appropriateness of ICD shock therapy between two groups. Results: During a mean follow-up of 28 ± 17 months, we identified a total of 62 episodes in 18 patients (30%) who received ICD shock therapy. ICD shock episodes were significantly less frequent in AMD group than in non-AMD group (15% versus 48%, P < 0.01), while inappropriate shock episodes were greater in non-AMD group than in AMD group (49% versus 4%, P = 0.03). In cumulative probability of shock events, the risk of events was significantly lower in AMD group (P = 0.007). Of 4 patients who died in AMD group, we observed one fatal pulmonary fibrosis. Conclusions: Additional AMD therapy in patients with an ICD may be effective in reducing the risk of shock discharge.
    Journal of Arrhythmia 01/2010; 26(2):103–110.
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    ABSTRACT: This prospective study was carried out to evaluate the benefits of intensive lowering of low-density lipoprotein cholesterol (LDL-C) with statin and intensive blood pressure (BP)-lowering therapy as aggressive medical interventions after stent implantation. Fifty-four patients with coronary artery disease initially received statin immediately after successful stent implantation. They were divided into intensive therapy (IT group, n = 27; therapeutic target levels of LDL-C and BP were 60 mg/dl and <120/80 mmHg at follow-up coronary angiography, respectively, 6-8 months after stent implantation) and conventional therapy groups (CT group, n = 27; target levels of LDL-C and BP were 100 mg/dl and <130/85 mmHg, respectively). Additional antihypertensive therapy with angiotensin II type 1 receptor blockers was begun according to the BP levels. There were significant differences in the levels of LDL-C at follow-up between the IT and CT groups [average, 68+/-10 (cut-off value,>or=83.4) mg/dl and 102+/-14 (<83.4) mg/dl, respectively]. Percentage diameter stenosis (P = 0.039) and diastolic BP (P = 0.005) in the IT group were significantly decreased compared with those in the CT group at follow-up. In addition, percentage diameter stenosis was most significantly related to the level of LDL-C (P = 0.03) among other metabolic factors (BP, body mass index, triglyceride, high-density lipoprotein cholesterol, hemoglobin A1c, and adiponectin) at follow-up as assessed by a stepwise multivariable regression analysis. These results suggest that intensive lowering of LDL-C by statin decreased the neointimal formation after stent implantation, and an LDL-C level of at least 83.4 mg/dl was the most acceptable clinical therapeutic target at follow-up.
    Coronary artery disease 06/2009; 20(4):288-94. · 1.56 Impact Factor
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    ABSTRACT: We evaluated the electrophysiological parameters before and after the intravenous infusion of diazepam (0.2 mg/kg) in 20 cardiac patients to investigate the drug's antiarrhythmic effect. Diazepam did not significantly change the arterial pressure. After the intravenous infusion of diazepam, the sinus cycle length significantly shortened from 847±132 to 747±155 ms (p>0.01). No significant change in the maximal sinus node recovery time was noted. The AH interval at the atrial pacing length of 600 ms shortened significantly from 140±40 to 127±39 ms (p>0.05). However, there was no significant change after the administration of diazepam in the longest atrial pacing rate associated with Wenckebach conduction in the atrioventricular (AV) node, effective and functional refractory periods of the AV node, HV interval, and QRS width during ventricular pacing at the cycle length of 600 ms. The atrial and ventricular effective refractory periods remained unchanged after the administration of diazepam. Six of the eight patients who showed dual AV nodal refractory period curves in the control study did not demonstrate them after diazepam administration by increasing the atrial or AV node effective refractory period. Thus, diazepam showed significant electrophysiological effects of the heart including shortening of the sinus cycle length, improvement in AV node conduction, and no significant effect on the His-Purkinje or intraventricular conduction and refractoriness of the atrium, AV node and ventricle. On the other hand, diazepam may influence the inducibility of supraventricular reentrant tachycardia incorporating the AV node.
    Clinical Cardiology 02/2009; 14(5):397 - 401. · 2.23 Impact Factor
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    ABSTRACT: This is a case report of a 60-year-old woman with acute myocardial infarction (AMI) who had coronary aneurysms and thrombus in the right coronary artery detected by multi-detector row computed tomography (MDCT). In this case, MDCT was useful for clarifying the thrombus complicated with coronary aneurysms, which was considered to be the cause of AMI. Thus, warfarin was started as an anticoagulant therapy for thrombus.
    Internal Medicine 02/2009; 48(5):339-41. · 0.97 Impact Factor
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    ABSTRACT: Although restenosis after successful coronary stenting is associated with changes in adhesion molecules and chemokines, it is unclear whether the differential effects of these molecules between a bare metal stent (BMS) and sirolimus-eluting stent (SES) may help to prevent coronary restenosis. The aim of this clinical study was to compare the expression levels of those molecules after elective placement of either a BMS or SES. The subjects included 32 consecutive patients with stable angina who had undergone successful coronary stenting and who randomly received either a BMS (n=16) or SES (n=16). Quantitative angiographic analysis 6 months after stenting showed that the minimal lumen diameter was significantly greater in the SES as compared to the BMS group, while the percent diameter stenosis and in-stent lumen loss were significantly lower. Plasma monocyte chemotactic protein-1 (MCP-1) increased significantly after 14 days and 6 months and monocyte CCR2 expression increased 24 hr and 48 hr after stenting in the BMS but not the SES group. Changes in plasma MCP-1 (DeltaMCP-1) within 6 months after stenting correlated significantly with in-stent lumen loss. The DeltaMCP-1 (between 6 months and baseline) was significantly related only to the lumen loss (r=0.443, p=0.023), which suggests that the reduction of MCP-1 is the best contributor to decreased lumen loss. These data suggest that reduction in MCP-1 production by SES may be one mechanism to prevent restenosis after coronary stenting.
    Internal Medicine 02/2008; 47(1):7-13. · 0.97 Impact Factor
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    ABSTRACT: A higher plasma concentration of highly-sensitive C-reactive protein (hs-CRP) has been found in patients with atrial fibrillation (AF). In addition, low-density lipoprotein (LDL)-associated platelet-activating factor acetylhydrolase (L-PAF-AH) is associated with inflammation. Therefore, the association between AF and PAF-AH was examined. Eighty subjects who were not taking aspirin or statin were investigated, and classified into paroxysmal AF (n=41) and normal sinus rhythm (NSR, n=39) groups. The lipid profile was analyzed by capillary isotachophoresis (cITP), plasma hs-CRP, plasma PAF-AH, high-density lipoprotein (HDL)-associated (H-PAF-AH), and L-PAF-AH. Although there were no significant differences in total cholesterol, HDL, LDL, hs-CRP, or plasma PAF-AH between the 2 groups, L-PAF-AH and the L-PAF-AH/H-PAF-AH ratio in the paroxysmal AF group were both significantly higher than in the NSR group. Interestingly, the ratio of L-PAF-AH to H-PAF-AH positively correlated with the left atrial diameter in all subjects. Although there were no differences in plasma lipoprotein subfractions, as characterized by cITP, slow-migrating LDL positively correlated with L-PAF-AH in both groups. The distribution of PAF-AH was associated with paroxysmal AF and may be a marker of inflammation in patients with paroxysmal AF. Antiinflammatory and antioxidant therapy that targets these factors might be effective for preventing paroxysmal AF.
    Circulation Journal 03/2007; 71(2):214-9. · 3.69 Impact Factor
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    ABSTRACT: Many angiotensin II type 1 receptor blockers (ARBs) are available for clinical use, but because they do not all have the same effects, the present study investigated whether all benefits conferred by ARBs are class effects. Study 1 was a case-control study of patients with coronary artery disease, which showed that a non-depressor dose of valsartan significantly decreased the rate of target lesion revascularization at 6 months after stenting compared with the control group without ARB treatment. In Study 2, 44 patients with acute myocardial infarction who randomly received an initial lower dose of either valsartan or losartan after stenting were evaluated. The late loss and decrease in %diameter stenosis in the valsartan group were significantly lower than those in the losartan group as assessed by quantitative coronary angiography after 6 months. In addition, the valsartan group showed a significantly lower expression of intracellular adhesion molecule-1 and L-selectin. A non-depressor dose of ARB may have beneficial effects on coronary restenosis that are associated with the regulation of adhesion molecules, and these effects might not be a class effect of ARBs.
    Circulation Journal 02/2007; 71(1):32-8. · 3.69 Impact Factor
  • International Journal of Cardiology 05/2006; 108(2):264-6. · 6.18 Impact Factor
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    ABSTRACT: We previously reported that angiotensin-converting enzyme inhibitors (ACE-Is) promote collateral circulation in patients with coronary artery disease (CAD). There have been many reports on the beneficial effects of angiotensin II type 1 receptor blockers (ARBs) on the cardiac microvasculature. Therefore, the following studies were performed to evaluate the association between treatment with an ARB and the enhancement of coronary collateral circulation as assessed by the Rentrop Score (RS) (Study 1) and to compare these results to those obtained with an ACE-I (Study 2). The subjects were 456 patients with angina who underwent coronary angiography. Study 1: Those who had one (1-V), two (2-V) or three significantly stenosed vessels (3-V) and who received only an ARB without any other anti-hypertensive medication were defined as the ARB group (n=81), and age-, sex- and body mass index-matched subjects (n=146) were selected as a comparative group. There were no significant differences in the percentage of patients with RS>or=1 between the two groups. Study 2: Those who received an ACE-I as the only anti-hypertensive treatment were defined as the ACE-I group (n=67), which was matched to the ARB group in Study 1. The percentage of patients with RS>or=1 in the ACE-I group was significantly higher than that in the ARB group as assessed by a Cochran-Mantel-Haenszel analysis. In addition, patients with 3-V disease who were treated with an ACE-I, but not an ARB, were most likely (odds ratio [confidence Interval]): 27.7 [4.8-161.0]) to show enhanced collateral circulation, as assessed by a multiple logistic regression analysis. These results suggest that treatment with an ACE-I, but not treatment with an ARB, was associated with the enhancement of collateral circulation in patients with CAD.
    Hypertension Research 03/2006; 29(3):135-41. · 2.94 Impact Factor
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    ABSTRACT: It is unclear whether the reduction of coronary restenosis by statins is due to a decrease in low-density lipoprotein (LDL) cholesterol and/or pleiotropic effects. Therefore, we performed quantitative coronary angiography (QCA) and analyzed the lipid profile and changes in adhesion molecules and chemokines caused by statin in patients with acute myocardial infarction (AMI). The subjects included AMI patients who had initial coronary angiograms and significant coronary stenosis and were implanted with a stent. After stent implantation, patients were treated either with (n = 36) or without (n = 14) statin. The primary end-point for this study was the absolute changes in the lipid profile, C-reactive protein (CRP), adhesion molecules, chemokines and stenosis measured by QCA between the post-stent and follow-up angiogram at 6 months after stenting. Treatment with statin reduced % coronary diameter stenosis (DS) and was associated with a greater reduction in LDL cholesterol at 6 months after stenting in patients with acute myocardial infarction (AMI), while there were no differences in adhesion molecules, chemokines, CC chemokine receptor or CXC chemokine receptor. Interestingly, changes in % DS between before and after statin treatment at 6 months (Delta%DS) were positively correlated with DeltaLDL cholesterol, and patients who had an LDL cholesterol level of less than 80 mg/dl had a significantly lower Delta%DS. In addition, Delta%DS was significantly related only to the reduction in LDL cholesterol as assessed by a stepwise multivariable regression analysis. These results suggest that the lower level of LDL cholesterol is the most critical factor in preventing coronary restenosis.
    Internal Medicine 02/2006; 45(15):885-90. · 0.97 Impact Factor
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    ABSTRACT: Angiotensin II receptor blockers (ARBs) and beta-blockers have contributed to longer life expectancies for patients with congestive heart failure. However, whether the use of ARBs is helpful for introducing carvedilol (beta-blocker) is unclear when patients with symptomatic congestive heart failure are admitted to the hospital. In this retrospective study, 27 patients with symptomatic congestive heart failure were given carvedilol upon admission. Five patients received carvedilol monotherapy (group A), and 22 were treated with a combination of carvedilol and ARBs (group B). There was no difference in medication between the groups except for ARBs. In addition, there were no significant differences in the decrease in plasma brain natriuretic peptide, or the improvement of left ventricular ejection fraction upon carvedilol treatment between the groups. Although there was no significant difference in the maintenance dose of carvedilol between the groups, the gross dose of carvedilol in group B was significantly lower than that in group A. In addition, the improvement of left ventricular ejection fraction in group B was positively correlated with the maintenance dose of carvedilol in patients who had wild-type beta1-adrenergic receptor at amino acid 389 (arginine/arginine genotype). These results suggest that ARBs are helpful for introducing carvedilol in patients with the wild-type beta1-adrenergic receptor gene, and that treatment with combined treatment with ARB or analysis of the beta1-adrenergic receptor genotype may offer advantages to control congestive heart failure in the short-term.
    Journal of Cardiology 02/2006; 47(1):1-7. · 2.57 Impact Factor
  • Journal of Cardiac Failure 12/2005; 11(9). · 3.07 Impact Factor
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    ABSTRACT: 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) enhances the inhibitory effects of angiotensin-receptor blocker (ARB) on vascular neointimal formation in mice. The present case-control study investigated the efficacy of combined treatment with statin and ARB for preventing restenosis in patients with coronary artery disease. We examined 210 patients with angina pectoris undergoing elective coronary stenting for de novo lesions of native coronary arteries. All enrolled patients received aspirin and ticlopidine. The subjects included patients who received no statin (control group, n = 137) or started statin treatment (statin group, n = 73) with or without ARB treatment after stenting. The rate of restenosis at 6 months after stent implantation in the statin group (19%) was significantly lower than that in the control group (32%). The restenosis rate in self-expanding Radius stents. (23%) was significantly lower than that in balloon-expandable Velocity stents (42%) independent of statin treatment. Patients treated with statins and ARBs were least likely [odds ratio (95% confidence interval): 0.30 (0.12-0.74)] to develop coronary restenosis, as assessed by multiple logistic regression analysis. These findings indicate that combined treatment with statin and ARB after stenting is a useful strategy for the prevention of coronary restenosis.
    Journal of Cardiology 04/2005; 45(3):107-13. · 2.57 Impact Factor

Publication Stats

226 Citations
124.10 Total Impact Points

Institutions

  • 1991–2012
    • St.Mary's Hospital (Fukuoka - Japan)
      Hukuoka, Fukuoka, Japan
  • 1990–2012
    • Fukuoka University
      • • Department of Cardiology
      • • Department of Internal Medicine
      • • Department of Laboratory Medicine
      Fukuoka-shi, Fukuoka-ken, Japan