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ABSTRACT: The study was designed to clarify the role of (123)I-β-methyl-iodophenylpentadecanoic acid ((123)I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI).
TEN CONTROLS (MEAN AGE: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic images were acquired at 30 min and at 4 h after (123)I-BMIPP injection to determine early and delayed BMIPP uptake, respectively. The heart-to-mediastinum (H/M) ratio and the washout rate (WR) were calculated from the planar images. All patients underwent scintigraphy one day before PCI and again 1 month after successful PCI.
NO SIGNIFICANT DIFFERENCES IN THE EARLY OR DELAYED H/M RATIOS WERE OBSERVED BETWEEN THE PATIENTS AND THE CONTROLS BEFORE PCI (EARLY: 2.70 ±0.36 vs. 2.73 ±0.57; delayed: 2.26 ±0.33 vs. 2.40 ±0.43; p > 0.2 for both). The early and delayed H/M ratios remained unchanged with the comparison with before PCI (early: 2.72 ±0.27, delayed: 2.23 ±0.22; p > 0.2 for both). The global WR before PCI was significantly higher in the patients than in the control group (36.7 ±9.3%, vs. 28.1 ±8.2%, p = 0.02). However, the WR after PCI did not significantly differ between the patients and the controls (34.3 ±7.8% vs. 28.1 ±8.2%, p = 0.1).
These data may suggest that the WR of (123)I-BMIPP determined from the planar images enhances the presence of myocardial ischaemia.
Archives of medical science : AMS. 06/2011; 7(3):428-32.
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Tatsuhiko Ito,
Ken Shimizu,
Yasuhiko Ichida, Yuki Ishibashi,
Nobuya Akizuki,
Asao Ogawa,
Maiko Fujimori,
Naoko Kaneko,
Ikuyo Ueda,
Kazuhiko Nakayama,
Yosuke Uchitomi
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ABSTRACT: Major depressive disorder (MDD) and adjustment disorder (AD) are common psychiatric disorders in cancer patients but are often overlooked in clinical oncology settings. We introduced a clinical screening program utilizing the Distress and Impact Thermometer (DIT) to identify MDD and AD in cancer outpatients receiving chemotherapy. This study assessed the usefulness of the screening program.
Pharmacists administered the DIT to consecutive patients undergoing chemotherapy at an outpatient clinic. Psychiatric treatment was recommended to all the patients with positive screening results. The proportion of patients referred to the Psychiatric Service during the program period was then compared with that during a usual care period.
Of the 520 patients who started chemotherapy during the 6-month program period, 5.0% (26/520) were referred to the Psychiatric Service and 2.7% (15/520) were diagnosed as having MDD or AD. No statistically significant difference in the referral rates was observed between the two periods (2.7 vs 1.0%, p = 0.46). However, the period from the first chemotherapy treatment until the visit to the Psychiatric Service was significantly shorter during the program period than during the period of usual care (12.9±13.2 days vs 55.6±17.6 days, p<0.001).
The proportion of patients referred to the Psychiatric Service for the treatment of MDD or AD during the program period was not different from that during the usual care period. However, the program was useful for introducing psychiatric treatment at an earlier stage. Further modifications to the program to improve the referral rate are necessary.
Psycho-Oncology 03/2011; 20(6):647-54. · 3.34 Impact Factor
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ABSTRACT: This study was designed to clarify the significance of washout rate (WR) determined from 99mTc-sestamibi myocardial scintigraphic images and the levels of cardiac enzymes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).
A total of 56 consecutive patients with AMI (mean age 65.8 ± 8.5 years), who underwent PCI on admission, were included. Cardiac enzyme, the MB isoenzyme of creatinine kinase (CK-MB), was measured every 3 h after admission. Two weeks after the onset of AMI, 99mTc-sestamibi myocardial scintigraphy was performed at early (30 min) and delayed (4 h) phases after tracer injection. The heart-to-mediastinum ratio (H/M) and WR were calculated from the planar images.
PCI was performed at 9.4 ± 6.0 h after the onset of AMI. In 26 patients the culprit lesion was located in the right coronary artery and in 24 patients it was located in the left anterior descending coronary artery. The peak CK-MB was 274.1 ± 169.4 IU/L (13.5 ± 3.9 h). The early and delayed H/Ms and WR of 99mTc-sestamibi were 2.74 ± 0.58, 3.00 ± 0.70, and 58.8 ± 10.0%, respectively. The delayed H/M was significantly correlated with the peak CK-MB (r = -0.37, p = 0.005). The WR of 99mTc-sestamibi was also significantly correlated with the peak CK-MB (r = -0.34, p = 0.012).
These results suggest that the WR determined from 99mTc-sestamibi myocardial scintigraphic images reflects the extent of myocardial damage in AMI patients.
Medical science monitor: international medical journal of experimental and clinical research 02/2011; 17(3):CR140-5. · 1.70 Impact Factor
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Archives of Medical Science 01/2011; 7:428-432. · 1.21 Impact Factor
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ABSTRACT: We assessed the usefulness of serum cystatin C for predicting contrast-induced nephropathy (CIN) in patients (n = 100) undergoing coronary catheterization. After a 12-month follow-up, the incidence of CIN was 8.3% (n = 5) in patients with mild renal insufficiency (estimated glomerular filtration rate [eGFR] 60-89 mL/min per 1.73 m²), 34.4% (n = 10) in those with moderate renal insufficiency (eGFR 30-59 mL/min per 1.73 m²), and 100% (n = 3) in those with severe renal insufficiency (eGFR 15-29 mL/min per 1.73 m²). The sensitivity was 81.8% and specificity was 90.9% at the cutoff level of serum cystatin C >1.18 mg/L. Serum cystatin C levels were significantly (P < .001) higher in the patients with moderate renal insufficiency in the CIN group than those in the non-CIN group. Multivariate logistic regression analysis demonstrated that baseline serum cystatin C independently predicted short-term mortality (odds ratio [OR], 0.311; 95% confidence interval [CI] 0.058-0.538; P = .026). Baseline serum cystatin C significantly predicted the occurrence of CIN in the patients with moderate renal insufficiency.
Angiology 11/2010; 61(8):724-30. · 1.51 Impact Factor
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Ken Shimizu, Yuki Ishibashi,
Shino Umezawa,
Hideko Izumi,
Nobuya Akizuki,
Asao Ogawa,
Yasuhiro Fujiwara,
Masashi Ando,
Noriyuki Katsumata,
Kenji Tamura,
Tsutomu Kouno,
Chikako Shimizu,
Kan Yonemori,
Mayu Yunokawa,
Yosuke Uchitomi
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ABSTRACT: Although the implementation of routine screening for distress is desirable, doing so is difficult in today's busy clinical oncology practice. We developed the 'Distress Screening Program in Ambulatory Care' (DISPAC program) as a practical means of screening for and facilitating the treatment of major depression and adjustment disorders in cancer patients. This study assessed the feasibility and usefulness of the DISPAC program in actual clinical situations.
As part of the DISPAC program, nurses administered a psychological screening measure, the Distress and Impact Thermometer (DIT), to consecutive cancer patients visiting an outpatient clinic in the waiting room. The attending physician then recommended psycho-oncology service referral to all positively screened patients. We compared the proportion of patients referred to a psycho-oncology service during the DISPAC period with the usual care period.
Of the targeted 491 patients treated during the DISPAC period, 91.9% (451/491) completed the DIT; the results were positive in 37.0% (167/451), recommendations for referrals were given to 93.4% (156/167), and 25.0% (39/156) accepted the referral. Ultimately 5.3% (26/491) of the targeted patients were treated by psycho-oncology service as having major depression or adjustment disorders, a significantly higher proportion than during the usual care period (0.3%; p<0.001). The nurses required 132+/-58 s per person to administer the DIT.
The DISPAC program is useful for facilitating the care of cancer patients with psychological distress. Nevertheless, the acceptance of referrals by patients and the reduction of the burden placed on nurses are areas requiring improvement.
Psycho-Oncology 09/2009; 19(7):718-25. · 3.34 Impact Factor
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Yuki Ishibashi,
Naohiko Osada,
Hiromitsu Sekiduka,
Masaki Izumo,
Takashi Shimozato,
Akio Hayashi,
Keisuke Kida,
Kihei Yoneyama,
Eiji Takahashi,
Kengo Suzuki,
Masachika Tamura,
Yoshihiro J Akashi,
Koji Inoue,
Kazuto Omiya,
Fumihiko Miyake,
Kazuhiro Izawa,
Satoshi Watanabe
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ABSTRACT: Recently, sleep disordered breathing (SDB) has gained attention in the field of cardiology. Until now, no study describing the relationship between acute coronary syndrome (ACS) and SDB has been carried out in Japan.
Among ACS patients admitted to our hospital, 44 patients (mean age 60.6+/-13.5 years) who received a portable polysomnography to measure apnea hypopnea index (AHI) were selected for this study. The circadian pattern of ACS onset was studied in 6-h intervals. In addition, all subjects were divided into three groups according to AHI severity (AHI < 5, 5 < or = AHI < 15, and 15 < or = AHI). Then, a comparative study between peak time of ACS and AHI severity was conducted for each group.
In the AHI < 5 group, 66.0% patients suffered from ACS between 12:00 h and 18:00 h and 17.0% between 18:00 h and 24:00 h, and a total of 83.0% patients had ACS between 12:00 h and 24:00 h. In the 5 < or = AHI < 15 group, 49.9% patients had ACS between 24:00 h and 06:00 h, 16.7% patients between 06:00 h and 12:00 h. 12:00-18:00 h and 18:00-24:00 h showed no significant difference. All 22 patients in the 15 < or = AHI group suffered from ACS between 24:00 h and 12:00 h.
The results of this study suggest a possible relationship between SDB and the onset of ACS between midnight to morning.
Journal of Cardiology 05/2009; 53(2):164-70. · 1.28 Impact Factor
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Kihei Yoneyama,
Naohiko Osada,
Takashi Shimozato, Yuki Ishibashi,
Akio Hayashi,
Eiji Takahashi,
Keisuke Kida,
Kengo Suzuki,
Masachika Tamura,
Koji Inoue,
Yoshihiro J Akashi,
Kazuto Omiya,
Fumihiko Miyake,
Kazuhiro P Izawa,
Satoshi Watanabe
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ABSTRACT: Sleep-disordered breathing (SDB) is frequently observed in patients with congestive heart failure. Recent studies have shown that SDB negatively affects the onset of congestive heart failure; however, no studies have addressed the relationship between the level of SDB and the onset time of acute dyspnea. We hypothesized that SDB affects the acute onset time of dyspnea (AOT) and investigated the relationship between SDB and AOT. We examined 80 patients (mean age, 61.6 years) with congestive heart failure in a clinically stable condition. AOT was divided into 5 time periods (0:00 - 6:00, 6:00 - 12:00, 12:00 - 18:00, 18:00 - 24:00, and unknown). The apnea-hypopnea index (AHI) was obtained based on the results of polysomnography (PSG) to evaluate the severity of SDB. Acute dyspnea occurred in 59 (73.7%) of the 80 patients. When we divided the patients into an AHI < 5 group and an AHI >or= 5 group, there was no significant difference in the AOT; however, a significant difference was observed in those divided into AHI < 20 and AHI >or= 20 groups (P < 0.001). The patients with AHI >or= 20 had more acute dys-pnea between 18:00 - 24:00 and between 0:00 - 6:00 than those with AHI < 20 (32% and 19%, and 4.1% and 4.1%, respectively). Severe SDB patients tended to have acute dyspnea between midnight and dawn. The results suggest SDB might be one of the risk factors of heart failure.
International Heart Journal 08/2008; 49(4):471-80. · 1.16 Impact Factor
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ABSTRACT: An evaluation of the relation between small dense low-density lipoprotein cholesterol (sd-LDL-C) levels measured by the heparin-magnesium precipitation method and metabolic syndrome (MetS).
We have prospectively measured sd-LDL-C levels by the heparin-magnesium precipitation method in 112 Japanese patients (male/female=80/32) with coronary artery disease (CAD) who received percutaneous coronary intervention (PCI). Patients were diagnosed with MetS according to modified Japanese criteria.
A total of 36 patients (32%) met the criteria for MetS. Sd-LDL-C levels were significantly higher in the MetS group than non-MetS group (20.7 +/- 1.5 mg/dL vs. 17.1 +/- 1.0 mg/dL, p=0.042), especially among patients without lipid-lowering therapy (26.4 +/- 2.6 mg/dL vs. 17.5 +/- 1.5 mg/dL, p= 0.0034). Sd-LDL-C levels gradually increased with the number of components used to define MetS (0; 14.5 +/- 1.8 mg/dL, 1; 16.5 +/- 1.8 mg/dL, 2; 16.7 +/- 1.3 mg/dL, 3; 19.3 +/- 1.7 mg/dL, 4; 23.1 +/- 2.1 mg/dL, 5; 40.0 mg/dL, p=0.0071). High-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in the patients with MetS (1.09 +/- 0.17 mg/L vs. 0.67 +/- 0.09 mg/L, p=0.0204).
The sd-LDL-C level measured by the heparin-magnesium precipitation method is a useful marker of MetS in Japanese patients with CAD.
Journal of atherosclerosis and thrombosis 09/2007; 14(4):202-7. · 2.69 Impact Factor
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Keisuke Kida,
Naohiko Osada,
Yoshihiro J Akashi,
Hiromitsu Sekizuka,
Masaki Izumo, Yuki Ishibashi,
Takashi Shimozato,
Akio Hayashi,
Kihei Yoneyama,
Eiji Takahashi,
Kengo Suzuki,
Masachika Tamura,
Koji Inoue,
Kazuto Omiya,
Fumihiko Miyake
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ABSTRACT: Previous studies have reported that skeletal muscle strength is closely related to exercise capacity in patients with myocardial infarction (MI). However, none of the previous studies have fully investigated the correlation between exercise capacity and the skeletal muscle volume (MV). Seventy patients with MI underwent symptom-limited cardiopulmonary exercise testing using a treadmill. The MV was evaluated by electrical impedance analysis and the maximal knee extension strength (Peak torque: PT) was measured by a Biodex. The subjects were divided into 2 groups according to the MV (group L, MV < 22 kg; group H, MV > or = 22 kg). The PT was positively and significantly correlated with the peak V(.)O(2) in both the L and H groups (r = 0.70 versus r = 0.71). The MV of the lower limbs was positively correlated with the peak V(.)O(2) in the L group (r = 0.57), but not in the H group. The lower limb MV was positively and significantly correlated with PT in the L group (r = 0.48), but not in the H group. The exercise capacity of patients with MI is thought to depend on both the strength and volume of the skeletal muscle. In MI patients with high muscle volume, exercise capacity was determined by skeletal muscle strength alone.
International Heart Journal 09/2006; 47(5):727-38. · 1.16 Impact Factor
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Medical science monitor: international medical journal of experimental and clinical research 17(3):CR140-CR145. · 1.70 Impact Factor
