Y Hada

The University of Tokyo, Tokyo, Tokyo-to, Japan

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Publications (79)99.27 Total impact

  • Journal of Echocardiography 01/2011; 9(3):125-126.
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    ABSTRACT: A 32 year-old woman with bilateral hilar lymphadenopathy suffered from syncopal attacks after her first delivery. Electrocardiograms showed complete atrioventricular block (AVB) and myocardial scintigrams demonstrated a decreased uptake in the anteroseptal area. She was diagnosed as having postpartal cardiac acceleration of sarcoidosis. Because she rejected permanent pacemaker implantation, we started steroid therapy under temporary pacing. Fortunately, the treatment was very effective. Even after tapering-off of the steroid, the AVB has never reappeared. Permanent pacemaker implantation with subsequent steroid therapy is generally recommended for complete AVB due to cardiac sarcoidosis. However, steroid therapy alone can be considered for some selected cases.
    International Heart Journal 06/2008; 49(3):377-84. · 1.23 Impact Factor
  • International Heart Journal - INT HEART J. 01/2008; 49(3):377-384.
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    ABSTRACT: Atrial fibrillation (AF) is well known to be male-dominant. Female sex hormones may be involved, since very few premenopausal women experience AF. However, a possible gender difference in older subjects has not been fully elucidated yet. We retrospectively reviewed the symptoms of 133 patients (111 males and 22 females) with paroxysmal AF (PAF) from the medical records at our hospital from 1995 to 2000, and classified the patients according to the time of the attacks as day type, night type, or unspecific type. In females, the age at the first diagnosis of PAF was significantly higher (males: 57 +/- 1 year old, females: 65 +/- 2 years old; P = 0.006) and the proportion of cases younger than 61 years old was significantly smaller (63%, 32%; P = 0.007). As in previous reports, the female group had more cases with unspecific type (26.5%, 47.6%) or with long duration (> 24 hours) (16.9%, 37.5%). In contrast to these published results, fewer women (10.5%) had frequent attacks (more than twice a week) than men (39.8%). The incidence of regular alcohol consumption, one of the most important PAF triggers, was significantly higher in men than women (84.7%, 13.6%; P < 0.0001). Even when we focused on cases older than 60 years old, the female group still had more cases with unspecific type (53.3% versus 23.1%) or with long duration (27.3% versus 14.7%) than men, and fewer with frequent attacks (0% versus 51.7%) or regular alcohol consumption (6.7% versus 82.9%; P < 0.0001) than men. The gender difference in symptoms related to PAF may depend not only on sex hormones, but also on intrinsic or social gender differences.
    International Heart Journal 08/2005; 46(4):669-78. · 1.23 Impact Factor
  • Hiromi Kiritani, Masako Asakawa, Yoshiyuki Hada
    Journal of Cardiology 11/2004; 44(4):165-7. · 2.30 Impact Factor
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    ABSTRACT: To compare plaque and calcification of the thoracic aorta with ischemic heart disease and risk factors, the authors used intravascular ultrasound (IVUS) and X-ray computed tomography (CT). The study included 29 patients (24 males and 5 females, mean age 61 ± 11 years): 21 with ischemic heart disease (IHD) and 8 with valvular disease or dilated cardiomyopathy. A Sonicath Ultra 6 imaging catheter (12.5 MHz, Scimed) was inserted through the femoral artery, and IVUS images were obtained around the descending aorta at the level of the pulmonary artery bifurcation. Percent plaque area (%PA) was calculated as vessel cross sectional area (CSA) surrounded by media minus lumen CSA divided by vessel CSA. The CVIS clear view system (Scimed) was used for image analysis. CT without contrast enhancement was performed from the aortic arch to the diaphragm in horizontal sections of 1 cm. The number of slices showing aortic calcification was determined as the CT calcification score. Coronary angiography (CAG) was also performed in each patient, and the authors analyzed the correlation of these imaging modalities with IHD with multiple risk factors. In the descending aorta the IVUS probe was not eccentric and gave accurate images of plaque. In the ascending aorta or aortic arch, the probe was somewhat eccentric. Plaque was observed to be diffuse without discrete lesions. The %PA was 2.5–28.6 (14.9 ± 5.5) %, and the CT score was 0–25 (8.2 ± 7.9). The %PA and CT score showed a significant correlation with each other (r = 0.57, p <0.05) and with age (r = 0.44 and 0.64, respectively, p <0.05). Neither showed a significant correlation with findings from CAG or risk factors. IVUS accurately detects the presence and extent of plaque in the thoracic aorta. The %PA shows a significant correlation with CT-detected calcification of the aorta. Neither calcification nor plaque is correlated with IHD or risk factors. IVUS-detected plaque and CT-detected calcification are strongly influenced by age.
    International Journal of Angiology 09/2002; 11(3):139-143.
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    ABSTRACT: A 15-year-old girl developed subacute constrictive pericarditis following successful surgical repair of double-chambered right ventricle. Two weeks after surgery, the patient had massive pericardial effusion, which acutely progressed to constrictive pericarditis with the symptoms of cardiac tamponade. Further surgery was necessary to resect the parietal pericardium. No blood transfusion was required for this patient, who was a Jehovah's Witness. She was doing well 9 months after the second operation, with residual pericardium of normal thickness.
    Journal of Cardiology 06/2002; 39(5):267-70. · 2.30 Impact Factor
  • Journal of The American College of Cardiology - J AMER COLL CARDIOL. 01/2002; 39:32-33.
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    ABSTRACT: Calcification in the pulmonary artery (PA) occurs in rare cases. There have been no studies of calcification in the PA at the site of its contact with a left coronary artery bypass graft (CABG). In the present study, X-ray computed tomography (CT) was employed for examination of such calcification. The subjects were 53 patients (49 male and 4 female, mean age of 56.7 years) who underwent 74 left CABGs (69 saphenous veins and five internal thoracic arteries). Following surgery, non-contrasted CT was performed from the lower level of the aortic arch to the lower boundary of the left ventricle at 5-mm horizontal intervals, and contrasted CT was performed at the level of the PA; this procedure was repeated at approximately six-month intervals after the operation. In addition, aortography and selective graft angiography were carried out at 7.6 months postoperatively. The inner diameter of the grafts and the levels of serum cholesterol were also examined. Calcification in the PA was detected in 24 cases (all of them saphenous vein grafts), but graft angiography found no stenosis in those sites. Calcification size varied from 1 mm to 14 mm, with 10 of the cases at or exceeding 10 mm and showing high density. Only three of the cases enlarged with time. Calcification appeared at 2.9 to 54.3 months postoperatively and the mean time of onset was 10.0 +/- 15.7 months. The mean age of the patients with PA calcification was 58.7 +/- 5.9 years while that of the patients without calcification was 57.3 +/- 10.0 years. Graft diameter was 5.9 +/- 1.9 mm in the former group and 5.6 +/- 1.7 mm in the latter. Serum cholesterol level was 235 +/- 32 mg/dl in the former group and 243 +/- 42 mg/dl in the latter. There were three cases of occlusion in the calcification group, and four in the other. There were no significant intergroup differences in these four parameters. The incidence of CT-detected calcification in the PA was found to be high at its point of contact with saphenous vein grafts. </hea
    International Journal of Angiology 02/2001; 10(1):53-57.
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    ABSTRACT: Continuous and uncontrolled wound pain frequently follows open heart surgery (median sternotomy). The authors investigated pain origins with x-ray computed tomography (CT). The assessment included 34 patients (29 males, 5 females, mean age 57 years) who underwent open heart surgery. All received unenhanced CT scans in horizontal 5 mm segments from the upper margin of the aortic arch to the diaphragm. Sternum alignment was measured on the horizontal sections. The maximum slide (mm) and number of slippage sections determined the severity of misalignment. Patients had postoperative wound pain duration (months) measurements and were grouped by an analogic pain scale three months after surgery: group 1, no pain or only slightly painful; group 2, ranging through painful, very painful, and unbearably painful. All received chest x-rays, Holter ECGs, stress ECGs and echocardiograms. Pain originating from angina pectoris, pericardial effusion or pleural effusion was excluded in all patients. Sternums were transfixed by 5 metal wires, and sternum cross-sections were clearly visible on the CT scans. Although no sternum separations existed, 29 of 34 patients had misalignments. The average vertical misalignment measured 5.53.6 mm (maximum 11 mm) with the average number of CT sections with misalignments being 21.29.5. The duration of post-operative pain was much longer for the 29 patients with misalignments than the 5 without misalignments (17.26.2 months and 3.92.5 months, respectively, p
    International Journal of Angiology 01/2000; 9(3):159-163.
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    ABSTRACT: Using X-ray computed tomography (CT) and selective graft angiography, the authors studied the necessity of metallic markers in coronary artery bypass grafts on 45 patients (mean age 57.2 years) with 87 saphenous vein grafts. Eight patients had 17 markers. X-ray CT was performed after surgery using an apparatus with a 1-second scanning time. Noncontrast X-ray CT was performed on horizontal sections, at 5-mm intervals, from the lower margin of the aortic arch to the lower left ventricle. A contrast medium was then injected into the antecubital vein (3 ml/second, total 30 ml) in one cross-section at the level of bifurcation of the pulmonary artery. Aortography (60 degrees in the left anterior and oblique positions, 20 ml/second, total 40 ml) was performed concurrently. Selective graft angiography was taken in the same direction, using 4 cm right of the Judkins with reference to the aortographic image and position of five clips on the sternum. Aortography revealed 79 patent and 8 occluded grafts. Selective graft angiography was easily performed even in grafts without markers. A cross-section of the occluded graft could not be seen with X-ray CT. Grafts with markers were often masked by artifacts produced by markers on X-ray CT. The number of observed graft slices (marker-positive grafts) was only 1.2 +/- 1.1 slices, significantly (p < 0.01) lower than marker-negative grafts (4.1 +/- 3.1 slices). In particular, the number of marker-positive right coronary artery grafts was 0.4 +/- 0.9 slices. Four of five right coronary artery grafts were unobservable due to artifacts. In grafts without markers, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of X-ray CT to graft patency were 100%, 85.7%, 98.4%, 100%, and 98.6%, respectively. This study suggests that metallic markers may not be necessary for coronary artery bypass grafts.
    International Journal of Angiology 02/1999; 8(1):29-32.
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    ABSTRACT: Using X-ray computed tomography (CT) and selective graft angiography, the authors studied the necessity of metallic markers in coronary artery bypass grafts on 45 patients (mean age 57.2 years) with 87 saphenous vein grafts. Eight patients had 17 markers. X-ray CT was performed after surgery using an apparatus with a 1-second scanning time. Noncontrast X-ray CT was performed on horizontal sections, at 5-mm intervals, from the lower margin of the aortic arch to the lower left ventricle. A contrast medium was then injected into the antecubital vein (3 ml/second, total 30 ml) in one cross-section at the level of bifurcation of the pulmonary artery. Aortography (60 in the left anterior and oblique positions, 20 ml/second, total 40 ml) was performed concurrently. Selective graft angiography was taken in the same direction, using 4 cm right of the Judkins with reference to the aortographic image and position of five clips on the sternum. Aortography revealed 79 patent and 8 occluded grafts. Selective graft angiography was easily performed even in grafts without markers. A cross-section of the occulded graft could not be seen with X-ray CT. Grafts with markers were often masked by artifacts produced by markers on X-ray CT. The number of observed graft slices (marker-positive grafts) was only 1.21.1 slices, significantly (p
    International Journal of Angiology 01/1999; 8(1):29-32.
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    ABSTRACT: The aim of this study was to evaluate the effects of pericardial effusion on coronary artery bypass grafts and their patency using X-ray computed tomography (CT). Uncontrasted CT of horizontal sections from the lower margin of the aortic arch to the left ventricle was done at 5-mm intervals. In one cross-section of the pulmonary bifurcation level, 30 ml of a contrast media (lohexol 350) was injected at a rate of 3 ml/second into the antecubital vein. All slices of uncontrasted CT were analyzed for the presence or absence of effusion. The severity was expressed as the maximum value of the thickness of effusion. CT was repeated about every 6 months postoperatively under the same conditions. Selective angiography was also performed 7.1 +/- 3.9 months postoperatively. A total of 46 patients (mean age 57 years) underwent CT and angiography. A total of 95 grafts were implanted: 90 saphenous veins and 5 internal thoracic arteries. Selective angiography revealed that 79 grafts were patent and 16 were occluded. The first postoperative CT (at 2.6 +/- 2.1 months) showed the retention of effusion in all patients. The mean maximum value was 1.0 +/- 0.5 cm; there were no significant differences between patent grafts (1.0 +/- 0.5 cm) and occluded grafts (1.0 +/- 0.5 cm). Occlusion was found in 10 grafts by the first CT (2.9 +/- 2.7 months postoperatively) and another 6 grafts by the second CT (11.3 +/- 4.2 months). Thereafter, all grafts were patent. Previously occluded grafts showed no cross-section images on uncontrasted or contrasted CT. Except for two grafts, all patent grafts could be observed even without contrast enhancement. The remaining two grafts were masked with effusion, but patency was confirmed by a contrast media. In conclusion, retention of effusion does not affect the patency of grafts. Occlusion occurs early after surgery, and grafts cannot be imaged on CT. Patent grafts can be observed by uncontrasted CT, as well as contrasted CT, except where a large amount of effusion is present.
    International Journal of Angiology 09/1998; 7(4):275-9.
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    ABSTRACT: The aim of this study was to evaluate the effects of pericardial effusion on coronary artery bypass grafts and their patency using X-ray computed tomography (CT). Uncontrasted CT of horizontal sections from the lower margin of the aortic arch to the left ventricle was done at 5-mm intervals. In one cross-section of the pulmonary bifurcation level, 30 ml of a contrast media (lohexol 350) was injected at a rate of 3 ml/second into the antecubital vein. All slices of uncontrasted CT were analyzed for the presence or absence of effusion. The severity was expressed as the maximum value of the thickness of effusion. CT was repeated about every 6 months postoperatively under the same conditions. Selective angiography was also performed 7.13.9 months postoperatively. A total of 46 patients (mean age 57 years) underwent CT and angiography. A total of 95 grafts were implanted: 90 saphenous veins and 5 internal thoracic arteries. Selective angiography revealed that 79 grafts were patent and 16 were occluded. The first postoperative CT (at 2.62.1 months) showed the retention of effusion in all patients. The mean maximum value was 1.00.5 cm; there were no significant differences between patent grafts (1.00.5 cm) and occluded grafts (1.00.5 cm). Occlusion was found in 10 grafts by the first CT (2.92.7 months postoperatively) and another 6 grafts by the second CT (11.34.2 months). Thereafter, all grafts were patent. Previously occluded grafts showed no cross-section images on uncontrasted or contrasted CT. Except for two grafts, all patent grafts could be observed even without contrast enhancement. The remaining two grafts were masked with effusion, but patency was confirmed by a contrast media. In conclusion, retention of effusion does not affect the patency of grafts. Occlusion occurs early after surgery, and grafts cannot be imaged on CT. Patent grafts can be observed by uncontrasted CT, as well as contrasted CT, except where a large amount of effusion is present.
    International Journal of Angiology 08/1998; 7(4):275-279.
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    ABSTRACT: Apical pulsed Doppler tissue imaging can be used to assess the function of regional myocardium. We hypothesized that septal dysfunction might be clarified in the hypertrophic cardiomyopathy (asymmetric septal hypertrophy) by this method. Twenty-one patients with asymmetric septal hypertrophy (mean age 54.8 +/- 11 years) and age-matched 24 normal subjects (52.4 +/- 8 years) were studied. The E/A ratio measured by mitral inflow Doppler was not different between the groups (1.1 vs 1.2). E wave velocities of the septum were significantly decreased in the hypertrophy group compared to the control group (4.0 +/- 1.5 vs 8.1 +/- 2.2 cm/sec), and A wave velocities were increased in the hypertrophic septum, resulting in a significantly lower E/A ratio (0.5 +/- 0.3) compared to the E/A ratio (0.9 +/- 0.3) of the normal septum. Deceleration time of the E wave and isovolumic relaxation time were significantly prolonged in the thick septum compared to the normal septum (136 +/- 51 vs 107 +/- 28 msec, 91 +/- 36 vs 63 +/- 19 msec, respectively). In conclusion, asymmetric septal hypertrophy was characterized by diastolic dysfunction of the thickened septum. Intramyocardial pulsed Doppler echocardiography can detect regional myocardial dysfunction earlier than the mitral inflow Doppler method.
    Journal of Cardiology 07/1998; 31(6):351-60. · 2.30 Impact Factor
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    ABSTRACT: A 66-year-old man presented with Ebstein's anomaly associated with left ventricular dysfunction. He had been followed since 40 years of age for cardiomegaly and arrhythmia, and experienced episodes of orthopnea at the age of 64. He was referred to our hospital in April 1997 because of lower extremity edema. Physical examination revealed dilated external jugular vein, tenderness of the right hypocondorium, and lower extremity edema. Electrocardiography confirmed atrial fibrillation. Transthoracic echocardiography revealed bilateral atrial and ventricular dilation, and paradoxical septal movement. The apical four-chamber view demonstrated 15 mm apical displacement of the septal leaflet. Color Doppler echocardiography revealed moderate tricuspid regurgitation. Transesophageal echocardiography revealed low echoic and hypoplastic tricuspid valve. Left ventriculography showed diffuse hypokinesis, and the ejection fraction was 49%. The coronary artery was normal. Atrial septal defect was not detected. Diffuse fibrosis, which may be found in the hearts of patients with Ebstein's anomaly at autopsy may have been responsible for the left ventricular depressed systolic function in this patient.
    Journal of Cardiology 02/1998; 31 Suppl 1:131-6; discussion 137. · 2.30 Impact Factor
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    ABSTRACT: The purpose of this study was to examine possible correlations among age, arteriosclerotic risk factors, and specific sites of calcification in the thoracic aorta as detected by X-ray computed tomography (CT). A total of 80 patients (mean age 599 years, 50 M/30 Fe) included 34 patients with ischemic heart disease, 32 with chest pain syndrome, 5 with valvular heart disease, and 9 with other diseases. The thoracic aortic calcification score, based on X-ray CT images, is the sum of the length (cm) of calcification detected in 1-cm-interval horizontal cross-sections. Differences in calcification were compared for patients with and without hypertension, diabetes, and hyperlipemia. Calcification occurred more often in the external left arch wall (52 cases), followed by the lower arch wall (50 cases). Calcification in the ascending aorta was detected in only 18 cases. Aortic calcification score ranged from 0 to 103.3 points with a mean of 8.814.9 points, showing a significant correlation (r=0.48,p
    International Journal of Angiology 01/1997; 6(1):1-4.
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    ABSTRACT: Doppler tissue imaging-guided pulsed Doppler echocardiography can record velocities of the regional ventricular wall, but the potential clinical applications have not yet been investigated. To propose a new modality for assessment of left ventricular wall dynamics, we investigated the longitudinal and latitudinal motions of the normal left ventricular wall with intramyocardial pulsed Doppler echocardiography under tissue imaging guidance, and characterized the velocity patterns in 31 normal subjects or normal volunteers (mean age 38 +/- 18 years old). Velocity patterns of the septal and posterior walls were recorded and compared using the parasternal and apical approaches. The apical approach showed that the entire left ventricle moved, coded in red, toward the transducer during systole, and moved away, coded in blue, during diastole. Pulsed Doppler echocardiography recorded the systolic S, early diastolic E and presystolic A waves from both windows. All three waves had higher velocities in the apical compared to the parasternal approach, and the velocities of S and E waves were increased more in the posterior wall than in the septum. Thus, the A/E ratio was significantly lower in the posterior compared to the septal wall (0.63 +/- 0.3 and 0.77 +/- 0.3, respectively, in the apical approach) and the A/E ratio of transmitral inflow was between those of the walls. Apical intramyocardial pulsed Doppler echocardiography can accurately evaluate septal and posterior wall dynamics. The present study provides important basic data for assessing regional myocardial function.
    Journal of Cardiology 09/1996; 28(2):85-92. · 2.30 Impact Factor
  • E Tamiya, Y Hada
    Journal of Cardiology 07/1996; 27(6):339-40. · 2.30 Impact Factor
  • E Tamiya, Y Hada
    Journal of Cardiology 06/1996; 27(5):273-5. · 2.30 Impact Factor