Takahisa Kondo

Social Insurance Chukyo Hospital, Nagoya, Aichi, Japan

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Publications (93)388.9 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Early ambulation after open abdominal aortic aneurysm (AAA) surgery is assumed to play a key role in preventing postoperative complications and reducing hospital length of stay. However, the factors predicting early ambulation after open AAA surgery have not yet been sufficiently investigated. Here, we investigated which preoperative and intraoperative variables are associated with start time for ambulation in patients after open AAA surgery. A total of 67 consecutive patients undergoing open AAA surgery were included in the study [male, 62 (92 %); mean age, 68 years (range, 47-82 years), mean AAA diameter, 53 mm (range, 28-80 mm)]. Preoperative physical activity was examined by means of 6-min walk distance (6MWD) and a medical interview. Patients were divided into two groups, according to when independence in walking was attained: early group <3 days (n = 36) and late group ≥3 days (n = 31), and the pre-, intra-, and postoperative recovery data were compared. There were no significant differences in patient baseline characteristics or intraoperative data between the two groups. The number of patients engaging in preoperative regular physical activity and 6MWD were significantly greater (p = 0.042 and p = 0.034, respectively) in the early group than in the late group. In addition, time to hospital discharge was significantly shorter in the early group than in the late group (p = 0.031). Binary logistic regression analysis showed that preoperative regular physical activity was the only independent factor for identifying patients in the early group (odds ratio 2.769, 95 % confidence interval 1.024-7.487, p = 0.045). These results suggest that engaging in regular physical activity is an effective predictor of early ambulation after open AAA surgery.
    Heart and Vessels 02/2015; DOI:10.1007/s00380-015-0644-6 · 2.11 Impact Factor
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    ABSTRACT: There is a link between sympathetic overactivity and sleep-disordered breathing (SDB), and both of which are important indicators of the development of heart failure. To manage the increasing numbers of heart failure patients, any method used to check for them needs to be as non-invasive, simple, and cost-effective as possible. The purpose of this study is to assess screening of SDB with a non-restrictive monitor and the autonomic nervous system in heart failure patients. The subjects were 49 patients (mean age: 67 years; male: 78%) hospitalized for worsening heart failure. After stabilization with appropriate medical therapy, each patient simultaneously underwent sleep apnea syndrome (SAS) screening with the SD-101 (Kenzmedico Co. Ltd., Saitama, Japan), which is a novel, non-restrictive, sheet-like monitor for SAS screening, and assessment of heart rate variability (HRV) with a Holter monitor. In addition, we assessed daytime sleepiness by using the Epworth Sleepiness Scale. The mean respiratory disturbance index (RDI) was 21.9events/h. Males had significantly greater RDI values than females (24.5±11.2events/h vs. 13.0±6.2events/h, p<0.001). RDI on SD-101 testing was closely correlated with cyclic variation of heart rate index obtained with a Holter electrocardiogram scanner (r=0.843). Although plasma brain natriuretic peptide level was not correlated with HRV, plasma norepinephrine level was moderately well correlated with the total low- to high-frequency ratio of HRV (r=0.529). SAS screening is important for heart failure patients, because absence of subjective sleepiness is not reliable in ruling out SDB. The SAS screening with SD-101 might apply for managing heart failure. Copyright © 2015. Published by Elsevier Ltd.
    Journal of Cardiology 02/2015; DOI:10.1016/j.jjcc.2014.12.018 · 2.57 Impact Factor
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    ABSTRACT: Statin therapy moderately increases high-density lipoprotein cholesterol (HDL-C) levels. Contrary to this expectation, a paradoxical decrease in HDL-C levels after statin therapy is seen in some patients. We evaluated 724 patients who newly started treatment with statins after acute myocardial infarction (AMI). These patients were divided into 2 groups according to change in HDL-C levels between baseline and 6 to 9 months after initial AMI (ΔHDL). In total, 620 patients had increased HDL-C levels and 104 patients had decreased HDL-C levels. Both groups achieved follow-up low-density lipoprotein cholesterol levels <100 mg/dl. Adverse cardiovascular events (a composite of all-cause death, myocardial infarction, and stroke) have more frequently occurred in the decreased HDL group compared with the increased HDL group (15.4% vs 7.1%, p = 0.01). Multivariate analysis showed that decreased HDL, onset to balloon time, and multivessel disease were the independent predictors of adverse cardiovascular events (hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.08 to 3.52; HR 1.05, 95% CI 1.01 to 1.09; and HR 2.08, 95% CI 1.22 to 3.56, respectively). In conclusion, a paradoxical decrease in serum HDL-C levels after statin therapy might be an independent predictor of long-term adverse cardiovascular events in patients with AMI. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American Journal of Cardiology 12/2014; DOI:10.1016/j.amjcard.2014.11.043 · 3.43 Impact Factor
  • Journal of Cardiac Failure 10/2014; 20(10):S141. DOI:10.1016/j.cardfail.2014.07.074 · 3.07 Impact Factor
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    ABSTRACT: Background Rivaroxaban is currently used to prevent stroke in patients with atrial fibrillation. Measuring coagulation function may help clinicians to understand the effects of this drug and the associated risk of bleeding. Methods and results Rivaroxaban was given to 136 patients with non-valvular atrial fibrillation. Mean age was 74.5 ± 9.0 years (men: 63.2%) and mean CHADS2 score (±SD) was 1.8 ± 1.2. Prothrombin times (PTs) and plasma soluble fibrin (SF) levels were examined in 84 out of 136 patients at baseline and at least 2 weeks thereafter. In 48 patients we were able to collect blood at exact times, namely just before and 3 h after rivaroxaban administration, corresponding to the trough and peak concentrations. Mean peak PT in 48 patients was 17.1 ± 3.6 s and median peak SF level was 1.46 μg/mL. Multiple regression analysis showed that female sex, high brain natriuretic peptide, and high dose were independent factors prolonging the peak PT. Patients with peak PTs ≥20 s experienced significantly more bleeding events. Among 29 of 46 patients newly treated with rivaroxaban without any previous anticoagulant, we examined coagulation function at the exact trough and peak times. In 29 patients, peak PT was significantly more prolonged than the baseline or trough PT (p < 0.001 for both), whereas trough PT was comparable to the baseline PT. In contrast, both trough and peak SF levels in these newly treated patients were significantly reduced than at baseline (p = 0.003 and p < 0.001, respectively). Conclusions In Japanese patients with non-valvular atrial fibrillation receiving rivaroxaban, a prolonged peak PT (≥20 s) could indicate increased risk of bleeding, and both trough and peak SF levels were reduced relative to baseline. PT and SF are both valuable measures of coagulation status in patients receiving rivaroxaban, regardless of prior anticoagulant history.
    Journal of Cardiology 09/2014; DOI:10.1016/j.jjcc.2014.07.021 · 2.57 Impact Factor
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    ABSTRACT: Background: Peak oxygen consumption (peak VO2) and late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) are prognostic in heart failure. We investigated whether LGE-CMR and peak VO2 combined had additive value in risk stratifying patients with nonischemic dilated cardiomyopathy (DCM). Methods and Results: Fifty-seven DCM patients underwent CMR and cardiopulmonary exercise testing. Cardiac events were cardiac death, hospitalization for decompensated heart failure, or lethal arrhythmia. Twenty-five (44%) were LGE-positive. The median peak VO2 was 18.5 mL.kg(-1).min(-1). On multivariate analysis, positive LGE (P = .048) and peak VO2 (P =.003) were independent cardiac event predictors. Cardiac event risk was significantly higher with positive LGE and peak VO2 < 18.5 mL.kg(-1).min(-1) than with negative LGE and peak VO2 >= 18.5 mL.kg(-1).min(-1) (hazard ratio 12.5; 95% CI 1.57-100; P = .017). In 3 patient groups (group A: no LGE, peak VO2 >= 18.5 mL.kg(-1).min(-1), n = 18; group B: positive LGE or peak VO2 < 18.5 mL.kg(-1).min(-1), n = 24; group C: positive LGE and peak VO2 < 18.5 mL.kg(-1).min(-1), n = 15) during follow-up (71 +/- 32 months), group C had higher cardiac event rates than the others. Conclusions: Combined assessment of LGE-CMR and peak VO2 provides additive prognostic information in ambulatory DCM.
    Journal of Cardiac Failure 08/2014; 20(11). DOI:10.1016/j.cardfail.2014.08.005 · 3.07 Impact Factor
  • Circulation Journal 04/2014; 78(5). DOI:10.1253/circj.CJ-14-0320 · 3.69 Impact Factor
  • Hypertension Research 03/2014; DOI:10.1038/hr.2014.37 · 2.94 Impact Factor
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    ABSTRACT: Background: Pulmonary hypertension (PH) because of left-sided heart disease carries a poor prognosis. We investigated whether non-ischemic dilated cardiomyopathy (DCM) with PH is associated with poor prognosis. Methods and Results: A total of 256 consecutive DCM patients were enrolled. We measured the ratio of the maximum first derivative of left ventricular pressure (LVdP/dtmax)/systolic blood pressure and pressure half-time (T1/2) as cardiac function. Patients were allocated to 2 groups on the basis of mean pulmonary arterial pressure (mPAP), namely DCM without PH group (mPAP <25mmHg; n=225) and DCM with PH group (mPAP ≥25mmHg; n=31). We followed all patients for a mean of 4.3 years for the occurrence of cardiac events, defined as cardiac death or hospitalization for worsening heart failure. Cardiac events were significantly more frequent in the DCM with PH group than in the DCM without PH group (P<0.001). Multivariate Cox regression analysis revealed that mPAP ≥25mmHg and LV end-systolic volume index were significant independent risk factors for cardiac death. Incidence of cardiac death was significantly higher in patients with DCM with PH than in those without PH [hazard ratio 11.79 (3.18-43.7), P<0.0001]. Conclusions: The presence of PH was independently associated with an increased incidence of cardiac death in ambulatory patients with DCM.
    Circulation Journal 03/2014; 78(5). DOI:10.1253/circj.CJ-13-1120 · 3.69 Impact Factor
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    ABSTRACT: Aims The 6-minute walking distance is often used for assessing the exercise capacity under the treatment with an endothelin receptor antagonist (ERA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The cardiopulmonary exercise testing (CPX) was reported to be more useful for the patients with pulmonary arterial hypertension (PAH), however, few reports exist in patients with inoperable CTEPH. The aim of this study was to investigate the effects of an oral dual ERA, bosentan, on exercise capacity using CPX in patients with PAH and inoperable CTEPH. Main Methods This study included all patients diagnosed with 17 PAH and 12 CTEPH in World Health Organization functional class II-IV who started treatment with bosentan therapy. They underwent CPX, which was performed before bosentan therapy and at 3 to 6 months of the treatment. Key findings In PAH patients, peak VO2 significantly increased after the bosentan treatment (p = 0.009). On the other hand, in CTEPH patients, there were no significant differences in the peak VO2. However, the peak PETCO2 was significantly increased from 23.9 ± 5.2 mmHg at baseline to 29.3 ± 10.7 mmHg after the bosentan treatment (p = 0.040). In addition, peak heart rate during exercise tended to decrease after the bosentan therapy (p = 0.089). Significance Bosentan therapy improved peak PETCO2 but not peak VO2 in patients with inoperable CTEPH. These findings demonstrated that CPX is useful for assessing exercise capacity of patients with PAH and inoperable CTEPH under the treatment with an ERA.
    Life sciences 03/2014; 118(2). DOI:10.1016/j.lfs.2014.03.009 · 2.56 Impact Factor
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    ABSTRACT: Aims To clarify the prognosis and prognostic factors in pulmonary arterial hypertension (PAH) patients in real-world medical practice of Tokai area in Japan. Main Methods We conducted a retrospective, multicenter observational study. The data of 81 patients diagnosed as Dana Point group 1 or 1’ PAH was collected from January 2005 to January 2013. The primary outcome was all-cause death. Key findings The patients consisted of 34 cases of idiopathic PAH (IPAH), 28 of connective tissue-associated PAH (CTD-PAH), 16 of congenital heart disease- associated PAH (CHD-PAH) and others. Mean age was 51 years and mean observation period was 46 months. The systolic blood pressure (BPs) was 117 ± 23 mmHg. Pericardial effusion was observed in 27.0% of patients. The mean right atrial pressure (mRAP) was 10.2 ± 7.3 mmHg. In the univariate Cox regression analysis, WHO-FC III & IV, a cardiac index (CI) < 2.5 L/min/m2, and the presence of pericardial effusion at baseline were significantly associated with all-cause death. In the multivariate analysis, the pericardial effusion (HR 3.3, 95%CI 1.03-10.63, p = 0.04) and mRAP (HR 3.2, 95%CI 1.03-9.83, p = 0.04) or CI < 2.5 L/min/m2 (HR 3.89, 95%CI 1.05-14.45, p = 0.04) were the independent predictors of mortality. Significance The presence of pericardial effusion and mRAP or CI < 2.5 L/min/m2 at diagnosis indicated high mortality.
    Life sciences 03/2014; 118(2). DOI:10.1016/j.lfs.2014.03.002 · 2.56 Impact Factor
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    ABSTRACT: A 43-year-old man presented with dyspnea on exertion. Right heart catheterization demonstrated pulmonary arterial hypertension (PAH). He was treated with bosentan, sildenafil and intravenous epoprostenol. Despite the administration of such intensive therapy, the patient's condition deteriorated to a World Health Organization functional class (WHO-FC) of IV. He participated in a clinical trial of imatinib for PAH. After three months of treatment with imatinib, the chest X-ray and echocardiography findings improved, and the WHO-FC class was III. One year after, however, the PAH worsened again, and the patient died 2.6 years after the first diagnosis. At autopsy, patchy capillary proliferation was observed in the lungs. The definitive diagnosis was pulmonary capillary hemangiomatosis.
    Internal Medicine 01/2014; 53(6):603-7. DOI:10.2169/internalmedicine.53.1157 · 0.97 Impact Factor
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    ABSTRACT: To investigate the independent associations of proteinuria and the estimated glomerular filtration rate (eGFR) with incident hypertension. We investigated 29,181 Japanese males 18-59years old without hypertension in 2000 and examined whether proteinuria and the eGFR predicted incident hypertension independently over 10years. Incident hypertension was defined as a newly detected blood pressure of ≥140/90mmHg and/or the initiation of antihypertensive drugs. Proteinuria and the eGFR were categorized as dipstick negative (reference), trace or ≥1+ and ≥60 (reference), 50-59.9 or <50ml/min/1.73m(2), respectively. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of incident hypertension. At baseline, 236 (0.8%) and 477 (1.6%) participants had trace and ≥1+ dipstick proteinuria, while 1,416 (4.9%) and 129 (0.4%) participants had an eGFR of 50-59.9 and <50ml/min/1.73m(2), respectively. The adjusted HRs were significant for proteinuria ≥1+ (HRs 1.20, 95% CI: 1.06-1.35) and an eGFR of <50ml/min/1.73m(2) (1.29, 1.03-1.61). When two non-referent categories were combined (dipstick≥trace vs. negative and eGFR <60 vs. ≥60ml/min/1.73m(2)), the association was more significant for proteinuria (1.15, 1.04-1.27) than for eGFR (0.99, 0.92-1.07). Proteinuria and a reduced eGFR are independently associated with future hypertension in young to middle-aged Japanese males.
    Preventive Medicine 12/2013; DOI:10.1016/j.ypmed.2013.12.009 · 2.93 Impact Factor
  • Life Sciences 12/2013; 93(25-26):e44-e45. DOI:10.1016/j.lfs.2013.12.155 · 2.30 Impact Factor
  • Life Sciences 12/2013; 93(25-26):e46-e47. DOI:10.1016/j.lfs.2013.12.161 · 2.30 Impact Factor
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    ABSTRACT: Background: Low adiponectin levels and high leptin levels are associated with a high incidence of developing cardiovascular disease. However, the relationship between the levels of these adipokines and the development of adverse events after acute myocardial infarction (AMI) remains unclear. Methods and Results: This study enrolled 724 Japanese subjects with AMI who underwent successful emergency percutaneous coronary intervention (PCI). Their serum adiponectin and leptin levels were measured 7 days after AMI onset. There were 63 adverse events during the 3-year follow-up. The levels of adiponectin and leptin and the leptin to adiponectin ratio, were significantly associated with adverse events [hazard ratio 2.08 (95% confidence interval (CI) 1.33-3.24), P=0.001; hazard ratio 0.62 (95% CI 0.43-0.90), P=0.012; hazard ratio 0.59 (95% CI 0.45-0.76), P<0.001, respectively]. The leptin to adiponectin ratio remained a significant independent predictor of adverse events during long-term follow-up in a multivariable analysis [adjusted hazard ratio 0.60 (95% CI 0.43-0.83), P=0.002]. Conclusions: Higher adiponectin and lower leptin levels are associated with a high incidence of adverse events in Japanese patients after AMI, and the leptin to adiponectin ratio independently predicts prognosis after AMI.
    Circulation Journal 11/2013; 77(11):2778-2785. DOI:10.1253/circj.CJ-13-0251 · 3.69 Impact Factor
  • Journal of Cardiac Failure 10/2013; 19(10):S133. DOI:10.1016/j.cardfail.2013.08.150 · 3.07 Impact Factor
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    ABSTRACT: Recently, we reported that angiotensin II receptor blocker (ARB), valsartan, and calcium channel blocker (CCB), amlodipine, had similar effects on the prevention of cardiovascular disease (CVD) events in diabetic hypertensive patients. We assessed the difference of cardiovascular protective effects between ARB and CCB in patients with and without previous CVD, respectively. A total of 1,150 Japanese diabetic hypertensive patients were randomized to either valsartan or amlodipine treatment arms, which were additionally divided into 2 groups according to the presence of previous CVD at baseline (without CVD, n = 818; with CVD, n = 332). The primary composite outcomes were sudden cardiac death, acute myocardial infarction, stroke, coronary revascularization, or hospitalization for heart failure. The incidence of primary end point events in patients with previous CVD was 3.5-times greater than that in patients without previous CVD (64.1 vs 17.9/1,000 person-years). The ARB- and the CCB-based treatment arms showed similar incidence of composite CVD events in both patients without previous CVD (hazard ratio [HR] 1.35, 95% confidence interval [CI] 0.76 to 2.40) and those with previous CVD (HR 0.79, 95% CI 0.48 to 1.31). The ARB-treatment arm showed less incidence of stroke compared with the CCB-based treatment arm in patients with previous CVD (HR 0.24, 95% CI 0.05 to 1.11, p = 0.068), whereas the 2 treatment arms showed similar incidence of stroke in patients without previous CVD (HR 1.52, 95% CI 0.59 to 3.91). In conclusion, the ARB- and the CCB-based treatments exerted similar protective effects of CVD events regardless of the presence of previous CVD. For stroke events, the ARB may have more protective effects than the CCB in diabetic hypertensive patients with previous CVD.
    The American journal of cardiology 09/2013; 112(11). DOI:10.1016/j.amjcard.2013.07.043 · 3.58 Impact Factor
  • Journal of Hypertension 09/2013; 31(9):1920-1921. DOI:10.1097/HJH.0b013e328363e891 · 4.22 Impact Factor
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    ABSTRACT: Mitochondrial damage is associated with histologic myocardial fibrosis. Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) can be used to identify focal fibrosis. We examined whether myocardial fibrosis on CMR and collagen volume fraction (CVF) from biopsies correlated with left ventricular (LV) and mitochondrial function in patients with nonischemic dilated cardiomyopathy (DCM). Fifty-nine DCM patients underwent CMR, cardiac catheterization, and endomyocardial biopsy. Minimum first derivative of LV pressure (LVdP/dtmin) was measured as an index of LV relaxation. Mitochondrial RNA expression was also analyzed. For quantitative analysis of myocardial fibrosis, percentage LGE (%LGE) and CVF were calculated. Patients were divided into 2 groups on the basis of the presence (LGE group; n = 27) or absence (non-LGE group; n = 32) of LGE. Mean CVF and absolute value of LVdP/dtmin were significantly higher and lower, respectively, in the LGE group than in the non-LGE group. Multivariate analysis revealed that %LGE was an independent determinant of LVdP/dtmin. The abundance of mitochondrial enzyme mRNA was significantly lower in the LGE group. Noninvasive CMR imaging is more useful in predicting diastolic dysfunction than invasive histologic assessments. In addition, it might indicate mitochondrial dysfunction in DCM.
    Journal of cardiac failure 08/2013; 19(8):557-64. DOI:10.1016/j.cardfail.2013.05.018 · 3.07 Impact Factor

Publication Stats

2k Citations
388.90 Total Impact Points

Institutions

  • 2011
    • Social Insurance Chukyo Hospital
      Nagoya, Aichi, Japan
  • 2001–2011
    • Nagoya University
      • • Division of Cardiology
      • • Division of of Internal Medicine
      Nagoya, Aichi, Japan
  • 2007
    • Mie University
      • Life Science Research Center
      Tsu-shi, Mie-ken, Japan
    • Yanbian University
      Yang-chi-t'eng, Jilin Sheng, China
  • 2004
    • National Cerebral and Cardiovascular Center
      Ōsaka, Ōsaka, Japan
    • Osaka City University
      Ōsaka, Ōsaka, Japan