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Eisuke Amiya,
Munenori Takata,
Masafumi Watanabe,
Takehiro Takahashi,
Yoshihide Asano,
Masaru Hatano, Atsuko Ozeki,
Aya Watanabe,
Shuichi Kawarasaki,
Zenshiro Tamaki,
Takashi Taniguchi,
Yohei Ichimura,
Tetsuo Toyama,
Ryozo Nagai,
Shinichi Sato,
Issei Komuro
International journal of cardiology 05/2013; · 7.08 Impact Factor
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Takehiro Takahashi,
Yoshihide Asano,
Eisuke Amiya,
Masaru Hatano,
Zenshiro Tamaki,
Munenori Takata, Atsuko Ozeki,
Aya Watanabe,
Shuichi Kawarasaki,
Takashi Taniguchi,
Yohei Ichimura,
Tetsuo Toyama,
Masafumi Watanabe,
Yasunobu Hirata,
Ryozo Nagai,
Issei Komuro,
Shinichi Sato
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ABSTRACT: OBJECTIVE: To investigate the clinical significance of flow-mediated dilation (FMD) in systemic sclerosis (SSc). METHODS: Thirty-three SSc patients and 12 healthy controls were studied. Ultrasound assessment of the brachial artery FMD was performed on all subjects. The results were expressed as the percentage of increase in brachial artery diameter following hyperemia. RESULTS: Limited cutaneous SSc (lcSSc) patients had significantly lower FMD values than healthy controls (5.3 ± 2.7 versus 7.7 ± 2.0 %, p < 0.05), while the values in diffuse cutaneous SSc (dcSSc) patients (6.7 ± 4.0 %) were comparable to those in lcSSc patients and healthy controls. Although FMD values did not correlate with any clinical features in dcSSc patients, there was an inverse correlation between FMD values and disease duration in lcSSc patients (r = -0.64, p < 0.05). Furthermore, lcSSc patients with decreased FMD values showed significantly higher prevalence of digital ulcers and elevated right ventricular systolic pressure than those with normal values (for each; 75 versus 10 %, p < 0.05). CONCLUSION: The FMD values represent the severity of vascular damages, which progress along with disease duration and lead to digital ulcers and pulmonary arterial hypertension, in lcSSc patients.
Modern Rheumatology 03/2013; · 1.58 Impact Factor
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Eisuke Amiya,
Masafumi Watanabe,
Munenori Takata,
Shogo Watanabe, Atsuko Ozeki,
Aya Watanabe,
Shuichi Kawarasaki,
Tomoko Nakao,
Yumiko Hosoya,
Kazuko Omori,
Koji Maemura,
Yasunobu Hirata,
Ryozo Nagai,
Issei Komuro
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ABSTRACT: Background: Differences in regulating factors and the clinical implications of body temperature variability (BTV) between subjects with and without diabetes have not been clarified to date. Methods and Results: In 66 subjects with ischemic heart disease (33 with diabetes and 33 without diabetes), BTV, the difference between the highest and lowest temperature measurements, and body temperature standard deviation (BT SD) were measured from axillary body temperature (ABT) records of 3 consecutive days and followed for 16.4±8.4 months. In subjects without diabetes BTV and BT SD were closely associated with endothelial function as evaluated on flow-mediated dilation (BTV, R=0.33, P=0.026; BT SD, R=0.41, P=0.029), whereas there was a poor association in subjects with diabetes. In the absence of an interrelationship between vascular function and thermoregulation, the contribution of inflammation to BTV was increased in subjects with diabetes (BTV, 0.59±0.21°C for C-reactive protein [CRP] <0.08mg/dl vs. 0.79±0.28°C for CRP >0.08mg/dl, P=0.014). Event-free survival analysis showed that in subjects with diabetes higher BT SD was associated with shorter event-free survival (log-rank P=0.012), but this relationship was not found in subjects without diabetes. Conclusions: In subjects with diabetes, the interrelationship between thermoregulation and vascular function was disrupted and the effect of inflammation on thermoregulation was enhanced, so that BTV had a sufficient predictive value for cardiovascular events in diabetic subjects.
Circulation Journal 03/2013; · 3.77 Impact Factor
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Shogo Watanabe,
Eisuke Amiya,
Masafumi Watanabe,
Munenori Takata, Atsuko Ozeki,
Aya Watanabe,
Shuichi Kawarasaki,
Tomoko Nakao,
Yumiko Hosoya,
Kazuko Omori,
Koji Maemura,
Issei Komuro,
Ryozo Nagai
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ABSTRACT: Background: Endothelial dysfunction and autonomic nervous system imbalance are both risk markers of atherosclerotic vascular damage. The relationship between these 2 factors, however, has not been clarified concisely. Methods and Results: Flow-mediated dilation (FMD) was measured in 47 patients with ischemic heart disease (IHD; mean age, 68.1±7.1 years) using an ultrasound semi-automatic measuring system (UNEXEF18G), and autonomic nervous system activity was evaluated by simultaneous measurements of heart rate variability. FMD was significantly correlated with standard deviation of normal-to-normal beats (r=0.33, P=0.022) and the power ratio of low-frequency power to high-frequency power (LF/HF; r=-0.38, P=0.0087). Furthermore, multiple regression analysis indicated that LF/HF was the most important predictor of the magnitude of FMD. This interaction was severely blunted by β-blockers and the presence of diabetes. Moreover, standardized FMD according to autonomic nervous system activity was a better predictor of future cardiovascular events than FMD. Subjects with cardiovascular events had a significantly smaller corrected FMD (event (+), 3.62±0.41; event (-), 5.10±2.35; P=0.001), and the higher corrected FMD was associated with longer event-free survival. Conclusions: Autonomic nervous system activity is an important regulatory factor of FMD in subjects with IHD. Assessment of this interaction can help provide more accurate risk stratification of subjects with IHD.
Circulation Journal 12/2012; · 3.77 Impact Factor
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Takehiro Takahashi,
Yoshihide Asano,
Eisuke Amiya,
Masaru Hatano,
Zenshiro Tamaki, Atsuko Ozeki,
Aya Watanabe,
Shuichi Kawarasaki,
Tomoko Nakao,
Takashi Taniguchi,
Yohei Ichimura,
Tetsuo Toyama,
Masafumi Watanabe,
Yasunobu Hirata,
Ryozo Nagai,
Shinichi Sato
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ABSTRACT: Intravenous cyclophosphamide pulse therapy (IVCY) exerts its efficacy against interstitial lung disease (ILD) associated with systemic sclerosis (SSc) by restoring vascular injuries as well as aberrant immune activation. We recently experienced two patients with SSc-ILD in whom the values of brachial flow-mediated dilation (FMD) reflected the efficacy of IVCY. We herein report the details of these cases and discuss the potential of FMD to predict and evaluate the effect of IVCY on SSc-ILD.
Modern Rheumatology 10/2011; 22(4):598-601. · 1.58 Impact Factor
