Hiroshi Ito

Akita University, Akita, Akita, Japan

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Publications (455)1830.61 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Coronary artery calcification (CAC) is associated with the incidence of congestive heart failure. We evaluated the association between CAC and left ventricular diastolic dysfunction (LVDD) in elderly patients without coronary artery disease. Coronary computed tomography was performed in 1,021 consecutive patients >55 years of age who were suspected of having coronary artery disease. A total of 530 patients (age, 70 ± 8 years; 56 % men) with a LV ejection fraction >50 % and without obstructive coronary artery disease and a history of coronary artery disease were included in the analysis. LVDD was defined according to a standard algorithm by echocardiography (septal e' <8, lateral e' <10, and left atrial volume index ≥34 mL/m(2)). A total of 224 of 530 patients had LVDD. CAC scores in patients with LVDD were higher than those in patients without LVDD (p < 0.01). The prevalence of LVDD in patients with CAC scores ≥400 was greater than that in patients with CAC scores of 0-9 (58 vs. 34 %, p < 0.01). After adjustment for confounding factors, the CAC score was associated with LVDD, with an odds ratio of 1.96 (95 % confidence interval: 1.11-3.43, p = 0.02) for a CAC score ≥400 compared with a CAC score of 0-9. A CAC score ≥400 was associated with LVDD in elderly patients without CAD in this population. Further prospective studies are needed to evaluate the clinical relevance of CAC as a risk of heart failure with preserved ejection fraction.
    Heart and vessels. 02/2015;
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    ABSTRACT: RIPC reduced acute kidney injury after emergency percutaneous coronary intervention.•RIPC was safe and was an easy strategy in real clinical settings.•RIPC is a promising strategy in patients with ST-elevation myocardial infarction.
    International Journal of Cardiology 01/2015; 178. · 6.18 Impact Factor
  • Circulation Journal 01/2015; · 3.69 Impact Factor
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    ABSTRACT: Postprandial hypertriglyceridemia impairs endothelial function and plays an important role in the development of atherosclerosis. The aim of the present study was to examine the postprandial effects of the dipeptidyl peptidase-4 inhibitor vildagliptin and the α-glucosidase inhibitor voglibose on endothelial dysfunction and lipid profiles following a single administration. A randomized cross-over trial using 11 normoglycemic individuals was performed. The postprandial effects of a single administration of vildagliptin (50 mg) or voglibose (0.3 mg) on endothelial function were analyzed using brachial artery flow-mediated dilation (FMD) and lipid profiles during fasting and 1.5 and 3 h after an oral cookie-loading test. Compared with voglibose, vildagliptin significantly suppressed postprandial endothelial dysfunction, (%FMD, -1.6±0.9 vildagliptin vs. -4.0±0.7 voglibose; P=0.01) and the postprandial incremental increase in the triglyceride level (28±18 vildagliptin vs. 51±26 mg/dl voglibose; P=0.01) 3 h after a cookie-loading test. In addition, vildagliptin significantly increased the levels of glucagon-like peptide-1 compared with voglibose 3 h after a loading cookie test (4.4±0.6 vs. 2.9±0.7 pmol/l, respectively; P=0.04). No significant differences in the levels of glucose, apolipoprotein B-48, glucagon or insulin were observed between vildagliptin and voglibose treatments. In conclusion, a single administration of vildagliptin attenuated postprandial endothelial dysfunction and postprandial hypertriglyceridemia, suggesting that vildagliptin may be a promising antiatherogenic agent.
    Experimental and therapeutic medicine 01/2015; 9(1):84-88. · 0.94 Impact Factor
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    ABSTRACT: A simplified diagnostic/monitoring instrument for use in primary screening for sleep-disordered breathing (SDB) has been desired. This study was designed to assess the validity of a newly developed piezoelectric sensor as a simple and noninvasive tool for primary screening for sleep-disordered breathing. Forty-three consecutive patients suspected of having sleep-disordered breathing and 10 healthy volunteers were enrolled. Breathing movement was detected with the piezoelectric sensor (180 × 30 × 1 mm), which was placed under a bed sheet under patients, and simultaneous polysomnographic recordings were obtained. We counted the number of apneas of >10 s, irrespective of central or obstructive, that appeared during Cheyne-Stokes-like breathing with a waxing and waning pattern with an amplitude ratio of >10 in the piezoelectric sensor signal. The correlation coefficient between the number of apneas and apnea–hypopnea index (AHI) was 0.74 (P < 0.0001). The sensitivity/specificity of the number of apneas for distinguishing non-SDB patients from mild SDB patients (AHI ≥ 5) were 92.1/60.0% and those for separating moderate to severe (AHI ≥ 15) and severe (AHI ≥ 30) SDB patients from the other patients were 96.9/100% and 93.8/86.5%, respectively. There were no complaints from patients about the use of the piezoelectric sensor. The results indicate that the number of apneas detected by this piezoelectric sensor during Cheyne-Stokes-like breathing is a potential new index for primary screening for SDB at least for cardiac patients. Thus, the piezoelectric-sensor system might be useful for simple, noninvasive and comfortable SDB screening at home, hospitals and health care facilities.
    Sleep and Biological Rhythms 01/2015; · 1.05 Impact Factor
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    International Journal of Cardiology 12/2014; 182C:216-218. · 6.18 Impact Factor
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    Circulation 12/2014; 130(25):2351-3. · 14.95 Impact Factor
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    ABSTRACT: This study investigated the effects of patients’ genetic variations in the pharmacokinetics of gefitinib at steady-state. We analyzed 31 NSCLC Japanese patients treated with gefitinib. We focused on common polymorphisms within important gefitinib exposure genes, including CYP3A4*1G, CYP3A5 (*3), CYP2D6 (*5 and *10), ABCG2 (421C>A) and ABCB1 (1236C>T, 2677G>T/A and 3435C>T).
    Clinical Lung Cancer 12/2014; · 2.04 Impact Factor
  • Respiratory care 12/2014; · 1.84 Impact Factor
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    ABSTRACT: The existence of a spin-disordered quantum state was predicted theoretically by Wannier in 1950 and Anderson in 1973. Various target materials had been considered before the discovery in 2003 of the first quantum spin liquid (QSL) system: a Mott insulator κ-(ET)2Cu2(CN)3, where ET is bis(ethylenedithio)tetrathiafulvalene. The family of dimer-type ET conductors κ-(ET)2X (where X = an anion) exhibits various conduction profiles ranging from insulators to metals to superconductors depending on the counter anion. In κ-(ET)2X, the anion molecules form characteristic patterns of anion openings, on each of which an ET dimer corresponding to a single spin site is positioned, namely a key-keyhole relation. The topological consideration of the crystal structure affords the information on both a spin geometry (t’/t) and electron correlation (U/W), where t and t’ are interdimer transfer interactions with an isosceles triangular geometry, and U and W are the on-site Coulomb repulsion energy and bandwidth, respectively. The QSL system κ-(ET)2Cu2(CN)3 is characterized by a spin lattice containing nearly equilateral triangles (t’/t = 1.09) with strong electron correlations (U/W = 0.93) at room temperature. The temperature dependences of t’/t and U/W are bases to understand the transport and magnetic behaviors of κ-(ET)2X. κ-(ET)2Cu2(CN)3 has a superconducting state next to the QSL state under pressure without passing through an antiferromagnetic state. Here, the design of QSL systems next to a superconducting state is discussed based on the crystal and the electronic structures and physical properties of κ-(ET)2X using the key-keyhole relation and temperature variant band parameters t, t’, U, and W.
    J. Mater. Chem. C. 12/2014;
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    ABSTRACT: Background:Recently, a non-invasive method using computational fluid dynamics to calculate vessel-specific fractional flow reserve (FFRCT) from routinely acquired coronary computed tomography angiography (CTA) was described. The Analysis of Coronary Blood Flow Using CT Angiography: Next Steps (NXT) trial, which was a prospective, multicenter trial including 254 patients with suspected coronary artery disease, noted high diagnostic performance of FFRCTcompared with invasive FFR. The aim of this post-hoc analysis was to assess the diagnostic performance of non-invasive FFRCTvs. standard stenosis quantification on coronary CTA in the Japanese subset of the NXT trial.Methods and Results:A total of 57 Japanese participants were included from Okayama University (n=36), Kyoto University (n=17), and Keio University (n=4) Hospitals. Per-patient diagnostic accuracy of FFRCT(74%; 95% confidence interval [CI]: 60-85%) was higher than for coronary CTA (47%; 95% CI: 34-61%, P<0.001) arising from improved specificity (63% vs. 27%, P<0.001). FFRCTcorrectly reclassified 53% of patients and 63% of vessels with coronary CTA false positives as true negatives. When patients with Agatston score >1,000 were excluded, per-patient accuracy of FFRCTwas 83% with a high specificity of 76%, similar to the overall NXT trial findings.Conclusions:FFRCThas high diagnostic performance compared with invasive FFR in the Japanese subset of patients in the NXT trial.
    Circulation Journal 12/2014; · 3.69 Impact Factor
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    ABSTRACT: Although high-degree atrioventricular block (AVB) is a common initial manifestation of cardiac sarcoidosis, little is known about the outcomes. The aim of this study was to assess outcomes in patients with AVB as an initial manifestation of cardiac sarcoidosis compared with those in patients with ventricular tachyarrhythmia (VT) and/or heart failure (HF). Fifty-three consecutive patients with cardiac sarcoidosis, who had high-degree AVB (n = 22) or VT and/or HF (n = 31), were enrolled. The end point was defined as major adverse cardiac events, including cardiac death, ventricular fibrillation, sustained VT, and hospitalization for HF. Over a median follow-up period of 34 months, the outcomes of major adverse cardiac events were better in patients with high-degree AVB than in those with VT and/or HF (log-rank test, p = 0.046). However, this difference was due mainly to HF hospitalization. The outcomes of fatal cardiac events, including cardiac death, ventricular fibrillation, and sustained VT, were comparable between the 2 groups (log-rank test, p = 0.877). The fatal cardiac events in patients with high-degree AVB were not associated with the initiation of steroid treatment or left ventricular dysfunction. In conclusion, the outcomes of major adverse cardiac events are better in patients with high-degree AVB than in those with VT and/or HF. However, patients with high-degree AVB have a high rate of fatal cardiac events, similar to those with VT and/or HF. An indication for an implantable cardioverter-defibrillator, but not a pacemaker system, can be considered in patients with cardiac sarcoidosis manifested by high-degree AVB. Copyright © 2014 Elsevier Inc. All rights reserved.
    The American Journal of Cardiology 11/2014; · 3.43 Impact Factor
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    ABSTRACT: Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P<0.001, and P=0.003, respectively). On multivariate analysis Sp1 and syncope were independent predictors of arrhythmic events. When dividing patients according to the number of these 3 risk factors present, patients with 2 or 3 risk factors experienced arrhythmic events more frequently than those with 0 or 1 risk factor (23/93 vs. 3/125; P<0.001).Conclusions:Syncope, Sp1, and PES+ are important risk factors and the combination of these risks well stratify the risk of later arrhythmic events.
    Circulation Journal 11/2014; · 3.69 Impact Factor
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    Circulation Journal 11/2014; · 3.69 Impact Factor
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    ABSTRACT: Postprandial elevation of triglycerides impairs endothelial function and contributes to the development of atherosclerosis. We investigated the effects of omega-3 fatty acids on postprandial endothelial function and lipid profiles.
    Biomedecine [?] Pharmacotherapy 10/2014; · 2.11 Impact Factor
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    ABSTRACT: Objective We examined whether early loading of eicosapentaenoic acid (EPA) reduces clinical adverse events by 1 month, accompanied by a decrease in C-reactive protein (CRP) values in patients with acute myocardial infarction (MI). Background Acute MI triggers an inflammatory reaction, which plays an important role in myocardial injury. EPA could attenuate the inflammatory response. Methods This prospective, open-label, blinded endpoint, randomized trial consisted of 115 patients with acute MI. They were randomly assigned to the EPA group (57 patients) and the control group (58 patients). After percutaneous coronary intervention (PCI), 1800 mg/day of EPA was initiated within 24 h. The primary endpoint was composite events, including cardiac death, stroke, re-infarction, ventricular arrhythmias, and paroxysmal atrial fibrillation within 1 month. Results Administration of EPA significantly reduced the primary endpoint within 1 month (10.5 vs 29.3%, p = 0.01), especially the incidence of ventricular arrhythmias (7.0 vs 20.6%, p = 0.03). Peak CRP values after PCI in the EPA group were significantly lower than those in the control group (median [interquartile range], 8.2 [5.6–10.2] mg/dl vs 9.7 [7.6–13.9] mg/dl, p < 0.01). Logistic regression analysis showed that EPA use was an independent factor related to ventricular arrhythmia until 1 month, with an odds ratio of 0.29 (95% confidence interval, 0.09 to 0.96, p = 0.04). Conclusions Early EPA treatment after PCI in the acute stage of MI reduces the incidence of ventricular arrhythmias, and lowers CRP values.
    International Journal of Cardiology 10/2014; 176(3):577–582. · 6.18 Impact Factor
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    ABSTRACT: Purulent pericarditis in adults is rare, but once it develops, it carries a high mortality rate. Adequate pericardial drainage and proper antibiotic treatment are essential in the successful management of purulent effusions, for which percutaneous catheter drainage is the most commonly performed technique. We herein report the case of a 75-year-old woman with purulent pericarditis attributable to methicillin-resistant Staphylococcus aureus. Although percutaneous pericardial drainage by catheter was used, the drainage was insufficient because of hyperviscous effusion. We performed surgical subxiphoid pericardial drainage, and a piece of a purulent stone was found in the pericardial cavity with purulent effusion. Additionally, daily intrapericardial washouts with physiologic saline alone were used as adjunct therapy. Five weeks later, the patient had a decreasing inflammatory reaction and symptom relief. She was discharged with no complications such as constrictive pericarditis.
    The Annals of Thoracic Surgery 10/2014; 98(4):1451-1454. · 3.63 Impact Factor
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    ABSTRACT: Background Short-duration adaptive servo-ventilation (ASV) therapy can be effective for heart failure (HF) patients. Albuminuria is recognized as a prognostic marker for HF. We investigated whether short-duration and short-term ASV therapy reduced albuminuria in HF patients. Methods and results Twenty-one consecutive HF patients were divided into two groups: those who tolerated ASV therapy (ASV group, n = 14) and those who did not (non-ASV group, n = 7). ASV therapy was administered to enrolled patients for 1 week for 2 h per day (1 h in the morning and 1 h in the afternoon). The urinary albumin to creatinine ratio (UACR), urinary 24 h norepinephrine (NE) excretion, high-sensitivity C-reactive protein (hs-CRP), and plasma brain natriuretic peptide (BNP) levels were measured before and 1 week after ASV therapy. In the ASV group, but not the non-ASV group, the UACR significantly decreased, together with a decrease in urinary NE and hs-CRP levels. There were significant correlations between the changes in UACR and hs-CRP and between the changes in urinary NE and hs-CRP. Multiple linear regression analyses indicated that ASV use was the strongest predictor of decreased UACR. Conclusion Albuminuria, urinary NE, and hs-CRP levels reduced in HF patients who could receive short-duration and short-term ASV therapy. Anti-inflammatory effects of ASV therapy may partly mediate the reduction of albuminuria.
    Journal of Cardiac Failure 10/2014; · 3.07 Impact Factor
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    ABSTRACT: This study investigated morning levels of pentraxin3 (PTX3) as a sensitive biomarker for acute inflammation in patients with obstructive sleep apnea (OSA). A total of 61 consecutive patients with OSA were divided into two groups: non-to-mild (n=20) and moderate-to-severe (n=41) OSA based on their apnea-hypopnea index (AHI) score. Those patients with moderate-to-severe OSA were further divided into continuous positive airway pressure (CPAP)-treated (n =21) and non-CPAP-treated (n=20) groups. Morning and evening serum PTX3 and high-sensitivity (hs)-C reactive protein (CRP) levels were measured before and after 3 months of CPAP therapy. The baseline hs-CRP and PTX3 levels were higher in patients with moderate-to-severe OSA than in those with non-to-mild OSA. Moreover, the serum PTX3, but not the hs-CRP, levels were significantly higher after than before sleep in the moderate-to-severe OSA group (morning PTX3; 1.96±0.52, evening PTX3; 1.71±0.44ng/mL). OSA severity as judged using the AHI was significantly correlated with serum PTX3, but not hs-CRP, levels. The highest level of correlation was found between the AHI and morning PTX3 levels (r=0.563, p<0.001). CPAP therapy reduced evening and morning serum hs-CRP and PTX3 levels in patients with moderate-to-severe OSA; however, the reduction in PTX3 levels in the morning was greater than that in the evening (morning: -29.8±16.7% vs. evening:-12.6±26.8%; p=0.029). Improvement in the AHI score following CPAP therapy was strongly correlated with reduced morning PTX3 levels(r=0.727, p<0.001). Based on these results, morning PTX3 levels reflect OSA-related acute inflammation, and are a useful marker for improvement in OSA following CPAP therapy.
    Journal of Applied Physiology 09/2014; · 3.43 Impact Factor

Publication Stats

6k Citations
1,830.61 Total Impact Points


  • 2005–2015
    • Akita University
      • • Department of Cardiovascular and Respiratory Medicine
      • • Faculty of Medicine
      Akita, Akita, Japan
  • 2009–2014
    • Okayama University
      • Department of Cardiovascular Medicine
      Okayama, Okayama, Japan
  • 2005–2014
    • Akita University Hospital
      Akita, Akita, Japan
  • 2011–2013
    • Kagawa Prefectural Central Hospital
      Takamatu, Kagawa, Japan
    • Fukaya Red Cross Hospital
      Fukaya, Saitama, Japan
    • Sakakibara Heart Institute
      Фучу, Tōkyō, Japan
  • 2012
    • Nagai Internal Medicine Clinic
      Okayama, Okayama, Japan
    • Hyogo College of Medicine
      • Department of Internal Medicine
      Nishinomiya, Hyogo-ken, Japan
  • 2003–2012
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
    • Himeji Institute of Technology
      Nagoya, Aichi, Japan
    • Musashino Red Cross Hospital
      Edo, Tōkyō, Japan
  • 1992–2012
    • Sakurabashi Watanabe Hospital
      Ōsaka, Ōsaka, Japan
  • 2008–2011
    • Juntendo University
      Edo, Tōkyō, Japan
  • 2004–2011
    • Nagoya University
      • • Graduate School of Engineering
      • • Research Center for Materials Science
      Nagoya, Aichi, Japan
  • 1991–2011
    • Tokyo Medical and Dental University
      • • Department of Cardiovascular Medicine
      • • Department of Internal Medicine
      Tokyo, Tokyo-to, Japan
  • 2010
    • Minami Okayama Medical Center
      Okayama, Okayama, Japan
  • 2004–2008
    • Osaka City University
      • Department of Cardiovascular Medicine
      Ōsaka, Ōsaka, Japan
  • 1996–2008
    • Chiba University
      • Graduate School of Medicine
      Tiba, Chiba, Japan
  • 2006
    • Tohoku University
      • Department of Chemistry
      Sendai-shi, Miyagi-ken, Japan
  • 1999–2006
    • Massachusetts General Hospital
      • Transplantation Biology Research Center
      Boston, MA, United States
  • 1995–2006
    • Yamaguchi University
      • Graduate School of Medicine
      Yamaguti, Yamaguchi, Japan
  • 2000–2001
    • Chiba University Hospital
      Tiba, Chiba, Japan
  • 1997
    • Queen's University Belfast
      Béal Feirste, N Ireland, United Kingdom