Hiroshi Ito

Akita University, Akita, Akita, Japan

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Publications (493)1902.58 Total impact

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    ABSTRACT: Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF).Methods and Results:HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4% from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75%; specificity, 88%). BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4% compared with baseline, in addition to the alert, however, may be a useful marker for the likelihood of HF (Clinical trial info: UMIN000003351).
    Circulation Journal 03/2015; DOI:10.1253/circj.CJ-15-0076 · 3.69 Impact Factor
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    ABSTRACT: Physical examination as an initial screening tool to diagnose abdominal aortic aneurysm (AAA) has lost favor over the past 20 years. This multicenter cohort study aimed to determine the prevalence of AAA in elderly Japanese patients with hypertension (HT) and to clarify the diagnostic accuracy of physical examination using a pocket-sized ultrasound imaging device (the "pocket-echo").Methods and Results:A total of 1,731 patients with HT aged >60 years from 20 collaborating institutions were enrolled in this study. Abdominal palpation was performed on physical examination, and the pocket-echo was used to confirm the diagnosis of AAA. The abdominal aorta was well visualized in 1,692 patients (98%). AAA was discovered in 69 patients (4.1%), with advanced age and male sex identified as independent risk factors. The prevalence of AAA increased according to age regardless of sex, and reached 9.2% and 5.7%, respectively, in males and females ≥80 years. Overall, 33 cases of AAA were missed on abdominal palpation (sensitivity, 52%), whereas for AAAs >40 mm, the sensitivity was 75%. We assessed the utility of the pocket-echo and physical examination for diagnosing AAA in Japanese patients with HT aged over 60 years. Our findings highlight the importance of AAA screening programs in high-risk Japanese populations, and confirm the ability of physical examination to detect large, but not small, AAAs. (Circ J 2015; 79: 524-529).
    Circulation Journal 02/2015; 79(3). DOI:10.1253/circj.CJ-14-0972 · 3.69 Impact Factor
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    European Heart Journal – Cardiovascular Imaging 02/2015; DOI:10.1093/ehjci/jev038 · 3.67 Impact Factor
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    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; DOI:10.1007/s00380-015-0645-5 · 2.11 Impact Factor
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    ABSTRACT: Patients with probable cardiac sarcoidosis (CS) who satisfy only clinical cardiac findings for CS are not uncommon. The aim of this study was to compare outcomes between patients with probable CS and those with definite CS treated with steroids. The study population consisted of 101 consecutive patients who satisfied clinical cardiac findings for CS. Patients with definite CS were defined as having histologic or clinical confirmation of CS according to the guidelines and were treated with steroids. Patients with probable CS were defined as having only clinical cardiac findings but not definite CS because of no histologic confirmation or extracardiac sarcoidosis and were not treated with steroids. The end point was major adverse cardiac events. Forty-seven patients had definite CS, and the other 54 had probable CS. Except for serum angiotensin-converting enzyme levels and left ventricular dysfunction, clinical characteristics were similar between the 2 groups. Over a median follow-up period of 15 months, major adverse cardiac events occurred more frequently in patients with probable CS than in those with definite CS (74% vs 53%, p = 0.029). The event-free survival rate was worse in patients with probable CS than in those with definite CS (log-rank test, p = 0.006). Cox proportional-hazards analysis showed that probable CS was an independent predictor of major adverse cardiac events. In conclusion, outcomes were worse in patients with probable CS than in those with definite CS treated with steroids. The initiation of steroid treatment may be considered for patients who satisfy only clinical cardiac findings for CS. Copyright © 2015 Elsevier Inc. All rights reserved.
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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. DOI:10.1016/j.ijcard.2014.10.135 · 6.18 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; 13(1). DOI:10.1111/sbr.12097 · 1.05 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. DOI:10.3892/etm.2014.2051 · 0.94 Impact Factor
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    International Journal of Cardiology 12/2014; 182C:216-218. DOI:10.1016/j.ijcard.2014.12.149 · 6.18 Impact Factor
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    Circulation 12/2014; 130(25):2351-3. DOI:10.1161/CIRCULATIONAHA.114.010732 · 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; DOI:10.1016/j.cllc.2014.12.004 · 2.04 Impact Factor
  • Respiratory care 12/2014; DOI:10.4187/respcare.03562 · 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.
    12/2014; DOI:10.1039/C4TC01701C
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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; DOI:10.1253/circj.CJ-14-1051 · 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; DOI:10.1016/j.amjcard.2014.11.028 · 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; DOI:10.1253/circj.CJ-14-1059 · 3.69 Impact Factor
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    Circulation Journal 11/2014; DOI:10.1253/circj.CJ-14-1120 · 3.69 Impact Factor
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    ABSTRACT: We here describe a case of Stage IV breast and gastric cancer in which S-1/paclitaxel therapy was effective in maintaining the patient's QOL. A 50-year-old woman visited our hospital with complaints of her right breast tumor and right brachialgia. She was diagnosed with breast cancer with multiple bone metastases including cervical vertebrae. Accordingly, local radiation therapy and tamoxifen(TAM)administration was started immediately. Gastrointestinal endoscopy revealed gastric cancer, but laparotomy disclosed the gastric cancer was unresectable. At that time, the complaints of pain, nausea, and fatigue had increased and S-1/paclitaxel therapy was started immediately. The treatment reduced the size of the lesions in the breast and stomach and improved the QOL without serious adverse events. We have been maintaining partial response(PR)in this patient for 28 months.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2014; 41(12):1960-1.
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    ABSTRACT: Gastroduodenal stenting for gastric outlet obstruction(GOO)caused by malignant disease has been covered by health insurance in Japan since April 2010. We have inserted WallFlexTM duodenal stents(WDS)in 3 patients with GOO caused by unresectable advanced gastric cancer. WDS placement was successful with no complications in all cases. Mean treatment time was 44.7(35-50)minutes, and mean survival time after WDS placement was 34.7(19-51)days. Oral food intake was improved in all patients but 1. Enteroparalysis due to peritoneal metastasis supposedly voided WDS placement in 1 patient. WDS placement for GOO caused by advanced gastric cancer is expected to be a safe and effective palliative treatment but sometimes yields no benefit in the patient with peritoneal metastasis.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2014; 41(12):2329-30.

Publication Stats

6k Citations
1,902.58 Total Impact Points

Institutions

  • 2005–2015
    • Akita University
      • • Department of Cardiovascular and Respiratory Medicine
      • • Faculty of Medicine
      Akita, Akita, Japan
    • Osaka Rosai Hospital
      Ōsaka, Ōsaka, Japan
    • University of Hyogo
      • Department of Material Science
      Kōbe, Hyōgo, Japan
    • Osaka Police Hospital
      Ōsaka, Ōsaka, Japan
  • 2009–2014
    • Okayama University
      • Department of Cardiovascular Medicine
      Okayama, Okayama, Japan
  • 2005–2014
    • Akita University Hospital
      Akita, Akita, Japan
  • 2004–2014
    • Nagoya University
      • • Graduate School of Engineering
      • • Research Center for Materials Science
      Nagoya, Aichi, Japan
  • 2013
    • Saitama Medical University
      • Center for Maternal, Fetal and Neonatal Medicine
      Saitama, Saitama, Japan
  • 2012
    • Yokohama Ekisaikai Hospital
      Yokohama, Kanagawa, Japan
  • 2011
    • Fukaya Red Cross Hospital
      Fukaya, Saitama, 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
  • 1992–2009
    • Sakurabashi Watanabe Hospital
      Ōsaka, Ōsaka, Japan
  • 2008
    • Juntendo University
      Edo, Tōkyō, Japan
  • 1996–2008
    • Chiba University
      • • Graduate School of Medicine
      • • Department of Oral Surgery
      Tiba, Chiba, Japan
  • 1995–2007
    • Yamaguchi University
      • • Graduate School of Medicine
      • • Department of Medical Bioregulation
      • • Department of Stress and Bio-response Medicine
      • • Yamaguchi University Hospital
      Yamaguti, Yamaguchi, Japan
  • 2006
    • Tohoku University
      • Department of Chemistry
      Sendai-shi, Miyagi-ken, Japan
    • Tokyo Metropolitan University
      • Department of Chemistry
      Edo, Tōkyō, Japan
  • 2004–2006
    • Massachusetts General Hospital
      • Transplantation Biology Research Center
      Boston, MA, United States
  • 1999–2004
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2003
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
    • Musashino Red Cross Hospital
      Edo, Tōkyō, Japan
  • 1998–2001
    • Chiba University Hospital
      Tiba, Chiba, Japan