Hiroshi Ito

Akita University, Akita, Akita, Japan

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Publications (509)2164.61 Total impact

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    ABSTRACT: Cardiac computed tomography (CT) is an excellent tool for evaluating the anatomy of a secundum atrial septal defect (ASD). However, a comprehensive assessment of its usefulness, including measurement of the pulmonary to systemic blood flow ratio in secundum ASD patients, has not been performed.
    Journal of Cardiovascular Computed Tomography 05/2015; DOI:10.1016/j.jcct.2015.04.007 · 4.51 Impact Factor
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    ABSTRACT: Although the volume overload of pulmonary circulation improves after atrial septal defect (ASD) closure, the increasing left ventricular preload may contribute to mitral regurgitation (MR) deterioration. We aimed to evaluate the impact of MR after transcatheter ASD closure on clinical outcomes in adults. A total of 288 consecutive patients who underwent transcatheter ASD closure were enrolled. Changes in MR were assessed at 1 month after the procedure. The end point was defined as cardiovascular events. After the procedure, MR ameliorated in 3 patients and unchanged in 253, whereas MR deteriorated in 32. During a median follow-up of 24 months, patients with MR deterioration had no cardiovascular events, and the event-free survival rate was not different between patients with MR deterioration and those with MR amelioration or no-change (p = 0.355). Even in patients with MR deterioration, the New York Heart Association functional class improved after the procedure, with no cases of worsening functional class. Multivariate logistic regression analysis showed that MR deterioration was independently related to advanced age and female gender. The degree of enlargement of mitral valve annulus diameter after the procedure was greater in patients with MR deterioration than in those with MR amelioration or no-change, and it was correlated with the degree of MR deterioration. In conclusion, MR deterioration occurs in a minority of adult patients after transcatheter ASD closure; however, it is not linked with adverse outcomes. MR deterioration may be provoked by geometric changes in mitral valve annulus, especially in women with advanced age. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American journal of cardiology 05/2015; DOI:10.1016/j.amjcard.2015.04.042 · 3.43 Impact Factor
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    ABSTRACT: Platelet-derived growth factor (PDGF) is implicated in the pathogenesis of pulmonary arterial hypertension (PAH). Imatinib, a PDGF-receptor tyrosine kinase inhibitor, improved hemodynamics, but serious side effects and drug discontinuation are common when treating PAH. A drug delivery system using nanoparticles (NPs) enables the reduction of side effects while maintaining the effects of the drug. We examined the efficacy of imatinib-incorporated NPs (Ima-NPs) in a rat model and in human PAH-pulmonary arterial smooth muscle cells (PASMCs). Rats received a single intratracheal administration of PBS, FITC-NPs, or Ima-NPs immediately after monocrotaline injection. Three weeks after monocrotaline injection, intratracheal administration of Ima-NPs suppressed the development of pulmonary hypertension, small pulmonary artery remodeling, and right ventricular hypertrophy in the rat model of monocrotaline-induced PAH. We also examined the effects of imatinib and Ima-NPs on PDGF-induced proliferation of human PAH-PASMCs by (3)H-thymidine incorporation. Imatinib and Ima-NPs significantly inhibited proliferation after 24 hours of treatment. Ima-NPs significantly inhibited proliferation compared with imatinib at 24 hours after removal of these drugs. Delivery of Ima-NPs into lungs suppressed the development of MCT-induced PAH by sustained antiproliferative effects on PAS-MCs.
    International Heart Journal 04/2015; 56(3). DOI:10.1536/ihj.14-338 · 1.13 Impact Factor
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    ABSTRACT: The increase in proprotein convertase subtilisin/kexin type 9 (PCSK9) leads to low-density lipoprotein (LDL) receptor degradation. Statins significantly reduce LDL-cholesterol levels, but upregulate PCSK9. This study evaluated the effect of ezetimibe monotherapy or ezetimibe in combination with a statin on serum levels of PCSK9 in patients with type 2 diabetes and hypercholesterolemia. Ezetimibe treatment was given to ten patients with diabetes without statin therapy and ten patients with statin therapy. Plasma levels of PCSK9 were examined at baseline and 24 weeks after treatment. At baseline, PCSK9 concentrations in patients with statin therapy were significantly higher than those in patients without statin use and in control subjects [median (25th-75th percentile) 411 (272-467) and 382 (356-453) ng/mL, respectively, p < 0.01]. After ezetimibe treatment for 24 weeks, LDL-cholesterol, triglyceride and remnant-like lipoprotein cholesterol were significantly decreased in both groups. However, PCSK9 concentration did not change compared with baseline measurements in both groups. The percentage change in LDL-cholesterol after ezetimibe therapy for 24 weeks was not correlated with the percentage change in PCSK9 concentration. Ezetimibe may reduce LDL-cholesterol levels without affecting PCSK9 in patients with type 2 diabetes and hypercholesterolemia.
    American Journal of Cardiovascular Drugs 04/2015; DOI:10.1007/s40256-015-0119-2 · 2.20 Impact Factor
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    ABSTRACT: This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. The clinical benefits of transcatheter ASD closure in this aged population are controversial. A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    JACC. Cardiovascular Interventions 04/2015; 8(4):600-6. DOI:10.1016/j.jcin.2015.02.002 · 7.44 Impact Factor
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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
  • Journal of the American College of Cardiology 03/2015; 65(10):A1728. DOI:10.1016/S0735-1097(15)61728-4 · 15.34 Impact Factor
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    European Heart Journal – Cardiovascular Imaging 02/2015; DOI:10.1093/ehjci/jev038 · 2.65 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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    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.
    The American Journal of Cardiology 02/2015; 115(9). DOI:10.1016/j.amjcard.2015.01.562 · 3.43 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: 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 · 0.76 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 · 3.22 Impact Factor
  • Respiratory care 12/2014; 60(5). 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; 3(6). DOI:10.1039/C4TC01701C
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Publication Stats

7k Citations
2,164.61 Total Impact Points


  • 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
  • 1992–2011
    • Sakurabashi Watanabe Hospital
      Ōsaka, Ōsaka, 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
  • 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