Are you Toshiharu Takeuchi?

Claim your profile

Publications (38)

  • [Show abstract] [Hide abstract] ABSTRACT: The pro-arrhythmic triggers in Brugada and early repolarization syndromes (BrS, ERS) have not been analyzed systematically except for case reports. We clinically investigated the circumstances which precede/predispose to arrhythmic events in these syndromes during long-term follow-up. A detailed history from the patients/witnesses was taken to investigate the antecedent events in the last few hours that preceded syncope/ventricular fibrillation (VF); medical records, ECG and blood test from the emergency room (ER) were reviewed. 19 patients that fulfilled the investigation criteria were followed up for 71 ± 49 months (34–190 months). Prior to the event (syncope/VF), the patients were partaking different activities in the following decreasing order; drinking alcoholic beverage, having meal, and getting up from sleep, exercise. 3 patients reported mental/physical stress prior to the event and 2 patients developed VF several days after starting oral steroid for treatment of bronchial asthma. In the ER, elevated J-wave amplitude (0.27 ± 0.15 mV) was found with 58 % of the patients having hypokalemia. After electrolyte correction and cessation of steroids, the following day plasma K+ (4.2 ± 0.3 mEq/L, P < 0.001) was significantly increased and J-wave amplitude (0.13 ± 0.1 mV, P < 0.001) was remarkably reduced. Three patients were kept on oral spironolactone/potassium supplements. During follow-up for 71 ± 49 (34–190) months, among 4 patients with VF recurrence, one patient developed VF after taking oral steroid. In ERS and BrS, hypokalemia and corticosteroid therapy add substantial pro-arrhythmic effects, but potentially treatable. Stopping steroid therapy and avoiding hypokalemia had excellent long-term outcome.
    Article · Mar 2016 · Heart and Vessels
  • [Show abstract] [Hide abstract] ABSTRACT: The distribution of late gadolinium enhancement (LGE) on the cardiac MRI (CMR) indicates myocardial fibrosis and provides information of possible reentry substrates. QT dynamicity reflecting repolarization abnormalities has gained attention as a potential prognostic predictive factor. To clarify the correlation between the LGE distribution on CMR and QT dynamicity represented by the QT/RR relationship. CMR and QT/RR analyses using Holter monitoring were performed in 34 patients (24 males, 60 ± 11 years) with ventricular tachycardia (VT) and/or ventricular fibrillation (VF). The LGE on CMR was scored using a 4-point score in 17 left ventricular segments. The sum of the LGE scores was calculated for each patient. The QT/RR slope and daytime/nighttime QT/RR ratio (day/night ratio) were calculated. The correlation between the slope or the day/night QT/RR ratio and late enhancement findings was analyzed. All patients were divided into 23 LGE positive (LGE(+)) and 11 LGE negative (LGE(-)) patients. The slopes of the QTe/RR and QTa /RR were significantly steeper in the LGE(+) than in LGE(-) patients (0.21 ± 0.03 vs 0.13 ± 0.02; P < 0.001, 0.19 ± 0.03 vs 0.13 ± 0.02; P < 0.001, respectively), and both slopes were significantly correlated with the total LGE scores (r = 0.83, P < 0.001; r = 0.71, P < 0.001, respectively). In the LGE(+) patients, the QTe day/night (1.37 ± 0.38 vs 0.91 ± 0.33; P = 0.002) and QTa day/night ratios (1.33 ± 0.26 vs 1.06 ± 0.30; P = 0.011) were significantly greater than those in the LGE(-) patients. The LGE distribution was closely related to the QT dynamicity, suggesting that a combination of these markers can be a powerful tool for understanding the background pathophysiology. © 2015 Wiley Periodicals, Inc.
    Article · Jun 2015 · Annals of Noninvasive Electrocardiology
  • [Show abstract] [Hide abstract] ABSTRACT: The presence of myocardial scar detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) has been described as a good independent predictor of mortality in patients with hypertrophic cardiomyopathy (HCM). Time-domain T-wave alternans (TWA) is also a potential predictor of cardiac mortality in patients with LV dysfunction. To elucidate the relationship between the LGE distribution and TWA in patients with HCM. CMR and TWA analyses using Holter monitoring were performed in 42 patients with HCM. The average transmural extent of the LGE was scored as 1 to 4 in each segment and the sum of the LGE scores (Total LGE score) was calculated in each patient. The correlation between the maximal time-domain TWA voltage and LGE findings was analyzed and the differences in the time-domain TWA, total LGE, and cardiac function assessed by CMR in the presence or absence of VT were also compared. The total LGE score was significantly and positively correlated with the maximal time-domain TWA voltage (r=0.59, P<0.001). Furthermore, the total LGE and maximal time-domain TWA voltage were significantly greater in the patients who had episodes of ventricular tachycardia (VT) (n=21) than in those without [23±7 vs. 10±8 (P<0.001); 87±26 vs. 62±12 μV (P<0.001), respectively]. However, the left ventricular ejection fraction did not statistically differ between the patients with VT and those without (56±14 vs. 61±7%, P=0.102). The magnitude of the localized LGE was significantly correlated with abnormalities in ventricular repolarization as assessed by TWA and QTd. Copyright © 2015. Published by Elsevier Inc.
    Article · Apr 2015 · Heart rhythm: the official journal of the Heart Rhythm Society
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: Relationship between microalbuminuria and worse outcome of coronary artery disease patients is discussed, but its underlying pathophysiological mechanism remains unclear. We investigated the role of microalbuminuria to the function of endothelial progenitor cells (EPCs), that might affect to outcome of acute myocardial infarction (AMI) patients.Forty-five AMI patients were divided into two groups according to their urinary albumin excretion: normal (n = 24) and microalbuminuria (>30 mg/day, n = 21). At day-2 and day-7 after AMI onset, circulating-EPCs (CD34+ Flk1+) were quantified by flow cytometry. The number of lectin-acLDL-positive cultured-EPCs immobilized on fibronectin was determined. To assess the cellular senescence of cultured-EPCs, the expression level of sirtuin-1 mRNA and the number of SA-β-gal positive cell were evaluated. Angiographic late in-stent loss after percutaneous coronary intervention (PCI) was evaluated at a six-month follow-up.No significant differences in coronary risk and the extent of myocardial damage were observed between the two groups. Late in-stent loss at the six-month follow-up was significantly higher in the microalbuminuria group (normal:microalbuminuria = 0.76±0.34:1.18±0.57 mm, p=0.021). The number of circulating-EPCs was significantly increased in microalbuminuria group at day-7, however, improved adhesion of EPCs was observed in normal group but not in microalbuminuria group from baseline to day-7 (+3.1±8.3:-1.3±4.4%: p
    Full-text available · Article · Apr 2015 · PLoS ONE
  • [Show abstract] [Hide abstract] ABSTRACT: Combination antihypertensive therapy with an angiotensin receptor blocker (ARB) and a calcium channel blocker (CCB) or diuretics is common. This subanalysis investigated blood pressure (BP) variability in patients receiving ARB-based combination therapy. In a prospective, randomized, open-label trial, hypertensive outpatients (≥65 years) who did not achieve their target BP with ARB monotherapy switched to losartan 50 mg/hydrochlorothiazide 12.5 mg (ARB + D) or ARB plus amlodipine 5 mg (ARB + C) for 12 months. Clinic BP and heart rate (HR), measured every 3 months, visit-to-visit variability and seasonal variation were evaluated. No significant between-group differences in average, maximum, or minimum systolic or diastolic BP, or HR, were found. Visit-to-visit BP variability (systolic) was significantly higher in the ARB + D group than in the ARB + C group. When each group was subdivided into two seasonal groups (summer and winter), no significant between-group differences in BP were found. Multivariate regression analyses showed a tendency toward negative correlation between outdoor temperature and urinary albumin:creatinine ratio and estimated glomerular filtration rate at 12 months in the ARB + D group. Combination therapy with an ARB plus a CCB may be preferable to that with an ARB plus diuretics for decreasing BP variability. As for seasonal variability, both treatments can be used safely regardless of season.
    Article · Apr 2015 · Clinical and Experimental Hypertension
  • Toshiharu Takeuchi · Masahide Goto · Makoto Aita · [...] · Naoyuki Hasebe
    Article · Mar 2015 · Journal of the American College of Cardiology
  • [Show abstract] [Hide abstract] ABSTRACT: The presence of a myocardial scar detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) has been described as a predictor of all-cause mortality in hypertrophic cardiomyopathy (HCM). However, the detailed spatial relationship between LGE site and electrical abnormality is unclear in high risk HCM with malignant arrhythmia. To elucidate the detailed relationship between the site on CMR imaging and the electrically damaged site, a potential origin of ventricular arrhythmias in patients with HCM. Fifty consecutive HCM patients underwent contrast-enhanced CMR. Among them, 18 patients with ventricular tachycardia (VT) underwent electrophysiologic study including endocardial mapping of the left ventricle (LV). LGE area was calculated at 12 different LV sites; Anterior, Lateral, Posterior and Septal segments of the Basal, Middle and Apical portions. At each LV site, the bipolar electrogram, effective refractory period (ERP), and monophasic action potential (MAP) were recorded. LGE-positive segments demonstrated a significantly lower amplitude (4.0±2.8 versus 7.3±3.6 mV, P<0.001), longer duration (54.7±17.8 versus 40.6±7.8 ms, P<0.001), longer ERP (320±42 versus 284±37 ms, P=0.001), and longer MAP duration measured at 90% repolarization (APD90) (321±19 versus 283±25 ms, P<0.001) than the LGE-negative segments. The LGE area negatively correlated with the amplitude (r=-0.59, P<0.001), and positively correlated with the duration (r=0.64, P<0.001), ERP (r=0.44, P<0.001) and APD90 (r=0.63, P<0.001). All of the observed VTs originated from the LGE positive segments. The spatial distribution of LGE significantly correlates with depolarizing and repolarizing electrical damage in high risk HCM with malignant ventricular arrhythmia. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
    Article · Feb 2015 · Heart rhythm: the official journal of the Heart Rhythm Society
  • [Show abstract] [Hide abstract] ABSTRACT: It remains unclear whether administration of ARB with reactive oxygen species (ROS) scavenging effects improves the prognosis of patients undergoing PCI. This study investigated whether the pre-intervention antioxidant effect of angiotensin receptor blocker (ARB) affects long-term outcomes in patients after successful percutaneous coronary intervention (PCI) without early adverse events. Fifty-two patients who underwent elective PCI were randomly assigned for treatment with or without ARB, which was administered within 48 hours before PCI. ROS levels in mononuclear cells (MNCs) and serum superoxide dismutase (SOD) activity were measured pre-PCI and 6 months post-PCI. After exclusion of unexpected early adverse events during angiographic follow-up period, the long-term outcome (major adverse cerebro-cardiovascular event; MACCE) was assessed in eligible patients. Forty-three patients (non-ARB n = 22, ARB n = 21) were followed up in this study. During angiographic follow-up period, ROS formation in MNCs was significantly increased in the non-ARB group (from 29.4 [21.6-35.2] to 37.2 [30.7-45.1] arbitrary units; p = 0.031) compared to that in the ARB group. Meanwhile, SOD activity was significantly impaired in the non-ARB group alone (from 24.0 ± 17.0 to 16.3 ± 13.8%, p = 0.004). During the follow-up period (median, 63.3 months), MACCEs were observed in 6 patients. The cumulative event ratio of MACCE was significantly higher in the non-ARB group than in the ARB group (p = 0.018). Concomitant administration of ARB effectively reduced ROS production of PCI patients during angiographic follow-up period. Initial ROS inhibition following ARB administration may contribute to improvement of worse outcomes in patients who have undergone successful PCI.
    Article · Dec 2014 · American Journal of Cardiovascular Disease
  • [Show abstract] [Hide abstract] ABSTRACT: Introduction: We reported impaired QT-rate dependence in early repolarization syndrome (ERS); however, contemporary data have shown peak incidence of sudden cardiac death (SCD) in ERS and Brugada syndrome (BrS) at mid-night and early morning. Taken together, we analyzed the nocturnal QT-rate dependence in both syndromes. Methods and results: A total of 172 subjects were enrolled: 11 ERS, 11 BrS patients, 50 subjects with an uneventful ER pattern (ERP), and 100 non-J-wave control subjects. Ambulatory ECG-derived parameters (QT, QTc, and QT/RR slope) and day-night QT difference were analyzed and compared. Among the groups, there was no significant difference in the average QT or QTc; however, the 24-hour QT/RR slope was significantly smaller in ERS and BrS patients (0.103 ± 0.01 and 0.106 ± 0.01, respectively) than in the control group (0.156 ± 0.03, P < 0.001). Detailed analysis showed a lower day-night QT difference in ERS and BrS patients (19 ±18.7 and 24 ±14 milliseconds, respectively) than in the controls (40 ± 22 milliseconds, P = 0.007) with the lowest QT/RR slopes seen in the ERS and BrS groups from 0 to 3:00 am (QT/RR; 0.076 ± 0.02 vs. 0.092 ± 0.04 vs. 0.117 ± 0.04, for the ERS, BrS, and controls, respectively, P = 0.004) and from 3 to 6 am (QT/RR 0.074 ± 0.03 vs. 0.079 ± 0.02 vs. 0.118 ± 0.04, P < 0.001). Conclusion: In a large population of age- and gender-matched groups, both ERS and BrS patients showed attenuated QT-rate dependence and impaired QT day-night modulation that may provide a baseline reentrant substrate. Importantly, QT/RR maladaptation was most evident at mid-night and early morning, which may explain the propensity of such patients to develop SCD during this critical period.
    Article · Oct 2014 · Journal of Cardiovascular Electrophysiology
  • [Show abstract] [Hide abstract] ABSTRACT: Renovascular hypertension is an important cause of secondary hypertension. We present the case of a 61-year-old man with renovascular hypertension caused by chronic total occlusion of the left renal artery resulting in an atrophic kidney. Although renography indicated almost no residual function of the left kidney, renal vein sampling showed a significant increase of renin secretion in the left kidney. The endocrine function of the left kidney was believed to be preserved; thus, we performed percutaneous transluminal renal angioplasty with stent placement. After the procedure, the patient's blood pressure decreased gradually to within the normal range without adverse events. The laboratory data on endocrine function and the renography findings drastically improved. Percutaneous transluminal renal angioplasty is a promising therapeutic procedure for renovascular hypertension with an atrophic kidney.
    Article · Jan 2014 · Heart and Vessels
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: We describe three cases of J-wave syndrome in which ventricular fibrillation (VF) was probably induced by corticosteroid therapy. The patients involved were being treated with prednisolone for concomitant bronchial asthma. One of the three patients had only one episode of VF during her long follow-up period (14 years). Two patients had hypokalemia during their VF episodes. Corticosteroids have been shown to induce various types of arrhythmia and to modify cardiac potassium channels. We discuss the possible association between corticosteroid therapy and VF in J-wave syndrome based on the cases we have encountered.
    Full-text available · Article · Nov 2013 · Heart and Vessels
  • Source
    Hisanobu Ota · Toshiharu Takeuchi · Nobuyuki Sato · Naoyuki Hasebe
    [Show abstract] [Hide abstract] ABSTRACT: Proteinuria and reduced estimated glomerular filtration rate (eGFR) are associated with an increased risk of mortality from acute myocardial infarction (AMI). However, it is unknown whether there is a difference in prognostic value for all-cause mortality between proteinuria and eGFR during post-AMI. A consecutive series of 101 patients admitted with AMI who received angioplasty were enrolled. Dipstick proteinuria and eGFR were assessed on admission: (i) the patients were divided into 2 groups according to the presence of proteinuria (proteinuria, n=25), or not (negative, n=76), (ii) the patients were divided into 2 groups according to lower eGFR (GFR<60mL/min/1.73m(2), n=31) or higher (GFR>60mL/min/1.73m(2), n=70). Clinical characteristics and 3-year all-cause mortality estimated by Kaplan-Meier method were evaluated in each group. Additionally, a multivariate Cox proportional hazards model was applied to evaluate which factor was associated with all-cause mortality. Mean follow-up period was 914 days. Higher brain natriuretic peptide (BNP) levels were shown in the proteinuria and lower eGFR groups, respectively (proteinuria, 301±324pg/mL; negative, 146±159pg/mL; p=0.02; lower eGFR, 294±305pg/mL; higher eGFR, 142±161pg/mL; p=0.02). Three-year all-cause mortality was higher in the proteinuria group than in the normal group (p<0.001) and in the lower eGFR group than in the higher group (p=0.006). In a Cox proportional hazards model, the presence of proteinuria [hazard ratio (95% confidence interval), 4.51 (1.07-18.96); p=0.04] was selected as one of the predictors for all-cause mortality. Dipstick proteinuria and lower eGFR in the early phase of AMI follow-up were related to increased plasma BNP level during the sub-acute phase and long-term adverse outcome. Dipstick proteinuria may be a prognostic marker for long-term all-cause mortality.
    Full-text available · Article · Jun 2013 · Journal of Cardiology
  • [Show abstract] [Hide abstract] ABSTRACT: Objective: Combination therapy with angiotensin receptor blockers (ARBs) and calcium channel blockers or diuretics is common for hypertensive patients. This study aimed to determine which combination is better for elderly hypertensive patients. Methods: In this prospective, randomized, open-label trial, hypertensive outpatients aged at least 65 years who had not achieved their target blood pressure (BP) with standard ARB dosages were randomly assigned to receive either a fixed-dose combination of losartan (50 mg) and hydrochlorothiazide (12.5 mg) (ARB+D; n = 72) or a combination of amlodipine (5 mg) and the typical dosage of ARBs (ARB+C; n = 68) to evaluate the change in the BP, laboratory values and cognitive function. Results: At 3 months, the SBP/DBP was found to have significantly decreased from 156/83 ± 15/11 mmHg to 139/76 ± 14/10 mmHg in the ARB+D group and 155/83 ± 11/10 mmHg to 132/72 ± 14/10 mmHg in the ARB+C group. The BP reduction efficacy was greater in the ARB+C group than in the ARB+D group. At 6 months, the SBP/DBP reached the same level in both groups. At 12 months, the urine albumin/creatinine ratio was significantly decreased from the geometric mean of 17.1 to 9.6 mg/g in the ARB+D group, whereas it was increased from 19.8 to 23.7 mg/g in the ARB+C group. Conversely, the estimated glomerular filtration rate tended to show a decrease in the ARB+D group. There was no significant difference in mini-mental state examination after 1 year. Conclusion: ARB+amlodipine (5 mg) yielded a greater BP reduction, whereas ARB+HCTZ (12.5 mg) resulted in a greater reduction in the albuminuria, suggesting that each combination therapy is advantageous in a different manner for elderly hypertensive patients.
    Article · Mar 2013 · Journal of Hypertension
  • Source
    Makoto Aita · Toshiharu Takeuchi · Naka Sakamoto · [...] · Naoyuki Hasebe
    Full-text available · Article · Mar 2013 · Journal of the American College of Cardiology
  • [Show abstract] [Hide abstract] ABSTRACT: Almost all current investigations on early repolarization syndrome (ERS) have focused on the J-wave characteristics and ST-segment configuration; however, few have reported on ventricular repolarization indexes in ERS. A total of 145 subjects were enrolled: 10 ERS patients, 45 uneventful ER pattern (ERP) subjects, and 90 healthy controls without J waves or ST-segment elevation. Ambulatory ECG-derived parameters (QT, QTc(B), QTc(F), T peak-Tend(Tpe), and QT/RR slope) were measured and statistically compared. Among the groups, there was no significant difference in the average QT and QTc(B); however, ERS patients had the shortest QTc(F) and longest Tpe (QTc(F): 396.2 ± 19 vs 410.4 ± 20 vs 419.2 ± 19 milliseconds, P = 0.036, Tpe: 84.9 ± 12 vs 70.4 ± 11 vs 66.9 ± 15 milliseconds, P < 0.001, for the ERS, ERP, and control groups, respectively). Importantly, the 24-hour QT/RR slope was significantly smaller in the ERS than ERP and control groups (QT/RR: 0.105 ± 0.01 vs 0.154 ± 0.02 vs 0.161 ± 0.03, respectively; P < 0.001). When analyzing the diurnal and nocturnal QT/RR slopes, ERS patients had small diurnal and nocturnal QT/RR slopes while the ERP and control groups had large diurnal and small nocturnal QT/RR slopes (diurnal QT/RR: 0. 077 ± 0.01 vs 0.132 ± 0.03 vs 0.143 ± 0.03, P < 0.001; nocturnal QT/RR: 0.093 ± 0.02 vs 0.129 ± 0.03 vs 0.130 ± 0.04, P = 0.02 in the ERS, ERP, and control groups, respectively). ERS patients had a continuously depressed diurnal and nocturnal adaptation of the QT interval to the heart rate. Such abnormal repolarization dynamics might provide a substrate for reentry and be an important element for developing ventricular fibrillation in the ERS cohort.
    Article · Dec 2012 · Journal of Cardiovascular Electrophysiology
  • [Show abstract] [Hide abstract] ABSTRACT: Large infarcts are associated with a terminal QRS-distortion in ST-elevation myocardial infarction (STEMI) patients. Late gadolinium enhancement (LGE) on the cardiac MRI (CMR) can depict an infarct distribution. However, less is known about the relationship between the LGE findings and QRS-distortion on admission, including the best ECG-lead location to reveal the QRS-distortion (DIS-lead) in STEMI patients. Fifty STEMI patients successfully treated with percutaneous coronary intervention were classified into two groups according to whether the QRS-distortion was positive (+) or negative (-). The LGE on a recent CMR was classified into 12 left ventricular segments (Basal-Middle-Apical × Anterior-Septal-Inferior-Lateral). The coincidences between the segmental LGE scores and DIS-lead were investigated. All patients were divided into 23 QRS-distortion (+) and 27 QRS-distortion (-) groups. The total LGE score was significantly greater in the QRS-distortion (+) group (14.7 ± 6.8 versus 9.6 ± 6.2, P < 0.01). The highest LGE score in 96% of QRS-distortion (+) patients was 4, and a score 4 segment indicated a good selection of the DIS-lead (86.4%). QRS-distortion in the ECG on admission represents severe transmural infarction in the LGE using CMR, which represents large infarcts in STEMI patients.
    Article · Oct 2012 · International Heart Journal
  • [Show abstract] [Hide abstract] ABSTRACT: We describe a case of early repolarization syndrome in which augmented J waves were documented during an electrical storm associated with hypokalemia. The patient was referred to our hospital for therapy to treat recurrent ventricular fibrillation (VF). The 12-lead electrocardiogram showed giant J waves associated with hypokalemia during multiple episodes of VF. Although antiarrhythmic agents or deep sedation were not effective for the VF, an intravenous supplementation of potassium completely suppressed the VF with a reduction in the J-wave amplitude. Our report discusses the possible relationship between hypokalemia and VF in early repolarization syndrome.
    Article · Jun 2012 · Pacing and Clinical Electrophysiology
  • [Show abstract] [Hide abstract] ABSTRACT: J Wave Syndromes. Introduction: Recently, great attention has been paid to the risk stratification of asymptomatic patients with an electrocardiographic early repolarization (ER) pattern. We investigated several repolarization parameters including the Tpeak-Tend interval and Tpeak-Tend/QT ratio in healthy individuals and patients with J wave syndrome who were aborted from sudden cardiac death. Methods and Results: Ninety-two subjects were enrolled: 12 patients with ventricular fibrillation associated with J waves, 40 healthy subjects with an uneventful ER pattern and 40 healthy control subjects (C) without any evident J waves. Using ambulatory electrocardiogram recordings, the average QT interval, corrected QT interval (QTc), Tpeak-Tend (Tp-e) interval, which is the interval from the peak to the end of the T wave, and Tp-e/QT ratio were calculated. Using ANOVA and post hoc analysis, there was no significant difference in the average QT and QTc in all 3 groups (QT; 396 ± 27 vs 405 ± 27 vs 403 ± 27 m, QTc; 420 ± 26 vs 421 ± 21 vs 403 ± 19 milliseconds in the C, ER pattern and J groups, respectively). The Tp-e interval and Tp-e/QT ratio were significantly more increased in the J wave group than the ER Pattern group (Tp-e: 86.7 ± 14 milliseconds vs 68 ± 13.2 milliseconds, P < 0.001, Tp-e/QT; 0.209 ± 0.04 vs 0.171 ± 0.03, P < 0.001), but they did not significantly differ between the C and ER pattern groups (Tp-e: 68.6 ± 7.5 vs 68 ± 13.2, P = 0.97, Tp-e/QT 0.174 ± 0.02 vs 0.171 ± 0.03, P = 0.4). Conclusion: As novel markers of heterogeneity of ventricular repolarization, Tpeak-Tend interval and Tp-Te/QT ratio are significantly increased in patients with J wave syndromes compared to age and sex-matched uneventful ER. (J Cardiovasc Electrophysiol, Vol. 23 pp. 1109-1114, October 2012)
    Article · Apr 2012 · Journal of Cardiovascular Electrophysiology
  • Toshiharu Takeuchi · Hisanobu Ota · Naoyuki Hasebe
    [Show abstract] [Hide abstract] ABSTRACT: Background Many trials have shown that 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors reduce the incidence of cardiovascular events and mortality. One method of decreasing the incidence of cardiovascular events could be to reduce the progression of coronary atherosclerosis, and a recent study found that atorvastatin can cause coronary plaque to regress. To generalize this finding, using conventional HMG-CoA reductase inhibitors at many Japanese centers, randomized trials of pitavastatin and atorvastatin will be conducted with patients with acute coronary syndrome (ACS). Methods and Results Patients with ACS who have undergone successful percutaneous coronary intervention under intravascular ultrasound guidance will be studied. They will be randomly allocated to pitavastatin or atorvastatin groups and followed up for 8-12 months. The primary endpoint will be the percent change in coronary plaque volume, and secondary endpoints will include absolute changes in coronary plaque volume, serum lipid levels and inflammatory markers. The safety profile will also be evaluated. Conclusions This study will examine the ability of HMG-CoA reductase inhibitors to regress coronary plaque in Japanese patients with ACS and the findings should help to improve the prognosis of such patients and clarify the involved mechanisms. (Circ J 2006; 70: 1624 - 1628)
    Article · Nov 2011 · Nippon rinsho. Japanese journal of clinical medicine
  • [Show abstract] [Hide abstract] ABSTRACT: Fabry disease is an X-linked lysosomal storage disorder caused by mutations of the α-galactosidase A gene (GLA), and the disease is a relatively prevalent cause of left ventricular hypertrophy mimicking idiopathic hypertrophic cardiomyopathy. We assessed clinically 5 patients of a three-generation family and also searched for GLA mutations in 10 family members. The proband had left ventricular hypertrophy with localized thinning in the basal posterior wall and late gadolinium enhancement (LGE) in the near-circumferential wall in cardiovascular magnetic resonance images and her sister had vasospastic angina pectoris without organic stenosis of the coronary arteries. LGE notably appeared in parallel with decreased α-galactosidase A activity and increased NT-pro BNP in our patients. We detected a new GLA missense mutation (G195V) in exon 4, resulting in a glycine-to-valine substitution. Of the 10 family members, 5 family members each were positive and negative for this mutation. These new data extend our clinical and molecular knowledge of GLA gene mutations and confirm that a novel missense mutation in the GLA gene is important not only for a precise diagnosis of heterozygous status, but also for confirming relatives who are negative for this mutation.
    Article · Sep 2011 · International Heart Journal