Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 13 de 13
Filter
1.
J Cardiol Cases ; 10(2): 54-57, 2014 Aug.
Article in English | MEDLINE | ID: mdl-30546505

ABSTRACT

Rates of morbidity and mortality from cardiovascular disease are high in patients with rheumatoid arthritis (RA); however, the mechanisms and biomarkers that reflect coronary plaque vulnerability have not yet been established. We present a case of acute coronary syndrome (ACS) presumably caused by exacerbation of chronic inflammation of RA, in which an abrupt increase in serum triglyceride was seen on the day of onset of ACS but not during effort angina. This case suggests that RA patients with an abrupt increase in triglyceride need intensive care including anti-platelet and statin therapy for the prevention of coronary plaque rupture. .

2.
Atherosclerosis ; 229(1): 182-5, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23639859

ABSTRACT

Evaluation of atherosclerotic plaques depends on invasive intravascular ultrasonography (IVUS). Carboxy-terminal telopeptide of type I collagen (ICTP) is produced by matrix metalloproteinase (MMP)-dependent digestion of type I collagen. Because vulnerable plaques are rich in type I collagen and MMPs from macrophages, we examined the association between serum ICTP and coronary plaques in patients with coronary disease. We recruited 46 men and 17 women without renal failure or bone diseases affecting serum ICTP, who underwent coronary IVUS. Serum ICTP levels were higher in patients with coronary plaques containing more than 10% necrotic core area than in patients with less than 10% necrotic core area. A positive correlation was found between serum ICTP and necrotic core area. Only serum ICTP was positively correlated with necrotic core area by multivariate analysis (p < 0.05). These results suggest that serum ICTP can be used as a non-invasive marker of vulnerable plaques in atherosclerotic patients.


Subject(s)
Collagen Type I/blood , Coronary Artery Disease/blood , Coronary Artery Disease/epidemiology , Peptides/blood , Plaque, Atherosclerotic/blood , Plaque, Atherosclerotic/epidemiology , Acute Coronary Syndrome/blood , Acute Coronary Syndrome/epidemiology , Acute Coronary Syndrome/pathology , Aged , Aged, 80 and over , Biomarkers/blood , Coronary Artery Disease/pathology , Cross-Sectional Studies , Female , Humans , Male , Matrix Metalloproteinases/metabolism , Middle Aged , Morbidity , Necrosis , Pilot Projects , Plaque, Atherosclerotic/pathology , Risk Factors
3.
Intern Med ; 49(10): 907-12, 2010.
Article in English | MEDLINE | ID: mdl-20467175

ABSTRACT

Congenital ventricular diverticulum (CVD) in adults is a rare cardiac malformation, which includes fibrous type congenital ventricular aneurysm (CVA). CVA is often clinically asymptomatic and shows no abnormality in the electrocardiogram or chest X-ray. However, some cases of sudden death resulting from ventricular tachycardia, cardiac embolism or ventricular rupture have been reported. Therefore, physicians should perform further cardiac imaging studies to detect a CVA if ventricular arrhythmia originating from the left ventricle is observed. Here, we report two successfully followed cases of CVA which were diagnosed from premature ventricular contractions.


Subject(s)
Heart Aneurysm/congenital , Heart Aneurysm/complications , Heart Ventricles/abnormalities , Ventricular Premature Complexes/etiology , Aged , Diverticulum/complications , Diverticulum/congenital , Echocardiography , Electrocardiography , Female , Heart Aneurysm/diagnosis , Heart Ventricles/diagnostic imaging , Humans , Male , Middle Aged , Tachycardia, Ventricular/etiology
4.
Acta Cardiol ; 64(5): 589-95, 2009 Oct.
Article in English | MEDLINE | ID: mdl-20058503

ABSTRACT

OBJECTIVE: The purpose of the present study was to determine whether change in plasma brain natriuretic peptide (BNP) level at an early phase of carvedilol therapy is a predictor of improvement in cardiac function and long-term prognosis in patients with systolic chronic heart failure (CHF). METHODS AND RESULTS: Neurohumoral factors and haemodynamics were examined in 64 patients with systolic CHF (left ventricular ejection fraction (LVEF) below 45%) before and one month (early phase) and 3 to 6 months (late phase) after the start of carvedilol therapy. These patients were followed up for a mean period of 57 months. Plasma BNP levels were already decreased in the early phase before improvement of LVEF in response to carvedilol therapy. Univariate and multivariate linear regression analyses showed that Delta log brain natriuretic peptide (BNP)E (= log BNP at baseline--log BNP at early phase) (P < 0.0001) was a significant independent predictor of improvement in LVEF in the late phase. Cardiac events occurred in I I patients during the follow-up period. In addition, multivariate Cox proportional hazards regression analysis showed that Delta log BNPE (P = 0.0045) and systolic blood pressure at baseline (P = -0.048) were significant independent predictors of the development of cardiac events. CONCLUSIONS: Decrease in plasma BNP level in the early phase of carvedilol therapy is a novel predictor of not only improvement of LVEF in the late phase but also prognosis in patients with systolic CHF.


Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Carbazoles/therapeutic use , Heart Failure, Systolic/blood , Natriuretic Peptide, Brain/blood , Propanolamines/therapeutic use , Adrenergic beta-Antagonists/administration & dosage , Adult , Aged , Biomarkers/blood , Carbazoles/administration & dosage , Carvedilol , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Heart Failure, Systolic/drug therapy , Heart Failure, Systolic/mortality , Humans , Immunoradiometric Assay , Japan/epidemiology , Male , Middle Aged , Propanolamines/administration & dosage , Retrospective Studies , Stroke Volume/drug effects , Survival Rate/trends , Time Factors , Treatment Outcome
5.
Intern Med ; 47(12): 1113-6, 2008.
Article in English | MEDLINE | ID: mdl-18552468

ABSTRACT

Lactobacillus (LB) is a gram-positive rod-shaped bacterium that inhabits the oral cavity, gastrointestinal tract, vagina and nasal cavity. Although LB plays a role in the prevention of infections caused by pathogenic bacteria, it causes some critical infectious diseases such as infective endocarditis (IE). IE due to LB is rare; however, early diagnosis and early treatment are important because of its high mortality rate. We report the onset of IE after otologic treatment in a heavy drinker of alcohol, the second case of IE due to LB in Japan.


Subject(s)
Endocarditis, Bacterial/microbiology , Gram-Positive Bacterial Infections/microbiology , Immunocompromised Host , Lactobacillus , Mitral Valve Insufficiency/microbiology , Adult , Alcoholism/immunology , Endocarditis, Bacterial/immunology , Endocarditis, Bacterial/surgery , Gram-Positive Bacterial Infections/immunology , Heart Valve Prosthesis Implantation , Humans , Male , Mitral Valve Insufficiency/immunology , Mitral Valve Insufficiency/surgery
6.
Intern Med ; 46(20): 1705-10, 2007.
Article in English | MEDLINE | ID: mdl-17938525

ABSTRACT

AL amyloidosis is a disease in which immunoglobulin L chain is deposited in multiple organs, and the prognosis of cardiac amyloidosis is extremely poor. Although several treatments based on that for multiple myeloma, have been performed, there is no clear evidence that cardiac function is improved. We report a case of AL cardiac amyloidosis with moderate cardiac dysfunction for which we performed autologous peripheral blood stem cell transplantation (auto-PBSCT) in combination with high-dose melphalan therapy. This treatment resulted in significant improvement in cardiac function and good prognosis for about 3.5 years after the diagnosis. Therefore, auto-PBSCT is a possible option as up-front therapy for AL cardiac amyloidosis.


Subject(s)
Amyloidosis/therapy , Cardiomyopathies/therapy , Peripheral Blood Stem Cell Transplantation , Amyloidosis/physiopathology , Cardiomyopathies/physiopathology , Combined Modality Therapy , Female , Heart/physiopathology , Humans , Melphalan/administration & dosage , Middle Aged , Prognosis
7.
Circ J ; 70(8): 1082-5, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16864946

ABSTRACT

Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are autoimmune inflammatory diseases associated with juvenile atherosclerosis and thrombosis, respectively. A 44-year-old woman who had SLE with secondary APS had been treated with corticosteroid therapy, however, her inflammatory marker had never been within a normal range in her clinical course, and finally acute myocardial infarction was developed. Intra-vascular ultrasound also revealed diffuse coronary atherosclerosis progression for her age, which might result from SLE and APS, including vascular inflammation.


Subject(s)
Antiphospholipid Syndrome/etiology , Antiphospholipid Syndrome/pathology , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/etiology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/pathology , Adrenal Cortex Hormones/therapeutic use , Adult , Coronary Artery Disease/pathology , Coronary Vessels/diagnostic imaging , Coronary Vessels/pathology , Female , Humans , Lupus Erythematosus, Systemic/drug therapy , Myocardial Infarction/etiology , Ultrasonography, Interventional
8.
Atherosclerosis ; 183(1): 49-55, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16216591

ABSTRACT

OBJECTIVE: We hypothesized that aspirin may exhibit its anti-atherosclerotic effects via mechanisms other than cyclooxygenase inhibition in platelets. METHODS AND RESULTS: Using enhanced subtraction hybridization analysis, we found in human umbilical vein endothelial cells (HUVECs) that aspirin up-regulates the expression of aminopeptidase N (APN/CD13) mRNA and its surface protein levels in a dose-dependent manner. Enzymatic activity of APN/CD13 on HUVECs was increased approximately 1.5-fold by 1 mmol L(-1) of aspirin, and treatment with bestatin, an inhibitor for APN/CD13 metalloprotease activity, attenuated the enhanced activities of APN/CD13. Since activated thrombin receptor is reported to be inactivated by APN/CD13 in vitro, protective actions of aspirin on HUVECs by thrombin stimulation were examined, resulting in the suppression of endothelin-1 and reactive oxygen species productions in HUVECs. These inhibitory actions of aspirin were partially abrogated by bestatin. CONCLUSIONS: Aspirin may exert its anti-atherothrombotic effects in part via the inhibition of thrombin action by up-regulating APN/CD13 on endothelial cells.


Subject(s)
Aspirin/pharmacology , CD13 Antigens/biosynthesis , Endothelium, Vascular/drug effects , Fibrinolytic Agents/pharmacology , CD13 Antigens/antagonists & inhibitors , CD13 Antigens/genetics , CD13 Antigens/physiology , Cells, Cultured/drug effects , Cells, Cultured/enzymology , Endothelial Cells/drug effects , Endothelial Cells/enzymology , Endothelin-1/biosynthesis , Endothelin-1/genetics , Endothelium, Vascular/enzymology , Enzyme Induction/drug effects , Genes, Reporter , Humans , Leucine/analogs & derivatives , Leucine/pharmacology , Protease Inhibitors/pharmacology , RNA, Messenger/biosynthesis , Reactive Oxygen Species/metabolism , Subtraction Technique , Thrombin/antagonists & inhibitors , Thrombin/pharmacology , Transcription, Genetic/drug effects , Transfection , Umbilical Veins
9.
J Biol Chem ; 280(33): 29661-6, 2005 Aug 19.
Article in English | MEDLINE | ID: mdl-15961403

ABSTRACT

Androgen has anabolic effects on cardiac myocytes and has been shown to enhance left ventricular enlargement and function. However, the physiological and patho-physiological roles of androgen in cardiac growth and cardiac stress-induced remodeling remains unclear. We aimed to clarify whether the androgen-nuclear androgen receptor (AR) system contributes to the cardiac growth and angiotensin II (Ang II)-stimulated cardiac remodeling by using systemic AR-null male mice. AR knock-out (ARKO) male mice, at 25 weeks of age, and age-matched wild-type (WT) male mice were treated with or without Ang II stimulation (2.0 mg/kg/day) for 2 weeks. ARKO mice with or without Ang II stimulation showed a significant reduction in the heart-to-body weight ratio compared with those of WT mice. In addition, echocardiographic analysis demonstrated impairments of both the concentric hypertrophic response and left ventricular function in Ang II-stimulated ARKO mice. Western blot analysis of the myocardium revealed that activation of extracellular signal-regulated kinases (ERK) 1/2 and ERK5 by Ang II stimulation were lower in ARKO mice than those of WT mice. Ang II stimulation caused more prominent cardiac fibrosis in ARKO mice than in WT mice with enhanced expression of types I and III collagen and transforming growth factor-beta1 genes and with increased Smad2 activation. These results suggest that, in male mice, the androgen-AR system participates in normal cardiac growth and modulates cardiac adaptive hypertrophy and fibrosis during the process of cardiac remodeling under hypertrophic stress.


Subject(s)
Angiotensin II/pharmacology , Cardiomegaly/etiology , Myocardium/pathology , Receptors, Androgen/physiology , Animals , Blood Pressure , DNA-Binding Proteins/metabolism , Fibrosis , Heart Rate , Male , Mice , Mice, Inbred C57BL , Mice, Inbred CBA , Mice, Knockout , Mitogen-Activated Protein Kinase 1/metabolism , Mitogen-Activated Protein Kinase 3/metabolism , Mitogen-Activated Protein Kinase 7/metabolism , RNA, Messenger/analysis , Receptors, Androgen/genetics , Smad2 Protein , Trans-Activators/metabolism , Transforming Growth Factor beta/genetics , Transforming Growth Factor beta1 , Ventricular Remodeling
10.
Atherosclerosis ; 178(1): 39-47, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15585199

ABSTRACT

Consistent with the physiological response to increased energy demand in proliferating cells, the number of mitochondria is upregulated in synthetic states of vascular smooth muscle cells (VSMC) in atherosclerotic lesion. We hypothesized that mitochondrial transcription factor A (mtTFA), a prerequisite factor for the transcription and replication of mtDNA, may be upregulated in VSMC of injured rat carotid artery, and that inhibition of its expression can attenuate the intimal thickening. Changes of intimal thickening and mtTFA expression by a treatment with antisense oligodeoxynucleotides (ODN) for mtTFA were investigated in balloon-injured rat carotid artery model. The expression of mtTFA was upregulated as early as 3 h up to 7 days after balloon injury. Delivery of ansisense ODN for mtTFA from adventitia side to injured arterial wall caused a significant decrease in intima-to-media (I/M) ratio. Furthermore, the increase in immunoreactivity and mRNA expression of mtTFA in injured artery as well as the number of mitochondria in intimal VSMC was abrogated by antisense ODN treatment. These data demonstrate that expression of mtTFA is upregulated in intimal VSMC of injured rat carotid artery, and that suppression of mtTFA expression by antisense ODN can attenuate intimal thickening after balloon injury.


Subject(s)
Carotid Artery Injuries/metabolism , Carotid Artery Injuries/pathology , DNA-Binding Proteins/metabolism , Mitochondrial Proteins/metabolism , Muscle, Smooth, Vascular/pathology , Myocytes, Smooth Muscle/pathology , Nuclear Proteins/metabolism , Transcription Factors/metabolism , Up-Regulation , Animals , Carotid Arteries/drug effects , Carotid Arteries/metabolism , Carotid Arteries/pathology , Carotid Artery Injuries/etiology , Catheterization , Cell Proliferation , DNA, Mitochondrial/antagonists & inhibitors , DNA-Binding Proteins/antagonists & inhibitors , DNA-Binding Proteins/genetics , Immunohistochemistry , Male , Microscopy, Electron , Mitochondrial Proteins/antagonists & inhibitors , Mitochondrial Proteins/genetics , Nuclear Proteins/antagonists & inhibitors , Nuclear Proteins/genetics , Oligonucleotides, Antisense/pharmacology , RNA, Messenger/metabolism , Rats , Rats, Sprague-Dawley , Tissue Distribution , Transcription Factors/antagonists & inhibitors , Transcription Factors/genetics
11.
J Biol Chem ; 279(34): 35798-802, 2004 Aug 20.
Article in English | MEDLINE | ID: mdl-15205460

ABSTRACT

Vitamin D metabolites influence the expression of various genes involved in calcium homeostasis, cell differentiation, and regulation of the immune system. Expression of these genes is mediated by the activation of the nuclear vitamin D receptor (VDR). Previous studies have shown that a hormonally active form of vitamin D, 1alpha,25-dihydroxyvitamin D3, exerts anticoagulant effects in cultured monocytic cells. To clarify whether activation of VDR plays any antithrombotic actions in vivo, hemostatic/thrombogenic systems were examined in normocalcemic VDR knock-out (KO) mice on a high calcium diet and compared with wild type and hypocalcemic VDRKO mice that were fed a regular diet. Platelet aggregation was enhanced significantly in normocalcemic VDRKO mice compared with wild type and hypocalcemic VDRKO mice. Aortic endothelial nitric-oxide (NO) synthase expression and urinary NOx excretions were reduced in hypocalcemic VDRKO mice, but not in normocalcemic VDRKO mice. Northern blot and RT-PCR analyses revealed that the gene expression of antithrombin in the liver as well as that of thrombomodulin in the aorta, liver and kidney was down-regulated in hypo- and normocalcemic VDRKO mice. Whereas tissue factor mRNA expression in the liver and kidney was up-regulated in VDRKO mice regardless of plasma calcium level. Furthermore, VDRKO mice manifested an exacerbated multi-organ thrombus formation after exogenous lipopolysaccharide injection regardless of the calcemic conditions. These results demonstrate that activation of nuclear VDR elicits antithrombotic effects in vivo, and suggest that the VDR system may play a physiological role in the maintenance of antithrombotic homeostasis.


Subject(s)
Blood Coagulation/genetics , Receptors, Calcitriol/genetics , Animals , Blood Coagulation/physiology , Calcium/administration & dosage , Calcium/metabolism , Diet , Down-Regulation , Gene Deletion , Gene Expression Regulation , Mice , Mice, Knockout , Nitric Oxide Synthase/biosynthesis , Nitric Oxide Synthase Type II , Nitric Oxide Synthase Type III , Organ Specificity , Receptors, Calcitriol/metabolism , Thrombin/biosynthesis , Thrombomodulin/biosynthesis
12.
Circulation ; 109(22): 2761-5, 2004 Jun 08.
Article in English | MEDLINE | ID: mdl-15148272

ABSTRACT

BACKGROUND: Thrombin plays a crucial role in atherothrombotic changes. Because heparin cofactor II (HCII) inhibits thrombin actions after binding to dermatan sulfate at injured arterial walls, HCII may negatively regulate thrombin actions in vascular walls. We hypothesized that plasma HCII activity is a preventive factor against atherosclerotic changes, especially in elderly individuals who already have atherosclerotic vascular injuries. METHODS AND RESULTS: Maximum plaque thickness (MPT) in the carotid artery was measured by ultrasonography in 306 Japanese elderly individuals (154 men and 152 women; age, 40 to 91 years; 68.9+/-11.1 years, mean+/-SD). The relevance of cardiovascular risk factors including plasma HCII activity to the severity of MPT was statistically evaluated. Plasma HCII activity decreased with age. Simple linear regression analysis after adjustments for age and sex showed that lipoprotein(a), glycosylated hemoglobin A1c, and presence of diabetes mellitus significantly contributed to an increase in MPT values (r=0.119, P<0.05; r=0.196, P<0.001; and r=0.227, P<0.0001, respectively). In contrast, high-density lipoprotein (HDL) cholesterol and HCII activity were negatively correlated with MPT values (r=-0.117, P<0.05, and r=-0.202, P<0.0005, respectively). Multiple regression analysis revealed that plasma HCII activity and HDL cholesterol independently contributed to the suppression of MPT values and that the antiatherogenic contribution of HCII activity was stronger than that of HDL cholesterol (P<0.001 and P<0.05, respectively). CONCLUSIONS: These results suggest that HCII can be a novel and independent antiatherogenic factor. Moreover, HCII is a stronger predictive factor than HDL cholesterol against carotid atherosclerosis in elderly individuals.


Subject(s)
Carotid Artery Diseases/blood , Heparin Cofactor II/physiology , Adult , Aged , Aged, 80 and over , Aging/blood , Antithrombins/analysis , Cardiovascular Diseases/blood , Carotid Artery Diseases/diagnostic imaging , Female , Heparin Cofactor II/analysis , Humans , Male , Middle Aged , Regression Analysis , Risk Factors , Severity of Illness Index , Ultrasonography
13.
Angiology ; 54(4): 485-90, 2003.
Article in English | MEDLINE | ID: mdl-12934770

ABSTRACT

A 52-year-old man was admitted to the hospital because of unstable angina pectoris. Coronary angiography revealed severe stenosis at a proximal site of the left anterior descending artery. Essential thrombocythemia (ET) was diagnosed on the basis of findings of marked thrombocytosis (106 x 10(4)/microL) and an increased number of immature megakaryocytes in the bone marrow. Because hyperaggregability of platelets was demonstrated by an ex vivo platelet aggregation assay and by elevated plasma levels of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4), antiplatelet therapy with aspirin and ticlopidine and cytoreduction therapy with hydroxyurea were started. This combination treatment resulted in a decrease in the platelet count to less than 60 x 10(4)/microL and decreases in plasma levels of both beta-TG and PF4 to almost normal values. Percutaneous coronary angioplasty and stenting were then performed successfully without thrombotic complications. These findings suggest that combination therapy with antiplatelet and cytoreduction agents before catheter intervention is useful for the prevention of thrombotic complications in patients with acute coronary syndrome associated with essential thrombocythemia.


Subject(s)
Angina, Unstable/complications , Angina, Unstable/therapy , Coronary Stenosis/therapy , Platelet Aggregation Inhibitors/therapeutic use , Stents , Thrombocythemia, Essential/complications , Acute Disease , Aspirin/therapeutic use , Combined Modality Therapy , Humans , Hydroxyurea/therapeutic use , Male , Middle Aged , Thrombocythemia, Essential/drug therapy , Ticlopidine/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL
...