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1.
Heart Vessels ; 25(2): 113-20, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20339972

ABSTRACT

An unhealthy lifestyle can increase the risk of cardiovascular disease. However, the mechanism by which lifestyle influences the development of cardiovascular disease remains unclear. Since coronary endothelial function is a predictor of cardiovascular prognosis, the goal of this study was to characterize the effect of enjoying hobbies on coronary endothelial function and cardiovascular outcomes. A total of 121 consecutive patients (76 men, 45 women) with almost normal coronary arteries underwent Doppler flow study of the left anterior descending coronary artery following sequential administration of papaverine, acetylcholine, and nitroglycerin. On the basis of responses to questionnaires, patients were divided into two groups; the Hobby group (n = 71) who enjoyed hobbies, and the Non-hobby group (n = 50) who had no hobbies. Cardiovascular outcomes were assessed at long-term follow-up using medical records or questionnaire surveys for major adverse cardiovascular events (MACE).The average follow-up period was 916 +/- 515 days. There were no significant differences in demographics when comparing the two groups. The percent change in coronary blood flow and coronary artery diameter induced by acetylcholine was significantly greater in the Hobby group than in the Non-hobby group (49% +/- 77% vs 25% +/- 37%, P < 0.05, 4% +/- 13% vs -3% +/- 20%, P < 0.05, respectively). The MACE rate was significantly lower in the Hobby group than in the Non-hobby group (P < 0.01). Enjoyment of hobbies was the only independent predictor of MACE (odds ratio 8.1 [95% confidence interval 1.60, 41.90], P = 0.01) among the variables tested. In the early stages of arteriosclerosis, enjoying hobbies may improve cardiovascular outcomes via its favorable effects on coronary endothelial function.


Subject(s)
Cardiovascular Diseases/psychology , Coronary Circulation , Coronary Vessels/physiopathology , Hobbies , Life Style , Pleasure , Risk Reduction Behavior , Stress, Psychological/complications , Acetylcholine/administration & dosage , Adolescent , Adult , Aged , Aged, 80 and over , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/etiology , Cardiovascular Diseases/physiopathology , Coronary Angiography , Coronary Circulation/drug effects , Coronary Vessels/diagnostic imaging , Coronary Vessels/drug effects , Disease-Free Survival , Echocardiography, Doppler , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Nitroglycerin/administration & dosage , Odds Ratio , Papaverine/administration & dosage , Prognosis , Proportional Hazards Models , Quality of Life , Risk Assessment , Risk Factors , Surveys and Questionnaires , Time Factors , Vasodilation , Vasodilator Agents/administration & dosage , Young Adult
2.
J Cardiol ; 53(2): 214-8, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19304125

ABSTRACT

BACKGROUND: We developed a Waon therapy (soothing warm therapy) and have previously reported that repeated Waon therapy improves hemodynamics, peripheral vascular function, arrhythmias, and clinical symptoms in patients with chronic heart failure (CHF). The aim of this study was to investigate the effect of Waon therapy on the prognosis of CHF patients. PATIENTS AND METHODS: We studied 129 patients with CHF in NYHA functional class III or IV who were admitted to our hospital between January 1999 and March 2001. In the Waon therapy group, 64 patients were treated with a far infrared-ray dry sauna at 60 degrees C for 15 min and then kept on bed rest with a blanket for 30 min. The patients were treated daily for 5 days during admission, and then at least twice a week after discharge. In the control group, 65 patients, matched for age, gender, and NYHA functional class, were treated with traditional CHF therapy. The follow-up time was scheduled for 5 years. RESULTS: Recent, complete follow-up data on each patient were obtained. The overall survival rate was 84.5% (Kaplan-Meier estimate). Twelve patients died in the control group and 8 patients died in the Waon therapy group at 60 months of follow-up. Cardiac events due to heart failure or cardiac death occurred in 68.7% of the control group but only 31.3% of the Waon therapy group (P<0.01) at 60 months of follow-up. CONCLUSION: Waon therapy reduced cardiac events in patients with CHF. This therapy is a promising non-pharmacological treatment for CHF.


Subject(s)
Heart Failure/therapy , Hyperthermia, Induced/methods , Chronic Disease , Female , Follow-Up Studies , Heart Failure/mortality , Humans , Infrared Rays , Male , Middle Aged , Prognosis , Steam Bath
3.
Heart Vessels ; 23(2): 83-90, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18389331

ABSTRACT

The comparative long-term antianginal efficacy of long-acting nitrates versus calcium channel antagonists remains unclear. The goal of the present study was to compare the coronary endothelial cell function and coronary artery vasoconstriction between patients with normal or mildly diseased coronary arteries treated with long-acting nitrates or calcium channel antagonists. Forty-two patients suspected to have angina pectoris and with normal or mildly diseased coronary arteries underwent Doppler flow study of the left anterior descending coronary artery. All patients were suspected to have angina pectoris and were receiving either long-acting nitrates (n = 18; Nitrates group) or calcium channel antagonists (n = 24; Ca-antagonists group) for at least 1 year. Vascular reactivity was assessed by intracoronary administration of papaverine, acetylcholine (Ach), and nitroglycerin using a Doppler guidewire. Segments that showed the greatest constrictive response to Ach were used for assessment of vasoconstriction. The percent increase in coronary blood flow (CBF) and coronary artery diameter (CAD) induced by Ach was significantly smaller in the Nitrates group than in the Ca-antagonists group (33% +/- 74% vs 83% +/- 77%, P < 0.05; -3% +/- 16% vs 11% +/- 12%, P < 0.01, respectively). The percent diameter reduction in the region of greatest constrictive response to Ach was significantly greater in the Nitrates group than in the Ca-antagonists group (44% +/- 39% vs 15% +/- 32%, P < 0.02). Long-term treatment with long-acting nitrates may produce less favorable effects on coronary endothelial function and the constrictive response to Ach when compared with long-acting calcium channel antagonists in patients with normal or mildly diseased coronary arteries.


Subject(s)
Angina Pectoris/drug therapy , Calcium Channel Blockers/therapeutic use , Coronary Artery Disease/drug therapy , Coronary Circulation/drug effects , Coronary Vessels/drug effects , Nitrates/therapeutic use , Vasoconstriction/drug effects , Vasodilation/drug effects , Acetylcholine/administration & dosage , Acetylcholine/adverse effects , Aged , Angina Pectoris/pathology , Angina Pectoris/physiopathology , Coronary Angiography , Coronary Artery Disease/pathology , Coronary Artery Disease/physiopathology , Coronary Vasospasm/chemically induced , Coronary Vasospasm/physiopathology , Coronary Vessels/pathology , Coronary Vessels/physiopathology , Female , Humans , Laser-Doppler Flowmetry , Male , Middle Aged , Nitroglycerin/administration & dosage , Papaverine/administration & dosage , Severity of Illness Index , Stress, Mechanical , Treatment Outcome , Vasodilator Agents/administration & dosage , Vasodilator Agents/adverse effects
4.
Int J Cardiol ; 126(1): 53-61, 2008 May 07.
Article in English | MEDLINE | ID: mdl-17477992

ABSTRACT

BACKGROUND: Previous studies have demonstrated that decreased levels of circulating adiponectin correlate with endothelial dysfunction in peripheral arteries. However, the relationship between adiponectin levels and endothelial function in coronary arteries remains unclear. The goal of the present study was to determine whether circulating adiponectin concentrations are a useful predictor of coronary endothelial function. METHODS: Thirty-six consecutive non-diabetic patients with normal or mildly diseased coronary arteries were enrolled in this study. Coronary endothelial function was evaluated by coronary vascular response to acetylcholine (Ach). The relationship between coronary vasoreactivity and adiponectin or other biochemical or anthropometric parameters was investigated. The predictive value of adiponectin level for assessment of coronary endothelial dysfunction was assessed at the best cut-off point. RESULTS: In a simple regression analysis, log-transformed adiponectin concentrations positively correlated with the percent change in coronary blood flow (CBF) and coronary artery diameter (CAD) induced by Ach (r=0.62, p<0.0001; r=0.63, p<0.0001, respectively). Insulin resistance index (HOMA-R), body mass index, immunoreactive insulin, and triglycerides concentrations also significantly correlated with the percent change in CBF and CAD. However, in a multiple regression analysis, log-transformed adiponectin concentration was the only independent predictor of the percent change in CBF and CAD (p<0.0001; p<0.0001, respectively). Furthermore, patients with adiponectin concentrations <6.3 mg/L demonstrated coronary endothelial dysfunction with high specificity both in terms of CBF and CAD response (85%; 88%, respectively). CONCLUSIONS: Adiponectin is a better predictor of coronary endothelial function than other factors such as HOMA-R, body mass index, immunoreactive insulin, and triglycerides.


Subject(s)
Adiponectin/blood , Body Mass Index , Coronary Circulation/physiology , Coronary Vessels/physiology , Endothelium, Vascular/physiology , Insulin Antibodies/blood , Insulin Resistance/immunology , Triglycerides/blood , Aged , Biomarkers/blood , Female , Homeostasis/physiology , Humans , Insulin Antibodies/biosynthesis , Male , Middle Aged , Models, Cardiovascular , Predictive Value of Tests
6.
Coron Artery Dis ; 18(1): 31-8, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17172927

ABSTRACT

OBJECTIVES: Toll-like receptors mediate the innate immune response triggered by pathogen-associated molecular patterns, and atherosclerosis can be considered a state of chronic inflammation whereby immune system cells accumulate within the intima of the arterial wall. The goal of this study was to determine the relation of Toll-like receptors to the extent and severity of coronary artery disease. METHODS: Angiographic vessel score and Gensini score were used to evaluate the extent and severity of coronary atherosclerosis. Sixty-two consecutive patients with stable angina were grouped as follows: those with insignificant (<50%) coronary stenosis (group 1), and those with 1 (group 2), 2 (group 3), or 3-vessel disease (group 4). The expression of Toll-like receptor 1, 2, and 4 on circulating CD14+ monocytes was analyzed by flow-cytometry in all patients. RESULTS: Toll-like receptor 2 had a positive correlation with the vessel score and Gensini score (r=0.46, P<0.001; r=0.32, P<0.02, respectively). Toll-like receptor 4 also positively correlated with the vessel score and Gensini score (r=0.47, P<0.001; r=0.29, P<0.05, respectively). No significant correlation existed between the expression of Toll-like receptor 1 and the vessel score or Gensini score. Further, there was no significant correlation between high-sensitivity C-reactive protein and the vessel score or Gensini score. CONCLUSION: These data suggest that Toll-like receptor 2 and 4 expression correlates with the extent and severity of coronary artery disease.


Subject(s)
Angina Pectoris/complications , Coronary Artery Disease/complications , Coronary Artery Disease/immunology , Toll-Like Receptors/immunology , Aged , Angina Pectoris/immunology , C-Reactive Protein/immunology , Coronary Angiography , Coronary Artery Disease/pathology , Disease Progression , Female , Humans , Lipopolysaccharide Receptors/immunology , Male , Monocytes/immunology , Toll-Like Receptor 1/immunology , Toll-Like Receptor 2/immunology , Toll-Like Receptor 4/immunology
7.
Pacing Clin Electrophysiol ; 29(9): 985-90, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16981923

ABSTRACT

BACKGROUND: Asynchronous electrical activation induced by right ventricular apex (RVA) pacing can cause various abnormalities in left ventricular (LV) function, particularly in the context of severe LV dysfunction or structural heart disease. However, the effect of RVA pacing in patients with normal LV and right ventricular (RV) function has not been fully elucidated. The aim of this study was to characterize the effects of RVA pacing on LV and RV function by assessing isovolumic contraction time and isovolumic relaxation time divided by ejection time (Tei index) and by assessing changes in plasma brain natriuretic peptide (BNP). METHODS: Doppler echocardiographic study and BNP measurements were performed at follow-up (mean intervals from pacemaker implantation, 44+/-75 months) in 76 patients with dual chamber pacemakers (sick sinus syndrome, n=30; atrioventricular block, n=46) without structural heart disease. Patients were classified based on frequency of RVA pacing, as determined by 24-hour ambulatory electrocardiogram (ECG) that was recorded just before echocardiographic study: pacing group, n=46 patients with RVA pacing>or=50% of the time, percentage of ventricular paced 100+/-2%; sensing group, n=30, patients with RVA pacing<50% of the time, percentage of ventricular paced 3+/-6%. RESULTS: There was no significant difference in mean heart rate derived from 24-hour ambulatory ECG recordings when comparing the two groups (66+/-11 bpm vs 69+/-8 bpm). LV Tei index was significantly higher in pacing group than in sensing group (0.67+/-0.17 vs 0.45+/-0.09, P<0.0001), and the RV Tei index was significantly higher in pacing group than in sensing group (0.34+/-0.19 vs 0.25+/-0.09, P=0.011). Furthermore, BNP levels were significantly higher in pacing group than in sensing group (40+/-47 pg/mL vs 18+/-11 pg/mL, P=0.017). With the exception of LV diastolic dimension (49+/-5 mm vs 45+/-5 mm, P=0.012), there were no significant differences in other echocardiographic parameters, including left atrium (LA) diameter (35+/-8 mm vs 34+/-5 mm), LA volume (51+/-27 cm3 vs 40+/-21 cm3), LV systolic dimension (30+/-6 mm vs 29+/-7 mm), or ejection fraction (66+/-9% vs 63+/-11%), when comparing the two groups. CONCLUSIONS: These findings suggest that the increase of LV and RV Tei index, LVDd, and BNP are highly correlated with the frequency of the RVA pacing in patients with dual chamber pacemakers.


Subject(s)
Cardiac Pacing, Artificial/adverse effects , Natriuretic Peptide, Brain/blood , Pacemaker, Artificial/adverse effects , Stroke Volume , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Right/diagnosis , Ventricular Dysfunction, Right/prevention & control , Aged , Equipment Failure , Female , Health Status Indicators , Humans , Male , Middle Aged , Treatment Outcome
8.
J Cardiol ; 48(3): 125-32, 2006 Sep.
Article in English | MEDLINE | ID: mdl-17007237

ABSTRACT

BACKGROUND: Plasma levels of brain natriuretic peptide (BNP) correlate with left ventricular remodeling, but the relationship between BNP induction and coronary function remains unclear. OBJECTIVES: The present study assessed BNP production in response to left ventricular enlargement and investigated the relationship between BNP production and coronary vasodilating function in patients with left ventricular remodeling. METHODS: Patients (n = 63) with normal or mildly diseased coronary arteries underwent Doppler flow study of the left anterior descending coronary artery. Vascular reactivity was examined using intracoronary acetylcholine, papaverine and nitroglycerin using a Doppler guidewire. RESULTS: Left ventricular end-diastolic dimension was positively correlated with BNP (r = 0.45, p < 0.001) in all patients. BNP was significantly and inversely correlated with percentage change in coronary artery diameter induced by acetylcholine (r = -0.56, p < 0.001) but not by nitroglycerin (r = -0.20, p = 0.28) in patients with left ventricular end-diastolic dimension > or = 55 mm (n = 32). By contrast, BNP was not significantly correlated with percentage change in coronary artery diameter induced by either acetylcholine or nitroglycerin in patients with left ventricular end-diastolic dimension < 55 mm (n = 31). Further, BNP was not correlated with the percentage change in coronary blood flow induced by acetylcholine or by papaverine in patients with or without left ventricular remodeling. CONCLUSIONS: The elevation in plasma BNP levels that occurs in association with left ventricular enlargement is a predictor of impaired endothelium-dependent vasodilation in conductance coronary arteries.


Subject(s)
Coronary Disease/diagnosis , Coronary Disease/physiopathology , Endothelium, Vascular/physiopathology , Natriuretic Peptide, Brain/blood , Ventricular Remodeling/physiology , Adult , Aged , Biomarkers/blood , Coronary Vessels/physiopathology , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Vasodilation
9.
J Psychosom Res ; 58(4): 383-7, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15992574

ABSTRACT

OBJECTIVE: This paper describes the successful treatment of two patients with chronic fatigue syndrome (CFS) using repeated thermal therapy. METHODS: Two patients with CFS underwent treatment with prednisolone (PSL), with no satisfactory effect. They were subjected to thermal therapy that consisted of a far-infrared ray dry sauna at 60 degrees C and postsauna warming. The therapy was performed once a day, for a total of 35 sessions. After discharge, these subjects continued the therapy once or twice a week on an outpatient basis for 1 year. RESULTS: Symptoms such as fatigue, pain, sleep disturbance, and low-grade fever were dramatically improved after 15 to 25 sessions of thermal therapy. Although PSL administration was discontinued, the subjects showed no relapse or exacerbation of symptoms during the first year after discharge. The patients became socially rehabilitated 6 months after discharge. CONCLUSIONS: These results suggest that repeated thermal therapy might be a promising method for the treatment of CFS.


Subject(s)
Fatigue Syndrome, Chronic/rehabilitation , Steam Bath , Adult , Fatigue Syndrome, Chronic/diagnosis , Female , Follow-Up Studies , Heating , Humans , Infrared Rays/therapeutic use , Pain Measurement , Prednisolone/therapeutic use , Retreatment , Treatment Failure , Treatment Outcome
10.
Circ J ; 68(12): 1146-51, 2004 Dec.
Article in English | MEDLINE | ID: mdl-15564698

ABSTRACT

BACKGROUND: The aim of the present study was to determine whether repeated 60 degrees C sauna treatment improves cardiac arrhythmias in chronic heart failure (CHF) patients, because ventricular arrhythmias are an important therapeutic target in CHF. METHODS AND RESULTS: Thirty patients (59+/-3 years) with New York Heart Association functional class II or III CHF and at least 200 premature ventricular contractions (PVCs)/24 h assessed by 24-h Holter recordings were studied. They were randomized into sauna-treated (n=20) or non-treated (n=10) groups. The sauna-treated group underwent a 2-week program of a daily 60 degrees C far infrared-ray dry sauna for 15 min, followed by 30 min bed rest with blankets, for 5 days per week. Patients in the non-treated group had bed rest in a temperature-controlled room (24 degrees C) for 45 min. The total numbers of PVCs/24 h in the sauna-treated group decreased compared with the non-treated group [848+/-415 vs 3,097+/-1,033/24 h, p<0.01]. Heart rate variability (SDNN, standard deviation of normal-to-normal beat interval) increased [142+/-10 (n=16) vs 112+/-11 ms (n=8), p<0.05] and plasma brain natriuretic peptide concentrations decreased [229+/-54 vs 419+/-110 pg/ml, p<0.05] in the sauna-treated group compared with the non-treated group. CONCLUSION: Repeated sauna treatment improves ventricular arrhythmias in patients with CHF.


Subject(s)
Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/therapy , Cardiac Output, Low/complications , Steam Bath , Ventricular Dysfunction/physiopathology , Ventricular Dysfunction/therapy , Adult , Aged , Aged, 80 and over , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/etiology , Chronic Disease , Echocardiography , Electrocardiography, Ambulatory , Female , Heart Rate , Humans , Male , Middle Aged , Neurotransmitter Agents/blood , Radiography, Thoracic , Retreatment , Time Factors , Ventricular Dysfunction/diagnosis , Ventricular Dysfunction/etiology , Ventricular Premature Complexes/diagnosis , Ventricular Premature Complexes/prevention & control
11.
Am J Cardiol ; 94(4): 484-7, 2004 Aug 15.
Article in English | MEDLINE | ID: mdl-15325935

ABSTRACT

This study assessed the impact of coronary vascular adaptive remodeling and coronary vascular reactivity on myocardial ischemia in patients with hypertension and left ventricular hypertrophy. Myocardial ischemia is associated with impaired endothelium-independent vasodilation of resistance coronary arteries and increased minimal coronary resistance. These changes may occur in association with lumen reduction caused by attenuated adaptive remodeling in response to plaque accumulation.


Subject(s)
Coronary Artery Disease/physiopathology , Coronary Circulation/physiology , Hypertension/physiopathology , Hypertrophy, Left Ventricular/physiopathology , Myocardial Ischemia/physiopathology , Vascular Resistance/physiology , Ventricular Remodeling/physiology , Acetylcholine , Aged , Blood Flow Velocity/physiology , Cardiac Volume/physiology , Coronary Angiography , Endothelium, Vascular/physiopathology , Exercise Test , Female , Gamma Cameras , Hemodynamics/physiology , Humans , Male , Middle Aged , Nitroglycerin , Papaverine , Statistics as Topic , Thallium Radioisotopes , Ultrasonography, Interventional , Vasodilation/physiology , Vasodilator Agents
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