Biomedical subjects

Fumitaka Tanaka

Publications and source records attributed to Fumitaka Tanaka.

4 recordsLinked to original sources

PubMed2005

Association between serum C-reactive protein levels and pulse wave velocity: a population-based cross-sectional study in a general population.

Arterial stiffness as determined by aortic pulse wave velocity (PWV) has been shown to predict cardiovascular events in high-risk subjects such as those with hypertension or end-stage renal disease. Although it is suspected that low-grade inflammation as represented by increased C-reactive protein (CRP) plays an important role in the progression of atherosclerosis, it is not yet known whether serum CRP levels are associated with PWV. To examine the relationship between brachial-ankle PWV (baPWV) and serum CRP levels, several cardiovascular risk factors including these two markers (baPWV and CRP) were measured in 870 participants (mean age 59 years) randomly selected from a general population. Age, male gender, systolic blood pressure, heart rate, diabetes, and serum CRP levels increased with the quartiles divided by baPWV (all, p<0.01). By multiple regression analysis, age (p<0.001), systolic blood pressure (p<0.001), heart rate (p<0.001), body mass index (p<0.001), and CRP (p<0.01) were significant and independent predictors for baPWV. In conclusion, this cross sectional study has demonstrated in the general population that the arterial stiffness marker baPWV was independently correlated with serum CRP levels after adjustment for other established cardiovascular risks factors. This result suggests that baPWV may be a surrogate marker for atherosclerotic vascular damages including an inflammatory component.

Adult↗

PubMed2005

B-type natriuretic peptide testing for structural heart disease screening: a general population-based study.

BACKGROUND: Several types of structural heart disease are important precursors for congestive heart failure or cardioembolic stroke. We have previously demonstrated that plasma B-type natriuretic peptide (BNP) measurement is useful for detection of structural heart disease in a multiphasic health screening setting. To extend our hypothesis to the general population, the utility of BNP testing for identifying structural heart disease was assessed in a general population and in subgroups divided by sex, age, and presence/absence of risk factors. METHODS AND RESULTS: This cross-sectional cohort study measured plasma BNP concentrations in 993 randomly selected community-dwelling adults (mean age 58 years). All subjects underwent plasma BNP measurement and transthoracic echocardiography. Using prejudged criteria, 41 subjects were diagnosed to have some form of structural heart disease (mild left ventricular systolic dysfunction in 11, valvular heart disease in 9, hypertensive heart disease in 3, hypertrophic cardiomyopathy in 2, ischemic heart disease in 2, lone atrial fibrillation in 14). The utility of BNP testing was evaluated by receiver operating characteristic (ROC) analysis and by cost analysis for detection of 1 case within each subgroup of the cohort. Overall, the sensitivity and specificity of BNP testing for identification of structural heart disease were 61% and 92%, respectively. The area under the ROC curve was 0.77 (95% CI; 0.74-0.79). When sex-specific ROC analyses were performed, sensitivity and specificity were 61% and 91% in men, and 50% and 95% in women, respectively. Although the performance of BNP testing on the basis of these figures might be suboptimal, efficacy was improved in subgroups with a high prevalence of heart disease (>8%) such as the cohort aged > or =65 years (men, area under ROC curve = 0.88; cost <US $1400: women, area under ROC curve = 0.83; cost <US $3000) as well as the cohort having cardiovascular risk factors such as hypertension or diabetes (men, area under ROC curve = 0.85; cost <US $1700: women, area under ROC curve = 0.83; cost <US $3100). CONCLUSION: The present results suggest that BNP testing for structural heart disease screening in community-based populations is useful for cohorts with a high prevalence of heart disease. However, its efficacy is reduced in cohorts with a low prevalence rate.

Adult↗

PubMed2003

The limited value of plasma B-type natriuretic peptide for screening for left ventricular hypertrophy among hypertensive patients.

BACKGROUND: Several reports have suggested that plasma B-type natriuretic peptide (BNP) levels are elevated in hypertensive patients especially with left ventricular (LV) hypertrophy. However, few data have been available concerning the utility of plasma BNP measurement to identify LV hypertrophy in hypertensive patients in a general population screening context. METHODS: We measured plasma BNP concentrations in 1112 volunteers in a health screening program (mean age, 57 years). All subjects underwent electrocardiography, chest X-ray, and echocardiography. Among the sample, 284 subjects were designated as hypertensive because they were on antihypertensive drugs or showed elevated systemic blood pressure. By echocardiography, 36 of the hypertensive patients showed significant LV hypertrophy. RESULTS: There were no significant differences in age and sex between the LV hypertrophy and non-LV hypertrophy groups. Plasma BNP levels in the LV hypertrophy group were significantly higher than in the non-LV hypertrophy group (19.4 +/- 18.9 v 28.2 +/- 28.2 pg/mL; P <.05). However, the ability of plasma BNP levels to discriminate between LV hypertrophy and non-LV hypertrophy patients was not sufficient as the area under the receiver operating characteristic curve was 0.588 (95% CI: 0.528-0.646) with sensitivity of 50.0% and specificity of 69.0%. Positive and negative predictive values for detecting LV hypertrophy among hypertensive patients were 18.9% and 90.5%, respectively. This ability did not improve significantly when the screening was limited to patients with untreated LV hypertrophy or concentric LV hypertrophy. CONCLUSIONS: Plasma BNP testing in a mass screening setting is of limited use for the identification of LV hypertrophy patients among hypertensive patients with heterogeneous etiology.

Adult↗

PubMed2003

A case of sick sinus syndrome that developed torsades de pointes, pacing failure and sensing failure during administration of bepridil.

A 65-year-old Japanese woman was admitted to hospital because of palpitations and faintness. She was diagnosed as having sick sinus syndrome and a permanent pacemaker was therefore implanted. Administration of bepridil (200 mg daily) was started for prevention of atrial flutter and fibrillation after PM implantation. On the twenty-fifth day of Bpd therapy, she developed recurrent syncope, ECG showed QT prolongation. torsades de pointes, and sensing failure. Electrical defibrillation (DF) was performed for ventricular fibrillation or ventricular tachycardia. It was presumed that Bpd had caused not only proarrhythmia but also a transient decrease in the amplitude of ventricular activation at the site of the pacing lead, as the sensing level was gradually restored after the drug was ceased and her plasma concentrations of Bpd decreased. It is also believed that DF had caused a sustained increase in pacing threshold because she developed pacing failure after DF and her pacing threshold had not returned to its prior level although the blood levels of Bpd had been below the minimum detectable level. Although it is well known that torsades de pointes occasionally develops in association with Bpd therapy, it is less evident that pacing and sensing failure may develop in association with Bpd therapy. This case report suggests that we should be aware of this possible outcome when employing Bpd and pacemaker implantation as combination therapy.

Aged↗