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Katsuo Fuse

Publications and source records attributed to Katsuo Fuse.

18 recordsLinked to original sources
PubMed2005

Gene expression profiling of human atrial myocardium with atrial fibrillation by DNA microarray analysis.

BACKGROUND: Atrial fibrillation (AF) is the most frequently encountered arrhythmia in the clinical setting. However, a comprehensive investigation of the molecular mechanism of AF has not been performed. The aim of this study was to clarify transcriptional profiling of genes modulated in the atrium of AF patients using DNA microarray technology. METHODS: We obtained 17 fresh cardiac specimens, right atrial appendages, isolated from 10 patients with normal sinus rhythm and seven chronic AF patients who underwent cardiac surgery. Affymetrix GeneChip (Human Genome U95A) investigating 12,000 human genes was used for each specimen. Quantitative analysis of selected genes was performed by the real-time PCR method. RESULTS: The left atrial diameter in the AF group was greater than that in the sinus rhythm group. We could identify 33 AF-specific genes that were significantly activated (>1.5-fold), compared with the sinus rhythm group, including an ion channel, an antioxidant, an inflammation, three cell growth/cell cycle, three transcription such as nuclear factor-interleukin 6-beta, several cell signaling and several protein genes, and seven expressed sequence tags (ESTs). In contrast, we found 63 sinus rhythm-specific genes, including several cell signaling/communication such as sarcoplasmic reticulum Ca2+-ATPase 2, several cellular respiration and energy production and two antiproliferative or negative regulator of cell growth genes, and 22 ESTs. CONCLUSIONS: The present study demonstrated that about one hundred genes were modulated in the atria of AF patients. These findings suggest that these genes may play critical roles in the initiation or perpetuation of AF and the pathophysiology of atrial remodeling.

Adolescent↗
PubMed2005

The CarboMedics prosthetic heart valve: experience with 180 implants.

At Jichi Medical School Hospital, three types of mechanical prosthetic valves (CarboMedics, Omnicarbon, Bicarbon) were used without randomization from 1991 to 2000. A retrospective study of valve replacements done between June 1991 and November 2000 utilizing 180 CarboMedics valves in 145 patients who had not previously undergone prosthetic valve replacement or aortic root and/or arch replacement was conducted to evaluate midterm patient outcomes to assess the future continuous use of CarboMedics valves. Women made up 47.6% of the patients and the mean age was 57.5 years (range 12-80 years). Preoperative New York Heart Association functional class was III or IV in 92.4% (134/145) of patients. Mean follow-up of 4.5 years (range 0-10.0 years) was 95.9% complete, with a total of 628 patient-years (PY). Early (within 30 postoperative days) mortality was 5.5% (8 of 145): 3 from hemorrhage, 3 from nonvalve-related heart failure, 1 from infection, and 1 from arrhythmia. There were 16 late deaths (2.54%/PY): 1 from hemorrhage, 4 from unknown causes/sudden death, 4 from nonvalve-related heart failure, and 7 from other noncardiac causes. A total of 121 patients (83.0%) were alive at the last follow-up, done in November 2000. The linearized death rate was 3.82%/year (including 1.11%/year for valve-related deaths). Linearized death rates from various causes were: bleeding, 0.96%/year; thromboembolism, 1.11%/year; thrombosis, 0.39%/year; perivalvular leak, 0.96%/year; endocarditis, 0%/year; hemolysis, 0%/year; and reoperation, 0.63%/year. No structural valve failure was observed. Comparative early mortality rates of valve replacement without aortic root replacement or arch replacement, excluding repeat valve replacement operations, in our institute, were 3.5% (12/307) for all valve types used contemporaneously, 2.6% (2/76) for Omnicarbon valves, and 2.3% (2/86) for Bicarbon valves. Although the CarboMedics valve had a rather high mortality rate of 5.5% (8/145) compared with the total early mortality rate of 3.5%, the low incidence of valve-related complications might support the continued use of the CarboMedics valve for valve replacement.

Adolescent↗
PubMed2004

Cardiac function-related gene expression profiles in human atrial myocytes.

To obtain insights into the molecular pathogenesis of heart failure in humans, we have analyzed the expression profiles of>12,000 genes in a total of 17 human specimens of right atrial myocytes. From this large data set, we here tried to identify gene clusters, expression level of which is correlated precisely with clinical parameter values of cardiac function. We could reveal that cardiac myocytes with normal sinus rhythm were clearly differentiated, in the point of view of gene expression, from those with atrial fibrillation. Further, an expression profile-based prediction of arrhythmia by a newly developed "weighted-distance method" could efficiently diagnose our samples. We could even construct calculation formulae for the values of left ventricular ejection fraction based on the expression level of selected genes. To our best knowledge, this is the first report to indicate that pumping ability of heart can be predicted by any measures of atrium.

Adolescent↗
PubMed2004

Increase in circulating endothelial progenitor cells after aortic aneurysm repair.

Rapid endothelialization of prosthetic vessels is essential to avoid fatal complications. We hypothesized that there may be mobilization of endothelial progenitor cells (EPCs) in patients who received aortic aneurysm repair, and measured the number of CD34-expressing EPCs (CD34(+) cells) in these patients. Blood samples were taken preoperatively, 6, 24, and 48 h, and 7 days after surgery in 13 patients with aortic aneurysm. Samples were also obtained from ten age-matched control subjects. The number of CD34(+) cells in the peripheral blood was quantified by flow cytometry. The levels of serum vascular endothelial growth factor (VEGF) were measured using an enzyme-linked immunosorbent assay kit. Baseline CD34(+) cell counts in the peripheral blood showed a tendency to be lower in patients with aortic aneurysm compared with healthy control subjects. The number of CD34(+) cells did not change over 48 h after aortic aneurysm repair; however, it had doubled by the 7th day. On the other hand, the baseline serum VEGF levels did not differ between the patients and control subjects. The VEGF levels increased gradually after vascular repair with a significant elevation after 48 h, which was followed by an increase in CD34(+) cell counts. In conclusion, the circulating CD34(+) cell counts and serum VEGF levels are increased after vascular prosthesis replacement in patients with aortic aneurysm, which might contribute to the rapid endothelialization of prosthetic vessels.

Antigens, CD34↗
PubMed2004

Successful weaning from cardiac extracorporeal membrane oxygenation by banding a hemodialysis arteriovenous fistula.

We report a case in which weaning from cardiac extracorporeal membrane oxygenation (ECMO) was achieved by temporarily occluding the hemodialysis arteriovenous fistula. A 68-year-old man with diabetic nephropathy underwent coronary artery bypass surgery, and cardiac ECMO was used to wean the patient from cardiopulmonary bypass. An ultrasonic flowmeter showed the arteriovenous flow to be over 750 ml/min, which can lead to increased preload on the weakened heart. On the sixth postoperative day, occlusion of the fistula by compression with a soft bandage provided the correct balance between myocardial reserve and shunt volume and hence facilitated successful weaning from cardiac ECMO.

Aged↗
PubMed2004

Transcriptional profile of genes induced in human atrial myocardium with pressure overload.

BACKGROUND: The molecular response of human myocardium to mechanical stimuli, particularly the difference between pressure or volume overload cardiac hypertrophy, remains incompletely defined. METHODS: We investigated the transcriptional profile of genes induced in human pressure- or volume-overloaded myocardium with DNA microarray technology. We used right atrial tissue from patients who underwent cardiac surgery. On the basis of pressure data and echocardiographic findings, the patients were divided into three groups: control group (n=3), pressure overload group (mean right atrial pressure of >7 mm Hg, n=3), and volume overload group (moderate or severe tricuspid regurgitation, n=3). Expression profiles of 2139 human genes were investigated with mRNA obtained from the samples. RESULTS: In the pressure overload group, expression of genes of cyclin-dependent kinase inhibitor 1A (CDKI1A, 11.7+/-3.1-fold vs. control), and mitogen-activated protein kinase phosphatase-1 (MKP-1, 26.2+/-2.1-fold) was significantly increased compared with those in control or volume overload group (P<0.05). The specificity of these gene expressions was confirmed by a quantitative "real-time" polymerase chain reaction (PCR) analysis. In addition, mechanical strain induced CDKI1A and MKP-1 protein expressions in neonatal rat cardiac myocytes in an amplitude-dependent manner. In contrast, transcripts of growth factors did not significantly increase. CONCLUSIONS: This study demonstrated that gene expressions of CDKI1A and MKP-1, but not growth factors, are induced in chronic pressure-overloaded myocardium. These findings suggest that suppressors of the cell cycle or cell proliferation may play a critical role in the pathophysiology of pressure overload.

Adolescent↗
PubMed2003

When and how does nonstructural mechanical prosthetic heart valve dysfunction occur?

OBJECTIVE: We discuss the clinical aspects related to mechanical valve dysfunction based upon 20 years' experience of our cases. METHODS: Between January 1982 and December 2001, 21 patients underwent surgical interventions because of mechanical valve dysfunction. Thirteen men and 8 women (mean age 47 +/- 20, range 3-75 years-old), were included. RESULTS: Mitral valve dysfunction was observed in 12 patients. Prosthetic valve stenosis occurred in 6 patients between 2 and 224 months, and paravalvular leaks in 4 between 1 and 71 months after surgery. The other 2 patients suffered from hemolytic anemia with mild paravalvular leaks between 102 and 104 months after surgery. Aortic valve dysfunction was observed in 8 patients including 3 stenotic lesions between 48 and 97 months and 5 paravalvular leaks between 3 and 150 months after surgery. Tricuspid regurgitation was seen in 1 patient with a huge right atrium at 42 months after surgery. Early death was seen in 1 patient. Late death occurred in 1 patient, 17 years after operation. Survival, including early death, was 95.2%, at 10 and 15 years. One valve-related complication of bioprosthetic valve endocarditis at the mitral and tricuspid positions occurred 12 years after a reoperation. The freedom from complications was 95.2% at 10 years, and 76.2% at 15 years. CONCLUSIONS: Paravalvular leaks without overt endocarditis had latency periods of up to 12 years, and pannus formation was observed 20 years after surgery. Early and late clinical results after surgery for mechanical valve dysfunction were excellent.

Adolescent↗
PubMed2003

Isolated traumatic vertebral pseudoaneurysm: report of a case.

We report a case of isolated traumatic pseudoaneurysm of the vertebral artery in a 20-year-old man who suffered blunt injury to the left foreneck and arm in a traffic accident. A chest computed tomography (CT) scan on admission showed an upper mediastinal hematoma, but the patient's vital signs were stable. A CT scan of the head and neck showed a cerebral mass, and an elective cerebral four-vessel angiography was performed, which revealed a pseudoaneurysm in the proximal portion of the left vertebral artery. At surgery, about 2 cm of the left vertebral artery was found to be lacerated, and suture ligation was done on each side of the laceration. Postoperative intravenous digital subtraction angiography showed an intact right vertebral artery with no residual pseudoaneurysm. There were no neurological complications and the patient was discharged on the 16th postoperative day.

Adult↗
PubMed2003

A repair of funnel chest without sternal dissection in aortic root replacement.

A 46-year-old man with Marfan syndrome was admitted for repair of annuloaortic etasia and funnel chest. Before median sternotomy, seven transverse skin incisions were made for resection of deformed ribs. The convex portions at the costochondral junctions of the right 4 approximately 7th and left 5 approximately 7th ribs were removed. Thereafter, the conventional median sternotomy was safely performed. Aortic root was replaced. After weaning from the cardiopulmonary bypass, the redundant distal end of the sternum was resected, fractured sites of the concave sternum were straightened and secured with wire fixation, and the split sternum was sutured with wires in an ordinary fashion.

Aorta↗
PubMed2002

Paravalvular leakage causing hemolytic anemia at 8-9 years after mitral valve replacement.

We report two similar cases of women, aged 52 and 71 years, who developed shortness of breath or easy fatigability at 8-9 years after mitral valve replacement of the mitral valve in each patient, the echocardiographic study revealed paravalvular leakage. Previous examination before the appearance of symptoms had revealed a well-functioned prosthetic valve, and no hematological abnormality had been detected. The hemoglobin levels at admission were 6.4 and 6.6 g/dl, and their serum lactate dehydrogenase levels were 5218 and 4608 mU/ml. Each successfully underwent another valve replacement, and after surgery, the hemolytic anemia and the symptoms disappeared.

Aged↗
PubMed2002

Successful surgical treatment of chronic traumatic thoracic aneurysm in two patients.

We successfully treated two patients with chronic traumatic aneurysm of the thoracic aorta. The first, a 40-year-old man involved in an automobile accident 24 years earlier, was treated by thoracic aorta graft replacement via left thoracotomy under femoro-femoral partial bypass. The second, a 57-year-old man with a 3-month history of hoarseness who had suffered blunt chest trauma 17 years earlier, was treated similarly. Both had a calcified pseudoaneurysm at the isthmus of the descending aorta, but neither had atherosclerosis other than at the aneurysm site. They have done well after surgery. We believe chronic traumatic thoracic aneurysm at the aortic isthmus should be treated surgically soon after diagnosis because elective surgery presents low risk of morbidity and mortality.

Adult↗
PubMed2002

Management of anomalous right coronary arteries encountered during aortic valve surgery.

We experienced three cases with anomalous right coronary arteries during aortic valve surgery. By rotating a Freestyle bioprosthesis by a subcoronary technique, the anomalous artery was secured in one patient. The anomalous artery was injured during the routine aortotomy incision in another patient; a saphenous vein graft was interposed between the ascending aorta and the separated artery. In the third patient, a subannular prosthetic valve was chosen to avoid obstructing the anomalous orifice.

Aged↗
PubMed2002

Single-center experience with the bicarbon bileaflet prosthetic heart valve in Japan.

We analyzed midterm results using the Bicarbon valve in a single center. Forty-four patients had aortic valve replacement (AVR), 48 had mitral valve replacement (MVR), and 13 had both aortic and mitral valve replacement (DVR). The mean age of the 105 patients was 61.2 +/- 11.3 years. The mean follow-up was 1.8 +/- 1.1 years with a cumulative follow-up of 188 patient-years. There were 5 early deaths (4.7%: 4 in the AVR group and 1 in the MVR group) and 5 late deaths (2.7% per patient-year: 3 malignancy, 1 cerebral hemorrhage, 1 myocardial infarction). Survival at 3 years was 91 +/- 4% in the AVR group, 92 +/- 5% in the MVR group, and 66 +/- 23% in the DVR group. The linearized incidence of thromboembolic complications, hemorrhagic complications, and paravalvular leaks in all patients was 1.06 +/- 2.34%, 1.60 +/- 2.53%, and 0.53 +/- 2.22% per patient-year, respectively. No other complications were observed. In conclusion, the Bicarbon prosthetic heart valve has shown excellent clinical results associated with a low incidence of valve-related complications.

Aged↗