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Biomedical subjects

Tomohiko Sakatani

Publications and source records attributed to Tomohiko Sakatani.

10 recordsLinked to original sources
PubMed2006

Usefulness of paroxetine in depressed men with paroxysmal atrial fibrillation.

The occurrence and the duration of paroxysmal atrial fibrillation (AF) are influenced by vagal tone. Paroxetine, an antidepressant, can modulate vagal tone at the level of the mid-brain and inhibit the vasovagal reflex. In this study, oral paroxetine 10 mg/day was administered to patients with multidrug-resistant paroxysmal AF. Nine consecutive men responded favorably to the drug. In 3 patients, AF resolved completely. One patient could not tolerate the drug because of nausea and nervousness. These preliminary results suggest that paroxetine could be a choice in the pharmacologic treatment of paroxysmal AF.

Adult↗
PubMed2006

Cardiac hypertrophy diminished the effects of isoproterenol on delayed rectifier potassium current in rat heart.

We investigated the association between sympathetic nerve activity and delayed rectifier potassium current (I(K)) in hypertrophic rat hearts. Left ventricular hypertrophy was induced by a 50% constriction of suprarenal abdominal aorta for 6 weeks. The effects of isoproterenol on action potential duration (APD), I(K), and L-type calcium current (I(Ca)) were investigated using the whole-cell patch clamp technique. In hypertrophic rats, I(K) was decreased by 28.2%, resulting in significant APD(90) (90% repolarization) prolongation (sham: 55 +/- 3.9, hypertrophy: 98 +/- 11 ms, P = 0.01). Isoproterenol (100 nM)-stimulated I(K) was increased by 54.9% +/- 0.10% in sham-operated rats, but not in hypertrophic rats. On the other hand, isoproterenol increased I(Ca) in both sham-operated (77.7% +/- 7.6%) and hypertrophic rats (69.6% +/- 9.7%). Consequently, isoproterenol prolonged further APD in hypertrophic rats (98 +/- 11 vs. 145 +/- 8.6 ms, P < 0.01), but not in sham-operated rats (55 +/- 3.9 vs. 61 +/- 5.6 ms, n.s.). Forskolin (1 microM, an adenylyl cyclase stimulator) did not enhance I(K) in hypertrophic rats, but IBMX (100 microM, a nonselective phosphodiesterase inhibitor) enhanced the current (30.2 +/- 0.05%), as much as in sham-operated rats. We concluded that in hypertrophic hearts, I(K) was not increased by isoproterenol because of the enhanced activity of phosphodiesterase, which leads to excessive APD prolongation.

1-Methyl-3-isobutylxanthine↗
PubMed2005

The association between cholesterol and mortality in heart failure. Comparison between patients with and without coronary artery disease.

Hypercholesterolemia is a risk factor for development of coronary artery disease (CAD), however, several reports have suggested that low serum cholesterol is associated with a worse prognosis in patients with congestive heart failure (CHF). The objective of this study was to determine the prognostic value of cholesterol for CHF. The study subjects consisted of 133 consecutive patients hospitalized in our institution for progressive heart failure from April 2000 to March 2003. Thirty-two percent of the patients had CAD. After improvement of congestive heart failure and discharge from the hospital, lipid profiles, including serum total cholesterol (TC), triglycerides, and high and low density lipoprotein cholesterol (HDL, LDL, respectively), were obtained. During the follow-up period (2.3 +/- 0.9 years), 21 patients died. There was a significant difference between survivors and nonsurvivors in HDL (53 +/- 15, 43 +/- 15 mg/dL, P = 0.01), but no differences were observed in other variables. In patients with CAD, survivors had significantly lower TC concentrations (179 +/- 30 versus 246 +/- 55 mg/dL, P = 0.004), although in patients without CAD, survivors had significantly higher TC concentrations (203 +/- 37 versus 170 +/- 40 mg/dL, P = 0.02). Multivariate analysis showed high TC predicted a worse outcome in patients with CAD (odds ratio (OR) = 1.052, 95% confidence interval (CI) 1.002-1.104, P = 0.04), but a better outcome in patients without CAD (OR = 0.972, 95% CI 0.948-0.997, P = 0.03), independent of age, gender, medication, and complications. Thus, low serum cholesterol is associated with an improved outcome in patients with CAD, while it predicts a worse outcome in patients without CAD.

Adult↗
PubMed2004

Clinical significance of preserving spontaneous QRS wave in the therapy of DDD pacing for sick sinus syndrome.

The aim of this clinical crossover study was to elucidate the effects of atrioventricular (AV) synchronous pacing on cardiac function in patients with sick sinus syndrome (SSS). Thirty SSS patients, each with dual chamber pacemaker (DDD), were enrolled and divided into two groups based on echocardiographic findings. Group A (n = 16) had hypertensive heart disease (wall thickness 11 approximately 12 mm) or mitral or aortic regurgitation (Grade I or II). Group B (n = 14) had no organic heart disease. Three successive 3-month pacing periods were tested. For the first 3 months, long AV delay that achieved > 80% ventricular sensing was chosen. For the next 3 months, AV delay was abbreviated to achieve > 80% ventricular pacing at an optimal AV interval. For the final 3 months, the first setting was resumed. At the end of each period, M mode echocardiography, pulsed-Doppler study, and measurement of plasma brain natriuretic peptide (BNP) level were conducted. In both groups, echocardiographic parameters were not significantly changed during the evaluation. In group A, plasma BNP level was significantly higher at the end of the short AV delay period than at the long AV delay period (P = 0.009), while in group B it did not differ during each period. AV synchronous pacing (> 80% ventricular pacing) in the SSS patients with a DDD pacemaker implanted could increase the ventricular load, and it is better to preserve the spontaneous QRS with the DDD mode with prolonged AV delay in patients with mild hypertensive or valvular disease.

Aged↗
PubMed2004

Usefulness of the percentage of plasma lymphocytes as a prognostic marker in patients with congestive heart failure.

This prospective study was designed to evaluate the prognostic value of the percentage of plasma lymphocytes in patients with diastolic dysfunction as well as systolic dysfunction of the left ventricle. The subjects were 70 consecutive patients who were hospitalized in our institution from April 2001 to August 2002. Following the improvement of congestive heart failure, leukocyte differentiation and neurohumoral factors (plasma levels of atrial and brain natriuretic peptide, norepinephrine, epinephrine, and dopamine) were measured. During the follow-up period (17 +/- 9 months), 18 patients experienced a cardiac event. In the univariate analysis, the percentage of plasma lymphocytes in the cardiac event group was significantly less than that in the noncardiac event group (24.7 +/- 8.40 vs 33.3 +/- 7.64%, P = 0.0006), and brain natriuretic peptide was significantly larger in the cardiac event group (402 +/- 168 vs 153 +/- 51 pg/mL, P = 0.04). However, in patients with preserved systolic function, there was a significant difference in the percentage of plasma lymphocytes between the cardiac and noncardiac event groups (21.7 +/- 9.42 vs 34.2 +/- 8.21%, P = 0.037), although no difference was observed in brain natriuretic peptide (133 +/- 43 vs 125 +/- 50 pg/mL, P = 0.87). Multivariate analysis showed the percentage of plasma lymphocytes was an independent predictor of a cardiac event. The percentage of plasma lymphocytes may be useful for predicting the course of patients with congestive heart failure based on diastolic dysfunction as well as systolic dysfunction.

Adult↗
PubMed2003

Prognostic value of heart rate variability in patients with hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) have been reported to display impaired heart rate variability, although little is known regarding its prognostic value. By using fast Fourier transformation of 24-hour Holter recordings in 73 HCM patients at a stable clinical condition, we computed 4 spectral components: very low frequency, low frequency, high frequency, and total power. During 28 months, 7 HCM patients experienced death or acquired hospitalization for heart failure. Sudden death did not occurred. High frequency component was lower in HCM patients with cardiac events than that in patients without cardiac events (3.78 +/- 0.66 vs. 4.43 +/- 0.92 In(ms(2)), P =.045). There were no significant differences in other heart rate variability variables between HCM patients with and without cardiac events. In multivariate analysis, high frequency component remained to be an independent predictor of cardiac events (relative risk=0.10, 95% CI 0.01-0.73, P =.023). Heart rate variability analysis is predictive of heart failure in our cohort of HCM patients, whereas its predictive value of sudden death remains unclear.

Adult↗
PubMed2003

Novel application of the hemostatic device TOMETA KUN.

A 79-year-old woman was admitted with worsening chest discomfort and diagnosed as having an acute myocardial infarction. She underwent emergency coronary angioplasty via the transradial artery, but during surgery the proximal portion of the radial artery was perforated by a wire injury. The TOMETA KUN compression system (Zeon Medical, Tokyo, Japan) was used for hemostasis at the perforation site and enabled an anterograde flow to be maintained in the radial and ulnar arteries without extravascular leakage. In addition to stabilizing the arterial perforation, the device allowed the successful completion of the percutaneous coronary intervention procedure without the need to cease anticoagulant therapy.

Aged↗
PubMed2002

[Chronic pulmonary thromboembolism originating from left forearm deep vein thrombosis: a case report].

Upper extremity deep venous thromboembolism has become increasingly common due to the use of subclavian venous access. However, forearm deep venous thrombosis is rare. We report a case of chronic pulmonary thromboembolism originating from left forearm deep venous thrombosis. A 66-year-old woman was admitted to our hospital because of dyspnea, which had worsened over the previous 2 months. Echocardiography showed severe right ventricular enlargement and pulmonary hypertension. Perfusion lung scintigraphy revealed multisegmental perfusion defects. No likely factors responsible for hypercoagulability were found. The patient had a history of left radial fracture and had been treated with external fixation. Venography of the upper and lower extremities revealed total occlusion of the deep veins of the left forearm with collateral vessels, but no evidence of other upper or lower extremity venous thrombosis.

Aged↗