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Biomedical subjects

Yoshinori Doi

Publications and source records attributed to Yoshinori Doi.

At least 19 recordsLinked to original sources
PubMed2006

Long-term prognosis of dilated cardiomyopathy revisited: an improvement in survival over the past 20 years.

BACKGROUND: Because of their favorable prognostic effects, angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB) and beta blockers have become background therapy in dilated cardiomyopathy (DCM). However, there are few reports concerning the long-term prognosis of Japanese patients with DCM in relation to these treatments. METHODS AND RESULTS: One hundred and fifty patients with DCM were divided into 2 groups: group A (n=46) (diagnosis: 1982-1989) and group B (n=104) (diagnosis: 1990-2002). During follow-up period of 6.9+/-4.8 years, 62 patients died and 1 patient had a heart transplant. The survival rate at 5 and 10 years was 60.9% and 34.8%, respectively, in group A patients, and 80.9% and 65.3%, respectively, in group B patients (p=0.0079). In group A patients, ACEI/ARB or beta blockers were less frequently used (p<0.0001), whereas antiarrhythmics (class Ia or Ib) were more often used (p<0.0001). The patients treated with ACEI/ARB and beta blockers showed a better survival rate than those without (p<0.0001). The patients with antiarrhythmics showed a worse survival rate than those without (p<0.0001). CONCLUSION: The prognosis of Japanese patients with DCM has significantly improved over the past 20 years. This improvement may be explained partly through the increased use of ACEI/ARB and beta blockers and a declining use of antiarrhythmics.

Adrenergic beta-Antagonists↗
PubMed2006

Nitric oxide stimulates vascular endothelial growth factor production in cardiomyocytes involved in angiogenesis.

BACKGROUND: Hypoxia-inducible factor (HIF)-1alpha regulates the transcription of lines of genes, including vascular endothelial growth factor (VEGF), a major gene responsible for angiogenesis. Several recent studies have demonstrated that a nonhypoxic pathway via nitric oxide (NO) is involved in the activation of HIF-1alpha. However, there is no direct evidence demonstrating the release of angiogenic factors by cardiomyocytes through the nonhypoxic induction pathway of HIF-1alpha in the heart. Therefore we assessed the effects of an NO donor, S-Nitroso-N-acetylpenicillamine (SNAP) on the induction of VEGF via HIF-1alpha under normoxia, using primary cultured rat cardiomyocytes (PRCMs). METHODS AND RESULTS: PRCMs treated with acetylcholine (ACh) or SNAP exhibited a significant production of NO. SNAP activated the induction of HIF-1alpha protein expression in PRCMs during normoxia. Phosphatidylinositol 3-kinase (PI3K)-dependent Akt phosphorylation was induced by SNAP and was completely blocked by wortmannin, a PI3K inhibitor, and NG-nitro-L-arginine methyl ester (L-NAME), a NO synthase inhibitor. The SNAP treatment also increased VEGF protein expression in PRCMs. Furthermore, conditioned medium derived from SNAP-treated cardiomyocytes phosphorylated the VEGF type-2 receptor (Flk-1) of human umbilical vein endothelial cells (a fourfold increase compared to the control group, p < 0.001, n = 5) and accelerated angiogenesis. CONCLUSION: Our results suggest that cardiomyocytes produce VEGF through a nonhypoxic HIF-1alpha induction pathway activated by NO, resulting in angiogenesis.

Acetylcholine↗
PubMed2006

[Reperfusion therapy for acute myocardial infarction in elderly patients].

Although there has been great progress in reperfusion therapy, the role of coronary reperfusion for elderly patients with acute myocardial infarction has not been fully investigated. In general, mean age of the subjects in major trials was about 60 years old and approximately only 10 to 15% of patients were over age 75. On the other hand, large-scale registries such as the US national registry of myocardial infarction (NRMI) showed a higher prevalence of elderly (especially women) in the clinical setting. This discrepancy may be due to the fact that elderly patients with myocardial infarction have some difficulties in the treatment such as severe multi-vessel coronary lesions, non-cardiac complications and relatively high prevalence of adverse reactions to reperfusion therapy. Here we focus on the situation of elderly patients (especially those 75 years or older) with myocardial infarction in the "real world" clinical setting, showing the clinical changes and outcome of our registry in rural Japan: the Kochi AMI (KAMI) registry.

Aged↗
PubMed2006

[Arrhythmogenic right ventricular cardiomyopathy with pulmonary embolism: a case report].

A 50-year-old man complained of dyspnea on exertion. Electrocardiography showed frequent premature ventricular contraction and inverted T wave in leads V1-V6. Echocardiography and right ventriculography showed dilation and systolic dysfunction of the right ventricle. The diagnosis was arrhythmogenic right ventricular cardiomyopathy. In addition, thrombus was also observed in the pulmonary artery on chest computed tomography and pulmonary artery angiography. The final diagnosis was arrhythmogenic right ventricular cardiomyopathy complicated by pulmonary embolism. Pulmonary embolism should be considered in patients with arrhythmogenic right ventricular cardiomyopathy with dyspnea.

Arrhythmias, Cardiac↗
PubMed2005

Low-dose aspirin for prevention of stroke in low-risk patients with atrial fibrillation: Japan Atrial Fibrillation Stroke Trial.

BACKGROUND AND PURPOSE: Although the efficacy of anticoagulant therapy for primary prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF) has been established, efficacy of antiplatelet therapy for low-risk patients is disputable in Japanese patients because of the frequent hemorrhagic complications. We examined the efficacy and safety of aspirin therapy in Japanese patients with NVAF in a prospective randomized multicenter trial. METHODS: Patients with NVAF were randomized to an aspirin group (aspirin at 150 to 200 mg per day) or a control group without antiplatelet or anticoagulant therapy. Primary end points included cardiovascular death, symptomatic brain infarction, or transient ischemic attack. RESULTS: A total of 426 patients were randomized to aspirin group and 445 to no treatment. The trial was stopped earlier because there were 27 primary end point events (3.1% per year; 95% CI, 2.1% to 4.6% per year) in the aspirin group versus 23 (2.4% per year; 95% CI, 1.5% to 3.5% per year) in the control group, suggesting a low possibility of superiority of the aspirin treatment for prevention of the primary end point. In addition, treatment with aspirin caused a marginally increased risk of major bleeding (7 patients; 1.6%) compared with the control group (2 patients; 0.4%; Fisher exact test P=0.101). CONCLUSIONS: For prevention of stroke in patients with NVAF, aspirin at 150 to 200 mg per day does not seem to be either effective or safe. Further prospective studies are needed to determine the best preventive therapy for cerebrovascular events in Japanese patients with NVAF.

Aged↗
PubMed2005

Modification of the functional reach test: analysis of lateral and anterior functional reach in community-dwelling older people.

The purpose of this study was to evaluate the validity and reproducibility of the modified lateral functional reach (FR), and to examine the associations between a variety of functional variables and the FR in community-dwelling older people (>65 years of age). A total of 383 aged Japanese participated in this study at the rural district Kahoku, Kochi, Japan, in 2002. The average age of the subjects was 78.6 years. The activity of daily living (ADL) and mental status were measured as outcomes. FR (anterior and lateral) and timed up and go (TUG) were measured as predictors. The test-retest reliability of lateral FR between the first and second measurement was very consistent. Subjects with greater lateral FR had higher basic and instrumental ADL (IADL) scores than did those with shorter lateral FR. However, there was no significant relationship between anterior FR and ADLs. The lateral FR of participants with depression was shorter than in those without depression, while the anterior FR did not correlate with the participants' scores on the geriatric depression scale (GDS). Lateral FR should be considered as a new, alternative means of assessing geriatric social activity and mental status in the elderly.

Activities of Daily Living↗
PubMed2005

Effect of serum albumin on QRS wave amplitude in patients free of heart disease.

We studied 193 patients free of heart disease to determine the relation between QRS amplitude and serum albumin. Although there were no significant differences in echocardiographic indexes between the 2 groups, albumin (35.1 +/- 4.3 vs 40.1 +/- 3.2 g/L) and colloid osmotic pressure (21 +/- 4 vs 24 +/- 3 mm Hg) were significantly lower in patients with low voltages compared with those without. Moreover, there was a good relation (r = 0.78) between change in QRS amplitude and change in albumin concentration.

Adult↗
PubMed2005

Three-dimensional stereotactic surface projection SPECT analysis in Parkinson's disease with and without dementia.

We investigated regional cerebral blood flow (rCBF) using three-dimensional stereotactic surface projection (3D-SSP) analysis in 30 patients initially diagnosed as Parkinson's disease (PD), and compared differences in rCBF between patients with and without PD-related manifestations. 3D-SSP analysis of cerebral perfusion was performed by use of a control database. Compared to age-matched controls, there were multiple hypoperfusion areas in cases where the original diagnosis was PD. Temporal bases showed the lowest perfusion; frontal bases and medial parietal lobes the second; visual cortices the third; and parietal association areas exhibited the fourth lowest. During the clinical course, 10 of the patients suffered dementia, 9 had fluctuating cognition, and 19 experienced repeated visual hallucinations. Significant negative correlations were observed between dementia and the bilateral posterior cingulate area, and among fluctuating cognition and bilateral medial parietal lobes, parietal association areas, and dorsal occipital lobes. Repeated visual hallucinations did not show any correlation with any region of interest. We concluded that multiple hypoperfusion areas were observed in the 3D-SSP SPECT analysis. Although the presence of dementia showed a significant relationship with the bilateral posterior cingulate areas, perfusion in the frontal bases, temporal bases, or parietal lobes was markedly more reduced than that seen in the bilateral posterior cingulate areas.

Aged↗
PubMed2005

Effects of growth factors on the growth and differentiation of mouse fetal liver epithelial cells in primary cultures.

BACKGROUND AND AIMS: Growth factors (GF) are thought to affect the growth and differentiation of hepatocytes during liver development. However, in the midfetal liver, little is known concerning the role of GF. METHODS: The DNA synthesis of fetal liver epithelial cells (FLEC) in monolayer culture and the liver-specific gene expressions of FLEC in 3-D culture were examined in medium supplemented with various GF. RESULTS: DNA synthesis of FLEC was higher than that of adult hepatocytes without GF, and was increased by hepatocyte growth factor (HGF), heparin-binding epidermal growth factor-like growth factor (HB-EGF), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) or transforming growth factor-alpha (TGF-alpha). However, FLEC responded less to GF in terms of DNA synthesis than adult hepatocytes. The liver-specific gene expressions were increased in the presence of HGF, HB-EGF, bFGF and EGF. In embryonic day (E) 13.5 FLEC, this increase was more apparent in the presence of HB-EGF, whereas in E14.5 FLEC, it was more apparent in the presence of HGF. CONCLUSIONS: Hepatocyte growth factor, HB-EGF, bFGF, EGF and TGF-alpha increased DNA synthesis of FLEC. HGF, HB-EGF, bFGF and EGF led to an increase in liver-specific gene expressions; and their effects on differentiation differ as a function of gestation age.

Animals↗
PubMed2005

Functional assessment by myocardial performance index (Tei index) correlates with plasma brain natriuretic peptide concentration in patients with hypertrophic cardiomyopathy.

BACKGROUND: Hypertrophic cardiomyopathy (HCM) might exhibit not only diastolic, but also latent systolic dysfunction. Therefore combined assessment of both systolic and diastolic function using myocardial performance index (Tei index) can be useful in HCM. Plasma brain natriuretic peptide (BNP) level is reported to be elevated in HCM, but the mechanism of BNP elevation in HCM remains to be established. METHODS AND RESULTS: The value of Tei index in 45 HCM patients was compared with that of 20 normal control subjects. The HCM patients showed a higher value of Tei index (0.55+/-0.12 vs 0.36+/-0.08, p < 0.0001) and longer isovolumic relaxation and contraction times than control subjects. The plasma BNP level correlated with Tei index in non-obstructive HCM (n = 35, r = 0.61, p < 0.0001), although the correlation was mild when overall HCM patients were included (r = 0.34, p = 0.02). The correlation was still significant after adjusting for age, or the extent and severity of left ventricular hypertrophy. Multiple stepwise regression analysis identified mitral E/A ratio (r = 0.49, F = 13.1) and Tei index (r = 0.37, F = 7.6) as independent predictors of higher plasma BNP level in non-obstructive HCM. CONCLUSIONS: Myocardial performance index was abnormal in HCM, reflecting both systolic and diastolic dysfunction in this disorder. Plasma BNP level correlated with functional assessment by Tei index in non-obstructive HCM.

Adult↗
PubMed2005

High morning home blood pressure is associated with a loss of functional independence in the community-dwelling elderly aged 75 years or older.

To elucidate the relationship between home systolic blood pressure (SBP) and functional impairment in the elderly 75 years or older, 461 community-dwelling subjects (192 men, 269 women, mean age: 80 years) were studied. Home blood pressure was measured twice in the morning and twice in the evening for 5 consecutive days with an automatic cuff-oscillometric device. Total/high-density lipoprotein cholesterol and several functional assessments were evaluated. A subject was determined to exhibit a loss of independence according to the activities of daily living (ADL) score in a study conducted in 2001. Based on the mean home SBPs (mSBP) and morning-evening SBP differences (dSBP), the subjects were classified into 4 groups as follows: hypertensive/morning-dominant (HM; mSBP > or = 135 mmHg, dSBP > or = 15 mmHg), hypertensive/sustained (HS; mSBP > or = 135 mmHg, dSBP<15 mmHg), normotensive/morning-dominant (NM; mSBP<135 mmHg, dSBP > or = 15 mmHg), and normotensive/controlled (NC; mSBP<135 mmHg, dSBP<15 mmHg). There were no differences in sex, cholesterol levels, history of stroke, other cardiovascular diseases (CVDs), and cognitive function, but there were significant differences in age, antihypertensive medications, the neurobehavioral test scores, and ADL scores. There were no significant differences in terms of mortality and CVD events. In the survivors, HM and HS were independent risk factors for a loss of independence, after adjustments were made for onset of stroke, age, antihypertensive therapy, history of CVD, as well as neurobehavioral test scores and ADL scores (odds ratio [OR]: 12.2 and 3.78, respectively). After the same adjustments as those mentioned above were made, HM and HS were found to be negative determinants of survival and maintenance of independence (OR: 0.082, 0.270, respectively). In conclusion, high home SBP (> or = 135 mmHg) and high dSBP (> or = 15 mmHg) were found to be important in determining the levels of disability for the very elderly.

Activities of Daily Living↗
PubMed2005

Hypertrophic cardiomyopathy with progression from apical hypertrophy to asymmetrical septal hypertrophy: a case report.

A 41-year-old man was referred to our hospital for further examination because of abnormal electrocardiography findings at a health-check examination. Transthoracic echocardiography showed left ventricular hypertrophy confined to the most distal portion of the left ventricle, which is a typical feature of apical hypertrophic cardiomyopathy. Ten years later, he was again admitted for the evaluation of chest pain. Echocardiography showed asymmetrical septal hypertrophy in addition to apical hypertrophy. These findings demonstrate morphologic evolution in hypertrophic cardiomyopathy from apical hypertrophy to asymmetrical septal hypertrophy.

Adult↗