Eisei Yamamoto

Usefulness of rosuvastatin to prevent periprocedural myocardial injury in patients undergoing elective coronary intervention.

The aim of the present study was to investigate whether percutaneous coronary intervention-related periprocedural myocardial infarction (MI) can be suppressed more significantly with high- compared with low-dose rosuvastatin. A total of 232 patients scheduled to undergo elective percutaneous coronary intervention within 5 to 7 days were assigned to groups that would receive either 2.5 or 20 mg/day of rosuvastatin (n = 116 each). The incidence of periprocedural MI did not significantly differ between the high and low-dose groups (8.7% vs 18.7%, p = 0.052). In patients who were not taking statins at the time of enrollment, high-dose rosuvastatin significantly suppressed periprocedural MI compared with the low dose (10.5% vs 30.0%, p = 0.037). The difference was not significant in patients who were already taking statins (high vs low dose 7.6% vs 10.6%, p = 0.582). In conclusion, the incidence of percutaneous coronary intervention-related periprocedural MI was reduced more effectively by high-dose than by low-dose rosuvastatin in statin-naive patients. However, low-dose rosuvastatin is sufficient for patients who are already taking statins.

Inhaled nitric oxide therapy for secondary pulmonary hypertension with hypertrophic obstructive cardiomyopathy and severe kyphoscoliosis

Inhaled nitric oxide therapy for secondary pulmonary hypertension with hypertrophic obstructive cardiomyopathy and severe kyphoscoliosis☆ YusukeHosokawa ⁎, Takeshi Yamamoto , Yuto Yabuno , KeisukeHara , Toshiyuki Aokage , KeikoNakazato , Hiroomi Suzuki , Manabu Suzuki , Akira Ueno , Ryo Munakata , Yukichi Tokita , Eisei Yamamoto , Koichi Akutsu , Hitoshi Takano , Naoki Sato , Morimasa Takayama , Keiji Tanaka , Kyoichi Mizuno b

Clinical usefulness of gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography with phase analysis for the management of patients with isolated ventricular noncompaction

Gated Tc-99m sestamibi myocardial perfusion single-photon emission computed tomography (GMPS) with phase analysis provides information on myocardial perfusion, left ventricular (LV) function, and LV dyssynchrony. We present a case of isolated left ventricular noncompaction (IVNC) cardiomyopathy in which GMPS with phase analysis proved to be beneficial and reliable to monitor the long-term response to cardiac resynchronization therapy with defibrillator (CRT-D). The patient was an 84-year-old man with shortness of breath on minimal exertion (New York Heart Association class III) who had severe drug-refractory heart failure with hypotension and ventricular tachycardia. He was diagnosed with IVNC using echocardiography. At baseline, GMPS with phase analysis revealed a reduced ejection fraction (EF, 21%), large perfusion defects in the inferior and inferolateral walls, and severe LV dyssynchrony [histogram bandwidth (HBW) 120°]. Combination therapy with CRT-D and a titrated beta-blocker was initiated to induce LV reverse remodeling and reduce LV dyssynchrony. Two years after CRT-D implantation, GMPS with phase analysis showed marked improvement in LV function and LV dyssynchrony (EF 28%, HBW 36°). This case demonstrates that GMPS with phase analysis is an important and useful modality to evaluate LV function and LV dyssynchrony in IVNC patients undergoing CRT-D. <Learning objective: We experienced a rare case of heart failure with isolated left ventricular noncompaction (IVNC) treated with cardiac resynchronization therapy with defibrillator (CRT-D). We demonstrate that gated Tc-99m myocardial perfusion SPECT (GMPS) with phase analysis can simultaneously evaluate myocardial perfusion and left ventricular dyssynchrony to assess the indication and efficacy of CRT-D. This case demonstrates that GMPS with phase analysis is useful to monitor IVNC patients before and after CRT-D.>.

OBESITY CARDIOMYOPATHY: A NEW CONCEPT OF SECONDARY CARDIOMYOPATHY WITH UNIQUE ULTRASTRUCTURAL FEATURES

Results: Obese patients had higher BMI (38.1 ± 7.7 vs. 23.7 ± 3.3 kg/m2, p < 0.001). LV ejection fraction and LV dimension were not significantly different between the two groups (27.9 ± 13.7 vs. 27.7 ± 11.4%, p = 0.484; 65.0 ± 8.2 vs. 62.2 ± 10.2 mm, p = 0.190, respectively). We measured the density of lipid droplets in 4 electron photomicrographs of biopsy specimens picked randomly and found the density of droplets in obese patients was significantly higher (1.97 ± 1.47 vs. 0.63 ± 0.10 /μm2, p < 0.001). Serum troponin T level in obese patients was also higher (0.05 ± 0.06 vs. 0.02 ± 0.02 ng/ml, p = 0.02).