Hirotoshi Kamishirado
Dokkyo University
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Featured researches published by Hirotoshi Kamishirado.
Journal of the American College of Cardiology | 2001
Teruo Inoue; Toshihiko Uchida; Hirotoshi Kamishirado; Kan Takayanagi; Terumi Hayashi; Shigenori Morooka
OBJECTIVESnThis study was designed to establish the clinical significance of antibodies against oxidized low density lipoprotein (anti-Ox-LDL) titer in atherosclerotic coronary artery disease (CAD).nnnBACKGROUNDnOxidative modification of LDL, which plays a key role in the development of atherosclerosis, induces immunogenic epitopes in the LDL molecule, and the presence of anti-Ox-LDL has been demonstrated in human sera.nnnMETHODSnAnti-Ox-LDL titer was measured by enzyme-linked immunosorbent assay in 108 patients who had angiographically verified CAD, and 31 patients who had chest pain but no significant CAD, as controls.nnnRESULTSnThe anti-Ox-LDL titer was higher (p < 0.01) in patients with multivessel CAD (19.4 +/- 10.1 AcU/ml, n = 68) than in the controls (9.8 +/- 4.1). However, no significant difference was shown between the single-vessel CAD group (15.1 +/- 6.4, n = 40) and the controls, or between the multivessel CAD group and the single-vessel CAD group. The titer was higher in patients with unstable angina (21.5 +/- 11.8 AcU/ml, n = 20, p < 0.01), or in patients with acute myocardial infarction (23.1 +/- 12.0, n = 20, p < 0.01) than in patients with stable-effort angina or old myocardial infarction (12.2 +/- 8.6, n = 68). Multiple logistic regression analysis indicated that the anti-Ox-LDL titer most powerfully discriminated CAD patients from controls (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.07-1.33, p = 0.0006) and acute coronary syndrome from chronic CAD (OR: 1.09, 95% CI: 1.04-1.14, p = 0.0008).nnnCONCLUSIONSnSerum anti-Ox-LDL titer not only can predict a presence of atherosclerotic CAD but also may be a marker of plaque instability. Low density lipoprotein oxidation may play an important role in the development of plaque instability.
Journal of the American College of Cardiology | 2001
Teruo Inoue; Toshihiko Uchida; Hirotoshi Kamishirado; Kan Takayanagi; Shigenori Morooka
OBJECTIVESnThis study aimed to elucidate whether an antibody against oxidized low density lipoprotein (anti-Ox-LDL) could predict short-term coronary artery atherosclerotic lesion progression.nnnBACKGROUNDnIt is still controversial whether higher levels of the anti-Ox-LDL titer are associated with atherosclerotic coronary artery disease.nnnMETHODSnIn 52 patients undergoing coronary angioplasty and six-month follow-up angiography, we performed quantitative coronary angiographic analysis of a lesion on a branch away from the intervention site vessel and assessed lesion progression or regression using the Progression-Regression score calculated as the baseline minimal lumen diameter minus the follow-up minimal lumen diameter. The serum anti-Ox-LDL titer was measured using an enzyme-linked immunosorbent assay method just before the initial angiography in all patients.nnnRESULTSnThe anti-Ox-LDL titer was 16.6+/-1.5 AcU/ml in the progression group (Progression-Regression score >0.15 mm; n = 20), which was significantly higher (p < 0.001) than the value of 9.5+/-1.2 in the regression group (< or =-0.15 mm; n = 14) and also higher (p < 0.01) than the value of 11.4+/-1.3 in the no-change group (-0.15 to 0.15 mm; n = 18). The Progression-Regression score was correlated with the antibody titer in all patients (r = 0.56, p < 0.001). Multiple regression analysis showed that the Progression-Regression score was independently correlated with the antibody titer (r = 0.44, p < 0.01) as well as lipoprotein (a) (r = 0.33, p < 0.05).nnnCONCLUSIONSnAnti-Ox-LDL may be an independent predictor of coronary atherosclerotic lesion progression in the short term.
Angiology | 1997
Hirotoshi Kamishirado; Teruo Inoue; Tsuneo Fujito; Makoto Kase; Minoru Shimizu; Yoshihiko Sakai; Kan Takayanagi; Shigenori Morooka; Satoshi Natsui
The effect of enalapril on cerebral blood flow (CBF) was studied in 11 patients with chronic heart failure (NYHA II or III, dilated cardiomyopathy in 6 and old myocardial infarction in 5). CBF was evaluated by analyzing the Patlak-Plot curve obtained from radionuclide angiography with technetium-99m hexamethylpropylene amine oxime (99mTc-HM-PAO). Cardiac index (CI) and stroke volume (SV) were simultaneously measured by impedance cardiography. These measurements were performed before and at four weeks after daily administration of 5 mg enalapril. The stroke volume, cardiac index, and heart rate were not significantly changed after four weeks of enalapril admin istration. However, CBF was increased by 6.5% from 36.72 ±4.66 to 39.13 ±5.65 mL/ 100g/min (P<0.05). These results suggest that enalapril increased cerebral blood flow, which was not related to increased cardiac output in congestive heart failure. Patlak-Plot analysis of radionuclide angiography using 99m Tc-HM-PAO may be available for quantitative assessment of brain perfusion.
The Cardiology | 2002
Teruo Inoue; Isao Yaguchi; Toshihiko Uchida; Hirotoshi Kamishirado; Shiro Nakahara; Terumi Hayashi; Shigenori Morooka
To establish the clinical significance of the antibody against oxidized low-density lipoprotein (anti-Ox-LDL) titer in patients with acute myocardial infarction (AMI), we measured the anti-Ox-LDL titer in 39 patients with AMI and 25 controls. In all AMI patients, the anti-Ox-LDL titer on admission was higher (p < 0.05) than the value in the controls. One month after admission, the titer decreased significantly (p < 0.001) reaching control levels. In patients who underwent thrombolytic therapy, the anti-Ox-LDL titer on admission was identical in patients with occluded infarct-related arteries (IRA) and patients with patent IRA during emergency coronary angiography. In patients who did not undergo thrombolytic therapy, the anti-Ox-LDL titer on admission was higher in patients with occluded IRA than in patients with patent IRA. An increased anti-Ox-LDL titer may be a risk factor for the onset of AMI. Spontaneous recanalization of the IRA may be associated with increased anti-Ox-LDL titers, while thrombolysis-induced recanalization may be independent of it.
The American Journal of the Medical Sciences | 2001
Toshihiko Uchida; Teruo Inoue; Hirotoshi Kamishirado; Toshiyuki Nakata; Yoshihiko Sakai; Kan Takayanagi; Shigenori Morooka
A 55-year-old man developed acute myocardial infarction (AMI) related to a large coronary artery aneurysm and a distal coronary stenotic lesion after steroid therapy for systemic lupus erythematosus (SLE). Only 13 SLE patients with AMI caused by coronary artery aneurysms have been reported, 11 of whom were young or middle-aged women and the 2 remaining were young men. This is the first report of a middle-aged man with multiple coronary lesions.
Angiology | 2003
Toshihiko Uchida; Teruo Inoue; Hirotoshi Kamishirado; Kan Takayanagi; Shigenori Morooka
This study assessed whether progression of coronary artery atherosclerotic lesions could be predicted in the short term using various lipid profiles. In 37 patients (61.9 ±9.5 years) under going coronary angioplasty and with 6-month follow-up angiography, quantitative coronary angiography of a new or changed lesion was performed in the follow-up examination, except for intervention vessels. The progression-regression score of the assessed lesion was calcu lated as the baseline minus the follow-up minimal lumen diameter. The serum lipoprotein (a) level was higher in the progression group (progression-regression score >0.15 mm), than in the regression group (≤ -0.15 mm; p<0.01) and the no change group (within ±0.15 mm; p < 0.05). Remnant-like lipoprotein particle-cholesterol and apolipoprotein-B levels were also higher in the progression group. However, multiple regression analysis of the progression showed that the progression-regression score was independently correlated with lipoprotein (a) alone (R = 0.50, p < 0.05). This shows that lipoprotein (a) is an independent predictor of coronary atherosclerotic lesion progression over the short term.
The American Journal of the Medical Sciences | 2000
Hirotoshi Kamishirado; Inoue Teruo; Tsuneo Fujito; Kaori Akiya; Eiko Ishiyama; Masashi Sakuma; Kan Takayanagi; Terumi Hayashi; Shigenori Morooka
A case of idiopathic adrenal hemorrhage is reported. A 76-year-old woman exhibited a left adrenal tumor, 3 cm in diameter, on abdominal computed tomography. The patient was receiving aspirin medication for atrial fibrillation. There was no evidence of increased adrenal hormones. The mass enlarged to 6 cm in diameter within 18 months, and malignancy was suspected. The mass was diagnosed as adrenal hematoma by operative findings.
International Journal of Cardiology | 2002
Hirotoshi Kamishirado; Teruo Inoue; Masashi Sakuma; Toshihiko Uchida; Saeko Tsuda; Kan Takayanagi; Terumi Hayashi; Shigenori Morooka
Diabetic patients have a higher restenosis rate and late morbidity following balloon angioplasty. However, the increased risk of restenosis after coronary stent implantation in diabetic patients is controversial. We compared the quantitative coronary angiographic (QCA) variables between 42 diabetic patients and 71 non-diabetic patients undergoing coronary stent implantation and for 6 months follow-up. Pre-procedural variables were identical in the diabetic and non-diabetic patients. The stent-artery ratio was lower (1.07+/-0.13 vs. 1.13+/-0.13, P=0.020), and acute gain after coronary stenting was lower (1.58+/-0.53 vs. 1.77+/-0.48, P=0.049) in the diabetic patients than in the non-diabetic patients. However, the late lumen loss (0.42+/-0.64 vs. 0.49+/-0.69), loss index (0.28+/-0.49 vs. 0.28+/-0.45), restenosis rate (19 vs. 23%) and target lesion revascularization rate (17 vs. 18%) after 6 months were identical in the diabetic and non-diabetic patients. These results suggest that diabetes itself does not increase stent restenosis.
American Heart Journal | 2002
Hirotoshi Kamishirado; Teruo Inoue; Keiichi Mizoguchi; Toshihiko Uchida; Toshiyuki Nakata; Masashi Sakuma; Kan Takayanagi; Shigenori Morooka
American Journal of Cardiology | 2003
Teruo Inoue; Toru Kato; Kan Takayanagi; Toshihiko Uchida; Isao Yaguchi; Hirotoshi Kamishirado; Shigenori Morooka; Nobuo Yoshimoto