Hisako Omori

Single administration of cerivastatin, an HMG-CoA reductase inhibitor, improves the coronary flow velocity reserve: a transthoracic Doppler echocardiography study

HMG-CoA reductase inhibitors (statins) have been shown to improve the endothelial function by lowering lipids. Recent studies also suggest a direct impact of statins on the vascular wall. We assessed the rapid effect of cerivastatin on the coronary flow velocity reserve (CFVR) using transthoracic Doppler echocardiography (TTDE). The coronary flow velocity from the distal left anterior descending artery was measured in 16 healthy subjects (all male, age 24–38 years) using a 5-MHz transducer, on the day before, just before, and 3 h after administering 0.3 mg of cerivastatin. Hyperemia was achieved by the intravenous administration of adenosine, and the CFVR was calculated as the radio of the mean diastolic hyperemic coronary flow velocity to the basal flow velocity. The serum lipid profile and high-sensitivity C-reactive protein (hsCRP) were measured. The CFVR following the single administration of cerivastatin increased from 2.93 ± 0.58 to 3.91 ± 0.86, P = 0.003, and was significantly higher than the CFVR measured at the same time on the previous day (3.91 ± 0.86 vs 3.37 ± 0.48, P = 0.009). Neither the serum lipid profile nor hsCRP exhibited a remarkable change after cerivastatin administration. We concluded that a single-dose administration of cerivastatin, an HMG-CoA reductase inhibitor, improves the coronary flow velocity reserve without modifying the serum lipid profile.

Adherence to medication and characteristics of Japanese patients with non-valvular atrial fibrillation

BACKGROUND Adherence to medication plays an important role in the prevention of morbidity and mortality in non-valvular atrial fibrillation (NVAF) patients. The aim of this study is to assess adherence to medication and risk factors for non-adherence in Japanese NVAF patients who are prescribed anticoagulants. METHODS A total of 378 outpatients with NVAF who completed self-reported questionnaires were analyzed in this prospective study (mean age 69±12 years; 26% female). Self-reported adherence to cardiovascular drugs including anticoagulants was measured with a modified Siegal scale. Depression was defined as a Patient Health Questionnaire-9 score of ≥10. Univariate and multivariate analyses were performed on several variables to analyze factors affecting non-adherence. RESULTS In total, 291 (77%) of our patients received warfarin, and the remainder received direct oral anticoagulants. Fifty-two (14%) patients were defined as non-adherent. Univariate analyses showed that age <65 years, ≥2 times daily dosing of cardiovascular drugs and employment, but not depression, were significantly associated with non-adherence, 1.87 (95% CI: 1.01-3.42, p=0.04), 2.97 (95% CI: 1.64-5.49, p<0.01), 2.11 (95% CI: 1.16-3.93, p=0.01), and 0.74 (95% CI: 0.26-2.64), respectively. Multivariate analysis showed that only ≥2 times daily dosing was a significant independent risk factor (HR 3.06, 95% CI: 1.67-5.69, p<0.01). CONCLUSIONS Our study showed that the prevalence of non-adherence to medications was 14% in NVAF patients. Frequent daily dosing was an independent risk factor for non-adherence to medication (UMIN-CTR No. UMIN 000023514).

Paroxysmal atrial fibrillation recurrences and quality of life in symptomatic patients: A crossover study of flecainide and pilsicainide

The therapeutic goals of atrial fibrillation (AF) patients are to reduce symptoms and prevent severe complications associated with AF. This study compared the efficacy of flecainide versus pilsicainide in reducing the frequency of AF and improving quality of life (QOL) in symptomatic paroxysmal AF patients without structural heart disease.

Dose T2-weighted Short TI Inversion Recovery Images on Cardiac Magnetic Resonance Reflect Disease Activity in Cardiac Involvement of Sarcoidosis Patients?

Background Cardiac involvement of sarcoidosis (CIS) in progressed and advanced stage increases cardiac events and mortality of systemic sarcoidosis, so early diagnosis and determination of disease activity are needed for treating in CIS. However, evaluating disease activity of CIS remains a major challenge because no single diagnostic test has yet been established with a high accuracy. High signal intensity of T2-weighted short TI inversion recovery images (T2-STIR) on cardiac magnetic resonance (CMR) might be useful technique for investigating myocardial edematous tissue caused by inflammation.We investigated the relationship between high signal intensity of T2-STIR and disease activity in patients with CIS. Methods 38 patients (male/female = 4/34, age 30-78 years) with CIS or suspect of CIS underwent T2-STIR on CMR. We defined CIS activity as follows; worsening cardiac symptoms, abnormal results of serum tests and other imaging findings. Results Eleven of 38 patients (28%) had high signal intensity of T2-STIR. In these patients with high intensity of T2STIR, 8 patients (73%) confirmed CIS activity, and 3 patients (27%) did not. In active CIS patients, 4 patients were treated with corticosteroid, then 3 patients improved cardiac symptoms or disappeared high signal intensity of T2-STIR. In the rest of all 4 patients without corticosteroid therapy showed worsening CIS. Conclusions High signal intensity of T2-STIR reflects disease activity in patient with CIS. Funding Nothing.