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  2. 小林 欣夫

小林 欣夫

コバヤシ ヨシオ  (Yoshio Kobayashi)

基本情報

所属
千葉大学 大学院医学研究院循環器内科学 教授
学位
博士(医学）(千葉大学)
J-GLOBAL ID
200901031812437900
researchmap会員ID
5000068706

研究キーワード

 1

研究分野

 1

経歴

 2

論文

 868
  • Kobayashi Y, Iwata A, Suzuki K, Suto A, Kawashima S, Saito Y, Owada T, Kobayashi M, Watanabe N, Nakajima H
    Proceedings of the National Academy of Sciences of the United States of America 110(13) 5121-5126 2013年3月  査読有り
  • Yo Iwata, Yoshihide Fujimoto, Tomoki Morino, Kazumasa Sugimoto, Kenji Ohkubo, Tadayuki Kadohira, Kenichi Fukushima, Hideki Kitahara, Issei Komuro, Yoshio Kobayashi
    AMERICAN HEART JOURNAL 165(3) 408-414 2013年3月  査読有り
    Background Stem cell mobilization by granulocyte colony-stimulating factor (G-CSF) has been shown to enhance endothelial healing after spontaneous or iatrogenic arterial disruption. Granulocyte colony-stimulating factor treatment might attenuate endothelial dysfunction after sirolimus-eluting stent (SES) implantation that may be associated with adverse cardiac events during follow-up. This prospective, double-blind, randomized, placebo-controlled study investigated whether G-CSF improved endothelial dysfunction after SES implantation. Methods One hundred patients who underwent SES implantation were randomly assigned to the G-CSF (n = 50) or the placebo group (n = 50). They received daily subcutaneous injection of 300 mu g G-CSF or saline for 5 days. Endothelial function was estimated by measuring the coronary vasoreactivity in the segments 15 mm proximal and distal to SES in response to intracoronary infusion of acetylcholine (10(-8) and 10(-7) mol/L) at 9-month follow-up. Results Follow-up angiography was performed in 41 G-CSF patients (82%) and 46 placebo patients (92%) (P =.14). Changes in coronary diameter in response to acetylcholine infusion in the proximal segment were not significantly different between the 2 groups. However, vasoconstriction in the distal segment in response to 10(-8) mol/L (-3.9% +/- 6.4% vs -7.0% +/- 8.1%, P < .05) and 10(-7) mol/L (-8.8% +/- 11.0% vs -15.2% +/- 7.6%, P < .01) acetylcholine infusion was attenuated in the G-CSF group. Endothelium-independent vasodilatation after nitrate infusion did not differ between the 2 groups. Conclusion Granulocyte colony-stimulating factor attenuates endothelial dysfunction after SES implantation. (Am Heart J 2013;165:408-14.)
  • Okada Sho, Odaka Kenichi, Zhang Ming-Rong, Tadokoro Hiroyuki, Yui Joji, Wakizaka Hidekatsu, Xie Lin, Uchino Yoshio, Kawamura Kazunori, Kumata Katsushi, Komuro Issei, Minamino Tohru, Kobayashi Yoshio
    CIRCULATION 126(21) 2012年11月20日  査読有り
  • H. Takano, H. Hasegawa, H. Narumi, S. Shindo, H. Mizuma, Y. Kuwabara, Y. Kobayashi, I. Komuro
    Journal of Human Hypertension 26(11) 656-663 2012年11月  査読有り
    The Valsartan Amlodipine Randomized Trial (VART) was performed to compare the beneficial effects of valsartan and amlodipine on cardiovascular events in Japanese hypertensive patients. In this subanalysis of the VART, we assessed the relationship between home blood pressure (HBP) levels and cardiovascular events in the enrolled patients. We enrolled 1021 patients with mild-to-moderate hypertension in the VART. The participants were allocated randomly to either the valsartan group or the amlodipine group. The primary end point was a composite of all-cause death, sudden death, cerebrovascular events, cardiac events, vascular events and renal events. A total of 621 patients (valsartan group: 305 and amlodipine group: 316) completed the measurements of HBP (morning and evening) throughout the trial. Both the agents evenly and significantly lowered morning HBP and evening HBP throughout the trial. There was no significant difference in the primary end point between the two groups. However, we observed significant decreases in the left ventricular mass index and urinary albumin to creatinine ratio in the valsartan group but not in the amlodipine group. There were no significant differences in HBP levels and the main outcome of the cardiovascular events between the valsartan and amlodipine groups. However, in the valsartan group, significant improvements in left ventricular hypertrophy and microalbuminuria were observed. © 2012 Macmillan Publishers Limited All rights reserved.
  • Ippei Shimizu, Yohko Yoshida, Junji Moriya, Taro Katsuno, Masayoshi Suda, Yoshio Kobayashi, Tohru Minamino
    CIRCULATION 126(21) 2012年11月  査読有り
  • Yohko Yoshida, Tohru Minamino, Kaoru Tateno, Ippei Shimizu, Sho Okada, Masataka Yokoyama, Takashi Ito, Aika Nojima, Taro Katsuno, Atsushi Nakagomi, Masayoshi Suda, Yoshio Kobayashi
    CIRCULATION 126(21) 2012年11月  査読有り
  • Masataka Yokoyama, Tohru Minamino, Sho Okada, Atsushi Nakagomi, Kaoru Tateno, Ippei Shimizu, Aika Nojima, Takashi Ito, Yohko Yoshida, Taro Katsuno, Issei Komuro, Yoshio Kobayashi
    CIRCULATION 126(21) 2012年11月  査読有り
  • Yoshio Kobayashi
    Journal of Cardiology Cases 6(4) e124-e125 2012年10月  査読有り
  • 上原 雅恵, 船橋 伸禎, 堀江 佐和子, 高岡 浩之, 小澤 公哉, 小林 欣夫
    脈管学 52(Suppl.) S107-S107 2012年9月  
  • Yoshihide Fujimoto, Yuji Matsudo, Yoshio Kobayashi
    JOURNAL OF INVASIVE CARDIOLOGY 24(9) E199-E201 2012年9月  査読有り
    Deployment of a polytetrafluoroethylene-covered stent is a useful option to seal coronary perforation. However, the high profile and low flexibility compromise its deliverability. To facilitate stent delivery, deep-vessel intubation with a 5 Fr guiding catheter through a 6 or 7 Fr guiding catheter (mother-and-child catheter) has been used. This case report describes a successful deployment of a polytetrafluoroethylene-covered stent through a 5 Fr Heartrail ST01 guiding catheter (Terumo) to seal coronary perforation. J INVASIVE CARDIOL 2012; 24(9): E199-E201
  • 上原 雅恵, 船橋 伸禎, 堀江 佐和子, 高岡 浩之, 小澤 公哉, 小林 欣夫
    日本心臓病学会誌 7(Suppl.I) 323-323 2012年8月  
  • 堀江 佐和子, 船橋 伸禎, 上原 雅恵, 高岡 浩之, 小澤 公哉, 小林 欣夫
    日本心臓病学会誌 7(Suppl.I) 334-334 2012年8月  
  • 片岡 明久, 船橋 伸定, 堀江 佐和子, 高岡 浩之, 上原 雅恵, 小林 欣夫
    日本心臓病学会誌 7(Suppl.I) 181-181 2012年8月  
  • 高岡 浩之, 船橋 伸禎, 上原 雅恵, 小澤 公哉, 片岡 明久, 小林 欣夫
    日本心臓病学会誌 7(Suppl.I) 262-262 2012年8月  
  • 高岡 浩之, 船橋 伸禎, 上原 雅恵, 小澤 公哉, 大門 道子, 片岡 明久, 小林 欣夫
    日本心臓病学会誌 7(Suppl.I) 322-322 2012年8月  
  • Ippei Shimizu, Tohru Minamino, Yohko Yoshida, Taro Katsuno, Issei Komuro, Yoshio Kobayashi
    CIRCULATION RESEARCH 111(4) 2012年8月  査読有り
  • Sho Okada, Masataka Yokoyama, Haruhiro Toko, Kaoru Tateno, Junji Moriya, Ippei Shimizu, Aika Nojima, Takashi Ito, Yohko Yoshida, Yoshio Kobayashi, Hideki Katagiri, Tohru Minamino, Issei Komuro
    ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY 32(8) 1902-1909 2012年8月  査読有り
    Objective-The central nervous system is thought to influence the regulation of the cardiovascular system in response to humoral and neural signals from peripheral tissues, but our understanding of the molecular mechanisms involved is still quite limited. Methods and Results-Here, we demonstrate a central nervous system-mediated mechanism by which brain-derived neurotrophic factor (BDNF) has a protective effect against cardiac remodeling after myocardial infarction (MI). We generated conditional BDNF knockout mice, in which expression of BDNF was systemically reduced, by using the inducible Cre-loxP system. Two weeks after MI was induced surgically in these mice, systolic function was significantly impaired and cardiac size was markedly increased in conditional BDNF knockout mice compared with controls. Cardiomyocyte death was increased in these mice, along with decreased expression of survival molecules. Deletion of the BDNF receptor (tropomyosin-related kinase B) from the heart also led to the exacerbation of cardiac dysfunction after MI. The plasma levels of BDNF were markedly increased after MI, and this increase was associated with the upregulation of BDNF expression in the brain, but not in the heart. Ablation of afferent nerves from the heart or genetic disruption of neuronal BDNF expression inhibited the increase of plasma BDNF after MI and led to the exacerbation of cardiac dysfunction. Peripheral administration of BDNF significantly restored the cardiac phenotype of neuronal BDNF-deficient mice. Conclusion-These results suggest that BDNF expression is upregulated by neural signals from the heart after MI and then protects the myocardium against ischemic injury. (Arterioscler Thromb Vasc Biol 2012;32:1902-1909.)
  • Akihisa Kataoka, Takatsugu Kajiyama, Yukiko Ozawa, Masashi Kabasawa, Goro Matsumiya, Yoshio Kobayashi, Nobusada Funabashi
    INTERNATIONAL JOURNAL OF CARDIOLOGY 158(1) E11-E12 2012年6月  査読有り
  • Nehiro Kuriyama, Yoshio Kobayashi, Yoshisato Shibata
    Journal of Cardiology Cases 5(3) e137-e139 2012年6月  査読有り
    This case report demonstrates iatrogenic left main coronary artery dissection during percutaneous coronary intervention. Intravascular ultrasound imaging showed that the entry site of the false lumen was located at the cranial part of the ostium of the left main coronary artery. Utilizing this information, the operator was able to achieve the guidewire entering into the true lumen. © 2012 Japanese College of Cardiology.
  • Ippei Shimizu, Yohko Yoshida, Taro Katsuno, Kaoru Tateno, Sho Okada, Junji Moriya, Masataka Yokoyama, Aika Nojima, Takashi Ito, Rudolf Zechner, Issei Komuro, Yoshio Kobayashi, Tohru Minamino
    CELL METABOLISM 15(5) 787-787 2012年5月  査読有り
  • Akihisa Kataoka, Hiroyuki Takano, Taro Imaeda, Kwangho Lee, Marehiko Ueda, Nobusada Funabashi, Shigeto Oda, Issei Komuro, Yoshio Kobayashi
    INTERNATIONAL JOURNAL OF CARDIOLOGY 157(2) E33-E34 2012年5月  査読有り
  • Raita Uchiyama, Hiroshi Hasegawa, Yoshihito Kameda, Kazutaka Ueda, Yoshio Kobayashi, Issei Komuro, Hiroyuki Takano
    JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY 52(5) 1038-1047 2012年5月  査読有り
    We and others have previously reported that granulocyte colony-stimulating factor (G-CSF) prevents left ventricular remodeling and dysfunction after myocardial infarction in animal models and human. We have also reported that G-CSF inhibits the progression of atherosclerosis in animal models, but its precise mechanism is still elusive. So, we examined the effects of G-CSF on atherosclerosis in apolipoprotein E-deficient (ApoE(-/-)) mice. Twelve-week-old male ApoE(-/-) mice were subcutaneously administrated with 200 mu g/kg of G-CSF or saline once a day for 5 consecutive days per a week for 4 weeks. Atherosclerotic lesion of aortic sinus was significantly reduced in the G-CSF-treated mice compared with the saline-treated mice (35% reduction, P<0.05). G-CSF significantly reduced the expression level of interferon-gamma by 31% and increased the expression level of interleukin-10 by 20% in atherosclerotic lesions of aortic sinus. G-CSF increased the number of CD4(+)CD25(+) regulatory T cells in lymph nodes and spleen, and enhanced the suppressive function of regulatory T cells in vitro. G-CSF markedly increased the number of Foxp3-positive regulatory T cells in atherosclerotic lesions of aortic sinus. Administration of anti-CD25 antibody (PC61) that depletes regulatory T cells abrogated these ather-oprotective effects of G-CSF. Moreover, in ApoE(-/-)/CD28(-/-) mice, that lack regulatory T cells, the protective effects of G-CSF on atherosclerosis were not recognized. These findings suggest that regulatory T cells play an important role in the ather-oprotective effects of G-CSF. (C) 2012 Elsevier Ltd. All rights reserved.
  • Yoshihito Kameda, Hiroshi Hasegawa, Akihiko Kubota, Hiroyuki Tadokoro, Yoshio Kobayashi, Issei Komuro, Hiroyuki Takano
    CIRCULATION JOURNAL 76(5) 1159-1168 2012年5月  査読有り
    Background: 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), which are widely used to lower plasma cholesterol levels, have been reported to have various pleiotropic effects such as protective effect of endothelial cells, angiogenic effect, antioxidant effect and anti-inflammatory effect. It is unclear, however, whether statins have any effects on the progression from left ventricular (LV) hypertrophy to heart failure in the established hypertrophied heart. Methods and Results: C57BL/6 mice were treated with pitavastatin (pitava) or vehicle (control) from 2 weeks (established hypertrophy stage) after transverse aortic constriction (TAC) and the treatment was continued for 4 weeks. Pitavastatin significantly inhibited the progression from LV hypertrophy to heart failure as assessed on echocardiography. The cardiomyocyte cross-sectional area was significantly increased in the control group compared to the sham-operated mice (sham group), but it was not significantly different between the control group and the pitava group at 6 weeks after TAG. Moreover, pitavastatin induced myocardial angiogenesis (ratio of number of endothelial cells to cardiomyocytes) and decreased the myocardial fibrosis and oxidative stress. The expression of angiopoietin-1 in the heart was significantly increased by pitavastatin at 6 weeks after TAG. Conclusions: Pitavastatin has preventive effects on the progression of heart failure even in the hypertrophied heart. (Circ J 2012; 76: 1159-1168)
  • Yoshihide Fujimoto, Yoshio Kobayashi, Masashi Yamaguchi
    JACC-CARDIOVASCULAR INTERVENTIONS 5(3) E5-E6 2012年3月  査読有り
  • Eiji Ichimoto, Yoshihide Fujimoto, Kenichirou Kubo, Tomoaki Miyayama, Yo Iwata, Hideki Kitahara, Yoshio Kobayashi
    JOURNAL OF INVASIVE CARDIOLOGY 24(2) 55-57 2012年2月  査読有り
    Objectives. The present study evaluated the mechanism of edge restenosis after sirolimus-eluting stent (SES) implantation using serial (post-intervention and follow-up) intravascular ultrasound (IVUS) analysis. Background. There is little information about the mechanism of edge restenosis after SES implantation. Methods. Serial IVUS analysis was performed at 5 mm reference segments immediately proximal and distal to the SES in 25 lesions with edge restenosis. Proximal and distal reference segments were divided into 1 mm subsegments. Results. Between post-intervention and follow-up IVUS studies, a decrease in external elastic membrane area was observed at the proximal edge. There was a significant increase in plaque & media area in the subsegment closest to the proximal edge. On the other hand, there was an increase in plaque & media area at the distal edge, with no change in external elastic membrane area. Conclusions. There may be different mechanisms between proximal and distal edge restenosis after SES implantation. Negative remodeling plays a major role in proximal edge restenosis. On the other hand, intimal hyperplasia may mainly contribute to distal edge restenosis.
  • 小笹 由香子, 赤澤 宏, 永井 敏雄, 小林 欣夫, 小室 一成
    血管 35(1) 30-30 2012年1月  
  • 古賀 俊輔, 長谷川 洋, 康田 典鷹, 李 光浩, 上田 希彦, 船橋 伸禎, 有村 卓, 木村 彰方, 永井 敏雄, 小林 欣夫
    心臓 44(11) 1399-1404 2012年  
    症例は43歳，男性．幼少時より心電図異常を指摘されていた．某年6月某日，自宅安静時に突然意識を消失し，家族により心肺蘇生が施行され，救急隊により自動体外式除細動器(automated external defibrillator；AED)で除細動され洞調律に復帰し，前医へ搬送された．第9病日に心室細動(ventricular fibrillation；VF)に対する植込み型除細動器(implantable cardioverter defibrillator；ICD)植え込み目的で当院転院となり，心エコー，心臓CTにて，瘤内血栓を伴う左室心尖部瘤と心室中部閉塞性肥大型心筋症を認め，第12病日にICD植え込み術を施行した．心室内血栓はヘパリンとワルファリンにて消失し，経過良好にて退院となった．心尖部瘤を合併した肥大型心筋症では，文献的にも心室頻拍やVFといった致死的不整脈の出現する危険性が高く，心室中部閉塞性肥大型心筋症に心尖部瘤を伴う症例では突然死や致死性不整脈のリスクが有意に上昇することが知られている．したがって，本症例においてもハイリスクとして管理する必要があり，心尖部瘤を合併した心室中部閉塞性肥大型心筋症では突然死の予防としてICDを積極的に考慮する必要があると考えられた．
  • Ippei Shimizu, Yohko Yoshida, Taro Katsuno, Kaoru Tateno, Sho Okada, Junji Moriya, Masataka Yokoyama, Aika Nojima, Takashi Ito, Rudolf Zechner, Issei Komuro, Yoshio Kobayashi, Tohru Minamino
    CELL METABOLISM 15(1) 51-64 2012年1月  査読有り
    Several clinical studies have shown that insulin resistance is prevalent among patients with heart failure, but the underlying mechanisms have not been fully elucidated. Here, we report a mechanism of insulin resistance associated with heart failure that involves upregulation of p53 in adipose tissue. We found that pressure overload markedly upregulated p53 expression in adipose tissue along with an increase of adipose tissue inflammation. Chronic pressure overload accelerated lipolysis in adipose tissue. In the presence of pressure overload, inhibition of lipolysis by sympathetic denervation significantly downregulated adipose p53 expression and inflammation, thereby improving insulin resistance. Likewise, disruption of p53 activation in adipose tissue attenuated inflammation and improved insulin resistance but also ameliorated cardiac dysfunction induced by chronic pressure overload. These results indicate that chronic pressure overload upregulates adipose tissue p53 by promoting lipolysis via the sympathetic nervous system, leading to an inflammatory response of adipose tissue and insulin resistance.
  • Hiroshi Hasegawa, Hiroyuki Takano, Yoshihito Kameda, Akihiko Kubota, Yoshio Kobayashi, Issei Komuro
    CLINICAL AND EXPERIMENTAL HYPERTENSION 34(2) 86-91 2012年  査読有り
    The Candesartan Cooperative Research of Therapy Design for Early Morning Hypertension in CHIBA was designed to investigate whether switching from angiotensin II receptor blockers (ARBs) except candesartan to candesartan might be effective in Japanese patients with morning hypertension. Seventy-eight mild to moderate hypertensive patients, who were treated with the standard doses of ARBs except candesartan (losartan, 50 mg; valsartan, 80 mg; telmisartan, 40 mg; or olmesartan, 20 mg), were entered into 12-week treatment period with candesartan 8 mg according to a multicenter, open-label design. Morning and office blood pressures (BPs) were significantly reduced (morning, -10.1 +/- 10.5/-4.5 +/- 8.4 mm Hg; office, -13.1 +/- 17.3/-6.2 +/- 11.3 mm Hg) after medication change. Target BPs (morning BPs <= 135/85 mm Hg and office BPs <= 140/90 mm Hg) achievement rates were 42.9% in the morning and 64.3% at office. No adverse events were recognized in all patients. Candesartan treatment significantly reduced the morning and office BPs compared with other ARBs in Japanese patients with morning hypertension.
  • Asano T, Kobayashi Y
    Nihon rinsho. Japanese journal of clinical medicine 69 Suppl 9 475-480 2011年11月  査読有り
  • Sho Okada, Tohru Minamino, Masataka Yokoyama, Kaoru Tateno, Junji Moriya, Ippei Shimizu, Aika Nojima, Takashi Ito, Yoko Ogasawara, Issei Komuro, Yoshio Kobayashi
    CIRCULATION 124(21) 2011年11月  査読有り
  • Kaoru Tateno, Tohru Minamino, Yohko Yoshida, Junji Moriya, Sho Okada, Ippei Shimizu, Masataka Yokoyama, Takashi Ito, Aika Nojima, Issei Komuro, Yoshio Kobayashi
    CIRCULATION 124(21) 2011年11月  査読有り
  • Yohko Yoshida, Tohru Minamino, Kaoru Tateno, Sho Okada, Junji Moriya, Ippei Shimizu, Masataka Yokoyama, Takashi Ito, Aika Nojima, Yoshio Kobayashi
    CIRCULATION 124(21) 2011年11月  査読有り
  • Junji Moriya, Ippei Shimizu, Kaoru Tateno, Sho Okada, Masataka Yokoyama, Aika Nojima, Takashi Ito, Yohko Ogasawara, Issei Komuro, Yoshio Kobayashi, Tohru Minamino
    CIRCULATION 124(21) 2011年11月  査読有り
  • Masataka Yokoyama, Tohru Minamino, Sho Okada, Kaoru Tateno, Junji Moriya, Ippei Shimizu, Aika Nojima, Takashi Ito, Yoko Ogasawara, Issei Komuro, Yoshio Kobayashi
    CIRCULATION 124(21) 2011年11月  査読有り
  • Hiroshi Hasegawa, Hiroyuki Takano, Hiroya Narumi, Masashi Ohtsuka, Tadahiko Mizuguchi, Takao Namiki, Yoshio Kobayashi, Issei Komuro
    HYPERTENSION RESEARCH 34(11) 1179-1184 2011年11月  査読有り
    The Telmisartan and Losartan Cardiac Evaluation Trial, a multicenter, prospective, randomized, open-labeled, blinded-endpoint trial, was designed to compare the effects of two angiotensin II receptor blockers (ARBs), telmisartan and losartan, on cardiovascular protection in Japanese patients with mild to moderate essential hypertension. We compared the effects of telmisartan and losartan on left ventricular (LV) hypertrophy, cardiac function, atherosclerosis of carotid arteries and surrogate markers related to the actions of peroxisome proliferator-activated receptor-gamma. A total of 58 patients were enrolled in the present trial and the follow-up period was 1 year. There were no significant differences in blood pressure (BP) levels between the telmisartan group and the losartan group throughout the trial. The percentage of the patients treated with ARB monotherapy was significantly higher in the telmisartan group compared with the losartan group. In addition, the progression of intima-media thickness of common carotid artery was significantly inhibited in the telmisartan group compared with the losartan group. Neither group experienced significant changes in cardiac function and LV mass index. There were no differences between the groups with respect to changes in surrogate markers such as serum adiponectin, creatinine, homeostasis model assessment index, plasminogen activator inhibitor-1 and high sensitivity C-reactive protein. Although BP levels were equal and well controlled in both groups, telmisartan showed more protective vascular effects than losartan. Hypertension Research (2011) 34, 1179-1184; doi:10.1038/hr.2011.114; published online 28 July 2011
  • Tadayuki Kadohira, Yoshio Kobayashi, Yo Iwata, Hideki Kitahara, Issei Komuro
    ANGIOLOGY 62(5) 397-400 2011年7月  査読有り
    There is little information about coronary artery endothelial dysfunction in patients with sleep apnea. We evaluated relation between severity of sleep apnea and coronary artery endothelial dysfunction. In all, 26 patients without significant coronary stenoses were enrolled. Endothelial function was estimated by measuring coronary vasoreactivity in response to acetylcholine infusion (10(-7) mol/L) into coronary arteries. Vasoconstriction rate was defined as ([lumen diameter after isosorbide dinitrate injection - lumen diameter after acetylcholine injection]/lumen diameter after isosorbide dinitrate injection x 100). Vasoconstriction rate was calculated at each major coronary artery and the highest value was used for that patient. Overnight sleep study was performed and the apnea-hypopnea index (AHI) was calculated as the mean number of apneas and hypopneas per hour of sleep. There was significant correlation between AHI and vasoconstriction rate (P=.04). There is significant correlation between severity of sleep apnea and endothelial function of coronary arteries.
  • Hideki Kitahara, Yoshio Kobayashi, Yo Iwata, Yoshihide Fujimoto, Issei Komuro
    AMERICAN JOURNAL OF CARDIOLOGY 108(2) 214-219 2011年7月  査読有り
    Previous studies have demonstrated endothelial dysfunction after sirolimus-eluting stent (SES) implantation. The present study evaluated the effect of pioglitazone on endothelial dysfunction after SES implantation in nondiabetic patients. A total of 50 nondiabetic patients who had undergone SES implantation were randomly assigned to the pioglitazone group (n = 25) or the control group (n = 25). Endothelial function was estimated by measuring the coronary vasoreactivity in the reference segment within 15 mm proximal and distal to the SES in response to intracoronary acetylcholine infusion (10(-8) and 10(-7) mol/L) at 9 months of follow-up. Endothelium-independent vasomotion was assessed after an intracoronary bolus of nitroglycerin. Changes in the coronary diameter in response to 10(-8) and 10(-7) mol/L acetylcholine in the segment proximal to the SES were not significantly different between the pioglitazone and control groups. In contrast, in the segment distal to the SES, vasoconstrictions to 10(-8) (-3.0 +/- 2.8% vs -7.1 +/- 4.5%, p < 0.01) and 10(-7) mol/L acetylcholine (-6.2 +/- 8.0% vs -13.1 +/- 8.9%, p < 0.01) were attenuated in the pioglitazone group compared to the control group. Endotheliumindependent vasodilation to nitrate did not differ between the 2 groups. Multivariate analysis showed that pioglitazone was an independent predictor improving endothelial dysfunction after SES implantation. In conclusion, pioglitazone might improve endothelial dysfunction after SES implantation in nondiabetic patients. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:214-219)
  • Seitaro Nomura, Nobusada Funabashi, Yukari Sekiguchi, Saeko Masuda, Satoshi Kuwabara, Sonoko Misawa, Michiko Daimon, Masae Uehara, Hideyuki Miyaiuchi, Issei Komuro, Yoshio Kobayashi
    INTERNATIONAL JOURNAL OF CARDIOLOGY 150(2) 213-216 2011年7月  査読有り
  • Kenji Ohkubo, Yoshio Kobayashi
    Cardiovascular Intervention and Therapeutics 26(2) 104-108 2011年5月  査読有り
    This study evaluated long-term safety and efficacy of low-dose (50-mg) clopidogrel in Japanese patients undergoing coronary stenting. A total of 126 patients with 153 lesions who consented to take a 50-mg maintenance dose of clopidogrel to prevent stent thrombosis were enrolled. The duration of clinical follow-up was 13.9 ± 9.7 months. There was one early stent thrombosis (0.65%). Neither late nor very late stent thrombosis was observed in patients on clopidogrel plus aspirin. Side effects of clopidogrel were observed in 9 patients (7.1%). This preliminary study shows that 50-mg maintenance dose of clopidogrel may be acceptable in Japanese patients undergoing coronary stenting. © 2010 Japanese Association of Cardiovascular Intervention and Therapeutics.
  • Nehiro Kuriyama, Yoshio Kobayashi, Masashi Yamaguchi, Yoshisato Shibata
    JACC-CARDIOVASCULAR INTERVENTIONS 4(5) 588-589 2011年5月  査読有り
  • Ken Kato, Yoshiyuki Hama, Marehiko Ueda, Yasunori Hiranuma, Seiichiro Matsuo, Taro Date, Teiichi Yamane, Yoshio Kobayashi
    journal of arrhythmia 27(4) 427 2011年  査読有り
    Background: Information about atrial premature beats(APBs) in patients with atrial fibrillation(AF) assessed by non-contact mapping system is limited. Methods: APBs mapping was performed in 42 patients with paroxysmal AF(n=35) and persistent AF(n=7) by deploying non-contact mapping balloon in left atrium(LA). APBs lasting more than 3 beats were mapped. Results: APBs were observed in 60%(2 5/42) of AF patients. A total of 70 spontaneous APBs were analyzed. The median number of APBs was 5 with range of 3-101. Analysis of APBs showed there were several origins within APBs. Only 34% of the APBs consisted of a single origin, while 47% consisted of two disparate regional or biatrial origins and 19% consisted of more than three origins. The locations of non- PVs foci included right atrium or SVC(33%), interatrial septum(17%), left atrial roof(22%), inferior LA(18%), anterior LA(6%), posterior LA(4%). After PV isolation, patients with more than two non-PV foci exhibited a trend towards higher recurrence rate of AF than patients with less than one non-PV focus(P = 0.14). Conclusions: Most of the APBs in patients with AF consisted of several origins. Patients who had several non-PVs foci might have higher recurrence rate of AF. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Yusuke Kondo, Naoki Hashiguchi, Tomonori Kanaeda, Masahiro Nakano, Yasunori Hiranuma, Marehiko Ueda, Yoshio Kobayashi
    Journal of Arrhythmia 27 2011年  査読有り
    An 82-year-old woman was admitted to our institution because of skin erosion, followed by the extrusion of the pacemaker out of the subcutaneous pocket. She had been implanted with a dual-chamber pacemaker for complete atrioventricular block 31 months previously. Upon admission, she presented with neither fever nor other manifestations of systemic infection. Blood cultures were negative but wound swabs grew Methicillin-sensitive Staphylococcus aureus. Removal of the pacemaker system was planned under antibiotic therapy. The atrial lead extraction was performed by simple traction after removal of the generator. While the ventricular lead was removed from the myocardial surface with gentle traction over the course of 2 hours, passage of the lead through subclavian vein was difficult. Computed tomography detected the lead tip with mass was adherent to the surrounding tissue in superior vena cava. It was speculated that the mass might have been organized with fibrosis predominantly in the area of lead-endocardial contact. Thus, we attempted to retrieve the fibrosis using a three-wire snare catheter. Finally, the pacemaker system was completely removed. The infected pocket was treated with vacuum-assisted wound closure, and a new pacemaker was implanted in the contralateral side. The postoperative course was uneventful and there was no evidence of recurrent infection after discharge. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Yusuke Kondo, Naoki Hashiguchi, Tomonori Kanaeda, Masahiro Nakano, Yasunori Hiranuma, Marehiko Ueda, Yoshio Kobayashi
    Journal of Arrhythmia 27 2011年  査読有り
    Purpose: To analyze the potential relationships between patient characteristics and the psychological impacts of defibrillator therapy. Method: A total of 92 Japanese patients with ICD/CRT-D were enrolled (Age 60.7±14.6years 72 males ICD patients: 52 patients). A total of 45 patients (49%) were implanted for the primary prevention of sudden cardiac death (SCD). Participants were characterized by four underlying syndromes (DCM, HCM, OMI, and other heart disease (Other)). All patients completed the Florida shock anxiety scale (FSAS). Result: Over a mean follow-up period of 694±434 days, 23 patients (25%) received at least one shock delivery. Tree patients (3%) saw a psychologist due to their anxiety The total mean score of FSAS was 17±8 points. There was no significant difference in the mean score of patients implanted for either primary or secondary prevention of SCD (17.6 vs 17.9 P=0.90). In addition, no significant difference was found in the mean score assigned on the basis of underlying disease (DCM: 17 ±8 HCM: 17±7 OMI: 18±11 Other: 16±6 P=0.65). Conclusion: The psychological response of ICD/CRT-D patients is unrelated to their underlying disease or to incidents of cardiac arrest. Interestingly, compared to previous studies involving patients in the U.S., the FSAS scores of Japanese patients are inclined to be higher. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Yoshiyuki Hama, Yuji Matsudo, Ken Kato, Masahiro Fukuda, Marehiko Ueda, Yasunori Hiranuma, Yoshio Kobayashi, Seiichiro Matsuo, Taro Date, Teiichi Yamane
    journal of arrhythmia 27(4) 277 2011年  査読有り
    Background: Information about the initiation of atrial fibrillation (AF) assessed by non-contact mapping system is still limited. Methods: AF mapping was performed in 39 patients with paroxysmal AF (n=33) and persistent AF (n=6) by deploying a non-contact mapping balloon in the left atrium. Atrial premature beats (APBs) which triggered the initiation of AF were mapped. Results: Spontaneous AF was observed in 61% (24/39) of the AF patients. A total of 32 spontaneous AF initiation episodes were analyzed. An analysis of AF initiation showed two mechanisms responsible for the initiation of AF. Repetitive firing from a single focus was related to the initiation of AF in 78.2% of the AF initiation episodes (monofocal type) whereas multifocal APBs with no regular focal activity preceded repetitive firing in 21.8% of the AF initiation episodes (multifocal type). In 71.5% of the multifocal type episodes, the origin of the first APB was different from that of repetitive firing. Conclusions: Focal repetitive activity from PVs played an important role in initiation of AF. In patients with a multifocal type, attention therefore needs to be paid in order to determine the origin of AF initiation. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Yusuke Kondo, Marehiko Ueda, Yoshio Kobayashi, Toru Ishizaka, Goro Matsumiya
    journal of arrhythmia 27(4) 314 2011年  査読有り
    A 64-year-old female was admitted to our institution with known atrial fibrillation (AF) and a 3-year history of worsening shortness of breath. Preoperative echocardiography revealed severe mitral regurgitation and dilated left atrium of 61mm. Following optimization of heart failure therapy, ganglionated plexi (GP) ablation was performed in addition to MAZE W procedure and mitral valve prosthetic ring annuloplasty (MVP). Autonomic GP was identified by rapid atrial pacing via a temporary pacemaker instead of a specific stimulator. A 27-point high-frequency stimulation (1000/minute, 18V) was achieved by placing tweezers directly on the left atrial epicardium. Locations where stimulation resulted in ventricular slowing with doubling of the electrocardiographic R-R interval were identified as active GPs. In this case, only 2 points of the 27 in the inferior right area of the left atrium were active. The other 25 were inactive. The cardiac response to GP stimulation was eliminated with bipolar radiofrequency ablation. GP ablation was followed by MAZE W procedure and MVP, these were successfully completed. The postoperative course was uneventful, and sinus rhythm was maintained upon discharge. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Yasunori Hiranuma, Marehiko Ueda, Takatsugu Kaiiyama, Naotaka Hashiguchi, Tomonori Kanaeda, Yusuke Kondo, Masahiro Nakano, Yoshio Kobayashi
    Journal of Arrhythmia 27 2011年  査読有り
    Synthesized 18-lead ECG derived from standard 12-lead ECG can provide virtual waveforms of right-sided chest leads (V3R, V4R, V5R) and back leads (V7, V8, V9). Several studies showed that P-wave dispersion reflecting inhomogeneous and discontinuous atrial conduction was predictive for atrial fibrillation (AF). Differences of P-wave dispersion between standard 12-lead ECG and synthesized 18-lead ECG are unknown. We measured P-wave duration of each 18-lead and calculated P-wave dispersion in paroxysmal AF patients (61 ±11 yo, 54 males/13 females). P-wave dispersion in synthesized 18-lead ECG was significantly longer than in standard 12-lead ECG (38±21 ms vs. 29±18 ms, p&lt 0.001). Synthesized 18-lead ECG magnifies P-wave dispersion in paroxysmal AF patients and significance of the findings needs to be confirmed in further studies. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Kenji Ohkubo, Yoshio Kobayashi, Yoshitake Nakamura, Akira Miyazaki
    Cardiovascular Intervention and Therapeutics 26(1) 33-37 2011年1月  査読有り
    There is little information about the incidence of the side-effects of clopidogrel in Japanese patients undergoing coronary stent implantation. The present study included 334 consecutive patients who were given clopidogrel (75 mg daily) after coronary stent implantation. Aspirin (100 mg daily) was used indefinitely. Clopidogrel was prescribed for at least 4 weeks in patients with bare metal stents and indefinitely in those with drug-eluting stents (DES). The duration of clinical follow-up was 164.7 ± 139.0 days. Half of the patients underwent stenting because of acute myocardial infarction. DES were used in 38% of the patients. Definite early stent thrombosis occurred in one patient (0.31%). There was one definite late stent thrombosis (0.31%). Side-effects of the clopidogrel were observed in 16 patients (4.9%). Liver dysfunction occurred in seven patients (2.1%), skin rash in six (1.8%), and bleeding in three (0.9%). There was no neutropenia or thrombocytopenia. The results of this study show that prescribing clopidogrel as well as aspirin is a safe treatment for Japanese patients undergoing coronary stenting. © 2010 Japanese Association of Cardiovascular Intervention and Therapeutics.
  • Nehiro Kuriyama, Yoshio Kobayashi, Tatsuya Nakama, Daigo Mine, Kensaku Nishihira, Mitsuhiro Shimomura, Katsumasa Nomura, Keiichi Ashikaga, Akihiko Matsuyama, Yoshisato Shibata
    JACC-CARDIOVASCULAR INTERVENTIONS 4(1) 123-128 2011年1月  査読有り
    Objectives This serial angiographic study evaluated the incidence and predictors of late restenosis after sirolimus-eluting stent (SES) implantation. Background Previous studies showed late restenosis (i.e., late catch-up phenomenon) after implantation of 7-hexanoyltaxol-eluting stents and nonpolymeric, paclitaxel-eluting stents. Methods Between August 2004 and December 2006, SES implantation was performed in 1,393 patients with 2,008 lesions, in whom 8-month and 2-year follow-up coronary angiography were planned. Results Of 2,008 lesions, 1,659 (83%) underwent 8-month follow-up angiography (8.3 +/- 2.2 months). Restenosis was observed in 122 lesions (7.4%). Coronary angiography 2 years (1.9 +/- 0.4 years) after SES deployment was performed in 1,168 lesions (74% of lesions without restenosis at 8-month follow-up angiography). Late restenosis was observed in 83 lesions (7.1%). There was significant decrease in minimum luminal diameter (MLD) between 8-month and 2-year follow-up (2.56 +/- 0.56 mm vs. 2.35 +/- 0.71 mm, p < 0.001). Multivariate analysis showed in-stent restenosis before SES implantation and MLD at 8-month follow-up as independent predictors of late restenosis. Conclusions Between 8-month and 2-year follow-up after SES implantation, MLD decreases, which results in late restenosis in some lesions. In-stent restenosis before SES implantation and MLD at 8-month follow-up are independent predictors of late restenosis. (J Am Coll Cardiol Intv 2011;4: 123-8) (C) 2011 by the American College of Cardiology Foundation
  • 片岡 明久, 高野 博之, 今枝 太郎, 上田 希彦, 小林 欣夫, 船橋 伸禎, 小室 一成
    心臓 42(10) 1364-1364 2010年10月  

MISC

 395
  • Yuichi Saito, Yoshio Kobayashi, Kenichi Tsujita, Koichiro Kuwahara, Yuji Ikari, Hiroyuki Tsutsui, Koichiro Kinugawa, Ken Kozuma
    Circulation Journal 88(11) 1727-1736 2024年11月  
    In patients with acute myocardial infarction (MI), heart failure (HF) is one of the most common complications that is associated with a significant burden of mortality and healthcare resources. The clinical benefits of key HF drugs, the so-called “4 pillars” or “fantastic 4”, namely β-blockers, mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitor, and sodium-glucose cotransporter 2 inhibitors, have been established in patients with HF with reduced ejection fraction, whereas the effects of these drugs are not comprehensively appreciated in patients with acute MI. This review summarizes current evidence on pharmacological and device-based interventions for preventing HF after acute MI.
  • Yoshiyasu Minami, Junya Ako, Kenichi Tsujita, Hiroyoshi Yokoi, Yuji Ikari, Yoshihiro Morino, Yoshio Kobayashi, Ken Kozuma
    Cardiovascular Intervention and Therapeutics 39(3) 223-233 2024年7月  
    Abstract: Non-culprit lesion-related coronary events are a significant concern in patients with coronary artery disease (CAD) undergoing coronary intervention. Since several studies using intra-coronary imaging modalities have reported a high prevalence of vulnerable plaques in non-culprit lesions at the initial coronary event, the immediate stabilization of these plaques by intensive pharmacological regimens may contribute to the reduction in the adverse events. Although current treatment guidelines recommend the titration of statin and other drugs to attain the treatment goal of low-density lipoprotein cholesterol (LDL-C) level in patients with CAD, the early prescription of strong LDL-C lowering drugs with more intensive regimen may further reduce the incidence of recurrent cardiovascular events. In fact, several studies with intensive regimen have demonstrated a higher percentage of patients with the attainment of LDL-C treatment goal in the early phase following discharge. In addition to many imaging studies showing plaque stabilization by LDL-C lowering drugs, several recent reports have shown the efficacy of early statin and proprotein convertase subtilisin/kexin type 9 inhibitors on the immediate stabilization of non-culprit coronary plaques. To raise awareness regarding this important concept of immediate plaque stabilization and subsequent reduction in the incidence of recurrent coronary events, the term ‘Drug Intervention’ has been introduced and gradually applied in the clinical field, although a clear definition is lacking. The main target of this concept is patients with acute coronary syndrome as a higher prevalence of vulnerable plaques in non-culprit lesions in addition to the worse clinical outcomes has been reported in recent imaging studies. In this article, we discuss the backgrounds and the concept of drug intervention. Graphical Abstract: (Figure presented.)
  • AOKI Shuhei, TAKAOKA Hiroyuki, KINOSHITA Makiko, YASHIMA Satomi, SUZUKI Katsuya, NISHIKAWA Yusei, NOGUCHI Yoshitada, YOSHIDA Kazuki, SASAKI Haruka, SUZUKI Noriko, KOBAYASHI Yoshio
    日本循環器学会学術集会(Web) 88th 2024年  
  • 與子田一輝, 與子田一輝, 佐々木晴香, 佐々木晴香, 佐々木晴香, 高岡浩之, 鎌田知子, 川崎健治, 江口紀子, 江口紀子, 江口紀子, 小林欣夫, 松下一之, 松下一之
    超音波医学 Supplement 51 2024年  
  • YASHIMA Satomi, TAKAOKA Hiroyuki, TAKAHASHI Manami, KINOSHITA Makiko, AOKI Shuhei, KOBAYASHI Yoshio
    日本循環器学会学術集会(Web) 87th 2023年  
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