Ankle-Brachial Index as a Prognostic Indicator in Patients with Atrial Fibrillation -A Subanalysis of the IMPACT-ABI Study

Article信州医学雑誌 67(3): 197-204(2019)journal articl

Prognostic Impact of Cardio-renal-anemia Syndrome in Patients at Risk for Heart Failure from the IMPACT-ABI study

Article信州医学雑誌 68(3): 139-147(2020)journal articl

The Traditional Japanese Medicine (Kampo) Boiogito has a Dual Benefit in Cardiorenal Syndrome: A Pilot Observational Study

Article信州医学雑誌 62(2):89-97(2014)journal articl

Impact of Ambulation Status in Patients with End-stage Renal Disease on Hemodialysis due to Diabetic Nephropathy : The PREDICT Study

Article信州医学雑誌 68(3): 131-138(2020)journal articl

Unique angiographic findings in a patient with myocardial ischemia and immunoglobulin G4-related disease

Immunoglobulin G4-related disease characteristically involves multiple organs including the heart and coronary arteries. Immunoglobulin G4-related coronary artery disease is thought to be due to periarteritis and histopathologically is characterized by marked thickening of the adventitia and periarterial fat with infiltration of immunoglobulin G4-positive plasma cells. Although comprehensive diagnostic criteria require a biopsy for a definite or probable diagnosis of immunoglobulin G4-related disease, obtaining a coronary artery biopsy is difficult and risky. However, imaging findings including coronary angiography and intravascular ultrasound might be useful tools to establish a diagnosis of immunoglobulin G4-related coronary artery disease. We report a case of a 63-year-old man with a history of immunoglobulin G4-related disease who presented with exertional chest pain. We found unique angiographic and intravascular ultrasound features of immunoglobulin G4-related coronary artery disease that distinguished it from those of arteriosclerotic coronary artery disease and suggest that coronary angiography and intravascular ultrasound might be useful tools in the diagnosis of immunoglobulin G4-related coronary artery disease

HDL-C and Plaque Calcification are Associated with Microcirculatory Damage after Percutaneous Coronary Intervention

Aims: Microvascular disturbance followed by percutaneous coronary intervention (PCI) was sometimes occurred. There were no report of the quantitative evaluation about microvascular disturbance after PCI. The aim of this study was to quantitate microcirculatory injury caused by elective PCI using index of microcirculatory resistance (IMR), and to clarify preprocedural predictors of microvascular damage.Methods: Fifty patients with stable angina and planned PCI for single vessel disease were enrolled in this study. IMR was measured after PCI. Plaque components were analyzed by integrated backscatter intravascular ultrasound.Results: Post-PCI IMR tended to correlate with high-density lipoprotein cholesterol levels (r = –0.298, p = 0.078) and plaque calcification (r = -0.22, p = 0.058) in the univariate analysis. Multivariate logistic analysis adjusted for these covariates revealed that the high-density lipoprotein cholesterol levels and plaque calcification were inversely associated with higher post-PCI IMR (odds ratio = 0.919, p = 0.049; and odds ratio = 0.546, p = 0.049, respectively).Conclusion: Low levels of high-density lipoprotein cholesterol and plaque calcification independently predict higher post-PCI IMR. Based on these results, Serum lipid and plaque calcification profiles might be important for predicting and preventing periprocedural myocardial damage during elective PCI