Curriculum Vitaes

fujiwara wakaya

  (藤原 稚也)

Profile Information

Affiliation
Fujita Health University

J-GLOBAL ID
201501000027701627
researchmap Member ID
7000012725

Research Areas

 1

Papers

 23
  • Wakaya Fujiwara, Hideki Ishii, Yoshihiro Sobue, Shinya Shimizu, Tomoya Ishiguro, Ryo Yamada, Sayano Ueda, Hideto Nishimura, Yudai Niwa, Akane Miyazaki, Wataru Miyagi, Shuhei Takahara, Hiroyuki Naruse, Junichi Ishii, Ken Kiyono, Eiichi Watanabe, Hideo Izawa
    Scientific Reports, 12(1), Dec, 2022  
    Contrast-associated acute kidney injury (CA-AKI) is a complication of percutaneous coronary intervention (PCI). Because proteinuria is a sentinel marker of renal dysfunction, we assessed its role in predicting CA-AKI in patients undergoing PCI. A total of 1,254 patients undergoing PCI were randomly assigned to a derivation (n = 840) and validation (n = 414) dataset. We identified the independent predictors of CA-AKI where CA-AKI was defined by the new criteria issued in 2020, by a multivariate logistic regression in the derivation dataset. We created a risk score from the remaining predictors. The discrimination and calibration of the risk score in the validation dataset were assessed by the area under the receiver-operating characteristic curves (AUC) and Hosmer–Lemeshow test, respectively. A total of 64 (5.1%) patients developed CA-AKI. The 3 variables of the risk score were emergency procedures, serum creatinine, and proteinuria, which were assigned 1 point each based on the correlation coefficient. The risk score demonstrated a good discriminative power (AUC 0.789, 95% CI 0.766–0.912) and significant calibration. It was strongly associated with the onset of CA-AKI (Cochran-Armitage test, p < 0.0001). Our risk score that included proteinuria was simple to obtain and calculate, and may be useful in assessing the CA-AKI risk before PCI.
  • Hiroyuki Naruse, Junnichi Ishii, Hiroshi Takahashi, Fumihiko Kitagawa, Eirin Sakaguchi, Hideto Nishimura, Hideki Kawai, Takashi Muramatsu, Masahide Harada, Akira Yamada, Wakaya Fujiwara, Mutsuharu Hayashi, Sadako Motoyama, Masayoshi Sarai, Eiichi Watanabe, Hiroyasu Ito, Yukio Ozaki, Hideo Izawa
    Journal of clinical medicine, 10(16), Aug 13, 2021  
    The prognostic role of D-dimer in different types of heart failure (HF) is poorly understood. We investigated the prognostic value of D-dimer on admission, both independently and in combination with the Get With The Guidelines-Heart Failure (GWTG-HF) risk score and N-terminal pro-B-type natriuretic peptide (NT-proBNP), in patients with preserved left ventricular ejection fraction (LVEF) and acute decompensated HF (HFpEF) or reduced LVEF (HFrEF). Baseline D-dimer levels were measured on admission in 1670 patients (mean age: 75 years) who were hospitalized for worsening HF. Of those patients, 586 (35%) were categorized as HFpEF (LVEF ≥ 50%) and 1084 as HFrEF (LVEF < 50%). During the 12-month follow-up period after admission, 360 patients died. Elevated levels (at least the highest tertile value) of D-dimer, GWTG-HF risk score, and NT-proBNP were all independently associated with mortality in all HFpEF and HFrEF patients (all p < 0.05). Adding D-dimer to a baseline model with a GWTG-HF risk score and NT-proBNP improved the net reclassification and integrated discrimination improvement for mortality greater than the baseline model alone in all populations (all p < 0.001). The number of elevations in D-dimer, GWTG-HF risk score, and NT-proBNP were independently associated with a higher risk of mortality in all study populations (HFpEF and HFrEF patients; all p < 0.001). The combination of D-dimer, which is independently predictive of mortality, with the GWTG-HF risk score and NT-proBNP could improve early prediction of 12-month mortality in patients with acute decompensated HF, regardless of the HF phenotype.
  • Yuji Kono, Hideo Izawa, Yoichiro Aoyagi, Ryo Yamada, Tomoya Ishiguro, Masataka Yoshinaga, Satoshi Okumura, Wakaya Fujiwara, Mutsuharu Hayashi, Yohei Otaka
    Heart and vessels, 36(12) 1856-1860, Jun 3, 2021  
    The study aimed to identify factors related to bone mineral density (BMD) among older patients with heart failure (HF). A total of 70 consecutive patients with HF aged 65 years or older who were admitted to an acute hospital due to worsening condition were enrolled before discharge. BMD of the femoral neck was evaluated using the DEXA method. Physical function, as well as echocardiographic and laboratory findings including biomarker of HF severity were collected. Bivariate and multiple regression analyses were employed to determine the association between BMD and the clinical variables. Bivariate analysis determined that age, grip strength, walking speed, serum albumin, and N-terminal pro B-type natriuretic peptide (NT-proBNP) were significantly correlated with BMD (P < 0.01), whereas other clinical parameters were not. The multiple regression analysis identified NT-proBNP as an independent related factor for BMD after adjusting with confounding clinical variables. NT-proBNP was independently related to BMD among older patients with HF. Our results suggest the inclusion of bone fracture prevention strategies in disease management programs, especially for older patients with HF.
  • Ueda Sayano, Kono Yuji, Yamada Ryo, Ishiguro Tomoya, Yoshinaga Masataka, Okumura Satoshi, Fujiwara Wakaya, Hayashi Mutsuharu, Aoyagi Yoichiro, Saitoh Eiichi, Otaka Yohei, Izawa Hideo
    Fujita Medical Journal, 7(2) 65-69, May, 2021  
  • Tomoya Ishiguro, Mutsuharu Hayashi, Wakaya Fujiwara, Satoshi Okumura, Masataka Yoshinaga, Ryo Yamada, Sayano Ueda, Takehiro Ito, Yudai Niwa, Akane Miyazaki, Masahide Harada, Hiroyuki Naruse, Junnichi Ishii, Yukio Ozaki, Hideo Izawa
    Fujita medical journal, 7(1) 18-22, 2021  
    OBJECTIVES: MicroRNAs (miRNA) are functional RNAs that have emerged as pivotal gene expression regulators in cardiac disease. Although several cardiomyocyte miRNAs have been reported to play roles in heart failure progression among patients with idiopathic dilated cardiomyopathy (DCM), the role of circulating miRNAs has not yet been well-examined. METHODS: After total RNA extraction from the peripheral blood samples of three control participants and six patients with DCM, miRNA profiling was performed using miRNA arrays. Based on the results of this initial screening, real-time polymerase chain reaction (RT-PCR) was used to perform a quantitative analysis of blood samples from a larger number of matched patients (DCM, n=20; controls, n=5). Finally, the correlations between specific miRNA expression levels and hemodynamic parameters were analyzed. RESULTS: A primary screening of 2,565 miRNAs resulted in the identification of nine miRNA candidates. Quantitative RT-PCR results revealed significantly increased miR-489 expression levels in the DCM group. Moreover, there was a significant positive correlation between miR-489 expression level and left ventricular ejection fraction. CONCLUSIONS: Our results suggest that circulating miR-489 could be a potential noninvasive diagnostic biomarker for DCM. Additionally, the quantification of circulating miR-489 may have value as a potential prognostic marker for patients with DCM.

Misc.

 36
  • 河野 裕治, 井澤 英夫, 青柳 陽一郎, 山田 亮, 石黒 智也, 良永 真隆, 奥村 聡, 藤原 稚也, 林 睦晴, 才藤 栄一
    日本循環器学会学術集会抄録集, 83回 CP03-1, Mar, 2019  
  • 河野裕治, 井澤英夫, 青柳陽一郎, 山田亮, 石黒智也, 良永真隆, 奥村聡, 藤原稚也, 林睦晴, 才藤栄一
    日本心不全学会学術集会プログラム・抄録集, 23rd, 2019  
  • Wakaya Fujiwara, Yasuchika Kato, Mutsuharu Hayashi, Yoshinori Sugishita, Satoshi Okumura, Masataka Yoshinaga, Tomoya Ishiguro, Ryo Yamada, Sayano Ueda, Masahide Harada, Hiroyuki Naruse, Junnichi Ishii, Yukio Ozaki, Hideo Izawa
    Journal of cardiology, 72(6) 452-457, Dec, 2018  Peer-reviewed
    BACKGROUND: Although cardiac sarcoidosis is associated with poor prognosis, diagnosis of the disease is challenging and the sensitivity and specificity of diagnostic modalities are limited. This study was performed to evaluate the potential of serum microRNAs (miRNAs) as diagnostic biomarkers for cardiac sarcoidosis. METHODS: We performed genome-wide expression profiling for 2565 miRNAs (Human-miRNA ver.21) using peripheral blood samples from 5 patients with cardiac sarcoidosis (61±9 years) and 3 healthy controls (54±7 years). From this screening study, we selected 12 miRNAs that were significantly related to cardiac sarcoidosis. Next, we performed real-time polymerase chain reaction (PCR) on blood samples from 15 new patients with cardiac sarcoidosis and 4 healthy controls to quantify the expression of these 12 miRNAs. RESULTS: In the screening study, 12 miRNAs were differentially expressed (p<0.01) in all 5 patients with cardiac sarcoidosis, showing greater fold-change values (>4 or <0.25) compared with the expression in the 3 healthy controls. Analysis of the real-time PCR for blood samples from the other 15 patients and 4 controls using Mann-Whitney U tests revealed that the expression of miR-126 and miR-223 was significantly higher in the patients than in the healthy individuals. However, there were no differences in the expressions of miRNA-126 and miR-223 between patients with only cardiac lesions and those with extra-cardiac lesions. CONCLUSIONS: Our results demonstrate the potential of serum miR-126 and miR-223 as new-generation biomarkers for the differential diagnosis of cardiac sarcoidosis in patients with heart failure.
  • 森 悦子, 河野 裕治, 石川 綾子, 杉浦 翼, 田中 康友, 青柳 陽一郎, 上田 清乃, 山田 亮, 石黒 智也, 藤原 稚也, 林 睦晴, 井澤 英夫
    心臓リハビリテーション, 24(3-4) 232-235, Nov, 2018  
    【目的】本研究の目的は、高齢心不全患者を対象に抑うつと身体機能との関連を検討した。【方法】65歳以上の心不全患者120例を対象とした。対象者をGeriatric Depression Scale(GDS-5)で抑うつなし群(GDS-5≦1)、抑うつあり群(GDS-5≧2)の2群に分け、心不全病態指標、身体機能、認知機能の項目についてχ2検定、対応のないt-検定を用いて比較した。【結果】全対象者のうち抑うつは58例(48%)に認めた。両群間の比較では年齢、性別、BMI、認知機能、病態指標には差を認めなかった。しかし身体機能(握力、等尺性膝伸展筋力、6分間歩行距離、歩行速度)は、抑うつ群で有意に低値を示した。【結論】本結果より高齢心不全患者の抑うつ合併例は身体機能が低下していることが明らかとなった。高齢心不全患者に対する身体的フレイル判定の際には、抑うつも評価する必要性が示唆された。(著者抄録)
  • 井澤英夫, 河野裕治, 青柳陽一郎, 上田清乃, 山田亮, 石黒智也, 良永真隆, 奥村聡, 藤原稚也, 林睦晴
    日本心不全学会学術集会プログラム・抄録集, 22nd, 2018  
  • Mutsuharu Hayashi, Yoshinari Yasuda, Susumu Suzuki, Manaka Tagaya, Takehiro Ito, Tomohito Kamada, Masataka Yoshinaga, Yoshinori Sugishita, Wakaya Fujiwara, Hiroatsu Yokoi, Yukio Ozaki, Hideo Izawa
    Heart and vessels, 32(3) 279-286, Mar, 2017  Peer-reviewed
    Although the renin-angiotensin system (RAS) is counter-balanced by a salt-sensitive mechanism in the hypertensive state, both are reported to be up-regulated in chronic kidney disease (CKD) patients. We conducted this study to evaluate the associations among the RAS, renal function, hypertension, and atherosclerosis, as well as to identify markers for salt-sensitivity. A total of 213 pre-dialysis CKD patients with preserved cardiac function (EF >50 %) were enrolled. Their renal and cardiac biochemical markers and plasma renin activity (PRA) were measured, and echocardiography and carotid artery ultrasound were performed. Their salt intake was estimated by the NaCl excretion from a 24-h collected urine sample. The PRA was higher in patients with hypertension (p = 0.018), and had a significant negative correlation with the eGFR (r = -0.23, p = 0.0067). Importantly, the PRA had a strong negative correlation with the brain natriuretic peptide (BNP) level (r = -0.28, p = 0.017) regardless of whether the patients were being treated with RAS inhibitors. The BNP level was related to the renal functions (eGFR: p = 0.001, ACR: p = 0.009). There was a significant positive correlation between the BNP level and carotid intima-media thickness (p < 0.001). A multivariate analysis revealed that older age and an excess of NaCl excretion were independent predictors of BNP elevation (p = 0.02 and 0.003, respectively). Our analysis revealed details of the counterbalance between BNP and PRA, as well as identifying that excess salt intake is a predictor of BNP elevation. These results indicate that the BNP could be a possible valuable marker for salt sensitivity, and that high salt sensitivity could facilitate atherosclerosis in CKD patients.
  • 河野裕治, 上田清乃, 山田亮, 石黒智也, 良永真隆, 杉下義倫, 奥村聡, 藤原稚也, 林睦晴, 井澤英夫
    日本心不全学会学術集会プログラム・抄録集, 21st, 2017  
  • 良永 真隆, 多賀谷 真央, 伊藤 丈浩, 石黒 智也, 山田 亮, 鎌田 智仁, 奥村 聡, 杉下 義倫, 藤原 稚也, 林 睦晴, 井澤 英夫
    藤田学園医学会誌, 41(1) 13-16, 2017  
  • 鎌田 智仁, 多賀谷 真央, 伊藤 丈浩, 石黒 智也, 山田 亮, 良永 真隆, 奥村 聡, 杉下 義倫, 藤原 稚也, 林 睦晴, 井澤 英夫
    藤田学園医学会誌, 41(1) 17-19, 2017  
  • 井澤英夫, 河野裕治, 粥川知子, 青柳陽一郎, 才藤栄一, 藤原稚也, 林睦晴
    現代医学, 65(2) 71-75, 2017  Invited
  • Tomohito Kamada, Mutsuharu Hayashi, Wakaya Fujiwara, Daiji Yoshikawa, Daisuke Mukaide, Yoshinori Sugishita, Masataka Yoshinaga, Takehiro Itoh, Hiroatsu Yokoi, Junichi Ishii, Eiichi Watanabe, Yukio Ozaki, Hideo Izawa
    Drug and chemical toxicology, 40(1) 110-114, Jan, 2017  Peer-reviewed
    OBJECTIVES: The number of elderly patients with hypertension has been steadily increasing. However, there are limited data on the safety and efficacy of the new angiotensin type 1 receptor blocker (ARB) azilsartan in elderly patients with hypertension. We investigated the clinical efficacy and safety of azilsartan in this population. METHODS: The study population comprised 56 ambulatory patients with essential hypertension. We evaluated the reduction in blood pressure and safety after 12 weeks of treatment with azilsartan in 29 hypertensive patients ≥65 years of age (aged group) in comparison with the findings in 27 patients <65 years of age (non-aged group). RESULTS: Systolic blood pressure in the aged group declined significantly from 155 ± 18 mmHg at baseline to 138 ± 11 mmHg after 12 weeks of treatment with azilsartan, and that in the non-aged group also declined significantly from 152 ± 20 mmHg at baseline to 142 ± 13 mmHg after 12 weeks of treatment with azilsartan. There were no significant differences in the magnitude of change in blood pressures from pre-treatment to post-treatment with azilsartan between the non-aged and aged groups. There were no changes in clinical laboratory findings, including serum levels of creatinine, potassium, lipids, and other metabolic variables, after 12 weeks of treatment with azilsartan in both groups. CONCLUSIONS: Our findings suggest that azilsartan is effective in lowering blood pressure in elderly patients and may be safe. Therefore, azilsartan could be a valuable option for treating hypertension in elderly and non-elderly patients.
  • Manaka Tagaya, Daiji Yoshikawa, Yoshinori Sugishita, Fumi Yamauchi, Takehiro Ito, Tomohito Kamada, Masataka Yoshinaga, Daisuke Mukaide, Wakaya Fujiwara, Hiroatsu Yokoi, Mutsuharu Hayashi, Eiichi Watanabe, Junichi Ishii, Yukio Ozaki, Hideo Izawa
    Heart and vessels, 31(6) 957-62, Jun, 2016  Peer-reviewed
    New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 %) patients were treated with NOACs and 109 (60 %) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.
  • Mutsuharu Hayashi, Tomohito Kamada, Hiroatsu Yokoi, Wakaya Fujiwara, Daiji Yoshikawa, Daisuke Mukaide, Yoshinori Sugishita, Masataka Yoshinaga, Takehiro Ito, Yukio Ozaki, Hideo Izawa
    Internal medicine (Tokyo, Japan), 55(3) 323-323, 2016  Peer-reviewed
  • 伊藤丈浩, 林睦晴, 横井博厚, 藤原稚也, 杉下義倫, 良永真隆, 鎌田智仁, 多賀谷真央, 井澤英夫
    日本循環器学会東海地方会(Web), 146th, 2015  
  • 良永真隆, 林睦晴, 横井博厚, 藤原稚也, 吉川大治, 杉下義倫, 鎌田智仁, 伊藤丈浩, 多賀谷真央, 井澤英夫
    日本循環器学会東海地方会(Web), 146th, 2015  
  • Tomohito Kamada, Mutsuharu Hayashi, Hiroatsu Yokoi, Wakaya Fujiwara, Daiji Yoshikawa, Daisuke Mukaide, Yoshinori Sugishita, Masataka Yoshinaga, Takehiro Ito, Yukio Ozaki, Hideo Izawa
    Internal medicine (Tokyo, Japan), 54(1) 31-5, 2015  Peer-reviewed
    Takotsubo cardiomyopathy is a disorder characterized by left ventricular apical ballooning with preceding emotional and/or physical stressors. This condition is also an important differential diagnosis of acute coronary syndrome. We herein describe a case of Takotsubo cardiomyopathy, a significant clinical phenomenon, triggered by delayed-onset rhabdomyolysis following the administration of long-term statin treatment, without any preceding stressors or changes in the patient's medical condition, in association with complaints of non-specific muscle-related symptoms. Although an electrocardiogram showed remarkable ST-segment elevation, a careful reading of the electrocardiogram findings revealed the features of Takotsubo cardiomyopathy. Withdrawing the statin therapy improved the patient's cardiac function.
  • Masataka Yoshinaga, Daiji Yoshikawa, Hideki Ishii, Akihiro Hirashiki, Takahiro Okumura, Aki Kubota, Shinichi Sakai, Ken Harada, Fuji Somura, Tomofumi Mizuno, Wakaya Fujiwara, Hiroatsu Yokoi, Mutsuharu Hayashi, Junichi Ishii, Yukio Ozaki, Toyoaki Murohara, Yukihiko Yoshida, Tetsuya Amano, Hideo Izawa
    International heart journal, 56(4) 415-20, 2015  Peer-reviewed
    Hypertrophic cardiomyopathy (HCM) has various morphological and clinical features. A decade has passed since the previous survey of the epidemiological and clinical characteristics of Japanese HCM patients. The Aichi Hypertrophic Cardiomyopathy (AHC) Registry is based on a prospective multicenter observational study of HCM patients. The clinical characteristics of 42 ambulant HCM patients followed up for up to 5 years were investigated. The primary endpoint was major adverse cardiac events (MACE), defined as death, non-fatal stroke, admission due to congestive heart failure (CHF), or episodes of sustained ventricular tachycardia/fibrillation. The MACE-free survival during the 5-year follow-up period was 76% according to Kaplan-Meier analysis. HCM-related death occurred in 3 (7%) patients and SCD occurred in 2 (5%) patients. Additionally, 3 (7%) patients were admitted to the hospital due to CHF. Meanwhile, sustained VT was detected in one (2%) of the patients who received ICD implantation and subsequently terminated with antitachycardia pacing using an ICD. The patients with HCM exhibiting left ventricular outflow obstruction (HOCM) had a slightly lower MACE-free survival rate than those with neither HOCM nor dilated-HCM (dHCM) (71% versus 81%, log-rank P = 0.581). Furthermore, the patients with dHCM demonstrated a significantly lower MACE-free survival rate than those with neither HOCM nor dHCM (33% versus 81%, log-rank P = 0.029). In the AHC Registry targeting current Japanese HCM patients, we demonstrated that many HCM patients continue to suffer from MACE despite the development of various treatments for HCM.
  • 良永真隆, 林睦晴, 横井博厚, 藤原稚也, 吉川大治, 向出大介, 杉下義倫, 鎌田智仁, 石黒智也, 山田亮, 伊藤丈浩, 井澤英夫
    日本循環器学会東海地方会(Web), 144th, 2014  
  • 伊藤丈浩, 林睦晴, 横井博厚, 藤原稚也, 吉川大治, 向出大介, 杉下義倫, 良永真隆, 鎌田智仁, 山田亮, 石黒智也, 井澤英夫
    日本循環器学会東海地方会(Web), 144th, 2014  
  • Wakaya Fujiwara, Hideo Izawa, Gen Ukai, Hiroatsu Yokoi, Daisuke Mukaide, Kohsuke Kinoshita, Shin-ichiro Morimoto, Junichi Ishii, Yukio Ozaki, Masanori Nomura
    HEART AND VESSELS, 28(3) 316-322, May, 2013  
    Previous studies have shown highly effective lowering of blood pressure with thiazide diuretics in combination with angiotensin receptor blockers. However, thiazide diuretics may cause the development of diabetes and abnormal lipid metabolism. Little is known as to whether dysmetabolic potential of thiazide diuretics could be neutralized when adding angiotensin receptor blockers. This study consisted of 26 patients with essential hypertension. Patients were randomized to 24 weeks of treatment with either candesartan, 12 mg monotherapy (n = 13, group A), or hydrochlorothiazide (HCTZ), 6.25 mg in combination with candesartan, 8 mg (n = 13, group B). Before and after treatment, we assessed glucose and lipid profiles including adiponectin, resistin, and active glucagon-like peptide-1 (GLP-1) levels. At baseline, there were no differences in age, body mass index, systolic blood pressure (SBP), and diastolic blood pressure (DBP), as well as plasma levels of hemoglobin A1c, insulin, low-density lipoprotein cholesterol, triglycerides, adiponectin, resistin, and active GLP-1 between the two groups. There were significant reductions in SBP (from 152 +/- 10 mmHg at baseline to 134 +/- 12 mmHg after treatment) and DBP (from 84 +/- 5 mmHg at baseline to 71 +/- 8 mmHg after treatment) in group A. There were also significant reductions in SBP (from 148 +/- 10 at baseline to 128 +/- 7 mmHg after treatment) and DBP (from 90 +/- 9 at baseline to 74 +/- 12 mmHg after treatment) in group B. There were no differences in reduction of SBP or DBP after 24 weeks of treatment between the two groups. There were no changes of the glucose and lipid profiles, including adiponectin, resistin, insulin, and active GLP-1 levels after 24 weeks of treatment in both groups. A low dose of HCTZ in combination with candesartan reduces blood pressure effectively without adverse effects on the glucose and lipid profiles. Therefore, the combination of thiazide diuretics and angiotensin receptor blockers could assist patients in achieving long-term control of blood pressure with good tolerability.
  • Wakaya Fujiwara, Hideo Izawa, Gen Ukai, Hiroatsu Yokoi, Daisuke Mukaide, Kohsuke Kinoshita, Shin-ichiro Morimoto, Junichi Ishii, Yukio Ozaki, Masanori Nomura
    Heart and vessels, 28(3) 316-22, May, 2013  Peer-reviewed
    Previous studies have shown highly effective lowering of blood pressure with thiazide diuretics in combination with angiotensin receptor blockers. However, thiazide diuretics may cause the development of diabetes and abnormal lipid metabolism. Little is known as to whether dysmetabolic potential of thiazide diuretics could be neutralized when adding angiotensin receptor blockers. This study consisted of 26 patients with essential hypertension. Patients were randomized to 24 weeks of treatment with either candesartan, 12 mg monotherapy (n = 13, group A), or hydrochlorothiazide (HCTZ), 6.25 mg in combination with candesartan, 8 mg (n = 13, group B). Before and after treatment, we assessed glucose and lipid profiles including adiponectin, resistin, and active glucagon-like peptide-1 (GLP-1) levels. At baseline, there were no differences in age, body mass index, systolic blood pressure (SBP), and diastolic blood pressure (DBP), as well as plasma levels of hemoglobin A1c, insulin, low-density lipoprotein cholesterol, triglycerides, adiponectin, resistin, and active GLP-1 between the two groups. There were significant reductions in SBP (from 152 ± 10 mmHg at baseline to 134 ± 12 mmHg after treatment) and DBP (from 84 ± 5 mmHg at baseline to 71 ± 8 mmHg after treatment) in group A. There were also significant reductions in SBP (from 148 ± 10 at baseline to 128 ± 7 mmHg after treatment) and DBP (from 90 ± 9 at baseline to 74 ± 12 mmHg after treatment) in group B. There were no differences in reduction of SBP or DBP after 24 weeks of treatment between the two groups. There were no changes of the glucose and lipid profiles, including adiponectin, resistin, insulin, and active GLP-1 levels after 24 weeks of treatment in both groups. A low dose of HCTZ in combination with candesartan reduces blood pressure effectively without adverse effects on the glucose and lipid profiles. Therefore, the combination of thiazide diuretics and angiotensin receptor blockers could assist patients in achieving long-term control of blood pressure with good tolerability.
  • Daisuke Mukaide, Tomotsugu Tabata, Kosuke Kinoshita, Hiroatsu Yokoi, Wakaya Fujiwara, Osamu Inami, Yoshinori Sugishita, Gen Ukai, Masataka Yoshinaga, Tomohito Kamada, Masanori Nomura, Hideo Izawa
    Journal of cardiology, 61(5) 365-71, May, 2013  Peer-reviewed
    BACKGROUND: Mechanisms of the pseudonormalization (PN) of the transmitral flow (TMF) velocity pattern have been mainly attributed to left ventricular diastolic function. PURPOSE: To assess the influence of left atrial (LA) function on the PN with two-dimensional tissue tracking technique. METHODS: The subjects consisted of 21 healthy volunteers and 70 patients with various cardiac diseases. Images of one cardiac cycle in the apical four-chamber view were stored by the HIVISION 900 (Hitachi Medico, Chiba, Japan). The LA volume (LAV) loop was created using two-dimensional tissue tracking technique and LAV index (LAVI) at a given cardiac phase was calculated. A preload of 90mmHg was applied using a customized lower body positive pressure (LBPP) system. Patients were divided into the PN group (n=18) with their early diastolic TMF velocity (E) increased and late diastolic TMF velocity (A) decreased, and the non-(N)-PN group (n=52) with both E and A wave velocities increased by LBPP. RESULTS: (1) During LBPP, the LAVImax in both the groups increased significantly. (2) In the N-PN group, the LAVIpass (p<0.001), LAVIact (p<0.01), and LAVItotal (p<0.0001) increased significantly. The dV/dts (p<0.0001) and dV/dtE (p<0.0001) increased significantly with an increase in the dV/dtA. On the other hand, there was no change in those parameters except LAVIpass (p<0.05) and dV/dtE (p<0.05) significantly increased in the PN group. (3) As a result, the LAVImin was significantly greater in the PN group than in the N-PN group (p<0.0001) during LBPP. The ratio of E velocity to early diastolic mitral annular velocity (E/E') during LBPP was significantly greater in the PN group than in the N-PN group (p<0.0001). CONCLUSIONS: The lack of an increase in active LA emptying volume in response to an increase of preload leads to elevated LA pressure and the pseudonormalization of the TMF velocity pattern in patients with various cardiac diseases.
  • 藤原稚也, 横井博厚, 向出大介, 木下幸輔, 杉下義倫, 鎌田智仁, 畳陽祐, 山田亮, 石黒智也, 良永真隆, 井澤英夫
    日本循環器学会東海地方会(Web), 139th, 2012  
  • 井澤英夫, 横井博厚, 藤原稚也, 向出大介, 石井潤一, 尾崎行男
    診療と新薬, 49(10) 1313-1319, 2012  
  • 井澤英夫, 藤原稚也
    現代医学, 59(2) 343-348, 2010  
  • Mukaide Daisuke, Tabata Tomotsugu, Yokoi Hiroatsu, Izawa Hideo, Fujiwara Wakaya, Inami Osamu, Kinoshita Kousuke, Sugishita Yoshinori, Ukai Gen, Kamata Tomohito, Yoshinaga Masataka, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 73 427-427, Mar 1, 2009  
  • Ukai Gen, Tabata Tomotsugu, Yokoi Hiroatsu, Izawa Hideo, Fujiwara Wakaya, Mukaide Daisuke, Inami Osamu, Kinoshita Kousuke, Sugishita Yoshinori, Yoshinaga Masataka, Kamata Tomohito, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 73 598-598, Mar 1, 2009  
  • 井澤英夫, 藤原稚也, 山田晶, 尾崎行男, 野村雅則
    内科, 103(3) 475-479, 2009  
  • Mukaide Daisuke, Tabata Tomotsugu, Yokoi Hiroatsu, Fujiwara Wakaya, Inami Osamu, Kinoshita Kousuke, Sugishita Yoshinori, Ukai Gen, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 72 635-635, Mar 1, 2008  
  • Kinoshita Kousuke, Tabata Tomotsugu, Yokoi Hiroatsu, Fujiwara Wakaya, Inami Osamu, Mukaide Daisuke, Sugishita Yoshinori, Ukai Gen, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 72 635-635, Mar 1, 2008  
  • Sugishita Yoshinori, Tabata Tomotsugu, Yokoi Hiroatsu, Inami Osamu, Fujiwara Wakaya, Mukaide Daisuke, Watanabe Atsushi, Kinoshita Kosuke, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 71 532-532, Mar 1, 2007  
  • Tabata Tomotsugu, Yokoi Hiroatsu, Fujiwara Wakaya, Inami Osamu, Mukaide Daisuke, Watanabe Atsushi, Kinoshita Kosuke, Sugishita Yoshinori, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 71 531-531, Mar 1, 2007  
  • Mukaide Daisuke, Tabata Tomotsugu, Yokoi Hiroatsu, Fujiwara Wakaya, Inami Osamu, Watanabe Atsushi, Kinoshita Kinoshita, Sugishita Sugishita, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 71 532-532, Mar 1, 2007  
  • Watanabe Atsushi, Tabata Tomotsugu, Yokoi Hiroatsu, Inami Osamu, Fujiwara Wakaya, Mukaide Daisuke, Kinoshita Kosuke, Sugishita Yoshinori, Nomura Masanori
    Circulation journal : official journal of the Japanese Circulation Society, 71 531-531, Mar 1, 2007  
  • Fujiwara Wakaya, Kakizawa Satoshi, Inami Osamu, Kondoh Takahisa, Yokoi Hiroatsu, Furuta Toshiya, Abo Yasuhiro, Watanabe Yoshihiko
    Circulation journal : official journal of the Japanese Circulation Society, 66 572-572, Mar 31, 2002  

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