Publications by authors named "Ryotaro Asano"

Unlabelled: Inherited antithrombin deficiency is an autosomal dominant thrombophilia, resulting from genetic variations in the serpin family C member 1 (SERPINC1) gene. Antithrombin deficiency increases the risk of venous thromboembolism (VTE) compared to the general population. In this report, a novel missense variant of , c.

View Article and Find Full Text PDF
Article Synopsis
  • - Takayasu arteritis (TAK) is a serious condition that affects large blood vessels, leading to issues like blockages and aneurysms; it's primarily treated with glucocorticoids, but new biological drugs like tocilizumab are proving effective.
  • - Patients on tocilizumab may face higher surgical complications, such as infection or delayed healing, and typically do not show increased inflammatory markers during infections, making management challenging.
  • - There is a lack of guidelines for the best perioperative care for TAK patients needing cardiovascular surgery, but this article proposes a protocol based on recent evidence to help reduce complications in these patients.
View Article and Find Full Text PDF

Background: The process underlying Fontan pathophysiology is multifactorial and may include gut dysbiosis (GD). We investigated the presence of GD and elucidated its correlation with Fontan pathophysiology.

Methods And Results: Gut microbiomes of 155 consecutive patients with Fontan pathophysiology and 44 healthy individuals were analyzed using 16S rRNA sequencing of bacterial DNA extracted from fecal samples.

View Article and Find Full Text PDF
Article Synopsis
  • Ring finger protein 213 is linked to moyamoya disease and other vascular issues, prompting research into its role in chronic thromboembolic pulmonary hypertension (CTEPH).
  • Among 112 CTEPH patients studied, 8 (7.1%) carried a heterozygous variant, while a significant 50% of the 10 patients with peripheral pulmonary artery stenosis (PPS) had a homozygous variant.
  • Clinical characteristics of heterozygous variant carriers with CTEPH were similar to noncarriers, but both groups exhibited tortuous blood vessels, contrasting with unique patterns observed in homozygous carriers with PPS.
View Article and Find Full Text PDF

Background: Direct oral anticoagulants are the established drugs for treating pulmonary thromboembolism. The advantage of direct oral anticoagulants over conventional therapy for clot lysis and right ventricular unloading in the acute phase remains unclear. This study aimed to evaluate the effect of acute treatment with direct oral anticoagulants on clot dissolution and right ventricular unloading in intermediate high-risk pulmonary thromboembolism.

View Article and Find Full Text PDF

Balloon pulmonary angioplasty (BPA) is beneficial for patients with chronic thromboembolic pulmonary disease (CTEPD) with pulmonary hypertension (PH). However, the clinical benefit of BPA for the patients with CTEPD without PH remains unknown. In this study, we aimed to evaluate the efficacy, safety, and long-term outcomes of BPA in patients with CTEPD without PH.

View Article and Find Full Text PDF

Background: Limited data exists on upfront combination therapy for portopulmonary hypertension. We evaluated the clinical efficacy, long-term outcomes, and safety of upfront combination therapy in patients with portopulmonary hypertension.

Methods: We performed a retrospective, single-center cohort study involving a final analysis of 33 consecutive patients diagnosed with portopulmonary hypertension who were taking pulmonary arterial hypertension-specific medication.

View Article and Find Full Text PDF
Article Synopsis
  • This study looked at the differences in liver extracellular volume fraction (ECV) between the left and right lobes in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and how these differences relate to heart function and medication intolerance.
  • Researchers analyzed data from 72 patients using CT scans and right heart catheterization (RHC) to assess liver ECVs and their correlation with heart function metrics.
  • The findings revealed that the left liver lobe's ECV was higher than the right, which was linked to lower cardiac index and a good predictor of intolerance to pulmonary hypertension medication.
View Article and Find Full Text PDF

Background: The accuracy of right ventricular (RV) quantification by three-dimensional echocardiography (3DE) has been reported mainly in patients with a normal right ventricle (RV). However, there are no data regarding the accuracy of 3DE in patients with a dilated RV, as in shunt diseases. In this study, we evaluated the accuracy of 3DE and that of volumetric (Vol) cardiac magnetic resonance (CMR) for assessment of RV and left ventricular (LV) stroke volume (SV) and the pulmonary (Q)/systemic (Q) blood flow ratio in patients with an atrial septal defect (ASD) using the two-dimensional phase contrast (2DPC) method as the gold standard.

View Article and Find Full Text PDF

Pulmonary arterial hypertension (PAH) is characterized by stenosis and occlusions of small pulmonary arteries, leading to elevated pulmonary arterial pressure and right heart failure. Although accumulating evidence shows the importance of interleukin (IL)-6 in the pathogenesis of PAH, the target cells of IL-6 are poorly understood. Using mice harboring the allele of , a subunit of the IL-6 receptor, we found substantial Cre recombination in all hematopoietic cell lineages from the primitive hematopoietic stem cell level in mice.

View Article and Find Full Text PDF
Article Synopsis
  • Balloon pulmonary angioplasty significantly improves the condition of patients with chronic thromboembolic pulmonary hypertension, but its long-term effects regarding recurrent pulmonary hypertension are not fully understood.
  • A study of 262 patients showed that only 11 experienced recurrent pulmonary hypertension after the procedure, with a low 5-year recurrence probability of 9.0%.
  • Most cases were mild and manageable with additional treatments, and serious complications like vascular restenosis were very rare, showing minimal risk of transition to death.
View Article and Find Full Text PDF

Background: Takayasu arteritis (TAK) is an autoimmune large vessel vasculitis that affects the aorta and its major branches, eventually leading to the development of aortic aneurysm and vascular stenosis or occlusion. This retrospective and prospective study aimed to investigate whether the gut dysbiosis exists in patients with TAK and to identify specific gut microorganisms related to aortic aneurysm formation/progression in TAK.

Methods: We analysed the faecal microbiome of 76 patients with TAK and 56 healthy controls (HCs) using 16S ribosomal RNA sequencing.

View Article and Find Full Text PDF

Background: Pulmonary arterial hypertension (PAH) is a type of pulmonary hypertension (PH) characterized by obliterative pulmonary vascular remodeling, resulting in right-sided heart failure. Although the pathogenesis of PAH is not fully understood, inflammatory responses and cytokines have been shown to be associated with PAH, in particular, with connective tissue disease-PAH. In this sense, Regnase-1, an RNase that regulates mRNAs encoding genes related to immune reactions, was investigated in relation to the pathogenesis of PH.

View Article and Find Full Text PDF

Antithrombin resistance (ATR) is a newly identified strong genetic predisposition to venous thromboembolism (VTE) caused by genetic variations in prothrombin with substitutions of Arg at position 596 with either Leu, Gln, or Trp. In the present report, we identified a missense variant p.Arg596Gln in 3 patients from 2 families with unprovoked VTE who each experienced their first VTE event at 19, 67, and 19 years old.

View Article and Find Full Text PDF

Objective: Pulmonary arterial hypertension (PAH), caused by pulmonary artery remodelling and increased pulmonary vascular resistance (PVR) due to an unknown mechanism, is an intractable disease with a poor prognosis. The recent development of PAH-specific treatment medications may allow for higher PVR reduction than previously achieved. This study aimed to identify the prognostic significance of follow-up PVR levels achieved shortly after the initiation of targeted treatment in patients with idiopathic/heritable pulmonary arterial hypertension (I/H-PAH).

View Article and Find Full Text PDF

The majority of the conventional techniques that are utilized for investigating the pathogenesis of cardiovascular disease in preclinical animal models do not permit microlevel assessment of cardiomyocyte and microvascular functions. Therefore, it has been difficult to establish whether cardiac dysfunction in complex multiorgan disease states, such as heart failure with preserved ejection fraction and pulmonary hypertension, have their origins in microvascular dysfunction or rather in the cardiomyocyte. Herein, we describe our approach of utilizing synchrotron radiation microangiography to, first, ascertain whether the growth hormone secretagogue (GHS) hexarelin is a vasodilator in the coronary circulation of normal and anesthetized Sprague-Dawley rats, and next investigate if hexarelin is able to prevent the pathogenesis of right ventricle (RV) dysfunction in pulmonary hypertension in the sugen chronic hypoxia model rat.

View Article and Find Full Text PDF

Background: Right ventricular function is an important prognostic marker for pulmonary arterial hypertension. Native T1 mapping using cardiovascular magnetic resonance imaging can characterize the myocardium, but accumulating evidence indicates that T1 values of the septum or ventricular insertion points do not have predictive potential in pulmonary arterial hypertension. We aimed to elucidate whether native T1 values of the right ventricular free wall (RVT1) can predict poor outcomes in patients with pulmonary arterial hypertension.

View Article and Find Full Text PDF

Pulmonary arterial hypertension (PAH) is a devastating disease characterized by arteriopathy in the small to medium-sized distal pulmonary arteries, often accompanied by infiltration of inflammatory cells. Aryl hydrocarbon receptor (AHR), a nuclear receptor/transcription factor, detoxifies xenobiotics and regulates the differentiation and function of various immune cells. However, the role of AHR in the pathogenesis of PAH is largely unknown.

View Article and Find Full Text PDF

Background: Numerous basic studies have shown a relationship between interleukin-6 (IL-6) and the development or severity of myocarditis. However, there has been no study in which the effect of IL-6 levels in patients with myocarditis was evaluated.

Methods: We enrolled control patients (n = 12) and consecutive patients with acute myocarditis (n = 13), including lymphocytic, eosinophilic, and giant cell myocarditis, and investigated the pathological and clinical effects of IL-6 on human myocarditis.

View Article and Find Full Text PDF

Background: Pulmonary arterial hypertension (PAH), particularly connective tissue disease-associated PAH (CTD-PAH), is a progressive disease and novel therapeutic agents based on the specific molecular pathogenesis are desired. In the pathogenesis of CTD-PAH, inflammation, immune cell abnormality, and fibrosis play important roles. However, the existing mouse pulmonary hypertension (PH) models do not reflect these features enough.

View Article and Find Full Text PDF
Article Synopsis
  • A 45-year-old man developed deep vein thrombosis (DVT) complications linked to his inferior vena cava (IVC) filter, which was totally covered in a large thrombus.
  • The medical team decided to remove the IVC filter, suspecting it might have caused a metallic allergy, and successfully did so using a multi-step catheter intervention technique.
  • This case is noted as the first documentation of using multi-step catheter intervention for the retrieval of an IVC filter covered in massive thrombus, highlighting the severity and difficulty of IVC filter thrombosis.
View Article and Find Full Text PDF
Article Synopsis
  • Balloon pulmonary angioplasty (BPA) can improve chronic thromboembolic pulmonary hypertension (CTEPH), but many patients still experience residual right ventricular (RV) dysfunction after the procedure.
  • A study of 61 CTEPH patients showed that 44% had residual dysfunction 12 months post-BPA, which was linked to worse functional outcomes.
  • Key risk factors for this dysfunction included male sex and prolonged QRS duration on heart monitors, suggesting that these factors may help identify patients at risk for poor recovery post-treatment.
View Article and Find Full Text PDF

Pulmonary arterial hypertension (PAH) is a rare, devastating disease, characterized by elevated pulmonary arterial pressure due to pulmonary microvascular obstruction, which can result in heart failure and death. PAH can be associated with exposure to certain drugs or toxins. We herein report a case in which PAH developed in a patient with refractory ulcerative colitis during treatment with "Qing-Dai," a Chinese herbal medicine.

View Article and Find Full Text PDF