On the mechanism for PPAR agonists to enhance ABCA1 gene expression.

Expression of ATP binding cassette transporter A1 (ABCA1), a major regulator of high density lipoprotein (HDL) biogenesis, is known to be up-regulated by the transcription factor liver X receptor (LXR) alpha, and expression is further enhanced by activation of the peroxisome proliferator activated receptors (PPARs). We investigated this complex regulatory network using specific PPAR agonists: four fibrates (fenofibrate, bezafibrate, gemfibrozil and LY518674), a PPAR delta agonist (GW501516) and a PPAR gamma agonist (pioglitazone). All of these compounds increased the expression of LXRs, PPARs and ABCA1 mRNAs, and associated apoA-I-mediated lipid release in THP-1 macrophage, WI38 fibroblast and mouse fibroblast.

High density lipoprotein cholesterol and apolipoprotein A-I are persistently elevated during long-term treatment with pitavastatin, a new HMG-CoA reductase inhibitor.

Although a low level of high density lipoprotein-cholesterol (HDL-C) is an important risk factor for coronary heart disease, few available agents are capable of significantly increasing HDL-C. This multicenter study demonstrated that administration of pitavastatin, a new HMG-CoA reductase inhibitor, significantly and persistently increased HDL-C (from 36.0+/-5.

Predictors of congestive heart failure in patients on maintenance hemodialysis.

Background: Cardiovascular disease is a major cause of death in patients on maintenance hemodialysis (HD). Predictors of congestive heart failure (CHF) events in patients on HD were investigated, focusing on left ventricular (LV) function.

Methods And Results: One hundred consecutive patients on HD were followed for at least 5 years after index examination performed 1 day after the last HD session.

Relationship between Doppler transmitral flow velocity pattern and plasma atrial and brain natriuretic peptide concentrations in anuric patients on maintenance hemodialysis.

Plasma atrial (ANP) and brain (BNP) natriuretic peptide levels were compared to determine if transmitral flow velocity pattern is an instantaneous marker of body fluid balance in anuric patients on hemodialysis (HD). We measured plasma ANP and BNP levels and performed Doppler echocardiography in 38 anuric patients before and after HD. Patients with valvular disease, left ventricular systolic dysfunction having a fractional shortening < 0.

The relationship between variables of 123-I-metaiodobenzylguanidine cardiac imaging and clinical status of the patients with diastolic heart failure.

Background: The status of cardiac sympathetic nerve activity in patients with diastolic heart failure has not been fully understood. 123-I-metaiodobenzylguanidine cardiac images are valuable for evaluating cardiac sympathetic nerve activity.

Methods: We obtained 123-I-metaiodobenzylguanidine cardiac images from 34 consecutive patients with moderate heart failure and an ejection fraction of > or = 45%.

Increased gene expression of collagen Types I and III is inhibited by beta-receptor blockade in patients with dilated cardiomyopathy.

Aims: To elucidate the cellular mechanisms of cardioprotection of beta-blockers in patients with heart failure, we investigated the effects of beta-blockers on collagen synthesis in patients with dilated cardiomyopathy (DCM).

Methods And Results: We examined the gene expression before and 4 months after the administration of a beta-blocker in 17 DCM patients. The messenger ribonucleic acid expression of collagen Types I and III (Col I and III) and transforming growth factor-beta(1) (TGF-beta(1)) of right ventricular tissues obtained by the endomyocardial biopsy were assessed by quantitative reverse transcriptase-polymerase chain reaction.

Effects of insulin on the acetylcholine-induced hyperpolarization in the guinea pig mesenteric arterioles.

Background: Insulin induces endothelium-dependent vasodilatation, which may be casually related to the insulin resistance and hypertension. Endothelium-derived nitric oxide (NO) is the most important mechanism of insulin-induced vasodilatation, and a possible contribution of endothelium-derived hyperpolarizing factor (EDHF) is also considered. Attempts were made to observe the effects of insulin on acetylcholine (ACh)-induced hyperpolarization in the submucosal arteriole of the guinea pig ileum, the objective being to investigate possible involvement of EDHF in the actions of insulin.

Novel technique using intravascular ultrasound-guided guidewire cross in coronary intervention for uncrossable chronic total occlusions.

The experience of using a novel application of intravascular ultrasound (IVUS)-guided percutaneous coronary interventions for chronic total occlusions is reported in 2 cases. In the first case, an IVUS catheter was advanced into a side branch to identify the entry point of the major branch. In the second case, IVUS-guided penetration of the guidewire from the false lumen to the true lumen after causing a dissection was successful.

The influence of diabetes mellitus on plaque volume and vessel size in patients undergoing percutaneous coronary intervention.

We evaluated the influence of diabetes on plaque volume and vessel size at a reference segment in diabetic patients undergoing percutaneous coronary intervention using both angiograms and quantitative intravascular ultrasound. A total of 344 patients with 449 de novo coronary lesions including 97 diabetics (133 lesions) who underwent elective percutaneous coronary intervention under intravascular ultrasound guidance were included in this study. Eleven diabetic patients (19 lesions) received insulin and 52 patients (77 lesions) oral hypoglycemic drugs.

Effects of carvedilol on plasma B-type natriuretic peptide concentration and symptoms in patients with heart failure and preserved ejection fraction.

Although the benefits of carvedilol in patients with heart failure and depressed ejection fraction (EF) have been elucidated, those in patients with preserved EF are not understood. We enrolled 40 patients with mild or moderate heart failure and EF >/=45%. They were randomly assigned to carvedilol (n = 19) or conventional therapy (n = 21).

Cilostazol inhibits high glucose-mediated endothelial-neutrophil adhesion by decreasing adhesion molecule expression via NO production.

Objective: Endothelial-neutrophil adhesion is crucial for vascular injury, the major cause of diabetic vascular complications. On the other hand, platelet aggregation inhibitors, frequently used for diabetic patients with intermittent claudication, have been shown to decrease the incidence of atherosclerosis-mediated diseases (acute myocardial infarction and stroke). However, whether these agents act directly on the endothelial reactions to hyperglycemia remains unclear.

The antidiabetic agent, gliclazide, reduces high insulin-enhanced neutrophil-transendothelial migration through direct effects on the endothelium.

Background And Aim: Many lines of evidence indicate that hyperinsulinemia might be associated with coronary atherosclerosis, and, currently, there are no effective strategies for preventing this. We previously reported that high insulin enhances neutrophil-transendothelial migration, a process that involves increased surface presentation of platelet endothelial cell adhesion molecule-1 (PECAM-1) through a mitogen-activated protein (MAP) kinase-dependent event. In this current study, we examined if antidiabetic agents, especially K(ATP) channel blockers, might similarly protect against the leukocyte-endothelial cell interactions enhanced by high insulin.

Effects of percutaneous coronary arterial thrombectomy during acute myocardial infarction on left ventricular remodeling.

The benefit of primary angioplasty for acute myocardial infarction (AMI) is limited by the no-reflow phenomenon, resulting in chronic left ventricular (LV) remodeling. The aim of this study was to evaluate the impact of thrombectomy with the Rescue percutaneous thrombectomy catheter on LV function after AMI. We performed a retrospective study comparing conventional angioplasty with the combination of angioplasty and thrombectomy using the Rescue catheter.

Noninvasive detection of coronary artery bypass graft patency by intravenous electron beam computed tomographic angiography.

This study evaluates the usefullness of intravenous electron beam computed tomographic angiography (EBA) for the detection of coronary artery bypass graft patency in 43 patients (33 men and 10 women, mean age, 65 years) who had coronary artery bypass graft surgery. EBA was performed a few days before selective bypass graft angiography (SGA). Forty axial cross-sections of angiographic images of the heart were acquired consecutively by an electrocardiographic trigger signal at 40% of the RR interval, which corresponds to the end-systolic phase.

Protective actions of gliclazide on high insulin-enhanced neutrophil-endothelial cell interactions through inhibition of mitogen activated protein kinase and protein kinase C pathways.

Background And Aim: There are many lines of evidence indicating that hyperinsulinemia but not hyperglycemia is linked to the development of atherosclerotic diseases such as coronary events in diabetic patients. K(ATP) channel blockers of the sulphonylurea class are used widely to treat type 2 diabetes mellitus even with hyperinsulinemia. In this study, we determined whether K(ATP) channel blockers can protect against atherosclerotic processes enhanced by hyperinsulinemia, namely leukocyte-endothelial cell interactions.

Cerivastatin ameliorates high insulin-enhanced neutrophil-endothelial cell adhesion and endothelial intercellular adhesion molecule-1 expression by inhibiting mitogen-activated protein kinase activation.

Background And Aims: There is growing evidence that hyperinsulinemia is linked to the development of atherosclerosis in patients with diabetes. We demonstrated previously that high insulin exacerbates neutrophil-endothelial cell adhesion and endothelial intercellular adhesion molecule (ICAM)-1 expression through activation of protein kinase C (PKC) and mitogen-activated protein (MAP) kinase. Though 3-hydroxymethyl-3-glutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) have been employed as therapeutic agents in the treatment of dyslipidemia, which is frequently accompanied by diabetes mellitus; it is not known whether statins protect against leukocyte-endothelial interactions, especially in hyperinsulinemia.

High-amplitude QRS complex in the electrocardiograms of normotensive people and risk of subsequent hypertension.

Background: Left ventricular hypertrophy sometimes develops in normotensive people with a genetic background for hypertension. The aim of this case-control study was to test the hypothesis that a high-amplitude QRS complex (high-QRS) is indicative of risk of eventual hypertension.

Methods: We reviewed medical charts that included blood pressure data obtained every 6 months from 7011 Japanese workers.

Elevated white blood cell count as a risk factor of coronary artery disease: inconsistency between forms of the disease.

White blood cells (WBC) destabilize coronary artery plaques and an elevated WBC count is a risk factor of coronary artery disease (CAD). Nevertheless, the differences between the forms of CAD in the relationship with WBC count remain to be elucidated. To study these differences, we reviewed the health-checkup records from 1994 to 1999 for 6021 Japanese post office workers without any cardiovascular abnormalities.

Statins inhibit high glucose-mediated neutrophil-endothelial cell adhesion through decreasing surface expression of endothelial adhesion molecules by stimulating production of endothelial nitric oxide.

Neutrophil-endothelial adhesion is a crucial step in vascular inflammation, which is recognized as the direct cause of atherosclerosis-mediated serious diseases. We demonstrated previously that high glucose increased adhesion in a protein kinase C (PKC)-dependent manner within 48 h through increasing surface expression of endothelial adhesion molecules. On the other hand, statins, used for patients with hypercholesterolemia, have been shown to decrease the incidence of atherosclerosis-mediated diseases, but direct effects of statins on endothelial cells remain unclear.

Plasma concentrations of LPL and LCAT are in putative association with females and alcohol use which are independent negative risk factors for coronary atherosclerosis among Japanese.

Background: Coronary heart disease (CHD) prevalence appears low among Japanese. Analysis of their negative risk factors is therefore important for public health strategy.

Methods: We analyzed the impact on coronary atherosclerosis of sex, alcohol intake, plasma lipoproteins and enzymes to regulate cholesterol transport, lipoprotein lipase (LPL) and lecithin:cholesterol acyltransferase (LCAT) for the 110 patients who underwent coronary angiography, consecutively enrolled by excluding those >70 years or under hypolipidemic-drug treatment.

Neointima in coronary stent does not increase during over 1-year in non-restenosed lesion at 6 months follow-up: serial volumetric intravascular ultrasound study.

The long-term outcomes of coronary artery stenting have been determined by coronary angiography only with has the limitation of determining stent expansion and neointimal proliferation at long-term follow-up. Volumetric intravascular analysis has the potential to evaluate the morphology and distribution of neointima longitudinally after coronary artery stenting. We used three-dimensional intravascular ultrasound (3-D IVUS) to evaluate serial changes in stent and neointimal volumes for over 1-year in 9 patients who did not exhibit angiographic restenosis at 6-month follow-up.

Usefulness of electron beam tomography in the prone position for detecting atrial thrombi in chronic atrial fibrillation.

Objective: We compared the usefulness of electron beam tomography (EBT) in the prone position relative to that in the supine position for detecting atrial thrombi.

Methods: We studied 96 patients with chronic atrial fibrillation, of whom 71 were scanned in the supine position and 25 were scanned in the prone position. Electron beam tomography was performed twice after contrast medium injection to obtain early- and late-phase images.

The mechanisms of inhibitory actions of gliclazide on neutrophils-endothelial cells adhesion and surface expression of endothelial adhesion molecules mediated by a high glucose concentration.

Background: We previously reported that culture of endothelial cells in the presence of high glucose concentrations (27.8 and 55.5 mM) increase neutrophils adhesion because of the increase in endothelial adhesion molecules expression via activation of a protein kinase C (PKC) pathway.

Mechanisms of inhibitory activity of the aldose reductase inhibitor, epalrestat, on high glucose-mediated endothelial injury: neutrophil-endothelial cell adhesion and surface expression of endothelial adhesion molecules.

Background: We have previously reported that endothelial cells cultured in the presence of high concentrations of glucose (27.8 and 55.5 mM) exhibited enhanced neutrophil adhesion through increased expression of endothelial adhesion molecules via the activation of a protein kinase C (PKC)-dependent pathway.