Publications by authors named "Masaki Wakita"

4 Publications

  • Page 1 of 1

Hemodynamic Collapse Caused by Cardiac Dysfunction and Abdominal Compartment Syndrome in a Patient with Mitochondrial Disease.

Intern Med 2021 Aug 13. Epub 2021 Aug 13.

Department of Cardiovascular Medicine, Nippon Medical School, Japan.

We herein report a case of mitochondrial disease with heart and intestinal tract involvement resulting in hemodynamic collapse. A 66-year-old woman was transferred to our hospital because of cardiogenic shock. Vasopressors were administered, and a circulatory support device was deployed. However, her hemodynamics did not improve sufficiently, and we detected abdominal compartment syndrome caused by the aggravation of chronic intestinal pseudo-obstruction as a complication. Insertion of a colorectal tube immediately decreased the intra-abdominal pressure, improving the hemodynamics. Finally, we diagnosed her with mitochondrial disease, concluding that the resulting combination of acute heart failure and abdominal compartment syndrome had aggravated the hemodynamics.
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August 2021

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry.

Clin Res Cardiol 2021 May 19. Epub 2021 May 19.

Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes.

Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients.

Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients.

Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers.

Trial Registration: URL: ; Unique Identifier: NCT01947621.
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May 2021

Effects of topiroxostat administration on brain natriuretic peptide levels in heart failure patients with a preserved ejection fraction: A pilot study.

J Nippon Med Sch 2021 Jan 16. Epub 2021 Jan 16.

Department of Cardiovascular Medicine, Nippon Medical School.

Background: Various optimal medical therapies have been established for the treatment of heart failure (HF) with a reduced ejection fraction (HFrEF). Like HFrEF, HF with a preserved ejection fraction (HFpEF) too is related to poor prognoses. We aimed to investigate the effect of topiroxostat, an oral xanthine oxidoreductase inhibitor, in HFpEF patients with hyperuricemia or gout.

Methods: In this non-randomized, open-label, single-arm trial, we administered topiroxostat (40-160 mg/day) to HFpEF patients with hyperuricemia or gout to achieve a target uric acid level of 6.0 mg/dl. The primary outcome was the rate of change in the log-transformed brain natriuretic peptide (BNP) levels from the baseline to 24 weeks after topiroxostat treatment. The secondary outcomes included the amount of change in the BNP levels, uric acid evaluation values, and oxidative stress marker levels after 24 weeks of topiroxostat treatment. Thirty-six patients were enrolled; three were excluded before study initiation.

Results: The log-transformed BNP levels decreased by -3.4 ± 8.9 % (p = 0.043) after 24 weeks of topiroxostat treatment. The rate of change in the BNP level decreased (-18.0 [-57.7, 4.0] pg/ml, p = 0.041). The levels of uric acid and 8-hydroxy-2'-deoxyguanosine/creatinine, an oxidative stress marker, also significantly decreased (-2.8 ± 1.6 mg/dl, p < 0.001, -2.3 ± 3.7 ng/mgCr, p = 0.009, respectively).

Conclusions: The BNP levels were significantly lowered in HFpEF patients with hyperuricemia or gout after topiroxostat administration; however, the rate of decrease was low. Further trials are needed to confirm our findings.
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January 2021

Double potential mapping: a novel technique for locating the site of incomplete ablation.

Innovations (Phila) 2012 Nov-Dec;7(6):429-34

Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan.

Objective: Double potential mapping using bipolar electrodes that straddle the ablation line should identify the site of incomplete ablation as a conduction gap without constructing the activation maps.

Methods: Bipolar electrograms were recorded during pacing using 11 custom-made bipolar electrodes straddling the ablation line created by a bipolar radiofrequency ablation device on the lateral right atrium in seven canines. A linear ablation was made with an ablation device, of which one jaw was inserted into the atrium through a purse-string suture. A 3-mm-wide tape was placed on both jaws 10 mm from the tip of the ablation electrode to intentionally create an incomplete ablation lesion. The activation times at each dipole across the ablation line were defined as the times of the maximum positive and negative derivatives of the double potentials, and the site of conduction gap was determined as the site of the earliest activation across the linear ablation. The lateral right atrium was mapped simultaneously with 45 different bipolar electrodes to construct the activation maps and the earliest activation site across the ablation line was determined.

Results: The double potential mapping located the conduction gap on a real-time basis without displaying any maps. There was no significant change in the accuracy between the different times after ablation and different pacing cycle lengths.

Conclusions: Double potential mapping locates the conduction gap on a real-time basis and would be useful in beating-heart epicardial ablation in off-pump setting.
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October 2013