基本情報
研究キーワード
4研究分野
1委員歴
5-
2012年 - 2014年
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2014年
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2014年
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2014年
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2012年
受賞
7-
2010年3月
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2009年5月
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2006年11月
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2002年7月
論文
969-
Journal of the American Heart Association 14(2) e034627 2025年1月21日BACKGROUND: The effect of worsening renal function and baseline chronic kidney disease (CKD) on outcomes in patients with chronic coronary syndrome in the setting of optimal medical therapy remains unknown. METHODS AND RESULTS: The REAL-CAD (Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery Disease) study is a prospective, multicenter, randomized trial of high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day) statin therapy in 12 118 patients with chronic coronary syndrome. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, stroke, or unstable angina requiring hospitalization (major adverse cardiac and cerebral events [MACCE]). CKD was defined as an estimated glomerular filtration rate [eGFR] <60 mL/min per 1.73 m2. WRF was defined as a decrease in eGFR ≥20% in the initial year; borderline renal function was an annual decrease of 0%<eGFR<20%, and stable renal function was no decrease. Of 12 118 patients, 4340 had baseline CKD and 7778 did not. The rate of MACCE at 5 years was significantly lower in those without (5.5%) versus with CKD (9.5%) (P<0.0001). After excluding 1247 patients who had MACCE, were censored, or missing eGFR within 1 year, 10 871 patients were included. Of these, 3885 were baseline CKD and the remaining 6986 did not have baseline CKD. Of the 10 871 patients, 577 patients had WRF, 6014 patients showed borderline renal function, and the remaining 4280 patients maintained stable renal function. In patients with CKD, WRF was an independent predictor for MACCE at 4 years as compared with stable renal function (hazard ratio [HR]: 1.67; [95% CI, 1.03-2.73; P=0.039]). In patients without CKD, borderline renal function was a significant predictor for MACCE at 4 years compared with stable renal function (HR: 1.40 [95% CI, 1.03-1.91; P=0.032]). CONCLUSIONS: Baseline CKD was an independent predictor for MACCE in patients with CCS. WRF was a significant predictor for MACCE in patients with CKD. Because borderline renal function was an independent predictor for MACCE even in patients without CKD, mild-to-moderate annual declines of eGFR should be carefully monitored (NCT01042730). REGISTRATION: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01042730.
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International Journal of Molecular Sciences 26(2) 556-556 2025年1月10日 査読有り
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IJC Heart & Vasculature 54 101507-101507 2024年10月
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Hypertension research : official journal of the Japanese Society of Hypertension 2024年9月19日The Japanese Society of Hypertension have established a blood pressure (BP) target of 130/80 mmHg for patients with coronary artery disease (CAD). We evaluated the data of 8793 CAD patients in the Clinical Deep Data Accumulation System database who underwent cardiac catheterization at six university hospitals and the National Cerebral and Cardiovascular Center (average age 70 ± 11 years, 78% male, 43% with acute coronary syndrome [ACS]). Patients were divided into two groups based on whether or not they achieved the guideline-recommended BP of <130/80 mmHg. We analyzed the relationship between BP classification and major adverse cardiac and cerebral event (MACCE) separately in two groups: those with ACS and those with chronic coronary syndrome (CCS). During an average follow-up period of 33 months, 710 MACCEs occurred. A BP below 130/80 mmHg was associated with fewer MACCEs in both the overall (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-1.00, p = 0.048) and the ACS group (HR 0.67, 95%CI 0.51-0.88, p = 0.003). In particular, stroke events were also lower among those with a BP below 130/80 mmHg in both the overall (HR 0.69, 95%CI 0.53-0.90, p = 0.006) and ACS groups (HR 0.44, 95%CI 0.30-0.67, p < 0.001). In conclusion, the achievement of BP guidelines was associated with improved outcomes in CAD patients, particularly in reducing stroke risk among those with ACS.
MISC
1923-
Japanese circulation journal 60 64-64 1996年2月20日
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Japanese circulation journal 60 457-457 1996年2月20日
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Japanese circulation journal 60 436-436 1996年2月20日
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Japanese circulation journal 60 441-441 1996年2月20日
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Japanese circulation journal 59 1996年2月20日
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The American journal of cardiology 77(4) 304-7 1996年2月1日 査読有り
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Life sciences 58(20) 1705-12 1996年 査読有り
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Research communications in molecular pathology and pharmacology 91(1) 17-32 1996年1月 査読有り
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Diabetes Res 31 1-18 1996年
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Laboratory investigation; a journal of technical methods and pathology 74(1) 120-8 1996年1月 査読有り
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動脈硬化 = The journal of Japan Atherosclerosis Society 23(1) 71-80 1995年10月20日We previously reported a clinical study in which (1) Probucol prevented restenosis after coronary angioplasty and (2) Pravastatin reduced the risk of restenosis associated with plasma cholesterol concentration. To examine these mechanism, we analyzed the effect of probucol and pravastatin on the intimal proliferation, the cellular makeup of lesion and the expression of PDGF after balloon injury in rabbits. Probucol study: Probucol was given orally 1.3 g/day from 2 weeks prior to carotid balloon injury to the time of killing (2 or 4 weeks after balloon injury). Probucol remarkably decreased intimal area by 70%, the number of Smooth Muscle Cell (SMC) and Proliferating Cell Nuclear Antigen (PCNA)-labeled cells in the intima. The expression of PDGF-A mRNA was markedly suppressed with probucol treatment. However, probucol did not suppress SMemb expression. SMemb is a good molecular marker for de-differentiated SMC. Probucol is effective in preventing SMC proliferation, which is possibly due to a decrease in the expression of PDGF.<br>Pravastatin study: Pravastatin was received orally 20mg/day with 0.5% cholestrol diet 2 weeks before iliac balloon injury. After 2 or 4 weeks, the rabbits were killed. Pravastatin reduced plasma cholesterol concentration, neointimal macrophage content and intimal area. The neointimal area was related to macrophage content. Moreover, macrophage content was correlated to plasma cholesterol level. Pravastatin effectively inhibits myointimal proliferation, which may be partly explained by its hypocholesterolemic activity.
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循環器専門医 : 日本循環器学会専門医誌 3(2) 301-309 1995年10月13日
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CIRCULATION 92(8) 1752-1752 1995年10月
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CIRCULATION 92(8) 106-106 1995年10月
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JOURNAL OF DIABETES AND ITS COMPLICATIONS 9(4) 282-284 1995年10月
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Journal of Immunological Methods 185(1) 57-63 1995年9月11日
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JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 6(3) 871-871 1995年9月
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JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 6(3) 330-330 1995年9月
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JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 6(3) 885-885 1995年9月
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ANNALS OF INTERNAL MEDICINE 123(5) 394-394 1995年9月
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Internal medicine (Tokyo, Japan) 34(8) 782-4 1995年8月 査読有り
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CIRCULATION RESEARCH 77(2) 258-265 1995年8月
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Kidney international 48(2) 372-82 1995年8月 査読有りThe contractility and distensibility of renal arterioles are important in the regulation of glomerular filtration. However, little is known regarding the characteristics of contractile proteins in these arterioles. Recently it was demonstrated that vascular smooth muscles contain two types of myosin heavy chain (MHC) isoforms, SM1 and SM2, which are unique molecular markers of smooth muscle cell phenotypes. SM1 is constitutively expressed in all types of smooth muscles, whereas SM2 exists only in mature smooth muscles. We characterized the expression of MHC isoforms as well as the ultrastructural myofilament assembly of renal arteriolar smooth muscles in human, rat and rabbit by immunohistochemical techniques. SM1 and alpha-smooth muscle actin were localized in both the preglomerular vessels (including the afferent arterioles) and efferent arterioles, whereas SM2 was present only in the preglomerular vessels. Renin-producing cells in the afferent arterioles (juxtaglomerular granular cells, JG cells) were positive for alpha-smooth muscle actin but negative for SM2. When renin synthesis was stimulated, the more proximal afferent arteriolar smooth muscles turned renin-positive and SM2 disappeared. Glomerular mesangial cells did not show immunoreactivities for SM1, SM2 or alpha-smooth muscle actin. The difference in MHC isoform expression in these arterioles was also reflected by ultrastructures; the afferent arteriolar smooth muscles contained abundant myofilaments including thick filaments, whereas the efferent arteriolar smooth muscles had a few myofilaments composed only of thin microfilaments. The JG cells displayed a myofilament assembly similar to that in the efferent arteriolar smooth muscles. We conclude from these observations that smooth muscles in pre-and postglomerular arterioles, the glomerular mesangial cells and JG cells differ in phenotypes, suggesting that they may have different contractile properties which may be critically involved in the regulation of glomerular filtration.
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The Journal of clinical investigation 96(1) 293-300 1995年7月 査読有り
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RENAL PHYSIOLOGY AND BIOCHEMISTRY 18(4) 183-190 1995年7月
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Clinical science (London, England : 1979) 89(1) 45-52 1995年7月 査読有り
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JOURNAL OF CLINICAL INVESTIGATION 96(1) 438-446 1995年7月
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Japanese circulation journal 59 624-624 1995年6月20日
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Japanese circulation journal 59 644-644 1995年6月20日
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Japanese circulation journal 59(7) 447-447 1995年6月20日
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Japanese circulation journal 59(7) 423-423 1995年6月20日
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Japanese circulation journal 59(7) 414-414 1995年6月20日
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Japanese circulation journal 59(7) 521-521 1995年6月20日
書籍等出版物
21-
Springer 2009年 (ISBN: 9784431877745)
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Signal Transduction and Cardiac Hypertrophy (Naranjan S. Dhalla, Larry Hryshko, Elissavet Kardami, Pawan K. Singal, KLUWER ACADEMIC PUBLISHERS) 2003年
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Signal Transduction and Cardiac Hypertrophy (Naranjan S. Dhalla, Larry Hryshko, Elissavet Kardami, Pawan K. Singal, KLUWER ACADEMIC PUBLISHERS) 2003年
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Rapid Cycle Real-Time PCR : methods and applications 2001年
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in"The Hypertrophied Heart" 2000年
共同研究・競争的資金等の研究課題
91-
日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 2020年7月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2019年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2019年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2018年6月 - 2023年3月