Faculty Profiles - MIYOSHI Toru

Papers - MIYOSHI Toru

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Evidence for Hypoxia-Induced Shift in ATP Production from Glycolysis to Mitochondrial Respiration in Pulmonary Artery Smooth Muscle Cells in Pulmonary Arterial Hypertension International journal

Satoshi Akagi, Kazufumi Nakamura, Megumi Kondo, Satoshi Hirohata, Heiichiro Udono, Mikako Nishida, Yukihiro Saito, Masashi Yoshida, Toru Miyoshi, Hiroshi Ito

Journal of Clinical Medicine 12 ( 15 ) 5028 - 5028 2023.7

Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Background: The metabolic state of pulmonary artery smooth muscle cells (PASMCs) from patients with pulmonary arterial hypertension (PAH) is not well understood. In this study, we examined the balance between glycolysis and mitochondrial respiration in non-PAH-PASMCs and PAH-PASMCs under normoxia and hypoxia. Methods: We investigated the enzymes involved in glycolysis and mitochondrial respiration, and studied the two major energy-yielding pathways (glycolysis and mitochondrial respiration) by measuring extracellular acidification rate (ECAR) and cellular oxygen consumption rate (OCR) using the Seahorse extracellular flux technology. Results: Under both normoxia and hypoxia, the mRNA and protein levels of pyruvate dehydrogenase kinase 1 and pyruvate dehydrogenase were increased in PAH-PASMCs compared with non-PAH-PASMCs. The mRNA and protein levels of lactate dehydrogenase, as well as the intracellular lactate concentration, were also increased in PAH-PASMCs compared with non-PAH-PASMCs under normoxia. However, these were not significantly increased in PAH-PASMCs compared with non-PAH-PASMCs under hypoxia. Under normoxia, ATP production was significantly lower in PAH-PASMCs (59 ± 5 pmol/min) than in non-PAH-PASMCs (70 ± 10 pmol/min). On the other hand, ATP production was significantly higher in PAH-PASMCs (31 ± 5 pmol/min) than in non-PAH-PASMCs (14 ± 3 pmol/min) under hypoxia. Conclusions: There is an underlying change in the metabolic strategy to generate ATP production under the challenge of hypoxia.

DOI： 10.3390/jcm12155028

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Myocardial Late Iodine Enhancement Using Photon-Counting Computed Tomography in Patients With Hypertrophic Cardiomyopathy

Takahiro Nishihara, Toru Miyoshi, Noriaki Akagi, Mitsutaka Nakashima, Kazufumi Nakamura, Hiroshi Ito

Circulation Reports 5 ( 6 ) 269 - 270 2023.6

Metabolic dysfunction associated fatty liver disease(MAFLD)における冠動脈プラーク性状の検討

西原大裕, 三好亨, 中島充貴, 三木崇史, 大澤和宏, 戸田洋伸, 吉田雅言, 中村一文, 伊藤浩

日本動脈硬化学会総会プログラム・抄録集 55回 235 - 235 2023.6

Effects of Agalsidase Alfa Enzyme Replacement Therapy on Left Ventricular Hypertrophy on Electrocardiogram in a Female Patient with Fabry Disease

Kazufumi Nakamura, Hiroshi Morita, Yoichi Takaya, Yukihiro Saito, Toru Miyoshi, Hiroshi Morinaga, Hitoshi Sugiyama, Jun Wada, Hiroshi Ito

International Heart Journal 64 ( 3 ) 502 - 505 2023.5

Diagnostic Performance of Cardiac Computed Tomography for Detecting Patent Foramen Ovale: Evaluation Using Transesophageal Echocardiography and Catheterization as Reference Standards. International journal

Takashi Miki, Koji Nakagawa, Keishi Ichikawa, Tomofumi Mizuno, Rie Nakayama, Kentaro Ejiri, Satoshi Kawada, Yoichi Takaya, Masakazu Miyamoto, Toru Miyoshi, Teiji Akagi, Hiroshi Ito

Journal of cardiovascular development and disease 10 ( 5 ) 2023.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Patent foramen ovale (PFO) is associated with various diseases such as cryptogenic stroke, migraine, and platypnea-orthodeoxia syndrome. This study aimed to evaluate the diagnostic performance of cardiac computed tomography (CT) for PFO detection. MATERIALS AND METHODS: Consecutive patients diagnosed with atrial fibrillation and who underwent catheter ablation with pre-procedural cardiac CT and transesophageal echocardiography (TEE) were enrolled in this study. The presence of PFO was defined as (1) the confirmation of PFO using TEE and/or (2) the catheter crossing the interatrial septum (IAS) into the left atrium during ablation. CT findings indicative of PFO included (1) the presence of a channel-like appearance (CLA) on the IAS and (2) a CLA with a contrast jet flow from the left atrium to the right atrium. The diagnostic performance of both a CLA alone and a CLA with a jet flow was evaluated for PFO detection. RESULTS: Altogether, 151 patients were analyzed in the study (mean age, 68 years; men, 62%). Twenty-nine patients (19%) had PFO confirmed by TEE and/or catheterization. The diagnostic performance of a CLA alone was as follows: sensitivity, 72.4%; specificity, 79.5%; positive predictive value (PPV), 45.7%; negative predictive value (NPV), 92.4%. The diagnostic performance of a CLA with a jet flow was as follows: sensitivity, 65.5%; specificity, 98.4%; PPV, 90.5%; NPV, 92.3%. The diagnostic performance of a CLA with a jet flow was statistically superior to that of a CLA alone (p = 0.045), and the C-statistics were 0.76 and 0.82, respectively. CONCLUSION: A CLA with a contrast jet flow in cardiac CT has a high PPV for PFO detection, and its diagnostic performance is superior to that of a CLA alone.

DOI： 10.3390/jcdd10050193

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Association Between Aortic Valve Calcification and Severity of Concomitant Aortic Regurgitation in Patients With Severe Aortic Stenosis.

Fumi Yokohama, Yoichi Takaya, Keishi Ichikawa, Rie Nakayama, Takashi Miki, Hironobu Toda, Norihisa Toh, Toru Miyoshi, Kazufumi Nakamura, Hiroshi Ito

Circulation journal : official journal of the Japanese Circulation Society 2023.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Patients with severe aortic stenosis (AS) frequently have concomitant aortic regurgitation (AR), but the association between aortic valvular calcification (AVC) and the severity of AR remains unclear.Methods and Results: We retrospectively reviewed patients with severe AS who underwent transthoracic echocardiography and multidetector computed tomography (MDCT) within 1 month. The patients were divided into 3 groups according to the degree of concomitant AR. The association between AVC and the severity of concomitant AR was assessed in patients with severe AS. The study population consisted of 95 patients: 43 men and 52 women with a mean age of 82±7 years. Of the 95 patients with severe AS, 27 had no or trivial AR, 53 had mild AR, and 15 had moderate AR. The AVC score (AVCS) and AVC volume (AVCV) significantly increased as the severity of concomitant AR increased (P=0.014 for both), and similar findings were obtained for the AVCS and AVCV indexes (P=0.004 for both). CONCLUSIONS: The severity of AR correlated with AVCS and AVCV measured by MDCT in patients with severe AS. AVC may cause concomitant AR, leading to worsening of disease condition.

DOI： 10.1253/circj.CJ-22-0746

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Association between High Pericoronary Adipose Tissue Computed Tomography Attenuation and Impaired Flow-Mediated Dilation of the Brachial Artery.

Keishi Ichikawa, Toru Miyoshi, Yuko Ohno, Kazuhiro Osawa, Mitsutaka Nakashima, Takahiro Nishihara, Takashi Miki, Hironobu Toda, Masatoki Yoshida, Hiroshi Ito

Journal of atherosclerosis and thrombosis 30 ( 4 ) 364 - 376 2023.4

Language：English Publishing type：Research paper (scientific journal)

AIMS: Pericoronary adipose tissue (PCAT) attenuation on coronary computed tomography angiography (CTA) is a noninvasive biomarker for pericoronary inflammation and is associated with cardiac mortality. We aimed to investigate the association between PCAT attenuation and endothelial dysfunction assessed using flow-mediated dilation (FMD). METHODS: A total of 119 outpatients who underwent both coronary CTA and FMD measurements were examined. PCAT attenuation values were assessed at the proximal 40-mm segments of all three major coronary arteries on coronary CTA. Endothelial function was assessed using FMD. Patients were then classified into two groups: those with endothelial dysfunction (FMD ＜4%, n=44) and those without endothelial dysfunction (FMD ≥ 4%, n=75). RESULTS: In all three coronary arteries, PCAT attenuation was significantly higher in patients with endothelial dysfunction than in those without endothelial dysfunction. Multivariate logistic regression analysis revealed that PCAT attenuation in the right coronary artery (odds ratio [OR]=1.543; 95% confidence interval [CI]=1.004-2.369, p=0.048) and left anterior descending artery (OR=1.525, 95% CI=1.004-2.369, p=0.049) was an independent predictor of endothelial dysfunction. Subgroup analysis of patients with adverse CTA findings (significant stenosis and/or high-risk plaque) and those with coronary artery calcium score ＞100 showed that high PCAT attenuation in all three coronary arteries was a significant predictor of endothelial dysfunction. CONCLUSION: High PCAT attenuation was significantly associated with FMD-assessed endothelial dysfunction in patients with suspected coronary artery disease. Our results suggest that endothelial dysfunction is one of the pathophysiological mechanisms linking pericoronary inflammation to cardiac mortality.

DOI： 10.5551/jat.63580

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Feasibility of Fractional Flow Reserve Derived from CT as a Gatekeeper of Prior to Invasive Angiography in Clinical Practice(タイトル和訳中)

西原大裕, 三好亨, 中島充貴, 三木崇史, 吉田雅言, 戸田洋伸, 伊藤浩

日本循環器学会学術集会抄録集 87回 OJ55 - 1 2023.3

Feasibility of Fibrosis-4 Index for Screening Obstructive Coronary Artery Disease in Patients with Non-alcoholic Fatty Liver Disease(タイトル和訳中)

中島充貴, 三好亨, 西原大裕, 三木崇史, 戸田洋伸, 吉田雅言, 伊藤浩

日本循環器学会学術集会抄録集 87回 OJ55 - 9 2023.3

Morphological Features on Cardiac CT of Patent Foramen Ovale Causing Cryptogenic Stroke(タイトル和訳中)

三木崇史, 中川晃志, 辻真弘, 中島充貴, 西原大裕, 中山理絵, 高谷陽一, 三好亨, 赤木禎治, 伊藤浩

日本循環器学会学術集会抄録集 87回 PJ004 - 6 2023.3

Association of Perivascular Fat Attenuation on Computed Tomography and Heart Failure with Preserved Ejection Fraction(タイトル和訳中)

西原大裕, 三好亨, 中島充貴, 中山理絵, 三木崇史, 高谷陽一, 伊藤浩

日本循環器学会学術集会抄録集 87回 PJ113 - 6 2023.3

Utility of Plasm Volume Status Calculation in Adult Fontan Patients(タイトル和訳中)

中島充貴, 杜徳尚, 川田哲史, 高谷陽一, 中川晃志, 三好亨, 西井伸洋, 赤木禎治, 伊藤浩

日本循環器学会学術集会抄録集 87回 OJ62 - 6 2023.3

Association between Cardiovascular Disease and Liver Disease, from a Clinically Pragmatic Perspective as a Cardiologist. International journal

Mitsutaka Nakashima, Kazufumi Nakamura, Takahiro Nishihara, Keishi Ichikawa, Rie Nakayama, Yoichi Takaya, Norihisa Toh, Satoshi Akagi, Toru Miyoshi, Teiji Akagi, Hiroshi Ito

Nutrients 15 ( 3 ) 2023.2

Language：English Publishing type：Research paper (scientific journal)

Cardiovascular diseases and liver diseases are closely related. Non-alcoholic fatty liver disease has the same risk factors as those for atherosclerotic cardiovascular disease and may also be a risk factor for atherosclerotic cardiovascular disease on its own. Heart failure causes liver fibrosis, and liver fibrosis results in worsened cardiac preload and congestion. Although some previous reports regard the association between cardiovascular diseases and liver disease, the management strategy for liver disease in patients with cardiovascular diseases is not still established. This review summarized the association between cardiovascular diseases and liver disease. In patients with non-alcoholic fatty liver disease, the degree of liver fibrosis progresses with worsening cardiovascular prognosis. In patients with heart failure, liver fibrosis could be a prognostic marker. Liver stiffness assessed with shear wave elastography, the fibrosis-4 index, and non-alcoholic fatty liver disease fibrosis score is associated with both liver fibrosis in patients with liver diseases and worse prognosis in patients with heart failure. With the current population ageing, the importance of management for cardiovascular diseases and liver disease has been increasing. However, whether management and interventions for liver disease improve the prognosis of cardiovascular diseases has not been fully understood. Future investigations are needed.

DOI： 10.3390/nu15030748

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Association between home-based exercise using a pedometer and clinical prognosis after endovascular treatment in patients with peripheral artery disease. International journal

Kohei Kawamura, Kentaro Ejiri, Hironobu Toda, Toshiaki Yamanaka, Masato Taniguchi, Kenji Kawamoto, Koji Tokioka, Yoichiro Naito, Ryo Yoshioka, Eiji Karashima, Hideki Fujio, Soichiro Fuke, Yasukazu Fujiwara, Atsushi Takaishi, Kosuke Seiyama, Toru Miyoshi, Kazufumi Nakamura, Hiroshi Ito

Journal of cardiology 81 ( 2 ) 222 - 228 2023.2

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Exercise therapy following endovascular treatment (EVT) is important for patients with peripheral artery disease (PAD); however, continuous exercise therapy is difficult to be performed in clinical practice. This study aimed to investigate the association between the implementation of home-based exercise using pedometers after EVT and 1-year clinical outcomes. METHODS: This multicenter observational prospective cohort registry included patients with PAD complaining of intermittent claudication who underwent EVT for aortoiliac and/or femoropopliteal artery lesions between January 2016 and March 2019. Patients were instructed to perform home-based exercises using a specific pedometer after EVT. The study population was divided into good and poor recording groups according to the frequency of the pedometer measurements. The good recording group was defined as those who completed ≥50 % of the prescribed daily pedometer recording during the follow-up period. The poor recording group was defined as those with an inability to use a pedometer and/or who completed <50 % of the prescribed daily pedometer recordings. The primary outcome was 1-year major adverse events (MAE), defined as a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, target vessel revascularization, and major amputation of the target limb. RESULTS: The mean age was 74.4 years; 78 % were male. A total of 623 lesions were analyzed (58.7 % aortoiliac, 41.3 % femoropopliteal). At 1 year, a lower cumulative incidence of MAE was observed in the good recording group compared to that in the poor recording group [10/233 (4.3 %) vs. 35/267 (13.7 %) patients, respectively; p < 0.001]. Multivariate Cox regression analysis showed that patients in the good recording group had a lower hazard ratio for 1-year MAE (0.33; 95 % confidence interval, 0.16-0.68; p = 0.004) than that in the poor recording group. CONCLUSIONS: Good self-recording of pedometer measurements was associated with favorable prognosis in patients with PAD following EVT.

DOI： 10.1016/j.jjcc.2022.09.005

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Microcalcification and 99mTc-Pyrophosphate Uptake without Increased Bone Metabolism in Cardiac Tissue from Patients with Transthyretin Cardiac Amyloidosis. International journal

Atsushi Mori, Yukihiro Saito, Kazufumi Nakamura, Toshihiro Iida, Satoshi Akagi, Masashi Yoshida, Makiko Taniyama, Toru Miyoshi, Hiroshi Ito

International journal of molecular sciences 24 ( 3 ) 2023.1

Language：English Publishing type：Research paper (scientific journal)

Transthyretin cardiac amyloidosis (ATTR-CA) is characterized by high 99mTc-labeled bone tracer uptake in the heart. However, the mechanism of bone tracer uptake into the heart remains controversial. Since bone tracer uptake into metastatic bone tumors is thought to be associated with increased bone metabolism, we examined 99mTc-pyrophosphate (PYP) scintigraphy findings, endomyocardial biopsy (EMB) tissue findings, and the expression of bone metabolism-related genes in the EMB tissues in patients with ATTR-CA, amyloid light-chain cardiac amyloidosis (AL-CA), and noncardiac amyloidosis (non-CA) in this study. The uptake of 99mTc-PYP in the heart was significantly higher in the ATTR-CA patients than in the AL-CA and non-CA patients. A higher percentage of ATTR-CA EMB tissue showed von Kossa-positive microparticles: ATTR-CA, 62%; AL-CA, 33%; and non-CA, 0%. Calcified microparticles were identified using transmission electron microscopy. However, none of the osteogenic marker genes, osteoclastic marker genes, or phosphate/pyrophosphate-related genes were upregulated in the EMB samples from ATTR-CA patients compared to those from AL-CA and non-CA patients. These results suggest that active calcification-promoting mechanisms are not involved in the microcalcification observed in the heart in ATTR-CA. The mechanisms explaining bone tracer uptake in the heart, which is stronger than that in the ribs, require further investigation.

DOI： 10.3390/ijms24031921

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奇異性脳塞栓症を起こした卵円孔開存は心臓CTでどう見えるのか?

三木崇史, 中川晃志, 辻真弘, 中島充貴, 西原大裕, 中山理絵, 高谷陽一, 三好亨, 赤木禎治, 伊藤浩

日本成人先天性心疾患学会雑誌 12 ( 1 ) 158 - 158 2023.1

In vivo tracking transplanted cardiomyocytes derived from human induced pluripotent stem cells using nuclear medicine imaging. International journal

Yukihiro Saito, Naoko Nose, Toshihiro Iida, Kaoru Akazawa, Takayuki Kanno, Yuki Fujimoto, Takanori Sasaki, Masaru Akehi, Takahiro Higuchi, Satoshi Akagi, Masashi Yoshida, Toru Miyoshi, Hiroshi Ito, Kazufumi Nakamura

Frontiers in cardiovascular medicine 10 1261330 - 1261330 2023

Language：English Publishing type：Research paper (scientific journal) Publisher：Frontiers Media SA

INTRODUCTION: Transplantation of human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) is a promising treatment for heart failure. Information on long-term cell engraftment after transplantation is clinically important. However, clinically applicable evaluation methods have not yet been established. METHODS: In this study, to noninvasively assess transplanted cell engraftment, human SLC5A5, which encodes a sodium/iodide symporter (NIS) that transports radioactive tracers such as 125I, 18F-tetrafluoroborate (TFB), and 99mTc-pertechnetate (99mTcO4-), was transduced into human induced pluripotent stem cells (iPSCs), and nuclear medicine imaging was used to track engrafted human iPSC-CMs. RESULTS: To evaluate the pluripotency of NIS-expressing human iPSCs, they were subcutaneously transplanted into immunodeficient rats. Teratomas were detected by 99mTcO4- single photon emission computed tomography (SPECT/CT) imaging. NIS expression and the uptake ability of 125I were maintained in purified human iPSC-CMs. NIS-expressing human iPSC-CMs transplanted into immunodeficient rats could be detected over time using 99mTcO4- SPECT/CT imaging. Unexpectedly, NIS expression affected cell proliferation of human iPSCs and iPSC-derived cells. DISCUSSION: Such functionally designed iPSC-CMs have potential clinical applications as a noninvasive method of grafted cell evaluation, but further studies are needed to determine the effects of NIS transduction on cellular characteristics and functions.

DOI： 10.3389/fcvm.2023.1261330

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Premature atrial contraction immediately after catheter ablation was associated with late recurrence of atrial fibrillation. International journal

Tomoki Fujisawa, Hiroshi Kawakami, Takayuki Nagai, Shigehiro Miyazaki, Yusuke Akazawa, Toru Miyoshi, Akinori Higaki, Fumiyasu Seike, Haruhiko Higashi, Kazuhisa Nishimura, Katsuji Inoue, Shuntaro Ikeda, Osamu Yamaguchi

Pacing and clinical electrophysiology : PACE 46 ( 2 ) 152 - 160 2022.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Although premature atrial contractions (PACs) just after catheter ablation (CA) for atrial fibrillation (AF) are common, their clinical significance is uncertain. This study aimed to evaluate whether the PAC burden after an initial CA for AF was associated with late recurrence. METHODS: We enrolled 346 patients with AF (median age, 65 years; 30% female; 57% with paroxysmal AF) who underwent an initial radiofrequency CA and a 24-h Holter monitoring the day after the procedure. PAC was defined as supraventricular complexes occurring ≥30% earlier than expected compared with a previous RR interval, and the number of PAC/24 h during post-procedural Holter monitoring was analyzed. RESULTS: AF recurred in 106 patients (31%) during a median follow-up of 19 months. These patients had significantly more PAC/24 h than those without (median [interquartile range], 891 [316-4,351] beats vs. 409 [162-1,303] beats; P<0.01). The number of PACs was independently associated with AF recurrence after adjustment for clinical parameters and left atrial (LA) enlargement. Receiver operating characteristic curve analysis revealed that 1,431 PAC/24 h was the optimal cut-off value for predicting AF recurrence. ???Adding the PAC/24 h to the prediction model with LA diameter appeared to correctly reclassify patients who were thought to be at high risk for AF recurrence into the low-risk group and vice versa. CONCLUSIONS: The number of PACs was an independent risk factor for AF recurrence. A 24-h Holter recording the day after an initial CA is a simple and beneficial tool for the risk stratification of AF recurrence. This article is protected by copyright. All rights reserved.

DOI： 10.1111/pace.14648

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Prognostic value of pericoronary adipose tissue attenuation in patients with non-alcoholic fatty liver disease with suspected coronary artery disease.

Keishi Ichikawa, Toru Miyoshi, Mitsutaka Nakashima, Takahiro Nishihara, Kazuhiro Osawa, Takashi Miki, Hironobu Toda, Masatoki Yoshida, Hiroshi Ito

Heart and vessels 37 ( 12 ) 1977 - 1984 2022.12

Language：English Publishing type：Research paper (scientific journal)

Pericoronary adipose tissue (PCAT) attenuation on coronary computed tomography angiography (CTA) has been emerged as a marker of pericoronary inflammation. We aimed to investigate the prognostic value of PCAT attenuation in patients with non-alcoholic fatty liver disease (NAFLD). We enrolled 232 NAFLD patients with suspected coronary artery disease and underwent coronary CTA. NAFLD was defined by abdominal CT as the ratio of hepatic attenuation to spleen attenuation less than 1.0. PCAT attenuation values were assessed by the crude analysis of mean CT attenuation value of the left anterior descending artery (LAD) and right coronary artery (RCA). As coronary CTA findings, luminal stenosis and high-risk plaque features were examined. Primary outcome was the composite of cardiovascular (CV) death, nonfatal acute coronary syndrome, and hospitalization for heart failure. During a median follow-up of 4.9 years, 17 patients had CV events. LAD-PCAT attenuation in patients with CV events was higher than that without CV events (-66.9 ± 7.0 versus -70.5 ± 6.6; p = 0.032), while RCA-PCAT attenuation was not. LAD-PCAT attenuation and high-risk plaque features were independent predictors of CV events. The addition of LAD-PCAT attenuation to high-risk plaque features increased the C-statistics and global chi-square from 0.66 to 0.75 (p = 0.042) and 6.8 to 12.7 (p = 0.015), respectively. The net reclassification achieved by adding LAD-PCAT attenuation to high-risk plaque features was 0.494 (p = 0.041). High-LAD-PCAT attenuation was an independent predictor of CV events in NAFLD patients, regardless of CTA-verified high-risk plaque features. In addition, LAD-PCAT attenuation had an incremental prognostic value over high-risk plaque features.

DOI： 10.1007/s00380-022-02107-x

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Association between high oxidized high-density lipoprotein levels and increased pericoronary inflammation determined by coronary computed tomography angiography. International journal

Keishi Ichikawa, Toru Miyoshi, Kazuhiko Kotani, Kazuhiro Osawa, Mitsutaka Nakashima, Takahiro Nishihara, Hiroshi Ito

Journal of cardiology 80 ( 5 ) 410 - 415 2022.11

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Impaired high-density lipoprotein (HDL) function is a risk factor for cardiac mortality. We aimed to investigate the association between oxidized HDL (oxHDL) and pericoronary adipose tissue (PCAT) attenuation, a novel imaging biomarker of pericoronary inflammation, by using coronary computed tomography angiography (CTA). METHODS: A total of 287 outpatients with suspected coronary artery disease who had undergone both oxHDL measurement and coronary CTA were examined. PCAT attenuation values were assessed at the proximal 10-50 mm segments of the right coronary artery on coronary CTA. The presence of significant stenosis (luminal narrowing of >50 %) and high-risk plaque characteristics were also evaluated. Patients were then classified into tertiles according to their oxHDL level: low (n = 95), moderate (n = 96), and high (n = 96) groups. RESULTS: PCAT attenuation in the high oxHDL group was significantly higher than that in other groups after adjusting for age and apolipoprotein-A-I. Multivariate linear regression analysis revealed that oxHDL was significantly associated with PCAT attenuation in the right coronary artery (β = 3.832, p < 0.001), whereas HDL cholesterol was not. Furthermore, subgroup analyses demonstrated that the association between oxHDL and PCAT attenuation remained significant in older patients (β = 6.367, p < 0.001) and in those with hypertension (β = 4.922, p < 0.011), dyslipidemia (β = 3.264, p = 0.010), diabetes mellitus (β = 4.284, p = 0.015), and significant stenosis (β = 3.075, p = 0.021). CONCLUSIONS: High oxHDL levels were significantly associated with increased pericoronary inflammation, as assessed using coronary CTA. Our results may explain the association between impaired HDL function and the development of coronary atherosclerosis.

DOI： 10.1016/j.jjcc.2022.06.015

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