Faculty Profiles - MORITA Hiroshi

Papers - MORITA Hiroshi

Division display 181 - 200 of about 349 ／ All the affair displays >>

左室心外膜側にて著明なJ波とOut of QRS Potentialが記録されたBrugada症候群(J Wave Syndrome)の1例

田中正道, 永瀬聡, 中川晃志, 多田毅, 村上正人, 西井伸洋, 中村一文, 幡芳樹, 森田宏, 河野晋久, 草野研吾, 伊藤浩, 大江透

臨床心臓電気生理 34 205 - 215 2011.5

Language：Japanese Publisher：臨床心臓電気生理研究会

症例は39歳、男性。心室細動自然発作を認めるBrugada症候群との診断で当院入院。心電図ではV2でのsaddle back型ST上昇とI、II、aV1、V3-6でのJ波を認めた。心臓電気生理学的検査では、経冠静脈的に左室側壁心外膜側に多極カテーテルを挿入し電位の記録を行ったところ、単極誘導では明瞭なJ波が記録され、双極誘導ではJ波の成分に伴いout of QRS potentialが記録された。単極誘導でのJ波は心房ペーシング、およびisoproterenol投与で減高し、pilsicainide投与で増高した。また双極誘導でのout of QRS電位は心房ペーシングおよびisoproterenol投与で短縮しpilsicainide投与で延長した。再分極異常の性質を示す左室心外膜側J波がout of QRS potentialとしても記録され、J wave syndromeの成因を考えるうえで興味深い症例と考えられここに報告する。(著者抄録)

53歳女性Brugada症例のLate Potential(LP)と心拍変動との関連性、LPの日内変動性の検討ホルター心電図を用いて

寒川睦子, 豊永慎二, 間島圭一, 中津高明, 藤田政雄, 草地省蔵, 大江透, 西井伸洋, 永瀬聡, 森田宏, 中村一文, 草野研吾, 伊藤浩

心電図 31 ( Suppl.1 ) S - 20 2011.5

IMPACT OF INCREASED ARTERIAL STIFFNESS AND WAVE REFLECTION ON THE PREVALENCE OF PAROXYSMAL ATRIAL FIBRILLATION

Toru Miyoshi, Msayuki Doi, Satoshi Hirohata, Shozo Kusachi, Kazufumi Nakamura, Satoshi Nagase, Kunihisa Kono, Hiroshi Morita, Kengo Kusano, Hiroshi Ito

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 57 ( 14 ) E563 - E563 2011.4

Indication of implantable cardioverter defibrillator for myotonic dystrophy in patients with high degree atrio-ventricular block

Take Yutaka, Morita Hiroshi, Nishii Nobuhiro, Nagase Satoshi, Nakamura Kazuhumi, Kohno Kunihisa, Kusano Kengo, Ito Hiroshi

Shinzo 43 ( 2 ) S2_39 - S2_45 2011

Significance of Delayed Gadolinium Enhancement Cardiac Magnetic Resonance in Patients with Brugada Syndrome

Murakami Masato, Nagase Satoshi, Morita Hiroshi, Kusano Kengo, Suenaga Hidetaka, Ito Hiroshi, Saito Shigeru

J Arrhythmia 27 OP36_2 2011

Language：English Publisher：Japanese Heart Rhythm Society

Introduction: Gadlinium-enhanced Cardiac magnetic resonance (CMR) is a useful diagnostic tool for evaluating myocardial abnormality. However, the prevalence of delyed Gadlinium enhancement (DGE) in CMR has not been yet reported in patients with Brugada syndrome (BrS). Methods and Results: Seventy consecutive patients with BrS who underwent Gadlinium-enhanced CMR were evaluated in this study. DGE was found in five patients (7.1%). All patients with DGE were symptomatic. Early repolarization (ER) in inferolateral leads was significantly highly detected in patients with DGE than without DGE (80.0% vs 16.9%, P<0.01). Late potentials examined with SAECG were present in all patients with DGE and in 42 of 65 patients without DGE (64.6%). The value of RMS40 evaluated with SAECG was significantly smaller in patients with DGE than in patients without DGE (p<0.0001). In electrophysiologic study, VF was induced with programmed ventricular stimulation in four of five patients with DGE (80.0%) and in 21 of 41 patients without DGE (51.2%). Mutation analysis revealed that DGE was present in one patient with SCN5A mutation and in 2 patients without SCN5A mutation. Conclusions: Depolarization abnormality is prominent in BrS patients with DGE. CMR with DGE might be a useful tool for evaluating high risk patient with BrS.

DOI： 10.4020/jhrs.27.OP36_2

Circulating KCNH2 current-activating factor in patients with heart failure and ventricular tachyarrhythmia. International journal

Hiroki Sugiyama, Kazufumi Nakamura, Hiroshi Morita, Satoshi Akagi, Yoshinori Tani, Yusuke Katayama, Nobuhiro Nishii, Toru Miyoshi, Satoshi Nagase, Kunihisa Kohno, Kengo Fukushima Kusano, Tohru Ohe, Junko Kurokawa, Tetsushi Furukawa, Hiroshi Ito

PloS one 6 ( 5 ) e19897 2011

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

BACKGROUND: It is estimated that approximately half of the deaths in patients with HF are sudden and that the most likely causes of sudden death are lethal ventricular tachyarrhythmias such as ventricular tachycardia (VT) or fibrillation (VF). However, the precise mechanism of ventricular tachyarrhythmias remains unknown. The KCNH2 channel conducting the delayed rectifier K(+) current (I(Kr)) is recognized as the most susceptible channel in acquired long QT syndrome. Recent findings have revealed that not only suppression but also enhancement of I(Kr) increase vulnerability to major arrhythmic events, as seen in short QT syndrome. Therefore, we investigated the existence of a circulating KCNH2 current-modifying factor in patients with HF. METHODOLOGY/PRINCIPAL FINDINGS: We examined the effects of serum of HF patients on recombinant I(Kr) recorded from HEK 293 cells stably expressing KCNH2 by using the whole-cell patch-clamp technique. Study subjects were 14 patients with non-ischemic HF and 6 normal controls. Seven patients had a history of documented ventricular tachyarrhythmias (VT: 7 and VF: 1). Overnight treatment with 2% serum obtained from HF patients with ventricular arrhythmia resulted in a significant enhancement in the peaks of I(Kr) tail currents compared to the serum from normal controls and HF patients without ventricular arrhythmia. CONCLUSIONS/SIGNIFICANCE: Here we provide the first evidence for the presence of a circulating KCNH2 channel activator in patients with HF and ventricular tachyarrhythmias. This factor may be responsible for arhythmogenesis in patients with HF.

DOI： 10.1371/journal.pone.0019897

Pronounced Late Potential at Night Time, Bradycardia, and Pronounced Vagal Activity May Be a Risk Marker of Ventricular Fibrillation in Brugada Syndrome

Mutsuko Sangawa, Hiroshi Morita, Nobuhiro Nishii, Sastoshi Nagase, Kazufumi Nakamura, Kengo Kusano, Hiroshi Ito

journal of arrhythmia 27 ( 4 ) 280 2011

Publishing type：Research paper (scientific journal)

Backgrond: Ventricular Late Potential(LPs) detected signal averaged ECGs have been used widely to detect high risk patients. In Brugada syndrome(BrS), Ventricular fibrillation(VF) frequently occurs at nighttime and pronounced vagal activity. Purpose: We examine relationship between LPs and Heart rate, Vagal activity, and circadian variation of LPs in BrS. Methods: We evaluated 24hours HolterECGs of total 14 BrS and 10 normal controls. We evaluated LPs (fQRS,LAS40,RMS40), RR interval and High frequency (HF:0.15-0.4Hz) of frequency domaine analysis. We examined relationship between LPs and RRinterval, LnHF. Results: Relationship between LAS40 and RRinterval, relationship between LAS40 and LnHF were obtained as a liner regression line and significant positive correlation inBrS. LAS40/RRslope was significantly sharpened in BrSwithVF than BrSwithout VF, Controls (24 ±11 vs 3±13 vs -4±20, p<0.01, BrSwithVF vs BrSwithoutVF vs Controls). LAS40 at bradycardia was significantly pronounced in BrS withVF than BrS withoutVF, Controls (48±3 vs 32±12 vs 22±11, p<0.01, BrS withVF vs BrS withoutVF vs Controls). LAS40/LnHFslope were significantly sharpened than Controls.(3.0±3.2 vs -0.4±3.0, p<0.05, BrS vs Controls). Conclusion: In BrS, LPs were pronounced at bradycardia and night time and at pronounced vagal acitivity. Pronounced LPs at bradycardia and nighttime, at pronounced vagalacitivity may be a risk marker of VF inBrS. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.OP36_4

J Waves in Patients with Vasospastic Angina

Koji Nakagawa, Satoshi Nagase, Masamichi Tanaka, Nobuhiro Nishii, Hiroshi Morita, Kunihisa Kohno, Kengo Kusano, Tohru Ohe, Hiroshi Ito

journal of arrhythmia 27 191 2011

Publishing type：Research paper (scientific journal)

Objectives: The purpose of this study was to determine whether J wave is a marker of arrhythmic risk in patients with vasospastic angina (VSA). Background: Both VSA and the presence of J waves in ECG are associated with fatal ventricular arrhythmias and sudden death. However, the prevalence of J waves among VSA patients is little known. Methods: We reviewed 66 patients with VSA in our hospital retrospectively and assessed the association between the presence of J wave and clinical backgrounds among them. J wave was defined as an elevation of the QRS-ST junction of > 0.1mV from baseline. Results: Spontaneous VF and syncope occurred in 9 (13.6%) and 14 (21.2%) of all patients, respectively. J waves were observed in 33 patients (50%) and were significantly more prevalent in males than females (60.4% vs. 16.7%, Pμ0.01). Arrhythmic symptoms (ventricular arrhythmias or syncope) were observed frequently in patients with J waves, compared to without J wave (48.4% vs. 23.8%, Pμ0.05). Both of the locations and height of J waves were not associated with the history of arrhythmic symptoms. Conclusions: J waves are observed frequently among male patients with VSA. The presence of J waves potentially influence the development of lethal ventricular arrhythmias associated with VSA. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.OP03_4

Impact of Infero/Lateral Early Repolarization Pattern in Patients with Brugada Syndrome

Koji Tokioka, Kengo Kusano, Hiroshi Morita, Satoshi Nagase, Kunihisa Kohno, Kazufumi Nakamura, Nobuhiro Nishii, Daiji Miura, Hiroshi Ito, Tohru Ohe

journal of arrhythmia 27 ( 4 ) 286 2011

Publishing type：Research paper (scientific journal)

Background: Inferolateral early repolarization (ER) pattern is often observed in Brugada syndrome (BrS). However, its clinical implication in this syndrome is still controversial. Method: Total two-hundred forty five Brugada ECG patients (mean age 48 years, men/female=235/10), including documented ventricular fibrillation (VF) in 27, were evaluated. Infero/lateral ER pattern was defined as a notched or slurring>1mm J-wave at least consecutive two of inferior (II, III, aVF) or lateral (I, aVL, V4, V5, V6) leads. The presence of this ER pattern was compared with clinical, electrocardiographic and genetic parameters. Results: Infero/lateral ER pattern was observed in 25 (10.2%) BrS patients (inferior leads in 12, lateral leads in 11 and both in 2) and was significantly associated with patients of documented VF (P<0.01) and with prolonged PQ interval (P<0.04). However they were not associated with the frequency of spontaneous type-1 ECG, wide QRS complex (>120ms), family history of sudden death, positive late potential on signal averaged ECG and SCN5A mutation. Increased number of positive ER leads have a trend of increasing documented VF patients (>3 leads; 54%). Conclusion: These data indicates that infero/lateral ER reflects the expansion of repolarization abnormality in the ventricle and may be associated with high-risk phenotype in BrS. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.CP1_07

PJ3-053 New Onset of Ventricular Fibrillation Episodes in Asymptomatic Patients with Brugada Syndrome -Are Patients with Class IIb Safe?-

Morita Hiroshi, Satoshi Nagase, Norihisa Toh, Nobuhiro Nishii, Kazufumi Nakamura, Kengo Kusano, Tohru Ohe, Hiroshi Ito

Journal of Arrhythmia 27 2011

Publishing type：Research paper (scientific journal)

Introduction: Japanese guideline of the Brugada syndrome (BS) defined the indication of the implantable cardioverter defibrillater (ICD) in asymptomatic patients with BS as patients having both family history of sudden death (FH) and induced ventricular fibrillation (VF) by programmed electrical stimulation (PES) (class IIa). When patients had one of these criteria, ICD indication considered as class IIb. We analyzed new onset of VF episodes in asymptomatic patients. Methods and Results: We analyzed 99 asymptomatic patients with Brugada type ECG. Fourty-seven patients had FH. VF was induced by PES in 44 patients. Criteria of ICD indication of class IIa, IIb, and III were met in 20, 50, and 29 patients, respectively. Three patients experienced new-onset VF episode during follow-up periods (84±43 months). Although there was no new-onset VF in patients with class IIa, all patients who experienced VF episodes belonged to class IIb (6%). All patients with new-VF had spontaneous type 1 ECG, induced VF by PES, positive late potential and fragmented QRS, but did not have FH and SCN5A mutation. Conclusion: Prediction of prognosis in patients with BS-ECG based on BS-guideline has limited value and occurrence of VF is not rare in patients with class IIb of ICD indication. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.PJ3_053

J Wave in Brugada Syndrome

Wataru Shimizu, Hiro Kawata, Shiro Kamakura, Hiroshi Morita

journal of arrhythmia 27 ( 4 ) 250 2011

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

J wave in inforo/ateral leads is more frequently recognized in patients (pts) with idiopahtic ventricular fibrillation (IVF) than in control subjects, and a new concept of early repolarization syndrome or J wave syndrome has been proposed. Brugada syndrome is characterized by ST-segment elevation in the right precordial leads. In our cohort of 49 Brugada pts with documented VF (46 males, 46±13years), J wave was recorded persistently in 15 pts (30.6%, P-group), intermittently in 16 pts (32.6%, I-group), and never recorded in 18 pts (36.7%, N-group). During follow-up period (7.7 ±3.8 years), VF recurred in all 15 pts with P-group (100%), and less in 12 pts with I-group (75%, p=0.11, log rank test) and in 8 pts with N-group (44%, p=0.0001, log rank test). These data suggest higher prevalence of J wave (31/49, 63.2%) in Brugada synforme with documented VF and a significant association between J wave and VF in Brugada syndrome. J wave amplitude in the infero/lateral leads was attenuated with sodium channel blocker in most Brugada pts, whereas ST-segment elevation was augmeted or coved type (type 1) ECG was unmasked in the right precordial leads, indicating the differential mechanism between the ST-segment elevation in the right precordial leads and J wave in the infero/lateral leads in Brugada syndrome. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.STL_4

Identification of High-Risk Syncope Related to Ventricular Fibrillation in Patients with Brugada Syndrome

Yutaka Take, Hiroshi Morita, Satoshi Nagase, Nobuhiro Nishii, Kazuhumi Nakamura, Kengo Kusano, Tohru Ohe, Hiroshi Itoh

journal of arrhythmia 27 ( 4 ) 209 2011

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

Background:Syncope in patients with Brugada syndrome (BS) is usually associated with ventricular tachyarrhythmia. However, some episodes of syncope could be related to autonomic disorders. We investigated the characteristics of syncope to differentiate high-risk syncope episodes from low-risk events. Methods and Results: Eighty patients with type 1 ECG and syncope were divided into two groups: patients with prdoromes (Prodromal group, N=40) and without prodromes (Non-prodromal group, N=40). Ventricular fibrillation (VF) was documented at initial episodes in 17 patients. Only 3 patients experienced prodromes before the onset of VF and 14 patients did not have prodromes (P=0.0023). Twenty-seven patients in the Prodromal group and 6 patients in the Non-prodromal group were considered to have syncope related to autonomic dysfunction. Recurrent syncope due to VF was more frequent in the Non-prodromal group (N=9) than in the Prodromal group (N=2
P=0.023) during the follow-up period (50±48months). Multivariate logistic regression analysis indicated that blurred vision (Hazard ratio 0.092) and existence of f-QRS (Hazard ratio 2.99) were independently associated with the occurrence of VF. Conclusion: Syncope without prodromes, especially blurred vision, and existence of fragmented QRS are high-risk signs for occurrence of VF in patients with BS. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.OP18_2

Intrathoracic Impedance Is Negatively Correlated with BNP Value in Patients with Implantable Cardioverter Defibrillator: MOMOTARO Study

Atsuyuki Watanabe, Nobuhiro Nishii, Yoji Okamoto, Satoki Fujii, Tadashi Wada, Motoki Kubo, Hiroshi Morita, Kengo Fukushima, Hiroshi Ito

journal of arrhythmia 27 ( 4 ) 299 2011

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

Introduction: Heart failure is one of the most common causes for hospitalizations. OptiVol alert, which was fluid status algorism calculated from intrathoracic impedance, may detect impending fluid accumulation. Then, we tried to examine the relationship of OptiVol alert or intrathoracic impedance with various parameters. Methods: The patients who were implanted high energy device with OptiVol feature were included in this study. The patients were evaluated various examinations at enrolment and following an OptiVol alert. We examined how various parameters were different between baseline and OptiVol alert. and the relationships among the factors included in OptiVol alert and intrathoracic impedance were evaluated by factor analysis. Results: From April in 2010, 191 patients were eligible for the present study. In all patients, there was no significant difference in all parameters between OptiVol alert and baseline. However, in the patients with ejection fraction less than 35%, BNP value was likely to increase in OptiVol alert compared with that in baseline, but not significantly. In factor analysis, there was no parameter correlated with OptiVol alert. However, intrathoracic impedance was negatively correlated with BNP value. Conclusions: Intrathoracic impedance, but OptiVol alert, seems to represent fluid retention. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.PJ2_053

Electroanatomical correlation of repolarization abnormalities in Brugada syndrome: detection of type 1 electrocardiogram in the right ventricular outflow tract. International journal

Satoshi Nagase, Shigeki Hiramatsu, Hiroshi Morita, Nobuhiro Nishii, Masato Murakami, Kazufumi Nakamura, Kengo F Kusano, Hiroshi Ito, Tohru Ohe

Journal of the American College of Cardiology 56 ( 25 ) 2143 - 5 2010.12

Fragmented QRS is associated with torsades de pointes in patients with acquired long QT syndrome. International journal

Kayo Haraoka, Hiroshi Morita, Yukihiro Saito, Norihisa Toh, Toru Miyoshi, Nobuhiro Nishii, Satoshi Nagase, Kazufumi Nakamura, Kunihisa Kohno, Kengo F Kusano, Kenji Kawaguchi, Tohru Ohe, Hiroshi Ito

Heart rhythm 7 ( 12 ) 1808 - 14 2010.12

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

BACKGROUND: Acquired long QT syndrome (LQTS) is a disease due to a secondary repolarization abnormality induced by various predisposing factors. In contrast to congenital LQTS, risk factors that produce acquired LQTS include organic heart diseases that often exhibit depolarization abnormality. Although various repolarization parameters have been evaluated in acquired LQTS, the existence of depolarization abnormality in association with torsades de pointes (TdP) has not been reported. OBJECTIVE: The purpose of this study was to evaluate both repolarization (QT components) and depolarization parameters (fragmented QRS [fQRS]) in acquired LQTS patients with markedly prolonged QT interval. METHODS: Seventy patients with acquired severe QT prolongation (QTc ≥ 550 ms) were studied. Thirty-two patients had syncope or TdP (syncope group). Thirty-eight patients did not have any symptoms (asymptomatic group). The existence of fQRS and QT components (QT, QTc, Tpe [interval between peak and end of T wave] intervals, and U-wave voltage) was analyzed. RESULTS: The syncope group had more frequent fQRS (81%) than did the asymptomatic group (21%, P < .01) and the incidence of fQRS was not different before and after removal of predisposing factors. The incidence of organic heart disease was not different between the two groups. No differences in QTc interval were noted between the syncope and asymptomatic groups, although the syncope group had longer QT and Tpe intervals and higher U wave than the asymptomatic group (P < .01). CONCLUSION: Acquired predisposing factors promoted repolarization abnormality (especially prolongation of QT and Tpe intervals), and the existence of fQRS had an important role in the development of TdP in patients with acquired LQTS.

DOI： 10.1016/j.hrthm.2010.09.008

Anti-tachycardia pacing degenerated fast ventricular tachycardia into undetectable life-threatening tachyarrhythmia in a patient with non-ischemic dilated cardiomyopathy.

Kei Yunoki, Nobuhiro Nishii, Hiroshi Morita, Jun Iwasaki, Satoshi Nagase, Kazufumi Nakamura, Yoshiki Hata, Kunihisa Kohno, Kengo F Kusano, Hiroshi Ito

Journal of cardiology cases 2 ( 3 ) e159-e162 2010.12

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

A 45-year-old man with dilated cardiomyopathy was admitted to our hospital due to congestive heart failure (CHF). Despite the optimal medical treatment, his condition had not improved because of severe left ventricular dysfunction. Because he experienced non-sustained ventricular tachycardia (VT), a biventricular implantable cardioverter-defibrillator (Bi-V ICD) was implanted for reduction of dyssynchrony and primary prevention of lethal tachyarrhythmia. After discharge, he developed CHF and was transported to our hospital by ambulance. In the ambulance, monomorphic sustained VT with 200 bpm suddenly occurred. The ICD detected it as fast VT and anti-tachycardia pacing (ATP) was delivered. After the ATP therapy, RR intervals of VT became irregular and prolonged. Ventricular fibrillation-like electrical activity was recorded by a far-field electrogram from the defibrillator, but the tachycardia cycle length exceeded 400 ms which is under the tachycardia detection rate. The device failed to deliver a shock and the patient had to be rescued with an external shock. This is a rare case of fast VT that degenerated into undetectable life-threatening tachyarrhythmia by ATP.

DOI： 10.1016/j.jccase.2010.06.003

SCN5A mutation is associated with early and frequent recurrence of ventricular fibrillation in patients with Brugada syndrome.

Nobuhiro Nishii, Masahiro Ogawa, Hiroshi Morita, Kazufumi Nakamura, Kimikazu Banba, Daiji Miura, Naoko Kumagai, Akira Matsunaga, Hiroshi Kawamura, Shigemi Urakawa, Kohei Miyaji, Masahiro Nagai, Katsumasa Satoh, Koji Nakagawa, Masamichi Tanaka, Shigeki Hiramatsu, Takeshi Tada, Masato Murakami, Satoshi Nagase, Kunihisa Kohno, Kengo Fukushima Kusano, Keijiro Saku, Tohru Ohe, Hiroshi Ito

Circulation journal : official journal of the Japanese Circulation Society 74 ( 12 ) 2572 - 8 2010.11

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

BACKGROUND: Mutations in SCN5A are reportedly linked to Brugada syndrome (BS), but recent observations suggest that they are not necessarily associated with ventricular fibrillation (VF) in BS patients. Therefore, the clinical importance of SCN5A mutations in BS patients was examined in the present study. METHODS AND RESULTS: The 108 BS patients were examined for SCN5A mutations and various parameters were compared between patients with and without mutations. An implantable cardioverter defibrillator (ICD) was implanted in 49 patients and a predictor of appropriate ICD shock was investigated. The existence of a SCN5A mutation was not associated with initial VF episodes (21.7% vs 20.0%, P=0.373). In the secondary prevention group, appropriate shock-free survival rate was significantly lower in patients with spontaneous type 1 ECG than in those without (41.1% vs 85.7% at 2 years, P=0.014). The appropriate shock-free survival rate was also significantly lower in patients with SCN5A mutations than in those without (28.6% vs 83.3% at 1 year, P=0.040). Appropriate shock was more frequent in patients with SCN5A mutations than in those without (6.6±6.2 vs 1.7±3.0, P=0.007). CONCLUSIONS: SCN5A mutations are associated with early and frequent VF recurrence, but not with initial VF episodes. This is the first report on the genotype-phenotype interaction and clinical significance of this mutation.

Imatinib in the Presence of Platelet-derived Growth Factor Inhibits Proliferation and Induces Apoptosis in Pulmonary Artery Smooth Muscle Cells from Patients with Idiopathic Pulmonary Arterial Hypertension Reviewed

Kazufumi Nakamura, Satoshi Akagi, Hiromi Matsubara, Aiko Ogawa, Aya Miura, Daiji Miura, Nobuhiro Nishii, Satoshi Nagase, Kunihisa Kohno, Hiroshi Morita, Kengo F. Kusano, Hiroshi Ito

CIRCULATION 122 ( 21 ) 2010.11

The pathophysiological mechanism underlying Brugada syndrome: depolarization versus repolarization. International journal

Arthur A M Wilde, Pieter G Postema, José M Di Diego, Sami Viskin, Hiroshi Morita, Jeffrey M Fish, Charles Antzelevitch

Journal of molecular and cellular cardiology 49 ( 4 ) 543 - 53 2010.10

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

This Point/Counterpoint presents a scholarly debate of the mechanisms underlying the electrocardiographic and arrhythmic manifestations of Brugada syndrome (BrS), exploring in detail the available evidence in support of the repolarization vs. depolarization hypothesis.

DOI： 10.1016/j.yjmcc.2010.07.012

Efficacy of low-dose bepridil for prevention of ventricular fibrillation in patients with Brugada syndrome with and without SCN5A mutation. International journal

Masato Murakami, Kazufumi Nakamura, Kengo F Kusano, Hiroshi Morita, Koji Nakagawa, Masamichi Tanaka, Takeshi Tada, Norihisa Toh, Nobuhiro Nishii, Satoshi Nagase, Yoshiki Hata, Kunihisa Kohno, Daiji Miura, Tohru Ohe, Hiroshi Ito

Journal of cardiovascular pharmacology 56 ( 4 ) 389 - 95 2010.10

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

It has been reported that bepridil prevents ventricular fibrillation (VF) in patients with Brugada syndrome, but the comparative efficacy with and without mutation in the SCN5A gene has not been elucidated. The purpose of this study was to assess the efficacy of low-dose bepridil (100 mg/day) for VF prevention in patients with Brugada syndrome with and without SCN5A mutation. Among 130 patients with Brugada-type electrocardiogram (ECG), low-dose bepridil was administered to seven patients because of repetitive VF episodes, including three with and four without SCN5A mutation. Preventive effect for VF recurrence and changes of the ECG and the signal-averaged ECG were evaluated. Frequencies of VF episodes were reduced after treatment with low-dose bepridil in all three patients with the SCN5A mutation (before: 0.33 versus after: 0.02 episodes/month, P < 0.01), but not in all four patients without the SCN5A mutation (before: 0.43 versus after: 2.94 episodes/month, P = nonsignificant). Levels of ST-segment elevation at J points and duration of low-amplitude signals less than 40 µV in the terminal filtered QRS complex (LAS40) in signal-averaged ECG were improved exclusively in patients with the SCN5A mutation. Treatment with bepridil prevented recurrence of VF along with improvement of ST elevation and LAS40 in patients with Brugada syndrome with the SCN5A mutation.

DOI： 10.1097/FJC.0b013e3181f03c2f

　 PREV - NEXT 　

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18