Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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Under-developed bronchial arteries as a risk factor for complications in balloon pulmonary angioplasty

Takei, Makoto, Kataoka, Masaharu, Kawakami, Takashi, Yamada, Yoshitake, Yamada, Minoru, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY 203 1016 - 1017 2016.01

Research paper (scientific journal), ISSN 0167-5273

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Under-developed bronchial arteries as a risk factor for complications in balloon pulmonary angioplasty

Takei, Makoto, Kataoka, Masaharu, Kawakami, Takashi, Yamada, Yoshitake, Yamada, Minoru, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY 203 1016 - 1017 2016.01

Research paper (scientific journal), ISSN 0167-5273

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Single-energy metal artifact reduction in postimplant computed tomography for I-125 prostate brachytherapy: Impact on seed identification

Shiraishi, Yutaka, Yamada, Yoshitake, Tanaka, Tomoki, Eriguchi, Takahisa, Nishimura, Shuichi, Yoshida, Kayo, Hanada, Takashi, Ohashi, Toshio, Shigematsu, Naoyuki, Jinzaki, Masahiro

BRACHYTHERAPY (Brachytherapy) 15 ( 6 ) 768 - 773 2016.01

Research paper (scientific journal), Accepted, ISSN 1538-4721

© 2016 American Brachytherapy Society Purpose To evaluate the effectiveness of the single-energy metal artifact reduction (SEMAR) technique for improving the accuracy of I-125 seed identification in postimplant computed tomography (CT) after prostate brachytherapy. Methods and Materials Postimplant CT images of 40 patients treated with I-125 prostate brachytherapy were acquired. For all patients, 2 data sets were reconstructed, 1 with SEMAR algorithms (SEMAR image), and the other without SEMAR algorithms (non-SEMAR image). Seed locations are automatically detected by the automatic seed finder tool, and their locations were compared between the SEMAR and non-SEMAR images. Dosimetric parameters using seed locations as detected were compared. Results The true-positive fraction of properly detected seeds on the SEMAR image as determined from a reference seed distribution defined by one investigator was significantly higher than the true-positive fraction on the non-SEMAR image (p = 0.011). The variabilities in D90 (p = 0.001), V100 (p = 0.007), and V150 (p = 0.007) were significantly reduced for seed location on the SEMAR image as compared with non-SEMAR image. Conclusions Prostate postimplant CT with SEMAR improved the accuracy of seed localization and postimplant dosimetric parameters.

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Significant reduction of left atrial volume concomitant with clinical improvement after percutaneous transluminal septal myocardial ablation for drug-refractory hypertrophic obstructive cardiomyopathy, and its precise detection with multidetector CT.

Yuichiro Maekawa, Keitaro Akita, Hikaru Tsuruta, Yoshitake Yamada, Kentaro Hayashida, Shinsuke Yuasa, Mitsushige Murata, Masahiro Jinzaki, Keiichi Fukuda

Open heart (Open Heart) 3 ( 1 ) e000359 2016

Accepted, ISSN 2053-3624

OBJECTIVE: In patients with hypertrophic obstructive cardiomyopathy (HOCM), left atrial (LA) volume measurement is very important to provide prognostic information. Recent studies demonstrated that multidetector CT (MDCT) is useful to assess the changes in LA volume. Our aim was to examine the utility of a follow-up cardiac MDCT for long-term evaluation of the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on LA volume. METHODS: We studied a consecutive cohort of 20 patients with drug-refractory symptomatic HOCM after PTSMA. We evaluated LA volume analyses with cardiac MDCT on patients who underwent PTSMA as compared to echocardiography. RESULTS: Before PTSMA, 75% of all patients had heart failure-associated symptoms in the New York Heart Association functional class III/IV. All patients experienced relief from heart failure-associated symptoms after PTSMA. Cardiac MDCT showed significant reduction in the index of maximum LA volume during follow-up compared to before PTSMA in the same way as in echocardiography (93.6±34.1 mL/m(2) vs 82.6±35.3 mL/m(2), p=0.035). A Bland-Altman plot showed small mean differences and limits of agreement in the measurements of the index of maximum LA volume before and after PTSMA between echocardiography and MDCT. CONCLUSIONS: The follow-up cardiac MDCT was a useful tool to evaluate the effectiveness of PTSMA on reduction of LA volume. Cardiac MDCT might provide comparable measurements of the LA volume in patients with drug-refractory symptomatic HOCM before and after PTSMA compared to echocardiography.

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Radiation-dose-lowering effects of landiolol hydrochloride in coronary angiography using computed tomography (DELIGHT)

Kido Teruhito, Mochizuki Teruhito, Hirano Masaharu, Yamada Yoshitake, Tanaka Ryoichi, Kanzaki Suzu, Higashi Masahiro, Jinzaki Masahiro, Yoshioka Kunihiro, Kuribayashi Sachio

Circulation Journal (Circulation Journal) 80 ( 5 ) 1225 - 1231 2016

ISSN 1346-9843

<p>Background: Controlling and decreasing the heart rate (HR) of patients during coronary computed tomography angiography (CCTA) is necessary to reduce radiation exposure and improve image quality. This prospective multicenter study aimed to investigate whether HR control with landiolol hydrochloride is useful for reducing radiation exposure during CCTA. Methods and Results: We investigated 219 patients with suspected ischemic heart disease whose pretest HRs were 50–80 beats/min. We measured the HR before and after administration of landiolol hydrochloride and compared the estimated exposure inferred from the HR before administration of landiolol hydrochloride with the actual dose. After administration of landiolol hydrochloride, the mean HR (59.9 ± 6.4 beats/min) at the time of CCTA was significantly lower than before administration (69.3 ± 7.3 beats/min; P</p>

Advance in cardiac CT

Yamada Yoshitake, Matsumoto Shunsuke, Suzuki Tatsuya, Hashimoto Masahiro, Okamura Teppei, Sugiura Hiroaki, Jinzaki Masahiro, Yamada Minoru

Respiration and Circulation 63 ( 12 ) 1199 - 1207 2015.12

ISSN 0452-3458

Impact of CT-guided balloon pulmonary angioplasty with identification of pulmonary arterial structures distal to target lesions

Kawakami Takashi, Kataoka Masaharu, Yamada Yoshitake, Takei Makoto, Yamada Minoru, Jinzaki Masahiro, Fukuda Keiichi

EuroIntervention (EuroPCR) 11 ( 7 ) e1 - e2 2015.11

Accepted, ISSN 1774-024X

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"Protruding Myocardium" as a Target for Percutaneous Transluminal Septal Myocardial Ablation in a Case of Hypertrophic Obstructive Cardiomyopathy

Maekawa, Yuichiro, Akita, Keitaro, Tsuruta, Hikaru, Yashima, Fumiaki, Kimura, Mai, Yamada, Yoshitake, Kawakami, Takashi, Kanazawa, Hideaki, Hayashida, Kentaro, Yuasa, Shinsuke, Murata, Mitsushige, Jinzaki, Masahiro, Fukuda, Keiichi

JACC-CARDIOVASCULAR INTERVENTIONS 8 ( 12 ) E201 - E202 2015.10

Research paper (scientific journal), ISSN 1936-8798

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Lateral cervical sinus: specific sonographic findings in two pediatric cases

Hosokawa, Takahiro, Yamada, Yoshitake, Sato, Yumiko, Tanami, Yutaka, Amano, Hizuru, Fujiogi, Michimasa, Kawashima, Hiroshi, Oguma, Eiji

JOURNAL OF MEDICAL ULTRASONICS (Journal of Medical Ultrasonics) 42 ( 4 ) 595 - 599 2015.10

Research paper (scientific journal), Accepted, ISSN 1346-4523

© 2015, The Japan Society of Ultrasonics in Medicine. A lateral cervical sinus, also known as a second pharyngeal or branchial cleft fistula/sinus, occurs when the second pharyngeal arch fails to grow caudally over the third and fourth arches, leaving remnants of the second branchial clefts in contact with the surface of the neck via a narrow canal. This type of sinus is detected on the lateral aspect of the neck directly anterior to the sternocleidomastoid muscle. We report two pediatric cases with lateral cervical sinus, and pathognomonic sonographic findings to confirm the diagnosis. The first case involved a 3-month-old boy with a sinus on the lateral neck and occasional drainage from a cervical sinus opening. Sonography revealed that the sinus tract extended between the external and internal carotid arteries. In case two, a 1-month-old girl presented with a sinus on the lateral neck and signs of acute infection at the site of a pinpoint opening. Sonography revealed an oval-shaped cystic lesion and sinus tract extending between the external and internal carotid arteries. Sonography does not require radiation or sedation for children. The best choice for the first examination for lateral cervical sinus is sonography, rather than CT, MRI, or contrast fistulograms.

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Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

Hosokawa, Takahiro, Yamada, Yoshitake, Sato, Yumiko, Tanami, Yutaka, Amano, Hizuru, Fujiogi, Michimasa, Kawashima, Hiroshi, Oguma, Eiji

JOURNAL OF MEDICAL ULTRASONICS (Journal of Medical Ultrasonics) 42 ( 4 ) 579 - 585 2015.10

Research paper (scientific journal), Accepted, ISSN 1346-4523

© 2015, The Japan Society of Ultrasonics in Medicine. Pyriform sinus fistulas are an unusual cause of neck cystic lesions in neonates. A definitive diagnosis requires detection of the fistula, which originates from the pyriform sinus and extends to the cystic lesion. Sonography has been reported to be useful for detecting fistulas. However, there have been no reports of neonatal cases in which sonography could detect fistulas not detected by other modalities, such as barium esophagography, computed tomography (CT), or magnetic resonance imaging (MRI). We describe five neonatal patients with pyriform sinus fistula-appearing cervical cystic lesions. All patients were examined by sonography; of these, three patients were also examined by barium esophagography, two by CT, and one by MRI. The fistula was detected by sonography but not CT in one patient and by barium esophagography but not MRI in one. Two patients whose fistulas were detected by sonography had an oval-shaped and relatively small cystic lesion. One patient whose fistula could be detected only by barium esophagography had a relatively large cystic lesion. In two patients, whose fistulas were not detected by sonography or barium esophagography, sonography revealed air bubbles within the cystic lesions, and a pyriform sinus fistula was suspected. Without requiring ionizing radiation, sonography was thus useful in diagnosing pyriform sinus fistula-appearing cervical cystic lesions in neonatal cases. On the other hand, in two patients whose fistulas were not detected by sonography, the shape of the cystic lesion was polygonal or multicystic. In two of three patients with infectious signs, a fistula could not be detected. The shape and size of the cystic lesion and the presence of infectious signs may be important factors for detecting fistulas.

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Potential association between thoracic empyema and collateral bronchial arteries in chronic thromboembolic pulmonary hypertension

Takei Makoto, Kataoka Masaharu, Kawakami Takashi, Yamada Yoshitake, Yamada Minoru, Fukuda Keiichi

Annals of the American Thoracic Society (American Thoracic Society) 12 ( 9 ) 1417 - 1419 2015.09

Accepted, ISSN 2325-6621

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Three-dimensional cardiac cine imaging using the kat ARC acceleration: Initial experience in clinical adult patients at 3 T

Okuda, Shigeo, Yamada, Yoshitake, Tanimoto, Akihiro, Fujita, Jun, Sano, Motoaki, Fukuda, Keiichi, Kuribayashi, Sachio, Jinzaki, Masahiro, Nozaki, Atsushi, Lai, Peng

MAGNETIC RESONANCE IMAGING (Magnetic Resonance Imaging) 33 ( 7 ) 911 - 917 2015.09

Research paper (scientific journal), Joint Work, Accepted, ISSN 0730-725X

© 2015 Elsevier Inc. Objective: Three-dimensional cardiac cine imaging has demonstrated promising clinical 1.5-Tesla results; however, its application to 3. T scanners has been limited because of the higher sensitivity to off-resonance artifacts. The aim of this study was to apply 3D cardiac cine imaging during a single breath hold in clinical patients on a 3. T scanner using the kat ARC (k- and adaptive-t auto-calibrating reconstruction for Cartesian sampling) technique and to evaluate the interchangeability between 2D and 3D cine imaging for cardiac functional analysis and detection of abnormalities in regional wall motion. Methods: Following institutional review board approval, we obtained 2D cine images with an acceleration factor of two during multiple breath holds and 3D cine images with a net scan acceleration factor of 7.7 during a single breath hold in 20 patients using a 3. T unit. Two readers independently evaluated the wall motion of the left ventricle (LV) using a 5-point scale, and the consistency in the detection of regional wall motion abnormality between 2D and 3D cine was analyzed by Cohen's kappa test. The LV volume was calculated at end-diastole and end-systole (LVEDV, LVESV); the ejection fraction (LVEF) and myocardial weight (LVmass) were also calculated. The relationship between functional parameters calculated for 2D and 3D cine images was analyzed using Pearson's correlation analysis. The bias and 95% limit of agreement (LA) were calculated using Bland-Altman plots. In addition, a qualitative evaluation of image quality was performed with regard to the myocardium-blood contrast, noise level and boundary definition. Results: Despite slight degradation in image quality for 3D cine, excellent agreement was obtained for the detection of wall motion abnormalities between 2D and 3D cine images (κ. = 0.84 and 0.94 for each reader). Excellent correlations between the two imaging methods were shown for the evaluation of functional parameters (r. >. 0.97). Slight differences in LVEDV, LVESV, LVEF and LVmass were observed, with average values of 1.6. ±. 8.9. mL, - 0.6. ±. 5.9. mL, 1.4. ±. 3.6%, and 1.3. ±. 8.7. g, respectively. Conclusions: Images obtained using the kat ARC 3D and conventional 2D cine techniques were equivalent in the detection of regional wall motion abnormalities and the evaluation of cardiac functional parameters.

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Usefulness of 3D SPECT/CT fusion image in CTEPH

Kawakami, Takashi, Kataoka, Masaharu, Nakahara, Tadaki, Yamada, Yoshitake, Takei, Makoto, Jinzaki, Masahiro, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY (International Journal of Cardiology) 194 39 - 40 2015.09

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

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縦隔に隣接し高度な石灰化を示した若年女性の肺腫瘤の1例

堤啓, 松本俊亮, 成松英俊, 浅田久美子, 山田祥岳, 杉浦弘明, 林雄一郎, 松田信作, 陣崎雅弘

日本医学放射線学会秋季臨床大会抄録集 ((公社)日本医学放射線学会) 51回 S537 - S537 2015.09

ISSN 0048-0428

Retroperitoneal low-flow vascular malformations: characteristic MRI findings correlated with histopathological findings

Akita, Hirotaka, Yamada, Yoshitake, Ito, Yoshiaki, Mikami, Shuji, Sugiura, Hiroaki, Okuda, Shigeo, Jinzaki, Masahiro

ABDOMINAL IMAGING (Abdominal Imaging) 40 ( 6 ) 1713 - 1720 2015.08

Research paper (scientific journal), Accepted, ISSN 0942-8925

© 2014, Springer Science+Business Media New York. Purpose: To evaluate the MRI findings of retroperitoneal low-flow vascular malformations (RLVMs) correlated with histopathological findings. Methods: Two radiologists reviewed the MRI findings of 4 RLVMs (3 with capillary malformations and 1 with a venous malformation). First, they evaluated the visibility, signal intensities, and signal homogeneity of each lesion on non-fat-suppressed breath-hold T2-weighted single-shot fast spin-echo (non-FS SSFSE) images and fat-suppressed T2-weighted fast spin-echo (FS T2-weighted FSE) images. Second, the kinetic patterns and the internal enhancement patterns were analyzed for each lesion on multi-phasic contrast-enhanced (CE) images. After these image analyses, the MRI findings were correlated with the histopathological findings. Result: Histopathologically, the 4 RLVMs did not exhibit remarkable degeneration and were present in the retroperitoneal fat tissue without clear capsules. On the non-FS SSFSE images, 3 of the 4 RLVMs could not be discriminated from the surrounding retroperitoneal fat tissue (invisible), and the remaining lesion was barely visible with an indistinct margin. On the FS T2-weighted FSE images, however, all the RLVMs were clearly visualized as homogeneous high-signal intensities. On the multi-phasic CE images, all the capillary malformations exhibited fast enhancement, while a venous malformation showed slow enhancement. Furthermore, the RLVMs tended to exhibit a centripetal filling pattern. Conclusion: The RLVMs blended in with the surrounding retroperitoneal fat tissue on non-FS SSFSE images, like phantoms, whereas they were clearly visualized on FS T2-weighted FSE images. On multi-phasic CE images, the RLVMs tended to exhibit a centripetal filling pattern. These imaging features may be useful diagnostic clues for RLVMs.

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CT Dose Reduction for Visceral Adipose Tissue Measurement: Effects of Model-Based and Adaptive Statistical Iterative Reconstructions and Filtered Back Projection

Yamada, Yoshitake, Jinzaki, Masahiro, Niijima, Yuki, Hashimoto, Masahiro, Yamada, Minoru, Abe, Takayuki, Kuribayashi, Sachio

AMERICAN JOURNAL OF ROENTGENOLOGY (American Journal of Roentgenology) 204 ( 6 ) W677 - W683 2015.06

Research paper (scientific journal), Joint Work, Accepted, ISSN 0361-803X

© American Roentgen Ray Society. OBJECTIVE. The objective of our study was to evaluate the effects of radiation dose reduction and the reconstruction algorithm used-filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), or model-based iterative reconstruction (MBIR)-on the measurement of abdominal visceral fat using CT. SUBJECTS AND METHODS. Standard-dose and low-dose abdominal CT examinations were performed simultaneously with automatic exposure control in 59 patients; the noise index for a 5-mm slice thickness was 12 for routine-dose CT and 24 for low-dose CT. The routine-dose CT images were reconstructed using FBP (reference standard), and the low-dose CT images were reconstructed using FBP, ASIR (so-called hybrid iterative reconstruction [IR]), and MBIR (so-called pure IR). In the 236 image series obtained, the visceral fat area was measured. Data were analyzed by the Pearson correlation coefficient test and a Bland-Altman difference analysis. RESULTS. The radiation dose of the low-dose abdominal CT examinations was 73.0% (mean) lower than that of routine-dose CT examinations. Excellent correlations were observed between the visceral fat areas measured on the routine-dose FBP images and those measured on the low-dose FBP, low-dose ASIR, and low-dose MBIR images (r = 0.998, 0.998, and 0.998, respectively; p < 0.001). A Bland-Altman difference analysis revealed excellent agreements, with mean biases of-0.47,-0.41, and 0.18 cm2 for the visceral fat area between the routine-dose FBP images and the low-dose FBP, low-dose ASIR, and low-dose MBIR images, respectively. CONCLUSION. A 73.0% reduction of the radiation dose would be possible in CT for the measurement of the abdominal visceral fat regardless of which reconstruction algorithm is used (i.e., FBP, hybrid IR, or pure IR).

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Renal Cyst Pseudoenhancement: Intraindividual Comparison Between Virtual Monochromatic Spectral Images and Conventional Polychromatic 120-kVp Images Obtained During the Same CT Examination...

Yamada, Yoshitake, Yamada, Minoru, Sugisawa, Koichi, Akita, Hirotaka, Shiomi, Eisuke, Abe, Takayuki, Okuda, Shigeo, Jinzaki, Masahiro

MEDICINE (Medicine (United States)) 94 ( 15 ) e754 2015.04

Research paper (scientific journal), Joint Work, Accepted, ISSN 0025-7974

© 2015 Wolters Kluwer Health, Inc. The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59-85 years; mean age, 73.2±5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0±14.7mm [range, 4-61mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0Hounsfield units [HU]; 95% confidence interval, 2.6-7.4/3.6-8.4HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8HU; 95% confidence interval, 9.8-14.5/10.4-15.1/9.4-14.2HU) (all P<.001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images.

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Evaluation of velopharyngeal closure by 4D imaging using 320-detector-row computed tomography

Sakamoto, Yoshiaki, Soga, Shigeyoshi, Jinzaki, Masahiro, Yamada, Yoshitake, Ogata, Hisao, Kishi, Kazuo

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY (Journal of Plastic, Reconstructive and Aesthetic Surgery) 68 ( 4 ) 479 - 484 2015.03

Research paper (scientific journal), Joint Work, Accepted, ISSN 1748-6815

© 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved. Objective Current imaging techniques for velopharyngeal closure (VPC) evaluation are two-dimensional, static, or distressing, thus necessitating multiple procedures to understand this three-dimensional and dynamic area. We validated the use of a novel four-dimensional (4D) computed tomography (CT) technique for the morphological and kinematic evaluation of VPC in cleft palate patients based on dynamic volume scanning with 320-detector-row CT. Methods Five patients aged 4-10 years (40% males) with persistent velopharyngeal insufficiency post palatoplasty underwent conventional tests (cephalometry and video-nasal endoscopy) and 4D-CT. For each patient, complete multiplanar reconstruction, 4D airway CT, and 4D-CT endoscopy data for all scanning phases were compared with cephalometric and video-nasal endoscopy data. The movements of the velum and posterior pharyngeal walls were graded by each modality. Results 4D airway CT revealed higher anatomical detail than cephalometry, additionally providing dynamic images. 4D-CT endoscopy and video-nasal endoscopy were in agreement for all patients regarding the patterns of VPC, with complete visualization of VPC in five versus one patient, respectively. 4D airway CT and cephalometry showed a discrepancy in one case, wherein grading by cephalometry was overestimated. 4D-CT was also useful in determining the width and length of a proposed pharyngeal flap. The examination time (mean ± standard deviation (SD), seconds), including patient preparation time, was 224 ± 73, 492 ± 145, and 718 ± 123 for cephalometric radiographs, CT, and video-nasal endoscopy, respectively. The mean estimated radiation dose during 4D-CT was 4.44 ± 1.64 mSv. Conclusions 4D-CT provides detailed morphological and kinematic analysis of VPC and may offer advantages over conventional procedures.

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Improved renal function in a patient with hypertrophic obstructive cardiomyopathy after multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation

Maekawa, Yuichiro, Jinzaki, Masahiro, Tsuruta, Hikaru, Akita, Keitaro, Yamada, Yoshitake, Kawakami, Takashi, Hayashida, Kentaro, Yuasa, Shinsuke, Murata, Mitsushige, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY (International Journal of Cardiology) 181 349 - 350 2015.02

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

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Adventitial CXCL1/G-CSF Expression in Response to Acute Aortic Dissection Triggers Local Neutrophil Recruitment and Activation Leading to Aortic Rupture

Anzai, Atsushi, Shimoda, Masayuki, Endo, Jin, Kohno, Takashi, Katsumata, Yoshinori, Matsuhashi, Tomohiro, Yamamoto, Tsunehisa, Ito, Kentaro, Yan, Xiaoxiang, Shirakawa, Kosuke, Shimizu-Hirota, Ryoko, Yamada, Yoshitake, Ueha, Satoshi, Shinmura, Ken, Okada, Yasunori, Fukuda, Keiichi, Sano, Motoaki

CIRCULATION RESEARCH (Circulation Research) 116 ( 4 ) 612 - U138 2015.02

Research paper (scientific journal), Joint Work, ISSN 0009-7330

© 2015 American Heart Association, Inc. Rationale: In-hospital outcomes are generally acceptable in patients with type B dissection; however, some patients present with undesirable complications, such as aortic expansion and rupture. Excessive inflammation is an independent predictor of adverse clinical outcomes. Objective: We have investigated the underlying mechanisms of catastrophic complications after acute aortic dissection (AAD) in mice. Methods and Results: When angiotensin II was administered in lysyl oxidase inhibitor-preconditioned mice, AAD emerged within 24 hours. The dissection was initiated at the proximal site of the descending thoracic aorta and propagated distally into an abdominal site. Dissection of the aorta caused dilatation, and ≈70% of the mice died of aortic rupture. AAD triggered CXCL1 and granulocyte-colony stimulating factor expression in the tunica adventitia of the dissected aorta, leading to elevation of circulating CXCL1/granulocyte-colony stimulating factor levels. Bone marrow CXCL12 was reduced. These chemokine changes facilitated neutrophil egress from bone marrow and infiltration into the aortic adventitia. Interference of CXCL1 function using an anti-CXCR2 antibody reduced neutrophil accumulation and limited aortic rupture post AAD. The tunica adventitia of the expanded dissected aorta demonstrated high levels of interleukin-6 (IL-6) expression. Neutrophils were the major sources of IL-6, and CXCR2 neutralization significantly reduced local and systemic levels of IL-6. Furthermore, disruption of IL-6 effectively suppressed dilatation and rupture of the dissected aorta without any influence on the incidence of AAD and neutrophil mobilization. Conclusions: Adventitial CXCL1/granulocyte-colony stimulating factor expression in response to AAD triggers local neutrophil recruitment and activation. This leads to adventitial inflammation via IL-6 and results in aortic expansion and rupture.

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