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Article ; Online: Phospholipidosis in cardiomyocytes suffering flecainide intoxication.

Saito, Tsunenori / Hayashi, Meiso / Shimizu, Wataru

2019 Volume 41, Issue 10, Page(s) 1141

MeSH term(s)	Anti-Arrhythmia Agents ; Electrocardiography ; Flecainide ; Humans ; Myocytes, Cardiac
Chemical Substances	Anti-Arrhythmia Agents ; Flecainide (K94FTS1806)
Language	English
Publishing date	2019-11-20
Publishing country	England
Document type	Journal Article
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehz833
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Article ; Online: Eosinophilic myocarditis associated with anti-mitochondrial M2 antibodies: a mechanism underlying the onset of myocarditis.

Saito, Tsunenori / Kodani, Eitaro / Katayama, Hironori / Kusama, Yoshiki

European heart journal

2018 Volume 39, Issue 37, Page(s) 3480–3481

MeSH term(s)	Aged ; Autoantibodies/blood ; Autoantibodies/immunology ; Eosinophilia ; Female ; Hamstring Muscles/pathology ; Humans ; Mitochondrial Proteins/immunology ; Muscular Dystrophies, Limb-Girdle ; Myocarditis ; Myocardium/cytology ; Myocardium/pathology
Chemical Substances	Autoantibodies ; Mitochondrial Proteins
Language	English
Publishing date	2018-04-23
Publishing country	England
Document type	Journal Article
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehy246
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Zs.A 1563: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Myocardial alterations in a patient with mucopolysaccharidosis type IS.

Izumi, Yuki / Saito, Tsunenori / Sato, Shigeru / Shimizu, Wataru

European heart journal

2018 Volume 39, Issue 20, Page(s) 1863

MeSH term(s)	Heart Diseases/etiology ; Heart Diseases/pathology ; Heart Valve Diseases/diagnostic imaging ; Heart Valve Diseases/etiology ; Humans ; Male ; Microscopy, Electron ; Middle Aged ; Mucopolysaccharidosis I/complications ; Mucopolysaccharidosis I/pathology ; Myocardium/ultrastructure
Language	English
Publishing date	2018-03-05
Publishing country	England
Document type	Case Reports ; Journal Article ; Video-Audio Media
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehy149
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Zs.A 1563: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Is steroid therapy really banned for lymphocytic myocarditis before excluding viral infection?

Saito, Tsunenori / Katayama, Hironori / Kodani, Eitaro

European heart journal

2018 Volume 40, Issue 12, Page(s) 1014–1015

MeSH term(s)	Autoantibodies/immunology ; Eosinophilia/immunology ; Humans ; Immunohistochemistry/methods ; Lymphocytosis/immunology ; Lymphocytosis/pathology ; Male ; Middle Aged ; Myocarditis/drug therapy ; Myocarditis/etiology ; Myocarditis/immunology ; Myocarditis/pathology ; Steroids/therapeutic use ; Treatment Outcome ; Virus Diseases/diagnosis
Chemical Substances	Autoantibodies ; Steroids
Language	English
Publishing date	2018-11-06
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehy738
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Article ; Online: Electron microscopy gain a glimpse into the pathogenesis of cardiac sarcoidosis.

Kuribayashi, Yoshiko / Ohtani, Kisho / Saito, Tsunenori / Ide, Tomomi

European heart journal cardiovascular Imaging

2017 Volume 18, Issue 8, Page(s) 944

MeSH term(s)	Aged ; Biopsy, Needle ; Cardiomyopathies/diagnostic imaging ; Cardiomyopathies/pathology ; Female ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging, Cine/methods ; Microscopy, Electron/methods ; Multimodal Imaging/methods ; Myocardium/pathology ; Myocardium/ultrastructure ; Positron Emission Tomography Computed Tomography/methods ; Prognosis ; Sarcoidosis/diagnostic imaging ; Sarcoidosis/pathology ; Severity of Illness Index ; Stroke Volume
Language	English
Publishing date	2017-08-02
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jex152
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Article ; Online: Histological validation of atrial structural remodelling in patients with atrial fibrillation.

Takahashi, Yuya / Yamaguchi, Takanori / Otsubo, Toyokazu / Nakashima, Kana / Shinzato, Kodai / Osako, Ryosuke / Shichida, Shigeki / Kawano, Yuki / Fukui, Akira / Kawaguchi, Atsushi / Aishima, Shinichi / Saito, Tsunenori / Takahashi, Naohiko / Node, Koichi

European heart journal

2023 Volume 44, Issue 35, Page(s) 3339–3353

Abstract: Background and aims: This study aimed to histologically validate atrial structural remodelling associated with atrial fibrillation.: Methods and results: Patients undergoing atrial fibrillation ablation and endomyocardial atrial biopsy were included ( ...

Abstract	Background and aims: This study aimed to histologically validate atrial structural remodelling associated with atrial fibrillation. Methods and results: Patients undergoing atrial fibrillation ablation and endomyocardial atrial biopsy were included (n = 230; 67 ± 12 years old; 69 women). Electroanatomic mapping was performed during right atrial pacing. Voltage at the biopsy site (Vbiopsy), global left atrial voltage (VGLA), and the proportion of points with fractionated electrograms defined as ≥5 deflections in each electrogram (%Fractionated EGM) were evaluated. SCZtotal was calculated as the total width of slow conduction zones, defined as regions with a conduction velocity of <30 cm/s. Histological factors potentially associated with electroanatomic characteristics were evaluated using multiple linear regression analyses. Ultrastructural features and immune cell infiltration were evaluated by electron microscopy and immunohistochemical staining in 33 and 60 patients, respectively. Fibrosis, intercellular space, myofibrillar loss, and myocardial nuclear density were significantly associated with Vbiopsy (P = .014, P < .001, P < .001, and P = .002, respectively) and VGLA (P = .010, P < .001, P = .001, and P < .001, respectively). The intercellular space was associated with the %Fractionated EGM (P = .001). Fibrosis, intercellular space, and myofibrillar loss were associated with SCZtotal (P = .028, P < .001, and P = .015, respectively). Electron microscopy confirmed plasma components and immature collagen fibrils in the increased intercellular space and myofilament lysis in cardiomyocytes, depending on myofibrillar loss. Among the histological factors, the severity of myofibrillar loss was associated with an increase in macrophage infiltration. Conclusion: Histological correlates of atrial structural remodelling were fibrosis, increased intercellular space, myofibrillar loss, and decreased nuclear density. Each histological component was defined using electron microscopy and immunohistochemistry studies.
MeSH term(s)	Humans ; Female ; Middle Aged ; Aged ; Atrial Fibrillation/surgery ; Electrophysiologic Techniques, Cardiac/methods ; Heart Atria ; Heart Rate ; Fibrosis ; Atrial Remodeling ; Catheter Ablation
Language	English
Publishing date	2023-06-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehad396
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Article ; Online: Crystalline cardiomyopathy due to secondary oxalosis after short-bowel syndrome and end-stage renal failure.

Saito, Tsunenori / Ikeda, Mariko / Asai, Kuniya / Shimizu, Wataru

Clinical research in cardiology : official journal of the German Cardiac Society

2016 Volume 105, Issue 8, Page(s) 714–716

MeSH term(s)	Adult ; Biopsy ; Calcium Oxalate/analysis ; Cardiomyopathies/diagnosis ; Cardiomyopathies/etiology ; Cardiomyopathies/physiopathology ; Crystallization ; Female ; Fibrosis ; Humans ; Hyperoxaluria/diagnosis ; Hyperoxaluria/etiology ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/therapy ; Microscopy, Electron ; Myocardium/chemistry ; Myocardium/ultrastructure ; Parenteral Nutrition, Total ; Renal Dialysis/adverse effects ; Short Bowel Syndrome/complications ; Short Bowel Syndrome/diagnosis ; Short Bowel Syndrome/therapy ; Treatment Outcome ; Ventricular Function, Left
Chemical Substances	Calcium Oxalate (2612HC57YE)
Language	English
Publishing date	2016-03-23
Publishing country	Germany
Document type	Case Reports ; Letter
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-016-0981-1
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Article ; Online: Myocardial ultrastructure can augment genetic testing for sporadic dilated cardiomyopathy with initial heart failure.

Saito, Tsunenori / Sato, Naoko Saito / Mozawa, Kosuke / Adachi, Akiko / Sasaki, Yoshihiro / Nakamura, Kotoka / Oka, Eiichiro / Otsuka, Toshiaki / Kodani, Eitaro / Asai, Kuniya / Mizuno, Kyoichi / Shimizu, Wataru / Gottlieb, Roberta A

ESC heart failure

2021 Volume 8, Issue 6, Page(s) 5178–5191

Abstract: Aims: The aim of the present study was to consider whether the ultrastructural features of cardiomyocytes in dilated cardiomyopathy can be used to guide genetic testing.: Methods and results: Endomyocardial biopsy and whole-exome sequencing were ... ...

Abstract	Aims: The aim of the present study was to consider whether the ultrastructural features of cardiomyocytes in dilated cardiomyopathy can be used to guide genetic testing. Methods and results: Endomyocardial biopsy and whole-exome sequencing were performed in 32 consecutive sporadic dilated cardiomyopathy patients [51.0 (40.0-64.0) years, 75% men] in initial phases of decompensated heart failure. The predicted pathogenicity of ultrarare (minor allele frequency ≤0.0005), non-synonymous variants was determined using the American College of Medical Genetics guidelines. Focusing on 75 cardiomyopathy-susceptibility and 41 arrhythmia-susceptibility genes, we identified 404 gene variants, of which 15 were considered pathogenic or likely pathogenic in 14 patients (44% of 32). There were five sarcomeric gene variants (29% of 17 variants) found in five patients (16% of 32), involving a variant of MYBPC3 and four variants of TTN. A patient with an MYBPC3 variant showed disorganized sarcomeres, three patients with TTN variants located in the region encoding the A-band domain showed sparse sarcomeres, and a patient with a TTN variant in encoding the I-band domain showed disrupted sarcomeres. The distribution of diffuse myofilament lysis depended on the causal genes; three patients with the same TMEM43 variant had diffuse myofilament lysis near nuclei (P = 0.011), while two patients with different DSP variants had lysis in the peripheral areas of cardiomyocytes (P = 0.033). Conclusions: Derangement patterns of myofilament and subcellular distribution of myofilament lysis might implicate causal genes. Large-scale studies are required to confirm whether these ultrastructural findings are related to the causative genes.
MeSH term(s)	Adult ; Cardiomyopathy, Dilated/diagnosis ; Cardiomyopathy, Dilated/genetics ; Cardiomyopathy, Dilated/pathology ; Carrier Proteins/genetics ; Connectin/genetics ; Desmoplakins/genetics ; Female ; Genetic Testing ; Heart Failure/diagnosis ; Heart Failure/genetics ; Humans ; Male ; Middle Aged ; Myocardium/ultrastructure ; Myofibrils/pathology ; Sarcomeres/genetics ; Sarcomeres/pathology
Chemical Substances	Carrier Proteins ; Connectin ; DSP protein, human ; Desmoplakins ; TTN protein, human ; myosin-binding protein C
Language	English
Publishing date	2021-09-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.13596
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Article ; Online: Long-term prognostic value of ultrastructural features in dilated cardiomyopathy: comparison with cardiac magnetic resonance.

Saito, Tsunenori / Asai, Kuniya / Tachi, Masaki / Sato, Shigeru / Mozawa, Kosuke / Adachi, Akiko / Sasaki, Yoshihiro / Amano, Yasuo / Mizuno, Kyoichi / Kumita, Shin-Ichiro / Shimizu, Wataru

ESC heart failure

2020 Volume 7, Issue 2, Page(s) 682–691

Abstract: Aims: This study aims to determine the implications associated with long-term prognosis of heart failure (HF) in patients with dilated cardiomyopathy (DCM) presenting initially as decompensated HF. We stratified the phase of DCM patients without late ... ...

Abstract	Aims: This study aims to determine the implications associated with long-term prognosis of heart failure (HF) in patients with dilated cardiomyopathy (DCM) presenting initially as decompensated HF. We stratified the phase of DCM patients without late gadolinium enhancement (LGE) based on ultrastructural changes in cardiomyocytes. Methods and results: Left ventricular (LV) endomyocardial biopsy was performed in 55 consecutive DCM patients with initial decompensated HF. Ultrastructural changes in cardiomyocytes detected by electron microscopy were compared with data including LGE with cardiac magnetic resonance and HF recurrence. Of the 55 DCM patients, 24 (44%) showed LGE, and 26 (47%) showed recurrence decompensated HF, while 23 patients (42%) showed autophagic vacuoles in cardiomyocytes by electron microscopy. Multivariate analysis identified atrial fibrillation [hazard ratio (HR), 3.40; 95% confidence interval (CI), 1.45-7.98], haemoglobin level (HR, 0.82; 95% CI, 0.68-0.99), beta-blocker use (HR, 0.18; 95% CI, 0.05-0.74), and autophagic vacuoles (HR, 0.25; 95% CI, 0.09-0.65) as predictors of HF recurrence in the total patient population. In patients without LGE, only autophagic vacuoles were independent predictors of readmission because of HF (HR, 0.29; 95% CI, 0.09-0.90). In patients with LGE, atrial fibrillation (HR, 19.10; 95% CI, 2.97-123.09), and mid-linear LGE (HR, 12.96; 95% CI, 2.02-82.94) were independent predictors of readmission because of HF. Conclusions: In DCM patients with LGE, characterised by progression of LV remodelling, the LGE pattern was a predictor of HF recurrence, whereas in patients without LGE, absence of autophagic vacuoles was a predictor of HF recurrence.
MeSH term(s)	Cardiomyopathy, Dilated/diagnosis ; Contrast Media ; Gadolinium ; Humans ; Magnetic Resonance Spectroscopy ; Prognosis
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2020-03-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.12662
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Article ; Online: Ultrastructural features of cardiomyocytes in dilated cardiomyopathy with initially decompensated heart failure as a predictor of prognosis.

Saito, Tsunenori / Asai, Kuniya / Sato, Shigeru / Takano, Hitoshi / Mizuno, Kyoichi / Shimizu, Wataru

European heart journal

2014 Volume 36, Issue 12, Page(s) 724–732

Abstract: Aims: The aim of the present study was to clarify the significance of myocardial ultrastructural changes in patients with dilated cardiomyopathy (DCM).: Methods and results: Endomyocardial biopsy of the left ventricle was performed in 250 consecutive ...

Abstract	Aims: The aim of the present study was to clarify the significance of myocardial ultrastructural changes in patients with dilated cardiomyopathy (DCM). Methods and results: Endomyocardial biopsy of the left ventricle was performed in 250 consecutive DCM patients (54.9 ± 13.9 years, 79% men), presenting initially as decompensated heart failure (HF). Myofilament changes of cardiomyocytes were evaluated by electron microscopy and compared with clinical and morphometric data. Mortality and HF recurrence were evaluated during the follow-up period. During the follow-up period (4.9 ± 3.9 years), 24 patients (10%) died and 67 (27%) were readmitted because of HF recurrence, including those who had died because of HF. Myofilament changes, classified as either focal derangement of myofilaments (sarcomere damage) or diffuse myofilament lysis (disappearance of most sarcomeres in cardiomyocytes), were identified in 164 patients (66%). Multivariate analysis identified a family history of DCM [hazard ratio (HR) 4.763; 95% confidence interval (CI) 1.012-12.518], atrial fibrillation (HR 6.132; 95% CI 2.188-17.180), haemoglobin level (HR 0.685; 95% CI 0.528-0.889), and diffuse myofilament lysis (HR 4.048; 95% CI 1.427-11.481) as independent predictors of mortality. A family history of DCM (HR 2.268; 95% CI 1.276-4.030), haemoglobin level (HR 0.876; 95% CI 0.785-0.979), focal derangement of myofilaments (HR 7.431; 95% CI 2.916-18.934), and diffuse myofilament lysis (HR 6.480; 95% CI 2.403-17.473) were predictors of readmission due to HF recurrence. Conclusions: In DCM patients with first-decompensated HF, myofilament changes are strongly associated with mortality and HF recurrence.
MeSH term(s)	Actin Cytoskeleton/ultrastructure ; Cardiomyopathy, Dilated/mortality ; Cardiomyopathy, Dilated/pathology ; Female ; Heart Failure/mortality ; Heart Failure/pathology ; Humans ; Kaplan-Meier Estimate ; Male ; Microscopy, Electron ; Middle Aged ; Myocytes, Cardiac/ultrastructure ; Prognosis ; Prospective Studies
Language	English
Publishing date	2014-10-21
Publishing country	England
Document type	Journal Article
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehu404
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