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Sawatari H, Chishaki A, Rahmawati A, Ando S. Growth-related changes in the influence of obesity on signs suggesting sleep-disordered breathing and sleepiness in young individuals with Down syndrome. J Intellect Disabil Res 2023; 67:1150-1160. [PMID: 37671733 DOI: 10.1111/jir.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Sleep-disordered breathing (SDB) is highly prevalent in individuals with Down syndrome (DS), who cease growing earlier than individuals without DS. These characteristics may be associated with increased obesity and subsequent SDB signs, such as snoring and apnoea or excessive daytime sleepiness (EDS). Thus, we assessed the influence of growth on the association between obesity and SDB signs or EDS; we used questionnaires sent to young individuals with DS and their caregivers, in a cross-sectional study. METHODS We sent out 2000 questionnaires to individuals with DS and their caregivers. The surveys included questions about SDB signs (witnessed snoring or apnoea), subjective sleeping time including witnessed midnight arousal, the Epworth sleepiness scale and witnessed napping as well as sex, age, body weight and body height. RESULTS Of the 1222 questionnaires we received, 660 were from young individuals and were included in the analysis. SDB signs were highly prevalent (77.1%), and frequency of SDB signs increased with growth (P-trend: P = 0.02) in individuals with DS. Multivariate analyses showed that EDS (Epworth sleepiness scale > 10 points) was associated with body mass index Z-score (Z-BMI) in the 6-9 years age group (odds ratio [OR] 95% confidence interval [95% CI]: 1.69 [1.09-2.62], P = 0.02). Conversely, SDB signs were associated with Z-BMI in the 13-15 (OR [95% CI]: 1.99 [1.06-3.72], P = 0.03) and 16-18 years age groups (OR [95% CI]: 3.04 [1.22-7.59], P = 0.02). For the 19-21 years age group, SDB signs were associated with only male sex (OR [95% CI]: 7.28 [1.22-43.38], P = 0.03). CONCLUSIONS This study showed that the association between Z-BMI and SDB or EDS was age dependent. In early school-age children with DS, high Z-BMI could not accurately predict the presence of SDB, but it was associated with EDS. In the pubescent period (i.e. 13-18 years), high Z-BMI was associated with SDB signs but not with EDS. Overall, obesity affected SDB signs and EDS differently based on age in young individuals with DS.
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Affiliation(s)
- H Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - A Chishaki
- Fukuoka Dental College Hospital and Fukuoka Nursing College, Graduate School of Nursing, Fukuoka, Japan
| | - A Rahmawati
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - S Ando
- Sleep Medicine Center, Saiseikai Futsukaichi Hospital, Chikushino, Japan
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Kawai S, Nagaoka K, Takase S, Sakamoto K, Ikuta H, Toyohara T, Okahara A, Tokutome M, Kuribayashi Y, Matsura H, Matsukawa R, Masuda S, Chishaki A, Tsutsui H, Mukai Y. Presence of low voltage area predicts atrial tachyarrhythmia inducibility with atrial burst pacing after pulmonary vein isolation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Induction of atrial fibrillation (AF)/atrial tachycardia (AT) by atrial burst pacing following ablation procedure may reflect the presence of residual substrates in the atria that maintain AF. However, the relation between the inducibility and left atrial low voltage area (LVA) has not been established.
Methods
Fifty-nine patients (65 years old, 43 males) with persistent AF who underwent pulmonary vein isolation (PVI)-based ablation were studied. All patients underwent left atrial voltage mapping during sinus rhythm and atrial burst pacing after PVI. Atrial burst pacing was performed with 30-beat at an amplitude of 10V from the ostium of the coronary sinus; increasing from 240 to 320 ppm in steps of 20 ppm or failure to 1:1 atrial capture. Inducibility was defined as AF/AT lasting more than 5 minutes following burst pacing. Left atrial LVA and other co-variates were analyzed with regard to burst pacing positivity.
Results
AF/AT was induced by burst pacing in 23 patients (39%). Univariate analysis revealed that past history of stroke, CHADS2 score and presence of left atrial LVA were significantly associated with the inducibility of AF/AT. Multivariate analysis revealed that only the presence of LVA was associated with the inducibility (OR 1.5: per 10% increase; p=0.04). We focused on the relationship between the extent of LVA and burst positivity. AF/AT inducibility increased as low voltage area increased, and it was as high as 72.7% when low voltage area was more than 20% (P<0.05). Interestingly, induced arrhythmia type was AT rather than AF when low voltage area was more than 20%.
Conclusions
Presence of left atrial LVA is an independent predictor of atrial tachyarrhythmia inducibility after PVI in patients with persistent AF. A large amount of low voltage area is related to AT inducibility rather than AF.
Extent of LVA and burst positivity
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Kawai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - H Ikuta
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - T Toyohara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Okahara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - H Matsura
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - S Masuda
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Hospital, Health Sciences, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Yakabe D, Ikeda S, Chishaki A, Tsutsui H. P3764Morphological mechanisms of atrial functional mitral regurgitation in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial functional mitral regurgitation (AFMR) occurs in patients with atrial fibrillation. However, morphological mechanisms of AFMR are poorly understood.
Purpose
The purpose of this study was to examine the morphological characteristics in patients with AFMR.
Methods
Among consecutive 795 patients undergoing initial radiofrequency catheter ablation (RFCA) at our hospital, twenty-five patients with persistent AF accompanied by AFMR (≥ moderate) before RFCA (AFMR group) were studied. Age-matched 25 patients with persistent AF without MR were defined as a control group.
Results
Left ventricular ejection fraction (LVEF) was lower and left atrium volume index was larger in the AFMR group (Table). Mitral valve annulus diameter and length of anterior mitral leaflet (AML) were similar between groups, whereas length of posterior mitral leaflet (PML) was significantly shorter in the AFMR group. Smaller tethering angle of AML (γ in the figure) and shorter tethering height were significantly associated with the occurrence of AFMR, which were different from morphology of functional mitral regurgitation in patients with dilated LV. Multiple regression analysis revealed that less tenting height (p<0.05) and LA dilatation toward the posterior (p<0.01) were significantly related to AFMR.
Echocardiographic parameters AFMR (n=25) Control (n=25) P value Age, y 69±8 66±10 NS Male, n (%) 9 (36) 20 (80) P=0.001 LVEF,% 60±9 67±6 P=0.004 LAD, mm 44±5 41±7 NS LAVI, ml/m2 56±17 41±13 P<0.001 MV diameter, mm 3.9±0.4 3.8±0.5 NS α angle, ° 34±9 35±7 NS β angle, ° 48±9 50±8 NS γ angle, ° 32±5 37±5 P=0.0005 AML length, mm 3.0±0.5 3.0±0.5 NS PML length, mm 2.1±0.1 2.4±0.1 P=0.03 Tenting height, mm 1.5±0.1 1.8±0.1 P=0.02 D, mm 0.8±0.3 0.5±0.3 P=0.001 LVEF: left ventricular ejection fraction; LAD: left atrial diameter; LAVI: left atrial volume index; AML: anterior mitral leaflet; PML: posterior mitral leaftlet.
Conclusions
AFMR occurs in patients with unique morphological features, such as less tethering height and LA dilatation toward the posterior.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Ikeda S, Chishaki A, Tsutsui H. P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) and clinical outcomes in patients with left ventricular systolic dysfunction (LVSD). However, predictors of the improvement of LV function and clinical outcomes by CA were poorly understood.
Purpose
We examined the efficacy of CA in AF patients with LVSD and predictive factors associated with clinical outcomes.
Method
Among consecutive 795 patients undergone initial RFCA at our hospital, we studied 51 patients with LVSD (LVEF ≤50%). Improved LVEF more then 5% at 1-year after CA was classified as “responder” to CA. We analyzed clinical variables and echocardiographic parameters before and after the CAs.
Results
In the responder group, LVEF was significantly improved 1-year after catheter ablation compared with the non-responder group. (ΔLVEF 22±12% vs. −1±4%, p<0.001). The responder group was significantly younger, had more non-paroxysmal AF, smaller LV systolic diameter and lower plasma BNP level before CA (Table). Late gadolinium enhancement (LGE)-positive rate in cardiovascular magnetic resonance imaging (CMR) before CA was higher in the non-responder group than in the responder group (100% [6/6] vs. 38% [5/13], p<0.005). After CAs of AF, event-free survival from hospitalization for heart failure was significantly higher in the responder group (Figure) with less AF recurrence (27% vs. 47%, p=0.04) than in the non-responder group.
Baseline characteristics Responder (N=35) Non-Responder (N=16) P value Age, y 62±11 69±8 p<0.01 Male, n (%) 26 (74) 13 (76) NS Non-pAF 26 (74) 4 (24) p<0.01 LAD, mm 48±7 48±8 NS LAVI, ml/m2 54±17 58±20 NS LVDd, mm 54±7 58±10 NS LVDs, mm 43±7 48±10 p=0.05 EF, % 37±8 38±8 NS BNP (pg/ml) 278±225 684±848 p<0.05
Conclusion
Younger age, absence of LV dilatation, lower plasma BNP, or absence of LGE may well predict favorable clinical outcomes after CA in patients with LVSD.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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Kawai S, Mukai Y, Yakabe D, Nagaoka K, Chishaki A, Tsutsui H. P2880Circumferential conduction delay within the pulmonary veins (PV) rather than the PV-LA conduction delay has a key role in the onset of atrial fibrillation - A quantitative analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Kawai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - K Nagaoka
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Hospital, cardiology, Fukuoka, Japan
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Yamasaki K, Sawatari H, Konagai N, Kamiya C, Yoshimatsu J, Muneuchi J, Watanabe M, Fukuda T, Mizuno A, Sakamoto I, Yamamura K, Ohkusa T, Tsutsui H, Niwa K, Chishaki A. P5475Predictors of cardiovascular events in pregnant women with congenital heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Yamasaki
- Ube Frontier University, Nursing, Faculty of Health Sciences, Ube, Japan
| | - H Sawatari
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Health Care for Adults, Hiroshima, Japan
| | - N Konagai
- National cerebral and Cardiovascular Center, Perinatology and Gynecology, Osaka, Japan
| | - C Kamiya
- National cerebral and Cardiovascular Center, Perinatology and Gynecology, Osaka, Japan
| | - J Yoshimatsu
- National cerebral and Cardiovascular Center, Perinatology and Gynecology, Osaka, Japan
| | - J Muneuchi
- Japan Community Healthcare Organization Kyushu Hospital, Pediatrics, Kitakyushu, Japan
| | - M Watanabe
- Japan Community Healthcare Organization Kyushu Hospital, Pediatrics, Kitakyushu, Japan
| | - T Fukuda
- St. Luke's International University Hospital, Cardiology Cardiovascular Center, Tokyo, Japan
| | - A Mizuno
- St. Luke's International University Hospital, Cardiology Cardiovascular Center, Tokyo, Japan
| | - I Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Yamamura
- Kyushu University Graduate School of Medical Sciences, Pediatrics, Fukuoka, Japan
| | - T Ohkusa
- Ube Frontier University, Nursing, Faculty of Health Sciences, Ube, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Niwa
- St. Luke's International University Hospital, Cardiology Cardiovascular Center, Tokyo, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Health Sciences, Fukuoka, Japan
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Moriyama N, Sawatari H, Chishaki A, Rahmawati A, Nishizaka M, Hashiguchi N, Kuroda H, Ando S. 0772 Age And Sex Impact On Symptoms Of Sleep-disordered Breathing In People With Down Syndrome -a Nation-wide Study In Japan-. Sleep 2018. [DOI: 10.1093/sleep/zsy061.771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Moriyama
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - H Sawatari
- Department of Health Care for Adults, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JAPAN
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - A Rahmawati
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - M Nishizaka
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fufuoka, JAPAN
- Department of Cardiovascular Medicine, Kimura Hospital, Fukuoka, JAPAN
| | - N Hashiguchi
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - H Kuroda
- Faculty of Fundamentals of Nursing, Japanese Red Cross Kyushu International College of Nursing, Fukuoka, JAPAN
| | - S Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, JAPAN
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Kawai S, Mukai Y, Inoue S, Chishaki A, Tsutsui H. 58Location and coupling interval of ectopic beats have key roles in the onset of atrial fibrillation from the pulmonary veins. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S. Kawai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - Y. Mukai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - S. Inoue
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - A. Chishaki
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - H. Tsutsui
- Kyushu University Hospital, cardiology, Fukuoka, Japan
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Kawai S, Mukai Y, Inoue S, Chishaki A, Tsutsui H. P1726Non-pulmonary vein trigger of atrial fibrillation is likely to arise from low voltage area in the left atrium. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Kawai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - Y. Mukai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - S. Inoue
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - A. Chishaki
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - H. Tsutsui
- Kyushu University Hospital, cardiology, Fukuoka, Japan
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Kuroda H, Sawatari H, Ando S, Ohkusa T, Rahmawati A, Ono J, Nishizaka M, Hashiguchi N, Matsuoka F, Chishaki A. A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome. J Intellect Disabil Res 2017; 61:656-667. [PMID: 28378398 DOI: 10.1111/jir.12379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 01/04/2017] [Accepted: 03/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with Down syndrome (DS) often have sleep-disordered breathing (SDB). Unusual sleep postures, such as leaning forward and sitting, are observed in people with DS. This study aimed to clarify the prevalence of unusual sleep postures and their relationships with SDB-related symptoms (SDB-RSs), such as snoring, witnessed apnoea, nocturnal awakening and excessive daytime sleepiness. METHODS A questionnaire, including demographic characteristics and the presence of unusual sleep postures, as well as SDB-RSs, was completed by 1149 parents of people with DS from Japan. RESULTS Unusual sleep postures were recorded in 483 (42.0%) people with DS. These participants were significantly younger and had a history of low muscle tone more frequently than people without unusual sleep postures. In all ages, the leaning forward posture was more frequent than sitting. People with DS with unusual sleep postures suffered from SDB-RSs. Those who slept in the sitting posture had more frequent SDB-RSs than did those who slept with the leaning forward posture. Snoring, witnessed apnoea and nocturnal awakening were observed in 73.6, 27.2 and 58.2% of participants, respectively. Snoring increased with aging. Witnessed apnoea was more common in males and in those with hypothyroidism than in females and in those without hypothyroidism. CONCLUSIONS Our study shows that there is a close relationship between unusual sleep postures and SDB-RSs. We recommend that all people with DS with unusual sleep postures should be checked for the presence of SDB.
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Affiliation(s)
- H Kuroda
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - S Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
| | - T Ohkusa
- Faculty of Health Sciences, Ube Frontier University, Ube, Japan
| | - A Rahmawati
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - J Ono
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - M Nishizaka
- Kirameki Projects Career Support Center, Kyushu University Hospital, Fukuoka, Japan
| | - N Hashiguchi
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - F Matsuoka
- Department of Medicine, Kyushu University School of Medicine, Fukuoka, Japan
| | - A Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Magota C, Ando S, Nishizaka M, Horikoshi K, Tanaka K, Miyazono M, Hashiguchi N, Ohkusa T, Chishaki A. A study on the meteorological analysis of nocturnal falls during sleep in hospital. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Sawatari H, Ando S, Nishizaka M, Miyazono M, Sakamoto T, Chishaki H, Ohkusa T, Magota C, Sunagawa K, Chishaki A. Accumulated nocturnal hypoxemia was a better predicting factor in vascular endothelial dysfunction in patients with chronic heart failure and sleep disordered breathing. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Kinoshita Y, Nokes KM, Kawamoto R, Kanaoka M, Miyazono M, Nakao H, Chishaki A, Mibu R. Health-related quality of life in patients with lower rectal cancer after sphincter-saving surgery: a prospective 6-month follow-up study. Eur J Cancer Care (Engl) 2015; 26. [PMID: 26603595 DOI: 10.1111/ecc.12417] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2015] [Indexed: 12/16/2022]
Abstract
This longitudinal descriptive study examined whether rectal cancer patients report changes in health-related quality of life (HRQOL) over a 6-month period after different types of sphincter-saving surgery (SSS): intersphincteric resection (ISR), ultra-low anterior resection (ULAR) and low anterior resection (LAR). It also compares HRQOL among the three groups of patients. Seventy-three patients from two hospitals in Japan completed questionnaires on HRQOL and defecation symptoms immediately before surgery and 1 and 6 months afterwards. Results showed that ISR patients had significantly worse HRQOL scores than ULAR and LAR patients and more defecation symptoms that persisted during the 6 months post-SSS. Thus, patients undergoing ISR require psychological and social support, including skills in competent self-management, during the early post-operative period. Furthermore, defecation problems substantially influence HRQOL. The first month post-SSS is particularly challenging. The assumption that HRQOL is better after SSS compared to living with a permanent stoma might not be valid.
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Affiliation(s)
- Y Kinoshita
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - K M Nokes
- Hunter College & Graduate Center, City University of New York, Stone Ridge, NY, USA
| | | | - M Kanaoka
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - M Miyazono
- School of Nursing, Fukuoka Prefectural University, Fukuoka
| | - H Nakao
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - A Chishaki
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - R Mibu
- International University of Health and Welfare, Fukuoka, Japan
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Sawatari H, Miyazono M, Nishizaka M, Ando S, Sunagawa K, Chishaki A. Leg thermal therapy improved sleep structure and subjective sleep quality in chronic heart failure. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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Hashiguchi N, Takeda A, Yasuyama Y, Chishaki A, Tochihara Y. Effects of 6-h exposure to low relative humidity and low air pressure on body fluid loss and blood viscosity. Indoor Air 2013; 23:430-436. [PMID: 23464811 DOI: 10.1111/ina.12039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 02/21/2013] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to investigate the effects of 6-h exposure to low relative humidity (RH) and low air pressure in a simulated air cabin environment on body fluid loss (BFL) and blood viscosity. Fourteen young healthy male subjects were exposed to four conditions, which combined RH (10% RH or 60% RH) and air pressure (NP: sea level or LP: equivalent to an altitude of 2000 m). Subjects remained seated on a chair in the chamber for 6 h. Their diet and water intake were restricted before and during the experiment. Insensible water loss (IWL) in LP10% condition was significantly greater than in NP60% condition; thus, combined 10%RH and LP conditions promoted a greater amount of IWL. The BFL under the LP condition was significantly greater than that under the NP condition. Blood viscosity significantly increased under LP conditions. Increases in red blood cell counts (RBCs) and BFL likely contributed to the increased blood viscosity. These findings suggest that hypobaric-induced hypoxia, similar to the conditions in the air cabin environment, may cause increased blood viscosity and that the combined low humidity and hypobaric hypoxia conditions increase IWL.
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Affiliation(s)
- N Hashiguchi
- Department of Health Science, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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16
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Sawatari H, Chishaki A, Nishizaka M, Matsuoka F, Kuroda H, Hashiguchi N, Anita R, Ono J, Miyazono M, Ando S. Cross-sectional general survey on the relationship between congenital heart diseases and sleep disordered breathing in patients with Down syndrome. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Chishaki H, Nakamura C, Inoue M, Hara N, Ide Y, Chishaki A. eGFR should be understood with cautions in diabetic patients - an observational study of annual health check-up results of middle aged Japanese. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Yamashita T, Inoue H, Okumura K, Kodama I, Aizawa Y, Atarashi H, Ohe T, Ohtsu H, Kato T, Kamakura S, Kumagai K, Kurachi Y, Koretsune Y, Saikawa T, Sakurai M, Sato T, Sugi K, Nakaya H, Hirai M, Hirayama A, Fukatani M, Mitamura H, Yamazaki T, Watanabe E, Ogawa S, Katoh T, Igawa O, Matsumoto N, Yamashita T, Kaneko Y, Watanabe E, Ogawa S, Osaka T, Fujii E, Niwano S, Yoshioka K, Kato M, Okazaki O, Kusano K, Okuyama Y, Furushima H, Suzuki M, Noda T, Kawara T, Sato T, Kamakura S, Endoh Y, Kumagai K, Hiyoshi Y, Ishiyama T, Ohtsuka T, Matsumoto M, Chishaki A, Shinohara T, Shirayama T, Koretsune Y, Yokoyama E, Ajiki K, Fujio K, Sugi K, Yamakawa T, Yusu S, Inoue H, Kawamura Y, Hayano M, Date T, Mizusawa Y, Kobayashi Y, Satomi K, Imai Y, Atarashi H, Fukunami M, Yokoshiki H, Betsuyaku T, Okumura K, Takeda H, Matsumoto K, Okishige K, Tagawa M, Hirai M, Okazaki H. Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study). Europace 2010; 13:473-9. [DOI: 10.1093/europace/euq439] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Hagihara A, Murakami M, Chishaki A, Nabeshima F, Nobutomo K. Rate of health insurance reimbursement and adherence to anti-hypertensive treatment among Japanese patients. Health Policy 2001; 58:231-42. [PMID: 11641001 DOI: 10.1016/s0168-8510(01)00171-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Although several studies have reported the effects of free medical care on compliance in patients with hypertension, no study has reported the effects of an economic incentive, such as subsidized medical costs, on compliance with medication protocol, in patients with hypertension. The unique characteristics of the Japanese health insurance system provide for a 10% decrease in the subsidy for medication immediately on retirement (approximately 60 years of age) for insured patients, and a 100% subsidy for insured patients who are 70 years of age or older. We examined the association between level of health insurance coverage and follow-up rate of medical treatment among Japanese patients with hypertension. METHODS The subjects, from throughout Japan, were patients with hypertension (n=1236). The study was conducted in 1991. The odds of completing a 1-year treatment in relation to the rate of health insurance reimbursement were calculated using multiple logistic regression analysis. RESULTS We found the following. (1) Compared with the base group, the odds of completing a 1-year treatment increased to 2.62 or 2.51 in the group whose reimbursement rate was 100%. (2) Compared with the base group, the odds of completing a 1-year treatment was no larger than 1 in the group whose reimbursement rate had been 100% for more than 6 years ('76-'). (3) Compared with the base level, the odds of completing a 1-year treatment increased to 1-1.81 in the group whose liability decreased to 80%. CONCLUSION Although the results imply that even a small economic incentive might be effective in securing a patient's compliance with anti-hypertensive medical treatment, the effect appear limited in both duration and magnitude.
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Affiliation(s)
- A Hagihara
- Department of Health Services Management and Policy, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan.
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20
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Chishaki A. [Possibility of analyzing Holter electrocardiographs by Lorenz Plot method]. Fukuoka Igaku Zasshi 2001; 92:217-24. [PMID: 11548668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A Chishaki
- Department of Nursing, Health Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Tomiyasu T, Chishaki A, Nakamura M. Magnesium deficiency in adult rats promotes the induction of ventricular tachycardia by the administration of epinephrine. Heart Vessels 1999; 13:122-31. [PMID: 10328182 DOI: 10.1007/bf01747829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The effects of magnesium deficiency on epinephrine-induced ventricular tachyarrhythmia were investigated in adult rats. Forty-two adult Wistar rats were fed a magnesium-deficient diet while 30 rats were fed a standard diet for 20 days. The plasma magnesium concentration was lower in the magnesium-deficient rats (0.22+/-0.01 mmol/l) than in the control rats (0.76+/-0.03 mmol/l, P < 0.001). Using a telemetry system, electrocardiograms and arterial blood pressure were recorded on a polygraph in an unrestrained condition. Epinephrine was infused intravenously starting at 5 microg/kg per minute. The QT interval was prolonged to 50+/-1 ms in the magnesium-deficient rats compared with 44+/-1 ms in the control rats (P < 0.001). Before the administration of epinephrine, no ventricular tachyarrhythmias or seizures were found in either the control or the magnesium-deficient rats. The incidence of epinephrine-induced sustained ventricular tachycardia (VT) was higher in the magnesium-deficient rats (86%) than in the control rats (43%, P < 0.01). However, this VT did not result in sudden death. Seizures always preceded death in both the magnesium-deficient and control rats while the arrhythmias observed immediately before death were mainly bradyarrhythmias. The present study in an adult rat magnesium-deficient model revealed that magnesium deficiency enhances the susceptibility to epinephrine-induced ventricular tachyarrhythmias.
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Affiliation(s)
- T Tomiyasu
- The Graduate School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan
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22
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Yanaga K, Takenaka K, Yamamoto K, Nishizaki T, Shirabe K, Shimada M, Kawahara N, Chishaki A, Sugimachi K. Cardiac complications after hepatic resection. Br J Surg 1996; 83:1448-51. [PMID: 8944469 DOI: 10.1002/bjs.1800831039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
During a period of 94 months between 1985 and 1993, 474 hepatic resections were performed in 451 patients, of whom 23 (5 per cent) had cardiac problems: ischaemic heart disease in 16 (previous myocardial infarction in five and angina pectoris in 11), arrhythmic disorders in three, valvular disease in three (previous mitral valve replacement in two) and hypertrophic cardiomyopathy in one. The cardiac patients had a higher incidence of cardiac complications (24 versus 0 per cent, P < 0.0001) including two myocardial infarctions, and of non-cardiac complications consisting of postoperative liver failure (16 versus 4 per cent, P < 0.01) and bile leak (16 versus 5 per cent, P = 0.02), as well as hospital death (16 versus 3 per cent, P < 0.001). However, long-term survival was similar in the two groups. Patients with preoperative cardiac conditions appear to be at increased risk for early postoperative morbidity and mortality after hepatic resection.
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Affiliation(s)
- K Yanaga
- Department of Surgery II, Kyushu University Faculty of Medicine, Fukuoka, Japan
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Nakamura M, Abe S, Goto Y, Chishaki A. Sudden sound-induced death in magnesium-deficient rats after repetitive episodes of seizures result from brain dysfunction. Magnes Res 1995; 8:47-53. [PMID: 7669507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To clarify the changes occurring in EEG and ECG from seizure induction to sudden death, 25 weanling male Sprague-Dawley rats were fed a severely Mg-deficient diet for 18 days. In nine of 25 Mg-deficient rats, both EEG and ECG were recorded from the beginning of seizures induction until sudden death. When flattening of EEG became after seizure occurrence, all nine Mg-deficient rats did not recover and death occurred within a few minutes. These results may support the idea that sudden death in Mg-deficient rats resulted from brain dysfunction after repetitive episodes of noise-induced seizures and not from simple apnoea due to tonic contraction of respiratory muscle.
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Affiliation(s)
- M Nakamura
- Department of Clinical Nutrition, Graduate School of Health and Nutrition Sciences, Nakamura-Gakuen College, Fukuoka, Japan
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Nakamura M, Abe S, Goto Y, Chishaki A, Akazawa K, Kato M. In vivo assessment of prevention of white-noise-induced seizure in magnesium-deficient rats by N-methyl-D-aspartate receptor blockers. Epilepsy Res 1994; 17:249-56. [PMID: 8013447 DOI: 10.1016/0920-1211(94)90055-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The behavioral changes associated with seizures induced by auditory stimulation in magnesium (Mg)-deficient rats originate in deep brain structures and secondarily project to neocortex. In the present study, we examined the roles of N-methyl-D-aspartate (NMDA) receptors in this seizure model. The intraperitoneal administration of the competitive NMDA receptor blocker DL-2-amino-7-phosphonoheptanoic acid (36 and 72 mg/kg) and the non-competitive NMDA receptor blocker MK-801 (1.35 and 2.7 mg/kg), completely prevented the induction of seizure and bradyarrhythmia or sudden death resulting from seizure. Therefore, the white-noise-induced seizures in Mg-deficient rats are linked to increased neuronal excitability via the NMDA receptor.
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Affiliation(s)
- M Nakamura
- Department of Clinical Nutrition, Graduate School of Health and Nutrition Sciences, Nakamura-gakuen College, Fukuoka, Japan
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Kubota T, Imaizumi T, Chishaki A, Hayashi Y, Inou T, Takeshita A. Acute myocardial infarction with a hemodynamic pattern resembling constrictive pericarditis. Jpn Heart J 1991; 32:515-20. [PMID: 1956121 DOI: 10.1536/ihj.32.515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 49-year-old woman experienced acute myocardial infarction with a hemodynamic pattern resembling constrictive pericarditis. To clarify its mechanism, we performed right atrial pacing and volume challenge test during the chronic state. Although these two interventions elevated diastolic pressures of the both ventricles, the dip and plateau pattern was not reproduced. Factors other than ischemia may be important in producing a hemodynamic pattern resembling constrictive pericarditis in acute myocardial infarction.
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Affiliation(s)
- T Kubota
- Research Institute of Angiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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