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Tanaka H, Kamiya CA, Horiuchi C, Morisaki H, Tanaka K, Katsuragi S, Hayata E, Hasegawa J, Nakata M, Sekizawa A, Ishiwata I, Ikeda T. Aortic dissection during pregnancy and puerperium: A Japanese nationwide survey. J Obstet Gynaecol Res 2021; 47:1265-1271. [PMID: 33480070 DOI: 10.1111/jog.14657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/11/2020] [Accepted: 12/26/2020] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to characterize the incidence and clinical significance of pregnancy-related aortic dissection using a large-scale survey in Japan. METHODS A questionnaire requesting the detailed information included in the clinical charts of pregnancy-related aortic dissection cases (without any personally identifying information) was designed between 2013 and 2017 and administered to 407 perinatal centers in Japan. The response rate was 70.5%. Seventeen cases of pregnancy-related aortic dissection were identified. RESULTS Maternal death due to aortic dissection was observed in nine patients (56.2%) while seven survived (43.8%). Dissection occurred during the postpartum period in 10 cases (62.5%), the third trimester in 4 (25.0%), labor in 1 (6.2%), and the second trimester in 1 (6.2%). The most common underlying diseases were: Marfan syndrome (25.0%), Loeys-Dietz syndrome (6.2%), hypertension (6.2%), and Takayasu aortitis (6.2%). Stanford type A aortic dissection was associated with maternal death during both pregnancy and the postpartum period. However, deceased patients showed lower rates of pre-diagnosed connective tissue disease than did survivors. CONCLUSIONS The mortality rate of aortic dissection that occurred during pregnancy or postnatal periods was more than 50%. Aortic dissection occurred more frequently in the postnatal period than during pregnancy, and less frequently in women previously diagnosed with connective tissue disease than in women without any medical history of aortic disorders. If symptoms suggestive of aortic dissection, such as severe back pain, are observed, even after the end of pregnancy, exhaustive diagnostic examinations should be carried out.
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Affiliation(s)
- Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Chizuko A Kamiya
- Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Chinami Horiuchi
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Tokyo, Japan
| | - Hiroko Morisaki
- Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Shinji Katsuragi
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Eijiro Hayata
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan
| | - Junichi Hasegawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masahiko Nakata
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Isamu Ishiwata
- Department of Obstetrics and Gynecology, Ishiwata Obstetrics and Gynecology Hospital, Ibaraki, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
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Sawada M, Yoshimatsuj J, Nakai M, Tsukinaga R, Yokouchi-Konishi T, Shionoiri T, Nakanishi A, Horiuchi C, Tsuritani M, Kamiya CA, Iwanaga N, Miyamoto Y, Nishimura K, Ohnishi Y. Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring. J Perinat Med 2020; 48:/j/jpme.ahead-of-print/jpm-2019-0348/jpm-2019-0348.xml. [PMID: 32284451 DOI: 10.1515/jpm-2019-0348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/14/2020] [Indexed: 11/15/2022]
Abstract
Background There are numerous significant physiological changes occurring in circulation during labor. To detect these rapid hemodynamic changes, invasive and intermittent measurement techniques are not reliable. To suggest a suitable delivery method for pregnancy with cardiac disease, this study analyzed how each delivery method influences cardiac function using a noninvasive and continuous measurement technique. Methods A prospective study was accomplished at the National Cerebral and Cardiovascular Center in Japan from October 1, 2014, to November 30, 2018. The classification of the healthy heart pregnant women was according to the delivery method: vaginal delivery (VD) without epidural anesthesia, VD with epidural anesthesia, and caesarean section (CS). The hemodynamic parameters cardiac index (CI), stroke volume index (SI), and heart rate (HR) were evaluated regularly throughout delivery by noninvasive electrical cardiometry monitor. Results Ten cases were examined for each group. CI and HR were significantly increased before VD, while the increase in CI and HR was mild in the epidural group in comparison to the nonepidural group. SI was increased toward the delivery in the epidural group, and it was constant in the nonepidural group. However, there was no alteration in the level of outcomes of the two groups. In CS, SI increased and HR decreased before delivery. After delivery, SI continued to increase, while HR did not change but CI increased. Conclusion In VD, the increase in venous circulation according to the autotransfusion is managed by increasing HR. By epidural anesthesia, the increase in HR was suppressed and SI was increased. However, as epidural anesthesia increases the vascular capacity, the level of SI outcome was comparable. In CS, the HR was decreased because of the spinal anesthesia and the SI was increased because of many factors like hydration. As there are many factors to control in CS, VD with epidural anesthesia will be the first preference for most cardiac patients.
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Affiliation(s)
- Masami Sawada
- Department of Obstetrics and Gynecology, Osaka Medical College, 2-7, Daigaku-chyo, Takatsuki, Osaka 569-8686, Japan
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shimmachi, Suita, Osaka 565-8565, Japan
| | - Jun Yoshimatsuj
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Rie Tsukinaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tae Yokouchi-Konishi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tadasu Shionoiri
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Atsushi Nakanishi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiro Miyamoto
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Nakanishi A, Kamiya C, Sawada M, Shionoiri T, Konishi T, Horiuchi C, Tsuritani M, Iwanaga N, Yoshimatsu J. Left ventricular hypertrophy in Japanese pregnant women with chronic hypertension predicts blood pressure elevation during pregnancy. Hypertens Res Pregnancy 2020. [DOI: 10.14390/jsshp.hrp2019-016] [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: 11/16/2022]
Affiliation(s)
- Atsushi Nakanishi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Masami Sawada
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Tadasu Shionoiri
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Tae Konishi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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Katsuragi S, Kamiya C, Yamanaka K, Neki R, Miyoshi T, Iwanaga N, Horiuchi C, Tanaka H, Yoshimatsu J, Niwa K, Takagi Y, Ogo T, Nakanishi N, Ikeda T. Corrigendum to "Maternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome" [Taiwan J Obstet Gynecol 58 (2019) 183-187]. Taiwan J Obstet Gynecol 2020; 59:171. [PMID: 32039794 DOI: 10.1016/j.tjog.2019.12.001] [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: 11/20/2022] Open
Affiliation(s)
- Shinji Katsuragi
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Japan; Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan.
| | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Kaoru Yamanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Hiroaki Tanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Koichiro Niwa
- Department of Cardiology, St. Luke's International Hospital, Japan
| | - Yaemi Takagi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Japan
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5
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Nakashima A, Miyoshi T, Aoki-Kamiya C, Nishio M, Horiuchi C, Tsuritani M, Iwanaga N, Katsuragi S, Neki R, Ikeda T, Yoshimatsu J. Predicting postpartum cardiac events in pregnant women with complete atrioventricular block. J Cardiol 2019; 74:347-352. [PMID: 31060956 DOI: 10.1016/j.jjcc.2019.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/12/2019] [Accepted: 04/01/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Women with complete atrioventricular block (CAVB) can tolerate hemodynamic changes during pregnancy; however, the incidence of cardiac events in women with CAVB may increase after delivery. The aim of this study was to investigate predictive factors for postpartum cardiac events in pregnant women with CAVB. METHODS AND RESULTS Pregnant women with CAVB who received perinatal management at a tertiary cardiac center from 1981 to 2015 were retrospectively reviewed. Univariate and multivariate logistic analyses of postpartum cardiac events were performed. Postpartum cardiac event was defined as cardiopulmonary arrest, cardiac failure, or the need for permanent pacemaker implantation (p-PMI) within 3 months after delivery. A total of 63 pregnancies in 36 women with CAVB were included in this study; 25 had undergone p-PMI before pregnancy. Regardless of p-PMI status, women with CAVB had no further increases in heart rate during the second and third trimesters. No heart failure was found during pregnancy and delivery. Postpartum cardiac events occurred in 9 pregnancies (14.3%) in 8 women with CAVB; 3 had cardiac failure and p-PMI, 3 had cardiac failure, 2 required p-PMI, and 1 had cardiopulmonary arrest. Multivariate analysis showed that perinatal ventricular pause (odds ratio 11.60, 95% confidence interval 1.90-82.18, p<0.01) and family history of CAVB (odds ratio 10.59, 95% confidence interval 1.36-90.56, p=0.03) were associated with postpartum cardiac events. CONCLUSIONS All cardiac events occurred during the postpartum period among women with CAVB, and ventricular pause during the perinatal period and a family history of CAVB were predictors of postpartum cardiac events. Close follow-up should be considered during the postpartum period for women with high-risk CAVB.
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Affiliation(s)
- Ayaka Nakashima
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Obstetrics and Gynecology, Mie University, Tsu, Japan.
| | - Chizuko Aoki-Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Miho Nishio
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shinji Katsuragi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
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6
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Katsurahgi S, Kamiya C, Yamanaka K, Neki R, Miyoshi T, Iwanaga N, Horiuchi C, Tanaka H, Yoshimatsu J, Niwa K, Takagi Y, Ogo T, Nakanishi N, Ikeda T. Maternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome. Taiwan J Obstet Gynecol 2019; 58:183-187. [PMID: 30910135 DOI: 10.1016/j.tjog.2019.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/10/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The goal of the study was to clarify the risk factors for pregnancy complicated with Eisenmenger syndrome (ES). MATERIALS AND METHODS A retrospective study was performed in 15 patients with ES who were managed throughout pregnancy at one institution from 1982 to 2013. Cases associated with congenital heart diseases other than atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) were excluded. RESULTS The congenital heart diseases in ES included ASD (n = 3), VSD (n = 9), and PDA (n = 3). Ten women chose termination and 5 continued with their pregnancies. In the 5 continuation cases (PDA 1, VSD 4), worsening of cyanosis, exertional fatigue and dyspnea appeared between 25 and 30 weeks gestation and cesarean section was performed at 30 (28-33) weeks. LVEF, PaO2, and SpO2 decreased and heart rate increased significantly from before pregnancy to 25-30 weeks gestation. From before to during the pregnancy, there were no significant changes in mean PABP or pulmonary vascular resistance (PVR) in four cases with data (582-592, 885 to 868, 1280 to 1291, 1476-1522 dyn × s/cm2). PVR at conception had a negative relationship with delivery weeks. NYHA classes before, during and 1 year after pregnancy were II, III and II. In one recent case, epoprostenol and tadalafil were administered during pregnancy. CONCLUSIONS Pregnancy with ES has a high risk due to hypooxygenation, cyanosis, and cardiac failure, which can appear as common complications as early as the 2nd trimester. Early interventions with meticulous care are required for these complications during pregnancy and delivery.
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Affiliation(s)
- Shinji Katsurahgi
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Japan; Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan.
| | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Kaoru Yamanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Hiroaki Tanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Koichiro Niwa
- Department of Cardiology, St. Luke's International Hospital, Japan
| | - Yaemi Takagi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Japan
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7
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Yokouchi-Konishi T, Yoshimatsu J, Sawada M, Shionoiri T, Nakanishi A, Horiuchi C, Tsuritani M, Iwanaga N, Kamiya CA, Neki R, Miyake A, Kurosaki K, Shiraishi I. Recurrent Congenital Heart Diseases Among Neonates Born to Mothers with Congenital Heart Diseases. Pediatr Cardiol 2019; 40:865-870. [PMID: 30830281 DOI: 10.1007/s00246-019-02083-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/27/2019] [Indexed: 01/08/2023]
Abstract
The frequency of newborns with congenital heart disease (CHD) is approximately 1% in the general population; however, the recurrence rate of CHD in mothers with CHD differs in ethnicity and reports. We therefore aimed to determine the prevalence of CHD among neonates born to mothers with CHD in our institute in Japan. We reviewed the medical charts of 803 neonates delivered by 529 women with CHD at the National Cerebral and Cardiovascular Center from 1982 to 2016. They included isolated ventricular septal defect (VSD,31.4%), isolated atrial septal defect (ASD, 23.3%), tetralogy of Fallot (TOF,10.6%). We defined CHD in neonates as being diagnosed within 1 month of birth. We estimated that the average rate of the CHD recurrence was 3.1%. The recurrence ratios in each maternal CHD were 8.6%, 7.1%, 6.2%, 4.8%, 3.6%, and 1.5% for PS, CoA, TOF, atrioventricular septal defect, VSD, and ASD, respectively. The rate of CHD in offsprings whose mothers have CHD was 3 times greater than that of mothers with healthy hearts. Almost half of neonates with CHD had the same phenotype as their mother in our series. Especially, PS and CoA were closely related to the type of maternal CHD.
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Affiliation(s)
- Tae Yokouchi-Konishi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Masami Sawada
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Tadasu Shionoiri
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Atsushi Nakanishi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Akira Miyake
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenichi Kurosaki
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Isao Shiraishi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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8
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Horiuchi C, Kamiya CA, Ohuchi H, Miyoshi T, Tsuritani M, Iwanaga N, Neki R, Niwa K, Kurosaki K, Ichikawa H, Ikeda T, Yoshimatsu J. Pregnancy outcomes and mid-term prognosis in women after arterial switch operation for dextro-transposition of the great arteries - Tertiary hospital experiences and review of literature. J Cardiol 2018; 73:247-254. [PMID: 30579805 DOI: 10.1016/j.jjcc.2018.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 11/03/2018] [Accepted: 11/10/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Arterial switch operation (ASO) for dextro-transposition of the great arteries (d-TGA) has gradually replaced the atrial switch operation and has become the standard operation. To date, the outcomes of pregnant women with d-TGA after this new operation have not been investigated. In this study, we investigated the impact of ASO on pregnant outcomes and mid-term prognosis in women with d-TGA and compared with the atrial switch operation through the literature review. METHODS AND RESULTS There were 20 pregnancies in 10 women with d-TGA after ASO and 6 resulted in abortion. Among 14 successful pregnancies in 10 women, 11 pregnancies achieved the term delivery and 3 pregnancies, including 1 twin pregnancy, resulted in preterm labor. Maternal cardiovascular events occurred in 4 (heart failure and arrhythmias in 3 and arrhythmia in 1), and all were controllable with medications. Risk factors for the peripartum cardiac events were older age at ASO and delivery, and higher concentration of brain natriuretic peptide (BNP) at first trimester (p<0.05). In 7-60 month-follow-up after delivery, no case showed deterioration of functional class and systemic ventricular function. According to the literature review, women after ASO demonstrated a better prognosis than those after the atrial switch operation. CONCLUSIONS The majority of women with d-TGA after ASO tolerated pregnancy and delivery well. The older age at ASO, an elderly pregnancy, and higher BNP levels at the first trimester were possibly risk factors of peripartum cardiovascular events among the group. The literature reviews and this study may indicate the advantage of systemic left ventricle compared with systemic right ventricle in long-term outcomes after delivery.
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Affiliation(s)
- Chinami Horiuchi
- Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Departments of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.
| | - Chizuko A Kamiya
- Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hideo Ohuchi
- Departments of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takekazu Miyoshi
- Departments of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Mitsuhiro Tsuritani
- Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Naoko Iwanaga
- Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Reiko Neki
- Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Koichiro Niwa
- Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan
| | - Kenichi Kurosaki
- Departments of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hajime Ichikawa
- Departments of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoaki Ikeda
- Departments of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Jun Yoshimatsu
- Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Ueda Y, Kamiya CA, Horiuchi C, Miyoshi T, Hazama R, Tsuritani M, Iwanaga N, Neki R, Ikeda T, Yoshimatsu J. Safety and efficacy of a 52-mg levonorgestrel-releasing intrauterine system in women with cardiovascular disease. J Obstet Gynaecol Res 2018; 45:382-388. [PMID: 30259601 DOI: 10.1111/jog.13828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/03/2018] [Indexed: 11/26/2022]
Abstract
AIM We sought to examine the safety and efficacy of a 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS), and to evaluate the changes in biomarkers of infection, anemia and cardiovascular conditions after LNG-IUS insertion in women with cardiovascular disease. METHODS We prospectively followed women with a cardiovascular disease in whom a 52-mg LNG-IUS was inserted between 2009 and 2015. The primary outcome was the frequency of cardiovascular and gynecologic side effects due to the LNG-IUS over the year after LNG-IUS insertion. The secondary outcomes were the changes in menstrual blood loss and biomarkers, e.g., white blood cell count and the levels of C-reactive protein, hemoglobin and brain natriuretic peptide. We also evaluated the 24-month continuation rate of LNG-IUS. RESULTS A total of 34 women were prospectively followed-up, including two women with pulmonary hypertension. No cardiovascular side effects were identified during the 1 year after LNG-IUS insertion, other than one case of mild vasovagal reaction at insertion. Neither the white blood cell count nor the C-reactive protein value increased after LNG-IUS insertion. The menstrual blood loss was decreased in most subjects and the median hemoglobin levels increased significantly within 1 year after insertion (P < 0.001 and P = 0.002). Moreover, brain natriuretic peptide levels tended to decrease in correspondence with the hemoglobin elevation (P = 0.074). The 24-month LNG-IUS continuation rate was 97% (95% confidence interval 85-100). CONCLUSION No clinically significant cardiovascular event was identified during the 1 year after 52-mg LNG-IUS insertion among women with cardiovascular disease. The 52-mg LNG-IUS may have specific favorable effects by decreasing the risk of iron deficiency anemia in these women.
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Affiliation(s)
- Yusuke Ueda
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ryoichi Hazama
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Tsu, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan
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Ueda Y, Kamiya CA, Nakanishi A, Horiuchi C, Miyoshi T, Hazama R, Tsuritani M, Iwanaga N, Neki R, Yoshimatsu J. Cardiomyopathy Phenotypes and Pregnancy Outcomes with Left Ventricular Noncompaction Cardiomyopathy. Int Heart J 2018; 59:862-867. [DOI: 10.1536/ihj.17-336] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/18/2022]
Affiliation(s)
- Yusuke Ueda
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Chizuko A. Kamiya
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Atsushi Nakanishi
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Chinami Horiuchi
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Takekazu Miyoshi
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Ryoichi Hazama
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Naoko Iwanaga
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Reiko Neki
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
| | - Jun Yoshimatsu
- Department of Perinatology and Obstetrics, National Cerebral and Cardiovascular Center
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11
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Daimon A, Kamiya CA, Sawada M, Ueda Y, Horiuchi C, Miyoshi T, Tsuritani M, Iwanaga N, Neki R, Okamura H, Kusano S, Yoshimatsu J. Utility of Fluid Assessment Based on the Intrathoracic Impedance Monitoring in a Peripartum Woman with Heart Disease. Int Heart J 2018; 59:435-438. [PMID: 29445057 DOI: 10.1536/ihj.17-096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recently, implantable cardioverter-defibrillators (ICD) have become capable of monitoring intrathoracic impedance to detect an increased fluid volume and heart failure. Pregnancy is a well-known cause of an increased body fluid volume; however, it is not clear whether the measurement of intrathoracic impedance by ICD is clinically useful for precisely detecting heart failure in pregnant women. We herein report the case of a 39-year-old woman with an ICD that had been implanted after an event of ventricular fibrillation due to severe aortic regurgitation with a bicuspid aortic valve. Elevated right ventricular pressure and brain natriuretic peptide levels were detected at 37 weeks of gestation and postpartum. At the same time, the ICD's stored fluid index gradually increased and exceeded the threshold on the 10th day after delivery. She was treated with diuretics and recovered from postpartum heart failure. The physiological volume changed in the perinatal period, but we were still able to detect heart failure by ICD. Intrathoracic impedance monitoring is effective in the perinatal field.
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Affiliation(s)
- Atsushi Daimon
- Department of Obstetrics and Gynecology, Osaka Medical College
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Masami Sawada
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Yusuke Ueda
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Hideo Okamura
- Cardiovascular Department, National Cerebral and Cardiovascular Center
| | - Shingo Kusano
- Cardiovascular Department, National Cerebral and Cardiovascular Center
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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12
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Tsuritani M, Kamiya CA, Sawada M, Horiuchi C, Iwanaga N, Yoshimatsu J. Intra- and post-partum acute aortic dissection (Stanford type B): Report of two cases. J Obstet Gynaecol Res 2017; 43:1629-1633. [DOI: 10.1111/jog.13412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/20/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Mitsuhiro Tsuritani
- Perinatology and Genecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Chizuko A. Kamiya
- Perinatology and Genecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Masami Sawada
- Perinatology and Genecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Chinami Horiuchi
- Perinatology and Genecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Naoko Iwanaga
- Perinatology and Genecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Jun Yoshimatsu
- Perinatology and Genecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
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13
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Sato H, Kamiya CA, Sawada M, Horiuchi C, Tsuritani M, Iwanaga N, Ohuchi H, Shiraishi I, Ichikawa H, Yoshimatsu J. Changes in echocardiographic parameters and hypertensive disorders in pregnancies of women with aortic coarctation. Pregnancy Hypertens 2017; 10:46-50. [PMID: 29153689 DOI: 10.1016/j.preghy.2017.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 05/14/2017] [Accepted: 05/27/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Pregnancy can be well tolerated after the repair of aortic coarctation. However, a higher incidence of hypertensive disorders during these pregnancies was reported. We analyzed the perinatal changes in echocardiographic parameters in women with aortic coarctation and investigated the risk factors of gestational hypertension (GH). METHODS We retrospectively identified 15 pregnancies in nine Japanese women with aortic coarctation between 1982 and 2015. We categorized the patients according to the presence/absence of GH as the group with GH(n=3) and that without GH(n=12). The echocardiographic parameters were compared between groups. RESULTS Our analysis revealed that a pre-pregnancy Doppler-measured pressure gradient≥20mmHg and a left ventricular mass index≥95g/m2 were significant risk factors for GH. The left ventricular end-diastolic diameters at the first and the third trimesters, the left ventricular end-systolic diameters at the first trimester, and the left ventricular ejection fraction at the third trimester were also significantly higher in the pregnancies with GH. All of these findings had been obtained before the patients' GH occurred. CONCLUSIONS Hypertrophy of the left ventricle with a lower ejection fraction and a high pressure gradient across the coarctation were risk factors for GH in the patients with aortic coarctation. Thus, serial measurements using echocardiography are important for predicting GH in women with aortic coarctation. However, further research investigating this finding with a larger sample size is needed.
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Affiliation(s)
- Hiroshi Sato
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan.
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Masami Sawada
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Mitsuhiro Tsuritani
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Hideo Ohuchi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Isao Shiraishi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Hajime Ichikawa
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
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14
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Katsuragi S, Sata M, Kobayashi Y, Miyoshi T, Yamashita Y, Neki R, Horiuchi C, Yamanaka K, Kamiya C, Iwanaga N, Tanaka H, Ikeda T, Yoshimatsu J. Antifungal Susceptibility of Candida Isolates at One Institution. Med Mycol J 2014; 55:E1-7. [DOI: 10.3314/mmj.55.e1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Katsuragi S, Kamiya C, Yamanaka K, Neki R, Miyoshi T, Iwanaga N, Horiuchi C, Tanaka H, Yoshimatsu J, Niwa K, Ikeda T. Risk factors for maternal and fetal outcome in pregnancy complicated by Ebstein anomaly. Am J Obstet Gynecol 2013; 209:452.e1-6. [PMID: 23860210 DOI: 10.1016/j.ajog.2013.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/02/2013] [Accepted: 07/01/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The goal of the study was to examine risks in pregnancy in patients with Ebstein anomaly. STUDY DESIGN Data were examined retrospectively for 13 patients (27 pregnancies, 21 live births) with Ebstein anomaly during pregnancy who were treated at our institution from 1985 to 2011. The associated anomalies in these patients were atrial septal defect (ASD) (n = 4) and the Wolff-Parkinson-White syndrome (n = 6). RESULTS Before pregnancy, 2 patients underwent ASD closure and 1 received tricuspid valve replacement (TVR). In all patients, the cardiothoracic ratio increased from 55.1 at conception to 57.0 during pregnancy and 58.0 postpartum (P < .05). Cesarean sections were performed in 3 cases: 1 with ventricular tachycardia and orthopnea (New York Heart Association [NYHA] III) preterm; at full term, and the third in a patient with a mechanical tricuspid valve who developed maternal cerebellum hemorrhage at 27 weeks. The baby died of prematurity in the third case. In all other cases (20 of 21), neonatal prognoses were good without congenital heart diseases. There were 6 spontaneous abortions. Recurrent paroxysmal supraventricular tachycardia occurred during pregnancy in 2 cases and was treated with adenosine triphosphate or verapamil. In 17 pregnancies, NYHA remained in class I and all had full-term vaginal delivery. CONCLUSION Maternal and fetal outcomes are good in patients with Ebstein anomaly and NYHA class I. However, pregnancy in Ebstein anomaly can be complicated with tachyarrhythmia or cardiac failure. In post-TVR cases, meticulous care is required for these complications during pregnancy and delivery.
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Affiliation(s)
- Shinji Katsuragi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Osaka, Japan.
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16
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Miyoshi T, Katsuragi S, Ikeda T, Horiuchi C, Kawasaki K, Kamiya CA, Sasaki Y, Osato K, Neki R, Yoshimatsu J. Retrospective review of thoracoamniotic shunting using a double-basket catheter for fetal chylothorax. Fetal Diagn Ther 2013; 34:19-25. [PMID: 23595018 DOI: 10.1159/000348776] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 02/05/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE From a single-center retrospective cohort with fetal chylothorax, we evaluated the factors related to the decision to use shunting, poor prognostic factors, and reported shunting outcomes with a new double basket-catheter device. METHODS A retrospective single-center study was performed in 35 cases of fetal chylothorax. RESULTS There were 35 cases of chylothorax: 23 with hydrops and 12 without hydrops. Twenty-one procedures were performed on 15 fetuses (11 with hydrops) with a single shunt in 11, two shunts in 3 and four shunts in 1. All 12 nonhydropic cases survived. In 23 hydropic cases, overall survival rates with and without thoracoamniotic shunting were 46 and 33%, respectively. The mortality rates of fetal hydropic cases with and without ascites were 93 and 11%, respectively. Fetal ascites, progression of fetal hydrops, and premature delivery at <33 weeks were significant risk factors for a poor prognosis. Progression of polyhydramnios after shunting was also associated with a poor prognosis. Obstruction of the catheter was observed in 38%. There were no direct fetal deaths associated with shunting. CONCLUSION Thoracoamniotic shunting should be considered for pleural effusion before development of fetal hydrops, or at least before the appearance of fetal ascites. A double-basket catheter tends to be obstructive, but may be less invasive for fetuses.
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Affiliation(s)
- Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Osaka, Japan.
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17
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Katsuragi S, Neki R, Yamanaka K, Kamiya C, Miyoshi T, Kobayashi Y, Horiuchi C, Suzuki R, Toyoda K, Iihara K, Minematsu K, Ikeda T, Yoshimatsu J. 680: Maternal outcomes in stroke during pregnancy and puerperium. Am J Obstet Gynecol 2013. [DOI: 10.1016/j.ajog.2012.10.846] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Miyoshi T, Kamiya CA, Katsuragi S, Ueda H, Kobayashi Y, Horiuchi C, Yamanaka K, Neki R, Yoshimatsu J, Ikeda T, Yamada Y, Okamura H, Noda T, Shimizu W. Safety and Efficacy of Implantable CardioverterDefibrillator During Pregnancy and After Delivery. Circ J 2013; 77:1166-70. [DOI: 10.1253/circj.cj-12-1275] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [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: 11/09/2022]
Affiliation(s)
- Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chizuko A. Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Shinji Katsuragi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Hiroto Ueda
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Yoshinari Kobayashi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Kaoru Yamanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Tomoaki Ikeda
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Yuko Yamada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideo Okamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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19
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Tomita Y, Kamei M, Jyujou S, Horiuchi C, Katsuragi S, Onishi Y. [Undiagnosed hereditary angioedema in a patient undergoing emergency caesarean section]. Masui 2012; 61:1376-1379. [PMID: 23362781] [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: 06/01/2023]
Abstract
Hereditary angioedema (HAE) is characterized by acute, recurrent attacks of localized edema. Surgical procedures, trauma, and infections have been considered as potential triggers of HAE. Although HAE is a rare genetic disorder, approximately 50-60% of all HAE patients are involved with at least one occurrence of upper airway obstruction. The airway trouble is the most life-threating complication in HAE patients because HAE-related edema does not respond to typical treatment, such as administration of epinephrine, antihistamines, or glucocorticoids. Indeed, mortality rates of laryngeal attack are estimated around 25% to 40%. Here we describe a case of undiagnosed HAE patient undergoing emergency caesarean section under neuraxial blockade. A 31-year-old woman showed multiple regions at her lip margin during surgery and rapidly developed lip swelling after admission to the ward. Neither respiratory nor hemodynamic instability was found during and after surgery. Immediately, in order to assess whether HAE caused these dermatological manifestations, we measured values of both complement component 4 (C4) and functional activity of C1-esterase inhibitor (C1-inh), a protein of the complement system. These laboratory data showed low levels, which were compatible with HAE definition. After commencement of C1-inhibitor replacement therapy, her lip swelling and erythema gradually disappeared without adverse drug reactions. The patient was finally discharged from our institution 10 days after surgery.
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Affiliation(s)
- Yukihiko Tomita
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita 565-0873
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20
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Kamiya CA, Shimizu W, Kabayashi Y, Miyoshi T, Horiuchi C, Umekawa T, Yamanaka K, Neki R, Katsuragi S, Yoshimatsu J, Ikeda T. Markedly reduced ventricular arrhythmia during the peripartum period in a pregnant woman with Andersen-Tawil syndrome. J Arrhythm 2012. [DOI: 10.1016/j.joa.2012.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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Katsuragi S, Yamanaka K, Neki R, Kamiya C, Sasaki Y, Osato K, Miyoshi T, Kawasaki K, Horiuchi C, Kobayashi Y, Ueda K, Yoshimatsu J, Niwa K, Takagi Y, Ogo T, Nakanishi N, Ikeda T. Maternal Outcome in Pregnancy Complicated With Pulmonary Arterial Hypertension. Circ J 2012; 76:2249-54. [DOI: 10.1253/circj.cj-12-0235] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [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: 11/09/2022]
Affiliation(s)
- Shinji Katsuragi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Kaoru Yamanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Yoshihito Sasaki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Kazuhiro Osato
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Kaoru Kawasaki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Yoshinari Kobayashi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Keiko Ueda
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Koichiro Niwa
- Department of Cardiology, St. Luke’s International Hospital
| | - Yaemi Takagi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, Pulmonary Circulation Group
| | | | - Tomoaki Ikeda
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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22
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Taguchi T, Tsukuda M, Mikami Y, Horiuchi C, Ishitoya JI, Katori H. Concurrent chemoradiotherapy with carboplatin and uracil–ftegafur in patients with stage two (T2 N0 M0) squamous cell carcinoma of the glottic larynx. J Laryngol Otol 2006; 120:478-81. [PMID: 16563197 DOI: 10.1017/s0022215106000880] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2005] [Indexed: 11/06/2022]
Abstract
This study aimed to evaluate the efficacy and toxicity of concurrent chemoradiotherapy as a primary treatment modality for larynx preservation in patients with stage two squamous cell carcinoma (SCC) of the glottic larynx. Between February 2000 and August 2003, a total of 20 patients received concurrent chemoradiotherapy. Carboplatin was given intravenously once a week during the period of radiotherapy. The weekly carboplatin dose was based on the area under the curve 1 to 1.25. Uracil–ftegafur (UFT) was given in a daily oral dose of 300 mg as tegafur. Radiotherapy was delivered five days a week using a once-daily fractionation of 2.0 Gray (Gy), to a total dose of 66–72 Gy. The three-year overall survival rate with larynx preservation was 100 per cent.Concurrent chemoradiotherapy with carboplatin and UFT for stage two SCC of the glottic larynx was safe and effective in improving local control with larynx preservation.
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Affiliation(s)
- T Taguchi
- Department of Otorhinolaryngology, Yokohama City University School of Medicine, Yokohama, Japan.
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Katori H, Tsukuda M, Ishitoya J, Mikami Y, Matsuda H, Tanigaki Y, Horiuchi C, Ikeda Y, Ono M, Hirose S. Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. Katori
- Yokohama City University, Yokohama, Japan
| | - M. Tsukuda
- Yokohama City University, Yokohama, Japan
| | | | - Y. Mikami
- Yokohama City University, Yokohama, Japan
| | - H. Matsuda
- Yokohama City University, Yokohama, Japan
| | | | | | - Y. Ikeda
- Yokohama City University, Yokohama, Japan
| | - M. Ono
- Yokohama City University, Yokohama, Japan
| | - S. Hirose
- Yokohama City University, Yokohama, Japan
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Katori H, Tsukuda M, Mochimatu I, Ishitoya J, Kawai S, Mikami Y, Matsuda H, Tanigaki Y, Horiuchi C, Ikeda Y, Taguchi T, Ono M, Yoshida T, Hirose S, Sakuma Y, Yamamoto K. Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Br J Cancer 2004; 90:348-52. [PMID: 14735175 PMCID: PMC2409561 DOI: 10.1038/sj.bjc.6601471] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to evaluate the efficacy and toxicity of a concurrent chemoradiotherapy using docetaxel, cisplatin and 5-fluorouracil (5-FU) (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). In total, 19 patients with previously untreated stage III–IV SCCHN were entered onto this trial. Patients received two cycles of chemotherapy. Cycles were repeated every 4 weeks. The starting doses (dose level 1) were docetaxel 60 mg m−2, cisplatin 70 mg m−2, and 5-day continuous infusion of 5-FU 600 mg m−2 day−1. Radiation was targeted to begin on the first day of chemotherapy, day 1. The total radiation dose to the primary tumour site and neck lymph nodes was between 63.0 and 74.0 Gy. At least three patients were examined at each dose level before advancing to the next level. The maximum-tolerated dose (MTD) of this regimen was docetaxel 60 mg m−2, cisplatin 60 mg m−2 and 5-FU 600 mg m−2 day−1. The main toxicities were mucositis (grade 3 and 4, 79%), leukocytopenia (grade 3 and 4, 53%), neutropenia (grade 3 and 4, 42%), anaemia (grade 3, 16%), liver dysfunction (grade 3, 11%) and renal dysfunction (grade 2, 11%). The overall response rate was 100%, including 84% complete responses (CRs). This concurrent chemoradiotherapy with TPF was safe and well tolerated. The high CR rate justifies further evaluation of this chemoradiotherapy modality in advanced SCCHN patients.
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Affiliation(s)
- H Katori
- Department of Otolaryngology, Yokohama City University School of Medicine Medical Center, 3-46 Urafune-chou, Minami-ku, Yokohama 232-0024, Japan.
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Horiuchi C. [Immunohistochemical studies on localization of CA 19-9 in normal human skin and tumors of the sweat apparatus]. Nihon Hifuka Gakkai Zasshi 1988; 98:1197-203. [PMID: 3230645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Horiuchi C, Ishikawa T, Okami Y, Kusuno T. [Clinical application of basic nursing. Prevention of bedsores during surgery]. Kurinikaru Sutadi 1987; 8:228-31. [PMID: 3648376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Hinoda M, Horiuchi C, Kusuno T. [Innovation in intraoperative posture and prevention of decubitus ulcer]. Kango Gijutsu 1986; 32:573-6. [PMID: 3636502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Seto K, Saito H, Edashige N, Kawakami T, Yoshimatsu K, Horiuchi C, Kawakami M. Influence of microinjection of insulin into amygdala on acetate metabolism in liver slices of rabbit. Exp Clin Endocrinol 1985; 86:233-6. [PMID: 3937741 DOI: 10.1055/s-0029-1210491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Insulin was injected directly into the medial amygdala (AMYG) of rabbits, and changes in hepatic acetate metabolism were studied. The injection of 50 microU insulin into the AMYG decreased the rates of 14C transfer from 14C-1-acetate into CO2 and cholesterol ester, and increased those into free cholesterol and phospholipids. But after insulin injection into parietal cortex of intact rabbits and into the AMYG of rabbits with lesions of stria terminalis (ST), hepatic acetate metabolism did not differ from that of the control rabbits, which received saline injection into the same brain regions. These observations support the hypothesis that the AMYG is a part of insulin-sensitive brain regulator system in the hepatic acetate metabolism.
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Seto K, Saito H, Horiuchi C, Tanaka J, Nakagawa M, Kawakami M. Influence of lesions in the limbic-hypothalamic system on metabolic responses of pyruvate to daily repeated heat exposures in rabbits. Exp Clin Endocrinol 1985; 86:335-45. [PMID: 4092744 DOI: 10.1055/s-0029-1210506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The effects of lesions of the limbic-hypothalamic structures on the pyruvate metabolic responses to daily repeated heat exposures in the liver of rabbits have been investigated. The experimental results were as follows: 1. The pyruvate metabolic responses to the 1st heat exposure (heat exposure on the 1st day) were altered by lesions of periventricular arcuate nucleus (ARC), ventromedial hypothalamus (VMH), stria terminalis (ST) and dorsal fornix (FX). 2. The pyruvate metabolic responses to heat exposure were completely abolished by the ten times repetition of daily heat exposures in rabbits with lesions of ARC, VMH and ST, as same as in each sham-operated group. 3. In rabbits with FX lesions, the pyruvate metabolic responses to heat exposure remained even after the ten times repetition of daily heat exposures. 4. From these results, it might be suggested that ARC, VMH, amygdala (AMYG)-ST system and dorsal hippocampus (HPC)-FX system played a certain role in the mechanisms of pyruvate metabolic responses to the 1st heat exposure, but only the HPC-FX system participated in the process of pyruvate metabolic adaptation to daily repeated heat exposures.
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Sugimura Y, Yoshizaki F, Katagiri J, Horiuchi C. Studies on algal cytochromes. I. Purification and properties of cytochrome b-561 from Enteromorpha prolifera. J Biochem 1980; 87:541-7. [PMID: 7358653 DOI: 10.1093/oxfordjournals.jbchem.a132776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Cytochrome b-561 (Enteromorpha prolifera) was extracted from a green alga, E. prolifera, by immersion of the dried thalli in phosphate buffer solution. Purification was carried out by ammonium sulfate fractionation, DEAE-cellulose and DEAE-Sephadex column chromatographies, Bio-Gel gel filtration, and hydroxyapatite column chromatography. The reduced form of the cytochrome exhibited absorption maxima at 561 (alpha), 530.5 (beta), and 428.5 nm (gamma), and the oxidized form at 530.5, 417 (gamma), and 275 nm. The alpha-band of the reduced form was symmetric without any shoulder. The pyridine hemochrome showed absorption maxima at 556, 524, and 418 nm. The cytochrome does not combine with carbon monoxide or cyanide. The cytochrome showed little peroxidase activity. The cytochrome is oxidized by ferricyanide and reduced by cysteine, ascorbate, and hydrosulfite. Ferrocyanide and hydroquinone do not completely reduce it. Autoxidation of the cytochrome was found to be very slow. The midpoint potential (Em) of the cytochrome was determined by equilibration with the ferro- and ferri-EDTA system to be +0.23 volt at pH 7.0 and 25 degrees C. The molecular weight of the cytochrome, estimated by Sephadex gel filtration, was 67 x 10(3).
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