1
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Garavatti E, Yamamoto E, Collins K, Selden N, Bushlin I. Surgical Resection of Focal Cortical Dysplasia in a Neonate with Novel TSC1 Mutation Leading to Resolution of Refractory Seizures: Case Report. Child Neurol Open 2023; 10:2329048X231219223. [PMID: 38107744 PMCID: PMC10722926 DOI: 10.1177/2329048x231219223] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/20/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
We describe a neonate presenting on first day of life with refractory seizures secondary to a single, large area of focal cortical dysplasia (FCD) who underwent surgical resection at age 3 weeks leading to resolution of seizure activity and dramatic improvement in developmental trajectory. Surgical intervention for epilepsy is infrequently offered for neonates, often reserved only for those with catastrophic presentations. This case demonstrates that surgical intervention can be safe and efficacious in neonates for pharmaco-resistant seizures associated with a focal lesion. Rapid whole exome sequencing in this case yielded a germline novel de novo TSC1 mutation, leading to a genetic diagnosis of tuberous sclerosis complex (TSC). Our patient demonstrates an atypical neonatal presentation of TSC. Limited data is available for those with isolated FCD in TSC; this is the first reported case in a neonate.
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Affiliation(s)
- Emily Garavatti
- Neurodevelopmental Disabilities, Oregon Health & Science University School of Medicine, Portland, OR, USA
| | - Erin Yamamoto
- Neurosurgery, Oregon Health & Science University School of Medicine, Portland, OR, USA
| | - Kelly Collins
- Department of Neurosurgery, Oregon Health & Science University, Portland, OR, USA
| | - Nathan Selden
- Department of Neurosurgery, Oregon Health & Science University, Portland, OR, USA
| | - Ittai Bushlin
- Department of Pediatric Neurology, Oregon Health & Science University, Portland, OR, USA
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2
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Takashio S, Morioka M, Fujiyama A, Oike F, Hanatani S, Usuku H, Yamamoto E, Matsushita K, Tsujita K. Clinical characteristics, patient selection and clinical outcomes of tafamidis treatment in transthyretin amyloidosis cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.964] [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
Tafamidis is a stabilizer of transthyretin, specifically designed to decrease or prevent amyloidogenesis, and improves prognosis in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). However, clinical coarse, selection of appropriate patients and monitoring therapeutic effect of tafamidis remained unclear.
Purpose
The aim of this study was to clarify the patients' characteristics, clinical coarse, and clinical outcomes of tafamidis in patients with ATTR-CM and to evaluate prognostic factors and changes in clinical data over time.
Methods
We evaluated consecutive 180 patients with ATTR-CM considering tafamids treatment. A total of 107 patients had tafamidis treatment (tafamidis treatment group) and 65 patients did not treat with tafamidis (treatment naïve group). The remaining 8 patients were preclinical. Clinical data were obtained at the consideration of tafamidis treatment. We divided the following the cut-off values of high-sensitivity cardiac troponin T (hs-cTnT); >0.05 ng/mL, B-type natriuretic peptide (BNP); >250 pg/ml, and estimated glomerular filtration rate (eGFR); <45 mL/min/1.73 m2 and calculated the score by adding 1 point if increased or decreased by more than the cut-off value. We divided patients into a low score group (0–1 point) and high score group (2–3 points).
Results
All of study patients in the tafamidis treatment group were wild-type ATTR-CM. Compared to tafamidis treatment group, tafamidis naïve group were significantly older (75.6±5.3 vs. 82.8±4.6 years; p<0.01), female dominant (8% vs. 28%; p<0.01), increased BNP levels (median 209 vs 306 pg/ml; p<0.01), and lower haemoglobin levels (14.1±1.8 vs. 12.4±1.8 g/dl; p<0.01). Tafamidis treatment group was significantly favourable clinical outcomes competed to treatment naïve group (p<0.05; log rank test). According to multivariate logistic regression analysis, prior heart failure hospitalization (hazard ratio [HR]: 5.93, 95% confidence interval [CI]: 1.25–28.03, p=0.03) and high score group (HR: 1.56, 95% CI: 0.37–7.25; <0.01) were the significant poor prognostic factors in tafamids treatment group. Among tafamidis treatment group, Hs-cTnT levels were significantly decreased after 12 months tafamidis treatment (0.055 [0.037–0.082] vs. 0.044 [0.033–0.077]; p<0.01) instead of no significant differences in BNP and significant decline of eGFR levels. There were no significant changes over time in the echocardiographic parameters after 12 months, and native T1 and extracellular volume fraction obtained by cardiac magnetic resonance in a limited number of patients.
Conclusion
The prognosis of ATTR-CM patients treated with tafamidis was favorable compared to tafamidis naïve group. Patient stratification combined with biomarkers predicted favorable prognosis in patients with tafamidis treatment. Hs-cTnT may be a useful maker for evaluating the therapeutic effect by tafamidis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Takashio
- Kumamoto University Hospital , Kumamoto , Japan
| | - M Morioka
- Kumamoto University Hospital , Kumamoto , Japan
| | - A Fujiyama
- Kumamoto University Hospital , Kumamoto , Japan
| | - F Oike
- Kumamoto University Hospital , Kumamoto , Japan
| | - S Hanatani
- Kumamoto University Hospital , Kumamoto , Japan
| | - H Usuku
- Kumamoto University Hospital , Kumamoto , Japan
| | - E Yamamoto
- Kumamoto University Hospital , Kumamoto , Japan
| | | | - K Tsujita
- Kumamoto University Hospital , Kumamoto , Japan
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3
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Morioka M, Takashio S, Fujiyama H, Oike F, Hanatani S, Usuku H, Yamamoto E, Matsushita K, Tsujita K. Change in echocardiography in patients with transthyretin amyloid cardiomyopathy with tafamidis treatment. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1764] [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
Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive and infiltrative disease caused by the deposition of insoluble transthyretin (TTR) amyloid fibrils in the myocardium, which leads to cardiomyopathy characterized by increased ventricular wall thickness and diastolic dysfunction. TTR amyloid fibrils are performed by dissociation of the tetrameric TTR into monomers and misfolding and misassemble into insoluble fibrils. Tafamidis stabilizes the tetramers and inhibits the TTR monomerization, leads to inhibit the formation and deposition of TTR fibril. Clinical trials suggested tafamidis could improve prognosis by slowing the progression of amyloidosis. Evaluation of serial measurement echocardiographic findings by tafamidis treatment is important, but these data has not been fully revealed.
Purpose
The aim of study was to evaluate the change of echocardiographic parameter in patients with ATTR-CM received tafamidis for 12 months. Especially in strain echocardiogram, global longitudinal strain (GLS) has reported to be associated with prognosis, and apical sparing pattern, which longitudinal strain (LS) in the basal and middle segments is more severely impaired than the apical segments, is specific finding in ATTR-CM.
Method
Echocardiographic findings before and 12 months were compared in 68 patients with ATTR-CM who started a new prescription of tafamidis and 18 tafamidis naïve patients with ATTR-CM patients who underwent echocardiography annually prior to the approval of tafamidis.
Result
Among tafamidis treatment group, echocardiographic parameters were not significant changes before and after 12 months tafamidis treatment [left ventricular ejection fraction (LVEF): 49.6±10.6% vs. LVEF: 49.9±10.7% (p=0.767), interventricular septum diameter (IVSd):16.0±2.3mm vs 15.7±2.1mm (p=0.241), left ventricular posterior wall diameter (LVPWd):16.1±2.5mm vs 16.1±2.5mm (p=0.964), GLS: −8.4±2.7% vs −8.2±2.8% (p=0.419), LS at base: −4.6±2.6% vs −4.2±2.4% (p=0.291), LS at middle: −6.9±3.6% vs −6.9±2.8% (p=0.922), LS at apical:-12.7±4.2% vs −12.4±4.4% (p=0.615). Among tafamidis naïve group, these parameters remained almost unchanged in 12 months as well, except for GLS and LS at apical. LS at apical showed a significant impairment. [LVEF: 53.8±9.2% vs 51.7±9.3% (p=0.244), IVSd: 15.5±2.3mm vs 16.0±1.8mm (p=0.321), LVPWd: 15.4±2.3mm vs 15.9±2.3mm (p=0.267), GLS: −10.4±2.4% vs −9.0±2.9% (p=0.065), LS at base: −5.0±2.7% vs −5.1±2.9% (p=0.865), LS at middle: −8.9±3.1% vs −8.5±3.5% (p=0.565), LS at apical: −15.4±4.0% vs −12.6±4.4% (p=0.02); Table 1]
Conclusion
We evaluated changes in echocardiographic findings with tafamidis treatment for 12 months. The echocardiographic parameters did not change over the course of 12 months, but the decrease in LS at apex observed in the tafamidis naïve group.Segmental LS could reflect a slight progression of cardiac amyloidosis and the short-term effects of tafamidis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Morioka
- Kumamoto University Hospital , Kumamoto , Japan
| | - S Takashio
- Kumamoto University Hospital , Kumamoto , Japan
| | - H Fujiyama
- Kumamoto University Hospital , Kumamoto , Japan
| | - F Oike
- Kumamoto University Hospital , Kumamoto , Japan
| | - S Hanatani
- Kumamoto University Hospital , Kumamoto , Japan
| | - H Usuku
- Kumamoto University Hospital , Kumamoto , Japan
| | - E Yamamoto
- Kumamoto University Hospital , Kumamoto , Japan
| | | | - K Tsujita
- Kumamoto University Hospital , Kumamoto , Japan
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4
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Haga Y, Opletal P, Tokiwa Y, Yamamoto E, Tokunaga Y, Kambe S, Sakai H. Effect of uranium deficiency on normal and superconducting properties in unconventional superconductor UTe 2. J Phys Condens Matter 2022; 34:175601. [PMID: 35120343 DOI: 10.1088/1361-648x/ac5201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Single crystals of the unconventional superconductor UTe2have been grown in various conditions which result in different superconducting transition temperature as well as normal state properties. Stoichiometry of the samples has been characterized by the single-crystal x-ray crystallography and electron microprobe analyses. Superconducting samples are nearly stoichiometric within an experimental error of about 1%, while non-superconducting sample significantly deviates from the ideal composition. The superconducting UTe2showed that the large density of states was partially gapped in the normal state, while the non-superconducting sample is characterized by the relatively large electronic specific heat as reported previously.
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Affiliation(s)
- Y Haga
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
| | - P Opletal
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
| | - Y Tokiwa
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
| | - E Yamamoto
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
| | - Y Tokunaga
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
| | - S Kambe
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
| | - H Sakai
- Advanced Science Research Center, Japan Atomic Energy Agency, Japan
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5
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Seko Y, Kato T, Morimoto T, Yaku H, Inuzuka Y, Tamaki Y, Ozasa N, Shiba M, Yamamoto E, Yoshikawa Y, Yamashita Y, Kitai T, Kuwahara K, Kimura T. Starting Neurohormonal Antagonists in Patients with Acute Heart Failure with Mid-Range and Preserved Ejection Fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1052] [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
The clinical benefits of neurohormonal antagonist in patients with heart failure (HF) with mid-range and preserved ejection fraction (HFmrEF and HFpEF) were uncertain. This study aimed to evaluate the prognostic effect of starting angiotensin-converting enzyme inhibitors (ACE-I) / angiotensin II receptor blockers (ARB) and β-blocker during HF hospitalization in these patients.
Methods
We analyzed 858 consecutive patients with HFmrEF (EF:40–49%) or HFpEF (EF≥50%), who were hospitalized for acute decompensated HF, were discharged alive, and were not taking ACE-I/ARB or β-blockers at admission. The study population was classified into four groups according to the status of prescription of ACE-I/ARB and β-blocker at discharge: no neurohormonal antagonist (N=342, 39.9%), ACE-I/ARB only (N=128, 14.9%), β-blocker only (N=189, 22.0%), and both ACE-I/ARB and β-blocker (N=199, 23.2%) groups. The primary outcome measure was a composite of all-cause death or HF hospitalization.
Results
The cumulative 1-year incidence of the primary outcome measure was 41.2% in the no neurohormonal antagonist group, 34.0% in the ACE-I/ARB only group, 28.6% in the β-blocker only group, and 16.4% in the both ACE-I/ARB and β-blocker group (P<0.001). Compared with the no neurohormonal antagonist group, the both ACE-I/ARB and β-blocker group were associated with a significantly lower risk for a composite of all-cause death or HF hospitalization (HR: 0.59, 95% CI: 0.38–0.91, P=0.02).
Conclusions
In hospitalized patients with HFmrEF and HFpEF, starting both ACE-I/ARB and β-blocker was associated with a reduced risk of a composite of all-cause death or HF hospitalization compared with not starting ACE-I/ARB or β-blocker.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Seko
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Kato
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Morimoto
- Hyogo College of Medicine, Nishinomiya, Japan
| | - H Yaku
- Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Y Inuzuka
- Shiga General Hospital, Moriyama, Japan
| | | | - N Ozasa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Shiba
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - E Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Yoshikawa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Yamashita
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Kuwahara
- Shinshu University School of Medicine, Matsumoto, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
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6
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Kuyama N, Kaikita K, Mitsuse T, Fujisue K, Nakanishi N, Tabata N, Yamanaga K, Sueta D, Kanazawa H, Takashio S, Araki S, Arima Y, Yamamoto E, Matsushita K, Tsujita K. Total thrombus-formation analysis system (T-TAS) can predict target lesion revascularization in patients undergoing endovascular therapy for critical limb ischemia. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2033] [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: 11/12/2022] Open
Abstract
Abstract
Background
Despite of the development of endovascular therapy (EVT), the frequency of target lesion revascularization (TLR) after EVT in patients with critical limb ischemia (CLI) is still high. Recent histrogical study suggested the possibility of thromboembolic phenomenon in the development of CLI; however, there is few monitoring system of total thrombogenicity in perioperative period of EVT in CLI patients. The total thrombus-formation analysis system (T-TAS), a novel system for quantitatively analyzing thrombus formation using microchips with thrombogenic surfaces (collagen plus tissue factor, atheroma [AR]-chip), is validated and can evaluate the total thrombogenicity.
Purpose
To investigate the utility of T-TAS parameters in predicting TLR after EVT in CLI patients.
Methods
We analyzed 27 CLI patients (45 lesions; aortoiliac 20%, femoropopliteal 40%, infrapopliteal 40%) who underwent EVT at our institution between January 2018 and December 2020. Patients undergoing hemodialysis were excluded. Blood sample was collected on the day of EVT and was used in T-TAS to compute the thrombus formation area under the curve (AUC; AUC for the first 30 minutes for AR tested at flow rate of 10 lL/min [AR10-AUC30]). We investigated the relationship between the AR10-AUC30 level and the occurrence of clinically-driven TLR, and the predictors of TLR among CLI patients.
Results
Study population had a mean age of 77 years, and 56% were male. During the follow-up period (mean 1.0±0.7 years), 11 lesions (24%) required clinically-driven TLR. The AR10-AUC30 level was significantly higher in patients requiring TLR than those without TLR (1783±121 vs. 1587±205; p<0.01). The frequency of TLR significantly increased in association with a tertile of the AR10-AUC30 level (Figure 1, p for trend=0.003). As shown in Figure 2, univariate logistic regression analysis demonstrated male sex and the third tertile of the AR10-AUC30 level compared to its first or second tertiles were significantly associated with TLR in patients with CLI, whereas platelet count, PT-INR, APTT, and atherosclerotic risk factors including glycated hemoglobin, low-density lipoprotein cholesterol, and renal function were not. Multivariate logistic regression analysis also revealed that the AR10-AUC30 level ≥1707 (=its third tertile) as an independent predictor for TLR, even after adjusted by age and sex (OR=6.28, 95% CI=1.18–33.3, p=0.03).
Conclusions
In patients with CLI, the AR10-AUC30 level measured by the T-TAS may be a potential predictor to identify the high-risk patients requiring TLR after EVT. This finding suggests the hypercoagulability in CLI patients and that an anticoagulant agent following EVT may be useful in preventing a restenosis in CLI patients. Further study with a larger sample size is warranted to validate this finding.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- N Kuyama
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - T Mitsuse
- Arao Municipal Hospital, Cardiology, Arao, Japan
| | - K Fujisue
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - N Nakanishi
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - N Tabata
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Yamanaga
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - D Sueta
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - H Kanazawa
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - S Takashio
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - S Araki
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - Y Arima
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Matsushita
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
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7
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Kato T, Yaku H, Yamamoto E, Inuzuka Y, Tamaki Y, Ozasa N, Kimura T. Impact of decreased lymphocyte, total cholesterol, and albumin levels at discharge on all-cause death in patients with acute heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0814] [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
Lymphocyte, total cholesterol, and albumin levels consist of Controlling Nutritional Status (CONUT) score, which has been reported to prognosticate patients with acute heart failure (AHF). However, the influence of each component of CONUT score on outcomes in patients with AHF was not fully elucidated.
Purpose
We aimed to evaluate the prognostic implication of the decrease in lymphocyte, total cholesterol, and albumin levels in patients with AHF.
Methods
We analyzed 1812 AHF patients in whom data at discharge were available from a multicenter registry. The decrease of lymphocyte (Ly) count was assigned with Ly≥1600/mL (31.0%), 1200≤ Ly <1600 (26.9%), 800≤ Ly <1200 (28.6%), Ly <800 (13.5% of patients). The decrease of total cholesterol (TC) was assigned with TC≥180mg/dL (28.9%), 140≤ TC <180 (42.2%), 100≤ TC <140 (26.7%), TC <100 (2.1% of patients). The decrease of albumin (Alb) was assigned and doubled with Alb≥3.5g/dL (45.7%), 3≤ Alb <3.5 (35.1%), 2.5≤ Alb <3 (15.2%), Alb <2.5 (3.9% of patients). The primary outcome measure was all-cause death after discharge from the index hospitalization. Cumulative incidences were estimated by the Kaplan-Meier method and differences were assessed with the log-rank test. We constructed multivariable Cox proportional hazard models to estimate the risk of the decrease in each value per grade, with the results expressed as the hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
Cumulative one-year incidence of the all-cause death was higher with decreasing Ly, TC, and Alb levels (P<0.0001, P<0.0001, and P=0.02, respectively) (Figure 1). The adjusted hazard ratio for all-case death per grade decrease is most prominent in albumin (HR: 1.36, 95% CI: 1.20–1.54), followed by lymphocyte count (HR: 1,23, 95% CI: 1.10–1.38), whereas it became insignificant in total cholesterol (HR: 1.05, 95% CI: 0.91–1.21).
Conclusions
The prognostic implications after discharge were different in albumin, lymphocyte count, and total cholesterol in patients with AHF.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- T Kato
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - H Yaku
- Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - E Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Inuzuka
- Shiga Medical Center for Adults, Moriyama, Japan
| | | | - N Ozasa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
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8
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Morioka M, Takashio S, Nakashima N, Nishi M, Hirakawa K, Hanatani S, Usuku H, Yamamoto E, Matsushita K, Kaikita K, Tsujita K. Correlations between pathological deposition and non-invasive diagnostic modalities like 99mTc-PYP scintigraphy, cardiac magnetic resonance, GLS in patients with transthyretin cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1815] [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
Although wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) was previously considered a rare disease, recent diagnostic imaging modalities have revealed that it is considerably underdiagnosed among elderly patients with heart failure. The severity of CM is thought to be related to the extent of amyloid deposition in heart.
99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy, cardiovascular magnetic resonance (CMR), global longitudinal strain (GLS) provide diagnostic and prognostic information in ATTRwt-CM. However, the relevance of these imaging modalities and their association with cardiac amyloid load has not been fully evaluated.
Purpose
The aim of study was to elucidate the associations between pathological amyloid load and cardiac retention evaluated by 99mTc-PYP scintigraphy, CMR, GLS in patients with ATTRwt-CM.
Method
Cardiac amyloid load was calculated as (amyloid deposition area/ total myocardium area)×100 using endomyocardial biopsy specimen. Cardiac retention was quantified by heart to contralateral (H/CL) ratio by 99mTc-PYP scintigraphy. Native T1 and extracellular volume (ECV) were obtained by CMR. GLS was analyzed using the 2D echo at the time of diagnosis.
Result
The mean cardiac amyloid load was 23.0±15.2% (n=57) and correlation with H/CL ratio (1.94±0.36 n=57), native T1 (1426.7±52.5 n=57), ECV (57.9±12.9 n=54), GLS (−9.1±2.4 n=57) were positive (r=0.375 p=0.004, r=0.496 r=0.304 p<0.001, r=0.304 p=0.025, r=0.473 p<0.001).
Conclusion
Increased cardiac amyloid load correlated with an increased 99mTc-PYP positivity, native T1, ECV, and an impaired GLS. These results suggest that imaging parameters may reflect histological and functional changes due to amyloid deposition in the myocardium.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Morioka
- Kumamoto University, Kumamoto, Japan
| | | | | | - M Nishi
- Kumamoto University, Kumamoto, Japan
| | | | | | - H Usuku
- Kumamoto University, Kumamoto, Japan
| | | | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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9
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Takashio S, Morioka M, Nishi M, Nakashima N, Yamada T, Hirakawa K, Hanatani S, Usuku H, Yamamoto E, Matsushita K, Kaikita K, Tsujita K. Gender differences in clinical characteristics in wild-type transthyretin amyloidosis cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1812] [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
Aims
A significant male predominance has been reported in wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM). In other words, the female ATTRwt-CM may be overlooked and gender differences in ATTRwt-CM remain unclear. This study aims to examine gender differences in clinical characteristics and diagnostic approaches in ATTRwt-CM.
Methods and results
We retrospectively evaluated 171 consecutive ATTRwt-CM patients diagnosed at our university hospital between December 2002 and December 2020. Twenty-two patients (12%) were women. Women were significantly older at diagnosis (77.3 years vs. 83.3 years; P<0.001) and had a higher advanced New York Health Association functional class (2.23±0.70 vs. 2.57±0.81; P=0.04) than men. In echocardiography, mean interventricular septum diameter was less thick (15.8 mm vs. 14.5 mm; P=0.03) and ejection fraction was preserved (51.7% vs. 57.7%; P=0.08) in women. The mean heart-to-contralateral ratio obtained using 99mTc-labeled pyrophosphate (99mTc-PYP) was significantly lower in women than in men (1.89 vs. 1.64; P=0.001). There was no significant gender difference in high-sensitivity median cardiac troponin T levels at diagnosis (0.055 ng/mL vs. 0.069 ng/mL; P=0.30) or history of carpal tunnel syndrome (57% vs. 55%; P=0.93) and electrocardiograms findings. However, the median B-type natriuretic peptide level was significantly higher (254 pg/mL vs. 434 pg/mL; P=0.02) in women. Moderate to severe aortic stenosis was more frequently observed in women (5% vs. 50%; P<0.001). Histological (78% vs. 59%; P=0.07) and genetic confirmation (78% vs. 59%; P=0.003) of ATTRwt-CM were not performed in women.
Conclusion
Women with ATTRwt-CM were predominantly octogenarians, less hypertrophic, and had weaker cardiac uptake of the 99mTc-PYP tracer than men with ATTRwt-CM. These characteristics contribute to the underdiagnosis of ATTRwt-CM in women. The diagnosis of ATTRwt-CM in women is challenging. Therefore, we must be familiar with the clinical characteristics of women with ATTRwt-CM.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Morioka
- Kumamoto University, Kumamoto, Japan
| | - M Nishi
- Kumamoto University, Kumamoto, Japan
| | | | - T Yamada
- Kumamoto University, Kumamoto, Japan
| | | | | | - H Usuku
- Kumamoto University, Kumamoto, Japan
| | | | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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10
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Adler C, Ahammed Z, Allgower C, Amonett J, Anderson BD, Anderson M, Averichev GS, Balewski J, Barannikova O, Barnby LS, Baudot J, Bekele S, Belaga VV, Bellwied R, Berger J, Bichsel H, Billmeier A, Bland LC, Blyth CO, Bonner BE, Boucham A, Brandin A, Bravar A, Cadman RV, Caines H, Calderón de la Barca Sánchez M, Cardenas A, Carroll J, Castillo J, Castro M, Cebra D, Chaloupka P, Chattopadhyay S, Chen Y, Chernenko SP, Cherney M, Chikanian A, Choi B, Christie W, Coffin JP, Cormier TM, Cramer JG, Crawford HJ, Csanád M, Deng WS, Derevschikov AA, Didenko L, Dietel T, Draper JE, Dunin VB, Dunlop JC, Eckardt V, Efimov LG, Emelianov V, Engelage J, Eppley G, Erazmus B, Fachini P, Faine V, Filimonov K, Finch E, Fisyak Y, Flierl D, Foley KJ, Fu J, Gagliardi CA, Gagunashvili N, Gans J, Gaudichet L, Germain M, Geurts F, Ghazikhanian V, Grachov O, Grigoriev V, Guedon M, Gushin E, Hallman TJ, Hardtke D, Harris JW, Henry TW, Heppelmann S, Herston T, Hippolyte B, Hirsch A, Hjort E, Hoffmann GW, Horsley M, Huang HZ, Humanic TJ, Igo G, Ishihara A, Ivanshin YI, Jacobs P, Jacobs WW, Janik M, Johnson I, Jones PG, Judd EG, Kaneta M, Kaplan M, Keane D, Kiryluk J, Kisiel A, Klay J, Klein SR, Klyachko A, Konstantinov AS, Kopytine M, Kotchenda L, Kovalenko AD, Kramer M, Kravtsov P, Krueger K, Kuhn C, Kulikov AI, Kunde GJ, Kunz CL, Kutuev RK, Kuznetsov AA, Lakehal-Ayat L, Lamont MAC, Landgraf JM, Lange S, Lansdell CP, Lasiuk B, Laue F, Lebedev A, Lednický R, Leontiev VM, LeVine MJ, Li Q, Lindenbaum SJ, Lisa MA, Liu F, Liu L, Liu Z, Liu QJ, Ljubicic T, Llope WJ, LoCurto G, Long H, Longacre RS, Lopez-Noriega M, Love WA, Ludlam T, Lynn D, Ma J, Ma R, Majka R, Margetis S, Markert C, Martin L, Marx J, Matis HS, Matulenko YA, McShane TS, Meissner F, Melnick Y, Meschanin A, Messer M, Miller ML, Milosevich Z, Minaev NG, Mitchell J, Moiseenko VA, Moore CF, Morozov V, de Moura MM, Munhoz MG, Nelson JM, Nevski P, Niida T, Nikitin VA, Nogach LV, Norman B, Nurushev SB, Odyniec G, Ogawa A, Okorokov V, Oldenburg M, Olson D, Paic G, Pandey SU, Panebratsev Y, Panitkin SY, Pavlinov AI, Pawlak T, Perevoztchikov V, Peryt W, Petrov VA, Planinic M, Pluta J, Porile N, Porter J, Poskanzer AM, Potrebenikova E, Prindle D, Pruneau C, Putschke J, Rai G, Rakness G, Ravel O, Ray RL, Razin SV, Reichhold D, Reid JG, Retiere F, Ridiger A, Ritter HG, Roberts JB, Rogachevski OV, Romero JL, Rose A, Roy C, Rykov V, Sakrejda I, Salur S, Sandweiss J, Saulys AC, Savin I, Schambach J, Scharenberg RP, Schmitz N, Schroeder LS, Schüttauf A, Schweda K, Seger J, Seliverstov D, Seyboth P, Shahaliev E, Shestermanov KE, Shimanskii SS, Shvetcov VS, Skoro G, Smirnov N, Snellings R, Sorensen P, Sowinski J, Spinka HM, Srivastava B, Stephenson EJ, Stock R, Stolpovsky A, Strikhanov M, Stringfellow B, Struck C, Suaide AAP, Sugarbaker E, Suire C, Šumbera M, Surrow B, Symons TJM, Szanto de Toledo A, Szarwas P, Tai A, Takahashi J, Tang AH, Thomas JH, Thompson M, Tikhomirov V, Todoroki T, Tokarev M, Tonjes MB, Trainor TA, Trentalange S, Tribble RE, Trofimov V, Tsai O, Ullrich T, Underwood DG, Van Buren G, VanderMolen AM, Vasilevski IM, Vasiliev AN, Vigdor SE, Voloshin SA, Wang F, Ward H, Watson JW, Wells R, Westfall GD, Whitten C, Wieman H, Willson R, Wissink SW, Witt R, Wood J, Xu N, Xu Z, Yakutin AE, Yamamoto E, Yang J, Yepes P, Yurevich VI, Zanevski YV, Zborovský I, Zhang H, Zhang WM, Zoulkarneev R, Zubarev AN. Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]. Phys Rev Lett 2021; 127:089901. [PMID: 34477449 DOI: 10.1103/physrevlett.127.089901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.89.132301.
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11
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Adams J, Adler C, Aggarwal MM, Ahammed Z, Amonett J, Anderson BD, Anderson M, Arkhipkin D, Averichev GS, Badyal SK, Balewski J, Barannikova O, Barnby LS, Baudot J, Bekele S, Belaga VV, Bellwied R, Berger J, Bezverkhny BI, Bhardwaj S, Bhaskar P, Bhati AK, Bichsel H, Billmeier A, Bland LC, Blyth CO, Bonner BE, Botje M, Boucham A, Brandin A, Bravar A, Cadman RV, Cai XZ, Caines H, Calderón de la Barca Sánchez M, Carroll J, Castillo J, Castro M, Cebra D, Chaloupka P, Chattopadhyay S, Chen HF, Chen Y, Chernenko SP, Cherney M, Chikanian A, Choi B, Christie W, Coffin JP, Cormier TM, Cramer JG, Crawford HJ, Csanád M, Das D, Das S, Derevschikov AA, Didenko L, Dietel T, Dong WJ, Dong X, Draper JE, Du F, Dubey AK, Dunin VB, Dunlop JC, Dutta Majumdar MR, Eckardt V, Efimov LG, Emelianov V, Engelage J, Eppley G, Erazmus B, Estienne M, Fachini P, Faine V, Faivre J, Fatemi R, Filimonov K, Filip P, Finch E, Fisyak Y, Flierl D, Foley KJ, Fu J, Gagliardi CA, Gagunashvili N, Gans J, Ganti MS, Gaudichet L, Germain M, Geurts F, Ghazikhanian V, Ghosh P, Gonzalez JE, Grachov O, Grigoriev V, Gronstal S, Grosnick D, Guedon M, Guertin SM, Gupta A, Gushin E, Gutierrez TD, Hallman TJ, Hardtke D, Harris JW, Heinz M, Henry TW, Heppelmann S, Herston T, Hippolyte B, Hirsch A, Hjort E, Hoffmann GW, Horsley M, Huang HZ, Huang SL, Humanic TJ, Igo G, Ishihara A, Jacobs P, Jacobs WW, Janik M, Jiang H, Johnson I, Jones PG, Judd EG, Kabana S, Kaneta M, Kaplan M, Keane D, Khodyrev VY, Kiryluk J, Kisiel A, Klay J, Klein SR, Klyachko A, Koetke DD, Kollegger T, Kopytine M, Kotchenda L, Kovalenko AD, Kramer M, Kravtsov P, Kravtsov VI, Krueger K, Kuhn C, Kulikov AI, Kumar A, Kunde GJ, Kunz CL, Kutuev RK, Kuznetsov AA, Lamont MAC, Landgraf JM, Lange S, Lansdell CP, Lasiuk B, Laue F, Lauret J, Lebedev A, Lednický R, LeVine MJ, Li C, Li Q, Lindenbaum SJ, Lisa MA, Liu F, Liu L, Liu Z, Liu QJ, Ljubicic T, Llope WJ, Long H, Longacre RS, Lopez-Noriega M, Love WA, Ludlam T, Lynn D, Ma J, Ma R, Ma YG, Magestro D, Mahajan S, Mangotra LK, Mahapatra DP, Majka R, Manweiler R, Margetis S, Markert C, Martin L, Marx J, Matis HS, Matulenko YA, McShane TS, Meissner F, Melnick Y, Meschanin A, Messer M, Miller ML, Milosevich Z, Minaev NG, Mironov C, Mishra D, Mitchell J, Mohanty B, Molnar L, Moore CF, Mora-Corral MJ, Morozov DA, Morozov V, de Moura MM, Munhoz MG, Nandi BK, Nayak SK, Nayak TK, Nelson JM, Nevski P, Niida T, Nikitin VA, Nogach LV, Norman B, Nurushev SB, Odyniec G, Ogawa A, Okorokov V, Oldenburg M, Olson D, Paic G, Pandey SU, Pal SK, Panebratsev Y, Panitkin SY, Pavlinov AI, Pawlak T, Perevoztchikov V, Perkins C, Peryt W, Petrov VA, Phatak SC, Picha R, Planinic M, Pluta J, Porile N, Porter J, Poskanzer AM, Potekhin M, Potrebenikova E, Potukuchi BVKS, Prindle D, Pruneau C, Putschke J, Rai G, Rakness G, Raniwala R, Raniwala S, Ravel O, Ray RL, Razin SV, Reichhold D, Reid JG, Renault G, Retiere F, Ridiger A, Ritter HG, Roberts JB, Rogachevski OV, Romero JL, Rose A, Roy C, Ruan LJ, Sahoo R, Sakrejda I, Salur S, Sandweiss J, Savin I, Schambach J, Scharenberg RP, Schmitz N, Schroeder LS, Schweda K, Seger J, Seliverstov D, Seyboth P, Shahaliev E, Shao M, Sharma M, Shestermanov KE, Shimanskii SS, Singaraju RN, Simon F, Skoro G, Smirnov N, Snellings R, Sood G, Sorensen P, Sowinski J, Spinka HM, Srivastava B, Stanislaus S, Stock R, Stolpovsky A, Strikhanov M, Stringfellow B, Struck C, Suaide AAP, Sugarbaker E, Suire C, Šumbera M, Surrow B, Symons TJM, Szanto de Toledo A, Szarwas P, Tai A, Takahashi J, Tang AH, Thein D, Thomas JH, Tikhomirov V, Todoroki T, Tokarev M, Tonjes MB, Trainor TA, Trentalange S, Tribble RE, Trivedi MD, Trofimov V, Tsai O, Ullrich T, Underwood DG, Van Buren G, VanderMolen AM, Vasiliev AN, Vasiliev M, Vigdor SE, Viyogi YP, Voloshin SA, Waggoner W, Wang F, Wang G, Wang XL, Wang ZM, Ward H, Watson JW, Wells R, Westfall GD, Whitten C, Wieman H, Willson R, Wissink SW, Witt R, Wood J, Wu J, Xu N, Xu Z, Xu ZZ, Yamamoto E, Yepes P, Yurevich VI, Zanevski YV, Zborovský I, Zhang H, Zhang WM, Zhang ZP, Żołnierczuk PA, Zoulkarneev R, Zoulkarneeva J, Zubarev AN. Erratum: Azimuthal Anisotropy at the Relativistic Heavy Ion Collider: The First and Fourth Harmonics [Phys. Rev. Lett. 92, 062301 (2004)]. Phys Rev Lett 2021; 127:069901. [PMID: 34420354 DOI: 10.1103/physrevlett.127.069901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.92.062301.
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Abstract
Pseudotumor cerebri also known as idiopathic intracranial hypertension is a relatively uncommon disorder of unknown pathophysiology. Although pseudotumor cerebri occurs in both children and adults, the pseudotumor cerebri literature is heavily dominated by adult studies. The aim of this study is to retrospectively describe the clinical presentation, imaging, treatment, and outcomes of a large pediatric pseudotumor cerebri population over a 23-year period. We also discuss secondary pseudotumor cerebri (44%) as well as the increasingly recognized patient subgroups without headache (13.3%) and without papilledema (7.3%). Female sex, obesity, and initial symptoms were consistent with the literature; however radiographic findings were surprisingly low in this cohort. Headache outcomes at 1 week, 1 month, and 3 months following initial lumbar puncture/treatment and visual function outcomes are reported.
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Affiliation(s)
- Erin Yamamoto
- 443553Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Darren Farber
- Norton Children's Medical Group, 204841The University of Louisville, Louisville, KY, USA
| | - David Rothner
- 443553Cleveland Clinic, Neurological Institute, Center for Pediatric Neurology, Cleveland, OH, USA
| | - Manikum Moodley
- 443553Cleveland Clinic, Neurological Institute, Center for Pediatric Neurology, Cleveland, OH, USA
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13
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Yamamoto E, Shahin MN, Safarpour D, Raslan AM. Bilateral GPi Stimulation for Neuroacanthocytosis. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_669] [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: 11/14/2022] Open
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14
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Yoshino T, Siena S, Di Bartolomeo M, Raghav K, Masuishi T, Loupakis F, Kawakami H, Yamaguchi K, Nishina T, Fakih M, Elez E, Rodriguez J, Ciardiello F, Saxena K, Yamamoto E, Kobayashi K, Bako E, Okuda Y, Grothey A. 84MO A phase II, multicenter, open-label study of trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2-expressing metastatic colorectal cancer (mCRC): DESTINY-CRC01. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.104] [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: 10/22/2022] Open
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Seko Y, Kato T, Yamamoto E, Yaku H, Morimoto T, Inuzuka Y, Tamaki Y, Ozasa N, Yoshikawa Y, Nagao K, Kawase Y, Kuwahara K, Kimura T. A decrease in tricuspid regurgitation pressure gradient during follow-up in patients with heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1015] [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
Objective
This study aimed to investigate the prognostic impact of the decrease in tricuspid regurgitation pressure gradient (TRPG) at 6-month follow-up in patients after discharge with heart failure (HF).
Background
No previous study has reported the association between TRPG decrease during follow-up and clinical outcomes in HF.
Methods
Among 748 patients with 6-months follow-up echocardiography after discharge from the acute decompensated heart failure in 19 centers in Japan, we analyzed 721 patients with available TRPG data and divided into two groups: the decrease in TRPG group (N=179) and no decrease in TRPG group (N=542). We defined the decrease in TRPG as >10mmHg decrease compared in the initial hospitalization. The primary outcome measure was a composite of all cause deaths and hospitalization due to HF.
Results
The patients in the decrease in TRPG group had a lower prevalence of hypertension, dyslipidemia, atrial fibrillation, and a reduced EF, higher levels of blood albumin and lower levels of sodium than those in no decrease in TRPG group. The median follow-up duration after the follow up echocardiography was 302 (inter quartile range: 206–490), with a 90.9% follow up rate at 6-month. The cumulative 6-month incidence of the primary outcome measure was significantly lower in the decrease in TRPG group than in no decrease in TRPG group (12.2% vs. 18.9%, P=0.0011). After adjusting confounders, the excess risk of the decrease in TRPG relative to no decrease in TRPG for the primary outcome measure remained significant (HR: 0.60, 95% CI 0.34–0.99). There were no significant interactions between the subgroup factors and the effect of the decrease in TRPG for primary outcomes.
Conclusions
HF patients with the decrease in TRPG at 6-month after discharge had a lower risk of clinical outcome than those without decrease in TRPG.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Seko
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Kato
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - E Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - H Yaku
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Morimoto
- Hyogo Medical University, Nishinomiya, Japan
| | - Y Inuzuka
- Shiga general hospital, Moriyama, Japan
| | | | - N Ozasa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Yoshikawa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Nagao
- Osaka Red Cross Hospital, Osaka, Japan
| | - Y Kawase
- Kurashiki Central Hospital, Kurashiki, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
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16
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Fujisue K, Yamamoto E, Sueta D, Takae M, Nishihara T, Oike F, Komorida T, Usuku H, Takashio S, Sakamoto K, Kaikita K, Tsujita K. P26 Soluble programed cell death ligand-1 is associated with acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.028] [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: 11/12/2022] Open
Abstract
Abstract
Background
Immune checkpoint by programmed cell death (PD)-1 and its ligand (PD-L1) play crucial role in T cell tolerance toward vascular wall antigens. PD-L1 is widely expressed on a number of cells including immune cells and vascular endothelium. It was reported that increased expression of PD-L1 in dendritic cells implicates upregulated inflammation in atherosclerotic lesions that is associated with plaque instability. Although plaque rupture in coronary atherosclerosis is an important pathogenesis of acute coronary syndrome (ACS), the association between PD-L1 and ACS is still unknown.
Purpose
We hypothesize that circulating PD-L1 might be associated with ACS, reflecting endothelial damage and coronary plaque rupture. To elucidate this hypothesis, we compared serum levels of soluble PD-L1 (sPD-L1) in stable coronary artery disease (CAD) patients with those in ACS patients.
Methods
Serum levels of sPD-L1 were measured by using commercially available ELISA kit (Human PD-L1/B7-H1 DuoSet, R&D Systems) in consecutive patients with CAD admitted to our University Hospital from February 2016 to March 2017. Patients with any malignant disease or severe inflammatory disease were excluded from this study. Serum levels of sPD-L1 and clinical backgrounds were compared between stable-CAD and ACS patients.
Results
In total, 269 patients with CAD were enrolled (28 cases [10.4 %] with ACS and 241 cases [89.6 %] with stable-CAD). PD-L1 had no correlation to C-reactive protein, cardiac troponin, and classical atherosclerotic risks such as age, body mass index, estimated glomerular filtration rate, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol, and hemoglobin A1c. Although age, sex, history of smoking, and the prevalences of hypertension, diabetes mellitus and dyslipidemia were comparable between both groups, the level of LDL-C was significantly higher in patients with ACS compared with those with stable-CAD (94.0 [77.0–112.0] mg/dL vs. 78.5 [65.0–97.0] mg/dL, P = 0.008). Also serum level of sPD-L1 was significantly increased in patients with ACS compared with those with stable-CAD (106.1 [60.9–157.7] pg/mL vs. 64.8 [30.9–102.5] pg/mL, P = 0.003). Univariate logistic regression analysis identified that serum levels of both sPD-L1 and LDL-C were independently associated with ACS. Moreover, multivariable logistic regression analysis with factors from univariate analysis identified that serum level of sPD-L1 was significantly and independently associated with ACS (odds ratio: 1.006, 95 % confidence interval: 1.001–1.012, P = 0.03).
Conclusions
This is the first study to elucidate that the increased serum levels of sPD-L1 was associated with ACS. This study suggests that sPD-L1 could be a risk marker and therapeutic target for ACS.
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Affiliation(s)
- K Fujisue
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - E Yamamoto
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - D Sueta
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - M Takae
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - T Nishihara
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - F Oike
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - T Komorida
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - H Usuku
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - S Takashio
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - K Sakamoto
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - K Kaikita
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
| | - K Tsujita
- Kumamoto University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto City, Japan
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Sakamoto K, Sato R, Yamashita T, Nagamatsu S, Motozato K, Ishii M, Takashio S, Arima Y, Fujisue K, Sueta D, Yamamoto E, Kaikita K, Tsujita K. P6513Temporal trends in coronary intervention strategies and the impact on one-year clinical events: data from a Japanese multi-center real-world cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1103] [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
While it is clear that device technology of percutaneous coronary intervention (PCI) has advanced over the course of the last 40 years and the evidence for improvements in the efficacy of PCI is clear, it is less clear whether the prognosis following PCI continues to improve year by year.
Methods
The Kumamoto Intervention Conference Study Real-World Registry is a multi-center registry that enrolls consecutive patients undergoing PCI in 17 centers in Kyushu area, Japan. To elucidate the clinical impact of recent changes in treatment strategies, 8,841 consecutive participants (historical PCI: n=4,038, enrolled between January 2013 and December 2014, and current PCI: n=4,803, between January 2015 and March 2017) with 1-year follow-up data were analysed. Baseline demographic data, cardiovascular risk factors, and the medication being taken at discharge were documented. The primary endpoint was defined as a major adverse cardiac event (MACE), comprising cardiovascular death or non-fatal MI, including stent thrombosis (ST), occurring within 1 year of PCI.
Results
Regarding the relationships between presenting symptoms and PCI status, ACS, STEMI, NSTEMI, and UAP were similarly common, but the proportion of patients with multi-vessel disease was lower and the proportion with type B2/C lesions was higher in the current PCI group (p=0.004 and p<0.001, respectively). The prevalences of left main trunk lesions and Killip classes III or IV were comparable between the groups, but in-stent restenotic lesions were significantly more frequent in the historical PCI group (p<0.001). In addition to the change in the DAPT regimen, more optimal medical therapy was introduced during this time period, including the use of β-blockers, ACE-Is, and statins.
The incidences of MACE were comparable between historical PCI and current PCI (2.2% vs. 2.1%, p=0.693), even though complex lesions were more frequent during the more recent period. During this period, the use of radial approaches, drug eluting stents, and coronary imaging increased, but the use of intra-aortic balloon pumping (IABP) or thromboaspiration decreased. The incidences of major adverse cardiac or cerebrovascular events (MACCE), cardiac death, non-fatal MI, and stent thrombosis were similar between the historical and current periods (Figure). Multivariate analysis for overall patients, after adjustment, showed that multi-vessel disease, type B2/C lesions, ACS, and DES use were significant independent predictors of MACE.
Figure 1. Comparison of Clinical Events
Conclusion
An improvement in the prognosis associated with PCI has not occurred in recent years. However, the lesions being treated are becoming more complex, and the selection of evidence-based approaches, the use of coronary imaging, and the optimal medication treatments may have contributed to comparable outcomes being maintained.
Acknowledgement/Funding
Daiichi Sankyo Co., Ltd. Japan.
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Affiliation(s)
- K Sakamoto
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - R Sato
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - T Yamashita
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - S Nagamatsu
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Motozato
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - M Ishii
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - S Takashio
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - Y Arima
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Fujisue
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - D Sueta
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
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18
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Kikuchi N, Yamamoto E, Nagao M, Momose M, Hattori H, Suzuki A, Shiga T, Niinami H, Hagiwara N, Nunoda S. P3359Myocardial flow reserve using 13N ammonia PET for detection of cardiac allograft vasculopathy in heart transplant patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0235] [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
Purpose
Risk stratification and early detection of cardiac allograft vasculopathy (CAV) are essential in heart transplantation patients. CAV is associated with poor outcome in the chronic phase after heart transplantation. CAV presents a diffuse vascular involvement and has been difficult to noninvasively diagnose by the lack of a sensitive method to detect developing vascular pathology in the allograft. The present study investigates the ability of 13N-ammonia PET for detection of CAV in heart transplant patients.
Methods
Data of adenosine-stress 13N-ammonia PET imaging for thirty-one patients (mean age, 39 years-old) after 11 + 7 years from transplant was analyzed. Five patients had undergone percutaneous coronary intervention (PCI), and the remaining 26 patients had no history of definite myocardial ischemia. Myocardial flow was generated from the time activity curve of left ventricle input and myocardial uptake using 3-compartment model and the first 2 minutes' dataset of list-mode acquisition. Global - myocardial flow reserve (MFR) was calculated by stress to rest flow ratio. Patient with global-MFR <2.0 was defined as significant decrease. Summed difference score (SDS) was used as an estimate for the extent of ischemia, and the patient showing SDS >2 was identified as those having significant ischemia.
Results
The mean Global-MFR of our subjects were 2.3 (1.2 to 3.9). MFR using 13N-ammonia PET significantly decreases in one third of heart transplant patients in chronic stage. Eleven patients with Global-MFR <2.0 (35%) were observed, and eight of them had no history of clinical myocardial ischemia. The proportion of patients with a history of PCI is 18% in patients with Global-MFR <2.0 (vs 5%, p=0.210). Moreover, there were eight patients with SDS >2 (26%) including three patients having a history of PCI. The proportion of patients with a history of PCI tends to be high with SDS >2 (38% vs 9%, p=0.056).
Conclusion
This modality using 13N ammonia PET is useful for easily detection of CAV before manifestation of symptomatic myocardial ischemia in heart transplant patients.
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Affiliation(s)
- N Kikuchi
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - E Yamamoto
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - M Nagao
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - M Momose
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - H Hattori
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - A Suzuki
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - T Shiga
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - H Niinami
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - S Nunoda
- Tokyo Women's Medical University, Shinjuku-ku, Japan
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19
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Kurihara O, Takano M, Yamamoto E, Yonetsu T, Kakuta T, Soeda T, Yan BP, Crea F, Higuma T, Minami Y, Adriaenssens T, Nef HM, Lee H, Mizuno K, Jang IK. P2651Seasonal variations in the pathogenesis of acute coronary syndromes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0972] [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
Seasonal variations in acute coronary syndrome (ACS) has been known with the winter being the peak in incidence and mortality. However, underlying pathophysiology for this variation has not been studied.
Purpose
We sought to compare pathobiology of the culprit lesions assessed by optical coherence tomography (OCT) among the four seasons.
Methods
Patients with ACS who underwent OCT were recruited from 6 countries in the Northern Hemisphere. The prevalence of 3 most common pathologies, plaque rupture, plaque erosion and calcified plaque, and other features of coronary plaques were compared among the four seasons.
Results
In 1113 patients with ACS, 284 (25%) patients were admitted in spring, 243 (22%) patients in summer, 290 (26%) patients in autumn and 296 (27%) patients in winter. The proportion of underlying 3 pathologies was significantly different in each season (prevalence of plaque rupture, plaque erosion, calcified plaque was 50%, 39%, and 11%, respectively in the spring; 44%, 43%, and 13% in the summer; autumn: 49%, 39%, and 12% in the autumn; 57%, 30%, and 13% in the winter; P=0.039). The proportion of plaque rupture was higher in winter but lower in summer, and that of plaque erosion was higher in summer, but lower in winter. Maximum and minimum temperatures on the day of OCT procedure were significantly lower in the plaque rupture group than in the plaque erosion group (P=0.02 and P=0.012, respectively). In the rupture group, the prevalence of hypertension was significantly higher in winter, but in the erosion group, it was not different among the four seasons.
Figure 1. The proportion of culprit lesion characteristics were significantly different among the 4 season groups. (P=0.039) The proportion of plaque rupture was significantly higher in winter but lower in summer. In contrast, the proportion of plaque erosion was higher in summer, but lower in winter.
Conclusions
Seasonal variation of the underlying mechanisms of ACS reflects different pathobiology. The proportion of plaque rupture is highest in winter and the proportion of plaque erosion is highest in summer. A different approach may be needed for the prevention and treatment of ACS depending on the season of its occurrence.
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Affiliation(s)
- O Kurihara
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - M Takano
- Nippon medical school chiba hokusoh hospital cardiovascular center, Kamakari 1715, Inzai, Chiba, Japan
| | - E Yamamoto
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Interventional Cardiology, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Division of Cardiovascular Medicine, Ibaraki, Japan
| | - T Soeda
- Nara Medical University, Department of Cardiovascular Medicine, Nara, Japan
| | - B P Yan
- Prince of Wales Hospital, Chinese University of Hong Kong, Division of Cardiology, Department of Medicine and Therapeutics, Hong Kong, Hong Kong
| | - F Crea
- Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - T Higuma
- St. Marianna University, Division of Cardiology, Kawasaki, Japan
| | - Y Minami
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - T Adriaenssens
- University Hospitals (UZ) Leuven, Department of Cardiovascular Medicine, Leuven, Belgium
| | - H M Nef
- University of Giessen, Department of Cardiology, Giessen, Germany
| | - H Lee
- Massachusetts General Hospital, Biostatistics Center, Boston, United States of America
| | - K Mizuno
- Mitsukoshi Health and Welfare Foundation, Tokyo, Japan
| | - I K Jang
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
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20
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Fracassi F, Sugiyama T, Yamamoto E, Kurihara O, Kim HO, Thondapu V, Lee H, Fujimoto JG, Fuster V, Jang IK. 108Biologic significance of healed culprit plaques in stable angina versus acute coronary syndromes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0036] [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: 11/15/2022] Open
Abstract
Abstract
Background
Healed plaques, the signature of prior subclinical plaque destabilization, are frequently found in autopsy studies and have recently been described in patients with acute coronary syndromes (ACS).
Objectives
To compare the prevalence and features of plaque vulnerability of healed culprit lesions in stable angina pectoris (SAP) versus ACS patients by using Optical Coherence Tomography (OCT).
Methods
A total of 752 patients were included: 376 patients with SAP were selected using propensity score matching, comparable to 376 patients with ACS. Healed plaques were identified using established criteria, defined as layers of different optical density on OCT. Healed plaque prevalence along with angiographic and OCT findings were compared between the two groups.
Results
Healed plaques were more frequent in SAP than in ACS patients (42.0% vs 28.7%, p<0.001). LDL-cholesterol and high sensitive C-reactive protein (hs-CRP) levels were significantly lower in SAP patients with layered plaque as compared to ACS patients with layered plaque [97.9±36.9 mg/dL vs 116.7±39.2 mg/dL, p<0.001; 0.20 (0.10–0.83) mg/L vs 4.98 (1.00–11.32) mg/L, p<0.001, respectively]. Thin-cap fibroatheroma, macrophage accumulation and microvessels were significantly less frequent in layered plaques in SAP patients as compared to those in ACS patients (12.7% vs 56.5%, p<0.001, 7.0% vs 79.6%, p<0.001, and 20.3% vs 43.5%, p<0.001, respectively). Calcifications were found more frequently among layered plaques in SAP patients than in ACS patients (51.3% vs 33.6%, p=0.006).
Conclusions
Healed plaques, detected more frequently in SAP than in ACS patients, portend different atherosclerotic backgrounds. In SAP patients, plaque destabilization frequently does not lead to occlusive thrombosis, possibly due to low level of local vulnerability and systemic inflammation. In ACS patients, the presence of high level of local vulnerability and systemic inflammation may play an important role in occlusive thrombus formation, resulting in terminating the cycles of subclinical thrombosis and healing.
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Affiliation(s)
- F Fracassi
- Harvard Medical School, Boston, United States of America
| | - T Sugiyama
- Harvard Medical School, Boston, United States of America
| | - E Yamamoto
- Harvard Medical School, Boston, United States of America
| | - O Kurihara
- Harvard Medical School, Boston, United States of America
| | - H O Kim
- Harvard Medical School, Boston, United States of America
| | - V Thondapu
- Harvard Medical School, Boston, United States of America
| | - H Lee
- Harvard Medical School, Boston, United States of America
| | - J G Fujimoto
- Harvard Medical School, Boston, United States of America
| | - V Fuster
- Harvard Medical School, Boston, United States of America
| | - I K Jang
- Harvard Medical School, Boston, United States of America
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21
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Yaku H, Kato T, Morimoto T, Inuzuka Y, Tamaki Y, Yamamoto E, Yoshikawa Y, Ozasa N, Kuwahara K, Kimura T. 1136Prognostic impact of mineralocorticoid receptor antagonists in patients hospitalized for acute heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0005] [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
The favourable effect of mineralocorticoid receptor antagonists (MRAs) on mortality was established in patients with stable heart failure (HF) with reduced ejection fraction (EF). However, its prognostic effect of MRAs in acute decompensated heart failure (ADHF) including HF with preserved EF (HFpEF) was unclear.
Purpose
This study sought to investigate the long-term impact of MRA on the post-discharge outcomes in patients with ADHF.
Methods
From the consecutive 3717 patients hospitalized for ADHF and discharged alive in the KCHF registry, we developed the propensity score (PS) for MRA use and constructed the PS-matched cohort. We compared the effect of MRA use on the primary outcome measure of all-cause death or HF hospitalization.
Results
A total of 1678 patients (45%) received MRA at discharge from the index hospitalization. Median follow-up was 470 days with 96% 1-year follow-up rate. In the PS-matched cohort (N=1034 in each group), the cumulative 1-year incidence of the primary outcome measure was significantly lower in the MRA group than in the no MRA group (28.4% vs. 33.9%, P=0.003) (Figure 1). The cumulative 1-year incidence of HF hospitalization was significantly lower in the MRA group than in the no MRA group (18.7% vs. 24.8%, P<0.001), while there was no difference in mortality between the 2 groups (15.6% vs. 15.8%, P=0.85). There was no interaction between the effect of MRA and the 3 subgroups stratified by EF (EF <40%, EF 40–49%, EF ≥50%) (interaction P=0.12).
Figure 1
Conclusion
The use of MRA was associated with lower risk for the primary composite outcome of all-cause death or HF hospitalization in patients hospitalized for ADHF including HFpEF, which was mainly driven by the lower risk for HF hospitalization.
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Affiliation(s)
- H Yaku
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Kato
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Morimoto
- Hyogo College of Medicine, Clinical Epidemiology, Nishinomiya, Japan
| | - Y Inuzuka
- Shiga General Hospital, Department of Cardiovascular Medicine, Moriyama, Japan
| | - Y Tamaki
- Tenri Hospital, Department of Cardiovascular Medicine, Tenri, Japan
| | - E Yamamoto
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Yoshikawa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Ozasa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - K Kuwahara
- Shinshu University Graduate School of Medicine, Department of Cardiovascular Medicine, Matsumoto, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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22
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Takae M, Yamamoto E, Oike F, Nishihara T, Fujisue K, Sueta D, Usuku H, Takashio S, Sakamoto K, Kaikita K, Tsujita K. P2613Clinical significance of brachial-ankle pulse wave velocity in patients with heart failure with reduced left ventricular ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0937] [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
Heart failure (HF) is characterized as a complex syndrome of structural and functional cardiac disorder that impair ventricular filling and/or blood ejection. Peripheral arterial disease (PAD) is accompanied by systemic inflammation and is frequently associated with other cardiovascular diseases. Although PAD and HF share cardiovascular risk and pathophysiological features, and each has been associated with increased morbidity and mortality. Pulse wave velocity (PWV) is known to be an indicator of arterial stiffness. We previously reported the prognostic significance of brachial–ankle PWV (baPWV) in patients with HF with preserved left ventricular ejection fraction. However, its association with cardiovascular outcomes in HF with reduced EF (HFrEF) and HF with mid-range EF (HFmrEF) patients remains uncertain.
Purpose
The first aim of this study was to investigate the impact of PAD on prognosis in HFrEF and HFmrEF. The second aim was to investigate the relationship between baPWV and the occurrence of cardiovascular events in patients with HFrEF and HFmrEF.
Methods
We measured ankle-brachial pressure index (ABI) and baPWV values at stable condition after optimal therapy for HF in 201 consecutive HFrEF and HFmrEF patients admitted to Kumamoto University Hospital from 2007 to 2015 who were enrolled and followed until the occurrence of cardiovascular events.
Results
The mean age of the two groups of patients was 67.5±11.8 years. The prevalence of PAD, defined as an ABI 0.9 or less, was 14% in patients. Kaplan–Meier analysis revealed that HFrEF and HFmrEF patients with PAD had a significant higher risk of total cardiovascular and HF-related events than those without PAD (P=0.03 and P=0.01, respectively). The hazard ratio (HR) between HFrEF and HFmrEF patients without PAD and those with PAD was compared after adjustment for other confounders. The probabilities of total cardiovascular and HF-related events in HFrEF and HFmrEF patients with PAD were significantly higher than those in HFrEF and HFmrEF patients without PAD (HR: 2.19; 95% CI: 1.02–4.73; P=0.04, and HR: 3.5; 95% CI: 1.27–9.66; P=0.01, respectively). Next, we divided HFrEF and HFmrEF patients without PAD into three groups according to baPWV values. In the Kaplan–Meier analysis, total cardiovascular and HF-related events in the highest baPWV group (1800 cm/s ≤ baPWV) had a significantly higher frequency than those in the mid-level baPWV group (1400 cm/s ≤ baPWV < 1800 cm/s) (P=0.007 and P=0.004, respectively) (Figure A, B). The hazard ratio (HR) between HFrEF and HFmrEF patients in the mid-level baPWV group and those with other baPWV groups was compared after adjustment for other cofounders. The probabilities of total cardiovascular and HF-related events were significantly higher in the highest baPWV group.
Conclusion
Identifying complications of PAD and measuring baPWV values in HFrEF and HFmrEF patients were useful for predicting their prognosis.
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Affiliation(s)
- M Takae
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - F Oike
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - T Nishihara
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - K Fujisue
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - D Sueta
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - H Usuku
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - S Takashio
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
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23
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Tamaki Y, Yaku H, Yamamoto E, Ozasa N, Inuzuka Y, Kondo H, Tamura T, Morimoto T, Nakagawa Y, Kimura T, Kato T. P4544Impact of hyponatremia improvement on one-year outcomes in patients with acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0935] [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
Impact of hyponatremia improvement on prognosis in patients with acute decompensated heart failure (ADHF) remains unclear.
Methods
Patients hospitalized for ADHF at 19 hospitals in Japan were enrolled between October 2014 and March 2016. Hyponatremia was defined as serum sodium concentration less than 135 mmol/l. Primary endpoint was composite of all-cause death and heart failure rehospitalization one year after discharge.
Results
Among 3805 patients enrolled, 486 patients with hyponatremia at admission showed higher in-hospital mortality (13.3% vs. 5.4%, p<0.001). Of 486 hyponatremic patients, 396 patients were discharged alive. One hundred forty-three patients showed persistent hyponatremia at discharge (group P), whereas 253 patients showed improvement of hyponatremia (group I). Baseline characteristics are shown in the table. Patients in group I showed higher sodium concentration at admission (132±3 mmol/l vs. 130±4 mmol/l, p<0.001) and more increase in serum sodium concentration at discharge (7±4 mmol/l vs. 1±5 mmol/l, p<0.001). One-year survival rate free from primary endpoint was not different between the groups (56.4% in group P vs. 58.5% in group I, p=0.79). After adjusting for confounders, improvement of hyponatremia was not associated with better prognosis (hazard ratio 1.00; 95% confidence interval 0.70–1.45, p=0.99). Hyponatremia improvement showed significant interaction with left ventricular ejection fraction (LVEF) less than 40% (p=0.01). In patients with LVEF<40%, improvement of hyponatremia was associated with better prognosis (hazard ratio 0.48, 95% confidence interval 0.28–0.85, p=0.01) whereas not in patients LVEF≥40%.
Patient characteristics Group P (n=143) Group I (n=253) p value Age (years) 81 (72–86) 81 (72–87) 0.73 Female 71 (49.7) 110 (43.5) 0.24 Ischemic etiology 42 (29.4) 81 (32.0) 0.58 Prior hospitalization 62 (43.7) 98 (39.5) 0.42 SBP at admission (mmHg) 140±36 144±38 0.40 HR at admission (bpm) 92±23 95±29 0.27 Atrial Fibrillation 47 (32.9) 103 (40.7) 0.12 NYHA class IV 60 (42.2) 138 (54.8) 0.02 Intravenous inotropic use 35 (24.5) 59 (23.3) 0.80 LVEF <40% 54 (37.8) 95 (37.6) 0.97 Values are median (interquartile range), mean ± standard deviation or number (%).
Conclusion
Improvement of hyponatremia at discharge was not associated with better prognosis in patients hospitalized for ADHF.
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Affiliation(s)
- Y Tamaki
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - H Yaku
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - E Yamamoto
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Ozasa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Inuzuka
- Shiga General Hospital, Department of Cardiology, Moriyama, Japan
| | - H Kondo
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - T Tamura
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - T Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - Y Nakagawa
- Shiga University of Medical Science, Department of Cardiovascular Medicine, Otsu, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Kato
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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24
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Takae M, Yamamoto E, Oike F, Nishihara T, Fujisue K, Sueta D, Usuku H, Takashio S, Sakamoto K, Kaikita K, Tsujita K. P1647Prognostic significance of circulating leukocyte subtype counts in patients with chronic heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0406] [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: 11/12/2022] Open
Abstract
Abstract
Background
Inflammation, characterized by early leukocyte recruitment, is known to be associated with vascular endothelial dysfunction and atherosclerosis. Previous studies have reported that an increased leukocyte count is a risk factor for the progression of atherosclerosis in cardiovascular diseases, and we previously reported that a high monocyte count was an independent and incremental of cardiovascular events in patients with coronary artery disease. Furthermore, previous study also reported that inflammation play a role in the pathophysiology of heart failure (HF), but few studies have evaluated the prognostic role of monocyte in patients with HF.
Purpose
To elucidate the prognostic value of monocyte in HF, we investigated the association of monocyte counts in patients with HF with their future cardiovascular events, and compared them among new categories of HF in this study.
Methods
Consecutive HF patients referred for hospitalization at Kumamoto University Hospital between 2006 and 2015 were registered. Finally, a total of 678 HF patients were enrolled in the study, and were followed prospectively until 2016 or until the occurrence of cardiovascular events. We defined high monocyte group as monocyte counts ≥360/mm3 according to previous clinical reports. We further divided HF patients into three types according to left ventricular ejection fraction (LVEF) (HF with reduced LVEF (HFrEF), HF with mid-range LVEF (HFmrEF), and HF with preserved LVEF (HFpEF)).
Results
In this study, HFrEF was 82 patients, HFmrEF was 118 patients and HFpEF was 478 patients, respectively. The average of total monocyte counts were 397±136 in HFrEF and 375±172 in HFmrEF, and 341±138 in HFpEF patients. Kaplan-Meier analysis revealed that both HFrEF and HFmrEF patients with high monocyte group (≥360 /mm3) had a significant higher risk of HF-related events (P=0.03 and P=0.02, respectively) but not of total cardiovascular events compared with those with low monocyte groups (<360/mm3) (P=0.001). By contrast, high and low monocyte groups in HFpEF patients had no significant difference in both total cardiovascular and HF-related events. Multivariate Cox hazard analysis identified a high monocyte count as an independent and significant predictor of future HF-related events in HFrEF and HFmrEF patients (hazard ratio: 3.02, 95% confidence interval: 1.20–7.59, p=0.018).
Next, by whether they had ischemic heart disease (IHD), we divided HFrEF and HFmrEF patients into two groups. Non-ischemic HF group with high monocyte counts had a significant higher risk of HF-related events compared to those with low monocyte counts (P=0.014). By contrast, there was no statistically significant difference of the occurrences of future HF-related events between in ischemic HF group with high and low monocyte counts.
Conclusion
A high monocyte count was an independent and incremental predictor of HF-related events in HFrEF and HFmrEF especially with IHD, but not in HFpEF patients.
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Affiliation(s)
- M Takae
- Kumamoto University, Kumamoto, Japan
| | | | - F Oike
- Kumamoto University, Kumamoto, Japan
| | | | - K Fujisue
- Kumamoto University, Kumamoto, Japan
| | - D Sueta
- Kumamoto University, Kumamoto, Japan
| | - H Usuku
- Kumamoto University, Kumamoto, Japan
| | | | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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25
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Nishihara T, Sueta D, Yamamoto E, Fujisue K, Usuku H, Oike F, Takae M, Takashio S, Sakamoto K, Kaikita K, Tsujita K. P2611The prognostic value of serum magnesium levels in patients with heart failure with preserved left ventricular ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0935] [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: 11/12/2022] Open
Abstract
Abstract
Background
In heart failure (HF) patients, various factors, such as hyperactivity of the renin-angiotensin system, influence of drug therapy such as loop and thiazide diuretics, undernutrition and others, can causes hypokalemia and hypomagnesemia. Although serum magnesium (Mg) levels are closely associated with the prognosis of HF patients, the clinical significance of serum Mg levels in cardiovascular outcomes of HF with preserved ejection fraction (HFpEF) patients is not fully understood.
Purpose
We examined the relationship between serum Mg and future HF-related events in patients with HFpEF.
Methods
This study was a retrospective, single-center, observational study. We enrolled 452 consecutive HFpEF patients admitted to our university hospital between January 2007 and September 2013 and followed them for 4 years or until occurrence of HF-related events. We defined lower serum Mg as <2.0 mg/dL (=0.8 mmol/L) and higher serum Mg as ≥2.0 mg/dL based on recent clinical evidences and compared their clinical characteristics and prognosis.
Results
The mean serum Mg level was 2.12 mg/dL (median, 2.1 mg/dL; interquartile range, 2.0–2.28 mg/dL). The follow-up period was 0–50 months (median, 47.3 months) and 48 HF-related events (10.6%) were recorded. The frequency of HF-related events was significantly higher in the lower serum Mg group compared with the higher serum Mg group (n=16, 17.4% vs. n=32, 8.9%; P=0.018). There were no significant differences between groups in the use of all drugs (loop diuretics, mineralcorticoid receptor antagonists, renin-angiotensin-aldosterone system inhibitors, calcium channel blockers, β-blockers, statins and Mg preparations). The lower serum Mg group (n=92) showed significantly higher prevalence of diabetes mellitus (DM), uric acid levels and B-type natriuretic peptide (BNP)levels compared with the higher serum Mg group (n=360). Kaplan-Meier curve revealed a significantly higher probability of HF-related events in the lower serum Mg group compared with the higher serum Mg group (log-rank test, P=0.012, Figure). Multivariate Cox proportional hazard analysis revealed that the lower serum Mg group had significantly and independently higher probabilities of HF-related events compared with those in the higher serum Mg group (hazard ratio: 2.37, 95% confidence intervals: 1.27–4.41, P=0.007). We reclassified the risk of a HF-related events after adding the lower serum Mg to the prognostic factors (age, previous hospitalization for HF, DM, ln-BNP); the continuous net reclassification improvement was 29.0% (p=0.041).
Conclusion
We first demonstrated that serum Mg was significantly correlated with the occurrence of future HF-related events in HFpEF patients. Lower serum Mg is able to successfully predict future HF-related events, and management of serum Mg in HFpEF patients is thus important.
Acknowledgement/Funding
None
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Affiliation(s)
| | - D Sueta
- Kumamoto University, Kumamoto, Japan
| | | | - K Fujisue
- Kumamoto University, Kumamoto, Japan
| | - H Usuku
- Kumamoto University, Kumamoto, Japan
| | - F Oike
- Kumamoto University, Kumamoto, Japan
| | - M Takae
- Kumamoto University, Kumamoto, Japan
| | | | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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26
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Yoshikawa Y, Tamaki Y, Yaku H, Yamamoto E, Ozasa N, Inuzuka Y, Morimoto T, Kato T, Kimura T. P772Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for heart failure patients with different left ventricular ejection fraction categories: from the KCHF Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0372] [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
The current guidelines recommend different medical treatment strategies for heart failure (HF) patients according to category of left ventricular ejection fraction (LVEF). Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACE-I/ARB) is an established medical treatment for heart failure with reduced ejection fraction (HFrEF), whereas its usefulness remains to be elucidated for non-HFrEF, especially for heart failure with mid-range ejection fraction (HFmrEF).
Purpose
This study aimed to assess the difference in association between ACE-I/ARB and clinical outcomes depending on LVEF category.
Methods
The Kyoto Congestive Heart Failure (KCHF) Registry is a multicentre registry without any exclusion criteria which included consecutive patients hospitalized for congestive HF in Japan. In each LVEF group (HFrEF, HFmrEF and heart failure with preserved ejection fraction [HFpEF]), we compared those who were prescribed ACE-I/ARB as discharge medication and those not, and assessed their 1-year clinical outcomes. We defined the primary outcome measure as a composite of all-cause death and HF hospitalization. We constructed a multivariable Cox regression model incorporating 24 clinically relevant factors. We assessed adjusted hazard ratios (HRs) of those with ACE-I/ARB relative to those not, and also interaction between ACE-I/ARB prescription at discharge and LVEF category.
Results
A total of 3717 patients were included in this study, where the number of patients in each LVEF group were as follows; 1383 patients with HFrEF, 703 with HFmrEF and 1631 with HFpEF, respectively (Figure). As shown in the table, the HRs for the primary outcome measure were significant in the HFrEF and HFmrEF groups, whereas the HR in the HFpEF group was insignificant. The interaction between ACE-I/ARB prescription and LVEF category for the primary outcome measure was statistically significant.
Hazard ratios by LVEF category Outcome measures HFrEF HFmrEF HFpEF P interaction HR (95% CI) P value HR (95% CI) P value HR (95% CI) P value All-cause death + HF hospitalization 0.66 (0.54–0.79) <0.001 0.61 (0.45–0.82) 0.001 0.95 (0.80–1.14) 0.61 0.01 All-cause death 0.62 (0.48–0.81) <0.001 0.52 (0.35–0.77) 0.001 0.73 (0.58–0.93) 0.01 0.10 HF hospitalization 0.73 (0.57–0.92) 0.009 0.59 (0.40–0.87) 0.007 1.14 (0.90–1.44) 0.28 0.07 Hazard ratios of ACE-I/ARB relative to non-ACE-I/ARB for primary outcome measures in each LVEF category.
Study flowchart
Conclusions
The risk ratios of those who were prescribed ACE-I/ARB relative to those not were significantly low in HFmrEF as well as HFrEF, whereas the risk ratios were insignificant in HFpEF. ACE-I/ARB could be a potential choice of treatment for HFmrEF patients.
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Affiliation(s)
- Y Yoshikawa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Tamaki
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - H Yaku
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - E Yamamoto
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Ozasa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Inuzuka
- Shiga General Hospital, Department of Cardiology, Moriyama, Japan
| | - T Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - T Kato
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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27
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Sueta D, Nishihara T, Yamamoto E, Tsujita K. P2609H2FPEF score as a prognostic value in HFpEF patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0933] [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
The H2FPEF score is recognized as a simple method to diagnose heart failure (HF) with preserved left ventricular ejection fraction (HFpEF).
Purpose
We investigated the value of the H2FPEF score in predicting subsequent cardiovascular events in HFpEF patients.
Methods
This study was a retrospective, single-center, observational study. We calculated the H2FPEF scores for 404 consecutive HFpEF patients. Subjects were subdivided into low- (0–3), intermediate- (4–6), and high-score (7–9) groups and followed for 50-months. The primary and secondary endpoints were composite cardiovascular/ cerebrovascular events (cardiovascular death, non-fatal myocardial infarction, unstable angina pectoris, hospitalization for HF decompensation and non-fatal stroke) occurrence and HF-related events (hospitalization for HF decompensation) occurrence at 50-months, respectively.
Results
Kaplan–Meier analyses demonstrated a significantly higher incidence of cardiovascular/cerebrovascular events in proportion to a higher H2FPEF score (log-rank test, P=0.005). The HF-related event rate was higher in proportion to the H2FPEF score (log-rank test, P<0.001). Multivariate Cox hazard analyses identified the H2FPEF score (per 1 point) as an independent predictor of cardiovascular and HF-related events (Table, hazard ratio, 1.179; 95% confidence interval, 1.066–1.305; P=0.001 and hazard ratio, 1.288; 95% confidence interval, 1.134–1.463; P=0.001, respectively). Receiver operating characteristic analysis showed that the H2FPEF significantly predicted cardiovascular events (Figure A, AUC 0.626, 95% CI 0.557–0.693; P<0.001) and HF-related events (Figure B, AUC 0.680, 95% CI 0.600–0.759; P<0.001). The cutoff H2FPEF score was 5.5 for the identification of cardiovascular and HF-related events.
Conclusion
The H2FPEF score is a potentially useful marker for the prediction of cardiovascular and HF-related events in HFpEF patients.
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Affiliation(s)
- D Sueta
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - T Nishihara
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Cardiovascular Medicine, Kumamoto, Japan
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28
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Kikuchi N, Yamamoto E, Hattori H, Nagao M, Momose M, Shiga T, Hagiwara N, Niinami H, Nunoda S. Myocardial Flow Reserve Using 13N Ammonia PET for Detection of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.704] [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] Open
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29
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Yamamoto E, Jørgensen TN. Immunological effects of vitamin D and their relations to autoimmunity. J Autoimmun 2019; 100:7-16. [PMID: 30853311 DOI: 10.1016/j.jaut.2019.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 01/23/2019] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 02/07/2023]
Abstract
Vitamin D deficiency is an established risk factor for many autoimmune diseases and the anti-inflammatory properties of vitamin D underscore its potential therapeutic value for these diseases. However, results of vitamin D3 supplementation clinical trials have been varied. To understand the clinical heterogeneity, we reviewed the pre-clinical data on vitamin D activity in four common autoimmune diseases: multiple sclerosis (MS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD), in which patients are commonly maintained on oral vitamin D3 supplementation. In contrast, many pre-clinical studies utilize other methods of manipulation (i.e. genetic, injection). Given the many actions of vitamin D3 and data supporting a vitamin D-independent role of the Vitamin D receptor (VDR), a more detailed mechanistic understanding of vitamin D3 activity is needed to properly translate pre-clinical findings into the clinic. Therefore, we assessed studies based on route of vitamin D3 administration, and identified where discrepancies in results exist and where more research is needed to establish the benefit of vitamin D supplementation.
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Affiliation(s)
- Erin Yamamoto
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA
| | - Trine N Jørgensen
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA.
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30
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Achey RL, Yamamoto E, Sexton D, Hammer C, Lee BS, Butler RS, Thompson NR, Nagel SJ, Machado AG, Lobel DA. Prediction of depression and anxiety via patient-assessed tremor severity, not physician-reported motor symptom severity, in patients with Parkinson’s disease or essential tremor who have undergone deep brain stimulation. J Neurosurg 2018; 129:1562-1571. [DOI: 10.3171/2017.8.jns1733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/28/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVEDeep brain stimulation (DBS) is an effective therapy for movement disorders such as idiopathic Parkinson’s disease (PD) and essential tremor (ET). However, some patients who demonstrate benefit on objective motor function tests do not experience postoperative improvement in depression or anxiety, 2 important components of quality of life (QOL). Thus, to examine other possible explanations for the lack of a post-DBS correlation between improved objective motor function and decreased depression or anxiety, the authors investigated whether patient perceptions of motor symptom severity might contribute to disease-associated depression and anxiety.METHODSThe authors performed a retrospective chart review of PD and ET patients who had undergone DBS at the Cleveland Clinic in the period from 2009 to 2013. Patient demographics, diagnosis (PD, ET), motor symptom severity, and QOL measures (Primary Care Evaluation of Mental Disorders 9-item Patient Health Questionnaire [PHQ-9] for depression, Generalized Anxiety Disorder 7-item Scale [GAD-7], and patient-assessed tremor scores) were collected at 4 time points: preoperatively, postoperatively, 1-year follow-up, and 2-year follow-up. Multivariable prediction models with solutions for fixed effects were constructed to assess the correlation of predictor variables with PHQ-9 and GAD-7 scores. Predictor variables included age, sex, visit time, diagnosis (PD vs ET), patient-assessed tremor, physician-reported tremor, Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) score, and patient-assessed tremor over time.RESULTSSeventy PD patients and 17 ET patients were included in this analysis. Mean postoperative and 1-year follow-up UPDRS-III and physician-reported tremor scores were significantly decreased compared with preoperative scores (p < 0.0001). Two-year follow-up physician-reported tremor was also significantly decreased from preoperative scores (p < 0.0001). Only a diagnosis of PD (p = 0.0047) and the patient-assessed tremor rating (p < 0.0001) were significantly predictive of depression. A greater time since surgery, in general, significantly decreased anxiety scores (p < 0.0001) except when a worsening of patient-assessed tremor was reported over the same time period (p < 0.0013).CONCLUSIONSPatient-assessed tremor severity alone was predictive of depression in PD and ET following DBS. This finding suggests that a patient’s perception of illness plays a greater role in depression than objective physical disability regardless of the time since surgical intervention. In addition, while anxiety may be attenuated by DBS, patient-assessed return of tremor over time can increase anxiety, highlighting the importance of long-term follow-up for behavioral health features in chronic neurological disorders. Together, these data suggest that the patient experience of motor symptoms plays a role in depression and anxiety—a finding that warrants consideration when evaluating, treating, and following movement disorder patients who are candidates for DBS.
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Affiliation(s)
- Rebecca L. Achey
- 1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
| | - Erin Yamamoto
- 1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
| | - Daniel Sexton
- 1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
| | - Christine Hammer
- 2Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
| | - Bryan S. Lee
- 3Department of Neurosurgery, Neurological Institute
| | | | | | - Sean J. Nagel
- 5Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute
| | - Andre G. Machado
- 5Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute
- 6Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and
| | - Darlene A. Lobel
- 5Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute
- 6Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and
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31
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Yoshino T, Siena S, Dalal R, Okuda Y, Yamamoto E, Grothey A. A multicenter, multicohort, phase II study of trastuzumab deruxtecan (DS-8201a) in subjects with HER2-expressing metastatic colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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32
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Yamamoto E, Thondapu V, Poon E, Sugiyama T, Fracassi F, Dijkstra J, Lee H, Ooi A, Barlis P, Jang IK. 1348Endothelial shear stress plays a key role in acute coronary syndromes with intact fibrous cap (plaque erosion): a computational fluid dynamics and optical coherence tomography study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1348] [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)
- E Yamamoto
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - V Thondapu
- University of Melbourne, Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, Melbourne, Australia
| | - E Poon
- University of Melbourne, Department of Mechanical Engineering, Melbourne, Australia
| | - T Sugiyama
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - F Fracassi
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - J Dijkstra
- Leiden University Medical Center, Department of Radiology, Leiden, Netherlands
| | - H Lee
- Massachusetts General Hospital, Biostatistics Center, Boston, United States of America
| | - A Ooi
- University of Melbourne, Department of Mechanical Engineering, Melbourne, Australia
| | - P Barlis
- University of Melbourne, Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, Melbourne, Australia
| | - I K Jang
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
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33
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Ishii M, Kaikita K, Sato K, Nakanishi N, Mitsuse T, Oimatsu Y, Takashio S, Izumiya Y, Yamamoto E, Kojima S, Tsujita K. P1684Prognostic impact of variant angina in patients with coronary spasm. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1684] [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)
- M Ishii
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sato
- Kumamoto City Hospital, Kumamoto, Japan
| | - N Nakanishi
- Kumamoto University Hospital, Kumamoto, Japan
| | - T Mitsuse
- Kumamoto University Hospital, Kumamoto, Japan
| | - Y Oimatsu
- Kumamoto University Hospital, Kumamoto, Japan
| | - S Takashio
- Kumamoto University Hospital, Kumamoto, Japan
| | - Y Izumiya
- Kumamoto University Hospital, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - S Kojima
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
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34
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Bryniarski KL, Yamamoto E, Sugiyama T, Zmudka K, Lee H, Wang Z, Fujimoto J, Jang IK. P5514Three-dimensional fibrous cap thickness pattern in patients with ST-elevation myocardial infarction vs. stable angina. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5514] [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: 11/15/2022] Open
Affiliation(s)
- K L Bryniarski
- John Paul II Hospital, Interventional Cardiology Department, Krakow, Poland
| | - E Yamamoto
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - T Sugiyama
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - K Zmudka
- John Paul II Hospital, Interventional Cardiology Department, Krakow, Poland
| | - H Lee
- Massachusetts General Hospital, Biostatistics Center, Boston, United States of America
| | - Z Wang
- Massachusetts Institute of Technology, Department of Electrical Engineering & Computer Science and Research Laboratory of Electronics, Cambridge, United States of America
| | - J Fujimoto
- Massachusetts Institute of Technology, Department of Electrical Engineering & Computer Science and Research Laboratory of Electronics, Cambridge, United States of America
| | - I K Jang
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
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35
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Sekiguchi H, Abe T, Yamamoto E, Koike T, Sakai A, Sato K, Hagiwara N. P6267Underdiagnosis and non-treatment of heterozygous familial hypercholesterolemia in association with cardiovascular disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6267] [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)
- H Sekiguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Yamamoto
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Koike
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Sato
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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36
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Sugiyama T, Yamamoto E, Fracassi F, Lee H, Jang IK. P2477Coronary plaque characteristics in diabetic patients who presented with acute coronary syndromes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2477] [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)
- T Sugiyama
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - E Yamamoto
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - F Fracassi
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
| | - H Lee
- Massachusetts General Hospital, Biostatistics Center, Boston, United States of America
| | - I K Jang
- Massachusetts General Hospital, Cardiology Division, Boston, United States of America
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37
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Zhang CJ, Wang C, Jiang M, Gu C, Xiao J, Chen X, Martin BN, Tang F, Yamamoto E, Xian Y, Wang H, Li F, Sartor RB, Smith H, Husni ME, Shi FD, Gao J, Carman J, Dongre A, McKarns SC, Coppieters K, Jørgensen TN, Leonard WJ, Li X. Act1 is a negative regulator in T and B cells via direct inhibition of STAT3. Nat Commun 2018; 9:2745. [PMID: 30013031 PMCID: PMC6048100 DOI: 10.1038/s41467-018-04974-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 05/23/2018] [Indexed: 01/05/2023] Open
Abstract
Although Act1 (adaptor for IL-17 receptors) is necessary for IL-17-mediated inflammatory responses, Act1- (but not Il17ra-, Il17rc-, or Il17rb-) deficient mice develop spontaneous SLE- and Sjögren's-like diseases. Here, we show that Act1 functions as a negative regulator in T and B cells via direct inhibition of STAT3. Mass spectrometry analysis detected an Act1-STAT3 complex, deficiency of Act1 (but not Il17ra-, Il17rc-, or Il17rb) results in hyper IL-23- and IL-21-induced STAT3 activation in T and B cells, respectively. IL-23R deletion or blockade of IL-21 ameliorates SLE- and Sjögren's-like diseases in Act1-/- mice. Act1 deficiency results in hyperactivated follicular Th17 cells with elevated IL-21 expression, which promotes T-B cell interaction for B cell expansion and antibody production. Moreover, anti-IL-21 ameliorates the SLE- and Sjögren's-like diseases in Act1-deficient mice. Thus, IL-21 blocking antibody might be an effective therapy for treating SLE- and Sjögren's-like syndrome in patients containing Act1 mutation.
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MESH Headings
- Adaptor Proteins, Signal Transducing/deficiency
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/immunology
- Animals
- Antibodies, Monoclonal/pharmacology
- B-Lymphocytes/drug effects
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Cell Differentiation
- Disease Models, Animal
- Female
- Gene Expression Regulation
- Interleukin-17/genetics
- Interleukin-17/immunology
- Interleukins/antagonists & inhibitors
- Interleukins/genetics
- Interleukins/immunology
- Leukocytes, Mononuclear/drug effects
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/pathology
- Lupus Erythematosus, Systemic/drug therapy
- Lupus Erythematosus, Systemic/genetics
- Lupus Erythematosus, Systemic/immunology
- Lupus Erythematosus, Systemic/pathology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Primary Cell Culture
- Receptors, Interleukin/deficiency
- Receptors, Interleukin/genetics
- Receptors, Interleukin/immunology
- Receptors, Interleukin-17/deficiency
- Receptors, Interleukin-17/genetics
- Receptors, Interleukin-17/immunology
- STAT3 Transcription Factor/genetics
- STAT3 Transcription Factor/immunology
- Signal Transduction
- Sjogren's Syndrome/drug therapy
- Sjogren's Syndrome/genetics
- Sjogren's Syndrome/immunology
- Sjogren's Syndrome/pathology
- Spleen
- T-Lymphocytes/drug effects
- T-Lymphocytes/immunology
- T-Lymphocytes/pathology
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Affiliation(s)
- Cun-Jin Zhang
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300051, China
- Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Chenhui Wang
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
- Wuhan Institute of Biotechnology, Wuhan, 430200, China
| | - Meiling Jiang
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300192, China
| | - Chunfang Gu
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Jianxin Xiao
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Xing Chen
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Bradley N Martin
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Fangqiang Tang
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Erin Yamamoto
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Yibo Xian
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Han Wang
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Fengling Li
- National Gnotobiotic Rodent Resource Center, Department of Medicine and Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - R Balfour Sartor
- National Gnotobiotic Rodent Resource Center, Department of Medicine and Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, 27599, USA
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Howard Smith
- Department of Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - M Elaine Husni
- Department of Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Fu-Dong Shi
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300051, China
- Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA
| | - Ji Gao
- Discovery Biology, Bristol-Myers Squibb, Princeton, NJ, 08540, USA
| | - Julie Carman
- Discovery Biology, Bristol-Myers Squibb, Princeton, NJ, 08540, USA
| | - Ashok Dongre
- Discovery Biology, Bristol-Myers Squibb, Princeton, NJ, 08540, USA
| | - Susan C McKarns
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA
- Department of Molecular Microbiology and Immunology, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Ken Coppieters
- Type 1 Diabetes Center, Novo Nordisk A/S, Søborg, 2860, Denmark
| | - Trine N Jørgensen
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA
| | - Warren J Leonard
- Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Xiaoxia Li
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA.
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Yoshino T, Siena S, Dalal R, Okuda Y, Yamamoto E, Grothey A. A multicenter, multicohort, phase 2 study of trastuzumab deruxtecan (DS-8201a) in subjects with HER2-expressing metastatic colorectal cancer - Trial in progress. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.294] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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39
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Abstract
Pediatric-onset multiple sclerosis (POMS), once thought to be rare, is now being diagnosed in increasing numbers in children. Despite improvements to diagnostic criteria, the diagnosis and management of POMS remains challenging. The aim of this study is to retrospectively describe a growing POMS patient population seen at a single center over a 13 year period. Epidemiologic, clinical, neuroimaging, laboratory features and therapeutic management and outcome data were collected and analyzed. These data support associations between MS and environmental triggers such as obesity and vitamin D deficiency. Presenting symptoms, magnetic resonance imaging and laboratory findings were consistent with the existing literature; however, the prevalence of cortical lesions and abnormal saccadic pursuit is higher than other reports. Data also demonstrate a shift in practice from first- to second-line therapies over the observed period.
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Affiliation(s)
- Erin Yamamoto
- 1 Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Matthew Ginsberg
- 2 Children's Hospital of Pittsburgh Department of Pediatric Neurology, Pittsburgh, PA, USA
| | - Mary Rensel
- 3 Mellen Center, Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Manikum Moodley
- 4 Center for Pediatric Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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Yamamoto E, Mourany L, Colleran R, Whitman C, Tousi B. Utility of Montreal Cognitive Assessment in Differentiating Dementia With Lewy Bodies From Alzheimer's Dementia. Am J Alzheimers Dis Other Demen 2017; 32:468-471. [PMID: 28871793 PMCID: PMC10852593 DOI: 10.1177/1533317517725811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are the 2 most common neurodegenerative dementias. Identification of patients with DLB is necessary to guide appropriate clinical management and medication trials. Patients with DLB are reported to perform poorly on tasks of visuospatial and executive function, compared to patients with AD who perform poorly on memory tasks. Using the Montreal Cognitive Assessment, we found that patients with DLB (n = 73) had statistically significant lower performance in clock drawing (visuospatial and executive function) and higher performance in delayed recall (memory) subscores compared to patients with AD (n = 57). This score pattern should raise suspicion for a DLB diagnosis at initial evaluation of patients with dementia.
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Affiliation(s)
- Erin Yamamoto
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lyla Mourany
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
| | - Rosemary Colleran
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
| | - Christine Whitman
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
| | - Babak Tousi
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
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41
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Yaku H, Kato M, Yokomatsu T, Yamamoto E, Tamaki Y, Inuzuka Y, Ozasa N, Morimoto T, Kato T, Kimura T. P1490Age-related differences in characteristics and management of acute decompensated heart failure in Japan: insights from the kyoto congestive heart failure registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1490] [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)
- H. Yaku
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - M. Kato
- Mitsubishi Kyoto Hospital, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T. Yokomatsu
- Mitsubishi Kyoto Hospital, Department of Cardiovascular Medicine, Kyoto, Japan
| | - E. Yamamoto
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y. Tamaki
- Tenri Hospital, Department of Cardiovascular Medicine, Tenri, Japan
| | - Y. Inuzuka
- Shiga Medical Center for Adults, Department of Cardiovascular Medicine, Moriyama, Japan
| | - N. Ozasa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T. Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - T. Kato
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T. Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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Sugiyama T, Zanchin T, Bryniarski K, Yamamoto E, Xing L, Jang I. P2339Comparison of the non-culprit plaque phenotype in patients with ruptured vs. eroded culprit plaque: a three-vessel optical coherence tomography imaging study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2339] [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: 11/13/2022] Open
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43
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Ishii M, Kaikita K, Yamamoto E, Izumiya Y, Kojima S, Hokimoto S, Tsujita K. P3677Prognostic implication of gender difference in patients with coronary spasm. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3677] [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: 11/13/2022] Open
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44
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Yamamoto E, Siasos G, Zaromytidou M, Coskun A, Xing L, Bryniarski K, Zanchin T, Sugiyama T, Lee H, Stone P, Jang I. P2341Low endothelial shear stress predicts high-risk evolution of coronary plaque phenotype in the future - a serial optical coherence tomography (OCT) and computational fluid dynamics (CFD) study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2341] [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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45
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Kato T, Sasaki K, Funasako M, Miyamoto S, Izumi T, Haruna T, Yaku H, Kawase Y, Yamamoto E, Tamaki Y, Inuzuka Y, Inoko M, Ozasa N, Kimura T. P5291Nutritional status in acute decompensated heart failure was closely linked to high in-hospital mortality (from the KCHF registry). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5291] [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)
- T. Kato
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - K. Sasaki
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - M. Funasako
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - S. Miyamoto
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - T. Izumi
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - T. Haruna
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - H. Yaku
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y. Kawase
- Kurashiki Central Hospital, Kurashiki, Japan
| | - E. Yamamoto
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y. Tamaki
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - Y. Inuzuka
- Shiga Medical Center for Adults, Department of Cardiology, Moriyama, Japan
| | - M. Inoko
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - N. Ozasa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T. Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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Ishii M, Kaikita K, Ito M, Sueta D, Oimatsu Y, Mitsuse T, Arima Y, Takashio S, Izumiya Y, Yamamoto E, Kojima S, Hokimoto S, Yamabe H, Tsujita K. P2696Differential patterns of antithrombotic effects on the system mimicking vessel wall injury in patients treated with various oral anticoagulants. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2696] [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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47
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Ishii M, Kaikita K, Oimatsu Y, Mitsuse T, Takashio S, Izumiya Y, Yamamoto E, Kojima S, Hokimoto S, Tsujita K. P3675Transcoronary gradients of heme oxygenase-1 and coronary spasm. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3675] [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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48
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Zanchin T, Sugiyama T, Yamamoto E, Xing L, Bryniarski K, Lee H, Jang I. P2329The effect of cardiac risk factors on global coronary atherosclerosis burden among patients undergoing percutaneous coronary intervention: a multicenter three vessel optical coherence tomography study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2329] [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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49
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Bryniarski K, Yamamoto E, Xing L, Zanchin T, Sugiyama T, Lee H, Jang I. P2343Is there racial difference in coronary plaque characteristics between white versus east Asians? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2343] [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: 11/13/2022] Open
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50
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Yoshikawa Y, Tamaki Y, Yaku H, Yamamoto E, Ozasa N, Inuzuka Y, Morimoto T, Inoko M, Nakagawa Y, Kato T, Kimura T. P4387Use or nonuse of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in patients hospitalized for acute heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4387] [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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