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Hata Y, Ichimata S, Hirono K, Yamaguchi Y, Oku Y, Ichida F, Nishida N. Pathological and Comprehensive Genetic Investigation of Autopsy Cases of Idiopathic Bradyarrhythmia. Circ J 2022; 87:111-119. [PMID: 36070930 DOI: 10.1253/circj.cj-22-0397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Idiopathic bradyarrhythmia is considered to be due to pathological degeneration of the cardiac conduction system (CCS) during aging. There appears to have been no comprehensive genetic investigations in patients with idiopathic bradyarrhythmia.Methods and Results: Ten autopsy cases with advanced bradyarrhythmia (6 men and 4 women; age: 70-94 years, 81.5±6.9 years; 5 cases each of sinus node dysfunction [SND] and complete atrioventricular block [CAVB]) were genetically investigated by using whole-exome sequencing. Morphometric analysis of the CCS was performed with sex-, age- and comorbidity-matched control cases. As a result, severe loss of nodal cells and distal atrioventricular conduction system were found in SND and CAVB, respectively. However, the conduction tissue loss was not significant in either the atrioventricular node or the proximal bundle of His in CAVB cases. A total of 13 heterozygous potential variants were found in 3 CAVB and 2 SND cases. Of these 13 variants, 4 were missense in the known progressive cardiac conduction disease-related genes: GATA4 and RYR2. In the remaining 9 variants, 5 were loss-of-function mutation with highly possible pathogenicity. CONCLUSIONS In addition to degenerative changes of selectively vulnerable areas in the heart during advancing age, the vulnerability of the CCS, which may be associated with "rare variants of small effect," may also be a contributing factor to the degeneration of CCS, leading to "idiopathic" bradyarrhythmia.
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Affiliation(s)
- Yukiko Hata
- Department of Legal Medicine, Faculty of Medicine, University of Toyama
| | - Shojiro Ichimata
- Department of Legal Medicine, Faculty of Medicine, University of Toyama
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama
| | - Yoshiaki Yamaguchi
- Department of Legal Medicine, Faculty of Medicine, University of Toyama.,Department of Cardiology, Saiseikai Takaoka Hospital
| | - Yuko Oku
- Department of Legal Medicine, Faculty of Medicine, University of Toyama
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health & Welfare
| | - Naoki Nishida
- Department of Legal Medicine, Faculty of Medicine, University of Toyama
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Ohuchi H, Kawata M, Uemura H, Akagi T, Yao A, Senzaki H, Kasahara S, Ichikawa H, Motoki H, Syoda M, Sugiyama H, Tsutsui H, Inai K, Suzuki T, Sakamoto K, Tatebe S, Ishizu T, Shiina Y, Tateno S, Miyazaki A, Toh N, Sakamoto I, Izumi C, Mizuno Y, Kato A, Sagawa K, Ochiai R, Ichida F, Kimura T, Matsuda H, Niwa K. JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair. Circ J 2022; 86:1591-1690. [DOI: 10.1253/circj.cj-22-0134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hideo Ohuchi
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, National Cerebral and Cardiovascular Center
| | - Masaaki Kawata
- Division of Pediatric and Congenital Cardiovascular Surgery, Jichi Children’s Medical Center Tochigi
| | - Hideki Uemura
- Congenital Heart Disease Center, Nara Medical University
| | - Teiji Akagi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
| | - Atsushi Yao
- Division for Health Service Promotion, University of Tokyo
| | - Hideaki Senzaki
- Department of Pediatrics, International University of Health and Welfare
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
| | - Hajime Ichikawa
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Hirohiko Motoki
- Department of Cardiovascular Medicine, Shinshu University School of Medicine
| | - Morio Syoda
- Department of Cardiology, Tokyo Women’s Medical University
| | - Hisashi Sugiyama
- Department of Pediatric Cardiology, Seirei Hamamatsu General Hospital
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Kei Inai
- Department of Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University
| | - Takaaki Suzuki
- Department of Pediatric Cardiac Surgery, Saitama Medical University
| | | | - Syunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tomoko Ishizu
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Yumi Shiina
- Cardiovascular Center, St. Luke’s International Hospital
| | - Shigeru Tateno
- Department of Pediatrics, Chiba Kaihin Municipal Hospital
| | - Aya Miyazaki
- Division of Congenital Heart Disease, Department of Transition Medicine, Shizuoka General Hospital
| | - Norihisa Toh
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoshiko Mizuno
- Faculty of Nursing, Tokyo University of Information Sciences
| | - Atsuko Kato
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Koichi Sagawa
- Department of Pediatric Cardiology, Fukuoka Children’s Hospital
| | - Ryota Ochiai
- Department of Adult Nursing, Yokohama City University
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Koichiro Niwa
- Department of Cardiology, St. Luke’s International Hospital
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Hirono K, Ichida F. Left ventricular noncompaction: a disorder with genotypic and phenotypic heterogeneity-a narrative review. Cardiovasc Diagn Ther 2022; 12:495-515. [PMID: 36033229 PMCID: PMC9412206 DOI: 10.21037/cdt-22-198] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/21/2022] [Indexed: 01/10/2023]
Abstract
Background and Objective Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by excessive trabecular formation and deep recesses in the ventricular wall, with a bilaminar structure consisting of an endocardial noncompaction layer and an epicardial compacted layer. Although genetic variants have been reported in patients with LVNC, understanding of LVNC and its pathogenesis has not yet been fully elucidated. We addressed the latest findings on genes reported to be associated with LVNC morphogenesis and possible pathologies to understand the diverse spectrum between genotype and phenotype in LVNC. Also, the latest findings and issues related to the diagnosis of LVNC were summarized. Methods This article is written as a commentary narrative review and will provide an update on the current literature and available data on common forms of LVNC published in the past 30 years in English through to May 2022 using PubMed. Key Content and Findings Familial forms of LVNC are frequent, and autosomal dominant mode of inheritance has been predominantly observed. Several of the candidate causative genes are also mutated in other cardiomyopathies, suggesting a possible shared molecular and/or cellular etiology. The most common gene functions were sarcomere function whereas genes in mice LVNC models were involved in heart development. Echocardiography and cardiac magnetic resonance imaging (CMR) are useful for diagnosis although there are no unified criteria due to overdiagnosis of imaging, poor consistency between techniques, and lack of association between trabecular severity and adverse clinical outcomes. Conclusions This review reflects the current lack of clarity regarding the pathogenesis and significance of LVNC and showed the complexity of imaging diagnostic criteria, interpretation of the role of LVNC as a cause, and uncertainty regarding the specific genetic basis of LVNC.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
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Mito A, Hirono K, Ide H, Ozawa S, Ichida F, Taguchi M. Effects of Concomitant Administration of PXR Ligand Drugs on the Anticoagulant Effects of Warfarin. Biol Pharm Bull 2022; 45:703-708. [PMID: 35370222 DOI: 10.1248/bpb.b21-00853] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We encountered cases in which the anticoagulant effects of warfarin (CYP2C9 substrate) were reversibly attenuated by the concomitant administration of rifampicin or bosentan, which are potent pregnane X receptor (PXR) ligands. The purpose of the present study is to report the previous case with rifampicin, and to evaluate the changes in the warfarin anticoagulant effects when withdrawing or switching bosentan treatment. The former is a case study of a 4-year-old girl undergoing warfarin treatment. The latter is a longitudinal study of 20 pediatric patients receiving stable warfarin treatment. The prothrombin time and international normalized ratio (PT-INR) values were extracted from the medical records and normalized by the daily-dose per body size as an index for the warfarin anticoagulant effects. Rifampicin treatment resulted in a 52.0% decrease in the anticoagulant index. On the other hand, 10 of 20 patients started bosentan and their anticoagulant index was reduced by a median of 2.00. Bosentan was withdrawn in 4 of 20 patients and their anticoagulant index increased by a median of 3.67. Six of 20 patients switched from bosentan to macitentan, which is considered not to activate PXR in clinical settings. However, switching from bosentan to macitentan resulted in a median of 2.25 reduction of the anticoagulant index rather than recovery of the response to warfarin. This study suggests not only the possibility of heterogeneity in the response to PXR activation and deactivation, but also the importance of long-term monitoring of drug-drug interactions when switching from bosentan to macitentan.
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Affiliation(s)
- Ayane Mito
- Department of Pharmacy Practice and Sciences, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama
| | - Haruka Ide
- Department of Pharmacy Practice and Sciences, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
| | - Sayaka Ozawa
- Department of Pediatrics, Faculty of Medicine, University of Toyama
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare
| | - Masato Taguchi
- Department of Pharmacy Practice and Sciences, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
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5
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Hirono K, Takarada S, Miyao N, Nakaoka H, Ibuki K, Ozawa S, Origasa H, Ichida F. Thromboembolic events in left ventricular non-compaction: comparison between children and adults - a systematic review and meta-analysis. Open Heart 2022; 9:openhrt-2021-001908. [PMID: 35613828 PMCID: PMC9134208 DOI: 10.1136/openhrt-2021-001908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/09/2022] [Indexed: 01/02/2023] Open
Abstract
Objective Left ventricular non-compaction (LVNC) is morphologically characterised by excessive trabeculations and deep recesses in the ventricular wall. The risk of thromboembolic disease in the paediatric patients with LVNC has not been clearly established. We conducted this systematic review to evaluate the prevalence and incidence of thromboembolism (TE) in paediatric and adult patients with LVNC and searched for risk factors for TE to explore management strategies. Methods The primary outcome was the prevalence and incidence of TE in the patients with LVNC. The secondary outcome was the TE and mortality and heart transplantation rates between paediatric and adult patients with LVNC. We searched for studies published in MEDLINE, Embase and Cochrane Central Register of Controlled Trials between January 1950 and December 2020. A systematic search of keywords related to LVNC, anticoagulants/antiplatelets and TE was conducted. Studies that did not present original research, non-human studies, duplicated studies were excluded. Results Fifty-seven studies met the inclusion criteria. A total of 726 paediatric and 3862 adult patients were included. The mean prevalence rates of TE in the paediatric and adult patients with LVNC were 2.6% and 6.2% (I2=0%; p<0.450 and I2=73.7%; p<0.001), respectively. The mean annual incidences of TE in paediatric and adult patients with LVNC were 1.4% and 2.9% (I2=99.4%; p<0.001 and I2=99.5%; p<0.001), respectively. Multivariate logistic regression analysis showed that TE was associated with left ventricular ejection fraction in <40% of paediatric patients (OR, 9.47; 95% CI, 1.35 to 188.23; p=0.0225). Conclusions The prevalence and incidence rates in paediatric patients were lower than those in adult patients. TE was associated with a reduced systolic function in paediatric patients with LVNC.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Shinya Takarada
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Nariaki Miyao
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Hideyuki Nakaoka
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Keijiro Ibuki
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Sayaka Ozawa
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Hideki Origasa
- Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Otawara, Japan
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Hirono K, Origasa H, Tsuboi K, Takarada S, Oguri M, Okabe M, Miyao N, Nakaoka H, Ibuki K, Ozawa S, Ichida F. Clinical Status and Outcome of Isolated Right Ventricular Hypoplasia: A Systematic Review and Pooled Analysis of Case Reports. Front Pediatr 2022; 10:794053. [PMID: 35529333 PMCID: PMC9069111 DOI: 10.3389/fped.2022.794053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background Isolated right ventricular hypoplasia (IRVH), not associated with severe pulmonary or tricuspid valve malformation, is a rare congenital myocardial disease. This study aims to evaluate the clinical status and outcome of IRVH. Methods A systematic search of keywords on IRVH was conducted. Studies were searched from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Ichushi) published between January 1950 and August 2021. Results Thirty studies met the inclusion criteria. All of these studies were case reports and included 54 patients (25 males and 29 females). The median age of the patients was 2.5 years old (0-15.3 years). Of the 54 patients, 13 (24.1%) reported a family history of cardiomyopathy. Moreover, 50 (92.6%), 19 (35.2%), and 17 (31.5%) patients were diagnosed with cyanosis, finger clubbing, and dyspnea, respectively. Furthermore, 53 (98.2%) patients had a patent foramen ovale or an atrial septal defect (ASD). Z-score of the tricuspid valve diameter on echocardiogram was -2.16 ± 1.53, concomitant with small right ventricular end-diastolic volume. In addition, 29 (53.7%), 21 (38.9%), 7 (13.0%), and 2 (3.7%) patients underwent surgery, ASD closure, Glenn operation, and one and a half ventricular repair, respectively. Among them, nine (20.4%) patients expired, and the multivariable logistic regression analysis showed that infancy, heart failure, and higher right ventricular end-diastolic pressure were risk factors for death. Conclusions IRVH was diagnosed early in children with cyanosis and was associated with high mortality. This systematic review and pooled analysis provided evidence to assess the of IRVH degree in order to evaluate the clinical status and outcome of IRVH.
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Affiliation(s)
- Keiichi Hirono
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Kaori Tsuboi
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Shinya Takarada
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Masato Oguri
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Mako Okabe
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Nariaki Miyao
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Hideyuki Nakaoka
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Keijiro Ibuki
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Sayaka Ozawa
- Departments of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
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Okabe M, Takarada S, Miyao N, Nakaoka H, Ibuki K, Ozawa S, Watanabe K, Tsuji H, Hashimoto I, Hatasaki K, Hayakawa S, Hamaguchi Y, Hamada M, Ichida F, Hirono K. G0S2 regulates innate immunity in Kawasaki disease via lncRNA HSD11B1-AS1. Pediatr Res 2022; 92:378-387. [PMID: 35292727 PMCID: PMC8922062 DOI: 10.1038/s41390-022-01999-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 11/23/2021] [Accepted: 02/02/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is a systemic vasculitis that is currently the most common cause of acquired heart disease in children. However, its etiology remains unknown. Long non-coding RNAs (lncRNAs) contribute to the pathophysiology of various diseases. Few studies have reported the role of lncRNAs in KD inflammation; thus, we investigated the role of lncRNA in KD inflammation. METHODS A total of 50 patients with KD (median age, 19 months; 29 males and 21 females) were enrolled. We conducted cap analysis gene expression sequencing to determine differentially expressed genes in monocytes of the peripheral blood of the subjects. RESULTS About 21 candidate lncRNA transcripts were identified. The analyses of transcriptome and gene ontology revealed that the immune system was involved in KD. Among these genes, G0/G1 switch gene 2 (G0S2) and its antisense lncRNA, HSD11B1-AS1, were upregulated during the acute phase of KD (P < 0.0001 and <0.0001, respectively). Moreover, G0S2 increased when lipopolysaccharides induced inflammation in THP-1 monocytes, and silencing of G0S2 suppressed the expression of HSD11B1-AS1 and tumor necrosis factor-α. CONCLUSIONS This study uncovered the crucial role of lncRNAs in innate immunity in acute KD. LncRNA may be a novel target for the diagnosis of KD. IMPACT This study revealed the whole aspect of the gene expression profile of monocytes of patients with Kawasaki disease (KD) using cap analysis gene expression sequencing and identified KD-specific molecules: G0/G1 switch gene 2 (G0S2) and long non-coding RNA (lncRNA) HSD11B1-AS1. We demonstrated that G0S2 and its antisense HSD11B1-AS1 were associated with inflammation of innate immunity in KD. lncRNA may be a novel key target for the diagnosis of patients with KD.
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Affiliation(s)
- Mako Okabe
- grid.267346.20000 0001 2171 836XDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Shinya Takarada
- grid.267346.20000 0001 2171 836XDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Nariaki Miyao
- grid.267346.20000 0001 2171 836XDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hideyuki Nakaoka
- grid.267346.20000 0001 2171 836XDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Keijiro Ibuki
- grid.267346.20000 0001 2171 836XDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Sayaka Ozawa
- grid.267346.20000 0001 2171 836XDepartment of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | | | - Harue Tsuji
- Department of Pediatrics, Takaoka City Hospital, Toyama, Japan
| | - Ikuo Hashimoto
- grid.417233.00000 0004 1764 0741Department of Pediatrics, Toyama City Hospital, Toyama, Japan
| | - Kiyoshi Hatasaki
- Department of Pediatrics, Toyama Prefectural Hospital, Toyama, Japan
| | - Shotaro Hayakawa
- grid.5290.e0000 0004 1936 9975Department of Electrical Engineering and Bioscience, Waseda University, Tokyo, Japan
| | - Yu Hamaguchi
- grid.5290.e0000 0004 1936 9975Department of Electrical Engineering and Bioscience, Waseda University, Tokyo, Japan
| | - Michiaki Hamada
- grid.5290.e0000 0004 1936 9975Department of Electrical Engineering and Bioscience, Waseda University, Tokyo, Japan
| | - Fukiko Ichida
- grid.411731.10000 0004 0531 3030Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.
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Gowda ST, Latson L, Sivakumar K, Hiremath G, Crystal M, Law M, Shahanavaz S, Asnes J, Veeram Reddy S, Kobayashi D, Alwi M, Ichida F, Hirono K, Tahara M, Takeda A, Minami T, Kutty S, Nugent AW, Forbes T, Prieto LR, Qureshi AM. Anatomical Classification and Posttreatment Remodeling Characteristics to Guide Management and Follow-Up of Neonates and Infants With Coronary Artery Fistula: A Multicenter Study From the Coronary Artery Fistula Registry. Circ Cardiovasc Interv 2021; 14:e009750. [PMID: 34903033 DOI: 10.1161/circinterventions.120.009750] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary artery fistulas (CAFs) presenting in infancy are rare, and data regarding postclosure sequelae and follow-up are limited. METHODS A retrospective review of all the neonates and infants (<1 year) was conducted from the CAF registry for CAF treatment. The CAF type (proximal or distal), size, treatment method, and follow-up angiography were reviewed to assess outcomes and coronary remodeling. RESULTS Forty-eight patients were included from 20 centers. Of these, 30 were proximal and 18 had distal CAF; 39 were large, 7 medium, and 2 had small CAF. The median age and weight was 0.16 years (0.01-1) and 4.2 kg (1.7-10.6). Heart failure was noted in 28 of 48 (58%) patients. Transcatheter closure was performed in 24, surgical closure in 18, and 6 were observed medically. Procedural success was 92% and 94 % for transcatheter closure and surgical closure, respectively. Follow-up data were obtained in 34 of 48 (70%) at a median of 2.9 (0.1-18) years. Angiography to assess remodeling was available in 20 of 48 (41%). I. Optimal remodeling (n=10, 7 proximal and 3 distal CAF). II. Suboptimal remodeling (n=7) included (A) symptomatic coronary thrombosis (n=2, distal CAF), (B) asymptomatic coronary thrombosis (n=3, 1 proximal and 2 distal CAF), and (C) partial thrombosis with residual cul-de-sac (n=1, proximal CAF) and vessel irregularity with stenosis (n=1, distal CAF). Finally, (III) persistent coronary artery dilation (n=4). Antiplatelets and anticoagulation were used in 31 and 7 patients post-closure, respectively. Overall, 7 of 10 (70%) with proximal CAF had optimal remodeling, but 5 of 11 (45%) with distal CAF had suboptimal remodeling. Only 1 of 7 patients with suboptimal remodeling were on anticoagulation. CONCLUSIONS Neonates/infants with hemodynamically significant CAF can be treated by transcatheter or surgical closure with excellent procedural success. Patients with distal CAF are at higher risk for suboptimal remodeling. Postclosure anticoagulation and follow-up coronary anatomic evaluation are warranted.
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Affiliation(s)
- Srinath T Gowda
- Department of Pediatrics, Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston (S.T.G., A.M.Q.)
| | - Larry Latson
- Pediatric Cardiology, Joe DiMaggio Children's Hospital, Hollywood, FL (L.L.)
| | | | - Gurumurthy Hiremath
- Department of Pediatrics, University of Minnesota, Masonic Children's Hospital, Minneapolis (G.H.)
| | - Matthew Crystal
- Pediatric Cardiology, Irving Medical Center, Columbia University, New York, NY (M.C.)
| | - Mark Law
- Pediatric Cardiology, Children's of Alabama, University of Alabama at Birmingham (M.L.)
| | | | - Jeremy Asnes
- Pediatric Cardiology, Yale New Haven Children's Hospital, CT (J.A.)
| | | | - Daisuke Kobayashi
- Pediatric Cardiology, Children's Hospital of Michigan, Detroit, MI (D.K., T.F.)
| | - Mazeni Alwi
- Pediatric Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia (M.A.)
| | - Fukiko Ichida
- Department of Pediatrics, University of Toyoma, Japan (F.I., K.H.)
| | - Keiichi Hirono
- Department of Pediatrics, University of Toyoma, Japan (F.I., K.H.)
| | - Masahiro Tahara
- Department of Pediatrics, Tsuchiya General Hospital, Hiroshima, Japan (M.T.)
| | - Atsuhito Takeda
- Department of Pediatrics, Hokkaido University Hospital, Japan (A.T.)
| | - Takaomi Minami
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan (T.M.)
| | - Shelby Kutty
- Pediatric Cardiology, Helen B. Taussig Heart Center, The Johns Hopkins Hospital, Baltimore, MD (S.K.)
| | - Alan W Nugent
- Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, IL (A.W.N.)
| | - Thomas Forbes
- Pediatric Cardiology, Children's Hospital of Michigan, Detroit, MI (D.K., T.F.)
| | - Lourdes R Prieto
- Pediatric Cardiology, Nicklaus Children's Hospital, Miami, FL (L.R.P.)
| | - Athar M Qureshi
- Department of Pediatrics, Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston (S.T.G., A.M.Q.)
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Yoshinaga M, Horigome H, Ayusawa M, Yasuda K, Kogaki S, Doi S, Tateno S, Ohta K, Hokosaki T, Nishihara E, Iwamoto M, Sumitomo N, Ushinohama H, Izumida N, Tauchi N, Kato Y, Kato T, Chisaka T, Higaki T, Yoneyama T, Abe K, Nozaki Y, Komori A, Kawai S, Ninomiya Y, Tanaka Y, Nuruki N, Sonoda M, Ueno K, Hazeki D, Nomura Y, Sato S, Hirono K, Hosokawa S, Takechi F, Ishikawa Y, Hata T, Ichida F, Ohno S, Makita N, Horie M, Matsushima S, Tsutsui H, Ogata H, Takahashi H, Nagashima M. Electrocardiographic Diagnosis of Hypertrophic Cardiomyopathy in the Pre- and Post-Diagnostic Phases in Children and Adolescents. Circ J 2021; 86:118-127. [PMID: 34615813 DOI: 10.1253/circj.cj-21-0376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The usefulness of electrocardiographic (ECG) voltage criteria for diagnosing hypertrophic cardiomyopathy (HCM) in pediatric patients is poorly defined.Methods and Results:ECGs at the 1st grade (mean [±SD] age 6.6±0.3 years) were available for 11 patients diagnosed with HCM at around the 7th grade (13.2±0.3 years). ECGs were available for another 64 patients diagnosed with HCM in the 1st (n=15), 7th (n=32), and 10th (n=17) grades. Fifty-one voltage criteria were developed by grade and sex using 62,841 ECGs from the general population. Voltage criteria were set at the 99.95th percentile (1/2,000) point based on the estimated prevalence of childhood HCM (2.9 per 100,000 [1/34,483]) to decrease false negatives. Conventional criteria were from guidelines for school-aged children in Japan. Of 11 patients before diagnosis, 2 satisfied conventional criteria in 1st grade; 5 (56%) of the remaining 9 patients fulfilled 2 voltage criteria (R wave in limb-lead I [RI]+S wave in lead V3 [SV3] and R wave in lead V3 [RV3]+SV3). Robustness analysis for sensitivity showed RV3+SV3 was superior to RI+SV3. For all patients after diagnosis, RI+SV4 was the main candidate. However, conventional criteria were more useful than voltage criteria. CONCLUSIONS Early HCM prediction was possible using RV3+SV3 in >50% of patients in 1st grade. Voltage criteria may help diagnose prediagnostic or early HCM, and prevent tragic accidents, although further prospective studies are required.
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Affiliation(s)
- Masao Yoshinaga
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
| | - Hitoshi Horigome
- Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Mamoru Ayusawa
- Department of Pediatrics, Nihon University Itabashi Hospital
| | - Kazushi Yasuda
- Department of Pediatric Cardiology, Kids' Heart Center, Aichi Children's Health and Medical Center
| | - Shigetoyo Kogaki
- Department of Pediatrics and Neonatology, Osaka General Medical Center
| | - Shozaburo Doi
- Department of Pediatrics, National Hospital Organization Disaster Medical Center
| | - Sigeru Tateno
- Department of Pediatrics, Chiba Kaihin Municipal Hospital
| | - Kunio Ohta
- Department of Pediatrics, Kanazawa University
| | | | | | - Mari Iwamoto
- Children's Center, Saiseikai Yokohamashi Tobu Hospital
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | | | | | | | - Yoshiaki Kato
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Taichi Kato
- Department of Pediatrics/Developmental Pediatrics, Nagoya University Graduate School of Medicine
| | | | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine
| | | | | | | | - Akiko Komori
- Department of Pediatrics and Child Health, Nihon University School of Medicine
| | - Satoru Kawai
- Department of Pediatric Cardiology, Kids' Heart Center, Aichi Children's Health and Medical Center
| | - Yumiko Ninomiya
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
| | - Yuji Tanaka
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
| | - Norihito Nuruki
- Department of Cardiovascular Medicine, National Hospital Organization Kagoshima Medical Center
| | - Masahiro Sonoda
- Department of Cardiovascular Medicine, National Hospital Organization Kagoshima Medical Center
| | - Kentaro Ueno
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | | | | | - Seiichi Sato
- Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama
| | - Susumu Hosokawa
- Department of Pediatrics, Perinatal and Maternal Medicine, Tokyo Medical and Dental University
| | - Fumie Takechi
- Department of Pediatrics, Chiba Cardiovascular Center
| | - Yuichi Ishikawa
- Department of the Cardiovascular System, Fukuoka Children's Hospital
| | - Tadayoshi Hata
- Department of Pediatrics, Fujita Health University School of Medicine
| | | | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute
| | - Naomasa Makita
- Omics Research Center, National Cerebral and Cardiovascular Center
| | - Minoru Horie
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
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10
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Hirono K, Takarada S, Okabe M, Miyao N, Nakaoka H, Ibuki K, Ozawa S, Origasa H, Ichida F, Imanaka-Yoshida K. Clinical significance of chronic myocarditis: systematic review and meta-analysis. Heart Vessels 2021; 37:300-314. [PMID: 34365565 DOI: 10.1007/s00380-021-01914-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
Chronic myocarditis is a prolonged inflammatory condition in the myocardium and its histological manifestation is defined by the presence of an inflammatory infiltrate. Chronic myocarditis has not been well known and its treatment of chronic myocarditis has not been established. Primary outcome of this study was to assess the efficacy of immunomodulatory treatment in addition to conventional treatment, and secondary outcomes were to clarity the prognosis of natural history of chronic myocarditis and incidence of chronic myocarditis in patients with dilated cardiomyopathy (DCM). We searched for studies in Medline, Embase, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi published between January 1946 and June 2020. Sixteen studies met the inclusion criteria. A meta-analysis revealed that patients receiving immunomodulatory treatment showed an improvement in left ventricular ejection fraction after immunomodulatory treatment compared to the control group (hazard ratio, 16.65; confidence interval, 4.55-28.74; p = 0.007). Five-year survival rate of the patients with inflammatory DCM (iDCM) and DCM was 52.7-70.3% and 51.9-91.1%, respectively. Moreover, 51.5%-62.7% of patients with DCM met the criteria of iDCM. Our systematic review revealed that patients with chronic myocarditis had poor prognosis and immunomodulatory treatment was significantly effective in addition to conventional treatment.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.
| | - Shinya Takarada
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Mako Okabe
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Nariaki Miyao
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Hideyuki Nakaoka
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Keijiro Ibuki
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Sayaka Ozawa
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health&Welfare, Tokyo, Japan
| | - Kyoko Imanaka-Yoshida
- Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine, Mie, Japan
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11
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Ozawa SW, Takarada S, Okabe M, Miyao N, Nakaoka H, Ibuki K, Ichida F, Hirono K. Clinical Characteristics and Prognosis of Fetal Left Ventricular Noncompaction in Japan. Circ J 2021; 86:98-105. [PMID: 34349074 DOI: 10.1253/circj.cj-20-1148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is morphologically characterized by numerous prominent trabeculations and a severely thickened, two-layered myocardium. The fetal onset of LVNC has rarely been described.Methods and Results:We conducted nationwide retrospective surveys on fetal cardiomyopathy (CM) in Japan from 2010 to 2016, from which 38 fetal patients with CM were enrolled, including 16 patients with LVNC. The rate of diagnostic concordance was 56.3% between fetal and postnatal visits in LVNC patients. The increase in the ratio of noncompacted to compacted (N/C) myocardium was time-dependent throughout the fetal period till birth (LV lateral: 1.6±0.1 to 2.8±0.2; LV apex: 2.0±0.1 to 3.2±0.2). Of all fetuses, 16 (42.1%) died or underwent heart transplantation (HT), with 3 intrauterine deaths. Lower fetal cardiovascular profile score (odds ratio, 26.9; P=0.0266) was a risk factor for death or HT. N/C ratio ≥1.6 at the apex at the first visit was a significant predictor of LVNC (odds ratio, 47.8; P=0.0113). CONCLUSIONS This is the first study to reveal the etiology of fetal CM based on results from a nationwide survey in Japan, highlighting the difficulty of diagnosing LVNC in fetal patients. To better understand and manage fetal CM, novel diagnostic criteria of LVNC in fetus should be established.
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Affiliation(s)
- Sayaka W Ozawa
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
| | - Shinya Takarada
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
| | - Mako Okabe
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
| | - Nariaki Miyao
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
| | - Hideyuki Nakaoka
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
| | - Keijiro Ibuki
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare
| | - Keiichi Hirono
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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12
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Kato R, Taneichi H, Takarada S, Okabe M, Miyao N, Nakaoka H, Ibuki K, Ozawa S, Adachi Y, Yoshimura N, Saito K, Ichida F, Hirono K. Reversible left ventricular noncompaction caused by hypertensive hydrocephalus: a pediatric case report. BMC Pediatr 2021; 21:205. [PMID: 33910553 PMCID: PMC8080348 DOI: 10.1186/s12887-021-02680-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Left ventricular noncompaction cardiomyopathy (LVNC) is characterized by prominent ventricular trabeculations on cardiovascular imaging. Acquired reversible LVNC has not been reported in pediatrics without a genetic background. CASE PRESENTATION A 9-year-old girl with a ventriculoperitoneal (VP) shunt for neonatal posthemorrhagic hydrocephalus was referred due to exacerbation of hydrocephalus caused by VP shunt dysfunction. Transthoracic echocardiography (TTE) revealed depressed left ventricular (LV) systolic function and thick prominent trabeculae in the LV, predominantly in the apex, suggesting LVNC. Following treatment with extraventricular drainage for hydrocephalus, prominent trabeculation of the LV was diminished on TTE within 3 months. Genetic testing using next-generation sequencing was performed, and no significant variants were identified. CONCLUSIONS We revealed for the first time a pediatric case of reversible LVNC without genetic predisposition. This case report provides valuable information on the pathogenesis of acquired LVNC and suggests that detailed evaluation is required to elucidate the diagnosis of this wide spectrum of etiologic-pathogenetic disorders.
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Affiliation(s)
- Riko Kato
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Hiromichi Taneichi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Shinya Takarada
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Mako Okabe
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Nariaki Miyao
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Hideyuki Nakaoka
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Keijiro Ibuki
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Sayaka Ozawa
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Naoki Yoshimura
- First Department of Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kazuyoshi Saito
- Department of Pediatrics, Fujita Health University, Toyoake city, Aichi, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
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13
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Muraji S, Sumitomo N, Imamura T, Yasuda K, Nishihara E, Iwamoto M, Tateno S, Doi S, Hata T, Kogaki S, Horigome H, Ohno S, Ichida F, Nagashima M, Yoshinaga M, Nakano S. Diagnostic value of P-waves in children with idiopathic restrictive cardiomyopathy. Heart Vessels 2021; 36:1141-1150. [PMID: 33496817 DOI: 10.1007/s00380-021-01784-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
Restrictive cardiomyopathy (RCM) is a rare myocardial disease with an impaired diastolic function and poor prognosis. Almost all RCM patients are reported to have abnormal P-waves due to atrial overloading. This study aimed to reveal the characteristics of the P-waves in RCM patients and to suggest the diagnostic index of RCM in children with a 12-lead electrocardiogram (ECG). We retrospectively investigated 17 ECGs of children with idiopathic RCM during the initial visit at 15 institutes in Japan between 1979 and 2013. The RCM group was divided into four groups based on the age (elementary school [ES] and junior high school [JHS] students) and inception of the diagnosis (abnormal ECG on school-heart-screening [e-RCM] and some cardiovascular symptoms [s-RCM]), the ES/e-RCM (n = 5), ES/s-RCM (n = 4), JHS/e-RCM (n = 4), and JHS/s-RCM (n = 4) groups. As an aged-match control group, school-heart-screening ECGs of 1st-grade ES students (16,770 students) and 1st-grade JHS students (18,126 students) from Kagoshima in 2016 were adopted. For a comparison between the groups, we used the effect size "Hedge's g" by calculating the mean and standard deviation of the two groups. An effect size of 0.8 (or above) had an overlap of 53% (or less). The effect sizes of the sum of the absolute values of the forward and backward amplitudes in lead V1 (P1 + P2 V1) was the largest, and the ES/e-RCM, ES/s-RCM, JHS/e-RCM, and JHS/s-RCM were 15.8, 22.1, 9.4, and 10.3, respectively. A P1 + P2 V1 > 200 μV was able to rule in all RCM patients, thus, we proposed 200 µV as the cutoff value for screening purposes. In conclusion, the P1 + P2 V1 in the school-heart-screening may be useful for detecting asymptomatic or early-stage RCM in school-age children.
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Affiliation(s)
- Shota Muraji
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan.
| | - Tomohiko Imamura
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kazushi Yasuda
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Eiki Nishihara
- Department of Pediatric Cardiology, Ogaki Municipal Hospital, Gifu, Japan
| | - Mari Iwamoto
- Department of Pediatrics, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Shigetu Tateno
- Department of Pediatrics, Chiba Kaihin Municipal Hospital, Chiba, Japan
| | - Shozaburo Doi
- National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Tadayosi Hata
- Graduate School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Shigetoyo Kogaki
- Department of Pediatrics, Osaka General Medical Center, Osaka, Japan
| | - Hitoshi Horigome
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University Health and Welfare, Chiba, Japan
| | | | - Masao Yoshinaga
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shintaro Nakano
- Department of Cardiology, Saitama Medical University International Medical Center, Hidaka, Japan
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14
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Hirono K, Hata Y, Ozawa SW, Toda T, Momoi N, Fukuda Y, Inuzuka R, Nagamine H, Sakaguchi H, Kurosaki K, Okabe M, Takarada S, Miyao N, Nakaoka H, Ibuki K, Origasa H, Bowles NE, Nishida N, Ichida F. A burden of sarcomere gene variants in fetal-onset patients with left ventricular noncompaction. Int J Cardiol 2020; 328:122-129. [PMID: 33309763 DOI: 10.1016/j.ijcard.2020.12.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 11/16/2020] [Accepted: 12/02/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a hereditary cardiomyopathy, associated with high morbidity and mortality, but the role of genetics in cases of fetal-onset has not been fully evaluated. The goal of this study was to identify the genetic background in LVNC fetal-onset patients using next-generation sequencing (NGS). METHODS Thirty-three fetal-onset Japanese probands with LVNC (20 males and 13 females) were enrolled. In the enrolled patients, 81 genes associated with cardiomyopathy were screened using next-generation sequencing (NGS) retrospectively. RESULTS Twenty-three patients had congestive heart failure (CHF), and six patients had arrhythmias. Prominent trabeculations were mostly observed in lateral LV, posterior LV, and apex of LV in patients with LVNC. Twelve died; three patients experienced intrauterine death or termination of pregnancy. Overall, 15 variants were found among eight genes in 16 patients. Seven variants were detected in MYH7 and two in TPM1. Sarcomere gene variants accounted for 75.0%. A multivariable proportional hazards model revealed that CHF at diagnosis and a higher ratio of the noncompacted layer/compacted layer in the LV posterior wall were independent risk factors for death in LVNC fetal-onset patients (odds ratio = 4.26 × 106 and 1.36 × 108, p = 0.0075 and 0.0005, respectively). CONCLUSIONS The present study is the first report focusing on genetic background combined with clinical features in LVNC fetal-onset patients using NGS. Sarcomere variants were most commonly identified in fetal-onset patients, and greater attention should be paid to fetal-onset patients with LVNC having prominent trabeculations in the LV because they are more likely to develop CHF.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Japan.
| | - Yukiko Hata
- Legal Medicine, Graduate School of Medicine, University of Toyama, Japan
| | | | - Takako Toda
- Department of Pediatrics, University of Yamanashi, Japan
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University, Japan
| | - Yutaka Fukuda
- Department of Pediatrics, Takeda General Hospital, Japan
| | - Ryo Inuzuka
- Department of Pediatrics, University of Tokyo, Japan
| | | | - Heima Sakaguchi
- Dvision of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Japan
| | - Kenichi Kurosaki
- Dvision of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Japan
| | - Mako Okabe
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Japan
| | - Shinya Takarada
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Japan
| | - Nariaki Miyao
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Japan
| | - Hideyuki Nakaoka
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Japan
| | - Keijiro Ibuki
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology, Graduate School of Medicine, University of Toyama, Japan
| | - Neil E Bowles
- Department of Pediatrics (Cardiology), University of Utah, Salt Lake City, USA
| | - Naoki Nishida
- Legal Medicine, Graduate School of Medicine, University of Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Japan
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15
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Oya Y, Watahiki D, Matsunaga M, Hirono K, Ichida F, Aoki M, Yoshimura N, Taguchi M. The Pharmacokinetics of Sildenafil May Be Affected by Intestinal Absorption Rate in Children Admitted to the Intensive Care Unit. Biol Pharm Bull 2020; 43:1917-1923. [DOI: 10.1248/bpb.b20-00614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yukino Oya
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Daisuke Watahiki
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Mitsuki Matsunaga
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Keiichi Hirono
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Fukiko Ichida
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Masaya Aoki
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Naoki Yoshimura
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Masato Taguchi
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
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16
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Imamura T, Sumitomo N, Muraji S, Yasuda K, Nishihara E, Iwamoto M, Tateno S, Doi S, Hata T, Kogaki S, Horigome H, Ohno S, Ichida F, Nagashima M, Makiyama T, Yoshinaga M. Impact of the T-wave characteristics on distinguishing arrhythmogenic right ventricular cardiomyopathy from healthy children. Int J Cardiol 2020; 323:168-174. [PMID: 32877757 DOI: 10.1016/j.ijcard.2020.08.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/03/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND T-wave inversion (TWI) is not considered useful for diagnosing pediatric arrhythmogenic right ventricular cardiomyopathy (ARVC), because right precordial TWI in ARVC resembles a normal juvenile pattern. OBJECTIVES The aims of this study were to clarify the electrocardiographic (ECG) characteristics of pediatric ARVC to distinguish those patients from healthy children. METHODS Between 1979 and 2017, 11 ARVC patients under 18 years old were registered and compared with school screening ECGs from 48,401 healthy children. RESULTS The mean age at the first arrhythmic event or diagnosis was 13.3 ± 4.7 years. Nine patients were asymptomatic initially and were found by ECG screening, but 6 developed severe symptoms during the follow-up. Healthy children had a normal juvenile pattern, while ARVC children, especially symptomatic patients, had a significant tendency to have inferior and anterior TWI. The phenomenon of T-wave discontinuity (TWD) in which the TWI became deeper from V1 to V3 and suddenly turned positive in V5 was significantly more frequent in ARVC (60%) than healthy children (0.55%). Anterior TWI and TWD were also significantly more frequent in those who developed severe symptoms. The sensitivity and specificity of TWD were 60% (95% CI, 31-83%), and 99% (95% CI, 99-99%) to distinguish ARVC from healthy children, as well as 100% (95% CI, 71-100%) and 80% (95% CI, 51-80%), respectively, to predict severe symptoms in the future. CONCLUSIONS The ECG is useful to distinguish ARVC children, even in the early phase. Anterior TWI and TWD could detect ARVC children and to predict the possible serious conditions.
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Affiliation(s)
- Tomohiko Imamura
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan; Department of Cardiology, Kyoto University, Kyoto, Japan
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan.
| | - Shota Muraji
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kazushi Yasuda
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Eiki Nishihara
- Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
| | - Mari Iwamoto
- Department of Pediatrics, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Shigeru Tateno
- Department of Pediatrics, Chiba Kaihin Municipal Hospital, Chiba, Japan
| | - Shozaburo Doi
- National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Tadayoshi Hata
- Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Shigetoyo Kogaki
- Department of Pediatrics, Osaka General Medical Center, Osaka, Japan
| | - Hitoshi Horigome
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
| | | | | | - Masao Yoshinaga
- Department of Pediatrics, Kagoshima Medical Center, Kagoshima, Japan
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Hirono K, Hata Y, Miyao N, Okabe M, Takarada S, Nakaoka H, Ibuki K, Ozawa S, Origasa H, Nishida N, Ichida F. Increased Burden of Ion Channel Gene Variants Is Related to Distinct Phenotypes in Pediatric Patients With Left Ventricular Noncompaction. Circ Genom Precis Med 2020; 13:e002940. [PMID: 32600061 DOI: 10.1161/circgen.119.002940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a hereditary type of cardiomyopathy. Although it is associated with high morbidity and mortality, the related ion channel gene variants in children have not been fully investigated. This study aimed to elucidate the ion channel genetic landscape of LVNC and identify genotype-phenotype correlations in a large Japanese cohort. METHODS We enrolled 206 children with LVNC from 2002 to 2017 in Japan. LVNC was classified as follows: LVNC with congenital heart defects, arrhythmia, dilated phenotype, or normal function. In the enrolled patients, 182 genes associated with cardiomyopathy were screened using next-generation sequencing. RESULTS We identified 99 pathogenic variants in 40 genes in 87 patients. Of the pathogenic variants, 8.8% were in genes associated with channelopathies, 27% were in sarcomere genes, and 11.5% were in mitochondrial genes. Ion channel gene variants were mostly associated with the arrhythmia classification, whereas sarcomere and mitochondrial gene variants were associated with the dilated phenotype. Echocardiography revealed that the group with ion channel gene variants had almost normal LV ejection fraction and LV diastolic diameter Z scores. Fragmented QRS, old age, and an arrhythmia phenotype were the most significant risk factors for ventricular tachycardia (P=0.165, 0.0428, and 0.0074, respectively). Moreover, the group with ion channel variants exhibited a greater risk of a higher prevalence of arrhythmias such as ventricular tachycardia, rather than congestive heart failure. CONCLUSIONS This is the first study that focused on genotype-phenotype correlations in a large pediatric LVNC patient cohort with ion channel gene variants that were determined using next-generation sequencing. Ion channel gene variants were strongly correlated with arrhythmia phenotypes. Genetic testing and phenotype specification allow for appropriate medical management of specific LVNC targets.
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Affiliation(s)
- Keiichi Hirono
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Yukiko Hata
- Legal Medicine (Y.H., N.N.), Graduate School of Medicine, University of Toyama, Japan
| | - Nariaki Miyao
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Mako Okabe
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Shinya Takarada
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Hideyuki Nakaoka
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan.,Legal Medicine (Y.H., N.N.), Graduate School of Medicine, University of Toyama, Japan
| | - Keijiro Ibuki
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Sayaka Ozawa
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology (H.O.), Graduate School of Medicine, University of Toyama, Japan
| | - Naoki Nishida
- Legal Medicine (Y.H., N.N.), Graduate School of Medicine, University of Toyama, Japan
| | - Fukiko Ichida
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
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18
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Ishikawa T, Mishima H, Barc J, Takahashi MP, Hirono K, Terada S, Kowase S, Sato T, Mukai Y, Yui Y, Ohkubo K, Kimoto H, Watanabe H, Hata Y, Aiba T, Ohno S, Chishaki A, Shimizu W, Horie M, Ichida F, Nogami A, Yoshiura KI, Schott JJ, Makita N. Cardiac Emerinopathy: A Nonsyndromic Nuclear Envelopathy With Increased Risk of Thromboembolic Stroke Due to Progressive Atrial Standstill and Left Ventricular Noncompaction. Circ Arrhythm Electrophysiol 2020; 13:e008712. [PMID: 32755394 DOI: 10.1161/circep.120.008712] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Mutations in the nuclear envelope genes encoding LMNA and EMD are responsible for Emery-Dreifuss muscular dystrophy. However, LMNA mutations often manifest dilated cardiomyopathy with conduction disturbance without obvious skeletal myopathic complications. On the contrary, the phenotypic spectrums of EMD mutations are less clear. Our aims were to determine the prevalence of nonsyndromic forms of emerinopathy, which may underlie genetically undefined isolated cardiac conduction disturbance, and the etiology of thromboembolic complications associated with EMD mutations. METHODS Targeted exon sequencing was performed in 87 probands with familial sick sinus syndrome (n=36) and a progressive cardiac conduction defect (n=51). RESULTS We identified 3 X-linked recessive EMD mutations (start-loss, splicing, missense) in families with cardiac conduction disease. All 3 probands shared a common clinical phenotype of progressive atrial arrhythmias that ultimately resulted in atrial standstill associated with left ventricular noncompaction (LVNC), but they lacked early contractures and progressive muscle wasting and weakness characteristic of Emery-Dreifuss muscular dystrophy. Because the association of LVNC with EMD has never been reported, we further genetically screened 102 LVNC patients and found a frameshift EMD mutation in a boy with progressive atrial standstill and LVNC without complications of muscular dystrophy. All 6 male EMD mutation carriers of 4 families underwent pacemaker or defibrillator implantation, whereas 2 female carriers were asymptomatic. Notably, a strong family history of stroke observed in these families was probably due to the increased risk of thromboembolism attributable to both atrial standstill and LVNC. CONCLUSIONS Cardiac emerinopathy is a novel nonsyndromic X-linked progressive atrial standstill associated with LVNC and increased risk of thromboembolism.
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Affiliation(s)
- Taisuke Ishikawa
- Omics Research Center (T.I., N.M.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hiroyuki Mishima
- Department of Human Genetics (H.M., K.-I.Y.), Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Julien Barc
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, France (J.B., J.-J.S.)
| | - Masanori P Takahashi
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan (M.P.T.)
| | - Keiichi Hirono
- Department of Pediatrics, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (K.H., F.I.)
| | - Shigenori Terada
- Department of Cardiovascular Medicine, Shin-Oyama City Hospital, Japan (S.T.)
| | - Shinya Kowase
- Division of Cardiology, Yokohama Rosai Hospital, Japan (S.K.)
| | - Teruki Sato
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Japan (T.S., H.W.)
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (Y.M.)
| | - Yoshiaki Yui
- Department of Cardiology, Faculty of Medicine, Tsukuba University, Japan (Y.Y., A.N.)
| | - Kimie Ohkubo
- Department of Cardiovascular Medicine, Nihon University School of Medicine, Tokyo, Japan (K.O.)
| | - Hiroki Kimoto
- Department of Molecular Physiology (H.K.), Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hiroyuki Watanabe
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Japan (T.S., H.W.)
| | - Yukiko Hata
- Department of Legal Medicine, Graduate School of Medicine, University of Toyama, Japan (Y.H.)
| | - Takeshi Aiba
- Department of Cardiovascular Medicine (T.A.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics (S.O.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akiko Chishaki
- Clinical Nursing Laboratory, School of Medicine, Kyushu University, Fukuoka, Japan (A.C.)
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (W.S.)
| | - Minoru Horie
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Ohtsu, Japan (M.H.)
| | - Fukiko Ichida
- Department of Pediatrics, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (K.H., F.I.)
| | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, Tsukuba University, Japan (Y.Y., A.N.)
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics (H.M., K.-I.Y.), Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Jean-Jacques Schott
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, France (J.B., J.-J.S.)
| | - Naomasa Makita
- Omics Research Center (T.I., N.M.), National Cerebral and Cardiovascular Center, Suita, Japan
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19
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Yoshida T, Hiraiwa A, Ibuki K, Makimoto M, Inomata S, Tamura K, Kawasaki Y, Ozawa S, Hirono K, Ichida F. Neurodevelopmental outcomes at 3 years for infants with congenital heart disease and very-low birthweight. Pediatr Int 2020; 62:797-803. [PMID: 31957091 DOI: 10.1111/ped.14160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 12/04/2019] [Accepted: 01/15/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Both congenital heart disease (CHD) and very-low birthweight (VLBW) infants are at a very high risk of neurodevelopmental delay. We investigated neurological development at 3 years in pediatric patients with CHD after surgical intervention, those of VLBW, and healthy controls. METHODS We enrolled pediatric patients with CHD (n = 67), VLBW (n = 67), and healthy controls (n = 81). Infants with CHD were grouped into those with single ventricle and two ventricles, and infants with VLBW were grouped into those with birthweights of <1000 and 1000-1499 g. Neurodevelopmental outcomes at 3 years were evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition. RESULTS Compared with healthy controls, a significant deficit in the language, cognition, and motor skills scores were observed in infants with CHD and VLBW. Infants with a single ventricle exhibited significantly low scores in language and gross motor skills. No statistically significant difference was observed between the birthweight groups of <1000 and 1000-1499 g. CONCLUSION Neurodevelopmental outcomes for infants with both CHD and VLBW showed impairment. Notably, neurodevelopmental delays in infants with a single ventricle were remarkable. Thus, because infants with both CHD and VLBW are at high risk of neurodevelopmental disorders, periodic developmental screenings and support are warranted for these children.
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Affiliation(s)
- Taketoshi Yoshida
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Akiko Hiraiwa
- Department of Pediatrics, Toyama University, Toyama, Japan
| | - Keijiro Ibuki
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Masami Makimoto
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Satomi Inomata
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Kentaro Tamura
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Yukako Kawasaki
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Sayaka Ozawa
- Department of Pediatrics, Toyama University, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Toyama University, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Toyama University, Toyama, Japan
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20
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Hirono K, Hata Y, Miyao N, Okabe M, Takarada S, Nakaoka H, Ibuki K, Ozawa S, Yoshimura N, Nishida N, Ichida F. Left Ventricular Noncompaction and Congenital Heart Disease Increases the Risk of Congestive Heart Failure. J Clin Med 2020; 9:jcm9030785. [PMID: 32183154 PMCID: PMC7141335 DOI: 10.3390/jcm9030785] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 02/12/2020] [Revised: 02/28/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a hereditary cardiomyopathy that is associated with high morbidity and mortality rates. Recently, LVNC was classified into several phenotypes including congenital heart disease (CHD). However, although LVNC and CHD are frequently observed, the role and clinical significance of genetics in these cardiomyopathies has not been fully evaluated. Therefore, we aimed to evaluate the impact on the perioperative outcomes of children with concomitant LVNC and CHD using next-generation sequencing (NGS). METHODS From May 2000 to August 2018, 53 Japanese probands with LVNC (25 males and 28 females) were enrolled and we screened 182 cardiomyopathy-associated genes in these patients using NGS. RESULTS The age at diagnosis of the enrolled patients ranged from 0 to 14 years (median: 0.3 months). A total of 23 patients (43.4%) were diagnosed with heart failure, 14 with heart murmur (26.4%), and 6 with cyanosis (11.3%). During the observation period, 31 patients (58.5%) experienced heart failure and 13 (24.5%) developed arrhythmias such as ventricular tachycardia, supraventricular tachycardia, and atrioventricular block. Moreover, 29 patients (54.7%) had ventricular septal defects (VSDs), 17 (32.1%) had atrial septal defects, 10 had patent ductus arteriosus (PDA), and 7 (13.2%) had Ebstein's anomaly and double outlet right ventricle. Among the included patients, 30 underwent surgery, 19 underwent biventricular repair, and 2 underwent pulmonary artery banding, bilateral pulmonary artery banding, and PDA ligation. Overall, 30 genetic variants were identified in 28 patients with LVNC and CHD. Eight variants were detected in MYH7 and two in TPM1. Echocardiography showed lower ejection fractions and more thickened trabeculations in the left ventricle in patients with LVNC and CHD than in age-matched patients with VSDs. During follow-up, 4 patients died and the condition of 8 worsened postoperatively. The multivariable proportional hazards model showed that heart failure, LV ejection fraction of < 24%, LV end-diastolic diameter z-score of > 8.56, and noncompacted-to-compacted ratio of the left ventricular apex of > 8.33 at the last visit were risk factors for survival. CONCLUSIONS LVNC and CHD are frequently associated with genetic abnormalities. Knowledge of the association between CHD and LVNC is important for the awareness of clinical implications during the preoperative and postoperative periods to identify the populations who are at an increased risk of additional morbidity.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
- Correspondence: ; Tel.: +81-76-434-7313; Fax: +81-76-434-5029
| | - Yukiko Hata
- Legal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (Y.H.); (N.N.)
| | - Nariaki Miyao
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
| | - Mako Okabe
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
| | - Shinya Takarada
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
| | - Hideyuki Nakaoka
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
| | - Keijiro Ibuki
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
| | - Sayaka Ozawa
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (N.M.); (M.O.); (S.T.); (H.N.); (K.I.); (S.O.)
| | - Naoki Yoshimura
- First Department of Surgery, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan;
| | - Naoki Nishida
- Legal Medicine, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan; (Y.H.); (N.N.)
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo 107-0052, Japan;
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21
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Hiraiwa A, Ibuki K, Tanaka T, Hirono K, Miya K, Yoshimura N, Ichida F. Toddler Neurodevelopmental Outcomes Are Associated With School-Age IQ in Children With Single Ventricle Physiology. Semin Thorac Cardiovasc Surg 2019; 32:302-310. [PMID: 31698030 DOI: 10.1053/j.semtcvs.2019.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 11/11/2022]
Abstract
To examine whether neurodevelopment at preschool age predicts IQ levels and needs for special education services in school-age children with single ventricle (SV) physiology. Thirty-five patients with SV physiology were assessed using the Bayley Scale of Infant and Toddler Development (BSID) II or III at 3 years and the Wechsler Intelligence Scale for Children-Fourth Edition (WISC) at 8 years. Whether the children were receiving special education services was also determined. Factors associated with the mental developmental index (MDI) of the BSID, the full-scale IQ (FSIQ) of the WISC, and special education services were also analyzed. The MDI and FSIQ of children with SV physiology were significantly lower than the values in healthy children (P < 0.01). The MDI at 3 years was moderately correlated with FSIQ at 8 years (P < 0.01, R2 = 0.41). Ten patients (28.6%) received special education services in their school. Children with MDI <85 were more likely than those with MDI ≥85 to require special education services at school age (53% and 10%, respectively, P < 0.01). Weight at birth and stage II were correlated with the MDI, extracorporeal circulation time at stage II was correlated with FSIQ, and age at Fontan operation was correlated with FSIQ and special education services. The toddler neurodevelopment index may predict not only IQ levels but also the need for special education services in school-age children. Children with low neurodevelopmental scores need to be followed closely for a long time.
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Affiliation(s)
- Akiko Hiraiwa
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Keijiro Ibuki
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kazushi Miya
- Faculty of Human Development, Department of Educational Sciences, University of Toyama, Toyama, Japan
| | - Naoki Yoshimura
- The 1(st) Department of Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
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22
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Abstract
Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by two layered structures composed of prominent trabecular meshwork and deep intertrabecular recesses. LVNC was thought to be rare; however, heightened awareness has resulted in an increased detection of the morphological features of LVNC in routine clinical practice especially in the adult population. Although LVNC was classified as an independent primary cardiomyopathy of genetic origin by the American Heart Association in 2006, its definition, diagnostic criteria and clinical implications are still being debated. Clinical manifestations are highly variable, even in the same family, ranging from no symptoms to disabling congestive heart failure, life-threatening arrhythmias, systemic thromboemboli, and sudden cardiac death. Among phenotypic subtypes of LVNC, children with isolated LVNC with normal cardiac function had the best outcomes: children with LVNC and dilated cardiomyopathy had the worst outcomes. Myocardial dysfunction or ventricular arrhythmias are predictors of mortality in adults with LVNC. LVNC, like other forms of inherited cardiomyopathy, is genetically heterogeneous and can be inherited as an autosomal dominant or X-linked recessive disorder. It has been linked to mutations in many genes, including ZASP, TAZ/G4.5, and those encoding sarcomeric, Z-disc, cytoskeleton proteins, and mitochondria. Disturbance of the NOTCH signaling pathway has been reported to be part of genetic pathway for LVNC as well. Although there are an increasing number of reports, genotype-phenotype correlations have been challenging and investigations are ongoing. Patients with mutations are more likely to have major adverse cardiovascular events, further, LV systolic dysfunction in mutation carriers makes them at high risk for cardiac events. Treatments focus on improvement in cardiac function and reduction of mechanical stress in patients with systolic dysfunction and on treatment of arrhythmia and implantation of an automatic implantable cardioverter-defibrillator for prevention of sudden death. Given that 20-40% of cases may be familial, family screening is recommended.
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Affiliation(s)
- Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Sanno Hospital, 8-10-16, Akasaka, Minato-ku, Tokyo 107-0052, Japan.
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23
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Muraji S, Sumitomo N, Imamura T, Yasuda K, Nishihara E, Iwamoto M, Tateno S, Doi S, Hata T, Kogaki S, Horigome H, Ohno S, Ichida F, Nagashima M, Yoshinaga M. P4654Clinical and electrocardiographic features of restrictive cardiomyopathy in children. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1036] [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
Introduction
Restrictive cardiomyopathy (RCM) is a rare myocardial disease with an impaired diastolic function and poor prognosis. The mean survival duration after a diagnosis of RCM is reported to be around 2 years in children and most need heart transplantations.
Purpose
This study aimed to determine the 12-lead electrocardiogram (ECG) diagnostic criteria of RCM based on the initial diagnostic electrocardiogram.
Methods
ECGs in pediatric cardiomyopathy patients were collected from 15 institutes in Japan between 1979 and 2013. We compared the ECG findings, especially of the P wave, in RCM patients between the cardiomyopathy group and healthy children group separately for each gender and the age. The ECGs in the healthy group were obtained from school heart screening in Japan of first-graders, and seventh-graders. Statistical significance was determined as p<0.001.
Results
Among 376 registered cardiomyopathy patients, 63 had hypertrophic cardiomyopathy (HCM) (36%), 91 (24%) dilated cardiomyopathy (DCM), 106 (28%) a left ventricular myocardial noncompaction (LVNCs), 25 (7%) restrictive cardiomyopathy (RCM), 14 (4%) arrhythmogenic right ventricular cardiomyopathy (ARVC), and 5 (1%) other cardiomyopathies. Of the 25 RCM patients (9.9±3.4 years old, F:M=11:14), 36% were discovered during school heart screening. The first onset was an abnormal ECG in 9, symptoms of heart failure in 6, respiratory tract infections in 3, syncope in 1, and 6 with other. Of those patients, 2 (8%) had a family history of RCM, 24 (92%) no family history. A genetic diagnosis was performed in 5 of the 25 cases, and 3 had genetic abnormalities related to RCM. The mean follow-up period was 65±95 months (mean±standard deviation). During follow up, 19 patients (76%) survived, 6 (24%) died, 7 (28%) had heart transplantations, and 3 (12%) were waiting for heart transplantations with a left ventricular assist device.
The P wave was bimodal in lead I or biphasic in lead V1 in 15 patients (93%), and 13 (81%) patients had both variations. We evaluated the duration and amplitude of the first and second component of the P wave as P1 and P2. The number of control and RCM patients (control/RCM), duration of P1+P2, and sum total absolute value of the amplitude of P1+P2 in lead V1 were 8350/5, 90±9/116±10ms, and 72±28/528±278μV in first grade boys, 8423/3, 91±10/120±22ms, and 66±28/326±229μV in first grade girls, 8943/1, 97±1/100ms, and 71±31/328μV in seventh grade boys, and 9183/5, 98±11/112±10ms, and 55±27/315±56μV in seventh grade girls. Although the number of patients in the RCM group was small, sum total absolute value of the amplitude of P1+P2 in lead V1 showed a significant difference in any group.
Conclusion
The ECG in children with RCM exhibits P wave abnormalities in almost all patients. In particular, not the P wave interval but P wave shape in I and V1 and the sum total absolute value of the amplitude of P1+P2 in lead V1 were observed differences.
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Affiliation(s)
- S Muraji
- Saitama International Medical Center, Pediatric cardiology, Hidaka, Japan
| | - N Sumitomo
- Saitama International Medical Center, Pediatric cardiology, Hidaka, Japan
| | - T Imamura
- Saitama International Medical Center, Pediatric cardiology, Hidaka, Japan
| | - K Yasuda
- Aichi Children's Medical Center, Cardiology, Obu, Japan
| | - E Nishihara
- Ogaki Municipal Hospital, Pediatric Cardiology, Ogaki, Japan
| | - M Iwamoto
- Saiseikai Yokohama City Eastern Hospital, Pediatrics, Yokohama, Japan
| | - S Tateno
- Chiba Cerebral and Cardiovascular Center, Pediatrics, Chiba, Japan
| | - S Doi
- Tokyo Medical and Dental University, Pediatrics, Tokyo, Japan
| | - T Hata
- Fujita Health University, Toyoake, Japan
| | - S Kogaki
- Osaka General Medical Center, Pediatrics, Osaka, Japan
| | - H Horigome
- Ibaraki Children's Hospital, Pediatric Cardiology, Mito, Japan
| | - S Ohno
- National Cerebral and Cardiovascular Center, Bioscience and Genetics, Osaka, Japan
| | - F Ichida
- University of Toyama, Toyama, Japan
| | - M Nagashima
- Aichi Saiseikai Rehabilitation Hospital, Nagoya, Japan
| | - M Yoshinaga
- National Hospital Organization Kagoshima Medical Center, Pediatrics, Kagoshima, Japan
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24
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Hata Y, Hirono K, Yamaguchi Y, Ichida F, Oku Y, Nishida N. Minimal inflammatory foci of unknown etiology may be a tentative sign of early stage inherited cardiomyopathy. Mod Pathol 2019; 32:1281-1290. [PMID: 31024045 DOI: 10.1038/s41379-019-0274-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/29/2019] [Accepted: 03/29/2019] [Indexed: 01/18/2023]
Abstract
Although relatively uncommon, pathologists may encounter minimal inflammatory foci in the absence of typical structural heart disease; however, the clinicopathological significance of minimal inflammatory foci, including correlation with sudden unexpected death, is unexplored. From 1072 serial autopsy subjects, cases with unexplained minimal inflammatory foci, the extent of which was under 1% of the whole examined ventricle, were extracted to exclude cases with borderline/focal myocarditis resulting from local, systemic infection, or autoimmune mechanisms. Immunohistochemistry and genetic analysis targeting viral genomes and heart disease-related genes using next generation sequencing were performed. We detected 10 cases with unexplained minimal inflammatory foci (five males, five females, aged 15-68 years). The cause and/or manner of death were sudden unexpected death (6 cases, 60%), sudden unexpected death with epilepsy (1 case, 10%), drowning in a hot bath (1 case, 10%), and suicide (2 cases, 20%). In none of these cases was pathogen-derived DNA or RNA detected. In 8 of the 10 cases (80%), 17 possible pathogenic genetic variants causative for arrhythmogenic right ventricular cardiomyopathy or dilated cardiomyopathy; DSP was the most frequently involved gene (three cases with two different variants), followed by LAMA4 and MYBPC3 (two cases, two variants for each gene), LDB3 (two cases, one variant), and the remaining 10 variants occurred in seven cases (DSC2, RYR2, SOS1, SCN5A, SGCD, LPL, PKP2, MYH11, GATA6, and DSG2). All mutations were missense mutations. DSP_Lys1581Glu and DSC2_p.Thr275Met were classified according to American College of Medical Genetics and Genomics consensus statement guidelines as pathogenic or likely pathogenic for arrhythmogenic cardiomyopathy in three patients (30%). The remaining 15 variants were classified as potentially pathogenic variants. Unexplained minimal inflammatory foci may be an early sign of inherited cardiomyopathy, and such cases might already have arrhythmogenic potential that can lead to sudden unexpected death. Detection of minimal inflammatory foci by careful pathological examination may indicate the value of conducting comprehensive genetic analysis, even if significant structural abnormalities are not evident.
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Affiliation(s)
- Yukiko Hata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yoshiaki Yamaguchi
- Second Department of Internal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yuko Oku
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
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Hiraiwa A, Kawasaki Y, Ibuki K, Hirono K, Matsui M, Yoshimura N, Origasa H, Oishi K, Ichida F. Brain Development of Children With Single Ventricle Physiology or Transposition of the Great Arteries: A Longitudinal Observation Study. Semin Thorac Cardiovasc Surg 2019; 32:936-944. [PMID: 31306764 DOI: 10.1053/j.semtcvs.2019.06.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 06/22/2019] [Accepted: 06/24/2019] [Indexed: 12/18/2022]
Abstract
To define the correlation between neuroanatomic and developmental outcomes of children with single ventricle (SV) or transposition of the great arteries (TGA), a prospective longitudinal study was performed in preschool and school-age children. Twenty-seven children with congenital heart disease (9, TGA; 18, SV) were included. Participants underwent 3-dimensional magnetic resonance imaging (MRI) and neurodevelopmental assessment at around 3 years (preschool age) and at 9 years (school age), and 48 healthy controls underwent MRI, and their data were used to derive best-fit models for normal brain volumes for comparisons with congenital heart disease patients. Total brain volume (TBV) and regional brain volumes remained significantly smaller in SV children than in TGA children at both time points, though the growth slope of TBV was not significantly different between the SV and TGA groups. Although the psychomotor developmental index at preschool was significantly lower in SV patients, the full-scale IQ at school age was not significantly lower in SV patients. There was a strong correlation between full-scale IQ and TBV (r = 0.49, P = 0.005). Despite the current best practices, persistently lower TBV was seen in SV patients until 9 years of age. For both the SV and TGA groups, TBV at 3 years was a strong predictor of TBV at 9 years. Since there was a correlation between TBV and IQ at 9 years, identification of factors that affect brain growth until 3 years will be imperative to improve patients' cognitive function at school age.
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Affiliation(s)
- Akiko Hiraiwa
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Yukako Kawasaki
- Department of Neonatology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Keijiro Ibuki
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Mie Matsui
- Laboratory of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Naoki Yoshimura
- The 1st Department of Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hideki Origasa
- Division of Biostatistics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kenichi Oishi
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fukiko Ichida
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
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26
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Hirono K, Saito K, Munkhsaikhan U, Xu F, Wang C, Lu L, Ichida F, Towbin JA, Purevjav E. Familial Left Ventricular Non-Compaction Is Associated With a Rare p.V407I Variant in Bone Morphogenetic Protein 10. Circ J 2019; 83:1737-1746. [PMID: 31243186 DOI: 10.1253/circj.cj-19-0116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Left ventricular non-compaction (LVNC) is a heritable cardiomyopathy characterized by hypertrabeculation, inter-trabecular recesses and thin compact myocardium, but the genetic basis and mechanisms remain unclear. This study identified novel LVNC-associated mutations inNOTCH-dependent genes and investigated their mutational effects.Methods and Results:High-resolution melting screening was performed in 230 individuals with LVNC, followed by whole exome and Sanger sequencing of available family members. Dimerization of bone morphogenetic protein 10 (BMP10) and its binding to BMP receptors (BMPRs) were evaluated. Cellular differentiation, proliferation and tolerance to mechanical stretch were assessed in H9C2 cardiomyoblasts, expressing wild-type (WT) or mutant BMP10 delivered by adenoviral vectors. Rare variants, p.W143*-NRG1and p.V407I-BMP10, were identified in 2 unrelated probands and their affected family members. Although dimerization of mutant V407I-BMP10 was preserved like WT-BMP10, V407I-BMP10 pulled BMPR1a and BMPR2 receptors more weakly compared with WT-BMP10. On comparative gene expression and siRNA analysis, expressed BMPR1a and BMPR2 receptors were responsive to BMP10 treatment in H9C2 cardiomyoblasts. Expression of V407I-BMP10 resulted in a significantly lower rate of proliferation in H9C2 cells compared with WT-BMP10. Cyclic stretch resulted in destruction and death of V407I-BMP10 cells. CONCLUSIONS The W143*-NRG1and V470I-BMP10variants are associated with LVNC. Impaired BMPR-binding ability, perturbed proliferation and differentiation processes and intolerance to stretch in V407I-BMP10 mutant cardiomyoblasts may underlie myocardial non-compaction.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama.,The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center
| | - Kazuyoshi Saito
- Department of Pediatrics, Graduate School of Medicine, University of Toyama.,The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center.,The Heart Institute, Department of Pediatrics, University of Tennessee Health Science Center
| | - Undral Munkhsaikhan
- The Heart Institute, Department of Pediatrics, University of Tennessee Health Science Center.,Children's Foundation Research Institute, Le Bonheur Children's Hospital Memphis
| | - Fuyi Xu
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center
| | - Ce Wang
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Lu Lu
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Jeffrey A Towbin
- The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center.,The Heart Institute, Department of Pediatrics, University of Tennessee Health Science Center.,Children's Foundation Research Institute, Le Bonheur Children's Hospital Memphis.,Pediatric Cardiology, St. Jude Children's Research Hospital
| | - Enkhsaikhan Purevjav
- The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center.,The Heart Institute, Department of Pediatrics, University of Tennessee Health Science Center
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Miyao N, Hirono K, Hata Y, Yoshimura N, Ichida F. Novel compound heterozygous TBX5 variants may induce hypoplastic left heart syndrome. Pediatr Int 2019; 61:607-609. [PMID: 31215120 DOI: 10.1111/ped.13854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/03/2018] [Accepted: 03/20/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Nariaki Miyao
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- Department of Forensic Medicine, University of Toyama, Toyama, Japan
| | - Naoki Yoshimura
- Department of Surgery 1, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, University of Toyama, Toyama, Japan
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28
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Sawada H, Mitani Y, Nakayama T, Fukushima H, Kogaki S, Igarashi T, Ichida F, Ono Y, Nakanishi T, Doi S, Ishikawa S, Matsushima M, Yamada O, Saji T. Detection of Pediatric Pulmonary Arterial Hypertension by School Electrocardiography Mass Screening. Am J Respir Crit Care Med 2019; 199:1397-1406. [DOI: 10.1164/rccm.201802-0375oc] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Hirofumi Sawada
- Department of Pediatrics, Mie University School of Medicine, Mie, Japan
| | - Yoshihide Mitani
- Department of Pediatrics, Mie University School of Medicine, Mie, Japan
| | - Tomotaka Nakayama
- Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan
| | - Hiroyuki Fukushima
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Shigetoyo Kogaki
- Department of Pediatrics, Osaka University School of Medicine, Osaka, Japan
| | - Takehiro Igarashi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Toyama University School of Medicine, Toyama, Japan
| | - Yasuo Ono
- Department of Cardiology, Shizuoka Children’s Hospital, Shizuoka, Japan
| | - Toshio Nakanishi
- Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Shozaburo Doi
- Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiro Ishikawa
- Department of Pediatric Cardiology, Fukuoka Children’s Hospital, Fukuoka, Japan; and
| | - Masaki Matsushima
- Department of Pediatric Cardiology, Social Insurance Chukyo Hospital, Aichi, Japan
| | - Osamu Yamada
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsutomu Saji
- Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan
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Goldstone AB, Baiocchi M, Wypij D, Stopp C, Andropoulos DB, Atallah J, Atz AM, Beca J, Donofrio MT, Duncan K, Ghanayem NS, Goldberg CS, Hövels-Gürich H, Ichida F, Jacobs JP, Justo R, Latal B, Li JS, Mahle WT, McQuillen PS, Menon SC, Pike NA, Pizarro C, Shekerdemian LS, Synnes A, Williams IA, Bellinger DC, Newburger J, Gaynor JW. The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants. Eur J Cardiothorac Surg 2019; 57:63-71. [DOI: 10.1093/ejcts/ezz123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/17/2019] [Accepted: 03/20/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
OBJECTIVES
Neurodevelopmental disability is the most common complication among congenital heart surgery survivors. The Bayley scales are standardized instruments to assess neurodevelopment. The most recent edition (Bayley Scales of Infant and Toddler Development 3rd Edition, Bayley-III) yields better-than-expected scores in typically developing and high-risk infants than the second edition (Bayley Scales of Infant Development 2nd Edition, BSID-II). We compared BSID-II and Bayley-III scores in infants undergoing cardiac surgery.
METHODS
We evaluated 2198 infants who underwent operations with cardiopulmonary bypass between 1996 and 2009 at 26 institutions. We used propensity score matching to limit confounding by indication in a subset of patients (n = 705).
RESULTS
Overall, unadjusted Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores (90.7 ± 17.2 vs 77.6 ± 18.8, P < 0.001), and unadjusted Bayley-III composite cognitive and language scores were higher than BSID-II Mental Development Index scores (92.0 ± 15.4 vs 88.2 ± 16.7, P < 0.001). In the propensity-matched analysis, Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores [absolute difference 14.1, 95% confidence interval (CI) 11.7–17.6; P < 0.001] and the Bayley-III classified fewer children as having severe [odds ratio (OR) 0.24; 95% CI 0.14–0.42] or mild-to-moderate impairment (OR 0.21; 95% CI 0.14–0.32). The composite of Bayley-III cognitive and language scores was higher than BSID-II Mental Development Index scores (absolute difference 4.0, 95% CI 1.4–6.7; P = 0.003), but there was no difference between Bayley editions in the proportion of children classified as having severe cognitive and language impairment.
CONCLUSIONS
The Bayley-III yielded higher scores than the BSID-II and classified fewer children as severely impaired. The systematic bias towards higher scores with the Bayley-III precludes valid comparisons between early and contemporary cardiac surgery cohorts.
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Affiliation(s)
- Andrew B Goldstone
- Department of Cardiothoracic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | | | - Joseph Atallah
- Stollery Children’s Hospital, Western Canadian Complex Pediatric Therapies Follow-up Program, Edmonton, AB, Canada
| | - Andrew M Atz
- Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - John Beca
- Starship Children’s Hospital, Auckland, New Zealand
| | | | - Kim Duncan
- Children’s Hospital and Medical Center, Omaha, NE, USA
| | - Nancy S Ghanayem
- Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Jeffrey P Jacobs
- Johns Hopkins All Children’s Heart Institute, St. Petersburg, FL, USA
| | | | - Beatrice Latal
- University Children’s Hospital Zurich, Zurich, Switzerland
| | | | | | | | - Shaji C Menon
- Primary Children’s Medical Center, Salt Lake City, UT, USA
| | - Nancy A Pike
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | | | | | - Anne Synnes
- University of British Columbia, Vancouver, BC, Canada
| | - Ismée A Williams
- New York-Presbyterian Morgan Stanley Children’s Hospital of New York, New York, NY, USA
| | | | | | - J William Gaynor
- Department of Cardiothoracic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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30
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Hata Y, Ichimata S, Yamaguchi Y, Hirono K, Oku Y, Ichida F, Nishida N. Clinicopathological and Genetic Profiles of Cases with Myocytes Disarray-Investigation for Establishing the Autopsy Diagnostic Criteria for Hypertrophic Cardiomyopathy. J Clin Med 2019; 8:jcm8040463. [PMID: 30959811 PMCID: PMC6518201 DOI: 10.3390/jcm8040463] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/06/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023] Open
Abstract
Myocyte disarray of >10% in the heart is broadly accepted as a diagnostic pitfall for hypertrophic cardiomyopathy (HCM) at postmortem. The present study aims to propose an additional diagnostic criterion of HCM. Heart specimens from 1387 serial forensic autopsy cases were examined. Cases with myocyte disarray were extracted and applied to morphometric analysis to determine the amount of myocyte disarray. Comprehensive genetic analysis by using next-generation sequencing was subsequently applied for cases with myocyte disarray. Fifteen cases with myocyte disarray were extracted as candidate cases (1.1%, 11 men and 4 women, aged 48–94 years). In terms of the cause of death, only 2 cases were cardiac or possible cardiac death, and the other was non-cardiac death. Six cases showed myocyte disarray of >10% and 3 cases showed myocyte disarray of 5% to 10%. The other 6 cases showed myocyte disarray of <5%. Nine rare variants in 5 HCM-related genes (MYBPC3, MYH7, MYH6, PRKAG2, and CAV3) were found in 8 of 9 cases with myocyte disarray of >5%. The remaining 1 and 6 cases with myocyte disarray of <5% did not have any such variant. Myocyte disarray of >5% with rare variants in related genes might be an appropriate postmortem diagnostic criterion for HCM, in addition to myocyte disarray of 10%.
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Affiliation(s)
- Yukiko Hata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
| | - Shojiro Ichimata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
| | - Yoshiaki Yamaguchi
- Second Department of Internal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
| | - Yuko Oku
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
| | - Naoki Nishida
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
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31
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Yoshimura N, Aoki M, Higashida A, Toritsuka D, Aihara T, Fukahara K, Ibuki K, Ozawa S, Hirono K, Ichida F. [Redo Right Ventricular Outflow Tract Reconstruction in Adult Patients with Congenital Heart Disease]. Kyobu Geka 2019; 72:251-255. [PMID: 31266909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Between April 2005 and February 2019, 11 adult patients underwent redo reconstruction of the right ventricular outflow tract. The primary malformation was Fallot's tetralogy in 8, transposition of the great arteries in 2, and pulmonary atresia with intact ventricular septum in 1. Mean age at redo operation was 27.4 years. Right ventricular outflow tract was reconstructed with expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in 9, transannular patch in 1, and right ventricular outflow patch in 1. There were no early and late deaths. One patient had residual branch pulmonary stenosis, while other 10 patients had no significant pulmonary stenosis and no significant pulmonary regurgitation. Signs and symptoms were improved in these 10 patients. Re-operation should be done before the development of right ventricular dysfunction, while it can be performed with satisfactory results in adult patients.
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Affiliation(s)
- Naoki Yoshimura
- 1st Department of Surgery, University of Toyama, Toyama, Japan
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32
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Armaroli G, Verweyen E, Pretzer C, Kessel K, Hirono K, Ichida F, Okabe M, Cabral DA, Foell D, Brown KL, Kessel C. Monocyte-Derived Interleukin-1β As the Driver of S100A12-Induced Sterile Inflammatory Activation of Human Coronary Artery Endothelial Cells: Implications for the Pathogenesis of Kawasaki Disease. Arthritis Rheumatol 2019; 71:792-804. [PMID: 30447136 DOI: 10.1002/art.40784] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 11/13/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Kawasaki disease (KD) is an acute vasculitis of childhood, predominantly affecting the coronary arteries. S100A12, a granulocyte-derived agonist of both the receptor for advanced glycation end products (RAGE) and Toll-like receptor 4 (TLR-4), is strongly up-regulated in KD. This study was undertaken to investigate the potential contributions of S100A12 to the pathogenesis of KD. METHODS Serum samples from patients with KD (n = 30) at different stages pre- and post-intravenous immunoglobulin (IVIG) treatment were analyzed for the expression of S100A12, cytokines, chemokines, and soluble markers of endothelial cell activation. Primary human coronary artery endothelial cells (HCAECs) were analyzed for responsiveness to direct stimulation with S100A12 or lipopolysaccharide (LPS), as assessed by real-time quantitative reverse transcription-polymerase chain reaction analysis of cytokine and endothelial cell adhesion molecule messenger RNA expression. Alternatively, HCAECs were cultured in conditioned medium obtained from primary human monocytes that were stimulated with LPS or S100A12 in the absence or presence of IVIG or cytokine antagonists. RESULTS In the serum of patients with KD, pretreatment S100A12 levels were associated with soluble vascular cell adhesion molecule 1 titers in the course of IVIG therapy (rs = -0.6, P = 0.0003). Yet, HCAECs were not responsive to direct S100A12 stimulation, despite the presence of appropriate receptors (RAGE, TLR-4). HCAECs did, however, respond to supernatants obtained from S100A12-stimulated primary human monocytes, as evidenced by the gene expression of inflammatory cytokines and adhesion molecules. This response was strictly dependent on interleukin-1β (IL-1β) signaling (P < 0.001). CONCLUSION In its role as a highly expressed mediator of sterile inflammation in KD, S100A12 appears to activate HCAECs in an IL-1β-dependent manner. These data provide new mechanistic insights into the contributions of S100A12 and IL-1β to disease pathogenesis, and may therefore support current IL-1-targeting studies in the treatment of patients with KD.
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Affiliation(s)
| | | | | | | | | | | | - Mako Okabe
- University of Toyama, Toyama City, Japan
| | - David A Cabral
- University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Dirk Foell
- University Children's Hospital, Munster, Germany
| | - Kelly L Brown
- University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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Tamura R, Watanabe N, Nakamura S, Yoshimura N, Ozawa S, Hirono K, Ichida F, Taguchi M. Evaluation of the effects of ontogenetic or maturation functions and chronic heart failure on the model analysis for the dose-response relationship of warfarin in Japanese children. Eur J Clin Pharmacol 2019; 75:913-920. [PMID: 30848333 DOI: 10.1007/s00228-019-02652-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/15/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE We previously demonstrated that the rational pediatric dosage of warfarin can be well-described by a SIZE parameter that includes an allometry exponent of weight. On the other hand, allometry alone is considered to be insufficient to predict drug clearance in neonates and infants. The primary purpose of the present study was to evaluate the effects of incorporation of the maturation process into the analysis model for the dose-response relationship of warfarin in Japanese children. In addition, we evaluated the effect of chronic heart failure (CHF) on the response to warfarin as an independent risk factor for increased anticoagulant effects. METHODS Thirty-eight patients with stable anticoagulation by warfarin were enrolled. During a mean follow-up period of 4.74 ± 3.51 years, 1092 data points including prothrombin time-international normalized ratio (PT-INR) were obtained. The data were subjected to multiple regression analysis to identify covariates related to the anticoagulant effects. RESULTS Two different models describing the maturation process did not improve the predictive performance for the dose-response relationship in pediatric patients. In addition to the SIZE-normalized daily dose, the vitamin K epoxide reductase complex 1 (VKORC1) genotype, and concomitant use of bosentan, CHF was identified as a covariate increasing the anticoagulant effects of warfarin to 118%. CONCLUSION The SIZE parameter was useful even without incorporation of maturation models to describe the response to warfarin in pediatric patients, and our longitudinal follow-up study design with multiple observations was beneficial to detect changes within individual subjects.
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Affiliation(s)
- Rika Tamura
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Nao Watanabe
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Saki Nakamura
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Naoki Yoshimura
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Sayaka Ozawa
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Keiichi Hirono
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Fukiko Ichida
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Masato Taguchi
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
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Hirono K, Ichida F, Nishio N, Ogawa‐Tominaga M, Fushimi T, Feichtinger RG, Mayr JA, Kohda M, Kishita Y, Okazaki Y, Ohtake A, Murayama K. Mitochondrial complex deficiency by novel compound heterozygous TMEM70 variants and correlation with developmental delay, undescended testicle, and left ventricular noncompaction in a Japanese patient: A case report. Clin Case Rep 2019; 7:553-557. [PMID: 30899493 PMCID: PMC6406168 DOI: 10.1002/ccr3.2050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/29/2018] [Accepted: 01/16/2019] [Indexed: 02/01/2023] Open
Abstract
We identified novel compound heterozygous TMEM70 variants in a Japanese patient who had hyperlactacidemia, metabolic acidosis, hyperalaninemia, developmental delay, undescended testicle, and left ventricular noncompaction. The urinary organic acids profile revealed elevated levels of 3-MGA, and BN-PAGE/Western blotting analysis and ETC. activity confirmed complex V deficiency.
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Affiliation(s)
- Keiichi Hirono
- Department of PediatricsGraduate School of MedicineUniversity of ToyamaToyamaJapan
| | - Fukiko Ichida
- Department of PediatricsGraduate School of MedicineUniversity of ToyamaToyamaJapan
| | - Natsuhito Nishio
- Department of PediatricsIshikawa Prefectural Central HospitalKanazawaJapan
| | - Minako Ogawa‐Tominaga
- Department of MetabolismCenter for Medical GeneticsChiba Children's HospitalMidori‐kuChibaJapan
| | - Takuya Fushimi
- Department of MetabolismCenter for Medical GeneticsChiba Children's HospitalMidori‐kuChibaJapan
| | - Rene′ G. Feichtinger
- Department of PediatricsUniversity Hospital SalzburgParacelsus Medical UniversitySalzburgAustria
| | - Johannes A. Mayr
- Department of PediatricsUniversity Hospital SalzburgParacelsus Medical UniversitySalzburgAustria
| | - Masakazu Kohda
- Intractable Disease Research CenterGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Yoshihito Kishita
- Intractable Disease Research CenterGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Yasushi Okazaki
- Intractable Disease Research CenterGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Akira Ohtake
- Faculty of MedicineDepartment of PediatricsSaitama Medical UniversitySaitamaJapan
| | - Kei Murayama
- Department of MetabolismCenter for Medical GeneticsChiba Children's HospitalMidori‐kuChibaJapan
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Mitani Y, Tsuda E, Kato H, Higaki T, Fujiwara M, Ogawa S, Satoh F, Nakamura Y, Takahashi K, Ayusawa M, Kobayashi T, Ichida F, Matsushima M, Kamada M, Suda K, Ohashi H, Sawada H, Komatsu T, Waki K, Shinoda M, Tsunoda R, Yokoi H, Hamaoka K. Emergence and Characterization of Acute Coronary Syndrome in Adults After Confirmed or Missed History of Kawasaki Disease in Japan: A Japanese Nationwide Survey. Front Pediatr 2019; 7:275. [PMID: 31338354 PMCID: PMC6629790 DOI: 10.3389/fped.2019.00275] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/17/2019] [Indexed: 01/09/2023] Open
Abstract
Background: Acute coronary syndrome (ACS), which is emerging in adults long after confirmed (followed-up or lost-to-follow), or missed Kawasaki disease (KD), is poorly characterized. Methods and Results: A Japanese retrospective nationwide hospital-based questionnaire survey of ACS during 2000-09 was conducted to characterize such patients. Among a total of 67 patients (median age 35, male 76%) recruited, low conventional coronary risks (≤1/6) was noted in 75%, a diagnosis of ST-elevation and myocardial infarction or cardiac arrest in 66%, medication before ACS in 22% (warfarin in 4%), and no prior history of acute myocardial infarction in 94%. One-month mortality was 19%. KD diagnosis was made in 32 during acute illness (Group A), in which 17 were lost to follow, and retrospectively in the other 35 from coronary imaging at ACS (Group B). Group A developed ACS at lower coronary risks (≤2/5 in 87 vs. 65% in group B, p = 0.043) at a younger age (26.5 vs. 40 yo, p < 0.001). In group A, followed-up patients developed ACS under medication before ACS (87 vs. 0% in lost-to-follow patients, p < 0.001) for giant aneurysm in culprit lesions (69 vs. 29%, p = 0.030). One-month mortality was comparable between groups A and B, and between patients followed-up and lost-to-follow in group A. The culprit lesion in group A was characterized by the association of an aneurysm ≥6 mm in acute KD (100%), lack of significant stenosis (61%) or giant aneurysm (50%) in the long-term (median interval 16 y), and the presence of intravascular ultrasound-derived calcification at ACS (86%). Conclusions: The present retrospective nationwide questionnaire survey demonstrated nationwide emergence of initial ACS in young adults at low coronary risks, who are followed-up or lost-to-follow after confirmed KD and initial coronary aneurysms ≥6 mm.
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Affiliation(s)
- Yoshihide Mitani
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Etsuko Tsuda
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hitoshi Kato
- Division of Clinical Research Planning, Department of Development Strategy and Cardiology, Center for Clinical Research and Development, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Masako Fujiwara
- Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan
| | - Shunichi Ogawa
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Fumiko Satoh
- Department of Forensic Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Yoshikazu Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Japan
| | - Kei Takahashi
- Department of Pathology, Toho University Medical Center, Ohashi Hospital, Tokyo, Japan
| | - Mamoru Ayusawa
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Tohru Kobayashi
- Division of Clinical Research Planning, Department of Development Strategy and Cardiology, Center for Clinical Research and Development, National Center for Child Health and Development, Tokyo, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Toyama University School of Medicine, Toyama, Japan
| | | | - Masahiro Kamada
- Department of Pediatric Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kenji Suda
- Department of Pediatrics and Child Health, Kurume University, Kurume, Japan
| | - Hiroyuki Ohashi
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hirofumi Sawada
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Takaaki Komatsu
- Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
| | - Kenji Waki
- Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Ryusuke Tsunoda
- Department of Cardiology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Hiroyoshi Yokoi
- Cardiovascular Center, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Kenji Hamaoka
- Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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36
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Shigetomi N, Kamiya K, Takamori T, Yoshimura N, Ozawa S, Hirono K, Ichida F, Taguchi M. Determination of the Serum Unbound Fraction of Tadalafil in Children with Protein-Losing Enteropathy and Its Specific Binding to Human Serum Proteins in Vitro. Biol Pharm Bull 2019; 42:110-115. [DOI: 10.1248/bpb.b18-00652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Nanami Shigetomi
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Kenta Kamiya
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Toru Takamori
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Naoki Yoshimura
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Sayaka Ozawa
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Keiichi Hirono
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Fukiko Ichida
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Masato Taguchi
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
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37
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Hirono K, Hata Y, Nakazawa M, Momoi N, Tsuji T, Matsuoka T, Ayusawa M, Abe Y, Hayashi T, Tsujii N, Abe T, Sakaguchi H, Wang C, Takasaki A, Takarada S, Okabe M, Miyao N, Nakaoka H, Ibuki K, Saito K, Ozawa S, Nishida N, Bowles NE, Ichida F. Clinical and Echocardiographic Impact of Tafazzin Variants on Dilated Cardiomyopathy Phenotype in Left Ventricular Non-Compaction Patients in Early Infancy. Circ J 2018; 82:2609-2618. [DOI: 10.1253/circj.cj-18-0470] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Yukiko Hata
- Legal Medicine, Graduate School of Medicine, University of Toyama
| | - Makoto Nakazawa
- Department of Pediatric and Lifelong Congenital Cardiology Institute, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University
| | - Tohru Tsuji
- Department of Pediatrics, Fukushima Medical University
| | - Taro Matsuoka
- Department of Pediatrics, Toyonaka Municipal Hospital
| | - Mamoru Ayusawa
- Department of Pediatrics and Child Health, Nihon University School of Medicine
| | - Yuriko Abe
- Department of Pediatrics and Child Health, Nihon University School of Medicine
| | | | | | - Tadaaki Abe
- Department of Pediatrics, Niigata City General Hospital
| | - Heima Sakaguchi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Ce Wang
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Asami Takasaki
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Shinya Takarada
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Mako Okabe
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Nariaki Miyao
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Hideyuki Nakaoka
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Keijiro Ibuki
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Kazuyoshi Saito
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Sayaka Ozawa
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
| | - Naoki Nishida
- Legal Medicine, Graduate School of Medicine, University of Toyama
| | - Neil E. Bowles
- Department of Occupational and Environmental Health and Safety, University of Utah
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine, University of Toyama
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38
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Okabe M, Hirono K, Tamura K, Ichida F, Kanegane H. Reactive peripheral blood plasmacytosis in Kawasaki disease. Pediatr Int 2018; 60:884-885. [PMID: 30125435 DOI: 10.1111/ped.13600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/13/2018] [Accepted: 05/18/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Mako Okabe
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Kentaro Tamura
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Hirokazu Kanegane
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan.,Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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39
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Sumitomo N, Baba R, Doi S, Higaki T, Horigome H, Ichida F, Ishikawa H, Iwamoto M, Izumida N, Kasamaki Y, Kuga K, Mitani Y, Musha H, Nakanishi T, Yoshinaga M, Abe K, Ayusawa M, Hokosaki T, Kato T, Kato Y, Ohta K, Sawada H, Ushinohama H, Yoshiba S, Atarashi H, Hirayama A, Horie M, Nagashima M, Niwa K, Ogawa S, Okumura K, Tsutsui H. Guidelines for Heart Disease Screening in Schools (JCS 2016/JSPCCS 2016) ― Digest Version ―. Circ J 2018; 82:2385-2444. [DOI: 10.1253/circj.cj-66-0153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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40
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Hirono K, Hata Y, Takarada S, Miyao N, Okabe M, Saito K, Ozawa SW, Nishida N, Ichida F. P2252Cardiomyopathy phenotypes and genotypes for children with left ventricular noncompaction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2252] [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)
- K Hirono
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - Y Hata
- University of Toyama, Department of Legal Medicine, Toyama, Japan
| | - S Takarada
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - N Miyao
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - M Okabe
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - K Saito
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - S W Ozawa
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - N Nishida
- University of Toyama, Department of Legal Medicine, Toyama, Japan
| | - F Ichida
- University of Toyama, Department of Pediatrics, Toyama, Japan
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41
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Fujino M, Tsuda E, Hirono K, Nakata M, Ichida F, Hata Y, Nishida N, Kurosaki K. The TNNI3 Arg192His mutation in a 13-year-old girl with left ventricular noncompaction. J Cardiol Cases 2018; 18:33-36. [PMID: 30279906 DOI: 10.1016/j.jccase.2018.04.001] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/24/2018] [Accepted: 04/02/2018] [Indexed: 10/28/2022] Open
Abstract
Left ventricular noncompaction (LVNC) is a distinct cardiomyopathy that is morphologically characterized by a two-layered myocardium, numerous prominent trabeculations, and deep intertrabecular recesses communicating with the left ventricular cavity. We present a case report regarding the identification of a new mutation in TNNI3 in a patient with LVNC using next-generation sequencing. A 13-year-old girl who had no family history of cardiac disease was hospitalized with dyspnea after exercise and electrocardiographic abnormalities during a school screening. Based on her clinical features, she was diagnosed with LVNC. Via genetic analysis, a TNNI3 heterozygous missense variant was identified in the proband. Although mutations in TNNI3 have been reported in patients with hypertrophic cardiomyopathy and restrictive cardiomyopathy, this is the first report of a mutation in this gene in a patient with LVNC. <Learning objective: We identified a variant in TNNI3 in a patient with isolated left ventricular noncompaction using next-generation sequencing (NGS). Mutations in TNNI3 have been reported in patients with hypertrophic cardiomyopathy and restrictive cardiomyopathy. The use of NGS also results in the identification of multiple genetic variants of unknown significance to the investigated disease.>.
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Affiliation(s)
- Mitsuhiro Fujino
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Etsuko Tsuda
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Masanori Nakata
- Department of Pediatrics, Hyogo Prefectural Awaji Medical Center, Hyogo, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- Department of Legal Medicine, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Kenichi Kurosaki
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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42
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Aoki M, Hirono K, Higuma T, Suzuki Y, Nakayama K, Ichida F, Origasa H, Nishida N, Imura J, Emoto N, Yoshimura N. Endothelin-1 may play an important role in the Fontan circulation. Interact Cardiovasc Thorac Surg 2018; 26:480-486. [PMID: 29177420 DOI: 10.1093/icvts/ivx378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 10/19/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Our goal was to evaluate whether endothlin-1 (ET-1) plays an important role in the Fontan circulation. METHODS Thirteen patients with single-ventricle physiology (Glenn circulation, n = 7; Fontan circulation, n = 6) were evaluated using lung histopathological and immunohistochemical studies and then compared with the normal autopsied controls without congenital heart disease (n = 13). We evaluated the medial thickness of the small pulmonary arteries. For 10 of these patients, quantitative real-time polymerase chain reaction analyses of ET-1, endothelin receptors Type A and Type B, endothelin-converting enzyme-1 and endothelial nitric oxide synthase were performed. RESULTS The medial thickness of the small pulmonary arteries in patients with single-ventricle physiology was greater than that of those in the control group (P = 0.0341). Severe medial hypertrophy of the pulmonary arteries was observed in patients who had poor outcomes. Immunohistochemical studies revealed that the marked expression of ET-1 was observed in the endothelium and media of their pulmonary arteries. In these patients, the messenger RNA expression of ET-1 was also increased. Two patients showed high levels of expression of ETAR and ETBR, although these 2 cases maintain good Fontan circulation. CONCLUSIONS Medial hypertrophy and the overexpression of ET-1 in the pulmonary arteries were observed in some patients in whom the Fontan circulation failed. Our data suggest that ET-1 may play an important role in maintaining the Fontan circulation.
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Affiliation(s)
- Masaya Aoki
- Department of Cardiovascular Surgery, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Tomonori Higuma
- Department of Cardiovascular Surgery, University of Toyama, Toyama, Japan
| | - Yoko Suzuki
- Department of Clinical Pharmacy, Kobe Pharmaceutical University, Kobe, Japan
| | - Kazuhiko Nakayama
- Department of Clinical Pharmacy, Kobe Pharmaceutical University, Kobe, Japan
| | - Fukiko Ichida
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, University of Toyama, Toyama, Japan
| | - Johji Imura
- Department of Diagnostic Pathology, University of Toyama, Toyama, Japan
| | - Noriaki Emoto
- Department of Clinical Pharmacy, Kobe Pharmaceutical University, Kobe, Japan
| | - Naoki Yoshimura
- Department of Cardiovascular Surgery, University of Toyama, Toyama, Japan
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44
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Imai-Okazaki A, Kishita Y, Kohda M, Yatsuka Y, Hirata T, Mizuno Y, Harashima H, Hirono K, Ichida F, Noguchi A, Yoshida M, Tokorodani C, Nishiuchi R, Takeda A, Nakaya A, Sakata Y, Murayama K, Ohtake A, Okazaki Y. Barth Syndrome: Different Approaches to Diagnosis. J Pediatr 2018; 193:256-260. [PMID: 29249525 DOI: 10.1016/j.jpeds.2017.09.075] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/18/2017] [Accepted: 09/27/2017] [Indexed: 12/28/2022]
Abstract
The diagnosis of Barth syndrome is challenging owing to the wide phenotypic spectrum with allelic heterogeneity. Here we report 3 cases of Barth syndrome with phenotypic and allelic heterogeneity that were diagnosed by different approaches, including whole exome sequencing and final confirmation by reverse-transcription polymease chain reaction.
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Affiliation(s)
- Atsuko Imai-Okazaki
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan; Division of Genomic Medicine Research, Medical Genomics Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshihito Kishita
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Masakazu Kohda
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yukiko Yatsuka
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoko Hirata
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yosuke Mizuno
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Hiroko Harashima
- Department of Pediatrics, Saitama Medical University, Saitama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Atsuko Noguchi
- Department of Pediatrics, Graduate School of Medicine, Akita University, Akita, Japan
| | - Masayuki Yoshida
- Department of Molecular Pathology and Tumor Pathology, Graduate School of Medicine, Akita University, Akita, Japan
| | - Chiho Tokorodani
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Atsuhito Takeda
- Department of Pediatrics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Akihiro Nakaya
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kei Murayama
- Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Akira Ohtake
- Department of Pediatrics, Saitama Medical University, Saitama, Japan; Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan
| | - Yasushi Okazaki
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan; Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan.
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45
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Yokoyama R, Kinoshita K, Hata Y, Abe M, Matsuoka K, Hirono K, Kano M, Nakazawa M, Ichida F, Nishida N, Tabata T. A mutant HCN4 channel in a family with bradycardia, left bundle branch block, and left ventricular noncompaction. Heart Vessels 2018; 33:802-819. [DOI: 10.1007/s00380-018-1116-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 01/05/2018] [Indexed: 01/09/2023]
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46
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Kuwabara M, Niwa K, Toyoda T, Shirai T, Tateno S, Ohuchi H, Tanaka Y, Ichida F, Fujisawa T, Akagi T, Mori Y. Liver Cirrhosis and/or Hepatocellular Carcinoma Occurring Late After the Fontan Procedure ― A Nationwide Survey in Japan ―. Circ J 2018; 82:1155-1160. [DOI: 10.1253/circj.cj-17-1053] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital
- Department of Cardiology, Cardiovascular Center, St. Luke’s International Hospital
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver
| | - Koichiro Niwa
- Department of Cardiology, Cardiovascular Center, St. Luke’s International Hospital
| | | | | | | | | | | | - Fukiko Ichida
- Department of Pediatrics, Faculty of Medicine, University of Toyama
| | | | - Teiji Akagi
- Cardiac Intensive Care Unit, Okayama University Graduate School of Medicine
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47
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Takatsuki S, Ogata S, Ishii M, Yokozawa M, Ono M, Fujiwara M, Ida H, Motomura H, Moriuchi H, Taketazu M, Kawamura Y, Kawano T, Izumi T, Shiono J, Tsuchiya S, Tsuchiya K, Goushi T, Ichida F, Saji T. Low risk of treatment resistance in Down syndrome with Kawasaki disease. Pediatr Int 2017; 59:1236-1239. [PMID: 28960680 DOI: 10.1111/ped.13429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/24/2017] [Accepted: 09/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND A Japanese nationwide survey has reported that Down syndrome (DS) is a less-frequently occurring comorbidity in Kawasaki disease (KD). Although altered immune responses are frequently observed in DS, no studies have focused on the treatment response and risk for coronary artery abnormalities (CAA) in DS patients with KD. The aim of this study was therefore to evaluate the clinical manifestations, treatment response and prevalence of CAA in DS with KD. METHODS We retrospectively reviewed the medical records of DS patients with KD from 2005 through 2012. The survey questionnaires were sent to facilities nationwide, and clinical data regarding KD in DS were collected. A control group consisted of non-DS patients with KD who were managed at Toho University. RESULTS Of the 94 233 children diagnosed with acute KD from 2005 to 2012, 16 children with acute KD also had DS (0.017%). The DS-KD patients were significantly older than the non-DS patients (median, 8 years vs 1 year, P < 0.05, respectively). Half of the DS patients had incomplete KD. Although 50% of the DS children were at high risk of immunoglobulin resistance, all children responded to initial treatment and none had CAA. CONCLUSIONS All DS-KD patients responded to initial i.v. immunoglobulin (IVIG) or aspirin despite having a high risk of IVIG resistance, and none of the DS patients had CAA. This suggests that the risk of treatment resistance and development of CAA may be not higher in DS patients with acute KD.
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Affiliation(s)
- Shinichi Takatsuki
- Department of Pediatrics, Toho University Omori Medical Center, ota, Tokyo, Japan
| | - Shohei Ogata
- Department of Pediatrics, Tokyo Teishin University Hospital, Chiyoda, Tokyo, Japan
| | - Masahiro Ishii
- Department of Pediatrics, Tokyo Teishin University Hospital, Chiyoda, Tokyo, Japan
| | - Masato Yokozawa
- Department of Pediatrics, Jikei University Hospital, Minato, Tokyo, Japan
| | - Masae Ono
- Department of Pediatrics, Japan Red Cross Medical Center, Shibuya, Tokyo, Japan
| | - Masako Fujiwara
- Department of Pediatrics, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Hiroyuki Ida
- Department of Pediatrics, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Hideki Motomura
- Department of Pediatrics, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Mio Taketazu
- Department of Pediatrics, Asahikawa-Koisei General Hospital, Asahikawa, Hokkaido, Japan
| | - Yoichi Kawamura
- Department of Pediatrics, Nagasaki Medical Center, Omura, Nagasaki, Japan
| | - Tatsuya Kawano
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | - Tatsuro Izumi
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | - Junko Shiono
- Department of Pediatrics, Soka Municipal Hospital, Soka, Saitama, Japan
| | - Shiro Tsuchiya
- Department of Pediatrics, Oita University Hospital, Yuhu, Japan
| | - Keiji Tsuchiya
- Department of Pediatrics, Nakatsu Municipal Hospital, Nakatsu, Oita
| | - Terufumi Goushi
- Department of Pediatric Cardiology, Ibaraki Children's Hospital, Mito, Ibaraki, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Toyama University Hospital, Toyama, Toyama, Japan
| | - Tsutomu Saji
- Department of Pediatrics, Toho University Omori Medical Center, ota, Tokyo, Japan
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Wang C, Hata Y, Hirono K, Takasaki A, Ozawa SW, Nakaoka H, Saito K, Miyao N, Okabe M, Ibuki K, Nishida N, Origasa H, Yu X, Bowles NE, Ichida F. A Wide and Specific Spectrum of Genetic Variants and Genotype-Phenotype Correlations Revealed by Next-Generation Sequencing in Patients with Left Ventricular Noncompaction. J Am Heart Assoc 2017; 6:JAHA.117.006210. [PMID: 28855170 PMCID: PMC5634278 DOI: 10.1161/jaha.117.006210] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) has since been classified as a primary genetic cardiomyopathy, but the genetic basis is not fully evaluated. The aim of the present study was to identify the genetic spectrum using next-generation sequencing and to evaluate genotype-phenotype correlations in LVNC patients. METHODS AND RESULTS Using next-generation sequencing, we targeted and sequenced 73 genes related to cardiomyopathy in 102 unrelated LVNC patients. We identified 43 pathogenic variants in 16 genes in 39 patients (38%); 28 were novel variants. Sarcomere gene variants accounted for 63%, and variants in genes associated with channelopathies accounted for 12%. MYH7 and TAZ pathogenic variants were the most common, and rare variant collapsing analysis showed variants in these genes contributed to the risk of LVNC, although patients carrying MYH7 and TAZ pathogenic variants displayed different phenotypes. Patients with pathogenic variants had early age of onset and more severely decreased left ventricular ejection fractions. Survival analysis showed poorer prognosis in patients with pathogenic variants, especially those with multiple variants: All died before their first birthdays. Adverse events were noted in 17 patients, including 13 deaths, 3 heart transplants, and 1 implantable cardioverter-defibrillator insertion. Congestive heart failure at diagnosis and pathogenic variants were independent risk factors for these adverse events. CONCLUSIONS Next-generation sequencing revealed a wide spectrum of genetic variations and a high incidence of pathogenic variants in LVNC patients. These pathogenic variants were independent risk factors for adverse events. Patients harboring pathogenic variants showed poor prognosis and should be followed closely.
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Affiliation(s)
- Ce Wang
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.,Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yukiko Hata
- Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Keiichi Hirono
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Asami Takasaki
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | | | - Hideyuki Nakaoka
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kazuyoshi Saito
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Nariaki Miyao
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Mako Okabe
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Keijiro Ibuki
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Xianyi Yu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Neil E Bowles
- Department of Pediatrics (Cardiology), University of Utah, Salt Lake City, UT
| | - Fukiko Ichida
- Departments of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
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49
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Fujino N, Yoshimuta T, Ichida F, Kinugawa K, Usuda K, Kitayama M, Ino H, Kawashiri MA, Tada H, Mizuno S, Hayashi K, Takemura H, Yamagishi M. Overview of the 81 st Annual Scientific Meeting of the Japanese Circulation Society - Cardiovascular Medicine for the Next Generation. Circ J 2017; 81:1261-1267. [PMID: 28794386 DOI: 10.1253/circj.cj-17-0706] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The 81stAnnual Scientific Meeting of the Japanese Circulation Society was held in Kanazawa, Japan, on March 17-19, 2017 under a miraculously clear sky. The frontlines of healthcare and medicine are dramatically changing. Thus, "Cardiovascular Medicine for Next Generation" was chosen as the main theme of this meeting. The program was constructed around major identified issues, including renewal of our understanding of basic cardiovascular medicine, translational research, and preventive molecular medicine, all of which are anticipated to transcend the medical field over the next generation. Despite the provincial location, 15,672 participants, including more than 400 from overseas countries, attended the 3-day meeting, and there were in-depth discussions in the various sessions. In particular, to our great pleasure, Her Imperial Highness Princess Takamado kindly attended the opening ceremony and extended congratulations to us. The meeting successfully completed and we sincerely appreciate the great cooperation and support from all affiliates.
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Affiliation(s)
- Noboru Fujino
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Tsuyoshi Yoshimuta
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Fukiko Ichida
- Department of Pediatrics, Faculty of Medicine, University of Toyama
| | - Koichiro Kinugawa
- Internal Medicine II, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Kazuo Usuda
- Division of Cardiology, Toyama Prefectural Central Hospital
| | | | - Hidekazu Ino
- Department of Internal Medicine, Komatsu Municipal Hospital
| | - Masa-Aki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Sumio Mizuno
- Department of Cardiology, Fukui Cardiovascular Center
| | - Kenshi Hayashi
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Hirofumi Takemura
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University
| | - Masakazu Yamagishi
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
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50
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Wang C, Yu X, Ichida F. Survival in Young Patients With Noncompaction May Not Only Depend on Cardiac But Also on Neuromuscular Comorbidity - Reply. Circ J 2017; 81:1239. [PMID: 28690310 DOI: 10.1253/circj.cj-17-0544] [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: 11/09/2022]
Affiliation(s)
- Ce Wang
- Department of Pediatrics, Faculty of Medicine, University of Toyama.,Department of Pediatrics, Shengjing Hospital of China Medical University
| | - Xianyi Yu
- Department of Pediatrics, Shengjing Hospital of China Medical University
| | - Fukiko Ichida
- Department of Pediatrics, Faculty of Medicine, University of Toyama
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