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Sugimura K. Resolving the Gap in Evidence on the Role of Warfarin in Venous Thromboembolism Management in Japan. Circ J 2024; 88:369-370. [PMID: 37673639 DOI: 10.1253/circj.cj-23-0582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
- Koichiro Sugimura
- Department of Cardiology, International University of Health and Welfare Narita Hospital
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2
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Yuge N, Manabe S, Hirayama D, Yamada R, Hori M, Saito T, Mochizuki N, Sugimura K, Shimokawa H. A Surgical Case of Partially Unroofed Coronary Sinus Atrial Septal Defect in an Elderly Patient Diagnosed by Preoperative Contrast-Enhanced Computed Tomography. Int Heart J 2024; 65:155-158. [PMID: 38296570 DOI: 10.1536/ihj.23-401] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Unroofed coronary sinus syndrome is a rare congenital cardiac anomaly, involving some anatomical variations. Approximately 60% of patients with unroofed coronary sinus syndrome have a concomitant atrial septal defect, which is termed unroofed coronary sinus atrial septal defect (CSASD). The precise detection of these abnormalities has been usually difficult with conventional echocardiography, mostly due to its small and complex structures. Herein, we report a case with unroofed coronary sinus atrial septal defect, in which preoperative contrast-enhanced computed tomography (CT) was useful in the operative decision making. We successfully repaired the defective roof of the coronary sinus with a bovine patch, while eliminating the inter-atrial shunt. The patient's postoperative course was uneventful with no residual shunt.
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Affiliation(s)
- Norihisa Yuge
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Susumu Manabe
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Daiki Hirayama
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Ryuki Yamada
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Mariko Hori
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Tomohiro Saito
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Nobuhiro Mochizuki
- Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
| | - Koichiro Sugimura
- Department of Cardiology, International University of Health and Welfare Narita Hospital
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3
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Tatebe S, Yasuda S, Konno R, Sakata Y, Sugimura K, Satoh K, Shiroto T, Miyata S, Adachi O, Kimura M, Mizuno Y, Enomoto J, Tateno S, Nakajima H, Oyama K, Saiki Y, Shimokawa H. Clinical and Sociodemographic Factors Associated With Health-Related Quality of Life in Patients With Adult Congenital Heart Disease - A Nationwide Cross-Sectional Multicenter Study. Circ J 2023; 88:62-70. [PMID: 37673658 DOI: 10.1253/circj.cj-23-0383] [Citation(s) in RCA: 1] [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] [Indexed: 09/08/2023]
Abstract
BACKGROUND Little is known about clinical or sociodemographic factors that influence health-related quality of life (HRQoL) in patients with adult congenital heart disease (ACHD).Methods and Results: We conducted a nationwide prospective cross-sectional multicenter study at 4 large ACHD centers in Japan. From November 2016 to June 2018, we enrolled 1,223 ACHD patients; 1,025 patients had an HRQoL score. Patients completed a questionnaire survey, including sociodemographic characteristics, and the 36-Item Short-Form Health Survey (SF-36). To determine factors associated with HRQoL, correlations between 2 SF-36 summary scores (i.e., physical component score [PCS] and mental component score [MCS]) and other clinical or sociodemographic variables were examined using linear regression analysis. In multivariable analysis, poorer PCS was significantly associated with 11 variables, including older age, higher New York Heart Association class, previous cerebral infarction, being unemployed, and limited participation in physical education classes and sports clubs. Poorer MCS was associated with congenital heart disease of great complexity, being part of a non-sports club, current smoking, and social drinking. Student status and a higher number of family members were positively correlated with MCS. CONCLUSIONS This study demonstrates that HRQoL in ACHD patients is associated with various clinical and sociodemographic factors. Further studies are needed to clarify whether some of these factors could be targets for future intervention programs to improve HRQoL outcomes.
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Affiliation(s)
- Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Ryo Konno
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Satoshi Miyata
- Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Osamu Adachi
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Masato Kimura
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | - Yoshiko Mizuno
- Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center
| | - Junko Enomoto
- Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center
- Faculty of Letters, Toyo University
| | - Shigeru Tateno
- Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center
| | | | - Kotaro Oyama
- Department of Pediatrics, Iwate Medical University
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
- Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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4
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Satoh T, Yaoita N, Nochioka K, Tatebe S, Hayashi H, Yamamoto S, Sato H, Takahama H, Suzuki H, Terui Y, Yamada K, Yamada Y, Inoue T, Aoki T, Satoh K, Sugimura K, Miyata S, Yasuda S. Inhaled nitric oxide testing in predicting prognosis in pulmonary hypertension due to left-sided heart diseases. ESC Heart Fail 2023; 10:3592-3603. [PMID: 37775984 PMCID: PMC10682891 DOI: 10.1002/ehf2.14515] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/13/2023] [Accepted: 08/18/2023] [Indexed: 10/01/2023] Open
Abstract
AIMS The pathophysiology of pulmonary hypertension (PH) due to left-sided heart disease (Group 2 PH) is distinct from that of other groups of PH, yet there are still no approved therapies that selectively target pulmonary circulation. The increase in pulmonary capillary pressure due to left-sided heart disease is a trigger event for physical and biological alterations of the pulmonary circulation, including the nitric oxide (NO)-soluble guanylate cyclase-cyclic guanosine monophosphate axis. This study investigated inhaled NO vasoreactivity tests for patients with Group 2 PH and hypothesized that these changes may have a prognostic impact. METHODS AND RESULTS This was a single-centre, retrospective study with a median follow-up of 365 days. From January 2011 to December 2015, we studied 69 patients with Group 2 PH [age, 61.5 ± 13.0 (standard deviation) years; male:female, 49:20; left ventricular ejection fraction, 50.1 ± 20.4%; mean pulmonary arterial pressure, ≥25 mmHg; and pulmonary arterial wedge pressure (PAWP), >15 mmHg]. No adverse events were observed after NO inhalation. Thirty-four patients with Group 2 PH showed increased PAWP (ΔPAWP: 3.26 ± 2.22 mmHg), while the remaining 35 patients did not (ΔPAWP: -2.11 ± 2.29 mmHg). Multivariate analysis revealed that increased PAWP was the only significant predictor of all-cause death or hospitalization for heart failure (HF) after 1 year (hazard ratio 4.35; 95% confidence interval, 1.27-14.83; P = 0.019). The acute response of PAWP to NO differed between HF with preserved and reduced ejection fractions. CONCLUSIONS Patients with Group 2 PH were tolerant of the inhaled NO test. NO-induced PAWP is a novel prognostic indicator.
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Affiliation(s)
- Taijyu Satoh
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Nobuhiro Yaoita
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Kotaro Nochioka
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Shunsuke Tatebe
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Hideka Hayashi
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Saori Yamamoto
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Haruka Sato
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Hiroyuki Takahama
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Hideaki Suzuki
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yosuke Terui
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Kaito Yamada
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yusuke Yamada
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Takumi Inoue
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Tatsuo Aoki
- Department of Cardiovascular Advanced Medicine in Pulmonary HypertensionNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kimio Satoh
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Koichiro Sugimura
- Department of CardiologyInternational University of Health and WelfareOtawaraJapan
| | - Satoshi Miyata
- Teikyo University Graduate School of Public HealthTokyoJapan
| | - Satoshi Yasuda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
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5
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Tamura Y, Tamura Y, Shigeta A, Hosokawa K, Taniguchi Y, Inami T, Adachi S, Tsujino I, Nakanishi N, Sato K, Sakamoto J, Tanabe N, Takama N, Nakamura K, Kubota K, Komura N, Kato S, Yamashita J, Takei M, Joho S, Ishii S, Takemura R, Sugimura K, Tatsumi K. Adult-onset idiopathic peripheral pulmonary artery stenosis. Eur Respir J 2023; 62:2300763. [PMID: 38061784 PMCID: PMC10733597 DOI: 10.1183/13993003.00763-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/20/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Peripheral pulmonary artery stenosis (PPS) refers to stenosis of the pulmonary artery from the trunk to the peripheral arteries. Although paediatric PPS is well described, the clinical characteristics of adult-onset idiopathic PPS have not been established. Our objectives in this study were to characterise the disease profile of adult-onset PPS. METHODS We collected data in Japanese centres. This cohort included patients who underwent pulmonary angiography (PAG) and excluded patients with chronic thromboembolic pulmonary hypertension or Takayasu arteritis. Patient backgrounds, right heart catheterisation (RHC) findings, imaging findings and treatment profiles were collected. RESULTS 44 patients (median (interquartile range) age 39 (29-57) years; 29 females (65.9%)) with PPS were enrolled from 20 centres. In PAG, stenosis of segmental and peripheral pulmonary arteries was observed in 41 (93.2%) and 36 patients (81.8%), respectively. 35 patients (79.5%) received medications approved for pulmonary arterial hypertension (PAH) and 22 patients (50.0%) received combination therapy. 25 patients (56.8%) underwent transcatheter pulmonary angioplasty. RHC data showed improvements in both mean pulmonary arterial pressure (44 versus 40 mmHg; p<0.001) and pulmonary vascular resistance (760 versus 514 dyn·s·cm-5; p<0.001) from baseline to final follow-up. The 3-, 5- and 10-year survival rates of patients with PPS were 97.5% (95% CI 83.5-99.6%), 89.0% (95% CI 68.9-96.4%) and 67.0% (95% CI 41.4-83.3%), respectively. CONCLUSIONS In this study, patients with adult-onset idiopathic PPS presented with segmental and peripheral pulmonary artery stenosis. Although patients had severe pulmonary hypertension at baseline, they showed a favourable treatment response to PAH drugs combined with transcatheter pulmonary angioplasty.
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Affiliation(s)
- Yudai Tamura
- Cardiovascular Center, International University of Health and Welfare School of Medicine, Narita, Japan
- Pulmonary Hypertension Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Yuichi Tamura
- Cardiovascular Center, International University of Health and Welfare School of Medicine, Narita, Japan
- Pulmonary Hypertension Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuya Hosokawa
- Faculty of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yu Taniguchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Takumi Inami
- Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Shiro Adachi
- Department of Cardiology, Nagoya University Hospital, Aichi, Japan
| | - Ichizo Tsujino
- Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Naohiko Nakanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jiro Sakamoto
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | - Nobuhiro Tanabe
- Pulmonary Hypertension Center, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Noriaki Takama
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuto Nakamura
- Department of Cardiology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kayoko Kubota
- Departments of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naohiro Komura
- Department of Cardiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Shigehiko Kato
- Department of Cardiology, Pulmonology and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Jun Yamashita
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Takei
- Department of Cardiology, Saiseikai Central Hospital, Tokyo, Japan
| | - Shuji Joho
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Shunsuke Ishii
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Ryo Takemura
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Koichiro Sugimura
- Department of Cardiology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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6
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Yuge N, Manabe S, Sugimura K, Shimokawa H. Localized dissection of the sinus of valsalva mimicking spontaneous coronary artery dissection. Interdiscip Cardiovasc Thorac Surg 2023:7192178. [PMID: 37289552 DOI: 10.1093/icvts/ivad091] [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] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/09/2023] [Accepted: 06/07/2023] [Indexed: 06/10/2023]
Abstract
A 56-year-old man, suspected of having ST-segment elevation myocardial infarction due to spontaneous coronary artery dissection, underwent emergent percutaneous coronary intervention. Although he had moderate aortic regurgitation with aortic root dilation and mild heart failure, it was controlled with medications. Two weeks after discharge, he was readmitted with severe heart failure due to severe aortic regurgitation and underwent aortic root replacement. Intraoperative findings revealed that localized dissection of the sinus of Valsalva involved the right coronary artery, resulting in a coronary artery dissection. Therefore, in cases of spontaneous coronary artery dissection, attention should be paid to coronary artery dissection caused by localized aortic root dissection.
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Affiliation(s)
- Norihisa Yuge
- Department of Cardiovascular Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan
| | - Susumu Manabe
- Department of Cardiovascular Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan
| | - Koichiro Sugimura
- Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Japan
| | - Hiroaki Shimokawa
- Graduate School, International University of Health and Welfare, Chiba, Japan
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7
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Terui Y, Sugimura K, Ota H, Tada H, Nochioka K, Sato H, Katsuta Y, Fujiwara J, Harada-Shoji N, Sato-Tadano A, Morita Y, Sun W, Higuchi S, Tatebe S, Fukui S, Miyamichi-Yamamoto S, Suzuki H, Yaoita N, Kikuchi N, Sakota M, Miyata S, Sakata Y, Ishida T, Takase K, Yasuda S, Shimokawa H. Usefulness of cardiac magnetic resonance for early detection of cancer therapeutics-related cardiac dysfunction in breast cancer patients. Int J Cardiol 2023; 371:472-479. [PMID: 36115441 DOI: 10.1016/j.ijcard.2022.09.025] [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] [Received: 05/12/2022] [Revised: 08/25/2022] [Accepted: 09/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Prognosis of breast cancer patients has been improved along with the progress in cancer therapies. However, cancer therapeutics-related cardiac dysfunction (CTRCD) has been an emerging issue. For early detection of CTRCD, we examined whether native T1 mapping and global longitudinal strain (GLS) using cardiac magnetic resonance (CMR) and biomarkers analysis are useful. METHODS We prospectively enrolled 83 consecutive chemotherapy-naïve female patients with breast cancer (mean age, 56 ± 13 yrs.) between 2017 and 2020. CTRCD was defined based on echocardiography as left ventricular ejection fraction (LVEF) below 53% at any follow-up period with LVEF>10% points decrease from baseline after chemotherapy. To evaluate cardiac function, CMR (at baseline and 6 months), 12‑lead ECG, echocardiography, and biomarkers (at baseline and every 3 months) were evaluated. RESULTS A total of 164 CMRs were performed in 83 patients. LVEF and GLS were significantly decreased after chemotherapy (LVEF, from 71.2 ± 4.4 to 67.6 ± 5.8%; GLS, from -27.9 ± 3.9 to -24.7 ± 3.5%, respectively, both P < 0.01). Native T1 value also significantly elevated after chemotherapy (from 1283 ± 36 to 1308 ± 39 msec, P < 0.01). Among the 83 patients, 7 (8.4%) developed CTRCD. Of note, native T1 value before chemotherapy was significantly higher in patients with CTRCD than in those without it (1352 ± 29 vs. 1278 ± 30 msec, P < 0.01). The multivariable logistic regression analysis revealed that native T1 value was an independent predictive factor for the development of CTRCD [OR 2.33; 95%CI 1.15-4.75, P = 0.02]. CONCLUSIONS These results indicate that CMR is useful to detect chemotherapy-related myocardial damage and predict for the development of CTRCD in breast cancer patients.
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Affiliation(s)
- Yosuke Terui
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Cardiology, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Hideki Ota
- Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Tada
- Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kotaro Nochioka
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruka Sato
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuko Katsuta
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junko Fujiwara
- Clinical Physiological Laboratory Center, Tohoku University Hospital, Sendai, Japan
| | - Narumi Harada-Shoji
- Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Sato-Tadano
- Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiaki Morita
- Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Wenyu Sun
- Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Higuchi
- Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shunsuke Tatebe
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shigefumi Fukui
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Saori Miyamichi-Yamamoto
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideaki Suzuki
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuhiro Yaoita
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuhiro Kikuchi
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Miku Sakota
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Yasuhiko Sakata
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Ishida
- Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Yasuda
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; International University of Health and Welfare, Graduate School, Narita, Japan.
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8
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Tamura Y, Tamura Y, Taniguchi Y, Tsujino I, Inami T, Matsubara H, Shigeta A, Sugiyama Y, Adachi S, Abe K, Baba Y, Hatano M, Ikeda S, Kusunose K, Sugimura K, Usui S, Takeishi Y, Dohi K, Hasegawa-Tamba S, Horimoto K, Kikuchi N, Kumamaru H, Tatsumi K. Clinical Management and Outcomes of Patients With Portopulmonary Hypertension Enrolled in the Japanese Multicenter Registry. Circ Rep 2022; 4:542-549. [PMID: 36408361 PMCID: PMC9638513 DOI: 10.1253/circrep.cr-22-0098] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 02/12/2024] Open
Abstract
Background: Portopulmonary hypertension (PoPH) is one of the major underlying causes of pulmonary arterial hypertension (PAH). However, PoPH, especially treatment strategies, has been poorly studied. Therefore, this study evaluated current treatments for PoPH, their efficacy, and clinical outcomes of patients with PoPH. Methods and Results: Clinical data were collected for patients with PoPH who were enrolled in the Japan Pulmonary Hypertension Registry between 2008 and 2021. Hemodynamic changes, functional class, and clinical outcomes were compared between patients with PoPH treated with monotherapy and those treated with combination therapies. Clinical data were analyzed for 62 patients with PoPH, including 25 treatment-naïve patients, from 21 centers in Japan. In more than half the patients, PAH-specific therapy improved the New York Heart Association functional class by at least one class. The 3- and 5-year survival rates of these patients were 88.5% (95% confidence interval [CI] 76.0-94.7) and 80.2% (95% CI 64.8-89.3), respectively. Forty-one (66.1%) patients received combination therapy. Compared with patients who had received monotherapy, the mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac index were significantly improved in patients who had undergone combination therapies. Conclusions: Combination therapy was commonly used in patients with PoPH with a favorable prognosis. Combination therapies resulted in significant hemodynamic improvement without an increased risk of side effects.
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Affiliation(s)
- Yudai Tamura
- Cardiovascular Center, International University of Health and Welfare (IUHW) Mita Hospital Tokyo Japan
| | - Yuichi Tamura
- Pulmonary Hypertension Center, IUHW Mita Hospital Tokyo Japan
| | - Yu Taniguchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine Kobe Japan
| | - Ichizo Tsujino
- Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University Sapporo Japan
| | - Takumi Inami
- Department of Cardiovascular Medicine, Kyorin University School of Medicine Mitaka Japan
| | - Hiromi Matsubara
- National Hospital Organization Okayama Medical Center Okayama Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba University Chiba Japan
| | - Yoichi Sugiyama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine Kurume Japan
| | - Shiro Adachi
- Department of Cardiology, Nagoya University Hospital Nagoya Japan
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University Nankoku Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo Tokyo Japan
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital Tokushima Japan
| | | | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences Kanazawa Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University Fukushima Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine Tsu Japan
| | - Saki Hasegawa-Tamba
- Department of Cardiology, Saitama Medical University International Medical Center Hidaka Japan
| | - Koshin Horimoto
- Department of Cardiology, Matsuyama Red Cross Hospital Matsuyama Japan
| | - Noriko Kikuchi
- Department of Cardiology, Tokyo Women's Medical University Tokyo Japan
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo Tokyo Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University Chiba Japan
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Gentile P, Merlo M, Peretto G, Ammirati E, Sala S, Della Bella P, Aquaro G, Imazio M, Potena L, Campodonico J, Foà A, Raafs A, Hazebroek M, Brambatti M, Cercek A, Nucifora G, Shrivastava S, Huang F, Schmidt M, Muser D, Van De Heyning C, Van Craenenbroeck E, Aoki T, Sugimura K, Shimokawa H, Cannatà A, Artico J, Porcari A, Colopi M, Bussani R, Barbati G, Garascia A, Cipriani M, Agostoni P, Pereira N, Heymans S, Adler E, Camici P, Frigerio M, Sinagra G. C65 POST–DISCHARGE ARRHYTHMIC RISK STRATIFICATION OF PATIENTS WITH ACUTE MYOCARDITIS AND LIFE–THREATENING VENTRICULAR TACHYARRHYTHMIAS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.063] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aims
The outcomes of patients presenting with acute myocarditis and life–threatening ventricular arrhythmias (LT–VA) are unclear. The aim of this study was to assess the incidence and predictors of recurrent major arrhythmic events (MAEs) after hospital discharge in this patient population.
Methods and Results
We retrospectively analysed 156 patients (median age 44 years; 77% male) discharged with a diagnosis of acute myocarditis and LT–VA from 16 hospitals worldwide. Diagnosis of myocarditis was based on histology or the combination of increased markers of cardiac injury and cardiac magnetic resonance (CMR) Lake Louise criteria. MAEs were defined as the relapse, after discharge, of sudden cardiac death or successfully defibrillated ventricular fibrillation, or sustained ventricular tachycardia (sVT) requiring implantable cardioverter–defibrillator therapy or synchronized external cardioversion. Median follow–up was 23months [first to third quartile (Q1–Q3) 7–60]. Fifty–eight (37.2%) patients experienced MAEs after discharge, at a median of 8 months (Q1–Q3 2.5–24.0 months; 60.3% of MAEs within the first year). At multivariable Cox analysis, variables independently associated with MAEs were presentation with sVT [hazard ratio (HR) 2.90, 95% confidence interval (CI) 1.38–6.11]; late gadolinium enhancement involving ≥2 myocardial segments (HR 4.51, 95% CI 2.39–8.53), and absence of positive short–tau inversion recovery (STIR) (HR 2.59, 95% CI 1.40–4.79) at first CMR.
Conclusions
In this international multicentre study, patients discharged free from HTx or LVAD after an acute myocarditis complicated by LT–VA had a recurrence of MAEs during follow–up of 37.2%, after a median time of 8 months. Initial CMR pattern and sVT at presentation stratify the risk of arrhythmia recurrence.
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Affiliation(s)
- P Gentile
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Merlo
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - G Peretto
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - E Ammirati
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - S Sala
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - P Della Bella
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - G Aquaro
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Imazio
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - L Potena
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - J Campodonico
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - A Foà
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - A Raafs
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Hazebroek
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Brambatti
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - A Cercek
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - G Nucifora
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - S Shrivastava
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - F Huang
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Schmidt
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - D Muser
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - C Van De Heyning
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - E Van Craenenbroeck
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - T Aoki
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - K Sugimura
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - H Shimokawa
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - A Cannatà
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - J Artico
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - A Porcari
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Colopi
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - R Bussani
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - G Barbati
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - A Garascia
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Cipriani
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - P Agostoni
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - N Pereira
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - S Heymans
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - E Adler
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - P Camici
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - M Frigerio
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
| | - G Sinagra
- DE GASPERIS CARDIO CENTER, AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; CARDIOTHORACOVASCULAR DEPARTMENT, AZIENDA SANITARIA UNIVERSITARIA INTEGRATA DI TRIESTE AND UNIVERSITY OF TRIESTE, TRIESTE; VITA SALUTE UNIVERSITY AND SAN RAFFAELE HOSPITAL, MILANO; DE GASPERIS CARDIO CENTER AND TRANSPLANT CENTER, NIGUARDA HOSPITAL, MILANO; FONDAZIONE TOSCANA G. MONASTERIO, MILANO; CARDIOTHORACIC DEPARTME
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Kato T, Yokota M, Sugimura K, Kawamura A. Sympathetic Reinnervation After Heart Transplantation Assessed by Iodine-123 Metaiodobenzylguanidine (123I-MIBG) Imaging and Heart Rate Response to Exercise. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kamada H, Ota H, Nakamura M, Sun W, Aoki T, Sato H, Sugimura K, Takase K. Quantification of vortex flow in pulmonary arteries of patients with chronic thromboembolic pulmonary hypertension. Eur J Radiol 2022; 148:110142. [DOI: 10.1016/j.ejrad.2021.110142] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/13/2021] [Accepted: 12/29/2021] [Indexed: 01/29/2023]
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12
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Ozaki D, Endo H, Tashiro R, Sugimura K, Tatebe S, Yasuda S, Tomata Y, Endo T, Tominaga K, Niizuma K, Fujimura M, Tominaga T. Association between RNF213 c.14576G>A Variant (rs112735431) and Peripheral Pulmonary Artery Stenosis in Moyamoya Disease. Cerebrovasc Dis 2021; 51:282-287. [PMID: 34710878 DOI: 10.1159/000519717] [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] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Moyamoya disease (MMD) and peripheral pulmonary artery stenosis (PPAS) are relatively rare and demonstrate steno-occlusive vascular lesions in different organs. Genetic studies identified RNF213 polymorphism c.14576G>A (rs112735431) as a susceptibility variant for East Asian MMD. RNF213 polymorphism c.14576G>A is further associated with various vascular lesions of other organs. In this study, we aimed to clarify the incidence and clinical manifestations of PPAS in MMD patients and analyze the correlation between RNF213 genotype and PPAS. METHODS This retrospective case-control study investigated the association between RNF213 polymorphism and PPAS in 306 MMD/quasi-MMD patients, reviewing the medical charts and imaging records of consecutive patients with MMD admitted from January 2015 to December 2020. RESULTS PPAS was observed in 3 MMD/quasi-MMD patients (0.98%, 3/306). RNF213 polymorphism c.14576G>A was determined for all 306 MMD/quasi-MMD patients. The incidence of PPAS in RNF213-wildtype, RNF213-heterozygote, and RNF213-homozygote MMD/quasi-MMD patients was 0% (0/101), 0.5% (1/200), and 40% (2/5), respectively. The association between PPAS and homozygote polymorphism of RNF213 c.14576G>A was statistically significant in MMD/quasi-MMD patients (p = 0.0018). In all cases, pulmonary artery hypertension due to PPAS was evident during their childhood and young adolescent stages. Surgical indications for MMD were discouraged in 1 case due to her severe cardiopulmonary dysfunction. CONCLUSIONS The homozygote variant of RNF213 polymorphism c.14576G>A can be a potential predisposing factor for PPAS in MMD/quasi-MMD patients. Despite the relatively rare entity, PPAS should be noted to determine surgical indications for MMD/quasi-MMD patients.
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Affiliation(s)
- Dan Ozaki
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.,Division of Advanced Cerebrovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryosuke Tashiro
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
| | - Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasutake Tomata
- Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan
| | - Toshiki Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keita Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Miki Fujimura
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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13
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Gentile P, Merlo M, Peretto G, Ammirati E, Sala S, Della Bella P, Aquaro GD, Imazio M, Potena L, Campodonico J, Foà A, Raafs A, Hazebroek M, Brambatti M, Cercek AC, Nucifora G, Shrivastava S, Huang F, Schmidt M, Muser D, Van de Heyning CM, Van Craenenbroeck E, Aoki T, Sugimura K, Shimokawa H, Cannatà A, Artico J, Porcari A, Colopi M, Perkan A, Bussani R, Barbati G, Garascia A, Cipriani M, Agostoni P, Pereira N, Heymans S, Adler ED, Camici PG, Frigerio M, Sinagra G. Post-discharge arrhythmic risk stratification of patients with acute myocarditis and life-threatening ventricular tachyarrhythmias. Eur J Heart Fail 2021; 23:2045-2054. [PMID: 34196079 DOI: 10.1002/ejhf.2288] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 01/23/2021] [Revised: 06/05/2021] [Accepted: 06/25/2021] [Indexed: 12/28/2022] Open
Abstract
AIMS The outcomes of patients presenting with acute myocarditis and life-threatening ventricular arrhythmias (LT-VA) are unclear. The aim of this study was to assess the incidence and predictors of recurrent major arrhythmic events (MAEs) after hospital discharge in this patient population. METHODS AND RESULTS We retrospectively analysed 156 patients (median age 44 years; 77% male) discharged with a diagnosis of acute myocarditis and LT-VA from 16 hospitals worldwide. Diagnosis of myocarditis was based on histology or the combination of increased markers of cardiac injury and cardiac magnetic resonance (CMR) Lake Louise criteria. MAEs were defined as the relapse, after discharge, of sudden cardiac death or successfully defibrillated ventricular fibrillation, or sustained ventricular tachycardia (sVT) requiring implantable cardioverter-defibrillator therapy or synchronized external cardioversion. Median follow-up was 23 months [first to third quartile (Q1-Q3) 7-60]. Fifty-eight (37.2%) patients experienced MAEs after discharge, at a median of 8 months (Q1-Q3 2.5-24.0 months; 60.3% of MAEs within the first year). At multivariable Cox analysis, variables independently associated with MAEs were presentation with sVT [hazard ratio (HR) 2.90, 95% confidence interval (CI) 1.38-6.11]; late gadolinium enhancement involving ≥2 myocardial segments (HR 4.51, 95% CI 2.39-8.53), and absence of positive short-tau inversion recovery (STIR) (HR 2.59, 95% CI 1.40-4.79) at first CMR. CONCLUSIONS Among patients discharged with a diagnosis of myocarditis and LT-VA, 37.2% had recurrences of MAEs during follow-up. Initial CMR pattern and sVT at presentation stratify the risk of arrhythmia recurrence.
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Affiliation(s)
- Piero Gentile
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.,De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Giovanni Peretto
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | - Enrico Ammirati
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Simone Sala
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | - Paolo Della Bella
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | | | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Luciano Potena
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Jeness Campodonico
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Alberto Foà
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anne Raafs
- Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Mark Hazebroek
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Andreja Cerne Cercek
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gaetano Nucifora
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia.,Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Florent Huang
- Department of Cardiology, Foch Hospital, Suresnes, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pítié-Salpêtriére Hospital, Medical Intensive Care Unit, Paris, France
| | - Daniele Muser
- Cardiothoracic Department, University Hospital, Udine, Italy
| | | | | | - Tatsuo Aoki
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | - Antonio Cannatà
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.,Department of Cardiology, King's College Hospital, London, UK
| | - Jessica Artico
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Aldostefano Porcari
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Marzia Colopi
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Andrea Perkan
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Rossana Bussani
- Department of Pathological Anatomy, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Andrea Garascia
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Manlio Cipriani
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Naveen Pereira
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephane Heymans
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Eric D Adler
- Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | | | - Maria Frigerio
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
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14
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Fujihashi T, Sakata Y, Nochioka K, Miura M, Abe R, Kasahara S, Sato M, Aoyanagi H, Yamanaka S, Hayashi H, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Prognostic impacts of serum uric acid levels in patients with chronic heart failure: insights from the CHART-2 study. ESC Heart Fail 2020; 8:1027-1038. [PMID: 33377627 PMCID: PMC8006606 DOI: 10.1002/ehf2.12765] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/29/2020] [Accepted: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
Aims Prognostic impacts of serum uric acid (UA) levels in patients with chronic heart failure (CHF) remain inconclusive, especially for the whole range of serum UA levels. Methods and results In the Chronic Heart Failure Registry and Analysis in the Tohoku District‐2 (CHART‐2) study, we enrolled 4652 consecutive patients with CHF and classified them into four groups based on baseline serum UA levels by the Classification and Regression Tree: G1 (<3.8 mg/dL, N = 313), G2 (3.8–7.1 mg/dL, N = 3070), G3 (7.2–9.2 mg/dL, N = 1018), and G4 (>9.2 mg/dL, N = 251). Mean age was 71 ± 12, 69 ± 12, 68 ± 13, and 69 ± 15 years in G1, G2, G3, and G4, respectively (P < 0.001). During the median follow‐up of 6.3 years, in G1, G2, G3, and G4, 111 (35%), 905 (29%), 370 (36%), and 139 (55%) patients died and 79 (25%), 729 (24%), 300 (29%), and 115 (46%) experienced heart failure hospitalization, respectively (both P < 0.001). G1 was characterized by a significantly high prevalence of women as compared with G2, G3, and G4 (59%, 32%, 24%, and 23%, respectively). Serum creatinine levels (0.8 ± 0.4, 0.9 ± 0.4, 1.2 ± 0.6, and 1.4 ± 0.8 mg/dL, respectively), prevalence of atrial fibrillation (34%, 39%, 45%, and 50%, respectively), and diuretics use (36%, 45%, 67%, and 89%, respectively) increased from G1, G2, G3 to G4 (all P < 0.001), while left ventricular ejection fraction decreased from G1, G2, G3 to G4 (59 ± 15, 58 ± 15, 54 ± 15, and 52 ± 17%, respectively, P < 0.001). Multivariable Cox proportional hazards models showed that, as compared with G2, both G1 and G4 had increased incidence of all‐cause death [adjusted hazard ratio (aHR) 1.34, 95% confidence interval (CI) 1.08–1.67, P = 0.009; aHR 1.28, 95% CI 1.02–1.61, P = 0.037, respectively] and heart failure admission (aHR 1.39, 95% CI 1.09–1.78, P = 0.008 and aHR 1.35, 95% CI, 1.06–1.71, P = 0.014, respectively). This U‐shaped relationship was evident in the elderly patients. Furthermore, abnormal transitions to either higher or lower levels of serum UA from G2 were associated with increased mortality (aHR 1.29, 95% CI 1.06–1.57, P = 0.012; aHR 1.57, 95% CI 1.12–2.20, P = 0.009). Conclusions These results demonstrate that serum UA levels have the U‐shaped prognostic effects and abnormal transitions to either higher or lower levels are associated with poor prognosis in the elderly patients with CHF.
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Affiliation(s)
- Takahide Fujihashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Ruri Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Shinsuke Yamanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hideka Hayashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Satoshi Miyata
- Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan.,Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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15
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Yaoita N, Satoh K, Satoh T, Shimizu T, Saito S, Sugimura K, Tatebe S, Yamamoto S, Aoki T, Kikuchi N, Kurosawa R, Miyata S, Nagasaki M, Yasuda J, Shimokawa H. Identification of the Novel Variants in Patients With Chronic Thromboembolic Pulmonary Hypertension. J Am Heart Assoc 2020; 9:e015902. [PMID: 33103541 PMCID: PMC7763425 DOI: 10.1161/jaha.120.015902] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 08/26/2020] [Indexed: 11/26/2022]
Abstract
Background Although chronic thromboembolic pulmonary hypertension (CTEPH) and acute pulmonary embolism (APE) share some clinical manifestations, a limited proportion of patients with CTEPH have a history of APE. Moreover, in histopathologic studies, it has been revealed that pulmonary vasculature lesions similar to pulmonary arterial hypertension existed in patients with CTEPH. Thus, it remains unknown whether these 3 disorders also share genetic backgrounds. Methods and Results Whole exome screening was performed with DNA isolated from 51 unrelated patients with CTEPH of Japanese ancestry. The frequency of genetic variants associated with pulmonary arterial hypertension or APE in patients with CTEPH was compared with those in the integrative Japanese Genome Variation Database 3.5KJPN. Whole exome screening analysis showed 17 049 nonsynonymous variants in patients with CTEPH. Although we found 6 nonsynonymous variants that are associated with APE in patients with CTEPH, there was no nonsynonymous variant associated with pulmonary arterial hypertension. Patients with CTEPH with a history of APE had nonsynonymous variants of F5, which encodes factor V. In contrast, patients with CTEPH without a history of APE had a nonsynonymous variant of THBD, which encodes thrombomodulin. Moreover, thrombin-activatable fibrinolysis inhibitor, which is one of the pathogenic proteins in CTEPH, was significantly more activated in those who had the variants of THBD compared with those without it. Conclusions These results provide the first evidence that patients with CTEPH have some variants associated with APE, regardless of the presence or absence of a history of APE. Furthermore, the variants might be different between patients with CTEPH with and without a history of APE.
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Affiliation(s)
- Nobuhiro Yaoita
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Kimio Satoh
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Taijyu Satoh
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Toru Shimizu
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Sakae Saito
- Department of Integrative GenomicsTohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Koichiro Sugimura
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Shunsuke Tatebe
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Saori Yamamoto
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Tatsuo Aoki
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Nobuhiro Kikuchi
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Ryo Kurosawa
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Miyata
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Masao Nagasaki
- Department of Integrative GenomicsTohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Jun Yasuda
- Department of Integrative GenomicsTohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Hiroaki Shimokawa
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
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16
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Hiramoto A, Suzuki Y, Ali A, Aoki S, Berns L, Fukuda T, Hanaoka Y, Hayato Y, Ichikawa A, Kawahara H, Kikawa T, Koga T, Komatani R, Komatsu M, Kosakai Y, Matsuo T, Mikado S, Minamino A, Mizuno K, Morimoto Y, Morishima K, Naganawa N, Naiki M, Nakamura M, Nakamura Y, Nakano N, Nakano T, Nakaya T, Nishio A, Odagawa T, Ogawa S, Oshima H, Rokujo H, Sanjana I, Sato O, Shibuya H, Sugimura K, Suzui L, Takagi H, Takao T, Tanihara Y, Yasutome K, Yokoyama M. First measurement of
ν¯μ
and
νμ
charged-current inclusive interactions on water using a nuclear emulsion detector. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.102.072006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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17
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Yamanaka S, Sakata Y, Nochioka K, Miura M, Kasahara S, Sato M, Aoyanagi H, Fujihashi T, Hayashi H, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Prognostic impacts of dynamic cardiac structural changes in heart failure patients with preserved left ventricular ejection fraction. Eur J Heart Fail 2020; 22:2258-2268. [PMID: 32592517 PMCID: PMC7891326 DOI: 10.1002/ejhf.1945] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 12/28/2022] Open
Abstract
Aims We aimed to examine temporal changes in left ventricular (LV) structures and their prognostic impacts in patients with heart failure (HF) and preserved ejection fraction (HFpEF). Methods and results In the Chronic Heart Failure Analysis and Registry in the Tohoku District‐2 (CHART‐2) study (n = 10 219), we divided 2698 consecutive HFpEF patients (68.9 ± 12.2 years, 32.1% female) into three groups by LV hypertrophy (LVH) and enlargement (LVE) at baseline: (−)LVH/(−)LVE (n = 989), (+)LVH/(−)LVE (n = 1448), and (+)LVH/(+)LVE (n = 261). We examined temporal changes in LV structures and their prognostic impacts during a median 8.7‐year follow‐up. From (−)LVH/(−)LVE, (+)LVH/(−)LVE to (+)LVH/(+)LVE at baseline, the incidence of the primary outcome, a composite of cardiovascular death or HF admission, significantly increased. Among 1808 patients who underwent echocardiography at both baseline and 1 year, we noted substantial group transitions from baseline to 1 year; the transition rates from (−)LVH/(−)LVE to (+)LVH/(−)LVE, from (+)LVH/(−)LVE to (−)LVH/(−)LVE, from (+)LVH/(−)LVE to (+)LVH/(+)LVE, and from (+)LVH/(+)LVE to (+)LVH/(−)LVE were 27% (182/671), 22% (213/967), 6% (59/967), and 26% (44/170), respectively. In the univariable Cox proportional hazard model, patients who transitioned from (+)LVH/(−)LVE to (+)LVH/(+)LVE or remained in (+)LVH/(+)LVE had the worst subsequent prognosis [hazard ratio (HR) 4.65, 95% confidence interval (CI) 3.09–6.99, P < 0.001; HR 4.01, 95% CI 2.85–5.65, P < 0.001, respectively], as compared with those who remained in (−)LVH/(−)LVE. These results were unchanged after adjustment for the covariates including baseline LV ejection fraction (LVEF) and 1‐year LVEF change. Conclusion In HFpEF patients, LV structures dynamically change over time with significant prognostic impacts, where patients who develop LVE with LVH have the worst prognosis.
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Affiliation(s)
- Shinsuke Yamanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahide Fujihashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideka Hayashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan.,Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Aoki T, Sugimura K, Terui Y, Tatebe S, Fukui S, Miura M, Yamamoto S, Yaoita N, Suzuki H, Sato H, Kozu K, Konno R, Miyata S, Nochioka K, Satoh K, Shimokawa H. Beneficial effects of riociguat on hemodynamic responses to exercise in CTEPH patients after balloon pulmonary angioplasty – A randomized controlled study. IJC Heart & Vasculature 2020; 29:100579. [PMID: 32685661 PMCID: PMC7356201 DOI: 10.1016/j.ijcha.2020.100579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/01/2020] [Accepted: 06/22/2020] [Indexed: 11/07/2022]
Abstract
Background Although balloon pulmonary angioplasty (BPA) improves symptoms and pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH), the effects of riociguat on hemodynamics and exercise capacity in patients after BPA remain to be elucidated. Methods and Results This study was a single-center, prospective, randomized, open-label trial. From November 2015 to November 2018, we prospectively examined 21 patients with CTEPH (65 ± 9 years old, M/F 2/19) who showed hemodynamic improvement with mean pulmonary arterial pressure (mPAP) < 30 mmHg after BPA without any vasodilators. We performed hemodynamic evaluation and expired gas analysis both at rest and during exercise in supine position using cycle ergometer. After right heart catheterization during exercise, they were randomly assigned to 2 groups with minimized method, using age, sex, and resting mPAP; riociguat (N = 10) and control (N = 11) groups. After 6 months, exercise capacity evaluated by 6-min walk distance and cardiopulmonary exercise testing, and resting hemodynamic parameters were comparable in both groups. However, cardiac output (CO) (6.0 ± 1.7–7.4 ± 1.6, P < 0.01) and pulmonary vascular resistance (4.8 ± 1.8–3.2 ± 0.7 Wood units, P = 0.02) at peak workload were significantly improved in the riociguat group as compared with the control group. The slope of linearized mPAP-CO relationship was significantly decreased in the riociguat group [14.5 (7.8, 14.7) to 6.41 (5.1, 11.4), P < 0.01] but not in the control group. Conclusions These results indicate that riociguat exerts beneficial effects on hemodynamic response to exercise in CTEPH patients even after hemodynamic improvement by BPA.
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19
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Suzuki H, Matsumoto Y, Sugimura K, Takahashi J, Miyata S, Fukumoto Y, Taki Y, Shimokawa H. Impacts of hippocampal blood flow on changes in left ventricular wall thickness in patients with chronic heart failure. Int J Cardiol 2020; 310:103-107. [DOI: 10.1016/j.ijcard.2020.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/04/2020] [Accepted: 01/09/2020] [Indexed: 02/07/2023]
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Aoki T, Sugimura K. BENEFICIAL EFFECTS OF RIOCIGUAT ON HEMODYNAMIC RESPONSES TO EXERCISE IN CTEPH PATIENTS AFTER BALLOON PULMONARY ANGIOPLASTY: A RANDOMIZED CONTROLLED STUDY. Chest 2020. [DOI: 10.1016/j.chest.2020.05.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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21
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Ammirati E, Veronese G, Brambatti M, Merlo M, Cipriani M, Potena L, Sormani P, Aoki T, Sugimura K, Sawamura A, Okumura T, Pinney S, Hong K, Shah P, Braun Ö, Van de Heyning CM, Montero S, Petrella D, Huang F, Schmidt M, Raineri C, Lala A, Varrenti M, Foà A, Leone O, Gentile P, Artico J, Agostini V, Patel R, Garascia A, Van Craenenbroeck EM, Hirose K, Isotani A, Murohara T, Arita Y, Sionis A, Fabris E, Hashem S, Garcia-Hernando V, Oliva F, Greenberg B, Shimokawa H, Sinagra G, Adler ED, Frigerio M, Camici PG. Fulminant Versus Acute Nonfulminant Myocarditis in Patients With Left Ventricular Systolic Dysfunction. J Am Coll Cardiol 2020; 74:299-311. [PMID: 31319912 DOI: 10.1016/j.jacc.2019.04.063] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [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: 03/11/2019] [Revised: 04/23/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Fulminant myocarditis (FM) is a form of acute myocarditis characterized by severe left ventricular systolic dysfunction requiring inotropes and/or mechanical circulatory support. A single-center study found that a patient with FM had better outcomes than those with acute nonfulminant myocarditis (NFM) presenting with left ventricular systolic dysfunction, but otherwise hemodynamically stable. This was recently challenged, so disagreement still exists. OBJECTIVES This study sought to provide additional evidence on the outcome of FM and to ascertain whether patient stratification based on the main histologic subtypes can provide additional prognostic information. METHODS A total of 220 patients (median age 42 years, 46.3% female) with histologically proven acute myocarditis (onset of symptoms <30 days) all presenting with left ventricular systolic dysfunction were included in a retrospective, international registry comprising 16 tertiary hospitals in the United States, Europe, and Japan. The main endpoint was the occurrence of cardiac death or heart transplantation within 60 days from admission and at long-term follow-up. RESULTS Patients with FM (n = 165) had significantly higher rates of cardiac death and heart transplantation compared with those with NFM (n = 55), both at 60 days (28.0% vs. 1.8%, p = 0.0001) and at 7-year follow-up (47.7% vs. 10.4%, p < 0.0001). Using Cox multivariate analysis, the histologic subtype emerged as a further variable affecting the outcome in FM patients, with giant cell myocarditis having a significantly worse prognosis compared with eosinophilic and lymphocytic myocarditis. In a subanalysis including only adults with lymphocytic myocarditis, the main endpoints occurred more frequently in FM compared with in NFM both at 60 days (19.5% vs. 0%, p = 0.005) and at 7-year follow up (41.4% vs. 3.1%, p = 0.0004). CONCLUSIONS This international registry confirms that patients with FM have higher rates of cardiac death and heart transplantation both in the short- and long-term compared with patients with NFM. Furthermore, we provide evidence that the histologic subtype of FM carries independent prognostic value, highlighting the need for timely endomyocardial biopsy in this condition.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy.
| | - Giacomo Veronese
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy; Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Marco Merlo
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | | | | | - Paola Sormani
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Tatsuo Aoki
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | - Sean Pinney
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kimberly Hong
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church, Virginia
| | - Öscar Braun
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
| | | | - Santiago Montero
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris Cedex 13, France
| | | | - Florent Huang
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris Cedex 13, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris Cedex 13, France
| | - Claudia Raineri
- Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Anuradha Lala
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marisa Varrenti
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy; Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Alberto Foà
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Ornella Leone
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Piero Gentile
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | - Jessica Artico
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | | | - Rajiv Patel
- Inova Heart and Vascular Institute, Falls Church, Virginia
| | | | | | | | | | | | - Yoh Arita
- Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Alessandro Sionis
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Enrico Fabris
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | - Sherin Hashem
- Department of Pathology, University of California, San Diego, La Jolla, California
| | - Victor Garcia-Hernando
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Barry Greenberg
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California
| | | | - Gianfranco Sinagra
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California.
| | - Maria Frigerio
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Paolo G Camici
- Vita Salute University and San Raffaele Hospital, Milano, Italy
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Takada T, Sakata Y, Nochioka K, Miura M, Abe R, Kasahara S, Sato M, Aoyanagi H, Fujihashi T, Yamanaka S, Suzuki K, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Risk of de-novo heart failure and competing risk in asymptomatic patients with structural heart diseases. Int J Cardiol 2020; 307:87-93. [PMID: 32107021 DOI: 10.1016/j.ijcard.2020.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/28/2020] [Accepted: 02/05/2020] [Indexed: 11/30/2022]
Abstract
AIMS Asymptomatic patients with structural heart diseases are classified as a population at high risk for heart failure (HF) in Stage B. However, limited data are available regarding incidence and related factors of de-novo HF (DNHF) considering competing risk in this population. METHODS AND RESULTS In 3362 Stage B patients (mean age 68 yrs, male 76%) from the CHART-2 Study (N = 10,219), we examined incidence of death and DNHF, defined as the first episode of either HF hospitalization or HF death, and factors related to DNHF. RESULTS During the median 6.0-year follow-up, 627 deaths (31/1000 person-years) and 293 DNHF (15/1000 person-years) occurred. Among the 627 deaths, 212 (34%) and 325 (52%) were specified as cardiovascular and non-cardiovascular deaths, respectively. During the follow-up of 271 DNHF hospitalizations, we observed 124 deaths, including 65 (52%) cardiovascular and 47 (40%) non-cardiovascular deaths. The competing risk model showed that age, diabetes mellitus, stroke, atrial fibrillation, diastolic blood pressure, hemoglobin levels, estimated glomerular filtration ratio and left ventricular ejection fraction was significantly associated with DNHF. Bayesian structural equation modeling showed that many of these cardiac and non-cardiac variables contribute to DNHF by affecting each other, while diabetes mellitus was independently associated with DNHF. CONCLUSIONS Stage B patients had a high incidence of DNHF as well as that of death due to both cardiovascular and non-cardiovascular causes. Thus, management of Stage B patients should include multidisciplinary approaches considering both cardiac and non-cardiac factors, in order to prevent DNHF as well as non-HF death as a competing risk. TRIAL REGISTRATION clinicaltrials.gov identifier: NCT00418041.
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Affiliation(s)
- Tsuyoshi Takada
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University, Sendai, Japan.
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ruri Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahide Fujihashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shinsuke Yamanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kota Suzuki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Evidenced-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University, Sendai, Japan; Department of Evidenced-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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23
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Aoyanagi H, Nochioka K, Sakata Y, Miura M, Shiroto T, Abe R, Kasahara S, Sato M, Fujihashi T, Yamanaka S, Hayashi H, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Temporal changes in left ventricular ejection fraction and their prognostic impacts in patients with Stage B heart failure. Int J Cardiol 2020; 306:123-132. [PMID: 32113664 DOI: 10.1016/j.ijcard.2020.02.040] [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: 08/21/2019] [Revised: 02/03/2020] [Accepted: 02/14/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND We have recently demonstrated that left ventricular ejection fraction (LVEF) dynamically changes over time with prognostic impacts in Stage C/D patients, namely, those who have a current or past history of heart failure (HF). However, it is unknown whether this is also the case in asymptomatic Stage B patients, namely, those who have a risk of HF, but do not have a history of HF. METHODS In our CHART-2 Study (N = 10,219), we enrolled 4005 Stage B patients and divided them into 3 groups by LVEF; preserved EF (pEF, LVEF ≥50%, N = 3526), mid-range EF (mrEF, LVEF 41-49%, N = 302), and reduced EF (rEF, LVEF ≤40%, N = 177). We examined the prognostic impacts of LVEF transitions among the 3 groups in comparison with 4477 patients with Stage C/D HF. RESULTS Stage B were characterized by less severe clinical status and better prognosis compared with Stage C/D. Stage B in mrEF and rEF at baseline dynamically transitioned to other groups at 1-year, whereas those in pEF unchanged; at 1-year, mrEF transitioned to pEF/rEF by 50/16%, and rEF transitioned to pEF/mrEF by 25/31%, respectively, whereas pEF transitioned to mrEF/rEF by only 3.6/0.7%, respectively, which were consistent with findings in findings with Stage C/D. Although LVEF decrease was directly associated with all-cause mortality in both the Stage B and Stage C/D with pEF, factors related to LVEF changes were different between the 2 groups. CONCLUSIONS In Stage B, LVEF dynamically changes with prognostic impacts as in Stage C/D, whereas different determination factors may be involved in the 2 stages. CLINICAL TRIAL REGISTRATION Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-2 (NCT00418041).
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Affiliation(s)
- Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan; Big Data Medicine Center, Tohoku University, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan; Big Data Medicine Center, Tohoku University, Japan.
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Ruri Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Takahide Fujihashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Shinsuke Yamanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hideka Hayashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | | | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan; Big Data Medicine Center, Tohoku University, Japan; Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
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Kozu K, Satoh K, Aoki T, Tatebe S, Miura M, Yamamoto S, Yaoita N, Suzuki H, Shimizu T, Sato H, Konno R, Terui Y, Nochioka K, Kikuchi N, Satoh T, Sugimura K, Miyata S, Shimokawa H. Cyclophilin A as a biomarker for the therapeutic effect of balloon angioplasty in chronic thromboembolic pulmonary hypertension. J Cardiol 2020; 75:415-423. [DOI: 10.1016/j.jjcc.2019.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/17/2019] [Accepted: 09/18/2019] [Indexed: 12/11/2022]
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Sugimura K. Effect of riociguat from a different angle. Int J Cardiol 2020; 304:156-157. [PMID: 31882359 DOI: 10.1016/j.ijcard.2019.12.017] [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: 11/24/2019] [Accepted: 12/09/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Sato M, Sakata Y, Sato K, Nochioka K, Miura M, Abe R, Oikawa T, Kasahara S, Aoyanagi H, Yamanaka S, Fujihashi T, Hayashi H, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Clinical characteristics and prognostic factors in elderly patients with chronic heart failure -A report from the CHART-2 study. Int J Cardiol Heart Vasc 2020; 27:100497. [PMID: 32215317 PMCID: PMC7090329 DOI: 10.1016/j.ijcha.2020.100497] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 01/03/2023]
Abstract
Background Since most of the randomized clinical trials for heart failure (HF) were designed to exclude elderly patients, limited data are available on their clinical characteristics, prognosis, and prognostic factors. Methods We compared clinical characteristics, prognosis, and prognostic factors among Stage C/D HF patients in our CHART-2 Study (N = 4876, mean 69 years, women 32%, 6.3-year follow-up) by age (G1, ≤64 years, N = 1521; G2, 65–74 years, N = 1510; and G3, ≥75 years, N = 1845). Results From G1 to G3, the prevalence of women, left ventricular ejection fraction (LVEF) and plasma levels of B-type natriuretic peptide (BNP) increased (all P < 0.001). Similarly, 5-year mortality increased (9.9, 17.3 to 39.9%, P < 0.001) along with a decrease in proportion of cardiovascular death and an increase in non-cardiovascular death in both sexes. While all-cause and cardiovascular mortality was comparable between the sexes, women had significantly lower incidence of non-cardiovascular death than men in G2 and G3, which was attributable to the higher incidence of cancer death and pneumonia death in men than in women. Although NYHA functional class III-IV, chronic kidney disease, cancer, LVEF, and BNP had significant impacts on all-cause death in all groups, their impacts were less evident in G3 as compared with G1. Conclusions The elderly HF patients, as compared with younger HF patients, were characterized by more severe clinical background, increased proportion of non-cardiovascular death and worse prognosis with different impacts of prognostic factors across the age groups.
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Affiliation(s)
- Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Kenjiro Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ruri Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuya Oikawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shinsuke Yamanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahide Fujihashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideka Hayashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Big Data Medicine Center, Tohoku University, Sendai, Japan.,Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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27
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Kamada H, Ota H, Aoki T, Sugimura K, Yaoita N, Shimokawa H, Takase K. 4D-flow MRI assessment of blood flow before and after endovascular intervention in a patient with pulmonary hypertension due to isolated pulmonary artery involvement in large vessel vasculitis. Radiol Case Rep 2020; 15:190-194. [PMID: 31890066 PMCID: PMC6928274 DOI: 10.1016/j.radcr.2019.11.019] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 11/24/2019] [Indexed: 12/03/2022] Open
Abstract
A 43-year-old woman presented with dyspnea during exertion and lower leg edema. Contrast-enhanced computed tomography images demonstrated extensive proximal narrowing in the right main pulmonary artery with thickening and enhancement. Right heart catheterization revealed the presence of precapillary pulmonary hypertension with a mean pulmonary arterial pressure of 45 mm Hg. The patient was diagnosed with large-vessel vasculitis with isolated pulmonary artery involvement. Takayasu's arteritis was suspected, but histological examination was not performed. Several sessions of pulmonary arterial intervention were stratified for the right main pulmonary artery. After treatment, mean pulmonary arterial pressure had decreased to 22 mm Hg with improvement in symptoms. Thoracic 4D-flow magnetic resonance imaging was performed before and after intervention to evaluate the volume flow rates of pulmonary arteries. The rates increased at the inlet of the right pulmonary artery (before: 23 mL/s vs after: 47.5 mL/s) and the main pulmonary artery (before: 71.2 mL/s vs after: 82.5 mL/s), and decreased at the inlet of the left pulmonary artery (before: 46.2 mL/s vs after: 31.7 mL/s). The split ratio of volume flow rate between the right and left pulmonary arteries improved after treatment (before. right:left = 33.1:66.9; after, right:left = 60.0:40.0), approaching normal values. This report quantitatively describes perioperative hemodynamic changes in a patient with pulmonary hypertension using 4D-flow magnetic resonance imaging. Stent placement for stenosis in the right pulmonary artery resulted in an increase in overall pulmonary blood flow and also improved blood flow balance between the right and the left pulmonary arteries.
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Affiliation(s)
- Hiroki Kamada
- Department of Diagnostic Radiology, Tohoku University Hospital, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Hospital, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuhiro Yaoita
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
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28
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Ishii Y, Fujii H, Sugimura K, Shirai T, Hoshi Y, Fujita Y, Shirota Y, Ishii T, Shimokawa H, Harigae H. Successful Treatment of Pulmonary Arterial Hypertension in Systemic Sclerosis with Anticentriole Antibody. Case Rep Rheumatol 2020; 2020:1926908. [PMID: 32158583 PMCID: PMC7061130 DOI: 10.1155/2020/1926908] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/26/2020] [Accepted: 01/31/2020] [Indexed: 11/18/2022] Open
Abstract
Systemic sclerosis (SSc) is characterized by skin sclerosis and multiple organ damages which may cause mortality and is usually accompanied with several specific autoantibodies, each of which is associated with characteristic complications. Among them, anticentriole antibody is recently reported to be highly associated with SSc-associated pulmonary arterial hypertension (SSc-PAH). In general, several vasodilators are used as therapeutic drugs for SSc-PAH, whereas immunosuppressive therapies are not. Here, we report the case of a 62-year-old female with anticentriole antibody-positive SSc-PAH treated with immunosuppressants and vasodilators. She presented with two-year exertional dyspnea and was diagnosed with PAH and SSc owing to the centriole staining pattern and other symptoms without digital sclerosis. Oral vasodilators were initially administered but were not sufficiently effective on dyspnea. Immunosuppressants such as prednisolone and cyclophosphamide were started. Both of them improved mean pulmonary arterial pressure and 6-minute walk distance, and the anticentriole antibody also disappeared. In this case, SSc-PAH with anticentriole antibody was properly diagnosed and immunosuppressants and vasodilators improved the hemodynamics of PAH with anticentriole antibody and stably maintained it and, in addition, reduced the titer of anticentriole antibody. This indicates that anticentriole antibody might represent a good responsive group to therapies among subgroups of patients with SSc-PAH.
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Affiliation(s)
- Yusho Ishii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Hiroshi Fujii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Yosuke Hoshi
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Yoko Fujita
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Yuko Shirota
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
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29
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Kamada H, Ota H, Terui Y, Sugimura K, Fukui S, Shimokawa H, Takase K. Three cases of pulmonary tumor thrombotic microangiopathy (PTTM): Challenge in antemortem diagnosis using lung perfusion blood volume images by dual-energy computed tomography. Eur J Radiol Open 2020; 7:100212. [PMID: 33102634 PMCID: PMC7569404 DOI: 10.1016/j.ejro.2020.01.001] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 12/14/2019] [Accepted: 01/05/2020] [Indexed: 12/22/2022] Open
Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a specific type of tumor embolism in the small and medium pulmonary arteries, leading to rapid progressive pulmonary hypertension. Antemortem diagnosis of PTTM is extremely difficult. We encountered three patients who were histopathologically or clinically diagnosed with PTTM. In all cases, lung perfused blood volume (PBV) images on dual-energy computed tomography (CT) demonstrated multiple subpleural wedge-shaped defects with no evidence of pulmonary embolism on CT pulmonary angiography. The lung PBV images demonstrated small pulmonary arterial obstruction reflecting the pathology of PTTM. Therefore, lung PBV imaging would be useful for antemortem diagnosis of PTTM.
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Affiliation(s)
- Hiroki Kamada
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Yosuke Terui
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shigefumi Fukui
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
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30
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Veronese G, Ammirati E, Brambatti M, Merlo M, Cipriani M, Potena L, Sormani P, Aoki T, Sugimura K, Sawamura A, Okumura T, Pinney S, Hong K, Shah P, Braun OÖ, Van de Heyning CM, Montero S, Petrella D, Huang F, Schmidt M, Raineri C, Lala A, Varrenti M, Foà A, Leone O, Gentile P, Artico J, Agostini V, Patel R, Garascia A, Van Craenenbroeck EM, Hirose K, Isotani A, Murohara T, Arita Y, Sionis A, Fabris E, Hashem S, Garcia-Hernando V, Oliva F, Greenberg B, Shimokawa H, Sinagra G, Adler ED, Frigerio M, Camici PG. Viral genome search in myocardium of patients with fulminant myocarditis. Eur J Heart Fail 2020; 22:1277-1280. [PMID: 31926056 DOI: 10.1002/ejhf.1738] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/08/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- Giacomo Veronese
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.,Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | | | - Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Marco Merlo
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | | | | | - Paola Sormani
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - Tatsuo Aoki
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | - Sean Pinney
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimberly Hong
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church, VI, USA
| | - Oscar Ö Braun
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
| | | | - Santiago Montero
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris, France
| | | | - Florent Huang
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris, France
| | | | - Anuradha Lala
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marisa Varrenti
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.,Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Alberto Foà
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Ornella Leone
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Piero Gentile
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | - Jessica Artico
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | | | - Rajiv Patel
- Inova Heart and Vascular Institute, Falls Church, VI, USA
| | | | | | | | | | | | - Yoh Arita
- Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Alessandro Sionis
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrico Fabris
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | - Sherin Hashem
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Victor Garcia-Hernando
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - Barry Greenberg
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | - Gianfranco Sinagra
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Maria Frigerio
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - Paolo G Camici
- Vita Salute University and San Raffaele Hospital, Milan, Italy
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31
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Ohtsuki T, Satoh K, Shimizu T, Ikeda S, Kikuchi N, Satoh T, Kurosawa R, Nogi M, Sunamura S, Yaoita N, Omura J, Aoki T, Tatebe S, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Identification of Adipsin as a Novel Prognostic Biomarker in Patients With Coronary Artery Disease. J Am Heart Assoc 2019; 8:e013716. [PMID: 31752640 PMCID: PMC6912964 DOI: 10.1161/jaha.119.013716] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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] [Indexed: 12/14/2022]
Abstract
Background Circulating proteins are exposed to vascular endothelial layer and influence their functions. Among them, adipsin is a member of the trypsin family of peptidases and is mainly secreted from adipocytes, monocytes, and macrophages, catalyzing the rate‐limiting step of the alternative complement pathway. However, its pathophysiological role in cardiovascular disease remains to be elucidated. Here, we examined whether serum adipsin levels have a prognostic impact in patients with coronary artery disease. Methods and Results In 370 consecutive patients undergoing diagnostic coronary angiography, we performed a cytokine array analysis for screening serum levels of 50 cytokines/chemokines and growth factors. Among them, classification and regression analysis identified adipsin as the best biomarker for prediction of their long‐term prognosis (median 71 months; interquartile range, 55–81 months). Kaplan–Meier curve showed that higher adipsin levels (≥400 ng/mL) were significantly associated with all‐cause death (hazard ratio [HR], 4.2; 95% CI, 1.7–10.6 [P<0.001]) and rehospitalization (HR, 2.4; 95% CI, 1.7–3.5 [P<0.001]). Interestingly, higher high‐sensitivity C‐reactive protein levels (≥1 mg/L) were significantly correlated with all‐cause death (HR, 3.2; 95% CI, 1.7–5.9 [P<0.001]) and rehospitalization (HR, 1.5, 95% CI, 1.1–1.9 [P<0.01]). Importantly, the combination of adipsin (≥400 ng/mL) and high‐sensitivity C‐reactive protein (≥1 mg/L) was more significantly associated with all‐cause death (HR, 21.0; 95% CI, 2.9–154.1 [P<0.001]). Finally, the receiver operating characteristic curve demonstrated that serum adipsin levels predict the death caused by acute myocardial infarction in patients with coronary artery disease (C‐statistic, 0.847). Conclusions These results indicate that adipsin is a novel biomarker that predicts all‐cause death and rehospitalization in patients with coronary artery disease, demonstrating the novel aspects of the alternative complementary system in the pathogenesis of coronary artery disease.
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Affiliation(s)
- Tomohiro Ohtsuki
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Kimio Satoh
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Toru Shimizu
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Shohei Ikeda
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Nobuhiro Kikuchi
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Taijyu Satoh
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Ryo Kurosawa
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Masamichi Nogi
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Shinichiro Sunamura
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Nobuhiro Yaoita
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Junichi Omura
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Shunsuke Tatebe
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
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32
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Konno R, Tatebe S, Sugimura K, Satoh K, Aoki T, Miura M, Suzuki H, Yamamoto S, Sato H, Terui Y, Miyata S, Adachi O, Kimura M, Saiki Y, Shimokawa H. Prognostic value of the model for end-stage liver disease excluding INR score (MELD-XI) in patients with adult congenital heart disease. PLoS One 2019; 14:e0225403. [PMID: 31743362 PMCID: PMC6863541 DOI: 10.1371/journal.pone.0225403] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022] Open
Abstract
Patients with adult congenital heart disease (ACHD) are at increased risk of developing late cardiovascular complication. However, little is known about the predictive factors for long-term outcome. The Model for End-Stage Liver Disease eXcluding INR (MELD-XI) score was originally developed to assess cirrhotic patients and has the prognostic value for heart failure (HF) patients. In the present study, we examined whether the score also has the prognostic value in this population. We retrospectively examined 637 ACHD patients (mean age 31.0 years) who visited our Tohoku University hospital from 1995 to 2015. MELD-XI score was calculated as follows; 11.76 x ln(serum creatinine) + 5.11 x ln(serum total bilirubin) + 9.44. We compared the long-term outcomes between the high (≥10.4) and the low (<10.4) score groups. The cutoff value of MELD-XI score was determined based on the survival classification and regression tree (CART) analysis. The major adverse cardiac event (MACE) was defined as a composite of cardiac death, HF hospitalization, and lethal ventricular arrhythmias. During a mean follow-up period of 8.6 years (interquartile range 4.4–11.4 years), MACE was noted in 51 patients, including HF hospitalization in 37, cardiac death in 8, and lethal ventricular arrhythmias in 6. In Kaplan-Meier analysis, the high score group had significantly worse MACE-free survival compared with the low score group (log-rank, P<0.001). Multivariable Cox regression analysis showed that the MELD-XI score remained a significant predictor of MACE (hazard ratio 1.36, confidence interval 1.17–1.58, P<0.001) even after adjusting for patient characteristics, such as sex, functional status, estimated glomerular filtration rate, and cardiac function. Furthermore, CART analysis revealed that the MELD-XI score was the most important variable for predicting MACE. These results demonstrate that the MELD-XI score can effectively predict MACE in ACHD patients, indicating that ACHD patients with high MELD-XI score need to be closely followed.
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Affiliation(s)
- Ryo Konno
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideaki Suzuki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruka Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yosuke Terui
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Osamu Adachi
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masato Kimura
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
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33
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Sakota M, Tatebe S, Sugimura K, Aoki T, Yamamoto S, Sato H, Kikuchi N, Konno R, Terui Y, Satoh K, Tezuka Y, Morimoto R, Saito M, Kuniyoshi S, Shimokawa H. Successful Management of Acute Congestive Heart Failure by Emergent Caesarean Section Followed by Adrenalectomy in a Pregnant Woman with Cushing's Syndrome-induced Cardiomyopathy. Intern Med 2019; 58:2819-2824. [PMID: 31243234 PMCID: PMC6815909 DOI: 10.2169/internalmedicine.2427-18] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Congestive heart failure (CHF) is rare during pregnancy. We herein report a 35-year-old woman who developed CHF with severe left ventricular dysfunction at 35 weeks' gestation. She underwent emergency Caesarean section followed by intensive-care treatment for CHF. The diagnosis of Cushing's syndrome (CS) caused by adrenal adenoma was confirmed by endocrinological examinations and histology after adrenalectomy. She was discharged on heart failure medications and glucocorticoid replacement therapy. Both the symptoms and cardiac function had recovered after 12 months of follow-up. This case highlights the importance of considering CS-induced cardiomyopathy as a cause of CHF in pregnant women.
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Affiliation(s)
- Miku Sakota
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Haruka Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Nobuhiro Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Ryo Konno
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Yosuke Terui
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Yuta Tezuka
- Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Ryo Morimoto
- Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Japan
| | - Shimpei Kuniyoshi
- Department of Pathology, Tohoku University Graduate School of Medicine, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
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34
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Fujihashi T, Sataka Y, Nochioka K, Miura M, Kasahara S, Sato M, Aoyanagi H, Yamanaka S, Hayashi H, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. P6337Prognostic impacts of serum uric acid levels in patients with chronic heart failure: insights from the CHART-2 Study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prognostic impact of serum uric acid (UA) levels in patients with heart failure (HF) remains to be fully elucidated, as previous studies were inconclusive with small study sample sizes. Furthermore, although the J-curve relationship between serum UA levels and cardiovascular events has been suggested in patients with hypertension and those with diabetes, it is still unclear whether this is also the case for patients with HF.
Purpose
We examined the prognostic impacts of serum UA levels in HF patients, using the database of our Chronic Heart Failure Registry and Analysis in the Tohoku district (CHART)-2 Study, the largest multicenter, prospective, observational cohort study for cardiovascular patients with HF or those at risk of HF in Japan (N=10,219).
Methods
First, we determined the cut-off value of serum UA levels at baseline by the Classification and Regression Tree (CART). Then, we divided 4,652 consecutive HF patients in the CHART-2 Study into 4 groups; G1 (<3.8 mg/dL, N=313), G2 (3.8–7.1 mg/dL, N=3,070), G3 (7.2–9.2 mg/dL, N=1,018), and G4 (≥9.3 mg/dL, N=251). Among the 4 groups, we compared clinical characteristics and incidence of all-cause death, HF hospitalization, and a composite of all-cause death and HF hospitalization.
Results
Mean age in G1, G2, G3, and G4 was 71±12, 69±12, 68±13, and 69±15 years, respectively (P<0.001). G1 was characterized by a significantly high prevalence of women as compared with G2, G3 and G4 (59, 32, 24 and 23%, respectively). Serum creatinine levels (0.8±0.4, 0.9±0.4, 1.2±0.6 and 1.4±0.8 mg/dL, respectively), prevalence of atrial fibrillation (34, 39, 45 and 50%, respectively), and diuretics use (36, 45, 67, 89%, respectively) increased from G1, G2, G3 to G4 (all P<0.001), while left ventricular ejection fraction decreased from G1, G2, G3 to G4 (59±15, 58±15, 54±15, and 52±17%, respectively, P<0.001). Median BNP levels were comparably low in G1 and G2 and then increased to G3 and G4 (94.4, 91.5, 130 and 192.5 pg/mL, respectively, P<0.001). As a HF etiology, prevalence of ischemic heart disease was highest in G2 and lowest in G4 (48, 52, 48, 38%, respectively, P<0.001), while that of dilated cardiomyopathy increased from G1, G2, G3 to G4 (11, 12, 16 and 20%, respectively, P<0.001). During the median follow-up period of 6.3 years, in G1, G2, G3 and G4, 111 (35%), 905 (29%), 370 (36%) and 139 (55%) patients died and 79 (25%), 729 (24%), 300 (29%) and 115 (46%) experienced HF hospitalization, respectively (both P<0.001). Cox proportional hazard models adjusted for clinical backgrounds showed that, as compared with G2, both G1 and G4 had increased risk for all-cause death, HF hospitalization and a composite of all-cause death, and HF hospitalization, indicating the J-curve relationship between serum UA levels and prognosis (Figure).
Prognostic impacts of serum UA levels
Conclusions
Both decreased and increased UA levels were associated with increased incidence of death and HF hospitalization in HF patients.
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Affiliation(s)
- T Fujihashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Sataka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - M Miura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Kasahara
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - M Sato
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Aoyanagi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Yamanaka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Hayashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Shiroto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sugimura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Miyata
- Tohoku University Graduate School of Medicine, Department of Evidence-based Cardiovascular Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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Terui Y, Sugimura K, Ota H, Hiroshi T, Sato H, Nochioka K, Tatebe S, Miyata S, Sakata Y, Ishida T, Takase K, Shimokawa H. P3117Usefulness of cardiac magnetic resonance imaging for early detection of subclinical chemotherapy-related cardiac dysfunction in cancer patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Long-term prognosis of cancer patients has been improved along with the progress in chemotherapies. However, chemotherapy-related cardiac dysfunction (CTRCD) is emerging as a serious adverse effect as it worsens patients' outcome and quality of life. Thus, early detection of subclinical CTRCD is an important emerging issue in the management of cancer patients. Cardiac magnetic resonance (CMR) utilizes parametric mapping approach and strain analysis to provide detailed information about cardiac tissue and diastolic cardiac function.
Purpose
We examined whether the novel CMR imaging techniques are useful for early detection of CTRCD.
Methods and results
We performed both retrospective and prospective studies. (1) Retrospective study: We retrospectively enrolled 52 cancer patients (mean age 55.6±13 yrs., M/F=14/38) who had been treated with anthracyclines. We examined the usefulness of CMR for quantitative assessment of myocardial fibrosis caused by chemotherapies. We found that native T1 value was significantly prolonged in cancer patients compared with healthy controls (N=10) (1,279±56 vs. 1,240±34 msec, P=0.036). (2) Prospective study: A total of 99 consecutive female patients with breast cancer treated with chemotherapies were enrolled in this study from August 2017 to January 2019. To evaluate CTRCD in those patients, we performed CMR (at baseline and/or 6 months) and biomarkers analysis for cardiac troponin T (cTnT) and BNP at baseline and every 3 months during chemotherapies. In the 99 patients, 52 (mean age 53.0±12.7 yrs.) completed cardiac assessment at 6 months, and 6 (12%) developed CTRCD defined as a reduction in left ventricular ejection fraction (LVEF) >10% from baseline and below 53% without symptoms. In patients with CTRCD (CTRCD group, N=6), as compared with those without it (non-CTRCD group, N=46), native T1 value was significantly prolonged after chemotherapies (1,303±32 vs. 1,322±22 msec at 6 months, P=0.03). Plasma cTnT levels at 3 months were also significantly higher in the CTRCD group compared with the non-CTRCD group [0.022 (IQR 0.015–0.026) vs. 0.01 (0.006–0.014) ng/mL, P=0.024], whereas there was no difference in BNP values. In the 52 patients, 28 (mean age 56.3±12.3 yrs.) underwent CMR both before and 6 months after chemotherapies. In those patients, LVEF and global radial strain were significantly decreased at 6 months from baseline (LVEF, from 70.5±4.6 to 66.0±7.1%; global radial strain, from 70.0±22.5 to 61.1±22.6%, respectively, both P<0.05). In patients with elevated cTnT levels at 3 months, as compared with those without it, LVEF and extracellular volume fraction (ECV) at 6 months were significantly worse (LVEF, 59.0±6.0 vs. 62.7±2.6%, P=0.042; ECV, 32.3±2.9 vs. 30.2±2.3%, P=0.049, respectively).
Conclusions
These results indicate that novel CMR imaging techniques are useful for early detection of CTRCD among cancer patients treated with chemotherapies.
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Affiliation(s)
- Y Terui
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sugimura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Ota
- Tohoku University Graduate School of Medicine, Department of Diagnostic Radiology, Sendai, Japan
| | - T Hiroshi
- Tohoku University Graduate School of Medicine, Department of Surgical Oncology, Sendai, Japan
| | - H Sato
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Tatebe
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Miyata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Ishida
- Tohoku University Graduate School of Medicine, Department of Surgical Oncology, Sendai, Japan
| | - K Takase
- Tohoku University Graduate School of Medicine, Department of Diagnostic Radiology, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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Akizuki M, Sugimura K, Aoki T, Kakihana T, Tatebe S, Yamamoto S, Sato H, Satoh K, Shimokawa H, Kohzuki M. Non‐invasive screening using ventilatory gas analysis to distinguish between chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension. Respirology 2019; 25:427-434. [DOI: 10.1111/resp.13618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/25/2019] [Accepted: 05/22/2019] [Indexed: 01/28/2023]
Affiliation(s)
- Mina Akizuki
- Department of Internal Medicine and Rehabilitation ScienceTohoku University Graduate School of Medicine Sendai Japan
| | - Koichiro Sugimura
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Tatsuo Aoki
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Takaaki Kakihana
- Department of Internal Medicine and Rehabilitation ScienceTohoku University Graduate School of Medicine Sendai Japan
| | - Shunsuke Tatebe
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Saori Yamamoto
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Haruka Sato
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Kimio Satoh
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular MedicineTohoku University Graduate School of Medicine Sendai Japan
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation ScienceTohoku University Graduate School of Medicine Sendai Japan
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Li M, Hirano KI, Ikeda Y, Higashi M, Hashimoto C, Zhang B, Kozawa J, Sugimura K, Miyauchi H, Suzuki A, Hara Y, Takagi A, Ikeda Y, Kobayashi K, Futsukaichi Y, Zaima N, Yamaguchi S, Shrestha R, Nakamura H, Kawaguchi K, Sai E, Hui SP, Nakano Y, Sawamura A, Inaba T, Sakata Y, Yasui Y, Nagasawa Y, Kinugawa S, Shimada K, Yamada S, Hao H, Nakatani D, Ide T, Amano T, Naito H, Nagasaka H, Kobayashi K. Triglyceride deposit cardiomyovasculopathy: a rare cardiovascular disorder. Orphanet J Rare Dis 2019; 14:134. [PMID: 31186072 PMCID: PMC6560904 DOI: 10.1186/s13023-019-1087-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/01/2019] [Indexed: 12/25/2022] Open
Abstract
Triglyceride deposit cardiomyovasculopathy (TGCV) is a phenotype primarily reported in patients carrying genetic mutations in PNPLA2 encoding adipose triglyceride lipase (ATGL) which releases long chain fatty acid (LCFA) as a major energy source by the intracellular TG hydrolysis. These patients suffered from intractable heart failure requiring cardiac transplantation. Moreover, we identified TGCV patients without PNPLA2 mutations based on pathological and clinical studies. We provided the diagnostic criteria, in which TGCV with and without PNPLA2 mutations were designated as primary TGCV (P-TGCV) and idiopathic TGCV (I-TGCV), respectively. We hereby report clinical profiles of TGCV patients. Between 2014 and 2018, 7 P-TGCV and 18 I-TGCV Japanese patients have been registered in the International Registry. Patients with I-TGCV, of which etiologies and causes are not known yet, suffered from adult-onset severe heart disease, including heart failure and coronary artery disease, associated with a marked reduction in ATGL activity and myocardial washout rate of LCFA tracer, as similar to those with P-TGCV. The present first registry-based study showed that TGCV is an intractable, at least at the moment, and heterogeneous cardiovascular disorder.
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Affiliation(s)
- Ming Li
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Ken-Ichi Hirano
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan.
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Chikako Hashimoto
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Bo Zhang
- Department of Biochemistry, Fukuoka University Medical School, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Junji Kozawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hideyuki Miyauchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1, Inohara, Chuo-ku, Chiba, 260-8670, Japan
| | - Akira Suzuki
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Yasuhiro Hara
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Atsuko Takagi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Yasuyuki Ikeda
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Kazuhiro Kobayashi
- Division of Molecular Brain Science, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshiaki Futsukaichi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Nobuhiro Zaima
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Kindai University, 3327-204, Nakamachi, Nara, 631-8505, Japan
| | - Satoshi Yamaguchi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Rojeet Shrestha
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Sapporo, 060-0812, Japan
| | - Hiroshi Nakamura
- Kure Medical Center and Chugoku Cancer Center, National Hospital Organization, 3-1, Aoyama-cho, Kure, Hiroshima, 737-0023, Japan
| | - Katsuhiro Kawaguchi
- Department of Cardiovascular Medicine, Komaki City Hospital, 1-20, Jobushi, Komaki, Aichi, 485-8520, Japan
| | - Eiryu Sai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shu-Ping Hui
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Sapporo, 060-0812, Japan
| | - Yusuke Nakano
- Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Akinori Sawamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Tohru Inaba
- Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yoko Yasui
- Faculty of Human Life Science, Osaka City University, 3-3-138, Sugimoto, Sumiyoshi-ku, Osaka, 558-8585, Japan
| | - Yasuyuki Nagasawa
- Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan
| | - Hiroyuki Hao
- Department of Pathology, Nihon University School of Medicine, 30-1 Ohyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Daisaku Nakatani
- Center for Global Health, Department of Medical Innovation, Osaka University Hospital.4F Center of Medical Innovation and Translational Research, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 (A8) Yamadaoka Suita, Osaka, 565-0871, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroaki Naito
- Department of Radiology, Nippon Life Hospital, 2-1-54, Enokojima, Nishi-ku, Osaka, 550-0006, Japan
| | - Hironori Nagasaka
- Department of Pediatrics, Takarazuka City Hospital, 4-5-1, Obama, Takarazuka, Hyogo, 665-0827, Japan
| | - Kunihisa Kobayashi
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, 1-1-1, Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan
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Oikawa T, Sakata Y, Nochioka K, Miura M, Abe R, Kasahara S, Sato M, Aoyanagi H, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Increased risk of cancer death in patients with chronic heart failure with a special reference to inflammation-A report from the CHART-2 Study. Int J Cardiol 2019; 290:106-112. [PMID: 31104823 DOI: 10.1016/j.ijcard.2019.04.078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/24/2019] [Accepted: 04/25/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although several factors, including heart failure (HF) and inflammation, are known to increase the incidence of cancer, it remains unknown whether HF may increase cancer mortality, especially with a reference to inflammation. METHODS AND RESULTS We examined 8843 consecutive cardiovascular patients without a prior history of cancer in our CHART-2 Study (mean 68 yrs., female 30.9%). As compared with patients without HF (Stage A/B, N = 4622), those with HF (Stage C/D, N = 4221) were characterized by higher prevalence of diabetes, previous myocardial infarction, atrial fibrillation, and stroke. During the median 6.5-year follow-up (52,675 person-years), 282 cancer deaths occurred. HF patients had significantly higher cancer mortality than those without HF in both the overall (3.7 vs, 2.8%, hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.12-1.79, P = 0.004) and the propensity score-matched cohorts (HR 1.46, 95%CI 1.10-1.93, P = 0.008), which was confirmed in the competing risk models. The multivariable Cox proportional hazard model in the matched cohort showed that HF was associated with increased cancer mortality in patients with C-reactive protein (CRP) ≥ 2.0 mg/L (HR 1.87, 95%CI 1.18-2.96, P = 0.008) at baseline, but not in those with CRP < 2.0 mg/L (HR 0.89, 95%CI 0.54-1.45, P = 0.64) (P for interaction = 0.03). Furthermore, temporal changes in CRP levels were associated with cancer death in the overall cohort; HF patients with CRP ≥ 2.0 mg/L at both baseline and 1-year had significantly increased cancer death, while those with CRP ≥ 2.0 mg/L at baseline and < 2.0 mg/L at 1-year not. CONCLUSIONS These results provide the first evidence that HF is associated with increased cancer death, especially when associated with prolonged inflammation.
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Affiliation(s)
- Takuya Oikawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ruri Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Big Data Medicine Center, Tohoku University Graduate School of Medicine, Sendai, Japan
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Kasahara S, Sakata Y, Nochioka K, Miura M, Abe R, Sato M, Aoyanagi H, Fujihashi T, Yamanaka S, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Conversion formula from B-type natriuretic peptide to N-terminal proBNP values in patients with cardiovascular diseases. Int J Cardiol 2019; 280:184-189. [DOI: 10.1016/j.ijcard.2018.12.069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/07/2018] [Accepted: 12/24/2018] [Indexed: 01/03/2023]
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Suzuki H, Matsumoto Y, Ota H, Sugimura K, Takahashi J, Ito K, Miyata S, Arai H, Taki Y, Furukawa K, Fukumoto Y, Shimokawa H. Reduced brain-derived neurotrophic factor is associated with cognitive dysfunction in patients with chronic heart failure. Geriatr Gerontol Int 2019; 17:852-854. [PMID: 28508502 DOI: 10.1111/ggi.12959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/27/2016] [Accepted: 10/03/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Hideaki Suzuki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenta Ito
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroyuki Arai
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Katsutoshi Furukawa
- Division of Regional Medical Studies, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Kurume University Graduate School of Medicine, Kurume, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Fukuda K, Date H, Doi S, Fukumoto Y, Fukushima N, Hatano M, Ito H, Kuwana M, Matsubara H, Momomura SI, Nishimura M, Ogino H, Satoh T, Shimokawa H, Yamauchi-Takihara K, Tatsumi K, Ishibashi-Ueda H, Yamada N, Yoshida S, Abe K, Ogawa A, Ogo T, Kasai T, Kataoka M, Kawakami T, Kogaki S, Nakamura M, Nakayama T, Nishizaki M, Sugimura K, Tanabe N, Tsujino I, Yao A, Akasaka T, Ando M, Kimura T, Kuriyama T, Nakanishi N, Nakanishi T, Tsutsui H. Guidelines for the Treatment of Pulmonary Hypertension (JCS 2017/JPCPHS 2017). Circ J 2019; 83:842-945. [PMID: 30853682 DOI: 10.1253/circj.cj-66-0158] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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: 12/27/2022]
Affiliation(s)
- Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University
| | - Shozaburo Doi
- Department of Pediatrics, Perinatal and Maternal Medicine, Graduate School, Tokyo Medical and Dental University
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masaru Hatano
- Department of Cardiovascular Medicine/Therapeutic Strategy for Heart Failure, The University of Tokyo Hospital
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Field of Functional Physiology, Okayama University Graduate School of Medicine
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School
| | - Hiromi Matsubara
- Department of Clinical Science, National Hospital Organization Okayama Medical Center
| | - Shin-Ichi Momomura
- Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Toru Satoh
- Internal Medicine II, Kyorin University School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Keiko Yamauchi-Takihara
- Health and Counseling Center and Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University
| | | | | | - Shunji Yoshida
- Department of Rheumatology and Infectious Diseases, Fujita Health University Hospital
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Kyushu University Hospital
| | - Aiko Ogawa
- Department of Clinical Science, National Hospital Organization Okayama Medical Center
| | - Takeshi Ogo
- Division of Pulmonary Circulation, Department of Cardiovascular Medicine/Department of Advanced Medicine for Pulmonary Hypertension, National Cerebral and Cardiovascular Center
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine
| | | | | | - Shigetoyo Kogaki
- Department of Pediatrics and Neonatology, Osaka General Medical Center
| | | | - Tomotaka Nakayama
- Department of Pediatrics, Toho University Medical Center Omori Hospital
| | - Mari Nishizaki
- Department of Rehabilitation, National Hospital Organization, Okayama Medical Center
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Nobuhiro Tanabe
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
| | - Ichizo Tsujino
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Atsushi Yao
- Division for Health Service Promotion, The University of Tokyo
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Motomi Ando
- Daiyukai General Hospital Cardiovascular Center
| | - Takeshi Kimura
- Department Cardiovascular Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | | | | | - Toshio Nakanishi
- Department of Pediatric Cardiology, Tokyo Women's Medical University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
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Sato H, Sugimura K, Miura M, Konno R, Kozu K, Yaoita N, Shimizu T, Yamamoto S, Aoki T, Tatebe S, Satoh K, Shimokawa H. Beneficial Effects of Imatinib in a Patient with Suspected Pulmonary Veno-Occlusive Disease. TOHOKU J EXP MED 2019; 247:69-73. [PMID: 30700638 DOI: 10.1620/tjem.247.69] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/18/2022]
Abstract
Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension (PH). The prognosis of PVOD patients remains poor, since no effective medical therapy is yet available. Imatinib is a tyrosine kinase inhibitor specific for platelet-derived growth factor receptor and is expected as a treatment option for pulmonary arterial hypertension (PAH). Recently, it has been reported that imatinib improved functional capacity of a patient with PVOD. We here report a patient with suspected PVOD who has been successfully treated with imatinib and is alive for 6 years after diagnosis. A 57-year-old woman was admitted to a hospital for severe dyspnea. Echocardiography suggested the presence of PH, because tricuspid regurgitation pressure gradient was elevated. The patient was then transferred to our hospital by an ambulance ahead of schedule due to fever and worsening dyspnea. Because the patient had no left heart disease, we diagnosed that she had PAH associated with severe right heart failure. We immediately started treatment with nitric oxide (NO) for her severe hypoxia; however, it caused pulmonary edema. We suspected PVOD from CT characteristics and pulmonary edema after PAH-targeted vasodilator therapy, and then started oral imatinib treatment. In response to imatinib, her pulmonary edema gradually improved. Since then, the patient has been alive for 6 years with imatinib and pulmonary vasodilators. At present, lung transplantation is the only effective therapy for PVOD with limited availability. We therefore propose that imatinib may be a treatment option for PVOD and a bridge to lung transplantation.
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Affiliation(s)
- Haruka Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Ryo Konno
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Katsuya Kozu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Nobuhiro Yaoita
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Toru Shimizu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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43
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Yamamoto S, Nagasawa T, Sugimura K, Kanno A, Tatebe S, Aoki T, Sato H, Kozu K, Konno R, Nochioka K, Satoh K, Shimokawa H. Clinical Diversity in Patients with Anderson-fabry Disease with the R301Q Mutation. Intern Med 2019; 58:603-607. [PMID: 30333391 PMCID: PMC6421142 DOI: 10.2169/internalmedicine.0959-18] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Anderson-Fabry disease (AFD) is a rare X-linked disorder caused by deficient activity of the lysosomal enzyme α-galactosidase A (α-GAL A). We herein report 10 cases of AFD in 5 families (3 men and 7 women) that were found to have a specific common mutation in R301Q [G-to-A transition in exon 6 (codon 301) resulting in the replacement of a glutamine with an arginine residue]. We evaluated their clinical characteristics, residual enzymatic activity, and plasma concentrations of globotriaosylsphingosine (Lyso-Gb3). Although all 10 cases had cardiac and renal manifestations in common, their clinical manifestations were markedly divergent despite the same genetic abnormality.
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Affiliation(s)
- Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Tasuku Nagasawa
- Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Atsuhiro Kanno
- Department of Nephrology, Japan Community Health Care Organization, Japan
| | - Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Haruka Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Katsuya Kozu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Ryo Konno
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
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Maruyama H, Miyata K, Mikame M, Taguchi A, Guili C, Shimura M, Murayama K, Inoue T, Yamamoto S, Sugimura K, Tamita K, Kawasaki T, Kajihara J, Onishi A, Sugiyama H, Sakai T, Murata I, Oda T, Toyoda S, Hanawa K, Fujimura T, Ura S, Matsumura M, Takano H, Yamashita S, Matsukura G, Tazawa R, Shiga T, Ebato M, Satoh H, Ishii S. Effectiveness of plasma lyso-Gb3 as a biomarker for selecting high-risk patients with Fabry disease from multispecialty clinics for genetic analysis. Genet Med 2019; 21:44-52. [PMID: 29543226 PMCID: PMC6363642 DOI: 10.1038/gim.2018.31] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/25/2018] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Plasma globotriaosylsphingosine (lyso-Gb3) is a promising secondary screening biomarker for Fabry disease. Here, we examined its applicability as a primary screening biomarker for classic and late-onset Fabry disease in males and females. METHODS Between 1 July 2014 and 31 December 2015, we screened 2,359 patients (1,324 males) referred from 168 Japanese specialty clinics (cardiology, nephrology, neurology, and pediatrics), based on clinical symptoms suggestive of Fabry disease. We used the plasma lyso-Gb3 concentration, α-galactosidase A (α-Gal A) activity, and analysis of the α-Gal A gene (GLA) for primary and secondary screens, respectively. RESULTS Of 8 males with elevated lyso-Gb3 levels (≥2.0 ng ml-1) and low α-Gal A activity (≤4.0 nmol h-1 ml-1), 7 presented a GLA mutation (2 classic and 5 late-onset). Of 14 females with elevated lyso-Gb3, 7 displayed low α-Gal A activity (5 with GLA mutations; 4 classic and 1 late-onset) and 7 exhibited normal α-Gal A activity (1 with a classic GLA mutation and 3 with genetic variants of uncertain significance). CONCLUSION Plasma lyso-Gb3 is a potential primary screening biomarker for classic and late-onset Fabry disease probands.
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Affiliation(s)
- Hiroki Maruyama
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Kaori Miyata
- Sanofi K.K., Sanofi Genzyme Medical Operations, Rare Disease Medical, Medical Science Liaison, Tokyo, Japan
| | - Mariko Mikame
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Atsumi Taguchi
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Chu Guili
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masaru Shimura
- Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Kei Murayama
- Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Takeshi Inoue
- Department of Pediatrics, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
| | - Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Tamita
- Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan
| | | | - Jun Kajihara
- Department of Cardiology, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Akifumi Onishi
- Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hitoshi Sugiyama
- Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | | | - Ichijiro Murata
- Department of Chronic Kidney Disease, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takamasa Oda
- Yamaguchi Prefectural Grand Medical Center, Hofu, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Kenichiro Hanawa
- Department of Cardiology, Internal Medicine, Iwaki Kyoritsu General Hospital, Iwaki, Japan
| | - Takeo Fujimura
- Department of Nephrology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Shigehisa Ura
- Division of Neurology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Mimiko Matsumura
- Department of Nephrology, Tokyo Teishin Hospital, Kashiwazaki, Japan
| | - Hideki Takano
- Department of Nephrology, Tokyo Teishin Hospital, Kashiwazaki, Japan
| | - Satoshi Yamashita
- Department of Cardiology, Japanese Red Cross Hamamatsu Hospital, Hamamatsu, Japan
| | - Gaku Matsukura
- Department of Cardiology, Japanese Red Cross Hamamatsu Hospital, Hamamatsu, Japan
| | - Ryushi Tazawa
- Division of Medical Genetics, Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Mio Ebato
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hiroshi Satoh
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan
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45
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Abe R, Sakata Y, Nochioka K, Miura M, Oikawa T, Kasahara S, Sato M, Aoyanagi H, Shiroto T, Sugimura K, Takahashi J, Miyata S, Shimokawa H. Gender differences in prognostic relevance of self-care behaviors on mortality and hospitalization in patients with heart failure - A report from the CHART-2 Study. J Cardiol 2018; 73:370-378. [PMID: 30606681 DOI: 10.1016/j.jjcc.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 11/06/2018] [Accepted: 11/26/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Self-care behaviors (ScB) are associated with symptoms and outcomes in patients with heart failure (HF). However, little is known about gender differences in the prognostic relevance of ScB in HF patients. METHODS We examined gender differences in ScB of HF patients regarding its prognostic associations with mortality and HF hospitalization with a reference to ScB dimensions. The European Heart Failure Self-Care Behavior Scale (EHFScBS) was used to evaluate ScB in 2233 patients with Stage C/D HF in the CHART-2 Study. RESULTS Male patients (n=1583) were younger (71 vs. 73 yrs) and had lower ScB (median 33 vs. 31) (all p<0.001) than females (n=650). During the median follow-up of 2.57 years, patients with high ScB (score 12-32, n=1090), as compared with low ScB patients (score 33-60, n=1143), had significantly increased all-cause mortality in males [adjusted hazard ratio (aHR) 1.44, p=0.02] but not in females (aHR 0.80, p=0.40) (p for interaction 0.02), while ScB was not significantly associated with incidence of HF hospitalization in both genders. Among the 3 dimensions in EHFScBS, complying with regimen was associated with decreased mortality in females, but not in males (p for interaction 0.003), while asking for help was related with increased incidence of HF hospitalization in males (aHR 1.34, p=0.072) but not in females (aHR 0.98, p=0.931) (p for interaction 0.048). CONCLUSIONS There were gender differences in the prognostic relevance of self-care with mortality and incidence of HF hospitalization, suggesting that self-care should be implemented considering gender differences to improve prognosis.
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Affiliation(s)
- Ruri Abe
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuya Oikawa
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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46
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Kasahara S, Sakata Y, Nochioka K, Tay WT, Claggett BL, Abe R, Oikawa T, Sato M, Aoyanagi H, Miura M, Shiroto T, Takahashi J, Sugimura K, Teng THK, Miyata S, Shimokawa H. The 3A3B score: The simple risk score for heart failure with preserved ejection fraction - A report from the CHART-2 Study. Int J Cardiol 2018; 284:42-49. [PMID: 30413304 DOI: 10.1016/j.ijcard.2018.10.076] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 04/02/2018] [Revised: 08/01/2018] [Accepted: 10/22/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few simple risk models, without echocardiography have been developed for patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF) (HFpEF). METHODS To develop a risk score to predict all-cause death for HFpEF patients, we examined 1277 HF patients with LVEF ≥50% and BNP ≥100 pg/ml in the CHART-2 Study, a large-scale prospective cohort study for HF in Japan. We selected the optimal subset of covariates for the score with Cox proportional hazard models and random survival forests (RSF). RESULTS During the median 5.7-year follow-up, 576 deaths occurred. Cox models and RSF analyses consistently indicated age ≥75 years, albumin <3.7 g/dl, anemia, BMI <22 kg/m2, BNP ≥300 pg/ml (or NT-proBNP ≥1400 pg/ml), and BUN ≥25 mg/dl, as the important 6 prognostic variables. Incorporating these 6 variables, we developed a scoring system (3A3B score, with 2 points given to age ≥75 years and 1 point to the others based on the hazard ratios. The discrimination ability of the risk score was excellent (c-index 0.708). Regarding model goodness-of-fit, the overall gradient in 5-year risk was well captured by the score. The predictive accuracy of the 3A3B score was confirmed in the external validation cohorts from the TOPCAT trial (N = 835, c-index 0.652) and the ASIAN-HF registry (N = 170, c-index 0.741). CONCLUSIONS We developed a simple risk score to predict long-term prognosis of HFpEF patients. The 3A3B score, comprising 6 commonly available parameters in daily practice, has potential utility in the risk stratification and management of HFpEF patients.
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Affiliation(s)
- Shintaro Kasahara
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; The Big Data Medicine Center, Tohoku University, Sendai, Japan.
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | - Ruri Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuya Oikawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Aoyanagi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masanobu Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Satoshi Miyata
- Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; The Big Data Medicine Center, Tohoku University, Sendai, Japan; Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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47
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Maruyama H, Miyata K, Mikame M, Taguchi A, Guili C, Shimura M, Murayama K, Inoue T, Yamamoto S, Sugimura K, Tamita K, Kawasaki T, Kajihara J, Onishi A, Sugiyama H, Sakai T, Murata I, Oda T, Toyoda S, Hanawa K, Fujimura T, Ura S, Matsumura M, Takano H, Yamashita S, Matsukura G, Tazawa R, Shiga T, Ebato M, Satoh H, Ishii S. Correction: Effectiveness of plasma lyso-Gb3 as a biomarker for selecting high-risk patients with Fabry disease from multispecialty clinics for genetic analysis. Genet Med 2018; 21:512-515. [PMID: 30190610 PMCID: PMC7608386 DOI: 10.1038/s41436-018-0125-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Hiroki Maruyama
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Kaori Miyata
- Sanofi K.K., Sanofi Genzyme Medical Operations, Rare Disease Medical, Medical Science Liaison, Tokyo, Japan
| | - Mariko Mikame
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Atsumi Taguchi
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Chu Guili
- Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masaru Shimura
- Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Kei Murayama
- Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Takeshi Inoue
- Department of Pediatrics, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
| | - Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Tamita
- Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan
| | | | - Jun Kajihara
- Department of Cardiology, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Akifumi Onishi
- Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hitoshi Sugiyama
- Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | | | - Ichijiro Murata
- Department of Chronic Kidney Disease, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takamasa Oda
- Yamaguchi Prefectural Grand Medical Center, Hofu, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Kenichiro Hanawa
- Department of Cardiology, Internal Medicine, Iwaki Kyoritsu General Hospital, Iwaki, Japan
| | - Takeo Fujimura
- Department of Nephrology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Shigehisa Ura
- Division of Neurology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | | | - Hideki Takano
- Department of Nephrology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Satoshi Yamashita
- Department of Cardiology, Japanese Red Cross Hamamatsu Hospital, Hamamatsu, Japan
| | - Gaku Matsukura
- Department of Cardiology, Japanese Red Cross Hamamatsu Hospital, Hamamatsu, Japan
| | - Ryushi Tazawa
- Division of Medical Genetics, Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Mio Ebato
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hiroshi Satoh
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan
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48
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Konno R, Tatebe S, Sugimura K, Satoh K, Aoki T, Yamamoto S, Sato H, Kozu K, Adachi O, Kimura M, Saiki Y, Shimokawa H. P5478Hepatitis C virus positivity adversely affects systemic ventricular function and long-term prognosis in patients with adult congenital heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5478] [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)
- R Konno
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Tatebe
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sugimura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Satoh
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Aoki
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Yamamoto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Sato
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Kozu
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - O Adachi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Surgery, Sendai, Japan
| | - M Kimura
- Tohoku University Graduate School of Medicine, Department of Pediatrics, Sendai, Japan
| | - Y Saiki
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Surgery, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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49
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Satoh K, Miyata S, Miura M, Ohtsuki T, Nochioka K, Sunamura S, Nogi M, Kurosawa R, Kikuchi N, Satoh T, Aoki T, Tatebe S, Sugimura K, Sakata Y, Shimokawa H. 1095Prognostic impacts of soluble form of basigin in patients with chronic heart failure - from a prospective large clinical trial with 1,147 patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Satoh
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Miyata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - M Miura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Ohtsuki
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Sunamura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - M Nogi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - R Kurosawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - N Kikuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Satoh
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Aoki
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Tatebe
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sugimura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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Kasahara S, Sakata Y, Nochioka K, Abe R, Sato M, Aoyanagi H, Miura M, Shiroto T, Takahashi J, Sugimura K, Miyata S, Shimokawa H. Development of Useful Conversion Equation between B-type Natriuretic Peptide and N-terminal pro BNP Levels. J Card Fail 2018. [DOI: 10.1016/j.cardfail.2018.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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