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Sudo K, Uematsu M, Suzuki J, Kuroki K, Sato A. Left bundle branch area pacing for chronic heart failure with transthyretin cardiac amyloidosis. Eur Heart J Cardiovasc Imaging 2024; 25:e107. [PMID: 37931149 DOI: 10.1093/ehjci/jead278] [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] [Received: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Affiliation(s)
- Koji Sudo
- Department of Cardiovascular Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi 409-3898, Japan
| | - Manabu Uematsu
- Department of Cardiovascular Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi 409-3898, Japan
| | - Jumpei Suzuki
- Department of Cardiovascular Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi 409-3898, Japan
| | - Kenji Kuroki
- Department of Cardiovascular Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi 409-3898, Japan
| | - Akira Sato
- Department of Cardiovascular Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi 409-3898, Japan
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Yamada R, Horikoshi T, Nakamura T, Uematsu M, Yamaguchi K, Kobayahi T, Ando R, Yoshizaki T, Watanabe Y, Kuroki K, Nakamura K, Sato A. Pretransfer Aspirin Administration and Its Impact on Angiographic Outcomes for Patients with ST-Elevation Myocardial Infarction. Int Heart J 2024; 65:21-28. [PMID: 38296575 DOI: 10.1536/ihj.23-389] [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: 02/08/2024]
Abstract
Although guidelines recommend early aspirin administration after diagnosis of ST-elevation myocardial infarction (STEMI), the decision of pretransfer aspirin administration is at the discretion of the primary physicians. Therefore, this study aimed to determine whether pretransfer aspirin administration was associated with better angiographical outcomes in patients with STEMI. This study compared the angiographic findings of thrombolysis in myocardial infarction (TIMI) flow grade in the infarct-related artery before percutaneous coronary intervention (PCI) between patients who received pretransfer aspirin and those who did not. In total, 28 patients (11.2%) were administered aspirin before transfer and 219 (88.8%) were administered aspirin upon arrival at the hospital. Propensity score matching yielded 135 patients [27 patients (20%) who were administered aspirin before transfer and 108 patients (80%) who were administered aspirin upon arrival at the hospital]. Patients who received pretransfer aspirin had a higher rate of TIMI-3 flow before PCI compared to those who did not receive pretransfer aspirin [8 (28.6%) versus 15 (6.8%), P < 0.01, in all study patients; 8 (26.6%) versus 7 (6.5%), P < 0.01, in propensity-score-matched patients]. Multivariable logistic regression analysis revealed that pretransfer aspirin administration was significantly associated with the presence of TIMI-3 flow before PCI, independent of age, gender, transfer time, and statin use (OR: 5.43, 95% CI: 1.94-15.2, P < 0.01, in all study patients; OR: 6.17, 95% CI: 1.86-20.46, P < 0.01, in propensity-score-matched patients). Pretransfer aspirin administration could lead to the early restoration of coronary blood flow in patients with STEMI, supporting its active use in STEMI care.
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Affiliation(s)
- Ryota Yamada
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Takeo Horikoshi
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Takamitsu Nakamura
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Manabu Uematsu
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Kazuyuki Yamaguchi
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Tsuyoshi Kobayahi
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Ryota Ando
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Toru Yoshizaki
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Yosuke Watanabe
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Kenji Kuroki
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Kazuto Nakamura
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
| | - Akira Sato
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine
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3
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Yamaguchi K, Nakamura T, Kobayashi T, Yoshizaki T, Nakamura K, Horikoshi T, Uematsu M, Yamada R, Ando R, Watanabe Y, Kuroki K, Sato A. Computed Tomography-Based Novel Aortic Tortuosity Assessment for Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2023; 16:3052-3054. [PMID: 37855808 DOI: 10.1016/j.jcin.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023]
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Horikoshi T, Nakamura T, Yoshizaki T, Nakamura J, Uematsu M, Kobayashi T, Saito Y, Obata JE, Sawanobori T, Takano H, Umetani K, Asakawa T, Sato A. Predictive Value of CHADS 2, CHA 2DS 2-VASc and R 2-CHADS 2 Scores for Short- and Long-Term Major Adverse Cardiac Events in Non-ST-Segment Elevation Myocardial Infarction. Circ J 2023:CJ-23-0733. [PMID: 38104976 DOI: 10.1253/circj.cj-23-0733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Non-ST-elevation myocardial infarction (NSTEMI) carries a poor prognosis, and accurately prognostication has significant clinical importance. In this study, we analyzed the predictive value of the CHADS2, CHA2DS2-VASc, and R2-CHADS2scores for major adverse cardiac events (MACE) following percutaneous coronary intervention (PCI) in patients with NSTEMI using data from a prospective multicenter registry.Methods and Results: The registry included 440 consecutive patients with NSTEMI and coronary artery disease who underwent successful PCI. Patients were clinically followed for up to 3 years or until the occurrence of MACE. MACE was defined as a composite of all-cause death and nonfatal MI. During the follow-up period, 55 patients (12.5%) experienced MACE. Risk analysis of MACE occurrence, adjusted for the multivariable model, demonstrated a significant increase in risk with higher CHADS2, CHA2DS2-VASc, and R2-CHADS2scores. Kaplan-Meier analysis showed a higher incidence of MACE in patients with higher CHADS2, CHA2DS2-VASc, and R2-CHADS2scores, both in the short- and long-term periods. CONCLUSIONS Patients with NSTEMI and higher CHADS2, CHA2DS2-VASc, and R2-CHADS2scores displayed a greater incidence of MACE.
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Affiliation(s)
- Takeo Horikoshi
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | | | - Toru Yoshizaki
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Manabu Uematsu
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | | | - Yukio Saito
- Department of Cardiology, Kofu Municipal Hospital
| | - Jun-Ei Obata
- Department of Cardiology, Fujieda Municipal General Hospital
| | | | | | - Ken Umetani
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital
| | | | - Akira Sato
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
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5
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Uematsu M, Yamada R, Sato A. Isolated septal myocardial infarction with non-obstructive coronary arteries. Eur Heart J 2023; 44:2873. [PMID: 37140005 DOI: 10.1093/eurheartj/ehad252] [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: 05/05/2023] Open
Affiliation(s)
- Manabu Uematsu
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
| | - Ryota Yamada
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
| | - Akira Sato
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
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Horikoshi T, Nakamura T, Yamaguchi K, Yoshizaki T, Watanabe Y, Kuroki K, Uematsu M, Nakamura K, Kobayashi T, Sato A. Prognostic Value of Novel Natriuretic Peptide Index After Percutaneous Coronary Intervention. Circ J 2023; 87:296-305. [PMID: 36261336 DOI: 10.1253/circj.cj-22-0531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The predictive value of both atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) is well known. This study evaluated the prognostic value of a novel natriuretic peptide index (NPI) combining ANP and BNP. Methods and Results: This study included 849 consecutive patients with coronary artery disease who underwent successful percutaneous coronary intervention (PCI). Patients were followed up clinically for up to 3 years or until the occurrence of major adverse cardiac events (MACE). The primary endpoint was a composite of all-cause death and non-fatal myocardial infarction. The NPI (pg/mL) was defined as √ANP×BNP. MACE occurred in 73 patients (8.6%) during the follow-up period. Receiver operating characteristic curve analysis showed the highest area under the curve for NPI (0.779) compared with ANP and BNP (0.773 and 0.755, respectively). A risk analysis of MACE occurrence adjusted for the multivariable model showed the highest hazard ratio (HR) for NPI (1.33; 95% confidence interval [CI] 1.18-1.51; P<0.001) compared with ANP and BNP (HR 1.25 [95% CI 1.13-1.39] and 1.30 [95% CI 1.13-1.49], respectively; P<0.001). The NPI was a significant independent predictor of MACE, among other clinical parameters, in the multivariable analysis. CONCLUSIONS Compared with ANP and BNP, the NPI was more effective in predicting future adverse events after PCI.
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Affiliation(s)
- Takeo Horikoshi
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | | | | | - Toru Yoshizaki
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Yosuke Watanabe
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Kenji Kuroki
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Manabu Uematsu
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Kazuto Nakamura
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | | | - Akira Sato
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
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Nakamura T, Horikoshi T, Kobayahi T, Yoshizaki T, Uematsu M, Watanabe Y, Nakamura J, Makino A, Saito Y, Obata JE, Sawanobori T, Takano H, Umetani K, Watanabe A, Asakawa T, Sato A. Optimal medical therapy after percutaneous coronary intervention in very elderly patients with coronary artery disease. Int J Cardiol Cardiovasc Risk Prev 2022; 16:200162. [PMID: 36506909 PMCID: PMC9731838 DOI: 10.1016/j.ijcrp.2022.200162] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/01/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND It is still unclear whether optimal medical therapy (OMT) after percutaneous coronary intervention (PCI) has beneficial effects on long-term clinical outcomes in patients aged ≥80 years with coronary artery disease (CAD). METHODS This study analyzed the time to the first major adverse clinical event including death or nonfatal myocardial infarction (MI), for up to 3 years after PCI using multicenter registry data. Data for 1056 patients aged > 80 years successfully treated with PCI were included in the analysis. OMT was defined as a combination of antiplatelet drug, statin, beta-blocker, and angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker. RESULTS In total, 204 (19%) patients in this study received OMT and 852 (81%) received sub-OMT. During a median follow-up of 725 days, adverse clinical events occurred in 183 patients (death, n=177; nonfatal MI, n=6). Kaplan-Meier analysis showed that patients who received OMT had a lower probability of adverse clinical events than those who received sub-OMT (p<0.01, log-rank test). Propensity score matching yielded 202 patient-pairs treated with OMT or sub-OMT, in whom 64 adverse clinical events (death, n=56, nonfatal MI, n=4) occurred during follow-up. OMT remained significant in the reduction of the risk of adverse clinical events in a multivariate Cox proportional hazards model (hazard ratio 0.44; 95% confidence interval 0.26-0.75; p=0.003). CONCLUSIONS OMT after PCI was associated with significantly fewer adverse clinical events, including all-cause death and nonfatal MI, in patients aged ≥ 80 years with CAD. OMT might be safe and effective for these very elderly patients.
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Affiliation(s)
- Takamitsu Nakamura
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan,Corresponding author. Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, 1110 Shimokato, Chuo, 409-3898, Japan.
| | - Takeo Horikoshi
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan
| | - Tsuyoshi Kobayahi
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan
| | - Toru Yoshizaki
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan
| | - Manabu Uematsu
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan
| | - Yosuke Watanabe
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital, Fujieda, Japan
| | - Aritaka Makino
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Yukio Saito
- Department of Cardiology, Kofu Municipal Hospital, Kofu, Japan
| | - Jun-ei Obata
- Department of Cardiology, Fujieda Municipal General Hospital, Fujieda, Japan
| | | | - Hajime Takano
- Department of Cardiology, Kofu Jonan Hospital, Kofu, Japan
| | - Ken Umetani
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Akinori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Fujieda, Japan
| | - Tetsuya Asakawa
- Department of Cardiology, Yamanashi Kosei Hospital, Yamanashi, Japan
| | - Akira Sato
- Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine, Chuo, Japan
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Horikoshi T, Nakamura T, Yoshizaki T, Nakamura J, Watanabe Y, Uematsu M, Makino A, Saito Y, Obata JE, Sawanobori T, Takano H, Umetani K, Watanabe A, Asakawa T, Sato A, Kugiyama K. A Propensity Score Matched Analysis of Statin Effects on Major Adverse Cardiac Events after Percutaneous Coronary Intervention in Patients Over 75 Years Old. Intern Med 2022; 61:2711-2719. [PMID: 35228422 PMCID: PMC9556242 DOI: 10.2169/internalmedicine.8932-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective In an extremely aging society, it is beneficial to reconsider the value of medical treatment for extremely elderly patients. We therefore focused on the efficacy of statin therapy in extremely elderly patients. This study investigated the efficacy of statins for secondary prevention in patients over 75 years old. Methods This prospective multicenter registry included 1,676 consecutive extremely elderly patients with coronary artery disease who underwent successful percutaneous coronary intervention (PCI). The patients were followed up clinically for up to three years or until the occurrence of major adverse cardiac events (MACEs), defined as a composite of all-cause death and non-fatal myocardial infarction. Using propensity score methodology to eliminate selection bias, in a 1:1 matching ratio, we selected 466 pairs of patients for the analysis. Results During the median follow-up period of 25 months, MACEs occurred in 176 patients. The Kaplan-Meier analysis showed that statin treatment correlated with a lower probability of initial MACE occurrences within 30 days compared with no statin treatment (log-rank test, p<0.001). According to a landmark analysis at day 30, statin treatment still showed consistent effectiveness for reducing MACE occurrence during the follow up period (p=0.04). A multivariable Cox hazard analysis showed that statin therapy significantly reduced MACE occurrence (hazard ratio 0.55 [0.40-0.75], p<0.001). In the stratification analysis, statin therapy was especially beneficial in patients without symptomatic heart failure. Conclusion Statins were effective in preventing MACEs in extremely elderly patients after PCI.
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Affiliation(s)
- Takeo Horikoshi
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | - Takamitsu Nakamura
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | - Toru Yoshizaki
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Yosuke Watanabe
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | - Manabu Uematsu
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | - Aritaka Makino
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Yukio Saito
- Department of Cardiology, Kofu Municipal Hospital, Japan
| | - Jun-Ei Obata
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | | | - Hajime Takano
- Department of Cardiology, Kofu Jonan Hospital, Japan
| | - Ken Umetani
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Akinori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | | | - Akira Sato
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Japan
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Uematsu M, Goto Y, Torasawa M, Matsumoto Y, Masuda K, Shinno Y, Okuma Y, Yoshida T, Horinouchi H, Yamamoto N, Ohe Y. EP07.03-004 Efficacy of Thoracic Radiotherapy for Local Progression in Advanced Thymic Carcinoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.569] [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: 11/30/2022]
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Horikoshi T, Nakamura T, Yoshizaki T, Nakamura J, Watanabe Y, Uematsu M, Makino A, Kobayashi T, Saito Y, Obata JE, Sawanobori T, Takano H, Umetani K, Watanabe A, Asakawa T, Sato A. A Stratified Analysis of the Risk Associated With Low Body Mass Index for Patients After Percutaneous Coronary Intervention. J Atheroscler Thromb 2022; 30:502-514. [PMID: 35753778 PMCID: PMC10164593 DOI: 10.5551/jat.63650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS The relationship between low body mass index (BMI) and prognostic factors for patients with coronary artery disease, commonly observed in elderly individuals in Japan, is important. Few studies have evaluated the prognosis for patients with low BMI after percutaneous coronary intervention (PCI). Using a multivariable-adjusted model and data from a prospective cohort registry, we analyzed the risk associated with low BMI for patients after PCI. METHODS This prospective, multicenter registry included 5965 consecutive patients with coronary artery disease who underwent successful PCI. The patients were followed-up clinically for up to 3 years or until the occurrence of major adverse cardiac events. The primary endpoint was all-cause death and nonfatal myocardial infarction composite. RESULTS Primary events occurred in 639 (10.7%) patients during the follow-up period. A risk analysis of the primary endpoint adjusted for the multivariable model showed a significant increase in risk for elderly individuals, underweight individuals [HR 1.43 (95% confidence interval (CI), 1.10-1.85), P<0.001], those with diabetes mellitus (DM), peripheral artery disease, low left ventricular ejection fraction or acute coronary syndrome (ACS), and smokers. A stratified adjusted risk analysis based on BMI levels showed that the risk associated with underweight status was significantly pronounced for male patients, those aged 60-74 years, and those with DM or ACS. CONCLUSION Underweight patients with several risk factors significantly increased risk after PCI. Furthermore, the risk associated with low BMI was significantly more pronounced for men, individuals aged 60-74 years, and patients with DM or ACS.
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Affiliation(s)
- Takeo Horikoshi
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | | | - Toru Yoshizaki
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Yosuke Watanabe
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Manabu Uematsu
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
| | - Aritaka Makino
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital
| | | | - Yukio Saito
- Department of Cardiology, Kofu Municipal Hospital
| | - Jun-Ei Obata
- Department of Cardiology, Fujieda Municipal General Hospital
| | | | | | - Ken Umetani
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital
| | | | | | - Akira Sato
- Department of Cardiology, University of Yamanashi, Faculty of Medicine
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Watanabe Y, Nakamura T, Uematsu M, Fujioka D, Inomata D, Saito Y, Horikoshi T, Yoshizaki T, Kobayashi T, Nakamura K, Kugiyama K. Glutaredoxin-1 levels in plasma can predict future events in patients with cardiovascular diseases. Free Radic Biol Med 2021; 176:241-245. [PMID: 34587543 DOI: 10.1016/j.freeradbiomed.2021.09.022] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023]
Abstract
Reactive oxygen species that increase during cardiovascular disease (CVD) react with protein cysteine residues to form a glutathione adduct by S-glutathionylation, which is selectively removed by glutaredoxin-1 (Glrx). We previously showed that S-glutathionylation and Glrx play important roles in mouse models of CVD, such as heart failure and peripheral artery disease models. However, there are few clinical studies on Glrx in CVD. Although Glrx is a cytosolic protein expressed in various organs, it is detectable in human plasma. Studies have reported that Glrx in plasma is a potential disease maker, such as CVD and chronic kidney disease and diabetes, however, it remains unclear whether Glrx is related to the prognosis of patients with CVD. The purpose of this study was to elucidate whether Glrx levels in plasma are associated with future events in patients with CVD. Plasma levels of Glrx were measured in 555 patients with CVD who underwent cardiac catheterization using enzyme-linked immunosorbent assay. All patients were followed prospectively for ≤36 months or until occurrence of adverse events, including all-cause death, non-fatal myocardial infarction, and worsening heart failure. During a mean follow-up period of 33 months, 54 adverse events occurred. Kaplan-Meier analysis showed that higher levels of Glrx (>0.622 ng/mL, determined by receiver-operating characteristic curve) resulted in a higher probability for adverse events compared with lower levels of Glrx (≤0.622 ng/mL) (P < 0.01, log-rank test). Multivariate Cox proportional hazards analysis showed that Glrx was a significant predictor of adverse events after adjustment for known risk factors. In conclusion, levels of plasma Glrx >0.662 ng/mL can predict future events in patients with CVD.
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Affiliation(s)
- Yosuke Watanabe
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan.
| | - Takamitsu Nakamura
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Manabu Uematsu
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Daisuke Fujioka
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Daichi Inomata
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Yukio Saito
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Takeo Horikoshi
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Toru Yoshizaki
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Tsuyoshi Kobayashi
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kazuto Nakamura
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kiyotaka Kugiyama
- Department of Cardiovascular Medicine, University of Yamanashi, Yamanashi, Japan
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12
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Nakamura T, Uematsu M, Horikoshi T, Yoshizaki T, Kobayashi T, Saito Y, Watanabe Y, Nakamura K, Obata JE, Kugiyama K. Improvement in Brachial Endothelial Vasomotor Function and Brachial-Ankle Pulse Wave Velocity Reduces the Residual Risk for Cardiovascular Events after Optimal Medical Treatment in Patients with Coronary Artery Disease. J Atheroscler Thromb 2021; 28:1133-1144. [PMID: 33229855 PMCID: PMC8592703 DOI: 10.5551/jat.57562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim:
To examine whether improvement in flow-mediated endothelium-dependent dilatation (FMD) of the brachial artery and brachial-ankle pulse wave velocity (baPWV) has an additive effect on achieving optimal goals of traditional risk factors to reduce cardiovascular risk in patients with coronary artery disease (CAD).
Methods:
We assessed 323 patients with CAD and impaired vascular function, defined as an impaired FMD of the brachial artery (<5.5%) and increased baPWV (>1,440 cm/sec). After FMD and baPWV measurements at 24 weeks of optimal medical treatment (OMT), the study patients were followed up for <60 months or until a composite of cardiac death, nonfatal myocardial infarction (MI), unstable angina, or ischemic stroke occurs.
Results:
During the median follow-up period of 35 months, cardiovascular events occurred in 72 patients. Multivariate Cox hazards analysis showed that patients with an improvement in FMD and baPWV had the lowest probability of future cardiovascular events. In addition, the improvement in FMD and baPWV had a significant incremental effect on the predictive value of the achievement of optimal goals for blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Conclusions:
The improvement in FMD and baPWV had additive effects on risk reduction of the achievement of the optimal goals of traditional risk factors in patients with CAD. Thus, serial measurements of FMD and baPWV may be useful for identifying CAD patients at residual risk for adverse cardiovascular events following OMT.
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Affiliation(s)
- Takamitsu Nakamura
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Manabu Uematsu
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Takeo Horikoshi
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Toru Yoshizaki
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Tsuyoshi Kobayashi
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Yukio Saito
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Yosuke Watanabe
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Kazuto Nakamura
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Jun-Ei Obata
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine
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13
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Uematsu M, Saito J, Sato S, Fukuhara A, Suzuki Y, Rikimaru M, Onuma T, Tomita H, Watanabe N, Saito M, Morimoto J, Kawamata T, Umeda T, Togawa R, Sato Y, Koizumi T, Hirai K, Minemura H, Nikaido T, Kanazawa K, Tanino Y, Munakata M, Shibata Y. Usefulness of diurnal variation of fractional exhaled nitric oxide for predicting early therapeutic response to asthma treatment. J Asthma 2021; 59:2039-2050. [PMID: 34550855 DOI: 10.1080/02770903.2021.1984524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Fractional exhaled nitric oxide (FeNO) is considered to be an adjunct for asthma management, although its usefulness remains controversial. Therefore, it may be necessary for new approaches to use FeNO for asthma management. We evaluated whether diurnal variations of FeNO can predict response to asthma treatment. METHODS This pilot study consisted of 22 uncontrolled asthmatics and 16 healthy subjects. FeNO and peak expiratory flow (PEF) were measured by themselves twice daily at home for three weeks (asthmatics) or two weeks (healthy subjects), and daily mean and diurnal variations of FeNO and PEF levels were calculated. In uncontrolled asthmatics, treatment was intensified a week after study entry, and then control status was reevaluated after three to four weeks. Asthmatics were then divided into two groups; good or poor responders. RESULTS Diurnal variations of FeNO levels, as well as daily mean FeNO and PEF levels, in uncontrolled asthmatics before intensive treatment were significantly higher than those in healthy subjects, regardless of treatment response (p < 0.01). Furthermore, in the good responders, diurnal variations of FeNO levels were significantly decreased in the 1st week (p < 0.05) of intensive treatment, whereas the daily mean FeNO levels significantly dropped in the 2nd week (p < 0.05). In the poor responders, no such changes were observed in FeNO levels. In terms of PEF, only the daily mean levels were significantly elevated after the initiation of intensive treatment, regardless of treatment response. CONCLUSIONS Diurnal variations of FeNO may contribute to predicting early therapeutic response to asthma treatment.
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Affiliation(s)
- Manabu Uematsu
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Junpei Saito
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Suguru Sato
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Atsuro Fukuhara
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Yasuhito Suzuki
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Takumi Onuma
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Hikaru Tomita
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Natsumi Watanabe
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Mikako Saito
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Julia Morimoto
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Kenichiro Hirai
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Mitsuru Munakata
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
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14
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Sato S, Saito J, Fukuhara A, Uematsu M, Suzuki Y, Rikimaru M, Kawamata T, Umeda T, Koizumi T, Togawa R, Sato Y, Nikaido T, Minemura H, Kanazawa K, Tanino Y, Shibata Y. Association Between Sleep Characteristics and Asthma Control in Middle-Aged and Older Adults: A Prospective Cohort Study. J Asthma Allergy 2021; 14:325-334. [PMID: 33854339 PMCID: PMC8040693 DOI: 10.2147/jaa.s301444] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/12/2021] [Indexed: 12/29/2022] Open
Abstract
Background Nocturnal asthma symptoms are a well-known feature of sleep disturbance. However, there are few reports on the association between sleep-related characteristics and asthma exacerbation. The aim of the current prospective observational study was to explore the factors while sleeping associated with future asthma exacerbation. Materials and Methods At baseline, adult asthmatics underwent home sleep monitoring by a Watch-PAT instrument and then they were prospectively followed-up for the occurrence of exacerbations. The number of asthma exacerbation was observed over a period of one year, and multivariable analyses of the factors associated with asthma exacerbation were performed. Results A total of 62 asthmatic subjects were enrolled (mean age 62.1 years), 59 of whom were finally included in the prospective observational study. Obstructive sleep apnea (defined by an apnea-hypopnea index based on peripheral arterial tone more than 5 times/hour) were observed in 81% of the subjects. During the one-year monitoring period, 14 of the 59 subjects (24%) used occasional systemic corticosteroids for their exacerbation asthma (worsened group) while the other 45 subjects did not experience asthma exacerbation (stable group). A comparison of the baseline clinical characteristics and sleep-related data between the two groups, mean forced expiratory volume one second percent (FEV1/FVC), mean baseline Asthma Control Test (ACT) score, median pAHI value, and median oxygen desaturation index value were significantly lower in the worsened group than those in the stable group. Additionally, mean prevalence of the left lateral decubitus (LLD) position in sleep monitoring were significantly higher in the worsened group than that in the stable group. Among the independent variables, baseline asthma severity, ACT score, and the LLD position showed significant associations with asthma exacerbation. Discussion/Conclusion The present study identified that sleeping in the LLD position was also associated with asthma exacerbation.
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Affiliation(s)
- Suguru Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Junpei Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Atsuro Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Yasuhito Suzuki
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
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15
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Kobayashi T, Nakamura T, Uematsu M, Horikoshi T, Yoshizaki T, Watanabe Y, Fujioka D, Saito Y, Nakamura K, Obata J, Kugiyama K. Evaluation of renal tubulointerstitial damage as a residual renal risk factor for adverse cardiac events in patients with myocardial infarction. J Cardiol 2021; 78:114-119. [PMID: 33832808 DOI: 10.1016/j.jjcc.2021.02.006] [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: 11/16/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Renal dysfunction, defined as a lower estimated glomerular filtration rate (eGFR), has been shown to be related to cardiovascular events in patients with myocardial infarction (MI). However, the contribution of renal tubulointerstitial damage to the predictive value for cardiovascular events has not been established. The aim of this study was to elucidate whether renal tubulointerstitial damage is associated with the occurrence of cardiac death and recurrence of MI in patients who have had MI. METHODS AND RESULTS Urinary β2-microglobulin (β2MG) was measured in 681 consecutive patients with MI in our hospital. All patients were followed up for <12 years or until the occurrence of cardiac death and MI. During a median follow-up period of 6 years, the cumulative cardiac death rate was 5.4%, and the MI rate was 3.1%. When outcomes were divided into two groups according to the β2MG levels, cardiac death and MI rates were lower in patients with lower levels of β2MG (<0.319 mg/gCre: determined by receiver operating characteristic analyses) than in those with β2MG ≥0.319 mg/gCre (5.9% versus 17.1%, p<0.01). When outcomes were stratified according to the β2MG levels in combination with eGFR levels, Kaplan-Meier analyses showed that cardiac death and MI rates increased depending on an increase in the β2MG levels (p<0.05). Moreover, multivariate Cox analyses revealed that high levels of β2MG were a significant independent predictor of adverse events (hazard ratio: 1.956; 95% confidence interval: 1.014-3.774; p = 0.045). The addition of high levels of β2MG to conventional risk factors, including eGFR and urinary albumin, improved the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.5447, p = 0.0002; IDI 0.0126, p = 0.0454). CONCLUSION Renal tubulointerstitial damage, as assessed by urinary β2MG, is associated with the occurrence of cardiac death and recurrence of MI independent of renal glomerular function in patients with MI.
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Affiliation(s)
- Tsuyoshi Kobayashi
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan.
| | - Takamitsu Nakamura
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Manabu Uematsu
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Takeo Horikoshi
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Toru Yoshizaki
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Yosuke Watanabe
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Daisuke Fujioka
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Yukio Saito
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Kazuto Nakamura
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Jyunei Obata
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Yamanashi, Japan
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16
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Umeda T, Minemura H, Tanino Y, Hirai K, Koizumi T, Nikaido T, Sato Y, Togawa R, Kawamata T, Watanabe N, Tomita H, Rikimaru M, Morimoto J, Suzuki Y, Uematsu M, Fukuhara N, Fukuhara A, Saito J, Kanazawa K, Shibata Y. P44.02 Mild Interstitial Pneumonia as a Risk Factor for Chemotherapy-Induced Acute Exacerbation of Interstitial Pneumonia in Patients with Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.841] [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: 10/21/2022]
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17
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Suzuki Y, Tanino Y, Nikaido T, Minemura H, Umeda T, Rikimaru M, Onuma T, Naito S, Takiguchi Y, Tomita H, Kawamata T, Togawa R, Sato Y, Uematsu M, Morimoto J, Kitakawa K, Tsukada Y, Nakamura K, Kanemitsu K, Iseki K, Shibata Y. Severe Coronavirus Disease 2019 That Recovered from Respiratory Failure by Treatment That Included High-dose Intravenous Immunoglobulin. Intern Med 2021; 60:457-461. [PMID: 33328409 PMCID: PMC7925270 DOI: 10.2169/internalmedicine.6326-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/01/2020] [Indexed: 12/13/2022] Open
Abstract
We herein report a case of severe coronavirus disease 2019 (COVID-19) in which high-dose intravenous immunoglobulin (IVIg) treatment achieved significant clinical improvement of deterioration of pulmonary inflammation after temporary clinical improvement. In the present case, clinical and radiological deterioration occurred despite a decrease in viral load, suggesting that deterioration was caused by reactivation of proinflammatory factors, such as tumor necrosis factor-α and interleukin-6, rather than direct viral effects. IVIg treatment may provide not only immunosuppressive effects but also inhibition of proinflammatory cytokines, indicating that treatment including IVIg may be effective by inhibiting cytokine storm in severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection.
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Affiliation(s)
- Yasuhito Suzuki
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takumi Onuma
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Shotaro Naito
- Department of General Internal Medicine, Fukushima Medical University, Japan
| | - Yoshinori Takiguchi
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Japan
| | - Hikaru Tomita
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Julia Morimoto
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | | | - Yasuhiko Tsukada
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Japan
| | - Kiwamu Nakamura
- Department of Infection Control, Fukushima Medical University, Japan
| | - Keiji Kanemitsu
- Department of Infection Control, Fukushima Medical University, Japan
| | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
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18
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Uematsu M, Nakamura T, Horikoshi T, Yoshizaki T, Watanabe Y, Kobayashi T, Saito Y, Nakamura K, Obata JE, Kugiyama K. Echolucency of carotid plaque is useful for selecting high-risk patients with chronic coronary artery disease who benefit from intensive lipid-lowering therapy. J Cardiol 2021; 77:590-598. [PMID: 33500186 DOI: 10.1016/j.jjcc.2021.01.002] [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: 08/14/2020] [Revised: 11/24/2020] [Accepted: 12/19/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Ultrasound assessment of the carotid artery provides prognostic information on coronary events. This study examined whether ultrasound assessments of plaque echolucency of the carotid artery are useful for identifying patients with coronary artery disease (CAD) who are at high risk but could benefit from lipid-lowering therapy for secondary prevention. METHODS Ultrasound assessment of carotid plaque echolucency with integrated backscatter (IBS) analysis was performed in 393 chronic CAD patients with low-density lipoprotein cholesterol (LDL-C) levels <100 mg/dL on statin therapy. All patients were prospectively followed up for a maximum of 96 months or until the occurrence of one of the following coronary events: cardiac death, nonfatal myocardial infarction, or unstable angina pectoris requiring unplanned revascularization. RESULTS During the follow-up period, 45 coronary events occurred. Patients were stratified by IBS (≤-16.3 or >-16.3 dB, median value) and LDL-C level (<70 or 70-99 mg/dL). Multivariate Cox proportional hazards analysis showed that patients with lower IBS and LDL-C 70-99 mg/dL had significantly higher probabilities of coronary events compared with those with higher IBS and LDL-C <70 mg/dL, after adjustment for a baseline model of risk factors (hazard ratio 5.15; 95% confidence interval 1.21-22.0, p = 0.03). In contrast, patients with lower IBS and LDL-C <70 mg/dL had an improved prognosis comparable with those with higher IBS. Addition of LDL-C levels to the baseline model of risk factors improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) in patients with lower IBS (NRI, 0.44, p = 0.04; and IDI, 0.035, p < 0.01), but not in those with higher IBS. CONCLUSIONS Evaluation of echolucency of the carotid artery was useful for selecting CAD patients at high risk of secondary coronary events but who could benefit from lipid-lowering therapy.
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Affiliation(s)
- Manabu Uematsu
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Takamitsu Nakamura
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Takeo Horikoshi
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Toru Yoshizaki
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Yosuke Watanabe
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Tsuyoshi Kobayashi
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Yukio Saito
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Kazuto Nakamura
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Jun-Ei Obata
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan.
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19
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Kume H, Uematsu M, Tomita H, Fukuhara A. [A CASE OF ALLERGIC RHINITIS WHO HAS DEVELOPED EOSINOPHILIC PNEUMONIA, FOLLOWED BY EOSINOPHILIC CELLULITIS]. Arerugi 2021; 70:1391-1397. [PMID: 34911892 DOI: 10.15036/arerugi.70.1391] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A-68-year-old man, who has allergic rhinitis with peripheral blood eosinophilia, hospitalized because of fever of unknown origin in May 2020. Five days after antibiotics were given, itchy exanthema occurred, followed by gland glass opacity on both lungs with bilateral pleural effusions. Since acute respiratory failure developed, bronchoscopy was hard to carry out. However, this case was considered acute eosinophilic pneumonia induced by antibiotics, based on radiological findings and laboratory data. Therefore, steroid pulse therapy using intravenous administration of methylprednisolone started, and this therapy was effective. Since these chest shadows and hypoxia were disappeared in two weeks, the amount of steroid was gradually reduced, however, eosinophilic pneumonia recurred once during this course. After discharge in June 2020, this patient came to the outpatient department. When oral administration of prednisolone was decreased less than 2.5mg/day, redness and swelling with slight itch were appeared in the left forearm in September 2020. Histological findings from shin biopsy showed that eosinophils excessively invade to the dermis without angiitis. Although flame figure was not observed in the specimen, we considered that this case has developed eosinophilic cellulitis, based on the clinical manifestation and pathological findings. When prednisolone was increased to 30mg/day, these symptoms were improved, and then prednisolone was gradually reduced. After that, recurrences of these diseases did not occur during the observation period. This case may be diagnosed as hypereosinophilic syndrome since eosinophilic pneumonia and eosinophilic cellulitis caused continuously by recruitment of eosinophils to lung and skin.
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Affiliation(s)
- Hiroaki Kume
- Center for Allergy and Respiratory Medicine, Nogami Hospital
- Department of Infectious Diseases and Respiratory Medicine, Fukushima Medical University Aizu Medical Center
| | - Manabu Uematsu
- Department of Infectious Diseases and Respiratory Medicine, Fukushima Medical University Aizu Medical Center
| | - Hikaru Tomita
- Department of Infectious Diseases and Respiratory Medicine, Fukushima Medical University Aizu Medical Center
| | - Atsuro Fukuhara
- Department of Infectious Diseases and Respiratory Medicine, Fukushima Medical University Aizu Medical Center
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20
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Fujita Y, Matsumoto H, Asano T, Sato S, Yashiro-Furuya M, Matsuoka N, Temmoku J, Nakatani-Enomoto S, Kimura S, Hoshi K, Uematsu M, Watanabe H, Migita K. Hemophagocytic Lymphohistiocytosis Associated with Disseminated Nontuberculous Mycobacterial Infection in a Patient with Mesenteric Panniculitis. TOHOKU J EXP MED 2021; 253:151-157. [PMID: 33658450 DOI: 10.1620/tjem.253.151] [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] [Indexed: 11/18/2022]
Abstract
Mesenteric panniculitis is a chronic inflammatory disease characterized by non-specific inflammation of the adipose tissue in the mesentery. Hemophagocytic lymphohistiocytosis is a life-threating disease associated with aberrant macrophage overactivation, in which infections can be a leading cause in immunocompromised hosts. Here, we report a rare case of mesenteric panniculitis and hemophagocytic lymphohistiocytosis complicated by disseminated Mycobacterium intracellulare. A 71-year-old male with mesenteric panniculitis was admitted to our hospital for fever and pancytopenia. He was treated with oral prednisolone (15 mg/day) and cyclosporin A (150 mg/day) at presentation. Physical and laboratory examinations revealed disseminated infection with nontuberculous mycobacteria; Mycobacterium intracellulare was detected in cultures of cerebrospinal fluid, blood, sputum, and gastric fluid. Patient signs and symptoms fulfilled the five criteria for a diagnosis of hemophagocytic lymphohistiocytosis, including fever, cytopenia, hemophagocytosis, hyperferritinemia, and high soluble interleukin-2 receptor levels. Therefore, the diagnosis of nontuberculous mycobacteria-associated hemophagocytic lymphohistiocytosis was established. An anti-mycobacterial chemotherapy including chloramphenicol (800 mg/day), rifampin (450 mg/day) and ethambutol (750 mg/day) together with streptomycin (750 mg twice per week) was initiated at 30 days after admission; maintenance doses of prednisolone were increased to 60 mg/day. Fever and pancytopenia improved in response to anti-mycobacterial chemotherapy. The present case suggests that mesenteric panniculitis could be complicated with hemophagocytic lymphohistiocytosis caused by immunosuppressive therapy-associated infections as well as underlying disease activity. In conclusion, the possibility of disseminated nontuberculous mycobacteria infection with hemophagocytic lymphohistiocytosis should be considered if unexplained fever or hematological dyscrasia were presented in patients of mesenteric panniculitis.
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Affiliation(s)
- Yuya Fujita
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Haruki Matsumoto
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Shuzo Sato
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | | | - Naoki Matsuoka
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Jumpei Temmoku
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | | | - Satoshi Kimura
- Department of Hematology, Fukushima Medical University School of Medicine
| | - Kenta Hoshi
- Department of Internal Medicine, Takeda General Hospital
| | - Manabu Uematsu
- Department of Pulmonary Medicine, Fukushima Medical University Aizu Medical Center
| | - Hiroshi Watanabe
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine
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21
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Kosugi S, Ueda Y, Abe H, Mishima T, Shinouchi K, Ozaki T, Takayasu K, Iida Y, Ohashi T, Toriyama C, Nakamura M, Date M, Uematsu M, Koretsune Y. Angioscopic evaluation of vascular healing at 1 and 12 months after drug-coated stent implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Polymer- and carrier-free Biolimus-A9-coated stent (DCS) is expected better vascular healing compared with conventional durable polymer drug-eluting stents (DES). Moreover, DCS had been demonstrated in clinical trials to allow one-month short dual antiplatelet therapy, which might achieve sufficient healing at only 1 month after implantation. However, the process of vascular healing after DCS implantation has not been elucidated by angioscopic observation.
Purpose
To evaluate the process of vascular healing at 1 month and 12 months after DCS implantation.
Methods
This study included 57 patients treated with DCS or durable polymer everolimus-eluting stents (EES) in our hospital from April 2017 to April 2019. Firstly, the angioscopic findings of DCS at 1 month (n=16) and 12 months (n=14) after implantation were respectively compared with EES at 12 months after implantation (EES-12, n=35) as a standard healing status of DES. Secondary, angioscopic findings of DCS at 1 month and 12 months after implantation were compared among the serially observed eight patients. Neointimal coverage (NIC) grade, yellow colour grade, and the presence of thrombus were evaluated. NIC grade was classified as grade 0 (no neointimal coverage), grade 1 (struts were bulged into lumen but covered), grade 2 (struts were embedded in the neointima but visible), or grade 3 (struts were fully embedded and invisible). Yellow colour grade was classified as grade 0 (white), grade 1 (light yellow), grade 2 (yellow), or grade 3 (intensive yellow).
Results
At 1 month after DCS implantation, dominant NIC grade was lower (0.3±0.5 vs. 1.5±0.7, p<0.001) and the frequency of thrombus was higher (38% vs. 6%, p=0.008) than EES-12. On the other hands, at 12 months after DCS implantation, dominant NIC grade was higher (2.1±0.6 vs. 1.5±0.7, p=0.013) and the frequency of thrombus was not different (7% vs. 6%, p=1.000) in comparison with EES-12. By serial observation of DCS, dominant NIC grade was higher at 12 months than at 1 month (2.3±0.5 vs. 0.4±0.5, p<0.001), while yellow colour grade (1.0±0.5 vs. 1.5±1.2, p=0.227) and the frequency of thrombus adhesion (0% vs. 38%, p=0.200) were not different.
Conclusion
Compared with EES-12, vascular healing of DCS was inferior at 1 month but superior at 12 months.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Kosugi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Ueda
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Abe
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Mishima
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Shinouchi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Ozaki
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Takayasu
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Iida
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Ohashi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - C Toriyama
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Nakamura
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Date
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Uematsu
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Koretsune
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
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22
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Suzuki Y, Minemura H, Tomita H, Saito M, Watanabe N, Umeda T, Kawamata T, Rikimaru M, Morimoto J, Koizumi T, Togawa R, Sato Y, Hirai K, Uematsu M, Nikaido T, Fukuhara N, Fukuhara A, Sato S, Saito J, Kanazawa K, Tanino Y, Shibata Y. Monomorphic Epitheliotropic Intestinal T-cell Lymphoma Involving the Lung and Brain: A Rare Case Study. Intern Med 2020; 59:2559-2563. [PMID: 32641648 PMCID: PMC7662048 DOI: 10.2169/internalmedicine.4710-20] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a primary intestinal T-cell lymphoma and other organ involvement is very rare. A rare case of MEITL involving the lung and brain is herein reported. The patient developed panperitonitis with a small intestinal perforation, and emergency surgery was performed. The pathological findings from the surgical specimens demonstrated atypical lymphoid cells which were positive for CD3, CD8, and CD56. Moreover, the pathological findings of lung specimens taken by bronchoscopy were consistent with those of the small intestine. It is therefore important to include the possibility of MEITL in the differential diagnosis of cancer patients.
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Affiliation(s)
- Yasuhito Suzuki
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Hikaru Tomita
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Mikako Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Natsumi Watanabe
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Julia Morimoto
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Kenichiro Hirai
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Naoko Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Atsuro Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Suguru Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Junpei Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Japan
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23
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Sugaya T, Hikichi T, Nakamura J, Hashimoto M, Takasumi M, Kato T, Kobashi R, Takagi T, Suzuki R, Sugimoto M, Sato Y, Irie H, Rikimaru M, Uematsu M, Minemura H, Kobayakawa M, Ohira H. Esophagobronchial fistula complicated by esophageal achalasia treated by per-oral endoscopic myotomy. Clin J Gastroenterol 2020; 13:1051-1056. [PMID: 32909156 DOI: 10.1007/s12328-020-01226-0] [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: 06/22/2020] [Accepted: 08/30/2020] [Indexed: 11/29/2022]
Abstract
A 48-year-old man who underwent balloon dilation for esophageal achalasia more than 20 years prior developed severe dysphagia and cough during mealtimes. Endoscopic findings showed a markedly dilated esophagus with residue, narrowing of the esophagogastric junction (EGJ), and a fistula in the middle thoracic esophagus. Esophagography showed narrowing of the EGJ and outflow of contrast from the esophagus to the bronchus. In addition, computed tomography showed marked esophageal dilatation and diffuse granular shading in both lungs. Based on these imaging findings, the patient was diagnosed with deterioration of esophageal achalasia and an esophagobronchial fistula (EBF) secondary to achalasia. The increased intra-esophageal pressure caused by the achalasia was suspected to have inhibited the closure of the EBF. Therefore, we believed that per-oral endoscopic myotomy (POEM) would help treat the achalasia and simultaneously contribute to closing of the EBF. Immediately after POEM, the dysphagia and cough improved. Furthermore, the EBF was closed. 14 months after POEM, the patient did not exhibit deterioration of esophageal achalasia and EBF. To the best of our knowledge, there have been no reports of POEM implemented in cases of esophageal achalasia complicated by EBF. Therefore, this case is worth reporting.
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Affiliation(s)
- Tatsuro Sugaya
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Japan.
| | - Jun Nakamura
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan.,Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Japan
| | - Minami Hashimoto
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan.,Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Japan
| | - Mika Takasumi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Tsunetaka Kato
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan.,Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Japan
| | - Ryoichiro Kobashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Tadayuki Takagi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Rei Suzuki
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Mitsuru Sugimoto
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Yuki Sato
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Hiroki Irie
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
| | - Masao Kobayakawa
- Department of Medical Research Center, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan
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24
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Sato Y, Tanino Y, Nikaido T, Togawa R, Kawamata T, Wang X, Fukuhara N, Tomita H, Saito M, Watanabe N, Rikimaru M, Umeda T, Morimoto J, Koizumi T, Suzuki Y, Hirai K, Uematsu M, Minemura H, Fukuhara A, Sato S, Saito J, Kanazawa K, Shibata Y. Clinical significance of thyroid hormone and antibodies in patients with idiopathic interstitial pneumonia. J Thorac Dis 2020; 12:522-537. [PMID: 32274118 PMCID: PMC7139094 DOI: 10.21037/jtd.2020.01.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Hypothyroidism was recently reported to be common and to predict mortality in patients with idiopathic pulmonary fibrosis (IPF). In addition, a high prevalence of hypothyroidism was shown in patients with idiopathic pleuroparenchymal fibroelastosis. However, in idiopathic interstitial pneumonia (IIP), a clinical significance of thyroid function has not been clarified in detail. The goal of this study was to investigate the clinical significance of thyroid function and the presence of thyroid antibodies in IIP. Methods We have reviewed IIP patients, and analyzed the positivity of thyroid antibodies at first. Next, the relationship of clinical characteristics with thyroid function and the positivity of thyroid antibodies was analyzed. Lastly, the positivity of thyroid antibodies and other autoantibodies was evaluated. Results In IIP patients, thyroglobulin and thyroid peroxidase antibodies were positive in 17 and 16%, respectively, and 22% of patients had either or both antibodies. Subclinical and/or overt hypothyroidism was confirmed in 7% of IIP patients. The free thyrotropin level had a significant positive correlation with vital capacity and a significant negative correlation with the C-reactive protein and surfactant protein-A levels, and erythrocyte sedimentation ratio (ESR). In addition, autoantibodies suggestive of connective tissue diseases (CTDs) were positive in more than two thirds of IIP patients with the thyroid antibody, and the positive rate of antinuclear and proteinase-3 anti-neutrophil cytoplasmic antibodies was significantly higher in IIP patients with thyroid antibodies than those without the antibodies. Conclusions Although thyroid dysfunction is not frequent, thyroid hormones and thyroid antibodies are possibly involved in the pathogenesis of IIP and their evaluation may be clinically useful to identify the clinical phenotype of IIP with autoimmune features.
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Affiliation(s)
- Yuki Sato
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Xintao Wang
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naoko Fukuhara
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hikaru Tomita
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mikako Saito
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Natsumi Watanabe
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Julia Morimoto
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yasuhito Suzuki
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenichiro Hirai
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsuro Fukuhara
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Suguru Sato
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junpei Saito
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
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25
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Watanabe Y, Watanabe K, Fujioka D, Nakamura K, Nakamura T, Uematsu M, Bachschmid MM, Matsui R, Kugiyama K. Protein S-glutathionylation stimulate adipogenesis by stabilizing C/EBPβ in 3T3L1 cells. FASEB J 2020; 34:5827-5837. [PMID: 32141127 DOI: 10.1096/fj.201902575r] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/07/2020] [Accepted: 02/20/2020] [Indexed: 02/02/2023]
Abstract
Reactive oxygen species (ROS) increase during adipogenesis and in obesity. Oxidants react with cysteine residues of proteins to form glutathione (GSH) adducts, S-glutathionylation, that are selectively removed by glutaredoxin-1 (Glrx). We have previously reported that Glrx knockout mice had increased protein S-glutathionylation and developed obesity by an unknown mechanism. In this study, we demonstrated that 3T3L1 adipocytes differentiation increased ROS and protein S-glutathionylation. Glrx ablation elevated protein S-glutathionylation and lipid content in 3T3L1 cells. Glrx replenishment decreased the lipid content of Glrx KO 3T3L1 cells. Glrx KO also increased protein expression and protein S-glutathionylation of the adipogenic transcription factor CCAAT enhancer-binding protein (C/EBP) β. Protein S-glutathionylation decreased the interaction of C/EBPβ and protein inhibitor of activated STAT (PIAS) 1, a small ubiquitin-related modifier E3 ligase that facilitates C/EBPβ degradation. Experiments with truncated mutant C/EBPβ demonstrated that PIAS1 interacted with the liver-enriched inhibitory protein (LIP) region of C/EBPβ. Furthermore, mass spectrometry analysis identified protein S-glutathionylation of Cys201 and Cys296 in the LIP region of C/EBPβ. The C201S, C296S double-mutant C/EBPβ prevented protein S-glutathionylation and preserved the interaction with PIAS1. In summary, Glrx ablation stimulated 3T3L1 cell differentiation and adipogenesis via increased protein S-glutathionylation of C/EBPβ, stabilizing and increasing C/EBPβ protein levels.
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Affiliation(s)
- Yosuke Watanabe
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
| | - Kazuhiro Watanabe
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
| | - Daisuke Fujioka
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
| | - Kazuto Nakamura
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
| | - Takamitsu Nakamura
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
| | - Manabu Uematsu
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
| | - Markus M Bachschmid
- Department of Medicine, Vascular Biology Section, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - Reiko Matsui
- Department of Medicine, Vascular Biology Section, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, University of Yamanashi, Chuo, Japan
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26
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Toriyama C, Abe H, Nishida H, Nakamura M, Ohashi T, Iida Y, Kosugi S, Ozaki T, Shinouchi K, Mishima T, Date M, Ueda Y, Uematsu M, Koretsune Y. P92 A novel method of correcting the left ventricular stroke volume by Doppler echocardiography: comparison with multidetector computed tomography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although transthoracic Doppler echocardiography is widely used for estimating left ventricular stroke volume (SV), accelerated blood flow in the left ventricular (LV) outflow tract may lead to overestimation. SV can be calculated accurately from left ventricular end-systolic and end-diastolic volume determined by multi-detector computed tomography (MDCT). However, radiation exposure as well as the use of contrast medium hampers its routine use.
Purpose
The purpose of this study was to examine whether the correction of SV measured by pulsed wave Doppler echocardiography (SVdop) can accurately predicts SV obtained by MDCT (SVct).
Methods: We enrolled consecutive 61 patients who underwent both MDCT and transthoracic echocardiography. Patients with moderate or severe valvular diseases and valve replacement surgery were excluded. Correction of SV was explored with SVct as a reference.
Results: Univariate analysis showed that SVdop (r = 0.42, P = 0.0007) and patient age (r=-0.50, P < 0.0001) were significantly correlated with SVct. On the other hand, left ventricular ejection fraction calculated by Teicholz method (EFteich) (r = 0.19, P = 0.14), systolic blood pressure (r = 0.07, P = NS), and LV mass index (r=-0.02, P = NS) were not correlated with SVct. Multivariate analysis showed that SVdop, patient age and EFteich were the independent predictive factors for SVct (R2 = 0.49, P < 0.0001). Based on these correlations, we postulated SV as: corrected SV = SVdop × 0.40 + EFteich × 0.46 – age × 0.67 + 44.77. As expected, the correlation between corrected SV and SVct significantly improved (r = 0.70, P < 0.0001). Bland-Altman plot analysis showed that corrected SV significantly reduced the variation between SVdop and SVct, and diminished the overestimation of SVdop (Figure).
Conclusion: The new correction formula of SVdop may correct the overestimation of SV obtained by pulsed wave Doppler echocardiography, although the formula remains to be validated in a separate cohort of patients.
Abstract P92 Figure
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Affiliation(s)
| | - H Abe
- Osaka National Hospital, Osaka, Japan
| | - H Nishida
- Osaka National Hospital, Osaka, Japan
| | | | - T Ohashi
- Osaka National Hospital, Osaka, Japan
| | - Y Iida
- Osaka National Hospital, Osaka, Japan
| | - S Kosugi
- Osaka National Hospital, Osaka, Japan
| | - T Ozaki
- Osaka National Hospital, Osaka, Japan
| | | | - T Mishima
- Osaka National Hospital, Osaka, Japan
| | - M Date
- Osaka National Hospital, Osaka, Japan
| | - Y Ueda
- Osaka National Hospital, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Osaka, Japan
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27
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Deyama J, Nakamura T, Ono S, Kobayashi A, Horikoshi T, Yoshizaki T, Watanabe Y, Uematsu M, Kobayashi T, Fujioka D, Saito Y, Nakamura K, Kawabata K, Obata J, Kugiyama K. P6415Combined assessment of contrast-enhanced ultrasound of carotid plaque and carotid intima-media thickness improves the prediction of future coronary events in patients with coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1009] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study examined whether combined ultrasound assessment of plaque size and intraplaque neovascularization in the carotid artery had an additive effect for predicting coronary events in patients with coronary artery disease (CAD).
Methods
CEUS of the carotid plaques using perfluorobutane microbubbles as an ultrasound contrast agent and Ultrasound assessment of carotid plaque maximum intima-media thickness (max IMT) was performed in 221 patients with CAD and carotid plaque IMT over 2mm. Intraplaque neovascularization was identified on the basis of microbubbles within the carotid plaque and graded as: G0, not visible; G1, moderate; or G2, extensive microbubbles. All study patients were followed up prospectively for 5 years or until the occurrence of a cardio-vascular event.
Result
During the follow-up period, 53 coronary events (9 cardiac deaths, 44 ACSs) were occurred. Multivariate Cox hazards analysis showed that max IMT and CEUS grade were independent predictors of coronary events (HR 1.59, 95% CI 1.15–2.21 p=0.005 and HR 2.26, 95% CI 1.52–3.36 p<0.01) that were independent of age, gender, diabetes and LDL-C levels. C-statistics for logistic models predicting future coronary events using conventional risk factors with or without the addition of max IMT alone, CEUS grade alone, and both max IMT and CEUS grade in combination (area under the ROC curve; 0.55,0.61,0.69 and 0.71, respectively). The addition of the plaque enhanced intensity to traditional risk factors resulted in net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.42, p=0.002; and IDI 0.04, p=0.002).
CEUS grade and ROC curve for 3models
Conclusions
Combined ultrasound assessment of carotid plaque IMT and intraplaque neovascularization has an additive value on the prediction of coronary events.
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Affiliation(s)
- J Deyama
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - T Nakamura
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - S Ono
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - A Kobayashi
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - T Horikoshi
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - T Yoshizaki
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - Y Watanabe
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - M Uematsu
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - T Kobayashi
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - D Fujioka
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - Y Saito
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - K Nakamura
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - K Kawabata
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - J Obata
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
| | - K Kugiyama
- University of Yamanashi, Internal Medicine II, Yamanashi, Japan
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Matsusaki N, Sotomi Y, Kobayashi T, Hayashi T, Takeda Y, Yasumura Y, Yamada T, Uematsu M, Tamaki S, Abe H, Hikoso S, Nakatani D, Hirayama A, Higuchi Y, Sakata Y. P4512Impact of pulmonary artery catheter on all-cause death of patients with acute heart failure with preserved ejection fraction: Short-term results from the PURSUIT-HFpEF registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Appropriate pulmonary artery catheter (PAC) use may effectively decrease mortality in acute heart failure patients. The concept that the pulmonary artery catheter (PAC) is a valuable tool for hemodynamic monitoring when used in appropriately selected patients and by physicians trained well to interpret and apply the data correctly provided has not been evaluated adequately yet in acute heart failure patients with preserved ejection fraction (HFpEF).
Methods
The PERSUIT-HFpEF Registry is a prospective, observational, multicenter cohort study on prognosis of HFpEF in Japan. Patients hospitalized for heart failure (diagnosed by using Framingham criteria) who met both of the following criteria were enrolled: 1) a left ventricular ejection fraction of 50% or more as measured at the local site by echocardiography; 2) an elevated level of N terminal pro brain natriuretic peptide (NT proBNP) (400 pg per milliliter or more) or brain natriuretic peptide (BNP) (100 pg per milliliter or more). In the present study, we evaluated the impact of PAC on all-cause death of the patients with HFpEF. PAC use was left at the discretion of attending physicians.
Results
The PERSUIT-HFpEF Registry enrolled 486 patients (81±9 years, 259 females, mean follow-up duration 198±195 days). Of these, data of PAC usage was available in 434 patients. Patients were further stratified according to use of a PAC: PAC 153 patients vs. non-PAC 281 patients. Length of hospitalization was numerically shorter in the PAC group than in the non-PAC group [20.3±14.7 vs. 22.5±17.4 days, p=0.182]. Kaplan-Meier estimated 1-year all-cause death rate was significantly lower in the PAC group than in the non-PAC group (9.5% vs. 19.1%, p=0.019). PAC use was associated with significant risk reduction of all-cause death [hazard ratio (HR) 0.425, 95% confidence interval (CI), 0.203–0.890, p=0.023] in the crude analysis. The significant risk reduction still existed after multivariate adjustment including potential confounders [HR 0.427, 95% CI, 0.185–0.984, p=0.046]
Kaplan Meier analysis
Conclusions
In the real-world Asian registry data, PAC use was associated with the improved all-cause death rate, suggesting that the PAC might be a useful guidance tool for treatment of the patients with HFpEF.
Acknowledgement/Funding
Roche diagnostics FUJIFILM Toyama Chemical
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Affiliation(s)
| | - Y Sotomi
- Osaka Police Hospital, Osaka, Japan
| | | | | | - Y Takeda
- Osaka Police Hospital, Osaka, Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Amagasaki, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - M Uematsu
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - H Abe
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Suita, Japan
| | | | | | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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Hoshida S, Watanabe T, Shinoda Y, Minamisaka T, Fukuoka H, Inui H, Ueno K, Yasumura Y, Yamada T, Uematsu M, Tamaki S, Higuchi Y, Abe H, Hikoso S, Sakata Y. P321A single factor related to left atrial pressure overload is useful for prognosis in elderly patients with heart failure with preserved ejection fraction: PURSUIT HFpEF study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
E/e' and the ratio of diastolic elastance (Ed)/arterial elastance (Ea) = (E/e')/(0.9 × systolic blood pressure), indices of left atrial (LA) pressure overload, are elevated in elderly women with heart failure with preserved ejection fraction (HFpEF). The severity of diastolic dysfunction is assessed by a combination of several indices of LA volume and pressure overload. However, which overload is more important as a single factor for the prognosis of these patients remains undefined.
Methods
We enrolled patients with HFpEF showing sinus rhythm (n=145; left ventricular ejection fraction >50%; men/women, 56/89; mean age, 80.5 years). Blood examination and transthoracic echocardiography were performed before discharge. All-cause mortality and admission for cardiac events were evaluated after more than 1 year (mean, 370 days).
Results
The all-cause mortality rate was 11% (16/145). There were significant differences in age (p=0.005), serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level (p<0.001), LA volume index (p=0.018), E/e' (p=0.022), and Ed/Ea (p=0.016) between patients with and without all-cause mortality. When cutoff points for mortality by receiver operating characteristic curve analysis were examined, the area under the curve in LA volume index (0.564) was slightly smaller than that in age (0.734), NT-proBNP level (0.732), E/e' (0.695), and Ed/Ea (0.709). Kaplan-Meier survival analysis clearly showed that age >85 years (p<0.001), NT-proBNP level >888 pg/mL (p=0.003), E/e' >14.4 (p=0.020), and Ed/Ea >0.153 (p<0.001) were determinant factors for mortality. Cox hazard ratios were also significant in these indices (p=0.002, p=0.012, p=0.028, and p=0.001, respectively). In the case of all-cause mortality or admission for cardiac events, the results were nearly similar as those in the case of all-cause mortality. Ed/Ea exhibited a larger Cox hazard ratio for prognosis than E/e' in the multivariate analysis.
Conclusions
LA pressure overload compared to volume overload was a useful marker for prognosis in elderly patients with HFpEF. As a single index for LA pressure overload in noninvasive echocardiographic findings, Ed/Ea may be more suitable than E/e'.
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Affiliation(s)
| | | | | | | | | | - H Inui
- Yao Municipal Hospital, Yao, Japan
| | - K Ueno
- Yao Municipal Hospital, Yao, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | | | - H Abe
- Osaka National Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
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Tamaki S, Yamada T, Morita T, Furukawa Y, Fukunami M, Yasumura Y, Abe H, Uematsu M, Higuchi Y, Hikoso S, Nakatani D, Sakata Y. P786Plasma volume status is associated with the change in nutritional status during hospitalization in acute decompensated heart failure patients with preserved left ventricular ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Plasma volume (PV) expansion has an essential role in heart failure (HF). PV can be estimated by a simple formula using hematocrit and body weight, and PV status (PVS) provides prognostic information in patients (pts) with chronic HF. Nutritional status (NS) based on the prognostic nutritional index (PNI) and NS change during hospitalization have been shown to predict prognosis in pts admitted with acute decompensated HF (ADHF).
Purpose
We sought to assess the hypothesis that PVS is associated with NS change during hospitalization in pts with HF with preserved LVEF (HFpEF) who are admitted with ADHF.
Methods
We prospectively studied 411 pts who were admitted for ADHF with LVEF ≥50% and survived to discharge. Body weight measurement and venous blood sampling were performed on admission and at discharge. PVS was defined as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females); and PVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). The pts were divided into 3 groups by PNI: normal (>38), moderate malnutrition (35–38), and severe malnutrition (<35). During admission, pts who remained in the moderate or severe malnutrition group or whose NS worsened were defined as no improvement in NS. Follow-up data was obtained in 203 cases. They were followed for up to 18 months, and the incidence of all-cause death was evaluated.
Results
On admission, PVS in the moderate (n=71, 13.3±13.9%) or severe malnutrition group (n=69, 14.8±10.8%) was significantly higher than in the normal PNI group (n=271, 5.4±10.8%, p<0.001). During hospitalization, 123 pts had no NS improvement. Admission PVS was significantly higher in pts with no NS improvement than in pts with improved NS (13.9±11.2% vs 5.9±12.8%, p<0.0001). In multivariate logistic regression analysis, admission PVS was independently associated with no NS improvement during hospitalization (OR 1.06, 95% CI 1.03–1.08, p<0.0001). Receiver operating characteristics curve analysis revealed that the optimal cut-off value of admission PVS for predicting no NS improvement was 9.4% (sensitivity: 72%, specificity: 63%). The area under the curve for predicting no NS improvement using admission PVS was significantly greater than for other independent factors (Figure 1A). During the follow-up period (median 12.4 months), 68 of 203 patients had all-cause death. Kaplan-Meier analysis showed that the patients with no NS improvement had a significantly higher risk of all-cause death (Figure 1B).
Figure 1
Conclusions
In this multicenter study, admission PVS was shown to be associated with poor improvement in NS during hospitalization in HFpEF pts admitted for ADHF.
Acknowledgement/Funding
Roche diagnostics, FUJIFILM Toyama Chemical
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Affiliation(s)
- S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - T Morita
- Osaka General Medical Center, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - M Fukunami
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - H Abe
- Osaka National Hospital, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Osaka, Japan
| | | | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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Masuda M, Kanda T, Asai M, Mano T, Yamada T, Yasumura Y, Uematsu M, Hikoso S, Nakatani D, Tamaki S, Higuchi Y, Nakagawa Y, Fuji H, Abe H, Sakata Y. P6356Comparisons of clinical outcomes in patients with heart failure with preserved ejection fraction with and without atrial fibrillation: results from a multicenter PURSUIT-HFpEF registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
The presence of atrial fibrillation (AF) has been demonstrated to be associated with poor clinical outcomes in heart failure patients with reduced ejection fraction.
Objective
This study aimed to elucidate the impact of the presence of atrial fibrillation (AF) on the clinical characteristics, therapeutics, and outcomes in patients with heart failure and preserved ejection fraction (HFpEF).
Methods
PURSUIT-HFpEF is a multicenter prospective observational study including patients hospitalized for acute heart failure with left ventricular ejection fraction of >50%. Patients with acute coronary syndrome or severe valvular disease were excluded.
Results
Of 486 HFpEF patients (age, 80.8±9.0 years old; male, 47%) from 24 cardiovascular centers, 199 (41%) had AF on admission. Patients with AF had lower systolic blood pressures (142±27 vs. 155±35mmHg, p<0.0001) and higher heart rates (91±29 vs. 82±26bpm, p<0.0001) than those without. There was no difference in the usage of inotropes or mechanical ventilation between the 2 groups. A higher quality of life score (EQ5D, 0.72±0.27 vs. 0.63±0.30, p=0.002) was observed at discharge in patients with than without AF. In addition, AF patients tended to demonstrate lower in-hospital mortality rates (0.5% vs. 2.4%, p=0.09) and shorter hospital stays (20.3±12.1 vs. 22.6±18.4 days, p=0.09) than those without. During a mean follow up of 360±111 days, mortality (14.1% vs. 15.3) and heart failure re-hospitalization rates (13.1% vs. 13.9%) were comparable between the 2 groups.
Conclusion
In contrast to heart failure patients with reduced ejection fraction, AF on admission was not associated with poor long-term clinical outcomes among HFpEF patients. Several in-hospital outcomes were better in patients with AF than in those without.
Acknowledgement/Funding
None
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Affiliation(s)
- M Masuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Kanda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Asai
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Mano
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - M Uematsu
- Osaka National Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiology, Suita, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Cardiology, Suita, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | | | - Y Nakagawa
- Kawanishi city hospital, Kawanishi, Japan
| | - H Fuji
- Kobe ekisaikai hospital, Kobe, Japan
| | - H Abe
- Osaka National Hospital, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiology, Suita, Japan
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Seo M, Yamada T, Tamaki S, Yasumura Y, Uematsu M, Abe H, Higuchi Y, Hikoso S, Nakatani D, Fukunami M, Sakata Y. P1649Prognostic significance of serum cholinesterase in patients with acute decompensated heart failure with preserved ejection fraction: insights from PURSUIT-HFpEF registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Comorbidities strongly influence the prognosis in heart failure with preserved ejection fraction (HFpEF). Malnutrition is one of the most important comorbidities among heart failure patients. Serum cholinesterase (CHE), one of the markers of malnutrition, was reported to be a prognostic factor in patients with chronic heart failure. In addition, we previously reported prognostic significance of CHE from a single center registry data of acute decompensated heart failure (ADHF). The aim of this study is to conduct external validation of the prognostic role of CHE using multi-center HFpEF registry.
Methods and results
Patients data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study. PURSUIT-HFpEF study is a prospective multicenter observational study in which collaborating hospitals in Osaka recorded clinical, echocardiographic, and outcome data of patients with ADHF and preserved ejection fraction. Between June 2016 and January 2018, 381 patients were enrolled and we excluded patients without sufficient laboratory data and in-hospital death. Finally, we analyzed 204 patients with survival discharge. Laboratory data including CHE and echocardiography were obtained just before discharge. The endpoint of this study is the composite of all-cause death and worsening heart failure re-admission (cardiac event). During a follow up period of 0.92±0.37 years, 49 patients had cardiac event. CHE was significantly lower in patients with than without cardiac event (183±67 vs 223±71 U/L, p<0.0001). At multivariate Cox analysis, CHE (p=0.0020) was significantly associated with cardiac event, independently of NT-pro BNP after adjustment of age, sex, eGFR and hemoglobin. ROC curve analysis showed that AUC of CHE for the prediction of cardiac event was 0.706 (95% CI 0.638–0.768). Kaplan-Meier analysis showed that patients with low CHE (<211U/L defined by median) had a significantly greater risk of cardiac event (35% vs 13% p=0.0002).
Figure 1
Conclusion
Serum cholinesterase level is the useful prognostic marker for the prediction of cardiac event in patients with ADHF with preserved ejection fraction.
Acknowledgement/Funding
Roche diagnostics, FUJIFILM Toyama Chemical
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Affiliation(s)
- M Seo
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology, Amagasaki, Japan
| | - M Uematsu
- Osaka National Hospital, Cardiology, Osaka, Japan
| | - H Abe
- Osaka National Hospital, Cardiology, Osaka, Japan
| | - Y Higuchi
- Osaka Police Hospital, Cardiology, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - M Fukunami
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
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Sunaga A, Hikoso S, Yamada T, Yasumura Y, Uematsu M, Abe H, Nakagawa Y, Higuchi Y, Fuji H, Mano T, Nakatani D, Mizuno H, Okada K, Kitamura T, Sakata Y. 128Change in geriatric nutritional risk index predicts one-year mortality in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0044] [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
Malnutrition is associated with adverse prognosis in heart failure patients. However, in patients with heart failure with preserved ejection fraction (HFpEF), the effects of change in nutritional status during hospitalization on prognosis is unknown. Geriatric nutritional risk index (GNRI) is a widely used objective index for evaluating nutritional status. Low GNRI (<92) has moderate or severe nutritional risk and high GNRI (≥92) has no or low nutritional risk.
Purpose
The purpose of this study was to clarify the effect of change in GNRI during hospitalization on one-year mortality and the association between the value of GNRI and one-year mortality in patients with HFpEF.
Methods
We prospectively registered patients with HFpEF in PURSUIT-HFpEF registry when they were hospitalized for heart failure in 29 hospitals. Preserved ejection fraction was defined as more than 50% of left ventricular ejection fraction. Of the 486 patients who registered PURSUIT-HFpEF, 228 cases with one-year follow-up data were examined. GNRI was calculated as follows: 14.89 × serum albumin (g/dl) + 41.7 × body mass index/22.
Results
Mean age was 81±10 years and 100 patients (44%) were male. During a median [interquartile range] follow-up period of 374 [342, 400] days, 28 patients (12%) died. Mortality was significantly higher in patients with low GNRI at admission (n=65) than those with high GNRI at admission (n=163) (26% vs. 9%, log-rank P=0.011) and higher in patients with low GNRI at discharge (n=109) than those with high GNRI at discharge (n=119) (22% vs. 6%, log-rank P=0.002). Multivariate analysis with Cox proportional hazard model with patient characteristics at admission revealed that low GNRI at admission was independently associated with mortality (hazard ratio: 0.96, 95% CI: 0.93–0.99, P=0.035) and that with patient characteristics at discharge revealed that low GNRI at discharge was independently associated with mortality (hazard ratio: 0.94, 95% CI: 0.91–0.97, P<0.001). We also compared mortality by dividing patients into 4 group according to whether GNRI was high or low at the time of admission and discharge. Patients with low GNRI at admission and at discharge (n=59) exhibited the highest mortality, on the other hand, patients with high GNRI at admission and low GNRI at discharge (n=50) exhibited higher mortality than those with high GNRI both at admission and at discharge (n=113) (Low and low: 28% vs. High and low: 14% vs. High and high: 6% vs. Low and high: 0%, log-rank P=0.010).
All cause mortality
Conclusion
GNRI at admission or at discharge was independently associated with one-year mortality in patients with HFpEF. Moreover, worsening GNRI during hospitalization is associated with the worse prognosis. It is important to prevent lowering GNRI during treatment of acute decompensated HFpEF.
Acknowledgement/Funding
Roche Diagnostics, FUJIFILM Toyama Chemical
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Affiliation(s)
- A Sunaga
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - S Hikoso
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology, Amagasaki, Japan
| | - M Uematsu
- Osaka National Hospital, Cardiology, Osaka, Japan
| | - H Abe
- Osaka National Hospital, Cardiology, Osaka, Japan
| | - Y Nakagawa
- Kawanishi City Hospital, Cardiology, Kawanishi, Japan
| | - Y Higuchi
- Osaka Police Hospital, Cardiology, Osaka, Japan
| | - H Fuji
- Kobe Ekisaikai Hospital, Cardiology, Kobe, Japan
| | - T Mano
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - D Nakatani
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - H Mizuno
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - K Okada
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - T Kitamura
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - Y Sakata
- Osaka University, Cardiovascular Medicine, Suita, Japan
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Fukuhara A, Saito J, Birring SS, Sato S, Uematsu M, Suzuki Y, Rikimaru M, Watanabe N, Saito M, Kawamata T, Umeda T, Togawa R, Sato Y, Koizumi T, Hirai K, Minemura H, Nikaido T, Kanazawa K, Tanino Y, Munakata M, Shibata Y. Clinical Characteristics of Cough Frequency Patterns in Patients with and without Asthma. J Allergy Clin Immunol Pract 2019; 8:654-661. [PMID: 31541769 DOI: 10.1016/j.jaip.2019.08.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cough is a frequent symptom of asthma. Cough frequency (CoFr) monitoring devices are now available to objectively measure cough counts and offer a novel endpoint to assess asthma. However, little is known about CoFr in asthma. OBJECTIVE The aims were, first, to determine whether unique features of CoFr exist in asthmatic and nonasthmatic patients and, secondly, to evaluate relationships between CoFr and pathophysiological parameters of asthma. METHODS In the current study, 73 asthmatic and 63 nonasthmatic patients suffering from persistent cough were enrolled. At study entry, the Leicester Cough Questionnaire (LCQ health status), cough visual analog scale (VAS), Leicester Cough Monitor (LCM), fractional exhaled nitric oxide (FeNO) measurements, and spirometry were performed. In asthmatic patients, the bronchial hyperresponsiveness (BHR) test was conducted if applicable. In 28 asthmatic and 17 nonasthmatic patients, LCQ, VAS, and LCM were examined before and after treatment. RESULTS CoFr during nighttime (asleep) was significantly higher in asthmatic patients than in nonasthmatic patients. Twenty-four-hour CoFr significantly decreased after appropriate treatment and was correlated with changes in VAS and LCQ in all patients. The improvement in cough in asthmatic patients was greater during nighttime than during daytime (awake). CoFr in asthmatic patients was significantly correlated with BHR, but not with FeNO. CONCLUSIONS In asthmatic patients, nocturnal CoFr can be associated with BHR, was significantly higher before treatment, but improved more after treatment compared with nonasthmatic patients. Monitoring nocturnal CoFr may provide unique and valuable information on making an early prediction of therapeutic effects in asthma.
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Affiliation(s)
- Atsuro Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Junpei Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan.
| | - Surinder S Birring
- Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Suguru Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuhito Suzuki
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Natsumi Watanabe
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mikako Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenichiro Hirai
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | | | - Yoko Shibata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
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Saito J, Kikuchi M, Fukuhara A, Sato S, Rikimaru M, Suzuki Y, Uematsu M, Fukuhara N, Kawamata T, Umeda T, Togawa R, Sato Y, Koizumi T, Hirai K, Minemura H, Nikaido T, Kanazawa K, Tanino Y, Shibata Y, Munakata M. Comparison of fractional exhaled nitric oxide levels measured by different analyzers produced by different manufacturers. J Asthma 2019; 57:1216-1226. [PMID: 31288573 DOI: 10.1080/02770903.2019.1642351] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Fractional exhaled nitric oxide (FeNO) is widely used as a biomarker of allergic airway inflammation. At present, both stationary chemiluminescence and portable electrochemical analyzers produced by different manufacturers are available. However, it remains debatable whether those analyzers are comparable to each other. We compare FeNO levels obtained by different analyzers.Methods: For the first study, 153 subjects were enrolled to compare differences in FeNO levels measured using three analyzers (NA623NP®, NObreath®, and NIOX MINO®) which were produced by different manufacturers. For the second study, 30 subjects were recruited to compare FeNO levels obtained by the two analyzers (NIOX MINO® and NIOX VERO®) produced by the same manufacturer. FeNO was measured twice using each analyzer in random order.Results: FeNO levels obtained using the NIOX MINO® and NObreath® were more variable than those measured using the NA623NP®. There were strong positive correlations in FeNO levels measured by the NA623NP®, NIOX MINO®, and NObreath® (p < 0.001). The NA623NP® and NIOX MINO® provided the highest and lowest FeNO levels, respectively; whereas, those obtained by NObreath® were intermediate. No significant differences were observed in FeNO levels obtained using the NIOX MINO® and NIOX VERO®.Conclusions: FeNO levels measured by the NIOX MINO® and NIOX VERO®, both of which were produced by the same manufacturer, have comparability. However, significant differences in FeNO levels exist when measured by analyzers manufactured by different manufacturers. This should be taken into account for FeNO measurement.
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Affiliation(s)
- Junpei Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masami Kikuchi
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Atsuro Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Suguru Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuhito Suzuki
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Naoko Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takeshi Umeda
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenichiro Hirai
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mitsuru Munakata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
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Okuma K, Okamoto H, Iijima K, Nishioka F, Kashihara T, Shima S, Uematsu M, Igaki H, Nakayama Y, Itami J, Murakami N, Nakamura S. EP-1403 Retrospective evaluation of usefulness of MR-guided adaptive radiotherapy of gastric MALT lymphoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31823-7] [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: 11/30/2022]
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Uematsu M, Nakamura T, Yoshizaki T, Watanabe Y, Deyama J, Watanabe K, Kobayashi T, Fujioka D, Saito Y, Nakamura K, Kawabata K, Obata JE, Kugiyama K. High levels of stromal cell-derived factor-1α predict short-term progression of renal dysfunction in patients with coronary artery disease. Clin Exp Nephrol 2019; 23:920-927. [PMID: 30830550 DOI: 10.1007/s10157-019-01722-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/25/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Stromal cell-derived factor-1α (SDF-1α) is an inflammatory chemokine that plays a critical role in cardiovascular disease. Although persistent inflammation causes renal dysfunction, it remains unclear whether SDF-1α is related to progression of chronic kidney disease. This study examined whether high levels of SDF-1α are associated with future declines in renal function in patients with coronary artery disease (CAD). METHODS Plasma levels of SDF-1α in the peripheral blood were measured by enzyme-linked immunosorbent assay in 344 patients with CAD. All patients were followed for 24 months or until the occurrence of renal dysfunction, defined as ≥ 25% decrease in estimated glomerular filtration rate (eGFR) from baseline. RESULTS During the follow-up period, 36 patients developed renal dysfunction. Multivariate logistic regression analysis showed that high plasma levels of SDF-1α were significantly associated with progression of renal dysfunction (odds ratio 1.65; 95% confidence intervals 1.07-2.35, p = 0.03). In addition, high plasma levels of SDF-1α had a significant incremental effect on the predictive value of known risk factors for renal dysfunction in analyses using net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.58 [0.07-1.02], p < 0.01; and IDI 0.030 [0.001-0.085], p = 0.02). CONCLUSION High plasma levels of SDF-1α were associated with the short-term decline of eGFR in patients with CAD. Thus, SDF-1α may be useful for predicting the progression of renal dysfunction in patients with CAD.
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Affiliation(s)
- Manabu Uematsu
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan.
| | - Takamitsu Nakamura
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Toru Yoshizaki
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Yosuke Watanabe
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Juntaro Deyama
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Kazuhiro Watanabe
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Tsuyoshi Kobayashi
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Daisuke Fujioka
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Yukio Saito
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Kazuto Nakamura
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Kenichi Kawabata
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Jun-Ei Obata
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, 409-3898, Japan
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38
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Uematsu M, Yokouchi H, Tanino Y, Munakata M. Renin-producing germ cell tumor in the pineal apparatus and mediastinum: A rare case report. J Cancer Res Ther 2018; 14:S806-S808. [PMID: 30249910 DOI: 10.4103/0973-1482.180682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Ectopic extrarenal renin-producing tumor is a rare disease with approximately 30 case reports in English literature. We herein present the first case of renin-producing germ cell tumors in the pineal apparatus and mediastinum. A 26-year-old man who had undergone craniotomy for the treatment of pineal tumor was found to have hypertension at a regular visit postoperatively. Laboratory findings revealed high plasma levels of renin activity and that of aldosterone concentration. Chest computed tomography demonstrated a large tumor in the mediastinum. The pathological findings revealed the mediastinal germ cell tumor positive for renin. The present case suggests that for young patients presenting with hypertension with a mediastinal tumor, the possibility of a renin-producing tumor should be considered.
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Affiliation(s)
- Manabu Uematsu
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hiroshi Yokouchi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Mitsuru Munakata
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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Nikaido T, Tanino Y, Wang X, Sato Y, Togawa R, Kikuchi M, Misa K, Saito K, Fukuhara N, Kawamata T, Rikimaru M, Umeda T, Morimoto J, Koizumi T, Suzuki Y, Hirai K, Uematsu M, Minemura H, Fukuhara A, Sato S, Saito J, Yokouchi H, Kanazawa K, Shibata Y. Serum decorin is a potential prognostic biomarker in patients with acute exacerbation of idiopathic pulmonary fibrosis. J Thorac Dis 2018; 10:5346-5358. [PMID: 30416782 DOI: 10.21037/jtd.2018.08.60] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Decorin is a small leucine-rich repeat proteoglycan that plays a critical role in collagen fibrillogenesis, and regulates inflammation, wound healing and angiogenesis. In idiopathic pulmonary fibrosis (IPF), decorin is expressed in fibrotic lesions; furthermore, intratracheal gene transfer of decorin has been demonstrated to inhibit bleomycin-induced pulmonary fibrosis. Although these results suggest the critical role of decorin in pulmonary fibrosis, the role of decorin in the acute exacerbation of idiopathic interstitial pneumonia (AE-IIP) has not been clarified in detail. Thus, the goal of this study was to determine the role of decorin in AE-IIP. Methods We retrospectively analyzed AE-IIP patients who had been admitted to our hospital. First, serum decorin levels were compared among patients with AE-IIP, patients with stable idiopathic interstitial pneumonia (SD-IIP), and healthy subjects. Next, the relationship between serum decorin levels and clinical parameters was analyzed in AE-IIP patients. Finally, the association between serum decorin levels and prognosis was evaluated in AE-IIP patients. IIP was divided into IPF and non-IPF, according to the published guidelines. Results The serum decorin levels of AE-IIP patients were significantly lower than those of both healthy subjects and SD-IIP patients. Serum decorin levels were not related with the clinical parameters and prognosis, when all IIP patients were analyzed. In IPF patients, serum decorin levels had a significant correlation with oxygenation, and IPF patients with low serum decorin levels had a significantly higher survival rate than those with high serum decorin levels. Conclusions Serum decorin levels are a potential prognostic biomarker in AE-IPF.
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Affiliation(s)
- Takefumi Nikaido
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Xintao Wang
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuki Sato
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ryuichi Togawa
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masami Kikuchi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenichi Misa
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazue Saito
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naoko Fukuhara
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takaya Kawamata
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mami Rikimaru
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Umeda
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Julia Morimoto
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tatsuhiko Koizumi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yasuhito Suzuki
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenichiro Hirai
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Manabu Uematsu
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsuro Fukuhara
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Suguru Sato
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junpei Saito
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroshi Yokouchi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
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Yasumura K, Abe H, Iida Y, Kato T, Nakamura M, Toriyama C, Nishida H, Idemoto A, Shinouchi K, Mishima T, Awata M, Date M, Ueda Y, Uematsu M, Koretsune Y. P5682A new prognostic indicator in patients with acute decompensated heart failure including both ambulatory and nutritional statuses. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- K Yasumura
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Abe
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Iida
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Kato
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Nakamura
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - C Toriyama
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Nishida
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - A Idemoto
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Shinouchi
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Mishima
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Awata
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Date
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Ueda
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Koretsune
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
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41
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Suzuki Y, Saito J, Kikuchi M, Uematsu M, Fukuhara A, Sato S, Munakata M. Sputum-to-serum hydrogen sulphide ratio as a novel biomarker of predicting future risks of asthma exacerbation. Clin Exp Allergy 2018; 48:1155-1163. [PMID: 29758106 DOI: 10.1111/cea.13173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/16/2018] [Accepted: 04/22/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Increased level of hydrogen sulphide (H2 S) in sputum is reported to be a new biomarker of neutrophilic airway inflammation in chronic airway disorders. However, the relationship between H2 S and disease activity remains unclear. OBJECTIVE We investigated whether H2 S levels could vary during different conditions in asthma. METHOD H2 S levels in sputum and serum were measured using a sulphide-sensitive electrode in 47 stable asthmatic subjects (S-BA), 21 uncontrolled asthmatic subjects (UC-BA), 26 asthmatic subjects with acute exacerbation (AE-BA) and 15 healthy subjects. Of these, H2 S levels during stable, as well as exacerbation states, were obtained in 13 asthmatic subjects. RESULTS Sputum H2 S levels were significantly higher in the AE-BA subjects compared to the UC-BA and healthy subjects (P < .05). However, serum H2 S levels in the AE-BA subjects were lower than in the S-BA subjects (P < .001) and similar to those in healthy subjects. Thus, the sputum-to-serum ratio of H2 S (H2 S ratio) in the AE-BA subjects was significantly higher than in the S-BA, UC-BA and healthy subjects (P < .05). Among all subjects, sputum H2 S levels showed a trend to decrease with FEV1 %predicted and significantly positive correlations with sputum neutrophils (%), sputum IL-8 and serum IL-8. A multiple linear regression analysis showed that sputum H2 S was independently associated with increased sputum neutrophils (%) and decreased FEV1 %predicted (P < .05). The cut-off level of H2 S ratio to indicate an exacerbation was ≥0.34 (area under the curve; 0.88, with a sensitivity of 81.8% and specificity of 72.7%, P < .001). Furthermore, half of the asthmatic subjects with H2 S ratios higher than the cut-off level experienced asthma exacerbations over the following 3 months after enrolment. CONCLUSIONS The H2 S ratio may provide useful information on predicting future risks of asthma exacerbation, as well as on obstructive neutrophilic airway inflammation as one of the non-Th2 biomarkers, in asthma.
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Affiliation(s)
- Y Suzuki
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - J Saito
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - M Kikuchi
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - M Uematsu
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - A Fukuhara
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - S Sato
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - M Munakata
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
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Abstract
We report on a patient with choriocarcinoma in the pineal region who was successfully treated with stereotactic radiation therapy (SRT). The increased level of serum human chorionic gonadotropin (HCG) was lowered during chemotherapy with etoposide, cisplatin, and ifosfamide. However, HCG was not normalized and magnetic resonance images still showed an enhanced tumor mass with gadolinium. The patient underwent SRT of 40 Gy at an 80% isodose line per 10 fractions over'two weeks, followed by conventional craniospinal irradiation of 32.4 Gy. The level of HCG dropped below the detection limit. The patient has been in good condition for more than four years after the completion of treatment, without any signs of recurrence. We propose SRT as a valid treatment option for malignant germ cell tumors in the pineal region.
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Affiliation(s)
- S Kohyama
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
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Hama Y, Uematsu M, Ichikura T, Tamura E, Aida S, Kohno M, Kusano S. A Case of Primary Small Cell Carcinoma of the Cervical Esophagus with Long-term Survival following Concurrent Chemoradiotherapy: Case Report and Review of the Literature. Tumori 2018; 85:284-7. [PMID: 10587033 DOI: 10.1177/030089169908500414] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors describe a case of small cell carcinoma of the esophagus that was treated by concurrent chemoradiotherapy. Both the esophageal tumor and the regional lymph node metastases disappeared after this treatment. The patient is alive and disease free after more than five years. Primary small cell carcinoma of the esophagus is a rare and aggressive neoplasm with a very poor prognosis, and the treatment modality is controversial. This case illustrates the possibility of treating this tumor type with concurrent chemoradiotherapy.
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Affiliation(s)
- Y Hama
- Department of Radiology, National Defense Medical College, Tokorozawa, Japan
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Sato M, Uematsu M, Hama Y, Kondo M, Kutsuki S, Shigematsu N, Ando Y, Kusano S, Kubo A. Low-Dose Induction Radiotherapy for Stomach Conservation in Patients with Massive Gastric Lymphoma. Tumori 2018; 86:286-8. [PMID: 11016705 DOI: 10.1177/030089160008600405] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Low-dose induction radiotherapy was performed in 4 patients with massive gastric lymphoma in order to treat the disease without gastrectomy. Following the radiotherapy, gastric lesions had shrunk considerably without any complications. Standard chemotherapy and/or radiotherapy could then be performed safely, and stomach conservation could be achieved in all 4 patients.
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Affiliation(s)
- M Sato
- Radiation Oncology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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45
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Irikura N, Uematsu M, Kitahara G, Osawa T, Sasaki Y. Association of interservice interval with conception rate in Japanese Black cattle. Reprod Domest Anim 2018; 53:1020-1023. [PMID: 29663567 DOI: 10.1111/rda.13191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 03/16/2018] [Indexed: 11/29/2022]
Abstract
This study aimed to clarify the association of interservice interval (ISI) with conception rate (CR) and to evaluate factors affecting ISI in Japanese Black cattle. Data used in this study covered 32,639 artificial insemination (AI) records on 972 farms. The mean ± SEM of ISI and CR was 57.0 ± 0.3 days and 44.6 ± 0.3%, respectively. The relative frequency of ISI differed significantly between parity groups (p < .05). For parity 0, the proportion of ISI at an 18- to 24-day interval was 43.6%, whereas the proportions in the other parity groups ranged from 27.2% to 29.1%. The CR was associated significantly with ISI, parity and AI number (p < .05), but not with season. Cows reinseminated at an 18- to 24-day interval had the highest CR (46.8%; p < .05). Cows reinseminated at a 39- to 45-day interval had a similar CR to those reinseminated at 25- 38-day and 46- to 59-day intervals. Cows reinseminated at 11-17, 60-66 and 67 days or longer intervals had the lowest CR (p < .05). Thus, cows returning to oestrus in a normal cycle tended to have a higher probability of conceiving compared with those that returned to oestrus after a normal cycle for any degree of parity and at any number of AI.
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Affiliation(s)
- N Irikura
- Faculty of Agriculture, Department of Animal and Grassland Sciences, University of Miyazaki, Miyazaki, Japan
| | - M Uematsu
- Miyazaki Agricultural Mutual Aid Association, Miyazaki, Japan
| | - G Kitahara
- Faculty of Agriculture, Department of Veterinary Sciences, University of Miyazaki, Miyazaki, Japan.,Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - T Osawa
- Faculty of Agriculture, Department of Veterinary Sciences, University of Miyazaki, Miyazaki, Japan.,Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - Y Sasaki
- Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan.,Organization for Promotion of Tenure Track, University of Miyazaki, Miyazaki, Japan
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46
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Yoshizaki T, Uematsu M, Obata JE, Nakamura T, Fujioka D, Watanabe K, Nakamura K, Kugiyama K. Angiotensin II receptor blockers suppress the release of stromal cell-derived factor-1α from infarcted myocardium in patients with acute myocardial infarction. J Cardiol 2017; 71:367-374. [PMID: 29129394 DOI: 10.1016/j.jjcc.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/09/2017] [Revised: 09/08/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although angiotensin II receptor blockers (ARBs) have been shown to have anti-inflammatory effects on infarcted myocardium in experimental models, little is known in humans. Stromal cell-derived factor-1α (SDF-1α), a pro-inflammatory chemokine, is released from infarcted tissue in patients with acute myocardial infarction (AMI). This study examined whether ARBs suppress SDF-1α production in the infarcted lesion in patients with AMI. METHODS SDF-1α levels were measured by enzyme-linked immunosorbent assays in plasma obtained from the aortic root (AO) and the anterior interventricular vein (AIV) in 50 patients with an anterior AMI. Measurement of SDF-1α levels and left ventriculography were repeated at discharge and 6 months after AMI. Patients were divided into 2 groups according to treatment with ARBs, which were administered at the discretion of the attending physician after admission. RESULTS The AIV-AO gradient of SDF-1α, reflecting SDF-1α release from the infarcted myocardial region, decreased between the time of discharge and 6 months after AMI in patients taking an ARB. In contrast, the SDF-1α transcardiac gradient did not change in patients not taking an ARB. Among the clinical parameters tested, only the use of ARBs was significantly associated with percent changes in the SDF-1α transcardiac gradient from the time of discharge to 6 months after AMI in a linear regression analysis (r=-0.31, p=0.03). The SDF-1α transcardiac gradient 6 months after AMI was inversely correlated with the percent change in left ventricular (LV) ejection fraction (r=-0.52, p<0.01) and positively correlated with the percent change in LV end-diastolic volume index (r=0.57, p<0.01) and LV end-systolic volume index (r=0.54, p<0.01) during 6 months after AMI. CONCLUSIONS ARB treatment suppressed SDF-1α release from the infarcted myocardial region, which was associated with improvement in LV dysfunction and adverse remodeling in AMI survivors.
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Affiliation(s)
- Toru Yoshizaki
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Manabu Uematsu
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Jun-Ei Obata
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Takamitsu Nakamura
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Daisuke Fujioka
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Kazuhiro Watanabe
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Kazuto Nakamura
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | - Kiyotaka Kugiyama
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan.
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Sato R, Arai-Ichinoi N, Kikuchi A, Matsuhashi T, Numata-Uematsu Y, Uematsu M, Fujii Y, Murayama K, Ohtake A, Abe T, Kure S. Novel biallelic mutations in the PNPT1
gene encoding a mitochondrial-RNA-import protein PNPase cause delayed myelination. Clin Genet 2017; 93:242-247. [DOI: 10.1111/cge.13068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/19/2017] [Accepted: 06/05/2017] [Indexed: 12/22/2022]
Affiliation(s)
- R. Sato
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
| | - N. Arai-Ichinoi
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
| | - A. Kikuchi
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
| | - T. Matsuhashi
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
| | - Y. Numata-Uematsu
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
| | - M. Uematsu
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
| | - Y. Fujii
- Department of Pediatrics; Hiroshima University Hospital; Hiroshima Japan
| | - K. Murayama
- Department of Metabolism; Chiba Children's Hospital; Chiba Japan
| | - A. Ohtake
- Department of Pediatrics; Saitama Medical University; Saitama Japan
| | - T. Abe
- Department of Nephrology, Endocrinology, and Vascular Medicine; Tohoku University School of Medicine; Miyagi Japan
| | - S. Kure
- Department of Pediatrics; Tohoku University School of Medicine; Miyagi Japan
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48
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Irikura N, Uematsu M, Kitahara G, Osawa T, Sasaki Y. Effects of service number on conception rate in Japanese Black cattle. Reprod Domest Anim 2017; 53:34-39. [PMID: 28801993 DOI: 10.1111/rda.13049] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/06/2017] [Indexed: 11/30/2022]
Abstract
The conception rate (CR) of Japanese Black cattle has been decreasing since 1990. The objectives of this study were to compare CR by artificial insemination (AI) number, and to assess the interaction between AI number and possible factors related to CR in Japanese Black cattle. Records of 11,182 AI records for 6,741 heifers and 61,302 AI records for 13,139 cows on 977 farms were analysed. The average CR of heifers was 47.0%, and CR at the first, second and third AI was higher than at the fourth or subsequent AI (p < 0.05). The average CR of cows was 47.8%, and their CR at first and second AI was higher than the fourth or subsequent AI (p < 0.05). Data analysis with CR as the dependent variable revealed significant interactions of AI number with interval from calving to first AI and AI season. Cows first serviced at ≤48 days post-partum had lower CR than those at ≥90 days at first AI (p < 0.05), but the interval from calving to first AI did not affect CR at second AI. Cows serviced in the autumn had a higher CR at first AI than those serviced in the spring and winter (p < 0.05); however, there was no seasonal difference in CR at the second AI. In summary, CR began to decrease from the fourth AI in heifers and the third AI in cows. The AI season and the interval from calving to first AI significantly affected CR only at the first AI.
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Affiliation(s)
- N Irikura
- Department of Animal and Grassland Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - M Uematsu
- Miyazaki Agricultural Mutual Aid Association, Miyazaki, Japan
| | - G Kitahara
- Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan.,Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - T Osawa
- Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan.,Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - Y Sasaki
- Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan.,Organization for Promotion of Tenure Track, University of Miyazaki, Miyazaki, Japan
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49
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Kanda T, Fujita M, Iida O, Masuda M, Okamoto S, Ishihara T, Nanto K, Tsujimura T, Sunaga A, Uematsu M, Mano T. P3367A novel index of left ventricular stiffness predicting clinical outcome in patients with heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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50
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Shinouchi K, Iida Y, Toriyama C, Nishida H, Yasumura K, Yorifuji H, Kato T, Idemoto A, Mishima T, Yokoi K, Abe H, Date M, Ueda Y, Uematsu M, Koretsune Y. P2737Impact of preexisting chronic total occlusions of the coronary artery on the outcome of out-of-hospital sudden cardiac arrest patients with acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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