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Ikeda S, Sato K, Takeda M, Shinozaki M, Miki K, Hirano M, Fukuda K, Shiba N. Corrigendum to "Oncostatin M mediates cardioprotection via angiogenesis in ischemic heart disease" [Am. Heart J. Plus Cardiol. Res. Pract. vol. 35, 2023, 100331]. Am Heart J Plus 2024; 40:100385. [PMID: 38586430 PMCID: PMC10994950 DOI: 10.1016/j.ahjo.2024.100385] [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] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
[This corrects the article DOI: 10.1016/j.ahjo.2023.100331.].
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Affiliation(s)
- Shohei Ikeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Koichi Sato
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Morihiko Takeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Mariko Shinozaki
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Keita Miki
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Michinori Hirano
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Koji Fukuda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Nobuyuki Shiba
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
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Suzuki K, Aizawa M, Tamazawa K, Ueda K, Wada J, Nakajima Y, Shibukawa G, Ikeda S, Tsunoda S, Togashi K. Relapse of Ulcerative Colitis with Immune Thrombocytopenia and Pyoderma Gangrenosum Subsequent to Receiving COVID-19 Vaccination. Intern Med 2024; 63:665-669. [PMID: 38171870 PMCID: PMC10982002 DOI: 10.2169/internalmedicine.2969-23] [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] [Received: 09/25/2023] [Accepted: 11/12/2023] [Indexed: 01/05/2024] Open
Abstract
This case illustrates the complex interactions of the immune responses after vaccination and highlights their potential connections to various autoimmune conditions. A 22-year-old man with quiescent ulcerative colitis (UC) presented with abdominal pain, rectal bleeding, and thrombocytopenia 7 days after receiving the third coronavirus disease 2019 mRNA vaccination. Laboratory data confirmed the diagnosis of immune thrombocytopenia. High-dose intravenous immunoglobulin administration boosted the patient's platelet count. Simultaneously, colonoscopy revealed that his UC had relapsed. Although salazosulfapyridine briefly improved his symptoms, his stool frequency worsened one week later. The patient also developed pyoderma gangrenosum. Subsequent treatment with infliximab notably improved both pyoderma gangrenosum and UC.
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Affiliation(s)
- Kohei Suzuki
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Masato Aizawa
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Kana Tamazawa
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Kenta Ueda
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Jun Wada
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Yuki Nakajima
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Goro Shibukawa
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
| | - Shohei Ikeda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Japan
| | - Saburo Tsunoda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Japan
| | - Kazutomo Togashi
- Department of Coloproctology & Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan
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Deng S, Morisako H, Beniwal M, Sasaki T, Ikegami M, Ikeda S, Teranishi Y, Goto T. Usefulness of Opening the Diaphragma Sellae Before Transecting Interclinoidal Ligament for Endoscopic Endonasal Transoculomotor Triangle Approach: Technical Nuances and Surgical Outcomes. World Neurosurg 2024:S1878-8750(24)00333-4. [PMID: 38428812 DOI: 10.1016/j.wneu.2024.02.120] [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] [Received: 12/29/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Opening the oculomotor triangle (OT) and removing the posterior fossa lesion by endoscopic endonasal approach (EEA) is challenging for even an experienced endoscopic neurosurgeon. We summarize the treatment experience and technical nuances with EEA for resection of pituitary neuroendocrine tumors and cavernous sinus (CS) meningiomas invading through the OT. METHODS Between 2018 and 2022, 8 patients, comprising 5 with pituitary neuroendocrine tumors (3 with nonfunctioning and 2 with somatotroph tumors with increased levels of growth hormone) and 3 CS meningiomas, were treated using an endoscopic endonasal transoculomotor triangle approach. The critical surgical technique is continuously opening the diaphragma sellae from medial to lateral toward the interclinoidal ligament and transecting it to enlarge the OT. We evaluated preoperative tumor size, previous surgical history, preoperative symptoms, extent of tumor resection, histopathology, and postoperative complications for all patients. RESULTS The gross total resection (defined as complete removal) in 3 patients (38%), near-total resection (defined as >95% removal) in 4 patients (50%), and subtotal resection (defined as ≤90% removal) in 1 patient (12%) and gross total resection of tumor invading through the OT was achieved in all patients through pure EEA. Two of 3 patients with visual deficits in nonfunctioning pituitary neuroendocrine tumors improved, and the other remained stable postoperatively. One patient showed transient oculomotor nerve palsy. The growth hormone level of the 2 patients with somatotroph tumors declined to normal. For 3 patients with CS meningiomas, cranial nerve palsy improved in 2 patients, whereas the other patient developed increased facial numbness after surgery. CONCLUSIONS The endoscopic endonasal transoculomotor triangle approach is an efficient surgical option for tumors with CS invasion and OT penetration.
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Affiliation(s)
- Shengze Deng
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Neurosurgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Hiroki Morisako
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
| | - Manish Beniwal
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Tsuyoshi Sasaki
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Masaki Ikegami
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shohei Ikeda
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yuichi Teranishi
- Department of Otolaryngology and Head and Neck Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takeo Goto
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Kayo T, Suzuki M, Mitsuma T, Suzuki M, Ikeda S, Sukegawa M, Tsunoda S, Ohta M. Bleeding Risk of Acupuncture for Patients with Hematological Malignancies Accompanying Thrombocytopenia: A Retrospective Chart Review. J Integr Complement Med 2024; 30:77-84. [PMID: 37405736 DOI: 10.1089/jicm.2022.0710] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Introduction: In recent years, it has been reported that acupuncture is useful for alleviating the symptoms of patients with hematological malignancies, but the safety of acupuncture for such patients has not been established. This study evaluated the risk of bleeding from acupuncture in patients with hematological malignancies accompanying thrombocytopenia. Methods: The authors performed a retrospective investigation of the medical records of patients with hematological malignancies who received acupuncture during hospitalization at the hematology department of a single medical center in Japan. The bleeding risk at the acupuncture site was evaluated in the following four groups according to the platelet count measured on the day of acupuncture treatment: (1) <20 × 103/μL, (2) 20-49 × 103/μL, (3) 50-99 × 103/μL, and (4) 100 × 103/μL or more. Occurrence of grade 2 or higher bleeding according to the Common Terminology Criteria for Adverse Events, version 5.0, within 24 h from the acupuncture session or before the next session was defined as an event, and the risk of occurrence of bleeding was examined in each group. Results: Of 2423 acupuncture sessions conducted on 51 patients with hematological malignancies, 815 were included in the analysis. Ninety sessions were performed in the <20 × 103/μL platelet count group, 161 in the 20-49 × 103/μL group, 133 in the 50-99 × 103/μL group, and 431 in the 100 × 103/μL or more group. No bleeding event according to the authors' definition occurred in any of these groups. Conclusions: This study is the largest to date to assess the bleeding risk of acupuncture in patients with hematological malignancies accompanying thrombocytopenia. The authors considered that acupuncture could be safely performed without causing serious bleeding for patients with hematological malignancies accompanying thrombocytopenia.
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Affiliation(s)
- Takumi Kayo
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masao Suzuki
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Tadamichi Mitsuma
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Manabu Suzuki
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Shohei Ikeda
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masumi Sukegawa
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Saburo Tsunoda
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masatsugu Ohta
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
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Ikeda S, Sato K, Takeda M, Shinozaki M, Miki K, Hirano M, Fukuda K, Shiba N. Oncostatin M mediates cardioprotection via angiogenesis in ischemic heart disease. Am Heart J Plus 2023; 35:100331. [PMID: 38511182 PMCID: PMC10946052 DOI: 10.1016/j.ahjo.2023.100331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 03/22/2024]
Abstract
Objective Oncostatin M (OSM) is an inflammatory cytokine belonging to the interleukin-6 family member, which plays an important role in various cardiovascular diseases. We recently reported increased serum OSM levels in patients with coronary artery disease. However, the specific role in HF with ischemic heart disease (IHD) remains unclear. Methods and results A total of 120 patients with HF and 48 control subjects were enrolled in this study. Serum OSM levels were measured using a sandwich technique immunoassay during the compensated state. The results revealed significantly higher serum OSM levels in HF patients compared to controls. Importantly, HF patients with IHD had higher OSM levels, and those with collateral flow showed the even higher levels, indicating a potential involvement in angiogenesis. Furthermore, a positive correlation was found between serum OSM levels and levels of vascular endothelial growth factor (VEGF). In vitro experiments demonstrated that recombinant OSM upregulated VEGF production in cultured human coronary artery endothelial cells. We additionally observed that endogenous OSM levels were enhanced through exercise. Lastly, we identified the potential of SGLT2 inhibitors to enhance OSM production. Conclusions Serum OSM levels were elevated in HF patients, particularly in those with IHD Our data indicated that endogenous OSM induces VEGF production in the heart, suggesting the activation of angiogenesis, which can be further enhanced by exercise or SGLT2 inhibitors.
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Affiliation(s)
- Shohei Ikeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Koichi Sato
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Morihiko Takeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Mariko Shinozaki
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Keita Miki
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Michinori Hirano
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Koji Fukuda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Nobuyuki Shiba
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
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Nakamura M, Keller MA, Fefelova N, Zhai P, Liu T, Tian Y, Ikeda S, Del Re DP, Li H, Xie LH, Sadoshima J. Ser14 phosphorylation of Bcl-xL mediates compensatory cardiac hypertrophy in male mice. Nat Commun 2023; 14:5805. [PMID: 37726310 PMCID: PMC10509265 DOI: 10.1038/s41467-023-41595-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
The anti-apoptotic function of Bcl-xL in the heart during ischemia/reperfusion is diminished by K-Ras-Mst1-mediated phosphorylation of Ser14, which allows dissociation of Bcl-xL from Bax and promotes cardiomyocyte death. Here we show that Ser14 phosphorylation of Bcl-xL is also promoted by hemodynamic stress in the heart, through the H-Ras-ERK pathway. Bcl-xL Ser14 phosphorylation-resistant knock-in male mice develop less cardiac hypertrophy and exhibit contractile dysfunction and increased mortality during acute pressure overload. Bcl-xL Ser14 phosphorylation enhances the Ca2+ transient by blocking the inhibitory interaction between Bcl-xL and IP3Rs, thereby promoting Ca2+ release and activation of the calcineurin-NFAT pathway, a Ca2+-dependent mechanism that promotes cardiac hypertrophy. These results suggest that phosphorylation of Bcl-xL at Ser14 in response to acute pressure overload plays an essential role in mediating compensatory hypertrophy by inducing the release of Bcl-xL from IP3Rs, alleviating the negative constraint of Bcl-xL upon the IP3R-NFAT pathway.
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Affiliation(s)
- Michinari Nakamura
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA.
| | - Mariko Aoyagi Keller
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Nadezhda Fefelova
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Peiyong Zhai
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Tong Liu
- Center for Advanced Proteomics Research, Department of Biochemistry & Molecular Biology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Yimin Tian
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Shohei Ikeda
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Dominic P Del Re
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Hong Li
- Center for Advanced Proteomics Research, Department of Biochemistry & Molecular Biology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Lai-Hua Xie
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Junichi Sadoshima
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers-New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA.
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Peng G, Tsukamoto S, Okumura K, Ogawa H, Ikeda S, Niyonsaba F. 192 Betacellulin alleviates Th2 cytokine-mediated impairment of skin tight junction barrier through epidermal growth factor receptor and protein kinase C pathway. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.203] [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: 11/19/2022]
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8
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Nguyen H, Peng G, Jujillo-paez J, Yue H, Okumura K, Ogawa H, Ikeda S, Niyonsaba F. 180 The antimicrobial peptide derived from insulin-like growth factor-binding protein 5 promotes skin barrier function and relieves dermatitis-like symptoms in a mouse model of atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.191] [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: 11/19/2022]
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Kaneda H, Hazama D, Kodama H, Miyazaki A, Azuma K, Kawashima Y, Sato Y, Ito K, Shiraishi Y, Miura K, Takahama T, Oizumi S, Namba Y, Ikeda S, Miura S, Tachihara M. 333P Efficacy and safety of immune checkpoint inhibitors alone or combined with chemotherapy in pulmonary sarcomatoid carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.371] [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: 12/07/2022] Open
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Iguchi M, Masunaga N, Ishii M, Fujino A, Ide Y, Hamatani Y, Yoshizawa T, Doi K, Ikeda S, Esato M, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. Association of beta blocker use with new-onset heart failure and mortality in atrial fibrillation without pre-existing heart failure: the Fushimi AF registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1041] [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
Heart failure (HF) is one of the major complications in atrial fibrillation (AF). We previously reported that not a few AF patients without pre-existing HF (defined as prior HF hospitalization, New York Heart Association functional class≥2, or left ventricular ejection fraction (LVEF)<40%) subsequently developed new-onset HF. Beta blockers are the established therapy for HF, but it remains unclear whether beta blockers prevent new-onset HF and improve outcomes in AF patients without preexisting HF.
Methods
In the Fushimi AF registry, 778 of 3,262 patients without pre-existing HF were receiving beta blockers at baseline. We investigated the incidence of new-onset HF defined as cardiac death or HF hospitalization, and all-cause death in a propensity-matched cohort (N=1,198; mean age, 71 years; 39% female; mean LVEF, 66%). Additionally, annual follow-up prescription data before the onset of events were collected in 294 of patients with beta blockers and 395 of those without beta blockers. We also investigated the association of starting or stopping beta blockers with the incidence of new-onset HF and all-cause death.
Results
During the median follow-up of 5.8 years, new-onset HF and all-cause death occurred in 77 (12.9%) and 118 (19.7%) of patients with beta blockers, and 70 (11.7%) and 131 (21.9%) of those without beta blockers, respectively. Incidence of new-onset HF was comparable between patients with and without beta blockers (Figure 1), and incidence of all-cause death was also comparable between the two groups (Figure 2). In exploratory subgroup analyses, there was no interaction in the association of beta blockers with the incidence of events, except for pulse rate for new-onset HF and left atrial size for all-cause death. Hazard ratio of beta blockers for new-onset HF tended to be lower in patients with higher pulse rates (>84 bpm) (Figure 1), and that for all-cause death was lower in those without left atrial enlargement (Figure 2). Of patients with follow-up prescription data, beta blockers were stopped in 55 (18.7%) and started in 97 (24.6%) patients, respectively. Patients with starting beta blockers had higher pulse rate (78.5±17.3 vs 74.9±13.9 bpm; p=0.03) and more symptomatic AF (58.8% vs 46.0%; p=0.03) compared to those without starting beta blockers, while there was no difference in baseline characteristics between those with and without stopping beta blockers. During the follow-up, the incidences of new-onset HF and all-cause death were also comparable between the patients with and without stopping beta blockers and those with and without starting beta blockers.
Conclusion
Beta blockers were not associated with the incidence of new-onset HF and all-cause death in AF patients without pre-existing HF. However, the exploratory subgroup analyses suggested the existence of subjects who may benefit from beta blockers.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi Sankyo, Novartis Pharma, MSD, Sanofi-Aventis, and Takeda Pharmaceutical.
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - N Masunaga
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Ide
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Yoshizawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - S Ikeda
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Esato
- Ogaki Tokushukai Hospital , Gifu , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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Masunaga N, Ogawa H, Ikeda S, Doi K, Yoshizawa T, Hamatani Y, Ide Y, Fujino A, Ishii M, Iguchi M, Esato M, Wada H, Hasegawa K, Abe M, Akao M. Clinical characteristics and outcomes of atrial fibrillation patients with peripheral artery disease: the Fushimi AF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.532] [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
Atrial fibrillation (AF) represents the common arrhythmia and increases the risk of thromboembolism. Risk assessment for thromboembolism is important for the management of AF patients. Peripheral artery disease (PAD) is identified as a risk factor for thromboembolism in CHA2DS2-VASc score. However, there are little data on clinical characteristics and cardiovascular events of AF patients with PAD.
Purpose
In this study, we investigated the clinical characteristics and outcomes of AF patients with PAD.
Methods
The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients who visited the participating medical institutions in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011 and follow up data including prescription status were available in 4,464 patients from March 2011 to August 2021. Median follow-up period was 1,848 days.
Results
Of 4,464 patients, 183 patients had PAD (4.1%; PAD group). The mean age was higher in PAD group than no-PAD group (PAD group vs. no-PAD group: 76.7 vs. 73.5; p<0.01). Patients with PAD had more co-morbidities such as stroke, systemic embolism, congestive heart failure, hypertension, diabetes mellitus, dyslipidemia coronary artery disease and chronic kidney disease than those without PAD. Thus, CHADS2 score, CHA2DS2-VASc score and HAS-BLED score were higher in PAD group than no-PAD group (2.81 vs. 2.00; p<0.01, 5.17 vs. 3.30; p<0.01, 2.42 vs. 1.71; p<0.01, respectively). The proportion of patients with oral anticoagulant was similar between the two groups and the proportion of patients with antiplatelet drug was higher in PAD group than no-PAD group (59.0% vs. 55.6%; p=0.36, 62.9% vs. 24.7%; p<0.01, respectively). The incidences of all-cause death, cardiac death and myocardial infarction were higher in PAD group than no-PAD group (11.4 vs. 4.6 per 100 person-years; log-rank p<0.01, 1.7 vs. 0.8 per 100 person-years; log-rank p<0.01, 1.2 vs. 0.2 per 100 person-years; log-rank p<0.01). However, the incidence of stroke or systemic embolism was similar between the two groups (2.9 vs. 2.2 per 100 person-years, log-rank p=0.19). Finally, the incidence of composite of cardiac death, stroke, systemic embolism or myocardial infarction was higher in PAD group than no-PAD group (6.0 vs. 3.0 per 100 person-years; log-rank p<0.01).
Conclusion
AF patients with PAD had significantly higher risk for death and cardiac events, whereas the incidence of thromboembolism was similar between AF patients with and without PAD.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- N Masunaga
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - S Ikeda
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Yoshizawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Ide
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Esato
- Ogaki Tokushukai Hospital , Ogaki , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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Ikeda S, Iguchi M, Ogawa H, Minami K, Ishigami K, Doi K, Hamatani Y, Yoshizawa T, Ide Y, Fujino A, Ishii M, Masunaga N, Wada H, Abe M, Akao M. Association of cardiothoracic ratio with heart failure hospitalization in patients with atrial fibrillation: the Fushimi AF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.934] [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
Chest radiography is the most common diagnostic imaging test in clinical medicine, and the cardiothoracic ratio (CTR) is a readily available and non-invasive tool with which to assess the volume status and cardiomegaly. However, it remains unknown whether CTR on chest radiography is associated with the incidence of HF hospitalization in AF patients remains unclear.
Methods
The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,489 patients by the end of August 2021. In the present study, 3,727 patients with available data of CTR were examined. We divided the patients into two groups according to their CTR at baseline; Higher group (CTR ≥50.0%, n=2,696) and Lower group (CTR <50.0%, n=1,031), and compared the clinical background and outcomes between the two groups.
Results
The proportion of female was grater in Higher group, and the patients in Higher group were older. The patients in Higher group had higher prevalence of HF, hypertension and chronic kidney disease. During the median follow-up of 3,033 days, in Kaplan-Meier analysis, the incidence rates of HF hospitalization were higher in Higher group (Higher group: 2.5% per person-year vs. Lower group: 1.1%; p<0.01). Multivariate Cox proportional hazards regression analysis revealed that higher CTR (≥50.0%) was an independent determinant of the incidence of HF hospitalization. Furthermore, when we divided the patients into four groups based on the quartile of CTR; Q1 (CTR<49.0%), Q2 (49.0≤CTR<53.8%), Q3 (53.8≤CTR<59.0%), Q4 (59.0%≤CTR), the incidence of HF hospitalization was more frequent in patients with higher CTR, regardless of the presence or absence of prior hospitalization for HF (Figure).
Conclusion
In Japanese AF patients, patients with higher CTR had significantly higher incidence of HF hospitalization, regardless of the prevalence of prior hospitalization for HF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Ikeda
- Kyoto Medical Centre , Kyoto , Japan
| | - M Iguchi
- Kyoto Medical Centre , Kyoto , Japan
| | - H Ogawa
- Kyoto Medical Centre , Kyoto , Japan
| | - K Minami
- Kyoto Medical Centre , Kyoto , Japan
| | | | - K Doi
- Kyoto Medical Centre , Kyoto , Japan
| | | | | | - Y Ide
- Kyoto Medical Centre , Kyoto , Japan
| | - A Fujino
- Kyoto Medical Centre , Kyoto , Japan
| | - M Ishii
- Kyoto Medical Centre , Kyoto , Japan
| | | | - H Wada
- Kyoto Medical Center, Division of Translational Research , Kyoto , Japan
| | - M Abe
- Kyoto Medical Centre , Kyoto , Japan
| | - M Akao
- Kyoto Medical Centre , Kyoto , Japan
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13
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Hiasa K, Ikeda S, Tsutsui H. Echocardiographic parameters of left atrial structure and function in elderly patients with atrial fibrillation, and clinical outcomes at 2 years: the ANAFIE echocardiographic substudy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.554] [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
Previous studies have shown an association between echocardiographic parameters of cardiac structure and function and prognosis in patients with atrial fibrillation (AF). However, only limited data are available for elderly patients (age, ≥75 years).
Purpose
The All Nippon Atrial Fibrillation In the Elderly (ANAFIE) Registry (UMIN000024006) was a prospective, multicenter, observational study which collected real-world data on the clinical status and prognosis of 33,062 Japanese patients aged ≥75 years and with non-valvular AF (NVAF). A prospective substudy of 1,474 patients who underwent transthoracic echocardiography at baseline was conducted to investigate relations between echocardiographic parameters of left atrial structure and function and clinical outcomes at 2 years.
Methods
Cumulative incidences and adjusted hazard ratios (HRs) of clinical outcomes were calculated using Kaplan–Meier analysis and the Cox proportional-hazards model, respectively. The data were analysed by left atrial volume index (LAVi) category, left atrial emptying fraction (LAEF) category, and direct oral anticoagulant (DOAC) use vs warfarin (WF) use. Cardiovascular (CV) events was a composite of stroke, myocardial infarction (MI), cardiac interventions, heart failure (HF) hospitalization, CV death. Cardiac events was a composite of MI, cardiac intervention, HF hospitalization, and CV death.
Results
Baseline characteristics were mean age of 80.7 years; male, 59.2%; paroxysmal AF, 45.9%; mean CHA2DS2-VASc score, 4.3; mean HAS-BLED score, 1.9; median LAVi, 48.7 mL/m2; median LAEF, 26.6%; comorbidity or history of HF, 32.2%; oral anticoagulant use, 92.7%; DOAC use, 68.7%; and WF use, 24.0%. Incidences (/100 patient-years) and HRs (95% CIs) for each clinical outcome according to LAVi and LAEF category are summarized in Table. Compared with patients with LAEF >45.0% (n=224), those with LAEF ≤45.0% (n=1,213) were at higher risk of CV events (2.19 [1.13–4.27], p=0.021) and HF hospitalization (2.25 [1.02–4.96], p=0.045). Risk of all-cause death was higher in patients with LAVi >48.0 mL/m2 (n=656) than in those with LAVi ≤48.0 mL/m2 (n=621) (1.69 [1.00–2.83], p=0.048). In the subgroups with LAEF ≤45.0% or LAVi >48.0 mL/m2, patients receiving a DOAC had significantly lower risk of cardiac events, CV events, and HF hospitalization than patients receiving warfarin.
Conclusion
In elderly Japanese patients with NVAF, those with LAEF ≤45.0% are at higher risk of CV events and HF hospitalization, and those with LAVi >48.0 mL/m2 are at higher risk of all-cause death. Thus, the higher risk differs between patients with LAEF ≤45.0% and those with LAVi >48.0 mL/m2.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Daiichi Sankyo Co., Ltd.
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Affiliation(s)
- K Hiasa
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine , Fukuoka , Japan
| | - S Ikeda
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine , Fukuoka , Japan
| | - H Tsutsui
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine , Fukuoka , Japan
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14
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Hamatani Y, Iguchi M, Minami K, Ishigami K, Ikeda S, Doi K, Yoshizawa T, Masunaga N, Esato M, Tsuji H, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. The association of left ventricular ejection fraction with incident heart failure in patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.553] [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
Atrial fibrillation (AF) increases the risk of incident heart failure (HF). Left ventricular ejection fraction (LVEF) is an important prognostic parameter in patients with HF. However, little is known regarding the association of LVEF with incident HF in patients with AF.
Purpose
The aim of this study is to investigate the relationship between LVEF at enrollment and incidence of HF hospitalization during follow-up period in patients with AF.
Methods
The Fushimi AF Registry is a community-based prospective survey of patients with AF in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,489 patients by the end of August 2021. In the present study, we investigated 3,544 patients with the data of LVEF at enrollment. We divided the patients into 4 groups stratified by LVEF (reduced LVEF [LVEF <40%], mildly reduced LVEF [LVEF: 40–49%], slightly reduced LVEF [LVEF: 50–59%], and normal LVEF [LVEF ≥60%]), and compared the backgrounds and outcomes between these 4 groups.
Results
Of 3,544 patients, the mean age was 73.6±10.7 years, 1,420 (40%) were female, 1,781 (50%) were paroxysmal AF, and 1,085 (30%) had pre-existing HF. The mean CHADS2 and CHA2DS2-VASc scores were 2.1±1.3 and 3.4±1.7, respectively. The mean LVEF at enrollment was 63±12% (reduced LVEF: 197 [6%], mildly reduced LVEF: 250 [7%], slightly reduced LVEF: 532 [15%] and normal LVEF: 2,565 [72%], respectively). Patients with lower LVEF demonstrated lower prevalence of female and paroxysmal AF, and had a higher CHADS2 and CHA2DS2-VASc scores (all P<0.01). A total of 605 patients were hospitalized for HF during the median follow-up period of 5.5 years, corresponding to an annual incidence of 3.4% per person-year. Kaplan-Meier curves demonstrated that LVEF at enrollment could stratify the incidence of HF hospitalization during follow-up in patients with AF (Picture 1). Multivariable Cox regression analysis revealed that lower LVEF strata were significantly associated with the increased risk of HF hospitalization even after adjustment by age, sex, type of AF and CHA2DS2-VASc score (Picture 1). An increased risk of HF hospitalization was observed even in patients with mildly reduced LVEF (adjusted hazard ratio: 2.56, 95% CI: 1.99–3.29) as well as in those with slightly reduced LVEF (adjusted hazard ratio: 1.79, 95% CI: 1.45–2.22) compared with those with normal LVEF. These results were also the case in AF patients without pre-existing HF (Picture 2).
Conclusion
LVEF at enrollment could stratify the incidence of HF hospitalization in patients with AF, suggesting the importance of measuring LVEF in all patients with AF. Even mildly (LVEF: 40–49%) or slightly (LVEF: 50–59%) reduced LVEF was independently associated with the risk of incident HF in patients with AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Hamatani
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Minami
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Ishigami
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - S Ikeda
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Doi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - T Yoshizawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - N Masunaga
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Arrhythmia , Ogaki , Japan
| | - H Tsuji
- Tsuji Clinic , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Ogawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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15
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Yamaguchi H, Wakuda K, Fukuda M, Kenmotsu H, Ito K, Tsuchiya-Kawano Y, Tanaka K, Harada T, Nakatani Y, Miura S, Yokoyama T, Nakamura T, Izumi M, Nakamura A, Ikeda S, Takayama K, Yoshimura K, Nakagawa K, Yamamoto N, Sugio K. 990P Osimertinib for RT-naïve CNS metastasis of EGFR mutation-positive NSCLC: Phase II OCEAN study (LOGIK 1603/WJOG 9116L), part of the first-line cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1117] [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: 11/16/2022] Open
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16
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Takii Y, Mizusawa J, Kanemitsu Y, Komori K, Shiozawa M, Ohue M, Ikeda S, Takiguchi N, Kobatake T, Ike H, Sato T, Tomita N, Ota M, Sunami E, Hamaguchi T, Shida D, Katayama H, Shimada Y, Fukuda H. 414P Long-term follow-up of the randomized trial of the conventional technique versus the no-touch isolation technique for primary tumor resection in patients with colon cancer ( JCOG1006). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.552] [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: 11/01/2022] Open
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17
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Guttman-Yassky E, Pavel A, Facheris P, Correa Da Rosa J, Pagan A, Del Duca E, Estrada Y, Bissonnette R, Kumar M, Trujillo D, Rulloda J, Lee N, Ikeda S, Jankicevic J, Wustrow D, Brockstedt D, Ho W, Cheng L, Kassner P. 822 RPT193, a CCR4 inhibitor, improves the inflammatory skin transcriptomic profile in patients with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.836] [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: 10/17/2022]
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18
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Peng G, Yoshiba S, Tsukamoto S, Okumura K, Ogawa H, Ikeda S, Niyonsaba F. 813 Insulin-like growth factor-binding protein 5 alleviates skin inflammation in psoriasis mice model. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.827] [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: 11/29/2022]
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19
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Fukushima T, Ikeda S, Tomita M, Mori Y, Fukami Y, Koike H, Katsuno M, Ogata H, Isobe N, Hattori N. A Case of Demyelinating Neuropathy with Markedly Elevated Serum IgG4 Levels and Anti-Contactin 1 IgG4 Antibody. Intern Med 2022; 62:1341-1344. [PMID: 35908968 DOI: 10.2169/internalmedicine.9286-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a 77-year-old man with a 4-month history of progressive gait and sensory disturbances of the extremities. A nerve conduction study indicated demyelinating polyneuropathy. Serum IgG4 levels and anti-contactin 1 IgG4 antibodies were markedly increased. The sural nerve biopsy specimen showed IgG4-positive plasma cell infiltration in the epineurium. Treatment with steroids resulted in an amelioration of functional status, improvement of nerve conduction parameters, decreased serum IgG4 levels, and negative conversion of anti-contactin1 antibody. Further studies are needed to clarify the significance of IgG4-positive plasma cell infiltration in anti-contactin 1 antibody-positive neuropathies.
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Affiliation(s)
| | - Shohei Ikeda
- Department of Neurology, Toyota Kosei Hospital, Japan
| | - Minoru Tomita
- Department of Neurology, Toyota Kosei Hospital, Japan
| | - Yu Mori
- Department of Neurology, Gifu Prefectural Tajimi Hospital, Japan
| | - Yuki Fukami
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Haruki Koike
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Hidenori Ogata
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Noriko Isobe
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Naoki Hattori
- Department of Neurology, Toyota Kosei Hospital, Japan
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20
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Takahashi Y, Kitadate A, Ikeda S, Iwama S, Abe K, Matsuda Y, Tagawa H, Wakui H, Takahashi N. P1272: GP130/STAT3 AXIS IS A POTENTIAL THERAPEUTIC TARGET FOR HISTONE DEACETYLASE INHIBITOR-RESISTANT CUTANEOUS T-CELL LYMPHOMA. Hemasphere 2022. [PMCID: PMC9429465 DOI: 10.1097/01.hs9.0000847952.99146.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Kojima Y, Uda T, Kawashima T, Koh S, Hattori M, Mito Y, Kunihiro N, Ikeda S, Umaba R, Goto T. Primary Experiences with Robot-assisted Navigation-based Frameless Stereo-electroencephalography: Higher Accuracy than Neuronavigation-guided Manual Adjustment. Neurol Med Chir (Tokyo) 2022; 62:361-368. [PMID: 35613881 PMCID: PMC9464478 DOI: 10.2176/jns-nmc.2022-0010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The use of robot-assisted frameless stereotactic electroencephalography (SEEG) is becoming more common. Among available robotic arms, Stealth Autoguide (SA) (Medtronic, Minneapolis, MN, USA) functions as an optional instrument of the neuronavigation system. The aims of this study were to present our primary experiences with SEEG using SA and to compare the accuracy of implantation between SA and navigation-guided manual adjustment (MA). Seventeen electrodes from two patients who underwent SEEG with SA and 18 electrodes from four patients with MA were retrospectively reviewed. We measured the distance between the planned location and the actual location at entry (De) and the target (Dt) in each electrode. The length of the trajectory did not show a strong correlation with Dt in SA (Pearson's correlation coefficient [r] = 0.099, p = 0.706) or MA (r = 0.233, p = 0.351). De and Dt in SA were shorter than those in MA (1.99 ± 0.90 vs 4.29 ± 1.92 mm, p = 0.0002; 3.59 ± 2.22 vs 5.12 ± 1.40 mm, p = 0.0065, respectively). SA offered higher accuracy than MA both at entry and target. Surgical times per electrode were 38.9 and 32 min in the two patients with SA and ranged from 51.6 to 88.5 min in the four patients with MA. During the implantation period of 10.3 ± 3.6 days, no patients experienced any complications.
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Affiliation(s)
- Yuichiro Kojima
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine
| | - Takehiro Uda
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.,Department of Pediatric Neurosurgery, Osaka City General Hospital
| | - Toshiyuki Kawashima
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine
| | - Saya Koh
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine
| | - Masato Hattori
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine
| | - Yuki Mito
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine
| | | | - Shohei Ikeda
- Department of Pediatric Neurosurgery, Osaka City General Hospital
| | - Ryoko Umaba
- Department of Pediatric Neurosurgery, Osaka City General Hospital
| | - Takeo Goto
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine
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22
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Fukuda K, Takada T, Satake H, Aizawa K, Miki K, Shimojyo T, Sato K, Ikeda S, Takeda M, Shiba N. Unique Left Pulmonary Vein Isolation in Straight Common Trunk Based on Longitudinal Conduction of Left Lateral Ridge. Pacing Clin Electrophysiol 2022; 45:598-604. [PMID: 35353402 DOI: 10.1111/pace.14476] [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] [Received: 11/12/2021] [Revised: 01/23/2022] [Accepted: 02/13/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND A left common pulmonary vein (LCPV) is the most common anatomical variation in the pulmonary vein (PV) and often influences strategies of PV isolation for atrial fibrillation (AF). Our objective was to elucidate the electrical properties of the specific shape of LCPV and to apply it to an ablation procedure. METHODS AND RESULTS We investigated consecutive 12 out of 204 paroxysmal AF patients who had the shape of a straight common trunk in LCPV defined by the formation of a single conduit with parallel cranial and caudal walls after the coalescence of superior and inferior pulmonary veins on the distal side. The distance between the top of the bifurcation of LPVs and the level coinciding with the middle of the anterior wall of LCPV (left lateral ridge: LLR) was more than 10 mm in all the patients. The activation pattern of the LLR showed longitudinal conduction without outside connections. All the LCPV except one were successfully isolated without ablating the LLR (C-shape ablation). Only one patient had AF recurrence during the follow-up period. CONCLUSION The LLR in LCPV with a straight common trunk has longitudinal conduction without outside connections, which permits the isolation of LCPV without ablating LLR. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Koji Fukuda
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Tsuyoshi Takada
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Hiroyuki Satake
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Kentaro Aizawa
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Keita Miki
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Takuya Shimojyo
- Department of Radiology(RT: Radiological technologist), International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Koichi Sato
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Shohei Ikeda
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Morihiko Takeda
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
| | - Nobuyuki Shiba
- Department of Cardiology, International University Health and Welfare Hospital, Nasushiobara, Japan
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23
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Suzuki M, Koyama D, Ikeda S, Sukegawa M, Teshirogi M, Misawa K, Tsunoda S. Serum IgG and lymphocyte counts are useful for the early detection of infection in patients receiving bendamustine-rituximab therapy. J Clin Exp Hematop 2022; 62:91-98. [PMID: 35153257 PMCID: PMC9353852 DOI: 10.3960/jslrt.21031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Bendamustine-rituximab (BR) therapy has been established as a highly effective regimen
for indolent non-Hodgkin lymphoma (NHL). However, patients who receive BR therapy exhibit
persistent hypogammaglobulinemia and lymphopenia, resulting in an increased incidence of
infections. As a sustained immunosuppressive state is a risk factor for infections, early
predictive biomarkers for infections related to BR therapy need to be identified. We
retrospectively analyzed 61 patients with indolent NHL who were followed up for 2 years
after the end of BR therapy. Progression-free survival was significantly influenced by the
incidence of infections. Patients with infections related to BR therapy exhibited
persistent hypogammaglobulinemia and lymphopenia. In addition, we determined the cutoff
values of serum IgG values and lymphocyte counts for infections using receiver operating
characteristic curve analysis. Minimum serum IgG and lymphocyte counts at the first BR
treatment cycle were significantly associated with the incidence of infections during and
after BR treatment. Furthermore, the development of skin reactions during BR therapy was
significantly associated with the incidence of infections after BR therapy. Our study
suggested that these values and symptom are predictive biomarkers for infections related
to BR therapy. Based on these findings, better management of indolent NHL patients will be
possible.
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Affiliation(s)
- Manabu Suzuki
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Daisuke Koyama
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan.,Department of Hematology, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Shohei Ikeda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Masumi Sukegawa
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Mayumi Teshirogi
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Kyohei Misawa
- Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Saburo Tsunoda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
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24
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Fukushima T, Tomita M, Ikeda S, Hattori N. A case of sensory ataxic Guillain-Barré syndrome with immunoglobulin G anti-GM1 antibodies following the first dose of mRNA COVID-19 vaccine BNT162b2 (Pfizer). QJM 2022; 115:25-27. [PMID: 34871447 PMCID: PMC8690109 DOI: 10.1093/qjmed/hcab296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- T Fukushima
- Department of Neurology, Toyota Kosei Hospital, 500-1 Ibobara Josui-cho, Toyota City JP470-0396, Japan
- Address correspondence to T. Fukushima, Department of Neurology, Toyota Kosei Hospital, 500-1 Ibobara Josui-cho, Toyota City JP470-0396, Japan.
| | - M Tomita
- Department of Neurology, Toyota Kosei Hospital, 500-1 Ibobara Josui-cho, Toyota City JP470-0396, Japan
| | - S Ikeda
- Department of Neurology, Toyota Kosei Hospital, 500-1 Ibobara Josui-cho, Toyota City JP470-0396, Japan
| | - N Hattori
- Department of Neurology, Toyota Kosei Hospital, 500-1 Ibobara Josui-cho, Toyota City JP470-0396, Japan
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25
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Abstract
Autophagy mediates cellular quality control mechanisms and energy homeostasis through lysosomal degradation. Autophagy is typically viewed as an adaptive process that allows cells to survive against stress, such as nutrient deprivation and hypoxia. However, autophagy also mediates cell death during development and in response to stress. Cell death accompanied by autophagy activation and accumulation of autophagosomes has been classified as type II programmed cell death. Compared to the wealth of knowledge regarding the adaptive role of autophagy, however, the molecular mechanisms through which autophagy induces cell death and its functional significance are poorly understood. Autophagy is activated excessively under some conditions, causing uncontrolled degradation of cellular materials and cell death. An imbalance between autophagosome formation and lysosomal degradation causes a massive accumulation of autophagosomes, which subsequently causes cellular dysfunction and death. Dysregulation of autophagy induces a unique form of cell death, termed autosis, with defined morphological and biochemical features distinct from other forms of programmed cell death, such as apoptosis and necrosis. In the heart, dysregulated autophagy induces death of cardiomyocytes and actively mediates cardiac injury and dysfunction in some conditions, including reperfusion injury, doxorubicin cardiomyopathy, and lysosomal storage disorders. The goal in this review is to introduce the concept of autophagic cell death and discuss its functional significance in various cardiac conditions.
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Affiliation(s)
- Shohei Ikeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan; Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Daniela Zablocki
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Junichi Sadoshima
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, NJ, USA.
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26
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Tong M, Saito T, Zhai P, Oka SI, Mizushima W, Nakamura M, Ikeda S, Shirakabe A, Sadoshima J. Alternative Mitophagy Protects the Heart Against Obesity-Associated Cardiomyopathy. Circ Res 2021; 129:1105-1121. [PMID: 34724805 DOI: 10.1161/circresaha.121.319377] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
RATIONALE Obesity-associated cardiomyopathy characterized by hypertrophy and mitochondrial dysfunction. Mitochondrial quality control mechanisms, including mitophagy, are essential for the maintenance of cardiac function in obesity-associated cardiomyopathy. However, autophagic flux peaks at around 6 weeks of high-fat diet (HFD) consumption and declines thereafter. OBJECTIVE We investigated whether mitophagy is activated during the chronic phase of cardiomyopathy associated with obesity (obesity cardiomyopathy) after general autophagy is downregulated and, if so, what the underlying mechanism and the functional significance are. METHODS AND RESULTS Mice were fed either a normal diet or a HFD (60 kcal% fat). Mitophagy, evaluated using Mito-Keima, was increased after 3 weeks of HFD consumption and continued to increase after conventional mechanisms of autophagy were inactivated, at least until 24 weeks. HFD consumption time-dependently upregulated both Ser555-phosphorylated Ulk1 (unc-51 like kinase 1) and Rab9 (Ras-related protein Rab-9) in the mitochondrial fraction. Mitochondria were sequestrated by Rab9-positive ring-like structures in cardiomyocytes isolated from mice after 20 weeks of HFD consumption, consistent with the activation of alternative mitophagy. Increases in mitophagy induced by HFD consumption for 20 weeks were abolished in cardiac-specific ulk1 knockout mouse hearts, in which both diastolic and systolic dysfunction were exacerbated. Rab9 S179A knock-in mice, in which alternative mitophagy is selectively suppressed, exhibited impaired mitophagy and more severe cardiac dysfunction than control mice following HFD consumption for 20 weeks. Overexpression of Rab9 in the heart increased mitophagy and protected against cardiac dysfunction during HFD consumption. HFD-induced activation of Rab9-dependent mitophagy was accompanied by upregulation of TFE3 (transcription factor binding to IGHM enhancer 3), which plays an essential role in transcriptional activation of mitophagy. CONCLUSIONS Ulk1-Rab9-dependent alternative mitophagy is activated during the chronic phase of HFD consumption and serves as an essential mitochondrial quality control mechanism, thereby protecting the heart against obesity cardiomyopathy.
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Affiliation(s)
- Mingming Tong
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.)
| | - Toshiro Saito
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.).,Yamaguchi University Graduate School of Medicine, Japan (T.S.)
| | - Peiyong Zhai
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.)
| | - Shin-Ichi Oka
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.)
| | - Wataru Mizushima
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.).,Graduate School of Medicine, Hokkaido University, Japan (W.M.)
| | - Michinari Nakamura
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.)
| | - Shohei Ikeda
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.).,International University of Health and Welfare Hospital, Japan (S.I.)
| | - Akihiro Shirakabe
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.).,Nippon Medical School Chiba Hokusoh Hospital, Japan (A.S.)
| | - Junichi Sadoshima
- Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School (M.T., T.S., P.Z., S.-i.O., W.M., M.N., S.I., A.S., J.S.)
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Ikeda S, Iguchi M, Ogawa H, Ishigami K, Doi K, Hamatani Y, Ide Y, Fujino A, Ishii M, Masunaga N, Esato M, Wada H, Hasegawa K, Abe M, Akao M. The relationship between diastolic blood pressure and the risk of cardiovascular events in patients with atrial fibrillation whose systolic blood pressure was treated to less than 130 mmHg. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2387] [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
Hypertension is one of the major risk factors of cardiovascular events in patients with atrial fibrillation (AF). Low diastolic blood pressure (DBP) has been reported to be associated with the incidence of cardiovascular events, but current guidelines recommend an intensive blood pressure target of less than 130/80 mmHg for AF patients taking oral anticoagulants without mentioning the lower limits of DBP.
Methods
The Fushimi AF Registry is a community-based prospective survey of AF patients in a city of Japan. Follow-up data were available in 4,472 patients, and hypertensive patients who received prescription of any antihypertensive agents and whose systolic blood pressure was treated to less than 130 mmHg were available were examined (n=1,319). We divided the patients into four groups according to their DBP at baseline; G1 (DBP<60 mmHg, n=349), G2 (60≤DBP<70, n=434), G3 (70≤DBP<80, n=386) and G4 (80≤DBP, n=150), and compared the clinical background and outcomes among groups.
Results
The proportion of female was grater in G1 group, and the patients in G1 group were older. During the median follow-up of 2,458 days, in Kaplan-Meier analysis, the incidence rates of cardiovascular events (composite of cardiac death, ischemic stroke, systemic embolism, non-fatal myocardial infarction and heart failure hospitalization during follow up) were the highest in G1 group and the lowest in G3 group (G1: 7.2% per person-year vs. G2: 4.9% vs. G3: 2.2% vs. G4: 4.4%; p<0.01). Multivariate Cox proportional hazards regression analysis revealed that DBP was an independent determinant of cardiovascular events (G1 vs. G3; hazard ratio (HR): 1.96, 95% confidence intervals (CI): 1.39–2.76, G2 vs. G3; HR: 1.79, 95% CI: 1.28–2.50, G4 vs. G3; HR: 1.56, 95% CI: 0.99–2.45) (Figure 1). When we examined the association of DBP according to 10 mmHg increment, patients with excessively low DBP (<50 mmHg) had significantly higher incidence of cardiovascular events than patients with DBP of 70–79 mmHg (HR: 2.80, 95% CI: 1.81–4.33), and DBP exhibited J curve association with higher incidence of cardiovascular events (Figure 2).
Conclusion
In Japanese AF patients whose systolic blood pressure was treated to less than 130 mmHg, patients with excessively low DBP had significantly higher incidence of cardiovascular events, and DBP exhibited J curve association with higher incidence of cardiovascular events.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Ikeda
- Kyoto Medical Centre, Kyoto, Japan
| | - M Iguchi
- Kyoto Medical Centre, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Centre, Kyoto, Japan
| | | | - K Doi
- Kyoto Medical Centre, Kyoto, Japan
| | | | - Y Ide
- Kyoto Medical Centre, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Centre, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Centre, Kyoto, Japan
| | | | - M Esato
- Ogaki Tokushukai Hospital, Arrhythmia, Ogaki, Japan
| | - H Wada
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - M Abe
- Kyoto Medical Centre, Kyoto, Japan
| | - M Akao
- Kyoto Medical Centre, Kyoto, Japan
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28
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Ikeda S, Hiasa K, Tsutsui H. Real-world clinical outcomes and anticoagulant therapy in elderly non-valvular atrial fibrillation patients with heart failure: sub-analysis of the ANAFIE Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0478] [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
Atrial fibrillation (AF) and heart failure (HF) are bidirectionally correlated; the more severe the NYHA classification, the higher the incidence rate of atrial fibrillation, and vice versa. HF is included in the items of CHA2DS2-VASc score used to calculate stroke risk in patients with AF, and is itself a risk factor for thromboembolism in such patients. Anticoagulant management in AF patients with HF is thus a key concern that remains to be sufficiently examined, especially in elderly patients aged ≥75 y.
Purpose
The All Nippon Atrial Fibrillation In the Elderly (ANAFIE) Registry enrolled more than 30,000 elderly (≥75 y) patients with non-valvular AF (NVAF), aiming to produce real-world data on their clinical status and prognosis. This sub-analysis of the ANAFIE Registry assessed the 2-year outcomes and status of anticoagulant treatment in elderly NVAF patients with HF.
Methods
A total of 32,275 patients from the ANAFIE Registry were divided into two groups according to whether they had HF (HF group and reference group). The incidence rates and adjusted hazard ratios (HR) of clinical outcomes were determined using Kaplan-Meier analysis and the Cox proportional-hazards model, respectively.
Results
A total of 20,159 (62.5%) patients were included in the reference group, and 12,116 (37.5%) in the HF group. Compared with the reference group, the HF group had higher mean age (82.4 vs 80.9 y), female ratio (46.6% vs 40.4%), non-paroxysmal AF (69.8% vs 50.8%), and had lower mean CrCL (43.3 vs 51.6 mL/min). In the HF group, the rate control drugs were frequently used (50.1% vs 35.8%), and the rhythm control drugs were less used (14.2% vs 22.7%) than in the reference group. More patients in the HF group were using anticoagulants (93.9% vs 91.6%; warfarin (WF), 29.6% vs 23.0%; direct oral anticoagulants (DOAC), 64.2% vs 68.5%) than those in the reference group. The HF group had a numerically higher incidence of stroke or systemic embolic events (SEE) (3.28% vs 2.84%, HR 0.96, p=0.558) and major bleeding (2.35% vs 1.79%, HR 1.14, p=0.130) than the reference group, but the differences were not statistically significant. The HF group had a significantly higher incidence rate of HF requiring hospitalization (12.99% vs 4.59%, HR 1.94, p<0.001) and all-cause mortality (9.83% vs 5.21%, HR 1.32, p<0.001). In the HF group, patients receiving DOAC had significantly lower incidence rates for major bleeding, HF requiring hospitalization, and all-cause mortality than those receiving WF, while there was no difference for stroke/SEE between both groups.
Conclusions
Elderly NVAF patients with HF had higher risk of HF requiring hospitalization and mortality than those without. Differences were seen in the incidence rates of major bleeding, HF requiring hospitalization, and all-cause mortality between patients on DOAC and those on WF. This study will explore relevant factors affecting clinical outcomes in elderly NVAF patients with HF.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Daiichi Sankyo Co., Ltd.
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Affiliation(s)
- S Ikeda
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Hiasa
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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29
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Ogawa H, Esato M, Minami K, Ikeda S, Doi K, Hamatani Y, Ide Y, Fujino A, Ishii M, Iguchi M, Masunaga N, Wada H, Hasegawa K, Abe M, Akao M. Previous pacemaker therapy was not associated with the risk of clinical events in patients with atrial fibrillation: the Fushimi AF Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0542] [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
Patients with atrial fibrillation (AF) occasionally require pacemaker implantation. Meanwhile, patients with implanted pacemaker are occasionally found to have subclinical AF and develop clinical AF. However, little is known about the clinical outcomes of AF patients with implanted pacemaker.
Purpose
We aimed to investigate the clinical outcomes in AF patients undergoing previous pacemaker therapy.
Methods
The Fushimi AF Registry is a community-based prospective survey of the AF patients in a city of Japan. Follow-up data including prescription status were available for 4,447 patients. After exclusion of patients with implantable cardioverter defibrillator and cardiac resynchronization therapy, we investigated 293 AF patients with pacemaker implantation at baseline. We performed propensity score-matching analysis to assess the impact of pacemaker therapy in AF patients.
Results
Of a total cohort, patients with pacemaker were more often female (51.2% vs. 39.7%; p<0.01) and older (78.0 vs. 73.3 years of age; p<0.01). Patients with pacemaker were more likely to have pre-existing heart failure (33.1% vs. 26.6%; p<0.01), valvular heart disease (22.9% vs. 16.8%; p<0.01), chronic kidney disease (48.8% vs. 34.7%; p<0.01), and history of performing direct current cardioversion (7.2% vs. 3.1%; p<0.01), compared with patients without pacemaker. Mean CHA2DS2-VASc score was higher in patients with pacemaker (3.80 vs. 3.34; p<0.01). Patients with pacemaker were more often prescribed oral anticoagulants (62.1% vs. 55.2%; p=0.02), verapamil (13.3% vs. 9.4%; p=0.03), and loop diuretics (30.7% vs. 21.8%; p<0.01). Using propensity score-matching, 291 patients with pacemaker and 291 without pacemaker were matched and baseline characteristics were comparable. The median follow-up period was 1,819 days. All-cause death occurred in 91 patients with pacemaker (6.0 /100 person-years) and 79 patients without pacemaker (5.9 /100 person-years), with a hazard ratio (HR) for patients with pacemaker of 1.01 (95% confidence interval [CI], 0.75 to 1.37; p=0.93). Furthermore, HR of cardiac death for patients with pacemaker was 1.00 (95% CI, 0.23 to 4.32; p=0.99), that of stroke or systemic embolism was 0.69 (95% CI, 0.44 to 1.07; p=0.10) and that of hospitalization for heart failure was 0.94 (95% CI, 0.65 to 1.37; p=0.76).
Conclusion
We identified that patients undergoing previous pacemaker therapy were not associated with the incidence of various adverse clinical events in Japanese AF patients.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi Sankyo, Novartis Pharma, MSD, Sanofi-Aventis, Takeda Pharmaceutical, and the Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus from Japan Agency for Medical Research and Development.
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Affiliation(s)
- H Ogawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Ogaki, Japan
| | - K Minami
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - S Ikeda
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y Ide
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Iguchi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - N Masunaga
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
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30
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Ishigami K, Ikeda S, Doi K, Hamatani Y, Ide Y, Fujino A, An Y, Ishii M, Iguchi M, Ogawa H, Masunaga N, Wada H, Hasegawa K, Abe M, Akao M. Association of the degree of thrombocytopenia with cause of death in patients with atrial fibrillation: the Fushimi AF Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0462] [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
Thrombocytopenia is sometimes found in routine blood tests and is associated with an increased risk of mortality in general population. We have previously reported that atrial fibrillation (AF) patients with thrombocytopenia have a higher mortality than those without thrombocytopenia. However, association of the degree of thrombocytopenia with cause of death in AF patients is unknown.
Purpose
We aimed to investigate the association of baseline platelet count with cause of death including cardiac death, intracranial death, malignancy, infection, extracranial bleeding death, renal failure death, respiratory failure death and undetermined death.
Methods
The Fushimi AF Registry was designed to enroll all of the AF patients in Fushimi-ku, Kyoto. Fushimi-ku is densely populated with a total population of 283,000 and is assumed to represent a typical urban community in Japan. We started to enroll patients from March 2011, and follow-up data with baseline platelet counts less than 150,000/μL were available in 853 patients by the end of September 2020. We divided them into 3 groups according to baseline platelet level: Mild thrombocytopenia (100,000–149,999/μL, n=703), Moderate thrombocytopenia (50,000–99,999/μL, n=120), and Severe thrombocytopenia (<50,000/μL, n=30).
Results
In the entire cohort, the mean age was 76 years, 34% were women, the mean body weight and body mass index was 59.3 kg and 22.9 kg/m2, and the median platelet count were 121,000/μL (interquartile range 109,000 to 141,000/μL). Compared to Mild thrombocytopenia, patients with Moderate or Severe thrombocytopenia were more likely to have chronic kidney disease (42.2% vs 54.2% vs 73.3%, p=0.0003), have higher HAS-BLED score (1.90 vs 2.14 vs 2.00, p=0.047) and lower hemoglobin (12.8g/dL vs 11.7g/dL vs 11.2g/dL, p<0.0001) and were less often prescribed anti platelet drugs. Age, sex, body weight, systolic blood pressure, previous stroke, previous major bleeding, hypertension, diabetes mellitus, CHADS2 score and CHA2DS2-VASc score were comparable between three groups. During the median follow-up period, the incidence rate (per 100 person-years) of all-cause death was 6.82 vs 15.27 vs 9.64. (p<0.001) On univariate analysis, the incidence of all-cause death was higher in Moderate group than Mild group. (HR: 2.15; 95% CI 1.61–2.87, p<0.0001), but there was no significant difference between Mild and Severe groups. (HR: 1.44; 95% CI 0.78–2.64, p=0.243). The incidence of cardiac death was comparable between three groups. (Mild vs Moderate: HR 0.65; 95% CI 0.15–2.75, p=0.56, Mild vs Severe: HR 1.11; 95% CI 0.15–8.23, p=0.92) Regarding other causes of death such as intracranial bleeding, extracranial bleeding, malignancy, infection, renal failure, respiratory failure and undetermined cause, there was no significant difference.
Conclusion
Mortality was higher according to the degree of thrombocytopenia in AF patients, but the cause of death was not different among three groups.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Ishigami
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - S Ikeda
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - K Doi
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y Hamatani
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y Ide
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y An
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Iguchi
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - N Masunaga
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - M Abe
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
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31
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Saito M, Nakao Y, Inoue K, Higaki R, Yokomoto Y, Ogimoto A, Suzuki M, Kawakami H, Hiasa G, Okayama H, Ikeda S, Yamaguchi O. Exploration of electrocardiographic and echocardiographic findings to screen transthyretin amyloid cardiomyopathy in patients with mild left ventricular hypertrophy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.010] [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 transthyretin amyloid cardiomyopathy (ATTR-CM), a common condition in the elderly, is a life-threatening disease; however, it is treatable. The early accurate diagnosis is, therefore, an important key to improve the patient's outcomes. Electrocardiography and echocardiography are instant diagnostic tools with red flags for the screening of the ATTR-CM. In fact, ATTR-CM often mimics left ventricular hypertrophy (LVH), and the differential diagnosis is difficult to establish. Thus, the characteristics of cardiac amyloidosis may be obscured in ATTR-CM patients with mild LVH, possibly making the disease difficult to diagnose. Therefore, in this study, the effect of LVH on the occurrence of electrocardiographic and echocardiographic parameters for ATTR-CM was investigated, and their incremental value over the age for the screening of ATTR-CM in the patients with mild LVH was recorded.
Methods
This study retrospectively studied 319 consecutive nonischemic LVH patients with a sinus rhythm who underwent detailed diagnostic tests. The light chain-associated amyloidosis was an exclusion criterion. The mean left ventricular wall thickness (MWT) <12 mm was defined as mild LVH, while MWT ≥12 mm was defined as moderate to severe LVH. The ATTR-CM was diagnosed with biopsy or 99 mTc-PYP scintigraphy. The elderly were defined as people aged ≥65 years in males and ≥70 years in females, according to the literature. Each electrocardiographic and echocardiographic parameter was binarized with an external cut-off point to increase the external validity, being the incremental benefit of each parameter over age for identifying ATTR-CM assessed using a receiver operating characteristic curve analysis and comparisons of the area under the curve (AUC).
Results
Fourteen patients (8%) among the 170 patients with mild LVH had ATTR-CM, while 27 patients (18%) among the 149 patients with moderate to severe LVH had ATTR-CM. The patients with mild LVH had fewer electrocardiographic and echocardiographic parameters, showing a significant difference between ATTR-CM and non-ATTR-CM patients than those with moderate to severe LVH (Table 1). Among several binarized parameters, the voltage-to-mass ratio, E/A ratio, the global longitudinal strain, and also the relative apical sparing pattern demonstrated additive value for identifying the ATTR-CM over aging (Table 2). In addition, the discriminative ability of the propensity score calculated from these four variables and age was considered excellent for the screening of ATTR-CM (AUC = 0.98).
Conclusion
The patients with mild LVH appear to have fewer electrocardiographic and echocardiographic specific findings of the ATTR-CM compared to patients with moderate to severe LVH. However, several red flags may be useful for screening ATTR-CM even in patients with a mild LVH.
Funding Acknowledgement
Type of funding sources: None. Table 1Table 2
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Affiliation(s)
- M Saito
- Kitaishikai Hospital, Ozu, Japan
| | - Y Nakao
- Ehime University, Cardiology, Toon, Japan
| | - K Inoue
- Ehime University, Cardiology, Toon, Japan
| | - R Higaki
- Kitaishikai Hospital, Ozu, Japan
| | - Y Yokomoto
- Uwajima City Hospital, Cardiology, Uwajima, Japan
| | - A Ogimoto
- Uwajima City Hospital, Cardiology, Uwajima, Japan
| | - M Suzuki
- Ehime Prefectural Imabari Hospital, Cardiology, Imabari, Japan
| | - H Kawakami
- Ehime Prefectural Imabari Hospital, Cardiology, Imabari, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Cardiology, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Cardiology, Matsuyama, Japan
| | - S Ikeda
- Ehime University, Cardiology, Toon, Japan
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32
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Hamatani Y, Iguchi M, Minami K, Ishigami K, Ikeda S, Doi K, Masunaga N, Esato M, Tsuji H, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. Predictors and risk model for heart failure hospitalization in atrial fibrillation patients without pre-existing heart failure: the Fushimi AF Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0476] [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
Atrial fibrillation (AF) increases the risk of hospitalization for heart failure (HF), as well as that of thromboembolism. The strategy for prediction of thromboembolism has been well-established; however, little focus has been placed on the risk stratification for and prevention of HF hospitalization in AF patients.
Purpose
The aim of this study is to investigate the predictors and risk model of HF hospitalization in non-valvular AF patients without pre-existing HF.
Methods
The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,472 patients by the end of October 2020. From the registry, we excluded patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction [LVEF] <40%), and those with valvular AF (mitral stenosis or prosthetic heart valve). Among 3,188 non-valvular AF patients without pre-existing HF, we explored the risk factors for the HF hospitalization during follow-up period. The risk model for predicting HF hospitalization was determined by the cumulative numbers of risk factors which were significant on multivariate analysis.
Results
The mean age was 72.4±10.8 years, 1197 were female and 1787 were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc scores were 1.7±1.2 and 2.9±1.6, respectively. During the median follow-up period of 5.1 years, HF hospitalization occurred in 285 (8.9%), corresponding to an annual incidence of 1.8 events per 100 person-years. In multivariable Cox regression analysis, advanced age (≥75 years), valvular heart disease, coronary artery disease, reduced LVEF (<60%), chronic obstructive pulmonary disease (COPD) and anemia were independently associated with the higher incidence of HF hospitalization (all P<0.001) (Picture 1). A risk model based on these 6 variables could stratify the incidence of HF hospitalization during follow-up period (log-rank; P<0.001) (Picture 2). Patients with ≥3 risk factors had an 11-fold higher incidence of HF hospitalization compared with those not having any of these risk factors (hazard ratio: 11.3, 95% confidence interval: 7.0–18.4; P<0.001).
Conclusions
Advanced age, coronary artery disease, valvular heart disease, reduced LVEF, COPD and anemia were independently associated with the risk of HF hospitalization in AF patients without pre-existing HF. There was good prediction for endpoint of HF hospitalization using these 6 variables, providing the opportunities for the implementation of strategies to reduce the incidence of HF among AF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Hamatani
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Minami
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Ishigami
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - S Ikeda
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Doi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - N Masunaga
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Arrhythmia, Ogaki, Japan
| | | | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Ogawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Kawakami H, Inoue K, Nagai T, Fujii A, Sasaki Y, Shikano Y, Sakuoka N, Miyazaki M, Takasuka Y, Ikeda S, Yamaguchi O. Left atrial dysfunction still exists in patients who obtain normal left atrial volume after successful ablation of atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Atrial fibrillation (AF) promotes left atrial (LA) remodeling and vice versa. LA volume index (LAVI) ≥34 mL/m2 is an established cut-off value for identifying an enlarged left atrium. Catheter ablation has become an established therapy for AF and provides a reduction of LA volume by maintaining sinus rhythm (reverse remodeling). However, the definition of LA reverse remodeling after AF ablation is undetermined.
Purpose
We hypothesized that patients with LA dilatation who obtain normal LA volume (LAVI <34 mL/m2) after AF ablation would have better long-term outcomes than those who do not. Furthermore, we investigated whether patients with a normal LA volume could also obtain normal LA function with AF ablation.
Methods
We enrolled 140 AF patients with baseline LAVI ≥34 mL/m2, without AF recurrence for 1 year after the initial AF ablation. We acquired conventional and speckle-tracking echocardiographic parameters within 24 h and at 1 year after the procedure. Late recurrence was defined as AF recurrence >1 year after the initial ablation. To define the normal range of LA function, age-and sex-matched 140 controls without a history of AF were also enrolled.
Results
After restoration of sinus rhythm, overall LA structural and functional parameters were significantly improved, and 75 patients (54%) had normal LA volume at the time of follow-up (Table). During a median follow-up of 44 (31–61) months, 32 patients (23%) experienced a late recurrence of AF. Patients who obtained normal LA volume after AF ablation had fewer late recurrences than those who did not (P<0.01) (Figure). However, LA functional abnormalities still existed in AF patients, even if LA volume was normalized as in controls (Table).
Conclusion
Patients who obtain normal LA volume have better long-term outcomes of AF ablation than those who do not. Although AF ablation promotes beneficial effects on LA structure and function, LA function cannot be normalized even in patients who obtain normal LA volume after successful ablation. Thus, physicians should carefully consider long-term follow-up and residual AF risks, regardless of sinus rhythm restoration by catheter ablation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - K Inoue
- Ehime University, Toon, Japan
| | - T Nagai
- Ehime University, Toon, Japan
| | - A Fujii
- Ehime University, Toon, Japan
| | | | | | | | | | | | - S Ikeda
- Ehime University, Toon, Japan
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Inoue K, Nakao Y, Saito M, Kinoshita M, Higaki R, Higashi H, Ikeda S, Yamagushi O. Left ventricular longitudinal shortening at cardiac base as a determinant of left atrial reservoir function in cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.095] [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
Objective
To investigate a mechanistic determinant of left atrial (LA) reservoir function in patients presenting left ventricular (LV) hypertrophy, and clarify diagnostic and prognostic values of LA reservoir strain in patients with cardiac amyloidosis (CA).
Methods
Three-hundred sixty patients (median age: 68 years, male gender: 65%) with left ventricular hypertrophy (LVH) assessed by echocardiography were retrospectively included. The LVH etiologies were diagnosed by any of biopsy, cardiac magnetic resonance imaging or 99mTc-PYP scintigraphy. LV segmental longitudinal strain was estimated from apical three views, and LA reservoir strain was measured from an apical 4-chamber view.
Results
The LVH etiologies were confirmed with CA in 81 patients, hypertensive heart disease in 87 patients, hypertrophic cardiomyopathy in 143 patients, and miscellaneous disorders in 49 patients. The median (25th, 75th percentile) value of LV ejection fraction was 59% (48–67). LV basal longitudinal strain and LA reservoir strain were significantly reduced in patients with CA compared with those with other etiologies; LV basal strain: 5.4% (3.9–8.7) vs. 11.9% (9.3–14.6), LA reservoir strain: 9.2% (6.3–12.3) vs. 17.5% (11.3–24.1), p<0.01 respectively. LV basal strain was significantly correlated with LA reservoir strain in patients with CA (r=0.57, p<0.01) and in those with other etiologies (r=0.45, p<0.01). The area under the receiver-operating characteristic curves of LA reservoir strain and E/e' (0.78 and 0.74) to identify CA etiology were significantly larger than that of LA volume index (0.62) (p<0.01). During the follow-up period (median 2.9 years), 53 patients experienced heart failure hospitalization. The Cox regression model including age, gender, LV ejection fraction, E/e' and LA reservoir strain showed that male gender (hazard ratio: 0.46, p=0.03), E/e' (hazard ratio: 1.04, p<0.01) and LA reservoir strain (hazard ratio: 0.94, p<0.01) independently predicted heart failure hospitalization.
Conclusions
The decrease of LV longitudinal shortening at cardiac base could worsen LA reservoir function especially in patients with CA. LA reservoir strain might be an alternative measure to identify CA etiology and have a predictive value of heart failure hospitalization in patients with LV hypertrophy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Inoue
- Ehime University, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Toon, Japan
| | - Y Nakao
- Ehime University, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Toon, Japan
| | - M Saito
- Kitaishikai Hospital, Department of Cardiology,, Ozu, Japan
| | - M Kinoshita
- Kitaishikai Hospital, Department of Cardiology,, Ozu, Japan
| | - R Higaki
- Kitaishikai Hospital, Department of Cardiology,, Ozu, Japan
| | - H Higashi
- Ehime University, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Toon, Japan
| | - S Ikeda
- Ehime University, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Toon, Japan
| | - O Yamagushi
- Ehime University, Department of Cardiology, Pulmonology, Hypertension & Nephrology, Toon, Japan
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Ikeda S, Takeda M, Sato K, Miki K, Fukuda K, Shiba N. A case of vasospastic angina with exertional sign. J Cardiol Cases 2021; 24:199-202. [DOI: 10.1016/j.jccase.2021.04.004] [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] [Received: 01/22/2021] [Revised: 04/05/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022] Open
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36
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Peng G, Umehara Y, Komatsu M, Okumura K, Ogawa H, Ikeda S, Niyonsaba F. 103 Autophagy activation is required for the maintenance of skin tight junction barrier. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.106] [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: 11/24/2022]
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37
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Sato Y, Ikeda S, Kato T, Kenmotsu H, Ogura T, Hino A, Harada T, Kubota K, Tokito T, Okamoto I, Furuya N, Yokoyama T, Hosokawa S, Iwasawa T, Kasajima R, Miyagi Y, Misumi T, Yamanaka T, Okamoto H. 1285P Final analysis of TORG1936/AMBITIOUS: Phase II study of atezolizumab for pretreated non-small cell lung cancer with idiopathic interstitial pneumonia. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1887] [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: 11/26/2022] Open
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38
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Fujii Y, Iwasaki R, Ikeda S, Chimura S, Goto M, Yoshizaki K, Sakai H, Ito N, Mori T. Gastrointestinal stromal tumour lacking mutations in the KIT and PDGFRA genes in a cat. J Small Anim Pract 2021; 63:239-243. [PMID: 34409605 DOI: 10.1111/jsap.13416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/05/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
Molecular subtyping in gastrointestinal stromal tumours is a useful method for predicting the efficacy of treatment using tyrosine kinase inhibitors in humans. However, owing to the paucity of reports on mutational analyses, the association between genetic mutations and the therapeutic response to tyrosine kinase inhibitors remains unclear in feline gastrointestinal stromal tumours. In this report, we describe the case of a cat with a gastrointestinal stromal tumour which was unresponsive to tyrosine kinase inhibitors. A mutational analysis revealed that the cat lacked mutations in both the KIT and platelet-derived growth factor receptor-alpha (PDGFRA) genes. Our findings are consistent with the fact that KIT/PDGFRA wild-type gastrointestinal stromal tumours are less responsive to tyrosine kinase inhibitors in humans. This signifies the need for further evaluation and possibly individualised treatment for gastrointestinal stromal tumours in cats on the basis of mutational analyses.
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Affiliation(s)
- Y Fujii
- Joint Graduate School of Veterinary Sciences, Gifu University, Gifu, Gifu, Japan.,Animal Medical Centre, Gifu University, Gifu, Gifu, Japan
| | - R Iwasaki
- Animal Medical Centre, Gifu University, Gifu, Gifu, Japan
| | - S Ikeda
- Chimura Animal Hospital, Iwakura, Aichi, Japan
| | - S Chimura
- Chimura Animal Hospital, Iwakura, Aichi, Japan
| | - M Goto
- Laboratory of Veterinary Pathology, Faculty of Applied Biological Sciences, Gifu University, Gifu, Gifu, Japan
| | - K Yoshizaki
- Laboratory of Veterinary Pathology, Faculty of Applied Biological Sciences, Gifu University, Gifu, Gifu, Japan
| | - H Sakai
- Joint Graduate School of Veterinary Sciences, Gifu University, Gifu, Gifu, Japan.,Laboratory of Veterinary Pathology, Faculty of Applied Biological Sciences, Gifu University, Gifu, Gifu, Japan
| | - N Ito
- Joint Graduate School of Veterinary Sciences, Gifu University, Gifu, Gifu, Japan
| | - T Mori
- Joint Graduate School of Veterinary Sciences, Gifu University, Gifu, Gifu, Japan.,Animal Medical Centre, Gifu University, Gifu, Gifu, Japan
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Ikeda S, Sato K, Takeda M, Miki K, Aizawa K, Takada T, Fukuda K, Shiba N. Oncostatin M is a novel biomarker for coronary artery disease - A possibility as a screening tool of silent myocardial ischemia for diabetes mellitus. Int J Cardiol Heart Vasc 2021; 35:100829. [PMID: 34235245 PMCID: PMC8250159 DOI: 10.1016/j.ijcha.2021.100829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
Objective Oncostatin M (OSM) is an inflammatory cytokine of the interleukin-6 family which plays a crucial role in the pathogenesis of atherosclerosis. Therefore, we tested our hypothesis that serum OSM levels are increased in patients with coronary artery diseases (CAD). Methods and results Serum OSM level was measured by sandwich technique immunoassay in 315 consecutive patients and who underwent coronary angiography at the International University of Health and Welfare Hospital from April 2019 to March 2021. A diagnosis of CAD was made in 169 patients. Serum OSM levels were significantly higher in patients with significant coronary stenosis compared to those without it. [123.0 ± 46.7 pg/mL (n = 169) vs. 98.3 ± 47.9 pg/mL (n = 146), p < 0.001]. A positive correlation was noted between serum OSM levels and severity and complexity of coronary stenosis. Importantly, the coronary revascularization significantly decreased the serum OSM levels. We furthermore detected a positive correlation between serum OSM levels and HbA1c levels. Finally, our data suggested that 120 pg/mL of serum OSM was the potential cutoff value for screening of silent myocardial ischemia related with diabetic mellitus (DM). Conclusion Serum OSM can be a novel biomarker for CAD and may be useful for the screening of asymptomatic CAD in patients with DM.
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Key Words
- BMI, body mass index
- BNP, brain natriuretic peptide
- Biomarker
- CACS, coronary computed tomography calcium score
- CAD, coronary artery disease
- CAG, coronary angiography
- Coronary artery diseases
- DM, diabetes mellitus
- Diabetes mellitus
- EF, ejection fraction
- FFR, fractional flow reserve
- HDL-C, high-density lipoprotein-cholesterol
- HF, heart failure
- LDL-C, low-density lipoprotein-cholesterol
- LVEF, left ventricular ejection fraction
- OSM
- OSM, oncostatin M
- PCI, percutaneous coronary intervention
- Silent myocardial ischemia
- YAP, yes-associated protein
- iFR, instantaneous wave-free ratio
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Affiliation(s)
- Shohei Ikeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Koichi Sato
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Morihiko Takeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Keita Miki
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Kentaro Aizawa
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Tsuyoshi Takada
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Koji Fukuda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Nobuyuki Shiba
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi, Japan
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40
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Ikeda S, Cruz AT, Starke JR. Epidemiology and clinical characteristics of childhood TB identified using active and passive case finding. Int J Tuberc Lung Dis 2021; 25:475-482. [PMID: 34049610 DOI: 10.5588/ijtld.20.0916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Childhood TB cases can be found using passive case finding (PCF), i.e., by diagnosing children presenting with symptoms, or using active case finding (ACF), i.e., by identifying children with TB through contact tracing. Our study determined epidemiologic, clinical, and radiographic differences between these groups.DESIGN/METHODS: Retrospective cohort study of children aged 0-19 years diagnosed with TB from January 1, 2012 to December 31, 2019 at a U.S. TB clinic, comparing clinical, radiographic, microbiologic, and epidemiological characteristics of children identified using PCF and ACF.RESULTS: Of 178 eligible patients, 99 (55.6%) were diagnosed using PCF. Children identified using PCF were older (mean 8.9 vs. 6.1 years, P = 0.003), more often non-US-born (OR 2.29, 95% CI 1.12-4.67), had more extrapulmonary disease (44.4% vs. 3.8%, OR 20.27, 95% CI 5.98-68.64) and severe intrathoracic findings (39.4% vs. 10.1%, OR 5.77, 95% CI 2.50-13.29). Children identified using ACF were often asymptomatic, had isolated hilar/mediastinal adenopathy, but had more availability of drug susceptibility data from a link to a source case.CONCLUSION: Children identified using PCF had more severe manifestations, while those identified using ACF had greater availability of drug susceptibility data. Clinicians should be aware that clinical and radiographic presentations in children identified using PCF and those identified using ACF differ, and that the latter may be eligible for shorter treatment regimens.
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Affiliation(s)
- S Ikeda
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - A T Cruz
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J R Starke
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Ito K, Morise M, Wakuda K, Hataji O, Shimokawaji T, Takahashi K, Furuya N, Takeyama Y, Goto Y, Abe T, Kato T, Ozone S, Ikeda S, Kogure Y, Yokoyama T, Kimura M, Yoshioka H, Murotani K, Kondo M, Saka H. A multicenter cohort study of osimertinib compared with afatinib as first-line treatment for EGFR-mutated non-small-cell lung cancer from practical dataset: CJLSG1903. ESMO Open 2021; 6:100115. [PMID: 33984681 PMCID: PMC8134659 DOI: 10.1016/j.esmoop.2021.100115] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background FLAURA, the prospective trial of osimertinib as a first-line therapy compared with first-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), did not show superior survival benefit for osimertinib in either the subgroup of Asians or the subgroup with the L858R mutation. In addition, the superiority of osimertinib compared with second-generation EGFR-TKI is thus far unclear. Patients and methods We reviewed the clinical data of all consecutive patients who were treated with osimertinib or afatinib as first-line therapy between May 2016 and October 2019 from 15 institutions in Japan. We defined the groups based on first-line EGFR-TKI as the afatinib group and the osimertinib group. Outcomes included time to discontinuation of any EGFR-TKI (TD-TKI), overall survival (OS), and time to treatment failure, with propensity score analysis carried out as an exploratory analysis in the survival and subgroup analyses. Results A total of 554 patients were enrolled. Data on 326 patients in the osimertinib group, and 224 patients in the afatinib group were analyzed. TD-TKI adjusted by propensity score in the afatinib and osimertinib groups was 18.6 months (95% confidence interval 15.8 to 22.0) and 20.5 months (95% confidence interval 13.8 to not reached), respectively, without significant difference (P = 0.204). OS adjusted by propensity score favored the afatinib group with a significant difference (P = 0.018). Subgroup analysis with propensity score showed that patients with L858R and without brain metastasis had superior survival benefit with afatinib compared with osimertinib (P < 0.001). Conclusions TD-TKI in the afatinib group was not significantly prolonged compared with the osimertinib group in the practical data. In the exploratory analysis of patients with L858R-mutated non-small-cell lung cancer without brain metastasis, afatinib showed more benefit in OS over osimertinib. The large-scale practical data of 550 patients who were treated with osimertinib or afatinib as first-line therapy were analyzed. The superiority of osimertinib compared with afatinib could not be demonstrated in all populations. Osimertinib therapy showed effectiveness in patients with brain metastasis. Afatinib therapy showed potential benefit in patients with L858R mutation and without brain metastasis.
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Affiliation(s)
- K Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan; Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - M Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
| | - K Wakuda
- Division of Thoracic Oncology, Shizuoka Cancer Center, Suntou-gun, Shizuoka, Japan
| | - O Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan
| | - T Shimokawaji
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - K Takahashi
- Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Aichi, Japan
| | - N Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Y Takeyama
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Y Goto
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - T Abe
- Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
| | - T Kato
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - S Ozone
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - S Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan
| | - Y Kogure
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
| | - T Yokoyama
- Department of Respiratory Medicine, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Aichi, Japan
| | - M Kimura
- Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - H Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - K Murotani
- Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan
| | - M Kondo
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - H Saka
- Department of Respiratory Medicine, Matsunami General Hospital, Kasamatsu, Gifu, Japan
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Yue H, Umehara Y, Nguyen H, Takahashi M, Peng G, Ikutama R, Okumura K, Ogawa H, Ikeda S, Niyonsaba F. 617 AMP-IBP5 improves diabetic wound healing via activation of EGFR/STAT/MAPK pathways. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.646] [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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Nguyen H, Trujillo J, Peng G, Yue H, Takahashi M, Ikutama R, Umehara Y, Ogawa H, Ikeda S, Niyonsaba F. 117 Effect of the antimicrobial peptide derived from insulin-like growth factor-binding protein 5 on skin barrier regulation. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.136] [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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44
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Ikeda S, Nah J, Shirakabe A, Zhai P, Oka SI, Sciarretta S, Guan KL, Shimokawa H, Sadoshima J. YAP plays a crucial role in the development of cardiomyopathy in lysosomal storage diseases. J Clin Invest 2021; 131:143173. [PMID: 33373332 DOI: 10.1172/jci143173] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/17/2020] [Indexed: 12/20/2022] Open
Abstract
Lysosomal dysfunction caused by mutations in lysosomal genes results in lysosomal storage disorder (LSD), characterized by accumulation of damaged proteins and organelles in cells and functional abnormalities in major organs, including the heart, skeletal muscle, and liver. In LSD, autophagy is inhibited at the lysosomal degradation step and accumulation of autophagosomes is observed. Enlargement of the left ventricle (LV) and contractile dysfunction were observed in RagA/B cardiac-specific KO (cKO) mice, a mouse model of LSD in which lysosomal acidification is impaired irreversibly. YAP, a downstream effector of the Hippo pathway, was accumulated in RagA/B cKO mouse hearts. Inhibition of YAP ameliorated cardiac hypertrophy and contractile dysfunction and attenuated accumulation of autophagosomes without affecting lysosomal function, suggesting that YAP plays an important role in mediating cardiomyopathy in RagA/B cKO mice. Cardiomyopathy was also alleviated by downregulation of Atg7, an intervention to inhibit autophagy, whereas it was exacerbated by stimulation of autophagy. YAP physically interacted with transcription factor EB (TFEB), a master transcription factor that controls autophagic and lysosomal gene expression, thereby facilitating accumulation of autophagosomes without degradation. These results indicate that accumulation of YAP in the presence of LSD promotes cardiomyopathy by stimulating accumulation of autophagosomes through activation of TFEB.
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Affiliation(s)
- Shohei Ikeda
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jihoon Nah
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Akihiro Shirakabe
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Peiyong Zhai
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Shin-Ichi Oka
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Sebastiano Sciarretta
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy, and Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Kun-Liang Guan
- Department of Pharmacology and Moores Cancer Center, University of California at San Diego, La Jolla, California, USA
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junichi Sadoshima
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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45
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Hayashi H, Yonesaka K, Sugawara S, Sato Y, Azuma K, Sakata S, Tachihara M, Ikeda S, Yokoyama T, Hataji O, Yano Y, Hirano K, Daga H, Okada H, Sakai K, Chiba Y, Nishio K, Yamamoto N, Nakagawa K. FP14.16 Phase 2 Trial of the Alternating Therapy with Osimertinib and Afatinib for Treatment-Naive Patients with EGFR-Mutated Advanced Non–Small Cell Lung Cancer (WJOG10818L/Alt Trial). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.159] [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: 11/17/2022]
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46
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Mitsuya S, Tsuruoka K, Kanaoka K, Funamoto T, Tsuji H, Matsunaga N, Nakamura T, Tamura Y, Imanishi M, Ikeda S, Fujisaka Y, Goto I. P76.23 A Retrospective Study of Non-Small Cell Lung Cancer Treated with Second- and Third-Generation EGFR Tyrosine Kinase Inhibitors. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1080] [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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47
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Ikeda S, Tsunoda S, Koyama D, Suzuki M, Sukegawa M, Misawa K, Hojo H, Zhu X, Utano K, Ohta M. Femoral marrow MRI is a non-invasive, non-irradiated and useful tool for detecting bone marrow involvement in non-Hodgkin lymphoma. J Clin Exp Hematop 2021; 61:78-84. [PMID: 33551438 PMCID: PMC8265490 DOI: 10.3960/jslrt.20054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Femoral marrow magnetic resonance imaging (MRI) is a non-invasive, non-irradiated and useful modality for evaluating bone marrow (BM) conditions. Human adult femoral BM is almost uniformly fatty marrow and has the largest volume of a single bone. MRI has an extremely high resolution for fat and water, which allows high-contrast imaging of cellular infiltration into fat tissue. In hematological diseases, femoral BM MRI can clearly detect cell infiltration, which is symmetrically imaged from the proximal to the distal direction of abnormal signal areas. Thus, we investigated the significance of femoral MRI for non-Hodgkin lymphoma (NHL). We analyzed the data of 69 NHL patients who received femoral MRI at diagnosis in this single-center retrospective cohort study. The median patient age was 73 years. MRI patterns were mainly classified as uniform patterns or nonuniform patterns. We also classified the range of cellular marrow as high-grade or low-grade based on whether it had spread to over half of the femur. Both overall survival (OS) and progression-free survival (PFS) were significantly influenced by abnormal femoral marrow MRI. In particular, the patients with cellular femoral marrow lesions had a worse OS and PFS based on log-rank tests. Multivariable analyses with the Cox proportional hazards model revealed that OS and PFS were significantly influenced by cellular marrow diagnosed by femoral MRI. We concluded that femoral marrow MRI is a useful tool for detecting BM involvement and an independent prognostic factor in NHL patients.
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Affiliation(s)
- Shohei Ikeda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Saburo Tsunoda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Daisuke Koyama
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Manabu Suzuki
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Masumi Sukegawa
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Kyohei Misawa
- Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Hiroshi Hojo
- Department of Pathology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Xin Zhu
- Biomedical Information Engineering Lab, The University of Aizu, Aizuwakamatsu, Fukushima, Japan
| | - Kenichi Utano
- Department of Radiology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Masatsugu Ohta
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
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48
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Suzuki M, Tsunoda S, Koyama D, Ikeda S, Sukegawa M, Hojo H, Ohta M. MTX-HOPE is a low-dose salvage chemotherapy for aged patients with relapsed or refractory non-Hodgkin lymphoma. J Clin Exp Hematop 2021; 61:22-28. [PMID: 33551437 PMCID: PMC8053567 DOI: 10.3960/jslrt.20051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
As the aging society advances, the number of non-Hodgkin lymphoma (NHL) patients is
increasing. Aged relapsed or refractory (r/r) NHL patients have limited treatment options.
Therefore, a safe and effective regimen is urgently needed for these patients. Thus, we
originally developed the MTX-HOPE (methotrexate, hydrocortisone, vincristine, sobuzoxane,
and etoposide) regimen for r/r NHL and validated the safety and efficacy of this regimen
in a clinical setting. We analyzed the data of 42 r/r NHL patients who received MTX-HOPE
in this single-center retrospective cohort study. The median age of the patients was 81
years. The overall response rate was 45.3%. The median overall survival (OS) was 7 months,
the one-year OS was 43.7%, and the two-year OS was 40.8%. Grade ≥3 neutropenia and renal
dysfunction were observed in 47.6% and 11.9% of patients, respectively, and
treatment-related death were not observed. Appropriate supportive care enabled these
patients to continue the MTX-HOPE regimen. The proportion of patients who needed
hospitalization during MTX-HOPE therapy was only 21.4%. Multivariable analyses with the
Cox proportional hazards model revealed that both OS and progression-free survival (PFS)
were significantly influenced by high Ki-67 expression in pathology, with response to the
MTX-HOPE regimen after three to five cycles as a time-dependent covariate. Our results
suggest that MTX-HOPE therapy can be an option for non-aggressive r/r NHL patients. To
validate MTX-HOPE therapy, further prospective investigation is needed.
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Affiliation(s)
- Manabu Suzuki
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Saburo Tsunoda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Daisuke Koyama
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Shohei Ikeda
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Masumi Sukegawa
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Hiroshi Hojo
- Department of Pathology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Masatsugu Ohta
- Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
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49
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Hao K, Takahashi J, Kikuchi Y, Suda A, Sato K, Sugisawa J, Tsuchiya S, Shindo T, Nishimiya K, Ikeda S, Tsuburaya R, Shiroto T, Matsumoto Y, Miyata S, Sakata Y, Yasuda S, Shimokawa H. Prognostic Impacts of Comorbid Significant Coronary Stenosis and Coronary Artery Spasm in Patients With Stable Coronary Artery Disease. J Am Heart Assoc 2021; 10:e017831. [PMID: 33455423 PMCID: PMC7955295 DOI: 10.1161/jaha.120.017831] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/05/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Stable coronary artery disease is caused by a variable combination of organic coronary stenosis and functional coronary abnormalities, such as coronary artery spasm. Thus, we examined the clinical importance of comorbid significant coronary stenosis and coronary spasm. METHODS AND RESULTS We enrolled 236 consecutive patients with suspected angina who underwent acetylcholine provocation testing for coronary spasm and fractional flow reserve (FFR) measurement. Among them, 175 patients were diagnosed as having vasospastic angina (VSA), whereas the remaining 61 had no VSA (non-VSA group). The patients with VSA were further divided into the following 3 groups based on angiography and FFR: no organic stenosis (≤50% luminal stenosis; VSA-alone group, n=110), insignificant stenosis of FFR>0.80 (high-FFR group, n=36), and significant stenosis of FFR≤0.80 (low-FFR group, n=29). The incidence of major adverse cardiovascular events, including cardiovascular death, nonfatal myocardial infarction, urgent percutaneous coronary intervention, and hospitalization attributed to unstable angina was evaluated. All patients with VSA received calcium channel blockers, and 28 patients (95%) in the low-FFR group underwent a planned percutaneous coronary intervention. During a median follow-up period of 656 days, although the incidence of major adverse cardiovascular events was low and comparable among non-VSA, VSA-alone, and high-FFR groups, the low-FFR group had an extremely poor prognosis (non-VSA group, 1.6%; VSA-alone group, 3.6%; high-FFR group, 5.6%; low-FFR group, 27.6%) (P<0.001). Importantly, all 8 patients with major adverse cardiovascular events in the low-FFR group were appropriately treated with percutaneous coronary intervention and calcium channel blockers. CONCLUSIONS These results indicate that patients with VSA with significant coronary stenosis represent a high-risk population despite current guideline-recommended therapies, suggesting the importance of routine coronary functional testing in this population.
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Affiliation(s)
- Kiyotaka Hao
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Jun Takahashi
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yoku Kikuchi
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Akira Suda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Koichi Sato
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Jun Sugisawa
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Tsuchiya
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Tomohiko Shindo
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Kensuke Nishimiya
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Shohei Ikeda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Ryuji Tsuburaya
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Takashi Shiroto
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yasuharu Matsumoto
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Miyata
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Yasuhiko Sakata
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Yasuda
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Hiroaki Shimokawa
- Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
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50
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Sugisawa J, Matsumoto Y, Takeuchi M, Suda A, Tsuchiya S, Ohyama K, Nishimiya K, Akizuki M, Sato K, Ohura S, Ota H, Ikeda S, Shindo T, Kikuchi Y, Hao K, Shiroto T, Takahashi J, Miyata S, Sakata Y, Takase K, Kohzuki M, Shimokawa H. Beneficial effects of exercise training on physical performance in patients with vasospastic angina. Int J Cardiol 2020; 328:14-21. [PMID: 33309635 DOI: 10.1016/j.ijcard.2020.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/23/2020] [Revised: 11/04/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022]
Abstract
AIMS In vasospastic angina (VSA), coronary vasomotion abnormalities could develop not only in epicardial coronary arteries but also in coronary microvessels, where calcium channel blockers (CCBs) have limited efficacy. However, efficacy of exercise training for VSA remains to be elucidated. We thus aimed to examine whether vasodilator capacity of coronary microvessels is impaired in VSA patients, and if so, whether exercise exerts beneficial effects on the top of CCBs. METHODS We performed 2 clinical protocols. In the protocol 1, we measured myocardial blood flow (MBF) using adenosine-stress dynamic computed tomography perfusion (CTP) in 38 consecutive VSA patients and 17 non-VSA controls. In the protocol 2, we conducted randomized controlled trial, where 20 VSA patients were randomly assigned to either 3-month exercise training group (Exercise group) or Non-Exercise group (n= 10 each). RESULTS In the protocol 1, MBF on CTP was significantly decreased in the VSA group compared with the Non-VSA group (138 ± 6 vs 166 ± 10 ml/100 g/min, P = 0.02). In the protocol 2, exercise capacity was significantly increased in the Exercise group than in the Non-Exercise group (11.5 ± 0.5 to 15.4 ± 1.8 vs 12.6 ± 0.7 to 14.0 ± 0.8 ml/min/kg, P < 0.01). MBF was also significantly improved after 3 months only in the Exercise group (Exercise group, 145 ± 12 to 172 ± 8 ml/100 g/min, P < 0.04; Non-Exercise group, 143 ± 14 to 167 ± 8 ml/100 g/min, P = 0.11), although there were no significant between-group differences. CONCLUSIONS These results provide the first evidence that, in VSA patients, exercise training on the top of CCBs treatment may be useful to improve physical performance, although its effect on MBF may be minimal.
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Affiliation(s)
- Jun Sugisawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masashi Takeuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Suda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Tsuchiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuma Ohyama
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mina Akizuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shoko Ohura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shohei Ikeda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoku Kikuchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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