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Watanabe R, Kono R, Arai O, Onishi T, Kakuda T, Noda T, Nishimura K, Fukumoto T, Miura N, Kurata M, Miyauchi Y, Kitazawa R, Haffner M, Kikugawa T, Nelson P, Saika T. Detection of intraductal carcinoma of the prostate (IDCP) cases focusing on high-grade prostatic intraepithelial neoplasia (PIN) findings regarding invasive carcinoma of the prostate. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01268-x] [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: 02/12/2023]
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2
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Noda T, Nochioka K, Kaikita K, Akao M, Ako J, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K, Ogawa H, Yasuda S. Antithrombotic monotherapy for stable coronary artery disease and atrial fibrillation patients with and without prior coronary artery revascularization: Insights from the AFIRE trial. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.052] [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: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Japan Cardiovascular Research Foundation under a contract with Bayer Yakuhin
Background
The AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial demonstrated that rivaroxaban monotherapy was noninferior to combination therapy with rivaroxaban plus a single antiplatelet therapy regarding efficacy and superior for safety endpoints in patients with atrial fibrillation and stable coronary artery disease including patients not requiring revascularization [prior percutaneous coronary intervention (PCI) or bypass grafting (CABG)].
Purpose
The aim of this post-hoc subgroup analysis was to investigate the efficacy and safety of rivaroxaban monotherapy compared to combination therapy in patients with and without prior revascularization.
Methods
Among 2,215 patients included in the modified intention-to-treat analysis in the AFIRE trial, 1445 patients (65.2%) had undergone previous PCI alone, and 252 (11.4%) had undergone previous CABG. The remaining 518 patients (23.4%) was categorized as a group without prior revascularization and then compared with a group with prior revascularization (PCI or CABG). The primary efficacy end point was a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death from any cause. The primary safety end point was major bleeding, according to the criteria of the International Society on Thrombosis and Hemostasis.
Results
In 1697 patients with prior revascularization, efficacy and safety endpoints of rivaroxaban monotherapy were superior to combination therapy (efficacy: HR 0.62, 95%CI 0.45-0.85, p=0.003; safety: HR 0.62, 95%CI 0.39-0.98, p=0.040), whereas there were no significant differences in efficacy and safety endpoints among 518 patients without prior revascularization (efficacy: HR 1.19, 95%CI 0.67-2.11, p=0.553; safety: HR 0.47, 95%CI 0.18-1.26, p=0.125). There was a borderline interaction of efficacy endpoint (P for interaction=0.055) by randomized treatment assignment (Figure 1 and Figure 2). Compared with combination therapy, the safety benefit of rivaroxaban monotherapy on any bleeding was significant in patients without prior revascularization (HR 0.59, 95%CI 0.38-0.93, p=0.022).
Conclusions
In patients with prior PCI or CABG, rivaroxaban monotherapy resulted in more favorable safety and efficacy outcomes than combination therapy. There was a borderline interaction for primary efficacy outcome between prior revascularization and anti-thrombotic therapy.
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Affiliation(s)
- T Noda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
| | - K Kaikita
- University of Miyazaki, Faculty of Medicine, Division of Cardiovascular Medicine and Nephrology, Department of Internal Medi , Miyazaki , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Department of Cardiology , Kyoto , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - T Matoba
- Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine , Fukuoka , Japan
| | - M Nakamura
- Toho University Ohashi Medical Center, Division of Cardiovascular Medicine , Tokyo , Japan
| | - K Miyauchi
- Juntendo Tokyo Koto Geriatric Medical Center, Department of Cardiovascular Medicine , Tokyo , Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology , Tokyo , Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiovascular Center , Yokohama , Japan
| | - A Hirayama
- Osaka Police Hospital, Department of Cardiology , Osaka , Japan
| | - K Matsui
- Kumamoto University, Department of General Medicine and Primary Care , Kumamoto , Japan
| | - H Ogawa
- Kumamoto University , Kumamoto , Japan
| | - S Yasuda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
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3
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Hamazaki N, Kamiya K, Nozaki K, Yamashita M, Uchida S, Noda T, Ogura K, Nagumo D, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Kitamura T, Ako J, Miyaji K. Trends and outcomes of early rehabilitation in intensive care unit for patients with cardiovascular disease – a cohort study with propensity score-matched analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2468] [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
Early rehabilitation in the intensive care unit (ICU), including early mobility therapy, is known to improve the clinical outcomes in patients with critically ill. However, the effectiveness of acute-phase cardiovascular rehabilitation (CR) during ICU treatment have not been thoroughly evaluated in patients with cardiovascular disease (CVD).
Purpose
We aimed to investigate the trends and outcomes of acute-phase CR in the ICU for patients with CVD, including in-hospital and long-term clinical outcomes.
Methods
We reviewed 1948 consecutive patients with CVD admitted to tertiary academic ICU at a university hospital. Patients were arbitrarily assessed by an ICU team consisting of medical and surgical doctors, nurses and physiotherapists within 24 hours after admission to ICU to discover whether their rehabilitation could be initiated according to the specific clinical trial and statement. As clinical characteristics, disease aetiology, comorbid conditions, and ICU treatment were obtained from an electronic database. We evaluated the probability of return to walking independence and return to home as in-hospital clinical outcomes. All patients were followed for five years and investigated all-cause and cardiovascular events after hospital discharge as long-term clinical outcomes. The associations between the implementation of CR during ICU treatment (ICU-CR) and clinical outcomes were evaluated using propensity score-matched analysis with adjustment for clinical characteristics in all matched patients and various subgroups, including aged >65 years, surgical patients, emergency, and length of ICU stay ≥48 hours.
Results
Out of studied patients, 1092 patients received ICU-CR, the number of which positively correlated with year-trend (r=0.986, P<0.001). After propensity score matching with adjustment for clinical characteristics including calendar years, 758 patients were included for analysis (pairs of n=379 ICU-CR and non-ICU-CR). The ICU-CR was significantly associated with a higher probability of return to walking independence (incident rate ratio [IRR], 2.04; 95% confidence interval [CI], 1.77–2.36) and return to home (IRR, 1.22 95% CI, 1.05–1.41). These associations were consistently observed in various subgroups regarding CVD conditions (Figure 1). During the median follow-up periods of 2.6 years, all-cause clinical events and cardiovascular events occurred in 289 patients (38.1%) and 153 patients (20.2%), respectively. The ICU-CR showed significantly lower rates of five-year all-cause and cardiovascular events than non-ICU-CR (hazard ratio [95% CI] for all-cause events and cardiovascular events, 0.71 [0.56–0.89] and 0.69 [0.50–0.95], respectively, Figure 2).
Conclusions
The implementation of acute-phase CR in the ICU increased with year-trend, considered beneficial to improve in-hospital and long-term clinical outcomes in patients with CVD and various subgroups of relatively severe disease conditions.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Ogura
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - D Nagumo
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - T Kitamura
- Kitasato University School of Medicine, Department of Cardiovascular Surgery , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - K Miyaji
- Kitasato University School of Medicine, Department of Cardiovascular Surgery , Sagamihara , Japan
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Ogura K, Hamazaki N, Kamiya K, Kitamura T, Kobayashi S, Ichikawa T, Yamashita M, Uchida S, Noda T, Nagumo D, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J, Miyaji K. Perme ICU Mobility Score as a comprehensive assessment tool of acute-phase rehabilitation is correlated with clinical outcomes in patients after cardiovascular surgery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2469] [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
Early mobility therapy in the intensive care unit (ICU) is widely employed to improve the physical function and prognosis of patients with critically ill. On the other hand, patients who undergo cardiovascular surgery frequently suffer from disabilities after ICU care due to their cardiopulmonary conditions and treatments. However, few studies have reported the procedures and assessments of acute-phase rehabilitation in these patients. Recently, the Perme ICU Mobility Score (Perme Score) was developed as a reliable tool to assess comprehensive mobility status of patients in the ICU. We hypothesised that the Perme Score is a useful tool for assessing the mobility levels in the ICU and predicting clinical outcomes in patients undergoing acute-phase rehabilitation after cardiovascular surgery.
Purpose
To investigate the associations between the Perme Score within the second days after cardiovascular surgery and the patients' clinical outcomes, including physical function and the incidence of clinical events.
Methods
We studied 224 consecutive patients (34.4% female; aged 65±13 years) who were admitted to the ICU of a tertiary academic hospital after cardiac and/or major vascular surgery. Clinical characteristics including patient profiles, comorbidities, surgical details and APACHE II and SOFA scores were evaluated on ICU admission. The Perme Score contains categories on mental status, potential mobility barriers, muscle strength and mobility level, with higher scores indicating greater activity levels in the ICU. We assessed the Perme Score within the second days after the surgery. As a physical function at hospital discharge, we measured the six-minute walk distance (6MWD). The primary endpoint was a composite outcome of the number of all-cause mortality and/or all-cause unplanned readmission. We analysed the associations of the Perme Score with the 6MWD and the incidence of clinical events using multiple regression analysis and multivariate Poisson regression analysis, respectively.
Results
After adjusting for clinical confounding factors, a higher Perme Score was an independent factor of a higher 6MWD (Table 1). During the median follow-up period of 1.3 years, 51 cases of all-cause mortality/readmission occurred in 37 (16.5%) patients, with an incidence rate of 18.6/100 person-years. In the multivariate Poisson regression analysis, even after adjusting for the severity score in the ICU, a higher Perme Score was significantly and independently associated with lower rates of all-cause clinical events (adjusted incident rate ratio: 0.96, 95% confidence interval: 0.93–0.99, P=0.008, Figure 1).
Conclusions
The Perme Score within the second days after cardiovascular surgery is correlated with physical function at hospital discharge and the incidence of clinical events after discharge. Thus, a comprehensive assessment of acute-phase rehabilitation after cardiovascular surgery may be useful in predicting clinical outcomes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Ogura
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - T Kitamura
- Kitasato University School of Medicine, Department of Cardiovascular Surgery , Sagamihara , Japan
| | - S Kobayashi
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - D Nagumo
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - K Miyaji
- Kitasato University School of Medicine, Department of Cardiovascular Surgery , Sagamihara , Japan
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5
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Miki T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Ueno K, Yamaoka-Tojo M, Maekawa E, Sasaki J, Matsunaga A, Ako J. Cancer as a risk factor for physical dysfunction and poor prognosis in patients with cardiovascular disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2573] [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
Introduction
The emerging interdisciplinary field of cardio-oncology is of interest to clinicians because a history of cancer or cancer treatment is considered a severe risk factor for cardiovascular disease (CVD). Both cancer and CVD can reduce skeletal muscle mass; together, they can lead to a poorer prognosis. However, it is unclear whether a patient's cancer history can lower physical function and lead to a poor prognosis with the coexistence of cancer history and physical dysfunction in patients with CVD. This study aimed to identify the relationship between cancer history and physical function, as well as the prognostic value of their combination, in patients with CVD.
Methods
We reviewed 3,640 patients with CVD (mean age, 67.9±13.5 years) who underwent physical-function tests (gait speed and 6-min walking distance [6MWD]). We performed multivariate linear regression analysis to assess potential associations between cancer history and physical-function tests in patients with CVD. Additionally, we used the Kaplan–Meier curve and Cox regression analyses to assess survival and prognostic significance for patients divided into four groups according to the presence or absence of cancer history and high or low physical function.
Results
In multivariate linear regression analysis, cancer history was independently associated with lower gait speed and 6MWD (gait speed, P=0.048 and 6MWD, P=0.040). A total of 581 deaths occurred over a median follow-up period of 3.08 years (interquartile range: 1.36–5.27). For all-cause mortality, patients with a history of cancer and reduced physical function were found to have a significantly higher mortality risk even after adjusting for several covariates (gait speed, HR: 1.66, P=0.003 and 6MWD, HR: 1.71, P=0.003).
Conclusion
Cancer history was correlated with physical dysfunction in patients with CVD. Moreover, the coexistence of cancer history and physical dysfunction resulted in poorer prognosis in patients with CVD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Miki
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Ueno
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - J Sasaki
- Kitasato University School of Medicine, Research and Development Center for New Medical Frontiers , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
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6
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Nozaki K, Hamazaki N, Kamiya K, Uchida S, Noda T, Maekawa E, Matsunaga A, Yamaoka-Tojo M, Ako J. Sex differences in frequency of instrumental activities of daily living after cardiac rehabilitation and its impact on long-term mortality in patients with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2755] [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
While the major outcome of cardiac rehabilitation for heart failure (HF) is the improvement of exercise tolerance, prognosis, and quality of life, instrumental activities of daily living (IADL) has also been focused on as one of the its outcomes. IADL has been reported to be associated with all-cause mortality and quality of life in community-dwelling people and in patients with stable heart disease, but no report has examined the relationship between IADL after cardiac rehabilitation for HF and prognosis. In addition, it is assumed that sex differences may affect the frequency of performing each component of IADL, but there are no reports examining the association with prognosis by sex.
Purpose
The present study aimed to investigate the sex differences in frequency of IADL and its impact on outcomes.
Methods
We retrospectively studied 490 consecutive patients who were admitted due to acute decompensated HF and participated in outpatient cardiac rehabilitation after discharge. The study was performed in accordance with the tenets of the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of our institution. IADL frequency was assessed using the questionnaire-based Frenchay Activities Index (FAI). The primary endpoint was all-cause death and secondary endpoint was combined events (all-cause death and/or readmission due to HF). We performed the Kaplan–Meier and log-rank tests and multivariable Cox regression analysis to evaluate the prognostic predictive capability of the FAI.
Results
The study population had a median age of 69 (interquartile range [IQR]: 58–76) years, and 33.9% of patients were females. The median FAI score was 24 (IQR: 16–29) points. According to the Youden index based on the area under the curve calculated by the receiver operating characteristics curve, the cut-off values of FAI for all-cause death in all-over, females, and males were 23, 22, and 23 points, respectively. Over a median follow-up period of 4.8 years (IQR: 2.3–6.6 years), all-cause death and combined events were occurred in 95 (19.4%) and 213 (43.5%), respectively. After adjustment for several pre-existing prognostic factors, IADL assessed by the FAI was independently associated with all-cause mortality (hazard ratio [HR]: 0.961, 95% confidence interval [CI]:0.937–0.986) and combined events (HR: 0.968, 95% CI: 0.952–0.985), respectively. In addition, there was no interaction between sex in prognostic capability (P=0.664).
Conclusion
Lower IADL frequency assessed by FAI at the end of outpatient cardiac rehabilitation was shown to be associated with poorer prognosis in patients with HF, regardless of sex. The IADL level is generally higher in females than in males but seems to be a useful marker for risk stratification at the end of cardiac rehabilitation in both females and males.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid [JSPS KAKENHI Grant Number JP 19K19884]
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Affiliation(s)
- K Nozaki
- Kitasato University Hospital , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital , Sagamihara , Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
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7
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Nagumo D, Hamazaki N, Kamiya K, Obara S, Kobayashi S, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Ogura K, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Impact of small-airway disease on exercise intolerance and long-term outcomes in patients with heart failure and reduced or preserved ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2482] [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
Exercise intolerance in patients with heart failure (HF) is a strong indicator of a poor prognosis. As the respiratory impairment in HF patients, the small airway is reportedly more susceptible than central airways, which results in increased airway resistance and may cause poor outcomes. However, the impact of small-airway disease (SAD) on exercise intolerance and prognosis in patients with HF is still unclear.
Purpose
We investigated the associations between SAD and exercise intolerance in patients with HF, and the clinical significance of SAD for long-term clinical events with a reduced or preserved ejection fraction.
Methods
We reviewed 1015 patients with HF (mean age, 66.9±14.6 years; male, 64.5%) admitted for medical treatment. Patients with a prior history of chronic respiratory disease or an obstructive lung pattern – defined as the forced expiratory volume (%) in 1 s relative to <70% forced vital capacity using spirometry – were excluded. Characteristics including HF aetiology, comorbidities conditions, medications, blood parameters, and echocardiographic variables were obtained from clinical records. All patients underwent spirometry at hospital discharge, and SAD was defined as the maximum mid-expiratory flow (%) relative to a <60% predicted value. At hospital discharge, we measured 6-min walk distance (6MWD), and <300 m was considered as exercise intolerance. The primary endpoint was a composite clinical event of all-cause death and/or unplanned readmission for HF. Multivariate logistic regression analysis was used to assess the association between SAD and exercise intolerance. The multivariate Cox proportional hazard model was used to clarify whether SAD was an independent predictor for the incidence of clinical events. We also performed subgroup analyses in each multivariate analysis based on a left ventricular ejection fraction (LVEF) of 40%.
Result
SAD was observed in 479 (47.2%) patients. LVEF subgroups included 458 (45.1%) and 518 (51.0%) patients with LVEF <40% and ≥40%, respectively. After adjusting for clinical characteristics, SAD was independently associated with 6MWD <300 m (Figure 1). Moreover, this association was consistently observed in the LVEF <40% and ≥40% (Figure 1). During the median follow-up period of 1.5 years, all-cause death/readmission occurred in 431 patients (42.5%), and the incidence rate was 17.5/100 person-years. In the multivariate Cox proportional hazard model, SAD was independently associated with lower event-free survival rates in all patients and the LVEF <40% subgroup, but not LVEF ≥40% subgroup (Figure 2A, B, and C, respectively).
Conclusion
This study is the first to reveal that SAD is associated with exercise intolerance in patients with HF regardless of LVEF. Moreover, SAD may have a predictive significance for long-term outcomes in patients with HF and subgroups with reduced, but not preserved ejection fraction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Nagumo
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Kamiya
- Kitasato University of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - S Obara
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - S Kobayashi
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Ogura
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
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8
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Ueno K, Maekawa E, Terada T, Reed J, Yamaoka-Tojo M, Matsunaga A, Ako J. SARC-F PREDICTS POOR MOTOR FUNCTION AND PROGNOSIS IN OLDER PATIENTS WITH CARDIOVASCULAR DISEASE WITH COGNITIVE IMPAIRMENT. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.169] [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] Open
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9
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Shakuta S, Yamashita M, Kamiya K, Hamazaki N, Nozaki K, Uchida S, Noda T, Ueno K, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Relationship between the spread of coronavirus disease 2019, social frailty and depressive symptoms in patients with heart failure. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.026] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the Japan Society for the Promotion of Science (JSPS) KAKENHI
Background
Owing to the spread of coronavirus disease 2019 (COVID-19), people have refrained from going out unnecessarily and have been maintaining social distance. These new lifestyle approaches have affected people physically, psychologically, and socially. Patients with heart failure (HF) are more likely to have social frailty, physical frailty, cognitive impairment, and depressive symptoms, and an overlap of these conditions leads to adverse events. Therefore, multi-domain assessment and understanding of the condition of patients with HF are important for disease management. The spread of COVID-19 is a predicted risk factor for these events, but its impact in patients with HF has not been investigated.
Purpose
We investigated whether the spread of COVID-19 is associated with the development of the multi-domain of frailty in patients with HF.
Methods
Patients who were independent in their daily activities before admission were included in the study. The presence of social frailty (Makizako’s five items), physical frailty (Fried phenotype model), cognitive impairment (Mini-Cog), and depressive symptoms (the Patient Health Questionnaire-2) in patients with HF were assessed at hospital discharge. Logistic regression analyses were used to examine the impact of the spread of COVID-19 on the development of the multi-domain of frailty in patients with HF.
Results
We included 482 patients in this study. Median patient age was 74 years, and 64.5% were male. In multivariate logistic regression analyses, the spread of COVID-19 was significantly associated with the development of social frailty (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.02–1.30) and depressive symptoms (OR: 1.14, 95% CI: 1.02–1.27) but not with the development of physical frailty (OR: 1.24, 95% CI: 0.51–3.02) and cognitive impairment (OR: 1.72, 95% CI: 0.80–3.73).
Conclusion
The spread of COVID-19 was associated with the development of social frailty and depressive symptoms in patients with HF. Evaluation of social frailty and depressive symptoms during hospitalization would support disease management and understand their social and psychological conditions specific to the spread of COVID-19.
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Affiliation(s)
- S Shakuta
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Rehabilitation, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - K Ueno
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Cardiovascular Medicine, Sagamihara, Japan
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10
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Prevalence of metabolic dysfunction-associated fatty liver disease and its association with physical function in patients with acute coronary syndrome. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.059] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI
Background
It is widely known that patients with acute coronary syndrome (ACS) are at increased risk of nonalcoholic fatty liver disease (NAFLD), which is linked to sarcopenia and physical dysfunction. However, the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and physical dysfunction remains unclear.
Purpose
The purpose of this study was to investigate the prevalence of MAFLD in patients with ACS to assess the relationship between MAFLD and muscle strength, walking speed, and 6-minute walking distance (6 MWD).
Methods
We reviewed patients with ACS who were assessed for hepatic steatosis using the fatty liver index, and the results were further assessed to determine the presence of MAFLD. Multiple regression analysis was used to examine the association between MAFLD and physical function.
Results
Among 479 enrolled hospitalized patients, MAFLD was identified in 234 (48.9%) patients. We conducted a multiple regression analysis in which MAFLD was independently associated with lower leg strength, gait speed, and 6 MWD (leg strength, P = 0.023; gait speed, P = 0.002 and 6 MWD, P = 0.017). Furthermore, having more metabolic impairment was still associated with lower physical function decline (leg strength, P for trend = 0.002; gait speed, P for trend = 0.019 and 6 MWD, P for trend = 0.003).
Conclusions
MAFLD is common in hospitalized patients with ACS, and most patients with MAFLD have many overlapping metabolic abnormalities. MAFLD is associated with impaired physical function, and the greater the number of overlapping metabolic abnormalities, the worse the motor function.
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Affiliation(s)
- T Noda
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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11
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Uchida S, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Noda T, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Skeletal muscle mass metrics as factors in the prognosis of heart failure patients. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.029] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI Grant
Background
Sarcopenia is a chronic condition that is characterized by the loss of skeletal muscle mass with declining muscle strength and/or performance that occurs gradually with aging. It has been reported that sarcopenia is highly prevalent in patients with heart failure (HF) and is a poor prognostic factor. Therefore, it is important to accurately assess skeletal muscle mass in patients with HF. However, there are no reports that have simultaneously examined different skeletal muscle mass metrics as factors in the prognosis of HF patients.
Purpose
The purpose of this study is to examine if the different skeletal muscle mass metrics are associated with the prognosis of HF patients.
Methods
We examined a total of 869 patients with HF, aged ≥20 years (73 [63, 80] years; 537 males), who were admitted to our hospital and participated in an inpatient cardiac rehabilitation program. We used skeletal muscle mass index (SMI) as measured by bioelectrical impedance analysis (BIA), mid-upper arm circumference (MUAC), arm muscle circumference (AMC), and calf circumference (CC) as metrics of skeletal muscle mass. The primary outcome was all-cause deaths, and secondary outcome was HF readmission. To investigate the association between each skeletal muscle mass metric and prognosis, patients were divided into three groups according to the tertiles of SMI, MUAC, AMC, and CC. In addition, cumulative event rates of survival curves, Gray test, and Fine & Gray test were performed to evaluate the prognostic predictive capability.
Results
Over a median follow-up period of 0.9 years (interquartile 0.4–1.9) years, a total of 80 deaths and 195 HF readmissions occurred in the patients. Cumulative event rates of survival curves and Gray test showed that there was a significant decrease in all-cause mortality and HF readmission in the high MUAC group and high AMC group compared to their respective low groups (P < 0.05). Fine & Gray test after multivariate adjustment showed significantly better prognosis in the high MUAC group and high AMC group compared to their respective low groups (All-cause mortality: high MUAC group, subdistribution hazard ratio [sHR] = 0.42, 95% confidence interval [CI] = 0.20-0.88, P < 0.05; high AMC group, sHR = 0.34, 95%CI = 0.16-0.72 P < 0.05, HF readmission: high MUAC group, sHR = 0.69, 95%CI = 0.47-1.00, P < 0.05; high AMC group, sHR = 0.63, 95%CI = 0.43-0.93, P < 0.05).
Conclusion
Patients with HF who maintained high MUAC and high AMC had a good prognosis. CC and SMI were not associated with the prognosis of HF patients. This suggests the importance of evaluating MUAC and AMC in HF patients.
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Affiliation(s)
- S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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12
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Tanaka S, Iida H, Ueno M, Hirokawa F, Yoshida H, Ishii H, Nomi T, Nakai T, Kaibori M, Ikoma H, Noda T, Shinkawa H, Maehira H, Hayami S, Komeda K, Kubo S. Postoperative loss of independence 1 year after liver resection: prospective multicentre study. Br J Surg 2022; 109:e54-e55. [PMID: 35041737 DOI: 10.1093/bjs/znab452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/08/2021] [Indexed: 11/14/2022]
Affiliation(s)
- S Tanaka
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Iida
- Division of Gastrointestinal, Breast, and General Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan
| | - M Ueno
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - F Hirokawa
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - H Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Ishii
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Nomi
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - T Nakai
- Department of Surgery, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - M Kaibori
- Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan
| | - H Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Noda
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - H Shinkawa
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Maehira
- Division of Gastrointestinal, Breast, and General Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan
| | - S Hayami
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - K Komeda
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - S Kubo
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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13
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Miura N, Okaichi T, Okamoto S, Mouri S, Sogabe H, Arai A, Maeda T, Watanabe R, Noda T, Nishimura K, Fukumoto T, Miyauchi Y, Kikugawa T, Saika T. Extended robot-assisted laparoscopic prostatectomy and extended pelvic lymph node dissection as a monotherapy for very high-risk prostate cancer patients. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03127-x] [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] Open
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14
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Hamazaki N, Kamiya K, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Maekawa E, Meguro K, Yamaoka-Tojo M, Matsunaga A, Ako J. Associations between kidney function and outcomes following cardiac rehabilitation in patients with heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2698] [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
Kidney dysfunction is considered one of the most prevalent comorbidities in patients with heart failure (HF). A combination of HF and kidney dysfunction is associated with peripheral muscle impairment, exercise intolerance, and poor prognosis. Conversely, cardiac rehabilitation (CR) for HF patients has been recognized to improve their clinical outcomes. However, the impact of kidney function on responses to CR in patients with HF is still unclear.
Purpose
This study aimed to investigate the associations between baseline kidney function and outcomes following CR including changes in physical function and prognosis in HF patients.
Methods
We reviewed a total of 3,727 patients who were admitted for HF treatment and underwent comprehensive CR during hospitalization. In addition to clinical characteristics, we assessed the kidney function using estimated glomerular filtration rate (eGFR) based on serum creatinine level at hospital discharge as baseline. The quadriceps strength (QS) and 6-minute walk distance (6MWD) were measured as muscle strength and functional capacity, respectively, at baseline. We also remeasured these parameter 5 months after hospital discharge in patients who participated in outpatient CR. The association between participation in outpatient CR and composite outcome of all-cause death and/or unplanned readmission were assessed using the multivariate Cox proportional hazard models in a subgroup of baseline eGFR. We also compared the changes in QS and 6MWD (ΔQS and Δ6MWD) between the eGFR stages.
Results
During the median follow-up period of 1.9 years, all-cause death/readmission occurred in 1604 (43.0%) patients, and their rate of incidence was 20.9/100 person-years. Out of studied patients, 1,585 (42.5%) patients participated in outpatient CR that was significantly associated with lower incidences of all-cause clinical events in patients with both eGFR ≥60 (adjusted hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.60–0.89, P=0.002) and eGFR <60 (adjusted HR: 0.88, 95% CI: 0.78–0.99, P=0.045), but those with an eGFR <60 showed significant interaction between CR participation and adverse clinical events (interaction P<0.035, Figure 1). Among the outpatient CR participants, QS and 6MWD were significantly higher after 5-month CR than those at baseline (P<0.001, respectively), but the low baseline eGFR correlated with low ΔQS and Δ6MWD (trend P<0.001, respectively) even after adjustment for clinical confounding factors (Figure 2).
Conclusions
Although the outcomes following CR is affected by baseline kidney function, outpatient CR is significantly associated with the positive change in physical function and better prognosis in HF patients with low kidney function.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Sagamihara, Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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15
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Yamamoto N, Nakano M, Hayashi H, Hasebe Y, Ueda N, Noda T, Kusano K, Yasuda S. Predictive value of QRS duration normalized to left ventricular volume for responding to cardiac resynchronization therapy in patients with mid-QRS duration enrolled in the multicenter registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0401] [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
For cardiac resynchronization therapy (CRT), patients with chronic heart failure (HF) and wide (>150msec) QRS duration (QRSd) received class I/A indication. However, its beneficial effect seemed to be limited for those with mid- (120–150msec) QRSd. Recent studies demonstrated that QRSd normalized to left ventricular end-diastolic volume (QRSd/ LVEDV) improved prediction of clinical outcome in patients with CRT. Therefore, we sought to investigate predictive value of QRSd/LVEDV for responding to CRT in patients with mid-QRSd.
Methods
This was retrospective multi-center observational cohort study. A total 506 consecutive patients who underwent CRT implantation in Tohoku University Hospital and National Cerebral and Cardiovascular Center were evaluated. Exclusion criteria were QRSd less than 120ms, upgrade procedures from other implanted non-CRT devices and bradycardia requiring pacing. We evaluated clinical variables, data of electrocardiogram and transthoracic echocardiography at baseline and 6 months after CRT implantation. Primary endpoint was a HF hospitalization after CRT implantation. Distribution of free from HF hospitalization during follow-up was calculated using Kaplan-Meier curves, and the effects of covariate on the time to endpoint were investigated using a Cox proportional hazards model.
Results
After 199 patients were excluded based on exclusion criterion, remaining 307 patients were included for the analysis. Mean age was 62±14 [SD] years, and 238 (77%) were male. Mean LVEF and LVEDV were 25±9% and 234±82ml, respectively, and 24% of patients had ischemic etiology of HF. During the median 948 days of follow-up, CRT patients with mid QRSd (n=126; 136±10msec), as compared with those with wide QRSd (n=181; 174±17msec), tended to have higher incidence of HF hospitalization (Wilcoxon p=0.03). Multivariate analysis showed that QRSd and QRSd/LVEDV were significant predictors for HF hospitalization in CRT patients with mid QRSd, and cut-off values (137msec of QRSd and 0.65 of QRSd/LVEDV), which was calculated by receiver operative curve analysis, was used for risk stratification. QRSd<137msec was significant negative predictors for HF hospitalization (p=0.005), and Mid-QRSd patients with QRSd≥137msec demonstrated equivalent clinical outcome with those with wide QRSd. Moreover, patients with QRSd/LVEDV≥0.65 tended to have lower incidence of HF hospitalization as compared with those without it among patients with QRSd<137msec (n=64, Figure).
Conclusion
The present study demonstrates that QRSd normalized to left ventricular end-diastolic volume (QRSd/ LVEDV) could be clinical value in predicting outcome in CRT patients with mid-QRSd. These findings indicate normalized QRSd reflects myocardial conduction properties and contribute to risk stratification.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Yamamoto
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Nakano
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Hayashi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Hasebe
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Kusano
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yasuda
- Tohoku University Graduate School of Medicine, Sendai, Japan
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16
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Wakabayashi T, Miyamoto S, Sasaoka Y, Kudo Y, Nakamura S, Noda T, Kawashima Y, Yamamoto Y, Sakai Y, Kawasaki Y. Gastrointestinal: Pediatric pseudo-single magnet ingestion diagnosed by multidirectional X-ray and computed tomography. J Gastroenterol Hepatol 2021; 36:2035. [PMID: 33569845 DOI: 10.1111/jgh.15408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/12/2021] [Indexed: 12/09/2022]
Affiliation(s)
- T Wakabayashi
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Miyamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Sasaoka
- Department of Pediatrics, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Y Kudo
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Nakamura
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - T Noda
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Kawashima
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Yamamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Sakai
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Kawasaki
- Department of Pediatrics, Sapporo Medical University, Sapporo, Hokkaido, Japan
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17
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Associations of severity of liver damages with physical function and prognosis in patients with heart failure. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.034] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Heart failure (HF) and liver dysfunction often coexist because of complex cardiohepatic interactions, which adversely affects prognosis. However, the association between liver dysfunction and physical dysfunction, and between coexistence of both and prognosis in HF patients remains unclear.
Purpose
We evaluated the associations of severity of liver damage and physical function and prognosis in patients with HF.
Methods
The study population consisted of 895 patients with HF (mean age, 69.4 ± 14.2 years) who underwent liver function test using model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and physical function test (grip strength, leg strength, gait speed, and 6-minute walking distance [6MWD]). The associations between MELD-XI score and physical function were assessed by multivariate linear regression model analysis. Moreover, we investigated the prognostic value of coexistence of liver dysfunction and physical dysfunction. The endpoint was all-cause mortality.
Results
After adjusting for covariates, MELD-XI score was independently associated with lower grip strength, leg strength, gait speed, and 6MWD (P < 0.001). In addition, hierarchical multivariate linear regression analysis revealed that adding MELD-XI scores or BNP explained additional variance in the physical function measures. The MELD-XI score added to the clinical model was significantly more predictive of physical function (grip strength, change in F: 27.105, P < 0.001; leg strength, change in F: 33.980, P < 0.001; gait speed, change in F: 22.826, P < 0.001; 6MWD, change in F: 59.193, P < 0.001) than BNP added to the clinical model. Eighty-six deaths occurred over a median follow-up period of 1.67 years (interquartile range: 0.62 – 3.04). Patients with high MELD-XI score and reduced physical function were found to have significantly higher mortality risk even after adjusting for several covariates (grip strength, hazard ratio [HR] = 3.80 [95% confidence interval (CI) = 2.04 – 7.08], P < 0.001; leg strength, HR = 4.65 [95% CI = 2.47 - 8.75], P < 0.001 and gait speed, HR = 2.49 [95% CI = 1.43 - 4.33], P = 0.001; 6MWD, HR = 5.48 [95% CI = 2.88 - 10.41], P < 0.001).
Conclusions
Liver dysfunction was correlated with reduced physical function. Moreover, the coexistence of lower physical function and liver dysfunction considerably affected prognosis in patients with HF.
Abstract Figure. Kaplan–Meier survival curves
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Affiliation(s)
- T Noda
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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18
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Affiliation(s)
- W Imoto
- Department of Infection Control Science, Osaka City University Graduate School of Medicine, Osaka, Japan, Department of Infectious Disease Medicine, Osaka City University Hospital, Osaka, Japan and Department of Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Kaga
- Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan and Department of Trauma and Critical Care Center, Osaka City University Hospital, Osaka, Japan
| | - T Noda
- Department of Infection Control Science, Osaka City University Graduate School of Medicine, Osaka, Japan and Department of Infectious Disease Medicine, Osaka City university Hospital, Osaka, Japan
| | | | - Y Mizobata
- Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan and Department of Trauma and Critical Care Center, Osaka City University Hospital, Osaka, Japan
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19
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Wada M, Yamagata K, Ishibashi K, Inoue Y, Noda T, Nagase S, Ota M, Aiba T, Nakajima T, Fukuda T, Kusano K. Ventricular tachycardia in cardiac sarcoidosis -prognosis, characterization of ventricular substrates and outcomes of treatment-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2141] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prognosis, the underlying substrate and clinical outcomes of treatment are unclear in patients with cardiac sarcoidosis (CS)-related ventricular tachycardia (VT).
Objective
This study investigated the prognosis and the relationship between electroanatomical mapping (EAM) and imaging findings in patients with CS-related VT.
Methods
A total of 203 CS patients (Age 68.1±11.6 years, 87 males) were enrolled at two tertiary care medical centers between 2000 and 2018. All met the 2016 Japanese Circulation Society guidelines for diagnosis of CS. They were followed for a composite of major adverse cardiac events (MACE) including cardiac death, heart transplantation, unscheduled hospitalization for heart failure, and life-threatening ventricular arrhythmias. Distribution of late gadolinium enhancement (LGE) on cardiac MRI (CMR) and/or an abnormal myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography at diagnosis were examined. The relationship between EAM and the image findings were also analyzed in patients with radiofrequency ablation (RFA) for VT.
Results
During a median follow-up of 53 months, 87 of the 203 patients (43%) experienced a MACE. Baseline factors associated with MACE were presence of sustained VT (HR, 2.43, 95% CI 1.54–3.85, P<0.001), left ventricular ejection fraction below 50% (HR, 1.95 95% CI 1.07–3.56, P=0.029), and abnormal myocardial FDG uptake (HR, 2.42 95% CI 1.04–5.61, P=0.039). Overall, 69 of the 203 patients (34%) experienced sustained VT. Abnormal myocardial FDG uptake was significantly more prevalent in patients with VT than in those without (92.7% vs. 78.5%, P=0.02). A total of 25 patients (9.9%) required RFA for CS-related VT (Age 64.0±8.7 years, 12 males, 1.32±0.56 RFAs per patient). Abnormal electrocardiograms (EGM) were observed in 22 of the 25 patients (88%). LGE was more frequent than abnormal FDG uptake in areas with an abnormal EGM (77% vs. 41%; P=0.002). Over a mean follow-up period of 67-months, 13 of the 25 patients with RFA (52%) remained free of VT episodes (Figure). VT recurred in nine of the 12 patients with RFA and in 17 of the 47 patients without RFA, but was suppressed by intensive pharmacologic therapy such as the combined use of amiodarone and sotalol. In patients with CS-related VT, survival without experiencing a MACE did not differ in participants with or without RFA.
Conclusions
In our 203 CS patients, sustained VT and abnormal FDG uptake were associated with worse cardiac outcomes. The prevalence of abnormal FDG uptake was significantly higher in patients with CS-related VT, LGE on CMR was more frequent within localized areas of an abnormal EGM, suggesting that both scar itself and the associated inflammation were involved in the pathogenesis of CS-related VT. Successful RFA of CS-related VT is still challenging, and recurrence is common. Preprocedural CMR can be useful in detecting abnormal EGMs that are potential targets for substrate ablation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Ota
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Nakajima
- Saitama Cardiovascular and Respiratory Center, Department of Cardiology, Kumagaya, Japan
| | - T Fukuda
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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20
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Cardiac function at diagnosis is important prognostic factor in patients with cardiac sarcoidosis -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2130] [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
Sarcoidosis is a systemic non-caseating granulomatous disease of unknown etiology. Cardiac involvement (cardiac sarcoidosis, CS) has been reported to be an important prognostic factor in this disease because of heart failure and/or ventricular arrhythmia, and corticosteroid therapy is usually prescribed to prevent cardiac events. However, little is known about the relationship of cardiac function and concomitant corticosteroid therapy on later cardiac events in CS.
Objective
We evaluated the relationship between prognosis and left ventricular ejection fraction (LVEF) at the time of diagnosis in CS patients from the Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, mean age 60±13 years old, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The relationship of adverse events (all-cause death, cardiovascular death, and appropriate ICD [Implantable Cardioverter Defibrillator] discharge) and LVEF (with corticosteroid 84%) (low LVEF: LVEF≤35% n=98 [with corticosteroid in 78%], moderate LVEF: LVEF 35–50% n=104 [with corticosteroid in 93%], normal LVEF: 50≤LVEF n=218 [with corticosteroid in 83%]) were evaluated respectively.
Results
89 CS patients developed all-cause death (n=50), cardiovascular death (n=30) or appropriate ICD discharge (n=48). The frequency of corticosteroid therapy was not different in the each LVEF group, but Kaplan-Meier analysis revealed that all-cause death, cardiovascular death, and all cardiovascular adverse events were more observed in lower LVEF group (log-rank p<0.0001). Furthermore, multivariate Cox hazard analysis revealed that LVEF was a most important independent prognostic factor in CS.
Conclusion
This Japanese nationwide questionnaire survey data showed that initial LVEF was an independent and strong prognostic predictor in CS, therefore primary prevention would be needed even after starting corticosteroid in patients with decreased cardiac function.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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21
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long time clinical course of cardiac sarcoidosis with corticosteroid therapy -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2109] [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
Sarcoidosis is a systemic inflammatory syndrome of unknown etiology and cardiac involvement has been reported to be an important prognostic factor in this disease. An autopsy study has reported that the frequency of this cardiac involvement (cardiac sarcoidosis: CS) varies in the different countries and races and very frequent in Japanese patients. We therefore performed the nationwide questionnaire survey and try to clarify the clinical characteristics and corticosteroid effect in CS, especially focused on arrhythmic events in this disease.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The clinical outcome and corticosteroid effect were evaluated.
Results
Clinical characteristics at diagnosis was as follows: female dominant (68%), mean age of 60±13 years old, mean left ventricular ejection fraction was 49±16%. Arrhythmic events were very frequently observed as an initial cardiac manifestation in 263 patients (62%) of CS, of which atrioventricular block (AVB) in 174 (41%), ventricular tachycardia (VT) in 73 (17%) and AVB with VT in 17 (4%) (Figure 1A). Pacemaker was implanted in 166 patients (40%) and defibrillators was 137 patients (33%). Corticosteroid was prescribed in 144 (83%) of 174 patients with AVB and in 62 (85%) of 73 patients with VT. Initial dose was mean 47.9 mg and maintenance dose of mean 7.3 mg. Corticosteroid improved VT as good as AVB (27% vs. 29%). However, corticosteroid sometimes worsened VT events compared with AVB (10% vs. 2%) (Figure 1B). During the course of follow-up, 32 patients were needed to increase corticosteroid in 23 of AVB and 10 of VT cases. However, there were no difference in mortality between the groups, whether or not to increase corticosteroid. All survival rate was 92% (5-year mortality), 83% (10-year mortality) and free from all cause death and defibrillator charge was 81% (5 year), 71% (10 year).
Conclusion
Fatal arrhythmia is commonly observed in CS as a primary symptom. Corticosteroid sometimes worsen ventricular arrhythmia and appropriate defibrillator discharge was common. Thus, careful attention for activating ventricular arrhythmia would be needed during the follow-up period even after corticosteroid therapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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22
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long-term follow up ventricular tachycardia patients with preserved cardiac function -from Japanese cardiac sarcoidosis nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2128] [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
Prior ventricular tachycardia (VT) and low left ventricular ejection fraction (LVEF) are the most important prognostic factors in cardiac sarcoidosis (CS). Recently diagnosis of CS was renewed according to Japanese new guidelines. Patients with preserved cardiac function often have VT events, thus new guidelines recommends to assess the implantable cardioverter defibrillator (ICD) implantation for CS patients with preserved LVEF (35%≤LVEF<50%). However, the long-term prognosis of CS patients with preserved LVEF is unclear.
Objective
In CS patients with preserved LVEF, we evaluated the prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis from Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, who had LVEF≤35%, LVEF>50%, or who underwent cardiac transplantations were excluded. 104 patients with LVEF 35–50% (67 females, mean age 60±15 years old, median follow-up periods 2134 days [interquartile range: 758–2935 days]) were analyzed. The prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis were evaluated.
Results
30 patients had VT manifestation at CS diagnosis and 24 patients (80%) received ICDs. 74 patients had no VT manifestation at CS diagnosis and 19 patients (44%) received ICDs during follow up period. All-cause mortality was not different between two groups (Figure). Appropriate ICD therapy of non-VT manifestation group was significantly lower compared with that of VT manifestation group (log-rank p=0.001), however considerable number (n=7, 15%) of non-VT manifestation group had appropriate ICD therapy event during follow-up period. Cox hazard analysis revealed that concomitant non-sustained VT (NSVT) with atrioventricular block (AVB) was a predictor of appropriate ICD therapy in non-VT manifestation group.
Conclusion
This nationwide survey showed that considerable number of CS patients with preserved LVEF had VT events, independent of VT manifestation. Concomitant NSVT with AVB was a predictor of VT events, and ICD implantation should be assessed.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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23
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Kamakura T, Yamagata K, Wada M, Ishibashi K, Inoue Y, Noda T, Nagase S, Aiba T, Kusano K. Micro-embolic risks during radiofrequency and cryoballoon-ablation of atrial fibrillation -analysis from real-time carotid artery doppler monitoring-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0486] [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
Catheter ablation of atrial fibrillation (AF) is associated with risks of silent cerebral events. However, the timing of intraprocedural micro-embolic events or differences between open-irrigated radiofrequency (RF) and cryoballoon (Cryo) ablation are unclear. Newly developed real-time carotid artery Doppler is a simple non-invasive method to detect micro-embolic signals (MESs) during ablation.
Objective
We investigated the timing of detecting MESs during RF and Cryo ablation of AF.
Methods
During the first pulmonary vein isolation (PVI) session of AF, MESs were monitored by real-time carotid artery Doppler monitoring throughout the procedure. The MES counts were collected and evaluated separately during the different steps of the procedure (Figure).
Results
Thirty-three AF patients (RF/Cryo: 22/11 cases, 9 females, 69.5±11.6 y.o) were included. PVI was successfully accomplished in all patients with no major complications. The MES count was significantly greater in the RF group than Cryo group (table). In both groups, left atrial (LA) access (interatrial puncture) and sheaths insertion to the LA generated a significant number of MESs (RF: 1690 of 9116 MESs [18.5% of the total MESs], Cryo: 793 of 2285 MESs [34.7%]). In the RF group, MESs were observed incessantly during PVI (Figure). The LA dwell time was significantly longer in the RF group than Cryo group (table). In the RF group, the MES count was significantly greater in the longer LA dwell time group (LA dwell time >130min) than the shorter group (464.2±179.7 vs 302.6±138.2: P=0.049). During the cryo-applications in the Cryo group, the MESs were greatest during the first cryoballoon application (625 of 2285 MESs [27.4%]).
Conclusions
There were more MESs during RF ablation than cryoablation. MESs were recorded during a variety of steps throughout the procedure. In the RF group, most of MESs were recorded incessantly during radiofrequency ablation and greater number of MESs were recorded in patients with longer LA dwell time. In the Cryo group, most of MESs occurred during phases with a high probability of gaseous emboli.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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24
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Yokoyama Y, Miyamoto K, Nakai M, Sumita Y, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Nagase S, Noda T, Aiba T, Kusano K. The safety of catheter ablation of atrial fibrillation in elderly patients -analysis of the nationwide database in Japan, JROAD-DPC-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0613] [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
“Age” is one of the major concerns and determinants of the indications for catheter ablation (CA) of atrial fibrillation (AF). There are little safety data on CA of AF according to the age. This study aimed to assess the safety of CA in elderly patients undergoing CA of AF.
Methods and results
We investigated the complication rate of CA of AF for the different age groups (<60 years, 60–65, 65–70, 70–75, 75–80, 80–85, and ≥85) by a nationwide database (Japanese Registry Of All cardiac and vascular Diseases [JROAD]-DPC). The JROAD-DPC included 73,296 patients (65±11 years, 52,883 men) who underwent CA of AF from 516 hospitals in Japan. Aged patients had more comorbidities and a significantly increased CHADS2 score and higher rate of female according to a higher age. The overall complication rate was 2.6% and in-hospital mortality was 0.05%. By comparing each age group, complications occurred more frequently in higher aged groups. A multivariate adjusted hazard ratio revealed an increased age was independently and significantly associated with the overall complications (odds ratio was 1.25, 1.35, 1.72, 1.86, 2.76 and 3.13 respectively; reference <60 years).
Conclusions
The frequency of complications was significantly higher according to a higher age. We should take note of the indications and procedure for CA of AF in aged patients.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Intramural Research Fund 17 (Kusano) for Cardiovascular Diseases of the National Cerebral and Cardiovascular Center
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Affiliation(s)
- Y Yokoyama
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Nakai
- National Cerebral and Cardiovascular Center Hospital, Center for Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - Y Sumita
- National Cerebral and Cardiovascular Center Hospital, Center for Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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25
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Matsukuma S, Eguchi H, Wada H, Noda T, Shindo Y, Tokumitsu Y, Matsui H, Takahashi H, Kobayashi S, Nagano H. Liver resection with thrombectomy for patients with hepatocellular carcinoma and tumour thrombus in the inferior vena cava or right atrium. BJS Open 2020; 4:241-251. [PMID: 32012492 PMCID: PMC7093783 DOI: 10.1002/bjs5.50258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 02/06/2023] Open
Abstract
Background Hepatocellular carcinoma (HCC) with tumour thrombus (TT) in the inferior vena cava (IVC) or right atrium (RA) is a rare advanced disease state with a poor prognosis. The aim of this study was to examine survival after surgical resection. Methods Patients with HCC and TT of either the IVC or RA, who underwent liver resection between February 1997 and July 2017, were included. Their short‐ and long‐term outcomes and surgical details were analysed retrospectively. Results Thirty‐seven patients were included; 16 patients had TT in the IVC below the diaphragm, eight had TT in the IVC above the diaphragm, and 13 had TT entering the RA. Twelve patients had advanced portal vein TT (portal vein invasion (Vp) greater than Vp3 and Vp4), ten had bilobar disease, and 12 had extrahepatic disease. There were no in‐hospital deaths, although two patients died within 90 days. Median survival did not differ between patients who had resection with curative intent (18·7 months) and those with residual tumour in the lung only (20·7 months), but survival was poor for patients with residual tumour in the liver (8·3 months). Conclusion Liver resection with thrombectomy for advanced HCC with TT in the IVC or RA is safe and feasible, leading to moderate survival.
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Affiliation(s)
- S Matsukuma
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - H Eguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - H Wada
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - T Noda
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Shindo
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Y Tokumitsu
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - H Matsui
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - H Takahashi
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - S Kobayashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - H Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
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Morita M, Ogawa C, Omura A, Noda T, Kubo A, Matsunaka T, Tamaki H, Shibatoge M, Seno H, Minami Y, Ueshima K, Sakurai T, Nishida N, Kudo M. The Efficacy of Sonazoid-enhanced Ultrasonography in Decision-making for Liver Abscess Treatment. Intern Med 2020; 59:471-477. [PMID: 32062622 PMCID: PMC7056389 DOI: 10.2169/internalmedicine.2510-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective The usefulness of contrast-enhanced ultrasonography (CEUS) for making decisions in the treatment of liver abscess is unknown. Methods We evaluated the internal blood flow in the arterial-predominant phase by CEUS using Sonazoid® in 21 patients. The stain area rate was evaluated in maximum parting plane of abscess in CEUS. Patients were divided into two groups: the vascular phase enhancement (VE) group, in which ≥50% of the abscess cavity was enhanced (12 patients), and the vascular phase non-enhancement (VNE) group, in which <50% of the abscess cavity was enhanced (9 patients). The rate of patients who were cured by conservative treatment alone was examined in both groups. The defect rate of all liver abscesses in the post-vascular phase was also evaluated. Results In the VE group, improvement by conservative treatment alone was obtained in 11 out of 12 patients (91.7%), while in the VNE group, improvement by conservative treatment alone was obtained in only 1 out of 9 patients (11.1%), a significant difference (p<0.001). In the VE group, one patient did not improve with conservative treatment alone because the abscess ruptured near the liver surface. In the VE group, the abscess size was smaller than in the VNE group. By examining the defect rate in the post-vascular phase, it was found that 16 out of 21 patients (76.2%) showed 71% or more defects. Conclusion The enhancement rate in the arterial-predominant phase of CEUS was considered useful for determining the treatment approach for liver abscess.
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Affiliation(s)
- Masahiro Morita
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Chikara Ogawa
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Akina Omura
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Teruyo Noda
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Atsushi Kubo
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Toshihiro Matsunaka
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Hiroyuki Tamaki
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Mitsushige Shibatoge
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Japan
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Kazuomi Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Toshiharu Sakurai
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Naoshi Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Yagasaki H, Minatoguchi S, Ono K, Murata I, Deguchi T, Arai M, Noda T, Okura H. P4384Noninvasive and novel method to evaluate left ventricular contractility using pressure-volume loop area obtained by 3-dimensional speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0789] [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
Introduction
Left ventricular (LV) pressure-volume (P-V) loop area reflects stroke work (SW), but clinical use of this index is limited by the need of invasive pressure measurement. A noninvasive method to obtain LV pressure-strain loop was recently introduced to assess myocardial work (MW). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau and we reported that Tau was noninvasively evaluated by speckle tracking echocardiography (STE).
Purpose
We sought to evaluate the impact of preload change by leg lifts on LV SW noninvasively obtained by the novel method and to examine the utility to assess LV contractility by SW and end-diastolic (ED) volume relation (SW-VED).
Methods
Thirty six controls (age 71±10) and 30 patients with heart failure with reduced ejection fraction (EF) <50% (HF) (age 73±6) were enrolled. LV pressure in a cardiac cycle was estimated using systolic blood pressure (SBP), minimum diastolic pressure (mDP) and ED pressure (EDP) by utilizing the profile of an empiric, normalized reference curve. The mDP and EDP were estimated as (Tau − 33.7)/2.06 and as 12.3 − 10.1 x Log (left atrial active emptying function/minimum volume) as we reported. LVSW was obtained by P-V loop by the combination of these pressures and LV volume using 3-D STE.
Results
LVEF and longitudinal strain in HF before leg up by 3D-STE were lower compared to normal (LVEF; normal: 58±5 vs HF: 39±10*% and strain; −12±3 vs −8±3%*, *p<0.05 vs normal). LVEF was increased after leg up by 7±6% in normal and by 8±8% in HF associated with increased LVED volume (normal: 84±24 to 90±24 and HF: 124±36* to 136±42*ml). LV MW and SW in HF before leg up were lower compared to normal (MW: 1790±412 vs 1002±432*mmHg% and SW: 3946±1682 vs 3352±1026mmHgml). LV SW increased after leg up by 26±19% in normal and by 25±20% in HF. LV SW-VED in normal was greater than HF (241±151 vs 90±54*).
Conclusion
LV SW noninvasively obtained by P-V loop area was increased after leg up in both normal and HF but SW-VED in HF was smaller than normal, indicating reduced contractility in HF. This noninvasive method may be a new echocardiographic approach for quantification of LV SW and contractility.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - I Murata
- Gifu Prefectural General Medical Center, Nephrology, Gifu, Japan
| | - T Deguchi
- Asahi University Hospital, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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28
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Minatoguchi S, Tanaka R, Yoshizane T, Deguchi T, Sato H, Ono K, Nagaya M, Miwa H, Iwama M, Noda T, Watanabe S, Kawasaki M, Okura H. P3548Noninvasive estimation of left ventricular diastolic function in patients with hypertension and normal ejection fraction using 3-dimensional speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0411] [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
Left ventricular (LV) relaxation (eTau) and pulmonary capillary wedge pressure (ePCWP) were reported to be estimated by speckle tracking echocardiography (STE). LV camber stiffness (e-c stiffness) may be estimated with the use of 2 diastolic pressure-volume coordinates. The minimum diastolic pressure (mP) is reported to have a strong correlation with Tau.
Purpose
We sought to examine the impact of hypertension on LV diastolic function and LA properties and to elucidate the feature of hypertensive heart failure with preserved EF (HFpEF).
Methods
The e', E/e', Tau, PCWP, LVEDP, LV stiffness, LAV, LA emptying function (LAEF) and LA strain were examined in 53 controls (age 66±11), 136 hypertensive patients (HTN) with normal EF (69±11) and 39 HFpEF (77±14). ePCWP and estimated EDP (eEDP) was calculated as previously reported. Tau was calculated as isovolumic relaxation time/(ln 0.9 x systolic blood pressure − ln PCWP). Myocardial stiffness (e-m stiffness) was estimated as LVED stress/LV strain. LV c-stiffness was calculated as LV pressure change (from mP to EDP) obtained by catheterization divided by LV volume change. Estimated LV c-stiffness (e-c-stiffness) was noninvasively obtained using e-mP and e-EDP. The eTau, eEDP and e-mP by STE were validated by catheterization (n=126).
Results
The mP had a good correlation with Tau (r=0.70, p<0.01). The eTau, eEDP and e-mP by STE had a good correlation with those by catheterization (r=0.75, 0.63 and 0.70, p<0.01). Multivariate analysis revealed that ePCWP and LA strain were independent predictors of HFpEF.
LV diastoric function Variables Control HTN HFpEF LVEF, % 68±6 68±8 63±9*+ LV longitudinal strain x (s–1) 19.1±3.0 16.8±4.3* 14.5±5.1*+ E/e' 9.2±2.6 11.6±4.5* 15.9±7.9*+ eTau, ms 35±12 48±17* 59±17*+ ePCWP, mmHg 7.3±2.7 8.3±4.3 15.0±4.4*+ eLVEDP, mmHg 9.4±2.2 10.4±3.5 15.9±3.7*+ LV e-myocardial stiffness, kdynes/cm 0.56±0.25 0.69±0.56 1.27±0.71*+ LV e-chamber stiffness, mmHg/ml 0.19±0.06 0.20±0.08 0.36±0.19*+ Maximum LAVI, ml/m2 42±15 50±21* 68±17*+ Total LAEF, % 55±7 51±11 36±12*+ LA peak strain 41±15 40±17 19±8*+ *p<0.05 vs Control, +p<0.05 vs HTN.
Conclusion
We demonstrated that LV diastolic function in HTN may be accurately and noninvasively evaluated by STE.
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Affiliation(s)
- S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi university Hospital, Department of Cardiology, Gifu, Japan
| | - T Yoshizane
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - T Deguchi
- Asahi university Hospital, Department of Cardiology, Gifu, Japan
| | - H Sato
- Sawada Hospital, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - H Miwa
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Iwama
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - S Watanabe
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | | | - H Okura
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
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29
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Murayama M, Yagasaki H, Minatoguchi S, Ono K, Tanihata S, Arai M, Noda T, Okura H. P2474Noninvasive estimation of pulmonary capillary wedge pressure by novel 3D speckle tracking echocardiography and validation study by cardiac catheterization. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0806] [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
We previously reported that pulmonary capillary wedge pressure (PCWP) was noninvasively evaluated by 2D speckle tracking echocardiography (STE). Recently, novel software was introduced to examine volume and function of left ventricular and left atrium (LA) by 3D-STE automatically.
Purpose
We sought to compare the PCWP estimated by conventional 2D-STE (2D-ePCWP) and by novel 3D-STE (3D-ePCWP), and validate those values by cardiac catheterization.
Methods
Echocardiography and catheterization were performed in 29 patients (age 72±2) (7 ischemic heart disease, 2 hypertensive heart disease, 5 dilated cardiomyopathy, 12 valvular heart disease and 3 primary pulmonary hypertension).The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 x Log (left atrial active emptying function/minimum volume) as we previously reported. Echocardiography was performed just before the catheterization and we analyzed the 2D and 3D data by novel off-line software. 3D data was automatically analyzed and the border settings were fixed at default (ES60, ED30) (Figure).
Results
2D-ePCWP and 3D-ePCWP had a good correlation with PCWP invasively obtained by catheterization (r=0.87 and 0.83, respectively, both p<0.001). There was an excellent correlation between 2D-ePCWP and 3D-ePCWP (r=0.94, p<0.001) and there was a good correlation between 2D-LA volume index and 3D- LA volume index (r=0.80, p<0.001). Bland-Altman analysis revealed a good agreement between 2D-ePCWP and 3D-ePCWP, and between 2D-ePCWP and 3D-ePCWP without fixed and proportional bias.
Conclusion
This study demonstrated that PCWP might be noninvasively assessed by not only 2D-STE but also 3D-STE with reasonable accuracy and 3D-STE might have utility and value in the routine clinical practice.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Murayama
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Tanihata
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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30
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Kamakura T, Nakajima K, Kataoka N, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Yasuda S, Kusano K. P5655Efficacy of new-generation atrial antitachycardia pacing for atrial tachyarrhythmias in patients with left ventricular dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0598] [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
The progression to persistent atrial fibrillation (AF) is associated with a worse clinical outcome in patients with previous atrial tachyarrhythmias. New-generation atrial antitachycardia pacing (ATP) (Reactive ATP) reduced the progression to persistent AF in patients with pacemaker and preserved left ventricular (LV) function. However, little is known about the efficacy of Reactive ATP in patients with cardiac implantable electronic devices (CIED) and LV dysfunction.
Purpose
We aimed to investigate the efficacy of Reactive ATP for atrial tachyarrhythmias in patients with LV dysfunction (LV ejection fraction [LVEF] <40%).
Methods
This study included 423 patients with CIED and previous atrial tachyarrthythmias. Reactive ATP was programmed in 284 patients (ATP group) and 139 were implanted with a dual-chamber device without ATP function (control group). The differences in the success rate of ATP and incidence of progression to persistent AF (≥7 days) between the ATP and control groups were evaluated in 108 patients with LVEF <40% (reduced LVEF) and 315 with LVEF ≥40% (preserved LVEF). Patients with persistent AF were excluded from this study.
Results
During 710±337 days of follow-up period, 16 patients (15%) with reduced LVEF and 51 (16%) with preserved LVEF progressed to persistent AF (p=0.88). The mean ATP success rate was lower in patients with reduced LVEF than in those with preserved LVEF, although not statistically significant (reduced LVEF: 27.2±19.4% and preserved LVEF: 35.1±29.2%, p=0.12). The incidence of progression to persistent AF was significantly lower in the ATP group than in the control group both in patients with reduced and preserved LVEF (log-rank, reduced LVEF: p=0.0070 and preserved LVEF: p<0.0001) (Figure). Multivariate analysis showed that use of Reactive ATP and smaller left atrium were associated with lower incidences of persistent AF, while LVEF was not predictive of progression to persistent AF (Reactive ATP: hazard ratio [HR] 0.28, 95% confidence interval [CI] 0.17–0.46, p<0.0001, left atrium diameter: HR 1.03, 95% CI 1.00–1.07, p=0.030).
Figure 1
Conclusions
Reactive ATP was effective in preventing AF progression in patients with LV dysfunction.
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Affiliation(s)
- T Kamakura
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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31
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Yagasaki H, Minatoguchi S, Ono K, Deguchi T, Tanihata S, Arai M, Noda T, Okura H. P4351Validation by cardiac catheterization of noninvasive evaluation of left ventricular chamber and myocardial stiffness as a diastolic function using speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0758] [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
Left ventricular (LV) diastolic function is mainly composed of LV relaxation and LV stiffness. We reported that pulmonary capillary wedge pressure (ePCWP) and LV relaxation assessed by Tau (eTau) are noninvasively evaluated by speckle tracking echocardiography (STE). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau. Therefore, LV chamber stiffness (c-stiffness) may be assessed with the use of two LV diastolic pressure-volume coordinates: the mLVP and volume and the end-diastolic pressure (EDP) and volume.
Purpose
We sought to noninvasively assess LV stiffness using STE and validate the value by cardiac catheterization.
Methods
Echocardiography and catheterization were performed in 124 patients (age 72±8) (70 angina pectoris, 20 prior myocardial infarction, 19 hypertensive heart disease, 11 congestive heart failure and 4 paroxysmal atrial fibrillation). The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 × Log (left atrial active emptying function/minimum volume) and the eTau (ms) is obtained as isovolumic relaxation time/(ln 0.9 × systolic blood pressure − ln ePCWP) as previously reported. The mLVP (e-mLVP) was estimate using Tau. The estimated EDP (e-EDP) was calculated as 12.3 − 10.1 × Log (left atrial active emptying function / minimum volume). LV c-stiffness (mmHg/ml) was calculated as LV pressure change (from mLVP to EDP) obtained by catheterization divided by LV volume change during diastole which equals to stroke volume by echocardiography. Estimated c-stiffness (e-c-stiffness) was noninvasively obtained using e-mLVP and e-EDP. Furthermore, LV myocardial stiffness (m-stiffness) was calculated by LVED stress / LV longitudinal strain by STE, where LV stress (kdynes/cm2) was calculated as 0.334 × pressure × dimension / [thickness (1 + thickness/dimension)]. The estimated m-stiffness (e-m-stiffness) was calculated using e-EDP.
Results
The eTau and e-EDP estimated by STE had a good correlation with Tau and EDP invasively obtained by catheterization (r=0.75 and 0.63, respectively, both p<0.001). There was a good correlation between Tau and mLVP (Tau = 2.06 mLVP + 33.7, r=0.70). The estimated LVED stress had good correlation with ED stress obtained by catheterization (r=0.77, p<0.001). The e-c-stiffness and e-m-stiffness had a good correlation with those obtained by catheterization (e-c-stiffness; 0.116±0.07 and c-stiffness; 0.115±0.06, r=0.603, e-m-stiffness; 0.81±0.41 and m-stiffness; 0.85±0.45, r=0.89, respectively). Bland-Altman analysis revealed a good agreement between e-c-stiffness and c-stiffness, and between e-m-stiffness and m-stiffness without fixed and proportional bias.
Conclusion
This study demonstrated that LV stiffness may be noninvasively assessed by STE with reasonable accuracy and may have utility and value in the routine clinical practice for the diagnosis and treatment in patients with diastolic dysfunction.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Deguchi
- Asahi University Hospital, Cardiology, Gifu, Japan
| | - S Tanihata
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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Noda T, Sakurai N, Nozawa K, Kobayashi S, Devlin DJ, Matzuk MM, Ikawa M. Nine genes abundantly expressed in the epididymis are not essential for male fecundity in mice. Andrology 2019; 7:644-653. [PMID: 30927342 PMCID: PMC6688925 DOI: 10.1111/andr.12621] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/07/2019] [Accepted: 03/05/2019] [Indexed: 01/14/2023]
Abstract
Background Spermatozoa become competent for fertilization during transit through the epididymis. As spermatozoa from the proximal caudal epididymis can fertilize eggs, proteins from the caput and corpus epididymis are required for sperm maturation. Objectives Microarray analysis identified that more than 17,000 genes are expressed in the epididymis; however, few of these genes demonstrate expression restricted to the epididymis. To analyze epididymis‐enriched gene function in vivo, we generated knockout (KO) mutations in nine genes that are abundantly expressed in the caput and corpus region of the epididymis. Materials and methods KO mice were generated using the CRISPR/Cas9 system. The histology of the epididymis was observed with hematoxylin and eosin staining. KO males were caged with wild‐type females for 3–6 months to check fertility. Results We generated individual mutant mouse lines having indel mutations in Pate1, Pate2, or Pate3. We also deleted the coding regions of Clpsl2, Epp13, and Rnase13, independently. Finally, the 150 kb region encoding Gm1110, Glb1l2, and Glb1l3 was deleted to generate a triple KO mouse line. Histology of the epididymis and sperm morphology of all KO lines were comparable to control males. The females mated with these KO males delivered pups at comparable numbers as control males. Discussion and conclusion We revealed that nine genes abundantly expressed in the caput and corpus epididymis are dispensable for sperm function and male fecundity. CRISPR/Cas9‐mediated KO mice generation accelerates the screening of epididymis‐enriched genes for potential functions in reproduction.
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Affiliation(s)
- T Noda
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - N Sakurai
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - K Nozawa
- Center for Drug Discovery, Baylor College of Medicine, Houston, TX, USA.,Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA
| | - S Kobayashi
- Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
| | - D J Devlin
- Center for Drug Discovery, Baylor College of Medicine, Houston, TX, USA.,Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.,Interdepartmental Program in Translational Biology & Molecular Medicine, Baylor College of Medicine, Houston, TX, USA
| | - M M Matzuk
- Center for Drug Discovery, Baylor College of Medicine, Houston, TX, USA.,Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA.,Department of Pharmacology and Chemical Biology, Baylor College of Medicine, Houston, TX, USA
| | - M Ikawa
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.,Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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33
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Tamaki H, Noda T, Morita M, Omura A, Kubo A, Ogawa C, Matsunaka T, Shibatoge M. Efficacy of 1.2 L polyethylene glycol plus ascorbic acid for bowel preparations. World J Clin Cases 2019; 7:452-465. [PMID: 30842956 PMCID: PMC6397816 DOI: 10.12998/wjcc.v7.i4.452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/24/2018] [Accepted: 01/24/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A low-volume polyethylene glycol (PEG) solution that combines ascorbic acid with PEG-based electrolyte solution (PEG-ASC) is gaining mainstream acceptance for bowel preparation due to reduced volume and improved taste. Although several reports showed that bowel preparation with PEG-ASC volume lower than 2.0 L with laxative agents could be an alternative to traditional preparation regimen, the cleansing protocols have not been fully investigated.
AIM To evaluate the cleansing efficacy of 1.2 L PEG-ASC solution comparing with 2.0 L PEG electrolyte (PEG-ELS) for bowel preparations.
METHODS A randomized, single-blinded, open-label, single-center, non-inferiority study was conducted. In total, 312 Japanese adult patients (aged > 18 years) who underwent colonoscopy were enrolled. Patients were randomly allocated to bowel lavage with either 1.2 L of PEG-ASC solution with at least 0.6 L of an additional clear fluid (1.2 L PEG-ASC group) or 2.0 L of PEG-ELS (PEG-ELS group). Then, 48 mg of sennoside was administered at bedtime on the day before colonoscopy, and the designated drug solution was administered at the hospital on the day of colonoscopy. Bowel cleansing was evaluated using the Boston Bowel Preparation Scale (BBPS). The volume of fluid intake and required time for bowel preparation were evaluated. Furthermore, compliance, patient tolerance, and overall acceptability were evaluated using a patient questionnaire, which was assessed using a visual analog scale.
RESULTS In total, 291 patients (1.2 L PEG-ASC group, 148; PEG-ELS group, 143) completed the study. There was no significant difference in successful cleansing, defined as a BBPS score ≥ 2 in each segment, between the two groups (1.2 L PEG-ASC group, 91.9%; PEG-ELS group, 90.2%; 95%CI: -0.03-0.09). The required time for bowel preparation was significantly shorter (164.95 min ± 68.95 min vs 202.16 min ± 68.69 min, P < 0.001) and the total fluid intake volume was significantly lower (2.23 L ± 0.55 L vs 2.47 L ± 0.56 L, P < 0.001) in the 1.2 L PEG-ASC group than in the PEG-ELS group. Palatability, acceptability of the volume of solution, and overall acceptability evaluated using a patient questionnaire, which was assessed by the visual analog scale, were significantly better in the 1.2 L PEG-ASC group than in the PEG-ELS group (7.70 cm ± 2.57 cm vs 5.80 cm ± 3.24 cm, P < 0.001). No severe adverse event was observed in each group.
CONCLUSION The 1.2 L PEG-ASC solution was non-inferior to the 2.0 L PEG-ELS solution in terms of cleansing efficacy and had better acceptability among Japanese patients.
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Affiliation(s)
- Hiroyuki Tamaki
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Teruyo Noda
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Masahiro Morita
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Akina Omura
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Atsushi Kubo
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Chikara Ogawa
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Toshihiro Matsunaka
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
| | - Mitsushige Shibatoge
- Department of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017, Japan
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Miyauchi Y, Noda T, Miura N, Kikugawa T, Saika T. Case Report of Living Kidney Transplantation Using Ectopic Pelvic Kidney Harvested by Reduced Port Laparoscopic Donor Nephrectomy. Transplant Proc 2018; 50:3917-3919. [PMID: 30586841 DOI: 10.1016/j.transproceed.2018.06.016] [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: 05/28/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
A 28-year-old woman was diagnosed as having an ectopic kidney in adolescence. She desired to donate her ectopic kidney to her mother, who was diagnosed as having renal failure. The ectopic kidney was located behind the sigmoid colon with 3 renal arteries and 3 renal veins. Laparoscopic donor nephrectomy was performed by reduced port surgery using the GelPOINT access platforms at a midline incision below the umbilicus with 1 accessory port. A thin artery of the donated kidney was ligated. An artery of the upper pole was anastomosed to the internal iliac artery, and a second artery was anastomosed directly to the inferior epigastric artery. Three veins were anastomosed to the external iliac vein: 1 anastomosed directly, 1 interposed by saphenous vein graft, and 1 interposed by harvested ovarian vein. To our knowledge, this is the first successful case of transplantation using an ectopic pelvic kidney by reduced port laparoscopic donor nephrectomy.
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Affiliation(s)
- Y Miyauchi
- Department of Urology, Ehime University, Shitsukawa, Toon, Ehime, Japan.
| | - T Noda
- Department of Urology, Ehime University, Shitsukawa, Toon, Ehime, Japan
| | - N Miura
- Department of Urology, Ehime University, Shitsukawa, Toon, Ehime, Japan
| | - T Kikugawa
- Department of Urology, Ehime University, Shitsukawa, Toon, Ehime, Japan
| | - T Saika
- Department of Urology, Ehime University, Shitsukawa, Toon, Ehime, Japan
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35
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Noda T, Kobayashi S, Sawamura J, Oshibuchi H, Nishimura K. Withdrawal of the Decision to Donate Kidney by Living Related Donors: A Single-center Study in Japan. Transplant Proc 2018; 50:3045-3052. [PMID: 30577164 DOI: 10.1016/j.transproceed.2018.06.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND In Japan, 90% of kidney transplantations involve living related donors. A third-party interview is conducted during latter stages of preparation for transplantation to ensure the donor's voluntary decision-making. In this study, we investigated the factors responsible for withdrawal of decision for kidney donation by related living donors after third-party interview. METHODS Related living donor candidates were divided into 2 groups based on their final decision: those who finally donated the kidney (FDG; n = 435); and those who withdrew their decision after third-party interview (WG; n = 11). The psychosocial and medical variables were compared and the reasons for withdrawal were investigated. RESULTS Multiple logistic regression analysis revealed that none of the variables were significantly related to WG. Six categories of reasons for withdrawal were identified: "avoiding pregnancy risk"; "selecting alternative treatment"; "avoiding physical burden for donor"; "recipients' intemperance"; "need to take more time for decision-making"; and "psychological pressure." CONCLUSION A certain number of donor candidates withdrew their decision for different reasons, even in the latter stages of the transplant preparation. Careful verification of the donor candidates' individual situation and provision of adequate information and time are important to protect the donor's right to refuse.
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Affiliation(s)
- T Noda
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - S Kobayashi
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan; Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
| | - J Sawamura
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - H Oshibuchi
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - K Nishimura
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
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36
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Affiliation(s)
- Y Ito
- Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan
| | - H Ureshino
- Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - N Tsuruoka
- Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan
| | - T Noda
- Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan
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37
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Osumi H, Shinozaki E, Zembutsu H, Takeda Y, Wakatsuki T, Ichimura T, Ota Y, Nakayama I, Ogura M, Suenaga M, Takahari D, Chin K, Saiura A, Takahashi S, Noda T, Yamaguchi K. Clinical relevance of circulating tumor DNA using amplicon-based deep sequencing panel in colorectal cancer patients with liver metastasis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Yoshizane T, Tanaka R, Kato M, Hayano Y, Takai A, Ueno C, Kishi R, Iwata T, Otsuka M, Nagaya M, Sato H, Noda T, Takatsu H, Minatoguchi S, Kawasaki M. P1769Impact of left ventricular size and deformational parameters on ejection fraction in patients with hemodialysis: a study using 3-dimensional speckle tracking echocardiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Murakami memorial Hospital, Gifu, Japan
| | - M Kato
- Chuno Kosei Hospital, Seki, Japan
| | - Y Hayano
- Chuno Kosei Hospital, Seki, Japan
| | - A Takai
- Chuno Kosei Hospital, Seki, Japan
| | - C Ueno
- Chuno Kosei Hospital, Seki, Japan
| | - R Kishi
- Chuno Kosei Hospital, Seki, Japan
| | - T Iwata
- Chuno Kosei Hospital, Seki, Japan
| | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Sato
- Sawada Hospital, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | | | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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39
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Wada M, Kamakura T, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Kusano K. P3217Relationship between conductor externalization and electrical malfunction in recalled and non-recalled implantable defibrillator leads. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Wada
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center, Osaka, Japan
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40
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Yoshizane T, Tanaka R, Minatoguchi S, Watanabe T, Otsuka M, Nagaya M, Yagasaki H, Ono K, Ueno T, Watanabe R, Warita S, Noda T, Minatoguchi S, Kawasaki M. P1771Left ventricular strain rate during early diastole and atrial contraction by real-time three-dimensional speckle tracking echocardiography with high volume rate is a novel index of diastolic function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Murakami Memorial Hospital, Cardiology, GIfu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - T Watanabe
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Ueno
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Watanabe
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Warita
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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41
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Korai K, Ishibashi K, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Noguchi T, Yasuda S, Kusano K. P5777Clinical outcomes of patient with single-coil vs. dual-coil implantable cardioverter defibrillation lead for secondary prevention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Korai
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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42
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Ueda N, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K. P5740Efficacy and safety of new-generation atrial antitachycardia pacing for atrial tachyarrhythmias in patients implanted with a cardiac resynchronization therapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Ueda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
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43
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Kawamura I, Yoshizane T, Tanaka R, Minatoguchi S, Nagaya M, Ono K, Iwama M, Okumura N, Tsuchiya A, Tomita S, Matsuo H, Noda T, Suzuki T, Minatoguchi S, Kawasaki M. P6510Noninvasive evaluation of left ventricular relaxation and stiffness as diastolic function using speckle tracking echocardiography: validation study by cardiac catheterization. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - T Yoshizane
- Gifu Prefectural General Medical Center, Gifu, Japan
| | - R Tanaka
- Murakami Memorial Hospital, Gifu, Japan
| | | | - M Nagaya
- Gifu Prefectural General Medical Center, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Gifu, Japan
| | - M Iwama
- Gifu Prefectural General Medical Center, Gifu, Japan
| | | | | | | | | | - T Noda
- Gifu Prefectural General Medical Center, Gifu, Japan
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44
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Otuki S, Kamakura T, Wada M, Ishibashi K, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K. P1904Comparison of the efficacy of new-generation atrial antitachycardia pacing between patients with sick sinus syndrome and atrioventricular block. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Otuki
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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45
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Minatoguchi S, Yoshizane T, Tanaka R, Watanabe T, Yagasaki H, Saeki M, Nagaya M, Iwama M, Ono K, Noda T, Watanabe S, Minatoguchi S, Kawasaki M. P1770Left ventricular torsion and untorsion rate assessed by one-beat real-time three-dimensional speckle tracking echocardiography as an novel index of systolic and diastolic function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - T Yoshizane
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - R Tanaka
- Murakami Memorial Hospital, Department of Cardiology, Gifu, Japan
| | - T Watanabe
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Saeki
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Iwama
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - S Watanabe
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
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46
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Ueda N, Noda T, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K. P1948The efficacy of a new device-based continuous optimization algorithm for mildly wide QRS and non-CLBBB patients with cardiac resynchronization therapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Ueda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
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47
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Yoshizane T, Tanaka R, Minatoguchi S, Kawamura I, Sato H, Otsuka M, Nagaya M, Ueno T, Watanabe R, Warita S, Noda T, Nagata K, Takatsu H, Minatoguchi S, Kawasaki M. P866Noninvasive and comprehensive evaluation of the impact of left ventricular pressure overload on both systolic and diastolic function using speckle tracking echocardiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Murakami Memorial Hospital, Cardiology, GIfu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | | | - H Sato
- Sawada Hospital, Gifu, Japan
| | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Ueno
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Watanabe
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Warita
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | | | | | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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48
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Yoshizane T, Tanaka R, Otsuka M, Nagaya M, Minatoguchi S, Kawamura I, Yagasaki H, Ueno T, Watanabe R, Ono K, Noda T, Amano K, Watanabe S, Minatoguchi S, Kawasaki M. P5612A novel clinical method for quantification of left ventricular pressure-strain and pressure-volume loop area: a noninvasive index of myocardial work and stroke work. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Murakami memorial Hospital, Gifu, Japan
| | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | | | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Ueno
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Watanabe
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Amano
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Watanabe
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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49
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Minatoguchi S, Yoshizane T, Tanaka R, Watanabe T, Ono K, Saeki M, Nagaya M, Yagasaki H, Kojima T, Iwama M, Noda T, Ohashi H, Watanabe S, Minatoguchi S, Kawasaki M. P860Left ventricular layer torsion in heart failure with preserved versus reduced ejection fraction assessed by one-beat real-time 3-dimensional speckle tracking echocardiography with high volume rate. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - T Yoshizane
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - R Tanaka
- Murakami Memorial Hospital, Department of Cardiology, Gifu, Japan
| | - T Watanabe
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Saeki
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - T Kojima
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - M Iwama
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - H Ohashi
- Murakami Memorial Hospital, Department of Cardiology, Gifu, Japan
| | - S Watanabe
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
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50
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Minatoguchi S, Yoshizane T, Kawamura I, Tanaka R, Kishi R, Nagaya M, Sato H, Iwata T, Ono K, Matsuo H, Noda T, Nagata K, Takatsu H, Minatoguchi S, Kawasaki M. P5649Impact of left ventricular pressure overload on relaxation and stiffness in patients with preserved ejection fraction: noninvasive study using speckle tracking echocardiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - T Yoshizane
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | | | - R Tanaka
- Murakami Memorial Hospital, Department of Cardiology, Gifu, Japan
| | - R Kishi
- Chuno Kosei Hospital, Seki, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | - H Sato
- Sawada Hospital, Gifu, Japan
| | - T Iwata
- Chuno Kosei Hospital, Seki, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | | | - T Noda
- Gifu Prefectural General Medical Center, Department of Cardiology, Gifu, Japan
| | | | | | - S Minatoguchi
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
| | - M Kawasaki
- Gifu University Graduate School of Medicine, Department of Cardiology, Gifu, Japan
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