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Tsutsui H, Momomura SI, Saito Y, Ito H, Yamamoto K, Sakata Y, Ohishi T, Kumar P, Kitamura T. Long-Term Treatment With Sacubitril/Valsartan in Japanese Patients With Chronic Heart Failure and Reduced Ejection Fraction - Open-Label Extension of the PARALLEL-HF Study. Circ J 2023; 88:43-52. [PMID: 37635080 DOI: 10.1253/circj.cj-23-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND The PARALLEL-HF study assessed the efficacy and safety of sacubitril/valsartan vs. enalapril in Japanese patients with chronic heart failure with reduced ejection fraction (HFrEF). This open-label extension (OLE) assessed long-term safety with sacubitril/valsartan.Methods and Results: This study enrolled 150 patients who received sacubitril/valsartan 50 or 100 mg, b.i.d., in addition to optimal background heart failure (HF) therapy. A dose level of sacubitril/valsartan 200 mg, b.i.d., was targeted by Week 8. At OLE baseline, higher concentrations of B-type natriuretic peptide (BNP) and urine cGMP, and lower concentrations of N-terminal pro B-type natriuretic peptide (NT-proBNP), were observed in the sacubitril/valsartan core group (patients who received sacubitril/valsartan in both the core and extension study) than in the enalapril core group (patients who received enalapril in the core study and were then transitioned to sacubitril/valsartan). The mean exposure to study drug was 98.9%. There was no trend of worsening of HF at Month 12. No obvious changes in cardiac biomarkers were observed, whereas BNP and urine cGMP increased and NT-proBNP decreased in the enalapril core group, which was evident at Weeks 2-4 and sustained to Month 12. CONCLUSIONS Long-term sacubitril/valsartan at doses up to 200 mg, b.i.d., has a positive risk-benefit profile; it was safe and well tolerated in Japanese patients with chronic HFrEF.
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Affiliation(s)
- Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | | | | | - Hiroshi Ito
- Department of General Internal Medicine 3, Kawasaki Medical School
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Tottori University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Tsutsui H, Momomura SI, Saito Y, Ito H, Yamamoto K, Sakata Y, Ohishi T, Iimori T, Kitamura T. Efficacy and Safety of Sacubitril/Valsartan in Japanese Patients With Heart Failure According to Baseline Systolic Blood Pressure - Results From a Subgroup Analysis of the PARALLEL-HF Study. Circ J 2023; 88:53-61. [PMID: 37989299 DOI: 10.1253/circj.cj-23-0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND Lower systolic blood pressure (SBP) is known to be associated with poor prognosis in heart failure (HF). We evaluated the efficacy and safety of sacubitril/valsartan according to baseline SBP tertiles in Japanese patients from the PARALLEL-HF study.Methods and Results: In all, 223 patients were stratified into tertiles according to baseline SBP (≤114 mmHg: n=75; >114 and ≤130 mmHg: n=76; and >130 mmHg: n=72). Patients with lower SBP (≤114 mmHg) had the highest median N-terminal pro B-type natriuretic peptide (NT-proBNP) concentrations at baseline (P=0.0184). No significant difference was observed between sacubitril/valsartan and enalapril for the composite outcome of cardiovascular death and HF hospitalization across SBP tertiles (P-interaction=0.2682). Although the P-interaction value was not significant (0.2106), a greater reduction in NT-proBNP with sacubitril/valsartan compared with enalapril was observed in patients with SBP >130 mmHg (P=0.0076). The incidence of hypotension-related events and reduction or discontinuation of treatment due to hypotension-related events was higher in the lower SBP subgroup, and these events were more frequent in the sacubitril/valsartan than enalapril group. CONCLUSIONS The efficacy of sacubitril/valsartan compared with enalapril was consistent across baseline SBP tertiles in Japanese patients from the PARALLEL-HF study. Hypotension-related events were more common in patients treated with sacubitril/valsartan with lower SBP.
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Affiliation(s)
- Hiroyuki Tsutsui
- School of Medicine and Graduate School, International University of Health and Welfare, Takagi Hospital
| | | | | | - Hiroshi Ito
- Department of General Internal Medicine 3, Kawasaki Medical School
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Tottori University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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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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Handa M, Takiuchi T, Kawaguchi S, Komukai S, Kitamura T, Miyake T, Ohara Y, Doshida M, Takeuchi T, Matsubayashi H, Ishikawa T, Kimura T. O-130 Reproductive outcomes of normal ovarian reserve patients after progestin-primed ovarian stimulation with chlormadinone acetate vs GnRH antagonist: A retrospective study with inverse-probability-of-treatment weighting. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
To evaluate the effectiveness of chlormadinone acetate (CMA) for preventing premature LH surge in patients with normal ovarian reserve compared to cetrorelix.
Summary answer
In progestin-primed ovarian stimulation (PPOS) than GnRH antagonist (GnRH-ant), the incidence of premature LH surge was significantly lower, without significant difference in oocyte maturation rate.
What is known already
The GnRH-ant protocol is one of the conventional protocols which has some disadvantages including increased premature LH surge rate and cancelation rate. In recent years, the PPOS protocol has attracted attention as a new ovarian stimulation using progestin as an alternative to GnRH analog for suppressing a premature LH surge, however its efficacy is still controversial. In addition, many studies have investigated the reproductive outcomes of PPOS using medroxy-progesterone acetate or dydrogesterone; however, there are few reports of CMA, an oral progestin, which is inexpensive and widely used in Japan.
Study design, size, duration
This retrospective cohort study was performed in a reproduction center between March 2018 and October 2020 which included 977 Japanese patients with normal ovarian reserve undergoing PPOS with CMA (n = 299), or GnRH antagonist (GnRH-ant) with cetrorelix (n = 608) in their first IVF cycle at the reproduction center. In subgroup analysis, pregnancy outcomes after frozen embryo transfers (FET) between PPOS (n = 284) and GnRH-ant (n = 579) were also compared.
Participants/materials, setting, methods
The inclusion criteria were patients aged < 40 years and AMH ≧ 1.1 ng/mL, who underwent autologous oocyte retrieval in their first IVF cycle with freeze-all strategy. The primary outcome was the incidence of premature LH surge, the secondary outcomes was oocyte maturation rate. To reduce the impact of treatment bias and potential confounding factors, we conducted logistic regression models with inverse-probability-of-treatment weighting (IPTW).
Main results and the role of chance
After IPTW, baseline clinical data were well-balanced between the two groups, including age, AMH, BMI, the duration, type, and cause of infertility, antral follicle count, the history of recurrent spontaneous abortion, and previous IVF attempts. The premature LH surge rate was significantly lower with PPOS (3.1%) compared to GnRH-ant (20.1%) (odds ratio, 0.21; 95% confidence interval, 0.11–0.36). No significant differences were found in total gonadotropin dose (2400IU for PPOS vs 2400IU for GnRH-ant, p = 0.136), the number of oocyte retrieval (n = 15 vs n = 15, p = 0.484), oocyte maturation rate (78.8% vs 77.8%, p = 0.275), fertilization rate (73.0% vs 72.0%, p = 0.412), viable embryo rate per oocyte retrieval (40% vs 40%, p = 0.890), and good quality blastocyst rate (72.0% vs 69.6%, p = 0.092). However, the good quality day-3 embryo rate was significantly lower with PPOS (37.2% vs 49.1%, p < 0.05). There were no differences in the incidence of moderate-to-severe OHSS (0.3% vs 0.7%, p = 0.481). In FET cycles, the pregnancy outcomes, such as implantation rate (43.1 % vs 51.9 %, p = 0.013) and clinical pregnancy rate (46.5% vs 54.7%, p = 0.027) were significantly lower with PPOS, however, no significant differences were found in ongoing pregnancy rate (75.6% vs 80.5%, p = 0.325), and live birth rate (72.4% vs 79.5 %, p = 0.142).
Limitations, reasons for caution
This was a retrospective cohort study conducted in a single center. The participants in this study were limited to Japanese ethnicity. The results need to be validated across different centers and other ethnicities.
Wider implications of the findings
This is the first report assessing the reproductive outcomes on PPOS using CMA, widely used in Japan. The PPOS with CMA significantly suppressed the premature LH surge rate compared to GnRH-ant protocol, without decrease in oocyte maturation rate.
Trial registration number
N/A
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Affiliation(s)
- M Handa
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
| | - T Takiuchi
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
- Osaka university Graduate School of Medicine, Clinical Genomics , Osaka, Japan
| | - S Kawaguchi
- Osaka university Graduate School of Medicine, Division of Biomedical Statistics- Integrated Medicine , Osaka, Japan
| | - S Komukai
- Osaka university Graduate School of Medicine, Division of Biomedical Statistics- Integrated Medicine , Osaka, Japan
| | - T Kitamura
- Osaka university Graduate School of Medicine, Division of Environmental Medicine and Population Services- Social and Environmental Medicine , Osaka, Japan
| | - T Miyake
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
| | - Y Ohara
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| | - M Doshida
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - T Takeuchi
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - H Matsubayashi
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - T Ishikawa
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - T Kimura
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
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Kimura A, Kitamura T. Components of specific physical activity associated with aortic-radial pulse wave velocity in the very elderly. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vlachos K, Denis A, Kitamura T, Takigawa M, Frontera A, Martin R, Bourier F, Martin CA, Cheniti G, Pambrun T, Sacher F, Hocini M, Haissaguerre M, Jais P, Derval N. The role of marshall bundle epicardial connections in atrial tachycardias after atrial fibrillation ablation. Europace 2021. [DOI: 10.1093/europace/euab116.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial tachycardias (ATs) are often seen in the context of AF ablation.
Objectives
We evaluated the role of the Marshall bundle (MB) network in left atrial (LA) ATs using high-density high-spatial resolution 3D mapping.
Methods
199 post-AF ablation LA tachycardias were mapped in 140 consecutive patients (112 (80%) males, mean age: 61.8 years); 133 (66.8%) were macro-reentrant and 66 (33.2%) were scar-related re-entry. MB-dependent perimitral AT (PMAT) was diagnosed where the difference between the post pacing interval and the tachycardia cycle length (PPI-TCL) was <20ms in parts of the expected MB-dependent perimitral circuit (within the VOM, the ridge between the left pulmonary veins and LA appendage (LAA), the anterior LA and between 6- and 11-o’clock of the mitral annulus) and the PPI-TCL was >20ms in areas bypassed by the VOM (the distal coronary sinus (CS), the posterior LA and the mitral isthmus). MB-related re-entry was diagnosed by PPI-TCL <20ms at the left lateral ridge, posterior base of LAA, inferolateral LA or VOM ostium; and PPI-TCL >20ms in the septal annulus. Typically, in MB-dependent localized re-entry, the earliest activation was found along the MB-LA endocardial connection or MB-CS epicardial connection.
Results
The MB network was found to participate in 60 (30.2%) re-entrant ATs, 31 PMATs and 29 localized re-entries. High-frequency multiphasic fragmented electrograms with long duration were often recorded endocardially or epicardially at the MB-LA or MB-CS connections. The amplitude and duration of these signals were 0.5 ± 0.79 mV and 65 ± 40 ms for MB-PMATs and 0.26 ± 0.28mV and 122 ± 67 ms for MB-localized re-entries. Unipolar EGMs at the site of endocardial-epicardial breakthrough had a rS pattern in all MB-related ATs. Of 60 MB-related ATs, 49 (81.6%) terminated with RF ablation, 44 (73.3%) at the MB-LA junction and 5 (8.3%) at the MB-CS junction, while 9 (15%) terminated after 2.5-5 cc of alcohol infusion inside the vein of Marshall (VOM). Of the 31 MB-related macroreentrant ATs, 17 (54.8%) terminated at the MB-LA junction, 5 (16.1%) at the MB-CS junction and 7 (22.6%) with alcohol infusion inside the VOM. Two macroreentries (6.5%) using the MB did not terminate with RF energy either endocardially at the MB-LA junction or epicardially at the MB-CS junction, and we were unable to identify or cannulate the VOM for ethanol infusion. Of the 29 localized re-entrant ATs using the MB, 27 (93.1%) terminated at the MB-LA junction, none terminated at the MB-CS junction and 2 (6.9%) terminated after alcohol infusion. After a mean follow up of 12 months, only 4 patients (6.7%) had AT recurrence.
Conclusions
MB re-entrant ATs accounted for up to 29% of the left ATs after AF ablation. Ablation of the MB-LA or CS-MB connections or alcohol infusion inside the VOM is required to treat these arrhythmias. Abstract Figure.
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Affiliation(s)
- K Vlachos
- University of Bordeaux, Bordeaux, France
| | - A Denis
- University of Bordeaux, Bordeaux, France
| | - T Kitamura
- University of Bordeaux, Bordeaux, France
| | - M Takigawa
- University of Bordeaux, Bordeaux, France
| | - A Frontera
- University of Bordeaux, Bordeaux, France
| | - R Martin
- University of Bordeaux, Bordeaux, France
| | - F Bourier
- University of Bordeaux, Bordeaux, France
| | - CA Martin
- University of Bordeaux, Bordeaux, France
| | - G Cheniti
- University of Bordeaux, Bordeaux, France
| | - T Pambrun
- University of Bordeaux, Bordeaux, France
| | - F Sacher
- University of Bordeaux, Bordeaux, France
| | - M Hocini
- University of Bordeaux, Bordeaux, France
| | | | - P Jais
- University of Bordeaux, Bordeaux, France
| | - N Derval
- University of Bordeaux, Bordeaux, France
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Yamashita M, Kamiya K, Matsunaga A, Kitamura T, Hamazaki N, Nozaki K, Ichikawa T, Maekawa E, Meguro K, Yamaoka-Tojo M, Miyaji K. Low skeletal muscle density combined with muscle dysfunction predicts adverse events after adult cardiovascular surgery. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.358] [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: Other. Main funding source(s): This study was supported by the Grant for Japan Society for the Promotion of Science (JSPS) KAKENHI.
Introduction
Although muscle dysfunction is widely known as a poor prognostic factor in patients with cardiovascular disease, no study has examined whether the addition of low skeletal muscle density (SMD) assessed by computed tomography (CT) to muscle dysfunction is useful.
Purpose
The present study aimed to examine whether SMDs can strengthen the predictive ability of muscle dysfunction for adverse events in patients who underwent cardiovascular surgery.
Methods
We retrospectively reviewed 853 patients (median age: 69 years, 65.1% male) aged ≥40 years who had preoperative CT for risk management purposes and muscle dysfunctions measured during postoperative cardiac rehabilitation. Muscle dysfunctions were determined from weakness (low grip strength) and slowness (slow gait speed) based on the Asia Working Group for Sarcopenia. Low SMD based on transverse abdominal CT images was defined as a mean Hounsfield unit of the psoas muscle <45. To examine the complementary prognostic value for all-cause deaths, all-cause events, and cardiovascular-related events when low SMDs were added to four patterns of muscle dysfunction (weakness only, slowness only, weakness or slowness, and weakness and slowness), the continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) index were calculated.
Results
For all definitions of muscle dysfunction, the addition of SMDs was shown to significantly improve the cNRI (estimates: 0.377 to 0.468 for all-cause death, 0.220 to 0.248 for all-cause events, 0.308 to 0.322 for cardiovascular-related events) and IDI (estimates: 0.005 to 0.011 for all-cause death, 0.005 to 0.010 for all-cause events, 0.009 to 0.012 for cardiovascular-related events) in all analyses. Low SMDs combined with muscle dysfunctions were associated with the highest risk of all-cause death (Figure 1: A-D). Patients with neither low SMDs nor muscle dysfunction had the lowest risk of all-cause events and cardiovascular-related events (Figure1: E-L).
Conclusion
The predictive ability of muscle dysfunction for adverse events was consistently increased by addition of SMDs in patients who underwent cardiovascular surgery. Our results suggest that when CT is performed for any clinical investigation, the addition of the organic assessment of skeletal muscle can strengthen the diagnostic accuracy of muscle wasting.
Abstract Figure 1
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Affiliation(s)
- M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Kitamura
- Kitasato University School of Medicine, Department of Cardiovascular Surgery, 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
| | - 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 Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Miyaji
- Kitasato University School of Medicine, Department of Cardiovascular Surgery, Sagamihara, Japan
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9
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Tsutsui H, Momomura SI, Saito Y, Ito H, Yamamoto K, Sakata Y, Desai AS, Ohishi T, Iimori T, Kitamura T, Guo W. Efficacy and Safety of Sacubitril/Valsartan in Japanese Patients With Chronic Heart Failure and Reduced Ejection Fraction - Results From the PARALLEL-HF Study. Circ J 2021; 85:584-594. [PMID: 33731544 DOI: 10.1253/circj.cj-20-0854] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In the Prospective Comparison of angiotensin receptor neprilysin inhibitor (ARNI) With ACEi to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) study, treatment with sacubitril/valsartan reduced the primary outcome of cardiovascular (CV) death and heart failure (HF) hospitalization compared with enalapril in patients with chronic HF and reduced ejection fraction (HFrEF). A prospective randomized trial was conducted to assess the efficacy and safety of sacubitril/valsartan in Japanese HFrEF patients.Methods and Results:In the Prospective comparison of ARNI with ACEi to determine the noveL beneficiaL trEatment vaLue in Japanese Heart Failure patients (PARALLEL-HF) study, 225 Japanese HFrEF patients (New York Heart Association [NYHA] class II-IV, left ventricular ejection fraction [LVEF] ≤35%) were randomized (1 : 1) to receive sacubitril/valsartan 200 mg bid or enalapril 10 mg bid. Over a median follow up of 33.9 months, no significant between-group difference was observed for the primary composite outcome of CV death and HF hospitalization (HR 1.09; 95% CI 0.65-1.82; P=0.6260). Early and sustained reductions in N-terminal pro-brain natriuretic peptide (NT-proBNP) from baseline were observed with sacubitril/valsartan compared with enalapril (between-group difference: Week 2: 25.7%, P<0.01; Month 6: 18.9%, P=0.01, favoring sacubitril/valsartan). There was no significant difference in the changes in NYHA class and Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score at Week 8 and Month 6. Sacubitril/valsartan was well tolerated with fewer study drug discontinuations due to adverse events, although the sacubitril/valsartan group had a higher proportion of patients with hypotension. CONCLUSIONS In Japanese patients with HFrEF, there was no difference in reduction in the risk of CV death or HF hospitalization between sacubitril/valsartan and enalapril, and sacubitril/valsartan was safe and well tolerated.
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Affiliation(s)
- Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | | | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Tottori University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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10
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Kitamura T, Kimura A. Does motion-induced blood pressure variability affect pulse wave velocity and advanced glycation end products relationships in elderly people in the okinawa healthy and long-lived areas of Japan? Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Kimura A, Kitamura T, Hashiguchi Y, Ghoch M. A study on the relationship between ergonomic factors, pulse wave velocity, and falling accidents in super-aged people in Okinawa during simulated agricultural operations. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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12
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Mizutani H, Kurita T, Ishise T, Seko T, Fujii E, Kitamura T, Kawasaki A, Makino K, Ito M, Dohi K. Right coronary artery as a culprit artery for better prognosis in patients with acute myocardial infarction (AMI) with or without shock. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although patients with acute myocardial infarction (AMI) complicated by cardiogenic shock, morbidity and mortality remain high even with early revascularization and modern intensive care.
Culprit artery and prognosis were associated in patients with acute myocardial infarction.
Purpose
Evaluation of short- and long-term prognosis of AMI with cardiogenic shock by right coronary artery (RCA) and left coronary artery (LCR)
Method
We investigated 3400 AMI patients (age 68.8±12.7 y.o.) were enrolled from Mie ACS registry. They were divided into 4 groups according to the culprit artery and presence or absence of cardiogenic shock: RCA without shock n=1114, RCA with shock n=74, LCA without shock n=2028, LCA with shock n=184. Primary endpoint was defined as all-cause mortality.
Results
During the median follow-up periods with 743 days, 12.6% of the patients experienced all-cause death. RCA and LAC with shock groups demonstrated significantly higher in-hospital mortality compared to groups without shock (p<0.001, Figure 1A). Interestingly, after discharge, LCA with shock group showed significant higher all-cause mortality compared with other 3 groups. Surprisingly, RCA with shock group showed similar favorable prognosis to that of without shock groups (Figure 1B). Multivariate analyses for after discharge mortality showed that LCA with shock group was strongest independent poor prognostic factor with hazard ratio of 2.3 (95% CI 1.4–3.7), but RCA with shock group was not.
Conclusion
Association of cardiogenic shock is the hazardous risk factor for cases with AMI, especially LCA infarction. Surprisingly, RCA AMI cases with shock showed favorable prognosis as well as AMI without shock.
Kaplan-Meier survival curves
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - T Kurita
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - T Ishise
- Okanami general hospital, Iga, Mie, Japan
| | - T Seko
- Ise Red Cross Hospital, Cardiology, Ise, Japan
| | - E Fujii
- Nabari city hospital, Nabari, Mie, Japan
| | | | - A Kawasaki
- Mie central medical center, Tsu, Mie, Japan
| | - K Makino
- Mie prefectural general medical center, Yokkaichi, Mie, Japan
| | - M Ito
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - K Dohi
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
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13
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Sunaga A, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Yano M, Nakatani D, Mizuno H, Okada K, Kitamura T, Dohi T, Kojima T, Kida H, Hikoso S, Yasushi S. Cardiac factors as well as non-cardiac factors were associated with frailty in patients with heart failure with preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0899] [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
Frailty is associated with malnutrition and poor prognosis in patients with heart failure with preserved ejection fraction (HFpEF). However, the cardiac factors associated with frailty have not been fully examined in patients with HFpEF.
Purpose
The purpose of this study is to clarify the cardiac factors related to frailty in patients with HFpEF.
Methods
Of the 756 patients who registered prospective, multicenter, observational study of patients with HFpEF (PURSUIT-HFpEF) registry, 481 cases with clinical frailty score (CFS) and prognosis after discharge were examined. Frailty was defined as CFS ≥5. Outcomes were composite endpoint of all-cause death and heart failure readmission, and all-cause mortality. We compared outcomes between patients without and with frailty, and sought to identify factors which were associated with increase in clinical frailty score by the correlation analysis and linear regression analysis.
Results
Of 481 patients, 131 patients (27.2%) were frail. Male gender was less in patients with frailty than those without frailty (26.7% vs 73.3%, P<0.001). Frail patients had higher age (85.2±7.3 vs 78.7±9.4 years, P<0.001). During follow-up period of 396 [343, 697] days, composite endpoint (Kaplan-Meier event rate estimates, 77% vs. 60%; log-rank P<0.001), and all-cause mortality (Kaplan-Meier event rate estimates, 57% vs. 28%; log-rank P<0.001) was higher in patients with frailty than those without frailty. Multivariate Cox regression analysis revealed frailty was significantly and independently associated with mortality (HR=1.40, 95% CI=1.17–1.68, P<0.001). CFS was significantly correlated with age (r=0.401, P<0.001), sex (r=0.223, P<0.001), body mass index (r=−0.146, P=0.001), hemoglobin (r=−0.148, P=0.001), albumin (r=−0.222, P<0.001), left ventricular diastolic diameter (r=−0.184, P<0.001), interventricular septum thickness (r=−0.124, P=0.008), left ventricular mass (r=−0.217, P<0.001), tricuspid annular plane systolic excursion (r=−0.165, P=0.001), and tricuspid regurgitation pressure gradient (TRPG) (r=0.189, P<0.001). Multivariate linear regression analysis using these factors as covariates revealed age (standardized β: 0.337, P<0.001), sex (standardized β: 0.120, P=0.014), albumin (standardized β: −0.151, P=0.003) and TRPG (standardized β: 0.129, P=0.005) were significantly and independently associated with increase in clinical frailty score.
Conclusion
Our results suggest that not only nutritional factors but also a cardiac factor were associated with frailty, and frailty was associated with mortality in patients with HFpEF. Improvement of hemodynamics in HFpEF patients as well as improvement of nutrition might contribute to alleviation of frail in HFpEF patients.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K.; Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- A Sunaga
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Cardiology, Amagasaki, Japan
| | - S Tamaki
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology, Osaka, Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology, Osaka, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Suita, Japan
| | - H Mizuno
- Osaka University Graduate School of Medicine, Suita, Japan
| | - K Okada
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Kitamura
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Kojima
- Osaka University Graduate School of Medicine, Suita, Japan
| | - H Kida
- Osaka University Graduate School of Medicine, Suita, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - S Yasushi
- Osaka University Graduate School of Medicine, Suita, Japan
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14
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Horii Y, Tamaki A, Hong W, Kitamura T, Wasano K. A Transmission-Line-Based Cochlear Standing Wave Model To Elucidate Mechanism of Human Auditory System. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:2328-2331. [PMID: 33018474 DOI: 10.1109/embc44109.2020.9176502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
How do people hear sounds? As a counterpart of Prof. G. V. Békésy's traveling wave theory, we have proposed resonance theory of outer hair cells and cochlear standing wave theory, respectively. Based on these proposals, this paper develops a transmission-line-based cochlear standing wave model. Since the macroscopic cochlear model is designed as it looks like, various auditory physiology can be explained. Transient analyses with pure-tone excitation and Gaussian pulse excitation are carried out, and Prof. D. Kemp's otoacoustic emission (OAE) is demonstrated successfully.Clinical relevance-Our new model has a great potential to explain auditory physiology including structural inner disorders, hearing loss, and even tinnitus.
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15
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Meguro K, Hashimoto T, Yanagisawa T, Kitamura T, Ako J. P1788The outcome of TAVI in patients with small annulus and the comparison between intra-annular and supra-annular devices in small anulus: From the analysis of the Japanese nationwide registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0540] [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
Transcatheter aortic valve implantation (TAVI) has been widely accepted strategy of the treatment for aortic stenosis in patients at intermediate to high or prohibitive surgical risk. The Asian people are of smaller body size compared to Western people. As the result, Asian people have smaller aortic annulus size, which accommodate only smaller transcatheter heart valves (THVs), however, the details and consequences of small aortic annulus size in TAVI is uncertain.
Purpose
The purposes of this study were to clarify the short-term outcomes of TAVI in patients with small annulus and the differences of intra-annular and supra-annular THVs in small annulus using Japanese national TAVI registry.
Methods
Multi-detector computed tomography (MDCT) was performed before TAVI and the annulus area was registered. We compared the 30-day clinical outcomes between patients with and without small annulus (annulus area 3.14cm2). Further investigation to compare intra-annular and supra-annular THVs in patients with small annulus was conducted.
Results
The total of 5,870 patients (103 sites in Japan) who underwent TAVI between August 2013 to December 2017 were enrolled in this study. Out of 5,870 patients, 647 had small annulus.
Thirty-day mortality, new pacemaker implantation and stroke rate were comparable between patients with and without small annulus. Echocardiography within 30 days after TAVI revealed that patients with small annulus had significantly smaller indexed effective orifice area (iEOA, 1.10.cm2/m2 [0.92–1.35] vs. 1.16 cm2/m2 [0.96–1.39], p<0.001), higher mean pressure gradient (10.0 mmHg [6.9–14.2] vs. 8.5 mmHg [6.0–11.5], p<0.001) and lower frequency of paravalvular leakage moderate (17.3% vs. 24.4%, p<0.001). Patient-prosthesis mismatch (PPM) were more frequent in patients with small annulus (p=0.002). Logistic regression analysis revealed that small annulus (OR: 1.82; 95% CI: 1.45–2.30, p<0.001), female gender (OR: 0.54; 95% CI: 0.42–0.70, p<0.001), weight (OR: 1.03; 95% CI: 1.02–1.04, p<0.001), height (OR: 1.04; 95% CI: 1.02–1.05, p<0.001), hyperlipidemia (OR: 1.25; 95% CI: 1.07–1.47, p=0.006), femoral access (OR: 0.80; 95% CI: 0.66–0.97, p=0.026) were significantly associated with the PPM after TAVI.
The use of SAPIEN 3 20mm THV in patients with small annulus was associated with the smaller iEOA (0.94 cm2/m2 [0.78–1.06] vs. 1.07 cm2/m2 [0.84–1.24], p=0.001) and higher mean pressure gradient (14.0 mmHg [10.0–18.5] vs. 11.0 [7.0–14.0], p<0.001) compared to the usage of Evolut R 23 mm THV. The rate of paravalvular leakage more than moderate was similar in both THVs (14.4% vs. 16.5%, p=0.69).
Conclusions
Small annulus did not affect clinical 30-day outcomes, however, small annulus was associated with smaller iEOA and higher mean pressure gradient. Supra-annular device might contribute the better hemodynamical improvement in patients with small annulus without increase of paravalvular leakage.
Acknowledgement/Funding
None
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Affiliation(s)
- K Meguro
- Kitasato University, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - T Yanagisawa
- Kitasato University, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - T Kitamura
- Kitasato University, Department of Cardiovascular Surgery, Sagamihara, Japan
| | - J Ako
- Kitasato University, Department of Cardiovascular Medicine, Sagamihara, Japan
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16
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Kida H, Hikoso S, Nakatani D, Suna S, Dohi T, Mizuno H, Okada K, Kitamura T, Kojima T, Oeun B, Sunaga A, Sakata Y. P5734The outcome of intra-aortic balloon pumping support for acute myocardial infarction with extracorporeal membrane oxygenation therapy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0674] [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
It has been reported that intra-aortic balloon pumping (IABP) support for acute myocardial infarction (AMI) with cardiogenic shock did not reduce short and long-term mortality. However, the significance of IABP support for AMI patients with extracorporeal membrane oxygenation (ECMO) therapy remains unclear. The aim of this study was to investigate the effect of IABP support for the short and long-term outcome in AMI patients who received ECMO.
Methods
Using the database of the Osaka Acute Coronary Insufficiency Study (OACIS), 12,093 consecutive AMI patients were enrolled in this analysis. Among these, we analyzed 520 patients with ECMO. We classified the patients into two groups, patients who received IABP support [IABP group (n=460)] and patients who did not [no IABP group (n=60)]. Primary outcome was all-cause death.
Results
Study patients had following baseline clinical characteristics, age: 66.8±12.0 year old, male: 78.3%, diabetes mellitus: 41.0%, Killip class≥II: 66.2%, multi-vessel disease: 72.3%, peak creatine phosphokinase >3000IU/L: 68.1%. During a mean follow-up period of 349±625 days, Kaplan-Meier analysis revealed that the all-cause death was significantly lower in IABP group than no IABP group for 30-day (45.5% vs 72.7%, log-rank p<0.001) and long-term (66.2% vs 78.4%, Log rank p=0.005) follow-up period. Cox multivariate analysis revealed that IABP support was significantly associated with a reduced risk of mortality (Hazard ratio 0.445, 95% confidence interval 0.289 to 0.687, p<0.001).
Conclusions
IABP support for AMI patients with ECMO was significantly associated with reduced risks of the short and long-term mortality, suggesting that IABP support might contribute to improvement of the survival in AMI patients with ECMO.
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Affiliation(s)
- H Kida
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - S Suna
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - H Mizuno
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - K Okada
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - T Kitamura
- Osaka University Graduate School of Medicine, Social and Environmental Medicine, Osaka, Japan
| | - T Kojima
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - B Oeun
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiology, Osaka, Japan
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17
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P1717The clinical impact of intra-aortic balloon pumping for acute coronary syndrome from Mie ACS registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Intra-Aortic Balloon Pumping (IABP) was widespread used in cases of Acute Coronary Syndrome (ACS) at daily clinical situation in Japan, even though the efficacy of IABP in AMI patients with cardiogenic shock was not proved. The aim of this study was to investigate the efficacy of IABP use in ACS patients in Japan.
Methods
We investigated 2-year all-cause-mortality of 2,660 enrolled ACS patients including 358 patients with IABP and 2,302 patients without IABP from Mie ACS registry.
Results
We compared a 1:1 propensity score-matched cohort of 426 ACS patients with or without IABP (n=213, respectively). 2-year mortality was significantly higher in patients with IABP than without IABP (p=0.02, Figure A). In addition, IABP usage was independent predictor of mortality with hazard ratio of 1.6 by multivariate analysis. However, 2-year mortality was not statistically different between 2 groups only when analyzed patients with shock (p=0.60, Figure B).
Figure 1
Conclusion
IABP was not commonly recommended in ACS patients. However, IABP was might as well used in some situation especially in shock.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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18
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Sunaga A, Hikoso S, Yamada T, Yasumura Y, Uematsu M, Abe H, Nakagawa Y, Higuchi Y, Fuji H, Mano T, Nakatani D, Mizuno H, Okada K, Kitamura T, Sakata Y. 128Change in geriatric nutritional risk index predicts one-year mortality in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Malnutrition is associated with adverse prognosis in heart failure patients. However, in patients with heart failure with preserved ejection fraction (HFpEF), the effects of change in nutritional status during hospitalization on prognosis is unknown. Geriatric nutritional risk index (GNRI) is a widely used objective index for evaluating nutritional status. Low GNRI (<92) has moderate or severe nutritional risk and high GNRI (≥92) has no or low nutritional risk.
Purpose
The purpose of this study was to clarify the effect of change in GNRI during hospitalization on one-year mortality and the association between the value of GNRI and one-year mortality in patients with HFpEF.
Methods
We prospectively registered patients with HFpEF in PURSUIT-HFpEF registry when they were hospitalized for heart failure in 29 hospitals. Preserved ejection fraction was defined as more than 50% of left ventricular ejection fraction. Of the 486 patients who registered PURSUIT-HFpEF, 228 cases with one-year follow-up data were examined. GNRI was calculated as follows: 14.89 × serum albumin (g/dl) + 41.7 × body mass index/22.
Results
Mean age was 81±10 years and 100 patients (44%) were male. During a median [interquartile range] follow-up period of 374 [342, 400] days, 28 patients (12%) died. Mortality was significantly higher in patients with low GNRI at admission (n=65) than those with high GNRI at admission (n=163) (26% vs. 9%, log-rank P=0.011) and higher in patients with low GNRI at discharge (n=109) than those with high GNRI at discharge (n=119) (22% vs. 6%, log-rank P=0.002). Multivariate analysis with Cox proportional hazard model with patient characteristics at admission revealed that low GNRI at admission was independently associated with mortality (hazard ratio: 0.96, 95% CI: 0.93–0.99, P=0.035) and that with patient characteristics at discharge revealed that low GNRI at discharge was independently associated with mortality (hazard ratio: 0.94, 95% CI: 0.91–0.97, P<0.001). We also compared mortality by dividing patients into 4 group according to whether GNRI was high or low at the time of admission and discharge. Patients with low GNRI at admission and at discharge (n=59) exhibited the highest mortality, on the other hand, patients with high GNRI at admission and low GNRI at discharge (n=50) exhibited higher mortality than those with high GNRI both at admission and at discharge (n=113) (Low and low: 28% vs. High and low: 14% vs. High and high: 6% vs. Low and high: 0%, log-rank P=0.010).
All cause mortality
Conclusion
GNRI at admission or at discharge was independently associated with one-year mortality in patients with HFpEF. Moreover, worsening GNRI during hospitalization is associated with the worse prognosis. It is important to prevent lowering GNRI during treatment of acute decompensated HFpEF.
Acknowledgement/Funding
Roche Diagnostics, FUJIFILM Toyama Chemical
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Affiliation(s)
- A Sunaga
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - S Hikoso
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology, Amagasaki, Japan
| | - M Uematsu
- Osaka National Hospital, Cardiology, Osaka, Japan
| | - H Abe
- Osaka National Hospital, Cardiology, Osaka, Japan
| | - Y Nakagawa
- Kawanishi City Hospital, Cardiology, Kawanishi, Japan
| | - Y Higuchi
- Osaka Police Hospital, Cardiology, Osaka, Japan
| | - H Fuji
- Kobe Ekisaikai Hospital, Cardiology, Kobe, Japan
| | - T Mano
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - D Nakatani
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - H Mizuno
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - K Okada
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - T Kitamura
- Osaka University, Cardiovascular Medicine, Suita, Japan
| | - Y Sakata
- Osaka University, Cardiovascular Medicine, Suita, Japan
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P2659Difference of prognostic impact of Killip classification in ACS patients with or without hemodialysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0979] [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
Cardiovascular deaths are more frequently in hemodialysis (HD) patients compared to general population. However, difference of prognosis of acute coronary syndrome (ACS) patients with or without HD were not well evaluated.
Purpose
The purpose of this study was to evaluate the clinical and prognostic characteristics of ACS patients with HD compared to that of ACS patients without HD.
Methods
We investigated 3427 ACS patients including 63 HD and 3364 non-HD patients between 2013 and 2017 using date from Mie ACS registry, a retrospective and multicenter registry. The primary outcome was defined as all-cause mortality.
Results
HD patients showed significantly higher prevalence of diabetes mellitus, past treatment of coronary artery disease, history of myocardial infarction and Killip ≥2 compared to non-HD patients (p<0.05, respectively). During the follow-up periods (median 719 days), 425 (12.4%) patients experienced all-cause death. HD patients demonstrated the higher all-cause mortality rate compared to that of non-HD patients during the follow-up (11.9% versus 38.1%, p<0.001, chi square). Kaplan Meier survival curves demonstrated that HD and non-HD patients with Killip 1 showed similar 30-day mortality, and Killip ≥2 patients also showed similar prognosis (Left side of figure). On the other hand, all cause mortality at 2 years were higher in Killip 1 HD patients compared to Killip 1 non-HD patients and similar between Killip 1 HD patients and Killip ≥2 non-HD patients in the 30 days landmark analysis (Right side of figure). In addition, cox regression analyses for all cause mortality demonstrated that HD was a strongest independent prognostic factor not of 30-day mortality but of after 30-day mortality with hazard ratio of 4.09 (95% confidential interval: 2.32–7.21, p<0.001).
Figure 1
Conclusion
Careful management are required in chronic phase for ACS patients with HD even in Killip 1 classification.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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Oishi H, Fujii T, Suzuki M, Takano N, Teranishi K, Yatomi K, Kitamura T, Yamamoto M, Aoki S, Arai H. Usefulness of Silent MR Angiography for Intracranial Aneurysms Treated with a Flow-Diverter Device. AJNR Am J Neuroradiol 2019; 40:808-814. [PMID: 31048297 DOI: 10.3174/ajnr.a6047] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/25/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The flow-diverter device has been established as a treatment procedure for large unruptured intracranial aneurysms. The purpose of this study was to compare the usefulness of Silent MR angiography and time-of-flight MRA to assess the parent artery and the embolization state of the aneurysm after a flow-diverter placement. MATERIALS AND METHODS Seventy-eight large, unruptured internal carotid aneurysms in 78 patients were the subjects of this study. After 6 months of treatment, they underwent follow-up digital subtraction angiography, Silent MRA, and TOF-MRA, performed simultaneously. All images were independently reviewed by 2 neurosurgeons and 1 radiologist and rated on a 4-point scale from 1 (not visible) to 4 (excellent) to evaluate the parent artery. The aneurysmal embolization status was assessed with 2 ratings: complete or incomplete occlusion. RESULTS The mean scores of Silent MRA and TOF-MRA regarding the parent artery were 3.18 ± 0.72 and 2.31 ± 0.86, respectively, showing a significantly better score with Silent MRA (P < .01). In the assessment of the embolization of aneurysms on Silent MRA and TOF-MRA compared with DSA, the percentages of agreement were 91.0% and 80.8%, respectively. CONCLUSIONS Silent MRA is superior for visualizing blood flow images inside flow-diverter devices compared with TOF-MRA. Furthermore, Silent MRA enables the assessment of aneurysmal embolization status. Silent MRA is useful for assessing the status of large and giant unruptured internal carotid aneurysms after flow-diverter placement.
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Affiliation(s)
- H Oishi
- From the Departments of Neuroendovascular Therapy (H.O., T.F., T.K.)
- Neurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
| | - T Fujii
- From the Departments of Neuroendovascular Therapy (H.O., T.F., T.K.)
| | - M Suzuki
- Radiology (M.S., N.T., S.A.), Juntendo University Faculty of Medicine, Tokyo, Japan
| | - N Takano
- Radiology (M.S., N.T., S.A.), Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | - K Yatomi
- Neurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
| | - T Kitamura
- From the Departments of Neuroendovascular Therapy (H.O., T.F., T.K.)
| | - M Yamamoto
- Neurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
| | - S Aoki
- Radiology (M.S., N.T., S.A.), Juntendo University Faculty of Medicine, Tokyo, Japan
| | - H Arai
- Neurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
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21
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Ito H, Masuda J, Takasaki A, Ichikawa K, Sato Y, Takeuchi T, Kakuta K, Matsuda A, Nakajima H, Omura T, Sawai T, Hoshino K, Seko T, Kitamura T, Ito M. P6043Prognostic impact of a chronic total occlusion in a non-infarct-related artery and left ventricular ejection fraction in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6043] [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)
- H Ito
- Ise Red Cross Hospital, cardiology, Ise, Japan
| | | | | | | | - Y Sato
- Mie CCU Network, Tsu, Japan
| | | | | | | | | | | | | | | | - T Seko
- Mie CCU Network, Tsu, Japan
| | | | - M Ito
- Mie CCU Network, Tsu, Japan
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22
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Fukuoka S, Kurita T, Dohi K, Sato Y, Ishise T, Seko T, Tanigawa T, Kitamura T, Miyahara M, Makino K, Ito M. P2706Impact of age on obesity paradox in patients with acute myocardial infarction after primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2706] [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 Fukuoka
- Mie University Hospital, Cardiology, Tsu, Japan
| | | | - K Dohi
- Mie CCU Network, Tsu, Japan
| | - Y Sato
- Mie CCU Network, Tsu, Japan
| | | | - T Seko
- Mie CCU Network, Tsu, Japan
| | | | | | | | | | - M Ito
- Mie CCU Network, Tsu, Japan
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23
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Tsutsui H, Momomura SI, Saito Y, Ito H, Yamamoto K, Ohishi T, Okino N, Kitamura T, Guo W. Angiotensin Receptor Neprilysin Inhibitor in Japanese Patients With Heart Failure and Reduced Ejection Fraction - Baseline Characteristics and Treatment of PARALLEL-HF Trial. Circ J 2018; 82:2575-2583. [PMID: 30047502 DOI: 10.1253/circj.cj-17-1424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The objective of the present analyses was to describe the baseline characteristics and treatment of the Japanese patients with HFrEF in THE PARALLEL-HF study. Methods and Results: Key demographic, clinical and laboratory findings, along with treatment, were reported and compared with patients enrolled in the PARADIGM-HF trial and other contemporary randomized clinical trials and registries of Japanese patients with HFrEF. In addition, the MAGGIC and EMPHASIS-HF risk scores were calculated. A total of 225 Japanese patients were randomized in PARALLEL-HF with a mean age of 67.9 years and the majority of the patients being male (85.8%) and in NYHA Class II (93.8%). Key baseline characteristics in PARALLEL-HF were generally comparable with PARADIGM-HF, and other contemporary clinical trials and registries of Japanese HFrEF patients. Patients enrolled in PARALLEL-HF were well treated with conventional evidence-based therapy at baseline (angiotensin-converting enzyme inhibitor inhibitor/angiotensin receptor blocker, 62.7%/37.3%; β-blockers, 94.7%; mineralocorticoid receptor antagonist, 59.1%). Despite the evidence-based treatment and most patients being in NYHA Class II, these patients had a low LVEF (mean 28.1%) and were at high risk of cardiovascular mortality and morbidity as assessed by the MAGGIC and EMPHASIS-HF risk scores. CONCLUSIONS Overall, the patients in PARALLEL-HF were largely representative of contemporary ambulatory patients with HFrEF who are well treated with evidence-based therapies. PARALLEL-HF will determine whether sacubitril/valsartan provides similar improvements in clinical outcomes in Japanese HFrEF patients as observed in the PARADIGM-HF study.
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Affiliation(s)
- Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Shin-Ichi Momomura
- Cardiovascular Division, Jichi Medical University, Saitama Medical Center
| | - Yoshihiko Saito
- First Department of Internal Medicine, Nara Medical University
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kazuhiro Yamamoto
- Department of Molecular Medicine and Therapeutics, Tottori University
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24
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Wolf M, Vlachos K, Kitamura T, Denis A, Jais P, Derval N. 260Vein-of-Marshall mediated complex atrial tachycardia. Europace 2018. [DOI: 10.1093/europace/euy015.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Wolf
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - K Vlachos
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - T Kitamura
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - A Denis
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - P Jais
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
| | - N Derval
- Hôpital Cardiologique du Haut-Lévêque - CHU de Bordeaux, Bordeaux-Pessac, France
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25
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Lam A, Wolf M, Kitamura T, Takigawa M, Martin C, Bourier F, Frontera A, Sacher F, Derval N, Denis A, Pambrun T, Duchateau J, Hochini M, Haissaguerre M, Jais P. 519Are recurrences of post MI VT due to substrate progression of insufficient index ablation? A 4 years FU study. Europace 2018. [DOI: 10.1093/europace/euy015.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Lam
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - M Wolf
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - T Kitamura
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - M Takigawa
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - C Martin
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - F Bourier
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - A Frontera
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - F Sacher
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - N Derval
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - A Denis
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - T Pambrun
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - J Duchateau
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | - M Hochini
- Hospital Haut Leveque, Bordeaux-Pessac, France
| | | | - P Jais
- Hospital Haut Leveque, Bordeaux-Pessac, France
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26
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Ohmori T, Kitamura T, Nishida T, Matsumoto T, Tokioka T. The impact of external fixation on mortality in patients with an unstable pelvic ring fracture: a propensity-matched cohort study. Bone Joint J 2018; 100-B:233-241. [PMID: 29437067 DOI: 10.1302/0301-620x.100b2.bjj-2017-0852.r1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIM There is not adequate evidence to establish whether external fixation (EF) of pelvic fractures leads to a reduced mortality. We used the Japan Trauma Data Bank database to identify isolated unstable pelvic ring fractures to exclude the possibility of blood loss from other injuries, and analyzed the effectiveness of EF on mortality in this group of patients. PATIENTS AND METHODS This was a registry-based comparison of 1163 patients who had been treated for an isolated unstable pelvic ring fracture with (386 patients) or without (777 patients) EF. An isolated pelvic ring fracture was defined by an Abbreviated Injury Score (AIS) for other injuries of < 3. An unstable pelvic ring fracture was defined as having an AIS ≥ 4. The primary outcome of this study was mortality. A subgroup analysis was carried out for patients who required blood transfusion within 24 hours of arrival in the Emergency Department and those who had massive blood loss (AIS code: 852610.5). Propensity-score matching was used to identify a cohort like the EF and non-EF groups. RESULTS With the use of propensity-score matching using the completed data, 346 patients were matched. When the propensity-score matching was adjusted, EF was associated with a significantly lower risk of death (p = 0.047). In the subgroup analysis of patients who needed blood transfusion within 24 hours and those who had massive blood loss, EF was associated with a significantly lower risk of death in patients who needed blood transfusion within 24 hours (p = 0.014) and in those with massive blood loss (p = 0.016). CONCLUSION The use of EF to treat unstable pelvic ring fractures was associated with a significantly lower risk of death, especially in patients with severe fractures. Cite this article: Bone Joint J 2018;100-B:233-41.
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Affiliation(s)
- T Ohmori
- Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555, Japan
| | - T Kitamura
- Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan
| | - T Nishida
- Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555, Japan
| | - T Matsumoto
- Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555, Japan
| | - T Tokioka
- Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555, Japan
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Denis A, Sacher F, Derval N, Martin R, Lim HS, Pambrun T, Massoullie G, Duchateau J, Cochet H, Pillois X, Cheniti G, Frontera A, Takigawa M, Vlachos K, Martin C, Kitamura T, Hocini M, Douard H, Jaïs P, Haïssaguerre M. Arrhythmogenic response to isoproterenol testing vs. exercise testing in arrhythmogenic right ventricular cardiomyopathy patients. Europace 2018; 20:f30-f36. [DOI: 10.1093/europace/euy007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/16/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Denis
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - F Sacher
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - N Derval
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - R Martin
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - H S Lim
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - T Pambrun
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - G Massoullie
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - J Duchateau
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - H Cochet
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - X Pillois
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - G Cheniti
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - A Frontera
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - M Takigawa
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - K Vlachos
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - C Martin
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - T Kitamura
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - M Hocini
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - H Douard
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - P Jaïs
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
| | - M Haïssaguerre
- Hôpital Cardiologique du Haut-Lévèque, CHU Bordeaux, LIRYC, L'institut de rythmologie et modélisation cardiaque, Université de Bordeaux, France
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Hoshino K, Irie Y, Mizunuma M, Kawano K, Kitamura T, Ishikura H. Incidence of elevated procalcitonin and presepsin levels after severe trauma: a pilot cohort study. Anaesth Intensive Care 2017; 45:600-604. [PMID: 28911289 DOI: 10.1177/0310057x1704500510] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses. In this study, 75 patients were included. PCT levels on days 0 and 1 were 0.1±0.4 and 1.8±6.3 ng/ml, respectively (P=0.02). PSEP levels on days 0 and 1 were 221±261 and 222±207 pg/ml, respectively (P=0.98). As per multivariate logistic regression analyses, packed red blood cell (PRBC) transfusion was the only independent risk factor for higher PCT levels on day 1 (P=0.04). Using PCT to diagnose sepsis in trauma patients on day 1 requires caution. PRBC transfusion was found to be a risk factor for increasing PCT levels. On the other hand, PSEP levels were not affected by trauma during the early phases.
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Martin CA, Martin R, Wong T, Maury P, Dallet C, Takigawa M, Frontera A, Cheniti G, Thompson N, Massouillie G, Kitamura T, Wolf M, Duchateau J, Vlachos K, Pambrun T, Denis A, Derval N, Hocini M, Haissaguerre M, Jais P, Sacher F. 37Effect of activation wavefront on electrogram characteristics during ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/europace/eux283.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Frontera A, Martin R, Takigawa M, Cheniti G, Dallet C, Kitamura T, Thompson N, Wolf M, Massoullie G, Vlachos K, Denis A, Hocini M, Cochet H, Sacher F, Jaïs P, Derval N, Haïssaguerre M. 073_16987-H2 EGM Fractionation in Apparently Healthy Tissue: Time to Redefine the Voltage Threshold for Diseased Atrium? JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Taniguchi Y, Oono Y, Kitamura T, Kimura A, Yamada K. Difference in responsiveness for corticosteroid therapy of cerebral amyloid angiopathy encephalopathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2885] [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: 11/28/2022]
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32
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Matsuyama T, Kitamura T, Katayama Y, Kiguchi T, Hirose T, Sado J, Kiyohara K, Izawa J, Ohta B. 239 Mortality of Motor Vehicle Accidents by Elderly Drivers: A Nationwide Hospital-Based Registry in Japan. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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33
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Muguruma K, Kitamura T, Fukuda T, Takebayashi Y, Kuga J, Sugimoto T. Investigating effectiveness of DaTView® and DaTQUANT® using LEUHR-FB in Parkinson's disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Martin CA, Sawhney V, Martin R, Takigawa M, Frontera A, Cheniti G, Thompson N, Massouillie G, Kitamura T, Wolf M, Duchateau J, Vlachos K, Denis A, Pambrun T, Sacher F, Hocini M, Jais P, Haissaguerre M, Ezzat V, Lowe MD, Derval N. 77USe of ultra-high density activation mapping to aid isthmus identification in atrial macro-reentrant tachycardias in complex congenital heart disease. Europace 2017. [DOI: 10.1093/europace/eux283.072] [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: 11/13/2022] Open
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Yamada K, Ohno T, Kitamura T, Ohno Y, Sato C, Kanai H, Kamimoto K. Neuroradiologic evaluation of ischemic or non-ischemic lesions of transient global amnesia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Frontera A, Takigawa M, Martin R, Thompson N, Cheniti G, Massouille G, Duchateau J, Kitamura T, Wolf M, Al-Jefairi N, Vlachos K, Yamashita S, Denis A, Hocini M, Cochet H, Sacher F, Jaïs P, Derval N, Haïssaguerre M. 073_16988-H2 Electrogram Signature of Specific Activation Patterns: Analysis of Atrial Arrhythmias at High-Density Endocardial Mapping. JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nezu T, Naka H, Hosomi N, Takamatsu K, Nomura E, Kitamura T, Torii T, Ohshita T, Imamura E, Nakamori M, Shimomura R, Aoki S, Maruyama H, Matsumoto M. Microbleeds evaluation study for prevention of brain hemorrhage in ischemic stroke (MB-evidence): Pilot analysis for multicenter longitudinal study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kato M, Masuda J, Kakimoto M, Dohi K, Kawasaki A, Kitamura T, Iwata A, Suzuki H, Miyahara M, Nishikawa H, Ito M. P4634The clinical impact of chronic total occlusion on acute myocardial infarction patients from mie acs registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4634] [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)
- M. Kato
- Mie Heart Center, Mie, Japan
| | | | | | | | | | | | | | | | | | | | - M. Ito
- Mie CCU Network, Mie, Japan
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Wolf M, Sacher F, Cochet H, Kitamura T, Takigawa M, Frontera A, Cheniti G, Vlachos K, Martin R, Denis A, Pambrun T, Derval N, Hocini M, Haissaguerre M, Jais P. P1112Long-term outcome of LAVA elimination in ablation of post-myocardial infarction ventricular tachycardia. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kawabata KC, Hayashi Y, Inoue D, Meguro H, Sakurai H, Fukuyama T, Tanaka Y, Asada S, Fukushima T, Nagase R, Takeda R, Harada Y, Kitaura J, Goyama S, Harada H, Aburatani H, Kitamura T. High expression of ABCG2 induced by EZH2 disruption has pivotal roles in MDS pathogenesis. Leukemia 2017; 32:419-428. [PMID: 28720764 DOI: 10.1038/leu.2017.227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 01/10/2023]
Abstract
Both proto-oncogenic and tumor-suppressive functions have been reported for enhancer of zeste homolog 2 (EZH2). To investigate the effects of its inactivation, a mutant EZH2 lacking its catalytic domain was prepared (EZH2-dSET). In a mouse bone marrow transplant model, EZH2-dSET expression in bone marrow cells induced a myelodysplastic syndrome (MDS)-like disease in transplanted mice. Analysis of these mice identified Abcg2 as a direct target of EZH2. Intriguingly, Abcg2 expression alone induced the same disease in the transplanted mice, where stemness genes were enriched. Interestingly, ABCG2 expression is specifically high in MDS patients. The present results indicate that ABCG2 de-repression induced by EZH2 mutations have crucial roles in MDS pathogenesis.
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Affiliation(s)
- K C Kawabata
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan.,Division of Hematology/Medical Oncology, Department of Medicine, Weill-Cornell Medical College, Cornell University, New York, NY, USA
| | - Y Hayashi
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - D Inoue
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan.,Human Oncology and Pathogenesis Program, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - H Meguro
- Laboratory of Oncology, School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| | - H Sakurai
- Division of Hematology, Department of Medicine, Juntendo University, Bunkyo, Japan.,Division of Hemalogy, Shizuoka Hospital, Juntendo University, Izunokuni, Japan
| | - T Fukuyama
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - Y Tanaka
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - S Asada
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - T Fukushima
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - R Nagase
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - R Takeda
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - Y Harada
- Division of Hematology, Department of Medicine, Juntendo University, Bunkyo, Japan.,Department of Clinical Laboratory Medicine, Faculty of Health Science Technology, Bunkyo Gakuin University, Bunkyo, Japan
| | - J Kitaura
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan.,Atopy Research Center, Juntendo University. School of Medicine, Bunkyo-ku, Japan
| | - S Goyama
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
| | - H Harada
- Laboratory of Oncology, School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan.,Division of Hematology, Department of Medicine, Juntendo University, Bunkyo, Japan
| | - H Aburatani
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Meguro, Japan
| | - T Kitamura
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Minato, Tokyo, Japan
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Wolf M, Takigawa M, Derval N, Vlachos K, Kitamura T, Frontera A, Cheniti G, Martin R, Thompson N, Denis A, Pambrun T, Sacher F, Haissaguerre M, Jais P, Hocini M. P1393Pattern and timing of coronary sinus activation in complex atrial tachycardia. Europace 2017. [DOI: 10.1093/ehjci/eux158.021] [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: 11/12/2022] Open
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Frontera A, Takigawa M, Martin R, Thompson N, Cheniti G, Kitamura T, Wolf M, Vlachos K, Massouille G, Denis A, Hocini M, Sacher F, Jais P, Haissaguerre M, Derval N. P253Can EGM fractionation occur in healthy tissue? Electrophysiological mechanism and significance during atrial tachycardia rhythm. Europace 2017. [DOI: 10.1093/ehjci/eux171.009] [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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Wolf M, Kitamura T, Sacher F, Cochet H, Vlachos K, Cheniti G, Frontera A, Takigawa M, Martin R, Thompson N, Derval N, Denis A, Hocini M, Haissaguerre M, Jais P. 1219Comparison of procedural endpoints for ablation of post-myocardial infarction ventricular tachycardia. Europace 2017. [DOI: 10.1093/ehjci/eux154.003] [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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Frontera A, Takigawa M, Thompson N, Martin R, Cheniti G, Kitamura T, Wolf M, Massouille G, Vlachos K, Hocini M, Denis A, Sacher F, Jais P, Haissaguerre M, Derval N. P385Relationship of voltage and EGM duration at sites of fractionation during atrial tachycardias and paced rhythms. Europace 2017. [DOI: 10.1093/ehjci/eux141.110] [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: 11/12/2022] Open
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Wolf M, Kitamura T, Sacher F, Cochet H, Vlachos K, Cheniti G, Frontera A, Takigawa M, Martin R, Thompson N, Derval N, Denis A, Hocini M, Haissaguerre M, Jais P. 752Long-term outcome of LAVA elimination in ablation of post-myocardial infarction ventricular tachycardia. Europace 2017. [DOI: 10.1093/ehjci/eux147.001] [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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Frontera A, Takigawa M, Kitamura T, Martin R, Vlachos K, Cheniti G, Thompson N, Massouille G, Wolf M, Hocini M, Denis A, Sacher F, Jais P, Haissaguerre M, Derval N. P386Relationship between scar and atrial tachycardia mechanisms: insight from registered magnetic resonance and ultra-high density activation mapping using the Rhythmia system. Europace 2017. [DOI: 10.1093/ehjci/eux141.111] [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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Frontera A, Takigawa M, Martin R, Dallet C, Kitamura T, Thompson N, Cheniti G, Vlachos K, Massouille G, Denis A, Sacher F, Hocini M, Jais P, Haissaguerre M, Derval N. P383Characterization of reentrant atrial tachycardia circuits with a high density mapping system. Europace 2017. [DOI: 10.1093/ehjci/eux141.108] [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: 11/12/2022] Open
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Frontera A, Martin R, Thompson N, Takigawa M, Kitamura T, Cheniti G, Massouille G, Vlachos K, Wolf M, Denis A, Hocini M, Sacher F, Jais P, Haissaguerre M, Derval N. P384Characterization of slow conductions areas in scar-related atrial tachycardia. Insights from high density mapping system. Europace 2017. [DOI: 10.1093/ehjci/eux141.109] [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: 11/13/2022] Open
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Yamada S, Otsuru M, Yanamoto S, Hasegawa T, Aizawa H, Kamata T, Yamakawa N, Kohgo T, Ito A, Noda Y, Hirai C, Kitamura T, Okura M, Kirita T, Ueda M, Yamashita T, Ota Y, Komori T, Umeda M, Kurita H. Progression level of extracapsular spread and tumour budding for cervical lymph node metastasis of oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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