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Dela Cruz M, Grinstein J, Kumai Y, Hu K, Siddiqi U, Smith B, Kim G, Sarswat N, Nguyen A, Chung B, Pinney S, Kalantari S. The Use of Cardiopulmonary Stress Testing to Predict Poor Outcomes Post-Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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2
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Fujino T, Kumai Y, Nitta D, Lourenco L, Nguyen A, Chung B, Rodgers D, Raikhelkar J, Kim G, Sayer G, Uriel N. Hypogammaglobulinemia Following Heart Transplantation - Prevalence and Clinical Importance. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. P1671Subclinical persistent hemolysis may affect late renal function deterioration after HeartMateII implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0428] [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
Late renal function dysfunction is an increasingly recognized complication in continuous flow left ventricular assist device (CF-LVAD) patients. Although hemolysis is prevalent in CF-LVAD patients and hemolysis may deteriorate renal function, the influence of persistent hemolysis on renal function in CF-LVAD patients remains to be investigated.
Purpose
To investigate the influence of persistent hemolysis on renal function in CF-LVAD patients, using lactate dehydrogenase (LDH) as a sensitive marker of hemolysis.
Methods
Excluding patients who died or underwent pump exchange for pump thrombosis, we retrospectively reviewed 65 consecutive adults who underwent HeartMateII implantation in our center from May 2011 to October 2017. Patient characteristics, chronotropic change of estimated glomerular filtration rate (eGFR) and LDH values weekly for 4 weeks and every 4 weeks between 4 and 48 weeks after implantation were collected. Then, calculating mean LDH during 48 weeks after implantation, study population was divided into low and high mean LDH groups at the median value of mean LDH.
Results
The median value of mean LDH was 304 U/l. Compared with low LDH patients, though high LDH patients were more likely female and had smaller body surface area, there were no significant difference in pre-operative eGFR between the groups (66.0±23.7 vs. 70.2±25.7 ml/min/1.73m2, p=0.495). After 40 weeks after implantation, high LDH patients had significantly lower eGFR than low LDH patients (71.0±23.7 vs. 87.1±31.4 ml/min/1.73m2, p=0.024). In multivariate linear regression analysis, mean LDH [parameter estimate: −0.10 (95% CI: −0.17 to −0.04), p=0.003] and post-operative pulse pressure [parameter estimate: 0.71 (95% CI: 0.05 to 1.37), p=0.036] were significantly associated with eGFR change during 48 weeks after HeartMateII implantation.
Univariate and multivariate linear regression analysis for eGFR change Univariate parameter estimate 95% CI p value Multivariate parameter estimate 95% CI p value Bilirubin, mg/dl 9.97 3.82 to 16.13 0.002 6.55 −0.43 to 13.53 0.065 BNP, pg/ml 0.01 0.00 to 0.02 0.044 0.00 −0.01 to 0.01 0.528 Mean LDH during 4 to 48 weeks, U/l −0.11 −0.18 to −0.05 <0.001 −0.10 −0.17 to −0.04 0.003 Pre-operative right atrial pressure, mmHg 1.43 0.35 to 2.51 0.010 −0.06 −1.52 to 1.40 0.935 Post-operative pulse pressure, mmHg 0.77 0.03 to 1.52 0.042 0.71 0.05 to 1.37 0.036
Conclusions
High mean LDH and low pulse pressure were associated with a significant decrease in eGFR late after HeartMateII implantation. Subclinical persistent hemolysis may be associated with late renal function deterioration in CF-LVAD patients.
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Affiliation(s)
- K Iwasaki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - O Seguchi
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - H Mochizuki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kimura
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kumai
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - K Kuroda
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - S Nakajima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - T Watanabe
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - M Yanase
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Matsumoto
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - S Fukushima
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - N Fukushima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
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Seguchi O, Fujita T, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Tsukiya T, Mizuno T, Katagiri N, Kakuta Y, Takewa Y, Hamasaki T, Yamamoto H, Tatsumi E, Kobayashi J, Fukushima N. Novel Extracorporeal Continuous-Flow Ventricular Assist System for Patients with Advanced Heart Failure. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.871] [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: 10/27/2022] Open
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5
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Kimura Y, Seguchi O, Mochizuki H, Iwasaki K, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Matsumoto Y, Fukushima S, Yanase M, Fujita T, Kobayashi J, Fukushima N. Role of Gallium-SPECT-CT in Predicting Outcomes of Patients with Ventricular Assist Device-Specific Percutaneous Driveline Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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6
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Terminal Ileac Ulcers Mimicked Post-transplantation Lymphoproliferative Disorder in a Heart Recipient Treated With Everolimus: A Case Report. Transplant Proc 2018; 50:4053-4056. [PMID: 30577313 DOI: 10.1016/j.transproceed.2018.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023]
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized and potentially fatal complication of cardiac transplantation that commonly involves the gastrointestinal tract. Herein, we report a case of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers mimicking PTLD in a heart recipient treated with everolimus (EVL). A 40-year-old man underwent heart transplantation for dilated cardiomyopathy 3 years prior to the current admission and was treated with tacrolimus and EVL. He was admitted to a local hospital because of fever, abdominal pain, and diarrhea. His symptoms persisted and, 3 weeks later, hematochezia occurred; thus, he was transferred to our hospital. As computed tomography and 18F-fluorodeoxyglucose positron emission tomography showed bowel-wall thickening of the terminal ileum, gastrointestinal PTLD was initially suspected. However, although colonoscopy- performed after switching EVL to mycophenolate mofetil (MMF)-showed terminal ileac ulcers, the histologic examination revealed no findings corresponding to PTLD. As EVL may delay ulcer healing, MMF was maintained for 3 months. After repeated colonoscopy showed ulcer healing, MMF was switched back to EVL for cardiac allograft vasculopathy prevention. Three weeks later, he was emergently admitted to a local hospital for life-threatening gastrointestinal bleeding from a recurrent terminal ileal ulcer, which required hemostatic forceps hemostasis. As EVL is suspected to be associated with recurrent ileal ulcers, EVL was again switched back to MMF. The ileal ulcers resolved, without recurrence in 3 months of clinical follow-up. This case demonstrates that cases of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers can mimic PTLD in a heart recipient treated with EVL.
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Affiliation(s)
- K Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - O Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - H Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Toda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - M Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - N Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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Kumai Y, Seguchi O, Sato T, Wada K, Shiozawa M, Yokota C, Kuroda K, Nakajima S, Sato T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Reversible Cerebral Vasoconstriction Syndrome After Heart Transplantation: A Case Report. Transplant Proc 2018; 49:2415-2418. [PMID: 29198694 DOI: 10.1016/j.transproceed.2017.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Reversible cerebral vasoconstriction syndrome (RCVS) is a transient cerebrovascular disorder putatively caused by some immunosuppressive agents. CASE REPORT We recently encountered a 47-year-old female patient diagnosed with dilated cardiomyopathy who developed RCVS after heart transplantation. A triple-drug regimen consisting of tacrolimus, mycophenolate mofetil, and a corticosteroid was started after surgery. On postoperative day (POD) 11, the patient developed a severe headache, although computed tomography of the head demonstrated no signs of hemorrhage or infarction. At first, both a painkiller and migraine drugs were regularly administered to the patient. On POD 21, however, she developed an unbearable headache with a visual field defect and mild hemiparesis of the right hand. Magnetic resonance imaging (MRI) of the brain revealed a cerebral infarction in the left occipital lobe with diffuse vasoconstriction of both the middle and posterior cerebral arteries. A diagnosis of RCVS was made and tacrolimus, a drug suspected to cause RCVS, was discontinued. In its place, two doses of basiliximab followed by everolimus, both of which are alternatives for tacrolimus, were given. The corticosteroid dose was also increased. Furthermore, to release vasoconstriction, both verapamil and diltiazem were administered. On POD 27, cerebrovascular constrictions were shown to be relieved on brain MRI and the patient's neurological symptoms subsequently almost completely diminished. CONCLUSION RCVS should always be considered as a cause of headache in heart transplant recipients because tacrolimus, an immunosuppressive agent, may trigger RCVS. This will allow rapid intervention that is essential for avoiding irreversible neurological deficits.
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Affiliation(s)
- Y Kumai
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - T Sato
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Shiozawa
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - C Yokota
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Sato
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
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Wakamiya A, Seguchi O, Shionoiri A, Kumai Y, Kuroda K, Nakajima S, Yanase M, Matsuda S, Wada K, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Paradoxical Reaction of Tuberculosis in a Heart Transplant Recipient During Antituberculosis Therapy: A Case Report. Transplant Proc 2018; 50:947-949. [PMID: 29661467 DOI: 10.1016/j.transproceed.2018.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Tuberculous paradoxical reactions (PRs) are excessive immune reactions occurring after antituberculosis (TB) treatment and are commonly observed in immunocompromised hosts such as patients infected with the human immunodeficiency virus. CASE REPORT We recently encountered a 63-year-old male heart transplant recipient who developed tuberculous PR after treatment for miliary TB. The patient had been receiving immunosuppressive therapy with cyclosporine and mycophenolate mofetil for over 15 years. The diagnosis of miliary TB was made based on the presence of intermittent fever and fatigue; thus, anti-TB treatments (isoniazid, levofloxacin, ethambutol, and pyrazinamide) were started, which led to rapid defervescence and regression of the granular shadow and pleural effusion. However, a new persistent fever and confused state developed 1 month after the anti-TB therapy was started. After excluding possible etiologies of the patient's symptom, a PR was suspected, and anti-TB drugs were continued; corticosteroids were added as anti-inflammatory agents. After that, he has shown a favorable course with long-term anti-TB chemotherapy. CONCLUSION A PR should always be considered when the patients' symptoms of tuberculosis re-exacerbate after an appropriate anti-TB therapy. A PR commonly occurs in patients with various immunologic conditions including heart transplant recipients.
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Affiliation(s)
- A Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - A Shionoiri
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Kumai
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Matsuda
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
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Iwasaki K, Kimura Y, Toda K, Kikuchi N, Kumai Y, Kuroda K, Seguchi O, Yanase M, Matsumoto Y, Fujita T, Kobayashi J, Fukushima N. Impact of Creatinine Excretion Rate, a Maker of Sarcopenia, on Prediction of Mortality and Neurological Events in Advanced Heart Failure Patients With Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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10
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Seguchi O, Kuroda K, Kumai Y, Nakajima S, Yanase M, Wada K, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Clinical Outcomes of Patients With the HeartMate II Left Ventricular Assist Device: A Single-center Experience From Japan. Transplant Proc 2018; 50:2726-2732. [PMID: 30401385 DOI: 10.1016/j.transproceed.2018.03.091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/02/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Left ventricular assist device (LVAD) therapy is the "gold standard" alternative therapy for patients with advanced heart failure. However, LVAD therapy is still uncommon in the Asia-Pacific region. Therefore, we aimed to elucidate the clinical outcomes of patients from Japan supported with the HeartMate II (HM-II) LVAD at our institution. METHODS Ninety-two patients (mean 44.3 ± 12.1 years, 68 men, average body mass index 1.65 ± 0.28 m2; 81 with nonischemic cardiomyopathy) who underwent HM-II implantation for bridge to transplantation (n = 91) or for destination therapy in a clinical study (n = 1) at the National Cerebral and Cardiovascular Center between April 2013 and October 2017 were enrolled in this analysis. Preoperatively, most patients (n = 73, 79%) had an INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profile of between level 2 and 4. Postoperatively, the average pump speed was 8602 ± 258 rpm and the hemodynamics were well compensated. RESULTS Adverse events consisted of 38 (41.3%) hemolysis, 30 (32.6%) major infection, 27 (29.3%) major bleeding (6 [6.5%] with gastrointestinal bleeding), and 18 (19.6%) neurologic dysfunction events. Eighteen patients underwent heart transplantation (HTx) after an average of 32.9 ± 8.9 months of VAD support, and overall survival at both 6 months and 3 years was 96.3%. CONCLUSION Clinical outcome among patients with HM-II at our institution is satisfactory for both survival and adverse events. The HM-II can provide effective hemodynamic support during the extremely long waiting period for HTx in Japan.
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Affiliation(s)
- O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Kumai
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
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Murofushi K, Tokumasu K, Kuwabara H, Kumai Y, Yoshida M, Harada A, Okubo H, Asari T, Toshiyasu T, Sumi M, Oguchi M. Interim MRI Provides Accurate Information of Brachytherapy for Patients with Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1329] [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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Kuroda K, Kumai Y, Sunami H, Nakajima S, Sato T, Seguchi O, Yanase M, Matsumoto Y, Hata H, Fujita T, Kobayashi J, Fukushima N. Ventricular Assist Device Support for Ischemic Cardiomyopathy: A Single-Center Experience in Japan. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.952] [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] Open
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13
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Nakajima N, Oguchi M, Kumai Y, Yoshida M, Iwase T, Ito Y, Akiyama F, Ohno S. Clinical Outcome and Prognostic Factors in Locally Advanced Breast Cancer Patients Treated With Neoadjuvant Chemotherapy Followed by Surgery and Postmastectomy Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.647] [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: 10/20/2022]
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Kumai Y, Oguchi M, Miyagi Y, Ito Y, Iwase T, Akiyama F, Yoshida K, Harada A, Okubo H, Asari T, Murofushi K, Toshiyasu T, Kozuka T, Sumi M. EP-1164: Outcomes of postmastectomy radiotherapy in patients with 1 to 3 positive nodes in single institute. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32414-8] [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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15
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Kobayashi M, Oshima K, Iwasaki Y, Kumai Y, Tsunoda Y, Kino M, Kobayashi H, Yamashina A, Takazawa K. Central rate pressure product; new marker of cardiac load with exercise. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Affiliation(s)
- Y Kumai
- Cerebrovascular and Neurology Center, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
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Hagiwara N, Kitazono T, Kamouchi M, Kuroda J, Ago T, Hata J, Ninomiya T, Ooboshi H, Kumai Y, Yoshimura S, Tamaki K, Fujii K, Nagao T, Okada Y, Toyoda K, Nakane H, Sugimori H, Yamashita Y, Wakugawa Y, Kubo M, Tanizaki Y, Kiyohara Y, Ibayashi S, Iida M. Polymorphism in the sorbin and SH3-domain-containing-1 (SORBS1) gene and the risk of brain infarction in the Japanese population: the Fukuoka Stroke Registry and the Hisayama study. Eur J Neurol 2008; 15:481-6. [DOI: 10.1111/j.1468-1331.2008.02105.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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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Kuroda J, Kitazono T, Ago T, Ninomiya T, Ooboshi H, Kamouchi M, Kumai Y, Hagiwara N, Yoshimura S, Tamaki K, Kusuda K, Fujii K, Nagao T, Okada Y, Toyoda K, Nakane H, Sugimori H, Yamashita Y, Wakugawa Y, Asano K, Tanizaki Y, Kiyohara Y, Ibayashi S, Iida M. NAD(P)H oxidase p22phoxC242T polymorphism and ischemic stroke in Japan: the Fukuoka Stroke Registry and the Hisayama study. Eur J Neurol 2007; 14:1091-7. [PMID: 17880563 DOI: 10.1111/j.1468-1331.2007.01904.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The C242T polymorphism of p22phox, a component of NAD(P)H oxidase, may have an impact on cardiovascular diseases; however, the association between this polymorphism and brain infarction is not fully understood. Here, we investigate the relationship between the C242T polymorphism and brain infarction in Japan. We recruited 1055 patients with brain infarction and 1055 control subjects. A chi-squared test revealed that the T-allele frequency was lower in patients with cardioembolic infarction (5.6%) than in control subjects (11.0%, P < 0.001); however, allele frequencies in patients with lacunar and atherothrombotic infarction (11.2%) were not significantly different from those in control subjects (11.0%). A multivariate-adjusted conditional logistic regression analysis also revealed no association between CT + TT genotype, and lacunar and atherothrombotic infarction (odds ratio = 0.97, 95% confidence interval: 0.72-1.32). To investigate the functional effects of the C242T polymorphism, we examined superoxide production in COS-7 cells cotransfected with Nox4 and p22phox of each genotype. The superoxide-producing activity in those cells expressing p22phox with the T allele was not significantly different from that in cells expressing p22phox with the C allele. The present results suggest that the p22phox C242T polymorphism may have a protective effect against cardioembolic infarction, but is not related to lacunar and atherothrombotic infarction in Japan.
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Affiliation(s)
- J Kuroda
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-ku, Fukuoka, Japan
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Yoshimura S, Ago T, Kitazono T, Yonekura T, Kumai Y, Kuroda J, Kamouchi M, Ooboshi H, Ibayashi S, Iida M. Cerebral sinus thrombosis in a patient with Cushing's syndrome. J Neurol Neurosurg Psychiatry 2005; 76:1182-3. [PMID: 16024907 PMCID: PMC1739739 DOI: 10.1136/jnnp.2004.057315] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Akimoto T, Kumai Y, Akama T, Hayashi E, Murakami H, Soma R, Kuno S, Kono I. Effects of 12 months of exercise training on salivary secretory IgA levels in elderly subjects. Br J Sports Med 2003; 37:76-9. [PMID: 12547749 PMCID: PMC1724582 DOI: 10.1136/bjsm.37.1.76] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The immune system declines in efficiency with advancing age, making the elderly less resistant to pathogenic microorganisms. Upper respiratory tract infection (URTI) is a common illness. Recent studies have shown that suppression of secretory immunoglobulin A (SIgA) is associated with increased incidence of URTI. OBJECTIVE To assess the effect of exercise on salivary SIgA in elderly subjects. METHODS Forty five elderly subjects (18 men, 27 women; mean (SD) age 64.9 (8.4) years) performed both 60 minute resistance and 60 minute moderate endurance training a week for 12 months. Saliva samples were obtained before training, and at four and 12 months during the training period. Salivary SIgA concentrations were measured by enzyme linked immunosorbent assay, and the SIgA secretion rate was calculated. RESULTS SIgA concentrations before training, and at four and 12 months during training were 24.7 (14.4), 27.2 (14.2), and 33.8 (18.5) micro g/ml respectively. SIgA secretion rates were 29.5 (26.0), 33.8 (27.2) and 46.5 (35.1) micro g/min respectively. The results indicate that both the concentration and secretion rate of SIgA significantly (p<0.01) increased during 12 months of exercise in these elderly subjects. CONCLUSION Regular moderate exercise seems to enhance mucosal immune function in elderly subjects.
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Affiliation(s)
- T Akimoto
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, 3-8-1 Komaba, Meguro, 153-8902 Tokyo, Japan.
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Abstract
Primary brain haemorrhage and infarction only very rarely occur simultaneously. A patient with end stage renal disease from diabetic nephropathy suddenly had motor aphasia and horizontal nystagmus soon after finishing haemodialysis. Neuroradiological studies showed a haematoma on the right side of the pons and an infarct in the left frontal lobe with occlusion of the left internal carotid artery. Specific conditions of the haemodialysis--including anticoagulant use, relative hypovolaemia and hypertension just before haemodialysis, and an abrupt decrease in blood pressure during haemodialysis--seemed to be the major reason for the simultaneous onset of dual strokes.
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Affiliation(s)
- K Toyoda
- Stroke Centre, Fukuoka Red Cross Hospital, Fukuoka, Japan.
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