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Aoyagi H, Tsujinaga S, Takahashi Y, Naito S, Sato T, Otsuka T, Tamaki Y, Motoi K, Ishizaka S, Chiba Y, Kamiya K, Iwano H, Nagai T, Wakasa S, Anzai T. Multimodal Imaging of Constrictive Pericarditis Induced by Long-term Pergolide Treatment for Parkinson's Disease. Intern Med 2023; 62:3637-3641. [PMID: 37005266 PMCID: PMC10781551 DOI: 10.2169/internalmedicine.1381-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/12/2023] [Indexed: 04/03/2023] Open
Abstract
We herein report the first case of constrictive pericarditis (CP) induced by long-term pergolide treatment for Parkinson's disease that was assessed using multimodal imaging in a 72-year-old patient with leg edema and dyspnea. The patient was correctly diagnosed with CP using multimodal imaging and successfully treated with pericardiectomy. The treatment history of Parkinson's disease and pathological findings of the removed pericardium suggested that long-term pergolide was the cause of CP. Properly recognizing pergolide as the cause of CP and accurately diagnosing CP using multimodal imaging may contribute to the early detection and treatment of pergolide-induced CP.
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Affiliation(s)
- Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
- Department of Cardiology, Hokkaido Ohno Memorial Hospital, Japan
| | - Yuki Takahashi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Seiichiro Naito
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takuma Sato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takuya Otsuka
- Department of Surgical Pathology, Hokkaido University Hospital, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
- Department of Cardiovascular Medicine, Teine Keijinkai Hospital, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Satoru Wakasa
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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2
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Chiba Y, Iwano H, Aoyagi H, Tamaki Y, Motoi K, Ishizaka S, Murayama M, Yokoyama S, Nakabachi M, Nishino H, Kaga S, Kamiya K, Nagai T, Anzai T. Associations of right ventricular pulsatile load and cardiac power output to clinical outcomes in heart failure: Difference from systemic circulation. J Cardiol 2023; 81:404-412. [PMID: 36503065 DOI: 10.1016/j.jjcc.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/21/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although left ventricular (LV) cardiac power output (CPO) is a powerful prognostic indicator in heart failure (HF), the significance of right ventricular (RV) CPO is unknown. In contrast, RV pulsatile load is a key prognostic marker in HF. We investigated the impact of RV-CPO and pulsatile load on cardiac outcome and the prognostic performance of the combined systemic and pulmonary circulation parameters in HF. METHODS Right heart catheterization and echocardiography were performed in 231 HF patients (62 ± 16 years, LV ejection fraction 42 ± 18 %). Invasive and noninvasive CPOs were calculated from mean systemic or pulmonary arterial pressure and cardiac output. LV-CPO was then normalized to LV mass (LV-P/M). Pulmonary arterial capacitance and the ratio of acceleration time to ejection time (AcT/ET) of RV outflow were used as parameters of RV pulsatile load. The primary endpoints, defined as a composite of cardiac death, HF hospitalization, ventricular arrythmia, and LVAD implantation after the examination, were recorded. RESULTS Noninvasive CPOs were moderately correlated with invasive ones (LV: ρ = 0.787, RV: ρ = 0.568, and p < 0.001 for both). During a median follow-up period of 441 days, 57 cardiovascular events occurred. Lower LV-P/M and higher RV pulsatile load were associated with cardiovascular events; however, RV-CPO was not associated with the outcome. Echocardiographic LV-P/M and AcT/ET showed significant incremental prognostic value over the clinical parameters. CONCLUSIONS RV pulsatile load assessed by AcT/ET may be a predictor of clinical events in HF patients. The combination of echocardiographic LV-P/M and AcT/ET could be a novel noninvasive prognostic indicator in HF patients.
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Affiliation(s)
- Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Division of Cardiology, Teine Keijinkai Hospital, Sapporo, Japan; Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
| | - Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Tanemura A, Murayama M, Iwano H, Chiba Y, Nishida M, Teshima T, Anzai T. Relevance of early-diastolic mitral regurgitation in dilated heart. J Echocardiogr 2023; 21:50-52. [PMID: 34462901 DOI: 10.1007/s12574-021-00547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Asuka Tanemura
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.,Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hiroyuki Iwano
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan. .,Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan. .,Division of Cardiology, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate, 041-8680, Japan.
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Mutsumi Nishida
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Takanori Teshima
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.,Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.,Department of Hematology, Faculty of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
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Chiba Y, Iwano H, Imagawa S, Yonezawa K. Stiff left atrial syndrome? Don't overlook underlying disease. Eur Heart J Cardiovasc Imaging 2023; 24:e44. [PMID: 36573939 DOI: 10.1093/ehjci/jeac261] [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: 12/28/2022] Open
Affiliation(s)
- Yasuyuki Chiba
- Division of Cardiology, National Hospital Organization Hakodate Hospital, Hakodate, Japan
| | - Hiroyuki Iwano
- Division of Cardiology, Teine Keijinkai Hospital, 1-40, Maeda 1-jo 12-chome Teine-ku, Sapporo 006-8555, Japan
| | - Shogo Imagawa
- Division of Cardiology, National Hospital Organization Hakodate Hospital, Hakodate, Japan
| | - Kazuya Yonezawa
- Division of Cardiology, National Hospital Organization Hakodate Hospital, Hakodate, Japan
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5
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Abe T, Okada K, Murayama M, Kaga S, Nakabachi M, Yokoyama S, Nishino H, Aoyagi H, Tamaki Y, Motoi K, Chiba Y, Ishizaka S, Tsujinaga S, Iwano H, Kamiya K, Nagai T, Anzai T. Usefulness of the pulmonary venous flow waveform for assessing left atrial stiffness. Int J Cardiovasc Imaging 2023; 39:23-34. [PMID: 36598682 DOI: 10.1007/s10554-022-02689-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/01/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE This study investigated the novel non-invasive left atrial (LA) stiffness parameter using pulmonary venous (PV) flow measurements and the clinical usefulness of the novel LA stiffness parameter. METHODS We retrospectively analyzed 237 patients who underwent right heart catheterization and echocardiography less than one week apart. From the pulmonary artery wedge pressure waveform, the difference between x-descent and v-wave (ΔP) was measured. Using the echocardiographic biplane method of disks, the difference between LA maximum volume and that just before atrial contraction (ΔVMOD) was calculated, and the ΔP/ΔVMOD was calculated as a standard LA stiffness index. From the PV flow waveform, the peak systolic velocity (S), peak diastolic velocity (D), and minimum velocity between them (R) were measured, and S/D, S/R, and D/R were calculated. From the speckle tracking echocardiography-derived time-LA volume curve, the difference between LA maximum volume and that just before atrial contraction (ΔVSTE) was measured. Each patient's prognosis was investigated until three years after echocardiography. RESULTS Among the PV flow parameters, D/R was significantly correlated with ΔP (r = 0.62), and the correlation coefficient exceeded that between S/D and ΔP (r = - 0.39) or S/R and ΔP (r = 0.14). The [D/R]/ΔVSTE was significantly correlated with ΔP/ΔVMOD (r = 0.61). During the follow-up, 37 (17%) composite endpoints occurred. Kaplan-Meier analysis showed that patients with [D/R]/ΔVSTE greater than 0.13 /mL were at higher risk of cardiac events. CONCLUSION The [D/R]/ΔVSTE was useful for assessing LA stiffness non-invasively and might be valuable in the prognostic evaluation of patients with cardiac diseases.
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Affiliation(s)
- Takehiro Abe
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Michito Murayama
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan.,Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Masahiro Nakabachi
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Division of Cardiology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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6
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Yanagi Y, Okada K, Kaga S, Mikami T, Aiba M, Masauzi N, Murayama M, Tanemura A, Yokoyama S, Nishino H, Nakabachi M, Tamaki Y, Aoyagi H, Motoi K, Ishizaka S, Chiba Y, Tsujinaga S, Iwano H, Anzai T. Difference in left atrial myocardial dynamics during reservoir phase between hypertrophic cardiomyopathy and hypertensive heart determined using three-dimensional speckle tracking echocardiography. Int J Cardiovasc Imaging 2022; 38:1781-1791. [PMID: 37726515 DOI: 10.1007/s10554-022-02604-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/18/2022] [Indexed: 12/18/2022]
Abstract
We aimed to investigate left atrial (LA) myocardial dynamics during reservoir phase using three-dimensional speckle-tracking echocardiography (3DSTE) focusing on its longitudinal-circumferential relationship in patients with left ventricular (LV) hypertrophy and clarifying the difference in LA myocardial reservoir dynamics between hypertrophic cardiomyopathy (HCM) and hypertension with LV hypertrophy (HT-LVH). We studied 4 age-matched groups consisting of 27 patients with HCM, 16 with HT-LVH, 22 hypertensive patients without LV hypertrophy (HT), and 18 normal controls. Using 3DSTE, we measured LA global longitudinal strain (LA-LSR), global circumferential strain (LA-CSR), and global area strain (LA-ASR) during the reservoir phase, as well as LV global longitudinal strain (LV-LS), global circumferential strain (LV-CS), and global area strain (LV-AS). LA-LSR was significantly lower in the HCM and HT-LVH groups than in the controls, but there was no significant difference between the HCM and HT-LVH groups. LA-CSR and LA-ASR were significantly lower in the HCM group than in the other three groups, among which no significant difference was detected. In all subjects, LA-LSR was significantly correlated with LV-LS but not with LV-CS. LA-CSR was correlated with neither LV-LS nor LV-CS. In conclusion, both longitudinal and circumferential LA myocardial expansion during reservoir phase were reduced in HCM, while only the longitudinal one was reduced in HT-LVH. Reduction of LA circumferential expansion may reflect a more serious and intrinsic impairment of LA myocardial distensibility in HCM. Measuring LA-CSR and LA-ASR using 3DSTE would contribute to a more accurate understanding of LA reservoir function abnormality in HCM.
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Affiliation(s)
- Yusuke Yanagi
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Taisei Mikami
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Miho Aiba
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Nobuo Masauzi
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michito Murayama
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Asuka Tanemura
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Chiba Y, Iwano H, Tsuneta S, Tsujinaga S, Meyers B, Vlachos P, Ishizaka S, Motoi K, Aoyagi H, Tamaki Y, Tanemura A, Murayama M, Yokoyama S, Nakabachi M, Nishino H, Kaga S, Kamiya K, Ohira H, Tsujino I, Anzai T. DETERMINANTS OF IMPAIRED LEFT VENTRICULAR SUCTION IN PRE-CAPILLARY PULMONARY HYPERTENSION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02669-9] [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: 11/26/2022]
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8
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Ishizaka S, Iwano H, Tsujinaga S, Murayama M, Aoyagi H, Tamaki Y, Motoi K, Chiba Y, Nakabachi M, Sato T, Kamiya K, Kaga S, Nagai T, Anzai T. IMPACT OF ALTERED RIGHT VENTRICULAR-PULMONARY ARTERY COUPLING BY EXERCISE ON EXERCISE CAPACITY IN HFPEF PATIENTS WITHOUT LEFT VENTRICULAR STRUCTURAL ABNORMALITY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02256-2] [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: 10/18/2022]
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9
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Murayama M, Iwano H, Obokata M, Harada T, Omote K, Tsujinaga S, Chiba Y, Ishizaka S, Motoi K, Nakabachi M, Nishino H, Yokoyama S, Nishida M, Kurabayashi M, Anzai T. Two-dimensional echocardiographic scoring system of the left ventricular filling pressure and clinical outcomes in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.154] [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
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science (JSPS)
Introduction
Elevated left ventricular (LV) filling pressure in non-decompensated state is a powerful indicator of worse clinical outcomes in heart failure regardless of LV ejection fraction. However, its detection is often challenging in heart failure with preserved ejection fraction (HFpEF).
Purpose
This study aimed to elucidate the predictive value of recently proposed echocardiographic parameter of LV filling pressure, Visually assessed time difference between the Mitral valve and Tricuspid valve opening (VMT) score in HFpEF.
Methods
We retrospectively analyzed 310 well-differentiated HFpEF patients in stable conditions. Using two-dimensional echocardiographic images, time sequence of opening of mitral valve and tricuspid valve was visually assessed in the apical four-chamber view and scored to 0 to 2 (0: tricuspid valve first, 1: simultaneous, 2: mitral valve first). When the inferior vena cava diameter was dilated, 1 point was added and VMT score was calculated as four grades from 0 to 3. Based on the previous study, VMT≥2 was regarded as a sign of elevated LV filling pressure (Figure 1). LV diastolic function was graded according to the guidelines. The primary endpoint was defined as a composite of cardiac death and heart failure hospitalisation during the two years after echocardiographic examination.
Results
During the follow-up period, 55 events (18%) occurred, including four cardiac deaths and 51 heart failure hospitalisations. Kaplan-Meier curves demonstrated that VMT≥2 (n = 54) was associated with worse outcomes compared to patients showing VMT ≤ 1 (n = 256) (log-rank test P <0.001). Furthermore, VMT≥2 was associated with worse outcomes when tested in 100 HFpEF patients with atrial fibrillation (log-rank test P = 0.026) (Figure 2). In the adjusted model including age, systolic blood pressure, serum albumin level, and the LV diastolic function grading, VMT≥2 was independently associated with the primary outcome (hazard ratio: 2.23; 95% confidence interval: 1.17 to 4.24, P = 0.014). Additionally, the nested regression model showed that VMT scoring provided an incremental prognostic value over clinically relevant variables (age, sex, the plasma brain natriuretic peptide level, atrial fibrillation) and LV diastolic function grading (chi-square 10.8 vs 16.3, P = 0.035).
Conclusions
In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it discriminated worse clinical outcome even in HFpEF patients with atrial fibrillation. Abstract Figure. VMT scoring Abstract Figure. Kaplan-Meier analysis
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Affiliation(s)
- M Murayama
- Hokkaido University Hospital, Diagnostic Center for Sonography, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - M Obokata
- Gunma University Graduate School of Medicine, Department of Cardiovascular Medicine, Gunma, Japan
| | - T Harada
- Gunma University Graduate School of Medicine, Department of Cardiovascular Medicine, Gunma, Japan
| | - K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Tsujinaga
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Chiba
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Ishizaka
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Motoi
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - M Nakabachi
- Hokkaido University Hospital, Diagnostic Center for Sonography, Sapporo, Japan
| | - H Nishino
- Hokkaido University Hospital, Diagnostic Center for Sonography, Sapporo, Japan
| | - S Yokoyama
- Hokkaido University Hospital, Diagnostic Center for Sonography, Sapporo, Japan
| | - M Nishida
- Hokkaido University Hospital, Diagnostic Center for Sonography, Sapporo, Japan
| | - M Kurabayashi
- Gunma University Graduate School of Medicine, Department of Cardiovascular Medicine, Gunma, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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10
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Aoyagi H, Tsujinaga S, Iwano H, Ishizaka S, Tamaki Y, Motoi K, Chiba Y, Murayama M, Nakabachi M, Nishino H, Yokoyama S, Sato T, Kaga S, Nagai T, Anzai T. Pathophysiological mechanism of worsened clinical outcome by lowered left ventricular cardiac power output in heart failure. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.383] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Cardiac power output (CPO) is a measure of cardiac pumping function, and CPO during exercise is known to be a powerful prognostic marker of heart failure. Despite its prognostic significance, pathophysiological mechanism of the association between reduced CPO and worse clinical outcome is unknown. We hypothesized that reduced CPO is associated with worse outcome through the reduced exercise capacity and enhanced ventilatory response.
Methods
Cardiopulmonary exercise testing and exercise stress echocardiography were performed in consecutive 64 patients with chronic heart failure who admitted to our department for the management of heart failure [60 ± 14 years old, left ventricular (LV) ejection fraction 39 ± 16%, ischemic etiology 16%, brain natriuretic peptide 124 pg/ml (51-313)]. Peak oxygen uptake (peak VO2) and the lowest minute ventilation / carbon dioxide production ratio (VE/VCO2) were measured as a parameter of exercise tolerance and that of ventilatory response, respectively. LV ejection fraction was measured by disk summation method at peak exercise. By using Doppler images, E/e" at peak exercise was measured as a marker of LV filling pressure, and CPO normalized by LV mass was obtained as 0.222 × cardiac output × mean blood pressure / LV mass [W/100 g]. Cardiac events defined as hospitalization for heart failure, cardiac death, or implantation of a LV assist device after the examinations were recorded.
Results
CPO at rest was weakly correlated with peak VO2 (r = 0.25, p = 0.046) but not with VE/VCO2. In contrast, CPO at peak exercise was positively correlated with peak VO2 (r = 0.50, p < 0.001) and inversely correlated with VE/VCO2 (r=-0.40, p = 0.002). Moreover, CPO at peak exercise determined both peak VO2 (b = 0.50) and VE/VCO2 (β=-0.54) independently of LV ejection fraction and E/e" at peak exercise. During a median follow-up period of 1211 days, 12 cardiac events were observed. Each of reduced peak VO2 (hazard ratio 0.78, 95% confidence interval 0.66-0.90) and increased VE/VCO2 (hazard ratio 1.10, 95% confidence interval 1.02-1.18) was associated with worse clinical outcome.
Conclusions
In patients with chronic heart failure, CPO during exercise was associated with prognosis of heart failure through the reduced exercise capacity and enhanced ventilatory response.
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Affiliation(s)
- H Aoyagi
- Hokkaido University, Sapporo, Japan
| | | | - H Iwano
- Hokkaido University, Sapporo, Japan
| | | | - Y Tamaki
- Hokkaido University, Sapporo, Japan
| | - K Motoi
- Hokkaido University, Sapporo, Japan
| | - Y Chiba
- Hokkaido University, Sapporo, Japan
| | - M Murayama
- Hokkaido University Hospital, Sapporo, Japan
| | - M Nakabachi
- Hokkaido University Hospital, Sapporo, Japan
| | - H Nishino
- Hokkaido University Hospital, Sapporo, Japan
| | - S Yokoyama
- Hokkaido University Hospital, Sapporo, Japan
| | - T Sato
- Hokkaido University, Sapporo, Japan
| | - S Kaga
- Hokkaido University, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Sapporo, Japan
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11
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Chiba Y, Iwano H, Tsuneta S, Tsujinaga S, Meyers B, Vlachos P, Ishizaka S, Motoi K, Aoyagi H, Tamaki Y, Tanemura A, Murayama M, Yokoyama S, Nakabachi M, Nishino H, Kaga S, Kamiya K, Ohira H, Tsujino I, Anzai T. Determinants of altered left ventricular suction in pre-capillary pulmonary hypertension. Eur Heart J Cardiovasc Imaging 2022; 23:1399-1406. [PMID: 35019957 DOI: 10.1093/ehjci/jeab285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS Although the left ventricular (LV) dysfunction in pre-capillary pulmonary hypertension (PH) has been recently recognized, the mechanism of LV dysfunction in this entity is not completely understood. We thus aimed to elucidate the determinants of intraventricular pressure difference (IVPD), a measure of LV suction, in pre-capillary PH. METHODS AND RESULTS Right heart catheterization and echocardiography were performed in 86 consecutive patients with pre-capillary PH (57 ± 18 years, 85% female). IVPD was determined using colour M-mode Doppler to integrate the Euler equation. In overall, IVPD was reduced compared to previously reported value in normal subjects. In univariable analyses, QRS duration (P = 0.028), LV ejection fraction (P = 0.006), right ventricular (RV) end-diastolic area (P < 0.001), tricuspid annular plane systolic excursion (P = 0.004), and LV early-diastolic eccentricity index (P = 0.009) were associated with IVPD. In the multivariable analyses, RV end-diastolic area and LV eccentricity index independently determined the IVPD. CONCLUSION Aberrant ventricular interdependence caused by RV enlargement could impair the LV suction. This study first applied echocardiographic IVPD, a reliable marker of LV diastolic suction, to investigate the mechanism of LV diastolic dysfunction in pre-capillary PH.
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Affiliation(s)
- Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan.,Division of Cardiology, Hakodate Municipal Hospital, 1-10-1, Minato-cho, Hakodate 041-8680, Japan
| | - Satonori Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Brett Meyers
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907-2088, USA
| | - Pavlos Vlachos
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907-2088, USA
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Asuka Tanemura
- Diagnostic Center for Sonography, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, Sapporo 060-0812, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Hiroshi Ohira
- Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan.,Division of Cardiology, KKR Sapporo Medical Center, 3-40, Hiragishi 1-6, Toyohira-ku, Sapporo 062-0931, Japan
| | - Ichizo Tsujino
- Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan
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12
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Toyoshima K, Seino S, Tamura Y, Ishikawa J, Chiba Y, Ishizaki T, Fujiwara Y, Shinkai S, Kitamura A, Araki A. Difference between "Physical Fitness Age" Based on Physical Function and Chronological Age Is Associated with Obesity, Hyperglycemia, Depressive Symptoms, and Low Serum Albumin. J Nutr Health Aging 2022; 26:501-509. [PMID: 35587763 DOI: 10.1007/s12603-022-1786-8] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to (1) develop the physical fitness age, which is the biological age based on physical function, (2) evaluate the validity of the physical fitness age for the assessment of sarcopenia, and (3) examine the factors associated with the difference between physical fitness age and chronological age. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Community-dwelling older adults and outpatients. MEASUREMENTS A formula for calculating the physical fitness age was created based on the usual walking speed, handgrip strength, one-leg standing time, and chronological age of 4,076 older adults from the pooled data of community-dwelling and outpatients using the principal component analysis. For the validation of the physical fitness age, we also used pooled data from community-dwelling older adults (n = 1929) and outpatients (n = 473). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. The association of D-age (the difference between physical and chronological ages) with cardiovascular risk factors, renal function, and cardiac function was examined. RESULTS The receiver operating characteristic analysis, with sarcopenia as the outcome, showed that the area under the curve (AUC) of physical fitness age was greater than that of chronological age (AUC 0.87 and 0.77, respectively, p < 0.001). Binomial logistic regression analysis revealed that the D-age was significantly associated with sarcopenia after adjustment for covariates (odds ratio 1.22, 95% confidence interval 1.19-1.26; p <0.001). In multivariate linear regression analysis with D-age as the dependent variable, D-age was independently associated with a history of diabetes mellitus (or hemoglobin A1c as a continuous variable), obesity, depression, and low serum albumin level. D-age was also correlated with estimated glomerular filtration rate derived from serum cystatin C, brain natriuretic peptide, and ankle-brachial index, reflecting some organ function and arteriosclerosis. CONCLUSIONS Compared to chronological age, physical fitness age calculated from handgrip strength, one-leg standing time, and usual walking speed was a better scale for sarcopenia. D-age, which could be a simple indicator of physical function, was associated with modifiable factors, such as poor glycemic control, obesity, depressive symptoms, and malnutrition.
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Affiliation(s)
- K Toyoshima
- Kenji Toyoshima, Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan, E-mail:
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13
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Abe K, Chiba Y, Ide K, Yoshimi A, Asami T, Suda A, Odawara T, Hishimoto A. Plasma MMP-9 Levels as the Future Risk of Conversion to Dementia in ApoE4-Positive MCI Patients: Investigation Based on the Alzheimer's Disease Neuroimaging Initiative Database. J Prev Alzheimers Dis 2022; 9:331-337. [PMID: 35543007 DOI: 10.14283/jpad.2022.19] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Matrix metalloproteinase 9 (MMP-9) has been reported to be correlated with declines in hippocampal volume and cognitive function in ApoE4-positive MCI patients. OBJECTIVES The present study was aimed to investigate the effects of plasma matrix MMP-9 on the conversion risk between mild cognitive impairment (MCI) patients with and without ApoE4. DESIGN AND SETTING Retrospective observational study using the data extracted from the Alzheimer's Disease Neuroimaging Initiative database. PARTICIPANTS We included 211 ApoE4-positive MCI subjects (ApoE4+ MCI) and 184 ApoE4-negative MCI subjects (ApoE4- MCI). MEASUREMENTS We obtained demographic and data including plasma MMP-9 levels at baseline and longitudinal changes in Clinical Dementia Rating (CDR) up to 15 years. We compared conversion rates between ApoE4+ MCI and ApoE4- MCI by the Log-rank test and calculated the hazard ratio (HR) for covariates including age, sex, educational attainment, drinking and smoking histories, medications, and plasma MMP-9 levels using a multiple Cox regression analysis of ApoE4+ MCI and ApoE4- MCI. RESULTS No significant differences were observed in baseline plasma MMP-9 levels between ApoE4+ MCI and ApoE4- MCI. High plasma MMP-9 levels increased the conversion risk significantly more than low plasma MMP-9 levels (HR, 2.46 [95% CI, 1.31-4.48]) and middle plasma MMP-9 levels (HR, 1.67 [95% CI, 1.04-2.65]) in ApoE4+ MCI, but not in ApoE4- MCI. CONCLUSION Plasma MMP-9 would be the risk of the future conversion to dementia in ApoE4+ MCI.
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Affiliation(s)
- K Abe
- Yuhei Chiba, 3-9 Fukuura Kanazawa-Ku Yokohama Kanagawa 236-0004, Japan, Telephone: +81-45-787-2667, FAX: +81-45-783-2540, E-mail:
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14
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Tanizaki J, Yonemori K, Akiyoshi K, Minami H, Ueda H, Takiguchi Y, Miura Y, Segawa Y, Takahashi S, Iwamoto Y, Kidera Y, Fukuoka K, Ito A, Chiba Y, Sakai K, Nishio K, Nakagawa K, Hayashi H. Open-label phase II study of the efficacy of nivolumab for cancer of unknown primary. Ann Oncol 2021; 33:216-226. [PMID: 34843940 DOI: 10.1016/j.annonc.2021.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/31/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cancer of unknown primary (CUP) has a poor prognosis. Given the recent approval of immune checkpoint inhibitors for several cancer types, we carried out a multicenter phase II study to assess the efficacy of nivolumab for patients with CUP. PATIENTS AND METHODS Patients with CUP who were previously treated with at least one line of systemic chemotherapy constituted the principal study population. Previously untreated patients with CUP were also enrolled for exploratory analysis. Nivolumab (240 mg/body) was administered every 2 weeks for up to 52 cycles. The primary endpoint was objective response rate in previously treated patients as determined by blinded independent central review according to RECIST version 1.1. RESULTS Fifty-six patients with CUP were enrolled in the trial. For the 45 previously treated patients, objective response rate was 22.2% [95% confidence interval (CI), 11.2% to 37.1%], with a median progression-free survival and overall survival of 4.0 months (95% CI, 1.9-5.8 months) and 15.9 months (95% CI, 8.4-21.5 months), respectively. Similar clinical benefits were also observed in the 11 previously untreated patients. Better clinical efficacy of nivolumab was apparent for tumors with a higher programmed death-ligand 1 expression level, for those with a higher tumor mutation burden, and for microsatellite instability-high tumors. In contrast, no differences in efficacy were apparent between tumor subgroups based on estimated tissue of origin. Adverse events were consistent with the known safety profile of nivolumab. No treatment-related death was observed. CONCLUSIONS Our results demonstrate a clinical benefit of nivolumab for patients with CUP, suggesting that nivolumab is a potential additional therapeutic option for CUP.
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Affiliation(s)
- J Tanizaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - K Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - K Akiyoshi
- Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan
| | - H Minami
- Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - H Ueda
- Respiratory Medicine and Medical Oncology, Wakayama Medical University, Wakayama, Japan
| | - Y Takiguchi
- Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Miura
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Y Segawa
- Department of Medical Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan
| | - S Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Y Iwamoto
- Department of Medical Oncology, Hiroshima City Hospital Organization, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Y Kidera
- Clinical Research Center, Kindai University Hospital, Osakasayama, Japan
| | - K Fukuoka
- Clinical Research Center, Kindai University Hospital, Osakasayama, Japan
| | - A Ito
- Department ofPathology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Y Chiba
- Clinical Research Center, Kindai University Hospital, Osakasayama, Japan
| | - K Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - K Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - H Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osakasayama, Japan.
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15
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Chiba Y, Yoshizaki K, Tian T, Miyazaki K, Martin D, Saito K, Yamada A, Fukumoto S. Integration of Single-Cell RNA- and CAGE-seq Reveals Tooth-Enriched Genes. J Dent Res 2021; 101:220345211049785. [PMID: 34806461 PMCID: PMC9052834 DOI: 10.1177/00220345211049785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Organ development is dictated by the regulation of genes preferentially expressed in tissues or cell types. Gene expression profiling and identification of specific genes in organs can provide insights into organogenesis. Therefore, genome-wide analysis is a powerful tool for clarifying the mechanisms of development during organogenesis as well as tooth development. Single-cell RNA sequencing (scRNA-seq) is a suitable tool for unraveling the gene expression profile of dental cells. Using scRNA-seq, we can obtain a large pool of information on gene expression; however, identification of functional genes, which are key molecules for tooth development, via this approach remains challenging. In the present study, we performed cap analysis of gene expression sequence (CAGE-seq) using mouse tooth germ to identify the genes preferentially expressed in teeth. The CAGE-seq counts short reads at the 5'-end of transcripts; therefore, this method can quantify the amount of transcripts without bias related to the transcript length. We hypothesized that this CAGE data set would be of great help for further understanding a gene expression profile through scRNA-seq. We aimed to identify the important genes involved in tooth development via bioinformatics analyses, using a combination of scRNA-seq and CAGE-seq. We obtained the scRNA-seq data set of 12,212 cells from postnatal day 1 mouse molars and the CAGE-seq data set from postnatal day 1 molars. scRNA-seq analysis revealed the spatiotemporal expression of cell type-specific genes, and CAGE-seq helped determine whether these genes are preferentially expressed in tooth or ubiquitously. Furthermore, we identified candidate genes as novel tooth-enriched and dental cell type-specific markers. Our results show that the integration of scRNA-seq and CAGE-seq highlights the genes important for tooth development among numerous gene expression profiles. These findings should contribute to resolving the mechanism of tooth development and establishing the basis for tooth regeneration in the future.
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Affiliation(s)
- Y. Chiba
- Section of Oral Medicine for
Children, Division of Oral Health, Growth and Development, Faculty of Dental
Science, Kyushu University, Fukuoka, Japan
| | - K. Yoshizaki
- Section of Orthodontics and
Dentofacial Orthopedics, Division of Oral Health, Growth and Development,
Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - T. Tian
- Section of Orthodontics and
Dentofacial Orthopedics, Division of Oral Health, Growth and Development,
Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - K. Miyazaki
- Section of Orthodontics and
Dentofacial Orthopedics, Division of Oral Health, Growth and Development,
Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - D. Martin
- Genomics and Computational
Biology Core, National Institute on Deafness and Other Communication
Disorders, National Institute of Dental and Craniofacial Research, National
Institutes of Health, Bethesda, MD, USA
| | - Genomics and Computational Biology Core
- Genomics and Computational
Biology Core, National Institute on Deafness and Other Communication
Disorders, National Institute of Dental and Craniofacial Research, National
Institutes of Health, Bethesda, MD, USA
| | - K. Saito
- Division of Pediatric Dentistry,
Department of Community Social Dentistry, Graduate School of Dentistry,
Tohoku University, Sendai, Japan
| | - A. Yamada
- Division of Pediatric Dentistry,
Department of Community Social Dentistry, Graduate School of Dentistry,
Tohoku University, Sendai, Japan
| | - S. Fukumoto
- Section of Oral Medicine for
Children, Division of Oral Health, Growth and Development, Faculty of Dental
Science, Kyushu University, Fukuoka, Japan
- Division of Pediatric Dentistry,
Department of Community Social Dentistry, Graduate School of Dentistry,
Tohoku University, Sendai, Japan
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16
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Murayama M, Iwano H, Obokata M, Harada T, Omote K, Kagami K, Tsujinaga S, Chiba Y, Ishizaka S, Motoi K, Tamaki Y, Aoyagi H, Nakabachi M, Nishino H, Yokoyama S, Tanemura A, Okada K, Kaga S, Nishida M, Nagai T, Kurabayashi M, Anzai T. Visual echocardiographic scoring system of the left ventricular filling pressure and outcomes of heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2021; 23:616-626. [PMID: 34694368 PMCID: PMC9016355 DOI: 10.1093/ehjci/jeab208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Indexed: 12/31/2022] Open
Abstract
Aims Elevated left ventricular filling pressure (LVFP) is a powerful indicator of worsening clinical outcomes in heart failure with preserved ejection fraction (HFpEF); however, detection of elevated LVFP is often challenging. This study aimed to determine the association between the newly proposed echocardiographic LVFP parameter, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, and clinical outcomes of HFpEF. Methods and results We retrospectively investigated 310 well-differentiated HFpEF patients in stable conditions. VMT was scored from 0 to 3 using two-dimensional echocardiographic images, and VMT ≥2 was regarded as a sign of elevated LVFP. The primary endpoint was a composite of cardiac death or heart failure hospitalization during the 2 years after the echocardiographic examination. In all patients, Kaplan–Meier curves showed that VMT ≥2 (n = 54) was associated with worse outcomes than the VMT ≤1 group (n = 256) (P < 0.001). Furthermore, VMT ≥2 was associated with worse outcomes when tested in 100 HFpEF patients with atrial fibrillation (AF) (P = 0.026). In the adjusted model, VMT ≥2 was independently associated with the primary outcome (hazard ratio 2.60, 95% confidence interval 1.46–4.61; P = 0.001). Additionally, VMT scoring provided an incremental prognostic value over clinically relevant variables and diastolic function grading (χ2 10.8–16.3, P = 0.035). Conclusions In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it could also predict clinical outcomes in HFpEF patients with AF.
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Affiliation(s)
- Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan
| | - Hiroyuki Iwano
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan.,Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan.,Division of Cardiology, Hakodate Municipal Hospital, 1-10-1, Minatocho, Hakodate 041-8680, Japan
| | - Masaru Obokata
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Tomonari Harada
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Kazunori Omote
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Kazuki Kagami
- Division of Cardiovascular Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Masahiro Nakabachi
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan
| | - Hisao Nishino
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan
| | - Shinobu Yokoyama
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan
| | - Asuka Tanemura
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-ku, Sapporo 060-0812, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-ku, Sapporo 060-0812, Japan
| | - Mutsumi Nishida
- Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo 060-8648, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Masahiko Kurabayashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
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17
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Fujisawa R, Okada K, Kaga S, Murayama M, Nakabachi M, Yokoyama S, Nishino H, Tanemura A, Masauzi N, Motoi K, Ishizaka S, Chiba Y, Tsujinaga S, Iwano H, Anzai T. Prognostic value of an echocardiographic index reflecting right ventricular operating stiffness in patients with heart failure. Heart Vessels 2021; 37:583-592. [PMID: 34655317 DOI: 10.1007/s00380-021-01960-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE We recently reported a noninvasive method for the assessment of right ventricular (RV) operating stiffness that is obtained by dividing the atrial-systolic descent of the pulmonary artery-RV pressure gradient (PRPGDAC) derived from the pulmonary regurgitant velocity by the tricuspid annular plane movement during atrial contraction (TAPMAC). Here, we investigated whether this parameter of RV operating stiffness, PRPGDAC/TAPMAC, is useful for predicting the prognosis of patients with heart failure (HF). METHODS We retrospectively included 127 hospitalized patients with HF who underwent an echocardiographic examination immediately pre-discharge. The PRPGDAC/TAPMAC was measured in addition to standard echocardiographic parameters. Patients were followed until 2 years post-discharge. The endpoint was the composite of cardiac death, readmission for acute decompensation, and increased diuretic dose due to worsening HF. RESULTS 58 patients (46%) experienced the endpoint during follow-up. Univariable and multivariable Cox regression analyses demonstrated that the PRPGDAC/TAPMAC was associated with the endpoint. In a Kaplan-Meier analysis, the event rate of the greater PRPGDAC/TAPMAC group was significantly higher than that of the lesser PRPGDAC/TAPMAC group. In a sequential Cox analysis for predicting the endpoint's occurrence, the addition of PRPGDAC/TAPMAC to the model including age, sex, NYHA functional classification, brain natriuretic peptide level, and several echocardiographic parameters including tricuspid annular plane systolic excursion significantly improved the predictive power for prognosis. CONCLUSION A completely noninvasive index of RV operating stiffness, PRPGDAC/TAPMAC, was useful for predicting prognoses in patients with HF, and it showed an incremental prognostic value over RV systolic function.
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Affiliation(s)
- Ryosuke Fujisawa
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michito Murayama
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan.,Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Asuka Tanemura
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Nobuo Masauzi
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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18
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Nakabachi M, Iwano H, Murayama M, Nishino H, Yokoyama S, Tsujinaga S, Chiba Y, Ishizaka S, Motoi K, Okada K, Kaga S, Nishida M, Teshima T, Anzai T. Application of the proximal isovelocity surface area method for estimation of the effective orifice area in aortic stenosis. Heart Vessels 2021; 37:638-646. [PMID: 34562142 DOI: 10.1007/s00380-021-01945-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/17/2021] [Indexed: 11/27/2022]
Abstract
Although the echocardiographic effective orifice area (EOA) calculated using the continuity equation is widely used for the assessment of severity in aortic stenosis (AS), the existence of high flow velocity at the left ventricular outflow tract (LVOT) potentially causes its overestimation. The proximal isovelocity surface area (PISA) method could be an alternative tool for the estimation of EOA that limits the influence of upstream flow velocity. EOA was calculated using the continuity equation (EOACont) and PISA method (EOAPISA), respectively, in 114 patients with at least moderate AS. The geometric orifice area (GOA) was also measured using the planimetry method in 51 patients who also underwent three-dimensional transesophageal echocardiography. Patients were divided into two groups according to the median LVOT flow velocity. EOAPISA could be obtained in 108 of the 114 patients (95%). Although there was a strong correlation between EOACont and EOAPISA (r = 0.78, P < 0.001), EOACont was statistically significantly larger than EOAPISA (0.86 ± 0.33 vs 0.75 ± 0.29 cm2, P < 0.001). Both EOACont and EOAPISA similarly correlated with GOA (r = 0.70, P < 0.001 and r = 0.77, P < 0.001, respectively). However, a fixed bias, which is hydrodynamically supposed to exist between EOA and GOA, was not observed between EOACont and GOA. In contrast, there was a negative fixed bias between EOAPISA and GOA with smaller EOAPISA than GOA. The difference between EOACont and GOA was significantly greater with a larger EOACont relative to GOA in patients with high LVOT flow velocity than in those without (0.16 ± 0.25 vs - 0.07 ± 0.10 cm2, P < 0.001). In contrast, the difference between EOAPISA and GOA was consistent regardless of the LVOT flow velocity (- 0.07 ± 0.12 vs - 0.07 ± 0.15 cm2, P = 0.936). The PISA method was applied to estimate EOA in patients with AS. EOAPISA could be an alternative parameter for AS severity grading in patients with high LVOT flow velocity in whom EOACont would potentially overestimate the orifice area.
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Affiliation(s)
- Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, Sapporo, 060-0812, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, Sapporo, 060-0812, Japan
| | - Mutsumi Nishida
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Takanori Teshima
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
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19
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Ishizaka S, Iwano H, Motoi K, Chiba Y, Tsujinaga S, Tanemura A, Murayama M, Nakabachi M, Yokoyama S, Nishino H, Okada K, Kaga S, Kamiya K, Nagai T, Anzai T. Influence of left ventricular systolic dysfunction on occurrence of pulsus tardus in patients with aortic stenosis. J Cardiol 2021; 78:322-327. [PMID: 33992500 DOI: 10.1016/j.jjcc.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/28/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although the time difference between peak of left ventricular (LV) and aortic systolic pressures (TLV-Ao), which is considered to in part reflect pulsus tardus, is reported to be associated with clinical outcome in aortic stenosis (AS), its physiological determinants remain to be elucidated. We hypothesized that not only AS severity but also LV systolic dysfunction could be associated with occurrence of pulsus tardus. METHODS TLV-Ao was measured by simultaneous LV and aortic pressure tracing in 74 AS patients and prolonged TLV-Ao was defined as ≥66 ms according to the previous report. Mean transaortic valvular pressure gradient (mPG) and effective orifice area index (EOAI) were estimated by Doppler echocardiography and severe AS was defined as EOAI ≤0.60 cm2/m2. Global longitudinal strain (GLS) was measured by using speckle-tracking method. RESULTS Although a weak correlation was observed between EOAI and TLV-Ao, there was substantial population showing discordance between the parameters: severe AS despite normal TLV-Ao (10 of 47 patients) and moderate AS despite prolonged TLV-Ao (9 of 17 patients). In severe AS, mPG was significantly higher in patients showing prolonged TLV-Ao (57±20 vs 36±10 mmHg, p<0.0001) whereas GLS was comparable between the groups (-15.2±3.5% vs -14.8±3.2%). In contrast, in moderate AS, GLS was significantly smaller in patients showing prolonged TLV-Ao (-12.6±4.7% vs -17.4±3.4%, p=0.0271) while mPG was comparable (34±7 mmHg vs 35±8 mmHg). Multivariable analysis revealed that not only mPG but also GLS was an independent determinant of TLV-Ao. CONCLUSIONS The occurrence of pulsus tardus could be associated with not only AS severity but also LV systolic dysfunction in AS patients.
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Affiliation(s)
- Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Asuka Tanemura
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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20
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Sarashina-Motoi M, Iwano H, Motoi K, Ishizaka S, Chiba Y, Tsujinaga S, Murayama M, Nakabachi M, Yokoyama S, Nishino H, Okada K, Kaga S, Anzai T. Functional significance of intra-left ventricular vortices on energy efficiency in normal, dilated, and hypertrophied hearts. J Clin Ultrasound 2021; 49:358-367. [PMID: 33098167 DOI: 10.1002/jcu.22938] [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] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/30/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To investigate the influence of changes in vortices within the left ventricle (LV) on energy efficiency (EE) in normal and diseased hearts. METHODS We performed vector flow mapping echocardiography in 36 normal participants (N), 36 patients with dilated cardiomyopathy (D), and 36 patients with LV hypertrophy (H). The circulation of the main anterior vortex was measured as a parameter of vortex strength. Energy loss (EL) was measured for one cardiac cycle, and EE was calculated as EL divided by stroke work (SW), which represents the loss of kinetic energy per unit of LV external work. RESULTS Circulation increased in the order of N, H, and D (N: 15 ± 4, D: 19 ± 8, H: 17 ± 6 × 10-3 m2 /s; analysis of variance [ANOVA] P < .01). Conversely, EE increased in the order of N, D, and H (N: 0.22 ± 0.07, D: 0.26 ± 0.16, H: 0.30 ± 0.16 10-5 J/mm Hg mL m s; ANOVA P = .04), suggesting worst EE in group H. We found a positive correlation between circulation and SW only in group N, and positive correlation between circulation and EE only in diseased groups (D: R = 0.55, P < .01; H: R = 0.44, P < .01). Multivariable analyses revealed that circulation was the independent determinant of EE in groups D and H. CONCLUSIONS Enhanced vortices could be associated with effective increase in LV external work in normal hearts. Conversely, they were associated with loss of EE without an optimal increase in external work in failing hearts, regardless of the LV morphology.
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Affiliation(s)
- Miwa Sarashina-Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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21
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Nakaya T, Tsujino I, Nakamura J, Chiba Y, Iwano H. Right ventricular pressure-volume loop produced with simultaneous application of three-dimensional echocardiography and high-fidelity micromanometry in a patient with pulmonary arterial hypertension. Echocardiography 2021; 38:805-807. [PMID: 33778995 DOI: 10.1111/echo.15032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/27/2022] Open
Abstract
Accurate assessment of right ventricular (RV) function has received a growing attention. Pressure-volume (PV) loop analysis is the gold standard method for evaluating RV function; however, it is not widely employed because of its invasive nature and complexity. The present report is the first to have drawn a RV PV loop in a patient with pulmonary hypertension, with a simultaneous recording of RV pressure and volume using high-fidelity micromanometry and three-dimensional echocardiography. This allows for less invasive and simple assessment of RV function, potentially promoting better understanding and management of pulmonary hypertension and other cardiovascular diseases.
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Affiliation(s)
- Toshitaka Nakaya
- Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichizo Tsujino
- Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Junichi Nakamura
- Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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22
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Hayashi H, Yonesaka K, Sugawara S, Sato Y, Azuma K, Sakata S, Tachihara M, Ikeda S, Yokoyama T, Hataji O, Yano Y, Hirano K, Daga H, Okada H, Sakai K, Chiba Y, Nishio K, Yamamoto N, Nakagawa K. FP14.16 Phase 2 Trial of the Alternating Therapy with Osimertinib and Afatinib for Treatment-Naive Patients with EGFR-Mutated Advanced Non–Small Cell Lung Cancer (WJOG10818L/Alt Trial). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Ishizaka S, Iwano H, Kamiya K, Nagai T, Motoi K, Chiba Y, Tsujinaga S, Kaga S, Anzai T. Influence of left ventricular systolic dysfunction on occurrence of pulsus tardus in patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.077] [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
Funding Acknowledgements
Type of funding sources: None.
Background
The time between left ventricular (LV) and aortic systolic pressure peaks (TLV-Ao) which could reflect pulsus tardus (PT) is reported to be a marker of severity and be associated with poor prognosis in patients with aortic stenosis (AS). Despite its worldwide recognition, physiological mechanism of PT has not been well elucidated. We hypothesized that not only severity of the AS but also LV systolic dysfunction could be associated with occurrence of PT.
Methods
TLV-Ao and mean trans-aortic valvular pressure gradient (mean PG) were measured by simultaneous pressure tracing of left ventricle and basal aorta in 74 AS patients with at least moderate severity (78 ± 8 years old). Effective orifice area index (EOAI) was estimated by using continuity equation from transthoracic echocardiography and severe AS was defined as EOAI ± 0.60 cm²/m². Global longitudinal strain (GLS) was measured by using speckle-tracking method and expressed as an absolute value.
Results
TLV-Ao, mean PG, and EOAI was 87 ± 30 msec, 51 ± 21 mmHg, and 0.51 ± 0.14 cm² respectively. A weak correlation was observed between EOAI and TLV-Ao (Figure). In 9 out of 17 moderate AS patients (A in Figure), TLV-Ao was prolonged over the previously reported cut-off value (≥66 msec), on the other hand, it was not prolonged in 11 out of 57 severe AS patients (D in Figure). When the patients were divided by TLV-Ao of 66 msec, mean PG was not different between patients with prolonged TLV-Ao and those without in moderate AS patients (Figure, A vs B; NS), whereas GLS was significantly reduced in prolonged TLV-Ao group (P = 0.0383). In patients with severe AS, mean PG was significantly higher (P < 0.0001) in patients with prolonged TLV-Ao than in those without (Figure, C vs D), whereas GLS was comparable between the groups. In overall patients, multivariable analysis revealed that not only mean PG (β=0.54) but also GLS (β=-0.23) was an independent determinant of TLV-Ao.
Conclusion
The occurrence of pulsus tardus could be associated not only with severity of the AS but also with LV systolic dysfunction in patients with AS.
Abstract Figure
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Affiliation(s)
- S Ishizaka
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Motoi
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Chiba
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Tsujinaga
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Kaga
- Hokkaido University, Faculty of Health Sciences, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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24
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Chiba Y, Iwano H, Murayama M, Kaga S, Motoi K, Ishizaka S, Tsujinaga S, Kamiya K, Nagai T, Anzai T. Presence and significance of mid-systolic notch on right ventricular outflow tract velocity envelopes in pulmonary hypertension due to heart failure. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
A mid-systolic notch (MSN) of the right ventricular outflow tract (RVOT) pulsed-wave Doppler envelope, which is recognized as a characteristic finding in pre-capillary pulmonary hypertension (PH), is often observed in heart failure (HF) patients. However, clinical significance of MSN formation in HF has not been elucidated.
Methods
Consecutive 233 HF patients who underwent right heart catheterization and echocardiography within 24 hours were enrolled. Isolated post-capillary PH (IpcPH) was defined as mean pulmonary arterial pressure (mPAP) >20 mmHg, mean pulmonary artery wedge pressure (mPAWP) >15 mmHg, and pulmonary vascular resistance (PVR) <3 Wood units and combined pre- and post-capillary PH (CpcPH) was as mPAP >20 mmHg, mPAWP >15 mmHg, and PVR ≥3 Wood units. Pulmonary arterial capacitance (PAC) was calculated as stroke volume / pulmonary arterial pulse pressure [mL/mmHg]. MSN was defined as formation of notch within first half of the RVOT pulsed-wave Doppler envelope.
Results
Prevalence of IpcPH, CpcPH, and without PH were 87 (37%), 45 (19%), and 101 (43%), respectively and MSN was observed in 8 (9%) of IpcPH, 17 (38%) of CpcPH, and 1 (1%) of patients without PH. Among the hemodynamic and echocardiographic parameters, mPAP and PAC independently determined occurrence of MSN in all the multivariable models (Table). Interestingly, when the PH patients were dimidiated according to median PAC (3.2 mL/mmHg), 25 out of 102 PH patients (25%) with low PAC showed MSN whereas any of PH patients with high PAC did not (Figure).
Conclusion
MSN was frequently observed in HF patients showing CpcPH. Combination of elevated pressure and reduced compliance of the pulmonary circulation could determine occurrence of MSN in HF.
Determinants of MSN occurrence Univariable analysis Multivariable analysis Model 1 Model 2 Model 3 Model 4 variables OR (95% CI) p OR (95% CI) p OR (95% CI) p OR (95% CI) p OR (95% CI) p LV ejection fraction 0.97 (0.94-0.99) 0.007 1.00 (0.96-1.03) 0.795 LV mass index 1.00 (1.00-1.02) 0.143 PAW pressure 1.13 (1.08-1.18) <0.001 0.92 (0.82-1.03) 0.135 Mean PA pressure 1.14 (1.09-1.19) <0.001 1.08 (1.02-1.14) 0.006 1.15 (1.04-1.27) 0.004 1.08 (1.00-1.17) 0.030 1.07 (1.01-1.14) 0.025 Mean RA pressure 1.14 (1.06-1.22) <0.001 1.00 (0.90-1.11) 0.978 Pulmonary vascular resistance 1.97 (1.45-2.67) <0.001 1.20 (0.88-1.63) 0.225 Pulmonary arterial capacitance 0.27 (0.15-0.48) <0.001 0.49 (0.26-0.92) 0.010 0.44 (0.23-0.85) 0.004 0.47 (0.24-0.93) 0.011 0.49 (0.26-0.93) 0.011 Abstract Figure.
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Affiliation(s)
- Y Chiba
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Iwano
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Murayama
- Hokkaido University Hospital, Diagnostic Center for Sonography, Sapporo, Japan
| | - S Kaga
- Hokkaido University, Faculty of Health Science, Sapporo, Japan
| | - K Motoi
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - S Ishizaka
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - S Tsujinaga
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - K Kamiya
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - T Nagai
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - T Anzai
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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25
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Chiba Y, Iwano H, Kaga S, Shinkawa M, Murayama M, Ohira H, Ishizaka S, Sarashina M, Tsujinaga S, Yokoyama S, Nakabachi M, Nishino H, Okada K, Kamiya K, Nagai T, Anzai T. Influence of advanced pulmonary vascular remodeling on accuracy of echocardiographic parameters of left ventricular filling pressure. Pulm Circ 2021; 11:2045894020983723. [PMID: 33532058 PMCID: PMC7829463 DOI: 10.1177/2045894020983723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/07/2020] [Indexed: 01/20/2023] Open
Abstract
Evaluation of left ventricular filling pressure plays an important role in the
clinical management of pulmonary hypertension. However, the accuracy of
echocardiographic parameters for the determination of left ventricular filling
pressure in the presence of pulmonary vascular lesions has not been fully
addressed. We retrospectively investigated 124 patients with pulmonary
hypertension due to pulmonary vascular lesions (noncardiac pulmonary
hypertension group) and 113 patients with ischemic heart disease (control group)
who underwent right heart catheterization and echocardiography. The noncardiac
pulmonary hypertension group was subdivided into less-advanced and advanced
groups according to median pulmonary vascular resistance. Pulmonary artery wedge
pressure was determined as left ventricular filling pressure. As
echocardiographic parameters of left ventricular filling pressure, the ratio of
early- (E) to late-diastolic transmitral flow velocity (E/A), ratio of E to
early-diastolic mitral annular velocity (E/e′), and left atrial volume index
were measured. In the less-advanced noncardiac pulmonary hypertension and
control groups, positive correlations were observed between pulmonary artery
wedge pressure and late-diastolic transmitral flow velocity
(R = 0.41, P = 0.002 and
R = 0.71, P < 0.001, respectively) and left
atrial volume index (R = 0.53, P < 0.001
and R = 0.41, P < 0.001), whereas in the
advanced noncardiac pulmonary hypertension group, pulmonary artery wedge
pressure was only correlated with left atrial volume index
(R = 0.27, P = 0.032). In the controls, only
pulmonary artery wedge pressure determined E (β = 0.48,
P < 0.001), whereas both pulmonary artery wedge pressure and
pulmonary vascular resistance were independent determinants of E (β = 0.29,
P < 0.001 and β = –0.28, P = 0.001,
respectively) in the noncardiac pulmonary hypertension group. In conclusion, in
the presence of advanced pulmonary vascular lesions, conventional
echocardiographic parameters may not accurately reflect left ventricular filling
pressure. Elevated pulmonary vascular resistance would lower the E, even when
pulmonary artery wedge pressure is elevated, resulting in blunting of
echocardiographic parameters for the detection of elevated left ventricular
filling pressure.
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Affiliation(s)
- Yasuyuki Chiba
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mio Shinkawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroshi Ohira
- Faculty of Medicine and Graduate School of Medicine, Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Miwa Sarashina
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kiwamu Kamiya
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Nagai
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Faculty of Medicine and Graduate School of Medicine, Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
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26
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Chiba Y, Iwano H, Murayama M, Kaga S, Motoi K, Ishizaka S, Tsujinaga S, Tanemura A, Yokoyama S, Nakabachi M, Nishino H, Okada K, Kamiya K, Nagai T, Anzai T. Presence and Relevance of Midsystolic Notching on Right Ventricular Outflow Tract Flow Velocity Envelopes in Pulmonary Hypertension due to Heart Failure. J Am Soc Echocardiogr 2021; 34:690-692.e1. [PMID: 33383123 DOI: 10.1016/j.echo.2020.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Asuka Tanemura
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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27
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Murayama M, Iwano H, Tsujinaga S, Nishino H, Yokoyama S, Nakabachi M, Sarashina M, Ishizaka S, Chiba Y, Okada K, Kaga S, Nishida M, Kamiya K, Nagai T, Anzai T. Simple echocardiographic scoring system to estimate left ventricular filling pressure based on visual assessment of time sequence of mitral and tricuspid valve opening. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In the presence of elevated left ventricular (LV) filling pressure, mitral valve (MV) becomes to open early and precedes tricuspid valve (TV) opening in early diastole. Accordingly, time-delay of right ventricular inflow relative to LV inflow assessed by dual Doppler system was recently reported as a parameter of LV filling pressure. We assumed that visually-assessed time-delay of TV relative to MV opening could be a simple and alternative marker of elevated LV filling pressure.
Purpose
This study aimed to elucidate the clinical usefulness of the 2-dimensional echocardiographic scoring system, Visual assessment of time-difference between Mitral and Tricuspid valve opening (VMT) score, in patients with heart failure (HF).
Methods
We analyzed 119 consecutive HF patients who underwent echocardiography and cardiac catheterization within a day. Elevated LV filling pressure was defined as mean pulmonary arterial wedge pressure (PAWP) ≥15 mmHg. LV diastolic function was graded according to the ASE/EACVI recommendations. Time sequence of opening of MV and TV was visually assessed in the apical 4-chamber view and scored to 3 grades (0: TV opening first, 1: simultaneous, 2: MV opening first). When the inferior vena cava diameter was >21 mm and collapsed <20% during normal respiration, 1 point was added and VMT score was calculated as 4 grades from 0 to 3. We also investigated 113 patients without worsening HF at VMT scoring for cardiac events defined as worsening HF, LV assist device implantation, or cardiac death for 1 year after the echocardiography.
Results
VMT was scored as 0 in 20 patients, 1 in 50 patients, 2 in 37 patients, and 3 in 12 patients. PAWP was elevated in patients with VMT score of 2 and 3 (0: 10±5, 1: 12±4, 2: 22±8, 3: 28±4 mmHg, ANOVA P<0.001) (Figure). In overall patients, VMT≥2 predicted elevated PAWP with accuracy of 86%. When the accuracy was tested in patients with reduced (<40%, HFrEF) and preserved LV ejection fraction (≥40%) respectively, the accuracy was excellent in HFrEF (96% and 77%, respectively). Importantly, VMT≥2 also had good accuracy of 82% for elevated PAWP in 33 patients in whom recommendations usually cannot grade diastolic function due to monophasic LV inflow. In the sequential Cox models, the addition of VMT score to the model including the plasma brain natriuretic peptide (BNP) level and LV diastolic grading improved the predictive power for elevated PAWP (P<0.001). During the follow-up, 20 cardiac events were observed (6 worsening HF, 9 LV assist device implantation and 5 cardiac death). Kaplan-Meier analysis showed that the patients with VMT≥2 were at higher risk of cardiac events than those with VMT≤1 (log-rank test P<0.001) (Figure).
Conclusions
The VMT score was a simple and accurate marker of elevated LV filling pressure and has an incremental benefit over BNP and LV diastolic function grading. Moreover, it could be a novel prognostic marker in patients with HF.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Murayama
- Hokkaido University Hospital, Sapporo, Japan
| | - H Iwano
- Hokkaido University Hospital, Sapporo, Japan
| | - S Tsujinaga
- Hokkaido University Hospital, Sapporo, Japan
| | - H Nishino
- Hokkaido University Hospital, Sapporo, Japan
| | - S Yokoyama
- Hokkaido University Hospital, Sapporo, Japan
| | - M Nakabachi
- Hokkaido University Hospital, Sapporo, Japan
| | - M Sarashina
- Hokkaido University Hospital, Sapporo, Japan
| | - S Ishizaka
- Hokkaido University Hospital, Sapporo, Japan
| | - Y Chiba
- Hokkaido University Hospital, Sapporo, Japan
| | - K Okada
- Hokkaido University, Sapporo, Japan
| | - S Kaga
- Hokkaido University, Sapporo, Japan
| | - M Nishida
- Hokkaido University Hospital, Sapporo, Japan
| | - K Kamiya
- Hokkaido University Hospital, Sapporo, Japan
| | - T Nagai
- Hokkaido University Hospital, Sapporo, Japan
| | - T Anzai
- Hokkaido University Hospital, Sapporo, Japan
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28
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Chiba Y, Kamiya K, Aikawa T, Iwano H, Nagai T, Ishigaki T, Shingu Y, Shimizu A, Matsui Y, Anzai T. Abnormal FDG uptake predicting the instability of thoracic aortic aneurysms. J Nucl Cardiol 2020; 27:1841-1843. [PMID: 31456117 DOI: 10.1007/s12350-019-01871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 08/16/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Yasuyuki Chiba
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan.
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Takahiro Ishigaki
- Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Yasushige Shingu
- Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Ai Shimizu
- Department of Surgical Pathology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Yoshiro Matsui
- Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
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29
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Tsujinaga S, Iwano H, Oshino T, Kadosaka T, Mizuguchi Y, Motoi K, Chiba Y, Koya T, Temma T, Kamiya K, Fukushima A, Koizumi T, Sato T, Takenaka S, Tada A, Ishizaka S, Sarashina M, Omote K, Kamada R, Konishi T, Sato T, Nagai T, Yamashita H, Anzai T. Reversible Cancer Therapeutics-related Cardiac Dysfunction Complicating Intra-cardiac Thrombi. Intern Med 2020; 59:2155-2160. [PMID: 32493855 PMCID: PMC7516330 DOI: 10.2169/internalmedicine.4792-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Epirubicin-based chemotherapy carries a risk of inducing heart failure, although the frequency is rare. Bevacizumab, an anti-vascular endothelial growth factor monoclonal antibody, has recently been widely used in patients with recurrent breast cancer as a first-line chemotherapeutic agent. Heart failure or arterial thromboembolism has been reported as a rare cardiovascular complication of bevacizumab. We herein report a breast cancer patient with reversible cancer therapeutics-related cardiac dysfunction associated with bevacizumab and epirubicin complicating intracardiac thrombi in the left atrium and left ventricle. This case underscores the importance of tailored medical planning according to the individual status in patients receiving anti-cancer therapies.
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Affiliation(s)
- Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Tomohiro Oshino
- Department of Breast Surgery, Hokkaido University Hospital, Japan
| | - Takahide Kadosaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yoshifumi Mizuguchi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Taro Koya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Taro Temma
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Arata Fukushima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takuya Koizumi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Tomoya Sato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Sakae Takenaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Atsushi Tada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Miwa Sarashina
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Kazunori Omote
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Rui Kamada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takao Konishi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takuma Sato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Hiroko Yamashita
- Department of Breast Surgery, Hokkaido University Hospital, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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30
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Chiba Y, Fukushima A, Nakao M, Kobayashi Y, Ishigaki T, Tenma T, Kamiya K, Shingu Y, Ooka T, Matsui Y, Anzai T. Refractory Right Ventricular Failure in a Patient with Emery-Dreifuss Muscular Dystrophy. Intern Med 2020; 59:1277-1281. [PMID: 32074578 PMCID: PMC7303449 DOI: 10.2169/internalmedicine.4113-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 23-year-old man had progressive muscle weakness and Emery-Dreifuss muscular dystrophy (EDMD) due to a LMNA (lamin A/C) mutation. Congestive heart failure diagnosed at 19 years of age. Maximal drug treatment/cardiac resynchronization failed to improve the cardiac function. He was therefore hospitalized due to heart failure. Despite extracorporeal membrane oxygenation, he developed severe right heart dysfunction and died (multiple organ failure). A cardiac lesion's presence determines the prognosis of EDMD. While there are many arrhythmia reports, few reports on heart failure (particularly severe heart failure requiring cardiac transplantation) have been published. Right heart function monitoring and early ventricular-assist device use plus right heart support considering heart transplantation are important.
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Affiliation(s)
- Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Arata Fukushima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
- Asabu Heart and Gastrointestinal Clinic, Japan
| | - Motoki Nakao
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yuta Kobayashi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takahiro Ishigaki
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Taro Tenma
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yasushige Shingu
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Tomonori Ooka
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yoshiro Matsui
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
- Hanaoka Seishu Memorial Cardiovascular Clinic, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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31
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Tsujinaga S, Iwano H, Chiba Y, Ishizaka S, Sarashina M, Murayama M, Nakabachi M, Nishino H, Yokoyama S, Okada K, Kaga S, Anzai T. Heart Failure With Preserved Ejection Fraction vs. Reduced Ejection Fraction - Mechanisms of Ventilatory Inefficiency During Exercise in Heart Failure. Circ Rep 2020; 2:271-279. [PMID: 33693241 PMCID: PMC7925313 DOI: 10.1253/circrep.cr-20-0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Ventilatory inefficiency during exercise assessed using the lowest minute ventilation/carbon dioxide production (V̇E/V̇CO2) ratio was recently proven to be a strong prognostic marker of heart failure (HF) regardless of left ventricular ejection fraction (LVEF). Its physiological background, however, has not been elucidated. Methods and Results: Fifty-seven HF patients underwent cardiopulmonary exercise testing and exercise-stress echocardiography. The lowest V̇E/V̇CO2 ratio was assessed on respiratory gas analysis. Echocardiography was obtained at rest and at peak exercise. LVEF was measured using the method of disks. Cardiac output (CO) and the ratio of transmitral early filling velocity (E) to early diastolic tissue velocity (e') were calculated using the Doppler method. HF patients were divided into preserved EF (HFpEF) and reduced EF (HFrEF) using the LVEF cut-off 40% at rest. Twenty-four patients were classified as HFpEF and 33 as HFrEF. In HFpEF, age (r=0.58), CO (r=-0.44), e' (r=-0.48) and E/e' (r=0.45) during exercise correlated with the lowest V̇E/V̇CO2 ratio (P<0.05 for all). In contrast, in HFrEF, age (r=0.47) and CO (r=-0.54) during exercise, but not e' and E/e', correlated with the lowest V̇E/V̇CO2 ratio. Conclusions: Loss of CO augmentation was associated with ventilatory inefficiency in HF regardless of LVEF, although lung congestion determined ventilatory efficiency only in HFpEF.
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Affiliation(s)
- Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
| | - Miwa Sarashina
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
| | - Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital Sapporo Japan
| | - Masahiro Nakabachi
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital Sapporo Japan
| | - Hisao Nishino
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital Sapporo Japan
| | - Shinobu Yokoyama
- Division of Clinical Laboratory and Transfusion Medicine, Hokkaido University Hospital Sapporo Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University Sapporo Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University Sapporo Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
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32
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Iwano H, Yokoyama S, Kamiya K, Nagai T, Tsujinaga S, Sarashina M, Ishizaka S, Chiba Y, Nakabachi M, Nishino H, Murayama M, Okada K, Kaga S, Anzai T. Significance and prognostic impact of v wave on pulmonary artery pressure in patients with heart failure: beyond the wedge pressure. Heart Vessels 2020; 35:1079-1086. [DOI: 10.1007/s00380-020-01580-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/28/2020] [Indexed: 01/28/2023]
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33
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Tsuboi M, Zenke Y, Chiba Y, Satouchi M, Mitsuoka S, Shimizu J, Daga H, Fujimoto D, Mori M, Aoki T, Sawa T, Omori S, Saka H, Iwamoto Y, Okuno M, Hirashima T, Kashiwabara K, Tachihara M, Yamamoto N, Nakagawa K. Histological type analysis of 10-year follow-up of WJTOG0105: A phase III study comparing second- and third-generation regimens with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz436.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zenke Y, Tsuboi M, Chiba Y, Satouchi M, Mitsuoka S, Shimizu J, Daga H, Fujimoto D, Mori M, Aoki T, Sawa T, Omori S, Saka H, Iwamoto Y, Okuno M, Hirashima T, Kshiwabara K, Tachihara M, Yamamoto N, Nakagawa K. Phase III study comparing second- and third-generation regimens with concurrent thoracic radiotherapy in patients with unresectable stage III non-small cell lung cancer: 10-year follow-up of West Japan thoracic oncology group WJTOG0105. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz259.001] [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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Murayama M, Iwano H, Tsujinaga S, Sarashina M, Ishizaka S, Chiba Y, Nakabachi M, Yokoyama S, Nishino H, Okada K, Kaga S, Shibuya H, Nishida M, Anzai T. Tricuspid regurgitation occurring in the early-diastolic phase in a case of heart failure: Insights from echocardiographic and invasive hemodynamic findings. Echocardiography 2019; 36:1771-1775. [PMID: 31424109 DOI: 10.1111/echo.14458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/24/2019] [Accepted: 07/27/2019] [Indexed: 11/30/2022] Open
Abstract
Although the presence and physiological significance of late-diastolic tricuspid regurgitation (TR) have been reported, those in TR occurring in early diastole have not been well known. We herein first presented a case of heart failure due to dilated cardiomyopathy showing functional TR occurring in the early-diastolic phase in whom the mechanism for its genesis could be precisely assessed from echocardiographic findings and intra-cardiac pressure recordings.
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Affiliation(s)
- Michito Murayama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.,Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Miwa Sarashina
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masahiro Nakabachi
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Shinobu Yokoyama
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Hisao Nishino
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Kazunori Okada
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Hitoshi Shibuya
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Mutsumi Nishida
- Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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36
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Chiba Y, Yonezawa K, Himeno M, Yukino M, Shimazu K, Imagawa S, Komuro K, Kimura N, Anzai T, Anzai T. Left ventricular noncompaction with intractable heart failure responsive to empagliflozin. J Cardiol Cases 2018; 18:192-196. [DOI: 10.1016/j.jccase.2018.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 01/14/2023] Open
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Iwami D, Miura M, Chiba Y, Ota M, Matsumoto T, Hotta K, Sasaki H, Hirose T, Harada H, Shinohara N. Optimal Settings for Double Filtration Plasmapheresis With Targeted Removal Rate of Preexisting Antibody in Antibody-Incompatible Kidney Transplant. Transplant Proc 2018; 50:3478-3482. [DOI: 10.1016/j.transproceed.2018.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/23/2018] [Indexed: 11/24/2022]
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38
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He B, Chiba Y, Li H, de Vega S, Tanaka K, Yoshizaki K, Ishijima M, Yuasa K, Ishikawa M, Rhodes C, Sakai K, Zhang P, Fukumoto S, Zhou X, Yamada Y. Identification of the Novel Tooth-Specific Transcription Factor AmeloD. J Dent Res 2018; 98:234-241. [PMID: 30426815 DOI: 10.1177/0022034518808254] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Basic-helix-loop-helix (bHLH) transcription factors play an important role in various organs' development; however, a tooth-specific bHLH factor has not been reported. In this study, we identified a novel tooth-specific bHLH transcription factor, which we named AmeloD, by screening a tooth germ complementary DNA (cDNA) library using a yeast 2-hybrid system. AmeloD was mapped onto the mouse chromosome 1q32. Phylogenetic analysis showed that AmeloD belongs to the achaete-scute complex-like ( ASCL) gene family and is a homologue of ASCL5. AmeloD was uniquely expressed in the inner enamel epithelium (IEE), but its expression was suppressed after IEE cell differentiation into ameloblasts. Furthermore, AmeloD expression showed an inverse expression pattern with the epithelial cell-specific cell-cell adhesion molecule E-cadherin in the dental epithelium. Overexpression of AmeloD in dental epithelial cell line CLDE cells resulted in E-cadherin suppression. We found that AmeloD bound to E-box cis-regulatory elements in the proximal promoter region of the E-cadherin gene. These results reveal that AmeloD functions as a suppressor of E-cadherin transcription in IEE cells. Our study demonstrated that AmeloD is a novel tooth-specific bHLH transcription factor that may regulate tooth development through the suppression of E-cadherin in IEE cells.
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Affiliation(s)
- B He
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,2 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,3 Protein Section, Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Y Chiba
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,4 Division of Pediatric Dentistry, Department of Oral Health and Development Sciences, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - H Li
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,5 Lifecare Acupuncture and Alternative Medicine Center, Colleyville, TX, USA
| | - S de Vega
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,6 Department of Pathophysiology for Locomotive and Neoplastic Diseases, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - K Tanaka
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,7 Department of Orthopedic Surgery, Oita University, Oita, Japan
| | - K Yoshizaki
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,8 Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - M Ishijima
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,9 Department of Medicine for Orthopedics and Motor Organ, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - K Yuasa
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,10 Pediatric Dentistry, St. Mary's Hospital, Kurume, Japan
| | - M Ishikawa
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,11 Division of Operative Dentistry, Laboratory of Cell and Department of Restorative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - C Rhodes
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - K Sakai
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,12 Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - P Zhang
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - S Fukumoto
- 4 Division of Pediatric Dentistry, Department of Oral Health and Development Sciences, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - X Zhou
- 2 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Yamada
- 1 Molecular Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
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Onuki T, Gokan T, Nakamura Y, Okada N, Chiba Y, Kawasaki S, Onishi Y, Munetsugu Y, Ito H, Shoji M, Watanabe N, Minoura Y, Adachi T, Kawamura M, Kobayashi Y. P4833Risk predictors of supraventricular tachycardia and bradycardia necessitating therapy in patients with unexplained syncope receiving implantable loop recorder. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4833] [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: 11/12/2022] Open
Affiliation(s)
- T Onuki
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - T Gokan
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Y Nakamura
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - N Okada
- Showa University Hospital, Department of hospital pharmaceutics, Tokyo, Japan
| | - Y Chiba
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - S Kawasaki
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Y Onishi
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Y Munetsugu
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - H Ito
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - M Shoji
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - N Watanabe
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Y Minoura
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - T Adachi
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - M Kawamura
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Y Kobayashi
- Showa University Hospital, Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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Haratani K, Hayashi H, Tanaka T, Kaneda H, Togashi Y, Sakai K, Hayashi K, Tomida S, Chiba Y, Yonesaka K, Nonagase Y, Takahama T, Tanizaki J, Tanaka K, Yoshida T, Tanimura K, Takeda M, Yoshioka H, Ishida T, Mitsudomi T, Nishio K, Nakagawa K. Tumor immune microenvironment and nivolumab efficacy in EGFR mutation-positive non-small-cell lung cancer based on T790M status after disease progression during EGFR-TKI treatment. Ann Oncol 2018; 28:1532-1539. [PMID: 28407039 DOI: 10.1093/annonc/mdx183] [Citation(s) in RCA: 223] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Indexed: 12/22/2022] Open
Abstract
Background The efficacy of programmed death-1 blockade in epidermal growth factor receptor gene (EGFR) mutation-positive non-small-cell lung cancer (NSCLC) patients with different mechanisms of acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) is unknown. We retrospectively evaluated nivolumab efficacy and immune-related factors in such patients according to their status for the T790M resistance mutation of EGFR. Patients and methods We identified 25 patients with EGFR mutation-positive NSCLC who were treated with nivolumab after disease progression during EGFR-TKI treatment (cohort A). Programmed death-ligand 1 (PD-L1) expression and tumor-infiltrating lymphocyte (TIL) density in tumor specimens obtained after acquisition of EGFR-TKI resistance were determined by immunohistochemistry. Whole-exome sequencing of tumor DNA was carried out to identify gene alterations. The relation of T790M status to PD-L1 expression or TIL density was also examined in an independent cohort of 60 patients (cohort B). Results In cohort A, median progression-free survival (PFS) was 2.1 and 1.3 months for T790M-negative and T790M-positive patients, respectively (P = 0.099; hazard ratio of 0.48 with a 95% confidence interval of 0.20-1.24). Median PFS was 2.1 and 1.3 months for patients with a PD-L1 expression level of ≥1% or <1%, respectively (P = 0.084; hazard ratio of 0.37, 95% confidence interval of 0.10-1.21). PFS tended to increase as the PD-L1 expression level increased with cutoff values of ≥10% and ≥50%. The proportion of tumors with a PD-L1 level of ≥10% or ≥50% was higher among T790M-negative patients than among T790M-positive patients of both cohorts A and B. Nivolumab responders had a significantly higher CD8+ TIL density and nonsynonymous mutation burden. Conclusion T790M-negative patients with EGFR mutation-positive NSCLC are more likely to benefit from nivolumab after EGFR-TKI treatment, possibly as a result of a higher PD-L1 expression level, than are T790M-positive patients.
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Affiliation(s)
- K Haratani
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - H Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - T Tanaka
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki
| | - H Kaneda
- Department of Medical Oncology, Kishiwada City Hospital, Kishiwada
| | - Y Togashi
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama.,Division of Cancer Immunology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa
| | - K Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - K Hayashi
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - S Tomida
- Department of Biobank, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama
| | - Y Chiba
- Clinical Research Center, Kindai University Hospital, Osaka-Sayama
| | - K Yonesaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - Y Nonagase
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - T Takahama
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - J Tanizaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - K Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - T Yoshida
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - K Tanimura
- Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada
| | - M Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - H Yoshioka
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki
| | - T Ishida
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki
| | - T Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - K Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
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Tanizaki J, Haratani K, Hayashi H, Chiba Y, Yonesaka K, Kudo K, Kaneda H, Hasegawa Y, Tanaka K, Takeda M, Nakagawa K. P1.07-010 Peripheral Blood Biomarkers Associated with Clinical Outcome in Non–Small Cell Lung Cancer Patients Treated with Nivolumab. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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42
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Kimura T, Kawaguchi T, Kudoh S, Chiba Y, Yoshioka H, Watanabe K, Kijima T, Kogure Y, Oguri T, Yoshimura N, Niwa T, Kasai T, Hayashi H, Ono A, Tanaka H, Yano S, Nakamura S, Yamamoto N, Nakanishi Y, Nakagawa K. P2.03-008 Phase I/II Study of Intermitted Erlotinib in Combination with Docetaxel in Patients with Recurrent NSCLC with Wild-Type EGFR: WJOG 4708L. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1259] [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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43
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Komuro K, Shimazu K, Chiba Y, Yukino M, Imagawa S, Anzai T, Yonezawa K. Alternation of Renal Perfusion by Ultrafiltration in a Refractory Heart Failure Patient as Assessed by Contrast-enhanced Ultrasonography. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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44
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Ozawa T, Chiba Y, Kim Y, Mashiko T, Tada M, Koide R, Shimazaki H, Matsuura T, Fujimoto S. Trigeminal herpes zoster with a long-segmental enhanced lesion of the spinal trigeminal nucleus and tract on magnetic resonance imaging. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3400] [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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Abstract
There are few data regarding the role of probiotics as a dietary intervention in the management of obesity in children. An open prospective examination was conducted to clarify the effects of Lactobacillus casei strain Shirota (LcS)-containing beverages in obese children. We compared the intestinal microbiota and organic acid levels between 12 obese (average age, 10.8 years; body mass index (BMI) Z score, 2.7±1.7) and 22 control children(average age, 8.5 years; BMI Z score, 0.1±0.7), and pre- and post-intervention in the obese children. The obese group underwent diet and exercise therapy for 6 months and then were given an LcS beverage daily for another 6 months and the body weight and serological markers were monitored. Significant reductions in the faecal concentrations of Bifidobacterium (obese group, 7.9±1.5 vs non-obese group, 9.8±0.5 Log10cells/g; P<0.01) along with a significant decline in the Bacteroides fragilis group, Atopobium cluster and Lactobacillus gasseri subgroup, and acetic acid (obese group, 45.1±16.9 vs non-obese group, 57.9±17.6 μmol/g; P<0.05) were observed in the obese group at baseline. A significant decline in body weight (-2.9±4.6%; P<0.05) and an elevation in the high density lipoprotein cholesterol level (+11.1±17.6%; P<0.05) were observed 6 months after ingestion of the LcS beverage compared to baseline. Furthermore, a significant increase in the faecal concentration of Bifidobacterium (7.0±1.2 before ingestion vs 9.1±1.2 Log10cells/g after ingestion; P<0.01) and an apparent increase in the acetic acid concentration (7.0±1.2 before ingestion vs 9.1±1.2 Log10cells/g after ingestion; P<0.01) were observed 6 months after ingestion. LcS contributed to weight loss while also improving the lipid metabolism in obese children via a significant increase in the faecal Bifidobacterium numbers and the acetic acid concentration.
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Affiliation(s)
- S. Nagata
- Department of Paediatrics, School of Medicine, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
- Probiotics Research Laboratory, Juntendo University Postgraduate School, 3rd floor, 2-9-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Y. Chiba
- Department of Paediatrics, School of Medicine, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
- Probiotics Research Laboratory, Juntendo University Postgraduate School, 3rd floor, 2-9-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - C. Wang
- Probiotics Research Laboratory, Juntendo University Postgraduate School, 3rd floor, 2-9-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Y. Yamashiro
- Probiotics Research Laboratory, Juntendo University Postgraduate School, 3rd floor, 2-9-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Chiba Y, Phillips OR, Onopa AK, Joshi SH, Grau JR, Takenoshita S, Nishino S, Singh MK. 0944 SUPERFICIAL WHITE MATTER AND CORTICAL THICKNESS ASSOCIATED WITH PARASOMNIAS IN CHILDREN. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.943] [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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47
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Chiba Y, Phillips OR, Onopa AK, Takenoshita S, Nishino S, Singh MK. 0943 DEMOGRAPHICAL AND CLINICAL FACTORS ASSOCIATED WITH PARASOMNIA IN CHILDREN: SECONDARY DATA ANALYSIS FROM THE PHILADELPHIA NEURODEVELOPMENTAL COHORT. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.942] [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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48
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Chiba Y, Ishiakwa T, Mastuo N, Kawasaki N, Watanabe Y, Ito K, Kato J, Nishikawa K, Hama H, Kawakubo T. MON-P198: The Relationship of Liver Function and Nutritional Characteristics under Total Parenteral Nutrition with Oil Emulsion. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30832-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Takano K, Kinoshita M, Arita H, Okita Y, Chiba Y, Kagawa N, Fujimoto Y, Kishima H, Kanemura Y, Nonaka M, Nakajima S, Shimosegawa E, Hatazawa J, Hashimoto N, Yoshimine T. Diagnostic and Prognostic Value of 11C-Methionine PET for Nonenhancing Gliomas. AJNR Am J Neuroradiol 2015; 37:44-50. [PMID: 26381556 DOI: 10.3174/ajnr.a4460] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/07/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Noninvasive radiologic evaluation of glioma can facilitate correct diagnosis and detection of malignant transformation. Although positron-emission tomography is considered valuable in the care of patients with gliomas, (18)F-fluorodeoxyglucose and (11)C-methionine have reportedly shown ambiguous results in terms of grading and prognostication. The present study compared the diagnostic and prognostic capabilities of diffusion tensor imaging, FDG, and (11)C-methionine PET in nonenhancing gliomas. MATERIALS AND METHODS Thirty-five consecutive newly diagnosed, histologically confirmed nonenhancing gliomas that underwent both FDG and (11)C-methionine PET were retrospectively investigated (23 grade II and 12 grade III gliomas). Apparent diffusion coefficient, fractional anisotropy, and tumor-to-normal tissue ratios of both FDG and (11)C-methionine PET were compared between grade II and III gliomas. Prognostic values of these parameters were also tested by using progression-free survival. RESULTS Grade III gliomas showed significantly higher average tumor-to-normal tissue and maximum tumor2-to-normal tissue than grade II gliomas in (11)C-methionine (P = .013, P = .0017, respectively), but not in FDG-PET imaging. There was no significant difference in average ADC, minimum ADC, average fractional anisotropy, and maximum fractional anisotropy. (11)C-methionine PET maximum tumor-to-normal tissue ratio of 2.0 was most suitable for detecting grade III gliomas among nonenhancing gliomas (sensitivity, 83.3%; specificity, 73.9%). Among patients not receiving any adjuvant therapy, median progression-free survival was 64.2 ± 7.2 months in patients with maximum tumor-to-normal tissue ratio of <2.0 for (11)C-methionine PET and 18.6 ± 6.9 months in patients with maximum tumor-to-normal tissue ratio of >2.0 (P = .0044). CONCLUSIONS (11)C-methionine PET holds promise for World Health Organization grading and could offer a prognostic imaging biomarker for nonenhancing gliomas.
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Affiliation(s)
- K Takano
- From the Department of Neurosurgery (K.T., M.K.), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
| | - M Kinoshita
- From the Department of Neurosurgery (K.T., M.K.), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
| | - H Arita
- Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
| | - Y Okita
- Department of Neurosurgery (Y.O., Y.K., M.N., S.N.)
| | - Y Chiba
- Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.) Department of Neurosurgery (Y.C.), Kansai Rosai Hospital, Itami, Japan
| | - N Kagawa
- Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
| | - Y Fujimoto
- Department of Neurosurgery (Y.F.), Osaka Neurological Institute, Osaka, Japan
| | - H Kishima
- Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
| | - Y Kanemura
- Department of Neurosurgery (Y.O., Y.K., M.N., S.N.) Division of Regenerative Medicine (Y.K.), Institute for Clinical Research, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - M Nonaka
- Department of Neurosurgery (Y.O., Y.K., M.N., S.N.) Department of Neurosurgery (M.N.), Kansai Medical University, Osaka, Japan
| | - S Nakajima
- Department of Neurosurgery (Y.O., Y.K., M.N., S.N.)
| | - E Shimosegawa
- Nuclear Medicine and Tracer Kinetics (E.S., J.H.), Osaka University Graduate School of Medicine, Osaka, Japan
| | - J Hatazawa
- Nuclear Medicine and Tracer Kinetics (E.S., J.H.), Osaka University Graduate School of Medicine, Osaka, Japan
| | - N Hashimoto
- Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
| | - T Yoshimine
- Departments of Neurosurgery (K.T., M.K., H.A., Y.C., N.K., H.K., N.H., T.Y.)
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Hashimoto N, Chiba Y, Kijima N, Arita H, Kinoshita M, Kagawa N, Tsuboi A, Oka Y, Oji Y, Sugiyama H, Yoshimine T. IT-12 * WT1 PEPTIDE VACCINATION AGAINST GLIOMAS; COMBINATION WITH TEMOZOLOMIDE, BIOMARKERS AND IMMUNOLOGICAL RESPONSE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou258.10] [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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