1
|
Katano S, Yano T, Yamano K, Numazawa R, Nagaoka R, Honma S, Fujisawa Y, Ohori K, Kouzu H, Kunihara H, Fujisaki H, Katayose M, Hashimoto A, Furuhashi M. Associations between in-hospital daily protein intake and adverse clinical outcomes in older patients with heart failure. ESC Heart Fail 2024. [PMID: 38705583 DOI: 10.1002/ehf2.14812] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/28/2024] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
AIMS The adverse effects of low daily protein intake (DPI) on clinical outcomes in patients with heart failure (HF) are known; however, an optimal DPI to predict event adverse outcomes remains undetermined. Moreover, whether protein restriction therapy for chronic kidney disease is applicable in patients with HF and renal dysfunction remains unclear. METHODS AND RESULTS In this single-centre, ambispective cohort study, we included 405 patients with HF aged ≥65 years (mean age, 78.6 ± 7.5 years; 50% women). DPI was estimated from consumption over three consecutive days before discharge and normalized relative to the ideal body weight [IBW, 22 kg/m2 × height (m)2]. The primary outcome was a composite of all-cause mortality and HF-related readmission within the 2 year post-discharge period. RESULTS During an average follow-up period of 1.49 ± 0.74 years, 100 patients experienced composite events. Kaplan-Meier survival curves revealed a significantly lower composite event-free rate in patients within the lowest quartile of DPI than in the upper quartiles (log-rank test, P = 0.02). A multivariate Cox proportional hazards analysis after adjusting for established prognostic markers and non-proteogenic energy intake revealed that patients in the lowest DPI quartile faced a two-fold higher risk of composite events than those in the highest quartile [hazard ratio (HR), 2.03; 95% confidence interval (CI), 1.08-3.82; P = 0.03]. The composite event risk linearly increased as DPI decreased (P for nonlinearity = 0.90), with each standard deviation (0.26 g/kg IBW/day) decrease in DPI associated with a 32% increase in composite event risk (HR, 1.32; 95% CI, 1.10-1.71; P = 0.04). There was significant heterogeneity in the effect of DPI, with the possible disadvantage of lower DPI in patients with HF with cystatin C-based estimated glomerular filtration rate <30 mL/min/1.73 m2. The cutoff value of DPI for predicting the occurrence of composite events calculated from the Youden index was 1.12 g/kg IBW/day. Incorporating a DPI < 1.12 g/kg IBW/day into the baseline model significantly improved the prediction of post-discharge composite events (continuous net reclassification improvement, 0.294; 95% CI, 0.072-0.516; P = 0.01). CONCLUSIONS Lower DPI during hospitalization is associated with an increased risk of mortality and HF readmission independent of non-proteogenic energy intake, and the possible optimal DPI for predicting adverse clinical outcomes is >1.12 g/kg IBW/day in older patients with HF. Caution is warranted when protein restriction therapy is administered to older patients with HF and renal dysfunction.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Suguru Honma
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
- Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Hokkaido, Japan
| | - Yusuke Fujisawa
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Hokkaido, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Hayato Kunihara
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Hiroya Fujisaki
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| |
Collapse
|
2
|
Nagaoka R, Katano S, Yano T, Numazawa R, Yamano K, Fujisawa Y, Honma S, Kamoda T, Sato K, Kouzu H, Ohori K, Katayose M, Hashimoto A, Furuhashi M. Optimal serum 25-hydroxyvitamin D level to prevent sarcopenia in patients with heart failure: Insights from a dose-response relationship. Nutr Metab Cardiovasc Dis 2024; 34:606-617. [PMID: 38000999 DOI: 10.1016/j.numecd.2023.10.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/09/2023] [Accepted: 10/04/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS Low serum 25-hydroxyvitamin D (25 [OH]D) levels have been associated with sarcopenia, frailty, and risk of cardiovascular disease, whereas high levels negatively impact clinical outcomes. We determined optimal serum 25(OH)D concentrations to minimise the probability of sarcopenia in patients with heart failure (HF) by examining the dose-dependent relationship between serum 25(OH)D levels and sarcopenia. METHODS AND RESULTS We enrolled 461 consecutive patients with HF (mean age, 72 ± 15 years; 39% female) who underwent dual-energy X-ray absorptiometry. Serum 25(OH)D levels were measured using a chemiluminescence immunoassay. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia criteria. Overall, 49% of enrolled patients were diagnosed with sarcopenia. Adjusted logistic regression with restricted cubic spline function revealed that the odds ratio (OR) of sarcopenia increased in patients with HF presenting serum 25(OH)D levels <14.6 ng/ml or > 31.4 ng/ml, reaching the lowest OR at ∼20 ng/ml. Multivariate logistic regression revealed that a serum 25(OH)D level below 14.6 ng/mL was independently associated with the presence of sarcopenia (adjusted OR: 2.16, 95% confidence interval [CI]: 1.24-3.78). Incorporating serum 25(OH)D levels <14.6 ng/ml, but not <20.0 ng/ml, in the baseline model improved continuous net reclassification (0.334, 95% CI: 0.122-0.546) in patients with HF. CONCLUSION A U-shaped relationship exists between serum 25(OH)D levels and sarcopenia probability in patients with HF. Maintaining serum 25(OH)D levels between 14.6 and 31.4 ng/ml may help prevent sarcopenia in patients with HF.
Collapse
Affiliation(s)
- Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan; Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan.
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Suguru Honma
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan; Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Japan
| | - Tatsuki Kamoda
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Kohei Sato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
3
|
Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
Collapse
|
4
|
Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, Emberson JR, Preiss D, Ng SYA, Roddick AJ, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Massey D, Landray MJ, Baigent C, Haynes R, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
Collapse
|
5
|
Numazawa R, Katano S, Yano T, Nagaoka R, Ohori K, Kouzu H, Honma S, Fujisawa Y, Yamano K, Osanami A, Koyama M, Hashimoto A, Furuhashi M. Independent Link Between Use of Mineralocorticoid Receptor Antagonists and Muscle Wasting in Heart Failure Patients Not Receiving Renin-Angiotensin System Inhibitors. Circ J 2023; 88:10-19. [PMID: 37813601 DOI: 10.1253/circj.cj-23-0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
BACKGROUND The renin-angiotensin system (RAS) activation is a proposed mechanism of muscle wasting (MW i.e., reduction in muscle mass). Although we reported that RAS inhibitors (RASIs) were associated with lower prevalence of MW in heart failure (HF) patients, the relationship between mineralocorticoid receptor (MR) signaling and MW has not been analyzed.Methods and Results: We analyzed data from 320 consecutive Japanese HF patients who underwent dual-energy X-ray absorptiometry scanning for assessment of appendicular skeletal muscle mass index (ASMI). In multiple linear regression analyses, plasma renin activity (PRA) was negatively correlated with ASMI in patients not receiving RASIs, indicating an untoward role of the RAS in MW. Results of analysis of covariance in which risk factors of MW served as covariates showed that use of MR antagonists (MRAs) was associated with lower ASMI and higher PRA in the non-RASIs group. The close relationship between use of MRAs and lower ASMI or higher PRA in the non-RASIs group was confirmed in analyses in which the differences in baseline characteristics between users and non-users of MRAs were minimized by using an inverse probability of treatment weighting. CONCLUSIONS Increased PRA by MR inhibition without concurrent RAS inhibition, possibly contributing to upregulation of angiotensin II signaling, may be associated with reduction in muscle mass.
Collapse
Affiliation(s)
- Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
- Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Suguru Honma
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science
- Department of Rehabilitation, Sapporo Cardiovascular Hospital
| | - Yusuke Fujisawa
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital
| | - Kotaro Yamano
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science
- Department of Rehabilitation, Teine Keijinkai Hospital
| | - Arata Osanami
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
- Department of Public Health, Sapporo Medical University School of Medicine
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
- Department of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| |
Collapse
|
6
|
Doi T, Nakata T, Tsuzuki T, Mita T, Nagahara D, Yuda S, Hashimoto A. Decreased cholinesterase level combined with renal dysfunction and sympathetic denervation associated with increased cardiac mortality in systolic heart failure. Front Cardiovasc Med 2023; 10:1131282. [PMID: 37840949 PMCID: PMC10570798 DOI: 10.3389/fcvm.2023.1131282] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Cardiac mortality in patients with heart failure (HF) is likely to be aggravated by malnutrition, assessed by serum cholinesterase (ChE) level, as well as by kidney dysfunction or impairment of cardiac sympathetic denervation. Their prognostic interactions, however, have not been determined. Methods A total of 991 systolic HF patients were enrolled in our HF database following clinical evaluation including evaluation of the nutrition state and assessment of standardized heart-to-mediastinum ratio (sHMR) of iodine-123-labeled meta-iodobenzylguanidine activity. Patients were followed up for an average of 43 months with the primary endpoint of fatal cardiac events (CEs). Results The CE patient group had a lower level of ChE, lower estimated glomerular filtration rate (eGFR) and lower late sHMR than those in the non-CE patient group. A five-parameter model with the addition of serum ChE selected in the multivariate logistic analysis (model 2) significantly increased the AUC predicting risk of cardiac events compared with a four-parameter model without serum ChE (model 1), and net reclassification analysis also suggested that the model with the addition of serum cholinesterase significantly improved cardiac event prediction. Moreover, in overall multivariate Cox hazard analysis, serum ChE, eGFR and late sHMR were identified to be significant prognostic determinants. HF patients with two or all of the prognostic variables of serum ChE < 230 U/L, eGFR < 48.8 ml/min/1.73 m2 and late sHMR < 1.90 had significantly and incrementally increased CE rates compared to those in HF patients with none or only one of the prognostic variables. Conclusion Decreases in cholinesterase level and kidney function further increase cardiac mortality risk in HF patients with impairment of cardiac sympathetic innervation.
Collapse
Affiliation(s)
- Takahiro Doi
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Tomoaki Nakata
- Department of Cardiology, Hakodate Goryokaku Hospital, Hakodate, Japan
| | - Taro Tsuzuki
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Tomohiro Mita
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Daigo Nagahara
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Satoshi Yuda
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiology, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo, Japan
| |
Collapse
|
7
|
Numazawa R, Katano S, Yano T, Koyama M, Nagaoka R, Fujisawa Y, Yamano K, Honma S, Ohori K, Kouzu H, Katayose M, Furuhashi M, Tsuchihashi K, Hashimoto A. Development and validation of osteoporosis risk assessment score, ORAS, in heart failure patients: comparison with the Osteoporosis Self-Assessment Tool for Asians (OSTA). Eur J Cardiovasc Nurs 2023:zvad089. [PMID: 37632768 DOI: 10.1093/eurjcn/zvad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 08/28/2023]
Abstract
AIM Osteoporosis is prevalent and is associated with poor prognosis in heart failure (HF) patients. However, bone mineral density (BMD) measurement by a dual-energy X-ray absorptiometry (DEXA) scan is not always available in a daily clinical setting and large-scale population-based studies. METHODS A single-center, cross-sectional observational study was conducted with 387 patients (median age: 77 years [interquartile range: 68 to 83 years]; 37% women). BMDs were measured by DEXA scans, and osteoporosis was diagnosed as ≤ -2.5 standard deviation of the BMDs in healthy young adults. Osteoporosis risk assessment score (ORAS) was developed using significant predictors from a logistic regression model for osteoporosis and was subsequently validated. RESULTS Osteoporosis was found in 103 (27%) of the 387 HF patients. Multivariate logistic regression analyses yielded the ORAS based on sex, BMI, handgrip strength, and anti-coagulant therapy utilization. The C-index of ORAS in the developmental set (0.796, 95% confidence interval: 0.747 to 0.845) was similar to the bootstrap validation of the prediction model (0.784), and tended to be higher than that of the Osteoporosis Self-Assessment Tool for Asians (OSTA). A nomogram of ORAS, established on the basis of the final logistic regression model, demonstrated 100% sensitivity at the lowest score (35 points), with an optimal cutoff point of 127 points, yielding 85% sensitivity and 62% specificity. CONCLUSIONS ORAS exhibits superior predictive performance to OSTA in predicting osteoporosis in HF patients, establishing itself as a valuable tool for early detection in both daily clinical practice and large-scale population-based studies.
Collapse
Affiliation(s)
- Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Suguru Honma
- Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazufumi Tsuchihashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Sapporo Medical University Hospital, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
8
|
Katano S, Yano T, Numazawa R, Nagaoka R, Yamano K, Fujisawa Y, Honma S, Watanabe A, Ohori K, Kouzu H, Fujito T, Ishigo T, Kunihara H, Fujisaki H, Katayose M, Hashimoto A, Furuhashi M. Impact of Radar Chart-Based Information Sharing in a Multidisciplinary Team on In-Hospital Outcomes and Prognosis in Older Patients With Heart Failure. Circ Rep 2023; 5:271-281. [PMID: 37431515 PMCID: PMC10329901 DOI: 10.1253/circrep.cr-23-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 07/12/2023] Open
Abstract
Background: A multidisciplinary team (MDT) approach is crucial for managing older patients with heart failure (HF). We investigated the impact on clinical outcomes of implementation of a conference sheet (CS) with an 8-component radar chart for visualizing and sharing patient information. Methods and Results: We enrolled 395 older inpatients with HF (median age 79 years [interquartile range 72-85 years]; 47% women) and divided them into 2 groups according to CS implementation: a non-CS group (before CS implementation; n=145) and a CS group (after CS implementation; n=250). The clinical characteristics of patients in the CS group were assessed using 8 scales (physical function, functional status, comorbidities, nutritional status, medication adherence, cognitive function, HF knowledge level, and home care level). In-hospital outcomes (Short Physical Performance Battery, Barthel Index score, length of hospital stay, and hospital transfer rate) were significantly better in the CS than non-CS group. During the follow-up period, 112 patients experienced composite events (all-cause death or admission for HF). Inverse probabilities of treatment-weighted Cox proportional hazard analyses demonstrated a 39% reduction in risk of composite events in the CS group (adjusted hazard ratio 0.65; 95% confidence interval 0.43-0.97). Conclusions: Radar chart-based information sharing among MDT members is associated with superior in-hospital clinical outcomes and a favorable prognosis.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science Sapporo Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University Sapporo Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
| | - Kotaro Yamano
- Department of Rehabilitation, Teine Keijinkai Hospital Sapporo Japan
| | - Yusuke Fujisawa
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital Asahikawa Japan
| | - Suguru Honma
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science Sapporo Japan
- Department of Rehabilitation, Sapporo Cardiovascular Hospital Sapporo Japan
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital Sapporo Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital Sapporo Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital Sapporo Japan
| | - Hayato Kunihara
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
| | - Hiroya Fujisaki
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science Sapporo Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine Sapporo Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| |
Collapse
|
9
|
Yoshida S, Nakata T, Naya M, Momose M, Taniguchi Y, Fukushima Y, Moroi M, Okizaki A, Hashimoto A, Kiko T, Hida S, Takehana K, Nakajima K. Prognostic Implications of Sarcoidosis Granulomas - Insights From the Multicenter Registry, the Japanese Cardiac Sarcoidosis Prognostic Study. Circ Rep 2023; 5:252-259. [PMID: 37305793 PMCID: PMC10247353 DOI: 10.1253/circrep.cr-23-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 06/13/2023] Open
Abstract
Background: Definitions of cardiac sarcoidosis (CS) differ among guidelines. Any systemic histological finding of CS is essential for the diagnosis of CS in the 2014 Heart Rhythm Society statement, but not necessary in the Japanese Circulation Society 2016 guidelines. This study aimed to reveal the differences in outcomes by comparing 2 groups, namely CS patients with or without systemic histologically proven granuloma. Methods and Results: This study retrospectively included 231 consecutive patients with CS. CS with granulomas in ≥1 organs was diagnosed in 131 patients (Group G), whereas CS without any granulomas was diagnosed in the remaining 100 patients (Group NG). Left ventricular ejection fraction (LVEF) was significantly reduced in Group NG compared with Group G (44±13% vs. 50±16%, respectively; P=0.001). However, Kaplan-Meier curves showed that major adverse cardiovascular events (MACE)-free survival outcomes were comparable between the 2 groups (log-rank P=0.167). Univariable analyses showed that significant predictors of MACE were Groups G/NG, histological CS, LVEF, and high B-type natriuretic peptide (BNP) or N-terminal pro BNP concentrations, but none of these was significant in multivariable analyses. Conclusions: Overall risks of MACE were similar between the 2 groups despite different manifestations in cardiac dysfunction. The data not only validate the prognostic value of non-invasive diagnosis of CS, but also show the need for careful observation and therapeutic strategy in patients with CS without any granuloma.
Collapse
Affiliation(s)
- Shohei Yoshida
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | | | - Masanao Naya
- Department of Cardiology, Hokkaido University Hospital Sapporo Japan
| | - Mitsuru Momose
- Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Woman's Medical University Tokyo Japan
| | - Yasuyo Taniguchi
- Department of General Medicine, Hyogo Harima-Himeji General Hospital Himeji Japan
| | | | - Masao Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center Tokyo Japan
| | - Atsutaka Okizaki
- Department of Radiology, Asahikawa Medical University Asahikawa Japan
| | | | - Takatoyo Kiko
- Department of Cardiology, Fukushima Medical University Fukushima Japan
| | - Satoshi Hida
- Department of Cardiology, Tokyo Medical University Tokyo Japan
| | - Kazuya Takehana
- Division of Cardiology, Department of Medicine II, Kansai Medical University Hirakata Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Kanazawa Japan
| |
Collapse
|
10
|
Watanabe A, Katano S, Yano T, Nagaoka R, Numazawa R, Honma S, Yamano K, Fujisawa Y, Ohori K, Kouzu H, Ishigo T, Katayose M, Hashimoto A, Furuhashi M. Loss of perceived social role, an index of social frailty, is an independent predictor of future adverse events in hospitalized patients with heart failure. Front Cardiovasc Med 2022; 9:1051570. [PMID: 36606289 PMCID: PMC9807608 DOI: 10.3389/fcvm.2022.1051570] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
Aims Although the impact of physical frailty on prognosis and the effect of cardiac rehabilitation in HF patients has been well established, data for the prognostic impact of social frailty (SF) in HF patients are limited. In addition, the relative importance of each SF domain in clinical outcomes remains unclear. We aimed to get a new insight into the associations of SF with clinical outcomes in elderly hospitalized HF patients. Methods A single-center, retrospective cohort study was conducted using data from 310 in-hospital HF patients aged ≥ 65 years (mean age of 78 ± 8 years; 49% women). Makizako's five questions, a self-reported questionnaire, were used to define SF. The primary outcome was composite events defined by all-cause death and cardiovascular events. Results Of the 310 elderly HF patients, 188 patients (61%) had SF. Seventy-five patients (24%) had composite events during a mean follow-up period of 1.93 ± 0.91 years. Kaplan-Meier curves showed that patients with SF had a significantly higher composite event rate than patients without SF. In multivariate Cox regression analyses, SF was independently associated with a higher composite event rate after adjusting for prognostic markers [adjusted hazard ratio (HR), 2.01; 95% confidence interval (CI), 1.07-3.78; p = 0.04]. Of the 5 questions for defining SF, an answer of yes to the question about not feeling helpful toward friends or family, which indicates loss of perceived social role, was an independent predictor of composite events (adjusted HR, 2.28; 95% CI, 1.36-3.82; p < 0.01). Inclusion of loss of perceived social role into the baseline prognostic model improved both the continuous net reclassification improvement (0.562; 95% CI, 0.298-0.827; p < 0.01) and integrated discrimination improvement (0.031; 95% CI, 0.006-0.056; p = 0.02). Conclusion Loss of perceived social role is associated with increased adverse event risk and provides additive prognostic information in elderly HF patients.
Collapse
Affiliation(s)
- Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan,*Correspondence: Satoshi Katano,
| | - Toshiyuki Yano
- Department of Cardiovascular, Sapporo Medical University School of Medicine, Renal and Metabolic Medicine, Sapporo, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Suguru Honma
- Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Japan,Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Sapporo Medical University School of Medicine, Renal and Metabolic Medicine, Sapporo, Japan,Department of Cardiology, Hokkaidō Cardiovascular Hospital, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Sapporo Medical University School of Medicine, Renal and Metabolic Medicine, Sapporo, Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Sapporo Medical University School of Medicine, Renal and Metabolic Medicine, Sapporo, Japan,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Sapporo Medical University School of Medicine, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
11
|
Katano S, Watanabe A, Nagaoka R, Numazawa R, Honma S, Ohori K, Kouzu H, Fujito T, Nishikawa R, Ohwada R, Nagano N, Koyama M, Katayose M, Hashimoto A, Yano T. Loss of social role awareness, a subdomain of social frailty, is an independent predictor of future adverse events in hospitalized older patients with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Frailty is a complex syndrome characterized by a decline in functional reserve, and associated with aging and chronic diseases including heart failure (HF). The impact of physical frailty on prognosis and the effect of cardiac rehabilitation in HF patients have been well established. However, the data on the prognostic impact of social frailty (SF) in HF patients is limited.
Aims
We aimed to get new insight into mechanisms of the association of SF with clinical outcomes in older hospitalized HF patients.
Methods
A single-center, retrospective cohort study was conducted using data from 308 HF patients aged ≥65 years (mean age of 78±8 years; 49% females) who were admitted to our institute for the management of HF. SF was assessed using the validated Makizako's five questions. The following responses were considered positive for SF: (1) going out less frequently compared with last year; (2) not visiting friends; (3) not talking with someone every day; (4) not feeling helpful toward friends or family; and (5) living alone. SF was defined as two or more positive responses. The primary outcome was composite events defined by all-cause death and cardiovascular events. The missing data were imputed using multiple imputation by chained -equations algorithm.
Results
Of 308 older HF patients, 189 patients (61%) were SF. Patients with SF were significantly older, had lower body mass index, and a higher percentage of patients with physical frailty and cognitive frailty than those without SF. Seventy-five patients (24%) experienced composite events during a median follow-up period of 1.55-years (interquartile range, 0.88–2.20 years). Kaplan-Meier curves showed a significantly higher composite event rate in patients with SF than those without SF. In multivariate Cox regression analyses, SF was independently associated with a higher composite event rate after adjusting for pre-existing risk factors [adjusted hazard ratio (HR), 1.91; 95% confidence interval (CI), 1.09–3.35; p=0.03] (Figure 1A). In addition, further analyses showed that only the positive response on the question corresponding to the social role – not feeling helpful toward friends or family – among the questionnaire was an independent predictor for the incidence of the composite event (adjusted HR, 2.10; 95% CI, 1.29–3.41; p<0.01, Figure 1B). Inclusion of the response to the question regarding the social role into the baseline prognostic model improved the accuracy of prediction of the composite event (continuous net reclassification improvement, 0.46; 95% CI, 0.21–0.71; p<0.01; integrated discrimination improvement, 0.025; 95% CI 0.004–0.047; p=0.02; Figure 2).
Conclusion
Loss of social role awareness was associated with increased composite event risk and provided additive prognostic information in older HF patients, suggesting the importance of healthcare professionals' decision-making on the prevention and management of SF.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- S Katano
- Sapporo Medical University Hospital , Sapporo , Japan
| | - A Watanabe
- Sapporo Medical University Hospital, Division of Nursing , Sapporo , Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation , Sapporo , Japan
| | - R Numazawa
- Sapporo Medical University, Graduate School of Medicine , Sapporo , Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation , Sapporo , Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology , Sapporo , Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - R Ohwada
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - M Koyama
- Sapporo Medical University, Department of Public Health , Sapporo , Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy , Sapporo , Japan
| | - A Hashimoto
- Sapporo Medical University, Division of Health Care Administration and Management , Sapporo , Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| |
Collapse
|
12
|
Numazawa R, Katano S, Nagaoka R, Honma S, Ohori K, Kouzu H, Watanabe A, Fujito T, Nishikawa R, Owada W, Nagano N, Koyama M, Katayose M, Hashimoto A, Yano T. Coexistence of sarcopenia and osteoporosis in patients with heart failure: prevalence and association with functional status. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sarcopenia, the loss of muscle mass and function, and osteoporosis, a condition of low bone mass and micro-architectural deterioration of bone, frequently coexist and are associated with low functional status in heart failure (HF) patients.
Aims
We aimed to investigate the impact of coexistence of sarcopenia and osteoporosis on functional status in HF patients.
Methods
This cross-sectional study was conducted using data from patients who admitted to our institute for the diagnosis and management of HF from 1 November 2015 to 30 April 2021. All patients received the dual-energy X-ray absorptiometry (DEXA) method before discharge. The diagnosis of sarcopenia was made according to the criteria of Asia Working Group for Sarcopenia 2019 recommendation as follows: reduced skeletal muscle mass [appendicular skeletal muscle mass index (ASMI) by DEXA, <7.00 kg/m2 in males and <5.40 kg/m2 in females] plus lower muscle strength (handgrip strength, <28 kg in males and <18 kg in females) and/or poor physical performance (gait speed, <1.0 m/s; chair stand test time. ≥12 s; short physical performance battery ≤9 points). In addition, bone mineral densities (BMDs) at the lumbar spine, femoral neck, and total femur were measured by DEXA, and osteoporosis was diagnosed when BMDs at any of the three sites were less than 70% of Young Adult Mean (YAM). Functional status was assessed by the Barthel Index (BI) within three days before discharge, and patients with a BI score of <85 points was defined as having functional dependence (FD). The missing data were imputed using multiple imputation by chained -equations algorithm.
Results
Four hundred-thirty eight patients [median age of 74 years (interquartile range, 65–82 years), 37% females] were included in the analyses. Of these, percentage of HF patients with sarcopenia, osteoporosis, and sarcopenia and osteoporosis was 45%, 34%, and 20%, respectively (Figure 1A). The analysis of covariance showed a lower %YAM at any sites in patients with sarcopenia than those without sarcopenia (Figure 1B). When patients were divided into subgroups according to the presence or absence of sarcopenia and osteoporosis, the prevalence of FD was 32%, 34%, and 48% in patients with osteoporosis alone, sarcopenia alone, and sarcopenia and osteoporosis, respectively. Multivariate logistic regression analysis indicated that an increase in adjusted odds ratio (OR) for predicting FD was observed across subgroups in the following order: patients with osteoporosis alone [OR, 1.64; 95% confidence interval (CI), 0.63–4.24; p=0.31], those with sarcopenia alone (OR, 2.44; 95% CI, 1.13–5.25; p=0.02) and those with both conditions (OR, 3.34; 95% CI, 1.52–7.38; p<0.01) (Figure 2).
Conclusion
There was considerable overlap between sarcopenia and osteoporosis in HF patients, which appeared to be a risk factor for FD.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- R Numazawa
- Sapporo Medical University, Graduate School of Medicine , Sapporo , Japan
| | - S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation , Sapporo , Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation , Sapporo , Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation , Sapporo , Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology , Sapporo , Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - A Watanabe
- Sapporo Medical University Hospital, Division of Nursing , Sapporo , Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - W Owada
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Department of Public Health , sapporo , Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy, School of Health Sciences , Sapporo , Japan
| | - A Hashimoto
- Sapporo Medical University School of Medicine, Division of Health Care Administration and Management , sapporo , Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine , Sapporo , Japan
| |
Collapse
|
13
|
Katano S, Honma S, Nagaoka R, Numazawa R, Yamano K, Fujisawa Y, Ohori K, Kouzu H, Hashimoto A, Katayose M, Yano T. Anthropometric parameters-derived estimation of muscle mass predicts all-cause mortality in heart failure patients. ESC Heart Fail 2022; 9:4358-4365. [PMID: 36065759 PMCID: PMC9773643 DOI: 10.1002/ehf2.14121] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/23/2022] [Accepted: 08/15/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS Reduction in appendicular skeletal muscle mass index (ASMI) assessed by dual-energy X-ray absorptiometry (DEXA) has been shown to be independently associated with a higher mortality rate in patients with heart failure (HF). However, DEXA is not suitable for measurement of muscle mass in a daily clinical setting and in large population-based studies. The aim of this study was to determine whether ASMI predicted from anthropometric indicators (predicted ASMI) serves as an alternative to DEXA-measured ASMI for predicting all-cause death in HF patients. METHODS AND RESULTS Data for 539 HF patients who received a DEXA scan and measurements of calf circumferences (CC) and mid-arm circumferences (MAC) in our hospital were analysed. Predicted ASMI was calculated as we previously reported: predicted ASMI (kg/m2 ) = [0.214 × weight (kg) + 0.217 × CC (cm) - 0.189 × MAC (cm) + 1.098 (male = 1, female = -1) + 0.576]/height2 (m2 ). Low ASMI values were defined as <7.00 kg/m2 and <5.40 kg/m2 for men and women, respectively, according to the criteria of the Asian Working Group for Sarcopenia. The median follow-up period was 1.75 years (interquartile range, 0.96-2.37 years), and 79 patients (15%) died. Kaplan-Meier survival curves showed that patients with low DEXA-measured ASMI and patients with low predicted ASMI had significantly lower survival rates than those for patients with high ASMI. In multivariate Cox proportional hazard analyses adjusted for age, sex, logarithmic B-type natriuretic peptide, cystatin C based-estimated glomerular filtration rate, and gait speed, DEXA-measured ASMI [hazard ratio (HR), 0.982; 95% confidence interval (CI), 0.967-0.998; P = 0.026] and predicted ASMI (HR, 0.979; 95% CI, 0.962-0.996; P = 0.018) were independent predictors of all-cause mortality. Inclusion of predicted ASMI into the adjustment model significantly improved continuous net reclassification improvement (0.338; 95% CI, 0.103-0.572; P < 0.01) and integrated discrimination improvement (0.020; 95% CI, 0.004-0.035; P < 0.05) for predicting mortality after discharge. CONCLUSIONS Predicted ASMI, as well as DEXA-measured ASMI, can predict all-cause death in HF patients, and calculation of predicted ASMI will be useful for detecting high-risk patients in a daily clinical setting and in large population-based studies.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Suguru Honma
- Department of RehabilitationSapporo Cardiovascular HospitalSapporoJapan
| | - Ryohei Nagaoka
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Ryo Numazawa
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Kotaro Yamano
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Yusuke Fujisawa
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan,Department of CardiologyHokkaido Cardiovascular HospitalSapporoJapan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan,Division of Health Care Administration and ManagementSapporo Medical University School of MedicineSapporoJapan
| | - Masaki Katayose
- Second Division of Physical TherapySapporo Medical University School of Health SciencesSapporoJapan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| |
Collapse
|
14
|
Nakata T, Nakajima K, Naya M, Yoshida S, Momose M, Taniguchi Y, Fukushima Y, Moroi M, Okizaki A, Hashimoto A, Kiko T, Hida S, Takehana K. Multicenter Registry in the Japanese Cardiac Sarcoidosis Prognostic (J-CASP) Study: Baseline Characteristics and Validation of the Non-invasive Approach Using 18F-FDG PET. Ann Nucl Cardiol 2022; 8:42-50. [PMID: 36540169 PMCID: PMC9749758 DOI: 10.17996/anc.22-00153] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 06/13/2023]
Abstract
Background: Recent advances in cardiac modalities contribute to the guidelines on the diagnosis of cardiac sarcoidosis (CS) updated by the Japanese Circulation Society. The multicenter registry, Japanese Cardiac Sarcoidosis Prognostic (J-CASP) study tried to reveal recent trends of diagnosis and outcomes in CS patients and to validate the non-invasive diagnostic approach, including cardiac 18F-fluorodeoxyglucose (FDG) study. Methods/results: Databases from 12 hospitals consisting of 231 CS patients (mean age, 64 years; female, 65%; LV ejection fraction, 47%) diagnosed by the guidelines with FDG positron emission tomography (PET) study were integrated to compile clinical information on the diagnostic criteria and outcomes. Cardiac 18F-FDG uptake and magnetic resonance imaging (CMR) was positive identically in the histology-proven and clinically-diagnosed groups. The histology-proven group more frequently had reduce LV ejection fraction, myocardial perfusion abnormality and low-grade electrocardiogram (ECG) abnormality (P=0.003 to 0.016) than did the clinical group. During a 45-month period, the histology-proven group more frequently underwent appropriate implantable cardioverter-defibrillator (ICD) treatment (14% versus 4%, P=0.013) and new electronic device implantation (30% versus 12%, P=0.007) than did clinical group, respectively. There, however, was no difference in all-cause or cardiac mortality or in new hospitalization due to heart failure progression between them. Conclusion: The J-CASP registry demonstrated the rationale and clinical efficacies of non-invasive approach using advanced cardiac imaging modalities in the diagnosis of CS even when histological data were available.
Collapse
Affiliation(s)
- Tomoaki Nakata
- Cardiology, Hakodate Goryoukaku Hospital, Hakodate, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
| | - Masanao Naya
- Department of Cardiology, Hokkaido University Hospital, Sapporo, Japan
| | - Shohei Yoshida
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Mitsuru Momose
- Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Woman's Medical University, Tokyo, Japan
| | - Yasuyo Taniguchi
- Department of Cardiology, Hyogo Brain and Heart Center, Himeji, Japan
| | | | - Masao Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Atsutaka Okizaki
- Department of Radiology, Asahikawa Medical University, Asahikawa, Japan
| | | | - Takatoyo Kiko
- Department of Cardiology, Fukushima Medical University, Fukushima, Japan
| | - Satoshi Hida
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuya Takehana
- Division of Cardiology, Department of Medicine II, Kansai Medical University, Hirakata, Japan
| |
Collapse
|
15
|
Doi T, Nakata T, Noto T, Mita T, Yuda S, Hashimoto A. Improved risk-stratification in heart failure patients with mid-range to severe abnormalities of QRS duration and systolic function using mechanical dyssynchrony assessed by myocardial perfusion-gated SPECT. J Nucl Cardiol 2022; 29:1611-1625. [PMID: 33629244 DOI: 10.1007/s12350-021-02554-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of left ventricular mechanical dyssynchrony (LVMD), which has been reported to be responsible for unfavorable outcomes, might improve conventional risk-stratification by clinical indices including QRS duration (QRSd) and systolic dysfunction in patients with heart failure (HF). METHODS AND RESULTS Following measurements of 12-lead QRSd and left ventricular ejection fraction (LVEF), three-dimensional (3-D) LVMD was evaluated as a standard deviation (phase SD) of regional mechanical systolic phase angles by gated myocardial perfusion imaging in 829 HF patients. Patients were followed up for a mean period of 37 months with a primary endpoint of lethal cardiac events (CEs). In an overall multivariate Cox proportional hazards model, phase SDs were identified as significant prognostic determinants independently. The patients were divided into 4 groups by combining with the cut-off values of LVEF (35% and 50%) and QRSd (130 ms and 150 ms). The groups with lower LVEF and prolonged QRSd more frequently had CEs than did the other groups. Patient groups with LVEF < 35% and with 35% ≦ LVEF < 50% were differentiated into low-risk and high-risk categories by using an optimal phase SD cut-off value of both QRSd thresholds. CONCLUSIONS 3-D LVMD can risk-stratify HF patients with mid-range as well as severe abnormalities of QRSd and systolic dysfunction.
Collapse
Affiliation(s)
- Takahiro Doi
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan.
| | - Tomoaki Nakata
- Department of Cardiology, Hakodate Goryokaku Hospital, Hakodate, Japan
| | - Takahiro Noto
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Tomohiro Mita
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Satoshi Yuda
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiology, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo, Japan
| |
Collapse
|
16
|
Doi T, Noto T, Mita T, Nagahara D, Yuda S, Hashimoto A, Nakata T, Nakajima K. Prognostic value of nutritional parameters in systolic heart failure with renal dysfunction. PLoS One 2022; 17:e0266839. [PMID: 35587474 PMCID: PMC9119558 DOI: 10.1371/journal.pone.0266839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/28/2022] [Indexed: 12/03/2022] Open
Abstract
Although it is known that assessment and management of the nutritional status of patients are important for treatment of patients with heart failure (HF), there are currently no established indicators. Therefore, we investigated the effects of nutritional parameters as well as conventional parameters on the prognosis of HF patients. A total of 1954 consecutive HF patients with left ventricular ejection fraction (LVEF) less than 50% were enrolled in this study. Transthoracic echocardiography was performed and conventional parameters for HF patients and parameters to assess nutritional status were measured in all patients. Patients were followed up with a primary endpoint of lethal cardiac events (CEs) for 30.2 months. During the follow-up period, cardiac events were documented in 619 HF patients. The CEs group had a lower level of cholinesterase (201.5U/L vs 265.2U/L, P <0.0001), lower estimated GFR (35.2 ml/min/1.73m2 vs 50.3ml/min/1.73m2, P< 0.0001), and lower Geriatric Nutritional Risk Index (GNRI) (91.9 vs 100.0, P< 0.0001) than those in the non-CEs group. Serum cholinesterase, estimated GFR, and GNRI were identified as significant prognostic determinants in multivariate analysis. ROC analyses revealed cut-off values of serum cholinesterase, estimated GFR, and GNRI of 229U/L, 34.2 ml/min/1.73m2, and 95.6, respectively, for identifying high-risk HF patients. HF patients with serum cholinesterase< 229U/L, estimated GFR<34.3 ml/min/1.73m2, and GNRI< 95.6 had a significantly greater rate of CEs than that in the other patients (P<0.0001). Low serum cholinesterase and low GNRI can predict cardiac mortality risk in systolic HF patients with renal dysfunction.
Collapse
Affiliation(s)
- Takahiro Doi
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
- * E-mail:
| | - Takahiro Noto
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Tomohiro Mita
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Daigo Nagahara
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Satoshi Yuda
- Department of Cardiology, Teine Kijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiology, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tomoaki Nakata
- Department of Cardiology, Hakodate Goryokaku Hospital, Hakodate, Japan
| | - Kenichi Nakajima
- Depeatment of of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
| |
Collapse
|
17
|
Nagaoka R, Katano S, Numazawa R, Kouzu H, Ohori K, Honma S, Kamoda T, Sato K, Nishikawa R, Owada W, Nagano N, Koyama M, Katayose M, Hashimoto A, Yano T. Does serum 25-hydroxyvitamin D levels have impacts on sarcopenia in patients with chronic heart failure? Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Sarcopenia is associated with poor functional status and clinical outcomes in heart failure (HF) patients. Although recent observational studies showed the relationship between lower serum vitamin D levels and the development of poor physical function in community-dwelling older adults, involvement of vitamin D status in the development of sarcopenia in HF patients remain unclear. This study aimed to investigate the impact of serum vitamin D concentrations on sarcopenia in patients with HF.
Methods
We retrospectively enrolled 269 consecutive patients [median age of 73 years (interquartile range 63-82 years); 35% female] admitted to our institute for diagnosis and management of HF, and received the dual-energy X-ray absorptiometry (DEXA) method during the period from 1 September 2018 to 30 September 2021. The 25-hydroxyvitamin D [25(OH)D] was detected by a chemiluminescence immunoassay (CLIA) technology. The diagnosis of sarcopenia was made according to the criteria of Asia Working Group for Sarcopenia incorporating reduced skeletal muscle mass (appendicular skeletal muscle index [ASMI], <7.00 kg/m2 in males and <5.40 kg/m2 in females), and lower muscle strength (handgrip strength, <28 kg in males and <18 kg in females) and/or poor physical performance (gait speed, <1.0 m/s; chair stand test time, ≥12 s; short physical performance battery, ≤9 points).
Results
Of 269 patients, 116 (43%) patients had sarcopenia. An adjusted logistic regression model with a restricted cubic spline function showed that the odds ratio (OR) for sarcopenia increased as the serum 25(OH)D levels decreased. When the value that corresponded to an upper limit of 95% confidence interval (CI) for an OR of 1.0 was defined as the cut-off value of 25(OH)D levels for predicting sarcopenia, it was 18 ng/mL (Figure 1A). A multivariate logistic regression model was fit to calculate the propensity score (PS) for the 25(OH)D levels being <18 ng/mL based on covariates such as age, sex, and N-terminal pro B-type natriuretic peptide. (C-statistics 0.761). The inverse probability of treatment weighting (IPTW) was computed using PS to minimize differences in potential confounding factors between patients with a low serum 25(OH)D levels (<18 ng/mL) and those with a high serum 25(OH)D levels (≥18 ng/mL, Figure 1B). Results of the multivariate logistic regression analysis in the IPTW-weighted patients showed that a low serum 25(OH)D was independently associated with presence of sarcopenia (adjusted OR 2.03, 95% CI 1.31-3.16, p<0.01). In addition, patients with a low serum 25(OH)D had a significantly lower muscle strength and poor physical performance, but not ASMI, than those with a high serum 25(OH)D (Figure 2).
Conclusion
Decreased serum 25(OH)D levels are associated with decline in muscle strength and physical performance in HF patients. Serum 25(OH)D levels of <18 ng/mL may be a novel risk factor of sarcopenia in HF patients.
Collapse
Affiliation(s)
- R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - R Numazawa
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - T Kamoda
- Sapporo Medical University, Graduate School of Health Sciences, Sapporo, Japan
| | - K Sato
- Sapporo Medical University, Graduate School of Health Sciences, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - W Owada
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Department of Public Health, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University School of Health Sciences, Second Division of Physical Therapy, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University School of Medicine, Division of Health Care Administration and Management, Sapporo, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
18
|
Honma S, Katano S, Nagaoka R, Numazawa R, Kouzu H, Ohori K, Nishikawa R, Ohwada W, Nagano N, Koyama M, Katayose M, Kobayashi C, Yoshioka N, Hashimoto A, Yano T. Novel equation for skeletal muscle mass estimation is useful for predicting mortality in patients with heart failure. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Skeletal muscle mass in heart failure (HF) patients is closely related to exercise tolerance and prognosis. Although the dual-energy X-ray absorptiometry (DEXA) method is a standard method for measuring skeletal muscle mass, it is not suitable in a daily clinical setting since it is a costly and hospital-based modality. We recently reported that an equation for appendicular skeletal muscle mass index (ASMI) estimation using anthropometric parameters predicted DEXA-measured ASMI in HF patients with reasonable accuracy. Here, we examined the prognostic impacts of ASMI predicted by the equation (predicted ASMI) in HF patients.
Methods
Data for 539 patients with HF ( 73 ± 14 years old, 43% female) who received the DEXA method and measurements of calf circumference (CC) and mid-arm circumference (MAC) between August 1, 2015, to August 31, 2020, were used for analyses. DEXA measured-appendicular skeletal muscle (ASM) was calculated as the sum of bone-free lean masses in the arms and legs, and ASMI was defined as ASM/height². Predicted ASMI was calculated as we previously reported: predicted ASMI (kg/m²) = [0.214 × weight (kg) + 0.217 × CC (cm) - 0.189 × MAC (cm) + 1.098 (male = 1, female = -1) + 0.576]/height² (m²). Low ASMI was defined as <7.0 kg/m² in males and <5.4 kg/m² in females, respectively. The primary endpoint was all-cause death. Multiple imputation using chained equations was used for the substitution of missing values.
Results
The median follow-up period was 1.75 years (interquartile range, 0.96 to 2.37 years), and 73 patients (15%) has died. Kaplan-Meier survival curves showed that patients with low DEXA measured-ASMI and patients with low predicted ASMI had significantly lower survival rates than those with high ASMI (Figure 1). In a multivariate Cox proportional hazard analyses adjusted for age, sex, logarithmic B-type natriuretic peptide, cystatin C based-estimated glomerular filtration rate, and gait speed, DEXA-measured ASMI [hazard ratio (HR), 0.982; 95% confidence interval (CI), 0.967 to 0.988; p<0.001] and predicted ASMI (HR, 0.979; 95% CI, 0.962 to 0.996; p=0.018) were independent predictors of all-cause mortality, respectively. Inclusion of predicted ASMI into the adjustment model improved the accuracy of prediction of the mortality after discharge [continuous net reclassification improvement, 0.338, p<0.01; integrated discrimination improvement, 0.020, p < 0.05] (Figure 2).
Conclusions
ASMI estimated by an equation using CC and MAC predicted the prognosis of HF patients at a similar level of accuracy to DEXA-measured ASMI, and it can be applied to the assessment of skeletal muscle mass in a daily clinical setting and in large population-based studies.
Collapse
Affiliation(s)
- S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - R Numazawa
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - W Ohwada
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Department of Public Health, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University School of Medicine, Second Division of Physical Therapy, Sapporo, Japan
| | - C Kobayashi
- Sapporo Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - N Yoshioka
- Sapporo Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University School of Medicine, Division of Health Care Administration and Management, Sapporo, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
19
|
Katano S, Yano T, Ohori K, Kouzu H, Nagaoka R, Honma S, Shimomura K, Numazawa R, Koyama M, Nagano N, Fujito T, Nishikawa R, Hashimoto A, Katayose M, Miura T. Barthel Index score predicts mortality in elderly heart failure: a goal of comprehensive cardiac rehabilitation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Accurate prediction of mortality in heart failure (HF) patients is crucial for decision-making regarding HF therapies, but a strategy for the prediction of mortality in elderly HF patients has not been established. In addition, although favorable effects of comprehensive cardiac rehabilitation (CR) on clinical outcomes and functional status in HF patients have been demonstrated, a goal of comprehensive CR during hospitalization for reducing mortality remains unclear.
Aims
We examined whether assessment of basic activities of daily living (ADL) by the Barthel Index (BI), the most widely used tool for assessment of basic ADL, is useful for predicting all-cause mortality in elderly HF patients who received comprehensive CR.
Methods
This study was a single-center, retrospective and observational study. We retrospectively examined 413 HF patients aged ≥65 years (mean age, 78±7 years; 50% female) who were admitted to our institute for management of HF and received comprehensive CR during hospitalization. Functional status for performing basic ADL ability was assessed by the BI within 3 days before discharge. The clinical endpoint was all-cause death during the follow-up period.
Results
Of 413 HF patients, 116 patients (28%) died during a follow-up period of median 1.90-years (interquartile range, 1.20–3.23 years). Results of an adjusted dose-dependent association analysis showed that the hazard ratio (HR) of mortality increases in an almost linear fashion as the BI score decreases and that the BI score corresponding the hazard ratio of 1.0 is 85 (Figure A). To minimize the differences in potential confounding factors between patient with low BI (<85) and patients with high BI (≥85), inverse probability treatment weighting (IPTW) was calculated using propensity score. Kaplan-Meier survival curves, in which selection bias was minimized by use of IPTW for confounders, showed that patients with low BI (<85) had a higher mortality rate than did patients with high BI (≥85) (Figure B). In multivariate Cox regression analyses, low BI was independently associated with higher mortality after adjustment for predictors including brain natriuretic peptide and prior HF hospitalization (IPTW-adjusted HR, 1.75 [95% confidence interval, 1.03–2.98], p<0.001). Inclusion of the BI into the adjustment model improved the accuracy of prediction of mortality (continuous net reclassification improvement, 0.292, p=0.008; integrated discrimination improvement, 0.017, p=0.022).
Conclusion
A BI score of <85 at the time of discharge is associated with increased mortality independently of known prognostic markers, and achievement of functional status of a BI score ≥85 by comprehensive CR during hospitalization may contribute to a favorable outcome in elderly HF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the Japan Society for the Promotion of Science
Collapse
Affiliation(s)
- S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - K Shimomura
- Hakodate Goryoukaku Hospital, Department of Rehabilitation, Hakodate, Japan
| | - R Numazawa
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Public Health, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Division of Health Care Administration and Management, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
20
|
Yano T, Hisahara S, Nagano N, Noto T, Ogawa T, Nishikawa R, Koyama M, Kouzu H, Muranaka A, Hashimoto A, Shimohama S, Miura T. Abrupt Onset of Cardiac Tamponade in Sarcoidosis. Int Heart J 2021; 62:1176-1181. [PMID: 34544983 DOI: 10.1536/ihj.21-167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sarcoidosis is a systemic inflammatory disease characterized by the formation of noncaseating epithelioid granulomas. Multiple organs, including the lung, eyes, and skin, are involved in this disorder, and cardiac involvement is a major cause of morbidity and mortality in patients with this disorder. We present the case history of a 22-year-old man with neurosarcoidosis complicated by abrupt onset of cardiac tamponade. Cardiac tamponade is a rare but potentially fatal manifestation of sarcoidosis, which is treatable with glucocorticoid therapy. Including the present case, previously reported cases of sarcoidosis with cardiac tamponade are reviewed to delineate its clinical characteristics.
Collapse
Affiliation(s)
- Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Shin Hisahara
- Department of Neurology, Sapporo Medical University School of Medicine
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Takahiro Noto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Toshifumi Ogawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Public Health, Sapporo Medical University School of Medicine
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Atsuko Muranaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Shun Shimohama
- Department of Neurology, Sapporo Medical University School of Medicine
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| |
Collapse
|
21
|
Katano S, Yano T, Ohori K, Kouzu H, Nagaoka R, Honma S, Shimomura K, Inoue T, Takamura Y, Ishigo T, Watanabe A, Koyama M, Nagano N, Fujito T, Nishikawa R, Ohwada W, Hashimoto A, Katayose M, Ishiai S, Miura T. Barthel Index Score Predicts Mortality in Elderly Heart Failure - A Goal of Comprehensive Cardiac Rehabilitation. Circ J 2021; 86:70-78. [PMID: 34544962 DOI: 10.1253/circj.cj-21-0584] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A strategy to predict mortality in elderly heart failure (HF) patients has not been established.Methods and Results:We retrospectively enrolled 413 HF patients aged ≥65 years (mean age 78 years) who had received comprehensive cardiac rehabilitation (CR) during hospitalization. Basic activities of daily life were assessed before discharge using the Barthel index (BI). Of 413 HF patients, 116 (28%) died during a median follow-up period of 1.90 years (interquartile range 1.20-3.23 years). An adjusted dose-dependent association analysis showed that the hazard ratio (HR) of mortality increased in an almost linear manner as the BI score decreased, and that a BI score of 85 corresponded to an HR of 1.0. Kaplan-Meier survival curves showed that the survival rate was lower for patients with a low BI (<85) than for those with a high BI (≥85; 65% vs. 74%, respectively; P=0.007). In multivariate Cox regression analyses, low BI was independently associated with higher mortality after adjusting for predictors, including B-type natriuretic peptide. Inclusion of the BI into the adjusted model improved the accuracy of the prediction of mortality. CONCLUSIONS A BI score <85 at the time of discharge is associated with increased mortality independent of known prognostic markers, and achieving functional status with a BI score ≥85 by comprehensive CR during hospitalization may contribute to favorable outcomes in elderly HF patients.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Suguru Honma
- Department of Rehabilitation, Sapporo Cardiovascular Hospital
| | | | | | - Yuhei Takamura
- Department of Rehabilitation, Hokkaido Ohno Memorial Hospital
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Public Health, Sapporo Medical University School of Medicine
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Wataru Ohwada
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences
| | - Sumio Ishiai
- Department of Rehabilitation, Sapporo Medical University School of Medicine
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science
| |
Collapse
|
22
|
Katano S, Yano T, Ohori K, Nagano N, Honma S, Shimomura K, Ishigo T, Watanabe A, Honma R, Fujito T, Koyama M, Kouzu H, Hashimoto A, Katayose M, Miura T. Novel prediction equation for appendicular skeletal muscle mass estimation in patients with heart failure: Potential application in daily clinical practice. Eur J Prev Cardiol 2021; 28:e18-e21. [DOI: 10.1177/2047487320904236] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Suguru Honma
- Division of Rehabilitation, Sapporo Medical University Hospital, Japan
| | - Kanako Shimomura
- Division of Rehabilitation, Sapporo Medical University Hospital, Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital, Japan
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital, Japan
| | - Remi Honma
- Division of Nursing, Sapporo Medical University Hospital, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| |
Collapse
|
23
|
Crous P, Lombard L, Sandoval-Denis M, Seifert K, Schroers HJ, Chaverri P, Gené J, Guarro J, Hirooka Y, Bensch K, Kema G, Lamprecht S, Cai L, Rossman A, Stadler M, Summerbell R, Taylor J, Ploch S, Visagie C, Yilmaz N, Frisvad J, Abdel-Azeem A, Abdollahzadeh J, Abdolrasouli A, Akulov A, Alberts J, Araújo J, Ariyawansa H, Bakhshi M, Bendiksby M, Ben Hadj Amor A, Bezerra J, Boekhout T, Câmara M, Carbia M, Cardinali G, Castañeda-Ruiz R, Celis A, Chaturvedi V, Collemare J, Croll D, Damm U, Decock C, de Vries R, Ezekiel C, Fan X, Fernández N, Gaya E, González C, Gramaje D, Groenewald J, Grube M, Guevara-Suarez M, Gupta V, Guarnaccia V, Haddaji A, Hagen F, Haelewaters D, Hansen K, Hashimoto A, Hernández-Restrepo M, Houbraken J, Hubka V, Hyde K, Iturriaga T, Jeewon R, Johnston P, Jurjević Ž, Karalti İ, Korsten L, Kuramae E, Kušan I, Labuda R, Lawrence D, Lee H, Lechat C, Li H, Litovka Y, Maharachchikumbura S, Marin-Felix Y, Matio Kemkuignou B, Matočec N, McTaggart A, Mlčoch P, Mugnai L, Nakashima C, Nilsson R, Noumeur S, Pavlov I, Peralta M, Phillips A, Pitt J, Polizzi G, Quaedvlieg W, Rajeshkumar K, Restrepo S, Rhaiem A, Robert J, Robert V, Rodrigues A, Salgado-Salazar C, Samson R, Santos A, Shivas R, Souza-Motta C, Sun G, Swart W, Szoke S, Tan Y, Taylor J, Taylor P, Tiago P, Váczy K, van de Wiele N, van der Merwe N, Verkley G, Vieira W, Vizzini A, Weir B, Wijayawardene N, Xia J, Yáñez-Morales M, Yurkov A, Zamora J, Zare R, Zhang C, Thines M. Fusarium: more than a node or a foot-shaped basal cell. Stud Mycol 2021; 98:100116. [PMID: 34466168 PMCID: PMC8379525 DOI: 10.1016/j.simyco.2021.100116] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Recent publications have argued that there are potentially serious consequences for researchers in recognising distinct genera in the terminal fusarioid clade of the family Nectriaceae. Thus, an alternate hypothesis, namely a very broad concept of the genus Fusarium was proposed. In doing so, however, a significant body of data that supports distinct genera in Nectriaceae based on morphology, biology, and phylogeny is disregarded. A DNA phylogeny based on 19 orthologous protein-coding genes was presented to support a very broad concept of Fusarium at the F1 node in Nectriaceae. Here, we demonstrate that re-analyses of this dataset show that all 19 genes support the F3 node that represents Fusarium sensu stricto as defined by F. sambucinum (sexual morph synonym Gibberella pulicaris). The backbone of the phylogeny is resolved by the concatenated alignment, but only six of the 19 genes fully support the F1 node, representing the broad circumscription of Fusarium. Furthermore, a re-analysis of the concatenated dataset revealed alternate topologies in different phylogenetic algorithms, highlighting the deep divergence and unresolved placement of various Nectriaceae lineages proposed as members of Fusarium. Species of Fusarium s. str. are characterised by Gibberella sexual morphs, asexual morphs with thin- or thick-walled macroconidia that have variously shaped apical and basal cells, and trichothecene mycotoxin production, which separates them from other fusarioid genera. Here we show that the Wollenweber concept of Fusarium presently accounts for 20 segregate genera with clear-cut synapomorphic traits, and that fusarioid macroconidia represent a character that has been gained or lost multiple times throughout Nectriaceae. Thus, the very broad circumscription of Fusarium is blurry and without apparent synapomorphies, and does not include all genera with fusarium-like macroconidia, which are spread throughout Nectriaceae (e.g., Cosmosporella, Macroconia, Microcera). In this study four new genera are introduced, along with 18 new species and 16 new combinations. These names convey information about relationships, morphology, and ecological preference that would otherwise be lost in a broader definition of Fusarium. To assist users to correctly identify fusarioid genera and species, we introduce a new online identification database, Fusarioid-ID, accessible at www.fusarium.org. The database comprises partial sequences from multiple genes commonly used to identify fusarioid taxa (act1, CaM, his3, rpb1, rpb2, tef1, tub2, ITS, and LSU). In this paper, we also present a nomenclator of names that have been introduced in Fusarium up to January 2021 as well as their current status, types, and diagnostic DNA barcode data. In this study, researchers from 46 countries, representing taxonomists, plant pathologists, medical mycologists, quarantine officials, regulatory agencies, and students, strongly support the application and use of a more precisely delimited Fusarium (= Gibberella) concept to accommodate taxa from the robust monophyletic node F3 on the basis of a well-defined and unique combination of morphological and biochemical features. This F3 node includes, among others, species of the F. fujikuroi, F. incarnatum-equiseti, F. oxysporum, and F. sambucinum species complexes, but not species of Bisifusarium [F. dimerum species complex (SC)], Cyanonectria (F. buxicola SC), Geejayessia (F. staphyleae SC), Neocosmospora (F. solani SC) or Rectifusarium (F. ventricosum SC). The present study represents the first step to generating a new online monograph of Fusarium and allied fusarioid genera (www.fusarium.org).
Collapse
Key Words
- Apiognomonia platani (Lév.) L. Lombard
- Atractium ciliatum Link
- Atractium pallidum Bonord.
- Calloria tremelloides (Grev.) L. Lombard
- Cephalosporium sacchari E.J. Butler
- Cosmosporella cavisperma (Corda) Sand.-Den., L. Lombard & Crous
- Cylindrodendrum orthosporum (Sacc. & P. Syd.) L. Lombard
- Dialonectria volutella (Ellis & Everh.) L. Lombard & Sand.-Den.
- Fusarium aeruginosum Delacr.
- Fusarium agaricorum Sarrazin
- Fusarium albidoviolaceum Dasz.
- Fusarium aleyrodis Petch
- Fusarium amentorum Lacroix
- Fusarium annuum Leonian
- Fusarium arcuatum Berk. & M.A. Curtis
- Fusarium aridum O.A. Pratt
- Fusarium armeniacum (G.A. Forbes et al.) L.W. Burgess & Summerell
- Fusarium arthrosporioides Sherb.
- Fusarium asparagi Delacr.
- Fusarium batatas Wollenw.
- Fusarium biforme Sherb.
- Fusarium buharicum Jacz. ex Babajan & Teterevn.-Babajan
- Fusarium cactacearum Pasin. & Buzz.-Trav.
- Fusarium cacti-maxonii Pasin. & Buzz.-Trav.
- Fusarium caudatum Wollenw.
- Fusarium cavispermum Corda
- Fusarium cepae Hanzawa
- Fusarium cesatii Rabenh.
- Fusarium citriforme Jamal.
- Fusarium citrinum Wollenw.
- Fusarium citrulli Taubenh.
- Fusarium clavatum Sherb.
- Fusarium coccinellum Kalchbr.
- Fusarium cromyophthoron Sideris
- Fusarium cucurbitae Taubenh.
- Fusarium cuneiforme Sherb.
- Fusarium delacroixii Sacc.
- Fusarium dimerum var. nectrioides Wollenw.
- Fusarium echinatum Sand.-Den. & G.J. Marais
- Fusarium epicoccum McAlpine
- Fusarium eucheliae Sartory, R. Sartory & J. Mey.
- Fusarium fissum Peyl
- Fusarium flocciferum Corda
- Fusarium gemmiperda Aderh.
- Fusarium genevense Dasz.
- Fusarium graminearum Schwabe
- Fusarium graminum Corda
- Fusarium heterosporioides Fautrey
- Fusarium heterosporum Nees & T. Nees
- Fusarium idahoanum O.A. Pratt
- Fusarium juruanum Henn.
- Fusarium lanceolatum O.A. Pratt
- Fusarium lateritium Nees
- Fusarium loncheceras Sideris
- Fusarium longipes Wollenw. & Reinking
- Fusarium lyarnte J.L. Walsh, Sangal., L.W. Burgess, E.C.Y. Liew & Summerell
- Fusarium malvacearum Taubenh.
- Fusarium martii f. phaseoli Burkh.
- Fusarium muentzii Delacr.
- Fusarium nigrum O.A. Pratt
- Fusarium oxysporum var. asclerotium Sherb.
- Fusarium palczewskii Jacz.
- Fusarium palustre W.H. Elmer & Marra
- Fusarium polymorphum Matr.
- Fusarium poolense Taubenh.
- Fusarium prieskaense G.J. Marais & Sand.-Den.
- Fusarium prunorum McAlpine
- Fusarium pusillum Wollenw.
- Fusarium putrefaciens Osterw.
- Fusarium redolens Wollenw.
- Fusarium reticulatum Mont.
- Fusarium rhizochromatistes Sideris
- Fusarium rhizophilum Corda
- Fusarium rhodellum McAlpine
- Fusarium roesleri Thüm.
- Fusarium rostratum Appel & Wollenw.
- Fusarium rubiginosum Appel & Wollenw.
- Fusarium rubrum Parav.
- Fusarium samoense Gehrm.
- Fusarium scirpi Lambotte & Fautrey
- Fusarium secalis Jacz.
- Fusarium spinaciae Hungerf.
- Fusarium sporotrichioides Sherb.
- Fusarium stercoris Fuckel
- Fusarium stilboides Wollenw.
- Fusarium stillatum De Not. ex Sacc.
- Fusarium sublunatum Reinking
- Fusarium succisae Schröt. ex Sacc.
- Fusarium tabacivorum Delacr.
- Fusarium trichothecioides Wollenw.
- Fusarium tritici Liebman
- Fusarium tuberivorum Wilcox & G.K. Link
- Fusarium tumidum var. humi Reinking
- Fusarium ustilaginis Kellerm. & Swingle
- Fusarium viticola Thüm.
- Fusarium werrikimbe J.L. Walsh, L.W. Burgess, E.C.Y. Liew & B.A. Summerell
- Fusarium willkommii Lindau
- Fusarium xylarioides Steyaert
- Fusarium zygopetali Delacr.
- Fusicolla meniscoidea L. Lombard & Sand.-Den.
- Fusicolla quarantenae J.D.P. Bezerra, Sand.-Den., Crous & Souza-Motta
- Fusicolla sporellula Sand.-Den. & L. Lombard
- Fusisporium andropogonis Cooke ex Thüm.
- Fusisporium anthophilum A. Braun
- Fusisporium arundinis Corda
- Fusisporium avenaceum Fr.
- Fusisporium clypeaster Corda
- Fusisporium culmorum Wm.G. Sm.
- Fusisporium didymum Harting
- Fusisporium elasticae Thüm.
- Fusisporium episphaericum Cooke & Ellis
- Fusisporium flavidum Bonord.
- Fusisporium hordei Wm.G. Sm.
- Fusisporium incarnatum Roberge ex Desm.
- Fusisporium lolii Wm.G. Sm.
- Fusisporium pandani Corda
- Gibberella phyllostachydicola W. Yamam.
- Hymenella aurea (Corda) L. Lombard
- Hymenella spermogoniopsis (Jul. Müll.) L. Lombard & Sand.-Den.
- Luteonectria Sand.-Den., L. Lombard, Schroers & Rossman
- Luteonectria albida (Rossman) Sand.-Den. & L. Lombard
- Luteonectria nematophila (Nirenberg & Hagedorn) Sand.-Den. & L. Lombard
- Macroconia bulbipes Crous & Sand.-Den.
- Macroconia phlogioides Sand.-Den. & Crous
- Menispora penicillata Harz
- Multi-gene phylogeny
- Mycotoxins
- Nectriaceae
- Neocosmospora
- Neocosmospora epipeda Quaedvl. & Sand.-Den.
- Neocosmospora floridana (T. Aoki et al.) L. Lombard & Sand.-Den.
- Neocosmospora merkxiana Quaedvl. & Sand.-Den.
- Neocosmospora neerlandica Crous & Sand.-Den.
- Neocosmospora nelsonii Crous & Sand.-Den.
- Neocosmospora obliquiseptata (T. Aoki et al.) L. Lombard & Sand.-Den.
- Neocosmospora pseudopisi Sand.-Den. & L. Lombard
- Neocosmospora rekana (Lynn & Marinc.) L. Lombard & Sand.-Den.
- Neocosmospora tuaranensis (T. Aoki et al.) L. Lombard & Sand.-Den.
- Nothofusarium Crous, Sand.-Den. & L. Lombard
- Nothofusarium devonianum L. Lombard, Crous & Sand.-Den.
- Novel taxa
- Pathogen
- Scolecofusarium L. Lombard, Sand.-Den. & Crous
- Scolecofusarium ciliatum (Link) L. Lombard, Sand.-Den. & Crous
- Selenosporium equiseti Corda
- Selenosporium hippocastani Corda
- Selenosporium sarcochroum Desm
- Selenosporium urticearum Corda.
- Setofusarium (Nirenberg & Samuels) Crous & Sand.-Den.
- Setofusarium setosum (Samuels & Nirenberg) Sand.-Den. & Crous.
- Sphaeria sanguinea var. cicatricum Berk.
- Sporotrichum poae Peck.
- Stylonectria corniculata Gräfenhan, Crous & Sand.-Den.
- Stylonectria hetmanica Akulov, Crous & Sand.-Den.
- Taxonomy
Collapse
Affiliation(s)
- P.W. Crous
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
- Wageningen University and Research Centre (WUR), Laboratory of Phytopathology, Droevendaalsesteeg 1, 6708 PB, Wageningen, the Netherlands
| | - L. Lombard
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - M. Sandoval-Denis
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
- Netherlands Institute of Ecology (NIOO-KNAW), Department of Microbial Ecology, Droevendaalsesteeg 10, 6708 PB, Wageningen, the Netherlands
| | - K.A. Seifert
- Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - H.-J. Schroers
- Plant Protection Department, Agricultural Institute of Slovenia, Hacquetova ulica 17, 1000, Ljubljana, Slovenia
| | - P. Chaverri
- Department of Plant Science and Landscape Architecture, University of Maryland, College Park, MD, USA
- Escuela de Biología and Centro de Investigaciones en Productos Naturales, Universidad de Costa Rica, San Pedro, Costa Rica
| | - J. Gené
- Unitat de Micologia, Facultat de Medicina i Ciències de la Salut i Institut d’Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, 43201, Reus, Spain
| | - J. Guarro
- Unitat de Micologia, Facultat de Medicina i Ciències de la Salut i Institut d’Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, 43201, Reus, Spain
| | - Y. Hirooka
- Department of Clinical Plant Science, Faculty of Bioscience, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo, 184-8584, Japan
| | - K. Bensch
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - G.H.J. Kema
- Wageningen University and Research Centre (WUR), Laboratory of Phytopathology, Droevendaalsesteeg 1, 6708 PB, Wageningen, the Netherlands
| | - S.C. Lamprecht
- ARC-Plant Health and Protection, Private Bag X5017, Stellenbosch, 7599, Western Cape, South Africa
| | - L. Cai
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - A.Y. Rossman
- Department of Botany & Plant Pathology, Oregon State University, Corvallis, OR, 97330, USA
| | - M. Stadler
- Department of Microbial Drugs, Helmholtz Centre for Infection Research GmbH (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany
| | - R.C. Summerbell
- Sporometrics, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - J.W. Taylor
- Plant and Microbial Biology, 111 Koshland Hall, University of California, Berkeley, CA, 94720-3102, USA
| | - S. Ploch
- Senckenberg Biodiversity and Climate Research Center, Senckenberganlage 25, D-60325, Frankfurt am Main, Germany
| | - C.M. Visagie
- Department of Biochemistry, Genetics and Microbiology, Forestry and Agricultural Biotechnology Institute (FABI), Faculty of Natural and Agricultural Sciences, University of Pretoria, P. Bag X20, Hatfield, 0028, Pretoria, South Africa
| | - N. Yilmaz
- Department of Biochemistry, Genetics and Microbiology, Forestry and Agricultural Biotechnology Institute (FABI), Faculty of Natural and Agricultural Sciences, University of Pretoria, P. Bag X20, Hatfield, 0028, Pretoria, South Africa
| | - J.C. Frisvad
- Department of Biotechnology and Biomedicine, DTU-Bioengineering, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - A.M. Abdel-Azeem
- Systematic Mycology Lab., Botany and Microbiology Department, Faculty of Science, Suez Canal University, Ismailia, 41522, Egypt
| | - J. Abdollahzadeh
- Department of Plant Protection, Faculty of Agriculture, University of Kurdistan, P.O. Box 416, Sanandaj, Iran
| | - A. Abdolrasouli
- Department of Medical Microbiology, King's College Hospital, London, UK
- Department of Infectious Diseases, Imperial College London, London, UK
| | - A. Akulov
- Department of Mycology and Plant Resistance, V. N. Karazin Kharkiv National University, Maidan Svobody 4, 61022, Kharkiv, Ukraine
| | - J.F. Alberts
- Department of Food Science and Technology, Cape Peninsula University of Technology, P.O. Box 1906, Bellville, 7535, South Africa
| | - J.P.M. Araújo
- School of Forest Resources and Conservation, University of Florida, Gainesville, FL, USA
| | - H.A. Ariyawansa
- Department of Plant Pathology and Microbiology, College of Bio-Resources and Agriculture, National Taiwan University, No.1, Sec.4, Roosevelt Road, Taipei, 106, Taiwan, ROC
| | - M. Bakhshi
- Iranian Research Institute of Plant Protection, Agricultural Research, Education and Extension Organization (AREEO), P.O. Box 19395-1454, Tehran, Iran
| | - M. Bendiksby
- Natural History Museum, University of Oslo, Norway
- Department of Natural History, NTNU University Museum, Trondheim, Norway
| | - A. Ben Hadj Amor
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - J.D.P. Bezerra
- Setor de Micologia/Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Rua 235 - s/n – Setor Universitário - CEP: 74605-050, Universidade Federal de Goiás/Federal University of Goiás, Goiânia, Brazil
| | - T. Boekhout
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - M.P.S. Câmara
- Departamento de Agronomia, Universidade Federal Rural de Pernambuco, Recife, 52171-900, PE, Brazil
| | - M. Carbia
- Departamento de Parasitología y Micología, Instituto de Higiene, Facultad de Medicina – Universidad de la República, Av. A. Navarro 3051, Montevideo, Uruguay
| | - G. Cardinali
- Department of Pharmaceutical Science, University of Perugia, Via Borgo 20 Giugno, 74 Perugia, Italy
| | - R.F. Castañeda-Ruiz
- Instituto de Investigaciones Fundamentales en Agricultura Tropical Alejandro de Humboldt (INIFAT), Académico Titular de la Academia de Ciencias de, Cuba
| | - A. Celis
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de Los Andes, Bogotá, 111711, Colombia
| | - V. Chaturvedi
- Mycology Laboratory, New York State Department of Health Wadsworth Center, Albany, NY, USA
| | - J. Collemare
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - D. Croll
- Laboratory of Evolutionary Genetics, Institute of Biology, University of Neuchatel, CH-2000, Neuchatel, Switzerland
| | - U. Damm
- Senckenberg Museum of Natural History Görlitz, PF 300 154, 02806, Görlitz, Germany
| | - C.A. Decock
- Mycothèque de l'Université catholique de Louvain (MUCL, BCCMTM), Earth and Life Institute – ELIM – Mycology, Université catholique de Louvain, Croix du Sud 2 bte L7.05.06, B-1348, Louvain-la-Neuve, Belgium
| | - R.P. de Vries
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - C.N. Ezekiel
- Department of Microbiology, Babcock University, Ilishan Remo, Ogun State, Nigeria
| | - X.L. Fan
- The Key Laboratory for Silviculture and Conservation of Ministry of Education, Beijing Forestry University, Beijing, 100083, China
| | - N.B. Fernández
- Laboratorio de Micología Clínica, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - E. Gaya
- Royal Botanic Gardens, Kew, Richmond, Surrey, TW9 3DS, UK
| | - C.D. González
- Laboratorio de Salud de Bosques y Ecosistemas, Instituto de Conservación, Biodiversidad y Territorio, Facultad de Ciencias Forestales y Recursos Naturales, Universidad Austral de Chile, casilla 567, Valdivia, Chile
| | - D. Gramaje
- Institute of Grapevine and Wine Sciences (ICVV), Spanish National Research Council (CSIC)-University of La Rioja-Government of La Rioja, Logroño, 26007, Spain
| | - J.Z. Groenewald
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - M. Grube
- Institut für Biologie, Karl-Franzens-Universität Graz, Holteigasse 6, 8010, Graz, Austria
| | - M. Guevara-Suarez
- Applied genomics research group, Universidad de los Andes, Cr 1 # 18 a 12, Bogotá, Colombia
| | - V.K. Gupta
- Center for Safe and Improved Food, Scotland's Rural College (SRUC), Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
- Biorefining and Advanced Materials Research Center, Scotland's Rural College (SRUC), Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | - V. Guarnaccia
- Department of Agricultural, Forestry and Food Sciences (DISAFA), University of Torino, Largo P. Braccini 2, 10095, Grugliasco, TO, Italy
| | | | - F. Hagen
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - D. Haelewaters
- Research Group Mycology, Department of Biology, Ghent University, 35 K.L. Ledeganckstraat, 9000, Ghent, Belgium
- Faculty of Science, University of South Bohemia, Branišovská 31, 370 05, České Budějovice, Czech Republic
| | - K. Hansen
- Department of Botany, Swedish Museum of Natural History, P.O. Box 50007, SE-104 05, Stockholm, Sweden
| | - A. Hashimoto
- Microbe Division/Japan Collection of Microorganisms RIKEN BioResource Research Center, 3-1-1 Koyadai, Tsukuba, Ibaraki, 305-0074, Japan
| | | | - J. Houbraken
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - V. Hubka
- Department of Botany, Charles University in Prague, Prague, Czech Republic
| | - K.D. Hyde
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chaing Rai, 57100, Thailand
| | - T. Iturriaga
- Cornell University, 334 Plant Science Building, Ithaca, NY, 14850, USA
| | - R. Jeewon
- Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Mauritius, Reduit, Mauritius
| | - P.R. Johnston
- Manaaki Whenua Landcare Research, Private Bag 92170, Auckland, 1142, New Zealand
| | - Ž. Jurjević
- EMSL Analytical, Inc., 200 Route 130 North, Cinnaminson, NJ, 08077, USA
| | - İ. Karalti
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Yeditepe University, Turkey
| | - L. Korsten
- Department of Plant and Soil Sciences, University of Pretoria, P. Bag X20 Hatfield, Pretoria, 0002, South Africa
| | - E.E. Kuramae
- Netherlands Institute of Ecology (NIOO-KNAW), Department of Microbial Ecology, Droevendaalsesteeg 10, 6708 PB, Wageningen, the Netherlands
- Institute of Environmental Biology, Ecology and Biodiversity, Utrecht University, 3584 CH, Utrecht, the Netherlands
| | - I. Kušan
- Laboratory for Biological Diversity, Ruđer Bošković Institute, Bijenička cesta 54, HR-10000, Zagreb, Croatia
| | - R. Labuda
- University of Veterinary Medicine, Vienna (VetMed), Institute of Food Safety, Food Technology and Veterinary Public Health, Veterinaerplatz 1, 1210 Vienna and BiMM – Bioactive Microbial Metabolites group, 3430 Tulln a.d. Donau, Austria
| | - D.P. Lawrence
- University of California, Davis, One Shields Ave., Davis, CA, 95616, USA
| | - H.B. Lee
- Department of Agricultural Biological Chemistry, College of Agriculture & Life Sciences, Chonnam National University, Yongbong-Dong 300, Buk-Gu, Gwangju, 61186, South Korea
| | - C. Lechat
- Ascofrance, 64 route de Chizé, 79360, Villiers-en-Bois, France
| | - H.Y. Li
- The Key Laboratory of Molecular Biology of Crop Pathogens and Insects of Ministry of Agriculture, The Key Laboratory of Biology of Crop Pathogens and Insects of Zhejiang Province, Institute of Biotechnology, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Y.A. Litovka
- V.N. Sukachev Institute of Forest SB RAS, Laboratory of Reforestation, Mycology and Plant Pathology, Krasnoyarsk, 660036, Russia
- Reshetnev Siberian State University of Science and Technology, Department of Chemical Technology of Wood and Biotechnology, Krasnoyarsk, 660037, Russia
| | - S.S.N. Maharachchikumbura
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Y. Marin-Felix
- Department of Microbial Drugs, Helmholtz Centre for Infection Research GmbH (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany
| | - B. Matio Kemkuignou
- Department of Microbial Drugs, Helmholtz Centre for Infection Research GmbH (HZI), Inhoffenstrasse 7, 38124 Braunschweig, Germany
| | - N. Matočec
- Laboratory for Biological Diversity, Ruđer Bošković Institute, Bijenička cesta 54, HR-10000, Zagreb, Croatia
| | - A.R. McTaggart
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Ecosciences Precinct, G.P.O. Box 267, Brisbane, 4001, Australia
| | - P. Mlčoch
- Department of Botany, Faculty of Science, Palacký University Olomouc, Šlechtitelů 27, CZ-783 71, Olomouc, Czech Republic
| | - L. Mugnai
- Department of Agricultural, Food, Environmental and Forestry Science and Technology (DAGRI), Plant Pathology and Entomology section, University of Florence, P.le delle Cascine 28, 50144, Firenze, Italy
| | - C. Nakashima
- Graduate school of Bioresources, Mie University, Kurima-machiya 1577, Tsu, Mie, 514-8507, Japan
| | - R.H. Nilsson
- Gothenburg Global Biodiversity Center at the Department of Biological and Environmental Sciences, University of Gothenburg, Box 461, 405 30, Gothenburg, Sweden
| | - S.R. Noumeur
- Department of Microbiology and Biochemistry, Faculty of Natural and Life Sciences, University of Batna 2, Batna, 05000, Algeria
| | - I.N. Pavlov
- V.N. Sukachev Institute of Forest SB RAS, Laboratory of Reforestation, Mycology and Plant Pathology, Krasnoyarsk, 660036, Russia
- Reshetnev Siberian State University of Science and Technology, Department of Chemical Technology of Wood and Biotechnology, Krasnoyarsk, 660037, Russia
| | - M.P. Peralta
- Laboratorio de Micodiversidad y Micoprospección, PROIMI-CONICET, Av. Belgrano y Pje. Caseros, Argentina
| | - A.J.L. Phillips
- Universidade de Lisboa, Faculdade de Ciências, Biosystems and Integrative Sciences Institute (BioISI), Campo Grande, 1749-016, Lisbon, Portugal
| | - J.I. Pitt
- Microbial Screening Technologies, 28 Percival Rd, Smithfield, NSW, 2164, Australia
| | - G. Polizzi
- Dipartimento di Agricoltura, Alimentazione e Ambiente, sez. Patologia vegetale, University of Catania, Via S. Sofia 100, 95123 Catania, Italy
| | - W. Quaedvlieg
- Phytopathology, Van Zanten Breeding B.V., Lavendelweg 15, 1435 EW, Rijsenhout, the Netherlands
| | - K.C. Rajeshkumar
- National Fungal Culture Collection of India (NFCCI), Biodiversity and Palaeobiology (Fungi) Group, Agharkar Research Institute, Pune, Maharashtra, 411 004, India
| | - S. Restrepo
- Laboratory of Mycology and Phytopathology – (LAMFU), Department of Chemical and Food Engineering, Universidad de los Andes, Cr 1 # 18 a 12, Bogotá, Colombia
| | - A. Rhaiem
- Plant Pathology and Population Genetics, Laboratory of Microorganisms, National Gene Bank, Tunisia
| | | | - V. Robert
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - A.M. Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, 04023062, Brazil
| | - C. Salgado-Salazar
- USDA-ARS Mycology & Nematology Genetic Diversity & Biology Laboratory, Bldg. 010A, Rm. 212, BARC-West, 10300 Baltimore Ave, Beltsville, MD, 20705, USA
| | - R.A. Samson
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - A.C.S. Santos
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Centro de Biociências, Cidade Universitária, Av. Prof. Moraes Rego, s/n, Recife, PE, CEP: 50670-901, Brazil
| | - R.G. Shivas
- Centre for Crop Health, University of Southern Queensland, Toowoomba, 4350, Queensland, Australia
| | - C.M. Souza-Motta
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Centro de Biociências, Cidade Universitária, Av. Prof. Moraes Rego, s/n, Recife, PE, CEP: 50670-901, Brazil
| | - G.Y. Sun
- College of Plant Protection, Northwest A&F University, Yangling, Shaanxi, China
| | - W.J. Swart
- Faculty of Natural and Agricultural Sciences, Department of Plant Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
| | | | - Y.P. Tan
- Centre for Crop Health, University of Southern Queensland, Toowoomba, 4350, Queensland, Australia
- Queensland Plant Pathology Herbarium, Department of Agriculture and Fisheries, Dutton Park, Queensland, 4102, Australia
| | - J.E. Taylor
- Royal Botanic Garden Edinburgh, 20A Inverleith Row, Edinburgh, EH3 5LR, United Kingdom
| | - P.W.J. Taylor
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - P.V. Tiago
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Centro de Biociências, Cidade Universitária, Av. Prof. Moraes Rego, s/n, Recife, PE, CEP: 50670-901, Brazil
| | - K.Z. Váczy
- Food and Wine Research Institute, Eszterházy Károly University, 6 Leányka Street, H-3300, Eger, Hungary
| | | | - N.A. van der Merwe
- Department of Biochemistry, Genetics and Microbiology, Forestry and Agricultural Biotechnology Institute (FABI), Faculty of Natural and Agricultural Sciences, University of Pretoria, P. Bag X20, Hatfield, 0028, Pretoria, South Africa
| | - G.J.M. Verkley
- Westerdijk Fungal Biodiversity Institute, 3508 AD, Utrecht, the Netherlands
| | - W.A.S. Vieira
- Departamento de Agronomia, Universidade Federal Rural de Pernambuco, Recife, 52171-900, PE, Brazil
| | - A. Vizzini
- Department of Life Sciences and Systems Biology, University of Torino and Institute for Sustainable Plant Protection (IPSP-SS Turin), C.N.R, Viale P.A. Mattioli, 25, I-10125, Torino, Italy
| | - B.S. Weir
- Manaaki Whenua Landcare Research, Private Bag 92170, Auckland, 1142, New Zealand
| | - N.N. Wijayawardene
- Center for Yunnan Plateau Biological Resources Protection and Utilization, College of Biological Resource and Food Engineering, Qujing Normal University, Qujing, Yunnan, 655011, China
| | - J.W. Xia
- Shandong Provincial Key Laboratory for Biology of Vegetable Diseases and Insect Pests, College of Plant Protection, Shandong Agricultural University, Taian, 271018, China
| | - M.J. Yáñez-Morales
- Fitosanidad, Colegio de Postgraduados-Campus Montecillo, Montecillo-Texcoco, 56230 Edo. de Mexico, Mexico
| | - A. Yurkov
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures GmbH, Inhoffenstrasse 7 B, 38124, Braunschweig, Germany
| | - J.C. Zamora
- Museum of Evolution, Uppsala University, Norbyvägen 16, SE-752 36, Uppsala, Sweden
| | - R. Zare
- Iranian Research Institute of Plant Protection, Agricultural Research, Education and Extension Organization (AREEO), P.O. Box 19395-1454, Tehran, Iran
| | - C.L. Zhang
- Ministry of Agriculture Key Laboratory of Molecular Biology of Crop Pathogens and Insects, Institute of Biotechnology, College of Agriculture and Biotechnology, Zhejiang University, No. 866 Yuhangtang Road, Hangzhou, 310058, China
| | - M. Thines
- Senckenberg Biodiversity and Climate Research Center, Senckenberganlage 25, D-60325, Frankfurt am Main, Germany
- Goethe-University Frankfurt am Main, Department of Biological Sciences, Institute of Ecology, Evolution and Diversity, Max-von-Laue Str. 13, D-60438, Frankfurt am Main, Germany
- LOEWE Centre for Translational Biodiversity Genomics, Georg-Voigt-Str. 14-16, D-60325, Frankfurt am Main, Germany
| |
Collapse
|
24
|
Yamagishi M, Tamaki N, Akasaka T, Ikeda T, Ueshima K, Uemura S, Otsuji Y, Kihara Y, Kimura K, Kimura T, Kusama Y, Kumita S, Sakuma H, Jinzaki M, Daida H, Takeishi Y, Tada H, Chikamori T, Tsujita K, Teraoka K, Nakajima K, Nakata T, Nakatani S, Nogami A, Node K, Nohara A, Hirayama A, Funabashi N, Miura M, Mochizuki T, Yokoi H, Yoshioka K, Watanabe M, Asanuma T, Ishikawa Y, Ohara T, Kaikita K, Kasai T, Kato E, Kamiyama H, Kawashiri M, Kiso K, Kitagawa K, Kido T, Kinoshita T, Kiriyama T, Kume T, Kurata A, Kurisu S, Kosuge M, Kodani E, Sato A, Shiono Y, Shiomi H, Taki J, Takeuchi M, Tanaka A, Tanaka N, Tanaka R, Nakahashi T, Nakahara T, Nomura A, Hashimoto A, Hayashi K, Higashi M, Hiro T, Fukamachi D, Matsuo H, Matsumoto N, Miyauchi K, Miyagawa M, Yamada Y, Yoshinaga K, Wada H, Watanabe T, Ozaki Y, Kohsaka S, Shimizu W, Yasuda S, Yoshino H. JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases. Circ J 2021; 85:402-572. [PMID: 33597320 DOI: 10.1253/circj.cj-19-1131] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [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: 01/10/2023]
Affiliation(s)
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine Graduate School
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | | | | | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School
| | | | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, University of Fukui
| | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | | | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa Universtiy
| | | | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Atsushi Nohara
- Division of Clinical Genetics, Ishikawa Prefectural Central Hospital
| | | | | | - Masaru Miura
- Department of Cardiology, Tokyo Metropolitan Children's Medical Center
| | | | | | | | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School
| | - Yuichi Ishikawa
- Department of Pediatric Cardiology, Fukuoka Children's Hospital
| | - Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Tokuo Kasai
- Department of Cardiology, Uonuma Kinen Hospital
| | - Eri Kato
- Department of Cardiovascular Medicine, Department of Clinical Laboratory, Kyoto University Hospital
| | | | - Masaaki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University
| | - Keisuke Kiso
- Department of Diagnostic Radiology, Tohoku University Hospital
| | - Kakuya Kitagawa
- Department of Advanced Diagnostic Imaging, Mie University Graduate School
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School
| | | | | | | | - Akira Kurata
- Department of Radiology, Ehime University Graduate School
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
| | - Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama Nagayama Hospital
| | - Akira Sato
- Department of Cardiology, University of Tsukuba
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | - Junichi Taki
- Department of Nuclear Medicine, Kanazawa University
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Japan
| | | | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Ryoichi Tanaka
- Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
| | | | | | - Akihiro Nomura
- Innovative Clinical Research Center, Kanazawa University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Hospital
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University
| | | | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Naoya Matsumoto
- Division of Cardiology, Department of Medicine, Nihon University
| | | | | | | | - Keiichiro Yoshinaga
- Department of Diagnostic and Therapeutic Nuclear Medicine, Molecular Imaging at the National Institute of Radiological Sciences
| | - Hideki Wada
- Department of Cardiology, Juntendo University Shizuoka Hospital
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Yukio Ozaki
- Department of Cardiology, Fujita Medical University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | | | | |
Collapse
|
25
|
Ohori K, Yano T, Katano S, Kouzu H, Honma S, Shimomura K, Inoue T, Takamura Y, Nagaoka R, Koyama M, Nagano N, Fujito T, Nishikawa R, Ishigo T, Watanabe A, Hashimoto A, Miura T. High percent body fat mass predicts lower risk of cardiac events in patients with heart failure: an explanation of the obesity paradox. BMC Geriatr 2021; 21:16. [PMID: 33407196 PMCID: PMC7789382 DOI: 10.1186/s12877-020-01950-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022] Open
Abstract
Background Although high body mass index (BMI) is a risk factor of heart failure (HF), HF patients with a higher BMI had a lower mortality rate than that in HF patients with normal or lower BMI, a phenomenon that has been termed the “obesity paradox”. However, the relationship between body composition, i.e., fat or muscle mass, and clinical outcome in HF remains unclear. Methods We retrospectively analyzed data for 198 consecutive HF patients (76 years of age; males, 49%). Patients who were admitted to our institute for diagnosis and management of HF and received a dual-energy X-ray absorptiometry scan were included regardless of left ventricular ejection fraction (LVEF) categories. Muscle wasting was defined as appendicular skeletal muscle mass index < 7.0 kg/m2 in males and < 5.4 kg/m2 in females. Increased percent body fat mass (increased FM) was defined as percent body fat > 25% in males and > 30% in females. Results The median age of the patients was 76 years (interquartile range [IQR], 67–82 years) and 49% of them were male. The median LVEF was 47% (IQR, 33–63%) and 33% of the patients had heart failure with reduced ejection fraction. Increased FM and muscle wasting were observed in 58 and 67% of the enrolled patients, respectively. During a 180-day follow-up period, 32 patients (16%) had cardiac events defined as cardiac death or readmission by worsening HF or arrhythmia. Kaplan-Meier survival curves showed that patients with increased FM had a lower cardiac event rate than did patients without increased FM (11.4% vs. 22.6%, p = 0.03). Kaplan-Meier curves of cardiac event rates did not differ between patients with and those without muscle wasting (16.5% vs. 15.4%, p = 0.93). In multivariate Cox regression analyses, increased FM was independently associated with lower cardiac event rates (hazard ratio: 0.45, 95% confidence interval: 0.22–0.93) after adjustment for age, sex, diabetes, muscle wasting, and renal function. Conclusions High percent body fat mass is associated with lower risk of short-term cardiac events in HF patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-020-01950-9.
Collapse
Affiliation(s)
- Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.,Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Suguru Honma
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Kanako Shimomura
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Takuya Inoue
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yuhei Takamura
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.,Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| |
Collapse
|
26
|
Yano T, Katano S, Kouzu H, Nagaoka R, Inoue T, Takamura Y, Ishigo T, Watanabe A, Ohori K, Koyama M, Nagano N, Fujito T, Nishikawa R, Hashimoto A, Miura T. Distinct determinants of muscle wasting in nonobese heart failure patients with and without type 2 diabetes mellitus. J Diabetes 2021; 13:7-18. [PMID: 32677311 DOI: 10.1111/1753-0407.13090] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/08/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Muscle wasting, that is, reduction in muscle mass, is frequently observed in patients with chronic heart failure (CHF) and diabetes mellitus (DM). METHODS We retrospectively examined 185 patients with CHF (median age of 71 years [interquartile range, 61-78 years]; 64% male) who received a dual-energy X-ray absorptiometry scan for assessment of appendicular skeletal muscle mass index (ASMI). RESULTS Seventy patients with CHF (38%) had DM. Patients with DM had higher prevalences of ischemic heart disease and hypertension, lower levels of estimated glomerular filtration rate (eGFR) and ASMI, and higher levels of plasma renin activity (PRA) than did patients without DM. In simple regression analyses, ASMI was positively correlated with the Mini Nutritional Assessment Short Form (MNA-SF) score and levels of hemoglobin, eGFR, and fasting plasma insulin and was negatively correlated with levels of N-terminal pro B-type natriuretic peptide, PRA, and cortisol. In multiple linear regression analyses, age, MNA-SF score, DM, fasting plasma insulin level, and PRA were independently associated with ASMI. When multiple linear regression analyses were separately performed in a non-DM group and a DM group, MNA-SF score and fasting plasma insulin level were independent variables for ASMI in both groups. PRA was independently associated with ASMI in the DM group but not in the non-DM group, whereas cortisol concentration was independently associated with ASMI only in the non-DM group. CONCLUSIONS In addition to malnutrition and reduction in plasma insulin, renin-angiotensin system activation may be responsible for the development of muscle wasting in CHF patients with DM.
Collapse
Affiliation(s)
- Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Takuya Inoue
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yuhei Takamura
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital, Sapporo, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
27
|
Muramatsu T, Suehara K, Kameoka T, Notaguchi M, Hashimoto A. Development of multiband optical sensing method for phenotyping of tomatoes in cultivation site. Food Res 2020. [DOI: 10.26656/fr.2017.4(s6).021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
For the development of a smart food chain, it is necessary to produce stable high-quality
agricultural products in the agricultural sector which is the starting point of the food
system, and it is important to accumulate and analyse the phenotypic information of
agricultural products during cultivation. An easy, rapid, non-destructive and quantitative
evaluation method of tree vigor is desirable. This study aimed to develop an X-ray
fluorescent (XRF) spectroscopy of fresh leaves and infrared (IR) spectroscopy of fruit
juice using a portable device. In addition, the relationship between the spectroscopic
information and the surface color of agricultural products was studied. The results showed
that the changes in leaf element were in balance and organic matters in the fruits due to
slight differences in cultivation conditions were grasped as the XRF and IR spectroscopic
information. Furthermore, such changes could be reflected as the differences in the surface
color information obtained using the digital camera. Therefore, it was experimentally
suggested that the multiband optical sensing could be a powerful and important tool for
realizing smart food chains and phenomics research starting from agricultural production.
Collapse
|
28
|
Nakata T, Takura T, Yokoi H, Nakajima K, Kohsaka S, Hashimoto A, Nakamura M. Design of the Japanese Comprehensive Health-Economic Assessment for Appropriate Cardiac Imaging Strategy Including Outcome and Cost-Effectiveness in Stable Coronary Artery Disease Study (J-CONCIOUS). Circ Rep 2020; 2:759-763. [PMID: 33693207 PMCID: PMC7937523 DOI: 10.1253/circrep.cr-20-0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 11/11/2022] Open
Abstract
Background: The evaluation of stable coronary artery disease (SCAD) has evolved, and contemporary clinical practice guidelines emphasize the importance of in-depth consideration of procedure indications, risk stratification, and results of non-invasive imaging tests. However, little is known about the appropriate selection of imaging modalities for ischemia evaluation and the comparative cost-effectiveness in real-world clinical practice. Methods and Results: The Japanese Comprehensive Health-Economic Assessment for Appropriate Cardiac Imaging Strategy including Outcome and cost-effectiveness in Stable Coronary Artery Disease Study (J-CONCIOUS), a multicenter observational study, was designed to prospectively enroll 2,500 patients with suspected or known SCAD, register clinical information and administrative records, and follow patients for 3 years. Any diagnostic or cardiac imaging modality (including stress tests using electrocardiography, echocardiography, or myocardial perfusion imaging; coronary computed tomographic angiography; and/or invasive coronary angiography with or without fractional flow reserve assessment) is acceptable. Clinical endpoints, such as all-cause mortality, cardiac death, and non-fatal myocardial infarction, will be obtained, along with quality of life assessment using the Seattle Angina Questionnaire. The cost-effectiveness of individual assessment patterns will be quantified by analysis of Diagnosis Procedure Combination (DPC) data, and quality-adjusted life years and the incremental cost-effectiveness ratio will be calculated. Conclusions: J-CONCIOUS is expected to establish a risk-based and cost-effective imaging strategy for the detection and evaluation of functional myocardial ischemia and/or anatomical coronary imaging in Japan.
Collapse
Affiliation(s)
| | - Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo Tokyo Japan
| | - Hiroyoshi Yokoi
- Cardiovascular Center, Fukuoka San-oh Hospital Fukuoka Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Kanazawa Japan
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine Tokyo Japan
| | - Akiyoshi Hashimoto
- Department of Cardiology, Nephrology and Metabolism and Endocrinology, Sapporo Medical University School of Medicine Sapporo Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center Tokyo Japan
| |
Collapse
|
29
|
Katano S, Yano T, Tsukada T, Kouzu H, Honma S, Inoue T, Takamura Y, Nagaoka R, Ohori K, Koyama M, Nagano N, Nishikawa R, Hashimoto A, Katayose M, Miura T. Clinical determinants and prognostic impact of osteoporosis in patients with chronic heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3418] [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: 11/14/2022] Open
Abstract
Abstract
Background
Despite accumulating evidence of a close association between orthopedic fractures and chronic heart failure (CHF), the clinical risk factors of osteoporosis, defined as reduction in bone mineral densities (BMDs), in CHF patients have not been systematically analyzed. In addition, the impact of osteoporosis on prognosis of CHF remains unclear.
Aims
We aimed to clarify the prevalence, clinical risk factors, and prognostic impact of osteoporosis in CHF patients.
Methods
We retrospectively examined 303 CHF patients (75 years, [interquartile range (IQR), 66–82 years]; 41% female). BMDs at the lumber spine, femoral neck, and total femur were measured by dual-energy X-ray absorptiometry (DEXA), and osteoporosis was diagnosed when BMD at any of the three sites was less than 70% of Young Adult Mean.
Results
The prevalence of osteoporosis in the CHF patients was 40%. Patients with osteoporosis were older (79 [IQR, 74–86] vs. 72 [IQR, 62–80] years), included a large percentage of females, had slower gait speed and had lower body mass index (BMI). Loop diuretics and warfarin were used more frequently and direct oral anticoagulants (DOACs) were used less frequently in patients with osteoporosis than in patients without osteoporosis. Multivariate logistic regression analysis indicated that sex (odds ratio [OR] 5.07, 95% Confidence Interval [CI] 2.68–9.61, p<0.01), BMI (OR, 0.83; 95% CI, 0.75–0.91; p<0.01), gait speed (OR, 0.80; 95% CI, 0.70–0.92; p<0.01), loop diuretics use (OR, 2.52; 95% CI, 1.20–5.27; p=0.01) and no DOACs use (OR, 0.43; 95% CI, 0.19–0.96; p=0.04) were independently associated with osteoporosis. During the mean follow-up period of 290±254 days, 92 patients (30.4%) had adverse events. When patients with osteoporosis were divided into subgroups according to the number of sites with BMD of an osteoporosis level, Kaplan-Meier survival curves showed that the rate of adverse events (death and cardiovascular events) was higher in patients with osteoporotic BMD at two or more sites than in patients without osteoporosis (51% vs. 23%, p=0.03) (Figure). In multivariate Cox regression analyses, osteoporotic BMD at two or more sites was an independent predictor of adverse events after adjustment for age, sex, and NT-proBNP level (Hazard ratio, 1.74; 95% CI, 1.01–2.99; p=0.04).
Conclusion
The risk of osteoporosis may be increased in users of loop diuretics and may be decreased in users of DOACs in CHF patients. Extent of osteoporosis is a novel predictor of adverse events in CHF patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Japan Society for the Promotion of Science KAKENHI
Collapse
Affiliation(s)
- S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Tsukada
- Social Welfare Corporation, Hokkaido Social Work Association Obihiro Hospital, Cardiac Rehabilitation Center, Obihiro, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - T Inoue
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - Y Takamura
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Public Health, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Division of Health Care Administration and Management, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
30
|
Katano S, Yano T, Tsukada T, Kouzu H, Honma S, Inoue T, Takamura Y, Nagaoka R, Ishigo T, Watanabe A, Ohori K, Koyama M, Nagano N, Fujito T, Nishikawa R, Takashima H, Hashimoto A, Katayose M, Miura T. Clinical Risk Factors and Prognostic Impact of Osteoporosis in Patients With Chronic Heart Failure. Circ J 2020; 84:2224-2234. [PMID: 33116003 DOI: 10.1253/circj.cj-20-0593] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The clinical significance of osteoporosis in chronic heart failure (CHF) remains unclear.Methods and Results:A total of 303 CHF patients (75 years, [interquartile range (IQR) 66-82 years]; 41% female) were retrospectively examined. Bone mineral densities (BMDs) at the lumbar spine, femoral neck, and total femur were measured by using dual-energy X-ray absorptiometry (DEXA), and osteoporosis was diagnosed when the BMD at any of the 3 sites was <70% of the Young Adult Mean percentage (%YAM). The prevalence of osteoporosis in CHF patients was 40%. Patients with osteoporosis were older (79 [IQR, 74-86] vs. 72 [IQR, 62-80] years), included a large percentage of females, had slower gait speed and had a lower body mass index. Multivariate logistic regression analysis indicated that sex, BMI, gait speed, loop diuretics use and no use of direct oral anticoagulants (DOACs) were independently associated with osteoporosis. Kaplan-Meier survival curves showed that the rate of death and heart failure hospitalization was higher in patients with osteoporotic BMD at 2 or 3 sites than in patients without osteoporosis (hazard ratio 3.45, P<0.01). In multivariate Cox regression analyses, osteoporotic BMD at 2 or 3 sites was an independent predictor of adverse events after adjustment for prognostic markers. CONCLUSIONS Loop diuretics use and no DOACs use are independently associated with osteoporosis in CHF patients. Osteoporosis is a novel predictor of worse outcome in patients with CHF.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Takanori Tsukada
- Cardiac Rehabilitation Center, Social Welfare Corporation, Hokkaido Social Work Association Obihiro Hospital
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Suguru Honma
- Department of Rehabilitation, Sapporo Cardiovascular Hospital
| | - Takuya Inoue
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Yuhei Takamura
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Hiroyuki Takashima
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Masaki Katayose
- Department of Public Health, Sapporo Medical University School of Medicine.,Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| |
Collapse
|
31
|
Ishigo T, Takada R, Kondo F, Ibe Y, Nakano K, Tateishi R, Fujii S, Katano S, Kitagawa M, Kimyo T, Nakata H, Hashimoto A, Miyamoto A. [Association Suvorexant and Ramelteon Use with the Risk of Falling: A Retrospective Case-control Study]. YAKUGAKU ZASSHI 2020; 140:1041-1049. [PMID: 32741862 DOI: 10.1248/yakushi.20-00018] [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] [Indexed: 11/22/2022]
Abstract
Sedative hypnotics are among the classes of drugs reported to influence falls. However, the effects of the sedative hypnotic drugs, suvorexant and ramelteon, on falls are not well known. Therefore, we conducted this retrospective case-control study to examine the association of the use of these two sedative hypnotics with the risk of falls. Conducted at the Sapporo Medical University Hospital in Japan, our study included 360 patients with fall incidents and 819 randomly selected control patients. Patients in the fall group were significantly older with a lower body mass index, and had a history of falls, disabilities in activities of daily living, cognitive impairment, and delirium. Monovariate analysis revealed that patients in the fall group frequently used ramelteon [odds ratio (OR) 2.38, 95% confidence interval (CI): 1.49-3.81, p<0.001], but rarely used suvorexant (OR 0.66, 95% CI: 0.29-1.39, p=0.317), compared with control patients. Furthermore, multivariate analysis revealed that ramelteon use did not increase the risk of falls (adjusted OR 1.43, 95% CI: 0.82-2.48, p=0.207), whereas suvorexant use significantly decreased the risk of falls (adjusted OR 0.32, 95% CI: 0.13-0.76, p=0.009). Although ramelteon tends to be used in patients at a high risk of falls, it may not increase the risk of falls. In contrast, the use of suvorexant may reduce the risk of falls.
Collapse
Affiliation(s)
- Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Ryo Takada
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Fuki Kondo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Yuta Ibe
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Keita Nakano
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Riho Tateishi
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Satoshi Fujii
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Manabu Kitagawa
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Tomoko Kimyo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Hiromasa Nakata
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Atsushi Miyamoto
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| |
Collapse
|
32
|
Doi T, Nakata T, Yuda S, Hashimoto A. Synergistic prognostication of left ventricular hypertrophy and three‐dimensional mechanical dyssynchrony in heart failure. ESC Heart Fail 2020; 7:361-370. [PMID: 31965750 PMCID: PMC7083410 DOI: 10.1002/ehf2.12578] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/07/2019] [Accepted: 11/11/2019] [Indexed: 11/22/2022] Open
Abstract
Aims In this study, we investigated the prognostic interplay of left ventricular hypertrophy and mechanical dyssynchrony (LVMD), both of which can be measured three‐dimensionally by gated myocardial perfusion imaging (MPI), in patients with chronic systolic heart failure (HF). Methods and results In 829 consecutive HF patients with reduced left ventricular ejection fraction less than 50%, LVMD was evaluated as a standard deviation (phase SD) of regional onset of mechanical contraction phase angles. A phase histogram was created by Fourier phase analysis applied to regional time‐activity curves obtained by gated MPI. Left ventricular mass index (LVMI) was measured by Corridor 4DM version 6.0. Patients were followed up with a primary endpoint of lethal cardiac events (CE) for a mean interval of 34 months. CE were documented in 223 (27%) of the HF patients. The CE group had a greater phase SD and a greater LVMI than those in the non‐CE group. Patients in the CE group had a more advanced age, greater New York Heart Association (NYHA) functional class, left ventricular cavity size, and left atrial diameter or septal E/e' and lower kidney or cardiac function than did patients in the non‐CE group. Phase SD > 37 and LVMI > 122.7 g/m2 were identified as optimal cut‐off values by receiver operating characteristic analyses for discrimination of the most increased risk HF subgroup from others (P < 0.0001). When classified into four patient subgroups using both cut‐off values, HF patients with phase SD > 37 (LVMD) and LVMI > 122.7g/m2 had the highest CE rate among the subgroups (P < 0.0001). Univariate analysis and subsequent multivariate analysis with a Cox proportional hazards model showed that phase SD and LVMI were significant independent predictors of CE with hazard ratios of 1.038 (confidence interval [CI], 1.024–1.051, P < 0.0001) and 1.005 (CI, 1.001–1.008, P = 0.0073), respectively, as well as conventional clinical parameters such as age, NYHA class, estimated glomerular filtration rate (eGFR), and BNP concentration. Patients with increased phase SD and LVMI had incrementally improved prognostic values of clinical parameters including age, NYHA functional class, eGFR, and BNP with increases in the global χ2 value: 5.9 for age; 139.5 for age and NYHA; 157.9 for age, NYHA, and eGFR; 163.9 for age, NYHA, eGFR, and BNP; 183.4 for age, NYHA, eGFR, BNP, and phase SD; and 192.5 for age, NYHA, eGFR, BNP, phase SD, and LVMI. Conclusions Three‐dimensionally assessed LVMD has independent prognostic values and can improve the risk stratification of chronic HF patients synergistically in combination with conventional clinical parameters.
Collapse
Affiliation(s)
- Takahiro Doi
- Department of Cardiology Teine‐Keijinkai General Hospital Sapporo Japan
| | - Tomoaki Nakata
- Department of Cardiology Hakodate Goryokaku Hospital Hakodate Japan
| | - Satoshi Yuda
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University Sapporo Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University Sapporo Japan
| |
Collapse
|
33
|
Doi T, Nakata T, Noto T, Mita T, Yuda S, Hashimoto A. Paradoxical Prognostic Implications of Visceral Adiposity for Lethal Cardiac Events in Association with Impaired Cardiac Sympathetic Innervation in Chronic Heart Failure. Ann Nucl Cardiol 2020; 6:15-26. [PMID: 37123490 PMCID: PMC10133937 DOI: 10.17996/anc.20-00118] [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] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/17/2020] [Accepted: 05/11/2020] [Indexed: 05/02/2023]
Abstract
Background: Obesity increases the risk for development of heart failure (HF) but, when present is likely to be related to better outcomes in patients with HF. This study aimed to clarify the paradoxical prognostic values of visceral obesity in association with cardiac sympathetic function in HF patients. Methods and Results: A total of 653 consecutive patients with systolic HF who underwent visceral adiposity area (VAA) measurements using a computed tomographic technique were divided into 3 groups: VAA 1, area <80 cm2; VAA 2, area 80-140 cm2; VAA 3, area >140 cm2. Sympathetic innervation was quantified by 123I-MIBG cardiac activity. Patients were followed up for an average of 22 months with a primary endpoint of lethal cardiac events (CE). The CE group (n=200) had a lower late heart-to mediastinum ratio (HMR) and a smaller VAA than those in the non-CE group. Rates of overall CE/HF death were inversely correlated with VAA: 39.2% ± 6.2% for VAA 1, 27.4% ± 19.9% for VAA 2 and 24.1% ± 15.3% for VAA 3. In addition to sudden cardiac death rate, lethal arrhythmic event rate increased in association with visceral fat obesity: 3.0% for VAA 1, 7.5% for VAA 2 and 8.8% for VAA 3. Late HMR identified high-risk sub-populations in each group. Conclusion: Visceral obesity has paradoxical prognostic implications in terms of HF mortality and lethal arrhythmic/sudden cardiac death events. Cardiac sympathetic denervation and quantitative visceral adiposity are synergistically associated with overall cardiac mortality, contributing to better risk stratification of HF patients.
Collapse
Affiliation(s)
- Takahiro Doi
- Department of Cardiology, Teine Kijinkai Hospital, Japan
- Reprint requests and correspondence: Takahiro Doi, MD, PhD, Department of Cardiology, Teine Keijinkai Hospital, 12-1-40 Maeda 1jo, Teine-ku, Sapporo, Hokkaido 006-0711, Japan / E-mail:
| | - Tomoaki Nakata
- Department of Cardiology, Hakodate Goryokaku Hospital, Japan
| | - Takahiro Noto
- Department of Cardiology, Teine Kijinkai Hospital, Japan
| | - Tomohiro Mita
- Department of Cardiology, Teine Kijinkai Hospital, Japan
| | - Satoshi Yuda
- Department of Cardiology, Teine Kijinkai Hospital, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Japan
| |
Collapse
|
34
|
Fujimura T, Tanita K, Sato Y, Lyu C, Kambayashi Y, Fujisawa Y, Uchi H, Yamamoto Y, Otsuka A, Yoshino K, Matsushita S, Funakoshi T, Fukushima S, Hata H, Hashimoto A, Aiba S. Immune checkpoint inhibitor‐induced vitiligo in advanced melanoma could be related to increased levels of CCL19. Br J Dermatol 2019; 182:1297-1300. [DOI: 10.1111/bjd.18721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- T. Fujimura
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - K. Tanita
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - Y. Sato
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - C. Lyu
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - Y. Kambayashi
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | | | - H. Uchi
- National Kyushu Cancer Center Fukuoka Japan
| | | | - A. Otsuka
- Kyoto University Graduate School of Medicine Kyoto Japan
| | - K. Yoshino
- Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital Tokyo Japan
| | - S. Matsushita
- National Hospital Organization Kagoshima Medical Center Kagoshima Japan
| | | | | | - H. Hata
- Hokkaido University Graduate School of Medicine Sapporo Japan
| | - A. Hashimoto
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - S. Aiba
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| |
Collapse
|
35
|
Ohori K, Yano T, Katano S, Honma S, Shimomura K, Watanabe A, Ishigo T, Fujito T, Nagano N, Koyama M, Kouzu H, Hashimoto A, Miura T. P4537Impact of body composition analysis on prediction of short-term readmission events in heart failure: muscle wasting vs. obesity. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity, defined as higher body mass index (BMI), is associated with better prognosis in patients with chronic heart failure (CHF), though the presence of obesity is a risk factor of development of CHF (Obesity paradox). On the other hand, muscle wasting, i.e. reduction in skeletal muscle mass, is frequently observed in CHF, leading to lower exercise capacity and poor cardiovascular outcome.
Purpose
The aim of this study was to examine whether analysis of body composition improves prediction of short-term readmission rates in patients with CHF.
Methods
We retrospectively analyzed data for 167 consecutive HF patients who were admitted to our institute for management of HF and received a Dual-energy X-ray absorptiometry (DEXA) scan. Muscle wasting was defined as DEXA-measured appendicular skeletal muscle mass index <7.0 kg/m2 in male and <5.4 kg/m2 in female according to the Asian Working Group for Sarcopenia criteria. Obesity was defined according to the criteria by the use of DEXA-measured percent body fat mass: >25% in male, >30% in female. The primary endpoint was readmission due to cardiac events including worsening heart failure, arrhythmia, and cardiopulmonary arrest during a 180-days follow-up period after discharge.
Results
The mean age of the patients was 74±13 years and 46% of them were male. The mean BMI was 21.8±3.8 kg/m2. Forty-seven percent of the patients were classified as NYHA functional class III. The most frequent etiology of HF was cardiomyopathy (30%), followed by ischemic heart disease (27%) and valvular heart disease (27%). The prevalence of muscle wasting and that of obesity were 69% and 59%, respectively. Patients with muscle wasting had lower BMI level, higher prevalence of NYHA functional class III and diabetes mellitus compared with those without muscle wasting. On the other hand, patients with obesity had higher prevalence of hypertension and dyslipidemia, higher level of BMI, fasting plasma insulin and triglyceride, and lower level of HDL-cholesterol compared with those without obesity. During the follow-up period, 34 patients (19%) were re-hospitalized due to cardiac events. Kaplan-Meier survival curves showed that patients with obesity had a significantly lower readmission rate during a 180-days follow-up period than did the patients without obesity (14.3% vs. 29.0%, Log-Rank test, p<0.01). There was no difference in readmission rates between patients with and without muscle wasting (20.0% vs. 21.2%, p=0.88). In multivariate Cox regression analyses adjusted for age, sex, diabetes, and renal function, obesity was independently associated with lower readmission rates (hazard ratio 0.45, 95% confidence interval 0.22–0.93). However, the association between obesity and readmission rate was lost after the adjustment for NT-proBNP levels.
Conclusion
Body composition analysis by DEXA enables to find CHF patients with increased fat mass who have lower risk of short-term readmission.
Collapse
Affiliation(s)
- K Ohori
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - S Katano
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - S Honma
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - K Shimomura
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - A Watanabe
- Sapporo Medical University, Division of Nursing, Sapporo, Japan
| | - T Ishigo
- Sapporo Medical University, Division of Hospital Pharmacy, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
36
|
Shimomura K, Katano S, Yano T, Ohori K, Honma S, Watanabe A, Ishigo T, Fujito T, Nagano N, Koyama M, Kouzu H, Hashimoto A, Miura T. P1538Low energy intake predicts readmission of elderly heart failure patients independently of nutritional status. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Malnutrition is frequently present and closely associated with poor clinical outcomes in elderly heart failure (HF) patients. Our previous study showed that low energy intake (EI) is associated with worse functional status in elderly HF inpatients after cardiac rehabilitation, but significance of EI in prediction of hospital readmission has not been elucidated fully.
Purpose
We examined whether low EI is a predictor of readmission for cardiac events in elderly HF patients.
Methods
We retrospectively retrieved data for 298 HF patients aged ≥65 years (median age of 77 years, interquartile range [IQR]: 71 - 82, female: 53%) who admitted to our institute for diagnosis and treatment of HF. Medical records were reviewed with regard to demography, medical history, comorbidities, medications, laboratory data, echocardiograms, functional status, nutritional status and total energy intake. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF) and total EI per day were calculated at discharge by a registered dietitian and a trained physical therapist. The primary endpoint was readmission due to cardiovascular events including worsening HF, arrhythmia, angina pectoris and myocardial infarction during a 1-year follow-up period.
Results
The median period of follow-up was 235 days (IQR: 78–365 days). The 1-year readmission rate for cardiovascular events was 54.4%. The cutoff values of MNA-SF score and EI, calculated by ROC curve analysis to predict the primary endpoint, were 7 points (area under the curve [AUC]: 0.59, sensitivity: 0.65, specificity: 0.50) and 31.8 kcal/kg/day (AUC: 0.59, sensitivity: 0.83, specificity: 0.35), respectively. Patients with low MNF-SF score (≤7) or low EI (≤31.8 kcal/kg/day) had significantly higher readmission rate during a 1-year follow-up period than did the patients with high MNF-SF score or EI (MNA-SF: 60.7% vs. 45.6%, p<0.01, EI: 60.4% vs. 36.8%, p<0.01), respectively. When patients were classified into four groups using cutoff values of MNA-SF score and EI, 1-year readmission rate was significantly higher in patients with low EI than in those with high EI regardless of MNF-SF scores. In multivariate Cox proportional hazard analyses adjusted for known prognostic factors in addition to age and gender, hazard ratios (HR) were significantly higher in patients with high MNA-SF score and low EI (adjusted HR: 2.81, 95% confidential interval [CI]: 1.15 - 9.32, p=0.02) and low MNA-SF score (≤7) and low EI (adjusted HR: 4.16, 95% CI: 1.72 - 13.72, p<0.01) than those with high MNA-SF score and high EI.
Kaplan-Meier curves of readmission rates
Conclusions
Low energy intake is a nutritional status-independent predictor of 1-year readmission rate in elderly HF patients.
Collapse
Affiliation(s)
- K Shimomura
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - S Honma
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - A Watanabe
- Sapporo Medical University Hospital, Division of Nursing, Sapporo, Japan
| | - T Ishigo
- Sapporo Medical University Hospital, Department of Hospital Pharmacy, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Department of Public Health, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University School of Medicine, Division of Health Care Administration and Management, Sapporo, Japan
| | - T Miura
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| |
Collapse
|
37
|
Kawamukai M, Hashimoto A, Koyama M, Nagano N, Nishida J, Mochizuki A, Kouzu H, Muranaka A, Kokubu N, Nagahara D, Yuda S, Tsuchihashi K, Miura T. Risk classification of pulmonary arterial hypertension by echocardiographic combined assessment of pulmonary vascular resistance and right ventricular function. Heart Vessels 2019; 34:1789-1800. [PMID: 31119378 DOI: 10.1007/s00380-019-01429-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 05/15/2019] [Indexed: 01/25/2023]
Abstract
Which combination of clinical parameters improves the prediction of prognosis in patients with pulmonary arterial hypertension (PAH) remains unclear. We examined whether combined assessment of pulmonary vascular resistance and right ventricular function by echocardiography is useful for classifying risks in PAH. In 41 consecutive patients with PAH (mean age of 48.9 ± 17.3 years, 31 females), a 6-min walk test, pulmonary function test, and echocardiography were performed at baseline and during PAH-specific therapies. The study endpoint was defined as a composite of cardiovascular death and hospitalization for PAH and/or right ventricular failure. During a follow-up period of 9.2 ± 8.7 months, 18 patients reached the endpoint. Multivariate regression analysis showed that the ratio of tricuspid regurgitation pressure gradient to the time-velocity integral of the right ventricular outflow tract (TRPG/TVI) and tricuspid annular plane systolic excursion (TAPSE) during PAH-specific treatment were independent prognostic predictors of the endpoint. Using cutoff values indicated by receiver operating characteristic analysis, the patients were divided into four subsets. Multivariate analyses by Cox's proportional hazards model adjusted for age, sex and body mass index indicated that subset 4 (TRPG/TVI ≥ 3.89 and TAPSE ≤ 18.9 mm) had a significantly higher event risk than did subset 1 (TRPG/TVI < 3.89 and TAPSE > 18.9 mm): HR = 25.49, 95% CI 4.70-476.97, p < 0.0001. Combined assessment of TRPG/TVI and TAPSE during adequate PAH-specific therapies enables classification of risks for death and/or progressive right heart failure in PAH.
Collapse
Affiliation(s)
- Mina Kawamukai
- Department of Cardiovascular Internal Medicine, Obihiro-Kosei General Hospital, Obihiro, Japan.,Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan. .,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Junichi Nishida
- Department of Cardiovascular Internal Medicine, Obihiro-Kosei General Hospital, Obihiro, Japan
| | - Atsushi Mochizuki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Atsuko Muranaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Nobuaki Kokubu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Daigo Nagahara
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Satoshi Yuda
- Division of Cardiology, Teine-Keijinkai Hospital, Cardiovascular Center, Sapporo, Japan
| | - Kazufumi Tsuchihashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| |
Collapse
|
38
|
Doi T, Nakata T, Yuda S, Hashimoto A. Synergistic prognostic implications of left ventricular mechanical dyssynchrony and impaired cardiac sympathetic nerve activity in heart failure patients with reduced left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging 2018; 19:74-83. [PMID: 28158459 DOI: 10.1093/ehjci/jew334] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/26/2016] [Indexed: 11/12/2022] Open
Abstract
Aims Impairment of cardiac sympathetic innervation is a potent prognostic marker in heart failure, while left ventricular mechanical dyssynchrony (LVMD) has recently been noted as a novel prognosis determinant in heart failure patients with reduced LV ejection fraction (HFrEF). This study was designed to determine the correlation between cardiac sympathetic innervation quantified by metaiodobenzylguanidine (MIBG) activity and LVMD measured by electrocardiogram-gated myocardial perfusion imaging and to evaluate their incremental prognostic values in HFrEF patients. Methods and results A total of 570 consecutive HFrEF patients were followed up for 19.6 months with a primary endpoint of lethal cardiac events (CE) such as sudden cardiac death, death due to pump failure and appropriate ICD shock against life-threatening ventricular tachyarrhythmias. Cardiac sympathetic function and innervation were quantified as heart-to-mediastinum ratio (HMR) and washout kinetics of cardiac MIBG activity. LVMD was assessed by a standard deviation (SD) of systolic phase angle in gated myocardial perfusion imaging. Patients with CE (n = 166, 29%) had a significantly lower HMR and a significantly greater phase SD than did non-CE patients: 1.46 ± 0.28 vs. 1.63 ± 0.29, P < 0.0001 and 39.1 ± 11.6 vs. 33.1 ± 10.1, P < 0.0001, respectively. Compared to the single use of optimal cut-offs of late HMR (1.54) and phase SD (38), their combination more precisely discriminated high-risk or low-risk patients from others with log rank values from 7.78 to 65.2 (P = 0.0053 to P ≤ 0.0001). Among significant univariate variables, multivariate Cox proportional hazards model identified NYHA functional class, estimated glomerular filtration rate (eGFR), HMR 1.54 and phase SD 60 as significant determinants of CE with hazard ratios of 3.108 (95% CI, 2.472-3.910; P < 0.0001), 0.988 (95% CI, 0.981-0.996; P = 0.0021), 0.257 (95% CI, 0.128-0.498; P < 0.0001) and 1.019 (95% CI, 1.019-1.037; P = 0.0228), respectively. By combining the four independent determinants, the prognostic powers synergistically (P < 0.0001) increased maximally to 263.8. Conclusions Left ventricular mechanical dyssynchrony and impairment of cardiac sympathetic innervation are synergistically related to lethal cardiac events, contributing to better stratification of lethal cardiac event-risks and probably to optimization of therapeutic strategy in patients with HFrEF.
Collapse
Affiliation(s)
- Takahiro Doi
- Department of Cardiology, Obihiro-Kosei General Hospital, W6-S8-1, Obihiro, Hokkaido, 81-080-0016, Japan
| | - Tomoaki Nakata
- Department of Cardiology, Hakodate Goryokaku Hospital, Goryokaku cho 38-3, Hakodate, Hokkaido, 81-040-8611, Japan
| | - Satoshi Yuda
- Department of Cardiology, Renal and Metabolic Medicine, Sapporo Medical University, Chuo-ku S1-W16-291, Sapporo, Hokkaido, 81-060-8543, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiology, Renal and Metabolic Medicine, Sapporo Medical University, Chuo-ku S1-W16-291, Sapporo, Hokkaido, 81-060-8543, Japan
| |
Collapse
|
39
|
Nagahara D, Fujito T, Mochizuki A, Shimoshige S, Hashimoto A, Miura T. Predictors of appropriate ICD therapy in Japanese patients with structural heart diseases: A major role of prior sustained ventricular tachycardia in secondary prevention. J Arrhythm 2018; 34:527-535. [PMID: 30327698 PMCID: PMC6174420 DOI: 10.1002/joa3.12086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/04/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Implantable cardioverter defibrillator (ICD) and cardiac resynchronization with a defibrillator (CRT-D) are established therapies for secondary prevention of sudden cardiac death (SCD) in patients with structural heart disease (SHD), but the rates of subsequent ICD/CRT-D therapy widely differ among patients with SHD. The aim of this study was to determine clinical factors associated with appropriate therapy for preventing SCD in patients with SHD. METHODS We enrolled 147 patients with SHD (mean age, 59 ± 15 years; mean ejection fraction [EF], 45 ± 15%) who underwent ICD/CRT-D implantation for secondary prevention of SCD (ischemic heart disease, n = 50; nonischemic heart disease, n = 97). ICD/CRT-D was implanted for aborted cardiopulmonary arrest (CPA, n = 65) or sustained ventricular tachycardia (VT, n = 82). RESULTS During a follow-up period of 3.2 ± 3.6 years, 79 of the 147 patients had appropriate ICD/CRT-D therapies. A Kaplan-Meier survival curve showed that the rate of appropriate therapy was 54% at 5-year follow-up. Prior sustained VT, lower EF, and use of a class I antiarrhythmic drug were significantly more frequent in patients with appropriate therapy. In multivariate analysis, prior sustained VT (hazard ratio, 2.8; 95% CI, 1.60-4.46; P = .001) was the only independent predictor for appropriate ICD/CRT-D therapy. Kaplan-Meier survival curves showed that rates of appropriate therapy during a 5-year follow-up period were 70% and 34% in patients with sustained VT and those with CPA, respectively (P = .001). CONCLUSIONS In SHD patients implanted with an ICD/CRT-D, prior sustained VT as an indication of ICD/CRT-D implantation, but not EF or an antiarrhythmic drug, predicts a high rate of appropriate therapy.
Collapse
Affiliation(s)
- Daigo Nagahara
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Atsushi Mochizuki
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Shinya Shimoshige
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| |
Collapse
|
40
|
Takeda Y, Takeda Y, Karashima S, Kometani M, Yoneda T, Aono D, Hashimoto A. P1867Long-term treatment with LCZ696 (sacubitril/valsartan) improves cardiac and renal function in stroke-prone spontaneously hypertensive rats. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Takeda
- Kanazawa University, Kanazawa, Japan
| | - Y Takeda
- Kanazawa University, Kanazawa, Japan
| | | | | | - T Yoneda
- Kanazawa University, Kanazawa, Japan
| | - D Aono
- Kanazawa University, Kanazawa, Japan
| | | |
Collapse
|
41
|
Fujimura T, Sato Y, Kambayashi Y, Tanita K, Tsukada A, Terui H, Hashimoto A, Aiba S. Three patients with advanced cutaneous angiosarcoma treated with eribulin: investigation of serum soluble CD163 and chemokine (C-X-C motif) ligand 10 as possible biomarkers predicting the biological behaviour of angiosarcoma. Br J Dermatol 2018; 179:1392-1395. [DOI: 10.1111/bjd.16676] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 01/23/2023]
Affiliation(s)
- T. Fujimura
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Y. Sato
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Y. Kambayashi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - K. Tanita
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - A. Tsukada
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - H. Terui
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - A. Hashimoto
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - S. Aiba
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| |
Collapse
|
42
|
Chono T, Onoguchi M, Hashimoto A. [Assessment of Left Ventricular Diastolic Function Using ECG-gated Myocardial Perfusion SPECT in Small Heart: Comparison with Ultrasound Echocardiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:572-579. [PMID: 29925752 DOI: 10.6009/jjrt.2018_jsrt_74.6.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Assessment of left ventricular (LV) diastolic function is important because it is possible to detect early sign of myocardial ischemia by this assessment. The purpose of this study was to compare between electrocardiogram (ECG) -gated myocardial perfusion single photon emission computed tomography (G-SPECT) and ultrasound echocardiography in assessment of LV diastolic function in the small heart (SH). METHODS The study population consisted of 144 patients who underwent both G-SPECT and ultrasound echocardiography. Peak filling rate (PFR), one-third mean filling rate (1/3 MFR) and the ratio of time to PFR to the RR interval (TPFR/RR) were calculated by quantitative gated SPECT (QGS) and heart risk view-F (HRV-F). Peak early mitral annular velocity (e') was used as the reference standard of LV diastolic function. RESULTS There were 33 patients with end-systolic volume (ESV) of ≤10 ml (SH10), 51 patients with ESV of 11-20 ml (SH 20) and 60 patients with ESV of >20 ml (normal-sized heart: NH). In SH10, PFR calculated by QGS was not correlated with e'. However, that by HRV-F was significantly correlated with e' (r=0.47, p=0.006). On the other hand, 1/3 MFR and TPFR/RR calculated by QGS and HRV-F were not correlated with e' in SH10 and SH20. PFR, 1/3 MFR and TPFR/RR calculated by QGS and HRV-F were correlated with e' in NH.
Collapse
Affiliation(s)
- Taiki Chono
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital.,Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| |
Collapse
|
43
|
Hashimoto A, Hirayama K, Takahashi H, Matsumura M, Okada G, Chen C, Huang J, Kakishima M, Ono T, Tanaka K. Resolving the Lophiostoma bipolare complex: Generic delimitations within Lophiostomataceae. Stud Mycol 2018; 90:161-189. [PMID: 29632417 PMCID: PMC5889712 DOI: 10.1016/j.simyco.2018.03.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Lophiostoma bipolare was taxonomically revised based on the morphological observations and phylogenetic analyses of molecular data from nuclear rDNA SSU-ITS-LSU, TUB, tef1, and rpb2 genes. Twenty-nine strains were morphologically similar to Lo. bipolare. A total of 174 sequences were generated from the Lo. bipolare complex. Phylogenetic analyses based on TUB sequence revealed 11 distinct species within the Lo. bipolare complex. Morphological features of the ascospores and the anatomical structure of the ascomata from both field collections as well as axenic culture, which have been reported previously as variable features at intraspecific levels, were compared to evaluate the taxonomic reliability of these features. To clarify the generic position of the 11 species, phylogenetic analyses were done on SSU-ITS-LSU-tef1-rpb2 gene sequences. The Lo. bipolare complex shared phylogenetic relationships with Pseudolophiostoma and Vaginatispora, and formed an additional five distinct clades from other members of Lophiostomataceae. According to its phylogenetic position, Lo. bipolare sensu stricto was distantly related to Lophiostoma s. str., and formed an independent clade within Lophiostomataceae. Lophiostoma bipolare s. str. could be distinguished from the other lophiostomataceous genera by the clypeus around the ostiolar neck and by the thin and uniformly thick peridium. A novel genus described as Lentistoma was established to accommodate this species, and the epitypification of Lentistoma bipolare (basionym: Massarina bipolaris) was proposed. Other lineages of the Lo. bipolare complex could not be separated on the basis of the ascospore size and sheath variations, but were distinguished based on ascomatal features, such as the existence of the clypeus, brown hyphae surrounding the peridium, and the contexture of the peridium, which were stable indicators of generic boundaries in Lophiostomataceae. Four additional new genera with five new species were recognised based on these morphological differences: Crassiclypeus (C. aquaticus), Flabellascoma (F. cycadicola and F. minimum), Leptoparies (Lep. palmarum), and Pseudopaucispora (Pseudop. brunneospora). Three new species were added to Pseudolophiostoma (Pseudol. cornisporum, Pseudol. obtusisporum, and Pseudol. tropicum) and two new species were added to Vaginatispora (V. amygdali and V. scabrispora). The re-evaluation of the validity of several previously recognised genera resulted in the introduction of two new genera with new combinations for Lophiostoma pseudoarmatisporum as Parapaucispora pseudoarmatispora and Vaginatispora fuckelii as Neovaginatispora fuckelii.
Collapse
Key Words
- 1 new typification
- 21 new taxa
- Crassiclypeus A. Hashim., K. Hiray. & Kaz. Tanaka
- Crassiclypeus aquaticus A. Hashim., K. Hiray. & Kaz. Tanaka
- Flabellascoma A. Hashim., K. Hiray. & Kaz. Tanaka
- Flabellascoma cycadicola A. Hashim., K. Hiray. & Kaz. Tanaka
- Flabellascoma minimum A. Hashim., K. Hiray. & Kaz. Tanaka
- Freshwater fungi
- Lentistoma A. Hashim., K. Hiray. & Kaz. Tanaka
- Lentistoma bipolare (K.D. Hyde) A. Hashim., K. Hiray. & Kaz. Tanaka
- Leptoparies A. Hashim., K. Hiray. & Kaz. Tanaka
- Leptoparies palmarum A. Hashim., K. Hiray. & Kaz. Tanaka
- Massarina bipolaris K.D. Hyde
- Neovaginatispora A. Hashim., K. Hiray. & Kaz. Tanaka
- Neovaginatispora fuckelii (Sacc.) A. Hashim., K. Hiray. & Kaz. Tanaka
- Parapaucispora A. Hashim., K. Hiray. & Kaz. Tanaka
- Parapaucispora pseudoarmatispora (Hay. Takah. et al.) A. Hashim., K. Hiray. & Kaz. Tanaka
- Pleosporales
- Pseudolophiostoma cornisporum A. Hashim., K. Hiray. & Kaz. Tanaka
- Pseudolophiostoma obtusisporum A. Hashim., K. Hiray. & Kaz. Tanaka
- Pseudolophiostoma tropicum A. Hashim., K. Hiray. & Kaz. Tanaka
- Pseudopaucispora A. Hashim., K. Hiray. & Kaz. Tanaka
- Pseudopaucispora brunneospora A. Hashim., K. Hiray. & Kaz. Tanaka
- Species complex
- Systematics
- Taxonomy
- Vaginatispora amygdali A. Hashim., K. Hiray. & Kaz. Tanaka
- Vaginatispora scabrispora A. Hashim., K. Hiray. & Kaz. Tanaka
Collapse
Affiliation(s)
- A. Hashimoto
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori 036-8561, Japan
- Research Fellow of the Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - K. Hirayama
- Apple Experiment Station, Aomori Prefectural Agriculture and Forestry Research Center, 24 Fukutami, Botandaira, Kuroishi, Aomori 036-0332, Japan
| | - H. Takahashi
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori 036-8561, Japan
| | - M. Matsumura
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori 036-8561, Japan
- The United Graduate School of Agricultural Sciences, Iwate University, 18–8 Ueda 3 chome, Morioka, Iwate 020-8550, Japan
| | - G. Okada
- Japan Collection of Microorganisms, RIKEN BioResource Center, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - C.Y. Chen
- National Chung Hsing University, 145 Xingda Rd., South Dis., Taichung 402, Taiwan, ROC
| | - J.W. Huang
- College of Agriculture and Natural Resources, National Chung Hsing University, 250 Kuo-kuang Rd., Taichung 402, Taiwan, ROC
| | - M. Kakishima
- Engineering Research Center of Chinese Ministry of Education for Edible and Medicinal Fungi, Jilin Agricultural University, Changchun, Jilin Province 130118, China
- Faculty of Life and Environmental Sciences, University of Tsukuba, Ibaraki 305-8572, Japan
| | - T. Ono
- Ogasawara Subtropical Branch of Tokyo Metropolitan Agriculture and Forestry Research Center, Chichijima, Ogasawara-mura, Tokyo 100-2101, Japan
| | - K. Tanaka
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori 036-8561, Japan
- The United Graduate School of Agricultural Sciences, Iwate University, 18–8 Ueda 3 chome, Morioka, Iwate 020-8550, Japan
| |
Collapse
|
44
|
Katano S, Hashimoto A, Ohori K, Watanabe A, Honma R, Yanase R, Ishigo T, Fujito T, Ohnishi H, Tsuchihashi K, Ishiai S, Miura T. Nutritional Status and Energy Intake as Predictors of Functional Status After Cardiac Rehabilitation in Elderly Inpatients With Heart Failure - A Retrospective Cohort Study. Circ J 2018; 82:1584-1591. [PMID: 29628459 DOI: 10.1253/circj.cj-17-1202] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Whether the short-term effect of cardiac rehabilitation (CR) in elderly patients with heart failure (HF) is influenced by nutritional status is uncertain, so the present study investigated the effect of nutritional status on functional recovery after CR in elderly HF inpatients.Methods and Results:We enrolled 145 patients admitted for treatment of HF who were aged ≥65 years and had a low functional status defined as a Barthel index (BI) score ≤85 points at the commencement of CR. Nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF) and total energy intake per day. The primary endpoint was functional status determined by the BI score at discharge. The median CR period was 20 days (interquartile range: 14-34 days), and 87 patients (60%) were functionally dependent (BI score ≤85) at discharge. Multivariate logistic regression analysis showed that MNA-SF score (odds ratio [OR]: 0.76, P=0.02) and total energy intake at the commencement of CR (OR: 0.91, P=0.02) were independent predictors of functional dependence after CR. MNA-SF score ≤7 and total energy intake ≤24.5 kcal/kg/day predicted functional dependence at discharge with moderate sensitivity and specificity. CONCLUSIONS MNA-SF score and total energy intake at the commencement of CR are novel predictors of the extent of functional recovery of elderly HF inpatients after in-hospital CR.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital
| | - Remi Honma
- Division of Nursing, Sapporo Medical University Hospital
| | - Rimi Yanase
- Division of Nursing, Sapporo Medical University Hospital
| | - Tomoyuki Ishigo
- Department of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Public Health, Sapporo Medical University School of Medicine
| | - Kazufumi Tsuchihashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Sumio Ishiai
- Department of Rehabilitation, Sapporo Medical University School of Medicine
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| |
Collapse
|
45
|
Hashimoto A, Matsumura M, Hirayama K, Fujimoto R, Tanaka K. Pseudodidymellaceae fam. nov.: Phylogenetic affiliations of mycopappus-like genera in Dothideomycetes. Stud Mycol 2017; 87:187-206. [PMID: 28794574 PMCID: PMC5542424 DOI: 10.1016/j.simyco.2017.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The familial placement of four genera, Mycodidymella, Petrakia, Pseudodidymella, and Xenostigmina, was taxonomically revised based on morphological observations and phylogenetic analyses of nuclear rDNA SSU, LSU, tef1, and rpb2 sequences. ITS sequences were also provided as barcode markers. A total of 130 sequences were newly obtained from 28 isolates which are phylogenetically related to Melanommataceae (Pleosporales, Dothideomycetes) and its relatives. Phylogenetic analyses and morphological observation of sexual and asexual morphs led to the conclusion that Melanommataceae should be restricted to its type genus Melanomma, which is characterised by ascomata composed of a well-developed, carbonaceous peridium, and an aposphaeria-like coelomycetous asexual morph. Although Mycodidymella, Petrakia, Pseudodidymella, and Xenostigmina are phylogenetically related to Melanommataceae, these genera are characterised by epiphyllous, lenticular ascomata with well-developed basal stroma in their sexual morphs, and mycopappus-like propagules in their asexual morphs, which are clearly different from those of Melanomma. Pseudodidymellaceae is proposed to accommodate these four genera. Although Mycodidymella and Xenostigmina have been considered synonyms of Petrakia based on sexual morphology, we show that they are distinct genera. Based on morphological observations, these genera in Pseudodidymellaceae are easily distinguished by their synasexual morphs: sigmoid, multi-septate, thin-walled, hyaline conidia (Mycodidymella); globose to ovoid, dictyosporus, thick-walled, brown conidia with cellular appendages (Petrakia); and clavate with a short rostrum, dictyosporus, thick-walled, brown conidia (Xenostigmina). A synasexual morph of Pseudodidymella was not observed. Although Alpinaria was treated as member of Melanommataceae in a previous study, it has hyaline cells at the base of ascomata and pseudopycnidial, confluent conidiomata which is atypical features in Melanommataceae, and is treated as incertae sedis.
Collapse
Affiliation(s)
- A Hashimoto
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori, 036-8561, Japan.,Research Fellow of the Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - M Matsumura
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori, 036-8561, Japan.,The United Graduate School of Agricultural Sciences, Iwate University, 18-8 Ueda 3 chome, Morioka, 020-8550, Japan
| | - K Hirayama
- Apple Experiment Station, Aomori Prefectural Agriculture and Forestry Research Centre, 24 Fukutami, Botandaira, Kuroishi, Aomori, 036-0332, Japan
| | - R Fujimoto
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori, 036-8561, Japan
| | - K Tanaka
- Faculty of Agriculture and Life Sciences, Hirosaki University, 3 Bunkyo-cho, Hirosaki, Aomori, 036-8561, Japan.,The United Graduate School of Agricultural Sciences, Iwate University, 18-8 Ueda 3 chome, Morioka, 020-8550, Japan
| |
Collapse
|
46
|
Tanabe N, Ikeda S, Tahara N, Fukuda K, Hatano M, Ito H, Nakayama T, Anzai T, Hashimoto A, Inoue T, Kajinami K, Kihara Y, Kinoshita H, Kuwahara K, Murohara T, Okazaki O, Sakai S, Satoh T, Takeda Y, Takeishi Y, Taniguchi M, Watanabe H, Yamamoto T, Yamauchi-Takihara K, Yoshioka K, Sasayama S. Efficacy and Safety of an Orally Administered Selective Prostacyclin Receptor Agonist, Selexipag, in Japanese Patients With Pulmonary Arterial Hypertension. Circ J 2017; 81:1360-1367. [DOI: 10.1253/circj.cj-16-1348] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 11/09/2022]
Affiliation(s)
- Nobuhiro Tanabe
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Nobuhiro Tahara
- Department of Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Masaru Hatano
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Hospital
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine
| | | | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University Hospital
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | | | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideyuki Kinoshita
- Department of Community Medicine Supporting System, Kyoto University Graduate School of Medicine
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Osamu Okazaki
- Department of Cardiology, National Center for Global Health and Medicine
| | - Satoshi Sakai
- Cardiovascular Division, Department of Clinical Medicine, Faculty of Medicine, University of Tsukuba
| | - Toru Satoh
- Division of Cardiology Department of Medicine, Kyorin University Hospital
| | - Yutaka Takeda
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences
| | | | - Mitsugu Taniguchi
- Department of Cardiology, Osaka Pref. Saiseikai Tondabayashi Hospital
| | - Hiroshi Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
| | - Takeshi Yamamoto
- Faculty of Health Science, Yamaguchi University Graduate School of Medicine
| | | | | | | |
Collapse
|
47
|
Hashimoto K, Hashimoto A, Kishimoto M, Sugawara K, Funahashi H, Nakano K, Takahashi H, Hashimoto S, Miura T, Tsuchihashi K. Operator Safety Zone During the Nitric Oxide Inhalation Vasoreactivity Test for Pulmonary Hypertension Patients. ABE 2017. [DOI: 10.14326/abe.6.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kanae Hashimoto
- Division of Clinical Engineering, Sapporo Medical University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Masumi Kishimoto
- Division of Clinical Engineering, Sapporo Medical University Hospital
| | - Kosuke Sugawara
- Division of Clinical Engineering, Sapporo Medical University Hospital
| | - Hitomi Funahashi
- Division of Clinical Engineering, Sapporo Medical University Hospital
| | - Kota Nakano
- Division of Clinical Engineering, Sapporo Medical University Hospital
| | | | - Syuichi Hashimoto
- Division of Clinical Engineering, Sapporo Medical University Hospital
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Kazufumi Tsuchihashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| |
Collapse
|
48
|
Chono T, Onoguchi M, Shibutani T, Hashimoto A, Nakata T, Yama N, Tsuchihashi K, Hatakenaka M. Improvement in automated quantitation of myocardial perfusion abnormality by using iterative reconstruction image in combination with resolution recovery, attenuation and scatter corrections for the detection of coronary artery disease. Ann Nucl Med 2016; 31:181-189. [DOI: 10.1007/s12149-016-1146-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 12/10/2016] [Indexed: 10/20/2022]
|
49
|
Muraoka H, Yoshimura C, Tsuji S, Hashimoto A, Mizutani T, Ohkubo S, Matsuo K, Utsugi T, Iwasawa Y. TAS4464, a novel highly potent NEDD8 activating enzyme inhibitor, demonstrates anti-tumor efficacy in rituximab-resistant double-hit lymphoma models. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33052-0] [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]
|
50
|
Irie H, Ito K, Kataoka Y, Fujioka Y, Oguchi K, Shimamura T, Kawai Y, Sagara T, Shibata Y, Araki H, Haruma T, Hashimoto A, Matsuo K, Utsugi T, Iwasawa Y. TPC-107, a next generation, HER2 selective covalent inhibitor demonstrates potent and sustained inhibition against the HER2–HER3 signaling while sparing EGFR activity, leading to a large therapeutic window. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32658-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|