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Yano M, Nishino M, Kawanami S, Ukita K, Kawamura A, Yasumoto K, Tsuda M, Okamoto N, Matsunaga‐Lee Y, Egami Y, Yamada T, Yasumura Y, Seo M, Hayashi T, Nakagawa A, Nakagawa Y, Tamaki S, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Low-density lipoprotein cholesterol, erythrocyte, and platelet in heart failure with preserved ejection fraction. ESC Heart Fail 2024; 11:1758-1766. [PMID: 38454876 PMCID: PMC11098649 DOI: 10.1002/ehf2.14734] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
AIMS Low-density lipoprotein cholesterol (LDL-C), anaemia and low platelets have been associated with worse clinical outcomes in heart failure patients. We investigated the relationship between the combination of these three components and clinical outcome in patients with heart failure with preserved ejection fraction (HFpEF). METHODS AND RESULTS We examined the data of 1021 patients with HFpEF hospitalized with acute decompensated heart failure (HF) from the PURSUIT-HFpEF registry, a prospective, multicenter observational study. The enrolled patients were classified into four groups by an LEP (LDL-C, Erythrocyte, and Platelet) score of 0 to 3 points, with 1 point each for LDL-C, erythrocyte and platelet values less than the cut-off values as calculated by receiver operating characteristic curve analysis. The endpoint, a composite of all-cause death and HF readmission, was evaluated among the four groups. Median follow-up duration was 579 [300, 978] days. Risk of the composite endpoint significantly differed among the four groups (P < 0.001). Kaplan-Meier analysis showed that the groups with an LEP score of 2 had higher risk of the composite endpoint than those with an LEP score of 0 or 1 (P < 0.001, and P = 0.013, respectively), while those with an LEP score of 3 had higher risk than those with an LEP score of 0, 1 or 2 (P < 0.001, P < 0.001 and P = 0.020, respectively). Cox proportional hazards analysis showed that an LEP score of 3 was significantly associated with the composite endpoint (P = 0.030). Kaplan-Meier analysis showed that risk of the composite of all-cause death and HF readmission was significantly higher in low LDL values (less than the cut-off values as calculated by receiver operating characteristic curve analysis) patients with statin use than in those without statin use (log rank P = 0.002). CONCLUSIONS LEP score, which comprehensively reflects extra-cardiac co-morbidities, is significantly associated with clinical outcomes in HFpEF patients.
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Affiliation(s)
| | | | | | - Kohei Ukita
- Division of CardiologyOsaka Rosai HospitalOsakaJapan
| | | | - Koji Yasumoto
- Division of CardiologyOsaka Rosai HospitalOsakaJapan
| | - Masaki Tsuda
- Division of CardiologyOsaka Rosai HospitalOsakaJapan
| | | | | | | | - Takahisa Yamada
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | | | - Masahiro Seo
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | | | - Akito Nakagawa
- Division of CardiologyAmagasaki Chuo HospitalAmagasakiJapan
- Department of Medical InformaticsOsaka University Graduate School of MedicineOsakaJapan
| | - Yusuke Nakagawa
- Division of CardiologyKawanishi City Medical CenterKawanishiJapan
| | - Shunsuke Tamaki
- Department of Cardiology, Pulmonology, Hypertension, NephrologyEhime University Graduate School of MedicineToonJapan
- Department of CardiologyRinku General Medical CenterOsakaJapan
| | - Yohei Sotomi
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Daisaku Nakatani
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Shungo Hikoso
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
- Department of Cardiovascular MedicineNara Medical UniversityNaraJapan
| | - Yasushi Sakata
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
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Hikoso S, Kida H, Sunaga A, Nakatani D, Okada K, Dohi T, Sotomi Y, Oeun B, Sato T, Matsuoka Y, Kitamura T, Yamada T, Kurakami H, Tamaki S, Seo M, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Yamada T, Yasumura Y, Sakata Y. β-blockers may be detrimental in frail patients with heart failure with preserved ejection fraction. Clin Res Cardiol 2024; 113:842-855. [PMID: 38019285 DOI: 10.1007/s00392-023-02301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 09/01/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The effectiveness of β-blocker in patients with heart failure with preserved ejection fraction (HFpEF) remains to be determined. We aimed to clarify the association between the use of β-blocker and prognosis according to the status of frailty. METHODS We compared prognosis between HFpEF patients with and without β-blockers stratified with the Clinical Frailty Scale (CFS), using data from the PURSUIT-HFpEF registry (UMIN000021831). RESULTS Among 1159 patients enrolled in the analysis (median age, 81.4 years; male, 44.7%), 580 patients were CFS ≤ 3, while 579 were CFS ≥ 4. Use of β-blockers was associated with a worse composite endpoint of all-cause death and heart failure readmission in patients with CFS ≥ 4 (adjusted hazard ratio (HR) 1.43, 95% CI 1.10-1.85, p = 0.007), but was not significantly associated with this endpoint in those with CFS ≤ 3 (adjusted HR 0.95, 95% CI 0.71-1.26, p = 0.719) in multivariable Cox proportional hazard models. These results were confirmed in a propensity-matched analysis (HR in those with CFS ≥ 4: 1.42, 95% CI 1.05-1.90, p = 0.020; that in those with CFS ≤ 3: 0.83, 95% CI 0.60-1.14, p = 0.249), and in an analysis in which patients were divided into CFS ≤ 4 and CFS ≥ 5. CONCLUSIONS Use of β-blockers was significantly associated with worse prognosis specifically in patients with HFpEF and high CFS, but not in those with low CFS. Use of β-blockers in HFpEF patients with frailty may need careful attention.
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Affiliation(s)
- Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
| | - Hirota Kida
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Akihiro Sunaga
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Katsuki Okada
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tomoharu Dohi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Bolrathanak Oeun
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Taiki Sato
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yuki Matsuoka
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tomomi Yamada
- Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Japan
| | - Hiroyuki Kurakami
- Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, 2-23 Ourai-kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Bandaihigashi, Osaka, 558-8558, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Takaharu Hayashi
- Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayamacho, Tennojiku, Osaka, 543-0035, Japan
| | - Akito Nakagawa
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo, 661-0976, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Medical Center, 1-4-1 Hiuchi, Kawanishi, 666-0017, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Bandaihigashi, Osaka, 558-8558, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo, 661-0976, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
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Tamaki S, Sotomi Y, Nagai Y, Shutta R, Masuda D, Makino N, Yamashita S, Seo M, Yamada T, Nakagawa A, Yasumura Y, Nakagawa Y, Yano M, Hayashi T, Hikoso S, Nakatani D, Ohtani T, Sakata Y. Relationship of interleukin-16 with different phenogroups in acute heart failure with preserved ejection fraction. ESC Heart Fail 2024. [PMID: 38686566 DOI: 10.1002/ehf2.14808] [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: 08/28/2023] [Revised: 03/13/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
AIMS Interleukin-16 (IL-16) has been reported to mediate left ventricular myocardial fibrosis and stiffening in patients with heart failure with preserved ejection fraction (HFpEF). We sought to elucidate whether IL-16 has a distinct impact on pathophysiology and prognosis across different subphenotypes of acute HFpEF. METHODS AND RESULTS We analysed 211 patients enrolled in a prospective multicentre registry of acute decompensated HFpEF for whom serum IL-16 levels after stabilization were available (53% female, median age 81 [interquartile range 75-85] years). We divided this sub-cohort into four phenogroups using our established clustering algorithm. The study endpoint was all-cause death. Patients were subclassified into phenogroup 1 ('rhythm trouble' [n = 69]), phenogroup 2 ('ventricular-arterial uncoupling' [n = 49]), phenogroup 3 ('low output and systemic congestion' [n = 41]), and phenogroup 4 ('systemic failure' [n = 52]). After a median follow-up of 640 days, 38 patients had died. Among the four phenogroups, phenogroup 2 had the highest IL-16 level. The IL-16 level showed significant associations with indices of cardiac hypertrophy, diastolic dysfunction, and congestion only in phenogroup 2. Furthermore, the IL-16 level had a significant predictive value for all-cause death only in phenogroup 2 (C-statistic 0.750, 95% confidence interval 0.606-0.863, P = 0.017), while there was no association between the IL-16 level and the endpoint in the other phenogroups. CONCLUSIONS Our results indicated that the serum IL-16 level had a significant association with indices that reflect the pathophysiology and prognosis of HFpEF in a specific phenogroup in acute HFpEF.
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Affiliation(s)
- Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiyuki Nagai
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Ryu Shutta
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Daisaku Masuda
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Nobuhiko Makino
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Shizuya Yamashita
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Medical Center, Kawanishi, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Seo M, Watanabe T, Yamada T, Morita T, Kawasaki M, Kikuchi A, Kondo T, Kawai T, Nishimoto Y, Nakamura J, Fujita T, Tanichi M, Chang Y, Oshita T, Kokubu Y, Fukuda Y, Shimizu K, Kinugawa M, Sakai K, Sakata Y, Fukunami M. The clinical relevance of mild cognitive impairment in acute heart failure: A comparison with cognitive impairment. J Cardiol 2024; 83:243-249. [PMID: 37684004 DOI: 10.1016/j.jjcc.2023.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/25/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Although mild cognitive impairment (MCI) has received much attention as a precursor of dementia, its prognostic role has not been fully clarified in patients with heart failure (HF). METHODS AND RESULTS We studied 274 patients admitted for acute decompensated HF. Cognitive function was evaluated using Mini Mental State Examination (MMSE). According to the previous definition, MMSE of 0-23, 24-27, and 28-30 were classified as CI (n = 132), MCI (n = 81), and normal cognitive function (n = 61). The primary endpoint was cardiac events, defined as the composite of unplanned HF hospitalization and cardiovascular mortality. During a mean follow-up period of 4.9 ± 3.1 years, 145 patients experienced cardiac events. Multivariable logistic regression analysis showed that hypertension (p = 0.043), low cardiac index (p = 0.022), and low serum albumin level (p = 0.041) had a significant association with cognitive abnormalities. Both CI and MCI were significantly associated with cardiac events after Cox multivariable adjustment [CI: p = 0.001, adjusted HR 2.66 (1.48-4.77); MCI: p = 0.025, adjusted HR 1.90 (1.09-3.31), normal cognitive function group: reference]. Patients with MCI had a significantly higher risk of unplanned HF hospitalization [p = 0.033, adjusted HR 1.91 (1.05-3.47)], but not all-cause mortality (p = 0.533) or cardiovascular mortality (p = 0.920), while CI was significantly associated with all-cause mortality (p = 0.025) and cardiovascular mortality (p = 0.036). CONCLUSION Even MCI had a significant risk of cardiac events in patients with acute decompensated HF. This risk was mainly derived from unplanned HF hospitalization.
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Affiliation(s)
- Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan.
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takashi Morita
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masato Kawasaki
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Atsushi Kikuchi
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takumi Kondo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Tsutomu Kawai
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yuji Nishimoto
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Jun Nakamura
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takeshi Fujita
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masanao Tanichi
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yongchol Chang
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takuya Oshita
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yuki Kokubu
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yuto Fukuda
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Kentaro Shimizu
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Makoto Kinugawa
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Katsuyoshi Sakai
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yasushi Sakata
- Division of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Sotomi Y, Tamaki S, Hikoso S, Nakatani D, Okada K, Dohi T, Sunaga A, Kida H, Sato T, Matsuoka Y, Sakamoto D, Kitamura T, Komukai S, Seo M, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Ohtani T, Yasumura Y, Yamada T, Sakata Y. Pathophysiological insights into machine learning-based subphenotypes of acute heart failure with preserved ejection fraction. Heart 2024; 110:441-447. [PMID: 37827559 DOI: 10.1136/heartjnl-2023-323059] [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: 06/03/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE The heterogeneous pathophysiology of the diverse heart failure with preserved ejection fraction (HFpEF) phenotypes needs to be examined. We aim to assess differences in the biomarkers among the phenotypes of HFpEF and investigate its multifactorial pathophysiology. METHODS This study is a retrospective analysis of the PURSUIT-HFpEF Study (N=1231), an ongoing, prospective, multicentre observational study of acute decompensated HFpEF. In this registry, there is a predefined subcohort in which we perform multibiomarker tests (N=212). We applied the previously established machine learning-based clustering model to the subcohort with biomarker measurements to classify them into four phenotypes: phenotype 1 (n=69), phenotype 2 (n=49), phenotype 3 (n=41) and phenotype 4 (n=53). Biomarker characteristics in each phenotype were evaluated. RESULTS Phenotype 1 presented the lowest value of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C reactive protein, tumour necrosis factor-α, growth differentiation factor (GDF)-15, troponin T and cystatin C, whereas phenotype 2, which is characterised by hypertension and cardiac hypertrophy, showed the highest value of these markers. Phenotype 3 showed the second highest value of GDF-15 and cystatin C. Phenotype 4 presented a low NT-proBNP value and a relatively high GDF-15. CONCLUSIONS Distinctive characteristics of biomarkers in HFpEF phenotypes would indicate differential underlying mechanisms to be elucidated. The contribution of inflammation to the pathogenesis varied considerably among different HFpEF phenotypes. Systemic inflammation substantially contributes to the pathophysiology of the classic HFpEF phenotype with cardiac hypertrophy. TRIAL REGISTRATION NUMBER UMIN-CTR ID: UMIN000021831.
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Affiliation(s)
- Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Katsuki Okada
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoharu Dohi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akihiro Sunaga
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hirota Kida
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taiki Sato
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuki Matsuoka
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daisuke Sakamoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Sho Komukai
- Division of Biomedical Statistics, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Akito Nakagawa
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Suita, Japan
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Medical Center, Kawanishi, Japan
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Maekawa M, Maekawa T, Sasase T, Wakashima T, Uemura A, Uno K, Ohta T, Yamada T. Renal transcriptome analysis of uninephrectomized db/db mice identified a mechanism for the transition to severe diabetic nephropathy. Exp Anim 2024; 73:29-40. [PMID: 37482420 PMCID: PMC10877145 DOI: 10.1538/expanim.22-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/09/2023] [Indexed: 07/25/2023] Open
Abstract
Diabetic nephropathy (DN), included in diabetic kidney disease (DKD), is a primary driver of end-stage renal disease (ESRD) leading to dialysis treatment. To develop new therapeutic drugs to prevent ESRD and avoid dialysis treatment, insight into DKD pathophysiology and animal models suitable for drug efficacy testing are needed. In this study, transcriptome analysis of kidneys from 26-week-old and 35-week-old uninephrectomized (UNX) db/db mice was used to identify the pathways that affect the deterioration of renal function in db/db mice. Differentially expressed genes suggested that there was increased interferon (IFN)-γ signaling during the 26 to 35-week period. Modules that changed between 26 and 35 weeks of age extracted by weighted gene co-expression network analysis (WGCNA) suggested increased the tumor necrosis factor (TNF)-α and nuclear factor-kappa B (NF-κB) signaling pathway in component cells of glomeruli. The protein-protein interaction (PPI) network analysis identified Cxcl16 as a hub gene for those signaling pathways, and it was shown that the pathways in this module changed when the glomerular filtration rate decreased in patients with DN. These results suggested the possibility that signaling mediated by Cxcl16 induced by IFN-γ and TNF-α between 26 and 35 weeks of age leads to renal fibrosis, resulting in severe disease. Drugs that target such pathways can be options for developing drugs for DN. We also think that the uninephrectomized db/db mouse can be used as an animal model of severe DKD and to evaluate efficacy in patients with DN.
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Affiliation(s)
- Mariko Maekawa
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
- Graduate School of Science and Technology, Niigata University, 8050 Ikarashi 2-no-cho, Nishi-ku, Niigata 950-2181, Japan
| | - Tatsuya Maekawa
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
- Department of Nutritional Science and Food Safety, Faculty of Applied Biosciences, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
| | - Tomohiko Sasase
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Takeshi Wakashima
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Atsuhiro Uemura
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Kinuko Uno
- Laboratory of Animal Physiology and Functional Anatomy, Graduate School of Agriculture, Kyoto University, Kitashirakawa Oiwake-cho, Sakyo-ku, Kyoto 606-8502, Japan
| | - Takeshi Ohta
- Laboratory of Animal Physiology and Functional Anatomy, Graduate School of Agriculture, Kyoto University, Kitashirakawa Oiwake-cho, Sakyo-ku, Kyoto 606-8502, Japan
| | - Takahisa Yamada
- Graduate School of Science and Technology, Niigata University, 8050 Ikarashi 2-no-cho, Nishi-ku, Niigata 950-2181, Japan
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Kuwata N, Mukohda H, Uchida H, Takamatsu R, Binici MM, Yamada T, Sugiyama T. Renal Endocytic Regulation of Vitamin D Metabolism during Maturation and Aging in Laying Hens. Animals (Basel) 2024; 14:502. [PMID: 38338146 PMCID: PMC10854989 DOI: 10.3390/ani14030502] [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] [Received: 01/15/2024] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Egg-laying hens undergo a specific and dramatic calcium metabolism to lay eggs with eggshells composed of calcium carbonate. Calcium metabolism is mainly regulated by vitamin D3. Although vitamin D3 metabolism is closely related to the deterioration of eggshell quality associated with aging and heat stress, the details of the mechanisms regulating vitamin D3 metabolism are not clear. In mammals, the vitamin D3 metabolite (25(OH)D3) produced in the liver binds to the vitamin binding protein (DBP), is subsequently taken up by renal proximal tubular cells via the endocytic receptors megalin (Meg) and cubilin (CUB), and is metabolized to 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). Therefore, the present study aimed to examine the expression and localization of Meg and CUB in the kidneys of immature chicks and mature and aged laying hens to prevent eggshell quality deterioration. As a result, we showed that as circulating 1,25(OH)2D3 concentrations increased from 156.0 ± 13.5 pg/mL to 815.5 ± 61.4 pg/mL with maturation in immature chicks, relative expression levels (arbitrary units; AU) of Meg and CUB mRNA in the kidneys of mature hens significantly increased 1.92- and 2.75-fold, respectively, compared to those in immature chicks. On the other hand, the Meg mRNA expression levels of mature hens did not change with age, while CUB mRNA expression levels (1.03 ± 0.11 AU) were significantly decreased compared to mature hens (2.75 ± 0.24 AU). Immunohistochemical observations showed that Meg and CUB proteins were localized to the apical membrane of renal proximal tubular epithelial cells in immature chicks, mature hens, and aged hens, and that DBP protein was observed as granular endosomes in the cytoplasm of proximal tubular cells from the apical membrane to the cell nucleus. Especially in mature hens, the endosomes were larger and more numerous than those in immature chicks. In contrast, in aged hens, DBP-containing endosomes were smaller and limited to the apical cytoplasm. These results indicate that with maturation, the expression of Meg and CUB is promoted in the renal proximal tubules of laying hens, facilitating the uptake of the 25(OH)D3-DBP complex and its conversion to 1,25(OH)2D3, and regulating calcium metabolism in eggshell formation. On the other hand, it is suggested that the age-related decrease in CUB expression suppresses the uptake of the 25(OH)D3-DBP complex in the kidney, resulting in a deterioration of eggshell quality.
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Affiliation(s)
- Nami Kuwata
- Graduate School of Science and Technology, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan
| | - Hatsune Mukohda
- Graduate School of Science and Technology, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan
| | - Hiroto Uchida
- Graduate School of Science and Technology, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan
| | - Ryo Takamatsu
- Graduate School of Science and Technology, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan
| | - Muhammet Mustafa Binici
- Graduate School of Science and Technology, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan
| | - Takahisa Yamada
- Department of Animal Science, Faculty of Agriculture, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan;
| | - Toshie Sugiyama
- Department of Animal Science, Faculty of Agriculture, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata 9502181, Japan;
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8
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Kokubu Y, Watanabe T, Yamada T, Morita T, Kawasaki M, Kikuchi A, Kondo T, Kawai T, Nishimoto Y, Seo M, Nakamura J, Kayama K, Tamura Y, Fujita T, Chang Y, Tanichi M, Oshita T, Fukuda Y, Fukunami M. A Rare Case of a Common Inferior Pulmonary Vein Presumed to Be a Remnant of the Common Pulmonary Vein. Intern Med 2024; 63:407-411. [PMID: 37316270 PMCID: PMC10901698 DOI: 10.2169/internalmedicine.2005-23] [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: 03/25/2023] [Accepted: 05/08/2023] [Indexed: 06/16/2023] Open
Abstract
A 74-year-old woman with an implanted physiological DDD pacemaker visited our department complaining of palpitations due to atrial fibrillation (AF). Catheter ablation therapy for AF was scheduled. Preoperative multidetector computed tomography showed that the inferior pulmonary vein (PV) was a common trunk, and the left and right superior PVs branched from the center of the left atrial roof. In addition, mapping of the left atrium before AF ablation revealed no potential in either the inferior PV or common trunk. We performed left and right superior PV and posterior wall isolation. After ablation, AF was not observed on pacemaker recordings.
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Affiliation(s)
- Yuki Kokubu
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Tetsuya Watanabe
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Takahisa Yamada
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Takashi Morita
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Masato Kawasaki
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Atsushi Kikuchi
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Takumi Kondo
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Tsutomu Kawai
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Yuji Nishimoto
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Masahiro Seo
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Jun Nakamura
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Kiyomi Kayama
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Yuto Tamura
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Takeshi Fujita
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Yongchol Chang
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Masanao Tanichi
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Takuya Oshita
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Yuto Fukuda
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
| | - Masatake Fukunami
- Department of Cardiovascular Medicine, Hyogo Prefectural Nishinomiya Hospital, Japan
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9
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Iwakura K, Onishi T, Okamura A, Koyama Y, Tanaka N, Okada M, Fujii K, Seo M, Yamada T, Yano M, Hayashi T, Yasumura Y, Nakagawa Y, Tamaki S, Nakagawa A, Sotomi Y, Hikoso S, Nakatani D, Sakata Y. The WATCH-DM risk score estimates clinical outcomes in type 2 diabetic patients with heart failure with preserved ejection fraction. Sci Rep 2024; 14:1746. [PMID: 38243047 PMCID: PMC10798943 DOI: 10.1038/s41598-024-52101-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/13/2024] [Indexed: 01/21/2024] Open
Abstract
The coexistence of heart failure is frequent and associated with higher mortality in patients with type 2 diabetes (T2DM), and its management is a critical issue. The WATCH-DM risk score is a tool to predict heart failure in patients with type 2 diabetes mellitus (T2DM). We investigated whether it could estimate outcomes in T2DM patients with heart failure with preserved ejection fraction (HFpEF). The WATCH-DM risk score was calculated in 418 patients with T2DM hospitalized for HFpEF (male 49.5%, age 80 ± 9 years, HbA1c 6.8 ± 1.0%), and they were divided into the "average or lower" (≤ 10 points), "high" (11-13 points) and "very high" (≥ 14 points) risk groups. We followed patients to observe all-cause death for 386 days (median). We compared the area under the curve (AUC) of the WATCH-DM score for predicting 1-year mortality with that of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score and of the Barcelona Bio-Heart Failure Risk (BCN Bio-HF). Among the study patients, 108 patients (25.8%) had average or lower risk scores, 147 patients (35.2%) had high risk scores, and 163 patients (39.0%) had very high risk scores. The Cox proportional hazard model selected the WATCH-DM score as an independent predictor of all-cause death (HR per unit 1.10, 95% CI 1.03 to 1.19), and the "average or lower" risk group had lower mortality than the other groups (p = 0.047 by log-rank test). The AUC of the WATCH-DM for 1-year mortality was 0.64 (95% CI 0.45 to 0.74), which was not different from that of the MAGGIC score (0.72, 95% CI 0.63 to 0.80, p = 0.08) or that of BCN Bio-HF (0.70, 0.61 to 0.80, p = 0.25). The WATCH-DM risk score can estimate prognosis in T2DM patients with HFpEF and can identify patients at higher risk of mortality.
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Affiliation(s)
- Katsuomi Iwakura
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan.
| | - Toshinari Onishi
- Department of Cardiovascular Medicine, Sakai City Medical Center, Sakai, Japan
| | - Atsunori Okamura
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan
| | - Yasushi Koyama
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan
| | - Nobuaki Tanaka
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan
| | - Masato Okada
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan
| | - Kenshi Fujii
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Medical Center, Kawanishi, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, Izumisano, Japan
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shungo Hikoso
- Cardiovascular Medicine, Nara Medical University, Kashihara, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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10
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Yamamoto Y, Nagakane Y, Tanaka E, Yamada T, Fujinami J, Ohara T. How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source. Clin Neuroradiol 2024:10.1007/s00062-023-01366-z. [PMID: 38169002 DOI: 10.1007/s00062-023-01366-z] [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] [Received: 09/29/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography. METHODS From a total of 992 consecutive patients with embolic stroke, 366 patients with the ESUS group were selected. ESUS was defined as no atrial fibrillation (Af) within 24h from admission and no PES after general examination. Clinical variables include age (> 80years, 70-80 years), sex, vascular risk factors and left atrial diameter > 4 cm. Age, sex and vascular risk factors adjusted odds ratio of each DWI for the different PESs were calculated. DWI was determined based on the arterial territories. Middle cerebral arteries were divided into 4 segments, i.e., M1-M4. Moreover, M2 segments were subdivided into superior and inferior branches. RESULTS The 366 patients consisted of 168 with paroxysmal Af (pAf), 77 with paradoxical embolism, 71 with aortic embolism and 50 with undetermined embolism after transesophageal echocardiography. The variables adjusted odds ratio (OR) of internal carotid artery (OR: 12.1, p = 0.037), M1 (4.2, p = 0.001), inferior M2 (7.5, p = 0.0041) and multiple cortical branches (12.6, p < 0.0001) were significantly higher in patients with pAf. Striatocapsular infarction (12.5, p < 0.0001) and posterior inferior cerebellar artery infarcts (3.6, p = 0.018) were significantly associated with paradoxical embolism. Clinical variables adjusted OR of multiple small scattered infarcts (8.3, p < 0.0001) were significantly higher in patients with aortic embolism. CONCLUSION The associations of DWI with different PES have their distinctive characteristics and DWI along with clinical variables may help predict PES in patients with ESUS.
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Affiliation(s)
- Y Yamamoto
- Department of Neurology, Kyoto Katsura Hospital, 615-8256. 17 Yamada Hiraocho, Nishikyoku, Kyoto, Japan.
| | - Y Nagakane
- Department of Neurology, Kyoto Second Red Cross Hospital, 602-8026. 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, Japan
| | - E Tanaka
- Department of Neurology, Kyoto Prefectural University of Medicine, 602-8566. 465 Kajiicho Kamigyoku, Kyoto, Japan
| | - T Yamada
- Department of Neurology and Stroke Treatment, Japanese Red Cross Kyoto Daiichi Hospital, 605-0981. 15-749 Honmachi, Higashiyama, Kyoto, Japan
| | - J Fujinami
- Department of Neurology, Kyoto Second Red Cross Hospital, 602-8026. 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, Japan
| | - T Ohara
- Department of Neurology, Kyoto Prefectural University of Medicine, 602-8566. 465 Kajiicho Kamigyoku, Kyoto, Japan
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11
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Seo M, Kikuchi A, Watanabe T, Yamada T, Shirakawa Y. Intracardiac Echocardiography-Guided Transcatheter Edge-to-Edge Repair for Mitral Regurgitation. CASE (Phila) 2024; 8:11-15. [PMID: 38264615 PMCID: PMC10801807 DOI: 10.1016/j.case.2023.09.007] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
•We occasionally encounter situations in which TEE is contraindicated. •ICE can be an effective alternative imaging guidance for mitral TEER. •The hybrid approach using TTE is effective to make ICE-guided TEER successful.
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Affiliation(s)
- Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Atsushi Kikuchi
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yukitoshi Shirakawa
- Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, Japan
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12
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Nishimoto Y, Inohara T, Kohsaka S, Sakakura K, Kawai T, Kikuchi A, Watanabe T, Yamada T, Fukunami M, Yamaji K, Ishii H, Amano T, Kozuma K. Changing Trends in Mechanical Circulatory Support Use and Outcomes in Patients Undergoing Percutaneous Coronary Interventions for Acute Coronary Syndrome Complicated With Cardiogenic Shock: Insights From a Nationwide Registry in Japan. J Am Heart Assoc 2023; 12:e031838. [PMID: 38038195 PMCID: PMC10727314 DOI: 10.1161/jaha.123.031838] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Temporal trends in the management of acute coronary syndrome complicated with cardiogenic shock after the revision of guideline recommendations for intra-aortic balloon pump (IABP) use and the approval of the Impella require further investigation, because their impact remains uncertain. METHODS AND RESULTS Using the Japanese Percutaneous Coronary Intervention (J-PCI) registry database from 2019 to 2021, we identified 12 171 patients undergoing percutaneous coronary intervention for acute coronary syndrome complicated with cardiogenic shock under mechanical circulatory support. The patients were stratified into 3 groups: (1) IABP alone, (2) Impella, and (3) venoarterial extracorporeal membrane oxygenation (VA-ECMO); the VA-ECMO group was further stratified into (3a) VA-ECMO alone, (3b) VA-ECMO in combination with IABP, and (3c) VA-ECMO in combination with Impella. The quarterly prevalence and outcomes were reported. The use of IABP alone decreased significantly from 63.5% in the first quarter of 2019 to 58.3% in the fourth quarter of 2021 (P for trend=0.01). Among 4245 patients requiring VA-ECMO, the use of VA-ECMO in combination with IABP decreased significantly from 78.7% to 67.3%, whereas the use of VA-ECMO in combination with Impella increased significantly from 4.2% to 17.0% (P for trend <0.001 for both). After adjusting for the confounders, the risk difference in the fourth quarter of 2021 relative to the first quarter of 2019 for in-hospital mortality was not significant (adjusted odds ratio, 0.84 [95% CI, 0.69-1.01]). CONCLUSIONS Our study revealed substantial changes in the use of different mechanical circulatory support modalities in acute coronary syndrome complicated with cardiogenic shock, but they did not significantly improve the outcomes.
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Affiliation(s)
- Yuji Nishimoto
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | - Taku Inohara
- Department of CardiologyKeio University School of MedicineTokyoJapan
| | - Shun Kohsaka
- Department of CardiologyKeio University School of MedicineTokyoJapan
| | - Kenichi Sakakura
- Division of Cardiovascular Medicine, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Tsutomu Kawai
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | - Atsushi Kikuchi
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | | | - Takahisa Yamada
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | | | | | - Hideki Ishii
- Department of Cardiovascular MedicineGunma University Graduate School of MedicineMaebashiJapan
| | - Tetsuya Amano
- Department of CardiologyAichi Medical UniversityNagakuteJapan
| | - Ken Kozuma
- Department of CardiologyTeikyo University HospitalTokyoJapan
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Yamamoto H, Miyashita Y, Minamiguchi H, Hosomichi K, Yoshida S, Kioka H, Shinomiya H, Nagata H, Onoue K, Kawasaki M, Kuramoto Y, Nomura A, Toma Y, Watanabe T, Yamada T, Ishihara Y, Nagata M, Kato H, Hakui H, Saito Y, Asano Y, Sakata Y. Human leukocyte antigen-DQ risk heterodimeric haplotypes of left ventricular dysfunction in cardiac sarcoidosis: an autoimmune view of its role. Sci Rep 2023; 13:19767. [PMID: 37957180 PMCID: PMC10643531 DOI: 10.1038/s41598-023-46915-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiac sarcoidosis (CS) is the scarring of heart muscles by autoimmunity, leading to heart abnormalities and patients with sarcoidosis with cardiac involvements have poor prognoses. Due to the small number of patients, it is difficult to stratify all patients of CS by human leukocyte antigen (HLA) analysis. We focused on the structure of antigen-recognizing pockets in heterodimeric HLA-class II, in addition to DNA sequences, and extracted high-affinity combinations of antigenic epitopes from candidate autoantigen proteins and HLA. Four HLA heterodimer-haplotypes (DQA1*05:03/05:05/05:06/05:08-DQB1*03:01) were identified in 10 of 68 cases. Nine of the 10 patients had low left ventricular ejection fraction (< 50%). Fourteen amino-acid sequences constituting four HLA anchor pockets encoded by the HLA haplotypes were all common, suggesting DQA1*05:0X-DQB1*03:01 exhibit one group of heterodimeric haplotypes. The heterodimeric haplotypes recognized eight epitopes from different proteins. Assuming that autoimmune mechanisms might be activated by molecular mimicry, we searched for bacterial species having peptide sequences homologous to the eight epitopes. Within the peptide epitopes form the SLC25A4 and DSG2, high-homology sequences were found in Cutibacterium acnes and Mycobacterium tuberculosis, respectively. In this study, we detected the risk heterodimeric haplotypes of ventricular dysfunction in CS by searching for high-affinity HLA-class II and antigenic epitopes from candidate cardiac proteins.
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Affiliation(s)
- Hironori Yamamoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yohei Miyashita
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
- Department of Legal Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan.
| | - Hitoshi Minamiguchi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kazuyoshi Hosomichi
- Laboratory of Computational Genomics, School of Life Science, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, 192-0392, Japan
| | - Shohei Yoshida
- Department of Cardiovascular Medicine, Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hidetaka Kioka
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Haruki Shinomiya
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Haruno Nagata
- Department of Cardiovascular Medicine, University of the Ryukyus Graduate School of Medicine, Nakagami, Okinawa, 903-0215, Japan
| | - Kenji Onoue
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Masato Kawasaki
- Department of Cardiology, Osaka General Medical Center, Osaka, Osaka, 558-8558, Japan
| | - Yuki Kuramoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Akihiro Nomura
- Innovative Research Center, Kanazawa University School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yuichiro Toma
- Department of Cardiovascular Medicine, University of the Ryukyus Graduate School of Medicine, Nakagami, Okinawa, 903-0215, Japan
| | - Tetsuya Watanabe
- Department of Cardiology, Osaka General Medical Center, Osaka, Osaka, 558-8558, Japan
| | - Takahisa Yamada
- Department of Cardiology, Osaka General Medical Center, Osaka, Osaka, 558-8558, Japan
| | - Yasuki Ishihara
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
- The 1st Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan
| | - Miho Nagata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Department of Medical Ethics and Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, 606-8501, Japan
| | - Hisakazu Kato
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan
| | - Hideyuki Hakui
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Prefecture Seiwa Medical Center, Nara, Nara, 636-0802, Japan
| | - Yoshihiro Asano
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
- Department of Genomic Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan.
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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14
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Doi Y, Nagata Y, Matsumo Y, Numata K, Sasaki R, Yamada T, Igaki H, Imagumbai T, Katoh N, Yoshitake T, Shimizuguchi T, Fujioka D, Inoue M, Koide Y, Kimura T, Ito Y. Multicenter Retrospective Study of Stereotactic Body Radiotherapy for Patients with Previously Untreated Initial Small Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e293. [PMID: 37785079 DOI: 10.1016/j.ijrobp.2023.06.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The effectiveness of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) has been shown in many studies and its therapeutic effect is similar to radiofrequency ablation (RFA). However, many of these studies were done in combination with transcatheter chemoembolization (TACE), for recurrent HCC, or on a small scale. To better understand the specific outcomes of SBRT for HCC, we conducted a multicenter retrospective analysis of SBRT for previously untreated initial HCC at Japanese Society of Clinical Oncology (JCOG) member hospitals. MATERIALS/METHODS Patientswho underwent SBRT for HCC at JCOG member hospitals between July 2013 and December 2017 and met the following eligibility criteria were included: (1) initial HCC; (2) ≤ 3 nodules, ≤ 5 cm in diameter; (3) a Child-Pugh (CP) score of A or B; and (4) unsuitability for or refusal of standard treatment, such as surgery, transplantation, RFA and TACE. We evaluated the overall survival (OS), recurrence-free survival (RFS) which was defined as the first instance of intra-hepatic recurrence after SBRT, disease-specific survival (DSS) using Kaplan-Meier analysis. Using Grey's test, patients who died of other diseases were analyzed as competing risks to estimate the cumulative incidence of local recurrence (CLR). Adverse events directly related to SBRT also analyzed using Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). RESULTS Seventy-three patients with 79 lesions from 14 hospitals were analyzed. The median age was 77 years (range; 50-89 years), and the median tumor size was 23 mm (range; 6-50 mm). The median radiation dose was 40 Gy (range; 35-60 Gy) in five fractions (range; 4-8). The median follow-up period was 45 months (range; 0-103 months). There were three cases where follow-up was not possible due to unexpected events unrelated to SBRT, while the remaining 70 patients were successfully followed for at least six months. The 2 and 3year OS, RFS, DSS, and CLR rates were 84.3% (95% CI: 75.8-92.8%) and 69.9% (95% CI: 58.7-81%), 67.5% (95% CI: 56.0-79.0%) and 57.9% (95% CI: 45.2-70.5%), 95.1% (95% CI:89.7-100%)/87.6% (95% CI:78.8-96.3%), and 11.4% (95% CI: 5.3-20.0%) and 20.0% (95% CI: 11.2-30.5%), respectively. Four cases (5.5%) of adverse events of grade 3 or higher were reported: one case of grade 3 laboratory toxicities, one case of grade 3 liver failure, one case of grade 3 portal tumor thrombosis, and one case of grade 4 duodenal ulcer. No grade 5 toxicities were observed. CONCLUSION The results of our study demonstrate that SBRT for HCC is highly effective in achieving local control and is safe to administer. In addition, survival outcomes are favorable. SBRT is a promising treatment modality, especially for small HCCs for that is not suitable for standard treatment.
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Affiliation(s)
- Y Doi
- Department of Radiation Oncology, Hiroshima High-precision Radiotherapy Cancer Center, Hiroshima, Japan
| | - Y Nagata
- Department of Radiation Oncology, Hiroshima University, Hiroshima, Japan
| | - Y Matsumo
- Department of Radiation oncology, Niigata cancer center hospital, Niigata, Japan
| | - K Numata
- Department of Gastroenterology, Yokohama City University Medical Center, Yokohama, Japan
| | - R Sasaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Yamada
- University of Yamanashi, Chuo, Japan
| | - H Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T Imagumbai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Katoh
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Yoshitake
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Shimizuguchi
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - D Fujioka
- Department of Radiation Oncology, Tsukuba University Hospital, Ibaraki, Japan
| | - M Inoue
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Koide
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Kimura
- Department of Radiation Oncology, Kochi University Hospital, Kochi, Japan
| | - Y Ito
- Department of Radiation Oncology, Showa University Hospital, Tokyo, Japan
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Nishimoto Y, Ohbe H, Matsui H, Nakata J, Takiguchi T, Nakajima M, Sasabuchi Y, Sato Y, Watanabe T, Yamada T, Fukunami M, Yasunaga H. Trends in Mechanical Circulatory Support Use and Outcomes of Patients With Cardiogenic Shock in Japan, 2010 to 2020 (from a Nationwide Inpatient Database Study). Am J Cardiol 2023; 203:203-211. [PMID: 37499600 DOI: 10.1016/j.amjcard.2023.06.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/15/2023] [Accepted: 06/24/2023] [Indexed: 07/29/2023]
Abstract
Little is known about the impact of the downgrade of guideline recommendations for intra-aortic balloon pump (IABP) use and the approval of the Impella in Japan, where IABPs have been predominantly used. This study aimed to describe the annual trends in the mechanical circulatory support (MCS) use and outcomes in patients with cardiogenic shock (CS) requiring MCS. Using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2021, we identified inpatients with CS requiring MCS. The patients were stratified into 3 groups: (1) IABP alone, (2) Impella alone, and (3) extracorporeal membrane oxygenation (ECMO), regardless of IABP or Impella use. The patient characteristics and outcomes were reported by the fiscal year. Of the 160,559 eligible patients, 117,599 (73.2%) used IABP alone, 1,465 (0.9%) Impella alone, and 41,495 (25.8%) ECMO. The prevalence of the use of an IABP alone significantly decreased from 80.5% in 2010 to 65.3% in 2020 (p for trend <0.001), whereas the prevalence of the use of an Impella alone significantly increased from 0.0% to 5.0% and ECMO from 19.5% to 29.6% (p for trend <0.001 for both). In-hospital mortality significantly increased from 29.3% in 2010 to 32.6% in 2020 in the overall patients with CS requiring MCS but significantly decreased in those requiring ECMO from 73.7% to 64.1% (p for trend <0.001 for both). In conclusion, there were significant annual changes in the patterns of MCS use and clinical outcomes in patients with CS requiring MCS.
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Affiliation(s)
- Yuji Nishimoto
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jun Nakata
- Division of Cardiovascular Intensive Care and
| | - Toru Takiguchi
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Mikio Nakajima
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development, Tokyo, Japan
| | | | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | | | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Watanabe A, Fujii M, Sano T, Ikegami S, Kamei J, Kojima S, Satake Y, Yamada T. Tracheal leiomyoma. QJM 2023; 116:563-565. [PMID: 36944268 DOI: 10.1093/qjmed/hcad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/15/2023] [Indexed: 03/23/2023] Open
Affiliation(s)
- A Watanabe
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - M Fujii
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - T Sano
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - S Ikegami
- Department of Otolaryngology, Head and Neck Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - J Kamei
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - S Kojima
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Y Satake
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - T Yamada
- Department of Respiratory Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
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Sotomi Y, Hikoso S, Nakatani D, Okada K, Dohi T, Sunaga A, Kida H, Sato T, Matsuoka Y, Kitamura T, Komukai S, Seo M, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Tamaki S, Ohtani T, Yasumura Y, Yamada T, Sakata Y. Medications for specific phenotypes of heart failure with preserved ejection fraction classified by a machine learning-based clustering model. Heart 2023; 109:1231-1240. [PMID: 36822821 PMCID: PMC10423528 DOI: 10.1136/heartjnl-2022-322181] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Our previously established machine learning-based clustering model classified heart failure with preserved ejection fraction (HFpEF) into four distinct phenotypes. Given the heterogeneous pathophysiology of HFpEF, specific medications may have favourable effects in specific phenotypes of HFpEF. We aimed to assess effectiveness of medications on clinical outcomes of the four phenotypes using a real-world HFpEF registry dataset. METHODS This study is a posthoc analysis of the PURSUIT-HFpEF registry, a prospective, multicentre, observational study. We evaluated the clinical effectiveness of the following four types of postdischarge medication in the four different phenotypes: angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB), beta blockers, mineralocorticoid-receptor antagonists (MRA) and statins. The primary endpoint of this study was a composite of all-cause death and heart failure hospitalisation. RESULTS Of 1231 patients, 1100 (83 (IQR 77, 87) years, 604 females) were eligible for analysis. Median follow-up duration was 734 (398, 1108) days. The primary endpoint occurred in 528 patients (48.0%). Cox proportional hazard models with inverse-probability-of-treatment weighting showed the following significant effectiveness of medication on the primary endpoint: MRA for phenotype 2 (weighted HR (wHR) 0.40, 95% CI 0.21 to 0.75, p=0.005); ACEi or ARB for phenotype 3 (wHR 0.66 0.48 to 0.92, p=0.014) and statin therapy for phenotype 3 (wHR 0.43 (0.21 to 0.88), p=0.020). No other medications had significant treatment effects in the four phenotypes. CONCLUSIONS Machine learning-based clustering may have the potential to identify populations in which specific medications may be effective. This study suggests the effectiveness of MRA, ACEi or ARB and statin for specific phenotypes of HFpEF. TRIAL REGISTRATION NUMBER UMIN000021831.
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Affiliation(s)
- Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Katsuki Okada
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoharu Dohi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akihiro Sunaga
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hirota Kida
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taiki Sato
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuki Matsuoka
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Sho Komukai
- Division of Biomedical Statistics, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Medical Center, Kawanishi, Japan
| | - Shunsuke Tamaki
- Department of Cardiovascular Medicine, Rinku General Medical Center, Izumisano, Japan
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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18
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Nishimoto Y, Ohbe H, Matsui H, Nakajima M, Sasabuchi Y, Sato Y, Watanabe T, Yamada T, Fukunami M, Yasunaga H. Trends in Treatment Patterns and Outcomes of Patients With Pulmonary Embolism in Japan, 2010 to 2020: A Nationwide Inpatient Database Study. J Am Heart Assoc 2023:e028981. [PMID: 37301745 DOI: 10.1161/jaha.122.028981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/01/2023] [Indexed: 06/12/2023]
Abstract
Background The impact of major changes in the treatment practice of pulmonary embolism (PE), such as limited indications for systemic thrombolysis and the introduction of direct oral anticoagulants, is not well documented. This study aimed to describe annual trends in the treatment patterns and outcomes in patients with PE. Methods and Results Using the Japanese Diagnosis Procedure Combination inpatient database from April 2010 to March 2021, we identified hospitalized patients with PE. Patients with high-risk PE were defined as those admitted for out-of-hospital cardiac arrest or who received cardiopulmonary resuscitation, extracorporeal membrane oxygenation, vasopressors, or invasive mechanical ventilation on the day of admission. The remaining patients were defined as patients with non-high-risk PE. The patient characteristics and outcomes were reported with fiscal year trend analyses. Of 88 966 eligible patients, 8116 (9.1%) had high-risk PE, and the remaining 80 850 (90.9%) had non-high-risk PE. Between 2010 and 2020, in patients with high-risk PE, the annual proportion of extracorporeal membrane oxygenation use significantly increased from 11.0% to 21.3%, whereas that of thrombolysis use significantly decreased from 22.5% to 15.5% (P for trend <0.001 for both). In-hospital mortality significantly decreased from 51.0% to 43.7% (P for trend=0.04). In patients with non-high-risk PE, the annual proportion of direct oral anticoagulant use increased from 0.0% to 38.3%, whereas that of thrombolysis use significantly decreased from 13.7% to 3.4% (P for trend <0.001 for both). In-hospital mortality significantly decreased from 7.9% to 5.4% (P for trend <0.001). Conclusions Substantial changes in the PE practice and outcomes occurred in patients with high-risk and non-high-risk PE.
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Affiliation(s)
- Yuji Nishimoto
- Division of Cardiology, Osaka General Medical Center Osaka Japan
| | - Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
| | - Mikio Nakajima
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
- Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development Tokyo Japan
| | | | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center Amagasaki Japan
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center Osaka Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center Osaka Japan
| | | | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
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19
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Nishino M, Egami Y, Kawanami S, Sugae H, Ukita K, Kawamura A, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Yano M, Tanouchi J, Yamada T, Yasumura Y, Seo M, Tamaki S, Hayashi T, Nakagawa A, Nakagawa Y, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Prognostic impact of cardiovascular polypharmacy on octogenarians with heart failure with preserved ejection fraction. Int J Cardiol 2023; 378:55-63. [PMID: 36796493 DOI: 10.1016/j.ijcard.2023.02.021] [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: 12/07/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUNDS Drug treatments of heart failure with preserved ejection fraction (HFpEF) have a little clinical benefit, but cardiovascular polypharmacy (CP) trend is observed in elderly HFpEF. We investigated the impact of CP on octogenarian with HFpEF. METHODS We examined 783 consecutive octogenarians (≥80 years) enrolled in the PURSUIT-HFpEF registry. We defined medications for hypertension, dyslipidemia, heart failure (HF), coronary artery disease, stroke, peripheral artery disease, and atrial fibrillation as cardiovascular medications (CM). In this study, we defined CP as ≥5 CM. We investigated whether CP was correlated with the composite end point (CE) of all-cause mortality and HF rehospitalization. RESULTS The proportion with CP was 51.9% (n = 406). Background characteristics correlated with CP were frailty, history of coronary artery disease, atrial fibrillation and left atrial dimension. Multivariable Cox proportional hazards analysis showed CP was significantly and independently correlated with CE (hazard ratio (HR): 1.31; 95% confidence Interval (CI): 1.01-1.70) in addition to age, clinical frailty scale, history of HF admission and N-terminal pro brain natriuretic peptide. Kaplan-Meier curve analysis showed that, compared with the non-CP group, the CP group had significantly higher risk of CE and HF (HR: 1.27; 95%CI: 1.04-1.56; P = 0.02 and HR: 1.46; 95%CI: 1.13-1.88; P < 0.01, respectively), but not any-cause death. In addition, diuretics were correlated with CE (HR: 1.61; 95%CI: 1.17-2.22; P < 0.01), but antithrombotic drugs and HFpEF medications were not. CONCLUSIONS CP at discharge is a prognostic factor driven by HF rehospitalization in octogenarians with HFpEF. In these patients, diuretics may be correlated with the prognosis.
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Affiliation(s)
- Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan.
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Shodai Kawanami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Hiroki Sugae
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Hitoshi Nakamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Yasuharu Matsunaga-Lee
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo 661-0976, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Shunsuke Tamaki
- Division of Cardiology, Rinku General Medical Center, 2-23 Rinkuoraikita, Izumisano, Osaka 598-0048, Japan
| | - Takaharu Hayashi
- Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayamacho, Tennoji-ku, Osaka 543-0035, Japan
| | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo 661-0976, Japan; Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Medical Center, 1-4-1 Hiuchi, Kawanishi, Hyogo 666-0017, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
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Nishino M, Egami Y, Yamada T, Yasumura Y, Nakatani D, Hikoso S, Sakata Y. Reply to "Prognostic impact of cardiovascular polypharmacy on octogenarians with heart failure with preserved ejection fraction". Int J Cardiol 2023:S0167-5273(23)00536-3. [PMID: 37076017 DOI: 10.1016/j.ijcard.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Affiliation(s)
- Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan.
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo 661-0976, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
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21
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Sera F, Ohtani T, Tamaki S, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Nakatani D, Yamada T, Yasumura Y, Hikoso S, Yamauchi-Takihara K, Sakata Y. Pulmonary hypertension with a precapillary component in heart failure with preserved ejection fraction. Heart 2023; 109:626-633. [PMID: 36543519 DOI: 10.1136/heartjnl-2022-321565] [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: 06/29/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Heart failure with preserved ejection fraction (HFpEF) is often complicated by pulmonary hypertension (PH), which is mainly characterised by postcapillary PH and occasionally accompanied by a precapillary component of PH. Haemodynamic changes in worsening heart failure (HF) can modify the characteristics of PH. However, the clinical features of PH after HF treatment in HFpEF remain unclear. We investigated the prevalence and clinical significance of the precapillary component of PH after HF treatment in HFpEF, using data from the Prospective Multicentre Observational Study of Patients with HFpEF (PURSUIT-HFpEF). METHODS From the PURSUIT-HFpEF registry, 219 patients hospitalised with acute HF who underwent right heart catheterisation after initial HF treatment were divided into four groups according to the 2015 and 2018 PH definitions: non-PH, isolated postcapillary pulmonary hypertension (Ipc-PH), precapillary PH and combined postcapillary and precapillary pulmonary hypertension (Cpc-PH). The latter two were combined as PH with the precapillary component. RESULTS Using the 2015 definition, we found that the prevalence of PH after HF treatment was 27% (Ipc-PH: 20%, precapillary PH: 3%, Cpc-PH: 4%). Applying the 2018 definition resulted in a doubled frequency of precapillary PH (6%). PH with a precapillary component according to the 2015 definition was associated with poor clinical outcomes and characterised by small left ventricular dimension and high early diastolic mitral inflow velocity/early diastolic mitral annular tissue velocity. CONCLUSION After initial HF treatment, 7% of hospitalised patients with HFpEF had precapillary component of PH according to the 2015 definition. Echocardiographic parameters of the left ventricle can contribute to the risk stratification of patients with HFpEF with a precapillary component of PH.
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Affiliation(s)
- Fusako Sera
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunsuke Tamaki
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Takaharu Hayashi
- Department of Cardiovascular Medicine, Osaka Police Hospital, Osaka, Japan
| | - Akito Nakagawa
- Division of Cardiovascular Medicine, Amagasaki Chuo Hospital, Amagasaki, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, Kawanishi, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yoshio Yasumura
- Division of Cardiovascular Medicine, Amagasaki Chuo Hospital, Amagasaki, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keiko Yamauchi-Takihara
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Health and Counseling Center, Osaka University, Toyonaka, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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22
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Shiba M, Hirayama A, Nishikawa T, Hayashi T, Yano M, Nakagawa A, Nakagawa Y, Seo M, Tamaki S, Yamada T, Yasumura Y, Sotomi Y, Hikoso S, Nakatani D, Higuchi Y, Sakata Y. PROGNOSTIC IMPACT OF TOLVAPTAN ON WORSENING CLINICAL OUTCOME IN PATIENTS WITH HFPEF. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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23
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Nakamura T, Matsumoto M, Amano K, Enokido Y, Zolensky ME, Mikouchi T, Genda H, Tanaka S, Zolotov MY, Kurosawa K, Wakita S, Hyodo R, Nagano H, Nakashima D, Takahashi Y, Fujioka Y, Kikuiri M, Kagawa E, Matsuoka M, Brearley AJ, Tsuchiyama A, Uesugi M, Matsuno J, Kimura Y, Sato M, Milliken RE, Tatsumi E, Sugita S, Hiroi T, Kitazato K, Brownlee D, Joswiak DJ, Takahashi M, Ninomiya K, Takahashi T, Osawa T, Terada K, Brenker FE, Tkalcec BJ, Vincze L, Brunetto R, Aléon-Toppani A, Chan QHS, Roskosz M, Viennet JC, Beck P, Alp EE, Michikami T, Nagaashi Y, Tsuji T, Ino Y, Martinez J, Han J, Dolocan A, Bodnar RJ, Tanaka M, Yoshida H, Sugiyama K, King AJ, Fukushi K, Suga H, Yamashita S, Kawai T, Inoue K, Nakato A, Noguchi T, Vilas F, Hendrix AR, Jaramillo-Correa C, Domingue DL, Dominguez G, Gainsforth Z, Engrand C, Duprat J, Russell SS, Bonato E, Ma C, Kawamoto T, Wada T, Watanabe S, Endo R, Enju S, Riu L, Rubino S, Tack P, Takeshita S, Takeichi Y, Takeuchi A, Takigawa A, Takir D, Tanigaki T, Taniguchi A, Tsukamoto K, Yagi T, Yamada S, Yamamoto K, Yamashita Y, Yasutake M, Uesugi K, Umegaki I, Chiu I, Ishizaki T, Okumura S, Palomba E, Pilorget C, Potin SM, Alasli A, Anada S, Araki Y, Sakatani N, Schultz C, Sekizawa O, Sitzman SD, Sugiura K, Sun M, Dartois E, De Pauw E, Dionnet Z, Djouadi Z, Falkenberg G, Fujita R, Fukuma T, Gearba IR, Hagiya K, Hu MY, Kato T, Kawamura T, Kimura M, Kubo MK, Langenhorst F, Lantz C, Lavina B, Lindner M, Zhao J, Vekemans B, Baklouti D, Bazi B, Borondics F, Nagasawa S, Nishiyama G, Nitta K, Mathurin J, Matsumoto T, Mitsukawa I, Miura H, Miyake A, Miyake Y, Yurimoto H, Okazaki R, Yabuta H, Naraoka H, Sakamoto K, Tachibana S, Connolly HC, Lauretta DS, Yoshitake M, Yoshikawa M, Yoshikawa K, Yoshihara K, Yokota Y, Yogata K, Yano H, Yamamoto Y, Yamamoto D, Yamada M, Yamada T, Yada T, Wada K, Usui T, Tsukizaki R, Terui F, Takeuchi H, Takei Y, Iwamae A, Soejima H, Shirai K, Shimaki Y, Senshu H, Sawada H, Saiki T, Ozaki M, Ono G, Okada T, Ogawa N, Ogawa K, Noguchi R, Noda H, Nishimura M, Namiki N, Nakazawa S, Morota T, Miyazaki A, Miura A, Mimasu Y, Matsumoto K, Kumagai K, Kouyama T, Kikuchi S, Kawahara K, Kameda S, Iwata T, Ishihara Y, Ishiguro M, Ikeda H, Hosoda S, Honda R, Honda C, Hitomi Y, Hirata N, Hirata N, Hayashi T, Hayakawa M, Hatakeda K, Furuya S, Fukai R, Fujii A, Cho Y, Arakawa M, Abe M, Watanabe S, Tsuda Y. Formation and evolution of carbonaceous asteroid Ryugu: Direct evidence from returned samples. Science 2023; 379:eabn8671. [PMID: 36137011 DOI: 10.1126/science.abn8671] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide-bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu's parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of <1 (by mass). Less altered fragments contain olivine, pyroxene, amorphous silicates, calcite, and phosphide. Numerical simulations, based on the mineralogical and physical properties of the samples, indicate that Ryugu's parent body formed ~2 million years after the beginning of Solar System formation.
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Affiliation(s)
- T Nakamura
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Matsumoto
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - K Amano
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Y Enokido
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M E Zolensky
- NASA Johnson Space Center; Houston, TX 77058, USA
| | - T Mikouchi
- The University Museum, The University of Tokyo, Tokyo 113-0033, Japan
| | - H Genda
- Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - S Tanaka
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - M Y Zolotov
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - K Kurosawa
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - S Wakita
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - R Hyodo
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - H Nagano
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - D Nakashima
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Y Takahashi
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan.,Isotope Science Center, The University of Tokyo, Tokyo 113-0032, Japan
| | - Y Fujioka
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Kikuiri
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - E Kagawa
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Matsuoka
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique (LESIA), Observatoire de Paris, Meudon 92195 France.,Geological Survey of Japan, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, 305-8567, Japan
| | - A J Brearley
- Department of Earth and Planetary Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - A Tsuchiyama
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu 525-8577, Japan.,Key Laboratory of Mineralogy and Metallogeny, Guangdong Provincial Key Laboratory of Mineral Physics and Materials, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences (CAS), Guangzhou 510640, China.,Center for Excellence in Deep Earth Science, CAS, Guangzhou 510640, China
| | - M Uesugi
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - J Matsuno
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu 525-8577, Japan
| | - Y Kimura
- Institute of Low Temperature Science, Hokkaido University, Sapporo 060-0819, Japan
| | - M Sato
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - R E Milliken
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - E Tatsumi
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan.,Instituto de Astrofísica de Canarias, University of La Laguna, Tenerife 38205, Spain
| | - S Sugita
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan.,Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Hiroi
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - K Kitazato
- Aizu Research Center for Space Informatics, The University of Aizu, Aizu-Wakamatsu 965-8580, Japan
| | - D Brownlee
- Department of Astronomy, University of Washington, Seattle, WA 98195 USA
| | - D J Joswiak
- Department of Astronomy, University of Washington, Seattle, WA 98195 USA
| | - M Takahashi
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - K Ninomiya
- Institute for Radiation Sciences, Osaka University, Toyonaka 560-0043, Japan
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan.,Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Osawa
- Materials Sciences Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - K Terada
- Department of Earth and Space Science, Osaka University, Toyonaka 560-0043, Japan
| | - F E Brenker
- Institute of Geoscience, Goethe University, Frankfurt, 60438 Frankfurt am Main, Germany
| | - B J Tkalcec
- Institute of Geoscience, Goethe University, Frankfurt, 60438 Frankfurt am Main, Germany
| | - L Vincze
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - R Brunetto
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - A Aléon-Toppani
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - Q H S Chan
- Department of Earth Sciences, Royal Holloway, University of London, Egham TW20 0EX, UK
| | - M Roskosz
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Muséum National d'Histoire Naturelle, Centre national de la recherche scientifique (CNRS), Sorbonne Université, Paris, France
| | - J-C Viennet
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Muséum National d'Histoire Naturelle, Centre national de la recherche scientifique (CNRS), Sorbonne Université, Paris, France
| | - P Beck
- Institut de Planétologie et d'Astrophysique de Grenoble, CNRS, Université Grenoble Alpes, 38000 Grenoble, France
| | - E E Alp
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - T Michikami
- Faculty of Engineering, Kindai University, Higashi-Hiroshima 739-2116, Japan
| | - Y Nagaashi
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan.,Department of Planetology, Kobe University, Kobe 657-8501, Japan
| | - T Tsuji
- Department of Earth Resources Engineering, Kyushu University, Fukuoka 819-0395, Japan.,School of Engineering, The University of Tokyo, Tokyo 113-0033, Japan
| | - Y Ino
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Physics, Kwansei Gakuin University, Sanda 669-1330, Japan
| | - J Martinez
- NASA Johnson Space Center; Houston, TX 77058, USA
| | - J Han
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX 77204, USA
| | - A Dolocan
- Texas Materials Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - R J Bodnar
- Department of Geoscience, Virginia Tech, Blacksburg, VA 24061, USA
| | - M Tanaka
- Materials Analysis Station, National Institute for Materials Science, Tsukuba 305-0047, Japan
| | - H Yoshida
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Sugiyama
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| | - A J King
- Department of Earth Science, Natural History Museum, London SW7 5BD, UK
| | - K Fukushi
- Institute of Nature and Environmental Technology, Kanazawa University, Kanazawa 920-1192, Japan
| | - H Suga
- Spectroscopy Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - S Yamashita
- Department of Materials Structure Science, The Graduate University for Advanced Studies (SOKENDAI), Tsukuba, Ibaraki 305-0801, Japan.,Institute of Materials Structure Science, High-Energy Accelerator Research Organization, Tsukuba 305-0801, Japan
| | - T Kawai
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Inoue
- Institute of Nature and Environmental Technology, Kanazawa University, Kanazawa 920-1192, Japan
| | - A Nakato
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Noguchi
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan.,Faculty of Arts and Science, Kyushu University, Fukuoka 819-0395, Japan
| | - F Vilas
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - A R Hendrix
- Planetary Science Institute, Tucson, AZ 85719, USA
| | | | - D L Domingue
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - G Dominguez
- Department of Physics, California State University, San Marcos, CA 92096, USA
| | - Z Gainsforth
- Space Sciences Laboratory, University of California, Berkeley, CA 94720, USA
| | - C Engrand
- Laboratoire de Physique des 2 Infinis Irène Joliot-Curie, Université Paris-Saclay, CNRS, 91405 Orsay, France
| | - J Duprat
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Muséum National d'Histoire Naturelle, Centre national de la recherche scientifique (CNRS), Sorbonne Université, Paris, France
| | - S S Russell
- Department of Earth Science, Natural History Museum, London SW7 5BD, UK
| | - E Bonato
- Institute for Planetary Research, Deutsches Zentrum für Luftund Raumfahrt, Rutherfordstraße 2 12489 Berlin, Germany
| | - C Ma
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena CA 91125, USA
| | - T Kawamoto
- Department of Geosciences, Shizuoka University, Shizuoka 422-8529, Japan
| | - T Wada
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - S Watanabe
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan
| | - R Endo
- Department of Materials Science and Engineering, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - S Enju
- Graduate School of Science and Engineering, Ehime University, Matsuyama 790-8577, Japan
| | - L Riu
- European Space Astronomy Centre, 28692 Villanueva de la Cañada, Spain
| | - S Rubino
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - P Tack
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - S Takeshita
- High Energy Accelerator Research Organization, Tokai 319-1106, Japan
| | - Y Takeichi
- Department of Materials Structure Science, The Graduate University for Advanced Studies (SOKENDAI), Tsukuba, Ibaraki 305-0801, Japan.,Institute of Materials Structure Science, High-Energy Accelerator Research Organization, Tsukuba 305-0801, Japan.,Department of Applied Physics, Osaka University, Suita 565-0871, Japan
| | - A Takeuchi
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - A Takigawa
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - D Takir
- NASA Johnson Space Center; Houston, TX 77058, USA
| | | | - A Taniguchi
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori 590-0494, Japan
| | - K Tsukamoto
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - T Yagi
- National Metrology Institute of Japan, AIST, Tsukuba 305-8565, Japan
| | - S Yamada
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - K Yamamoto
- Japan Fine Ceramics Center, Nagoya 456-8587, Japan
| | - Y Yamashita
- National Metrology Institute of Japan, AIST, Tsukuba 305-8565, Japan
| | - M Yasutake
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - K Uesugi
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - I Umegaki
- High Energy Accelerator Research Organization, Tokai 319-1106, Japan.,Toyota Central Research and Development Laboratories, Nagakute 480-1192, Japan
| | - I Chiu
- Institute for Radiation Sciences, Osaka University, Toyonaka 560-0043, Japan
| | - T Ishizaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - S Okumura
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - E Palomba
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica, Rome 00133, Italy
| | - C Pilorget
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France.,Institut Universitaire de France, Paris, France
| | - S M Potin
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique (LESIA), Observatoire de Paris, Meudon 92195 France.,Faculty of Aerospace Engineering, Delft University of Technology, Delft, Netherlands
| | - A Alasli
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - S Anada
- Japan Fine Ceramics Center, Nagoya 456-8587, Japan
| | - Y Araki
- Department of Physical Sciences, Ritsumeikan University, Shiga 525-0058, Japan
| | - N Sakatani
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - C Schultz
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - O Sekizawa
- Spectroscopy Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - S D Sitzman
- Physical Sciences Laboratory, The Aerospace Corporation, CA 90245, USA
| | - K Sugiura
- Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - M Sun
- Key Laboratory of Mineralogy and Metallogeny, Guangdong Provincial Key Laboratory of Mineral Physics and Materials, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences (CAS), Guangzhou 510640, China.,Center for Excellence in Deep Earth Science, CAS, Guangzhou 510640, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - E Dartois
- Institut des Sciences Moléculaires d'Orsay, Université Paris-Saclay, CNRS, 91405 Orsay, France
| | - E De Pauw
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - Z Dionnet
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - Z Djouadi
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - G Falkenberg
- Deutsches Elektronen-Synchrotron Photon Science, 22603 Hamburg, Germany
| | - R Fujita
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - T Fukuma
- Nano Life Science Institute, Kanazawa University, Kanazawa 920-1192, Japan
| | - I R Gearba
- Texas Materials Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - K Hagiya
- Graduate School of Life Science, University of Hyogo, Hyogo 678-1297, Japan
| | - M Y Hu
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - T Kato
- Japan Fine Ceramics Center, Nagoya 456-8587, Japan
| | - T Kawamura
- Institut de Physique du Globe de Paris, Université de Paris, Paris 75205, France
| | - M Kimura
- Department of Materials Structure Science, The Graduate University for Advanced Studies (SOKENDAI), Tsukuba, Ibaraki 305-0801, Japan.,Institute of Materials Structure Science, High-Energy Accelerator Research Organization, Tsukuba 305-0801, Japan
| | - M K Kubo
- Division of Natural Sciences, International Christian University, Mitaka 181-8585, Japan
| | - F Langenhorst
- Institute of Geosciences, Friedrich-Schiller-Universität Jena, 07745 Jena, Germany
| | - C Lantz
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - B Lavina
- Center for Advanced Radiation Sources, University of Chicago, Chicago, IL 60637, USA
| | - M Lindner
- Institute of Geoscience, Goethe University, Frankfurt, 60438 Frankfurt am Main, Germany
| | - J Zhao
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - B Vekemans
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - D Baklouti
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - B Bazi
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - F Borondics
- Optimized Light Source of Intermediate Energy to LURE (SOLEIL) L'Orme des Merisiers, Gif sur Yvette F-91192, France
| | - S Nagasawa
- Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan.,Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - G Nishiyama
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Nitta
- Spectroscopy Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - J Mathurin
- Institut Chimie Physique, Université Paris-Saclay, CNRS, 91405 Orsay, France
| | - T Matsumoto
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - I Mitsukawa
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - H Miura
- Graduate School of Science, Nagoya City University, Nagoya 467-8501, Japan
| | - A Miyake
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - Y Miyake
- High Energy Accelerator Research Organization, Tokai 319-1106, Japan
| | - H Yurimoto
- Department of Natural History Sciences, Hokkaido University, Sapporo 060-0810, Japan
| | - R Okazaki
- Department of Earth and Planetary Sciences, Kyushu University, Fukuoka 819-0395, Japan
| | - H Yabuta
- Graduate School of Advanced Science and Engineering, Hiroshima University, Higashi-Hiroshima 739-8526, Japan
| | - H Naraoka
- Department of Earth and Planetary Sciences, Kyushu University, Fukuoka 819-0395, Japan
| | - K Sakamoto
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - S Tachibana
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - H C Connolly
- Department of Geology, Rowan University, Glassboro, NJ 08028, USA
| | - D S Lauretta
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - M Yoshitake
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Yoshikawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - K Yoshikawa
- Research and Development Directorate, JAXA, Sagamihara 252-5210, Japan
| | - K Yoshihara
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Yokota
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Yogata
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - H Yano
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - Y Yamamoto
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - D Yamamoto
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Yamada
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - T Yamada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Yada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Wada
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - T Usui
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - R Tsukizaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - F Terui
- Department of Mechanical Engineering, Kanagawa Institute of Technology, Atsugi 243-0292, Japan
| | - H Takeuchi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - Y Takei
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - A Iwamae
- Marine Works Japan, Yokosuka 237-0063, Japan
| | - H Soejima
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - K Shirai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Shimaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - H Senshu
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - H Sawada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Saiki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Ozaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - G Ono
- Research and Development Directorate, JAXA, Sagamihara 252-5210, Japan
| | - T Okada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Chemistry, The University of Tokyo, Tokyo 113-0033, Japan
| | - N Ogawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Ogawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - R Noguchi
- Faculty of Science, Niigata University, Niigata 950-2181, Japan
| | - H Noda
- National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - M Nishimura
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - N Namiki
- Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan.,National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - S Nakazawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Morota
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - A Miyazaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - A Miura
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Mimasu
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Matsumoto
- Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan.,National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - K Kumagai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - T Kouyama
- Digital Architecture Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan
| | - S Kikuchi
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan.,National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - K Kawahara
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - S Kameda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - T Iwata
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - Y Ishihara
- JAXA Space Exploration Center, JAXA, Sagamihara 252-5210, Japan
| | - M Ishiguro
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - H Ikeda
- Research and Development Directorate, JAXA, Sagamihara 252-5210, Japan
| | - S Hosoda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - R Honda
- Department of Information Science, Kochi University, Kochi 780-8520, Japan.,Center for Data Science, Ehime University, Matsuyama 790-8577, Japan
| | - C Honda
- Aizu Research Center for Space Informatics, The University of Aizu, Aizu-Wakamatsu 965-8580, Japan
| | - Y Hitomi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - N Hirata
- Department of Planetology, Kobe University, Kobe 657-8501, Japan
| | - N Hirata
- Aizu Research Center for Space Informatics, The University of Aizu, Aizu-Wakamatsu 965-8580, Japan
| | - T Hayashi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Hayakawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Hatakeda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - S Furuya
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - R Fukai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - A Fujii
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Cho
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - M Arakawa
- Department of Planetology, Kobe University, Kobe 657-8501, Japan
| | - M Abe
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - S Watanabe
- Department of Earth and Environmental Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - Y Tsuda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
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24
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Nishimoto Y, Ohbe H, Matsui H, Nakajima M, Sasabuchi Y, Sato Y, Watanabe T, Yamada T, Fukunami M, Yasunaga H. Effectiveness of systemic thrombolysis on clinical outcomes in high-risk pulmonary embolism patients with venoarterial extracorporeal membrane oxygenation: a nationwide inpatient database study. J Intensive Care 2023; 11:4. [PMID: 36740697 PMCID: PMC9901114 DOI: 10.1186/s40560-023-00651-w] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/24/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Current guidelines recommend systemic thrombolysis as the first-line reperfusion treatment for patients with high-risk pulmonary embolism (PE) who present with cardiogenic shock but do not require venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, little is known about the optimal reperfusion treatment in high-risk PE patients requiring VA-ECMO. We aimed to evaluate whether systemic thrombolysis improved high-risk PE patients' outcomes who received VA-ECMO. METHODS This was a retrospective cohort study using the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2021. We identified patients who were diagnosed with PE and received VA-ECMO on the day of admission. Patients who received systemic thrombolysis with monteplase or urokinase within two days of initiating VA-ECMO were defined as the thrombolysis group and the remaining patients as the control group. The primary outcome was in-hospital mortality and secondary outcomes were favorable neurological outcomes, length of hospital stay, VA-ECMO duration, total hospitalization cost, major bleeding, and blood transfusion volume. Propensity-score inverse probability of treatment weighting (IPTW) was performed to compare the outcomes between the groups. RESULTS Of 1220 eligible patients, 432 (35%) received systemic thrombolysis within two days of initiating VA-ECMO. Among the unweighted cohort, patients in the thrombolysis group were less likely to have poor consciousness at admission, out-of-hospital cardiac arrest, and left heart catheterization. After IPTW, the patient characteristics were well-balanced between the two groups The crude in-hospital mortality was 52% in the thrombolysis group and 61% in the control group. After IPTW, in-hospital mortality did not differ significantly between the two groups (risk difference: - 3.0%, 95% confidence interval: - 9.6% to 3.5%). There were also no significant differences in the secondary outcomes. Sensitivity analyses showed a significant difference in major bleeding between the monteplase and control groups (risk difference: 6.9%, 95% confidence interval: 1.7% to 12.1%), excluding patients who received urokinase. There were no significant differences in the other sensitivity and subgroup analyses except for the total hospitalization cost. CONCLUSIONS Systemic thrombolysis was not associated with reduced in-hospital mortality or increased major bleeding in the high-risk PE patients receiving VA-ECMO. However, systemic thrombolysis with monteplase was associated with increased major bleeding.
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Affiliation(s)
- Yuji Nishimoto
- grid.416985.70000 0004 0378 3952Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Hiroyuki Ohbe
- grid.26999.3d0000 0001 2151 536XDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033 Japan
| | - Hiroki Matsui
- grid.26999.3d0000 0001 2151 536XDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033 Japan
| | - Mikio Nakajima
- grid.26999.3d0000 0001 2151 536XDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033 Japan ,Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development, Tokyo, Japan
| | - Yusuke Sasabuchi
- grid.410804.90000000123090000Data Science Center, Jichi Medical University, Tochigi, Japan
| | - Yukihito Sato
- grid.413697.e0000 0004 0378 7558Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Tetsuya Watanabe
- grid.416985.70000 0004 0378 3952Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- grid.416985.70000 0004 0378 3952Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masatake Fukunami
- grid.416985.70000 0004 0378 3952Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Hideo Yasunaga
- grid.26999.3d0000 0001 2151 536XDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033 Japan
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25
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Shiina K, Tomiyama H, Tanaka A, Imai T, Hisauchi I, Taguchi I, Sezai A, Toyoda S, Dohi K, Kamiya H, Kida K, Anzai T, Chikamori T, Node K, Ako J, Amano R, Asai M, Eguchi K, Eshima K, Fujiki S, Fujita M, Hikoso S, Hiramitsu S, Hoshide S, Hoshino A, Ikeda Y, Ikehara Y, Inomata T, Inoue T, Ishii K, Ishizaka N, Ito M, Iwahashi N, Iwakura K, Kadokami T, Kanbara T, Kanzaki Y, Kashimura K, Kimura K, Kishi S, Kitada S, Kitakaze M, Kiyosue A, Kodama K, Kojima T, Kondo T, Kubota Y, Kusunose K, Machii N, Matsunaga K, Matsuo Y, Matsuzawa Y, Mikami T, Minamino T, Murohara T, Nagai T, Nagano Y, Nagumo M, Nakamura I, Nakamura K, Nakatani D, Nanasato M, Naruse H, Nishino M, Niwano S, Oguri M, Ohte N, Oikawa M, Okumura T, Okumura M, Onishi K, Oyama JI, Ozaki Y, Saito K, Sakamoto T, Sakata Y, Sakuma M, Sata M, Sekino H, Shimabukuro M, Shimizu W, Suzuki M, Suzuki K, Takahama H, Takahashi N, Takeishi Y, Tamaki S, Tanaka A, Tanimoto S, Teragawa H, Tobushi T, Toita T, Tokuda K, Tsutsui H, Ueda S, Uehara H, Uematsu M, Watada H, Yahagi K, Yamada T, Yamada H, Yoshida T, Yoshihisa A. Canagliflozin independently reduced plasma volume from conventional diuretics in patients with type 2 diabetes and chronic heart failure: a subanalysis of the CANDLE trial. Hypertens Res 2023; 46:495-506. [PMID: 36380202 DOI: 10.1038/s41440-022-01085-x] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/24/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022]
Abstract
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce the risk of heart failure progression and mortality rates. Moreover, osmotic diuresis induced by SGLT2 inhibition may result in an improved heart failure prognosis. Independent of conventional diuretics in patients with type 2 diabetes (T2D) and chronic heart failure, especially in patients with heart failure with preserved ejection fraction (HFpEF), it is unclear whether SGLT2i chronically reduces estimated plasma volume (ePV). As a subanalysis of the CANDLE trial, which assessed the effect of canagliflozin on N-terminal pro-brain natriuretic peptide (NT-proBNP), we examined the change (%) in ePV over 24 weeks of treatment based on the baseline level associated with diuretic usage. In the CANDLE trial, nearly all patients were clinically stable (NYHA class I-II), with approximately 70% of participants presenting a baseline phenotype of HFpEF. A total of 99 (42.5%) patients were taking diuretics (mostly furosemide) at baseline, while 134 (57.5%) were not. Relative to glimepiride, canagliflozin significantly reduced ePV without worsening renal function in patients in both groups: -4.00% vs. 1.46% (p = 0.020) for the diuretic group and -6.14% vs. 1.28% (p < 0.001) for the nondiuretic group. Furthermore, canagliflozin significantly reduced serum uric acid without causing major electrolyte abnormalities in patients in both subgroups. The long-term beneficial effect of SGLT2i on intravascular congestion could be independent of conventional diuretic therapy without worsening renal function in patients with T2D and HF (HFpEF predominantly). In addition, the beneficial effects of canagliflozin are accompanied by improved hyperuricemia without causing major electrolyte abnormalities.
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Affiliation(s)
- Kazuki Shiina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
| | | | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Itaru Hisauchi
- Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Isao Taguchi
- Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Akira Sezai
- The Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Haruo Kamiya
- Department of Cardiology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
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26
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Guo X, Li T, Lu D, Yamada T, Li X, Bao S, Liu J, Borjigin G, Cang M, Tong B. Effects of the Expressions and Variants of the CAST Gene on the Fatty Acid Composition of the Longissimus Thoracis Muscle of Grazing Sonid Sheep. Animals (Basel) 2023; 13:ani13020195. [PMID: 36670735 PMCID: PMC9855194 DOI: 10.3390/ani13020195] [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: 11/16/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
Fatty acid (FA) composition has an important impact on the nutrition and flavor of meat, and on consumer health, and is receiving more attention in the sheep industry. This study aimed to evaluate the relationship between the expression levels of the CAST gene and the FA composition in the longissimus thoracis (LL) muscle, to identify novel variants of CAST, and to perform association analysis with the FA composition in grazing Sonid lambs. The correlation results showed that high expression levels of CAST are correlated with better FA compositions and classes in LL. For association studies, the results showed that c.1210C>T and c.1437G>A in LD-M, and c.2097C>T mutations are associated with some compositions and classes of FA in the LL of grazing Sonid sheep. Two missense c.646G>C (G216R) and c.1210C>T (R404C) mutations were predicted to influence the Calpain_inhib domains of CAST. Thus, the correlation results and associated mutations are expected to be genetic selection markers for the FA composition and meat quality of grazing Sonid lamb muscle and provide new insights into sheep meat quality traits influenced by the ovine CAST gene.
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Affiliation(s)
- Xin Guo
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot 010021, China
| | - Terigele Li
- Inner Mongolia Agriculture Animal Husbandry Fishery and Biology Experiment Research Centre, Inner Mongolia Agricultural University, Hohhot 010010, China
| | - Datong Lu
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot 010021, China
| | - Takahisa Yamada
- Department of Agrobiology, Faculty of Agriculture, Niigata University, Niigata 950-2181, Japan
| | - Xihe Li
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot 010021, China
| | - Siqin Bao
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot 010021, China
| | - Jiasen Liu
- Institute of Animal Science, Inner Mongolia Academy of Agricultural and Animal Husbandry Sciences, Hohhot 010031, China
| | - Gerelt Borjigin
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot 010010, China
| | - Ming Cang
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot 010021, China
- Correspondence: (M.C.); (B.T.)
| | - Bin Tong
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot 010021, China
- Correspondence: (M.C.); (B.T.)
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27
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Yoshida M, Seo M, Watanabe T, Matsuoka K, Fushimi H, Shirakawa Y, Yamada T. A Case of Cardiac Undifferentiated Pleomorphic Sarcoma With Right Ventricular Outflow Tract Obstruction. Int Heart J 2023; 64:779-782. [PMID: 37518358 DOI: 10.1536/ihj.23-037] [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: 08/01/2023]
Abstract
Malignant tumors originating from the heart are extremely rare. Here, we report a case of severe right ventricular outflow tract (RVOT) stenosis in a 67 year-old woman caused by a massive intimal sarcoma that required venous-arterial extracorporeal membrane oxygenation to support systemic circulation. Surgical resection and RVOT reconstruction with tricuspid and pulmonary valve replacement were performed. The pathological diagnosis was cardiac undifferentiated pleomorphic sarcoma. Although the patient was discharged 65 days after surgery in good condition, she subsequently died from multiple metastases detected in the early phase after surgery.
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Affiliation(s)
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center
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28
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Yano M, Nishino M, Kawanami S, Sugae H, Ukita K, Kawamura A, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Egami Y, Tanouchi J, Yamada T, Yasumura Y, Seo M, Hayashi T, Nakagawa A, Nakagawa Y, Tamaki S, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Impact of Structural Abnormalities in Left Ventricle and Left Atrium on Clinical Outcomes in Heart Failure with Preserved Ejection Fraction. Int Heart J 2023; 64:875-884. [PMID: 37778990 DOI: 10.1536/ihj.23-277] [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: 10/03/2023]
Abstract
Two key echocardiographic parameters, left ventricular mass index (LVMI) and left atrial volume index (LAVI), are important in assessing structural myocardial changes in heart failure (HF) with preserved ejection fraction (HFpEF). However, the differences in clinical characteristics and outcomes among groups classified by LVMI and LAVI values are unclear.We examined the data of 960 patients with HFpEF hospitalized due to acute decompensated HF from the PURSUIT-HFpEF registry, a prospective, multicenter observational study. Four groups were classified according to the cut-off values of LVMI and LAVI [LVMI = 95 g/m2 (female), 115 g/m2 (male) and LAVI = 34 mL/m2]. Clinical endpoints were the composite of HF readmission and all-cause death. Study endpoints among the 4 groups were evaluated. The composite endpoint occurred in 364 patients (37.9%). Median follow-up duration was 445 days. Kaplan-Meier analysis revealed significant differences in the composite endpoint among the 4 groups (P < 0.001). Cox proportional hazards analysis demonstrated that patients with increased LAVI alone were at significantly higher risk of HF readmission and the composite endpoints than those with increased LVMI alone (P = 0.030 and P = 0.024, respectively). Age, male gender, systolic blood pressure at discharge, atrial fibrillation (AF) hemoglobin, renal function, and LAVI were significant determinants of LVMI and female gender, AF, hemoglobin, and LVMI were significant determinants of LAVI.In HFpEF patients, increased LAVI alone was more strongly associated with HF readmission and the composite of HF readmission and all-cause death than those with increased LVMI alone.
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Affiliation(s)
| | | | | | | | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital
| | | | | | | | | | | | | | | | | | | | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center
| | | | - Akito Nakagawa
- Department of Medical Informatics, Osaka University Graduate School of Medicine
| | | | | | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Oeun B, Hikoso S, Nakatani D, Mizuno H, Kitamura T, Okada K, Dohi T, Sotomi Y, Kida H, Sunaga A, Sato T, Matsuoka Y, Kurakami H, Yamada T, Tamaki S, Seo M, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Yamada T, Yasumura Y, Sakata Y, Watanabe T, Yamada T, Hayashi T, Higuchi Y, Masuda M, Asai M, Mano T, Fuji H, Tamaki S, Masuda D, Shutta R, Yamashita S, Sairyo M, Nakagawa Y, Abe H, Ueda Y, Matsumura Y, Nagai K, Yano M, Nishino M, Tanouchi J, Arita Y, Ogasawara N, Ishizu T, Ichikawa M, Takano Y, Rin E, Shinoda Y, Tachibana K, Hoshida S, Izumi M, Yamamoto H, Kato H, Nakatani K, Yasuga Y, Nishio M, Hirooka K, Yoshimura T, Kashiwase K, Hasegawa S, Tani A, Okumoto Y, Makino Y, Onishi T, Iwakura K, Kijima Y, Kitao T, Fujita M, Harada K, Kumada M, Nakagawa O, Nakagawa A, Yasumura Y, Matsuoka Y, Sato T, Sunaga A, Oeun B, Kida H, Sotomi Y, Dohi T, Akazawa Y, Nakamoto K, Okada K, Sera F, Kioka H, Ohtani T, Takeda T, Nakatani D, Mizuno H, Hikoso S, Sakata Y. Clinical trajectories and outcomes of patients with heart failure with preserved ejection fraction with normal or indeterminate diastolic function. Clin Res Cardiol 2023; 112:145-157. [PMID: 36357804 DOI: 10.1007/s00392-022-02121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/19/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND We recently reported that nearly half of patients with heart failure with preserved ejection fraction (HFpEF) did not show echocardiographic diastolic dysfunction (DD), but had normal diastolic function (ND) or indeterminate diastolic function (ID). However, the clinical course and outcomes of patients with HFpEF with ND or ID (ND/ID) remain unknown. METHODS From the PURSUIT-HFpEF registry, we extracted 289 patients with HFpEF with ND/ID at discharge who had echocardiographic data at 1-year follow-up. Patients were classified according to the status of progression from ND/ID to DD at 1 year. Primary endpoint was a composite of all-cause death or HF rehospitalization. RESULTS Median age was 81 years, and 138 (47.8%) patients were female. At 1 year, 107 (37%) patients had progressed to DD. The composite endpoint occurred in 90 (31.1%) patients. Compared to patients without progression to DD, those with progression had a significantly higher cumulative rate of the composite endpoint (P < 0.001) and HF rehospitalization (P < 0.001) after discharge and at the 1-year landmark (P = 0.030 and P = 0.001, respectively). Progression to DD was independently associated with the composite endpoint (hazard ratio (HR): 2.014, 95%CI 1.239-3.273, P = 0.005) and HF rehospitalization (HR: 2.362, 95%CI 1.402-3.978) after discharge. Age (odds ratio (OR): 1.043, 95%CI 1.004-1.083, P = 0.031), body mass index (BMI) (OR: 1.110, 95%CI 1.031-1.195, P = 0.006), and albumin (OR: 0.452, 95%CI 0.211-0.969, P = 0.041) were independently associated with progression from ND/ID to DD. CONCLUSIONS More than one-third of HFpEF patients with ND/ID progressed to DD at 1 year and had poor outcomes. Age, BMI and albumin were independently associated with this progression. UMIN-CTR ID UMIN000021831.
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Affiliation(s)
- Bolrathanak Oeun
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Hiroya Mizuno
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Katsuki Okada
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.,Department of Transformative System for Medical Information, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tomoharu Dohi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Hirota Kida
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Akihiro Sunaga
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Taiki Sato
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yuki Matsuoka
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Hiroyuki Kurakami
- Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Japan
| | - Tomomi Yamada
- Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Bandaihigashi, Osaka, 558-8558, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-Ku, Sakai, Osaka, 591-8025, Japan
| | - Takaharu Hayashi
- Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayamacho, Tennojiku, Osaka, 543-0035, Japan
| | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo, 661-0976, Japan.,Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, 5-21-1 Higashiuneno, Kawanishi, 666-0117, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Bandaihigashi, Osaka, 558-8558, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo, 661-0976, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
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30
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Tamaki S, Nagai Y, Shutta R, Masuda D, Yamashita S, Seo M, Yamada T, Nakagawa A, Yasumura Y, Nakagawa Y, Yano M, Hayashi T, Hikoso S, Nakatani D, Sotomi Y, Sakata Y. Combination of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as a Novel Predictor of Cardiac Death in Patients With Acute Decompensated Heart Failure With Preserved Left Ventricular Ejection Fraction: A Multicenter Study. J Am Heart Assoc 2022; 12:e026326. [PMID: 36565197 PMCID: PMC9973595 DOI: 10.1161/jaha.122.026326] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are novel inflammation markers. Their combined usefulness for estimating the prognosis of patients with heart failure with preserved ejection fraction (HFpEF) admitted for acute decompensated heart failure remains elusive. Methods and Results We investigated 1026 patients registered in the Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction. Both NLR and PLR values were measured at the time of admission. Comorbidity burden was defined as the number of occurrences of 8 common comorbidities of HFpEF. The primary end point was cardiac death. The patients were stratified into 3 groups based on the optimal cut-off values of NLR and PLR on the receiver operating characteristic curve analysis for predicting cardiac death (low NLR and PLR, either high NLR or PLR, and both high NLR and PLR). After a median follow-up of 429 days, 195 patients died, with 85 of these deaths attributed to cardiac causes. An increased comorbidity burden was significantly associated with a higher proportion of patients with high NLR (>4.5) or PLR (>193), or both. High NLR and PLR values were independently associated with cardiac death, and a combination of both values was the strongest predictor (hazard ratio, 2.66 [95% CI, 1.51%-4.70%], P=0.0008). A significant difference was found in the rate of cardiac death among the 3 groups stratified by NLR and PLR values. Conclusions The combination of NLR and PLR is useful for the prediction of postdischarge cardiac death in patients with acute HFpEF. Registration URL: ClinicalTrials.gov; Unique identifier: UMIN000021831.
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Affiliation(s)
- Shunsuke Tamaki
- Department of CardiologyRinku General Medical CenterOsakaJapan
| | - Yoshiyuki Nagai
- Department of CardiologyRinku General Medical CenterOsakaJapan
| | - Ryu Shutta
- Department of CardiologyRinku General Medical CenterOsakaJapan
| | - Daisaku Masuda
- Department of CardiologyRinku General Medical CenterOsakaJapan
| | | | - Masahiro Seo
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | - Takahisa Yamada
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | - Akito Nakagawa
- Division of CardiologyAmagasaki Chuo HospitalAmagasakiJapan,Department of Medical InformaticsOsaka University Graduate School of MedicineOsakaJapan
| | | | | | | | | | - Shungo Hikoso
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Daisaku Nakatani
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Yohei Sotomi
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Yasushi Sakata
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
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31
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Seo M, Watanabe T, Yamada T, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Tamaki S, Yasumura Y, Sotomi Y, Hikoso S, Nakatani D, Fukunami M, Sakata Y. The clinical relevance of quality of life in heart failure patients with preserved ejection fraction. ESC Heart Fail 2022; 10:995-1002. [PMID: 36510693 PMCID: PMC10053171 DOI: 10.1002/ehf2.14270] [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] [Received: 08/26/2022] [Revised: 10/26/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS Patient reported outcomes (PROs) are gradually being incorporated into daily practice to assess individual health-related quality of life (QOL). However, despite accumulating evidence of the prognostic utility of heart failure (HF)-specific QOL indices, evidence on the generic QOL score is scarce, especially in patients with HF with preserved ejection fraction (HFpEF). METHODS AND RESULTS Patient data were extracted from the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study. EuroQol 5 dimensions 5-level (EQ-5D-5L) data were obtained at discharge to evaluate patients' health-related QOL. The study population (n = 864) was divided into tertiles based on their EQ-5D-5L index as follows: low EQ-5D-5L 0.038-0.664 (n = 287), middle EQ-5D-5L 0.665-0.867 (n = 293), and high EQ-5D-5L 0.871-1.000 (n = 284). A total of 206 patients died over a mean follow-up period of 2.0 ± 1.2 years. Kaplan-Meier analysis revealed that the risk of mortality increased with the tertile of the EQ-5D-5L index (34% vs. 23% vs. 14%, P < 0.001). Cox multivariable analysis revealed that patients with EQ-5D-5L index in the low and middle tertiles had a significantly greater risk of mortality than those with EQ-5D-5L index in the high tertile [low EQ-5D-5L: adjusted hazard ratio (HR): 1.81 (1.12-2.92), P = 0.002, middle EQ-5D-5L: adjusted HR 1.91 (1.21-3.03), P = 0.006]. Among the dimensions of EQ-5D-5L, mobility (P = 0.014), self-care (P = 0.023) and usual activities (P = 0.008) were significant factors associated with all-cause mortality after multivariable adjustment. CONCLUSIONS EQ-5D-5L is useful tool for risk stratification in patients with HFpEF.
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Affiliation(s)
- Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Takaharu Hayashi
- Division of Cardiology, Osaka Police Hospital, 10-31 Kitayamacho, Tennoji-ku, Osaka, 543-0035, Japan
| | - Akito Nakagawa
- Division of Cardiovascular Medicine, Amagasaki-Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo, 661-0976, Japan.,Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, 5-21-1, Kawanishi, Hyogo, 666-0195, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, 2-23 Ourai-kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Yoshio Yasumura
- Division of Cardiovascular Medicine, Amagasaki-Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo, 661-0976, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Masatake Fukunami
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
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32
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Ohte N, Tanaka A, Kitada S, Yamada T, Eguchi K, Teragawa H, Takeishi Y, Kodama K, Seo Y, Node K. Influence of left ventricular ejection fraction on the reduction in N-terminal pro-brain natriuretic peptide by canagliflozin in patients with heart failure and type 2 diabetes: a sub analysis of the CANDLE trial. J Cardiol 2022; 81:508-512. [PMID: 36481298 DOI: 10.1016/j.jjcc.2022.11.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 12/10/2022]
Abstract
AIM To investigate the effect of left ventricular ejection fraction (LVEF) on the behavior of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with heart failure and type 2 diabetes mellitus with the use of canagliflozin compared to glimepiride. METHODS Patients (n = 233) from the CANDLE trial were randomly assigned to either the add-on canagliflozin (n = 113) or glimepiride treatment groups (n = 120). The patients were followed-up for 24 weeks. The NT-proBNP levels were measured at baseline and after 24 weeks. The LVEF was determined at baseline. RESULTS There was a significant relationship between the baseline NT-proBNP level (X1) and the change in NT-proBNP levels from baseline to 24 weeks (Y) in the canagliflozin group (Y = -0.533 × X1 + 178; r = -0.860, p < 0.001). However, this relationship was not observed in the glimepiride group (p = 0.428). The baseline LVEF (X2) correlated with Y with a marginal significance in the canagliflozin group (Y = 7.72 × X2-549; r = 0.192, p = 0.054), but no relationship was observed in the glimepiride group. In the canagliflozin group, bivariate regression analysis showed a significant correlation between Y, X1, and X2; Y = -0.567 × X1-6.04 × X2 + 542 (R = 0.871, p < 0.001). The partial regression coefficients of X1 (p < 0.001) and X2 (p = 0.006) significantly explained the variance in Y. The correlation coefficient for X2 was negative. There was a significant relationship between the logarithmically transformed NT-proBNP [ln(NT-proBNP)] at baseline (X1') and the change in ln(NT-proBNP) values from baseline to 24 weeks (Y'), a surrogate of the rate of change in NT-proBNP levels, in the canagliflozin group (Y' = -0.18 × X1' + 0.93; r = 0.450, p = 0.001). CONCLUSIONS The baseline NT-proBNP level significantly affected the extent and the rate of its decrease by canagliflozin. The reduction in NT-proBNP levels by canagliflozin was prominent in patients with a higher LVEF at baseline. However, its confounding effect of LVEF on canagliflozin treatment was not recognized without adjusting for the NT-proBNP level at baseline.
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Kuyama S, Yoshioka H, Kaneda H, Kataoka Y, Miura S, Katakami N, Yamanaka Y, Tamiya A, Yamada T, Yokoyama T, Hara S, Tanaka H, Fujisaka Y, Nakamura A, Azuma K, Namba M, Hata A, Sawa K, Ishikawa H, Kurata T. 330P A real-world multi-center prospective observational study of atezolizumab (Atezo) + bevacizumab (Bev) + carboplatin (CBDCA) + paclitaxel (PTX) (ABCP) in patients (pts) with advanced EGFR-mutated (EGFRm) NSCLC after EGFR-TKIs failure. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.369] [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: 12/07/2022] Open
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34
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Seo M, Watanabe T, Kikuchi A, Kawai T, Kayama K, Shirakawa Y, Yamada T. Transcatheter Mitral Valve Edge-to-Edge Repair for Commissure Prolapse Successfully Guided by Stitch Artifact Technique. CASE (Phila) 2022; 6:443-449. [PMID: 36589343 PMCID: PMC9794525 DOI: 10.1016/j.case.2022.09.004] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Illustration of the "Stitch Artifact Technique". (A) By conducting 2-beat image acquisition without stopping the ventilation, we can create stitch artifact on the 3D image intentionally. (B) This stitch artifact on 3D image indicates the exact position and angle of 2D cut-plane image which we visualized just before showing 3D-image.
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Affiliation(s)
- Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan,Correspondence: Masahiro Seo, MD, Division of Cardiology, Osaka General Medical Center, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Atsushi Kikuchi
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Tsutomu Kawai
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Kiyomi Kayama
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yukitoshi Shirakawa
- Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
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35
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Sunaga A, Hikoso S, Yamada T, Yasumura Y, Tamaki S, Yano M, Hayashi T, Nakagawa Y, Nakagawa A, Seo M, Kurakami H, Yamada T, Kitamura T, Sato T, Oeun B, Kida H, Sotomi Y, Dohi T, Okada K, Mizuno H, Nakatani D, Sakata Y. Change in Nutritional Status during Hospitalization and Prognosis in Patients with Heart Failure with Preserved Ejection Fraction. Nutrients 2022; 14:nu14204345. [PMID: 36297028 PMCID: PMC9611174 DOI: 10.3390/nu14204345] [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: 09/15/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
The impact of changes in nutritional status during hospitalization on prognosis in patients with heart failure with preserved ejection fraction (HFpEF) remains unknown. We examined the association between changes in the Geriatric Nutritional Risk Index (GNRI) and prognosis during hospitalization in patients with HFpEF stratified by nutritional status on admission. Nutritional status did and did not worsen in 348 and 349 of 697 patients with high GNRI on admission, and in 142 and 143 of 285 patients with low GNRI on admission, respectively. Kaplan–Meier analysis revealed no difference in risk of the composite endpoint, all-cause death, or heart failure admission between patients with high GNRI on admission whose nutritional status did and did not worsen. In contrast, patients with low GNRI on admission whose nutritional status did not worsen had a significantly lower risk of the composite endpoint and all-cause death than those who did. Multivariable analysis revealed that worsening nutritional status was independently associated with a higher risk of the composite endpoint and all-cause mortality in patients with low GNRI on admission. Changes in nutritional status during hospitalization were thus associated with prognosis in patients with malnutrition on admission, but not in patients without malnutrition among those with HFpEF.
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Affiliation(s)
- Akihiro Sunaga
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
- Correspondence: ; Tel.: +81-668-793-632; Fax: +81-6-6879-3299
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki 661-0976, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, 2-23 Ourai-kita, Rinku, Izumisano 598-8577, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kitaku, Sakai 591-8025, Japan
| | - Takaharu Hayashi
- Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayamacho, Tennojiku, Osaka 543-0035, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, 5-21-1, Kawanishi 666-0195, Japan
| | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki 661-0976, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Hiroyuki Kurakami
- Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita 565-0871, Japan
| | - Tomomi Yamada
- Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita 565-0871, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Taiki Sato
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Bolrathanak Oeun
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Hirota Kida
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Tomoharu Dohi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Katsuki Okada
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Hiroya Mizuno
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
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Tamaki S, Nagai Y, Shutta R, Masuda D, Yamashita S, Seo M, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Relation of lymphopenia to comorbidity burden and its prognostic value in patients with acute decompensated heart failure with preserved left ventricular ejection fraction: a multicentre study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1082] [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
Systemic inflammation resulting from comorbidities is postulated to play a central role in the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). Lymphopenia is a common manifestation of systemic inflammation and a prognostic factor in patients with HF. However, the association of lymphopenia with the comorbidity burden is unknown, and its prognostic value in patients with HFpEF admitted due to acute decompensated heart failure (ADHF) also remains elusive.
Purpose
We sought to clarify the relation of lymphopenia with the comorbidity burden, as well as its prognostic value and complementarity with the Get with the Guidelines-Heart Failure (GWTG-HF) risk score in ADHF patients with HFpEF.
Methods
Patients' data were extracted from the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT-HFpEF), which is a prospective multicentre registry for patients with ADHF with a LVEF ≥50%. We analysed data of patients admitted between June 2016 and December 2020 who survived to discharge. The total lymphocyte count (per μL) and GWTG-HF risk score were obtained on admission, as previously reported. Comorbidity burden was defined as the number of comorbidities from the following: atrial fibrillation, hypertension, diabetes mellitus, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease, anaemia, and obesity. The study endpoint was all-cause death.
Results
Over a median follow-up of 417 days, 181 of the 1013 included patients died. The proportion of patients with a total lymphocyte count in the lowest tertile was increasing with the increase in comorbidity burden (Figure 1). In the multivariate Cox analysis, a total lymphocyte count in the intermediate (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.00–2.41, p=0.0486) and lowest tertile (HR 2.23, 95% CI 1.47–3.38, p=0.0002) was independently associated with all-cause death. There was a significant difference in the all-cause death rate among the groups stratified by total lymphocyte count tertile (Figure 2). The total lymphocyte count had a higher C-statistic value (0.627) for the prediction of all-cause death than the GWTG-HF risk score, and the C-statistic value of the GWTG-HF risk score was improved when the total lymphocyte count was added (0.613 to 0.636, p=0.0260).
Conclusions
Lymphopenia was significantly associated with comorbidity burden. Furthermore, it was a useful marker of poor prognosis in hospitalised patients with acute HFpEF and was shown to be complementary to the contemporary HF prognostic score.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche Diagnostics K.K.Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- S Tamaki
- Rinku General Medical Center , Izumisano , Japan
| | - Y Nagai
- Rinku General Medical Center , Izumisano , Japan
| | - R Shutta
- Rinku General Medical Center , Izumisano , Japan
| | - D Masuda
- Rinku General Medical Center , Izumisano , Japan
| | - S Yamashita
- Rinku General Medical Center , Izumisano , Japan
| | - M Seo
- Osaka General Medical Center , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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Oeun B, Hikoso S, Nakatani D, Okada K, Dohi T, Sotomi Y, Kida H, Sunaga A, Sato T, Seo M, Yano M, Hayashi T, Yamada T, Yasumura Y, Sakata Y. Clinical trajectory and outcomes of patients with heart failure with preserved ejection fraction with normal or indeterminate diastolic function. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.783] [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
Heart failure (HF) with preserved ejection fraction (HFpEF) is a chronic and progressive disease, but limited therapeutic strategies are currently available. Although left ventricular diastolic dysfunction (DD) is a prominent mechanism of HFpEF, a certain number of patients with HFpEF have a normal diastolic function (ND) or indeterminate diastolic function (ID). With the progressive nature of HFpEF, diastolic function may change over time. However, the change of diastolic function, its predictor and prognosis in patients with clinically established HFpEF remains unknown.
Purpose
To investigate the clinical trajectory and outcomes of patients with HFpEF with ND or ID and to identify factors associated with progression from ND or ID at discharge to DD at 1-year follow-up.
Methods
Using data from a prospective multicenter observational study of patients with HFpEF, we extracted 289 patients with HFpEF with ND or ID at discharge who had echocardiographic data at 1-year follow-up for the re-evaluation of diastolic function. Diastolic function was assessed according to the 2016 American Society of Echocardiography recommendations. Patients were classified according to the absence or presence of progression from ND or ID to DD at 1 year. The primary endpoint was a composite of all-cause death and HF rehospitalization.
Results
Median age was 81 years, and 138 (47.8%) patients were female. At 1 year, 107 (37%) patients progressed to DD. During a median follow-up of 709 days, the composite endpoint occurred in 90 (31.1%) patients. Compared to patients without progression to DD, those with progression to DD had a significantly higher cumulative incidence rate of the composite endpoint (incidence rate: 11.7/100 person-year versus 23.3/100 person-year, P<0.001). Progression to DD (adjusted HR: 2.014, 95% CI: 1.239–3.273, P=0.005) was independently associated with the composite endpoint. Age (adjusted OR: 1.046, 95% CI: 1.008–1.087, P=0.018), body mass index (BMI) (adjusted OR: 1.107, 95% CI: 1.029–1.192, P=0.006), and serum albumin (adjusted OR: 0.459, 95% CI: 0.216–0.974, P=0.042) were independently associated with progression from ND or ID to DD at 1 year.
Conclusion
More than one-third of patients with HFpEF with ND or ID progressed to DD at 1 year and had poor clinical outcomes. Age, BMI, and serum albumin were independently associated with this progression.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by grants from Japan Society for the Promotion of Science KAKENHI (No. JP 17K09496) and Japan Agency for Medical Research and Development (No. JP16lk1010013).
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Affiliation(s)
- B Oeun
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine , Suita , Japan
| | - K Okada
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Dohi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Kida
- Osaka University Graduate School of Medicine , Suita , Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Sato
- Osaka University Graduate School of Medicine , Suita , Japan
| | - M Seo
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Cardiology , Amagasaki , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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Sunaga A, Hikoso S, Tamaki S, Yano M, Hayashi T, Oeun B, Kida H, Sotomi Y, Dohi T, Okada K, Mizuno H, Nakatani D, Yamada T, Yasumura Y, Sakata Y. Association between prognosis and the use of angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blocker in frail patients with heart failure with preserved ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.770] [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
The effectiveness of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) has not been demonstrated in patients with heart failure with preserved ejection fraction (HFpEF). We recently reported significant interaction between the use of ACE-I and/or ARB (ACE-I/ARB) and frailty on prognosis in patients with HFpEF.
Purpose
In the present study, we examined the association between ACE-I/ARB and prognosis in patients with HFpEF stratified by the presence or absence of frailty.
Methods
We examined the association between the use of ACE-I/ARB and prognosis according to the presence (Clinical Frailty Scale (CFS) ≥5) or absence (CFS ≤4) of frailty in patients with HFpEF in a post-hoc analysis of registry data. Primary endpoint was the composite of all-cause mortality and heart failure admission. Secondary endpoints were all-cause mortality and heart failure admission.
Results
Of 1059 patients, median age was 83 years and 45% were male. Kaplan-Meier analysis showed that the risk of composite endpoint (log-rank P=0.001) and all-cause death (log-rank P=0.005) in patients with ACE-I/ARB was lower in those with CFS ≥5, but similar between patients with and without ACE-I/ARB in patients with CFS ≤4 (composite endpoint: log-rank P=0.830; all-cause death: log-rank P=0.192). In a multivariable Cox proportional hazards model, use of ACE-I/ARB was significantly associated with lower risk of the composite endpoint (hazard ratio = 0.52, 95% CI: 0.33–0.83, P=0.005) and heart failure admission (hazard ratio = 0.45, 95% CI: 0.25–0.83, P=0.010) in patients with CFS ≥5, but not in patients with CFS ≤4 (composite endpoint: hazard ratio = 1.41, 95% CI: 0.99–2.02, P=0.059; heart failure admission: hazard ratio = 1.43, 95% CI: 0.94–2.18, P=0.091). The association between ACE-I or ARB and prognosis did not significantly differ by CFS (CFS ≤4: log-rank P=0.562; CFS ≥5: log-rank P=0.100, for with ACE-I vs. ARB, respectively). Adjusted HRs for CFS 1–4 were higher than 1.0, but were less than 1.0 at CFS 5.
Conclusions
In patients with HFpEF, use of ACE-I/ARB was associated with better prognosis in patients with frailty as assessed with the CFS, but not in those without frailty.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche
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Affiliation(s)
- A Sunaga
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Tamaki
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - B Oeun
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Kida
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Dohi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - K Okada
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Mizuno
- Osaka University Graduate School of Medicine , Suita , Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology , Amagasaki , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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Seo M, Watanabe T, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. The clinical relevance of quality of life in patients with acute decompensated heart failure with preserved ejection fraction: insights from the PURSUIT-HFpEF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Improvement of quality of life (QOL) is one of the most important therapeutic goals for patients with heart failure with preserved ejection fraction (HFpEF). It is, therefore, clinically relevant to comprehensively identify aggravating factors among cardiac factors, non-cardiac comorbidities, and social factors. The aim of this study was to elucidate determinant factors of impaired QOL and clarify the association between QOL and prognosis in patients with HFpEF.
Methods and results
Patient data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study. EuroQol 5 dimensions 5-level (EQ-5D-5L) data were obtained at discharge to evaluate patients' health-related QOL. A total of 864 patients were enrolled in this study. Multivariable logistic regression analysis revealed that only non-cardiac factors such as age, female sex, frailty, malnutrition and inflammation were significantly associated with low EQ-5D-5L score, whereas cardiac factors showed no significant association after multivariable adjustment. A total of 206 patients died over a mean follow-up period of 2.0±1.2 years. Kaplan–Meier survival curve analysis demonstrated a significant increase in risk of mortality stratified by tertiles of EQ-5D-5L score (p<0.0001). Cox multivariable analysis revealed that patients with low EQ-5D-5L score had a significantly greater risk of mortality than those with high EQ-5D-5L score (adjusted hazard ratio: 2.20 (1.40–3.45), p=0.001).
Conclusion
Among patients with HFpEF, non-cardiac factors such as age, female sex, frailty, malnutrition and inflammation are significantly associated with impaired QOL. The QOL score itself also offers useful prognostic information in patients with HFpEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Seo
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - T Watanabe
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology , Osaka , Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiovascular Medicine , Osaka , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Cardiovascular Medicine , Osaka , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiovascular Medicine , Osaka , Japan
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Nakagawa Y, Sairyo M, Miyazawa K, Tamaki S, Yano M, Hayashi T, Yamada T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Insight into the relationship between heart rate and mortality in patients in sinus rhythm with heart failure with preserved ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.772] [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
There are several reports showing that elevated heart rate (HR) is associated with poor outcomes in patients in sinus rhythm (SR) with heart failure with preserved ejection fraction (HFpEF), although the association is weak or none in HFpEF patients with atrial fibrillation (Af). However, in previous studies, cardiac and non-cardiac factors which may be associated with elevated HR, have not been fully adjusted for.
Purpose
The purpose of this study is to explore covariates of elevated HR and to investigate the relationship between heart rate and mortality in HFpEF patients in SR.
Methods and results
Of the 1161 patients, who registered prospective multicenter, observational study of patients with HFpEF (PURSUIT-HFpEF), 726 patients in SR were examined. We performed laboratory testing and echocardiography in the compensated stage (in stable condition after treatment of acute decompensated HF). Geriatric nutritional risk index (GNRI) was calculated as nutrition index. Resting heart rate (HR) was analyzed as categorical (tertiles, T1–3). We followed the patients for median of 598 days (interquartile range 329–1028 days) to observe the outcome all-cause mortality.
The Kaplan analysis revealed that there was a significant difference between heart rate and mortality (log-rank, p=0.001). Characteristics were compared between patients in T1 (HR ≤63) and T3 (HR ≥75). There were no differences in cardiac factors between patients in T1 and T3. C-reactive protein (CRP) was significantly higher in patients in T3 than those in T1 (p=0.0004,). GNRI was significantly lower in patients in T3 than those in T1 (p=0.001). After adjustment for covariates including N-terminal pro-B type natriuretic peptide and estimated glomerular filtration rate, CRP and GNRI significantly correlated with HR (continuous variable) by multiple regression analysis (beta-coefficient = 1.52, p=0.003 and beta-coefficient = −0.14, p=0.04, respectively). Taking T1 as the reference, multivariable Cox regression analysis revealed that T3 was independently associated with mortality (hazard ratio: 2.10, 95% confidence interval: 1.33–3.32, p=0.001).
Conclusion
Although elevated HR was associated with enhanced inflammation and malnutrition, it itself was an independent predictor of death in HFpEF patients in SR.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche Diagnosis K.K.Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- Y Nakagawa
- Kawanishi city Hospital , Kawanishi , Japan
| | - M Sairyo
- Kawanishi city Hospital , Kawanishi , Japan
| | - K Miyazawa
- Kawanishi city Hospital , Kawanishi , Japan
| | - S Tamaki
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Osaka , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - Y Yasumura
- Amagasaki Central Hospital , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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Sakamoto D, Seo M, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Prognostic impact of the serial change of a systemic inflammation-nutrition index in patients with heart failure with preserved ejection fraction: insights from pursuit-hfpef registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.876] [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
Malnutrition and inflammation are associated with poor outcomes with heart failure (HF). It has been reported that advanced lung cancer inflammation index (ALI), calculated by body mass index × serum albumin level / neutrophil to lymphocyte ratio (NLR) can be useful for the risk stratification and predicting the post-discharge prognosis of the patients with acute decompensated heart failure (ADHF). However, there is no information available on the prognostic value of the serial ALI change in ADHF patients with preserved ejection fraction (HFpEF).
Methods and results
Patients' data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, which is a prospective multicenter observational registry for ADHF-HFpEF in Osaka. Laboratory data and body weight measurements were performed at the discharge and 1 year after the discharge. We analyzed 527 patients after exclusion of patients on dialysis, in-hospital death, missing follow-up data, or missing data to calculate ALI. The study patients were categorized by the serial change from baseline to 1 year after the discharge (ΔALI) as follows: low tertile: ΔALI <−6.99 (n=176), middle tertile: −6.99 ≤ ALI <8.44 (n=176), and high tertile: 8.44 ≤ ΔALI (n=175). The endpoints of the present study were all-cause death (ACD) and cardiovascular death (CVD). During a mean follow-up period of 1.5±1.0 years, 94 patients had ACD and 40 patients had CVD. The Kaplan-Meier analysis revealed that the patients with middle and low ΔALI at 1 year after heart failure hospitalization had a significantly greater risk of reaching the ACD and CVD than those with high ΔALI (ACD: 22% vs 22% vs 10%, p=0.0011, CVD: 10% vs 9% vs 3%, p=0.014). On multivariate Cox analysis, ΔALI was significantly associated with ACD independently of age, gender, serum NT-proBNP level, and baseline ALI after adjustment for NYHA functional class, serum creatinine level, serum hemoglobin level, serum CRP level, serum sodium level and LVEF.
Conclusion
This study showed that patients with the increased ALI after the discharge had improved outcome in comparison to those without the increased ALI. The serial change of ALI, a systemic inflammation-nutrition index, might be useful for stratifying ADHF patients with HFpEF at risk for the total mortality and cardiovascular mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Sakamoto
- Osaka General Medical Center , Osaka , Japan
| | - M Seo
- Osaka General Medical Center , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology , Osaka , Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Cardiology , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiology , Osaka , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Cardiology , Osaka , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiology , Osaka , Japan
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Kida H, Kawasaki M, Kikuchi Y, Okada K, Watanabe T, Yamada T. Electrocardiographic characteristics for the prediction of under‐sensing in implantable loop recorders. J Arrhythm 2022; 38:1063-1069. [DOI: 10.1002/joa3.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/18/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Hirota Kida
- Department of Clinical Engineering Osaka General Medical Center Osaka Japan
| | - Masato Kawasaki
- Division of Cardiology Osaka General Medical Center Osaka Japan
| | - Yoshitaka Kikuchi
- Department of Clinical Engineering Osaka General Medical Center Osaka Japan
| | - Kana Okada
- Department of Clinical Engineering Osaka General Medical Center Osaka Japan
| | | | - Takahisa Yamada
- Division of Cardiology Osaka General Medical Center Osaka Japan
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Nishino M, Egami Y, Kawanami S, Sugae H, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Yano M, Tanouchi J, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Nakagawa A, Nakagawa Y, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Lowering Uric Acid May Improve Prognosis in Patients With Hyperuricemia and Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc 2022; 11:e026301. [PMID: 36129035 PMCID: PMC9673694 DOI: 10.1161/jaha.122.026301] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background An association between uric acid (UA) and cardiovascular diseases, including heart failure (HF), has been reported. However, whether UA is a causal risk factor for HF is controversial. In particular, the prognostic value of lowering UA in patients with HF with preserved ejection fraction (HFpEF) is unclear. Methods and Results We enrolled patients with HFpEF from the PURSUIT‐HFpEF (Prospective Multicenter Observational Study of Patients With Heart Failure With Preserved Ejection Fraction) registry. We investigated whether UA was correlated with the composite events, including all‐cause mortality and HF rehospitalization, in patients with hyperuricemia and HFpEF (UA >7.0 mg/dL). Additionally, we evaluated whether lowering UA for 1 year (≥1.0 mg/dL) in them reduced mortality or HF rehospitalization. We finally analyzed 464 patients with hyperuricemia. In multivariable Cox regression analysis, UA was an independent determinant of composite death and rehospitalization (hazard ratio [HR], 1.15 [95% CI, 1.03–1.27], P=0.015). We divided them into groups with severe and mild hyperuricemia according to median estimated value of serum UA (8.3 mg/dL). Cox proportional hazards models revealed the incidence of all‐cause mortality was significantly higher in the group with severe hyperuricemia than in the group with mild hyperuricemia (HR, 1.73 [95% CI, 1.19–2.25], P=0.004). The incidence of all‐cause mortality was significantly decreased in the group with lowering UA compared with the group with nonlowering UA (HR, 1.71 [95% CI, 1.02–2.86], P=0.041). The incidence of urate‐lowering therapy tended to be higher in the group with lowering UA than in the group with nonlowering UA (34.9% versus 24.6%, P=0.06). Conclusions UA is a predictor for the composite of all‐cause death and HF rehospitalization in patients with hyperuricemia and HFpEF. In these patients, lowering UA, including the use of urate‐lowering therapy, may improve prognosis.
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Affiliation(s)
| | | | | | - Hiroki Sugae
- Division of Cardiology Osaka Rosai Hospital Osaka Japan
| | - Kohei Ukita
- Division of Cardiology Osaka Rosai Hospital Osaka Japan
| | | | | | | | - Koji Yasumoto
- Division of Cardiology Osaka Rosai Hospital Osaka Japan
| | - Masaki Tsuda
- Division of Cardiology Osaka Rosai Hospital Osaka Japan
| | | | | | | | - Jun Tanouchi
- Division of Cardiology Osaka Rosai Hospital Osaka Japan
| | - Takahisa Yamada
- Division of Cardiology Osaka General Medical Center Osaka Japan
| | | | - Shunsuke Tamaki
- Division of Cardiology Rinku General Medical Center Osaka Japan
| | | | - Akito Nakagawa
- Division of Cardiology Amagasaki Chuo Hospital Hyogo Japan.,Department of Medical Informatics Osaka University Graduate School of Medicine Suita Japan
| | - Yusuke Nakagawa
- Division of Cardiology Kawanishi City Hospital Kawanishi Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Japan
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Yano M, Nishino M, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Egami Y, Tanouchi J, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Nakagawa A, Nakagawa Y, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Clinical impact of blood urea nitrogen, regardless of renal function, in heart failure with preserved ejection fraction. Int J Cardiol 2022; 363:94-101. [PMID: 35777488 DOI: 10.1016/j.ijcard.2022.06.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/06/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Blood urea nitrogen (BUN) reflects decreased glomerular filtration rate (GFR). The effect of BUN on clinical outcomes, excluding the impact of GFR, in heart failure with preserved ejection fraction (HFpEF) patients remains unknown. METHODS We enrolled HFpEF (left ventricular ejection fraction ≥50%) patients hospitalized due to acute decompensated heart failure (HF) from PURSUIT-HFpEF registry which was prospective, multicenter and observational study. For excluding the effect of renal function on BUN value, propensity score-matching was performed using the variables which were associated with GFR. The incidence of composite of all-cause death and HF readmission among the patients stratified by BUN and the association between BUN and echocardiographic parameters in HFpEF patients were evaluated. RESULTS We finally analyzed 1029 patients. In the present study, BUN cut-off value was defined as 24.4 mg/dL, which was the median value in overall population. The high and low BUN groups consisted of 193 patients after 1:1 propensity score-matching, respectively. The median follow-up duration was 401 days and the composite endpoint occurred in 129 patients (33.4%). Kaplan-Meier analysis showed the high BUN group had a significantly greater risk of the composite endpoint than the low group in the propensity score-matched pairs (p = 0.032). BUN value significantly correlated with left atrial volume index by multiple regression analysis using echocardiographic parameters (standardized beta-coefficient = 0.139, p = 0.043). CONCLUSION BUN was a useful marker for the composite of all-cause death and HF readmission, regardless of the baseline renal function and correlated with left atrial function in HFpEF patients. CLINICAL TRIAL REGISTRATION UMIN000021831 <https://uplaod.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024414>; PURSUIT-HFpEF.
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Affiliation(s)
- Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan.
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Hitoshi Nakamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Yutaka Matsuhiro
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Yasuharu Matsunaga-Lee
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Yoshio Yasumura
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo 661-0076, Japan
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, 2-23 Ourai-kita, Rinku, Izumisano, Osaka 598-8577, Japan
| | - Takaharu Hayashi
- Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayamacho, Tennoji-ku, Osaka 543-0035, Japan
| | - Akito Nakagawa
- Division of Cardiology, Amagasaki Chuo Hospital, 1-12-1 Shioe, Amagasaki, Hyogo 661-0076, Japan; Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, 1-21-5 Higashiueno, Kawanishi 666-0195, Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
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Nisbet G, Beutier G, De Boissieu M, Yamada T, Takakura H. Fingerprinting phason strain. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322095493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Hoshida S, Hikoso S, Shinoda Y, Tachibana K, Minamisaka T, Shunsuke T, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Yamada T, Yasumura Y, Nakatani D, Sakata Y. Time-sensitive prognostic performance of an afterload-integrated diastolic index in heart failure with preserved ejection fraction: a prospective multicentre observational study. BMJ Open 2022; 12:e059614. [PMID: 35948381 PMCID: PMC9379494 DOI: 10.1136/bmjopen-2021-059614] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The prognostic significance of an afterload-integrated diastolic index, the ratio of diastolic elastance (Ed) to arterial elastance (Ea) (Ed/Ea=[E/e']/[0.9×systolic blood pressure]), is valid for 1 year after discharge in older patients with heart failure with preserved ejection fraction (HFpEF). We aimed to clarify the association with changes in Ed/Ea from enrolment to 1 year and prognosis thereafter in patients with HFpEF. SETTING A prospective, multicentre observational registry of collaborating hospitals in Osaka, Japan. PARTICIPANTS We enrolled 659 patients with HFpEF hospitalised for acute decompensated heart failure (men/women: 296/363). Blood tests and transthoracic echocardiography were performed before discharge and at 1 year after. PRIMARY OUTCOME MEASURES All-cause mortality and/or re-admission for heart failure were evaluated after discharge. RESULTS High Ed/Ea assessed before discharge was a significant prognostic factor during the first, but not the second, year after discharge in all-cause mortality or all-cause mortality and/or re-admission for heart failure. When re-analysis was performed using the value of Ed/Ea at 1 year after discharge, high Ed/Ea was significant for the prognosis during the second year for both end points (p=0.012 and p=0.033, respectively). The poorest mortality during 1‒2 years after enrolment was observed in those who showed a worsening Ed/Ea during the first year associated with larger left ventricular mass index and reduced left ventricular ejection fraction. In all-cause mortality and/or re-admission for heart failure, the event rate during 1‒2 years was highest in those with persistently high Ed/Ea even after 1 year. CONCLUSIONS Time-sensitive prognostic performance of Ed/Ea, an afterload-integrated diastolic index, was observed in older patients with HFpEF. TRIAL REGISTRATION NUMBER UMIN000021831.
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Affiliation(s)
- Shiro Hoshida
- Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukinori Shinoda
- Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Japan
| | - Koichi Tachibana
- Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Japan
| | - Tomoko Minamisaka
- Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Japan
| | - Tamaki Shunsuke
- Department of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Akito Nakagawa
- Division of Cardiovascular Medicine, Amagasaki Chuo Hospital, Amagasaki, Japan
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, Kawanishi, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yoshio Yasumura
- Division of Cardiovascular Medicine, Amagasaki-Chuo Hospital, Amagasaki, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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D, Davis M, Daw E, Dean R, DeBra D, Deenadayalan M, Degallaix J, De Laurentis M, Deléglise S, Del Favero V, De Lillo F, De Lillo N, Dell’Aquila D, Del Pozzo W, DeMarchi L, De Matteis F, D’Emilio V, Demos N, Dent T, Depasse A, De Pietri R, De Rosa R, De Rossi C, DeSalvo R, De Simone R, Dhurandhar S, Díaz M, Didio N, Dietrich T, Di Fiore L, Di Fronzo C, Di Giorgio C, Di Giovanni F, Di Giovanni M, Di Girolamo T, Di Lieto A, Di Michele A, Ding B, Di Pace S, Di Palma I, Di Renzo F, Divakarla A, Dmitriev A, Doctor Z, Donahue L, D’Onofrio L, Donovan F, Dooley K, Doravari S, Drago M, Driggers J, Drori Y, Ducoin JG, Dupej P, Dupletsa U, Durante O, D’Urso D, Duverne PA, Dwyer S, Eassa C, Easter P, Ebersold M, Eckhardt T, Eddolls G, Edelman B, Edo T, Edy O, Effler A, Eguchi S, Eichholz J, Eikenberry S, Eisenmann M, Eisenstein R, Ejlli A, Engelby E, Enomoto Y, Errico L, Essick R, Estellés H, Estevez D, Etienne Z, Etzel T, Evans M, Evans T, Evstafyeva T, Ewing B, Fabrizi F, Faedi F, Fafone V, Fair H, Fairhurst S, Fan P, Farah A, Farinon S, Farr B, Farr W, Fauchon-Jones E, Favaro G, Favata M, Fays M, Fazio M, Feicht J, Fejer M, Fenyvesi E, Ferguson D, Fernandez-Galiana A, Ferrante I, Ferreira T, Fidecaro F, Figura P, Fiori A, Fiori I, Fishbach M, Fisher R, Fittipaldi R, Fiumara V, Flaminio R, Floden E, Fong H, Font J, Fornal B, Forsyth P, Franke A, Frasca S, Frasconi F, Freed J, Frei Z, Freise A, Freitas O, Frey R, Fritschel P, Frolov V, Fronzé G, Fujii Y, Fujikawa Y, Fujimoto Y, Fulda P, Fyffe M, Gabbard H, Gabella W, Gadre B, Gair J, Gais J, Galaudage S, Gamba R, Ganapathy D, Ganguly A, Gao D, Gaonkar S, Garaventa B, Núñez CG, García-Quirós C, Garufi F, Gateley B, Gayathri V, Ge GG, Gemme G, Gennai A, George J, Gerberding O, Gergely L, Gewecke P, Ghonge S, Ghosh A, Ghosh A, Ghosh S, Ghosh S, Ghosh T, Giacomazzo B, Giacoppo L, Giaime J, Giardina K, Gibson D, Gier C, Giesler M, Giri P, Gissi F, Gkaitatzis S, Glanzer J, Gleckl A, Godwin P, Goetz E, Goetz R, Gohlke N, Golomb J, Goncharov B, González G, Gosselin M, Gouaty R, Gould D, Goyal S, Grace B, Grado A, Graham V, Granata M, Granata V, Grant A, Gras S, Grassia P, Gray C, Gray R, Greco G, Green A, Green R, Gretarsson A, Gretarsson E, Griffith D, Griffiths W, Griggs H, Grignani G, Grimaldi A, Grimes E, Grimm S, Grote H, Grunewald S, Gruning P, Gruson A, Guerra D, Guidi G, Guimaraes A, Guixé G, Gulati H, Gunny A, Guo HK, Guo Y, Gupta A, Gupta A, Gupta I, Gupta P, Gupta S, Gustafson R, Guzman F, Ha S, Hadiputrawan I, Haegel L, Haino S, Halim O, Hall E, Hamilton E, Hammond G, Han WB, Haney M, Hanks J, Hanna C, Hannam M, Hannuksela O, Hansen H, Hansen T, Hanson J, Harder T, Haris K, Harms J, Harry G, Harry I, Hartwig D, Hasegawa K, Haskell B, Haster CJ, Hathaway J, Hattori K, Haughian K, Hayakawa H, Hayama K, Hayes F, Healy J, Heidmann A, Heidt A, Heintze M, Heinze J, Heinzel J, Heitmann H, Hellman F, Hello P, Helmling-Cornell A, Hemming G, Hendry M, Heng I, Hennes E, Hennig J, Hennig M, Henshaw C, Hernandez A, Vivanco FH, Heurs M, Hewitt A, Higginbotham S, Hild S, Hill P, Himemoto Y, Hines A, Hirata N, Hirose C, Ho TC, Hochheim S, Hofman D, Hohmann J, Holcomb D, Holland N, Hollows I, Holmes Z, Holt K, Holz D, Hong Q, Hough J, Hourihane S, Howell E, Hoy C, Hoyland D, Hreibi A, Hsieh BH, Hsieh HF, Hsiung C, Hsu Y, Huang HY, Huang P, Huang YC, Huang YJ, Huang Y, Huang Y, Hübner M, Huddart A, Hughey B, Hui D, Hui V, Husa S, Huttner S, Huxford R, Huynh-Dinh T, Ide S, Idzkowski B, Iess A, Inayoshi K, Inoue Y, Iosif P, Isi M, Isleif K, Ito K, Itoh Y, Iyer B, JaberianHamedan V, Jacqmin T, Jacquet PE, Jadhav S, Jadhav S, Jain T, James A, Jan A, Jani K, Janquart J, Janssens K, Janthalur N, Jaranowski P, Jariwala D, Jaume R, Jenkins A, Jenner K, Jeon C, Jia W, Jiang J, Jin HB, Johns G, Johnston R, Jones A, Jones D, Jones P, Jones R, Joshi P, Ju L, Jue A, Jung P, Jung K, Junker J, Juste V, Kaihotsu K, Kajita T, Kakizaki M, Kalaghatgi C, Kalogera V, Kamai B, Kamiizumi M, Kanda N, Kandhasamy S, Kang G, Kanner J, Kao Y, Kapadia S, Kapasi D, Karathanasis C, Karki S, Kashyap R, Kasprzack M, Kastaun W, Kato T, Katsanevas S, Katsavounidis E, Katzman W, Kaur T, Kawabe K, Kawaguchi K, Kéfélian F, Keitel D, Key J, Khadka S, Khalili F, Khan S, Khanam T, Khazanov E, Khetan N, Khursheed M, Kijbunchoo N, Kim A, Kim C, Kim J, Kim J, Kim K, Kim W, Kim YM, Kimball C, Kimura N, Kinley-Hanlon M, Kirchhoff R, Kissel J, Klimenko S, Klinger T, Knee A, Knowles T, Knust N, Knyazev E, Kobayashi Y, Koch P, Koekoek G, Kohri K, Kokeyama K, Koley S, Kolitsidou P, Kolstein M, Komori K, Kondrashov V, Kong A, Kontos A, Koper N, Korobko M, Kovalam M, Koyama N, Kozak D, Kozakai C, Kringel V, Krishnendu N, Królak A, Kuehn G, Kuei F, Kuijer P, Kulkarni S, Kumar A, Kumar P, Kumar R, Kumar R, Kume J, Kuns K, Kuromiya Y, Kuroyanagi S, Kwak K, Lacaille G, Lagabbe P, Laghi D, Lalande E, Lalleman M, Lam T, Lamberts A, Landry M, Lane B, Lang R, Lange J, Lantz B, La Rosa I, Lartaux-Vollard A, Lasky P, Laxen M, Lazzarini A, Lazzaro C, Leaci P, Leavey S, LeBohec S, Lecoeuche Y, Lee E, Lee H, Lee H, Lee K, Lee R, Legred I, Lehmann J, Lemaître A, Lenti M, Leonardi M, Leonova E, Leroy N, Letendre N, Levesque C, Levin Y, Leviton J, Leyde K, Li A, Li B, Li J, Li K, Li P, Li T, Li X, Lin CY, Lin E, Lin FK, Lin FL, Lin H, Lin LC, Linde F, Linker S, Linley J, Littenberg T, Liu G, Liu J, Liu K, Liu X, Llamas F, Lo R, Lo T, London L, Longo A, Lopez D, Portilla ML, Lorenzini M, Loriette V, Lormand M, Losurdo G, Lott T, Lough J, Lousto C, Lovelace G, Lucaccioni J, Lück H, Lumaca D, Lundgren A, Luo LW, Lynam J, Ma’arif M, Macas R, Machtinger J, MacInnis M, Macleod D, MacMillan I, Macquet A, Hernandez IM, Magazzù C, Magee R, Maggiore R, Magnozzi M, Mahesh S, Majorana E, Maksimovic I, Maliakal S, Malik A, Man N, Mandic V, Mangano V, Mansell G, Manske M, Mantovani M, Mapelli M, Marchesoni F, Pina DM, Marion F, Mark Z, Márka S, Márka Z, Markakis C, Markosyan A, Markowitz A, Maros E, Marquina A, Marsat S, Martelli F, Martin I, Martin R, Martinez M, Martinez V, Martinez V, Martinovic K, Martynov D, Marx E, Masalehdan H, Mason K, Massera E, Masserot A, Masso-Reid M, Mastrogiovanni S, Matas A, Mateu-Lucena M, Matichard F, Matiushechkina M, Mavalvala N, McCann J, McCarthy R, McClelland D, McClincy P, McCormick S, McCuller L, McGhee G, McGuire S, McIsaac C, McIver J, McRae T, McWilliams S, Meacher D, Mehmet M, Mehta A, Meijer Q, Melatos A, Melchor D, Mendell G, Menendez-Vazquez A, Menoni C, Mercer R, Mereni L, Merfeld K, Merilh E, Merritt J, Merzougui M, Meshkov S, Messenger C, Messick C, Meyers P, Meylahn F, Mhaske A, Miani A, Miao H, Michaloliakos I, Michel C, Michimura Y, Middleton H, Mihaylov D, Milano L, Miller A, Miller A, Miller B, Millhouse M. Search for continuous gravitational wave emission from the Milky Way center in O3 LIGO-Virgo data. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.042003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Nakagawa A, Yasumura Y, Yoshida C, Okumura T, Tateishi J, Yoshida J, Seo M, Yano M, Hayashi T, Nakagawa Y, Tamaki S, Yamada T, Kurakami H, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Predictors and Outcomes of Heart Failure With Preserved Ejection Fraction in Patients With a Left Ventricular Ejection Fraction Above or Below 60. J Am Heart Assoc 2022; 11:e025300. [PMID: 35904209 PMCID: PMC9375469 DOI: 10.1161/jaha.122.025300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although potential therapeutic candidates for heart failure with preserved ejection fraction (HFpEF) are emerging, it is still unclear whether they will be effective in patients with left ventricular ejection fraction (LVEF) of 60% or higher. Our aim was to identify the clinical characteristics of these patients with HFpEF by comparing them to patients with LVEF below 60%. Methods and Results From a multicenter, prospective, observational cohort (PURSUIT-HFpEF [Prospective Multicenter Obsevational Study of Patients with Heart Failure with Preserved Ejection Fraction]), we investigated 812 consecutive patients (median age, 83 years; 57% women), including 316 with 50% ≤ LVEF <60% and 496 with 60% ≤ LVEF, and compared the clinical backgrounds of the 2 groups and their prognoses for cardiac mortality or HF readmission. Two hundred four adverse outcomes occurred at a median of 366 days. Multivariable Cox regression tests adjusted for age, sex, heart rate, atrial fibrillation, estimated glomerular filtration rate, N-terminal pro-B-type natriuretic peptide, and prior heart failure hospitalization revealed that systolic blood pressure (hazard ratio [HR], 0.925 [95% CI, 0.862-0.992]; P=0.028), high-density lipoprotein to C-reactive protein ratio (HR, 0.975 [95% CI, 0.944-0.995]; P=0.007), and left ventricular end-diastolic volume index (HR, 0.870 [95% CI, 0.759-0.997]; P=0.037) were uniquely associated with outcomes among patients with 50% ≤ LVEF <60%, whereas only the ratio of peak early mitral inflow velocity to velocity of mitral annulus early diastolic motion e'(HR, 1.034 [95% CI, 1.003-1.062]; P=0.034) was associated with outcomes among patients with 60% ≤ LVEF. Conclusions Prognostic factors show distinct differences between patients with HFpEF with 50% ≤ LVEF <60% and with 60% ≤ LVEF. These findings suggest that the 2 groups have different inherent pathophysiology. Registration URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024414; Unique identifier: UMIN000021831 PURSUIT-HFpEF.
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Affiliation(s)
- Akito Nakagawa
- Division of Cardiovascular Medicine Amagasaki-Chuo Hospital Amagasaki Hyogo Japan.,Department of Medical Informatics Osaka University Graduate School of Medicine Suita Osaka Japan
| | - Yoshio Yasumura
- Division of Cardiovascular Medicine Amagasaki-Chuo Hospital Amagasaki Hyogo Japan
| | - Chikako Yoshida
- Division of Cardiovascular Medicine Amagasaki-Chuo Hospital Amagasaki Hyogo Japan
| | - Takahiro Okumura
- Division of Cardiovascular Medicine Amagasaki-Chuo Hospital Amagasaki Hyogo Japan
| | - Jun Tateishi
- Division of Cardiovascular Medicine Amagasaki-Chuo Hospital Amagasaki Hyogo Japan
| | - Junichi Yoshida
- Division of Cardiovascular Medicine Amagasaki-Chuo Hospital Amagasaki Hyogo Japan
| | - Masahiro Seo
- Division of Cardiology Osaka General Medical Center Osaka Osaka Japan
| | - Masamichi Yano
- Division of Cardiology Osaka Rosai Hospital Sakai Osaka Japan
| | | | - Yusuke Nakagawa
- Division of Cardiology Kawanishi City Hospital Kawanishi Hyogo Japan
| | - Shunsuke Tamaki
- Department of Cardiology Rinku General Medical Center Izumisano Osaka Japan
| | - Takahisa Yamada
- Division of Cardiology Osaka General Medical Center Osaka Osaka Japan
| | - Hiroyuki Kurakami
- Department of Medical Innovation Osaka University Hospital Suita Osaka Japan
| | - Yohei Sotomi
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
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Nakagawa A, Yasumura Y, Yoshida C, Okumura T, Tateishi J, Seo M, Yano M, Hayashi T, Nakagawa Y, Tamaki S, Yamada T, Sotomi Y, Nakatani D, Hikoso S, Sakata Y. Right ventricular dimension for heart failure with preserved ejection fraction involving right ventricular-vascular uncoupling. CJC Open 2022; 4:929-938. [DOI: 10.1016/j.cjco.2022.07.014] [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: 05/20/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
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Seo M, Watanabe T, Yamada T, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Tamaki S, Yasumura Y, Sotomi Y, Hikoso S, Nakatani D, Fukunami M, Sakata Y. Clinical Determinants of Quality of Life in Patients With Acute Decompensated Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-Heart Failure With Preserved Ejection Fraction Registry. Circ Heart Fail 2022; 15:e009789. [PMID: 35861075 PMCID: PMC9561243 DOI: 10.1161/circheartfailure.122.009789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Japan (M.S., T.W., T.Y., M.F.)
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Center, Japan (M.S., T.W., T.Y., M.F.)
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Japan (M.S., T.W., T.Y., M.F.)
| | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Japan (M.Y.)
| | | | - Akito Nakagawa
- Division of Cardiovascular Medicine, Amagasaki-Chuo Hospital, Hyogo, Japan (A.N., Y.Y.).,Department of Medical Informatics, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan (A.N.)
| | - Yusuke Nakagawa
- Division of Cardiology, Kawanishi City Hospital, Hyogo, Japan (Y.N.)
| | - Shunsuke Tamaki
- Department of Cardiology, Rinku General Medical Center, Izumisano, Osaka, Japan (S.T.)
| | - Yoshio Yasumura
- Division of Cardiovascular Medicine, Amagasaki-Chuo Hospital, Hyogo, Japan (A.N., Y.Y.)
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan (Y. Sotomi, S.H., D.N., Y. Sakata)
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan (Y. Sotomi, S.H., D.N., Y. Sakata)
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan (Y. Sotomi, S.H., D.N., Y. Sakata)
| | - Masatake Fukunami
- Division of Cardiology, Osaka General Medical Center, Japan (M.S., T.W., T.Y., M.F.)
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan (Y. Sotomi, S.H., D.N., Y. Sakata)
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