0518 Sleep Facilitation by Artificial Carbonated Bathing in Healthy Elderly; EEG, Core, Proximal, and Distal Temperature Evaluations

Introduction

Bathing, especially with hot spring with various mineral compositions, is known to facilitate / improve sleep by warming the body. Artificial carbonated bathing (ACB) is known to keep the body warm too. Previous our study examined that ACB before sleep more specifically affected body temperature and sleep on healthy young subjects. In this study, we evaluated the effects of usual (plain hot water; PH) and artificial carbonated bathing, on sleep using clinical thermometers and EEG in healthy elderly subjects.

Methods

Nine healthy elderly women (average age 71.3 years old) were divided into 2 groups ACB (858 ppm, Awacomachi, Danrei Co.) and PH with a week interval. Subjects soaked in the bath (38 C degree) deep enough their chests touched the water for 10 min. From the time they finished bathing to the next morning, we measured their distal skin temperature (top side of the foot), proximal skin temperature (lower part of the clavicle) and EEG using a single channel portable device (Brain wave sensor, Proassist Co.). Subjects were told to sleep from 23:00-6:00. As the same time, subjects were examined with visual analog scale (VAS) and clinical flicker fusion test (CFF).

Results

There was no significant difference in body temperature (proximal, distal, distal-proximal temperature gradient: DPG) before and during sleep between ACB and PH. The condition of the ACB tended to have less light sleep compared to PH (150min vs 201min, p=0.08), but there was no significant difference in the SWS (44.1min vs 39.1min, ns), EEG delta power analysis, VAS and CFF.

In the previous study, bathing was performed for 15 min at a water temperature of 40 C degree, but this condition was considered to be a high risk for the elderly. The reason why there was no significant difference in body temperature. The effects of ACB were not fully demonstrated due to changes in hot water temperature and bathing time.

Conclusion

The effect of ACB on the body temperature of healthy elderly people could not be confirmed. However, a tendency to reduce light sleep was observed.

Support

This work was supported by JSPS KAKENHI Grant Number JP19K11294

P3117Usefulness of cardiac magnetic resonance imaging for early detection of subclinical chemotherapy-related cardiac dysfunction in cancer patients

Background

Long-term prognosis of cancer patients has been improved along with the progress in chemotherapies. However, chemotherapy-related cardiac dysfunction (CTRCD) is emerging as a serious adverse effect as it worsens patients' outcome and quality of life. Thus, early detection of subclinical CTRCD is an important emerging issue in the management of cancer patients. Cardiac magnetic resonance (CMR) utilizes parametric mapping approach and strain analysis to provide detailed information about cardiac tissue and diastolic cardiac function.

Purpose

We examined whether the novel CMR imaging techniques are useful for early detection of CTRCD.

Methods and results

We performed both retrospective and prospective studies. (1) Retrospective study: We retrospectively enrolled 52 cancer patients (mean age 55.6±13 yrs., M/F=14/38) who had been treated with anthracyclines. We examined the usefulness of CMR for quantitative assessment of myocardial fibrosis caused by chemotherapies. We found that native T1 value was significantly prolonged in cancer patients compared with healthy controls (N=10) (1,279±56 vs. 1,240±34 msec, P=0.036). (2) Prospective study: A total of 99 consecutive female patients with breast cancer treated with chemotherapies were enrolled in this study from August 2017 to January 2019. To evaluate CTRCD in those patients, we performed CMR (at baseline and/or 6 months) and biomarkers analysis for cardiac troponin T (cTnT) and BNP at baseline and every 3 months during chemotherapies. In the 99 patients, 52 (mean age 53.0±12.7 yrs.) completed cardiac assessment at 6 months, and 6 (12%) developed CTRCD defined as a reduction in left ventricular ejection fraction (LVEF) >10% from baseline and below 53% without symptoms. In patients with CTRCD (CTRCD group, N=6), as compared with those without it (non-CTRCD group, N=46), native T1 value was significantly prolonged after chemotherapies (1,303±32 vs. 1,322±22 msec at 6 months, P=0.03). Plasma cTnT levels at 3 months were also significantly higher in the CTRCD group compared with the non-CTRCD group [0.022 (IQR 0.015–0.026) vs. 0.01 (0.006–0.014) ng/mL, P=0.024], whereas there was no difference in BNP values. In the 52 patients, 28 (mean age 56.3±12.3 yrs.) underwent CMR both before and 6 months after chemotherapies. In those patients, LVEF and global radial strain were significantly decreased at 6 months from baseline (LVEF, from 70.5±4.6 to 66.0±7.1%; global radial strain, from 70.0±22.5 to 61.1±22.6%, respectively, both P<0.05). In patients with elevated cTnT levels at 3 months, as compared with those without it, LVEF and extracellular volume fraction (ECV) at 6 months were significantly worse (LVEF, 59.0±6.0 vs. 62.7±2.6%, P=0.042; ECV, 32.3±2.9 vs. 30.2±2.3%, P=0.049, respectively).

Conclusions

These results indicate that novel CMR imaging techniques are useful for early detection of CTRCD among cancer patients treated with chemotherapies.

Low absolute peripheral blood CD4+ T-cell count predicts poor prognosis in R-CHOP-treated patients with diffuse large B-cell lymphoma

The absolute peripheral blood lymphocyte count at diagnosis is known to be a strong prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), but it remains unclear as to which peripheral blood lymphocyte population is reflective of DLBCL prognosis. In this cohort, 355 patients with DLBCL treated with R-CHOP from 2006 to 2013 were analyzed. The low absolute CD4+ T-cell count (ACD4C) at diagnosis negatively correlated with the overall response rate and the complete response rate significantly (P<0.00001). An ACD4C<343 × 106/l had a significant negative impact on the 5-year progression-free survival and the overall survival as compared with an ACD4C⩾343 × 106/l (73.7% (95% confidence interval (CI)=66.7-79.5) versus 50.3% (95% CI=39.0-60.6), P<0.00001 and 83.3% (95% CI=77.1-88.0) versus 59.0% (95% CI=47.9-68.5), P<0.00000001, respectively). Multivariate analysis revealed that the ACD4C was an independent prognostic marker (hazard ratio=2.2 (95% CI=1.3-3.7), P<0.01). In conclusion, a low ACD4C at diagnosis served as an independent poor prognostic marker in patients with DLBCL.