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Takahashi H, Miyoshi N, Uemura M, Mizushima T, Doki Y, Eguchi H. Indocyanine green near-infrared fluorescence imaging in laparoscopic resection of small bowel carcinoma for definitive central vascular ligation - a video vignette. Colorectal Dis 2020; 22:2347-2348. [PMID: 33245594 DOI: 10.1111/codi.15315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 02/08/2023]
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Asada M, Nagata M, Mizuno T, Uchida T, Takahashi H, Makita K, Arai H, Kijima S, Echizen H, Yasuhara M. Population pharmacokinetics of cefazolin before, during and after cardiopulmonary bypass in adult patients undergoing cardiac surgery. Eur J Clin Pharmacol 2020; 77:735-745. [PMID: 33211137 DOI: 10.1007/s00228-020-03045-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The aims of the present study were to establish a population pharmacokinetic (PPK) model of cefazolin for adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and to assess the probability of target attainment (PTA) for the prophylaxis of surgical site infection (SSI) using cefazolin. METHODS Adult patients who underwent cardiac surgery with CPB were enrolled in the prospective study. Blood samples for plasma cefazolin assay were collected, and total and unbound drug concentrations were measured and analysed using the nonlinear mixed-effects modelling (NONMEM) software considering saturable plasma protein binding. Using the PPK model, plasma unbound cefazolin concentration-time courses with current prophylaxis protocols were simulated, and the PTA for common SSI pathogens was estimated. RESULTS A total of 199 blood samples were obtained from 27 patients. A one-compartment model with first-order elimination plus an on/off CPB compartment best described the data. The population mean for systemic drug clearance (CL) was reduced and that for the volume of distribution (V) was increased during CPB compared with the pre-CPB values. CPB-induced hypoalbuminemia was associated with reduced maximum protein binding (Bmax). The simulation studies suggested that the current dosing protocols are insufficient for attaining PTA > 0.9 throughout surgery against pathogens with minimum inhibitory concentrations (MICs) >8 mg/L. A new dosing protocol that achieves a PTA > 0.9 for pathogens with a MIC of 16 mg/L was proposed. CONCLUSION PPK modelling with simulation may be valuable for devising a cefazolin prophylaxis protocol for patients undergoing cardiac surgery with CPB.
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Aono T, Watanabe T, Toshima T, Takahashi T, Otaki Y, Wanezaki M, Kutsuzawa D, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. Elevated serum carboxy-terminal telopeptide of type I collagen predicts clinical outcome in patients with acute coronary syndrome who underwent percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Serum carboxy-terminal telopeptide of type I collagen (I-CTP) is a collagen degradation product of type I collagen in the extracellular matrix of the heart, blood vessels, and bone. The serum levels of I-CTP were reportedly a predictive marker for cardiac remodeling after acute myocardial infarction. However, it remains unclear whether I-CTP can predict poor clinical outcome in patient with acute coronary syndrome (ACS).
Purpose
The aim of this study was to investigate the association between serum levels of I-CTP and clinical outcome in patients with ACS.
Methods
Serum levels of I-CTP were measured in 200 patients with ACS who underwent percutaneous coronary intervention (PCI). All patients were prospectively followed during the median follow-up period of 1312 days with the end point of major adverse cardiovascular events (MACE). We divided the patients into tertiles according to serum I-CTP level: low I-CTP group (≤4.4 ng/ml, n=72), middle I-CTP group (4.4–6.4 ng/ml, n=65), and high I-CTP group (≥6.5 ng/ml, n=63).
Results
There were 44 MACE, including 24 all-cause death and 9 rehospitalization due to heart failure. I-CTP was significantly higher in patients with MACE than those without (4.90 [interquartile range (IQR): 3.80–6.38] ng/ml vs. 6.65 [IQR: 5.00–10.08] ng/ml, p<0.001). Kaplan-Meier analysis demonstrated that patients in the highest tertile of I-CTP had the greatest risk of MACE. In a univariate analysis, age, Albumin, estimated glomerular filtration rate (eGFR), low-density lipoprotein cholesterol (LDL-C), brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hsCRP) and I-CTP were significant predictors of MACE. A multivariate Cox proportional hazard analysis showed that the high I-CTP group had a higher risk for MACE (Hazard ratio [HR] 2.6, p=0.049) compared with the low I-CTP group after adjusting for confounding factors.
Conclusions
I-CTP was significantly associated with MACE, suggesting that I-CTP could be a reliable marker for clinical outcome in patients with ACS who underwent PCI.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Takahara K, Oguri M, Yasuda K, Sumi T, Izumi K, Takikawa T, Takahashi H, Ishii H, Murohara T. Efficacy of rapid decongestion strategy in patients hospitalized for acute heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clinical congestion is the most dominant feature in patients with acute decompensated heart failure (HF). However, uncertainty exists due to the permutations and combinations of congestion status and decongestion strategies. We aimed to investigate the impact of congestion status and its improvement on 1-year mortality.
Methods
We prospectively included 453 consecutive patients hospitalized for acute decompensated HF between July 2015 and March 2017. Congestion was evaluated using the congestion score which consists of signs and symptoms including dyspnea, fatigue, orthopnea, jugular vein distension, rales, and edema. This score ranges from 0 to 3 for each value, and calculated by summing each score. We assessed this score at admission, day 3, and discharge.
Results
The median age was 81 (interquartile range 75–87) years, and 54.1% of the subjects were male. The 1-year mortality rate was 22.7%. The congestion scores at admission, day 3, and discharge were 10.7±3.9, 3.4±3.5, and 0.3±0.8, respectively. The rate of improvement during the first 3 days was 78% and 46.6% had residual congestion, defined as scores at day 3 ≥3. The score at day 3 and improvement rate during the first 3 days were related to 1-year all-cause mortality (P<0.001). We examined combined predictive values by calculating multivariable-adjusted hazard ratios for associations of residual congestion and improvement rate during the first 3 days (cut-off value 64%); and prognostic variables identified by univariate Cox regression model (age, body mass index, systolic blood pressure, potassium level, albumin level, the prevalence of anemia and hypertension, left ventricular ejection fraction, ischemic etiology, previous HF hospitalization). Residual congestion and lesser improvement (% improvement <64%) were associated with higher relative risk of 1-year all-cause mortality than residual congestion and higher improvement (% improvement ≥64%) [adjusted hazard ratio (aHR) 2.33, 95% CI 1.11–4.91, P=0.025], or resolved congestion (aHR 2.17, 95% CI 1.30–3.63, P=0.003). Similar analysis revealed significant relationship of the score at day 3 and the rate of improvement from admission to day 3 to cardiovascular mortality. Combined predictive values of residual congestion and lesser improvement with adjustment for prognostic variables identified by univariate Cox regression model (age, body mass index, systolic blood pressure, potassium level, albumin level, the prevalence of anemia, reduced eGFR, and hypertension, left ventricular ejection fraction, ischemic etiology, previous HF hospitalization) were higher than those with residual congestion and higher improvement (aHR 3.04, 95% CI 1.15–8.03, P=0.025), or resolved congestion (aHR 3.17, 95% CI 1.65–6.11, P<0.001).
Conclusions
This study suggested that rapid decongestion therapy after hospital admission could be prerequisite to improve 1-year mortality in acute decompensated HF.
Funding Acknowledgement
Type of funding source: None
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Goto J, Watanabe T, Kobayashi Y, Toshima T, Wanezaki M, Nishiyama S, Otaki Y, Kutsuzawa D, Kato S, Tamura H, Arimoto T, Takahashi H, Shishido T, Kubota I, Watanabe M. Impact of percutaneous coronary intervention on short and long-term prognosis of elderly patients with acute myocardial infarction from 2010 to 2017 in Japanese population. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Advances in therapies have successfully decreased short-term mortality in patients with acute myocardial infarction (AMI). Although aging population is recently increasing in developed countries, there are few reports about the association between prevalence of percutaneous coronary intervention (PCI) and long-term prognosis in elderly patients with AMI in Japan.
Purpose
The aim of this study was to clarify the prevalence of PCI and the impact of PCI on short and long-term prognosis of elderly patients with AMI.
Methods and results
We investigated the prevalence of PCI and short-term mortality in 4,109 patients with AMI who were registered in Yamagata AMI Registry from 2010 to 2017. Long-term mortality was investigated using data from death certification in July 2019. We divided patients with AMI into three age groups (group 1, <65 years old; group 2, 65–79 years old; and group 3, ≥80 years old). Short-term mortality within 30 days was 6.5%, 12.1%, and 28.6%, respectively. Also, prevalence of PCI was 88.0%, 84.7%, and 62.7%, respectively. Multivariate analysis revealed that age, PCI, and severity of Killip classification were significantly associated with short-term mortality after adjustment for confound factors in group 3. Since the prevalence of PCI in group 3 was the lowest among three groups, the cause of PCI not being executed was investigated in 1,429 patients aged ≥80 years old. Elderly patients who didn't undergo PCI was older, more women, and had higher prevalence of chronic kidney disease, previous stroke, and severe Killip classification. Multivariate analysis revealed that age and Killip III/IV were significantly associated with non-executed PCI after adjustment for confound factors. Next, we investigated impact of PCI on long-term mortality in elderly patients who escaped acute death. Multivariate Cox hazard analysis revealed that PCI was associated with lower mortality after adjustment for confound factors (adjusted hazard ratio 2.47, 95% CI: 1.47–4.06; p=0.0008).
Conclusion
Lower prevalence of PCI and higher short-term mortality were observed in elderly patients with AMI aged ≥80 years old. PCI ameliorated long-term mortality as well as short-term mortality in elderly patients with AMI.
Funding Acknowledgement
Type of funding source: None
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Abe M, Ozaki Y, Takahashi H, Akao M, Kimura T, Nagai R. Impact of chronic kidney disease on mid-term prognosis of stable angina patients with high-dose or low-dose pitavastatin treatment: REAL-CAD sub-study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
We previously demonstrated that high-dose (4 mg/day) compared with low-dose (1 mg/day) pitavastatin therapy significantly reduced cardiovascular events in Japanese patients with stable coronary artery disease in the Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study. However, little is known about whether the advantage of high-dose statins over low-dose statins is consistent among non-, mild, and moderate to severe chronic kidney disease (CKD) patients.
Purpose
The aim of this study was to clarify the effect of high-dose statins on cardiovascular events in Japanese patients with or without CKD.
Methods
The REAL-CAD study is a prospective, multicenter, randomized, open-label, blinded endpoint, physician-initiated superiority trial. In this sub-analysis of REAL-CAD study, patients were categorized into three groups according to estimated glomerular filtration rate (eGFR). Patients on hemodialysis were excluded in this study. The primary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction (MI), non-fatal ischemic stroke, or unstable angina requiring emergency hospitalization. A secondary composite endpoint was defined as a composite of the primary endpoint event or clinically-indicated coronary revascularization excluding target-lesion revascularization.
Results
The total population of the REAL-CAD study was 12,413 patients. After exclusion of patients lacking eGFR data, the numbers of patients categorized into non-CKD (eGFR ≥60 mL/min/1.73m2), mild CKD (eGFR; 45–60), and moderate to severe CKD (eGFR <45) were 7,778 (64%), 3,176 (26%), and 1,164 (10%), respectively. The median follow-up period was 3.9 years. The baseline characteristics and medications were well balanced between the two groups in each CKD group. While high-dose compared to low-dose pitavastatin significantly reduced the primary endpoint in non-CKD patients, the effect was not observed in mild CKD and moderate to severe CKD patients (Figure 1). High-dose compared with low-dose pitavastatin did not significantly reduce the secondary composite endpoint in both mild and moderate to severe CKD patients as well. High-dose pitavastatin significantly reduced the risks of MI and any coronary revascularization in non-CKD patients, however, the effects were diminished in mild CKD and moderate to severe CKD patients. There was no significant difference between high-dose and low-dose pitavastatin treatment in the risk of all-cause death, cardiovascular death, ischemic stroke, or unstable angina requiring emergency hospitalization in patients with or without CKD.
Conclusion
Although high-dose pitavastatin therapy significantly reduced cardiovascular events in non-CKD patients with stable angina compared to low-dose pitavastatin, such beneficial effects had diminished in Japanese patients with mild or moderate to severe CKD patients.
Figure 1. Kaplan-Meier Curves for Endpoints
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Clinical Research of Lifestyle-Related Disease of the Public Health Research Foundation
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Ohta M, Ozaki Y, Toriya T, Nagasaya R, Takatsu H, Yoshiki Y, Hashimoto Y, Ishikawa M, Kawai H, Muramatsu T, Naruse H, Takahashi H, Ishii J, Izawa H. Five-year major adverse cardiac and cerebrovascular events of patients with lipid core abutting lumen (LCAL) on integrated-backscatter intravascular ultrasound undergoing PCI with current DES. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous Coronary Intervention (PCI) using the new generation drug-eluting stent (DES) has been extremely reduced target lesion revascularization (TLR) in recent years. However, a high incidence of non-target lesion-related cardiovascular events in patients undergoing PCI is an important problem to be solved. According to the previous findings, patients with vulnerable plaques particularly have a high recurrence of cardiovascular events. Little studies, however, has been done to examine the relationship between plaque characteristics on intravascular imaging in a target lesion and non-target lesion-related cardiovascular events.
Purpose
The main objective of this study is to investigate the five-year major adverse cardiac and cerebrovascular events (MACCE) of patients with lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound (IB-IVUS) in a target lesion undergoing PCI with current DES.
Methods and results
Between February 2010 and September 2013, in total 780 patients with ischemic heart disease undergoing PCI, 166 target lesions in 166 consecutive patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) and stable angina pectoris (SAP) undergoing IVUS-guided PCI were studied.
Plaque characteristics in all target lesions were analyzed by three-dimensional IB-IVUS system using the mechanical IVUS catheter. Our previous study has found that LCAL which is defined as a lipid pool directly in contact with the lumen visualizes the thin fibrous cap of less than 75μm on optical coherence tomography (OCT). On the basis of this data, LCAL at minimal lumen area (MLA) site was identified.
In total, 39 patients had lesions with LCAL at MLA site (LCAL(+)), and 127 patients had those without LCAL (LCAL(−)).
The primary endpoint was defined as MACCE, including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke and non-TLR for the new lesion during a median follow up of five years. The MACCE occurred significantly higher in the LCAL(+) than in the LCAL(−) (38.5% vs. 17.3%; p<0.005). And the Kaplan-Meier estimates have shown that the cumulative incidence of MACCE was significantly higher in the LCAL(+) than in the LCAL(−) (log rank test, p=0.041). Additionally, after adjustment for confounders, gender, prior PCI and LCAL was the independent predictors for the MACCE of patients undergoing PCI with current DES.
Furthermore, after adding LCAL to a baseline model with established factors consisting of age, gender, diabetes mellitus, prior PCI and percentage lipid volume on IB-IVUS, the net reclassification (p<0.002) and integrated discrimination improvement (p<0.004) significantly improved compared to baseline model alone.
Conclusions
In this study, it has become clear that LCAL on IB-IVUS is likely to be a surrogate marker of MACCE in patients undergoing PCI with current DES.
Funding Acknowledgement
Type of funding source: None
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Tanaka Y, Nagoshi T, Yoshii A, Oi Y, Takahashi H, Kimura H, Kashiwagi Y, Tanaka T, Yoshimura M. Xanthine oxidase inhibition attenuates doxorubicin-induced cardiotoxicity in mice. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Accumulating evidence suggests that high serum uric acid (UA) is associated with left ventricular (LV) dysfunction. Although xanthine oxidase (XO) activation is a critical regulatory mechanism of the terminal step in ATP and purine degradation, the pathophysiological role of cardiac tissue XO in LV dysfunction remains unclear.
Objectives
We hypothesized that cardiac XO is activated in doxorubicin-induced LV dysfunction, and XO inhibitors ameliorate LV function by inhibiting cell death signals as well as by modifying cardiac purine metabolism.
Methods
Either doxorubicin (10 mg/kg) or vehicle was intraperitonially administered in a single injection to ICR mice. Mice were treated with or without oral XO inhibitors (febuxostat 3 mg/kg/day or topiroxostat 5 mg/kg/day) for 8 days starting 24 hours before doxorubicin-injection. The LV function was assessed by echocardiography at day 6 and by ex vivo heart perfusion at day 7.
Results
Cardiac tissue XO activity measured by a highly sensitive assay with liquid chromatography/mass spectrometry (n=8 each) and cardiac UA content (n=3–6) were significantly increased in doxorubicin-treated mice at day 7 and dramatically reduced by XO inhibitors. Accordingly, XO inhibitors substantially improved LV ejection fraction (n=8 each) and LV developed pressure (n=9 each) that had been impaired by doxorubicin administration. Intriguingly, the expression of GPX4, a negative regulator of ferroptosis, was decreased in doxorubicin-treated hearts but improved by XO inhibitors (n=6 each). Furthermore, metabolome analyses revealed an enhanced purine metabolism in doxorubicin-treated hearts, and XO inhibitors suppressed the serial metabolic reaction of hypoxanthine–xanthine–UA.
Conclusions
Doxorubicin administration induces cardiac tissue XO activation associated with an impaired LV function. XO inhibition attenuates the doxorubicin-induced cardiotoxicity partly through an anti-ferroptotic effect and the conservation of tissue ATP levels by modulating purine metabolism. The present study suggests that pharmacological XO inhibition represents a potential therapeutic strategy for the treatment of doxorubicin-induced cardiotoxicity.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was supported in part by grants-in-aid for Ministry of Education Culture, Sports, Science and Technology.
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Ono R, Fukushima K, Yamazaki T, Takahashi H, Hori Y. The correlations between anti-factor Xa activity values and PT/APTT at peak and trough times in patients with venous thromboembolism using high dose of apixaban. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The high dose (20mg/day) of apixaban is used for the initial treatment of venous thromboembolism for the first week. Although patients taking direct oral anticoagulants do not require routine coagulation monitoring, the correlations between anti-factor Xa activity (AXA) and routine coagulation markers such as prothrombin time (PT) and activated partial thromboplastin time (APTT) at peak and trough times especially when using high dose of apixaban have not been reported so far.
Purpose
The purpose is to assess the correlations between AXA values and PT/APTT at peak and trough times in patients with venous thromboembolism using high dose of Apixaban.
Methods
Twenty-six patients (10 male; 71±15 years) with proximal venous thromboembolism or pulmonary embolism using high dose (20mg/day) of apixaban were enrolled. We measured AXA, using chromogenic assay with the HemosIL Liquid Heparin kit, PT and APTT at peak and trough times. The peak time was defined as 3 hours after the intake of apixaban, and the trough time was defined as that immediately before the intake of apixaban.
Results
A significant and strong positive correlation was observed between AXA and PT at both peak and trough times (R=0.795, p<0.01 and R=0.766, p<0.01, respectively). A significant and moderate positive correlation was observed between AXA and APTT at trough time (R=0.527, p<0.01), but no correlation was observed between AXA and APTT at peak time (R=0.366, p=0.07).
Conclusion
Our findings reveal the relationship between AXA and PT at peak and trough times has a significant strong correlation. These results suggest measuring of PT may be alternative and effective way of monitoring of AXA values when using high dose of apixaban.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Ishii J, Takahashi H, Nishimura H, Fujiwara W, Ohta M, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Motoyama S, Watanabe E, Izawa H, Ozaki Y. Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.
Objective
We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.
Methods
We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.
Results
During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.
Conclusions
Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.
Presepsin quartiles and mortality
Funding Acknowledgement
Type of funding source: None
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Ono R, Fukushima K, Yamazaki T, Takahashi H, Hori Y. The distribution of anti-factor Xa activity value, PT and APTT at peak and trough times in patients with direct anti-factor Xa inhibitors. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although patients taking direct oral anticoagulants (DOACs) do not require routine coagulation monitoring, the distribution of anti-factor Xa activity (AXA) values, prothrombin time (PT), PT-international normalized ratio (INR) and activated partial thromboplastin time (APTT) in patients on apixaban, edoxaban and rivaroxaban therapy is still not clear.
Purpose
The aim is to set the standard values of AXA values, PT, PT-INR and APTT in patients using DOACs.
Methods
We measured AXA, using chromogenic assay with the HemosIL Liquid Heparin kit, PT, PT-INR and APTT at trough and peak times in 224 patients with non-valvular atrial fibrillation and venous thromboembolism, of whom 90 received apixaban, 100 received edoxaban and 34 received rivaroxaban. The peak time was defined as 3 hours after the intake of apixaban or rivaroxaban, and 2 hours after the intake of edoxaban. The trough time was defined as that immediately before the intake. The AXA values, PT, PT-INR and APTT were measured at least 72 hours after the start of treatment. The dosage of DOACs is defined according to the prescribing information in Japan.
Results
(The order of results below is apixaban, edoxaban and rivaroxaban, respectively.) The average AXA values were 2.29, 0.23 and 0.39 (IU/mL) at trough time, and 3.04, 1.01 and 1.70 (IU/mL) at peak time. The average PT values were 17.9, 12.9 and 13.1 (s) at trough time, and 19.7, 15.5 and 17.5 (s) at peak time. The average PT-INR values were 1.49, 1.07 and 1.08 at trough time, and 1.65, 1.29 and 1.45 at peak time. The average APPT values were 34.5, 31.3 and 32.0 (s) at trough time, and 39.5, 35.9 and 39.8 (s) at peak time.
Conclusion
Our findings reveal the standard values of AXA, PT, PT-INR and APTT in patients using apixaban, edoxaban and rivaroxaban in each dosage. The DOACs should be changed if the measured value is out of those standard values in 90% confidence interval.
Funding Acknowledgement
Type of funding source: None
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Ito R, Oshima S, Ishii H, Takahashi H, Umemoto N, Sakakibara T, Murohara T. Long term clinical outcome after self-expandable nitinol stent implantation for femoropopliteal occlusive disease in hemodialysis patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Endovascular therapy (EVT) using self-expandable bare nitinol stent (BNS) has been commonly accepted in patients with symptomatic femoropopliteal (FP) occlusive disease. However, poor clinical outcomes in hemodialysis (HD) patients are major problems. We investigated the impact of HD on clinical outcome after EVT in patients with FP disease.
Methods
A total of 427 consecutive HD patients undergoing successful EVT with BNS for FP disease were enrolled with 157 non-HD patients as a control group. They were followed-up for 5 years. We collected data on target lesion revascularization (TLR) rate, and limb salvage rate as well as survival rate. Propensity-score matching analysis was performed to investigate the true impact of HD on the outcome.
Results
Critical limb ischemia was observed in 44.0% of overall population (43.0% in HD group vs. 46.8% in non-HD group, p=0.42). Rates of diabetes (67.1% vs. 58.1%, p=0.045) and coronary artery disease (73.5% vs. 58.3%, p=0.0008) were higher, while age (70±10 years old vs. 76±10 years old, p<0.0001) and TASC2 C/D lesion (27.9% vs. 44.6%, p=0.0002) were lower in HD group compared to non-HD group. Pre-procedural C-reactive protein level (0.4mg/l vs. 0.3mg/l, p=0.045) was higher and serum albumin level (3.6g/dl vs. 3.8g/dl, p=0.0045) was lower in HD group than those in non-HD group. The freedom rate from TLR at 5 years was significantly lower in HD group than in non-HD group [47.2% vs. 65.2%, hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.23–2.64, p=0.0017]. The limb salvage rate was comparable between the groups (93.3% vs. 97.1%, HR 1.57, 95% CI 0.58–5.47, p=0.41), while the survival rate was significantly lower in HD group compared to non-HD group (60.6% vs. 86.0%, HR 2.53, 95% CI 1.56–4.36, p=0.0002). After propensity-score analysis, 250 patients (125 in each group) were matched without any difference of clinical characteristics in both groups. In the matched cohort, the freedom rate from TLR was still lower in HD group compared to non-HD group (46.7% vs. 66.6%, HR 2.25, 95% CI 1.35–3.87, p=0.0019). The adjusted limb salvage rate was consistently similar between the groups (95.4% vs. 97.3%, HR 1.10, 95% CI 0.20–5.94, p=0.91). Also, the adjusted survival rate was lower in HD group than in non-HD group (47.6% vs. 89.9%, HR 3.60, 95% CI 1.89–7.44, p<0.0001).
Conclusion
The freedom rate from TLR at 5 years after BNS implantation for FP disease were significantly lower in HD group than in non-HD group, though the limb salvage rate was similar between the groups. The survival rate was consistently lower in HD group compared to non-HD group. HD status had a great impact on TLR and mortality after EVT with BNS in patients with FP disease.
Funding Acknowledgement
Type of funding source: None
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Takahashi H, Machii R, Nakayama T. Analysis of population-based and worksite cancer screening in Japan. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In some European countries, cancer screening is conducted and evaluated by the nation. In Japan, about half of cancer screenings are conducted by the government or local governments, while the other half is in a worksite, conducted by business owners and insurers as part of a welfare program. The Ministry of Health, Labor and Welfare (MHLW) have prepared guidelines for cancer screening in worksite and provided specific recommendation methods to practitioners. For an understanding of its use does not progress, it is necessary to identify problems.
Methods
A research group, organized by the MHLW grant, surveyed 20 major insurers in Japan about the guidelines for cancer screening in worksite. The contents of the questionnaire are related to the establishment of a system with a view to organizing screening, and consist of a total of 45 items. Answers to these questions were obtained in the following format. (1. Yes, 2. No, 3. Can't answer, 4. Can't understand the meaning of the question)
Results
Around 30% of insurers were able to answer all items, but 70% were not able to answer any items. Approximately 10% of the respondents answered that they had implemented the items in the guidelines, while 70% did not, and 20% can't answer or can't understand the meaning of the question. The reasons for not being able to answer were that the terms were difficult to understand, there was no need to grasp the data of cancer screening, and there was a legal problem and personal information could not be obtained.
Conclusions
This suggests that employers and insurers differ in their understanding of cancer screening, resulting in various implementations and evaluations. In order to establish organized screening in the whole country, it is necessary to develop a system that can also evaluate data, such as cancer screenings and health check conducted in worksite. It is also important to improve the literacy of cancer screening practitioners.
Key messages
Integrating cancer screening across the country. Improving the literacy of cancer screening practitioners.
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Sagisaka R, Nakagawa K, Kayanuma M, Tanaka S, Takahashi H, Komine T, Tanaka H. Sustaining improvement of dispatcher-assisted cardiopulmonary resuscitation for out-of-hospital cardiac arrest patients in Japan: An observational study. Resusc Plus 2020; 3:100013. [PMID: 34223297 PMCID: PMC8244355 DOI: 10.1016/j.resplu.2020.100013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/25/2020] [Accepted: 06/12/2020] [Indexed: 11/28/2022] Open
Abstract
Objectives We aimed to estimate the relationship between the promotion of bystander cardiopulmonary resuscitation (CPR) with dispatcher-assistance over time and good cerebral function after out-of-hospital cardiac arrests (OHCAs). Methods This was a retrospective observational study, using a nationwide OHCA database in Japan. The eligible 267,193 witnessed cardiogenic OHCA patients between 2005 and 2016 were analysed. Multivariable logistic regression models were performed to estimate the effect of dispatcher-assisted bystander CPR per year. In addition, we calculated the number of patients with good cerebral function, which was attributed to dispatcher-assisted bystander CPR. Results Dispatcher-assisted bystander CPR was performed to 84,076 (31.5%), those without dispatcher-assistance were 48,389 (18.1%), and non-bystander CPR were 134,728 (50.4%). The adjusted odds ratio (AOR) of dispatcher-assisted bystander CPR vs. non-bystander CPR was significantly related to good cerebral function, regardless of the year (AOR, 1.47, 1.62; 95%CI, 1.19-1.80, 1.42-1.85, 2005 and 2016, respectively). The association of dispatcher-assisted bystander CPR with good cerebral function tended to increase (AOR, 1.11, 2.97; 95%CI, 0.99-1.24, 2.69-3.28, 2006 and 2016, based on 2005, respectively). Estimating the number of patients with good cerebral function who attributed to dispatcher-assisted bystander CPR was a significant increase from 41 in 2005 to 580 in 2016 (p < .0001, r = 0.98). Furthermore, chest compression consistently contributed to higher number of patients with good cerebral function than that with a combination of chest compression and shock with public-access-defibrillation. Conclusion We found that the increased dispatcher-assisted bystander CPR rate was related to good cerebral function at 1-month post OHCA. Chest compression without public-access-defibrillation was most helpful to that number, explaining the effects of dispatcher-assistance and sustaining improvement.
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Kanda M, Tsuji T, Mukai M, Takahashi H, Atsumi T, Hübner N. THU0232 INTERFERON SIGNATURE IN LUPUS KIDNEY IS CORRELATED WITH REMISSION WITHIN 56 WEEKS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Activation of the type I interferon (IFN) pathway has been implicated in the initiation of systemic lupus erythematosus(SLE) and most SLE patients show increased expression of IFN-regulated genes in peripheral blood mononuclear cells or whole blood. However, the IFN signature in lupus kidney is not well examined especially at single cell resolution.Objectives:To clarify the significance of the IFN signature in lupus kidney at single cell resolutionMethods:18 lupus kidney (LN) and 34 transplanted kidney (KTx) samples were included in the study. Residual frozen kidney biopsies were collected after clinical diagnosis. The tissue from one donor was split into two. One portion was used for total RNA-Seq (tRNA-Seq) by SMARTer Stranded Total RNA-Seq Kit v2 - Pico Input Mammalian (Takara/Clontech). The rest was used for single nucleus RNA-Seq (snRNA-Seq) using Chromium Single Cell 3’ Reagent Kits v3 (10x Genomics) (7 LN and 17 KTx). For the tRNA-Seq, the sequence reads were aligned to Ensembl genome annotation (Ens93) by STAR and the aligned reads were counted by htseq. IFN score of tRNA-Seq was calculated using the reported method [1] per each module (M1.2, M3.4 and M5.12). For the snRNA-Seq, the sequenced reads were processed on the standard pipeline of CellRanger (10x Genomics) and the data was visualized using Seurat. IFN score of snRNA-Seq was computed by the method reported by Arazi A,et al[2].Clinical outcomes of LN were examined on the medical records retrospectively and the clinical remission in 56 weeks for LN was defined as a urinary protein/creatinine ratio less than 0.5 g/gCr.Results:11 LN had clinical remission and 7 LN showed non remitted disease within 56 weeks after the biopsy. There were no statistical significance co-variants such as age, gender and WHO class in pathology. IFN score of M1.2, M3.4 and M5.12 were significantly increased in LN with remission within 56 weeks (median 0.773 vs 0.659, 0.595 vs 0.243 and 0.415 vs 0.100: p-value 0.03, 0.01 and 0.02 [Wilcox rank-test]) in tRNA-Seq. In the snRNA-Seq, the lupus kidney with low IFN score showed restricted IFN signature in the endothelial cells mainly, which can be detected even in the controls, but those with high IFN score indicated broadly spread IFN signature among all of the cell types.Conclusion:LN with high IFN score in kidney tissue is correlated with remission within 56 weeks. LN with low IFN score showed IFN signature restricted to endothelial cells but those with a higher IFN score revealed broadly affected cell types with IFN signature. These results suggest that the IFN signature of LN may start from endothelial cells and then spread to the whole kidney.References:[1]Chiche L, Jourde-Chiche N, Whalen E,et al.Modular Transcriptional Repertoire Analyses of Adults With Systemic Lupus Erythematosus Reveal Distinct Type I and Type II Interferon Signatures.Arthritis & Rheumatology2014;66:1583–95.doi:10.1002/art.38628[2]Arazi A, Rao DA, Berthier CC,et al.The immune cell landscape in kidneys of patients with lupus nephritis.Nat Immunol2019;20:902–14.doi:10.1038/s41590-019-0398-xDisclosure of Interests: :Masatoshi Kanda: None declared, Takahiro Tsuji: None declared, Masaya Mukai: None declared, Hiroki Takahashi: None declared, Tatsuya Atsumi Grant/research support from: Eli Lily Japan K.K., Alexion Pharmaceuticals, Inc., Bristol-Myers Squibb Co., AbbVie Inc., Daiichi Sankyo Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., Consultant of: Gilead Sciences, Inc., Eli Lilly Japan K.K., UCB Japan Co. Ltd., AbbVie Inc., Daiichi Sankyo Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Speakers bureau: Eli Lilly Japan K.K., UCB Japan Co. Ltd., Bristol-Myers Squibb Co., AbbVie Inc., Eisai Co. Ltd., Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Takeda Pharmaceutical Co., Ltd., Astellas Pharma Inc., Norbert Hübner: None declared
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Kawakami T, Saitoh N, Asukai Y, Wada S, Sasaki H, Takahashi H, Hatori K, Itou N, Fukunaga H, Toubaru T. P377Zero-fluoroscopy ablation with ultrasound-guided sheath insertion. Europace 2020. [DOI: 10.1093/europace/euaa162.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Radiation exposure during catheter ablation procedures is a risk for both the patient and electrophysiology staff. Recently, the feasibility and effectiveness of zero-fluoroscopy ablation have been shown. However, ensuring a safe sheath insertion through the venous system toward the heart is a concern in catheter ablation using the zero-fluoroscopy technique.
Purpose
The objective of this study was to confirm feasibility and safety for zero-fluoroscopy ablation using ultrasound-guided sheath insertion.
Methods
Zero-fluoroscopy catheter ablation was performed in 220 patients (185 patients with atrial fibrillation (AF), 26 patients with supraventricular tachycardia (SVT), and nine patients with ventricular arrhythmias (VA)) using a 3-dimensional electro-anatomical mapping system, contact force monitoring, and intracardiac echocardiography (ICE) imaging. In all cases, ultrasound-guided sheath insertion was performed through the femoral vein. In 6 cases of VA, the retrograde approach through the femoral artery was performed with ICE imaging and contact-force monitoring. The endpoint of ablation for AF was pulmonary vein ablation in all cases and addition of left atrial posterior wall isolation in persistent AF cases. The endpoint of ablation for SVT and VA was noninducibility after ablation.
Results
The endpoints of ablation were achieved in all cases. The fluoroscopic time during ablation procedures was 0 seconds. There were two complications (one cardiac tamponade and one acute heart failure). There were no complications related to sheath insertion.
Conclusions
Zero-fluoroscopy catheter ablation with ultrasound-guided sheath insertion may be feasible and can be performed safely. This method eliminates exposure radiation safely, which is a concern of zero-fluoroscopy endocardial catheter ablation.
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Abe S, Tsuboi H, Honda F, Takahashi H, Kondo Y, Matsumoto I, Sumida T. AB0122 DETECTION OF CIRCULATING M3 MUSCARINIC ACETYLCHOLINE RECEPTOR REACTIVE TH17 CELLS IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Sjögren’s syndrome (SS) is an autoimmune disease which is characterized by lymphocytic infiltration including CD4+IL-17 producing helper T (Th17) cells to the lacrimal and salivary glands. We previously detected anti-M3 muscarinic acetylcholine receptor (M3R) antibodies (1) and M3R reactive CD4+IFNγ producing helper T (Th1) cells (2) in SS patients. Moreover, we clarified that M3R reactive Th1 and Th17 cells had pathogenic roles in the development of auto-immune sialadenitis in SS mouse model (3).Objectives:The purpose of this study was to identify circulating M3R reactive Th17 cells among primary SS (pSS) patients, and to determine functional properties of those cells.Methods:1)Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood of 10 pSS patients, age gender matched 10 healthy controls (HC), and 5 IgG4-related disease (IgG4-RD) patients. According to their HLA-DRB1 typing, top 10 ranked 20 mer peptides from the full length of M3R, which were highly predicted to bind to each HLA molecules according to the immune epitope database website, were selected for each subjects. PBMCs were stimulated with these selected M3R peptides mixed for 40 hours, and M3R peptide reactive IL-17 secreting cells were detected by IL-17 enzyme-linked immunospot assay (ELISpot).2)PBMCs from 5 pSS patients who were positive for M3R specific IL-17 secreting cells, were stimulated with selected 12-20 mer M3R peptides separately, to identify the dominant M3R peptides responsible for IL-17 secretion by ELISpot.3)To identify whether detected IL-17 secreting cells were Th17 cells or not, isolated CD4+T cells from 3 pSS patients who were positive for M3R specific IL-17 secreting cells, were co-cultured with auto-monocyte derived dendritic cells (DCs), and stimulated with the dominant IL-17 secreting M3R peptides detected in method 2.4)Anti-M3R antibodies were examined using ELISA method.5)Clinical features were compared between M3R specific Th17 cells positive and negative pSS patients.Results:1)5 of 10 (50%) pSS patients, while none of 10 (0%) HC, and 5 (0%) IgG4-RD patients, showed significantly increased IL-17 positive spots against selected M3R peptides mixed stimulation compared with non-stimulation in ELISpot (Figure 1). M3R specific IL-17 secreting cells were detected significantly more frequently in pSS (5/10, 50%) than in HC (0/10, 0%) (p=0.03).2)All 5 pSS patients, who were positive for M3R specific IL-17 secreting cells, showed significantly increased IL-17 positive spots against M3R AA76-95 peptides.3)Co-culturing CD4+ T cells with DCs, stimulated with identified dominant M3R peptides in method 2, showed significantly increased spots, clarifying that IL-17 secreting cells were peripheral M3R reactive Th17 cells.4)Titers of anti-M3R antibodies were significantly higher among M3R reactive Th17 cells positive pSS patients than negative pSS patients.5)5 pSS patients positive for M3R reactive Th17 cells had significantly higher disease activity score (ESSDAI: 8.0±4.3) than 5 negative pSS patients (2.8±1.7) (P=0.01).Conclusion:We detected circulating M3R reactive Th17 cells in pSS patients using ELISpot, whose T cell epitopes were shown to be included in M3R AA76-95. Moreover, M3R reactive Th17 cells might correlate with higher disease activity and production of anti-M3R antibodies in pSS patients.References:[1]Tsuboi H, et al. New epitopes and function of anti-M3 muscarinic acetylcholine receptor antibodies in patients with Sjögren’s syndrome.Clin Exp Immunol2010;162:53-61[2]Naito Y, et al. Altered peptide ligands regulate muscarinic acetylcholine receptor reactive T cells of patients with Sjögren’s syndrome.Ann Rheum Dis2005;65:269-71[3]Iizuka M, et al. Pathogenic role of immune response to M3 muscarinic acetylcholine receptor in Sjögren’s syndrome-like sialoadenitis.J Autoimmun.2010;35:383-9Disclosure of Interests:None declared
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Mitsuishi N, Sugita Y, Bahramy MS, Kamitani M, Sonobe T, Sakano M, Shimojima T, Takahashi H, Sakai H, Horiba K, Kumigashira H, Taguchi K, Miyamoto K, Okuda T, Ishiwata S, Motome Y, Ishizaka K. Switching of band inversion and topological surface states by charge density wave. Nat Commun 2020; 11:2466. [PMID: 32424170 PMCID: PMC7235022 DOI: 10.1038/s41467-020-16290-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/25/2020] [Indexed: 11/10/2022] Open
Abstract
Topologically nontrivial materials host protected edge states associated with the bulk band inversion through the bulk-edge correspondence. Manipulating such edge states is highly desired for developing new functions and devices practically using their dissipation-less nature and spin-momentum locking. Here we introduce a transition-metal dichalcogenide VTe2, that hosts a charge density wave (CDW) coupled with the band inversion involving V3d and Te5p orbitals. Spin- and angle-resolved photoemission spectroscopy with first-principles calculations reveal the huge anisotropic modification of the bulk electronic structure by the CDW formation, accompanying the selective disappearance of Dirac-type spin-polarized topological surface states that exist in the normal state. Thorough three dimensional investigation of bulk states indicates that the corresponding band inversion at the Brillouin zone boundary dissolves upon the CDW formation, by transforming into anomalous flat bands. Our finding provides a new insight to the topological manipulation of matters by utilizing CDWs' flexible characters to external stimuli.
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Kamata A, Kurihara Y, Funakoshi T, Takahashi H, Kuroda K, Hachiya T, Amagai M, Yamagami J. How certain molecules of the immune system affect bullous pemphigoid. Br J Dermatol 2020. [DOI: 10.1111/bjd.18988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kamata A, Kurihara Y, Funakoshi T, Takahashi H, Kuroda K, Hachiya T, Amagai M, Yamagami J. 免疫系统的某些分子如何影响大疱性类天疱疮. Br J Dermatol 2020. [DOI: 10.1111/bjd.18999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Takahashi M, Uchihara T, Yoshida M, Wakabayashi K, Kakita A, Takahashi H, Toru S, Orimo S. Clinical and pathological features affecting cardiac sympathetic denervation in autopsy-confirmed dementia with Lewy bodies. Eur J Neurol 2020; 27:1155-1163. [PMID: 32239599 DOI: 10.1111/ene.14240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to clarify the features affecting cardiac sympathetic denervation in autopsy-confirmed dementia with Lewy bodies (DLB) patients. METHODS Fifty-four autopsy-confirmed DLB patients were enrolled. Tissue samples of the left ventricular anterior wall were immunostained with anti-tyrosine hydroxylase antibody to identify catecholaminergic nerve axons. Immunostained areas were quantified as residual cardiac sympathetic nerve (CSN) axons and the relationship between the degree of residual CSN axons and clinical and neuropathological features was examined. RESULTS Virtually all patients showed small amounts of residual CSN axons (0.87%, range 0.02%-9.98%), with 50 patients (92.6%) showing <2.0% of residual axons. The patients who showed psychological symptoms within the first year of the disease had significantly more residual CSN axons than the remaining patients did (1.50% vs. 0.40%, P < 0.01). Patients with a short disease duration and neocortical-type Lewy body pathology tended to have more preserved CSN axons, although this difference was not statistically significant. Fifty-three patients (98.1%) who had neurofibrillary tangles in the brain and strong concomitant Alzheimer's disease pathology also had statistically significantly more preserved CSN axons. The patient with the most preserved CSN axons showed different characteristics from the results, except for the first symptom. CONCLUSION Psychological symptoms within the first year of the disease, a short disease duration, neocortical-type Lewy body pathology and strong concomitant Alzheimer's disease pathology may be related to mild CSN degeneration in DLB patients. Thus, DLB patients with broad Lewy body pathology in the brain in the early stages may show mild CSN degeneration.
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Ii Tsujimura T, Mizuno Y, Yanai R, Tokuzawa T, Ito Y, Nishiura M, Kubo S, Shimozuma T, Yoshimura Y, Igami H, Takahashi H, Tanaka K, Yoshinuma M, Ohshima S. Real-time control of the deposition location of ECRH in the LHD. FUSION ENGINEERING AND DESIGN 2020. [DOI: 10.1016/j.fusengdes.2020.111480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stickley A, Koyanagi A, Takahashi H, Ruchkin V, Inoue Y, Kamio Y. Attention-deficit/hyperactivity disorder and physical multimorbidity: A population-based study. Eur Psychiatry 2020; 45:227-234. [DOI: 10.1016/j.eurpsy.2017.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 01/09/2023] Open
Abstract
AbstractBackground:There has been little research on the association of attention-deficit/hyperactivity disorder (ADHD) with co-occurring physical diseases. The aim of this study was to examine the association between possible ADHD and physical multimorbidity (i.e. = 2 physical diseases) among adults in the English general population.Methods:Data were analyzed from 7274 individuals aged = 18 years that came from the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed with the Adult Self-Report Scale (ASRS) Screener. Information was also obtained on 20 self-reported doctor/other health professional diagnosed physical health conditions present in the past 12 months. Multivariable logistic regression and mediation analyses were conducted to assess the associations.Results:There was a monotonic relation between the number of physical diseases and possible ADHD (ASRS score = 14). Compared to those with no diseases, individuals with = 5 diseases had over 3 times higher odds for possible ADHD (odds ratio [OR]: 3.30, 95% confidence interval [CI]: 2.48–4.37). This association was observed in all age groups. Stressful life events (% mediated 10.3–24.3%), disordered eating (6.8%), depression (12.8%), and anxiety (24.8%) were significant mediators in the association between possible ADHD and physical multimorbidity.Conclusion:Adults that screen positive for ADHD are at an increased risk for multimorbidity and several factors are important in this association. As many adults with ADHD remain undiagnosed, the results of this study highlight the importance of detecting adult ADHD as it may confer an increased risk for poorer health outcomes, including physical multimorbidity.
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Wells AU, Flaherty KR, Brown KK, Inoue Y, Devaraj A, Richeldi L, Moua T, Crestani B, Wuyts WA, Stowasser S, Quaresma M, Goeldner RG, Schlenker-Herceg R, Kolb M, Aburto M, Acosta O, Andrews C, Antin-Ozerkis D, Arce G, Arias M, Avdeev S, Barczyk A, Bascom R, Bazdyrev E, Beirne P, Belloli E, Bergna M, Bergot E, Bhatt N, Blaas S, Bondue B, Bonella F, Britt E, Buch K, Burk J, Cai H, Cantin A, Castillo Villegas D, Cazaux A, Cerri S, Chaaban S, Chaudhuri N, Cottin V, Crestani B, Criner G, Dahlqvist C, Danoff S, Dematte D'Amico J, Dilling D, Elias P, Ettinger N, Falk J, Fernández Pérez E, Gamez-Dubuis A, Giessel G, Gifford A, Glassberg M, Glazer C, Golden J, Gómez Carrera L, Guiot J, Hallowell R, Hayashi H, Hetzel J, Hirani N, Homik L, Hope-Gill B, Hotchkin D, Ichikado K, Ilkovich M, Inoue Y, Izumi S, Jassem E, Jones L, Jouneau S, Kaner R, Kang J, Kawamura T, Kessler R, Kim Y, Kishi K, Kitamura H, Kolb M, Kondoh Y, Kono C, Koschel D, Kreuter M, Kulkarni T, Kus J, Lebargy F, León Jiménez A, Luo Q, Mageto Y, Maher T, Makino S, Marchand-Adam S, Marquette C, Martinez R, Martínez M, Maturana Rozas R, Miyazaki Y, Moiseev S, Molina-Molina M, Morrison L, Morrow L, Moua T, Nambiar A, Nishioka Y, Nunes H, Okamoto M, Oldham J, Otaola M, Padilla M, Park J, Patel N, Pesci A, Piotrowski W, Pitts L, Poonyagariyagorn H, Prasse A, Quadrelli S, Randerath W, Refini R, Reynaud-Gaubert M, Riviere F, Rodríguez Portal J, Rosas I, Rossman M, Safdar Z, Saito T, Sakamoto N, Salinas Fénero M, Sauleda J, Schmidt S, Scholand M, Schwartz M, Shapera S, Shlobin O, Sigal B, Silva Orellana A, Skowasch D, Song J, Stieglitz S, Stone H, Strek M, Suda T, Sugiura H, Takahashi H, Takaya H, Takeuchi T, Thavarajah K, Tolle L, Tomassetti S, Tomii K, Valenzuela C, Vancheri C, Varone F, Veeraraghavan S, Villar A, Weigt S, Wemeau L, Wuyts W, Xu Z, Yakusevich V, Yamada Y, Yamauchi H, Ziora D. Nintedanib in patients with progressive fibrosing interstitial lung diseases-subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial. THE LANCET RESPIRATORY MEDICINE 2020; 8:453-460. [PMID: 32145830 DOI: 10.1016/s2213-2600(20)30036-9] [Citation(s) in RCA: 263] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis. METHODS The INBUILD trial was a randomised, double-blind, placebo-controlled, parallel group trial done at 153 sites in 15 countries. Participants had an investigator-diagnosed fibrosing ILD other than IPF, with chest imaging features of fibrosis of more than 10% extent on high resolution CT (HRCT), forced vital capacity (FVC) of 45% or more predicted, and diffusing capacity of the lung for carbon monoxide (DLco) of at least 30% and less than 80% predicted. Participants fulfilled protocol-defined criteria for ILD progression in the 24 months before screening, despite management considered appropriate in clinical practice for the individual ILD. Participants were randomly assigned 1:1 by means of a pseudo-random number generator to receive nintedanib 150 mg twice daily or placebo for at least 52 weeks. Participants, investigators, and other personnel involved in the trial and analysis were masked to treatment assignment until after database lock. In this subgroup analysis, we assessed the rate of decline in FVC (mL/year) over 52 weeks in patients who received at least one dose of nintedanib or placebo in five prespecified subgroups based on the ILD diagnoses documented by the investigators: hypersensitivity pneumonitis, autoimmune ILDs, idiopathic non-specific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, and other ILDs. The trial has been completed and is registered with ClinicalTrials.gov, number NCT02999178. FINDINGS Participants were recruited between Feb 23, 2017, and April 27, 2018. Of 663 participants who received at least one dose of nintedanib or placebo, 173 (26%) had chronic hypersensitivity pneumonitis, 170 (26%) an autoimmune ILD, 125 (19%) idiopathic non-specific interstitial pneumonia, 114 (17%) unclassifiable idiopathic interstitial pneumonia, and 81 (12%) other ILDs. The effect of nintedanib versus placebo on reducing the rate of FVC decline (mL/year) was consistent across the five subgroups by ILD diagnosis in the overall population (hypersensitivity pneumonitis 73·1 [95% CI -8·6 to 154·8]; autoimmune ILDs 104·0 [21·1 to 186·9]; idiopathic non-specific interstitial pneumonia 141·6 [46·0 to 237·2]; unclassifiable idiopathic interstitial pneumonia 68·3 [-31·4 to 168·1]; and other ILDs 197·1 [77·6 to 316·7]; p=0·41 for treatment by subgroup by time interaction). Adverse events reported in the subgroups were consistent with those reported in the overall population. INTERPRETATION The INBUILD trial was not designed or powered to provide evidence for a benefit of nintedanib in specific diagnostic subgroups. However, its results suggest that nintedanib reduces the rate of ILD progression, as measured by FVC decline, in patients who have a chronic fibrosing ILD and progressive phenotype, irrespective of the underlying ILD diagnosis. FUNDING Boehringer Ingelheim.
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Homma K, Takahashi H, Tsuburaya N, Naguro I, Fujisawa T, Ichijo H. Genome-wide siRNA screening reveals that DCAF4-mediated ubiquitination of optineurin stimulates autophagic degradation of Cu,Zn-superoxide dismutase. J Biol Chem 2020; 295:3148-3158. [PMID: 32014991 DOI: 10.1074/jbc.ra119.010239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/26/2020] [Indexed: 12/12/2022] Open
Abstract
Cu, Zn superoxide dismutase (SOD1) is one of the genes implicated in the devastating neurodegenerative disorder amyotrophic lateral sclerosis (ALS). Although the precise mechanisms of SOD1 mutant (SOD1mut)-induced motoneuron toxicity are still unclear, defects in SOD1 proteostasis are known to have a critical role in ALS pathogenesis. We previously reported that the SOD1mut adopts a conformation that exposes a Derlin-1-binding region (DBR) and that DBR-exposed SOD1 interacts with Derlin-1, leading to motoneuron death. We also found that an environmental change, i.e. zinc depletion, induces a conformational change in WT SOD1 (SOD1WT) to the DBR-exposed conformation, suggesting the presence of an equilibrium state between the DBR-masked and DBR-exposed states even with SOD1WT Here, we conducted a high-throughput screening based on time-resolved FRET to further investigate the SOD1WT conformational change, and we used a genome-wide siRNA screen to search for regulators of SOD1 proteostasis. This screen yielded 30 candidate genes that maintained an absence of the DBR-exposed SOD1WT conformation. Among these genes was one encoding DDB1- and CUL4-associated factor 4 (DCAF4), a substrate receptor of the E3 ubiquitin-protein ligase complex. Of note, we found that DCAF4 mediates the ubiquitination of an ALS-associated protein and autophagy receptor, optineurin (OPTN), and facilitates autophagic degradation of DBR-exposed SOD1. In summary, our screen identifies DCAF4 as being required for proper proteostasis of DBR-exposed SOD1, which may have potential relevance for the development of therapies for managing ALS.
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Matsukuma S, Eguchi H, Wada H, Noda T, Shindo Y, Tokumitsu Y, Matsui H, Takahashi H, Kobayashi S, Nagano H. Liver resection with thrombectomy for patients with hepatocellular carcinoma and tumour thrombus in the inferior vena cava or right atrium. BJS Open 2020; 4:241-251. [PMID: 32012492 PMCID: PMC7093783 DOI: 10.1002/bjs5.50258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 02/06/2023] Open
Abstract
Background Hepatocellular carcinoma (HCC) with tumour thrombus (TT) in the inferior vena cava (IVC) or right atrium (RA) is a rare advanced disease state with a poor prognosis. The aim of this study was to examine survival after surgical resection. Methods Patients with HCC and TT of either the IVC or RA, who underwent liver resection between February 1997 and July 2017, were included. Their short‐ and long‐term outcomes and surgical details were analysed retrospectively. Results Thirty‐seven patients were included; 16 patients had TT in the IVC below the diaphragm, eight had TT in the IVC above the diaphragm, and 13 had TT entering the RA. Twelve patients had advanced portal vein TT (portal vein invasion (Vp) greater than Vp3 and Vp4), ten had bilobar disease, and 12 had extrahepatic disease. There were no in‐hospital deaths, although two patients died within 90 days. Median survival did not differ between patients who had resection with curative intent (18·7 months) and those with residual tumour in the lung only (20·7 months), but survival was poor for patients with residual tumour in the liver (8·3 months). Conclusion Liver resection with thrombectomy for advanced HCC with TT in the IVC or RA is safe and feasible, leading to moderate survival.
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Betzwieser J, Bhandare R, Bidler J, Bilenko IA, Bilgili SA, Billingsley G, Birch J, Birney R, Birnholtz O, Biscans S, Biscoveanu S, Bisht A, Bitossi M, Bizouard MA, Blackburn JK, Blair CD, Blair DG, Blair RM, Bloemen S, Bode N, Boer M, Boetzel Y, Bogaert G, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Booth CD, Bork R, Boschi V, Bose S, Bossie K, Bossilkov V, Bosveld J, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branchesi M, Brau JE, Briant T, Briggs JH, Brighenti F, Brillet A, Brinkmann M, Brisson V, Brockill P, Brooks AF, Brown DA, Brown DD, Brunett S, Buikema A, Bulik T, Bulten HJ, Buonanno A, Buskulic D, Buy C, Byer RL, Cabero M, Cadonati L, Cagnoli G, Cahillane C, Bustillo JC, Callister TA, Calloni E, Camp JB, Campbell WA, Canepa M, Cannon K, Cannon KC, Cao H, Cao J, Capocasa E, Carbognani F, Caride S, Carney MF, Carullo G, Diaz JC, Casentini C, Caudill S, Cavaglià M, Cavalier F, Cavalieri R, Cella G, Cerdá-Durán P, Cerretani G, Cesarini E, Chaibi O, 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Costa CF, Datrier LEH, Dattilo V, Dave I, Davier M, Davis D, Daw EJ, DeBra D, Deenadayalan M, Degallaix J, De Laurentis M, Deléglise S, Pozzo WD, DeMarchi LM, Demos N, Dent T, De Pietri R, Derby J, De Rosa R, De Rossi C, DeSalvo R, de Varona O, Dhurandhar S, Díaz MC, Dietrich T, Fiore LD, Giovanni MD, Girolamo TD, Lieto AD, Ding B, Pace SD, Palma ID, Renzo FD, Dmitriev A, Doctor Z, Doi K, Donovan F, Dooley KL, Doravari S, Dorrington I, Downes TP, Drago M, Driggers JC, Du Z, Ducoin JG, Dupej P, Dwyer SE, Easter PJ, Edo TB, Edwards MC, Effler A, Eguchi S, Ehrens P, Eichholz J, Eikenberry SS, Eisenmann M, Eisenstein RA, Enomoto Y, Essick RC, Estelles H, Estevez D, Etienne ZB, Etzel T, Evans M, Evans TM, Fafone V, Fair H, Fairhurst S, Fan X, Farinon S, Farr B, Farr WM, Fauchon-Jones EJ, Favata M, Fays M, Fazio M, Fee C, Feicht J, Fejer MM, Feng F, Fernandez-Galiana A, Ferrante I, Ferreira EC, Ferreira TA, Ferrini F, Fidecaro F, Fiori I, Fiorucci D, Fishbach M, Fisher RP, Fishner JM, Fitz-Axen M, Flaminio R, Fletcher M, Flynn E, Fong H, Font JA, Forsyth PWF, Fournier JD, Frasca S, Frasconi F, Frei Z, Freise A, Frey R, Frey V, Fritschel P, Frolov VV, Fujii Y, Fukunaga M, Fukushima M, Fulda P, Fyffe M, Gabbard HA, Gadre BU, Gaebel SM, Gair JR, Gammaitoni L, Ganija MR, Gaonkar SG, Garcia A, García-Quirós C, Garufi F, Gateley B, Gaudio S, Gaur G, Gayathri V, Ge GG, Gemme G, Genin E, Gennai A, George D, George J, Gergely L, Germain V, Ghonge S, Ghosh A, Ghosh A, Ghosh S, Giacomazzo B, Giaime JA, Giardina KD, Giazotto A, Gill K, Giordano G, Glover L, Godwin P, Goetz E, Goetz R, Goncharov B, González G, Castro JMG, Gopakumar A, Gorodetsky ML, Gossan SE, Gosselin M, Gouaty R, Grado A, Graef C, Granata M, Grant A, Gras S, Grassia P, Gray C, Gray R, Greco G, Green AC, Green R, Gretarsson EM, Groot P, Grote H, Grunewald S, Gruning P, Guidi GM, Gulati HK, Guo Y, Gupta A, Gupta MK, Gustafson EK, Gustafson R, Haegel L, Hagiwara A, Haino S, Halim O, Hall BR, Hall ED, Hamilton EZ, Hammond G, Haney M, Hanke MM, Hanks J, Hanna C, Hannam MD, Hannuksela OA, Hanson J, Hardwick T, Haris K, Harms J, Harry GM, Harry IW, Hasegawa K, Haster CJ, Haughian K, Hayakawa H, Hayama K, Hayes FJ, Healy J, Heidmann A, Heintze MC, Heitmann H, Hello P, Hemming G, Hendry M, Heng IS, Hennig J, Heptonstall AW, Heurs M, Hild S, Himemoto Y, Hinderer T, Hiranuma Y, Hirata N, Hirose E, Hoak D, Hochheim S, Hofman D, Holgado AM, Holland NA, Holt K, Holz DE, Hong Z, Hopkins P, Horst C, Hough J, Howell EJ, Hoy CG, Hreibi A, Hsieh BH, Huang GZ, Huang PW, Huang YJ, Huerta EA, Huet D, Hughey B, Hulko M, Husa S, Huttner SH, Huynh-Dinh T, Idzkowski B, Iess A, Ikenoue B, Imam S, Inayoshi K, Ingram C, Inoue Y, Inta R, Intini G, Ioka K, Irwin B, Isa HN, Isac JM, Isi M, Itoh Y, Iyer BR, Izumi K, Jacqmin T, Jadhav SJ, Jani K, Janthalur NN, Jaranowski P, Jenkins AC, Jiang J, Johnson DS, Jones AW, Jones DI, Jones R, Jonker RJG, Ju L, Jung K, Jung P, Junker J, Kajita T, Kalaghatgi CV, Kalogera V, Kamai B, Kamiizumi M, Kanda N, Kandhasamy S, Kang GW, Kanner JB, Kapadia SJ, Karki S, Karvinen KS, Kashyap R, Kasprzack M, Katsanevas S, Katsavounidis E, Katzman W, Kaufer S, Kawabe K, Kawaguchi K, Kawai N, Kawasaki T, Keerthana NV, Kéfélian F, Keitel D, Kennedy R, Key JS, Khalili FY, Khan H, Khan I, Khan S, Khan Z, Khazanov EA, Khursheed M, Kijbunchoo N, Kim C, Kim C, Kim JC, Kim J, Kim K, Kim W, Kim WS, Kim YM, Kimball C, Kimura N, King EJ, King PJ, Kinley-Hanlon M, Kirchhoff R, Kissel JS, Kita N, Kitazawa H, Kleybolte L, Klika JH, Klimenko S, Knowles TD, Knyazev E, Koch P, Koehlenbeck SM, Koekoek G, Kojima Y, Kokeyama K, Koley S, Komori K, Kondrashov V, Kong AKH, Kontos A, Koper N, Korobko M, Korth WZ, Kotake K, Kowalska I, Kozak DB, Kozakai C, Kozu R, Kringel V, Krishnendu N, Królak A, Kuehn G, Kumar A, Kumar P, Kumar R, Kumar R, Kumar S, Kume J, Kuo CM, Kuo HS, Kuo L, Kuroyanagi S, Kusayanagi K, Kutynia A, Kwak K, Kwang S, Lackey BD, Lai KH, Lam TL, Landry M, Lane BB, Lang RN, Lange J, Lantz B, Lanza RK, Lartaux-Vollard A, Lasky PD, Laxen M, Lazzarini A, Lazzaro C, Leaci P, Leavey S, Lecoeuche YK, Lee CH, Lee HK, Lee HM, Lee HW, Lee J, Lee K, Lee RK, Lehmann J, Lenon A, Leonardi M, Leroy N, Letendre N, Levin Y, Li J, Li KJL, Li TGF, Li X, Lin CY, Lin F, Lin FL, Lin LCC, Linde F, Linker SD, Littenberg TB, Liu GC, Liu J, Liu X, Lo RKL, Lockerbie NA, London LT, Longo A, Lorenzini M, Loriette V, Lormand M, Losurdo G, Lough JD, Lousto CO, Lovelace G, Lower ME, Lück H, Lumaca D, Lundgren AP, Luo LW, Lynch R, Ma Y, Macas R, Macfoy S, MacInnis M, Macleod DM, Macquet A, Magaña-Sandoval F, Zertuche LM, Magee RM, Majorana E, Maksimovic I, Malik A, Man N, Mandic V, Mangano V, Mansell GL, Manske M, Mantovani M, Marchesoni F, Marchio M, Marion F, Márka S, Márka Z, Markakis C, Markosyan AS, Markowitz A, Maros E, Marquina A, Marsat S, Martelli F, Martin IW, Martin RM, Martynov DV, Mason K, Massera E, Masserot A, Massinger TJ, Masso-Reid M, Mastrogiovanni S, Matas A, Matichard F, Matone L, Mavalvala N, Mazumder N, McCann JJ, McCarthy R, McClelland DE, McCormick S, McCuller L, McGuire SC, McIver J, McManus DJ, McRae T, McWilliams ST, Meacher D, Meadors GD, Mehmet M, Mehta AK, Meidam J, Melatos A, Mendell G, Mercer RA, Mereni L, Merilh EL, Merzougui M, Meshkov S, Messenger C, Messick C, Metzdorff R, Meyers PM, Miao H, Michel C, Michimura Y, Middleton H, Mikhailov EE, Milano L, Miller AL, Miller A, Millhouse M, Mills JC, Milovich-Goff MC, Minazzoli O, Minenkov Y, Mio N, Mishkin A, Mishra C, Mistry T, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Miyamoto A, Miyazaki Y, Miyo K, Miyoki S, Mo G, Moffa D, Mogushi K, Mohapatra SRP, Montani M, Moore CJ, Moraru D, Moreno G, Morisaki S, Moriwaki Y, Mours B, Mow-Lowry CM, Mukherjee A, Mukherjee D, Mukherjee S, Mukund N, Mullavey A, Munch J, Muñiz EA, Muratore M, Murray PG, Nagano K, Nagano S, Nagar A, Nakamura K, Nakano H, Nakano M, Nakashima R, Nardecchia I, Narikawa T, Naticchioni L, Nayak RK, Negishi R, Neilson J, Nelemans G, Nelson TJN, Nery M, Neunzert A, Ng KY, Ng S, Nguyen P, Ni WT, Nichols D, Nishizawa A, Nissanke S, Nocera F, North C, Nuttall LK, Obergaulinger M, Oberling J, O’Brien BD, Obuchi Y, O’Dea GD, Ogaki W, Ogin GH, Oh JJ, Oh SH, Ohashi M, Ohishi N, Ohkawa M, Ohme F, Ohta H, Okada MA, Okutomi K, Oliver M, Oohara K, Ooi CP, Oppermann P, Oram RJ, O’Reilly B, Ormiston RG, Ortega LF, O’Shaughnessy R, Oshino S, Ossokine S, Ottaway DJ, Overmier H, Owen BJ, Pace AE, Pagano G, Page MA, Pai A, Pai SA, Palamos JR, Palashov O, Palomba C, Pal-Singh A, Pan HW, Pan KC, Pang B, Pang HF, Pang PTH, Pankow C, Pannarale F, Pant BC, Paoletti F, Paoli A, Papa MA, Parida A, Park J, Parker W, Pascucci D, Pasqualetti A, Passaquieti R, Passuello D, Patil M, Patricelli B, Pearlstone BL, Pedersen C, Pedraza M, Pedurand R, Pele A, Arellano FEP, Penn S, Perez CJ, Perreca A, Pfeiffer HP, Phelps M, Phukon KS, Piccinni OJ, Pichot M, Piergiovanni F, Pillant G, Pinard L, Pinto I, Pirello M, Pitkin M, Poggiani R, Pong DYT, Ponrathnam S, Popolizio P, Porter EK, Powell J, Prajapati AK, Prasad J, Prasai K, Prasanna R, Pratten G, Prestegard T, Privitera S, Prodi GA, Prokhorov LG, Puncken O, Punturo M, Puppo P, Pürrer M, Qi H, Quetschke V, Quinonez PJ, Quintero EA, Quitzow-James R, Raab FJ, Radkins H, Radulescu N, Raffai P, Raja S, Rajan C, Rajbhandari B, Rakhmanov M, Ramirez KE, Ramos-Buades A, Rana J, Rao K, Rapagnani P, Raymond V, Razzano M, Read J, Regimbau T, Rei L, Reid S, Reitze DH, Ren W, Ricci F, Richardson CJ, Richardson JW, Ricker PM, Riles K, Rizzo M, Robertson NA, Robie R, Robinet F, Rocchi A, Rolland L, Rollins JG, Roma VJ, Romanelli M, Romano R, Romel CL, Romie JH, Rose K, Rosińska D, Rosofsky SG, Ross MP, Rowan S, Rüdiger A, Ruggi P, Rutins G, Ryan K, Sachdev S, Sadecki T, Sago N, Saito S, Saito Y, Sakai K, Sakai Y, Sakamoto H, Sakellariadou M, Sakuno Y, Salconi L, Saleem M, Samajdar A, Sammut L, Sanchez EJ, Sanchez LE, Sanchis-Gual N, Sandberg V, Sanders JR, Santiago KA, Sarin N, Sassolas B, Sathyaprakash BS, Sato S, Sato T, Sauter O, Savage RL, Sawada T, Schale P, Scheel M, Scheuer J, Schmidt P, Schnabel R, Schofield RMS, Schönbeck A, Schreiber E, Schulte BW, Schutz BF, Schwalbe SG, Scott J, Scott SM, Seidel E, Sekiguchi T, Sekiguchi Y, Sellers D, Sengupta AS, Sennett N, Sentenac D, Sequino V, Sergeev A, Setyawati Y, Shaddock DA, Shaffer T, Shahriar MS, Shaner MB, Shao L, Sharma P, Shawhan P, Shen H, Shibagaki S, Shimizu R, Shimoda T, Shimode K, Shink R, Shinkai H, Shishido T, Shoda A, Shoemaker DH, Shoemaker DM, ShyamSundar S, Siellez K, Sieniawska M, Sigg D, Silva AD, Singer LP, Singh N, Singhal A, Sintes AM, Sitmukhambetov S, Skliris V, Slagmolen BJJ, Slaven-Blair TJ, Smith JR, Smith RJE, Somala S, Somiya K, Son EJ, Sorazu B, Sorrentino F, Sotani H, Souradeep T, Sowell E, Spencer AP, Srivastava AK, Srivastava V, Staats K, Stachie C, Standke M, Steer DA, Steinke M, Steinlechner J, Steinlechner S, Steinmeyer D, Stevenson SP, Stocks D, Stone R, Stops DJ, Strain KA, Stratta G, Strigin SE, Strunk A, Sturani R, Stuver AL, Sudhir V, Sugimoto R, Summerscales TZ, Sun L, Sunil S, Suresh J, Sutton PJ, Suzuki T, Suzuki T, Swinkels BL, Szczepańczyk MJ, Tacca M, Tagoshi H, Tait SC, Takahashi H, Takahashi R, Takamori A, Takano S, Takeda H, Takeda M, Talbot C, Talukder D, Tanaka H, Tanaka K, Tanaka K, Tanaka T, Tanaka T, Tanioka S, Tanner DB, Tápai M, Martin ENTS, Taracchini A, Tasson JD, Taylor R, Telada S, Thies F, Thomas M, Thomas P, Thondapu SR, Thorne KA, Thrane E, Tiwari S, Tiwari S, Tiwari V, Toland K, Tomaru T, Tomigami Y, Tomura T, Tonelli M, Tornasi Z, Torres-Forné A, Torrie CI, Töyrä D, Travasso F, Traylor G, Tringali MC, Trovato A, Trozzo L, Trudeau R, Tsang KW, Tsang TTL, Tse M, Tso R, Tsubono K, Tsuchida S, Tsukada L, Tsuna D, Tsuzuki T, Tuyenbayev D, Uchikata N, Uchiyama T, Ueda A, Uehara T, Ueno K, Ueshima G, Ugolini D, Unnikrishnan CS, Uraguchi F, Urban AL, Ushiba T, Usman SA, Vahlbruch H, Vajente G, Valdes G, Bakel NV, Beuzekom MV, Brand JFJVD, Broeck CVD, Vander-Hyde DC, Schaaf LVD, Heijningen JVV, Putten MHPMV, Veggel AAV, Vardaro M, Varma V, Vass S, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venugopalan G, Verkindt D, Vetrano F, Viceré A, Viets AD, Vine DJ, Vinet JY, Vitale S, Vivanco FH, Vo T, Vocca H, Vorvick C, Vyatchanin SP, Wade AR, Wade LE, Wade M, Walet R, Walker M, Wallace L, Walsh S, Wang G, Wang H, Wang J, Wang JZ, Wang WH, Wang YF, Ward RL, Warden ZA, Warner J, Was M, Watchi J, Weaver B, Wei LW, Weinert M, Weinstein AJ, Weiss R, Wellmann F, Wen L, Wessel EK, Weßels P, Westhouse JW, Wette K, Whelan JT, Whiting BF, Whittle C, Wilken DM, Williams D, Williamson AR, Willis JL, Willke B, Wimmer MH, Winkler W, Wipf CC, Wittel H, Woan G, Woehler J, Wofford JK, Worden J, Wright JL, Wu CM, Wu DS, Wu HC, Wu SR, Wysocki DM, Xiao L, Xu WR, Yamada T, Yamamoto H, Yamamoto K, Yamamoto K, Yamamoto T, Yancey CC, Yang L, Yap MJ, Yazback M, Yeeles DW, Yokogawa K, Yokoyama J, Yokozawa T, Yoshioka T, Yu H, Yu H, Yuen SHR, Yuzurihara H, Yvert M, Zadrożny AK, Zanolin M, Zeidler S, Zelenova T, Zendri JP, Zevin M, Zhang J, Zhang L, Zhang T, Zhao C, Zhao Y, Zhou M, Zhou Z, Zhu XJ, Zhu ZH, Zimmerman AB, Zucker ME, Zweizig J. Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA. LIVING REVIEWS IN RELATIVITY 2020; 23:3. [PMID: 33015351 PMCID: PMC7520625 DOI: 10.1007/s41114-020-00026-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/27/2020] [Indexed: 05/05/2023]
Abstract
We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star-black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 10 5 , 10 6 , 10 7 Mpc 3 for binary neutron star, neutron star-black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1 - 1 + 12 ( 10 - 10 + 52 ) for binary neutron star mergers, of 0 - 0 + 19 ( 1 - 1 + 91 ) for neutron star-black hole mergers, and 17 - 11 + 22 ( 79 - 44 + 89 ) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers.
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Grob U, Krass MD, Héritier M, Pachlatko R, Rhensius J, Košata J, Moores BA, Takahashi H, Eichler A, Degen CL. Magnetic Resonance Force Microscopy with a One-Dimensional Resolution of 0.9 Nanometers. NANO LETTERS 2019; 19:7935-7940. [PMID: 31647666 DOI: 10.1021/acs.nanolett.9b03048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Magnetic resonance force microscopy (MRFM) is a scanning probe technique capable of detecting MRI signals from nanoscale sample volumes, providing a paradigm-changing potential for structural biology and medical research. Thus far, however, experiments have not reached sufficient spatial resolution for retrieving meaningful structural information from samples. In this work, we report MRFM imaging scans demonstrating a resolution of 0.9 nm and a localization precision of 0.6 nm in one dimension. Our progress is enabled by an improved spin excitation protocol furnishing us with sharp spatial control on the MRFM imaging slice, combined with overall advances in instrument stability. From a modeling of the slice function, we expect that our arrangement supports spatial resolutions down to 0.3 nm given sufficient signal-to-noise ratio. Our experiment demonstrates the feasibility of subnanometer MRI and realizes an important milestone toward the three-dimensional imaging of macromolecular structures.
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Tanaka H, Toyoshima Y, Kawakatsu S, Kobayashi R, Yokota O, Terada S, Kuroda S, Miura T, Higuchi Y, Otsu H, Sanpei K, Otani K, Ikeuchi T, Onodera O, Kakita A, Takahashi H. Morphological characterisation of glial and neuronal tau pathology in globular glial tauopathy (Types II and III). Neuropathol Appl Neurobiol 2019; 46:344-358. [DOI: 10.1111/nan.12581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
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Miyoshi N, Fujino S, Saso K, Sasaki M, Ogino T, Takahashi H, Uemura M, Chu M, Mizushima T, Mori M, Doki Y. Patient-derived tumour model by new culture method leading to the precision medicine. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz421.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kono K, Matsuda K, Machii R, Saika K, Takahashi H, Nakayama T. The status of compliance with guidelines of cancer screening in Japan. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Ministry of Health, Labour and Welfare (MHLW) establishes screening recommendations specifying screening methods, age, and interval for gastric, colon, lung, breast, and cervical cancers. Screening programs are provided via local healthcare departments (LHD), who are responsible for managing programs and reporting the screening status through a survey annually.
Methods
We analyzed screening status provided by LHDs in fiscal 2017 in regards to appropriate screening age and interval. Briefly, current recommended screening age by MHLW is followed: colon, lung, breast cancer screening are age 40 years and older, and cervical cancer for aged 20 and older, and gastric cancer for aged 50 and older. Screening intervals are gastric, breast, and cervical cancer screening are two years, and colon and lung cancer screening are one year.
Results
The survey was completed by 1736 LHD (response rate: 99.9%). Regarding age-appropriate compliance, in cervical cancer, 96.4% of LHDs reported following recommended target age, while compliance was lower for lung, colon, breast, and gastric cancers at 79.4%, 75.7%, 60.2% and 4.2%, respectively. High compliance with recommendations for screening interval was identified for colon (99.7%) and lung (98.7%) cancers; this was substantially less for breast, cervical, and gastric cancer screening at 39.8%, 34.1%, and 4.6%, respectively.
Conclusions
In 2016, MLHW changed the starting screening age for gastric cancer from 40 to 50 years old, likely resulting in the lowest compliance in our analysis. Though it may take time for screening facilities to come into compliance with newer recommendations. Many LHDs provide screening without adhering to recommended starting ages, with a general tendency to provide screening at younger than recommended ages. This is a barrier to maximizing effectiveness and minimize harms of screening and warrants closer monitoring to promote efficiency in cancer screening programs.
Key messages
There is relatively low compliance with cancer screening guidelines in Japan. Establishing an environment of appropriate monitoring and support to achieve the goal of cancer screening is warranted.
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Kamata A, Kurihara Y, Funakoshi T, Takahashi H, Kuroda K, Hachiya T, Amagai M, Yamagami J. Basement membrane zone IgE deposition is associated with bullous pemphigoid disease severity and treatment results. Br J Dermatol 2019; 182:1221-1227. [PMID: 31330562 DOI: 10.1111/bjd.18364] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND A subset of patients with bullous pemphigoid (BP) show deposition of IgE in the basement membrane zone (BMZ), yet the relationship between BMZ IgE and the clinical presentation of BP remains unclear. OBJECTIVES To investigate the relationship between IgE deposition, IgE levels in serum, and disease severity in patients with BP. METHODS We investigated IgE autoantibodies in 53 patients with BP by direct immunofluorescence (DIF), indirect immunofluorescence and enzyme-linked immunosorbent assay. RESULTS Of 53 patients with BP, 23 (43%) had IgE deposition, 10 (19%) of whom were IgE+ and 13 (25%) IgE± according to DIF analyses. Erosion/blister (E/B) Bullous Pemphigoid Disease Area Index (BPDAI) scores were significantly higher in IgE+ patients than in IgE- patients (n = 15), while no significant differences were found for urticaria/erythema BPDAI scores. IgE+ and IgE± patients took longer to reduce their E/B BPDAI score by 75% after systemic corticosteroid treatment. BP180-IgE levels were significantly higher among IgE+ patients than IgE± or IgE- patients (n = 10). Total IgE levels in the serum and blood eosinophil counts did not differ between IgE+, IgE± and IgE- patients. A significant correlation was detected between BP180-IgG and BP180-IgE, but not between BPDAI scores and any of BP180-IgG, BP180-IgE or blood eosinophil count. CONCLUSIONS IgE deposition in the BMZ is associated with higher E/B BPDAI scores and longer treatment periods. We conclude that IgE binding in the BMZ may contribute to BP pathogenesis by promoting blister formation. What's already known about this topic? BP180-IgE autoantibodies have an important role in the pathogenesis of bullous pemphigoid (BP). A subset of patients with BP display deposition of IgE within the basement membrane zone (BMZ) of skin tissue. What does this study add? Patients with in vivo IgE deposition in the BMZ displayed higher erosion/blister Bullous Pemphigoid Disease Area Index (BPDAI) scores, while urticaria/erythema BPDAI scores were not significantly different. Patients with in vivo IgE deposition in the BMZ took longer to reduce their erosion/blister BPDAI score by 75% after systemic corticosteroid treatment. BP180-specific IgE levels in serum were higher among patients with linear IgE deposition in the BMZ than in those with granular or no IgE deposition.
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Matsubara D, Takahashi H, Kataoka K, Minami T, Furukawa R, Matsubara S, Yamagata T. Tracheal stenosis due to vascular rings: its possible prenatal diagnosis based on four cases of vascular rings with or without eventual tracheal stenosis. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4787.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kenichiro Y, Oguri M, Takahara K, Sumi T, Takahashi H, Ishii H, Murohara T. P2619Combined evaluation of nutrition screening indexes on long-term mortality in patients hospitalized for acute heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Along with an aging society, the global burden of heart failure (HF) is evident in Japan. Recent reports showed that malnutrition is one of the frequent comorbidity in patients with HF, and this grievous issue is related to worsening prognosis in such subjects. There are many screening tools of nutrition risks, however, feasible indexes or strategies for evaluating nutrition risk in patients with HF remain to be identified definitively.
Purpose
The purpose of the present study was to examine the effectiveness of various nutrition indexes on 3-year mortality in hospitalized acute HF patients.
Methods
The study population comprised a total of 817 individuals who were hospitalized for acute HF between November 2009 and December 2015, and was followed up for 3 years. All the previously established objective nutritional indexes [The controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and subjective global assessment (SGA)] were evaluated at the time of hospital admission. Malnutrition status of each index was defined as CONUT score ≥5, GNRI <91, or SGA (B and C), respectively. We evaluated combined predictive values of these indexes for 3-year mortality by Cox regression model, and calculated the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI).
Results
The median age was 79 (interquartile range 70–85) years, and 55.7% of the subjects were male. The frequency of malnutrition was 18.1% in CONUT score, 31.9% in GNRI, and 25.9% in SGA. The rate of 3-year mortality was 32.2%. All indexes were related to the occurrence of 3-year mortality by univariate analyses (P<0.001). We examined combined predictive values by calculating multivariable-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for associations of malnutrition by these 3 indexes and prognostic variables identified by multivariable Cox regression model (age, body mass index, systolic blood pressure, reduced eGFR, albumin, and prior HF hospitalization). Malnutrition of all 3 indexes (5.6% of the subjects) was associated with higher relative risk of 3-year mortality than well-nutrition (aHR 1.90; 95% CI 1.07–3.35, P=0.028), or malnutrition of any 1 index (aHR 1.95; 95% CI 1.18–3.21, P=0.009). Next, we individually included each value into a reference model (age, body mass index, reduced eGFR, albumin, prior HF hospitalization, and ischemic etiology by multivariable logistic regression analysis with P<0.05). SGA was superior according to comprehensive discrimination, calibration, and reclassification analysis (NRI 0.212, P=0.003; IDI 0.005, P=0.029). Similar analysis with other indexes (CONUT score or GNRI) revealed no improvement.
Conclusion
Our present results suggest that simultaneous addition of CONUT, GNRI, and SGA seems useful for predicting long-term mortality in acute HF. In addition, nutritional screening with SGA independently improves mortality risk stratification.
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Aono T, Watanabe T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. 5950Lymphocyte-to-monocyte ratio could predict adverse clinical outcomes in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure with preserved ejection fraction (HFpEF) is increasing with aging of the population, whereas the mechanisms of HFpEF remain poorly understood. It was reported that systemic inflammation is associated with pathophysiology of HFpEF. Lymphocyte-to-monocyte ratio (LMR) is a marker of systemic inflammation, which predicts clinical outcomes in various cancers. However, the prognostic value of LMR has not yet been elucidated in patients with HFpEF.
Purpose
The aim of this study was to investigate the impact of LMR on clinical outcomes in patients with HFpEF.
Methods and results
We prospectively analyzed 414 consecutive patients with HFpEF. Preserved EF was defined as an EF ≥50%. During a median follow-up period of 740 days, there were 111 major adverse cardiovascular events (MACE). When patients were divided into tertiles according to LMR, Kaplan-Meier analysis demonstrated that the low LMR was associated with the greatest risk for MACE. Multivariate Cox proportional hazard regression analysis showed that the low LMR was significantly associated with MACE after adjustment for confounding factors.
Conclusions
Low LMR could predict poor clinical outcomes in patients with HFpEF. LMR is a feasible marker for predicting MACE in patients with HFpEF.
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Shoji T, Kikuchi E, Kikuchi J, Maeda M, Takashima Y, Furuta M, Takahashi H, Kinoshita I, Dosaka-Akita H, Sakakibara-Konishi J, Konno S. P2.03-53 Immunoproteasome as a Potential Therapeutic Target in Cisplatin-Resistant Small and Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Miyajima K, Motoyama S, Sarai M, Kawai H, Takahashi H, Muramatsu T, Naruse H, Ishii J, Ozaki Y. P6178The optimal point of CT-FFR measurement in comparison with invasive FFR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Currently, invasive fractional flow reserve (FFR), has become a gold standard to select patients requiring revascularization. Coronary computed tomography angiography (CTA) -derived FFR (FFRCT/CT-FFR) can be used for the management of coronary artery disease, which would be a gatekeeper of invasive coronary angiography. In most of the previous report to evaluate the diagnostic performance of FFRCT/CT-FFR, FFRCT/CT-FFR value was measured at the same point as the invasive FFR. Clinically, FFRCT/CT-FFR should be measured without the information of invasive FFR. However, optimal measurement point for CT-FFR has not been established yet.
Purpose
To assess the optimal measurement point of CT-FFR in comparison with invasive FFR as a gold standard.
Methods
CTA images scanned at 70–99% of R-R interval with 320 slice CT were screened. In the de-novo lesions with invasive FFR data were included in this study. Since calcified lesions could affect CT-FFR value, severe calcified lesions on CTA were excluded from the analysis. The CT-FFR analysis was performed by 2 cardiologists blinded to the results of the invasive FFR using a standard desktop computer and dedicated software. CT-FFR values could be provided at any point from ostium of coronary artery to the distal with vessel diameter of 1.8mm. To determine the optimal point for measurement of CT-FFR, CT-FFR values were obtained at 3 points in each coronary artery; 1) at the same point as invasive FFR; 2) lowest CT-FFR at distal point of coronary artery; 3) at 2.0 cm distal to the lesion. The diagnostic performance at each point was compared with invasive FFR.
Results
Fifty vessels of 44 patients (average age 68 years, male were 32) were included. Average Agatston score was 279.4. There was significant correlation between CT-FFR at each point and invasive FFR. CT-FFR at the same point as invasive FFR showed the good correlation with invasive FFR (R=0.641, 95% CI= 0.041–0.127, p<0.0001). Compared to the lowest CT-FFR at distal (R=0.608, 95% CI= 0.069–0.160, p<0.0001), CT-FFR at 2.0 cm distal to the lesion (R=0.604, 95% CI= 0.007–0.061, p<0.0001) revealed better correlation with invasive FFR. Sensitivity, specificity, positive and negative predictive value at each point were 92.8 / 93.3 / 81.8; 75.0 / 57.1 / 94.2; 61.9 / 48.2 / 60.0; and 96.0 / 95.2 / 84.6, respectively. Diagnostic accuracy showed that CT-FFR at 2cm distal to the lesion (0.84) was similar to CT-FFR at the same point as invasive FFR (0.80), and it was better than far distal (0.68) to detect invasive FFR derived ischemia.
Conclusions
CT-FFR was feasible to detect invasive FFR derived ischemia at the same point.
CT-FFR at 2.0 cm distal to the lesion showed higher diagnostic performance compared with CT-FFR measured at the far distal. CT-FFR measurement at 2.0 cm distal to the lesion would be a optimal position clinically.
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Watanabe K, Watanabe T, Otaki Y, Shishido T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Watanabe M. 129Elevated plasma xanthine oxidoreductase activity predicts cardiovascular events in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains poorly understood, although reactive oxygen species (ROS) is reportedly involved in underlying mechanisms. Xanthine oxidoreductase (XOR) is the rate-limiting enzyme of purine metabolism that plays an important role in producing uric acid, and also generates the ROS. However, the impact of plasma XOR activity on the clinical outcomes in patients with HFpEF remains unclear.
Purpose
The aim of this study was to assess whether plasma XOR activity predicts cardiovascular events in patients with HFpEF.
Methods and results
We measured plasma XOR activity in 257 patients with HFpEF. The patients were divided into 3 groups based on XOR activity: low XOR group (<33 pmol/h/mL, n=45), normal XOR group (33 - 120 pmol/h/mL, n=160), and high XOR group (≥120 pmol/h/mL, n=52). During a median follow-up period of 809 days, there were 74 major adverse cardiovascular events (MACEs). Kaplan-Meier analysis demonstrated that the patients with high XOR activity were at greatest risk for MACEs. A multivariate Cox proportional hazard regression analysis showed that high XOR activity was significantly associated with MACEs after adjustment for confounding factors. Furthermore, we divided the patients into 4 groups according to the presence of high XOR activity and/or hyperuricemia. Cox multivariate hazard regression analysis revealed that the patients with high XOR activity were associated with cardiovascular events in patients with HFpEF, regardless of whether hyperuricemia was present or not.
Conclusions
Elevated plasma XOR activity is significantly associated with adverse clinical outcomes in patients with HFpEF. Inhibition of XOR could be a potential therapy for HFpEF.
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Watanabe K, Narumi T, Watanabe T, Aono T, Goto J, Sugai T, Toshima T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. P1626MicroRNA-21 deteriorates left ventricular reverse remodeling by promoting cardiac fibrosis in non-ischemic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Left ventricular reverse remodeling (LVRR) contributes to better outcomes in patients with non-ischemic cardiomyopathy (NICM). It is reported that LVRR is associated with progression of cardiac fibrosis. MicroRNAs (miRs) have emerged as powerful regulators of post-transcriptional gene expression. We focused on miR-21, which plays a key role in pathogenesis of fibrosis in multiple organs. The aim of this study was to clarify the effect of miR-21 on cardiac fibrosis and LVRR in patients with NICM.
Methods
We measured plasma miR-21 levels in 16 patients with NICM. LVRR was defined as increased LVEF by ≥10% and decreased LV end-diastolic diameter index by ≥10% from baseline data after optimal medication treatment at 1-year of follow-up. Further, we examined miR-21 expression and its potential role in cardiac fibrosis induced by transverse aortic constriction (TAC) in mice and angiotensin II (Ang II) stimulation in neonatal rat cardiomyocytes (NRCMs).
Results
There were 12 patients without LVRR and 4 patients with LVRR. Plasma miR-21 levels were significantly higher in patients without LVRR compared with those with LVRR. In TAC mice heart, miR-21 levels were significantly increased and programmed cell death 4 (PDCD4), a main target of miR-21, was decreased. In vitro, miR-21 levels were significantly increased and its upstream transcriptional factor, activator protein 1 (AP-1), was activated by Ang II stimulation in NRCMs. After transfection of miR-21 specific inhibitor, PDCD4 levels were upregulated. Furthermore, AP-1 activity, expression of collagen type I, and α-smooth muscle actin levels were significantly decreased after miR-21 inhibition.
Conclusions
These findings suggested that miR-21/PDCD4/AP-1 feedback loop pathway was involved in LVRR in patients with NICM by promoting cardiac fibrosis. MiR-21 can be the therapeutic target in NICM.
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Kenichiro Y, Oguri M, Takahara K, Takahashi H, Ishii H, Murohara T. P3529Prognostic impact of cohabitation status in hospitalized patients with acute heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The prevalence of heart failure (HF) in the elderly is steadily increasing, therefore, the prudent care and treatment according to individual's characteristics, comorbidities, or prognosis, should be prerequisite. Although cohabitations status in each elderly patient is different, an association of this condition with long-term prognosis remains to be identified definitively in Japan.
Purpose
The purpose of the present study was to examine the prognostic impact of cohabitation status on 3-year mortality among hospitalized acute HF patients.
Methods
The study population comprised a total of 817 individuals who were hospitalized for acute HF between November 2009 and December 2015, and was followed up for 3 years. We classified patients into three groups (cohabitation with spouse, cohabitation with another generation, and living alone). We evaluated relative predictive values between these three groups for 3-year mortality by Cox regression model.
Results
The median age was 79 (interquartile range 70–85) years, and 55.7% of the subjects were male. Median length of hospital stay was 16 (interquartile range 11–23) days. The distribution of three groups was cohabitation with spouse (50.9%), cohabitation with another generation (28.5%), and living alone (20.6%). The overall rate of 3-year mortality was 32.2% (n=263), 31.5% (n=131) in cohabitation with spouse, 38.2% (n=89) in cohabitation with another generation, and 25.6% (n=43) in living alone. Cohabitation with another generation was significantly related to the occurrence of 3-year mortality by univariate analysis (P<0.001). Age (84 years vs. 77 years), the frequency of female (69.1% vs. 33.4%), left ventricular ejection fraction (52.7% vs. 47.5%) were significantly greater, whereas body mass index (21.2 vs. 22.6), smoking status (27.0% vs. 53.4%), ischemic etiology (27.5% vs. 35.6%), and the prevalence of type 2 diabetes mellitus (32.2% vs. 41.4%) and atrial fibrillation (20.6% vs. 29.8%) were significantly (P<0.05) smaller in cohabitation with another generation than others. The ratio of home return and optimal medical therapy were similar between the 2 groups. Cohabitation with another generation was associated with higher relative risk of 3-year mortality than living alone [Hazard Ratio (HR) 1.65; 95% Confidence Interval (CI) 1.15–2.38, P=0.007], or cohabitation with spouse (HR 1.46; 95% CI 1.12–1.92, P=0.006). Multivariable Cox regression model, with adjustment for age, albumin, brain natriuretic peptide, and prior HF hospitalization, revealed that cohabitation with another generation was no longer significant.
Conclusion
Our present results suggest that cohabitation status affected on long-term prognosis in patients with HF, especially cohabitation with another generation posed as worst predictor. We should pay more attention to social factors including cohabitation status in the clinical practice.
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Kumada Y, Ishii H, Oshima T, Sakakibara T, Ito R, Takahashi H, Murohara T. P1959Impact of hemodialysis in patients undergoing bypass surgery for peripheral arterial disease - 10-year follow-up study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although lower extremities bypass surgery has been commonly performed as the standard option to treat peripheral artery disease (PAD) even in patients on hemodialysis (HD) as well as general population, poorer prognosis still remains major problems in this specific population. In this 10-year follow-up study, we investigated the impact of HD after surgical revascularization in patients with PAD.
Methods
A total of 660 patients undergoing successfully bypass surgery were enrolled. Patients with acute limb ischemia were excluded. We compared 392 HD patients with 428 limbs and 268 non-HD (NHD) patients with 296 limbs during 10 years follow-up period. Primary endpoint was defined as major adverse cardiovascular events (MACE) including all-cause death, non-fatal myocardial infarction and stroke. Second endpoint was major adverse limb events (MALE) including any revascularization and major amputation. To minimize the differences of clinical characteristics between the two groups, propensity score adjusting with all baseline variables was performed.
Results
Prevalence of diabetes (53.3% vs. 35.2%), critical limb ischemia (77.5% vs. 52.1%) and infra-popliteal artery (48.2% vs. 19.6%) were higher in HD group compared to NHD group (p<0.0001 in all), inversely, age was younger in HD group than in NHD group (67±9 years vs. 71±9 years, p<0.0001). The 30-day mortality rate was comparable (3.1% in HD group vs. 1.5% in NHD group, p=0.19). The 10-year event-free survival rate for MACE was significantly lower in HD group compared to NHD group (45.3% vs. 67.4%, p<0.0001) and for MALE (60.0% vs. 80.0%, p=0.0007), respectively. After propensity score adjustment, the freedom rate from MACE was still lower in HD group compared to NHD group [45.6% vs. 67.6%, hazard ratio (HR) 1.89, 95% confidence interval (CI) 1.33–2.72, p=0.0003], however, the rate from MALE was statistically comparable between the two group (65.7% vs. 76.9%, 1.27, 95% CI 0.87–1.90, p=0.21). Furthermore, although the 10-year limb salvage rate was crudely lower in HD group compared to NHD group (80.6% vs. 91.6%, HR 1.57, 95% CI 1.05–2.40, p=0.0027), it was comparable after propensity score adjustment (89.4% vs. 90.1%, HR 1.09, 95% CI 0.59–1.88, p=0.79). Also, the mortality rate was consistently lower in HD patients (adjusted HR 2.37, 95% CI 1.62–3.50, p<0.0001).
Conclusion
The long-term freedom rate from MACE and mortality was markedly lower in HD patients compared to non-HD patients. However, the rate from MALE, especially limb salvage rate was similar between HD and NHD after adjustment for clinical characteristics. These results suggest that detection at the early stage of PAD may potentially improve the poor outcomes in this high risk population.
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Katoh S, Watanabe T, Arimoto T, Narumi T, Aono T, Goto J, Sugai T, Takahashi T, Tamura H, Nishiyama S, Takahashi H, Shishido T, Watanabe M. P3355Stress-induced left ventricular dyssynchrony predicts future cardiac events in patients with known or suspected coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Prognostic value of stress induced left ventricular (LV) dyssynchrony has not been fully understood.
The aim of this study was to evaluate the possible impact between cardiovascular events and stress induced worsening LV dyssynchrony.
Methods and results
One hundred and eighty consecutive subjects with known or suspected coronary artery disease (CAD) (142 men, mean age 68±12 years) underwent both gated myocardial single photon emission computed tomography (SPECT) with 99mTc-sestamibi or tetrofosmin according to a standard same day stress-rest protocol and coronary angiography or coronary computed tomography. The summed difference score (SDS) was calculated in every subjects. LV ejection fraction (EF) and phase Entropy at after stress and rest were determined by cardioREPO software. We determined %ΔEntropy = (stress Entropy - rest Entropy)/rest Entropy x100, as an indicator of stress-induced LV dyssynchrony. In the study population, the mean SDS was 2.7±3.9 and LVEF was 58±16%, stress and rest Entropy were 0.62±0.15 and 0.57±0.13, respectively.
%ΔEntropy was higher in patients with CAD than in those without CAD (3.3±11.5 vs. 10.2±15.0, respectively). Moreover, there was a strict correlation between the presence of CAD and %ΔEntropy, indicator of stress induced LV dyssynchrony (non-CAD vs. CAD and/or 1 vessel disease vs. multivessel disease: 4.3±12.5 vs. 8.8±15.6 vs. 12.7±14.3, respectively. p<0.05)
We examined all study subjects and they were divided into 2 groups by cut off value of the %ΔEntropy constructed with receiver operating characteristic curve (=15.4). Kaplan-Meier analysis revealed that future cardiovascular event rate was significantly higher in %ΔEntropy >15.4 group (20/57) than in %ΔEntropy <15.4 group (24/123) (Log-rank p<0.01). On the other hand, summed stress score and SDS were no significant differences between 2 groups.
However, SDS was higher in patients with future cardiovascular event than in those without cardiovascular event (4.4±5.4 vs. 2.2±3.2, respectively. p=0.001).
Conclusion
In patients with known or suspected CAD, stress-induced worsening LV dyssynchrony may predict the presence of CAD and future cardiac events.
Acknowledgement/Funding
None
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Kawai H, Motoyama S, Miyajima K, Hoshino M, Ohta M, Takahashi H, Ishii J, Muramatsu T, Sarai M, Ozaki Y. P6171Role of myocardial mass for identifying FFR-verified ischemia and determining therapeutic strategy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Conventional noninvasive approach using coronary CT angiography (CTA) focusing on only coronary artery lesions remains mismatch in identifying functional ischemia and determining indication for coronary revascularization.
Purpose
We aimed to assess the usefulness of CT-verified myocardial mass for identifying FFR-verified myocardial ischemia and determining the indication of coronary revascularization after FFR examination.
Methods
We examined 244 vessels with intermediate stenoses (50 to 90% stenosis visually on CTA) in 216 patients (mean age 69.2±9.2, 166 men) who underwent both coronary CTA and invasive FFR. In addition to coronary stenosis severity and plaque characteristics on visual, minimal lumen diameter (MLD), minimal lumen area (MLA), plaque volume, the entire myocardial volume of the target vessel (MTV) and that exposed to ischemia (FFR ≤0.80) (myocardial volume of ischemia: MVI) were evaluated. Additionally, therapeutic strategy after FFR was recorded.
Results
Of 244 vessels, myocardial ischemia (FFR ≤0.80) was shown in 99 (40.6%). MTV was larger in the patients with FFR-verified ischemia than those without (53.3±19.2 vs. 41.5±21.6, P<0.001); MLA, plaque burden (PB) and percentage of aggregated plaque volume (%APV) were also associated with ischemia. The area under the curves (AUCs) of MLA, PB, %APV, and MTV were 0.69, 0.67, 0.64, and 0.71, respectively. Addition of MTV to a model with coronary stenosis on visual, MLA, PB, and %APV improved C-index (from 0.72 to 0.79, P<0.01), net reclassification improvement (NRI) (0.71, P<0.01), and integrated discrimination improvement (IDI) (0.10, P<0.01). Of 99 vessels with FFR ≤0.80, MVI was larger in the vessels with early revascularization after FFR than those without (38.8 vs. 29.1, P=0.01).
Conclusions
The measurement of myocardial mass improves the diagnostic performance of coronary CTA for the identification of coronary arteries with FFR-verified ischemia. Furthermore, it is associated with therapeutic strategy for the diseased vessels after FFR examination.
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Takahashi H, Kawakita D, Fushimi C, Nagao T, Hirai H, Saigusa N, Masubuchi T, Matsuki T, Okada T, Baba D, Miura K, Saotome T, Tada Y. Trastuzumab plus docetaxel in patients with advanced HER2-positive salivary duct carcinoma: Exploratory biomarker analyses. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Takahashi H, Ishii H, Kumada Y, Oshima T, Sakakibara T, Ito R, Murohara T, Ozaki Y. P1582Prognostic value of C-reactive protein/albumin ratio for cardiovascular morbidity and mortality in end-stage renal disease patients with incident haemodialysis therapy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hypoalbuminemia, a manifestation of protein-energy wasting or malnutrition, is commonly observed in patients with end-stage renal disease (ESRD), and is associated with chronic inflammation and increasing cardiovascular (CV) risk. Recently, C-reactive protein (CRP)/albumin ratio at discharge is reportedly a well-predictor of mortality in severe sepsis or cancer patients.
We investigated prognostic value of the CRP/albumin ratio at just starting haemodialysis (HD) therapy for CV morbidity and mortality in patients with ESRD.
Methods
A total of 1,548 ESRD patients were enrolled and were divided into quartiles according to CRP/albumin levels at initiation of HD; quartile 1 (Q1): <0.22, Q2: 0.23–0.54, Q3: 0.55–1.83 and Q4: >1.84. They were followed up for 10-year after starting HD therapy. Primary endpoint was CV events defined as hospitalization due to CV events such as cardiac disease, stroke and peripheral artery disease and CV death. We also evaluated the incremental value with C-index when CRP alone, albumin alone and the CRP/albumin ratio were added into a model with established risk factors.
Results
During follow-up period (median: 59 months), 512 cases experienced CV events (33.1%) including 165 cases of CV deaths (10.7%). Kaplan-Meier analysis shows that CV event-free survival rates for 10 years were 63.5%, 53.8%, 47.5% and 31.9% in Q1, Q2, Q3 and Q4, and that CV survival rates were 90.4%, 83.9%, 77.2% and 64.6% in Q1, Q2, Q3 and Q4, respectively (p<0.0001 in both). After adjustment for all baseline variables, elevated CRP/albumin ratio was identified as an independent predictor for CV events [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.11–2.07, p=0.0093 for Q2 vs. Q1, HR 1.79, 95% CI 1.33–2.42, p<0.0001 for Q3 vs. Q1and HR 2.27, 95% CI 1.70–3.07, p<0.0001 for Q4 vs. Q1, respectively]. As to CV mortality, similar results were obtained (HR 1.80, 95% CI 0.98–3.44, p=0.056 for Q2 vs. Q1, HR 2.56, 95% CI 1.45–4.71, p=0.0009 for Q3 vs. Q1 and HR 2.66, 95% CI 1.53–4.86, p=0.0004 for Q4 vs. Q1, respectively). Furthermore, adding the CRP/albumin ratio to a baseline model with established risk factors improved the C-index greater than that of CRP alone or albumin alone, respectively (0.715 from 0.692, p=0.0095 and from 0.683, p=0.0019)
Conclusion
The CRP/albumin ratio, which easily available from daily practice, could strongly stratify the risk of future CV morbidity and mortality in ESRD patients who need HD therapy.
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Aono T, Watanabe T, Takahashi T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. 5945Single nucleotide polymorphisms of PAR2 gene is associated with subclinical myocardial damage in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The protease activated receptor (PAR) 2 is a G protein-coupled receptor and expressed in cardiomyocytes, vascular cells, and leukocytes. Experimental studies demonstrated that PAR2 signaling is associated with adverse cardiac remodeling, heart failure, vascular inflammation and atherosclerosis. Recently, we and others demonstrated that subclinical myocardial damage is associated with cardiovascular mortality in general population. However, the impact of single nucleotide polymorphisms (SNPs) of PAR2 gene on subclinical myocardial damage in general population is unclear.
Purpose
The aim of this study was to investigate whether SNPs of PAR2 gene is associated with subclinical myocardial damage in general population.
Methods
The present study included 2,926 apparently healthy subjects (aged ≥40) who participated in a community-based health checkup. We investigated 639 SNPs and measured serum heart-type fatty acid binding protein (H-FABP) as markers of subclinical myocardial damage.
Results
We found the association of SNPs rs616235 within a PAR2 gene with subclinical myocardial damage. The homozygous A-allele (AA), heterozygous (AG), and homozygous G-allele (GG) carriers of rs616235 were identified in 2084 (71%), 791 (27%), and 51 (2%) subjects, respectively. The prevalence rates of subclinical myocardial damage were 29% in AA carriers, 23% in AG carriers, and 18% in GG carriers. Multivariate logistic analysis showed that the homozygous (AA) of rs616235 was independently associated with subclinical myocardial damage (odds ratio: 1.330, 95% confidence interval: 1.077–1.641, P=0.0080) after adjustment for conventional cardiovascular risk factors.
Conclusions
Genetic variant of PAR2 gene was independently associated with subclinical myocardial damage in the general population.
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Fushimi C, Kawakita D, Takahashi H, Nagao T, Hirai H, Saigusa N, Masubuchi T, Matsuki T, Okada T, Baba D, Miura K, Saotome T, Tada Y. Combined androgen blockade in patients with advanced androgen receptor-positive salivary gland carcinoma: Exploratory biomarker analyses. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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98
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Motoyama S, Sarai M, Kawai H, Miyajima K, Muramatsu T, Takahashi H, Naruse H, Ishii J, Ozaki Y. P2240CTA derived plaque characteristics and cardiac events in deferred lesions by invasive FFR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Fractional flow reserve (FFR) based strategy for coronary artery disease (CAD) is widely accepted. However, cardiac events could occur at deferred lesions after FFR. We previous reported that CT derived high risk plaque (HRP) and residual stenosis were the independent predictors of cardiac events.
Purpose
The purpose of this study was to investigate if plaque characteristics on CTA could predict cardiac events in deferred lesions after FFR.
Methods
We included 211 vessels of 193 patients who were deferred revascularization after CTA and invasive FFR. The presence of HRP and the stenosis grading on CTA were analyzed.
Results
Median follow-up period after CTA was 623 days (IQR 302–945). HRP and obstructive stenosis were detected in 58 (27.5%) and 87 (41.2%) lesions, respectively. Cardiac events were occurred in 10 lesions at 440±167 days in average (range: 150–770 days). Multivaliate cox hazard regression analysis revealed that HRP (HR8.01, p=0.0032) and obstructive stenosis with ≥70% (HR 34.93, p<0.0001) were the independent predictors of cardiac events after adjusted for age, sex, and FFR≤0.8. Of 21 lesions with both HRP and obstructive stenosis, 29% lesions resulted in cardiac events in 2 years.
Conclusions
Even in the deferred lesions by invasive FFR, lesions with HRP and obstructive stenosis showed high rate of cardiac events. These lesions should be treated with intensive medical therapy to prevent cardiac events.
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Hashimoto N, Watanabe T, Tamura H, Tsuchiya H, Wanezaki M, Kato S, Nishiyama S, Arimoto T, Takahashi H, Shishido T, Watanabe M. P2462Left atrial appendage wall velocity evaluated by transthoracic echocardiography is a feasible parameter for predicting cardiac prognosis in patients with heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It was reported that left atrial (LA) remodeling is occurred in patients with heart failure (HF), and increased LA volume index (LAVI) is a feasible predictor for poor prognosis of HF. It was reported that LA remodeling is associated with LA appendage (LAA) dysfunction. We previously reported that LAA wall motion velocity (LAWV) obtained by transthoracic echocardiography (TTE) can noninvasively evaluate LAA dysfunction. However, it remains to be determined whether LAWV is useful for predicting poor prognosis in patients with HF.
Purpose
We investigated whether LAA dysfunction assessed by LAWV is associated with poor prognosis in patients with HF.
Methods
We performed TTE at discharge in 217 consecutive patients who hospitalized for HF (126 males, 71±13 years) and prospectively followed them up. LAWV was measured using Doppler tissue imaging at the LAA tip from the parasternal short-axis view on TTE imaging.
Results
There were 86 patients with cardiac events including 14 cardiac deaths and 72 rehospitalizations for HF during a median follow-up period of 404 days (interquartile range 168–748 days). LAWV was significantly lower in patients with cardiac events than in those without. LAWV was significantly decreased with advancing left ventricular diastolic dysfunction grade. Kaplan-Meier analysis demonstrated that significantly higher cardiac event rate was observed in patients with low LAWV (log-rank test, P=0.004). Cox multivariate hazard analysis revealed that LAWV was an independent predictor for cardiac events after adjusting for confounding factors (hazard ratio 0.57, 95% confidence interval 0.40–0.82, P<0.05). Further, we categorized the patients into 3 groups based on the median of LAWV and left atrial volume index (LAVI), and Kaplan-Meier analysis showed that patients with both low LAWV and high LAVI had the highest rate of cardiac events among 3 groups (log-rank test, P<0.001; Figure).
Figure 1
Conclusion
LAWV may be a feasible parameter for predicting cardiac prognosis in patients with HF.
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Tachibana T, Omori T, Uchida O, Takahashi H, Ikeda N. EP1.09-16 A Case of Pulmonary Primary Enteric Adenocarcinoma Diagnosed Preoperatively. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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