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Tanaka H, Yamanokuchi G, Shibutani Y. Creep trajectory transition of a nonstationary viscoelastic model onto a single rate parameter. Phys Rev E 2021; 104:045001. [PMID: 34781439 DOI: 10.1103/physreve.104.045001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/23/2021] [Indexed: 11/07/2022]
Abstract
A system of three-variable differential equations, which has a nonstationary trajectory transition through the control of a single rate parameter, is formulated. For the nondimensional system, the critical trajectory creeps before a transition in a long-lasting plateau region in which the velocity vector of the system hardly changes and then diverges positively or negatively in finite time. The mathematical model well represents the compressive viscoelasticity of a spring-damper structure simulated by the multibody dynamics analysis. In the simulation, the post-transition behaviors realize a tangent stiffness of the self-contacted structure that is polarized after transition. The mathematical model is reduced not only to concisely express the abnormal compression problem, but also to elucidate the intrinsic mechanism of creep-to-transition trajectories in a general system.
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Tanaka H, Ono T, Takano H, Manabe Y, Kajima M, Fujimoto K, Yuasa Y, Shiinoki T, Yamaji Y, Matsunaga K, Matsuo M. Monocyte-to-Lymphocyte Ratio is a Significant Prognostic Factor for Patients With Non-Small Cell Lung Cancer Who Treated By Stereotactic Body Radiation Therapy: A Multi Institutional Study. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Shima A, Tanaka H, Okamura T, Nishikawa T, Godai K, Kimura T, Tatsumi Y, Morino A, Kawatsu Y, Miyamatsu N. Providing mammography in workplaces improved screening rates: cluster randomized controlled trial. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.375] [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
Despite sufficient evidence on the importance of breast cancer screening, the screening rate has remained less than 50% in Japan. To promote behavioral change of individuals, it is important to reduce barriers to taking screening. The purpose of this study was to examine the effect of an environmental approach providing opportunities for mammography (MMG) in workplaces.
Methods
Female employees aged 40 years or older were eligible. Supermarket stores were randomly assigned into two groups, the intervention arm (leaflet and MMG) and the control arm (leaflet). From May to July 2018, participants in the intervention arm were given a leaflet informing the subsidies for breast cancer screening and were provided the opportunity to have MMG in their workplace. Participants in the control group were given the same leaflet, but they had to take the screening outside the workplace as usual. The primary outcome was the breast cancer screening rate in 2018, evaluated using self-administered questionnaires. The odds ratio (OR) and 95% confidence intervals (CIs) for the screening rate in the intervention arm compared with the control arm was estimated using multilevel logistic regression.
Results
We analyzed 1624 participants (mean age was 53 years) from 25 supermarket stores (intervention: 578 patients in 8 stores, control: 1046 patients in 17 stores). The screening rate in the intervention arm was 312 (54%) and was 125 (12%) in the control arm. The OR (and 95% CIs) was 7.81 (5.03-12.12) in the final model adjusted store level effects (i.e., stores and screening rate in 2017 at each store) and individual age and current smoking.
Conclusions
In a worksite-based cluster-randomized controlled trial conducted in a Japanese population, an environmental approach providing MMG opportunities in workplaces significantly increased the self-reported breast cancer screening rate within one year. (UMIN000030465)
Key messages
Providing the opportunity of mammography in Japanese supermarket stores improved the breast cancer screening rate. An environmental approach reducing barriers to screening may be more effective than conventional approaches in improving breast cancer screening rate.
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Sakai R, Sekimoto T, Arai T, Tanaka H, Ogura K, Oishi Y, Nomura K, Sakai K, Arai K, Tsujita H, Kondo S, Tsukamoto S, Mori H, Koba S, Shinke T. Contributions of small dense LDL and oxidized LDL on the formation of neoatherosclerosis in patients under statin treatment. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aim
In-stent neoatherosclerosis (NA) has emerged as an important contributing factor to late stent failure and cardiovascular events. The aim of this study was to investigate whether lipid markers are associated with NA using optical coherence tomography (OCT) after percutaneous coronary intervention (PCI) in patients with coronary artery disease under well-controlled low density lipoprotein cholesterol (LDL-c) on statin treatment.
Methods
We enrolled consecutive 115 patients under statin treatment who underwent PCI with current-generation drug-eluting stent for acute and chronic coronary syndrome. OCT image and various lipid markers were obtained at 1-year for scheduled research assessment. NA was defined as a lipid laden neointima or calcified neointima. Both small dense LDL-c (sd-LDL-c) and remnant lipoprotein cholesterol (RL-c) were measured using direct homogenous assay.
Results
During an average follow-up of 13 months, NA was observed in 14 (13.6%) patients. Not LDL-c but sd-LDL-c, Malondialdehyde-modified LDL (MDA-LDL) as oxidized LDL and (RL-c) were significantly higher in patients with NA. The optimal threshold values of sd-LDL-c, MDA-LDL and RL-c for predicting NA according to receiver operating characteristics analysis were 32.3 mg/dl, 91.0 U/L, and 3.3 mg/dL, respectively. On multivariate logistic regression analysis, sd-LDL-c (≥32.3 mg/dL) and MDA (≥91.0 U/L) were significantly associated with NA (odds ratio [OR]:13.62, p=0.016, OR: 12.68, p=0.01, respectively).
Conclusions
In statin-treated patients, sd-LDL-c and MDA-LDL but not LDL-c might be useful biomarkers to identify the formation of NA at 1 years after PCI. Aggressive reduction of these atherogenic LDL may have a potential to prevent the formation of NA.
Funding Acknowledgement
Type of funding sources: None.
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Arai T, Sekimoto T, Mori H, Sakai R, Tanaka H, Oishi Y, Ogura K, Nomura K, Sakai K, Tsujita H, Kondo S, Koba S, Shinke T. Higher plasma level of small dense low-density lipoprotein cholesterol in ST-segment-elevation myocardial infarction patients with plaque rupture. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2569] [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: 11/15/2022] Open
Abstract
Abstract
Aim
The aim of this study was to compare small dense low-density lipoprotein cholesterol (sd-LDL-c) and various lipid markers between patients exhibiting plaque rupture (PR) in the culprit lesions evaluated by optical coherence tomography (OCT) imaging and those without PR in ST-segment elevation myocardial infarction (STEMI) patients.
Methods
We studied consecutive 60 de novo culprit lesions in 60 patients with STEMI who underwent pre-intervention OCT. PR was defined as a plaque containing a cavity that had overlying residual fibrous caps. Plasma sd-LDL-c was measured directly by homogeneous assay at the time of primary percutaneous coronary intervention.
Results
The patients were classified into PR (n=40, 66.7%) or non-PR (n=20, 33.3%). There were no significant differences in low-density lipoprotein cholesterol (LDL-c), non-high-density lipoprotein cholesterol (non-HDL-c) and pre-admission statin therapy between two groups (135.1±38.0 mg/dL vs 129.2±43.8 mg/dL; p=0.35, 157.1±37.4 mg/dL vs 143.0±37.7 mg/dL; p=0.24, 15.0% vs 20.0%; p=0.93). However, sd-LDL-c level was significantly higher in patients with PR than those with non-PR (44.0±18.1 mg/dL vs 28.0±9.3 mg/dL; p=0.0005). On multiple logistic regression analysis, sd-LDL-c was an independent predictor of PR (odds ratio, 1.14 per 1 mg/dL; p=0.0063).
Conclusion
Sd-LDL-c was significantly associated with PR of the culprit lesion in patients with STEMI.
Funding Acknowledgement
Type of funding sources: None.
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Ido S, Masuda K, Yoshimura S, Tanaka H, Stugaard M. Loss of apical suction assessed by noninvasive pressure differences and twist in acute heart failure: a novel method using vector flow mapping. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0150] [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
Early diastolic intraventricular pressure difference (IVPD) reflects left ventricular (LV) apical suction, and IVPD is closely related to cardiac function, especially LV twist. Vector Flow Mapping (VFM) allows visualization of regional pressure distribution and noninvasive quantification of IVPD. The purpose of the present study was to investigate if and how IVPDs are related to LV twist in a model of acute heart failure (HF).
Methods
In 15 open-chest dogs, HF was induced by intracoronary injection of microspheres. The HF model was classified into two groups based on the LV end-diastolic pressure (LVEDP) (group1: LVEDP<18 mmHg (n=10), group2: LVEDP≥18 mmHg (n=8)).
Color Doppler images from apical long-axis views were acquired at baseline and during HF. From these images, pressure differences (ΔP) were calculated along the LV inflow tract throughout the cardiac cycle. For the purpose of this study, the differences between apex and base during isovolumic relaxation time (ΔPIRT) and rapid early inflow period (ΔPE) were used for analyses. Furthermore, apical and basal short axis high frame rate 2D images were acquired, and peak rotation and peak twist were analyzed.
Results
LVEDP was 7±9, 14±2, 21±3 mmHg for baseline, group1 HF, and group2 HF, respectively. Pressure differences (both ΔPIRT and ΔPE) were visibly changed by the increase of LVEDP (Figure), and the magnitude of ΔPIRT, ΔPE and peak twist decreased significantly with the severity of heart failure. There were significant relationships between pressure differences (ΔPIRT and ΔPE) and dP/dtmin, tau, EF and peak twist (Table). In multivariate analyses, tau and peak twist were independent predictors for ΔPIRT and peak twist was independent predictor for ΔPE.
Conclusion
VFM analysis is feasible to noninvasively assess the IVPDs in acute heart failure. The IVPDs are closely related to the twisting motion of the LV, and reflect loss of apical suction during severe HF.
Funding Acknowledgement
Type of funding sources: None. VFM images of pressure differencesCorrelations of pressure differences
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Kobayashi M, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Nagano Y, Nakamura A, Aso M, Kimura N, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Fujita Y, Oizumi S. P16.05 Real World Data of First-Line Treatment With Pembrolizumab for Highly PD-L1-Expressing NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tanaka H, Asao S, Shibutani Y. Auxetic vibration behaviours of periodic tetrahedral units with a shared edge. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210768. [PMID: 34703621 PMCID: PMC8527201 DOI: 10.1098/rsos.210768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
A very low-frequency mode supported within an auxetic structure is presented. We propose a constrained periodic framework with corner-to-corner and edge-to-edge sharing of tetrahedra and develop a kinematic model incorporating two types of linear springs to calculate the momentum term under infinitesimal transformations. The modal analysis shows that the microstructure with its two degrees of freedom has both low- and high-frequency modes under auxetic transformations. The low-frequency mode approaches zero frequency when the corresponding spring constant tends to zero. With regard to coupled eigenmodes, the stress-strain relationship of the uniaxial forced vibration covers a wide range. When excited, a very slow motion is clearly observed along with a structural expansion for almost zero values of the linear elastic modulus.
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Miura S, Azuma K, Yoshioka H, Teraoka S, Ishii H, Koyama K, Kibata K, Ozawa Y, Tokito T, Koh Y, Shimokawa T, Kurata T, Yamamoto N, Tanaka H. MA02.05 A Phase I Study of Afatinib in Combination With Osimertinib in Patients After Failure of Prior Osimertinib. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ohyama K, Hirakawa K, Sasazaki K, Tanaka H, Hori Y, Takeuchi H. Time-to-onset of diabetes with everolimus use: analysis of a spontaneous reporting system database. DIE PHARMAZIE 2021; 76:515-518. [PMID: 34620282 DOI: 10.1691/ph.2021.1624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The incidence of hyperglycemia and diabetes induced by everolimus has been shown in previous studies. Our study analyzed diabetes time-to-onset profiles after everolimus use in patients who underwent transplantation and patients with cancer. Using data from April 2007 to December 2018 in the Japanese Adverse Drug Event Report database, the reports with everolimus were classified according to its use as an immunosuppressant or anticancer drug. The median (25%-75%) days of diabetes time-to-onset in patients who underwent transplantation and patients with cancer were 172 (56-315) and 32 (18.5-57), respectively. There were no significant variations among patients with breast cancer, neuroendocrine tumor, and renal cell carcinoma. By conducting a Weibull shape parameter test, the lower limits of the 95% confidence intervals of the shape parameter β values for the indications of the cancer types were >1, indicating the wear out failure type profile, whereas those for transplantation data indicated a random failure type profile. The diabetes time-to-onset profiles after everolimus use differed between usage as an anticancer drug and immunosuppressant and there were no significant variations among the type of cancer. It was suggested that the incidence of diabetes should be monitored for 1-2 months in patients with cancer, whereas continuous monitoring is needed in patients who undergo transplantation.
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Saiki R, Momozawa Y, Nannya Y, Nakagawa M, Ochi Y, Yoshizato T, Terao C, Kuroda Y, Shiraishi Y, Chiba K, Tanaka H, Niida A, Imoto S, Matsuda K, Morisaki T, Murakami Y, Kamatani Y, Matsuda S, Kubo M, Miyano S, Makishima H, Ogawa S. Topic: AS04-MDS Biology and Pathogenesis/AS04a-Normal, MDS, and leukemic stem cells. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106679.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nakamura A, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Kitamura Y, Morita M, Aso M, Tsukita Y, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Nakamura K, Yokouchi H. 1306P Real-world data of first-line treatment with pembrolizumab for highly PD-L1 expressing NSCLC (HOT/NJLCG2001). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1908] [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] Open
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Yokoi T, Ma S, Kasahara Y, Kasahara S, Shibauchi T, Kurita N, Tanaka H, Nasu J, Motome Y, Hickey C, Trebst S, Matsuda Y. Half-integer quantized anomalous thermal Hall effect in the Kitaev material candidate α-RuCl 3. Science 2021; 373:568-572. [PMID: 34326240 DOI: 10.1126/science.aay5551] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 04/19/2020] [Accepted: 06/29/2021] [Indexed: 02/01/2023]
Abstract
Half-integer thermal quantum Hall conductance has recently been reported for the two-dimensional honeycomb material α-RuCl3 We found that the half-integer thermal Hall plateau appears even for a magnetic field with no out-of-plane components. The measured field-angular variation of the quantized thermal Hall conductance has the same sign structure as the topological Chern number of the pure Kitaev spin liquid. This observation suggests that the non-Abelian topological order associated with fractionalization of the local magnetic moments persists even in the presence of non-Kitaev interactions in α-RuCl3.
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Nozawa Y, Uchida M, Igami H, Kajita R, Tanaka H, Maekawa T. Homodyne interferometry using a phase rotator for calibration of sine-cosine phase detection of a 70 GHz probe beam through a plasma. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2021; 92:083501. [PMID: 34470391 DOI: 10.1063/5.0049771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/09/2021] [Indexed: 06/13/2023]
Abstract
Homodyne interferometry using a motorized phase rotator for calibration of sine-cosine detection of the phase shift of a 70 GHz probe beam through a plasma has been developed. Four interferometers based on this interferometry have been installed on the low aspect ratio torus experiment (LATE) device with four horizontal probe beams on the mid-plane, which has measured the line-integrated electron densities with a time resolution of 10 μs and a resolution of line-integrated density of 5 × 1015 m-2.
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Abbott R, Abbott TD, Abraham S, Acernese F, Ackley K, Adams A, Adams C, Adhikari RX, Adya VB, Affeldt C, Agarwal D, Agathos M, Agatsuma K, Aggarwal N, Aguiar OD, Aiello L, Ain A, Ajith P, Akutsu T, Aleman KM, Allen G, Allocca A, Altin PA, Amato A, Anand S, Ananyeva A, Anderson SB, Anderson WG, Ando M, Angelova SV, Ansoldi S, Antelis JM, Antier S, Appert S, Arai K, Arai K, Arai Y, Araki S, Araya A, Araya MC, Areeda JS, Arène M, Aritomi N, Arnaud N, Aronson SM, Asada H, Asali Y, Ashton G, Aso Y, Aston SM, Astone P, Aubin F, Auclair P, Aufmuth P, AultONeal K, Austin C, Babak S, Badaracco F, Bader MKM, Bae S, Bae Y, Baer AM, Bagnasco S, Bai Y, Baiotti L, Baird J, Bajpai R, Ball M, Ballardin G, Ballmer SW, Bals M, Balsamo A, Baltus G, Banagiri S, Bankar D, Bankar RS, Barayoga JC, Barbieri C, Barish BC, Barker D, Barneo P, Barnum S, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Barton MA, Bartos I, Bassiri R, Basti A, Bawaj M, Bayley JC, Baylor AC, Bazzan M, Bécsy B, Bedakihale VM, Bejger M, Belahcene I, Benedetto V, Beniwal D, Benjamin MG, Bennett TF, Bentley JD, BenYaala M, Bergamin F, Berger BK, Bernuzzi S, Bersanetti D, Bertolini A, Betzwieser J, Bhandare R, Bhandari AV, Bhattacharjee D, Bhaumik S, Bidler J, Bilenko IA, Billingsley G, Birney R, Birnholtz O, Biscans S, Bischi M, Biscoveanu S, Bisht A, Biswas B, Bitossi M, Bizouard MA, Blackburn JK, Blackman J, Blair CD, Blair DG, Blair RM, Bobba F, Bode N, Boer M, Bogaert G, Boldrini M, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Bork R, Boschi V, Bose N, Bose S, Bossilkov V, Boudart V, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branch A, Branchesi M, Breschi M, Briant T, Briggs JH, Brillet A, Brinkmann M, Brockill P, Brooks AF, Brooks J, Brown DD, Brunett S, Bruno G, Bruntz R, Bryant J, Buikema A, Bulik T, Bulten HJ, Buonanno A, Buscicchio R, Buskulic D, Cadonati L, Caesar M, Cagnoli G, Cahillane C, Cain HW, Calderón Bustillo J, Callaghan JD, Callister TA, Calloni E, Camp JB, Canepa M, Cannavacciuolo M, Cannon KC, Cao H, Cao J, Cao Z, Capocasa E, Capote E, Carapella G, Carbognani F, Carlin JB, Carney MF, Carpinelli M, Carullo G, Carver TL, Casanueva Diaz J, Casentini C, Castaldi G, Caudill S, Cavaglià M, Cavalier F, Cavalieri R, Cella G, Cerdá-Durán P, Cesarini E, Chaibi W, Chakravarti K, Champion B, Chan CH, Chan C, Chan CL, Chan M, Chandra K, Chanial P, Chao S, Charlton P, Chase EA, Chassande-Mottin E, Chatterjee D, Chaturvedi M, Chatziioannou K, Chen A, Chen C, Chen HY, Chen J, Chen K, Chen X, Chen YB, Chen YR, Chen Z, Cheng H, Cheong CK, Cheung HY, Chia HY, Chiadini F, Chiang CY, Chierici R, Chincarini A, Chiofalo ML, Chiummo A, Cho G, Cho HS, Choate S, Choudhary RK, Choudhary S, Christensen N, Chu H, Chu Q, Chu YK, Chua S, Chung KW, Ciani G, Ciecielag P, Cieślar M, Cifaldi M, Ciobanu AA, Ciolfi R, Cipriano F, Cirone A, Clara F, Clark EN, Clark JA, Clarke L, Clearwater P, Clesse S, Cleva F, Coccia E, Cohadon PF, Cohen DE, Cohen L, Colleoni M, Collette CG, Colpi M, Compton CM, Constancio M, Conti L, Cooper SJ, Corban P, Corbitt TR, Cordero-Carrión I, Corezzi S, Corley KR, Cornish N, Corre D, Corsi A, Cortese S, Costa CA, Cotesta R, Coughlin MW, Coughlin SB, Coulon JP, Countryman ST, Cousins B, Couvares P, Covas PB, Coward DM, Cowart MJ, Coyne DC, Coyne R, Creighton JDE, Creighton TD, Criswell AW, Croquette M, Crowder SG, Cudell JR, Cullen TJ, Cumming A, Cummings R, Cuoco E, Curyło M, Canton TD, Dálya G, Dana A, DaneshgaranBajastani LM, D'Angelo B, Danilishin SL, D'Antonio S, Danzmann K, Darsow-Fromm C, Dasgupta A, Datrier LEH, Dattilo V, Dave I, Davier M, Davies GS, Davis D, Daw EJ, Dean R, Deenadayalan M, Degallaix J, De Laurentis M, Deléglise S, Del Favero V, De Lillo F, De Lillo N, Del Pozzo W, DeMarchi LM, De Matteis F, D'Emilio V, Demos N, Dent T, Depasse A, De Pietri R, De Rosa R, De Rossi C, DeSalvo R, De Simone R, Dhurandhar S, Díaz MC, Diaz-Ortiz M, Didio NA, Dietrich T, Di Fiore L, Di Fronzo C, Di Giorgio C, Di Giovanni F, Di Girolamo T, Di Lieto A, Ding B, Di Pace S, Di Palma I, Di Renzo F, Divakarla AK, Dmitriev A, Doctor Z, D'Onofrio L, Donovan F, Dooley KL, Doravari S, Dorrington I, Drago M, Driggers JC, Drori Y, Du Z, Ducoin JG, Dupej P, Durante O, D'Urso D, Duverne PA, Dwyer SE, Easter PJ, Ebersold M, Eddolls G, Edelman B, Edo TB, Edy O, Effler A, Eguchi S, Eichholz J, Eikenberry SS, Eisenmann M, Eisenstein RA, Ejlli A, Enomoto Y, Errico L, Essick RC, Estellés H, Estevez D, Etienne Z, Etzel T, Evans M, Evans TM, Ewing BE, Fafone V, Fair H, Fairhurst S, Fan X, Farah AM, Farinon S, Farr B, Farr WM, Farrow NW, Fauchon-Jones EJ, Favata M, Fays M, Fazio M, Feicht J, Fejer MM, Feng F, Fenyvesi E, Ferguson DL, Fernandez-Galiana A, Ferrante I, Ferreira TA, Fidecaro F, Figura P, Fiori I, Fishbach M, Fisher RP, Fishner JM, Fittipaldi R, Fiumara V, Flaminio R, Floden E, Flynn E, Fong H, Font JA, Fornal B, Forsyth PWF, Franke A, Frasca S, Frasconi F, Frederick C, Frei Z, Freise A, Frey R, Fritschel P, Frolov VV, Fronzé GG, Fujii Y, Fujikawa Y, Fukunaga M, Fukushima M, Fulda P, Fyffe M, Gabbard HA, Gadre BU, Gaebel SM, Gair JR, Gais J, Galaudage S, Gamba R, Ganapathy D, Ganguly A, Gao D, Gaonkar SG, Garaventa B, García-Núñez C, García-Quirós C, Garufi F, Gateley B, Gaudio S, Gayathri V, Ge G, Gemme G, Gennai A, George J, Gergely L, Gewecke P, Ghonge S, Ghosh A, Ghosh A, Ghosh S, Ghosh S, Ghosh S, Giacomazzo B, Giacoppo L, Giaime JA, Giardina KD, Gibson DR, Gier C, Giesler M, Giri P, Gissi F, Glanzer J, Gleckl AE, Godwin P, Goetz E, Goetz R, Gohlke N, Goncharov B, González G, Gopakumar A, Gosselin M, Gouaty R, Grace B, Grado A, Granata M, Granata V, Grant A, Gras S, Grassia P, Gray C, Gray R, Greco G, Green AC, Green R, Gretarsson AM, Gretarsson EM, Griffith D, Griffiths W, Griggs HL, Grignani G, Grimaldi A, Grimes E, Grimm SJ, Grote H, Grunewald S, Gruning P, Guerrero JG, Guidi GM, Guimaraes AR, Guixé G, Gulati HK, Guo HK, Guo Y, Gupta A, Gupta A, Gupta P, Gustafson EK, Gustafson R, Guzman F, Ha S, Haegel L, Hagiwara A, Haino S, Halim O, Hall ED, Hamilton EZ, Hammond G, Han WB, Haney M, Hanks J, Hanna C, Hannam MD, Hannuksela OA, Hansen H, Hansen TJ, Hanson J, Harder T, Hardwick T, Haris K, Harms J, Harry GM, Harry IW, Hartwig D, Hasegawa K, Haskell B, Hasskew RK, Haster CJ, Hattori K, Haughian K, Hayakawa H, Hayama K, Hayes FJ, Healy J, Heidmann A, Heintze MC, Heinze J, Heinzel J, Heitmann H, Hellman F, Hello P, Helmling-Cornell AF, Hemming G, Hendry M, Heng IS, Hennes E, Hennig J, Hennig MH, Hernandez Vivanco F, Heurs M, Hild S, Hill P, Himemoto Y, Hines AS, Hiranuma Y, Hirata N, Hirose E, Hochheim S, Hofman D, Hohmann JN, Holgado AM, Holland NA, Hollows IJ, Holmes ZJ, Holt K, Holz DE, Hong Z, Hopkins P, Hough J, Howell EJ, Hoy CG, Hoyland D, Hreibi A, Hsieh B, Hsu Y, Huang GZ, Huang HY, Huang P, Huang YC, Huang YJ, Huang YW, Hübner MT, Huddart AD, Huerta EA, Hughey B, Hui DCY, Hui V, Husa S, Huttner SH, Huxford R, Huynh-Dinh T, Ide S, Idzkowski B, Iess A, 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AB, Ying M, Yokogawa K, Yokoyama J, Yokozawa T, Yoon A, Yoshioka T, Yu H, Yu H, Yuzurihara H, Zadrożny A, Zanolin M, Zeidler S, Zelenova T, Zendri JP, Zevin M, Zhan M, Zhang H, Zhang J, Zhang L, Zhang R, Zhang T, Zhao C, Zhao G, Zhao Y, Zhao Y, Zhou Z, Zhu XJ, Zhu ZH, Zucker ME, Zweizig J. Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run. PHYSICAL REVIEW LETTERS 2021; 126:241102. [PMID: 34213926 DOI: 10.1103/physrevd.97.102002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 05/23/2021] [Indexed: 05/21/2023]
Abstract
We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.
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Rodriguez-Soto RD, Rolland L, Rollins JG, Roma VJ, Romanelli M, Romano R, Romel CL, Romero A, Romero-Shaw IM, Romie JH, Rose CA, Rosińska D, Rosofsky SG, Ross MP, Rowan S, Rowlinson SJ, Roy S, Roy S, Rozza D, Ruggi P, Ryan K, Sachdev S, Sadecki T, Sadiq J, Sago N, Saito S, Saito Y, Sakai K, Sakai Y, Sakellariadou M, Sakuno Y, Salafia OS, Salconi L, Saleem M, Salemi F, Samajdar A, Sanchez EJ, Sanchez JH, Sanchez LE, Sanchis-Gual N, Sanders JR, Sanuy A, Saravanan TR, Sarin N, Sassolas B, Satari H, Sato S, Sato T, Sauter O, Savage RL, Savant V, Sawada T, Sawant D, Sawant HL, Sayah S, Schaetzl D, Scheel M, Scheuer J, Schindler-Tyka A, Schmidt P, Schnabel R, Schneewind M, Schofield RMS, Schönbeck A, Schulte BW, Schutz BF, Schwartz E, Scott J, Scott SM, Seglar-Arroyo M, Seidel E, Sekiguchi T, Sekiguchi Y, Sellers D, Sengupta AS, Sennett N, Sentenac D, Seo EG, Sequino V, Setyawati Y, Shaffer T, Shahriar MS, Shams B, Shao L, Sharifi S, Sharma A, Sharma P, Shawhan P, Shcheblanov NS, Shen H, Shibagaki S, Shikauchi M, Shimizu R, Shimoda T, Shimode K, Shink R, Shinkai H, Shishido T, Shoda A, Shoemaker DH, Shoemaker DM, Shukla K, ShyamSundar S, Sieniawska M, Sigg D, Singer LP, Singh D, Singh N, Singha A, Sintes AM, Sipala V, Skliris V, Slagmolen BJJ, Slaven-Blair TJ, Smetana J, Smith JR, Smith RJE, Somala SN, Somiya K, Son EJ, Soni K, Soni S, Sorazu B, Sordini V, Sorrentino F, Sorrentino N, Sotani H, Soulard R, Souradeep T, Sowell E, Spagnuolo V, Spencer AP, Spera M, Srivastava AK, Srivastava V, Staats K, Stachie C, Steer DA, Steinlechner J, Steinlechner S, Stops DJ, Stover M, Strain KA, Strang LC, Stratta G, Strunk A, Sturani R, Stuver AL, Südbeck J, Sudhagar S, Sudhir V, Sugimoto R, Suh HG, Summerscales TZ, Sun H, Sun L, Sunil S, Sur A, Suresh J, Sutton PJ, Suzuki T, Suzuki T, Swinkels BL, Szczepańczyk MJ, Szewczyk P, Tacca M, Tagoshi H, Tait SC, Takahashi H, Takahashi R, Takamori A, Takano S, Takeda H, Takeda M, Talbot C, Tanaka H, Tanaka K, Tanaka K, Tanaka T, Tanaka T, Tanasijczuk AJ, Tanioka S, Tanner DB, Tao D, Tapia A, Tapia San Martin EN, Tapia San Martin EN, Tasson JD, Telada S, Tenorio R, Terkowski L, Test M, Thirugnanasambandam MP, Thomas M, Thomas P, Thompson JE, Thondapu SR, Thorne KA, Thrane E, Tiwari S, Tiwari S, Tiwari V, Toland K, Tolley AE, Tomaru T, Tomigami Y, Tomura T, Tonelli M, Torres-Forné A, Torrie CI, Tosta E Melo I, Töyrä D, Trapananti A, Travasso F, Traylor G, Tringali MC, Tripathee A, Troiano L, Trovato A, Trozzo L, Trudeau RJ, Tsai DS, Tsai D, Tsang KW, Tsang T, Tsao JS, Tse M, Tso R, Tsubono K, Tsuchida S, Tsukada L, Tsuna D, Tsutsui T, Tsuzuki T, Turconi M, Tuyenbayev D, Ubhi AS, Uchikata N, Uchiyama T, Udall RP, Ueda A, Uehara T, Ueno K, Ueshima G, Ugolini D, Unnikrishnan CS, Uraguchi F, Urban AL, Ushiba T, Usman SA, Utina AC, Vahlbruch H, Vajente G, Vajpeyi A, Valdes G, Valentini M, Valsan V, van Bakel N, van Beuzekom M, van den Brand JFJ, Van Den Broeck C, Vander-Hyde DC, van der Schaaf L, van Heijningen JV, van Putten MHPM, van Remortel N, Vardaro M, Vargas AF, Varma V, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venneberg J, Venugopalan G, Verkindt D, Verma Y, Veske D, Vetrano F, Viceré A, Viets AD, Villa-Ortega V, Vinet JY, Vitale S, Vo T, Vocca H, von Reis ERG, Vorvick C, Vyatchanin SP, Wade LE, Wade M, Wagner KJ, Walet RC, Walker M, Wallace GS, Wallace L, Walsh S, Wang J, Wang JZ, Wang WH, Ward RL, Warner J, Was M, Washimi T, Washington NY, Watchi J, Weaver B, Wei L, Weinert M, Weinstein AJ, Weiss R, Weller CM, Wellmann F, Wen L, Weßels P, Westhouse JW, Wette K, Whelan JT, White DD, Whiting BF, Whittle C, Wilken D, Williams D, Williams MJ, Williamson AR, Willis JL, Willke B, Wilson DJ, Winkler W, Wipf CC, Wlodarczyk T, Woan G, Woehler J, Wofford JK, Wong ICF, Wrangel J, Wu C, Wu DS, Wu H, Wu S, Wysocki DM, Xiao L, Xu WR, Yamada T, Yamamoto H, Yamamoto K, Yamamoto K, Yamamoto T, Yamashita K, Yamazaki R, Yang FW, Yang L, Yang Y, Yang Y, Yang Z, Yap MJ, Yeeles DW, Yelikar AB, Ying M, Yokogawa K, Yokoyama J, Yokozawa T, Yoon A, Yoshioka T, Yu H, Yu H, Yuzurihara H, Zadrożny A, Zanolin M, Zeidler S, Zelenova T, Zendri JP, Zevin M, Zhan M, Zhang H, Zhang J, Zhang L, Zhang R, Zhang T, Zhao C, Zhao G, Zhao Y, Zhao Y, Zhou Z, Zhu XJ, Zhu ZH, Zucker ME, Zweizig J. Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run. PHYSICAL REVIEW LETTERS 2021; 126:241102. [PMID: 34213926 DOI: 10.1103/physrevlett.126.241102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 05/23/2021] [Indexed: 06/13/2023]
Abstract
We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.
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Sugawara S, Lee JS, Kang JH, Kim HR, Inui N, Hida T, Lee KH, Yoshida T, Tanaka H, Yang CT, Nishio M, Ohe Y, Tamura T, Yamamoto N, Yu CJ, Akamatsu H, Namba Y, Sumiyoshi N, Nakagawa K. Nivolumab with carboplatin, paclitaxel, and bevacizumab for first-line treatment of advanced nonsquamous non-small-cell lung cancer. Ann Oncol 2021; 32:1137-1147. [PMID: 34139272 DOI: 10.1016/j.annonc.2021.06.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/26/2021] [Accepted: 06/10/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This international, randomized, double-blind phase III study (ONO-4538-52/TASUKI-52) evaluated nivolumab with bevacizumab and cytotoxic chemotherapy as first-line treatment for nonsquamous non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Between June 2017 and July 2019, this study enrolled treatment-naïve patients with stage IIIB/IV or recurrent nonsquamous NSCLC without sensitizing EGFR, ALK, or ROS1 alterations. They were randomly assigned in a 1 : 1 ratio to receive nivolumab or placebo in combination with carboplatin, paclitaxel, and bevacizumab every 3 weeks for up to six cycles, followed by nivolumab/placebo with bevacizumab until progressive disease or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) assessed by an independent radiology review committee (IRRC). RESULTS Overall, 550 patients from Japan, Korea, and Taiwan were randomized; of these patients, 273 and 275 received the nivolumab and placebo combinations, respectively. In the present preplanned interim analysis with a median follow up of 13.7 months, the IRRC-assessed median PFS was significantly longer in the nivolumab arm than in the placebo arm (12.1 versus 8.1 months; hazard ratio 0.56; 96.4% confidence interval 0.43-0.71; P < 0.0001). The PFS benefit was observed across all patients with any programmed death-ligand 1 (PD-L1) expression levels including PD-L1-negative patients. The IRRC-assessed objective response rates were 61.5% and 50.5% in the nivolumab and placebo arms, respectively. The incidence of treatment-related adverse events of grade 3 or 4 was comparable between the two arms; treatment-related adverse events leading to death were observed in five and four patients in the nivolumab and placebo arms, respectively. CONCLUSION The TASUKI-52 regimen should be considered a viable new treatment strategy for treatment-naïve patients with advanced nonsquamous NSCLC.
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Tanaka H, Yamaguchi Y, Fukuda S, Fukushima H, Uehara S, Yasuda Y, Yoshida S, Yokoyama M, Matsuoka Y, Campbell S, Fujii Y. Prognostic significance of radiologic infiltrative feature of primary renal tumor in metastatic renal cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Peterson B, Kawamura G, van de Giessen P, Mukai K, Tanaka H, Sano R, Pandya S, Dai S, Masuzaki S, Akiyama T, Kobayashi M, Goto M, Motojima G, Sakamoto R, Ohno N, Morisaki T, Miyazawa J. Experimental observations and modelling of radiation asymmetries during N2 seeding in LHD. NUCLEAR MATERIALS AND ENERGY 2021. [DOI: 10.1016/j.nme.2020.100848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Suzuki T, Hishida T, C. M, Matsuda K, Nakagomi T, Omura S, Tanaka H, Masai K, Kaseda K, Asakura K, Asamura H. P26.07 Video-Assisted Thoracoscopic Surgery for Stage I Thymoma: Short-Term Outcomes and Appropriate Indications. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shono A, Matsumoto K, Yamada N, Kusunose K, Suzuki M, Sumimoto K, Tanaka Y, Yamashita K, Shibata N, Yokota S, Suto M, Dokuni K, Tanaka H, Hirata K. Impaired preload reserve is an important haemodynamic characteristics that discriminates between physiological ageing and overt heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.211] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Ageing process per se is a major risk factor for heart failure (HF). In fact, the incidence of HF with preserved ejection fraction (HFpEF) dramatically increases with age. Although ageing plays a central role in the development of HFpEF, not all the elderly patients develop clinical HFpEF. Multiple abnormalities in the cardiovascular system have been proposed to contribute to the development of HFpEF. However, the pathophysiology that discriminates between physiological ageing and overt HFpEF is incompletely understood.
Purpose
The purpose of this study was to assess the effects of ageing on the cardiac structures and haemodynamics. Moreover, we evaluated the determinant factor that discriminates between physiological ageing and overt HFpEF by non-invasive preload increasing manoeuvre using leg-positive pressure (LPP) stress echocardiography.
Methods
A total of 91 subjects were prospectively recruited in this study: 22 patients with HFpEF and 69 healthy controls. Normal controls were further stratified into 3 age groups: young (n = 19, 20-40 years of age), middle-aged (N = 25, 40-65 years) and elderly (n = 25, >65 years). All subjects underwent LPP stress with a continuous external pressure of 90 mmHg around both lower limbs using dedicated airbags (Fig.).
Results
The left ventricular mass index (LVMI; young, 68 ± 19 g/m²; middle-age, 70 ± 18 g/m²; elderly, 84 ± 21 g/m²) and also the relative wall thickness (RWT; young, 0.34 ± 0.09; middle-age, 0.41 ± 0.06; elderly 0.55 ± 0.10) increased with ageing, which was accelerated in HFpEF (LVMI: 111 ± 32 g/m², RWT; 0.63 ± 0.19, ANOVA P < 0.001, respectively). Although baseline LV ejection fraction and cardiac output were quite comparable between groups, E/e’ ratio significantly increased with with ageing (ANOVA P < 0.001, Fig.). During LPP stress, E/e’ ratio significantly increased in the middle-aged and elderly groups (from 8.8 ± 2.7 to 9.7 ± 3.3, and from 11.4 ± 2.4 to 13.0 ± 2.2, P < 0.05, respectively), which was further deteriorated in HFpEF (from 16.8 ± 5.8 to 18.0 ± 7.6, P < 0.05). On the other hand, stroke volume index (SVi) significantly increased in each healthy group during LPP stress (young; from 45 ± 10 to 50 ± 11 mL/m², middle-age; from 39 ± 7 to 44 ± 6 mL/m² and elderly; from 37 ± 7 to 43 ± 8 mL/m², all P < 0.001), while SVi failed to increase in the HFpEF group (from 45 ± 13 to 45 ± 14 mL/m², P = 0.60). In a multivariate logistic regression analysis, LVMI (hazard ratio; HR 1.055, P < 0.05), baseline E/e’ (HR 1.444; P < 0.05), and ΔSVi (HR 0.755; P < 0.05) during LPP stress were the independent parameters that characterised overt HFpEF.
Conclusions
Striking parallels between structure-function alterations were observed in the physiological cardiovascular ageing process, which was further accelerated in patients with HFpEF. Not only structural remodeling and impaired diastolic function, but also impaired systolic reserve during preload stress is important haemodynamic feature that characterise the pathophysiology of HFpEF.
Abstract Figure.
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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Shibata N, Yokota S, Suto M, Dokuni K, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.020] [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
Funding Acknowledgements
Type of funding sources: None.
Background
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity.
Purpose
Our purpose was to investigate the impact of baseline risk factors on left ventricular (LV) function in patients with preserved LV ejection fraction (LVEF) who have undergone chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59 ± 13 years and LVEF was 67 ± 5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥ 240mg/m², (2) age ≥ 65-year-old, (3) body mass index ≥ 30kg/m², (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥ 100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (-9.3 ± 10.8% vs. -2.2 ± 10.2%; p = 0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p = 0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3 ± 29.0g/m² vs. 83.2 ± 21.0g/m², p < 0.001), lower global longitudinal strain (18.4 ± 2.8% vs. 20.0 ± 2.6%, p = 0.06) and higher E/e’ (10.4 (8.9-13.0) vs. 9.0 (7.4-10.9), p = 0.06) compared to those without.
Furthermore, receiver-operator characteristics curve analysis showed that an optimal cut off value of a cumulative total doxorubicin dose for developing LV dysfunction in patients with more than any of four risk factors was lower than that in those without (180 mg/m² vs. 280 mg/m²).
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Abstract Figure.
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Soga F, Tanaka H, Tatsumi K, Mochizuki Y, Sano H, Toki H, Matsumoto K, Shite J, Takaoka H, Doi T, Hirata K. impact of dapagliflozin on left ventricular diastolic function in diabetic patients with heart failure complicating cardiovascular risk factors. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.021] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Type 2 diabetes mellitus (T2DM) is a well-known risk factor for heart failure (HF), even in patients without a structural heart disease or a symptom of HF. Diabetes-related cardiomyopathy is presented as an left ventricular (LV) diastolic dysfunction, which, like cardiovascular disease, is a contributor of the development of HF in both patients with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Furthermore, comorbid factors other than T2DM also have been identified as high risk factors for of progression to HF. Dapagliflozin is a sodium glucose cotransporter type 2 (SGLT2) inhibitor, and represents a new class of anti-hyperglycemic agents for T2DM. A result from a recent large clinical trial showed that dapagliflozin reduced risk of worsening HF or death from cardiovascular causes for patients with HFrEF compared to those who received a placebo, regardless of the presence or absence of T2DM. However, the effect of SGLT2 inhibitors on LV diastolic function in T2DM patients with HF who had cardiovascular risk factors other than T2DM remains uncertain.
Purpose
Our purpose was to investigate the impact of dapagliflozin on LV diastolic function in T2DM patients with stable HF complicating cardiovascular risk factors.
Methods
We analyzed data from our previous prospective multicenter study, which investigate the effect of dapagliflozin on LV diastolic function of 53 T2DM patients with stable HF at five institutions in Japan. Patients who had been taking at least one antidiabetic drugs other than SGLT2 inhibitor started the administration of dapagliflozin. Cardiovascular risk factors other than T2DM was determined as age, gender, hypertension, dyslipidemia, history of cardiovascular events and overweight.
Results
E/e′ significantly decreased from 9.3 to 8.5 cm/s 6 months after administration of dapagliflozin (p = 0.020) as previously described. Multivariate logistic regression analysis showed that dyslipidemia was the only independent determinant of an improvement of E/e’ among cardiovascular risk factors. Furthermore, relative changes in E/e’ from baseline to 6 months after administration of dapagliflozin seen in HFpEF patients with dyslipidemia were significantly larger than those in HFpEF patients without dyslipidemia (-15.2% vs. 29.6%, p = 0.014), but such a difference was not observed in non-HFpEF patients. In addition, relative changes in high-density lipoprotein cholesterol (HDL-C) from baseline to 6 months after administration of dapagliflozin had significant correlation with those in E/e’ (r=-0.300, p = 0.038). However, such correlations were not observed in low-density lipoprotein cholesterol (LDL-C) and triglyceride (r = 0.05, p = 0.72 and r = 0.05, p = 0.73). Conclusion: Dapagliflozin was more beneficial effect on LV diastolic function for T2DM patients with stable HF, especially those with complicating dyslipidemia. Our findings may thus offer a new insight into the management of T2DM patients with HF.
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Shibata N, Matsumoto K, Shiraki H, Yamauchi Y, Yoshigai Y, Shono A, Sumimoto K, Suzuki M, Tanaka Y, Yamashita K, Yokota S, Suto M, Dokuni K, Tanaka H, Hirata K. Preload stress echocardiography by using dynamic postural alteration can identify high risk patients with heart failure with reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.209] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Haemodynamic assessment during stress testing is not commonly performed for patients with heart failure with reduced ejection fraction (HFrEF) due to its invasiveness, less feasibility, and safety concerns. Passive leg-lifting (PLL) manoeuvres have been introduced as a simple alternative for non-invasive preload stress testing; however, the haemodynamic load imposed on the cardiovascular system is unsatisfactory, which precludes the accurate assessment of the preload reserve for patients with HF.
Purpose
The purpose of this study was to assess the haemodynamic characteristics of patients with HFrEF in response to a preload stress during dynamic postural alterations by combining the semi-sitting position (SSP) and PLL. We also evaluated whether combined postural stress could be used for risk stratification for these patients.
Methods
For this study, 101 patients with HFrEF and 35 age- and sex-matched normal controls were prospectively recruited. At each postural position (i.e., baseline, SSP, and PLL), all standard echocardiographic and Doppler variables were obtained. Adverse cardiac events were prespecified as the combined endpoints of death from or hospitalisation for deteriorated HF, or sudden cardiac death. Clinical follow-up was conducted for a median of 7 months.
Results
During PLL stress, the stroke volume index (SVi) significantly increased in both controls (from 40 ± 6 to 43 ± 6 mL/m², P = 0.03) and HFrEF patients (from 31 ± 9 to 34 ± 10 mL/m², P = 0.03). Conversely, during SSP stress, the SVi significantly decreased for both controls (from 40 ± 6 to 37 ± 6 mL/m², P = 0.03) and HFrEF patients (31 ± 9 to 28 ± 8 mL/m², P = 0.03). During the follow-up period, 16 patients developed cardiac events. In patients without events, the Frank-Starling mechanism was well preserved (Fig. A). Namely, the SVi significantly increased from 31 ± 9 to 35 ± 10 mL/m² (P = 0.02) during PLL stress, while the SVi significantly decreased from 31 ± 8 to 28 ± 8 mL/m² (P = 0.02) during SSP stress. In contrast, for patients with cardiac events, the SVi did not change during postural alterations (n.s), which indicated that the failing heart operates on the flat portion of the Frank-Starling curve (Fig. A). When patients were divided into three equal sub-groups based on the total difference in the SVi during dynamic postural stress, patients with impaired preload reserve (third trimester, ΔSVi ≤ 3.0 mL/m²) showed significantly worse event-free survival than the other two sub-groups (Fig. B; P < 0.001). In a Cox proportional-hazard analysis, baseline LVEF (hazard ratio 0.93; P = 0.04), and ΔSVi during postural stress (hazard ratio 0.76; P = 0.004) were predictors of future cardiac events.
Conclusions
The combined assessment of dynamic postural stress during PLL and SPP is a simple, time-saving, and easy-to-use clinical tool for the assessment of preload reserve for patients with HFrEF. Moreover, postural stress echocardiography proved to contribute to the risk stratification for these patients.
Abstract Figure.
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Dokuni K, Matsumoto K, Tatsumi K, Shono A, Suzuki M, Sumimoto K, Tanaka Y, Yamashita K, Shibata N, Yokota S, Sutou M, Tanaka H, Kiuchi K, Fukuzawa K, Hirata K. Cardiac resynchronization therapy improves left atrial reservoir function through resynchronization of the left atrium in patients with heart failure. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.123] [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
Funding Acknowledgements
Type of funding sources: None.
Background
The structural remodeling of the left atrium (LA) has been proposed as an important determinant of adverse outcomes in patients with heart failure (HF). However, little is known about the potential impact of LA mechanical dyssynchrony on its reservoir function and the prognosis of patients with HF. In addition, it has not been fully investigated whether cardiac resynchronization therapy (CRT) is also beneficial to LA function.
Purposes
The purposes of this study were to test whether left ventricular (LV) dyssynchrony may negatively affect LA synchronicity and reservoir function, and to assess whether residual LA dyssynchrony after CRT affects the prognosis in patients with HF with reduced ejection fraction (HFrEF).
Methods
This study included total of 90 subjects: 40 HFrEF with a wide-QRS complex (≧130 ms), 28 HFrEF with a narrow-QRS, and 22 age- and sex-matched normal controls. LA global longitudinal strain (LA-GLS) and LA dyssynchrony were quantified using speckle-tracking strain analysis. LA dyssynchrony was defined as the maximal difference of time-to-peak strain (LA time-diff). All wide-QRS HFrEF received CRT, and event-free survival was tracked for 24 months.
Results
At baseline, HFrEF patients showed significant LA remodeling coupled with the reduced LA reservoir function, as evidenced by larger LA volume index (LAVi: 46 ± 16 vs. 30 ± 14 mL/m², P < 0.01) and smaller LA-GLS (13.0 ± 4.8 vs. 30.6 ± 10.7%, P < 0.01). Of note was that, not only LV dyssynchrony (381 ± 178 vs. 177 ± 62 ms, P < 0.01) but also LA dyssynchrony (298 ± 136 vs. 186 ± 78 ms, P < 0.01) were significantly larger in patients with HFrEF compared to normal subjects and this applied even more to patients with a wide-QRS complex. All patients with a wide-QRS complex underwent CRT, and only responders exhibited the significant decrease in LA time-diff (from 338 ± 123 to 245 ± 141 ms, P < 0.05) and increase in LA-GLS (from 11.9 ± 4.7 to 19.6 ± 10.1%, P < 0.05) in parallel with the reduction in LAVi (from 48 ± 17 to 37 ± 18 mL/m², P < 0.05) at 6 months after CRT. Receiver operating characteristic curve analysis identified the optimal cut-off value of LA time-diff at 6 months after CRT as 202 ms (P < 0.05) and that of LA-GLS as 14.6% (P < 0.05) for predicting adverse cardiac events. The patients whose LA time-diff reduced <202 ms after CRT showed significantly favorable event-free survival than the others. Similarly, the patients whose LA-GLS improved >14.6% after CRT exhibited significantly favorable event-free survival than the others (P < 0.05, respectively). Of note was that, when the patients were restricted to CRT responders only, those who showed LA time-diff less than 202 ms at 6 months after CRT almost never experienced cardiac events (P < 0.05).
Conclusions
The improved LV coordination by CRT also resulted in resynchronization of discoordinated LA wall motion and a consecutive improvement of LA reservoir function, which ultimately lead to the favorable outcome for HFrEF patients with wide-QRS complex.
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