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Aoyama D, Morishita T, Yamaguchi J, Shiomi Y, Ikeda H, Tama N, Fukuoka Y, Hasegawa K, Kaseno K, Ishida K, Miyazaki S, Uzui H, Tada H. P6339Sequential organ failure assessment score on admission predicts long-time mortality of the patients with acute heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0936] [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
Despite the remarkable advances in the treatment options of acute heart failure (HF), prognosis assessment remains an ongoing challenge. Previous studies revealed only a moderate accuracy of models predicting mortality. Sequential Organ Failure Assessment (SOFA) Score are widely used in the intensive care unit (ICU) to predict outcome and predicted higher long-time mortality in unselected patients in cardiac ICU. In addition, the American Heart Association Get With the Guidelines–Heart Failure (GWTG-HF) risk score allows for risk stratification of 30-day outcome for patients hospitalized with HF. The purpose of this study was to evaluate whether SOFA score on admission is useful for long-time mortality prediction in acute HF patients and also to assess the discriminative performance as compared with GWTG-HF risk score.
Methods
This was a single-centre, retrospective cohort study. Between January 2007 and December 2016, we screened eligible 661 consecutive patients with acute HF administered at our hospital. SOFA score on admission of 294 patients was able to calculate retrospectively. We enrolled 269 patients who could complete follow up evaluation for more than 1 year. Endpoint was all-cause mortality after admission. Additive information of SOFA score was evaluated by area under the curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI) and decision curve analysis (DCA).
Results
The 269 patients were included in this study (78.5±10.9 years; 136 men; left ventricular ejection fraction [EF], 49.8±16.6%) during a mean follow-up of 32.1±22.3 months. Patients with all-cause death had higher SOFA score (4.2±2.3 versus 2.8±1.8, p<0.001; AUC, 0.689) and GWTG-HF risk score (44.0±7.6 versus 38.1±7.9, P<0.001, AUC, 0.692).
Kaplan-Meier survival analysis demonstrated higher SOFA scores (P<0.001) and GWTG-HF risk scores (P<0.001) appears to be related to increase probabilities of all cause death. A multivariate Cox proportional hazard model were made with adjustment for SOFA score, GWTG-HF risk score, age, gender and ejection fraction. As a result, SOFA score (hazard ratio [HR] 1.227; 95% confidence interval [CI], 1.130 to 1.326; P<0.001), GWTG-HF (HR, 1.054; 95% CI, 1.029 to 1.078; P<0.001) and age (HR, 1.069; 95% CI 1.048 to 1.092; P<0.001) were independent predictors of all cause death and HR of SOFA score was the highest in these parameters. Incorporating SOFA score into GWTG-HF score yielded a significant NRI (0.528 (95% CI 0.291 to 0.765) and IDI (0.046 (95% CI 0.020 to 0.072). In DCA, compared with the reference model, the net benefit for SOFA score model was greater across the range of threshold probabilities.
Conclusions
The SOFA score, simple and validated mortality risk score can predict long-term all-cause mortality in patients with acute HF. Discriminative performance metrics such as NRI, IDI and DCA were improved on incorporation of the SOFA score for prediction of mortality.
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Hasegawa K, Miyazaki S, Kaseno K, Hisazaki K, Amaya N, Miyahara K, Aiki T, Ishikawa E, Mukai M, Matsui A, Aoyama D, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Pressure-guided second-generation cryoballoon pulmonary vein isolation: Prospective comparison of the procedural and clinical outcomes with the conventional strategy. J Cardiovasc Electrophysiol 2019; 30:1841-1847. [PMID: 31328311 DOI: 10.1111/jce.14080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/05/2019] [Accepted: 06/13/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The utility of pressure waveform analyses to assess pulmonary vein (PV) occlusions has been reported in cryoballoon PV isolation (CB-PVI) using first-generation CBs. This prospective randomized study compared the procedural and clinical outcomes of pressure-guided and conventional CB-PVI. METHODS AND RESULTS Sixty patients with paroxysmal atrial fibrillation underwent CB-PVI with 28-mm second-generation CBs. PV occlusions were assessed either by real-time pressure waveforms without contrast utilization (pressure-guided group) or contrast injections (conventional group) and randomly assigned. Before the randomization, 24 patients underwent pressure-guided CB-PVIs. In the derivation study, a vein occlusion was obtained in 88/96 (91.7%) PVs among which 86 (97.7%) were successfully isolated by the application. In the validation study, the nadir balloon temperature and total freezing time did not significantly differ per PV between the two groups. The positive predictive value of the vein occlusion for predicting successful acute isolations was similar (93 of 103 [90.2%] and 89 of 98 [90.8%] PVs; P = 1.000), but the negative predictive value was significantly higher in pressure-guided than angiographical occlusions (14 of 17 [82.3%] vs 7 of 22 [31.8%]; P = .003). Both the procedure (57.7 ± 14.2 vs 62.6 ± 15.8 minutes; P = .526) and fluoroscopic times (16.3 ± 6.4 vs 20.1 ± 6.1; P = .732) were similar between the two groups, however, the fluoroscopy dose (130.6 ± 97.7 vs 353.2 ± 231.4 mGy; P < .001) and contrast volume used (0 vs 17.5 ± 7.7 mL; P < .001) were significantly smaller in the pressure-guided than conventional group. During 27.8 (5-39) months of follow-up, the single procedure arrhythmia freedom was similar between the two groups (P = .438). CONCLUSIONS Pressure-guided second-generation CB-PVIs were similarly effective and as safe as conventional CB-PVIs. This technique required no contrast utilization and significantly reduced radiation exposure more than conventional CB-PVIs.
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Sato Y, Uzui H, Mukai M, Shiomi Y, Hasegawa K, Ikeda H, Tama N, Fukuoka Y, Morishita T, Ishida K, Kaseno K, Miyazaki S, Nakano A, Tada H. Efficacy and Safety of Tolvaptan in Patients More Than 90 Years Old With Acute Heart Failure. J Cardiovasc Pharmacol Ther 2019; 25:47-56. [PMID: 31280620 DOI: 10.1177/1074248419861962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The oral vasopressin-2 receptor antagonist, tolvaptan, causes aquaresis and improves symptoms in patients with congestive heart failure. However, few studies have explored the effect of tolvaptan in acute heart failure (AHF) patients ≥90 years old. METHODS This study enrolled 106 AHF patients treated with tolvaptan added to standard therapy. The subjects were divided into 2 groups: ≥90-year-old patients (over-90 group, mean 92 ± 2 years, n = 45) and <90-year-old patients (under-90 group, mean 76 ± 11 years, n = 61). Patients' characteristics were assessed, and efficacy and safety were compared between the 2 groups. RESULTS The over-90 group had a lower proportion of male patients, lower body weight, and higher ejection fraction. The under-90 group had significantly higher prevalence of ischemic heart disease and diabetes mellitus. There were no significant differences between the 2 groups in total urine volume at 24 and 48 hours (1934 ± 983 mL vs 1816 ± 1028 mL, P = 0.58 and 3806 ± 1444 mL vs 4078 ± 1851 mL, P=0.47, respectively), the mean change in body weight (-3.0 ± 2.7 kg vs -2.6 ± 2.6 kg, P = 0.50), improvement of congestive symptoms, changes in serum sodium and creatinine levels, the incidences of hypernatremia (n = 0, 0% vs n = 1, 1.6%, P = 0.63), and worsening renal function (n = 9, 20% vs n = 17, 28%, P = 0.48). CONCLUSION The efficacy and safety of tolvaptan in AHF patients aged more than 90 years were comparable to those of <90 years old. Tolvaptan provides a complementary therapeutic option for AHF patients aged more than 90 years.
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Lee S, Fujita K, Negoro E, Morishita T, Yamauchi H, Oiwa K, Ueda T, Yamauchi T. The impact of diagnostic wait time on the survival of patients with diffuse large B-cell lymphoma: effect modification by the International Prognostic Index. Br J Haematol 2019; 187:195-205. [PMID: 31247676 DOI: 10.1111/bjh.16078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/11/2019] [Indexed: 12/09/2022]
Abstract
Despite the importance of a prompt diagnosis to improve cancer patients' survival, little has been reported on diagnostic delay in diffuse large B-cell lymphoma (DLBCL). A single-centre, retrospective study was conducted to examine the association between diagnostic wait time (DWT), the interval from the initial hospital visit to diagnosis, and survival in patients with DLBCL. A total of 193 patients were enrolled from 2007 to 2017 in our institution. A covariate-adjusted Cox proportional hazards model with restricted cubic spline was used to evaluate the impact of DWT on survival, with a subgroup analysis according to the International Prognostic Index (IPI). DWT was not associated with survival in the entire DLBCL population, but the impact of DWT on survival differed between IPI < 3 and ≥ 3; prolongation of DWT steadily exacerbated the prognosis in patients with IPI ≥ 3, whereas there was a patient population with IPI < 3 who had a high mortality rate despite rather early diagnosis. The opposite trend in the effect of DWT on survival between patients with IPI < 3 and ≥ 3 offset survival in all DLBCL patients. DWT had no observable impact on outcomes in the entire DLBCL population, but longer DWT worsened the prognosis, particularly in patients with IPI ≥ 3.
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Hasegawa K, Miyazaki S, Morishita T, Kaseno K, Hisazaki K, Amaya N, Uzui H, Tada H. A Slower Heart Rate and Therapeutic Hypothermia Unmasked Early Repolarization Syndrome in a Ventricular Fibrillation Survivor. Int Heart J 2019; 60:185-188. [PMID: 30464125 DOI: 10.1536/ihj.18-024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patients presenting with aborted cardiac arrest who display early repolarization generally are diagnosed with early repolarization syndrome. Therapeutic hypothermia is a standard strategy to improve neurological outcome in comatose patients after cardiac arrest. We present here a patient in whom therapeutic hypothermia exacerbated the J-wave amplitude and morphology, which resulted in episodes of refractory ventricular fibrillation.
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Hasegawa K, Morishita T, Miyanaga D, Hisazaki K, Kaseno K, Miyazaki S, Uzui H, Ohno S, Horie M, Tada H. Medical Castration is a Rare but Possible Trigger of Torsade de Pointes and Ventricular Fibrillation. Int Heart J 2018; 60:193-198. [PMID: 30518719 DOI: 10.1536/ihj.18-127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Prostate cancer is the most common non-cutaneous malignancy in men and has been steadily rising in an aging society. Medical castration therapy is effective for metastatic prostate cancer, but the proarrhythmic properties have not been reported. We present a 71-year-old Japanese man with metastasis prostate cancer that, during medical castration therapy, had torsades de pointes (TdP) with a QT prolongation and ventricular fibrillation (VF). His QT interval diminished after discontinuing the medical castration, and he developed no further VF recurrences for 15 months. Medical castration is a rare but possible trigger of TdP with QT prolongation and VF.
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Sato Y, Morishita T, Uzui H, Tada H. Successful Percutaneous Coronary Intervention in a Double Aortic Arch With a Right Descending Aorta: Usefulness of 3-Dimensional Computed Tomography Angiography. JACC Cardiovasc Interv 2018; 11:e185-e186. [PMID: 30391387 DOI: 10.1016/j.jcin.2018.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 08/30/2018] [Indexed: 11/25/2022]
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Morishita T, Sato Y, Fukuoka Y, Ishida K, Urabe R, Shigehara R, Minegishi Y, Uzui H, Tada H. Mid-axillary pacemaker re-implantation after contralateral pocket infection in an emaciated elderly case. J Cardiol Cases 2018; 18:70-73. [PMID: 30279914 DOI: 10.1016/j.jccase.2018.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 10/14/2022] Open
Abstract
The number of implantations of cardiac implantable electrophysiological devices (CIEDs) has increased over the past several years. However, the aging population and expansion of indications for CIEDs have led to an increase in associated infections. We experienced a case of a 99-year-old man presenting with skin erosion at the pocket site, where a 6-month-old implantable pacemaker was replaced. He was referred for pacemaker pocket infection and presented with fever accompanied by pain and swelling around pacemaker generator. We could not explant 7-year-old pacemaker leads and the patient refused to undergo either laser lead extraction or surgical removal. We planned to re-implant in the contralateral chest. However, the patient was emaciated with low body-mass-index (15.2 kg/m2), thus concerns arose about the possibility of tissue disruption and re-infection owing to thin skin and absence of sufficient subcutaneous tissue in contralateral subclavian region. Axillary placement of CIEDs has been adopted in patients with limited venous access. We applied a mid-axillary pacemaker implant procedure to this elderly and emaciated patient. Postoperative clinical course was uneventful. After discharge, no history of unexplained fever or illness was recorded. Mid-axillary pacemaker pocket could be an alternative approach for re-implantation in patients with emaciated, cachexic, or limited pocket preparation. <Learning objective: We apply the mid-axillary pacemaker implant procedure to a nonagenarian with contralateral pacemaker infection to minimize the risk of skin disruption after implantation. This implies that implantation is possible in patients with emaciated or cachexic or infection of the contralateral subclavian pocket. Mid-axillary pacemaker pocket could be an alternative approach for re-implantation in patients with emaciated, cachexic, or limited pocket preparation.> .
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Hisazaki K, Hasegawa K, Kaseno K, Miyazaki S, Amaya N, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Endothelial damage and thromboembolic risk after pulmonary vein isolation using the latest ablation technologies: a comparison of the second-generation cryoballoon vs. contact force-sensing radiofrequency ablation. Heart Vessels 2018; 34:509-516. [DOI: 10.1007/s00380-018-1257-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
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Morishita T, Uzui H, Ishida K, Kaseno K, Miyazaki S, Fukuoka Y, Ikeda H, Tama N, Shiomi Y, Yamaguchi J, Sato Y, Aoyama D, Ishikawa E, Miyahara K, Tada H. P4730Associations of cachexia and prognosis in patients with heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hasegawa K, Miyazaki S, Hisazaki K, Kaseno K, Amaya N, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Gastric Hypomotility After Luminal Esophageal Temperature Guided Second-Generation Cryoballoon Pulmonary Vein Isolation. Circ Arrhythm Electrophysiol 2018; 11:e006691. [DOI: 10.1161/circep.118.006691] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kelemen P, Aines R, Bennett E, Benson S, Carter E, Coggon J, de Obeso J, Evans O, Gadikota G, Dipple G, Godard M, Harris M, Higgins J, Johnson K, Kourim F, Lafay R, Lambart S, Manning C, Matter J, Michibayashi K, Morishita T, Noël J, Okazaki K, Renforth P, Robinson B, Savage H, Skarbek R, Spiegelman M, Takazawa E, Teagle D, Urai J, Wilcox J. In situ carbon mineralization in ultramafic rocks: Natural processes and possible engineered methods. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.egypro.2018.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kaseno K, Hisazaki K, Nakamura K, Ikeda E, Hasegawa K, Aoyama D, Shiomi Y, Ikeda H, Morishita T, Ishida K, Amaya N, Uzui H, Tada H. The impact of the CartoSound® image directly acquired from the left atrium for integration in atrial fibrillation ablation. J Interv Card Electrophysiol 2018; 53:301-308. [DOI: 10.1007/s10840-018-0368-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
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Hayashi Y, Higuchi M, Morishita T, Mishima T, Inoue T, Tsuboi Y. The efficacy and safety of unilateral deep brain stimulation for patients with Parkinson’s disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fukuoka Y, Nakano A, Tama N, Hasegawa K, Ikeda H, Morishita T, Ishida K, Kaseno K, Amaya N, Uzui H, Okazawa H, Tada H. Impaired myocardial microcirculation in the flow-glucose metabolism mismatch regions in revascularized acute myocardial infarction. J Nucl Cardiol 2017; 24:1641-1650. [PMID: 27301963 DOI: 10.1007/s12350-016-0526-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 04/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND In successfully revascularized acute myocardial infarction (AMI), microvascular function in a myocardial flow-glucose metabolism mismatch pattern has not been reported. We aimed to elucidate myocardial flow reserve (MFR) and myocardial viability in mismatch segments. METHODS 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and adenosine stress 13N-ammonia PET were performed in eighteen AMI patients to evaluate myocardial glucose metabolism, myocardial blood flow (MBF), and MFR. Infarct segments were classified into 3 groups: normal (preserved resting MBF), mismatch (preserved FDG uptake but reduced resting MBF), and match (reduced FDG uptake and resting MBF). Regional wall motion score (WMS) was assessed immediately after reperfusion and recovery periods. RESULTS MFR in the mismatch group was significantly lower than that in non-infarct-related segments (1.655 ± 0.516 vs 2.282 ± 0.629, P < .01) and similar to that in the match group (1.635 ± 0.528, P = .999). WMS in the mismatch group was significantly improved (3.07 ± 0.48 vs 2.07 ± 1.14, P = .003); however, in recovery periods, WMS in the mismatch group was significantly higher than that in the normal group (1.05 ± 1.04, P < .01). CONCLUSIONS In successfully revascularized AMI, microvascular function is impaired despite preserved myocardial glucose metabolism in mismatch segments.
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Morishita T, Uzui H, Amaya N, Kaseno K, Ishida K, Fukuoka Y, Ikeda H, Hasegawa K, Tama N, Shiomi Y, Sato Y, Miyoshi M, Kataoka T, Tsuji T, Tada H. P1550CHADS2, CHA2DS2-VASc and SYNTAX scores in the prediction of clinical outcomes in patients with acute coronary syndrome after percutaneous coronary intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hisazaki K, Kaseno K, Hasegawa K, Amaya N, Sato Y, Miyoshi M, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. P872How to predict phrenic nerve injury during cryoballoon ablation of atrial fibrillation?: Importance of the CMAP amplitude and cryoballoon temperature monitoring. Europace 2017. [DOI: 10.1093/ehjci/eux151.054] [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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Morishita T, Uzui H, Mitsuke Y, Amaya N, Kaseno K, Ishida K, Fukuoka Y, Ikeda H, Tama N, Yamazaki T, Lee JD, Tada H. Association between matrix metalloproteinase-9 and worsening heart failure events in patients with chronic heart failure. ESC Heart Fail 2017; 4:321-330. [PMID: 28772055 PMCID: PMC5542740 DOI: 10.1002/ehf2.12137] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 11/30/2016] [Accepted: 12/28/2016] [Indexed: 12/14/2022] Open
Abstract
AIMS Matrix metalloproteinase (MMP) is up-regulated during heart failure (HF) and influences ventricular remodeling. We hypothesized that disparity between MMP-9 and tissue inhibitors of MMP-1 (TIMP-1) results in clinical manifestations and is related to prognostic risk in patients with chronic HF. METHODS AND RESULTS Plasma levels of MMP-9, TIMP-1, and brain natriuretic peptide (BNP) were measured in 173 patients with chronic HF. Combined endpoints of worsening HF events were assessed during follow-up (median 109 months). MMP-9 and TIMP-1 levels and the MMP-9/TIMP-1 ratio increased with increasing severity of the New York Heart Association class (P for trend = 0.003, 0.011, and 0.005, respectively). Patients with HF events (n = 35) had significantly higher MMP-9 than those without HF events (P = 0.004). Kaplan-Meier analysis demonstrated a higher probability of HF events with high MMP-9 values (>23.2 ng/mL; P = 0.005). A multivariate Cox proportional hazard model showed that high MMP-9 values were an independent predictor of HF events (hazard ratio, 3.73; 95% confidence interval (CI), 1.03-13.46; P = 0.043). In patients with lower BNP levels (≤210 pg/mL), the adjusted hazard ratio for HF events was 3.63 (95% CI, 1.20-11.02; P = 0.023) among patients with high MMP-9 values compared with patients with low BNP and low MMP-9 values. CONCLUSIONS MMP-9 and TIMP-1 levels correlate with the severity of chronic HF. MMP-9 is a strong predictor of HF events, suggesting that a disparity between MMP-9 and TIMP-1 levels and increased MMP-9 levels may help predict HF events.
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Morishita T, Uzui H, Ikeda H, Amaya N, Kaseno K, Ishida K, Fukuoka Y, Lee JD, Tada H. Association of CD34/CD133/VEGFR2-Positive Cell Numbers with Eicosapentaenoic Acid and Postprandial Hyperglycemia in Patients with Coronary Artery Disease. Int J Cardiol 2016; 221:1039-42. [PMID: 27447811 DOI: 10.1016/j.ijcard.2016.07.079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/22/2016] [Accepted: 07/04/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Circulating endothelial progenitor cells (EPCs), which have the ability to differentiate into mature endothelial cells, can elicit angiogenesis, vasculogenesis and vessel repair in cardiac ischemia and vascular injuries caused by endothelial damage. Serum 1,5-anhydro-d-glucitol (1,5-AG), which is a useful clinical marker of postprandial hyperglycemia, eicosapentaenoic acid (EPA), and arachidonic acid (AA) are newly identified risk factors for coronary artery disease (CAD). However, no previous study has reported the associations between EPCs and 1,5-AG, EPA, and AA levels in CAD patients with type 2 diabetes mellitus (DM). METHODS Peripheral EPCs, assessed as CD34+ cells co-expressing CD133 and vascular endothelial growth factor receptor-2, were studied in 76 CAD patients (mean age, 69.2±11.3years) with DM. Serum 1,5-AG, EPA, and AA levels were measured. RESULTS EPC numbers showed a significant association with 1,5-AG and HbA1c (r=0.290; p=0.037 and r=-0.328; p=0.011, respectively). In addition, there were significant associations between EPC numbers and EPA and body mass index (BMI) (r=0.354; p=0.027 and r=-0.402; p=0.002, respectively). In multiple linear regression analysis, HbA1c, BMI, and EPA values had significant associations with EPC numbers (β=-0.316, 95% confidence interval (CI) -0.256 to -0.008, p=0.037; β=-0.413, 95% CI -0.099 to -0.017, p=0.007; and β=0.400, 95% CI 0.004 to 0.002, p=0.010, respectively). CONCLUSIONS EPC number is associated with HbA1c, 1,5-AG, EPA, and BMI values, suggesting that postprandial hyperglycemia and n-3 polyunsaturated fatty acids contribute to EPC recruitment in CAD patients with type 2 DM.
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Ikeda H, Uzui H, Morishita T, Fukuoka Y, Sato T, Ishida K, Kaseno K, Arakawa K, Amaya N, Tama N, Shiomi Y, Lee JD, Tada H. Effect of postprandial hyperglycaemia on coronary flow reserve in patients with impaired glucose tolerance and type 2 diabetes mellitus. Diab Vasc Dis Res 2015; 12:405-10. [PMID: 26297527 DOI: 10.1177/1479164115597866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study investigated whether postprandial hyperglycaemia has an adverse effect on coronary microvascular function and left ventricular diastolic function. METHODS In all, 28 patients with type 2 diabetes mellitus with no significant stenosis in left anterior descending artery were enrolled. In all subjects, plasma 1,5-anhydroglucitol was measured, and coronary flow reserve in the left anterior descending artery was evaluated using a Doppler wire. Membrane type-1 matrix metalloproteinase expression on circulating peripheral blood mononuclear cells was measured by flow cytometry. Correlation analyses were performed for coronary flow reserve and 1,5-anhydroglucitol, other coronary risk factors, membrane type-1 matrix metalloproteinase and E/e'. RESULTS Strong correlations were found only between 1,5-anhydroglucitol and coronary flow reserve and membrane type-1 matrix metalloproteinase. On multiple regression analysis, 1,5-anhydroglucitol remained an independent predictor of coronary flow reserve (β = 0.38, p = 0.048). CONCLUSION Postprandial hyperglycaemia appears to have an adverse effect on coronary microvascular function, suggesting that improvement of postprandial hyperglycaemia may contribute to the improvement of coronary microvascular dysfunction.
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Zimerman M, Weide S, Wessel M, Schulz R, Timmermann J, Bönstrup M, Morishita T, Koch P, Gerloff C, Hummel F. V37. Interactions between primary and secondary motor areas for recovered hand functions after stroke. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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72
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Kraus PM, Tolstikhin OI, Baykusheva D, Rupenyan A, Schneider J, Bisgaard CZ, Morishita T, Jensen F, Madsen LB, Wörner HJ. Observation of laser-induced electronic structure in oriented polyatomic molecules. Nat Commun 2015; 6:7039. [PMID: 25940229 PMCID: PMC4432593 DOI: 10.1038/ncomms8039] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/26/2015] [Indexed: 11/09/2022] Open
Abstract
All attosecond time-resolved measurements have so far relied on the use of intense near-infrared laser pulses. In particular, attosecond streaking, laser-induced electron diffraction and high-harmonic generation all make use of non-perturbative light-matter interactions. Remarkably, the effect of the strong laser field on the studied sample has often been neglected in previous studies. Here we use high-harmonic spectroscopy to measure laser-induced modifications of the electronic structure of molecules. We study high-harmonic spectra of spatially oriented CH3F and CH3Br as generic examples of polar polyatomic molecules. We accurately measure intensity ratios of even and odd-harmonic orders, and of the emission from aligned and unaligned molecules. We show that these robust observables reveal a substantial modification of the molecular electronic structure by the external laser field. Our insights offer new challenges and opportunities for a range of emerging strong-field attosecond spectroscopies.
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Morishita T, Uzui H, Mitsuke Y, Arakawa K, Amaya N, Kaseno K, Ishida K, Nakaya R, Lee JD, Tada H. Predictive utility of the changes in matrix metalloproteinase-2 in the early phase for left ventricular reverse remodeling after an acute myocardial infarction. J Am Heart Assoc 2015; 4:e001359. [PMID: 25616975 PMCID: PMC4330062 DOI: 10.1161/jaha.114.001359] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The relationship between the serum levels of matrix metalloproteinase (MMP) and tissue inhibitors of MMP (TIMP) and left ventricular (LV) reverse remodeling (LV-RR) after an acute myocardial infarction (AMI) has not been sufficiently examined. METHODS AND RESULTS In 25 patients with successful reperfusion after an AMI and 15 normal control subjects, the serum MMP-2 and TIMP-2 levels were measured on days 1, 2, 3, and 7 and at 1 and 6 months after the AMI onset. LV-RR was defined as a >15% decrease in the LV end-systolic volume index at 6 months after the AMI. The MMP-2 level on day 1 and TIMP-2 levels throughout the study period were comparable between the patients with and without LV-RR. The MMP-2 on day 7 (P<0.05) and the changes in the MMP-2 from day 1 to day 7 (∆MMP-2; P<0.01) were lower in patients with than in those without LV-RR. The ∆MMP-2 was strongly correlated with the changes in the LV volume and ejection fraction from 1 month to 6 months after the AMI. The ∆MMP-2 value of <-158.5 ng/mL predicted LV-RR with a high accuracy (91.7% sensitivity and 76.9% specificity; area under the curve=0.82). CONCLUSIONS Changes in MMP-2 are associated with LV-RR after an AMI. The ΔMMP-2 might be a useful predictor of subsequent LV-RR.
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Tsuchiya M, Nakajima Y, Waku T, Hiyoshi H, Morishita T, Furumai R, Hayashi Y, Kishimoto H, Kimura K, Yanagisawa J. CHIP buffers heterogeneous Bcl-2 expression levels to prevent augmentation of anticancer drug-resistant cell population. Oncogene 2014; 34:4656-63. [DOI: 10.1038/onc.2014.387] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/25/2014] [Accepted: 10/14/2014] [Indexed: 01/12/2023]
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75
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Uehara K, Morishita T, Kubota S, Hirano M, Funase K. P686: A comparison between short and long latency interhemispheric inhibition from the active to resting primary motor cortex during a unilateral muscle contraction. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50780-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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