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Baba Y, Yagi T, Kosumi K, Okadome K, Nomoto D, Eto K, Hiyoshi Y, Nagai Y, Ishimoto T, Iwatsuki M, Iwagami S, Miyamoto Y, Yoshida N, Komohara Y, Watanabe M, Baba H. Morphological lymphocytic reaction, patient prognosis and PD-1 expression after surgical resection for oesophageal cancer. Br J Surg 2020; 106:1352-1361. [PMID: 31414718 DOI: 10.1002/bjs.11301] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 04/15/2019] [Accepted: 06/06/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors, such as antibody against programmed cell death protein (PD-1), have demonstrated antitumour effects in patients with malignancies, including oesophageal cancer. A lymphocytic reaction observed by pathological examination is a manifestation of the host immune response to tumour cells. It was hypothesized that a stronger lymphocytic reaction to tumours might be associated with favourable prognosis in oesophageal cancer. METHODS Using a database of resected oesophageal cancers, four morphological components of lymphocytic reactions (peritumoral, intranest, lymphoid and stromal) to tumours were evaluated in relation to clinical outcome, PD-1 expression by immunohistochemistry and total lymphocyte count in blood. RESULTS Resected oesophageal cancer specimens from 436 patients were included in the study. Among the four morphological components, only peritumoral reaction was associated with patient prognosis (multivariable P for trend <0·001); patients with a higher peritumoral reaction had significantly longer overall survival than those with a lower reaction (multivariable hazard ratio 0·48, 95 per cent c.i. 0·34 to 0·67). The prognostic effect of peritumoral reaction was not significantly modified by other clinical variables (all P for interaction >0·050). Peritumoral reaction was associated with total lymphocyte count in the blood (P < 0·001), supporting the relationship between local immune response and systemic immune competence. In addition, higher morphological peritumoral reaction was associated with high PD-1 expression on lymphocytes in tumours (P = 0·034). CONCLUSION These findings should help to improve risk-adapted therapeutic strategies and help stratify patients in the future clinical setting of immunotherapy for oesophageal cancer.
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Nosaki Y, Mashimo S, Watanabe M, Yokoi T, Kobayashi Y, Iwai K. Paraspinal muscle involvement in pembrolizumab-associated myositis. Oxf Med Case Reports 2020; 2020:omaa003. [PMID: 32123568 PMCID: PMC7037045 DOI: 10.1093/omcr/omaa003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/29/2019] [Accepted: 01/15/2020] [Indexed: 11/13/2022] Open
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78
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Ohyama K, Watanabe M, Nosaki Y, Hara T, Iwai K, Mokuno K. Correlation Between Skeletal Muscle Mass Deficit and Poor Functional Outcome in Patients with Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2020; 29:104623. [PMID: 31952978 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104623] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/28/2019] [Accepted: 12/22/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND AIMS To date, the correlation between sarcopenia, which exists before a stroke, and acute stroke outcome remains partially understood. This study aims to evaluate the skeletal muscle mass deficit using the bioelectrical impedance analysis in patients with acute ischemic stroke. METHODS We enrolled 164 geriatric patients with acute ischemic stroke (108 males and 56 females) who underwent the bioelectrical impedance analysis. We evaluated clinical outcomes and their impact on patients with the skeletal muscle mass deficit determined using the skeletal muscle mass index. RESULTS The skeletal muscle mass deficit was obtained using the bioelectrical impedance analysis in 101 patients. Patients with the skeletal muscle mass deficit determined by the skeletal muscle mass index exhibited severe neurological impairment and functional status on admission; moreover, they tended to display poor functional outcome and prolonged hospital stay. Logistic regression analysis revealed that the skeletal muscle mass deficit remained an independent poor outcome predictor. CONCLUSIONS This study establishes the presence of the skeletal muscle mass deficit in over half patients with acute ischemic stroke. Furthermore, the skeletal muscle mass deficit correlates with neurological impairment owing to stroke with poorer functional prognosis.
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Mine S, Watanabe M, Kumagai K, Okamura A, Yuda M, Hayami M, Yamashita K, Imamura Y, Ishizuka N. Comparison of mediastinal lymph node metastases from adenocarcinoma of the esophagogastric junction versus lower esophageal squamous cell carcinoma with involvement of the esophagogastric junction. Dis Esophagus 2019; 32:5355647. [PMID: 30791046 DOI: 10.1093/dote/doz002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/07/2018] [Accepted: 01/08/2019] [Indexed: 12/11/2022]
Abstract
The distribution of mediastinal lymph node metastasis in patients with adenocarcinoma of the esophagogastric junction (AEG) remains unclear. Additionally, the distribution of nodal mediastinal metastasis from squamous cell carcinoma (SCC) of the lower esophagus with involvement of the esophagogastric junction remains unclear, given the very limited number of these patients. In this retrospective review, we compared the outcomes of radical lymphadenectomy of the mediastinum, including upper mediastinal lymphadenectomy, between patients with AEG and those with SCC. From 2005 to 2017, 69 consecutive patients underwent esophagectomy via right thoracotomy or minimally invasive esophagectomy for a Siewert type I or II tumor with esophageal invasion ≥3 cm. We analyzed the incidences of mediastinal lymph node metastasis in this group relative to those of 73 patients with SCC with involvement of the esophagogastric junction who consecutively underwent esophagectomy during the same period. Mediastinal lymph node metastasis was seen in 26 of 69 patients with AEG (38%), with upper, middle, lower mediastinal nodal metastasis instances of 20%, 17%, and 23%, respectively. Mediastinal lymph node metastasis was seen in 23 of 73 patients with SCC (32%), with upper, middle, lower mediastinal nodal metastasis instances of 12%, 16%, and 19%, respectively. This mediastinal lymph nodal metastasis distribution did not statistically differ between patients with AEG and those with SCC. The relapse-free survival outcomes were poor for patients with clinical (P < 0.01) or pathological (P < 0.01) nodal metastasis of the mediastinum with AEG. In contrast, patients with clinical or pathological mediastinal nodal metastases of SCC did not have extremely poor survival outcomes, compared to patients with AEG. Despite the limited dataset available for analysis, patients with AEG and those with SCC might exhibit similar incidences and distribution of mediastinal lymph node metastasis. However, the clinical or pathological metastasis of AEG to the mediastinum was associated with poor survival outcomes, even if radical mediastinal lymphadenectomy including the upper mediastinal lymphadenectomy was performed.
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Kawase-Koga Y, Kimoto A, Hamada H, Watanabe M, Chikazu D. Simple predictive technique to establish the osteotomy line for intraoral vertical ramus osteotomy. Br J Oral Maxillofac Surg 2019; 58:238-239. [PMID: 31862117 DOI: 10.1016/j.bjoms.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
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81
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Yamaguchi A, Muramatsu H, Hayashi T, Yuasa N, Nakamura K, Takimoto M, Haba H, Konashi K, Watanabe M, Kikunaga H, Maehata K, Yamasaki NY, Mitsuda K. Energy of the ^{229}Th Nuclear Clock Isomer Determined by Absolute γ-ray Energy Difference. PHYSICAL REVIEW LETTERS 2019; 123:222501. [PMID: 31868403 DOI: 10.1103/physrevlett.123.222501] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 10/12/2019] [Indexed: 06/10/2023]
Abstract
The low-lying isomeric state of ^{229}Th provides unique opportunities for high-resolution laser spectroscopy of the atomic nucleus. We determine the energy of this isomeric state by taking the absolute energy difference between the excitation energy required to populate the 29.2-keV state from the ground state and the energy emitted in its decay to the isomeric excited state. A transition-edge sensor microcalorimeter was used to measure the absolute energy of the 29.2-keV γ ray. Together with the cross-band transition energy (29.2 keV→ground) and the branching ratio of the 29.2-keV state measured in a recent study, the isomer energy was determined to be 8.30±0.92 eV. Our result is in agreement with the latest measurements based on different experimental techniques, which further confirms that the isomeric state of ^{229}Th is in the laser-accessible vacuum ultraviolet range.
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Li H, Vossen A, Aihara H, Asner D, Aulchenko V, Aushev T, Babu V, Badhrees I, Bakich A, Bennett J, Bhardwaj V, Bilka T, Biswal J, Bobrov A, Bračko M, Campajola M, Cao L, Červenkov D, Chekelian V, Chen A, Cheon B, Cho H, Cho K, Choi Y, Choudhury S, Cinabro D, Cunliffe S, Di Capua F, Di Carlo S, Dong T, Eidelman S, Ferber T, Fulsom B, Gaur V, Garmash A, Giri A, Goldenzweig P, Hartbrich O, Hayasaka K, Hayashii H, Huang K, Inami K, Ishikawa A, Itoh R, Iwasaki M, Jacobs W, Jang EJ, Jia S, Jin Y, Kang K, Karyan G, Kim D, Kim S, Kodyš P, Korpar S, Kotchetkov D, Križan P, Kroeger R, Krokovny P, Kwon YJ, Lee S, Li Y, Li Gioi L, Libby J, Lieret K, Liventsev D, Luo T, MacQueen C, Masuda M, Matsuda T, Merola M, Miyabayashi K, Miyata H, Mizuk R, Mussa R, Nakano T, Nakao M, Naruki M, Nath K, Natkaniec Z, Nishida S, Ono H, Ostrowicz W, Pakhlov P, Pakhlova G, Pal B, Pardi S, Patra S, Paul S, Pedlar T, Pestotnik R, Piilonen L, Popov V, Prencipe E, Prim M, Russo G, Sahoo D, Sakai Y, Santelj L, Sanuki T, Savinov V, Schneider O, Schnell G, Schueler J, Schwanda C, Seidl R, Seino Y, Senyo K, Shiu JG, Simon F, Solovieva E, Starič M, Stottler Z, Takizawa M, Tanida K, Tenchini F, Uchida M, Uglov T, Uno S, Van Tonder R, Varner G, Wang B, Wang C, Wang MZ, Wang P, Watanabe M, Won E, Yang S, Ye H, Zhang Z, Zhilich V, Zhukova V, Zhulanov V. Azimuthal asymmetries of back-to-back
π±−(π0, η, π±)
pairs in
e+e−
annihilation. Int J Clin Exp Med 2019. [DOI: 10.1103/physrevd.100.092008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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83
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Hagino H, Narita R, Yokoyama Y, Watanabe M, Tomomitsu M. A multicenter, randomized, rater-blinded, parallel-group, phase 3 study to compare the efficacy, safety, and immunogenicity of biosimilar RGB-10 and reference once-daily teriparatide in patients with osteoporosis. Osteoporos Int 2019; 30:2027-2037. [PMID: 31243480 PMCID: PMC6795613 DOI: 10.1007/s00198-019-05038-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/28/2019] [Indexed: 01/16/2023]
Abstract
UNLABELLED The efficacy and safety of RGB-10 and reference teriparatide were evaluated in a randomized 52-week study in 250 patients with osteoporosis at high risk of fracture. RGB-10 was equivalent to reference teriparatide in efficacy and had a comparable safety profile. INTRODUCTION RGB-10 is the first biosimilar teriparatide authorized in the European Union. This multicenter, randomized, rater-blinded, parallel-group phase 3 study evaluated equivalence in efficacy and compared safety between RGB-10 and reference teriparatide in patients with osteoporosis at high risk of fracture for registration in Japan. METHODS Ambulatory postmenopausal women and men (≥ 55 years of age) with osteoporosis at high risk of fracture were randomized 1:1 to receive either RGB-10 or reference teriparatide 20 μg once daily via subcutaneous self-injection for 52 weeks. The primary efficacy endpoint was the percent change from baseline to 52 weeks in lumbar spine (L2-L4) bone mineral density (BMD). Safety outcomes and immunogenicity were also assessed. RESULTS In total, 250 patients (125 in each group) were randomized. The percent change from baseline to 52 weeks in lumbar spine (L2-L4) BMD (mean ± standard deviation) was 8.94% ± 6.19% in the RGB-10 group and 9.65% ± 6.22% in the reference teriparatide group. The estimated between-group difference (95% confidence interval) was - 0.65% (- 2.17% to - 0.87%) within the pre-specified equivalence margin (± 2.8%), which indicates equivalence in efficacy between the two groups. Changes in BMD at lumbar spine (L1-L4), femoral neck, and total hip and serum procollagen type I amino-terminal propeptide were also similar between the groups. Safety profiles, including immunogenicity, were comparable. CONCLUSIONS The therapeutic equivalence of RGB-10 to reference teriparatide was demonstrated. RGB-10 had comparable safety profile to that of reference teriparatide.
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Aono T, Watanabe T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. 5950Lymphocyte-to-monocyte ratio could predict adverse clinical outcomes in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure with preserved ejection fraction (HFpEF) is increasing with aging of the population, whereas the mechanisms of HFpEF remain poorly understood. It was reported that systemic inflammation is associated with pathophysiology of HFpEF. Lymphocyte-to-monocyte ratio (LMR) is a marker of systemic inflammation, which predicts clinical outcomes in various cancers. However, the prognostic value of LMR has not yet been elucidated in patients with HFpEF.
Purpose
The aim of this study was to investigate the impact of LMR on clinical outcomes in patients with HFpEF.
Methods and results
We prospectively analyzed 414 consecutive patients with HFpEF. Preserved EF was defined as an EF ≥50%. During a median follow-up period of 740 days, there were 111 major adverse cardiovascular events (MACE). When patients were divided into tertiles according to LMR, Kaplan-Meier analysis demonstrated that the low LMR was associated with the greatest risk for MACE. Multivariate Cox proportional hazard regression analysis showed that the low LMR was significantly associated with MACE after adjustment for confounding factors.
Conclusions
Low LMR could predict poor clinical outcomes in patients with HFpEF. LMR is a feasible marker for predicting MACE in patients with HFpEF.
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Kyodo A, Soeda T, Kamon D, Hashimoto Y, Ueda T, Watanabe M, Saito Y. P5626The clinical impact of the angle of OCT detected irregular protrusion after primary PCI at the STEMI culprit lesions. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and introduction
The percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) shows worse clinical outcomes than that for stable angina. As the one of the reasons, a recent optical coherence tomography (OCT) registry showed that the presence of irregular protrusion (IP)after coronary stenting was the worse predictor of 1-year device-oriented clinical end points. However, the impact of the quantitative findings on IP has not been well investigated in ACS patients.
Aim
To investigate the clinical impact of the post stent OCT findings, especially IP, detected by OCT after coronary stenting in ACS patients.
Methods
Consecutive 256 ACS lesions treated with OCT-guided PCI in our Medical University Hospital from January 2013 to November 2016 was retrospectively analyzed. In 256 lesions, 173 lesions were enrolled which had ST-elevation acute myocardial infarction (STEMI) with the onset to recanalization time within 720 minutes. In 170 lesions, the OCT images were available. In OCT image, IP was detected in 140 lesions (82.3%). Quantitative analysis of IP in post-procedure OCT imaging was observed to identify the OCT predictors for clinical endpoint including cardiac death, target vessel revascularization ant stent thrombosis in 1 year after index PCI.
Result
In post-procedure OCT findings, stent edge dissection was detected in 32.4% of lesions. Incomplete stent apposition was detected in 74.1%. Maximum angle of irregular protrusion was 194±86 degree and the incidence of maximum IP angle >180 degree was 52.9%. Maximum height of IP was 0.26±0.11mm. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm2 in a drug-eluting stent or <5.6 mm2 in a bare metal stent, was observed in 32.4% of lesions. Maximum IP angle and that of >180degree was significantly associated with the clinical endpoint (p=0.0259 and 0.0429, respectively).
Conclusion
In STEMI patients, IP was frequently observed in post-procedure OCT imaging during primary PCI. The maximum angle of IP was significantly associated with the clinical end points. The prognostic impact of maximum IP angle in STEMI patient needs further investigations.
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Watanabe K, Watanabe T, Otaki Y, Shishido T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Watanabe M. 129Elevated plasma xanthine oxidoreductase activity predicts cardiovascular events in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains poorly understood, although reactive oxygen species (ROS) is reportedly involved in underlying mechanisms. Xanthine oxidoreductase (XOR) is the rate-limiting enzyme of purine metabolism that plays an important role in producing uric acid, and also generates the ROS. However, the impact of plasma XOR activity on the clinical outcomes in patients with HFpEF remains unclear.
Purpose
The aim of this study was to assess whether plasma XOR activity predicts cardiovascular events in patients with HFpEF.
Methods and results
We measured plasma XOR activity in 257 patients with HFpEF. The patients were divided into 3 groups based on XOR activity: low XOR group (<33 pmol/h/mL, n=45), normal XOR group (33 - 120 pmol/h/mL, n=160), and high XOR group (≥120 pmol/h/mL, n=52). During a median follow-up period of 809 days, there were 74 major adverse cardiovascular events (MACEs). Kaplan-Meier analysis demonstrated that the patients with high XOR activity were at greatest risk for MACEs. A multivariate Cox proportional hazard regression analysis showed that high XOR activity was significantly associated with MACEs after adjustment for confounding factors. Furthermore, we divided the patients into 4 groups according to the presence of high XOR activity and/or hyperuricemia. Cox multivariate hazard regression analysis revealed that the patients with high XOR activity were associated with cardiovascular events in patients with HFpEF, regardless of whether hyperuricemia was present or not.
Conclusions
Elevated plasma XOR activity is significantly associated with adverse clinical outcomes in patients with HFpEF. Inhibition of XOR could be a potential therapy for HFpEF.
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Watanabe K, Narumi T, Watanabe T, Aono T, Goto J, Sugai T, Toshima T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. P1626MicroRNA-21 deteriorates left ventricular reverse remodeling by promoting cardiac fibrosis in non-ischemic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Left ventricular reverse remodeling (LVRR) contributes to better outcomes in patients with non-ischemic cardiomyopathy (NICM). It is reported that LVRR is associated with progression of cardiac fibrosis. MicroRNAs (miRs) have emerged as powerful regulators of post-transcriptional gene expression. We focused on miR-21, which plays a key role in pathogenesis of fibrosis in multiple organs. The aim of this study was to clarify the effect of miR-21 on cardiac fibrosis and LVRR in patients with NICM.
Methods
We measured plasma miR-21 levels in 16 patients with NICM. LVRR was defined as increased LVEF by ≥10% and decreased LV end-diastolic diameter index by ≥10% from baseline data after optimal medication treatment at 1-year of follow-up. Further, we examined miR-21 expression and its potential role in cardiac fibrosis induced by transverse aortic constriction (TAC) in mice and angiotensin II (Ang II) stimulation in neonatal rat cardiomyocytes (NRCMs).
Results
There were 12 patients without LVRR and 4 patients with LVRR. Plasma miR-21 levels were significantly higher in patients without LVRR compared with those with LVRR. In TAC mice heart, miR-21 levels were significantly increased and programmed cell death 4 (PDCD4), a main target of miR-21, was decreased. In vitro, miR-21 levels were significantly increased and its upstream transcriptional factor, activator protein 1 (AP-1), was activated by Ang II stimulation in NRCMs. After transfection of miR-21 specific inhibitor, PDCD4 levels were upregulated. Furthermore, AP-1 activity, expression of collagen type I, and α-smooth muscle actin levels were significantly decreased after miR-21 inhibition.
Conclusions
These findings suggested that miR-21/PDCD4/AP-1 feedback loop pathway was involved in LVRR in patients with NICM by promoting cardiac fibrosis. MiR-21 can be the therapeutic target in NICM.
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Takagi H, Zhao S, Muto S, Mine H, Watanabe M, Ozaki Y, Okabe N, Hasegawa T, Shio Y, Aoki M, Tan C, Shimoyama S, Nakamura K, Inano A, Suzuki H. P1.03-23 Delta-Like 1 Homolog (DLK1) Expression in Non-Small-Cell Lung Cancer and the Development of Radioimmunotherapy Targeting DLK1. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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89
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Katoh S, Watanabe T, Arimoto T, Narumi T, Aono T, Goto J, Sugai T, Takahashi T, Tamura H, Nishiyama S, Takahashi H, Shishido T, Watanabe M. P3355Stress-induced left ventricular dyssynchrony predicts future cardiac events in patients with known or suspected coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Prognostic value of stress induced left ventricular (LV) dyssynchrony has not been fully understood.
The aim of this study was to evaluate the possible impact between cardiovascular events and stress induced worsening LV dyssynchrony.
Methods and results
One hundred and eighty consecutive subjects with known or suspected coronary artery disease (CAD) (142 men, mean age 68±12 years) underwent both gated myocardial single photon emission computed tomography (SPECT) with 99mTc-sestamibi or tetrofosmin according to a standard same day stress-rest protocol and coronary angiography or coronary computed tomography. The summed difference score (SDS) was calculated in every subjects. LV ejection fraction (EF) and phase Entropy at after stress and rest were determined by cardioREPO software. We determined %ΔEntropy = (stress Entropy - rest Entropy)/rest Entropy x100, as an indicator of stress-induced LV dyssynchrony. In the study population, the mean SDS was 2.7±3.9 and LVEF was 58±16%, stress and rest Entropy were 0.62±0.15 and 0.57±0.13, respectively.
%ΔEntropy was higher in patients with CAD than in those without CAD (3.3±11.5 vs. 10.2±15.0, respectively). Moreover, there was a strict correlation between the presence of CAD and %ΔEntropy, indicator of stress induced LV dyssynchrony (non-CAD vs. CAD and/or 1 vessel disease vs. multivessel disease: 4.3±12.5 vs. 8.8±15.6 vs. 12.7±14.3, respectively. p<0.05)
We examined all study subjects and they were divided into 2 groups by cut off value of the %ΔEntropy constructed with receiver operating characteristic curve (=15.4). Kaplan-Meier analysis revealed that future cardiovascular event rate was significantly higher in %ΔEntropy >15.4 group (20/57) than in %ΔEntropy <15.4 group (24/123) (Log-rank p<0.01). On the other hand, summed stress score and SDS were no significant differences between 2 groups.
However, SDS was higher in patients with future cardiovascular event than in those without cardiovascular event (4.4±5.4 vs. 2.2±3.2, respectively. p=0.001).
Conclusion
In patients with known or suspected CAD, stress-induced worsening LV dyssynchrony may predict the presence of CAD and future cardiac events.
Acknowledgement/Funding
None
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Takahashi T, Watanabe T, Watanabe M. P4341Sex differences in the U-shaped relationship between physical activity and cardiovascular mortality in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The beneficial effect of moderate physical activity on morbidity and mortality has been observed in the general population. However, sex differences in the impact of physical activity on cardiovascular mortality remain unclear. The aim of this study was to investigate the relationship between physical activity and cardiovascular mortality in the general population.
Methods
This longitudinal cohort study included 1,826 apparently healthy subjects who participated in a community-based health checkup.
Results
There were 97 deaths, including 31 cardiovascular deaths during 10-year follow-up. Subjects were divided into 4 groups based on the quartiles of physical activity (low, mild, moderate and high). There was a U-shaped relationship between physical activity and cardiovascular mortality in male subjects, but not in female subjects. Kaplan-Meier analysis demonstrated that high and low physical activity groups showed higher cardiovascular mortality compared with mild and moderate physical activity groups in male subjects. Cox proportional hazard analysis revealed that low and high physical activities were associated with cardiovascular mortality (hazard ratio 3.59 and 5.11, respectively) in male subjects. In contrast, physical activity was not associated with cardiovascular mortality in female subjects.
Conclusion
We identified a U-shaped relationship between the amount of physical activity and cardiovascular mortality in male subjects, but not in female subjects.
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Aono T, Watanabe T, Takahashi T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. 5945Single nucleotide polymorphisms of PAR2 gene is associated with subclinical myocardial damage in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The protease activated receptor (PAR) 2 is a G protein-coupled receptor and expressed in cardiomyocytes, vascular cells, and leukocytes. Experimental studies demonstrated that PAR2 signaling is associated with adverse cardiac remodeling, heart failure, vascular inflammation and atherosclerosis. Recently, we and others demonstrated that subclinical myocardial damage is associated with cardiovascular mortality in general population. However, the impact of single nucleotide polymorphisms (SNPs) of PAR2 gene on subclinical myocardial damage in general population is unclear.
Purpose
The aim of this study was to investigate whether SNPs of PAR2 gene is associated with subclinical myocardial damage in general population.
Methods
The present study included 2,926 apparently healthy subjects (aged ≥40) who participated in a community-based health checkup. We investigated 639 SNPs and measured serum heart-type fatty acid binding protein (H-FABP) as markers of subclinical myocardial damage.
Results
We found the association of SNPs rs616235 within a PAR2 gene with subclinical myocardial damage. The homozygous A-allele (AA), heterozygous (AG), and homozygous G-allele (GG) carriers of rs616235 were identified in 2084 (71%), 791 (27%), and 51 (2%) subjects, respectively. The prevalence rates of subclinical myocardial damage were 29% in AA carriers, 23% in AG carriers, and 18% in GG carriers. Multivariate logistic analysis showed that the homozygous (AA) of rs616235 was independently associated with subclinical myocardial damage (odds ratio: 1.330, 95% confidence interval: 1.077–1.641, P=0.0080) after adjustment for conventional cardiovascular risk factors.
Conclusions
Genetic variant of PAR2 gene was independently associated with subclinical myocardial damage in the general population.
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Guada L, Watanabe M, Bates K, Yavagal D. Novel canine stroke models using reversible MCA-occlusion alone vs RMCAO plus permanent ACA-occlusion to determine reproducibility and its potential use for translation stroke therapies. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.744] [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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Watanabe M, Higashi T, Mine H, Takagi H, Ozaki Y, Muto S, Okabe N, Hasegawa T, Shio Y, Sugimoto K, Chiba H, Suzuki H. P2.06-20 Characterization of Claudin15 as a New Diagnostic Marker for Malignant Pleural Mesotheliomas. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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94
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Hirasawa K, Izumo M, Mizukoshi K, Suzuki T, Sato Y, Watanabe M, Kamijima R, Ohara H, Harada T, Akashi YJ. P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0257] [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
Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear.
Purpose
To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE).
Methods and results
This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P<0.001) The estimated cumulative cardiac event free survival using the Kaplan-Meier method was significantly lower in patients with reduced Ex-TAPSE (<24mm) than those with preserved Ex-TAPSE (Log-rank, P<0.01).
K-M curve according to Ex-TAPSE
Conclusion
Ex-TAPSE had a strong predictive value of clinical outcomes in non-obstructive HCM patients. Right ventricular function during exercise may have crucial role in the risk stratification of non-obstructive HCM.
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95
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Hashimoto N, Watanabe T, Tamura H, Tsuchiya H, Wanezaki M, Kato S, Nishiyama S, Arimoto T, Takahashi H, Shishido T, Watanabe M. P2462Left atrial appendage wall velocity evaluated by transthoracic echocardiography is a feasible parameter for predicting cardiac prognosis in patients with heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It was reported that left atrial (LA) remodeling is occurred in patients with heart failure (HF), and increased LA volume index (LAVI) is a feasible predictor for poor prognosis of HF. It was reported that LA remodeling is associated with LA appendage (LAA) dysfunction. We previously reported that LAA wall motion velocity (LAWV) obtained by transthoracic echocardiography (TTE) can noninvasively evaluate LAA dysfunction. However, it remains to be determined whether LAWV is useful for predicting poor prognosis in patients with HF.
Purpose
We investigated whether LAA dysfunction assessed by LAWV is associated with poor prognosis in patients with HF.
Methods
We performed TTE at discharge in 217 consecutive patients who hospitalized for HF (126 males, 71±13 years) and prospectively followed them up. LAWV was measured using Doppler tissue imaging at the LAA tip from the parasternal short-axis view on TTE imaging.
Results
There were 86 patients with cardiac events including 14 cardiac deaths and 72 rehospitalizations for HF during a median follow-up period of 404 days (interquartile range 168–748 days). LAWV was significantly lower in patients with cardiac events than in those without. LAWV was significantly decreased with advancing left ventricular diastolic dysfunction grade. Kaplan-Meier analysis demonstrated that significantly higher cardiac event rate was observed in patients with low LAWV (log-rank test, P=0.004). Cox multivariate hazard analysis revealed that LAWV was an independent predictor for cardiac events after adjusting for confounding factors (hazard ratio 0.57, 95% confidence interval 0.40–0.82, P<0.05). Further, we categorized the patients into 3 groups based on the median of LAWV and left atrial volume index (LAVI), and Kaplan-Meier analysis showed that patients with both low LAWV and high LAVI had the highest rate of cardiac events among 3 groups (log-rank test, P<0.001; Figure).
Figure 1
Conclusion
LAWV may be a feasible parameter for predicting cardiac prognosis in patients with HF.
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96
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Higuchi A, Takita M, Ozaki A, Kimura H, Watanabe M. Forced sterilization during post-war era in Japan. QJM 2019; 112:829. [PMID: 31168577 DOI: 10.1093/qjmed/hcz136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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97
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Hosoda K, Azuma M, Katada C, Ishido K, Niihara M, Ushiku H, Sakuraya M, Washio M, Wada T, Watanabe A, Harada H, Tanabe S, Koizumi W, Yamashita K, Hiki N, Watanabe M. A phase I study of docetaxel/oxaliplatin/S-1 (DOS) combination neoadjuvant chemotherapy for patients with locally advanced adenocarcinoma of the esophagogastric junction. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.114] [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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98
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Ehara M, Shibata K, Kameshima M, Fujiyama H, Terai M, Shimizu K, Matsui Y, Higashida Y, Watanabe M, Shimada A, Ohkawa Y, Yamada S. P2528Responsiveness to nutritional intervention would impact on future cardiovascular prognosis in poor fitness patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0857] [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
Purpose
Nutritional improvement has been proposed for long-term cardiovascular prognosis as well as fitness recovery. We aimed to examine whether “responsiveness” to nutritional and exercise interventions would impact patients' cardiovascular prognosis even patients in low baseline fitness level.
Methods
We included 254 consecutive patients who participated in the phase II comprehensive cardiovascular rehabilitation (CCR) for at least three months. All patients underwent cardiopulmonary exercise test (CPX) at the initial and completion phases of CCR. Nutritional guidance was periodically performed individually during CCR. Peak oxygen uptake (PVO2) was measured through CPX to evaluate the fitness level, whereas nutritional status was evaluated using the geriatric nutritional risk index (GNRI). Patients were divided into “low fitness” and “normal fitness” groups based on the median of baseline PVO2. Each group was further classified into four categories according to the changes in VO2 and GNRI during CCR: “Both NOT improved”, “Only GNRI improved”, “Only PVO2 improved”, and “Both improved”.
Results
Cox proportional regression analysis showed that the category of “both NOT improved” was an independent predictor for cardiovascular risk among the baseline low fitness group (Hazard ratio: 4.5, p=0.007); whereas no significant difference among the normal fitness group. Kaplan-Meier analysis revealed that the event-free survival rate was significantly lower in the “both NOT improved” category (log rank p=0.002) among the baseline low fitness group (figure); whereas no significant difference among the normal fitness group.
GNRI/PVO2 improvement vs. prognosis
Conclusion
Responsiveness to nutritional and exercise intervention could be a predictive factor of cardiovascular prognosis even in low fitness patients.
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99
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Hikihara Y, Watanabe M, Aoyama T, Wakabayashi H, Hanawa S, Tanaka S. Earlier acquisition of fundamental movement skills promotes adolescent physical activity in Japanese elementary school children: a 4-year follow-up study. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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100
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Watanabe M, Hikihara Y, Aoyama T, Wakabayashi H, Hanawa S, Tanaka S. What factors during young childhood affect adolescent aerobic fitness in Japanese children? A 4-year follow-up study. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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