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Genomic findings of hypertrophic and dilated cardiomyopathy characterized in a Thai clinical genetics service. PLoS One 2022; 17:e0267770. [PMID: 36166435 PMCID: PMC9514623 DOI: 10.1371/journal.pone.0267770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/13/2022] [Indexed: 11/19/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM) are the most common referrals in the Inherited Cardiovascular Condition (ICC) Genetics Service. Several issues must be discussed with patients and their families during the genetic consultation session, including the options for genetic testing and cardiovascular surveillance in family members. We developed an ICC registry and performed next-generation-based DNA sequencing for all patients affected by non-syndromic HCM and idiopathic DCM in our joint specialist genetics service. The target gene sequencing panel relied on the Human Phenotype Ontology with 237 genes for HCM (HP:0001639) and 142 genes for DCM (HP:0001644). All subjects were asked to contact their asymptomatic first-degree relatives for genetic counseling regarding their risks and to initiate cardiovascular surveillance and cascade genetic testing. The study was performed from January 1, 2014, to December 31, 2020, and a total of 62 subjects (31-HCM and 31-DCM) were enrolled. The molecular detection frequency was 48.39% (32.26% pathogenic/likely pathogenic, 16.13% variant of uncertain significance or VUS for HCM, and 25.81% (16.13% pathogenic/likely pathogenic, 9.68% VUS) for DCM. The most prevalent gene associated with HCM was MYBPC3. The others identified in this study included ACTN2, MYL2, MYH7, TNNI3, TPM1, and VCL. Among the DCM subjects, variants were detected in two cases with the TTN nonsense variants, while the others were missense and identified in MYH7, DRSP3, MYBPC3, and SCN5A. Following the echocardiogram surveillance and cascade genetic testing in the asymptomatic first-degree relatives, the detection rate of new cases was 8.82% and 6.25% in relatives of HCM and DCM subjects, respectively. Additionally, a new pre-symptomatic relative belonging to an HCM family was identified, although the genomic finding in the affected case was absent. Thus, ICC service is promising for the national healthcare system, aiming to prevent morbidity and mortality in asymptomatic family members.
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Miyamoto Y, Kubo T, Ochi Y, Baba Y, Hirota T, Yamasaki N, Kawai K, Yamamoto K, Kondo F, Bando K, Yamada E, Furuno T, Yabe T, Doi YL, Kitaoka H. Clinical Features of Heart Failure in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort - Results From the Kochi RYOMA Study. Circ J 2022; 86:1934-1940. [PMID: 35675987 DOI: 10.1253/circj.cj-22-0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The clinical features of heart failure (HF) in patients with hypertrophic cardiomyopathy (HCM) in Japan have not been fully elucidated.Methods and Results: In 293 patients with HCM (median age at registration, 65 (57-72) years) in a prospective cardiomyopathy registration network in Kochi Prefecture (Kochi RYOMA study), HF events (HF death or hospitalization for HF) occurred in 35 patients (11.9%) (median age, 76 (69-80) years), including 11 HF deaths during a median follow-up of 6.1 years. The 5-year HF events rate was 9.6%. Atrial fibrillation, low percentage of fractional shortening, and high B-type natriuretic peptide level at registration were predictors of HF events. The combination of these 3 factors had a relatively high positive predictive value (55%) for HF events and none of them had a high negative predictive value (99%). There were 4 types of HF profile: left ventricular (LV) systolic dysfunction (40%), severe LV diastolic dysfunction (34%), LV outflow tract obstruction (LVOTO) (20%), and primary mitral regurgitation (MR) (6%). HF deaths occurred in patients with LV systolic dysfunction or LV diastolic dysfunction, but none of patients with LVOTO or primary MR due to additional invasive therapies. CONCLUSIONS In a Japanese HCM cohort, HF was an important complication, requiring careful follow-up and appropriate treatment.
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Affiliation(s)
- Yuya Miyamoto
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuri Ochi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Takayoshi Hirota
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Naohito Yamasaki
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Kazuya Kawai
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Katsuhito Yamamoto
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Fumiaki Kondo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Kanji Bando
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Eisuke Yamada
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Takashi Furuno
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Toshikazu Yabe
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yoshinori L Doi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
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Sugiura K, Kubo T, Ochi Y, Miyagawa K, Baba Y, Noguchi T, Hirota T, Yamasaki N, Doi YL, Kitaoka H. Very long-term prognosis in patients with hypertrophic cardiomyopathy: a longitudinal study with a period of 20 years. ESC Heart Fail 2022; 9:2618-2625. [PMID: 35652322 PMCID: PMC9288772 DOI: 10.1002/ehf2.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/26/2022] [Accepted: 05/08/2022] [Indexed: 11/10/2022] Open
Abstract
AIMS We aim to clarify the prognosis on patients with hypertrophic cardiomyopathy (HCM) for a follow-up period of more than 10 years. METHODS AND RESULTS We retrospectively analysed 102 consecutive patients with HCM diagnosed by 31 December 2000. Complete and detailed clinical records were obtained for 93 (91%) of the 102 patients. Sixty-three (68%) of the 93 patients were men, and the mean age of the patients at the initial evaluation was 51.5 ± 13.0 years. During the mean follow-up period of 19.6 ± 8.1 years (median 20.1 years), HCM-related deaths occurred in 20 patients (21% [1.1%/year]). HCM-related adverse events (including HCM-related deaths and nonfatal HCM-related events: hospitalization for heart failure, embolic stroke admission, and sustained ventricular tachycardia with haemodynamic instability or appropriate implantable cardioverter-defibrillator discharge) occurred in 45 patients (48%). The first HCM-related adverse events occurred in approximately 20% of the patients in every decade, the first decade to the third decade, from the initial evaluation. Forty-seven patients (51%) had documentation of atrial fibrillation at the last follow-up. There were seven patients in the end-stage HCM group at the initial evaluation, and 22 patients (24%) had progression to end-stage HCM during the follow-up period. CONCLUSIONS In our cohort of patients, HCM-related mortality was relatively favourable. However, approximately half of the patients suffered from HCM-related adverse events during the follow-up period of 20 years. It is important for HCM patients to be carefully followed up over the long-term because HCM is a lifelong disease.
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Affiliation(s)
- Kenta Sugiura
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Yuri Ochi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Kazuya Miyagawa
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Tatsuya Noguchi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Takayoshi Hirota
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Naohito Yamasaki
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Yoshinori L Doi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
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Enzan N, Matsushima S, Ide T, Kaku H, Tohyama T, Funakoshi K, Higo T, Tsutsui H. Clinical Characteristics and Contemporary Management of Patients With Cardiomyopathies in Japan - Report From a National Registry of Clinical Personal Records. Circ Rep 2021; 3:142-152. [PMID: 33738347 PMCID: PMC7956877 DOI: 10.1253/circrep.cr-21-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background:
The clinical features of patients with cardiomyopathy, including dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), or restrictive cardiomyopathy (RCM), have not been recently elucidated in Japan. Methods and Results:
We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM from 2003 to 2014 and in HCM and RCM from 2009 to 2014 from the national registry of clinical personal records organized by the Japanese Ministry of Health, Labour and Welfare. In all, 44,136 patients were included in this registry: 40,537 with DCM, 3,553 with HCM, and 46 with RCM. The median age at diagnosis was older for DCM and HCM than RCM (54 and 55 vs. 42 years, respectively). Male patients accounted for 74.6%, 58.7%, and 60.9% of the DCM, HCM, and RCM groups, respectively. NYHA functional Class III–IV was found in 26.9%, 11.3%, and 58.1% of patients in the DCM, HCM, and RCM groups, respectively. In the DCM group, the rates of β-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription were 69% and 76%, respectively. In regional subgroup analysis, the median age at diagnosis of DCM and HCM was younger in the Kanto region. A family history of HCM was less frequent in the Hokkaido/Tohoku region. Conclusions:
The national registry of clinical personal records of cardiomyopathy could provide important information regarding the demographics, clinical characteristics, and management of cardiomyopathy throughout Japan.
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Affiliation(s)
- Nobuyuki Enzan
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Fukuoka Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Fukuoka Japan
| | - Tomomi Ide
- Department of Experimental and Clinical Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Fukuoka Japan
| | - Hidetaka Kaku
- Department of Cardiology, Japan Community Healthcare Organization, Kyushu Hospital Kitakyushu Japan
| | - Takeshi Tohyama
- Center for Clinical and Translational Research, Kyushu University Hospital Fukuoka Japan
| | - Kouta Funakoshi
- Center for Clinical and Translational Research, Kyushu University Hospital Fukuoka Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Fukuoka Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Fukuoka Japan
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Kubo T, Baba Y, Ochi Y, Takahashi A, Hirota T, Yamasaki N, Hamashige N, Yamamoto K, Kondo F, Bando K, Yamada E, Furuno T, Yabe T, Doi YL, Kitaoka H. Sudden Cardiac Death-Relevant Events of Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From the Kochi RYOMA Study ―. Circ Rep 2020; 2:433-439. [PMID: 33693265 PMCID: PMC7819656 DOI: 10.1253/circrep.cr-20-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background:
Sudden cardiac death (SCD) is a most devastating complication of hypertrophic cardiomyopathy (HCM). The aim of this study was to clarify the clinical features of HCM in patients who experienced SCD-relevant events in an aged Japanese community. Methods and Results:
In 2004, we established a cardiomyopathy registration network in Kochi Prefecture, and herein report on 293 patients with HCM who are followed as part of the registry. The mean (±SD) age at registration and diagnosis was 63±14 and 56±16 years, respectively. SCD-relevant events occurred in 19 patients during a mean follow-up period of 6.1±3.2 years (incidence rate 1.0%/year): sudden death in 9 patients, successful recovery from cardiopulmonary arrest in 4 patients, and appropriate implantable cardioverter–defibrillator discharge in 6 patients. At registration, 13 patients were in the dilated phase of HCM (D-HCM). During the follow-up period, HCM developed to D-HCM in 21 patients; thus, 34 patients in total had D-HCM. Multivariate analysis revealed that D-HCM at registration or during follow-up and detection of non-sustained ventricular tachycardia (NSVT) during follow-up were significant predictors of SCD-relevant events. Conclusions:
In this HCM population in an aged Japanese community, the annual rate of SCD-relevant events was 1.0%. HCM developed to D-HCM in a considerable number of patients, and D-HCM and NSVT were shown to be independently associated with an increased risk of SCD-relevant events.
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Affiliation(s)
- Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuri Ochi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Asa Takahashi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Takayoshi Hirota
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Naohito Yamasaki
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | | | | | - Fumiaki Kondo
- Department of Cardiology, Japanese Red Cross Kochi Hospital
| | - Kanji Bando
- Department of Cardiology, Tosa Municipal Hospital
| | | | - Takashi Furuno
- Department of Cardiology, Kochi Prefectural Aki General Hospital
| | - Toshikazu Yabe
- Department of Cardiology, Kochi Prefectural Hata Kenmin Hospital
| | - Yoshinori L. Doi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
- Department of Cardiology, Chikamori Hospital
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
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Kitaoka H, Kubo T, Doi YL. Hypertrophic Cardiomyopathy - A Heterogeneous and Lifelong Disease in the Real World. Circ J 2020; 84:1218-1226. [PMID: 32669480 DOI: 10.1253/circj.cj-20-0524] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) is the most frequent hereditary cardiomyopathy, showing an autosomal-dominant f inheritance. A great deal of attention has been paid to genetics, left ventricular tract obstruction and the prediction and prevention of sudden cardiac death in HCM. Needless to say, these are very important, but we should recognize the heterogeneity in etiology, morphology, clinical course and management of this unique cardiomyopathy. Another important perspective is that HCM causes left ventricular remodeling over time and is a disease that requires lifelong management in the real world.
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Affiliation(s)
- Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
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7
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Hen Y, Iguchi N, Kanisawa M, Takada K, Machida H, Takara A, Teraoka K, Takamisawa I, Takayama M, Yoshikawa T. Additive prognostic significance of ejection fraction for ESC risk model in hypertrophic cardiomyopathy patients. Heart Vessels 2020; 35:391-398. [PMID: 31482217 DOI: 10.1007/s00380-019-01496-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/23/2019] [Indexed: 12/14/2022]
Abstract
The European Society of Cardiology (ESC) clinical risk model is reported in predicting sudden death of hypertrophic cardiomyopathy (HCM). We examined the validity of this model and investigated the significance of ejection fraction (EF) in predicting the prognosis using ESC risk model in HCM patients. 305 HCM patients (198 males) were followed (median follow-up 4.8 years) for life-threatening arrhythmic events (sudden death, aborted sudden death, sustained VT/VF, appropriate ICD intervention for VT/VF) and were divided using ESC risk model into low- (Group L), intermediate- (Group I) and high- (Group H) risk groups. There was a significant difference in the events rate among the 3 groups (L, 0.9%/year; I, 3.9%/year; H, 6.8%/year; log-rank p < 0.001) in all study patients. Reduced EF (<50%) was identified in 27 (8.9%) cases. There was a significant difference in the events rate among the 3 groups in patients with reduced EF (L, 2.4%/year; I, 4.9%/year; H, 16.1%/year; log-rank p = 0.025). There was a significant difference in the events rate among 2 groups in patients stratified as Group H (preserved EF, 3.1%/year vs. reduced EF, 16.1%/year; log-rank p = 0.041). ESC risk model precisely predicts life-threatening events in patients with HCM. Adding EF to ESC risk model are useful for further risk stratification of life-threatening arrhythmic events.
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MESH Headings
- Aged
- Cardiomyopathy, Hypertrophic/complications
- Cardiomyopathy, Hypertrophic/diagnosis
- Cardiomyopathy, Hypertrophic/mortality
- Cardiomyopathy, Hypertrophic/physiopathology
- Databases, Factual
- Death, Sudden, Cardiac/etiology
- Decision Support Techniques
- Female
- Heart Rate
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Predictive Value of Tests
- Prognosis
- Reproducibility of Results
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Stroke Volume
- Tachycardia, Ventricular/diagnosis
- Tachycardia, Ventricular/etiology
- Tachycardia, Ventricular/mortality
- Tachycardia, Ventricular/physiopathology
- Time Factors
- Ventricular Fibrillation/diagnosis
- Ventricular Fibrillation/etiology
- Ventricular Fibrillation/mortality
- Ventricular Fibrillation/physiopathology
- Ventricular Function, Left
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Affiliation(s)
- Yasuki Hen
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan.
| | - Nobuo Iguchi
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan
| | - Mitsuru Kanisawa
- Department of Radiology, Sakakibara Heart Institute, Fuchu-City, Japan
| | - Kaori Takada
- Department of Radiology, Sakakibara Heart Institute, Fuchu-City, Japan
| | - Haruhiko Machida
- Department of Radiology, Kyorin University School of Medicine, Mitaka, Japan
| | - Ayako Takara
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan
| | - Kunihiko Teraoka
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan
| | - Itaru Takamisawa
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan
| | - Morimasa Takayama
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan
| | - Tsutomu Yoshikawa
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-City, Tokyo, 183-0003, Japan
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Chou NK, Okano R, Tedoriya T, Wu IH, Yu HY, Chen YS, Wang MJ, Chi NH. Robotic Transmitral Approach for Hypertrophic Cardiomyopathy With Systolic Anterior Motion. Circ J 2018; 82:2761-2766. [DOI: 10.1253/circj.cj-17-1369] [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: 11/09/2022]
Affiliation(s)
- Nai-Kuan Chou
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine
| | - Ryoi Okano
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine
- Department of Cardiovascular Surgery, Ageo Central General Hospital
| | - Takeo Tedoriya
- Department of Cardiovascular Surgery, Ageo Central General Hospital
| | - I-Hui Wu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine
| | - Hsi-Yu Yu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine
| | - Yih-Sharng Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine
| | - Ming-Jiuh Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine
| | - Nai-Hsin Chi
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine
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Kubo T, Hirota T, Baba Y, Ochi Y, Takahashi A, Yamasaki N, Hamashige N, Yamamoto K, Kondo F, Bando K, Yamada E, Furuno T, Yabe T, Doi YL, Kitaoka H. Patients' Characteristics and Clinical Course of Hypertrophic Cardiomyopathy in a Regional Japanese Cohort - Results From Kochi RYOMA Study. Circ J 2018; 82:824-830. [PMID: 29332907 DOI: 10.1253/circj.cj-17-0845] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There have been few studies on the clinical course of hypertrophic cardiomyopathy (HCM) in a community-based patient cohort in Japan.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture (the Kochi RYOMA study) that consisted of 9 hospitals, and finally, 293 patients with HCM were followed. The ages at registration and at diagnosis were 63±14 and 56±16 years, respectively, and 197 patients (67%) were male. HCM-related deaths occurred in 23 patients during a mean follow-up period of 6.1±3.2 years. The HCM-related 5-year survival rate was 94%. In addition, a total of 77 cardiovascular events that were clinically severe occurred in 70 patients, and the HCM-related 5-year event-free rate was 80%. Multivariate Cox proportional hazards model analysis showed that the presence of NYHA class III at registration was a significant predictor of HCM-related deaths and that the presence of atrial fibrillation, lower fractional shortening and presence of left ventricular outflow tract obstruction in addition to NYHA class III were significant predictors of cardiovascular events. CONCLUSIONS In our unselected registry in an aged Japanese community, HCM mortality was favorable, but one-fifth of the patients commonly suffered from HCM-related adverse cardiovascular events during the 5-year follow-up period. Careful management of HCM patients is needed, particularly for those with the above-mentioned clinical determinants.
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Affiliation(s)
- Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Takayoshi Hirota
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuri Ochi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Asa Takahashi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Naohito Yamasaki
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | | | | | - Fumiaki Kondo
- Department of Cardiology, Japanese Red Cross Kochi Hospital
| | - Kanji Bando
- Department of Cardiology, Tosa Municipal Hospital
| | | | - Takashi Furuno
- Department of Cardiology, Kochi Prefectural Aki General Hospital
| | - Toshikazu Yabe
- Department of Cardiology, Kochi Prefectural Hata Kenmin Hospital
| | - Yoshinori L Doi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University.,Department of Cardiology, Chikamori Hospital
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
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10
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Gavino AI, McLachlan CS. Review of screening studies for atrial fibrillation in rural populations of 11 countries. Proc (Bayl Univ Med Cent) 2017; 30:280-285. [PMID: 28670057 DOI: 10.1080/08998280.2017.11929615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Atrial fibrillation (AF) is a common cardiac arrhythmia, and pathological burden can be influenced by environmental factors. The rural environment may influence the burden of AF, although no systematic review studies have been conducted to address this issue. We performed a systematic review of AF screening studies conducted in rural global populations to determine the burden, risk factors, and screening methods surrounding AF in these settings. Out of the 1792 articles gathered from a keyword search of medical databases and reference lists, 18 publications from 11 countries were included in our analysis. The pooled prevalence of AF across the studies was 2.05% (95% confidence interval, 1.97%-2.13%) and ranged from 0.3% to 10.87%. Only one study utilized a handheld electrocardiogram to screen AF, while the rest used the 12-lead electrocardiogram. AF risk factors reported across studies varied and included increasing age, male gender, hypertension, diabetes, prior myocardial infarction or stroke, obesity, hyperlipidemia/hypercholesterolemia, alcohol consumption, and heart failure. However, none of the studies assessed all risk factors. We suggest that future research on AF in rural communities examine a complete checklist of AF risk factors to better understand their influence on AF burden and development. This will aid in understanding rural prevention strategies and the management of detected AF cases specific to rural areas. At present, the burden of AF in rural communities is poorly understood and has been underreported.
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Affiliation(s)
- Alex I Gavino
- Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Craig S McLachlan
- Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
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11
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Kubo T, Baba Y, Hirota T, Tanioka K, Yamasaki N, Doi YL, Kitaoka H. Prognostic Significance of Non-Dilated Left Ventricular Size and Mitral Regurgitation in Patients With Dilated Phase of Hypertrophic Cardiomyopathy. Int Heart J 2017; 58:63-68. [DOI: 10.1536/ihj.16-109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Takayoshi Hirota
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Katsutoshi Tanioka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Naohito Yamasaki
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Yoshinori L. Doi
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
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12
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Hen Y, Iguchi N, Utanohara Y, Takada K, Machida H, Takara A, Teraoka K, Sumiyoshi T, Takamisawa I, Takayama M, Yoshikawa T. Extent of Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging in Japanese Hypertrophic Cardiomyopathy Patients. Circ J 2016; 80:950-7. [PMID: 26902449 DOI: 10.1253/circj.cj-15-1100] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In addition to the presence of late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR), the extent of LGE is considered clinically important in hypertrophic cardiomyopathy (HCM). We evaluated the extent of LGE on CMR in a large series of Japanese HCM patients. METHODS AND RESULTS CMR was performed in 317 HCM patients (147 male). The extent of LGE was scored as the sum of LGE-positive segments in a left ventricle (LV) 17-segment model. LGE was present in 246 patients (77.6%). LGE was detected in 3.5±3.1 segments on average. When the patients were divided according to maximum wall thickness (mild, <20 mm; moderate, 20-29 mm; severe, ≥30 mm), median LGE score increased as wall thickness increased (mild, 2 vs. moderate, 4 vs. severe, 5; P=0.000). When the patients were divided according to ejection fraction (EF) (reduced, <50%; low-normal, 50-65%; normal, >65%), median LGE score increased as EF decreased (reduced, 7 vs. low-normal, 4 vs. normal, 2; P=0.000). On multivariate analysis, reduced EF (OR, 0.947, P=0.015), pressure gradient <30 mmHg (OR, 0.359, P=0.000) and increased maximum wall thickness (OR, 1.236, P=0.000) were independent factors associated with extensive LGE. CONCLUSIONS Progression of LGE was related to increased wall thickness, decreased contractility, and reduced intraventricular pressure gradient.
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Affiliation(s)
- Yasuki Hen
- Department of Cardiology, Sakakibara Heart Institute
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13
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Guttmann OP, Rahman MS, O'Mahony C, Anastasakis A, Elliott PM. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart 2013; 100:465-72. [DOI: 10.1136/heartjnl-2013-304276] [Citation(s) in RCA: 189] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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14
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Tian T, Liu Y, Zhou X, Song L. Progress in the Molecular Genetics of Hypertrophic Cardiomyopathy: A Mini-Review. Gerontology 2013; 59:199-205. [DOI: 10.1159/000346146] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 11/28/2012] [Indexed: 11/19/2022] Open
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15
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Kitaoka H, Kubo T, Hayashi K, Yamasaki N, Matsumura Y, Furuno T, Doi YL. Tissue Doppler imaging and prognosis in asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2012; 14:544-9. [DOI: 10.1093/ehjci/jes200] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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16
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Kitaoka H, Kubo T, Baba Y, Yamasaki N, Matsumura Y, Furuno T, Doi YL. Serum tenascin-C levels as a prognostic biomarker of heart failure events in patients with hypertrophic cardiomyopathy. J Cardiol 2012; 59:209-14. [PMID: 22218323 DOI: 10.1016/j.jjcc.2011.11.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Revised: 11/10/2011] [Accepted: 11/26/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Although serum tenascin-C (TN-C) levels are related to left ventricular (LV) remodeling in patients with myocardial infarction and are useful as a prognostic biomarker of heart failure in patients with dilated cardiomyopathy, the clinical significance of TN-C levels has not yet been studied in patients with hypertrophic cardiomyopathy (HCM). Therefore, the purpose of this study is to elucidate whether serum TN-C levels are a prognostic biomarker for heart failure in patients with HCM. METHODS The relationship between serum TN-C levels and heart failure events was studied in 36 patients with HCM during follow-up. RESULTS Levels of serum TN-C were 28±13 ng/ml (range 11-80 ng/ml). Although patients with LV systolic impairment showed higher TN-C levels than those with preserved LV systolic function (33±11 ng/ml vs. 27±14 ng/ml; p=0.16), TN-C levels were not related to any echocardiographic parameters. During the follow-up period of 4.8±1.4 years, heart failure events were observed in six patients and TN-C levels in patients with events were higher than those in patients without events. Kaplan-Meier analysis showed that the prognosis was worse in patients with high TN-C levels (≥39.2 ng/ml) than in those with low TN-C levels. CONCLUSIONS Heart failure events were more frequently observed in patients with high serum TN-C levels than in those with low TN-C levels. Serum TN-C levels may be a new prognostic biomarker for heart failure in patients with HCM.
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Affiliation(s)
- Hiroaki Kitaoka
- Cardiology Division, Department of Medicine and Geriatrics, Kochi Medical School, Oko-cho, Kochi 783-8505, Japan.
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17
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Plasma metalloproteinase levels and left ventricular remodeling in hypertrophic cardiomyopathy in patients with an identical mutation. J Cardiol 2011; 58:261-5. [DOI: 10.1016/j.jjcc.2011.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 07/16/2011] [Accepted: 07/24/2011] [Indexed: 12/17/2022]
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18
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Kitaoka H, Kubo T, Okawa M, Takenaka N, Sakamoto C, Baba Y, Hayashi K, Yamasaki N, Matsumura Y, Doi YL. Tissue Doppler Imaging and Plasma BNP Levels to Assess the Prognosis in Patients with Hypertrophic Cardiomyopathy. J Am Soc Echocardiogr 2011; 24:1020-5. [DOI: 10.1016/j.echo.2011.05.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Indexed: 01/29/2023]
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19
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Hamada T, Kubo T, Kitaoka H, Hirota T, Hoshikawa E, Hayato K, Shimizu Y, Okawa M, Yamasaki N, Matsumura Y, Yabe T, Takata J, Doi YL. Clinical features of the dilated phase of hypertrophic cardiomyopathy in comparison with those of dilated cardiomyopathy. Clin Cardiol 2010; 33:E24-8. [PMID: 20641106 DOI: 10.1002/clc.20533] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although the dilated phase of hypertrophic cardiomyopathy (D-HCM) characterized by left ventricular (LV) systolic dysfunction and cavity dilatation has been reported to be a poor prognosis, this is now in contrast to the improved prognosis of dilated cardiomyopathy (DCM) in the era of advancements in heart failure management. There has been no investigation of the clinical features of D-HCM compared with those of DCM from the point of management of systolic dysfunction. HYPOTHESIS The aim of this study was to investigate the clinical features of D-HCM in comparison with those of DCM in a single institute. METHODS We studied 20 consecutive patients with D-HCM (global ejection fraction < 50%) and 115 consecutive patients with DCM. RESULTS At diagnosis of D-HCM, 8 (40%) of the D-HCM patients already experienced dyspnea (New York Heart Association [NYHA] class >or= III). Left atrial diameter was larger and prevalence of atrial fibrillation was higher in the D-HCM group, although LV size was larger and LV ejection fraction was lower in the DCM group. During the follow-up period (4.0 years), 11 (55%) of the patients with D-HCM died. The 5-year survival rate from all-cause mortality including cardiac transplantation was 45.6% in patients with D-HCM vs 81.6% in patients with DCM (log-rank P = .0001). CONCLUSIONS Patients with D-HCM were more symptomatic at diagnosis, although LV dilatation and impaired fractional shortening seemed more severe in patients with DCM. The prognosis for D-HCM patients was worse than that for patients with DCM despite similar or even more intensive treatment for heart failure.
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Affiliation(s)
- Tomoyuki Hamada
- Department of Medicine and Geriatrics, Kochi Medical School, Nankoku-shi, Kochi, Japan
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20
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Hitomi N, Kubo T, Kitaoka H, Hirota T, Hamada T, Hoshikawa E, Hayato K, Okawa M, Kimura A, Doi YL. A frameshift deletion mutation in the cardiac myosin-binding protein C gene associated with dilated phase of hypertrophic cardiomyopathy and dilated cardiomyopathy. J Cardiol 2010; 56:189-96. [PMID: 20605413 DOI: 10.1016/j.jjcc.2010.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 04/19/2010] [Accepted: 04/20/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES A few studies reported that some mutations in the cardiac myosin-binding protein C (MyBPC) gene were associated with dilated phase of hypertrophic cardiomyopathy (D-HCM) resembling dilated cardiomyopathy (DCM). We studied 5 unrelated cardiomyopathy probands caused by an identical mutation in the MyBPC gene. The results of clinical and genetic investigations in these patients are presented in this paper. METHODS We analyzed MyBPC gene in DCM patients as well as patients with HCM. RESULTS An R945fs/105 mutation, 2-base deletion at nucleotides 18,535 and 18,536, was identified in 4 of the 176 HCM probands and in 1 of the 54 DCM probands. Genetic analysis in relatives of those probands revealed another one member with this mutation. A total of 6 subjects had R945fs/105 mutation. The mean age of these six patients at diagnosis was 61 years. At initial evaluation, three of them were diagnosed as having HCM with normal left ventricular (LV) systolic function. The other two patients already had D-HCM. The remaining one patient was diagnosed as having DCM because of reduced LV systolic function (ejection fraction=31%) without increased LV wall thickness. During follow-up (7.6 years), all three patients with impaired LV systolic function were admitted for treatment of heart failure and/or sustained ventricular tachycardia. Finally, one patient with the diagnosis of D-HCM died of heart failure. CONCLUSIONS The patients with this mutation may develop LV systolic dysfunction and suffer from cardiovascular events through mid-life and beyond.
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Affiliation(s)
- Nobuhiko Hitomi
- Department of Medicine and Geriatrics, Kochi Medical School, Oko-cho, Nankoku-shi, Kochi 783-8505, Japan
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21
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Kitaoka H, Kubo T, Okawa M, Yamasaki N, Matsumura Y, Nishinaga M, Doi YL. Plasma adiponectin levels and left ventricular remodeling in hypertrophic cardiomyopathy. Int Heart J 2010; 51:51-5. [PMID: 20145352 DOI: 10.1536/ihj.51.51] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Adiponectin, which is an adipose-derived protein with antiatherosclerogenic activities, has been reported to be elevated in patients with heart failure. However, there are no reports on the significance of adiponectin in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to elucidate the clinical significance of plasma adiponectin levels in HCM patients. Clinical characteristics, echocardiographic parameters, and levels of plasma B-type natriuretic peptide (BNP) and adiponectin were evaluated in 106 HCM patients. The plasma adiponectin levels were 10.8 +/- 6.3 (range, 2.7-37.3) microg/mL. Plasma adiponectin levels were positively related to age and inversely related to body mass index (BMI). Among echocardiographic parameters, % fractional shortening (r = -0.20, P = 0.03) and maximum LV wall thickness (r = -0.23, P = 0.02) were inversely related to plasma adiponectin levels. A significant correlation between plasma adiponectin levels and BNP levels was also observed (r = 0.27, P = 0.005). In multivariate analysis, BMI, % fractional shortening, and plasma BNP levels were independent predictors of plasma adiponectin levels. Plasma adiponectin levels are associated with impaired LV systolic function in HCM patients, but not with the LV outflow gradient. Together with BNP, adiponectin can be a useful biomarker for assessing disease severity in HCM patients.
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22
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Kubo T, Kitaoka H, Okawa M, Nishinaga M, Doi YL. Hypertrophic cardiomyopathy in the elderly. Geriatr Gerontol Int 2010; 10:9-16. [DOI: 10.1111/j.1447-0594.2009.00572.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Kitaoka H, Kubo T, Okawa M, Hayato K, Yamasaki N, Matsumura Y, Doi YL. Impact of Metalloproteinases on Left Ventricular Remodeling and Heart Failure Events in Patients With Hypertrophic Cardiomyopathy. Circ J 2010; 74:1191-6. [DOI: 10.1253/circj.cj-09-1013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Toru Kubo
- Department of Medicine and Geriatrics, Kochi Medical School
| | - Makoto Okawa
- Department of Medicine and Geriatrics, Kochi Medical School
| | - Kayo Hayato
- Department of Medicine and Geriatrics, Kochi Medical School
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24
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Experimental therapies in hypertrophic cardiomyopathy. J Cardiovasc Transl Res 2009; 2:483-92. [PMID: 20560006 DOI: 10.1007/s12265-009-9132-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 09/16/2009] [Indexed: 12/31/2022]
Abstract
The quintessential clinical diagnostic phenotype of human hypertrophic cardiomyopathy (HCM) is primary cardiac hypertrophy. Cardiac hypertrophy is also a major determinant of mortality and morbidity including the risk of sudden cardiac death (SCD) in patients with HCM. Reversal and attenuation of cardiac hypertrophy and its accompanying fibrosis is expected to improve morbidity as well as decrease the risk of SCD in patients with HCM.The conventionally used pharmacological agents in treatment of patients with HCM have not been shown to reverse or attenuate established cardiac hypertrophy and fibrosis. An effective treatment of HCM has to target the molecular mechanisms that are involved in the pathogenesis of the phenotype. Mechanistic studies suggest that cardiac hypertrophy in HCM is secondary to activation of various hypertrophic signaling molecules and, hence, is potentially reversible. The hypothesis is supported by the results of genetic and pharmacological interventions in animal models. The results have shown potential beneficial effects of angiotensin II receptor blocker losartan, mineralocorticoid receptor blocker spironolactone, 3-hydroxy-3-methyglutaryl-coenzyme A reductase inhibitors simvastatin and atorvastatin, and most recently, N-acetylcysteine (NAC) on reversal or prevention of hypertrophy and fibrosis in HCM. The most promising results have been obtained with NAC, which through multiple thiol-responsive mechanisms completely reversed established cardiac hypertrophy and fibrosis in three independent studies. Pilot studies with losartan and statins in humans have established the feasibility of such studies. The results in animal models have firmly established the reversibility of established cardiac hypertrophy and fibrosis in HCM and have set the stage for advancing the findings in the animal models to human patients with HCM through conducting large-scale efficacy studies.
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25
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Kubo T, Kitaoka H, Okawa M, Hirota T, Hayato K, Yamasaki N, Matsumura Y, Yabe T, Takata J, Doi YL. Clinical impact of atrial fibrillation in patients with hypertrophic cardiomyopathy. Results from Kochi RYOMA Study. Circ J 2009; 73:1599-605. [PMID: 19590139 DOI: 10.1253/circj.cj-09-0140] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There have been few studies of the clinical features of hypertrophic cardiomyopathy (HCM) in a community-based patient cohort in Japan. METHODS AND RESULTS Cardiomyopathy registration was established in Kochi Prefecture and named the Kochi RYOMA (registry of myocardial diseases) study, consisting of 9 hospitals that registered 261 patients with a diagnosis of HCM. At registration, 74 patients (28%) had documented paroxysmal or chronic atrial fibrillation (AF). Although most patients (93%) were in New York Heart Association (NYHA) class I or II, 17 of the 18 patients in NYHA III had AF; 37 of the 74 patients with AF suffered from morbid events (embolism and/or heart failure (HF) admission), and 15 of 19 patients with embolic events had AF prior to or at the time of embolism. Of the 29 patients who had a history of HF admission, 8 had left ventricular systolic dysfunction, and the other 21 patients were hospitalized because of diastolic HF. AF occurred prior to HF in 20 of those 21 patients. Furthermore, 19 of those 20 patients with AF and diastolic HF were hospitalized within 1 year after detection of AF. CONCLUSIONS In an unselected regional registry, AF was the major determinant of clinical deteriorations in patients with HCM.
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Affiliation(s)
- Toru Kubo
- Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan
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26
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Long term exercise capacity in patients with hypertrophic cardiomyopathy treated with percutaneous transluminal septal myocardial ablation. Eur J Heart Fail 2008; 10:1123-6. [DOI: 10.1016/j.ejheart.2008.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 08/04/2008] [Accepted: 09/17/2008] [Indexed: 11/22/2022] Open
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27
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Motoyasu M, Kurita T, Onishi K, Uemura S, Tanigawa T, Okinaka T, Takeda K, Nakano T, Ito M, Sakuma H. Correlation between late gadolinium enhancement and diastolic function in hypertrophic cardiomyopathy assessed by magnetic resonance imaging. Circ J 2008; 72:378-83. [PMID: 18296832 DOI: 10.1253/circj.72.378] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Diastolic dysfunction is common in patients with overt hypertrophic cardiomyopathy (HCM). Steady-state cine magnetic resonance imaging (MRI) enables measurement of the diastolic function of the left ventricle (LV), and late gadolinium enhanced MRI can delineate the presence and extent of fibrosis in HCM. The purpose of this study was to determine the relationship between the extent of myocardial fibrosis demonstrated by late gadolinium-enhanced MRI and diastolic dysfunction. METHODS AND RESULTS Seventeen patients (13 men, mean age 57.7+/-9.8 years) with HCM were studied. The severity index of late gadolinium enhancement was determined by scoring the extent of enhanced tissue in 30 myocardial segments. The peak filling rate (PFR), LV ejection fraction and LV mass were determined by cine MRI. Contrast-enhanced MRI demonstrated late gadolinium enhancement in 97 of 510 segments (19%) and 13 of the 17 patients (77%). The severity index of late gadolinium enhancement demonstrated a significant negative correlation with PFR (r= -0.86, p<0.01) and with the LV ejection fraction (r= -0.59, p<0.05). No significant correlation was observed between the severity index of late gadolinium enhancement and LV mass (r=0.23, p=0.30). CONCLUSION The extent of myocardial fibrosis revealed by late gadolinium-enhanced MRI has a strong relationship to diastolic dysfunction in patients with HCM.
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Affiliation(s)
- Munenobu Motoyasu
- Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan
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28
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Hayato K, Okawa M, Matsumura Y, Kitaoka H, Kubo T, Hitomi N, Yamasaki N, Yabe T, Furuno T, Takata J, Nishinaga M, Doi YL. Hypertrophic cardiomyopathy with mild left ventricular remodeling: Echocardiographic assessment using left ventricular wall motion score. J Cardiol 2008; 51:95-105. [DOI: 10.1016/j.jjcc.2008.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 12/24/2007] [Accepted: 01/10/2008] [Indexed: 10/22/2022]
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29
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Efthimiadis GK, Giannakoulas G, Parcharidou DG, Karvounis HI, Mochlas ST, Styliadis IH, Papadopoulos CE, Kounatiadis P, Pliakos CI, Parcharidis GE, Louridas GE. Clinical significance of tissue Doppler imaging in patients with hypertrophic cardiomyopathy. Circ J 2007; 71:897-903. [PMID: 17526987 DOI: 10.1253/circj.71.897] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A transmitral E/septal Ea ratio > or =15 is a predictor of adverse outcome in cardiac disease, so it was hypothesized that a septal E/Ea >/=15 would predict the risk of adverse outcome, including sustained ventricular tachycardia (VT), cardiac arrest, implantable cardioverter defibrillator (ICD) discharge, or sudden death (SD) in patients with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS The study group comprised 96 consecutive patients with HCM (median age 53 years) who completed all noninvasive tests for risk stratification. The endpoint of the study was defined as death, cardiac arrest, documented sustained VT, or ICD-discharge. The median follow-up was 20.6 months. All patients were alive at the end of follow-up, although 8 patients had reached the endpoint during the study period. The variables that were predictive of adverse clinical outcome were family history of premature SD (p=0.03), syncope (p<0.001), maximum wall thickness > or =3 cm (p=0.02), and septal E/Ea > or =15 (p<0.001). In a stepwise multivariable model the only independent prognostic indicator was a septal E/Ea > or =15 (relative risk 0.26, 95% confidence interval 0.2-0.58, p<0.001). The cumulative event-free survival rate was 78.9% in patients with septal E/Ea > or =15, and 100% in patients with septal E/Ea <15 (p=0.0003). CONCLUSIONS Septal E/Ea > or =15 predicts patients with HCM who are at risk of sustained VT, cardiac arrest, ICD-discharge, or SD. (Circ J 2007; 71: 897 - 903).
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MESH Headings
- Adult
- Cardiomyopathy, Hypertrophic/complications
- Cardiomyopathy, Hypertrophic/diagnostic imaging
- Cardiomyopathy, Hypertrophic/mortality
- Cardiomyopathy, Hypertrophic/physiopathology
- Death, Sudden, Cardiac/etiology
- Defibrillators, Implantable
- Disease-Free Survival
- Echocardiography, Doppler
- Female
- Follow-Up Studies
- Heart Arrest/diagnostic imaging
- Heart Arrest/etiology
- Heart Arrest/mortality
- Heart Arrest/physiopathology
- Humans
- Male
- Middle Aged
- Risk Assessment
- Risk Factors
- Survival Rate
- Tachycardia, Ventricular/diagnostic imaging
- Tachycardia, Ventricular/etiology
- Tachycardia, Ventricular/mortality
- Tachycardia, Ventricular/physiopathology
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Affiliation(s)
- Georgios K Efthimiadis
- First Cardiology Department, AHEPA Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, GR-54637 Thessaloniki, Greece.
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Nagai T, Ogimoto A, Okayama H, Ohtsuka T, Shigematsu Y, Hamada M, Miki T, Higaki J. A985G Polymorphism of the Endothelin-2 Gene and Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy. Circ J 2007; 71:1932-6. [DOI: 10.1253/circj.71.1932] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takayuki Nagai
- Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | - Akiyoshi Ogimoto
- Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | - Hideki Okayama
- Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | - Tomoaki Ohtsuka
- Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | - Yuji Shigematsu
- Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | | | - Tetsuro Miki
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine
| | - Jitsuo Higaki
- Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
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31
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Daitoku K, Fukuda I, Kitagawa R, Minakawa M, Suzuki Y, Fukui K. Aortic Valve Replacement in a Patient With Myelodysplastic Syndrome and Interstitial Pneumonia. Circ J 2007; 71:1826-8. [DOI: 10.1253/circj.71.1826] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kazuyuki Daitoku
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
| | - Ikuo Fukuda
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
| | - Rieko Kitagawa
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
| | - Masahito Minakawa
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
| | - Yasuyuki Suzuki
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
| | - Kozo Fukui
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
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