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Miura S, Watanabe E, Senzaki K, Hiruki S, Matsumoto S, Morikawa T, Uchiyama Y, Kurata S, Ochi M, Ohyagi Y, Shibata H. Episodic ataxia type 2 with a novel missense variant (Leu602Arg) in CACNA1A. Hum Genome Var 2024; 11:3. [PMID: 38221525 PMCID: PMC10788331 DOI: 10.1038/s41439-023-00261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 01/16/2024] Open
Abstract
Autosomal dominant episodic ataxia type 2 (EA2) is caused by variants in CACNA1A. We examined a 20-year-old male with EA symptoms from a Japanese family with hereditary EA. Cerebellar atrophy was not evident, but single photon emission computed tomography showed cerebellar hypoperfusion. We identified a novel nonsynonymous variant in CACNA1A, NM_001127222.2:c.1805T>G (p.Leu602Arg), which is predicted to be functionally deleterious; therefore, this variant is likely responsible for EA2 in this pedigree.
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Affiliation(s)
- Shiroh Miura
- Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan.
| | - Emina Watanabe
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Kensuke Senzaki
- Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Shigeyoshi Hiruki
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Sayaka Matsumoto
- Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Takuya Morikawa
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Yusuke Uchiyama
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Seiji Kurata
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Masayuki Ochi
- Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Yasumasa Ohyagi
- Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Hiroki Shibata
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan
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Makrakis LR, Oliveira VC, Santos ES, Nascimento C, Watanabe E, Ribeiro AB, Silva-Lovato CH. Analysis of microbial communities of ocular prostheses and anophthalmic sockets using 16S rRNA gene sequencing. Biofouling 2023; 39:555-564. [PMID: 37470406 DOI: 10.1080/08927014.2023.2236562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/06/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
Ocular prostheses are liable to host microbial adhesion, which can favor conjunctival inflammation. Knowing the microbiota of the ocular prosthesis and anophthalmic socket is important for predicting infection-related pathogens. This study evaluated the microbiota of the prostheses and anophthalmic sockets of six individuals by 16S rRNA sequencing. The microbial abundance and diversity were analyzed using the Operational Taxonomic Units at the genus level. Forty-seven phyla, capturing 1,258 named genera, were recorded in the sample set. In both sites, the most frequent genera were Fusobacterium, Staphylococcus, Prevotella, and Streptococcus. The microbial abundance was higher for the anophthalmic socket than for the prosthesis. Alpha diversity showed no significant differences in bacterial richness or diversity between sites. Although the microbial abundance in the anophthalmic socket was higher, both sites had similar microbiota with high diversity and low dominance among the genera.
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Affiliation(s)
- L R Makrakis
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - V C Oliveira
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Human Exposome and Infectious Diseases Network-HEID, School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - E S Santos
- Department of Clinical Toxicological and Bromatologic Analysis, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - C Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - E Watanabe
- Human Exposome and Infectious Diseases Network-HEID, School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - A B Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - C H Silva-Lovato
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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3
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Lima NG, Monteiro RM, Torres CP, de Souza-Gabriel AE, Watanabe E, Borsatto MC. Influence of antimicrobial photodynamic therapy with different pre-irradiation times on children's dental biofilm: randomized clinical trial. Eur Arch Paediatr Dent 2022; 23:897-904. [PMID: 35666375 DOI: 10.1007/s40368-022-00716-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Photodynamic therapy (PDT) is effective in reducing pathogenic microorganisms in the oral cavity and in preventing dental diseases. This study evaluated the pre-irradiation time using PDT (diode laser associated with 0.01% methylene blue) to decrease the number of microorganisms in the visible plaque in permanent teeth. METHODS This randomized clinical trial included 108 homologous lower permanent first molars (36 and 46) with biofilm from 54 children aged six to 12 years. PDT was performed (0.01% methylene blue photosensitizer/therapeutic laser-InGaAIP), according to the following protocols: Group 1, biofilm collection of the distal area of the lingual surface of 36 µm before PDT; group 2, mesial area of the lingual surface of 36 µm 1 min after PDT; group 3, area of the lingual surface of 46 µm before PDT; and group 4, mesial area of the lingual surface of 46 µm 5 min after PDT. RESULTS After statistical analysis, significant differences were observed between the groups (p = 0.000). In groups 2 and 4, the number of bacteria tended to decrease, with a more evident bacterial reduction in group 4. CONCLUSIONS Pre-irradiation reduced the number of colony-forming units of mature bacterial biofilms in vivo. A time of 5 min resulted in a greater reduction in the number of colony-forming units. CLINICAL TRIAL REGISTRATION ReBEC Identifier: RBR-6bqfp3; Date of Register: March 2nd, 2020. Retrospectively Registered.
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Affiliation(s)
- N G Lima
- Department of Pediatric Clinics, Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto Dental School, University of São Paulo (USP), Av. do Café, s/n Subsetor Oeste 11, Ribeirão Prêto, SP, 14040-940, Brazil
| | - R M Monteiro
- Department of Fundamental Nursing, The College of Nursing, University of São Paulo, Ribeirão Prêto, SP, Brazil
| | - C P Torres
- Department of Pediatric Clinics, Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto Dental School, University of São Paulo (USP), Av. do Café, s/n Subsetor Oeste 11, Ribeirão Prêto, SP, 14040-940, Brazil
| | - A E de Souza-Gabriel
- Department of Restorative Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Prêto, SP, Brazil
| | - E Watanabe
- Department of Restorative Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Prêto, SP, Brazil
| | - M C Borsatto
- Department of Pediatric Clinics, Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto Dental School, University of São Paulo (USP), Av. do Café, s/n Subsetor Oeste 11, Ribeirão Prêto, SP, 14040-940, Brazil.
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Sato T, Nakajima M, Takeishi Y, Nakajima K, Egawa K, Watanabe E, Hasegawa M. Effect of brown rice intake on obese people with exercise habits. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Iwami N, Kawamata M, Ozawa N, Yamamoto T, Watanabe E, Mizuuchi M, Moriwaka O, Kamiya H. P–763 Neonatal outcomes of the first 65 infants delivered after IVF treatment with progestin-primed ovarian stimulation using dienogest in patients with endometriosis. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the perinatal outcome of pregnancies resulting from a controlled ovarian hyperstimulation (COH) regimen of progestin-primed ovarian stimulation (PPOS) protocol using dienogest (DNG) in patients with endometriosis?
Summary answer
No difference in mean birth weight, however preterm and low birth weight babies are significantly more in the group treated with PPOS using DNG.
What is known already
Dienogest is an oral progestin effective for the treatment of endometriosis, such as reduction of endometrial lesion and control of pain intensity with safety profile and good tolerability. We reported for the first time in the world that DNG was better than dydrogesterone (DYG) for PPOS in terms of the mature oocytes rate and the fertilization rate in patients with endometriosis. Although there have been several reports of infants born with PPOS using DYG, it is essential to report on the perinatal outcome of embryos transferred after treatment with PPOS using DNG from now on. Study design, size, duration: We prospectively investigated the perinatal outcomes of 65 newborns which were the result of using a new COH regimen; PPOS with DNG. The results were compared with perinatal outcome data of babies born between 2018 and 2020 to 815 patients who underwent assisted reproductive technology (ART) treatment at our fertility center. As for the congenital malformation rate, the data was also compared with the 2017 Japanese data bank of babies born after ART treatment.
Participants/materials, setting, methods
We studied the perinatal data of all babies born after transfer of frozen embryos acquired by COH using PPOS protocol with DNG. The rate of maternal complications during pregnancy, pregnancy duration, birth weight, congenital malformations and method of delivery were investigated. We compared the perinatal outcomes of infants born after in vitro fertilization (IVF) and frozen embryo transfer at our center during the same period.
Main results and the role of chance
Perinatal data of 65 babies (study group) were compared with the perinatal data of 840 babies born after IVF at our center, and 47807 babies born after ART in Japan, 2017. We found 3 twin and 59 singleton pregnancies in the study group, compared to 23 twins, 1 triplet and 791 singleton pregnancies during the same period at our center. Considering singletons, there was no difference in mean birthweight (study group; 2893.2±652g vs. total at our center; 3001.2±425g, respectively, p = 0.102). Preterm births (<37 weeks) were significantly more frequent in the PPOS using DNG treatment group than in total at our center (19.2% vs. 9.7%, p = 0.016). The percentage of infants with a birth weight < 2.5 kg was also significantly higher in the PPOS treatment group compared to the total at our center (22.6% vs.11.9%, p = 0.015). The Caesarean section rate was 53.2% in the study group vs. 47.1% control group of our center respectively (p = 0.353). One babies in the study group had malformations in the ocular region. There was no significant difference in congenital malformations between the study group and ART data bank in Japan, 2017 (OR 0.67, 95% CI 0.093: 4.836).
Limitations, reasons for caution
The number of babies is still low, further prospective studies including larger populations are needed to confirm the efficacy of PPOS protocol with DNG.
Wider implications of the findings: This is the first report on the perinatal outcome of babies born by a new COH method using PPOS with DNG, which is a combination of endometriosis treatment and COH for IVF. The association of endometriosis with preterm birth and low birth weight needs to be further investigated.
Trial registration number
UMIN000031111
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Affiliation(s)
- N Iwami
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - M Kawamata
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - N Ozawa
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - T Yamamoto
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - E Watanabe
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - M Mizuuchi
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - O Moriwaka
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - H Kamiya
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
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Otsuki H, Arashi H, Nakazawa M, Inagaki Y, Ebihara S, Tanaka K, Nakao M, Watanabe E, Ogawa H, Yamaguchi J, Hagiwara N. Aggressive lipid lowering therapy with pitavastatin and ezetimibe improve cardiovascular outcomes in patients with ST segment elevation myocardial infarction: insights from the HIJ-PROPER Study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
The purpose of this study was to evaluate the effect of aggressive lipid-lowering therapy with pitavastatin and ezetimibe in patients with ST-segment elevation myocardial infarction (STEMI) as compared with those with other classification of an acute coronary syndrome (ACS) including non-STEMI (NSTEMI) and unstable angina pectoris (UA).
Methods
This is a post hoc sub-analysis of the HIJ-PROPER study. In the original study, ACS patients with dyslipidemia were randomized to either pitavastatin + ezetimibe therapy or pitavastatin monotherapy. In the present analysis, we divided HIJ-PROPER participants into the STEMI group (n=880) and NSTEMI + UA group (n=841). Cardiovascular events were analyzed between the two groups. The primary endpoint was a composite of major advanced cardiovascular events (MACE; all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina pectoris, and ischemia-driven revascularization)
Result
During median follow-up period of 3.4 years, the cumulative incidence of the primary endpoint in STEMI group was 31.9% in the pitavastatin+ezetimibe therapy, compared with 39.7% in the pitavastatin-monotherapy (HR, 0.77; 95% CI, 0.62–0.97; p=0.02). However, there was no effect of pitavastatin+ezetimibe therapy on the primary endpoint in the NSTEMI + UA group. Concerning the individual components of the primary endpoint in STEMI group, the percentage of occurrence of all-cause death was significantly lower in the pitavastatin+ezetimibe therapy compared to pitavastatin mono-therapy (14 patients (3.2%) vs. 31 patients (6.9%), respectively; HR, 0.45; 95% CI, 0.23–1.84, p=0.01). Multivariate analysis revealed that use of ezetimibe and prevalence of diabetes mellitus at baseline were independent predictors of primary endpoints in STEMI group (HR, 0.79; 95% CI, 0.63–0.99; p=0.04 for use of ezetimibe, HR 1.54; 95% CI, 1.22–1.94, p=0.0003 for diabetes mellitus).
Conclusion
Patients with pitavastatin+ezetimibe therapy as compared with pitavastatin-monotherapy had lower cardiovascular event in patients with ST-segment elevation myocardial infarction.
Kaplan-Meier curves for primary endpoint
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Otsuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Arashi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nakazawa
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - Y Inagaki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - S Ebihara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nakao
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Watanabe
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Ogawa
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - J Yamaguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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Ohtake H, Ishii J, Nishimura H, Kawai H, Muramatsu T, Harada M, Motoyama S, Watanabe E, Ozaki Y, Iwata M. Prospective validation of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I in Japanese patients presenting to emergency department. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The diagnostic performance of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I (hsTnI) for non-ST-segment elevation myocardial infarction (NSTEMI) has not been evaluated in an Asian population.
Purpose
We aimed to prospectively validate the 0-hour/1-hour algorithm using hsTnI in a Japanese population.
Method
We enrolled 754 Japanese patients (mean age of 70 years, 395 men) presenting to our emergency department with symptoms suggestive of NSTEMI. The hsTnI concentration was measured using the Siemens ADVIA Centaur hsTnI assay at presentation and after 1 hour. Patients were divided into three groups according to the algorithm: hsTnI below 3 ng/L (only applicable if chest pain onset >3 hours) or below 6 ng/L and delta 1 hour below 3 ng/L were the “rule-out” group; hsTnI at least 120 ng/L or delta 1 hour at least 12 ng/L were in the “rule-in” group; the remaining patients were classified as the “observe” group. Based on the Fourth Universal Definition of Myocardial Infarction, the final diagnosis was adjudicated by 2 independent cardiologists using all available information, including coronary angiography, coronary computed tomography, and follow-up data. Safety of rule-out was quantified by the negative predictive value (NPV) for NSTEMI, accuracy of rule-in by the positive predictive value (PPV), and overall efficacy by the proportion of patients triaged towards rule-out or rule-in within 1 hour.
Results
Prevalence of NSTEMI was 6.5%. The safety of rule-out (NPV 100%), accuracy of rule-in (PPV 26%), and overall efficacy (54%) were shown in Figure.
Conclusion
The 0-hour/1-hour algorithm using hsTnI is very safe and effective in triaging Japanese patients with suspected NSTEMI.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Ohtake
- Fujita Health University, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Toyoake, Japan
| | | | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - M Harada
- Fujita Health University, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - M Iwata
- Fujita Health University, Toyoake, Japan
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8
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Harada M, Nomura Y, Nishimura A, Motoike Y, Koshikawa M, Watanabe E, Izawa H, Ozaki Y. Factors associated with silent cerebral events during catheter ablation for atrial fibrillation in the era of uninterrupted oral anticoagulation therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A silent cerebral event (SCE), detected by brain magnetic resonance imaging (MRI), is defined as an acute new brain lesion without clinically apparent neurological deficit, and is frequently observed after catheter ablation in atrial fibrillation (AF) patients. Although the small number of SCEs does not cause neurocognitive dysfunction, the greater volume and/or larger number of SCE lesions are reportedly related to neuropsychological decline; SCE incidence may be a surrogate marker for the potential thromboembolic risk. Thus, strategies to reduce SCEs would be beneficial. Uninterrupted oral anticoagulation strategy for peri-procedural period reportedly reduced the risk of SCEs, but the incidence hovers at 10% to 30%. We sought factors associated with SCEs during catheter ablation for AF in patients with peri-procedural uninterrupted oral anticoagulation (OAC) therapy.
Methods
AF patients undergoing catheter ablation were eligible (n=255). All patients took non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonist (VKA) for peri-procedural OAC (>4 weeks) without interruption during the procedure. Brain MRI was performed within 2 days after the procedure to detect SCEs. Clinical characteristics and procedure-related parameters were compared between patients with and without SCEs.
Results
SCEs were detected in 59 patients (23%, SCE[+]) but not in 196 patients (77%, SCE[-]). Average age was higher in SCE[+] than SCE[-] (66±10 years vs. 62±12 years, p<0.05). Persistent AF prevalence, CHADS2/CHA2DS2-VASc scores, and serum NT-ProBNP levels increased in SCE[+] vs. SCE[-]. In transthoracic/transesophageal echocardiography, left-atrial dimension (LAD) was larger and AF rhythm/spontaneous echo contrast were more frequently observed in SCE[+] than SCE[-]. SCE[+] had lower initial activated clotting time (ACT) before unfractionated heparin (UFH) injection and longer time to reach optimal ACT (>300 sec) before trans-septal puncture than SCE [-]. In multivariate analysis, LAD, initial ACT before UFH injection, and time to reach optimal ACT were predictors for SCEs.
Conclusions
LAD and intra-procedural ACT kinetics affect SCEs during the procedure in patients with uninterrupted OAC for AF ablation. Shortening time to achieve optimal ACT during the procedure may reduce the risk of SCEs.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | | | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - H Izawa
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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Ishii J, Takahashi H, Nishimura H, Fujiwara W, Ohta M, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Motoyama S, Watanabe E, Izawa H, Ozaki Y. Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.
Objective
We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.
Methods
We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.
Results
During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.
Conclusions
Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.
Presepsin quartiles and mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - W Fujiwara
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - M Ohta
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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10
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Kubo T, Takano H, Takayama M, Doi Y, Minami Y, Ebato M, Inomata T, Katoh T, Okamoto R, Chikamori T, Watanabe E, Furugen A, Maekwa Y, Shimizu W, Kitaoka H. Baseline clinical features in a large-scale registration survey of patient with hypertrophic cardiomyopathy throughout Japan: J-HCM registry study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a most prevalent primary myocardial disorder with heterogeneous clinical features. However, there have been few studies on clinical features of HCM as a prospective cohort. In 2015, we established a large-scale registration survey of patients with HCM throughout Japan, named J-HCM registry study.
Purpose
The aim of this study was to clarify the clinical features of Japanese patients with HCM.
Methods
J-HCM registry study is a prospective, multicenter investigation, consisting of 24 hospitals. This time, we present the baseline clinical characteristics in this survey.
Results
Total 1484 patients were registered. The ages at registration and at diagnosis were 65±15 and 56±17 years, respectively, and 806 patients (54%) were men. Majority of the patients (95%) was NYHA class I or II. With regard to subtypes of HCM, there were 526 patients (36%) in the HCM with left ventricular (LV) outflow tract obstruction, 126 patients (8%) in the mid-ventricular obstruction, 57 patients (4%) in the end-stage phase characterized by LV ejection fraction <50%, and 197 patients (14%) in apical HCM. At registration, 80 patients (6%) had prior successful recovery from sustained ventricular tachycardia or ventricular fibrillation, 162 patients (11%) suffered from heart failure hospitalization, and 64 patients (4%) had history of embolic event. Regarding invasive treatment, 160 patients (10%) had prior septal reduction therapy and 162 patients (11%) had ICD implantation. According to the 2014 European Society of Cardiology Guidelines on sudden cardiac death (SCD) prevention, the study patients were divided into 3 categories by the HCM Risk-SCD calculator: patients distribution, 4% in the high risk group (≥6% calculated HCM Risk-SCD at 5 years), 7% in the intermediate risk group (4% to <6%), 69% in the low risk group (<4%), and 16% in the patients with extreme characteristics (Figure 1).
Conclusions
In this multicenter registration survey of patients with HCM, the baseline clinical characteristics were almost similar to several retrospective large-scale cohorts in Western countries except older age and less symptomatic state. This study will provide important knowledge regarding management of HCM.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Kubo
- Kochi Medical School, Kochi, Japan
| | - H Takano
- Nippon Medical School Teaching Hospital, Tokyo, Japan
| | - M Takayama
- Sakakibara Heart Institute, Fucyu Tokyo, Japan
| | - Y.L Doi
- Kochi Medical School, Kochi, Japan
| | - Y Minami
- Tokyo Women's Medical University, Tokyo, Japan
| | - M Ebato
- Showa University Fujigaoka Hospital, Yokohama, Japan
| | - T Inomata
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Katoh
- Kyoto University, Kyoto, Japan
| | - R Okamoto
- Mie University Graduate School of Medicine, Tsu, Japan
| | - T Chikamori
- Tokyo Medical University Hospital, Tokyo, Japan
| | - E Watanabe
- Fujita Health University School of Medicine, Toyoake, Japan
| | - A Furugen
- Sapporo Cardio Vascular Clinic, Sapporo, Japan
| | - Y Maekwa
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - W Shimizu
- Nippon Medical School Teaching Hospital, Tokyo, Japan
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11
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Yamamoto A, Nagao M, Ando K, Nakao R, Sakai A, Watanabe E, Momose M, Sato K, Sakai S, Hagiwara N. High-risk plaque burdens myocardial flow reserve in intermediate coronary artery disease: hybrid analysis of 13N-ammonia PET and coronary CT angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
13N-ammonia PET (NH3-PET) can detect myocardial perfusion abnormalities in patients with coronary artery disease (CAD) and also obtain diagnostic quantitative values of absolute myocardial blood flow and myocardial flow reserve (MFR). Low MFR (MFR<2.0) is an independent prognostic factor for major adverse cardiac event in patients with ischemic and non-ischemic heart disease. A feature of low attenuation plaque (LAP) on coronary CT angiography (CCTA) has been known as high-risk plaque (HRP) for acute coronary syndrome even if there is no significant coronary stenosis. The presence of HRP potentially adversely affects MFR, but the hypothesis has not been elucidated.
Purpose
We aimed to investigate the affect of LAP to MFR in intermediate CAD.
Methods
One hundred five patients (age 67±9 years, 65% male) with CAD underwent NH3-PET and CCTA within 6 months between April 2015 and March 2019 were enrolled. Based on the results of CCTA, mild and moderate stenosis were defined as 1% to 49% and 50% to 69% stenosis. Ischemic territories for major three vessels were identified by stress/rest NH3-PET images. Finally, 194 coronary arteries with mild to moderate stenosis corresponding to non-ischemic territory were analyzed in this study. LAP was defined as plaques containing CT value less than 90HU. Partially calcified plaques were included in LAP. Entirely calcification plaque without LAP was defined as calcified plaque. MFR for major three vessels were calculated from dynamic scan at stress/rest NH3-PET.
Results
CCTA showed 80 coronary arteries with LAP (41%), 104 coronary arteries with calcified plaque (54%), 102 vessels with mild stenosis (53%), and 92 vessels with moderate stenosis (47%). MFRs for coronary arteries with LAP were significantly lower than those without LAP (2.1±0.6 vs 2.5±0.6, p<0.0001). The significant difference in MFR between with and without LAP was observed in both mild and moderate stenosis (mild: 2.0±0.6 vs 2.5±0.6, p=0.0015, moderate: 2.1±0.6 vs 2.5±0.6, p<0.0001). In contrast, coronary arteries with calcified plaque had significantly higher MFR than those without (2.5±0.6 vs 2.1±0.6, p<0.0001).
In 58 coronary arteries with MFR<2.0, 71% (41/58) had LAP and 24% (14/58) had calcified plaque. In 136 coronary arteries with MFR≥2.0, 29% (39/136) had LAP and 66% (90/136) had calcified plaque. LAP was significantly more frequent in the former and calcified plaque was significantly more frequent in the latter.
Conclusion
The presence of LAP burdens MFR in mild to moderate CAD. On the other hand, calcified plaque alone had no adverse effect on MFR. LAP is an important sign in CAD risk assessment even without significant coronary stenosis.
MFR and stress MPI
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Yamamoto
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - M Nagao
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - K Ando
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - R Nakao
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - A Sakai
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - E Watanabe
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - M Momose
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - K Sato
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - S Sakai
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - N Hagiwara
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
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12
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Proshutinsky A, Krishfield R, Toole JM, Timmermans M, Williams W, Zimmermann S, Yamamoto‐Kawai M, Armitage TWK, Dukhovskoy D, Golubeva E, Manucharyan GE, Platov G, Watanabe E, Kikuchi T, Nishino S, Itoh M, Kang S, Cho K, Tateyama K, Zhao J. Analysis of the Beaufort Gyre Freshwater Content in 2003-2018. J Geophys Res Oceans 2019; 124:9658-9689. [PMID: 32055432 PMCID: PMC7003849 DOI: 10.1029/2019jc015281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 05/31/2023]
Abstract
Hydrographic data collected from research cruises, bottom-anchored moorings, drifting Ice-Tethered Profilers, and satellite altimetry in the Beaufort Gyre region of the Arctic Ocean document an increase of more than 6,400 km3 of liquid freshwater content from 2003 to 2018: a 40% growth relative to the climatology of the 1970s. This fresh water accumulation is shown to result from persistent anticyclonic atmospheric wind forcing (1997-2018) accompanied by sea ice melt, a wind-forced redirection of Mackenzie River discharge from predominantly eastward to westward flow, and a contribution of low salinity waters of Pacific Ocean origin via Bering Strait. Despite significant uncertainties in the different observations, this study has demonstrated the synergistic value of having multiple diverse datasets to obtain a more comprehensive understanding of Beaufort Gyre freshwater content variability. For example, Beaufort Gyre Observational System (BGOS) surveys clearly show the interannual increase in freshwater content, but without satellite or Ice-Tethered Profiler measurements, it is not possible to resolve the seasonal cycle of freshwater content, which in fact is larger than the year-to-year variability, or the more subtle interannual variations.
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Affiliation(s)
| | | | - J. M. Toole
- Woods Hole Oceanographic InstitutionWoods HoleMAUSA
| | | | - W. Williams
- Fisheries and Oceans CanadaInstitute of Ocean SciencesSidneyBritish ColumbiaCanada
| | - S. Zimmermann
- Fisheries and Oceans CanadaInstitute of Ocean SciencesSidneyBritish ColumbiaCanada
| | - M. Yamamoto‐Kawai
- Graduate School of Marine Science and TechnologyTokyo University of Marine Science and TechnologyTokyoJapan
| | - T. W. K. Armitage
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - D. Dukhovskoy
- Center for Ocean‐Atmospheric Prediction StudiesFlorida State UniversityTallahasseeFLUSA
| | - E. Golubeva
- Institute of Computational Mathematics and Mathematical GeophysicsSiberian Branch of Russian Academy of ScienceNovosibirskRussia
- Laboratory of Mathematical Modeling of Atmosphere and Hydrosphere ProcessesNovosibirsk State UniversityNovosibirskRussia
| | - G. E. Manucharyan
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - G. Platov
- Institute of Computational Mathematics and Mathematical GeophysicsSiberian Branch of Russian Academy of ScienceNovosibirskRussia
- Laboratory of Mathematical Modeling of Atmosphere and Hydrosphere ProcessesNovosibirsk State UniversityNovosibirskRussia
| | - E. Watanabe
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - T. Kikuchi
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - S. Nishino
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - M. Itoh
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - S.‐H. Kang
- Korea Polar Research InstituteIncheonRepublic of Korea
| | - K.‐H. Cho
- Korea Polar Research InstituteIncheonRepublic of Korea
| | - K. Tateyama
- Kitami Institute of TechnologyKitami, HokkaidoJapan
| | - J. Zhao
- Physical Oceanography LaboratoryOcean University of China, QingdaoChina
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13
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Harada M, Motoike Y, Nomura Y, Nishimura A, Nagasaka R, Koshikawa M, Ichikawa T, Watanabe E, Ozaki Y. P1901Use of direct thrombin inhibitor on the day of atrial fibrillation ablation decreases incidence of silent cerebral ischemia detected by magnetic resonance imaging. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is increasing evidence to use direct oral anticoagulants (DOACs) in atrial fibrillation (AF) ablation. Uninterrupted use of DOACs is recommended for peri-procedural anticoagulation; the ways of choosing and/or using DOACs depend on physicians' decisions and preferences. Uninterrupted dabigatran (DAB), a direct thrombin inhibitor, reportedly decreased the risk of major bleeding (MB) in AF ablation, compared to uninterrupted warfarin (NEJM 2017; 376:1627). Among DOACs, only regular-dose of DAB (150 mg b.i.d.), showed superiority to warfarin for preventing ischemic thromboembolism (TE) in patients with non-valvular AF, implicating the powerful anti-thrombotic agent. DAB may decrease the potential risk of procedure-related TE.
Purpose
To evaluate whether use of DAB on the day of AF ablation decreases the prevalence of silent cerebral ischemia (SCI) detected by magnetic resonance imaging (MRI).
Methods
414 AF patients on DOACs were enrolled and admitted on the day before AF ablation. Among 354 patients on factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), the original DOACs were switched to DAB (150 mg b.i.d.) on the day of the procedure in 172 patients (Group D); the treatment remained unchanged in 182 patients (Group non-D). In both groups, DOACs were continuously used throughout the procedure. After propensity-score matching, procedure-related parameters/events and the incidence of MRI-detected SCI were compared between Group D (n=134) and Group non-D (n=134). These parameters in patients originally taking DAB, used without interruption during the procedure (uninterrupted DAB, n=55), were also compared to Group D (n=55) after propensity-score matching.
Results
Baseline activated clotting time (ACT) before initial heparin injection was increased in Group D vs. Group-non-D (179±25* vs. 146±23 sec, *p<0.05 vs. Group non-D). The time to achieve optimal ACT (>300 sec) was shorter in Group D (34±29* vs. 43±32 min). The amounts of heparin needed to achieve optimal ACT and the total amount of heparin used during the procedure were unchanged between Group D and Group non-D. The incidence of SCI decreased in Group D (13.1%* vs. 21.9%), suggesting the potential anti-thrombotic efficacy of DAB. No MB or symptomatic TE events were observed in either group. Baseline ACT, the time to achieve ACT >300 sec, and the incidence of SCI in Group D were comparable to those in uninterrupted DAB (183±38 vs. 181±32 sec, 39±31 vs. 42±28 min, and 14.5% vs. 16.4%, respectively). No MB or symptomatic TE events were observed either in Group D or uninterrupted DAB.
Conclusions
Temporarily switching to DAB from the other DOACs and using it on the day of procedure enable us to achieve optimal ACT quickly and decrease the incidence of SCI, showing similar potential anti-thrombotic efficacy to uninterrupted DAB. Use of DAB on the day of AF ablation also benefits from the availability of its antidote in the case of MB during the procedure.
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - R Nagasaka
- Fujita Health University, Toyoake, Japan
| | | | - T Ichikawa
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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14
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Kinoshita T, Hashimoto K, Yoshioka K, Miwa Y, Yodogawa K, Watanabe E, Nakamura K, Nakagawa M, Nakamura K, Watanabe T, Yusu S, Tachibana M, Nakahara S, Mizumaki K, Ikeda T. P5639Risk stratification for mortality using electrocardiographic markers based on 24-hour holter recordings: the JANIES-SHD study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent guidelines have stated that reduced left ventricular ejection fraction (LVEF) is the gold standard marker for identifying patients at risk for cardiac mortality. Although reduced LVEF identifies patients at an increased risk of cardiac arrest, sudden cardiac deaths (SCDs) occur considerably more often in patients with relatively preserved LVEF. Current guidelines on SCD risk stratification do not adequately cover this general population pool. Several noninvasive electrocardiographic (ECG) risk stratifiers that reflect depolarization abnormality, repolarization abnormality, and autonomic imbalance have been evaluated so far. With current therapeutic advances using new medicines or devices, an LVEF is often preserved in patients with structural heart disease (SHD). However, the usefulness of noninvasive ECG markers for risk stratification in such a patient population has not yet been elucidated.
Purpose
This study aimed to assess clinical indices and ECG markers based on 24-hour Holter ECG recordings for predicting cardiac mortality in patients with SHD who have left ventricular dysfunction (LVD) but relatively preserved LVEF.
Methods
In total, 1,829 patients were enrolled into the Japanese Multicenter Observational Prospective Study (JANIES study). In this study, we analyzed data of 719 patients (569 men, age 64±13 years) with SHD including mainly ischemic heart disease (65.8%). As ECG markers based on 24-hour Holter recordings, nonsustained ventricular tachycardia (NSVT), ventricular late potentials, and heart rate turbulence (HRT) were assessed. The primary endpoint was all-cause mortality, and the secondary endpoint was fatal arrhythmic events.
Results
During a mean follow-up of 21±11 months, all-cause mortality was eventually observed in 39 patients (5.4%). Among those patients, 32 patients (82%) suffered from cardiac causes such as heart failure and arrhythmia. Multivariate Cox regression analysis showed that after adjustment for age and LVEF, documented NSVT (hazard ratio=2.82, 95% confidence interval [CI]: 1.38–5.76, P=0.005) and abnormal HRT (hazard ratio=2.31, 95% CI: 1.15–4.65, P=0.02) were significantly associated with the primary endpoint. These two ECG markers also had significant predictive values with the secondary endpoint. The combined assessment documented NSVT and abnormal HRT improved predictive accuracy.
Conclusion
This study demonstrated that combined assessment of documented NSVT and abnormal HRT based on 24-hour Holter ECG recordings are recommended for predicting future serious events in SHD patients who have relatively preserved LVEF.
Acknowledgement/Funding
Grants-in-Aid (21590909, 24591074, and 15K09103 to T.I.) for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technol
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Affiliation(s)
- T Kinoshita
- Toho University Faculty of Medicine, Tokyo, Japan
| | - K Hashimoto
- National Defense Medical College, Saitama, Japan
| | - K Yoshioka
- Tokai University School of Medicine, Kanagawa, Japan
| | - Y Miwa
- Kyorin University, Tokyo, Japan
| | - K Yodogawa
- Nippon Medical School Hospital, Tokyo, Japan
| | | | - K Nakamura
- Cardiovascular Hospital of Central Japan, Gunma, Japan
| | | | | | | | - S Yusu
- Inagi Municipal Hospital, Tokyo, Japan
| | | | - S Nakahara
- Dokkyo Medical University, Tochigi, Japan
| | | | - T Ikeda
- Toho University Faculty of Medicine, Tokyo, Japan
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15
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Nakao R, Nagao M, Momose M, Kasuga N, Matsuo Y, Fukushima K, Watanabe E, Sakai A, Hagiwara N. P3354Papillary muscle ischemia and global myocardial flow reserve: assessment by high-resolution cine imaging of 13N ammonia PET. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
Papillary muscle ischemia (PMI) is caused by micro-vessels' occlusion in the broad endocardium because papillary muscle perfusion is supply from micro-vessels of peripheral coronary arteries and is easy to fail by the increase in peripheral vascular resistance. However, the clinical significant is not understood because PMI could not be detected by existing perfusion imaging such as SPECT and MRI. We propose the detection method of PMI using 13N-ammonia PET (NH3-PET), and investigate the association with the global myocardial flow reserve (Global-MFR) reflecting coronary microvascular dysfunction.
Methods
Data of adenosine-stress NH3-PET for consecutive 260 patients with coronary artery disease (CAD) or suspected CAD was retrospectively analyzed. Using high-resolution cine imaging derived from NH3-PET, PMI was defined as the absence of the PM accumulation at stress conditions. Myocardial flow was generated from the time activity curve of left ventricle input and myocardial uptake using 3-compartment model and the first 2 minutes' dataset of list mode images. Global-MFR was calculated by stress to rest flow ratio. Summed stress score (SSS) was used as an estimate of the extent of myocardial ischemia. 150 out of 260 patients (58%) with SSS ≥4 or with the past history of coronary artery diseases were classified as ischemic group, and 110 patients (42%) with SSS<4 were classified as non-ischemic group.
Results
PMI was seen in 68 of 260 patients (26.6%). The frequency of PMI was higher in the ischemic group than the non-ischemic group (37.8% vs. 10.1%, p<0.0001). Global-MFR was significantly lower in patients with PMI than those without (1.87±0.55 vs. 2.39±0.80, p<0.0001). In both ischemic and non-ischemic group, global-MFR was significantly reduced in patients with PMI. (Ischemic group: 1.83±0.56 vs. 2.12±0.52, p=0.0043, Non-ischemic group: 2.06±0.45 vs. 2.63±0.91, p=0.040).
Typical case of PMI
Conclusion
High-resolution cine imaging derived from NH3-PET makes it possible to detect PMI in about a quarter of patients with CAD or suspected CAD. PMI associates with reduced Global-MFR regardless of the presence of myocardial ischemia, suggesting that PMI is an important sign of early ischemia confined to the papillary muscle or the broad microvascular injury.
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Affiliation(s)
- R Nakao
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nagao
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - M Momose
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - N Kasuga
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - Y Matsuo
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - K Fukushima
- Saitama International Medical Center, Department of Nuclear Medicine, Cardiology, Hidaka, Japan
| | - E Watanabe
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
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16
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Watanabe E, Yamashita T, Inoue H, Atarashi H, Okumura K, Kodani E, Origasa H, Kiyono K. P5668A decision-support tool framework to predict adverse outcome in patients with atrial fibrillation: J-Rhythm registry substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is associated with increased mortality and morbidity. Modelling the risk of thrombosis, major bleeding and total mortality are often limited by the inadequate number of independent predictors.
Purpose
We compared the predictive accuracy of the decision-support tool framework and conventional risk score in AF patients.
Methods
We used data of AF patients enrolled into the nationwide AF registry. A random forest model was implemented to predict each outcome, and its predictive power was tested by a 5-fold cross-validation.
Results
We analyzed 7,937 patients with AF (age 70±10 years, female 31%). The type of AF was paroxysmal (37%), persistent (14%), and permanent (49%). The number of antithrombotic treatments were follows: warfarin only (n=5461), antiplatelet only (n=581), both warfarin and antiplatelet (n=1471) and no antithrombotic agents (424). The mean CHA2DS2-VASc score was 2.8±1.6 and HAS-BLED score was 2.7±1.2, respectively. We selected 20 from 50 clinical parameters and compared by the area-under-curve with the CHA2DS2-VASc score for thromboses and the HAS-BLED score for major bleeding. During the 2-year follow-up, 126 patients (1.6%) had thromboses, 140 (1.8%) had major bleeding, and 195 (2.5%) died. A random forest model had a higher value of the area-under-curve for predicting thromboses compared with the CHA2DS2-VASc (0.66 vs. 0.61, P<0.05), and had a significantly higher area-under-curve for major bleeding compared with the HAS-BLED (0.67 vs. 0.61, P<0.05). The area-under-curve for the all-cause mortality was 0.77.
Conclusions
A random forest model has a higher accuracy than conventional risk scheme in predicting thromboses and major bleeding, in addition to total mortality.
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Affiliation(s)
- E Watanabe
- Fujita Health University School of Medicine, Toyoake, Japan
| | | | - H Inoue
- Saiseikai Toyama Hospital, Toyama, Japan
| | - H Atarashi
- Minami Hachioji Hospital, Hachioji, Japan
| | - K Okumura
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - E Kodani
- Nippon Medical School, Tokyo, Japan
| | | | - K Kiyono
- Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
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17
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Ishii J, Takahashi H, Nishimura T, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Hayashi M, Motoyama S, Sarai M, Watanabe E, Izawa H, Ozaki Y. P4620Circulating concentration of presepsin improves early prediction of short-term mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocytic activation. Presepsin appears to be an accurate diagnostic marker of sepsis, but its clinical significance remains unclear in cardiovascular disease.
Purpose
This prospective study aimed to investigate the predictive value of plasma presepsin levels on admission to medical (non-surgical) cardiac intensive care units (MCICUs) for short-term mortality.
Methods
We examined 1560 patients hospitalized in MCICUs and measured the baseline plasma presepsin levels at admission.
Results
Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Before MCICUs admission, emergent coronary angiography or percutaneous coronary intervention was performed in 36%, mechanical ventilation was required for respiratory insufficiency in 2.1%, and intraaortic balloon pumps were needed for hemodynamic instability in 8.9%. During 6 months after admission, there were 113 (7.2%) deaths. Patients who died were older (median: 77 vs. 71 years, P<0.0001); had higher levels of presepsin (263 vs. 119 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 696 vs. 186 pg/mL, P<0.0001), high-sensitivity troponin T (hsTnT: 81 vs. 47 pg/mL, P=0.004), and high-sensitivity C-reactive protein (13.8 vs. 2.2 mg/L, P<0.0001); and had lower levels of estimated glomerular filtration rate (50 vs. 65 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (43% vs. 51%, P<0.0001) than those of the survivors. In the multivariate Cox regression analysis, higher levels of presepsin (P=0.0002), BNP (P=0.04), and hsTnT (P=0.009) were all independent predictors of 6-month deaths. Quartiles of presepsin levels were associated with higher mortality rates within 6 months after admission (Table). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsTnT further enhanced reclassification (P=0.004) and discrimination (P=0.003) beyond that of the baseline model.
Mortality rates according to presepsin Presepsin quartile 1st 2nd 3rd 4th P value ≤80 pg/mL 81–124 pg/mL 125–232 pg/mL >232 pg/mL 1-month mortality 0.8% 2.0% 3.3% 8.0% <0.0001 6-month mortality 0.8% 3.8% 8.2% 16.3% <0.0001
Conclusions
Presepsin levels at admission could improve the prediction of short-term mortality in patients hospitalized at MCICUs.
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Hayashi
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Sarai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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Lopes LKO, Costa DM, Tipple AFV, Watanabe E, Castillo RB, Hu H, Deva AK, Vickery K. Complex design of surgical instruments as barrier for cleaning effectiveness, favouring biofilm formation. J Hosp Infect 2018; 103:e53-e60. [PMID: 30423413 DOI: 10.1016/j.jhin.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/02/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Inadequately reprocessed reusable surgical instruments (RSIs) may harbour infectious agents which may then be transferred to a suitable site for replication. AIM To determine the cumulative effect of 20 cycles of contamination, cleaning (manual or manual followed by automated) and steam sterilization on high-complex-design RSIs used for orthopaedic surgery. METHODS New flexible medullary reamers and depth gauges were contaminated by soaking in tryptone soya broth, containing 5% sheep blood and 109 cfu/mL of Staphylococcus aureus (ATCC 25923), for 5 min. To mimic a worse-case scenario, RSIs were dried 7 h and subjected to either (a) rinsing in distilled water, (b) manual cleaning or (c) manual plus automated cleaning (reference standard), and steam sterilization. The contamination, cleaning, and sterilization cycle was repeated 20 times. Adenosine triphosphate (ATP) was measured after cleaning procedures; microbial load and residual protein were measured following the 10th and 20th reprocessing, in triplicate. Scanning electron microscopy (SEM) was used to confirm soil and biofilm presence on the RSIs after the 20th reprocessing. FINDINGS Manual and manual plus automated cleaning significantly reduced the amount of ATP and protein residues for all RSIs. Viable bacteria were not detected following sterilization. However, SEM detected soil after automated cleaning, and soil, including biofilms, after manual cleaning. CONCLUSION Soil and/or biofilms were evident on complex-design RSIs following 20 cycles of contamination and reprocessing, even using the reference standard method of cleaning. Although the depth gauges could be disassembled, biological residues and biofilm accumulated in its lumen. The current design of these RSIs prevents removal of all biological soil and this may have an adverse effect on patient outcome.
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Affiliation(s)
- L K O Lopes
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil; Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - D M Costa
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil; Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - A F V Tipple
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil
| | - E Watanabe
- School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - R B Castillo
- Macquarie University Hospital, Macquarie University, Sydney, Australia
| | - H Hu
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - A K Deva
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - K Vickery
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
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Abe T, Sakai A, Watanabe E, Nagao M, Sakai S, Hagiwara N. P3701Analysis of myocardial fibrosis using cardiac magnetic resonance T1 imaging and late gadolinium enhancement: Association with ventricular tachycardia in hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Abe
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - E Watanabe
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - M Nagao
- Tokyo Women's Medical University, Department of Diagnostic Imaging & Nuclear Medicine, Tokyo, Japan
| | - S Sakai
- Tokyo Women's Medical University, Department of Diagnostic Imaging & Nuclear Medicine, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
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20
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Valenza G, Wendt H, Kiyono K, Hayano J, Watanabe E, Yamamoto Y, Abry P, Barbieri R. Multiscale properties of instantaneous parasympathetic activity in severe congestive heart failure: A survivor vs non-survivor study. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:3761-3764. [PMID: 29060716 DOI: 10.1109/embc.2017.8037675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Multifractal analysis of cardiovascular variability series is an effective tool for the characterization of pathological states associated with congestive heart failure (CHF). Consequently, variations of heartbeat scaling properties have been associated with the dynamical balancing of nonlinear sympathetic/vagal activity. Nevertheless, whether vagal dynamics has multifractal properties yet alone is currently unknown. In this study, we answer this question by conducting multifractal analysis through wavelet leader-based multiscale representations of instantaneous series of vagal activity as estimated from inhomogeneous point process models. Experimental tests were performed on data gathered from 57 CHF patients, aiming to investigate the automatic recognition accuracy in predicting survivor and non-survivor patients after a 4 years follow up. Results clearly indicate that, on both CHF groups, the instantaneous vagal activity displays power-law scaling for a large range of scales, from ≃ 0.5s to ≃ 100s. Using standard SVM algorithms, this information also allows for a prediction of mortality at a single-subject level with an accuracy of 72.72%.
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Amino M, Yoshioka K, Ichikawa T, Watanabe E, Nakamura M, Hashida T, Kanda S, Ikari Y. P5528The positive result of late potential after percutaneous coronary intervention for acute coronary syndromes may help the evaluation of the cardiovascular events. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Watanabe E, Smith DM, Delcarpio JB, Sun J, Smart FW, Van Meter CH, Claycomb WC. Cardiomyocyte Transplantation in a Porcine Myocardial Infarction Model. Cell Transplant 2017; 7:239-46. [PMID: 9647433 DOI: 10.1177/096368979800700302] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Transplantation of cardiomyocytes into the heart is a potential treatment for replacing damaged cardiac muscle. To investigate the feasibility and efficiency of this technique, either a cardiac-derived cell line (HL-1 cells), or normal fetal or neonatal pig cardiomyocytes were grafted into a porcine model of myocardial infarction. The myocardial infarction was created by the placement of an embolization coil in the distal portion of the left anterior descending artery in Yorkshire pigs (n = 9). Four to 5 wk after creation of an infarct, the three preparations of cardiomyocytes were grafted, at 1 × 106 cells/20 μL into normal and into the middle of the infarcted myocardium. The hearts were harvested and processed for histologic examinations 4 to 5 wk after the cell grafts. Histologic evaluation of the graft sites demonstrated that HL-1 cells and fetal pig cardiomyocytes formed stable grafts within the normal myocardium without any detrimental effect including arrhythmia. In addition, a marked increase in angiogenesis was observed both within the grafts and adjacent host myocardium. Electron microscopy studies demonstrated that fetal pig cardiomyocytes and the host myocardial cells were coupled with adherens-type junctions and gap junctions. Histologic examination of graft sites from infarct tissue failed to show the presence of grafted HL-1 cells, fetal, or neonatal pig cardiomyocytes. Cardiomyocyte transplantation may provide the potential means for cell-mediated gene therapy for introduction of therapeutic molecules into the heart.
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Affiliation(s)
- E Watanabe
- Department of Biochemistry and Molecular Biology, Louisiana State University Medical Center, New Orleans 70112, USA
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23
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Maruyama K, Watanabe E, Saito K, Sato K, Yoshida H, Kume S, Noguchi A, Shiokawa Y, Nagane M. P04.17 Novel augmented reality-based neuronavigation using smart glasses and clinical application to brain tumor surgery. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Ichihara G, Suzuki Y, Watanabe E, Hayashida A, Osada Y, Furutani T, Izuoka K, Ichihara S. Effect of physicochemical characteristics of nano-sized titanium dioxide on adhesion of monocytes to endothelial cells. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Tsujimura M, Fujita T, Endo S, Nagai S, Watanabe E. AB1030 Effects of Conducting Directly Observed Treatment, Short-Course (DOTS) Strategy and Conferences on Latent Tuberculosis Infection in Rheumatoid Arthritis Patients Undergoing Immunosuppressive Therapy. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Valenza G, Wendt H, Kiyono K, Hayano J, Watanabe E, Yamamoto Y, Abry P, Barbieri R. Point-process high-resolution representations of heartbeat dynamics for multiscale analysis: A CHF survivor prediction study. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:1951-4. [PMID: 26736666 DOI: 10.1109/embc.2015.7318766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiscale analysis of human heartbeat dynamics has been proved effective in characterizeing cardiovascular control physiology in health and disease. However, estimation of multiscale properties can be affected by the interpolation procedure used to preprocess the unevenly sampled R-R intervals derived from the ECG. To this extent, in this study we propose the estimation of wavelet coefficients and wavelet leaders on the output of inhomogeneous point process models of heartbeat dynamics. The RR interval series is modeled using probability density functions (pdfs) characterizing and predicting the time until the next heartbeat event occurs, as a linear function of the past history. Multiscale analysis is then applied to the pdfs' instantaneous first order moment. The proposed approach is tested on experimental data gathered from 57 congestive heart failure (CHF) patients by evaluating the recognition accuracy in predicting survivor and non-survivor patients, and by comparing performances from the informative point-process based interpolation and non-informative spline-based interpolation. Results demonstrate that multiscale analysis of point-process high-resolution representations achieves the highest prediction accuracy of 65.45%, proving our method as a promising tool to assess risk prediction in CHF patients.
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Wendt H, Kiyono K, Abry P, Hayano J, Watanabe E, Yamamoto Y. Multiscale wavelet p-leader based heart rate variability analysis for survival probability assessment in CHF patients. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:2809-12. [PMID: 25570575 DOI: 10.1109/embc.2014.6944207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A priori discrimination of high mortality risk amongst congestive heart failure patients constitutes an important clinical stake in cardiology and involves challenging analyses of the temporal dynamics of heart rate variability (HRV). The present contribution investigates the potential of a new multifractal formalism, constructed on wavelet p-leader coefficients, to help discrimination between survivor and non survivor patients. The formalism, applied to a high quality database of 108 patients collected in a Japanese hospital, enables to assess the existence of multifractal properties amongst congestive heart failure patients and to reveal significant differences in the multiscale properties of HRV between survivor and non survivor patients, for scales ranging from approximately 60 to 250 beats.
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Tsuchiya R, Lee J, Watanabe E, Park J, Fukahori A, Mori K, Kawakubo K. Socio-demographic characteristics and daily physical activity among rural Japanese residents with back pain and knee pain. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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29
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Higashiyama R, Aikawa J, Iwase D, Minatani A, Watanabe H, Yoshihira T, Kenmoku T, Fukushima K, Watanabe E, Takaso M. Arthroscopic anterior talofibular ligament reconstruction using an autogenic gracilis tendon. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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30
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Sato M, Toriumi T, Watanabe N, Watanabe E, Akita D, Mashimo T, Akiyama Y, Isokawa K, Shirakawa T, Honda MJ. Characterization of mesenchymal progenitor cells in crown and root pulp from human mesiodentes. Oral Dis 2014; 21:e86-97. [PMID: 24605962 DOI: 10.1111/odi.12234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/08/2014] [Accepted: 02/02/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Mesiodentes are usually found in the central position of the upper or lower jaw as supernumerary teeth. Here, we obtained 10 mesiodentes and three permanent teeth (PT) and separated the dental pulp (DP) from these into crown and root portions. We then characterized and compared the isolated crown portion-derived cells (crown cells) with root portion-derived cells (root cells) using a range of in vitro assays. MATERIALS AND METHODS Crown cells and root cells were examined for cell surface marker expression, colony-forming unit-fibroblast (CFU-F), cell proliferation, cell cycle characteristics and markers, and osteogenic and adipogenic differentiation. RESULTS The proportion of CD105-positive cells (CD105(+) cells) in the crown cells vs the root cells varied among the mesiodentes, but not among the PT. When there were more CD105(+) cells in the root cells than in the crown cells, the root cells showed higher CFU-F, proliferation capacity, and osteogenic differentiation capacity. In contrast, when the crown cells contained more CD105(+) cells than the root cells, the crown cells showed the higher CFU-F, proliferation capacity, and osteogenic differentiation capacity. In addition, the sorted CD105(+) cells showed higher CFU-F and proliferation capacity than the sorted CD105(-) cells. CONCLUSION These results indicated that proportion of CD105(+) cells is an effective means of characterizing DP-derived cells in mesiodentes.
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Affiliation(s)
- M Sato
- Nihon University Graduate School of Dentistry, Tokyo, Japan
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31
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Guerreiro-Tanomaru JM, Nascimento CA, Faria-Júnior NB, Graeff MSZ, Watanabe E, Tanomaru-Filho M. Antibiofilm activity of irrigating solutions associated with cetrimide. Confocal laser scanning microscopy. Int Endod J 2014; 47:1058-63. [PMID: 24433253 DOI: 10.1111/iej.12248] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/10/2014] [Indexed: 02/02/2023]
Abstract
AIM To evaluate the antibiofilm activity of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) solutions associated with cetrimide (CTR), and QMiX using confocal laser scanning microscopy. METHODOLOGY Enterococcus faecalis (ATCC- 29212) biofilms were induced on bovine dentine blocks for 14 days. The dentine blocks containing biofilm were immersed for 1 min in the following solutions: 2.5% NaOCl; 2.5% NaOCl + 0.2% CTR; 2% CHX; 2% CHX + 0.2% CTR; 0.2% CTR; QMiX. After contact with the solutions, the dentine blocks were stained with Live/Dead(®) BacLight for analysis of the remaining biofilm using confocal laser scanning microscope. Images were evaluated using the BioImage_L software to determine the total biovolume (μm(3) ), the green biovolume (live cells) (μm(3) ) and the percentage of substrate coverage (%). The data were subjected to nonparametric statistical test using Kruskal-Wallis and Dunn's tests at 5% significance level. RESULTS After exposure to irrigants, the total biovolume observed for CHX, CHX+CTR, CTR, QMiX was similar to distilled water (P > 0.05). NaOCl and NaOCl+CTR had the lowest total and green biovolume. The CTR and QMiX had intermediate green biovolume, with greater antibacterial activity than CHX and CHX+CTR (P < 0.05). The NaOCl and NaOCl+CTR solutions were associated with microorganism removal and substrate cleaning ability. CONCLUSIONS NaOCl and NaOCl+CTR solutions were effective on microorganism viability and were able to eliminate biofilm. The addition of cetrimide did not influence antibacterial activity.
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Affiliation(s)
- J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara Dental School, UNESP (Univ Estadual Paulista), Araraquara, SP, Brazil
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Kawai H, Watanabe E, Yamamoto M, Ichikawa T, Harigaya H, Okuda K, Sobue Y, Motoyama S, Sarai M, Ozaki Y. What is the optimal antithrombotic therapy of atrial fibrillation patients after coronary artery stent deployment? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yokoyama Y, Matsumoto K, Watanabe E, Shigemi A, Umezaki Y, Takeshita A, Nakamura K, Okuno M, Ikawa K, Morikawa N, Takeda Y. P14 Pharmacokinetic and pharmacodynamic evaluation of sulbactam against Acinetobacter baumannii in a murine thigh infection model. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Otsuka T, Dan H, Dan I, Sase M, Sano T, Tsuzuki D, Fujita A, Sasaguri K, Okada N, Kusama M, Jinbu Y, Watanabe E. Effect of local anesthesia on trigeminal somatosensory-evoked magnetic fields. J Dent Res 2012; 91:1196-201. [PMID: 23018817 DOI: 10.1177/0022034512462398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
For objective neurophysiological evaluation of the function of the trigeminal system, magnetoencephalography- based TSEF (trigeminal somatosensory-evoked field) assessment would be valuable in providing spatial and temporal profiles of cortical responses. However, this necessitates knowledge of how TSEF varies with trigeminal nerve dysfunctions. We introduced a conduction block of the trigeminal nerve using local anesthesia (lidocaine) to temporally mimic nerve dysfunctions, and monitored TSEF changes. Following an electrical stimulation of the lower lip, a magnetic response with peak latency of approximately 20 ms was identified in all participants. Dipole for the peak was estimated on the post-central gyrus in the participant's own magnetic resonance image. After normalization to Montreal Neurological Institute (MNI) space and inter-participant data integration, the summary equivalent current dipole localization among participants remained in the post-central gyrus, suggesting validity of the use of MNI space. Partial anesthesia of the lower lip led to a loss of the waveform characteristics of TSEF for electrical stimulation to the trigeminal nerve. We verified that the 20-ms latency cortical response of TSEF components localized at the primary sensory cortex can serve as a robust neurofunctional marker of experimental trigeminal nerve dysfunction.
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Affiliation(s)
- T Otsuka
- Department of Craniofacial Growth and Developmental Dentistry, Kanagawa Dental College, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan
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Heydari B, Shah R, Coelho-Filho O, Chen Y, Watanabe E, Neilan T, Jerosch-Herold M, Kwong R. 760 Prognostic Significance of Stress Perfusion Cardiac Magnetic Resonance Imaging in Patients with Established Symptomatic Coronary Artery Disease. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Watanabe E, Kobara Y, Miyake S. Validation of a commercial ELISA for the analysis of the insecticide dinotefuran in a variety of analytically challenging vegetables. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2012; 29:1067-73. [DOI: 10.1080/19440049.2012.681400] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Korkes H, Oliveira L, Watanabe E, Aoki T, Ramos C, Nagahama G, Marques R, Negrao C, Denise V, Sass N. PP022 The haemostatic suture (technique of B-Lynch) may be an alternative to control uterine hemorrhage associated with hypertensive disorders. Pregnancy Hypertens 2012; 2:252-3. [DOI: 10.1016/j.preghy.2012.04.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shinozaki K, Oda S, Sadahiro T, Nakamura M, Watanabe E, Abe R, Nakada T, Morita Y, Nakanishi K, Kitamura N, Hirasawa H. Correlation between IL-6 and S-100B blood levels and outcome of post-cardiac arrest syndrome and influence of therapeutic hypothermia on these mediator blood levels. Crit Care 2012. [PMCID: PMC3363695 DOI: 10.1186/cc10884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Shinozaki
- Chiba Aoba Municipal Hospital, Chiba City, Japan
| | - S Oda
- Chiba University, Chiba City, Japan
| | | | | | | | - R Abe
- Chiba University, Chiba City, Japan
| | - T Nakada
- Chiba University, Chiba City, Japan
| | - Y Morita
- Chiba University, Chiba City, Japan
| | - K Nakanishi
- Narita Red Cross Hospital, Narita City, Japan
| | - N Kitamura
- Kimitsu Chuo Hospital, Kisarazu City, Japan
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Tajima T, Haberkorn NF, Civale L, Schulze RK, Inoue H, Guo J, Dolgashev VA, Martin D, Tantawi S, Yoneda C, Moeckly B, Yung C, Proslier T, Pellin M, Matsumoto A, Watanabe E. Studies on thin film MgB2 for applications to RF structures for particle accelerators. ACTA ACUST UNITED AC 2012. [DOI: 10.1063/1.4712109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Watanabe E, Maia CG, Andrade DD. In vitro evaluation of antimicrobial activity of essential oils with potential application in biomaterial (castor oil based polyurethane). BMC Proc 2011. [PMCID: PMC3239776 DOI: 10.1186/1753-6561-5-s6-p43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Shimura CN, De Andrade D, Watanabe E, Ferreira AM. MRSA on surface: is it possible to control? BMC Proc 2011. [PMCID: PMC3239741 DOI: 10.1186/1753-6561-5-s6-p307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Silva JD, Sonobe HM, Andrade DD, Giordani AT, Shimura CMN, Watanabe E. Complications after surgery in patients with colorectal cancer: the evidence for nursing care. BMC Proc 2011. [PMCID: PMC3239617 DOI: 10.1186/1753-6561-5-s6-p196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sobue Y, Watanabe E, Yamamoto M, Sano K, Harigaya H, Okuda K, Ozaki Y. Beat-to-beat variability of T-wave amplitude for the risk assessment of ventricular tachyarrhythmia in patients without structural heart disease. Europace 2011; 13:1612-8. [DOI: 10.1093/europace/eur177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lichtman JH, Jones SB, Wang Y, Watanabe E, Leifheit-Limson E, Goldstein LB. Outcomes after ischemic stroke for hospitals with and without Joint Commission-certified primary stroke centers. Neurology 2011; 76:1976-82. [PMID: 21543736 PMCID: PMC3109877 DOI: 10.1212/wnl.0b013e31821e54f3] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 12/27/2010] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Joint Commission (JC) began certifying primary stroke centers (PSCs) in the United States in 2003. We assessed whether 30-day risk-standardized mortality (RSMR) and readmission (RSRR) rates differed between hospitals with and without JC-certified PSCs in 2006. METHODS The study cohort included all fee-for-service Medicare beneficiaries ≥65 years old discharged with a primary diagnosis of ischemic stroke (International Classification of Diseases, ninth revision, Clinical Modification 433, 434, 436) in 2006. Hierarchical linear regression models calculated hospital-level RSMRs and RSRRs, adjusting for patient demographics, comorbid conditions, and hospital referral region. Hospitals were categorized as being higher than, no different from, or lower than the national average. RESULTS There were 310,381 ischemic stroke discharges from 315 JC-certified PSC and 4,231 noncertified hospitals. Mean overall 30-day RSMR and RSRR were 10.9% ± 1.7% and 12.5% ± 1.4%, respectively. The RSMRs of hospitals with JC-certified PSCs were lower than in noncertified hospitals (10.7% ± 1.7% vs 11.0% ± 1.7%), but the RSRRs were comparable (12.5% ± 1.3% vs 12.4% ± 1.7%). Almost half of JC-certified PSC hospitals had RSMRs lower than the national average compared with 19% of noncertified hospitals, but 13% of JC-certified PSC hospitals had lower RSRRs vs 15% of noncertified hospitals. CONCLUSIONS Hospitals with JC-certified PSCs had lower RSMRs compared with noncertified hospitals in 2006; however, differences were small. Readmission rates were similar between the 2 groups. PSC certification generally identified better-performing hospitals for mortality outcomes, but some hospitals with certified PSCs may have high RSMRs and RSRRs whereas some hospitals without PSCs have low rates. Unmeasured factors may contribute to this heterogeneity.
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Affiliation(s)
- J H Lichtman
- Yale University School of Medicine, PO Box 208034, New Haven, CT 06520, USA.
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Watanabe E, Sobue Y, Osaka M, Ozaki Y, Kodama I, Tanabe T, Aizawa Y, Lousinha A, Oliveira M, Silva Cunha P, Nogueira Silva M, Lopes J, Silva S, Carlos I, Cruz Ferreira R, Chiladakis I, Kalogeropoulos A, Koutsogiannis N, Zagkli F, Arvanitis P, Alexopoulos D, Sepsi M, Kadlecova V, Zeman M, Sindler M, Gaillyova R, Vasku A, Kozak M, Krivan L, Talib A, Sato N, Talib A, Nakagawa N, Sakamoto N, Takeuchi T, Kawamura Y, Hasebe N. Non invasive of risk stratification sudden cardiac death. Europace 2011. [DOI: 10.1093/europace/eur216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shinozaki K, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Watanabe E, Tateishi Y, Nakanishi K, Kitamura N, Hirasawa H. Ammonia and lactate blood levels on hospital arrival predict neurological outcome in patients with out-of-hospital cardiac arrest. Crit Care 2011. [PMCID: PMC3066979 DOI: 10.1186/cc9725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yamashita T, Inoue H, Okumura K, Kodama I, Aizawa Y, Atarashi H, Ohe T, Ohtsu H, Kato T, Kamakura S, Kumagai K, Kurachi Y, Koretsune Y, Saikawa T, Sakurai M, Sato T, Sugi K, Nakaya H, Hirai M, Hirayama A, Fukatani M, Mitamura H, Yamazaki T, Watanabe E, Ogawa S, Katoh T, Igawa O, Matsumoto N, Yamashita T, Kaneko Y, Watanabe E, Ogawa S, Osaka T, Fujii E, Niwano S, Yoshioka K, Kato M, Okazaki O, Kusano K, Okuyama Y, Furushima H, Suzuki M, Noda T, Kawara T, Sato T, Kamakura S, Endoh Y, Kumagai K, Hiyoshi Y, Ishiyama T, Ohtsuka T, Matsumoto M, Chishaki A, Shinohara T, Shirayama T, Koretsune Y, Yokoyama E, Ajiki K, Fujio K, Sugi K, Yamakawa T, Yusu S, Inoue H, Kawamura Y, Hayano M, Date T, Mizusawa Y, Kobayashi Y, Satomi K, Imai Y, Atarashi H, Fukunami M, Yokoshiki H, Betsuyaku T, Okumura K, Takeda H, Matsumoto K, Okishige K, Tagawa M, Hirai M, Okazaki H. Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study). Europace 2010; 13:473-9. [DOI: 10.1093/europace/euq439] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Watanabe E. S24-3 Clinical application of NIRS. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)60156-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Costa P, Terini R, Freitas M, Watanabe E. SU-GG-E-03: Current Status of Medical Physics Undergraduation Courses in Brazil. Med Phys 2010. [DOI: 10.1118/1.3468033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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