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Yamasaki H, Kondo H, Shiroo T, Iwata N, Masuda T, Makita T, Iwabuchi Y, Tanazawa K, Takahashi M, Ono Y, Ogawa N, Harada T, Mitarai K, Yamauchi S, Takano M, Kodama N, Hirota K, Miyoshi M, Yonezu K, Tawara K, Abe I, Saito S, Fukui A, Fukuda T, Akioka H, Shinohara T, Akiyoshi K, Teshima Y, Yufu K, Daa T, Matsubara E, Asayama Y, Ueda M, Takahashi N. Efficacy of Computed Tomography-Based Evaluation of Myocardial Extracellular Volume Combined With Red Flags for Early Screening of Concealed Cardiac Amyloidosis in Patients With Atrial Fibrillation. Circ J 2024:CJ-23-0948. [PMID: 38522901 DOI: 10.1253/circj.cj-23-0948] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
BACKGROUND The prevalence of transthyretin amyloid cardiomyopathy (ATTR-CM) in atrial fibrillation (AF) patients remains unclear. We explored the efficacy of computed tomography-based myocardial extracellular volume (CT-ECV) combined with red flags for the early screening of concealed ATTR-CM in AF patients undergoing catheter ablation.Methods and Results: Patients referred for AF ablation at Oita University Hospital were prescreened using the red-flag signs defined by echocardiographic or electrocardiographic findings, medical history, symptoms, and blood biochemical findings. Myocardial CT-ECV was quantified in red flag-positive patients using routine pre-AF ablation planning cardiac CT with the addition of delayed-phase cardiac CT scans. Patients with high (>35%) ECV were evaluated using technetium pyrophosphate (99 mTc-PYP) scintigraphy. A cardiac biopsy was performed during the planned AF ablation procedure if 99 mTc-PYP scintigraphy was positive. Between June 2022 and June 2023, 342 patients were referred for AF ablation. Sixty-seven (19.6%) patients had at least one of the red-flag signs. Myocardial CT-ECV was evaluated in 57 patients because of contraindications to contrast media, revealing that 16 patients had high CT-ECV. Of these, 6 patients showed a positive 99 mTc-PYP study, and 6 patients were subsequently diagnosed with wild-type ATTR-CM via cardiac biopsy and genetic testing. CONCLUSIONS CT-ECV combined with red flags could contribute to the systematic early screening of concealed ATTR-CM in AF patients undergoing catheter ablation.
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Affiliation(s)
- Hirochika Yamasaki
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tomoaki Shiroo
- Department of Medical Technology, Oita University Hospital
| | - Naohiro Iwata
- Department of Medical Technology, Oita University Hospital
| | - Teruaki Masuda
- Department of Neurology, Faculty of Medicine, Oita University
| | - Taiki Makita
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yuki Iwabuchi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kota Tanazawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yuma Ono
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Naoko Ogawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kazuki Mitarai
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shuichiro Yamauchi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Masayuki Takano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Nozomi Kodama
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kumiko Akiyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Faculty of Medicine, Oita University
| | | | - Yoshiki Asayama
- Department of Radiology, Faculty of Medicine, Oita University
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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Sato T, Yufu K, Yamasaki H, Harada T, Yamauchi S, Ishii Y, Fukuda T, Kawashima T, Shuto T, Akioka H, Shinohara T, Teshima Y, Wada T, Miyamoto S, Takahashi N. Quality of epicardial adipose tissue predicts major adverse cerebral and cardiovascular events following transcatheter aortic valve implantation. Heart Vessels 2024:10.1007/s00380-024-02374-w. [PMID: 38502318 DOI: 10.1007/s00380-024-02374-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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/07/2024] [Indexed: 03/21/2024]
Abstract
Epicardial adipose tissue (EAT) have been shown to be associated with several heart disease, including coronary artery disease (CAD), atrial fibrillation (AF), and heart failure (HF). It is reported that the quality of EAT, represented by fat attenuation determined using computed tomography (CT) imaging, can detect the histologically-assessed remodeled EAT. We tested the hypothesis that quality of EAT would predict major adverse cerebral and cardiovascular events (MACCE) following transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS). A total of 125 consecutive severe AS patients who underwent TAVI were enrolled (39 male, mean 85.4 ± 4.0 years). Using CT imaging before TAVI, we measured the average CT fat attenuation of EAT (EAT attenuation) and investigated the association with MACCE. During the mean follow up period of 567 ± 371 days, 21 cases of MACCE were observed. Patients with MACCE had greater levels of EAT attenuation compared to those without (- 74 ± 3.7 Hounsfield Units (HU) vs - 77 ± 5.5 HU, p = 0.010). Based on the ROC curves, the high EAT attenuation was defined as > - 74.3 HU. According to this cut-off index, 44 patients were classified into the high EAT attenuation group (28 female, mean age 87 ± 3.6 years), whereas 81 patients were classified into the low EAT attenuation group (13 female, 85 ± 4.1 years). Kaplan-Meier survival curve demonstrated that the patients in the high EAT attenuation group showed greater prevalence of MACCE (log-rank 6.64, p = 0.010). Cox proportional hazards regression analysis revealed that EAT attenuation and Logistic EuroSCORE were independently associated with the incidence of MACCE. Our results suggest that quality of EAT, assessed by EAT attenuation detected by CT imaging, can predict the cerebral and cardiovascular events after TAVI in patients with AS.
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Affiliation(s)
- Takaaki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
| | - Hirochika Yamasaki
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Shuichiro Yamauchi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Takayuki Kawashima
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Takashi Shuto
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Tomoyuki Wada
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Shinji Miyamoto
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
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3
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Sato H, Yonezu K, Saito S, Abe I, Tawara K, Akioka H, Shinohara T, Teshima Y, Yufu K, Abe R, Takahashi N. Impact of the COVID-19 Pandemic on the Long-Term Prognosis of Acute Myocardial Infarction in Japan. Cureus 2024; 16:e51905. [PMID: 38333491 PMCID: PMC10850441 DOI: 10.7759/cureus.51905] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Background During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, a global reduction in hospitalizations for acute myocardial infarction (AMI) was observed. Generally, patients experienced increased severity of AMI with delays in time from symptom onset to treatment during the pandemic. However, the impact of the COVID-19 pandemic on in-hospital mortality among patients with AMI remains unclear. This study aimed to compare the long-term prognosis of patients with AMI during the COVID-19 pandemic to that observed in the pre-pandemic period and to evaluate the influence of the COVID-19 pandemic on the prognosis of patients with AMI. Methods We reviewed the data of patients admitted to our hospital for AMI treatment between April 1, 2018, and March 31, 2021. The time from admission to major adverse cardiac events (MACE), as well as the time from admission to all-cause death, were examined between the pandemic period (April 1, 2020, to March 31, 2021) and the pre-pandemic period (April 1, 2018, to March 31, 2020). Results Eighty patients were included in the study, and those admitted during the pandemic exhibited a higher likelihood of advanced age, lower levels of LDL-cholesterol, and a reduced prevalence of hypertension. The 2.5-year MACE-free survival and overall survival rates between the patients during the pre-pandemic and pandemic periods were not significantly different. Conclusion The long-term prognosis of patients with AMI during the COVID-19 pandemic remains unclear. In this study, we reported that the 2.5-year MACE-free survival and overall survival rates of the patients with AMI admitted during the COVID-19 pandemic were not significantly different from those during the pre-pandemic period. The impact of the COVID-19 pandemic on the prognosis of patients with AMI appears to vary according to the study population.
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Affiliation(s)
- Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Ryuzo Abe
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
- Department of Emergency Medicine, Faculty of Medicine, Oita University, Oita, JPN
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
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4
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Tawara K, Akioka H, Sato H, Sato T, Takahashi M, Ogawa N, Aoki T, Harada T, Mitarai K, Yamauchi S, Hirota K, Miyoshi M, Yonezu K, Abe I, Kondo H, Saito S, Fukui A, Fukuda T, Shinohara T, Akiyoshi K, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Role of polyunsaturated fatty acids in Japanese patients with coronary spastic angina. J Cardiol 2023; 82:455-459. [PMID: 37459964 DOI: 10.1016/j.jjcc.2023.07.001] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/10/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND n-3 polyunsaturated fatty acids (PUFAs) reduce the risk of ischemic heart disease. However, there are few reports of a relationship between n-3 PUFAs and coronary spastic angina (CSA). This study aimed to assess the age-dependent role of serum levels of fatty acid in patients with CSA. METHODS AND RESULTS We enrolled 406 patients who underwent ergonovine tolerance test (ETT) during coronary angiography for evaluation of CSA. All ETT-positive subjects were diagnosed as having CSA. We categorized the patients by age and results of ETT as follows: (1) young (age ≤ 65 years) CSA-positive (n = 32), (2) young CSA-negative (n = 134), (3) elderly (age > 66 years) CSA-positive (n = 36), and (4) elderly CSA-negative (n = 204) groups. We evaluated the serum levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid, and dihomo-gamma-linolenic acid. In the young groups, the serum levels of EPA (64.3 ± 37.7 μg/mL vs. 49.4 ± 28.8 μg/mL, p = 0.015) and DHA (135.7 ± 47.6 μg/mL vs. 117.4 ± 37.6 μg/mL, p = 0.020) were significantly higher in the CSA-positive group than in the CSA-negative group, respectively. However, this was not the case with elderly groups. In the multivariate analysis in young groups, the serum levels of EPA (p = 0.028) and DHA (p = 0.049) were independently associated with the presence of CSA, respectively. CONCLUSION Our results suggested that the higher serum levels of EPA and/or DHA might be involved in the pathophysiology of CSA in the young population but not in the elderly population.
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Affiliation(s)
- Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan.
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Takaaki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Naoko Ogawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Takanori Aoki
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Kazuki Mitarai
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Shuichiro Yamauchi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Kumiko Akiyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan
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Yamamoto K, Akiyoshi K, Kondo H, Akioka H, Teshima Y, Yufu K, Takahashi N, Nakagawa M. Innovations in online classes introduced during the COVID-19 pandemic and their educational outcomes in Japan. BMC Med Educ 2023; 23:894. [PMID: 37993866 PMCID: PMC10666336 DOI: 10.1186/s12909-023-04874-1] [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: 03/06/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The novel coronavirus disease (COVID-19) pandemic emerged in Japan in February 2020, forcing the adoption of online education by university medical schools across Japan. The advantages and disadvantages of online education have been studied in Japan; however, the educational outcome of online classes conducted during the COVID-19 pandemic has not been completely evaluated. In this study, we examined the relationship between lecture format (e.g., face-to-face or online) and performance of third-year university students in their organ-specific cardiovascular course examination. METHODS This retrospective, nonclinical, and noninterventional comparative educational study included 550 third-year medical students who took a cardiovascular course between April 2018 and May 2022. Cardiovascular coursework was conducted in-person in 2018 and 2019, online in 2020 and 2021, and again in-person in 2022. The course comprised 62 lecture and 2 problem-based learning (PBL) sessions. A quiz was set up in advance on Moodle based on all lectures conducted in 2021 and 2022. A written examination was administered at the end of the course to evaluate the knowledge of students. The student online course evaluation questionnaires were administered in 2020 and 2021. Examination scores and proportion of failures in each year were compared. RESULTS The mean examination scores were significantly higher in 2021 and 2022 than in 2018, 2019, and 2020 (p < 0.05). Univariate and multivariate analyses adjusted for the class type, online quiz, and PBL revealed that only online quiz was significantly associated with better examination results (p < 0.05). A student course evaluation survey indicated that the online format did not interfere with the students' learning and was beneficial. CONCLUSIONS The introduction of online classes into medical education due to the COVID-19 pandemic was as effective as face-to-face classes owing to learning management system and other innovations, such as online quizzes. Online education may confer more benefits when provided in a combination with face-to-face learning after COVID-19 pandemic.
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Affiliation(s)
- Kyoko Yamamoto
- Medical Education Center, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Kumiko Akiyoshi
- Medical Education Center, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan
| | - Mikiko Nakagawa
- Medical Education Center, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan.
- Department of Cardiology and Clinical Examination and Diagnosis, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hsama-Machi, Yufu, Oita, 879-5593, Japan.
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6
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Yufu K, Shimomura T, Kawano K, Sato H, Yonezu K, Saito S, Kondo H, Fukui A, Akioka H, Shinohara T, Teshima Y, Abe R, Takahashi N. Usefulness of Prehospital 12-Lead Electrocardiography System in ST-Segment Elevation Myocardial Infarction Patients in Oita - Comparison Between Urban and Rural Areas, Weekday Daytime and Weekday Nighttime/Holidays. Circ J 2023:CJ-23-0365. [PMID: 37612071 DOI: 10.1253/circj.cj-23-0365] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND We have reported that a prehospital 12-lead electrocardiography system (P-ECG) contributed to transport of suspected acute coronary syndrome (ACS) patients to appropriate institutes and in this study, we compared its usefulness between urban and rural areas, and between weekday daytime and weekday nighttime/holiday.Methods and Results: Consecutive STEMI patients who underwent successful primary percutaneous coronary intervention after using P-ECG were assigned to the P-ECG group (n=123; 29 female, 70±13 years), and comparable STEMI patients without using P-ECG were assigned to the conventional group (n=117; 33 females, mean age 70±13 years). There was no significant difference in door-to-reperfusion times between the rural and urban cases (70±32 vs. 69±29 min, P=0.73). Door-to-reperfusion times in the urban P-ECG group were shorter than those in the urban conventional group for weekday nighttime/holiday (65±21 vs. 83±32 min, P=0.0005). However, there was no significance different between groups for weekday daytime. First medical contact to reperfusion time (90±22 vs. 105±37 min, P=0.0091) in the urban P-ECG group were significantly shorter than in the urban conventional groups for weekday nighttime/holiday, but were not significantly different between the groups for weekday daytime. CONCLUSIONS P-ECG is useful even in urban areas, especially for patients who develop STEMI during weekday nighttime or while on a holiday.
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Affiliation(s)
- Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | | | - Kyoko Kawano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Ryuzo Abe
- Advanced Trauma Emergency and Critical Care Center, Oita University Hospital
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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Miyoshi M, Abe I, Kodama N, Zhan Y, Kira S, Ishii Y, Harada T, Takano M, Takahashi M, Sato H, Tawara K, Kondo H, Fukui A, Fukuda T, Akioka H, Shinohara T, Teshima Y, Yufu K, Nakagawa M, Daa T, Shimada T, Takahashi N. Association between interatrial septum adiposity and atrial fibrillation: transesophageal echocardiography imaging and autopsy study. Sci Rep 2023; 13:9828. [PMID: 37330552 PMCID: PMC10276811 DOI: 10.1038/s41598-023-36677-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/08/2023] [Indexed: 06/19/2023] Open
Abstract
Recent clinical evidence has suggested that interatrial septal (IAS) adiposity contributes to atrial fibrillation (AF). The present study aimed to confirm the usefulness of transesophageal echocardiography (TEE) to estimate IAS adiposity in patients with AF. The histological IAS analysis based on autopsy samples sought to clarify characteristics that underlie the contribution of IAS adiposity to AF. The imaging study analyzed the TEE results in patients with AF (n = 184) in comparison with transthoracic echocardiography (TTE) and computed tomography (CT) results. The autopsy study histologically analyzed IAS in subjects with (n = 5) and without (n = 5) history of AF. In the imaging study, the ratio of interatrial septum adipose tissue (IAS-AT) volume per epicardial adipose tissue (EpAT) volume was greater in patients with persistent AF compared (PerAF) to those with paroxysmal AF (PAF). Multivariable analysis revealed that both TEE-assessed IAS thickness and TTE-assessed left atrial dimension were predicted by CT-assessed IAS-AT volume. In the autopsy study, the histologically-assessed IAS section thickness was greater in the AF group than that in the non-AF group and was positively correlated with the IAS-AT area percentage. In addition, the size of adipocytes in IAS-AT was smaller, compared to EpAT and subcutaneous adipose tissue (SAT). IAS-AT infiltrated into the IAS myocardium, as if adipose tissue split the myocardium (designated as myocardial splitting by IAS-AT). The number of island-like myocardium pieces as a result of myocardial splitting by IAS-AT was greater in the AF group than in the non-AF group and was positively correlated with the IAS-AT area percentage. The present imaging study confirmed the usefulness of TEE to estimate IAS adiposity in patients with AF without radiation exposure. The autopsy study suggested that the myocardial splitting by IAS-AT may contribute to atrial cardiomyopathy leading to AF.
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Affiliation(s)
- Miho Miyoshi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan.
| | - Nozomi Kodama
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Yinge Zhan
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Shintaro Kira
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Masayuki Takano
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan
| | - Mikiko Nakagawa
- Medical Education Center, Oita University Faculty of Medicine, Oita, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Oita University Faculty of Medicine, Oita, Japan
| | - Tatsuo Shimada
- Oita Medical Technology School, College of Judo Therapy and Acupuncture-Moxibustion, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan.
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Uemura T, Kondo H, Shinohara T, Takahashi M, Akamine K, Ogawa N, Hirota K, Fukui A, Akioka H, Yufu K, Takahashi N. Multiple accessory pathways coexisting with a persistent left superior vena cava: a case report. J Med Case Rep 2023; 17:111. [PMID: 36967399 PMCID: PMC10041748 DOI: 10.1186/s13256-023-03865-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/28/2023] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND Wolff-Parkinson-White syndrome is characterized by a short PR interval (delta-wave), long QRS complex, and the appearance of paroxysmal supraventricular tachycardia. Patients with Wolff-Parkinson-White syndrome usually have one accessory pathway, whereas cases with multiple accessory pathways are rare. Persistent left superior vena cava is a vascular anomaly in which the vein drains into the right atrium through the coronary sinus at the junction of the left internal jugular and subclavian veins due to abnormal development of the left cardinal vein. The simultaneous presence of multiple accessory pathways and persistent left superior vena cava has not been reported before. CASE PRESENTATION A 56-year-old Japanese man with a 5-year history of palpitations was referred for radiofrequency catheter ablation due to increased frequency of tachycardia episodes in the previous 2 months. Persistent left superior vena cava was confirmed by transthoracic echocardiography and computed tomography. An electrophysiological study revealed that the accessory pathways were located in the left lateral wall, anterolateral wall, and posteroseptal region. They were completely ablated with radiofrequency energy application. CONCLUSIONS We reported an extremely rare case of a patient with multiple accessory pathways and persistent left superior vena cava. Our case may suggest a potential embryological relationship between the multiple accessory pathways and persistent left superior vena cava.
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Affiliation(s)
- Tetsuya Uemura
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Koshiro Akamine
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Naoko Ogawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
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Fukuda T, Shinohara T, Yonezu K, Mitarai K, Hirota K, Kondo H, Fukui A, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Vagal response is involved in the occurrence of ventricular fibrillation in patients with early repolarization syndrome. Heart Rhythm 2023; 20:879-885. [PMID: 36870380 DOI: 10.1016/j.hrthm.2023.02.029] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/31/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Patients with early repolarization syndrome (ERS) and Brugada syndrome (BruS) have comparable clinical symptoms. In both conditions, ventricular fibrillation (VF) is experienced often near midnight or in the early morning hours when the parasympathetic tone is augmented. However, differences between ERS and BruS regarding the risk of VF occurrence have recently been reported. The role of vagal activity remains especially unclear. OBJECTIVE The goal of this study was to determine the relationship between VF occurrence and autonomic nervous activity in patients with ERS and BruS. METHODS We enrolled 50 patients with ERS (n = 16) and BruS (n = 34) who received an implantable cardioverter-defibrillator. Of these, 20 patients (5 ERS and 15 BruS) experienced VF recurrence (recurrent VF group). We investigated baroreflex sensitivity (BaReS) with the phenylephrine method and heart rate variability using Holter electrocardiography in all patients to estimate autonomic nervous function. RESULTS In both patients with ERS and BruS, there was no significant difference in heart rate variability between the recurrent VF and nonrecurrent VF groups. However, in patients with ERS, BaReS was significantly higher in the recurrent VF group than in the nonrecurrent VF group (P = .03); this difference was not evident in patients with BruS. High BaReS was independently associated with VF recurrence in patients with ERS according to Cox proportional hazards regression analyses (hazard ratio 1.52; 95% confidence interval 1.031-3.061; P = .032). CONCLUSION Our findings suggest that in patients with ERS, an exaggerated vagal response, as represented by increased BaReS indices, may be involved in the risk of VF occurrence.
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Affiliation(s)
- Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan.
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazuki Mitarai
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
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Uemura T, Kondo H, Sato H, Takahashi M, Shinohara T, Mitarai K, Fukui A, Hirota K, Fukuda T, Kodama N, Miyoshi M, Ogawa N, Wada M, Yamasaki H, Iwanaga K, Uno A, Tawara K, Yonezu K, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Predictors of outcome after catheter ablation for atrial fibrillation: Group analysis categorized by age and type of atrial fibrillation. Ann Noninvasive Electrocardiol 2023; 28:e13020. [PMID: 36527236 PMCID: PMC10023880 DOI: 10.1111/anec.13020] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The outcome of catheter ablation could probably differ among patients with atrial fibrillation (AF), depending on age and AF type. We aimed to investigate the difference in predictors of outcome after catheter ablation for AF among the patient categories divided by age and AF type. METHODS AND RESULTS A total of 396 patients with AF (mean age 65.69 ± 11.05 years, 111 women [28.0%]) who underwent catheter ablation from January 2018 to December 2019 were retrospectively analyzed. We divided the patients into four categories: patients with paroxysmal AF (PAF) or persistent AF (PeAF) who were 75 years or younger (≤75 years) or older than 75 years (>75 years). Kaplan-Meier survival analysis demonstrated that patients with PAF aged ≤75 years had the lowest AF recurrence among the four groups (log-rank test, p = .0103). In the patients with PAF aged ≤75 years (N = 186, 46.7%), significant factors associated with recurrence were female sex (p = .008) and diabetes (p = .042). In the patients with PeAF aged ≤75 years (N = 142, 35.9%), the only significant factor associated with no recurrence was medication with a renin-angiotensin system inhibitor (p = .044). In the patients with PAF aged >75 years (N = 53, 14.4%), diabetes was significantly associated with AF recurrence (p = .021). No significant parameters were found in the patients with PeAF aged >75 years (N = 15, 4.1%). CONCLUSIONS Our findings indicate that the risk factors for AF recurrence after catheter ablation differed by age and AF type.
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Affiliation(s)
- Tetsuya Uemura
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Kazuki Mitarai
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Nozomi Kodama
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Naoko Ogawa
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Masato Wada
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Hirochika Yamasaki
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Kenzo Iwanaga
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Akihiro Uno
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita UniversityYufuOitaJapan
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11
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Hirota K, Fukui A, Yamaguchi T, Takahashi M, Kondo H, Akioka H, Shinohara T, Yufu K, Node K, Takahashi N. Interatrial conduction time is associated with left atrial low voltage area and predicts the recurrence after single atrial fibrillation ablation. J Arrhythm 2023; 39:142-148. [PMID: 37021021 PMCID: PMC10068931 DOI: 10.1002/joa3.12820] [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] [Received: 07/11/2022] [Revised: 12/29/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Background Interatrial conduction time (IACT) prolongs in fibrotic left atrium. We tested the hypothesis that IACT is related to left atrial low voltage area (LVA) and predicts the recurrence after single atrial fibrillation (AF) ablation. Methods One hundred sixty-four consecutive AF patients (79 non-paroxysmal) who underwent initial ablation in our institute were analyzed. IACT and LVA were defined as interval from the onset of P-wave to the basal left atrial appendage (P-LAA) activation, and area with bipolar electrogram < 0.5 mV covering over 5% of the total left atrial surface area during sinus rhythm, respectively. Pulmonary vein antrum isolation, non-PV foci ablation, and atrial tachycardia (AT) ablation were performed without substrate modification. Results LVA was frequently identified in patients with prolonged P-LAA ≥ 84 ms (n = 28) compared with patients with P-LAA < 84 ms (n = 136). Patients with P-LAA ≥ 84 ms were older (71 ± 10 vs. 65 ± 10 years, p = .0061), and had more frequent non-paroxysmal AF (75% vs. 43%, p = .0018), larger left atrial diameter (43.5 ± 4.5 vs. 39.3 ± 5.7 mm, p = .0003), and higher E/e' ratio (14.4 ± 6.5 vs. 10.5 ± 3.7, p < .0001) compared with P-LAA < 84 ms patients. After a mean follow-up period of 665 ± 153 days, Kaplan-Meier curve analysis showed that AF/AT recurrences was more frequently observed in patients with prolonged P-LAA (Log-rank p = .0001). Additionally, univariate analysis revealed that P-LAA prolongation (OR = 1.055 per 1 ms, 95% CI: 1.028-1.087, p < .0001) and the existence of LVA (OR = 5.000, 95% CI: 1.653-14.485 p = .0053) were predictors of AF/AT recurrences after single AF ablation. Conclusions Our results suggested that prolonged IACT as measured by P-LAA was associated with LVA and predicts AT/AF recurrence after single AF ablation.
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Affiliation(s)
- Kei Hirota
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | | | - Masaki Takahashi
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
| | - Koichi Node
- Department of Cardiovascular Medicine Saga University Saga Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination Oita University Yufu Japan
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12
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Kawano K, Shinohara T, Kondo H, Ishii Y, Takahashi M, Mitarai K, Hirota K, Fukui A, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Risk stratification of ventricular fibrillation in patients with symptomatic Brugada syndrome using pharmacological tests. J Cardiovasc Electrophysiol 2023; 34:180-188. [PMID: 36352766 DOI: 10.1111/jce.15746] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Brugada syndrome (BrS), which is characterized by J-point elevation in right precordial leads of a 12-lead electrocardiogram, is associated with the occurrence of ventricular fibrillation (VF). However, risk stratification of VF in patients with BrS remains challenging. OBJECTIVE The aim of this study was to identify a risk predictor of VF in patients with BrS using pharmacological tests. METHODS Twenty-one consecutive patients with BrS and a history of documented spontaneous VF (n = 16) or syncope presumed to be caused by lethal ventricular arrhythmia (n = 5) were enrolled. J-wave changes in response to intravenous verapamil, propranolol, and pilsicainide were separately assessed. RESULTS During the median follow-up period of 86.0 months, 8 patients had VF recurrence (recurrence group) and 13 patients did not have VF recurrence (non-recurrence group). Intravenous propranolol injection induced significant J-wave augmentation (i.e., increase in amplitude >0.1 mV) in the inferior and/or lateral leads in the recurrence group compared to the non-recurrence group (p = .048 and p = .015, respectively). Kaplan-Meier analysis revealed that VF recurrence is significantly higher in patients with BrS and J-wave augmentation due to intravenous propranolol than in patients without J-wave augmentation (p = .014). CONCLUSION The study results show that propranolol-induced J-wave augmentation is involved in the risk of VF in patients with BrS. The results suggest that early repolarization patterns in response to pharmacological tests may be useful for risk stratification of VF in patients with symptomatic BrS.
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Affiliation(s)
- Kyoko Kawano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazuki Mitarai
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
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13
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Harada T, Kondo H, Yufu K, Uno A, Takahashi M, Wada M, Yamasaki H, Ogawa N, Takano M, Hirota K, Ishii Y, Yonezu K, Saito S, Fukui A, Akioka H, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. Role of computed tomography-based evaluation of skeletal muscle area in predicting cardiovascular outcomes in patients with chronic heart failure after cardiac resynchronization therapy. Geriatr Gerontol Int 2022; 22:1013-1018. [PMID: 36271608 DOI: 10.1111/ggi.14498] [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: 06/06/2022] [Revised: 09/16/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to determine possible associations between sarcopenia and poor cardiovascular outcomes in patients with chronic heart failure after cardiac resynchronization therapy. METHODS This retrospective study evaluated 120 patients who underwent cardiac resynchronization therapy between March 2004 and June 2018. In total, 58 patients who underwent computed tomography within 30 days of cardiac resynchronization therapy implantation were eligible for inclusion, and their data were analyzed (25 women; 33 men; mean age 71.6 ± 8.7 years). Skeletal muscle area was measured at the third lumbar vertebra, and skeletal muscle index was calculated. Major adverse cardiovascular events included cardiovascular death, hospitalization due to heart failure, cerebral infarction, acute myocardial infarction and cardiac arrest. RESULTS During the follow-up period (mean 868 ± 617 days), major adverse cardiovascular events occurred in 22 of 58 patients (38%). The patients were allocated to two groups according to sex-based tertiles of skeletal muscle index. The lowest tertile was defined as the low skeletal muscle index group. Kaplan-Meier survival analysis showed that the low skeletal muscle index group had a higher incidence of major adverse cardiovascular events (log-rank 4.38; P = 0.036). Cox proportional hazards regression analysis also showed that low skeletal muscle index values were significantly associated with major adverse cardiovascular events (hazard ratio 3.08; 95% confidence interval 1.26-7.66, P = 0.014). CONCLUSIONS Decreases in skeletal mass index on computed tomography might predict the occurrence of major adverse cardiovascular events in patients with chronic heart failure who underwent cardiac resynchronization therapy. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Taisuke Harada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Akihiro Uno
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Masato Wada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hirochika Yamasaki
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Naoko Ogawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Masayuki Takano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Japan
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14
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Kawano K, Yufu K, Shimomura T, Sato H, Ishii Y, Yonezu K, Saito S, Kondo H, Akioka H, Shinohara T, Teshima Y, Sakamoto T, Takahashi N. Prehospital 12-Lead Electrocardiography System in Oita Assisted Transport of "True" Acute Coronary Syndrome Patients to Optimal Institutes. Circ J 2022; 86:1481-1487. [PMID: 35944978 DOI: 10.1253/circj.cj-22-0178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Mobile cloud electrocardiography (C-ECG) can reduce the door-to-balloon time of acute coronary syndrome (ACS) patients, so we hypothesized it would also assist in transporting ACS-suspected patients to the optimal institutes.Methods and Results: Initially, 10 fire departments in Oita had 10 ambulances equipped with C-ECG. Ambulance crews recorded a 12-lead ECG from the patient at the first point of contact and transmitted them to 18 hospitals (13 institutions (PCII) with 24-h availability for percutaneous coronary intervention (PCI) and 5 regional core hospitals (RCH) without 24-h PCI) for analysis by a cardiologist. During 41 months, 476 ECGs suspected to be ACS were transmitted and analyzed. Of these, 24 ECGs transmitted to PCII were judged as not requiring PCI, and the patients were directly transported to a RCH (PCII-RCH); 35 ECGs sent to a RCH were judged as requiring PCI, and the patients were directly transported to a PCII (RCH-PCII). The prevalence of cardiovascular disease was significantly higher in the RCH-PCII group than in the PCII-RCH group (P<0.01). There was no significant difference in the door-to-balloon time between the RCH-PCII and the group in which the C-ECG was sent to a PCII and the patients were transported directly to PCII (PCII-PCII) (49±14 vs. 59±20 min, P=0.14). CONCLUSIONS Prehospital 12-lead ECG can assist in transporting ACS-suspect patients to the optimal treatment facility.
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Affiliation(s)
- Kyoko Kawano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | | | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Teruo Sakamoto
- Advanced Trauma Emergency and Critical Care Center, Oita University Hospital
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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15
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Shinohara T, Yonezu K, Hirota K, Kondo H, Fukui A, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Fragmented QRS as a risk marker for the occurrence of ventricular fibrillation in patients with variant angina. Ann Noninvasive Electrocardiol 2022; 27:e12937. [PMID: 35170178 PMCID: PMC9107091 DOI: 10.1111/anec.12937] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Variant angina (VA) is caused by reversible coronary artery spasm, which is characterized by chest pain with ST-segment elevations on standard 12-lead electrocardiogram (ECG) at rest. Ventricular fibrillation (VF) is often caused by VA attack, but the risk stratification is not well understood. The purpose of this study was to evaluate the impact of fragmented QRS (fQRS) on VF occurrence in VA patients. METHODS Ninety-four patients who showed ST elevation on 12-lead ECGs with total or nearly total occlusion in response to coronary spasm provocation test were enrolled. Among them, 16 patients had documented VF before hospital admission (n = 12) or experienced VF during provocation test (n = 4) (VF occurrence group). The fQRS was defined as the presence of spikes within the QRS complex of two or more consecutive leads. RESULTS The prevalence of fQRS was more often observed in the VF occurrence group than in the non-VF occurrence group (63% [10/16] vs. 27% [21/78], p = 0.009). Univariate analyses revealed that age, history of syncope, QTc, and the presence of fQRS were associated with VF occurrence (p = 0.004, 0.005, 0.029, and 0.008, respectively). Furthermore, upon multivariate analyses using those risk factors, age, QTc, and fQRS predicted VF occurrence independently (p = 0.007, 0.041, and 0.014, respectively). CONCLUSIONS The present study demonstrated that fQRS in VA patients is a risk factor for VF. The fQRS may be a useful factor for the risk stratification of VF occurrence in VA patients.
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Affiliation(s)
- Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
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16
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Akioka H, Yufu K, Harada T, Akamine K, Uemura T, Takahashi M, Nishimizu K, Hirota K, Ishii Y, Kira S, Yonezu K, Abe I, Tawara K, Kondo H, Saito S, Fukui A, Okada N, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. Reduction of bleeding complications on puncture site after percutaneous coronary intervention using a 6.5-French sheathless guiding catheter. Heart Vessels 2022; 37:954-960. [PMID: 35022882 DOI: 10.1007/s00380-021-02005-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reducing complications at the puncture site after percutaneous coronary intervention (PCI) is important. The diameter of a 6.5-French (Fr) sheathless guiding catheter (GC) is smaller by approximately 2-Fr compared to a 6-Fr conventional sheath. In the present study, we investigated the post-PCI puncture site complications of a transradial approach in each gender while using a 6.5-Fr sheathless GC. METHODS AND RESULTS Our study consisted of 332 patients who underwent transradial coronary intervention (TRI) between August 2017 and July 2019. We classified the patients into either the 6.5-Fr sheathless GC (Asahi, Intecc, Aichi, Japan) Group (Sheathless group: n = 182 males, 58 females) or the 6-Fr sheathed GC Group (Sheathed group: n = 150 males, 36 females). We determined the complications at the puncture site: oozing, subcutaneous hemorrhage, formation of hematoma, pseudoaneurysms, and peripheral neuropathy. The body mass index of the patients was greater in the sheathless GC group compared to the sheathed GC group (24.5 ± 3.5 kg/m2 vs. 23.6 ± 3.7 kg/m2, p = 0.02). In males, there was no significant difference in the complication rate at the puncture site between the sheathless GC and sheathed GC groups (19.3% vs. 18.6%, p = 0.88). However, the complication rate at the puncture site in females was higher in the sheathed GC group than in the sheathless GC group (36% vs. 15.5%, p = 0.02). A multiple logistic regression analysis revealed that the use of a 6.5-Fr sheathless GC independently reduced the complications in female patients (p = 0.006). CONCLUSION The use of the 6.5-Fr sheathless GC system in a transradial approach reduced the complications at the puncture site in female patients. The 6.5-Fr sheathless GC system may be a safe option for them compared to the conventional sheath system.
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Affiliation(s)
- Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Koshiro Akamine
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Tetsuya Uemura
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kyohei Nishimizu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Shintaro Kira
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
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17
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Tanino T, Yufu K, Shuto T, Sato H, Takano M, Ishii Y, Kira S, Saito S, Kondo H, Fukui A, Fukuda T, Akioka H, Teshima Y, Wada T, Miyamoto S, Takahashi N. Proposal criteria of paradoxical low-flow low-gradient aortic stenosis for predicting prognosis in patients undergoing transcatheter aortic valve implantation. Heart Vessels 2021; 37:1044-1054. [PMID: 34822000 DOI: 10.1007/s00380-021-01992-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Paradoxical low-flow, low-gradient (PLF-LG) aortic stenosis (AS) is associated with poor prognosis in patients undergoing transcatheter aortic valve implantation (TAVI). This study aimed to verify the conventional criteria of PLF-LG AS (left ventricular ejection fraction [LVEF] > 50%, mean aortic valve pressure gradient [AVPG] < 40 mm Hg and stroke volume index [SVI] < 35 ml/m2 by measuring Doppler method) compatible for predicting prognosis in patients undergoing TAVI. MATERIALS AND METHODS A total of 128 consecutive patients who underwent TAVI for AS with LVEF > 50% were enrolled. The primary endpoint was the hospital readmission due to heart failure (HRHF) and the secondary endpoint was all-cause mortality after hospital discharge. The patients were classified by both the conventional criteria of PLF-LG AS and the proposal criteria of PLF-LG AS if mean aortic valve pressure gradient (AVPG) < 40 mmHg and SVI by measuring Simpson's method < cut off value based on the ROC curve for predicting HRHF. RESULTS According to the conventional criteria, only 6 patients were diagnosed with PLF-LG AS. However, according to the proposal criteria, 16 patients were diagnosed with PLF-LG AS. Fourteen patients developed HRHF during the follow-up period after TAVI. Based on the ROC curves, SVI by measuring Simpson's method (cut off value = 25 ml/m2) had higher sensitivity and specificity for predicting HRHF (AUC = 0.74, p = 0.0013) than SVI by measuring Doppler method (AUC = 0.63, p = 0.045). The multivariate analysis revealed that PLF-LG AS defined by the proposal criteria (HR: 5.25; 95% CI: 1.60-17.16; p = 0.0073) but not by the conventional criteria was independently associated with HRHF. PLF-LG AS defined by the conventional criteria and the proposal criteria were not associated with all-cause mortality in the univariate analysis. CONCLUSIONS Our results demonstrated that new criteria of PLF-LG AS defined as SVI < 25 ml/m2 measured by Simpson's method could predict HRHF in patients with severe AS who underwent TAVI.
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Affiliation(s)
- Tomomi Tanino
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan.
| | - Takashi Shuto
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Masayuki Takano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Shintaro Kira
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
| | - Tomoyuki Wada
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Shinji Miyamoto
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan
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18
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Ishii Y, Nakagawa M, Abe I, Kondo H, Fukui A, Akioka H, Shinohara T, Teshima Y, Yufu K, Takahashi N. Possible Role of Narrow Anteroposterior Thorax in Patients With Brugada Syndrome. JACC Clin Electrophysiol 2021; 7:673-675. [PMID: 34016394 DOI: 10.1016/j.jacep.2020.12.019] [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] [Received: 11/09/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 11/25/2022]
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19
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Yufu K, Abe I, Kondo H, Saito S, Fukui A, Okada N, Akioka H, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. Distinctively different predictors for long-term outcomes between responders and nonresponders who underwent cardiac resynchronization therapy. J Arrhythm 2021; 37:173-181. [PMID: 33664900 PMCID: PMC7896449 DOI: 10.1002/joa3.12447] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/11/2020] [Accepted: 10/08/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It is common to develop heart failure (HF) events even in respondents to cardiac resynchronization therapy (CRT) during a long-term observation period. We investigated the predictors for long-term outcome in responders in comparison with nonresponders in patients diagnosed with HF along with implanted CRT. METHODS We enrolled 133 consecutive patients (mean age, 70 ± 10 years; 72 males) implanted with CRT from April 2010 to July 2019. Accurate follow-up information (mean follow-up period, 983 ± 801 days) was obtained from 66 responders and 53 nonresponders. RESULTS Kaplan-Meier event-free curves showed that major adverse cerebral and cardiovascular event (MACCE)-free ratio was significantly lower as the stage of renal function progresses (log rank, 19.5; P < .0001). The baseline estimated glomerular filtration rate (e-GFR) before CRT was not significantly different between nonresponders and responders. The e-GFR after judgment of CRT response was lower in patients with MACCEs than those without. Cox proportional hazards regression analysis revealed that low baseline e-GFR before CRT and after judgment of CRT response was closely related with MACCEs in responders, but not in nonresponders. The survival rate in responders without MACCEs assessed using Kaplan-Meier analysis was significantly larger in the preserved e-GFR (baseline value before CRT, >44 mL/min/1.73 m2) group than in the depressed group (log rank, 20.29; P < .0001). CONCLUSION We demonstrate that the factors for MACCEs during long follow-up periods were distinctively different between responders and nonresponders. Patients with depressed e-GFRs are suggested to have poor prognosis even if they are responders to CRT.
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Affiliation(s)
- Kunio Yufu
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Ichitaro Abe
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Shotaro Saito
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Akira Fukui
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Norihiro Okada
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Yasushi Teshima
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical ExaminationFaculty of MedicineOita UniversityOitaJapan
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20
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Miyoshi M, Kondo H, Ishii Y, Shinohara T, Yonezu K, Harada T, Sato H, Yano Y, Yoshimura S, Abe I, Shuto T, Akioka H, Teshima Y, Wada T, Yufu K, Nakagawa M, Anai H, Miyamoto S, Takahashi N. Baroreflex Sensitivity in Patients With Atrial Fibrillation. J Am Heart Assoc 2020; 9:e018019. [PMID: 33263265 PMCID: PMC7955376 DOI: 10.1161/jaha.120.018019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background It has been reported that atrial fibrillation (AF) may contribute to impairment of baroreflex sensitivity (BRS). However, the difference of BRS between patients with persistent AF (PeAF) and those with paroxysmal AF (PAF) is unknown. We tested the hypothesis that patients with PeAF have a more impaired BRS compared with those with PAF. Methods and Results From October 2015 onwards, a total of 67 patients (14 women [20.9%]; mean age 65.2±10.1 years) with PAF (n=46, 68.7%) and PeAF (n=21, 31.3%), who underwent catheter ablation, were prospectively enrolled. The baseline BRS was evaluated during sinus rhythm. The baseline BRS in patients with PeAF was significantly lower than those with PAF (2.97 [0.52–6.62] ms/mm Hg versus 4.70 [2.36–8.37] ms/mm Hg, P=0.047). The BRS was significantly depressed after catheter ablation in all the patients (4.66 [1.80–7.37] ms/mm Hg versus 0.55 [−0.15 to 1.22] ms/mm Hg, P<0.001). However, the depression of BRS because of catheter ablation appeared attenuated in patients with PeAF when compared with those with PAF. The number of patients who did not show depression of BRS was significantly greater, that is, patients with PeAF (3/12, 25%) than those with PAF (0/46, 0%, P<0.01). Conclusions Our findings demonstrated that the baseline BRS was more depressed in patients with PeAF compared with PAF. Catheter ablation depressed BRS irrespective of the type of AF, with a greater effect in patients with PAF than PeAF.
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Affiliation(s)
- Miho Miyoshi
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Yudai Yano
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Seiichiro Yoshimura
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Takashi Shuto
- Department of Cardiovascular Surgery Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Tomoyuki Wada
- Department of Cardiovascular Surgery Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Hirofumi Anai
- Department of Cardiovascular Surgery Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Shinji Miyamoto
- Department of Cardiovascular Surgery Faculty of Medicine Oita University Yufu-City Oita Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination Faculty of Medicine Oita University Yufu-City Oita Japan
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21
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Abe I, Miyoshi M, Fukuda T, Harada T, Yonezu K, Akioka H, Yufu K, Takahashi N. Fractured Sternal Wire With Distal Migration and Penetration of the Right Ventricle. Circ J 2020; 84:2032. [DOI: 10.1253/circj.cj-20-0418] [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: 11/09/2022]
Affiliation(s)
- Ichitaro Abe
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Taisuke Harada
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine
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22
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Ito T, Matsuyama S, Shiozaki T, Nishikawa D, Akioka H, Yamanaka T, Kitahara T. Differences between primary care physicians and specialised neurotologists in the diagnosis of dizziness and vertigo in Japan. J Laryngol Otol 2020; 134:1-5. [PMID: 32940200 DOI: 10.1017/s0022215120001309] [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] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Vertigo and dizziness are frequent symptoms in patients at out-patient services. An accurate diagnosis for vertigo or dizziness is essential for symptom relief; however, it is often challenging. This study aimed to identify differences in diagnoses between primary-care physicians and specialised neurotologists. METHOD In total, 217 patients were enrolled. To compare diagnoses, data was collected from the reference letters of primary-care physicians, medical questionnaires completed by patients and medical records. RESULTS In total, 62.2 per cent and 29.5 per cent of the patients were referred by otorhinolaryngologists and internists, respectively. The cause of vertigo or dizziness and diagnosis was missing in 47.0 per cent of the reference letters. In addition, 67.3 per cent of the diagnoses by previous physicians differed from those reported by specialised neurotologists. CONCLUSION To ensure patient satisfaction and high quality of life, an accurate diagnosis for vertigo or dizziness is required; therefore, methods or materials to improve the diagnostic accuracy are needed.
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Affiliation(s)
- T Ito
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - S Matsuyama
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - T Shiozaki
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - D Nishikawa
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - H Akioka
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - T Yamanaka
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - T Kitahara
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
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23
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Teshima Y, Shiga R, Saito S, Kondo H, Fukui A, Fukuda T, Okada N, Akioka H, Shinohara T, Akiyoshi K, Yufu K, Nakagawa M, Takahashi N. Potential Risk of Hypoglycemia in Patients with Heart Failure. Int Heart J 2020; 61:776-780. [PMID: 32684608 DOI: 10.1536/ihj.20-134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The properties of glucose changes in patients with chronic heart failure remain elusive. In the present study, we investigated the sequential changes of interstitial glucose concentrations in patients with chronic heart failure and heart disease who were not undergoing antidiabetic therapy.A glucose monitoring device (FreeStyle Libre Pro) was attached to the backside of an upper arm and the interstitial glucose concentration was monitored every 15 minutes for 1 week. Eleven patients with chronic heart failure (Heart failure (+) ) and 7 patients with chronic heart diseases but not with heart failure (Heart failure (-) ) were enrolled. The average level and peak value of interstitial glucose concentrations, and the duration of hyperglycemia (≥ 140 mg/dL) were not significantly different between Heart failure (+) and Heart failure (-). The duration of hypoglycemia (< 80 mg/dL) was significantly longer and the trough value was significantly lower in Heart failure (+) compared with Heart failure (-). Most of the patients in Heart failure (+) were exposed to a long duration of hypoglycemia from midnight to morning. Importantly, none of the patients who showed hypoglycemia complained of any subjective symptoms during hypoglycemia. Malabsorption may be one of the mechanisms of hypoglycemia.In summary, patients with chronic heart failure are at risk of developing hypoglycemia even if they do not undergo any antidiabetic therapy.
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Affiliation(s)
- Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Ryosuke Shiga
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tomoko Fukuda
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kumiko Akiyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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24
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Akioka H, Yufu K, Hara M, Abe I, Kondo H, Saito S, Fukui A, Okada N, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. Impact of Age on Gender Differences in the Acute Myocardial Infarction Onset–Weather Association ― Oita AMI Registry ―. Circ Rep 2020; 2:152-157. [PMID: 33693222 PMCID: PMC7921360 DOI: 10.1253/circrep.cr-19-0134] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background:
The onset of acute myocardial infarction (AMI) is related to weather conditions, but the impact of age on gender differences in the AMI onset–weather association has not been elucidated. Methods and Results:
We analyzed the Oita AMI Registry and obtained data for 403 enrolled patients. To examine the impact of age, we categorized the patients into 4 groups: young (age ≤65 years) women (n=20); young men (n=123); elderly (age >65 years) women (n=84); and elderly men (n=176). The analyzed meteorological factors were maximum and minimum temperature, intraday temperature difference, average humidity, and average atmospheric pressure. The young women group had a higher minimum temperature (17.7±5.7℃ vs. 13.8±8.2℃, P=0.04), lower intraday temperature difference (7.0±2.6℃ vs. 8.4±2.9℃, P=0.03), higher average humidity (74.5±12.1% vs. 68.1±12.0%, P=0.03), and lower average atmospheric pressure (1,009.5±5.0 hPa vs. 1,012.9±5.8 hPa, P=0.01) than the young men group on the onset day. In the elderly groups, there was no significant difference in meteorological variables except for the intraday temperature difference 2 days before AMI onset. Conclusions:
AMI onset appears to be more sensitive to weather conditions (i.e., minimum temperature, average atmospheric pressure, and average humidity) in young patients than in elderly patients. In particular, young women had AMI on days with low intraday temperature difference and high humidity relative to men.
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Affiliation(s)
- Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Masahide Hara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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25
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Fukui A, Tanino T, Yamaguchi T, Hirota K, Saito S, Okada N, Akioka H, Shinohara T, Yufu K, Takahashi N. Catheter ablation of atrial fibrillation reduces heart failure rehospitalization in patients with heart failure with preserved ejection fraction. J Cardiovasc Electrophysiol 2020; 31:682-688. [DOI: 10.1111/jce.14369] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/17/2019] [Accepted: 12/25/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Tomomi Tanino
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | | | - Kei Hirota
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Yufu Japan
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26
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Yufu K, Shimomura T, Fujinami M, Nakashima T, Saito S, Ayabe R, Kawano K, Ishii Y, Okada N, Akioka H, Teshima Y, Sakamoto T, Nakagawa M, Takahashi N. CORRIGENDUM: Impact of Mobile Cloud Electrocardiography System on Door-to-Balloon Time in Patients With Acute Coronary Syndrome in Oita Prefecture. Circ Rep 2019; 1:468. [PMID: 33704265 PMCID: PMC7897972 DOI: 10.1253/circrep.cr-66-0004] [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: 11/09/2022] Open
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27
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Ishii Y, Yufu K, Kira S, Miyoshi M, Abe I, Oniki T, Kondo H, Saito S, Fukui A, Okada N, Akioka H, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. 4090Maximum standardized uptake value of pericardial fat for prediction of ventricular arrhythmias in patients with cardiac sarcoidosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0102] [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
Cardiac sarcoidosis is a cause of epicarditis and sustained life-threatening ventricular arrhythmias. These arrhythmias occasionally arise from epicardial. Positron emission tomogramphy-comututed tomography (PET-CT) is useful for diagnosis with sarcoidosis. However, the usefulness for prediction of ventricular arrhythmias in patients with cardiac sarcoidosis is unknown.
Objective
We hypothesized that the evaluation of pericardial fat inflammation could identify high-risk sarcoidosis patients for ventricular arrhythmias.
Methods
We enrolled 20 consecutive patients with cardiac sarcoidosis performed PET-CT between August 2016 and December 2018. In each case, we measured the maximum standardized uptake value (SUVmax) of pericardial fat around the left atrium, both ventricules, atrioventricular groove, and left main coronary.
Results
Seven patients experienced ventricular tachycardia (VT) or ventricular fibrillation (VF). VT/VF patients had significantly more complete right bundle branch block (P=0.035), larger left atrial dimension (P=0.021), larger left ventricular end-diastolic dimension (P=0.005), lower ejection fraction (P=0.007), and higher E/e' (P=0.004). SUVmax of pericardial fat in the roof of left atrium (LA) and left ventricular (LV) with VT/VF patients were significantly higher than non-VT/VF patients (LA: 1.63 vs 1.32, P=0.0311; LV: 1.84 vs 1.26, P=0.045). The cut-off values of SUVmax derived from the ROC curve in the roof of LA and LV are 1.47 and 1.59 respectively. The Kaplan Meire estimator showed that high SUVmax patients in the roof of LA had significantly more detection of NSVT.
Conclusions
Our results suggest the relationship between SUVmax and VT/VF occurrence in patients with cardiac sarcoidosis. The evaluateon of SUVmax may be useful for VT/VF risk stratification.
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Affiliation(s)
- Y Ishii
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - K Yufu
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - S Kira
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - M Miyoshi
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - I Abe
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - T Oniki
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - H Kondo
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - S Saito
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - A Fukui
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - N Okada
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - H Akioka
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - T Shinohara
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - Y Teshima
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - M Nakagawa
- Oita University, Department of Medical Education Center, Faculty of Medicine, Yufu, Japan
| | - N Takahashi
- Oita University, Department of Medical Education Center, Faculty of Medicine, Yufu, Japan
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28
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Yufu K, Shimomura T, Fujinami M, Nakashima T, Saito S, Ayabe R, Kawano K, Ishii Y, Okada N, Akioka H, Teshima Y, Sakamoto T, Nakagawa M, Takahashi N. Impact of Mobile Cloud Electrocardiography System on Door-to-Balloon Time in Patients With Acute Coronary Syndrome in Oita Prefecture. Circ Rep 2019; 1:241-247. [PMID: 33693145 PMCID: PMC7889482 DOI: 10.1253/circrep.cr-19-0020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background:
The mobile cloud electrocardiography (C-ECG) system is useful for reducing door-to-balloon (DTB) time in patients with acute coronary syndrome (ACS), but few studies have reported the usefulness of the C-ECG system across a wide provincial prefecture, such as Oita, in Japan. Methods and Results:
On 17 April 2017, the C-ECG system was integrated into the Oita remote image transmission system, in 10 ambulances of 10 respective fire departments in Oita Prefecture. During 6 months, 162 ECG indicating suspected ACS were transmitted to 18 hospitals using the C-ECG system. Of 162 patients, 17 who received emergency percutaneous coronary intervention (PCI) were assigned to the cloud group (mean age, 71±11 years). The control group consisted of 29 consecutive ACS patients who were transported to Oita University Hospital without using the C-ECG system (mean age, 66±12 years). Another 40 consecutive patients were diagnosed with ACS before transportation to Oita University Hospital, and were assigned to the diagnosed group (mean age, 70±14 years). DTB time (70±26 min vs. 96±24 min, P<0.005) and door-to-catheterization laboratory time (33±20 min vs. 53±22 min, P<0.0001) were shorter in the cloud group than in the control group, respectively. Conclusions:
C-ECG system integration in Oita Prefecture was useful to appropriately transfer ACS patients to hospital and to facilitate earlier PCI than in the conventional diagnostic system.
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Affiliation(s)
- Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | | | - Mami Fujinami
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Tatsunori Nakashima
- Department of Medical Engineering Center, Oita University Hospital Yufu Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Reika Ayabe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Kyoko Kawano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Teruo Sakamoto
- Advanced Trauma Emergency and Critical Care Center, Oita University Hospital Yufu Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University Yufu Japan
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29
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Ishii Y, Shinohara T, Kondo H, Fukui A, Tanino T, Harada T, Mitarai K, Kawano K, Yoshimura S, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Response of J point elevation to cardio-active agents and risk of ventricular fibrillation in patients with early repolarization syndrome. J Electrocardiol 2019. [DOI: 10.1016/j.jelectrocard.2019.01.049] [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: 11/29/2022]
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30
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Ishii Y, Akioka H, Yufu K, Kawano K, Miyoshi M, Imamura T, Ayabe R, Kondo H, Saito S, Fukui A, Okada N, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. Successful Percutaneous Coronary Intervention to Single Coronary Artery From the Right Sinus of Valsalva. Circ J 2019; 83:492. [PMID: 30158374 DOI: 10.1253/circj.cj-18-0551] [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: 11/09/2022]
Affiliation(s)
- Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kyoko Kawano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Takaaki Imamura
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Reika Ayabe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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31
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Yufu K, Kondo H, Shinohara T, Ishii Y, Yoshimura S, Abe I, Saito S, Fukui A, Okada N, Akioka H, Teshima Y, Nakagawa M, Takahashi N. Assessment of coronary flow reserve predicts long-term outcome of responders to cardiac resynchronization therapy. Heart Vessels 2018; 34:763-770. [PMID: 30483876 DOI: 10.1007/s00380-018-1308-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/16/2018] [Indexed: 10/27/2022]
Abstract
Cardiac resynchronization therapy (CRT) has been established as a treatment for patients with chronic heart failure (HF). We tested the hypothesis that assessment of coronary flow reserve (CFR) predicts the long-term outcome of CRT. The study consisted of 114 HF patients implanted with a CRT device for the treatment of advanced HF between April 2010 and April 2018. After excluding patients that withdrew from long-term follow-up and patients missing a baseline CFR measurement, we enrolled 53 eligible patients. CFR was determined non-invasively by transthoracic echocardiography. Based on the ROC curve for predicting the appearance of major adverse cerebral and cardiovascular events (MACCE), the level of preserved CFR was set at >1.35 in responders. Accurate follow-up information (mean 873 ± 498 days) was obtained in 23 patients with a preserved CFR (16 females; mean age 71 ± 7.9 years) and 11 patients with a depressed CFR (5 females; mean age, 73 ± 7.6 years) in responders. Kaplan-Meier survival analysis demonstrated that the depressed CFR group had a higher prevalence of MACCE than the preserved CFR group (log rank, 9.83; p = 0.0021). Multivariate analysis revealed that depressed CFR was associated with MACCE (hazard ratio 4.88, 95% confidence interval 1.13-26.5, p = 0.0329). Our results suggest that the assessment of CFR predicts the outcome in responders to CRT. Preservation of coronary circulation flow might underlie one of the mechanisms for a better response to CRT in responders.
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Affiliation(s)
- Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan.
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Seiichiro Yoshimura
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan
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32
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Kawano K, Fukui A, Shinohara T, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N, Ohno S, Horie M. A case of catecholaminergic polymorphic ventricular tachycardia diagnosed as having long QT syndrome 25 years ago. J Electrocardiol 2018. [DOI: 10.1016/j.jelectrocard.2018.10.050] [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: 11/28/2022]
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Kondo H, Kira S, Oniki T, Gotoh K, Fukui A, Abe I, Ikebe Y, Kawano K, Saito S, Aoki K, Okada N, Nagano Y, Akioka H, Shinohara T, Akiyoshi K, Masaki T, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Interleukin-10 treatment attenuates sinus node dysfunction caused by streptozotocin-induced hyperglycaemia in mice. Cardiovasc Res 2018; 115:57-70. [DOI: 10.1093/cvr/cvy162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 06/20/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Shintaro Kira
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Takahiro Oniki
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Oita University, Facultyof Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Yuki Ikebe
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Kyoko Kawano
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Kohei Aoki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Oita University, Facultyof Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Yasuko Nagano
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Kumiko Akiyoshi
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Takayuki Masaki
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University, Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita, Japan
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Shinohara T, Kondo H, Fukui A, Akioka H, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Early repolarization is involved in ventricular fibrillation in patients with variant angina. Pacing Clin Electrophysiol 2018; 41:734-740. [DOI: 10.1111/pace.13355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/31/2018] [Accepted: 04/08/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of MedicineOita University Oita Japan
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Kondo H, Abe I, Gotoh K, Fukui A, Takanari H, Ishii Y, Ikebe Y, Kira S, Oniki T, Saito S, Aoki K, Tanino T, Mitarai K, Kawano K, Miyoshi M, Fujinami M, Yoshimura S, Ayabe R, Okada N, Nagano Y, Akioka H, Shinohara T, Akiyoshi K, Masaki T, Teshima Y, Yufu K, Nakagawa M, Takahashi N. Interleukin 10 Treatment Ameliorates High-Fat Diet–Induced Inflammatory Atrial Remodeling and Fibrillation. Circ Arrhythm Electrophysiol 2018; 11:e006040. [DOI: 10.1161/circep.117.006040] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/20/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Hidekazu Kondo
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Koro Gotoh
- and Department of Endocrinology, Metabolism, Rheumatology and Nephrology (K.G., K.A., T.M.)
| | - Akira Fukui
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Hiroki Takanari
- Oita University Faculty of Medicine, Japan. Clinical Research Center for Diabetes, Tokushima University Hospital, Japan (H.T.)
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Yuki Ikebe
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Shintaro Kira
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Takahiro Oniki
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Kohei Aoki
- and Department of Endocrinology, Metabolism, Rheumatology and Nephrology (K.G., K.A., T.M.)
| | - Tomomi Tanino
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Kazuki Mitarai
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Kyoko Kawano
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Mami Fujinami
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Seiichiro Yoshimura
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Reika Ayabe
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Yasuko Nagano
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Kumiko Akiyoshi
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Takayuki Masaki
- and Department of Endocrinology, Metabolism, Rheumatology and Nephrology (K.G., K.A., T.M.)
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination (H.K., I.A., A.F., Y.I., S.K., T.O., S.S., T.T., K.M., K.K., M.M., M.F., S.Y., R.A., N.O., Y.N., H.A., T.S., K.A., Y.T., K.Y., M.N., N.T.)
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Ishii Y, Yufu K, Shinohara T, Kondo H, Fukui A, Okada N, Akioka H, Teshima Y, Nakagawa M, Nishihara T, Okuyama E, Watanabe K, Kikuta K, Takahashi N. Congenital Ostial Atresia of the Left Anterior Descending Artery. Circ J 2017; 81:1550-1552. [DOI: 10.1253/circj.cj-16-1137] [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: 11/09/2022]
Affiliation(s)
- Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | | | | | | | | | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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Yufu K, Kondo H, Shinohara T, Kawano K, Ishii Y, Miyoshi M, Imamura T, Saito S, Okada N, Akioka H, Teshima Y, Nakagawa M, Takahashi N. Outcome of Patients With Cardiac Sarcoidosis Who Received Cardiac Resynchronization Therapy: Comparison With Dilated Cardiomyopathy Patients. J Cardiovasc Electrophysiol 2016; 28:177-181. [PMID: 27862596 DOI: 10.1111/jce.13119] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/28/2016] [Accepted: 11/01/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cardiac resynchronization therapy (CRT) has been shown to be effective for patients with chronic heart failure; however, the efficacy of CRT in patients with cardiac sarcoidosis (CS) has not been established. METHODS We compared the outcomes of patients with CS who received CRT to patients with dilated cardiomyopathy (DCM). The incidence of major adverse cerebral and cardiovascular events (MACCE) in 11 consecutive CS patients (8 females; mean age, 66 ± 8.0 years) who received CRT were compared with 29 DCM patients (9 females; mean age, 70 ± 8.9 years). RESULTS Females and patients with previous right ventricular pacing were largely included in the comparison of CS and DCM patients (P < 0.05 and P < 0.0001, respectively). During the mean follow-up period (465 ± 383 days for CS and 729 ± 393 days for DCM), MACCE were evident in 9 patients (23%); specifically, 5 CS and 4 DCM patients developed MACCE (45% vs. 14%, P < 0.05), respectively. Kaplan-Meier survival analysis demonstrated that CS patients had a higher prevalence of MACCE than DCM patients (log rank = 6.306, P = 0.0120; and Wilcoxon = 7.1333, P = 0.0076). Based on univariate analysis, the etiology of CS was associated with MACCE. CONCLUSION Our results suggest that the long-term outcome of CRT in patients with CS was very poor compared with DCM patients. Thus, caution should be exercised regarding the indication of CRT in patients with CS.
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Affiliation(s)
- Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Kyoko Kawano
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Miho Miyoshi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Takaaki Imamura
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu-city, Oita, Japan
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Haraguchi M, Kondo H, Ishii Y, Kobukata M, Imamura T, Otsubo T, Ayabe R, Saito S, Nagano Y, Akioka H, Shinohara T, Teshima Y, Yufu K, Nakagawa M, Takahashi N. A case of Type-C Wolff-Parkinson-White syndrome with severe left ventricular dysfunction: Efficacy of catheter ablation. J Cardiol Cases 2016; 15:32-35. [PMID: 30524579 DOI: 10.1016/j.jccase.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 07/19/2016] [Revised: 09/08/2016] [Accepted: 10/05/2016] [Indexed: 01/04/2023] Open
Abstract
The present case report describes a 59-year-old female with manifest Wolff-Parkinson-White syndrome and severe left ventricular (LV) dysfunction, however, there was no indication of heart palpitations. The polarity of delta is consistent with the features of the right anteroseptal accessory pathways (APs). The echocardiography showed a remarkable dyssynchrony of the LV wall motion. To circumvent the cardiac dysfunctions, radiofrequency catheter ablation (RFCA) was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and the clinical reports observed 6 months following RFCA showed that the LV ejection fraction had been improved from 13% up to 48%, in addition to the improvement in other parameters. The RFCA prevented her from receiving a cardiac resynchronization therapy defibrillator as well as a heart transplantation. <Learning Objective: There is a concern about the possibility that some patients with Wolff-Parkinson-White (WPW) syndrome and heart failure may be diagnosed with dilated cardiomyopathy (DCM). Because catheter ablation of the accessory pathway may improve the left ventricular (LV) dysfunction, one should exclude the accessory pathway conduction-induced LV dyssynchrony and LV dysfunction before diagnosing DCM. Even in absence of palpitations, catheter ablation may be effective in patients with manifest WPW syndrome to prevent the progression of LV dysfunction.>.
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Affiliation(s)
- Miho Haraguchi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Mami Kobukata
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Takaaki Imamura
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Toyokazu Otsubo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Reika Ayabe
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Yasuko Nagano
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
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Imamura T, Kondo H, Ishii Y, Haraguchi M, Kobukata M, Otsubo T, Saito S, Akioka H, Shinohara T, Yufu K, Takahashi N. A case of anomalous origin of the left coronary artery from the pulmonary artery presenting with sudden cardiac arrest due to coronary artery steal generated by excessive exercise. J Cardiol Cases 2016; 14:145-148. [PMID: 30546680 DOI: 10.1016/j.jccase.2016.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/14/2016] [Revised: 05/25/2016] [Accepted: 07/11/2016] [Indexed: 11/26/2022] Open
Abstract
This case report describes a 43-year-old man who temporarily survived cardiac arrest that was prospectively related to ventricular fibrillation due to the anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Prior to admission to our hospital, he was asymptomatic for ALCAPA syndrome. Emergent coronary angiography revealed that the dilated right coronary artery was connected with extensive collateral vessels to the left coronary artery. The origin of the latter was in the pulmonary artery. Moreover, coronary steal phenomenon was identified by examining the pulmonary arterial blood oxygen saturation. The patient later died of acute decompensated acidosis. <Learning objective: It is common that oxygen saturation exams may be normal or show a slight increase within the pulmonary artery in this anomaly. However, moderate to severe left to right shunt was remarkably detected in this patient, which may have contributed to acute ischemia in addition to inadequate collateral flow.>.
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Affiliation(s)
- Takaaki Imamura
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Miho Haraguchi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Mami Kobukata
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Toyokazu Otsubo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Yufu, Japan
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Uemura K, Kondo H, Ishii Y, Kobukata M, Haraguchi M, Imamura T, Otsubo T, Ikebe-Ebata Y, Abe I, Ayabe R, Saito S, Aoki K, Nagano-Torigoe Y, Akioka H, Shinohara T, Teshima Y, Masaki T, Yufu K, Nakagawa M, Takahashi N. Mast Cells Play an Important Role in the Pathogenesis of Hyperglycemia-Induced Atrial Fibrillation. J Cardiovasc Electrophysiol 2016; 27:981-9. [PMID: 27097848 DOI: 10.1111/jce.12995] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 03/23/2016] [Accepted: 04/14/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Recently, it was reported that mast cells (MCs) could underlie the mechanisms of several cardiovascular diseases. However, the role of MCs in diabetes-induced atrial fibrillation (AF) has not been notably investigated. We tested the hypothesis that MC deficiency attenuates hyperglycemia-induced AF in mice. METHODS AND RESULTS Mast cell-deficient W/W(v) mice, and congenic +/+ littermates (WT) were divided into either the vehicle (VEH)-injection group or the streptozotocin (STZ)-injection group (MCKO-VEH, MCKO-STZ, WT-VEH, and WT-STZ groups). On day 28 of our studies, we observed that (1) STZ-induced hyperglycemia increased MC infiltration in the left atrium (LA) in WT mice (P < 0.01), (2) atrium isolated from the WT-STZ group showed inhomogeneous interstitial fibrosis, abundant infiltration of macrophages, and enhanced apoptosis compared to the WT-VEH group (P < 0.01, P < 0.01, P < 0.05, respectively). However, the changes observed in the WT-STZ group were significantly attenuated in the MCKO-STZ mice. In addition, we observed that (3) messenger RNA levels of tumor necrosis factor-α, monocyte chemoattractant protein-1, interleukin-1β, transforming growth factor-β, and collagen-1 in the LA were increased in the WT-STZ group, but not in the MCKO-STZ group, (4) STZ-induced hyperglycemia increased AF induction and prolonged interatrial conduction time in the WT mice, which were not observed in the MCKO mice, and that (5) hyperglycemia-enhanced atrial production of reactive oxygen species (ROS) was equally observed in the WT and MCKO mice. CONCLUSIONS Our results suggest that MCs contribute to the pathogenesis of hyperglycemia-induced AF via enhancement of inflammation and fibrosis.
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Affiliation(s)
- Kenshi Uemura
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Yumi Ishii
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Mami Kobukata
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Miho Haraguchi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Takaaki Imamura
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Toyokazu Otsubo
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Yuki Ikebe-Ebata
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Reika Ayabe
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Kohei Aoki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Oita University Faculty of Medicine, Oita, Japan
| | - Yasuko Nagano-Torigoe
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Oita University Faculty of Medicine, Oita, Japan
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Oita, Japan
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41
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Teshima Y, Yufu K, Akioka H, Iwao T, Anan F, Nakagawa M, Yonemochi H, Takahashi N, Hara M, Saikawa T. Early atorvastatin therapy improves cardiac function in patients with acute myocardial infarction. J Cardiol 2009; 53:58-64. [DOI: 10.1016/j.jjcc.2008.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 08/21/2008] [Accepted: 08/25/2008] [Indexed: 01/08/2023]
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42
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Hirata Y, Matsumoto A, Aoyagi T, Yamaoki K, Komuro I, Suzuki T, Ashida T, Sugiyama T, Hada Y, Kuwajima I, Nishinaga M, Akioka H, Nakajima O, Nagai R, Yazaki Y. Measurement of plasma brain natriuretic peptide level as a guide for cardiac overload. Cardiovasc Res 2001; 51:585-91. [PMID: 11476749 DOI: 10.1016/s0008-6363(01)00320-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES We examined whether measurement of the plasma BNP concentrations might be useful for the early diagnosis of the existence and severity of disease in patients with heart disease in daily clinical practice. METHODS AND RESULTS The plasma BNP and ANP concentrations in 415 patients with heart disease and hypertension and 65 control subjects were measured. Patients with heart disease had higher plasma BNP and ANP concentrations than did those with hypertension or control subjects. Among the etiology of cardiac diseases, specifically dilated cardiomyopathy and hypertrophic cardiomyopathy, was associated with the highest plasma BNP concentrations, whereas dilated cardiomyopathy was associated with the highest plasma ANP concentrations. Plasma BNP concentrations showed an increase as the severity of the heart disease, as graded according to the NYHA classification of cardiac function, increased. In both patients with heart disease and hypertension, the plasma BNP values were higher in those who had abnormalities in their echocardiogram and electrocardiogram as compared to those without any abnormalities. The plasma BNP levels also showed a significant correlation with left ventricular wall thickness and left ventricular mass. On the other hand, the plasma ANP levels showed significant correlations with left ventricular dimension. Receiver operative characteristic analysis revealed that plasma BNP levels showed substantially high sensitivity and specificity to detect the existence of heart diseases. CONCLUSION Measurements of the plasma BNP concentrations is useful to detect the existence of the diseases, and abnormalities of left ventricular function and hypertrophy in patients with heart disease in daily clinical practice.
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Affiliation(s)
- Y Hirata
- Department of Cardiovascular Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
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Nakajima O, Arishiro K, Kani K, Moriguchi T, Tamoto S, Akioka H, Higashiura W, Sakaguchi H, Ohue S. Massive deep vein thrombosis after cesarean section treated with a temporary inferior vena cava filter: a case report. J Cardiol 2000; 36:337-42. [PMID: 11107556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
A 25-year-old woman suffered a massive deep vein thrombus in her left common iliac vein extending to the inferior vena cava after an abdominal cesarean section. The massive and floating inferior vena cava thrombus was considered to pose a high risk of pulmonary thromboembolism. After placement of a temporary inferior vena cava filter via the left brachial vein, thrombolytic therapy and anticoagulation therapy were instituted. The filter successfully prevented pulmonary thromboembolism during thrombolytic therapy. This patient was confined to bed because the filter moved vertically with left shoulder joint abduction. Although a temporary inferior vena cava filter is very useful for the prevention of pulmonary thromboembolism in a patient with deep vein thrombus, the appropriate range of activity for such a patient needs careful consideration.
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Affiliation(s)
- O Nakajima
- First Department of Internal Medicine, Nissay Hospital, Osaka
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Nakajima O, Akioka H, Miyazaki M. Effect of the calcium antagonist benidipine hydrochloride on 24-h ambulatory blood pressure in patients with mild to moderate hypertension in a double-blind study against placebo. Arzneimittelforschung 2000; 50:620-5. [PMID: 10965418 DOI: 10.1055/s-0031-1300260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The effects of benidipine hydrochloride (benidipine, CAS 91559-74-5), a dihydropyridine calcium antagonist, on the 24-h ambulatory blood pressure were studied by a double-blind test against placebo in 8 patients with essential hypertension. The mean resting systolic (SBP) and diastolic (DBP) blood pressures were 173 mmHg and 104 mmHg, respectively, at the time of patients enrollment. Blood pressure was measured every 30 min for 24 h after a single oral administration of either benidipine (4 mg/day) or the placebo. The mean through/peak (T/P) ratios were calculated from blood pressure measurements obtained using 2-h moving averages, and the smoothness index (SI) was calculated by subtracting the effect of the placebo from that of benidipine at each interval. The mean SBP and DBP fell to 135 and 88 mmHg, respectively, after dosing, which gave T/P ratios of 82% and 64%, respectively. The SIs for SBP and DBP were 1.82 and 0.76, respectively. These findings indicate that benidipine maintained a satisfactory and durable antihypertensive effect by once-a-day dosing.
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Affiliation(s)
- O Nakajima
- First Department of Internal Medicine, Nissay Hospital, Osaka, Japan.
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Suzuki T, Yamaoki K, Nakajima O, Yamazaki T, Yamada Y, Akioka H, Yazaki Y, Nagai R. Screening for cardiac dysfunction in asymptomatic patients by measuring B-type natriuretic peptide levels. Jpn Heart J 2000; 41:205-14. [PMID: 10850536 DOI: 10.1536/jhj.41.205] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Early diagnosis and treatment of heart failure lead to improved survival; pre-clinical detection would thus be beneficial. A non-invasive biochemical testing method would indeed be ideal to screen for the condition. In the present study, we sought to determine whether circulating levels of B-type natriuretic peptide (BNP) correlate with cardiac function in asymptomatic subjects. 294 consenting asymptomatic subjects were examined. BNP levels in elevated patients (> 18.4 pg / ml) showed significant correlation with echocardiographic parameters of the systolic and diastolic functions (EF r = -0.51, FS r = -0.50, E/A r = 0.42, p < 0.01). Moderate correlation with the CTR on chest X-ray was also seen (r = 0.23, p < 0.01). Multiple regression analysis showed numerous echocardiographic and hemodynamic parameters including those of systolic and diastolic function in addition to left ventricular wall thickness, blood pressure and serum creatinine levels to be significantly associated with raised BNP levels. Elevated BNP levels reflect cardiac function (both systolic and diastolic) in the asymptomatic population. Detection of cardiac dysfunction by the non-invasive biochemical test may prove useful in early pre-clinical diagnosis of heart failure.
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Affiliation(s)
- T Suzuki
- Department of Cardiovascular Medicine, University of Tokyo, Japan
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46
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Affiliation(s)
- O Nakajima
- First Department of Internal Medicine, Nissei Hospital, Osaka, Japan
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Nakajima O, Yamada Y, Ii M, Moriguchi T, Sano I, Akioka H. Bilateral atrial tumors--report of an elderly man with a heavily calcified left atrial tumor. Jpn Circ J 1996; 60:715-8. [PMID: 8902592 DOI: 10.1253/jcj.60.715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We report here an 88-year-old male who had been treated with antiarrhythmic drugs because of occasional premature ventricular contraction. The plain chest X-ray film showed a heavily calcified mass within the cardiac silhouette. Transthoracic echocardiography revealed a mobile tumor in the left atrium, which had not prolapsed through the mitral valve into the left ventricle. Transthoracic echocardiography also revealed a tumor in the right atrium. Magnetic resonance imaging of the heart showed that these tumors were attached to the atrial septum by a stalk. The patient had had no history of systemic embolization, syncopal attack or heart failure caused by these tumors. Considering his advanced age, a conservative treatment was agreed upon. At present, he is 93 year-old and in good health. Although the surgical treatment of cardiac tumors has progressed to the point where it represents low risk, even for elderly patients, our present case suggests that some cases of atrial tumors may have a good prognosis even with conservative treatment.
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Affiliation(s)
- O Nakajima
- First Department of Internal Medicine, Nissei Hospital, Osaka, Japan
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48
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Yokota K, Kagawa S, Shimizu Y, Akioka H, Tsurumi C, Noda C, Fujimuro M, Yokosawa H, Fujiwara T, Takahashi E, Ohba M, Yamasaki M, DeMartino GN, Slaughter CA, Toh-e A, Tanaka K. CDNA cloning of p112, the largest regulatory subunit of the human 26s proteasome, and functional analysis of its yeast homologue, sen3p. Mol Biol Cell 1996; 7:853-70. [PMID: 8816993 PMCID: PMC275938 DOI: 10.1091/mbc.7.6.853] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [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] [Indexed: 02/02/2023] Open
Abstract
The 26S proteasome is a large multisubunit protease complex, the largest regulatory subunit of which is a component named p112. Molecular cloning of cDNA encoding human p112 revealed a polypeptide predicted to have 953 amino acid residues and a molecular mass of 105,865. The human p112 gene was mapped to the q37.1-q37.2 region of chromosome 2. Computer analysis showed that p112 has strong similarity to the Saccharomyces cerevisiae Sen3p, which has been listed in a gene bank as a factor affecting tRNA splicing endonuclease. The SEN3 also was identified in a synthetic lethal screen with the nin1-1 mutant, a temperature-sensitive mutant of NIN1. NIN1 encodes p31, another regulatory subunit of the 26S proteasome, which is necessary for activation of Cdc28p kinase. Disruption of the SEN3 did not affect cell viability, but led to temperature-sensitive growth. The human p112 cDNA suppressed the growth defect at high temperature in a SEN3 disruptant, indicating that p112 is a functional homologue of the yeast Sen3p. Maintenance of SEN3 disruptant cells at the restrictive temperature resulted in a variety of cellular dysfunctions, including defects in proteolysis mediated by the ubiquitin pathway, in the N-end rule system, in the stress response upon cadmium exposure, and in nuclear protein transportation. The functional abnormality induced by SEN3 disruption differs considerably from various phenotypes shown by the nin1-1 mutation, suggesting that these two regulatory subunits of the 26S proteasome play distinct roles in the various processes mediated by the 26S proteasome.
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Affiliation(s)
- K Yokota
- Department of Urology, School of Medicine, Tokushima, Japan
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Akioka H, Forsberg NE, Ishida N, Okumura K, Nogami M, Taguchi H, Noda C, Tanaka K. Isolation and characterization of the HC8 subunit gene of the human proteasome. Biochem Biophys Res Commun 1995; 207:318-23. [PMID: 7857283 DOI: 10.1006/bbrc.1995.1190] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 01/27/2023]
Abstract
For study of the molecular basis of regulation of proteasome gene expression, we isolated the gene encoding the alpha-type HC8 subunit of the human proteasome. About 2.3 kb of the 5' flanking region of this gene was tested for promoter function by chloramphenicol acetyltransferase assay. This analysis revealed that CAAT and TATA boxes, but not a GC box, are essential for its promoter activity. These results differed from previous findings that the genes for the alpha-type HC3 and beta-type HC5 subunits of the human proteasome have a TATA-less promoter and that two or three GC boxes function as the promoter sequences (Tamura, T. et al. (1994) J. Mol. Biol. 244, 1117-1124). We mapped the HC8 gene at q23 on human chromosome 14, which differs from the chromosomal locations of nine other proteasomal subunit genes mapped so far.
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Affiliation(s)
- H Akioka
- Institute for Enzyme Research, Tokushima University, Japan
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Akiyama K, Yokota K, Kagawa S, Shimbara N, Tamura T, Akioka H, Nothwang HG, Noda C, Tanaka K, Ichihara A. cDNA cloning and interferon gamma down-regulation of proteasomal subunits X and Y. Science 1994; 265:1231-4. [PMID: 8066462 DOI: 10.1126/science.8066462] [Citation(s) in RCA: 150] [Impact Index Per Article: 5.0] [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: 01/28/2023]
Abstract
Proteasomes are the proteolytic complex responsible for major histocompatibility complex (MHC) class I-restricted antigen presentation. Interferon gamma treatment increases expression MHC-encoded LMP2 and LMP7 subunits of the proteasome and decreases expression of two proteasome subunits, named X and Y, which alters the proteolytic specificity of proteasomes. Molecular cloning of complementary DNAs encoding X and Y showed that their proteins are proteasomal subunits with high amino acid similarity to LMP7 and LMP2, respectively. Thus, interferon gamma may induce subunit replacements of X and Y by LMP7 and LMP2, respectively, producing proteasomes perhaps more appropriate for the immunological processing of endogenous antigens.
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Affiliation(s)
- K Akiyama
- Department of Urology, School of Medicine, University of Tokushima, Japan
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