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Ahmed R, Sawatari H, Amanullah K, Okafor J, Wafa SEI, Deshpande S, Ramphul K, Ali I, Khanji M, Mactaggart S, AbouEzzeddine O, Kouranos V, Sharma R, Somers VK, Mohammed SF, Chahal CAA. CHARACTERISTICS AND OUTCOMES OF HOSPITALISED PATIENTS WITH HEART FAILURE AND SARCOIDOSIS: A PROPENISTY-MATCHED ANALYSIS OF THE NATIONWIDE READMISSIONS DATABASE 2010-2019. Am J Med 2024:S0002-9343(24)00206-7. [PMID: 38588938 DOI: 10.1016/j.amjmed.2024.03.039] [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: 02/04/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Sarcoidosis is associated with a poor prognosis. There is a lack of data examining the outcomes and readmission rates of sarcoidosis patients with heart failure (SwHF) and without heart failure (SwoHF). We aimed to compare the impact of non-ischemic heart failure on outcomes and readmissions in these two groups. METHODS The US Nationwide Readmission Database was queried from 2010-2019 for SwHF and SwoHF patients identified using the International Classification of Diseases, Ninth and Tenth Editions. Those with ischemic heart disease were excluded, and both cohorts were propensity matched for age, gender, and Charlson Comorbidity Index (CCI). Clinical characteristics, length of stay, adjusted healthcare-associated costs, 90-day readmission and mortality were analyzed. RESULTS We identified 97,961 hospitalized patients (median age 63 years, 37.9% male) with a diagnosis of sarcoidosis (35.9% SwHF vs. 64.1% SwoHF). On index admission, heart failure patients had higher prevalences of atrioventricular block (3.3% vs. 1.4%, p<0.0001), ventricular tachycardia (6.5% vs. 1.3%, p<0.0001), ventricular fibrillation (0.4% vs. 0.1%, p<0.0001) and atrial fibrillation (22.1% vs. 7.5%, p<0.0001). SwHF patients were more likely to be readmitted (hazard ratio 1.28, p<0.0001), had higher length of hospital stay (5 vs. 4 days, p<0.0001), adjusted healthcare-associated costs ($9,667.0 vs. $9,087.1, p<0.0001) and mortality rates on readmission (5.1% vs. 3.8%, p<0.0001). Predictors of mortality included heart failure, increasing age, male sex, higher CCI and liver disease. CONCLUSION SwHF is associated with higher rates of arrhythmia at index admission, as well as greater hospital cost, readmission and mortality rates compared to those without heart failure.
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Affiliation(s)
- Raheel Ahmed
- Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, part of Guys and St Thomas's NHS Trust, London, United Kingdom
| | - Hiroyuki Sawatari
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Joseph Okafor
- Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, part of Guys and St Thomas's NHS Trust, London, United Kingdom
| | | | - Saurabh Deshpande
- Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | | | - Isma Ali
- The Online Clinic, Harley St Service, London, United Kingdom
| | - Mohammed Khanji
- Department of Cardiology, Barts Heart Centre, London, United Kingdom
| | | | - Omar AbouEzzeddine
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Vasilis Kouranos
- Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, part of Guys and St Thomas's NHS Trust, London, United Kingdom
| | - Rakesh Sharma
- Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, part of Guys and St Thomas's NHS Trust, London, United Kingdom
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Selma F Mohammed
- Department of Cardiology, Creighton University, Omaha, NE 68124, USA
| | - C Anwar A Chahal
- Department of Cardiology, Barts Heart Centre, London, United Kingdom; Northumbria Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdon; William Harvey Research Institute, Queen Mary University of London, United Kingdom; Center for Inherited Cardiovascular Diseases, Department of Cardiology, WellSpan Health, York, PA 17403, USA.
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Sawatari H, Kumagai H, Kawaguchi K, Kiyohara Y, Konishi N, Arita A, Hayashi M, Shiomi T. Risk factors for collisions attributed to microsleep-related behaviors while driving in professional truck drivers. Sci Rep 2024; 14:6378. [PMID: 38493230 PMCID: PMC10944504 DOI: 10.1038/s41598-024-57021-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
Sleep-disordered breathing (SDB) is prevalent among professional drivers. Although SDB is a known risk factor for truck collisions attributed to microsleep-related behaviors at the wheel (TC-MRBs), the usefulness of overnight pulse oximetry for predicting TC-MRBs is debatable. This retrospective study assessed the association between overnight pulse oximetry parameters, the Epworth Sleepiness Scale (ESS), and TC-MRBs, confirmed by dashcam footage. This study included 108 matched professional truck drivers (TC-MRBs: N = 54; non-TC-MRBs: N = 54), with a mean age and body mass index of 41.9 ± 11.3 years and 23.0 ± 3.7 kg/m2, respectively. Night-time drivers, 4% oxygen desaturation index (ODI), and nadir oxygen saturation (SpO2) were associated with TC-MRBs (odds ratio [95% confidence interval]: 25.63 [5.88-111.77], p < 0.0001; 2.74 [1.02-7.33], p = 0.045; and 3.87 [1.04-14.39], p = 0.04, respectively). The area under the curve of 4% ODI and nadir SpO2 for TC-MRBs were 0.50 and 0.57, respectively. In conclusion, night-time driving, 4% ODI, and nadir SpO2 were significantly associated with TC-MRBs in professional truck drivers. However, the sensitivity of overnight pulse oximetry parameters to predict TC-MRBs in a real-world application was poor. Therefore, combining subjective and objective assessments such as dashcam video footage may be needed to achieve high accuracy for predicting TC-MRBs among professional truck drivers.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan.
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan.
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
| | - Aki Arita
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
| | - Mitsuo Hayashi
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
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Tanaka H, Sawatari H, Ando SI. Difference in the Dynamics of Antibody Titers between COVID-19 Vaccination and SARS-CoV-2 Infection in Healthcare Workers - A Case Study Based on Long-Term and Densely Repeated Measurements of Antibody Titers. Jpn J Infect Dis 2024; 77:51-54. [PMID: 37779029 DOI: 10.7883/yoken.jjid.2023.175] [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] [Indexed: 10/03/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is prevalent worldwide, and effective and safe vaccines against this virus have been developed. Although trends in antibody titers after vaccination and/or SARS-CoV-2 infection have been reported, long-term studies with high frequency of measurements are limited. This report describes the long-term and detailed trends in the antibodies against SARS-CoV-2 S protein receptor-binding domain (S-RBD) measured repeatedly after vaccination and/or infection in 3 healthcare workers. All healthcare workers were administered 30 µg of the messenger RNA vaccine, BNT162b2, during all vaccinations. The peak value of the SARS-CoV-2 S-RBD titer was reached at 1-2 weeks after vaccination and then decreased by half within 8 weeks after vaccination; the peak values of the antibody titer increased with repeated vaccinations. In contrast, after SARS-CoV-2 infection, the peak value of the antibody titer was reached at 4-8 weeks after infection, and the antibody titer remained elevated up to 16-40 weeks after the peak. This report describes the long-term and detailed trends in the anti-SARS-CoV-2 S-RBD titers, showing different patterns after vaccination and/or SARS-CoV-2 infection.
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Affiliation(s)
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Shin-Ichi Ando
- Cardiovascular Division and Sleep Medicine Center, Saiseikai Futsukaichi Hospital, Japan
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Ueno K, Teramoto C, Nishioka D, Kino S, Sawatari H, Tanabe K. Factors associated with prolonged on-scene time in ambulance transportation among patients with minor diseases or injuries in Japan: a population-based observational study. BMC Emerg Med 2024; 24:10. [PMID: 38185622 PMCID: PMC10773094 DOI: 10.1186/s12873-023-00927-2] [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: 10/16/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Prolonged prehospital time is a major global problem in the emergency medical system (EMS). Although factors related to prolonged on-scene times (OSTs) have been reported in patients with trauma and critical medical conditions, those in patients with minor diseases or injuries remain unclear. We examined factors associated with prolonged OSTs in patients with minor diseases or injuries. METHODS This population-based observational study used the ambulance transportation and request call record databases of the Higashihiroshima Fire Department, Japan, between January 1, 2016, and December 31, 2022. The participants were patients with minor diseases or injuries during the study period. We performed a multivariable logistic regression analysis with robust error variance to examine the association between patient age, sex, severity, accident type, date and time of ambulance call, and the coronavirus disease 2019 (COVID-19) pandemic with prolonged OSTs. Prolonged OST was defined as ≥ 30 min from the ambulance arrival at the scene to departure. RESULTS Of the 60,309 people transported by ambulance during the study period, 20,069 with minor diseases or injuries were included in the analysis. A total of 1,241 patients (6.2%) experienced prolonged OSTs. Fire accidents (adjusted odds ratio [aOR]: 7.77, 95% confidence interval [CI]: 3.82-15.79), natural disasters (aOR: 28.52, 95% CI: 2.09-389.76), motor vehicle accidents (aOR: 1.63, 95% CI: 1.30-2.06), assaults (aOR: 2.91, 95% CI: 1.86-4.53), self-injuries (aOR: 5.60, 95% CI: 3.37-9.32), number of hospital inquiries ≥ 4 (aOR: 77.34, 95% CI: 53.55-111.69), and the COVID-19 pandemic (aOR: 2.01, 95% CI: 1.62-2.50) were associated with prolonged OSTs. Moreover, older and female patients had prolonged OSTs (aOR: 1.18, 95% CI: 1.01-1.36 and aOR: 1.12, 95% CI: 1.08-1.18, respectively). CONCLUSIONS Older age, female sex, fire accidents, natural disasters, motor vehicle accidents, assaults, self-injuries, number of hospital inquiries ≥ 4, and the COVID-19 pandemic influenced prolonged OSTs among patients with minor diseases or injuries. To improve community EMS, we should reconsider how to intervene with potentially modifiable factors, such as EMS personnel performance, the impact of the presence of allied services, hospital patient acceptance systems, and cooperation between general emergency and psychiatric hospitals.
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Affiliation(s)
- Keiko Ueno
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Floor 2, Science Frontier Laboratory, Yoshidakonoe-cho, Sakyo-ku, Kyoto-shi, 606-8315, Kyoto, Japan.
| | - Chie Teramoto
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Daisuke Nishioka
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Floor 2, Science Frontier Laboratory, Yoshidakonoe-cho, Sakyo-ku, Kyoto-shi, 606-8315, Kyoto, Japan
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shiho Kino
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Floor 2, Science Frontier Laboratory, Yoshidakonoe-cho, Sakyo-ku, Kyoto-shi, 606-8315, Kyoto, Japan
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Tanabe
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Sawatari H, Yoshikawa T, Ando SI. Impact of zolpidem and lemborexant on sleep and morning symptoms when used as a single dose for polysomnography. Sleep Biol Rhythms 2024; 22:155-158. [PMID: 38476849 PMCID: PMC10900022 DOI: 10.1007/s41105-023-00485-x] [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: 08/13/2022] [Accepted: 08/15/2023] [Indexed: 03/14/2024]
Abstract
This study evaluated the effect of zolpidem and lemborexant on sleep and morning symptoms in patients undergoing type-1 polysomnography for suspected sleep-disordered breathing based on questionnaires and polysomnography results. We enrolled 127 patients (lemborexant: N = 57, zolpidem: N = 25, without hypnotics: N = 45). Rapid eye movement sleep in patients on lemborexant was higher than that in patients without hypnotics (P = 0.02). Frequency of unsteadiness in the morning was higher in patients on zolpidem than that in patients without hypnotics (P = 0.04), which remained after adjustment for potential confounders (P = 0.03). Low-dose lemborexant might be suitable when administered as a single dose during polysomnography.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoko Yoshikawa
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shin-ichi Ando
- Sleep Medicine Center, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino, Fukuoka 818-8516 Japan
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Sawatari H, Chahal AA, Ahmed R, Collins GB, Deshpande S, Khanji MY, Provedenciae R, Khan H, Wafa SEI, Salloum MN, Karim S, Shenthar J, Cha YM, Hyman M, Brady PA, Somers VK, Padmanabhan D, Nkomo VT. Corrigendum to 'Impact of Cardiac Implantable Electronic Devices on Cost and Length of Stay in Patients With Surgical Aortic Valve Replacement and Transcutaneous Aortic Valve Implantation' [American Journal of Cardiology 192 (2023)69-78]. Am J Cardiol 2023:S0002-9149(23)01406-6. [PMID: 38141659 DOI: 10.1016/j.amjcard.2023.12.024] [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: 12/25/2023]
Affiliation(s)
- Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Anwar A Chahal
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom; Division of Cardiac Electrophysiology, University of Pennsylvania, Philadelphia
| | - Raheel Ahmed
- Department of Cardiology, Northumbria Healthcare National Health Service Foundation Trust, Newcastle, New South Wales
| | - George B Collins
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Saurabh Deshpande
- Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Mohammed Y Khanji
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Rui Provedenciae
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Hassan Khan
- Emory University School of Medicine, Atlanta, Georgia
| | - Syed Emir Irfan Wafa
- Department of Cardiology, Northampton General Hospital, Northampton, Massachusetts
| | - Mohammad N Salloum
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Queens Hospital Center, New York, New York
| | - Shahid Karim
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jayaprakash Shenthar
- Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Yong-Mei Cha
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Matthew Hyman
- Division of Cardiac Electrophysiology, University of Pennsylvania, Philadelphia
| | - Peter A Brady
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Deepak Padmanabhan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Division of Cardiac Electrophysiology, University of Pennsylvania, Philadelphia; Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Vuyisile T Nkomo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
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Kumagai H, Tsuda H, Kawaguchi K, Sawatari H, Kiyohara Y, Konishi N, Taniyama Y, Takaoka T, Shiomi T. Truck collisions attributed to falling asleep at the wheel in two commercial drivers prescribed oral appliance therapy for obstructive sleep apnea. J Clin Sleep Med 2023; 19:2117-2122. [PMID: 37551827 PMCID: PMC10692933 DOI: 10.5664/jcsm.10758] [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: 05/18/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/09/2023]
Abstract
Falling asleep at the wheel is attributed to sleepiness, and obstructive sleep apnea is a significant cause of sleepiness that increases the risk of motor vehicle collisions due to falling asleep at the wheel. Although continuous positive airway pressure therapy for obstructive sleep apnea reduces the risk of motor vehicle collisions, similar evidence for alternatives such as oral appliance therapy is lacking. We discuss two truck collisions attributed to microsleep confirmed with dashcam video footage of commercial drivers with obstructive sleep apnea. Our results highlight the current situation where there is insufficient evidence for the prevention and reduction of the risk of motor vehicle collisions by oral appliance therapy, objective adherence monitoring of oral appliance therapy, and effectiveness confirmation tests. Therefore, it is suggested that for commercial truck drivers who require a high level of driving safety, careful selection for oral appliance therapy, systematic follow-up, and monitoring of the driver and truck status with dashcam video footage are crucial. CITATION Kumagai H, Tsuda H, Kawaguchi K, et al. Truck collisions attributed to falling asleep at the wheel in two commercial drivers prescribed oral appliance therapy for obstructive sleep apnea. J Clin Sleep Med. 2023;19(12):2117-2122.
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Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroko Tsuda
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- General Dentistry, Kyushu University Hospital, Fukuoka, Japan
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukari Taniyama
- Department of Internal Medicine, Kagoshima Takaoka Hospital, Kagoshima, Japan
| | - Toshio Takaoka
- Department of Internal Medicine, Kagoshima Takaoka Hospital, Kagoshima, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
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Sawatari H, Chishaki A, Rahmawati A, Ando S. Growth-related changes in the influence of obesity on signs suggesting sleep-disordered breathing and sleepiness in young individuals with Down syndrome. J Intellect Disabil Res 2023; 67:1150-1160. [PMID: 37671733 DOI: 10.1111/jir.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Sleep-disordered breathing (SDB) is highly prevalent in individuals with Down syndrome (DS), who cease growing earlier than individuals without DS. These characteristics may be associated with increased obesity and subsequent SDB signs, such as snoring and apnoea or excessive daytime sleepiness (EDS). Thus, we assessed the influence of growth on the association between obesity and SDB signs or EDS; we used questionnaires sent to young individuals with DS and their caregivers, in a cross-sectional study. METHODS We sent out 2000 questionnaires to individuals with DS and their caregivers. The surveys included questions about SDB signs (witnessed snoring or apnoea), subjective sleeping time including witnessed midnight arousal, the Epworth sleepiness scale and witnessed napping as well as sex, age, body weight and body height. RESULTS Of the 1222 questionnaires we received, 660 were from young individuals and were included in the analysis. SDB signs were highly prevalent (77.1%), and frequency of SDB signs increased with growth (P-trend: P = 0.02) in individuals with DS. Multivariate analyses showed that EDS (Epworth sleepiness scale > 10 points) was associated with body mass index Z-score (Z-BMI) in the 6-9 years age group (odds ratio [OR] 95% confidence interval [95% CI]: 1.69 [1.09-2.62], P = 0.02). Conversely, SDB signs were associated with Z-BMI in the 13-15 (OR [95% CI]: 1.99 [1.06-3.72], P = 0.03) and 16-18 years age groups (OR [95% CI]: 3.04 [1.22-7.59], P = 0.02). For the 19-21 years age group, SDB signs were associated with only male sex (OR [95% CI]: 7.28 [1.22-43.38], P = 0.03). CONCLUSIONS This study showed that the association between Z-BMI and SDB or EDS was age dependent. In early school-age children with DS, high Z-BMI could not accurately predict the presence of SDB, but it was associated with EDS. In the pubescent period (i.e. 13-18 years), high Z-BMI was associated with SDB signs but not with EDS. Overall, obesity affected SDB signs and EDS differently based on age in young individuals with DS.
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Affiliation(s)
- H Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - A Chishaki
- Fukuoka Dental College Hospital and Fukuoka Nursing College, Graduate School of Nursing, Fukuoka, Japan
| | - A Rahmawati
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - S Ando
- Sleep Medicine Center, Saiseikai Futsukaichi Hospital, Chikushino, Japan
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Patel KP, Sawatari H, Chahal A, Vuyisile NT, Somers V, Mullen MJ, Ricci F, Khanji MY. Health Care Resource, Economic, and Readmission Implications After Acute Decompensated Aortic Stenosis-A Nationwide Study. Am J Cardiol 2023; 204:200-206. [PMID: 37544145 DOI: 10.1016/j.amjcard.2023.07.081] [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: 04/11/2023] [Revised: 06/22/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Abstract
Acute decompensated aortic stenosis (ADAS) is common. The cumulative burden of ADAS from a clinical, health care resource, and financial perspective is unknown. This study sought to assess the national impact of ADAS compared with electively treated, stable patients with aortic stenosis (non-ADAS). Using the National Readmissions Database between 2016 and 2019, patients with ADAS and non-ADAS were identified using International Classification of Diseases, Tenth Revision codes. Patients with ADAS were propensity-matched to non-ADAS patients (1:2) using age, gender, and Charlson co-morbidity index. We compared in-hospital mortality, length of stay (LOS), health care-associated costs, and 90-day readmission data between the 2 cohorts. A total of 51,498 propensity-matched patients were included in this study: median age 75 years, 64% men. The in-hospital mortality for ADAS was higher than non-ADAS (2.8% vs 1.5%, p <0.0001). The LOS during the index admission was longer for ADAS (9 [5 to 13] vs 4 [2 to 6] days, p <0.0001). The health care-associated costs per patient was greater for ADAS ($55,450.0 [41,860.4 to 74,500.7] vs $43,405.7 [34,218.5 to 56,034.8], p <0.0001). Readmission to hospital within 90 days was more frequent in ADAS (21.1 vs 16.8%, p <0.001). The in-hospital mortality during readmission was higher with ADAS (3.9% vs 2.8%, p = 0.004). The readmission LOS was longer with ADAS (4 [2 to 7] vs 3 [2 to 6] days, p <0.0001). In conclusion, ADAS imposes a significant burden clinically and financially and on health care resources compared with non-ADAS during the index admission and 90-day follow-up. There is an urgent need to predict ADAS and optimize the timing of aortic valve replacement to reduce the incidence and the burden associated with ADAS.
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Affiliation(s)
- Kush P Patel
- Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom; Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Anwar Chahal
- Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Nkomo T Vuyisile
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Virend Somers
- Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael J Mullen
- Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, G.d'Annunzio University of Chieti-Pescara, Chieti, Italy; Clinical Research Center, Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Malmö, Sweden; Fondazione Villaserena per la Ricerca, Città Sant'Angelo, Italy
| | - Mohammed Y Khanji
- Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Department of Cardiology, Newham University Hospital, Barts Health NHS Trust, London, United Kingdom.
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10
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Kumagai H, Kawaguchi K, Sawatari H, Kiyohara Y, Hayashi M, Shiomi T. Dashcam video footage-based analysis of microsleep-related behaviors in truck collisions attributed to falling asleep at the wheel. Accid Anal Prev 2023; 187:107070. [PMID: 37060664 DOI: 10.1016/j.aap.2023.107070] [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] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/23/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE With the rapid spread of dashcams, many car accidents have been recorded; however, behavioral approaches using these dashcam video footage have not been sufficiently examined. We employed dashcam video footage to evaluate microsleep-related behaviors immediately prior to real-world truck collisions in professional drivers to explore a new solution to reduce collisions attributed to falling asleep at the wheel. METHODS In total, 3,120 s of video footage (60 s/case × 52 cases) from real-world truck collisions of 52 professional drivers obtained from interior and exterior dashcams were used and visually analyzed in a second-by-second manner to simultaneously evaluate any eye changes and microsleep-related behaviors (the driver's anti-sleepiness behavior, behavioral signs of microsleep, and abnormal vehicle behavior) during driving. RESULTS Assessment of the frequency of occurrence of each item of microsleep-related behavior in the 52 collisions revealed that the item "touching" in terms of anti-sleepiness behavior, "absence of body movement" in terms of behavioral signs of microsleep, and "inappropriate line crossing" in terms of abnormal vehicle behavior were observed at the highest rate in all drivers (46.2%, 75.0%, and 78.8%, respectively). Decreases in anti-sleepiness behavior coincided with increases in behavioral signs of microsleep and abnormal vehicle behavior, with collisions occurring within approximately 40 s of these changes. Collisions were more common among young people and in the early morning and evening. CONCLUSION Our dashcam video footage-based analysis in truck collisions attributed to falling asleep at the wheel revealed the process of changes in microsleep-related driver and vehicle behaviors, classified as anti-sleepiness behavior, behavioral signs of microsleep, and abnormal vehicle behavior. Based on these findings, to prevent collisions caused by falling asleep at the wheel, it is crucial to monitor not only the driver's eyes, but also the driver's whole body and vehicle behavior simultaneously to reliably detect microsleep-related behaviors.
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Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan.
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
| | - Mitsuo Hayashi
- Graduate School of Integrated Arts and Sciences, Hiroshima University, 1-7-1 Kagamiyama, Higashi-Hiroshima 7398521, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
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11
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Sawatari H, Chahal AA, Ahmed R, Collinss GB, Deshpande S, Khanji MY, Provedenciae R, Khan H, Wafa SEI, Salloum MN, Karim S, Shenthar J, Cha YM, Hyman M, Brady PA, Somers VK, Padmanabhan D, Nkomo VT. Impact of Cardiac Implantable Electronic Devices on Cost and Length of Stay in Patients With Surgical Aortic Valve Replacement and Transcutaneous Aortic Valve Implantation. Am J Cardiol 2023; 192:69-78. [PMID: 36753975 DOI: 10.1016/j.amjcard.2023.01.013] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/08/2022] [Accepted: 01/07/2023] [Indexed: 02/09/2023]
Abstract
Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) in aortic stenosis are associated with arrhythmic complications that can require cardiac implantable electronic device (CIED) implantation, but impact on healthcare-associated cost (HAC) and length of stay (LOS) are unknown. This study aimed to assess differences among SAVR/TAVI patients with CIED implantation on HAC and LOS. Patients hospitalized for SAVR or TAVI between 2011 and 2017 on the National Inpatient Sample database were identified and stratified according to presence/type of CIED implantation. During this period, 95,262 patients were identified; 6,435 (6.8%) patients received CIED (median [interquartile range] age: 74.0 [66.0 to 82.0] years). The median adjusted HAC was $44,271 and LOS was 6 days. CIED implantation was associated with longer LOS and higher adjusted HAC in patients with SAVR and TAVI (p <0.0001). Patients with in-hospital death and complications because of SAVR or TAVI had longer preceding in-hospital days of admission. Male patients admitted to small hospitals and the West region had the highest HAC. In conclusion, CIED implantation for arrhythmias results in higher HAC and longer LOS in patients with aortic stenosis for both SAVR and TAVI.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Anwar A Chahal
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom; Division of Cardiac Electrophysiology, University of Pennsylvania, Philadelphia
| | - Raheel Ahmed
- Department of Cardiology, Northumbria Healthcare National Health Service Foundation Trust, Newcastle, New South Wales
| | - George B Collinss
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Saurabh Deshpande
- Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Mohammed Y Khanji
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Rui Provedenciae
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Hassan Khan
- Emory University School of Medicine, Atlanta, Georgia
| | - Syed Emir Irfan Wafa
- Department of Cardiology, Northampton General Hospital, Northampton, Massachusetts
| | - Mohammad N Salloum
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Queens Hospital Center, New York, New York
| | - Shahid Karim
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jayaprakash Shenthar
- Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Yong-Mei Cha
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Matthew Hyman
- Division of Cardiac Electrophysiology, University of Pennsylvania, Philadelphia
| | - Peter A Brady
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Deepak Padmanabhan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Division of Cardiac Electrophysiology, University of Pennsylvania, Philadelphia; Department of Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Vuyisile T Nkomo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
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12
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Arita A, Kumagai H, Sawatari H, Hoshino T, Konishi N, Murase Y, Urabe A, Nomura A, Sasanabe R, Shiomi T. Advanced emergency braking system reduces the risk of motor vehicle collisions caused by falling asleep while driving in patients with untreated obstructive sleep apnea. J Sleep Res 2023; 32:e13713. [PMID: 36053798 DOI: 10.1111/jsr.13713] [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: 06/08/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 02/03/2023]
Abstract
Obstructive sleep apnea leads to excessive daytime sleepiness and cognitive dysfunction, which are risk factors for motor vehicle collisions. We aimed to clarify if vehicles with an advanced emergency braking system could reduce motor vehicle collisions caused by falling asleep while driving among patients with untreated obstructive sleep apnea. We enrolled patients with untreated obstructive sleep apnea who underwent polysomnography. The questionnaires included the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, history of drowsy driving accidents, and use of an advanced emergency braking system. Multivariate analysis was performed, and odds ratios and 95% confidence intervals were calculated. This study included 1097 patients (mean age, 51.2 ± 12.9 years). Collisions caused by falling asleep while driving were recorded in 59 (5.4%) patients, and were more frequently observed in vehicles without an advanced emergency braking system (p = 0.045). Multivariate analysis showed that these collisions were associated with use of an advanced emergency braking system (odds ratio [95% confidence interval]: 0.39 [0.16-0.97], p = 0.04), length of driving (2.79 [1.19-6.50], p = 0.02), total sleep time (2.40 [1.62-3.55], p < 0.0001), sleep efficiency (0.94 [0.90-0.98], p = 0.003) and periodic limb movement index (1.02 [1.01-1.03], p = 0.004). The collision risk caused by falling asleep while driving in vehicles with an advanced emergency braking system was significantly lower. This study indicates that advanced emergency braking systems may be a preventive measure to reduce motor vehicle collisions among patients with untreated obstructive sleep apnea.
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Affiliation(s)
- Aki Arita
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroyuki Sawatari
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan.,Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Yoko Murase
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Ayako Urabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Atsuhiko Nomura
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
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13
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Sato T, Sakamoto I, Hiasa KI, Kawakubo M, Ishikita A, Umemoto S, Kang MJ, Sawatari H, Chishaki A, Shigeto H, Tsutsui H. High-echoic line tracing of transthoracic echocardiography accurately assesses right ventricular enlargement in adult patients with atrial septal defect. Int J Cardiovasc Imaging 2023; 39:87-95. [PMID: 36598698 DOI: 10.1007/s10554-022-02712-x] [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: 06/05/2022] [Accepted: 08/07/2022] [Indexed: 01/07/2023]
Abstract
Accurate measurement of right ventricular (RV) size using transthoracic echocardiography (TTE) is important for evaluating the severity of congenital heart diseases. The RV end-diastolic area index (RVEDAi) determined using TTE is used to assess RV dilatation; however, the tracing line of the RVEDAi has not been clearly defined by the guidelines. This study aimed to determine the exact tracing method for RVEDAi using TTE. We retrospectively studied 107 patients with atrial septal defects who underwent cardiac magnetic resonance imaging (CMR) and TTE. We measured the RVEDAi according to isoechoic and high-echoic lines, and compared it with the RVEDAi measured using CMR. The isoechoic line was defined as the isoechoic endocardial border of the RV free wall, whereas the high-echoic line was defined as the high-echoic endocardial border of the RV free wall more outside than the isoechoic line. RVEDAi measured using high-echoic line (high-RVEDAi) was more accurately related to RVEDAi measured using CMR than that measured using isoechoic line (iso-RVEDAi). The difference in the high-RVEDAi was 0.3 cm2/m2, and the limit of agreement (LOA) was - 3.7 to 4.3 cm2/m2. With regard to inter-observer variability, high-RVEDAi was superior to iso-RVEDAi. High-RVEDAi had greater agreement with CMR-RVEDAi than with iso-RVEDAi. High-RVEDAi can become the standard measurement of RV size using two-dimensional TTE.
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Affiliation(s)
- Tasuku Sato
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan. .,Heart Center, Kyushu University Hospital, Fukuoka, Japan.
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, School of Medical Sciences, Kyushu University Graduate, Kyushu University, Fukuoka, Japan
| | - Ken-Ichi Hiasa
- Department of Cardiovascular Medicine, School of Medical Sciences, Kyushu University Graduate, Kyushu University, Fukuoka, Japan
| | - Masateru Kawakubo
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Ishikita
- Department of Cardiovascular Medicine, School of Medical Sciences, Kyushu University Graduate, Kyushu University, Fukuoka, Japan
| | - Shintaro Umemoto
- Department of Cardiovascular Medicine, School of Medical Sciences, Kyushu University Graduate, Kyushu University, Fukuoka, Japan
| | - Min-Jeong Kang
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Hiroyuki Sawatari
- Department of Health Care for Adults, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akiko Chishaki
- Health Care Center, Fukuoka Dental College Hospital, Fukuoka, Japan
| | - Hiroshi Shigeto
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, School of Medical Sciences, Kyushu University Graduate, Kyushu University, Fukuoka, Japan
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14
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Kumagai H, Sawatari H, Kiyohara Y, Kanoh A, Asada K, Kawaguchi K, Arita A, Murase Y, Konishi N, Hoshino T, Hayashi M, Shiomi T. Nocturnal hypoxemia is related to morning negative affectivity in untreated patients with severe obstructive sleep apnea. Sci Rep 2022; 12:21262. [PMID: 36482199 PMCID: PMC9732184 DOI: 10.1038/s41598-022-25842-7] [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] [Received: 10/11/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
The relationship between sleep apnea and morning affectivity remains unclear. We aimed to clarify how sleep disturbance in patients with obstructive sleep apnea (OSA) influences their affectivity. The enrolled participants underwent the Positive and Negative Affect Schedule on their beds immediately before and after overnight polysomnography. Thirty patients with OSA were divided into two groups according to the apnea-hypopnea index (AHI): mild to moderate OSA (5 ≤ AHI < 30/h) and severe OSA (AHI ≥ 30/h) groups. Additionally, 11 healthy participants (AHI < 5/h) were included as the control group. No independent association was found between affectivity and OSA severity markers in the whole population; however, the severe OSA group had a significantly higher cumulative percentage of sleep time at saturations < 90% (CT90) and worsened morning negative affectivity. Multiple regression analysis showed that CT90 was an independent factor for increasing negative affectivity in the severe OSA group (p = 0.0422). In patients with OSA, the receiver operating characteristic curve analysis showed that the best cutoff value for CT90 for predicting no decrease in negative affectivity after sleep was 1.0% (sensitivity = 0.56, specificity = 0.86); the corresponding area under the curve was 0.71. Worsening of negative affectivity in the morning was influenced by nocturnal hypoxemia in patients with severe OSA.
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Affiliation(s)
- Hajime Kumagai
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan ,grid.470097.d0000 0004 0618 7953Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, 7348553 Japan ,Hiroshima Minato Clinic, Hiroshima, 7340014 Japan
| | - Hiroyuki Sawatari
- grid.257022.00000 0000 8711 3200Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Yuka Kiyohara
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan ,grid.470097.d0000 0004 0618 7953Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, 7348553 Japan
| | - Akiko Kanoh
- grid.470097.d0000 0004 0618 7953Division of Clinical Support, Hiroshima University Hospital, Hiroshima, 7348553 Japan
| | - Kana Asada
- grid.470097.d0000 0004 0618 7953Division of Clinical Support, Hiroshima University Hospital, Hiroshima, 7348553 Japan
| | - Kengo Kawaguchi
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Aki Arita
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Yoko Murase
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Noriyuki Konishi
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Tetsuro Hoshino
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Mitsuo Hayashi
- grid.257022.00000 0000 8711 3200Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, 7398521 Japan
| | - Toshiaki Shiomi
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan ,grid.470097.d0000 0004 0618 7953Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, 7348553 Japan
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15
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Deshpande S, Sawatari H, Ahmed R, Nair RG, Khan H, Khanji MY, Somers VK, Chahal CAA, Padmanabhan D. Impact of intracardiac echocardiography on readmission morbidity and mortality following atrial fibrillation ablation. J Cardiovasc Electrophysiol 2022; 33:2496-2503. [PMID: 36128625 DOI: 10.1111/jce.15683] [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: 06/15/2022] [Revised: 09/08/2022] [Accepted: 09/17/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The use of intracardiac echocardiography (ICE) is beneficial during the ablation of atrial fibrillation (AF). Evidence is conflicting regarding the clinical impact of using ICE on arrhythmia recurrence and mortality. METHODS Patients undergoing catheter ablation of AF during 2010-2017 were identified using the International Classification of Diseases-9th and 10th Revision-Clinical Modification (ICD-9-CM and ICD-10-CM) from the Nationwide Readmissions Database. Propensity matching was used to generate a control group. Patient demographics, Charlson comorbidity indexes, time from discharge to readmission, and the reason of readmission were extracted. RESULTS From 2010 to 2017, 51 129 patients were included in the analysis out of which ICE was used in 8005 (15.7%) patients. The in-hospital mortality at readmission was significantly higher in the patients without ICE use (2.9% vs. 1.7%, p = .02). The length of stay (LOS) at readmission was significantly higher in non-ICE arm (median [interquartile range, IQR]: 3 [2-6] vs. 2 [3-5] days, p < .0001) with similar healthcare-associated cost (HAC) in both the groups (median [IQR]: US$7507.3 [4057.8-15 474.2] vs. 7339.4 [4024.8-15 191.6], p = .43). Freedom from readmission was 12% higher (hazard ratio [HR] [95% confidence interval, CI]: 0.88 [0.83-0.94], p < .0001) with the use of ICE at 90-day follow-up, which was driven by 24% reduction in heart failure (HF) at follow-up (HR [95% CI]: 0.76 [0.60-0.96], p = .02). CONCLUSIONS ICE use during AF ablation procedure reduces readmissions at 90 days by 12%, driven by a 24% decrease in HF-related admissions. The non-ICE arm showed a significantly higher LOS which offsets marginally higher HAC in the ICE arm.
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Affiliation(s)
- Saurabh Deshpande
- Department of Cardiac Electrophysiology, Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Hiroyuki Sawatari
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Raheel Ahmed
- Department of Cardiology, Northumbria Healthcare NHS Foundation Trust, Newcastle, UK
| | - Rakesh Gopinathan Nair
- Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Hassan Khan
- Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | - Mohammed Y Khanji
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Virend K Somers
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - C Anwar A Chahal
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.,Cardiac Electrophysiology Section, Division of Cardiovascular Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Deepak Padmanabhan
- Department of Cardiac Electrophysiology, Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
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16
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Sasabe Y, Niitani M, Teramoto C, Yamaga S, Shime N, Tanabe K, Kataoka T, Sawatari H. Deep sedation predicts pressure injury in patients admitted to intensive care units. Nurs Crit Care 2022; 27:877-884. [PMID: 35048476 DOI: 10.1111/nicc.12753] [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] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/22/2021] [Accepted: 01/04/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients in intensive care units (ICU) are frequently prescribed sedatives, which might increase the risk for pressure injury (PI). Although the association between sedation and incidence of PI has been noted, the adequate sedation level to prevent the incidence of PI in patients admitted to ICU is still unclear. AIM This study aimed to investigate the association between fluctuating sedation levels and the incidence of PI in patients admitted to ICU. STUDY DESIGN We retrospectively reviewed the medical records of 104 patients admitted to ICU. Data regarding the length of ICU stay (LOS) and comorbid infection were abstracted from medical records. The Richmond Agitation-Sedation Scale (RASS) was scored twice per day, and the standardized RASS (S-RASS, summation of RASS values divided by the number of samples) was used to evaluate changes in sedation levels. RESULTS Among the 104 included patients, 65 patients (62.5%) were male (median age: 68.0 years), and 13 patients (12.5%) had PI during ICU admission. S-RASS scores were lower in patients with PI than in those without PI (P = .0001) even after adjustment for confounders (OR [95%CI]: 0.14 [0.03-0.58], P = .006). The LOS and infections were higher in patients with PI than in those without PI (P < .0001 and P = .005, respectively). The cut-off value of S-RASS for PI incidence was -3.2 (sensitivity: 88%; specificity: 85%), and a significant predictor of PI incidence (HR [95%CI]: 20.07 [2.53-159.11], P = .005). CONCLUSIONS Deeper sedation levels based on S-RASS scores, which account for the effects of fluctuating sedation levels, were a strong, highly accurate predictor of PI incidence in patients admitted to ICU. RELEVANCE TO CLINICAL PRACTICE Assessing fluctuations in the level of sedation using the S-RASS might help to identify sedative-induced PI in patients admitted to ICU.
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Affiliation(s)
- Yayoi Sasabe
- Department of Nursing, Hiroshima University Hospital, Hiroshima, Japan
| | - Mayumi Niitani
- Department of Nursing, Graduate School of Nursing, Yasuda Women's University, Hiroshima, Japan
| | - Chie Teramoto
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Yamaga
- Department of Radiation Disaster Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Tanabe
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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17
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Wafa SEI, Chahal CAA, Sawatari H, Khanji MY, Khan H, Asatryan B, Ahmed R, Deshpande S, Providencia R, Deshmukh A, Owens AT, Somers VK, Padmanabhan D, Connolly H. Frequency of Arrhythmias and Postural Orthostatic Tachycardia Syndrome in Patients With Marfan Syndrome: A Nationwide Inpatient Study. J Am Heart Assoc 2022; 11:e024939. [PMID: 36000435 PMCID: PMC9496423 DOI: 10.1161/jaha.121.024939] [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] [Indexed: 11/16/2022]
Abstract
Background Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder affecting multiple systems, particularly the cardiovascular system. The leading causes of death in MFS are aortopathies and valvular disease. We wanted to identify the frequency of arrhythmia and postural orthostatic tachycardia syndrome, length of hospital stay, health care-associated costs (HAC), and in-hospital mortality in patients with MFS. Methods and Results The National Inpatient Sample database from 2005 to 2014 was queried using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for MFS and arrhythmias. Patients were classified into subgroups: supraventricular tachycardia, ventricular tachycardia (VT), atrial fibrillation, atrial flutter, and without any type of arrhythmia. Data about length of stay, HAC, and in-hospital mortality were also abstracted from National Inpatient Sample database. Adjusted HAC was calculated as multiplying HAC and cost-to-charge ratio; 12 079 MFS hospitalizations were identified; 1893 patients (15.7%) had an arrhythmia; and 4.9% of the patients had postural orthostatic tachycardia syndrome. Median values of length of stay and adjusted HAC in VT group were the highest among the groups (VT: 6 days, $18 975.8; supraventricular tachycardia: 4 days, $11 906.6; atrial flutter: 4 days, $11 274.5; atrial fibrillation: 5 days, $10431.4; without any type of arrhythmia: 4 days, $8336.6; both P=0.0001). VT group had highest in-patient mortality (VT: 5.3%, atrial fibrillation: 4.1%, without any type of arrhythmia: 2.1%, atrial flutter: 1.7%, supraventricular tachycardia: 0%; P<0.0001) even after adjustment for potential confounders (without any type of arrhythmia versus VT; odds ratio [95% CI]: 3.18 [1.62-6.24], P=0.001). Conclusions Arrhythmias and postural orthostatic tachycardia syndrome in MFS were high and associated with increased length of stay, HAC, and in-hospital mortality especially in patients with VT.
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Affiliation(s)
- Syed Emir Irfan Wafa
- Department of Cardiology Northampton General Hospital Northampton United Kingdom
| | - C Anwar A Chahal
- Division of Cardiology, Department of Medicine University of Pennsylvania Philadelphia PA.,Department of Cardiovascular Diseases Mayo Clinic Rochester MN.,Department of Cardiology, Barts Heart Centre Barts Health NHS Trust London United Kingdom
| | - Hiroyuki Sawatari
- Department of Cardiovascular Diseases Mayo Clinic Rochester MN.,Department of Perioperative and Critical Care Management Hiroshima University Hiroshima Japan
| | - Mohammed Y Khanji
- NIHR Barts Cardiovascular Biomedical Research Centre, Barts and The London School of Medicine and Dentistry Queen Mary University of London London United Kingdom.,Department of Cardiology St. Bartholomew's Hospital London United Kingdom.,Department of Cardiology Newham University Hospital, Barts Health NHS Trust London United Kingdom
| | - Hassan Khan
- Leon H. Charney Division of Cardiology New York University Langone Health New York NY
| | - Babken Asatryan
- Department of Cardiology Inselspital, Bern University Hospital, University of Bern Bern Switzerland
| | - Raheel Ahmed
- Department of Cardiology Royal Brompton Hospital London United Kingdom
| | - Saurabh Deshpande
- Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore Karnataka
| | - Rui Providencia
- Department of Cardiology, Barts Heart Centre Barts Health NHS Trust London United Kingdom
| | | | - Anjali Tiku Owens
- Division of Cardiology, Department of Medicine University of Pennsylvania Philadelphia PA
| | - Virend K Somers
- Department of Cardiovascular Diseases Mayo Clinic Rochester MN
| | - Deepak Padmanabhan
- Division of Cardiology, Department of Medicine University of Pennsylvania Philadelphia PA.,Department of Cardiovascular Diseases Mayo Clinic Rochester MN.,Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore Karnataka
| | - Heidi Connolly
- Department of Cardiovascular Diseases Mayo Clinic Rochester MN
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18
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Kumagai H, Sawatari H, Hoshino T, Konishi N, Kiyohara Y, Kawaguchi K, Murase Y, Urabe A, Arita A, Shiomi T. Effects of Continuous Positive Airway Pressure Therapy on Nocturnal Blood Pressure Fluctuation Patterns in Patients with Obstructive Sleep Apnea. Int J Environ Res Public Health 2022; 19:9906. [PMID: 36011538 PMCID: PMC9407792 DOI: 10.3390/ijerph19169906] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
This retrospective study was designed to evaluate the effects of continuous positive airway pressure (CPAP) therapy, a well-established treatment for obstructive sleep apnea (OSA), on nocturnal blood pressure fluctuations (NBPFs) during rapid eye movement (REM) and non-REM sleep, and to evaluate the NBPF patterns in patients with OSA. We included 34 patients with moderate-to-severe OSA who underwent polysomnography using pulse transit time before and at 3−6 months after CPAP therapy. Nocturnal BP and NBPF frequency in REM and non-REM sleep were investigated, as well as NBPF pattern changes after receiving CPAP therapy. CPAP therapy resulted in significant reductions in the apnea−hypopnea index (AHI), arousal index, nocturnal systolic and diastolic BP, and NBPF frequency in REM and non-REM sleep (all p < 0.01). A higher AHI before CPAP resulted in lower nocturnal systolic BP (r = 0.40, p = 0.019) and NBPFs (r = 0.51, p = 0.002) after CPAP. However, 58.8% of patients showed no change in NBPF patterns with CPAP therapy. CPAP therapy significantly improved almost all sleep-related parameters, nocturnal BP, and NBPF frequency in REM and non-REM sleep periods, but NBPF patterns showed various changes post-CPAP therapy. These results suggest that factors other than OSA influence changes in NBPF patterns.
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Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Hiroshima Minato Clinic, Hiroshima 7340014, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Yoko Murase
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Ayako Urabe
- Department of Psychology and Medical Science, Graduate School of Psychology and Medical Sciences, Aichi Shukutoku University, Nagakute 4801197, Japan
| | - Aki Arita
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
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19
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Kako J, Kobayashi M, Kajiwara K, Kimura Y, Oosono Y, Takegata M, Nakano K, Matsuda Y, Nakamura N, Kawashima N, Hirano Y, Kitae M, Yamaguchi K, Iwamoto H, Hattori N, Sawatari H, Shiono S, Ogino H, Nishioka Y, Amano K, Yorke J. Validity and Reliability of the Japanese Version of the Dyspnea-12 Questionnaire in Patients With Lung Cancer. J Pain Symptom Manage 2022; 64:e83-e89. [PMID: 35452793 DOI: 10.1016/j.jpainsymman.2022.04.171] [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: 02/07/2022] [Revised: 03/24/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT The Dyspnea-12 questionnaire is a simple tool to assess dyspnea using qualitative descriptors that include both physical and emotional domains. However, the reliability and validity of the Japanese version in patients with lung cancer have not been assessed. OBJECTIVE To determine the reliability and validity of the Japanese version of the Dyspnea-12 questionnaire in patients with lung cancer. METHODS The assessment was based on the numerical rating scale (NRS), cancer dyspnea scale (CDS), and hospital anxiety and depression scale (HADS). Spearman's correlation assessed the convergent validity of Dyspnea-12 using these three scales. Exploratory factor analysis examined the construct validity. The reliability was verified using Cronbach's alpha. Anxiety, depression, clinical dyspnea, presence of chronic obstructive pulmonary disease (COPD), and patient status were identified by discriminating performance. RESULTS The analysis included 113 patients with lung cancer. A significant positive correlation was found between Dyspnea-12 and NRS, CDS, and HADS scores. Similar to the original version, factor analysis clearly classified Dyspnea-12 into two components (physical and emotional), thereby confirming its construct validity. Cronbach's alpha values for the total Dyspnea-12 and its physical and emotional components were 0.97, 0.95, and 0.96, respectively. Patients with anxiety, depression, and clinical dyspnea and those in the palliative phase had significantly higher Dyspnea-12 scores than their respective counterparts. The Dyspnea-12 scores of patients with and without COPD were similar. CONCLUSION The Japanese version of the Dyspnea-12 questionnaire is a useful and reliable tool to assess the multi-dimensional aspects of dyspnea in patients with lung cancer.
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Affiliation(s)
- Jun Kako
- College of Nursing Art and Science (J.K.), University of Hyogo, Akashi, Japan.
| | - Masamitsu Kobayashi
- Faculty of Nursing, National Defense Medical College (M.K.), Tokorozawa, Japan
| | - Kohei Kajiwara
- Faculty of Nursing, Japanese Red Cross Kyushu International College of Nursing (K.K.), Munakata, Japan
| | | | - Yasufumi Oosono
- Faculty of Nursing (Y.O.), Mejiro University, Saitama, Japan
| | - Mizuki Takegata
- Department of Pediatric Infectious Diseases, Institution of Tropical Medicine (M.T.), Nagasaki University, Nagasaki, Japan
| | - Kimiko Nakano
- Clinical Research Center for Developmental Therapeutics (K.N.), Tokushima University Hospital, Tokushima, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center (Y.M.), Sakai, Japan
| | - Naomi Nakamura
- Department of Nursing, National Hospital Organization Kinki-Chuo Chest Medical Center (N.N.), Sakai, Japan
| | - Natsuki Kawashima
- Department of Nursing, National Cancer Center Hospital East (N.K., Y.H.), Kashiwa, Japan
| | - Yuta Hirano
- Department of Nursing, National Cancer Center Hospital East (N.K., Y.H.), Kashiwa, Japan
| | - Misako Kitae
- Faculty of Nursing (M.K.), Tokyo Healthcare University, Wakayama, Japan
| | - Kakuhiro Yamaguchi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences (K.Y., H.I., N.H.), Hiroshima University, Hiroshima, Japan
| | - Hiroshi Iwamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences (K.Y., H.I., N.H.), Hiroshima University, Hiroshima, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences (K.Y., H.I., N.H.), Hiroshima University, Hiroshima, Japan
| | | | - Satoshi Shiono
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital (S.S.), Yamagata, Japan
| | - Hirokazu Ogino
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences (H.O., Y.N.), Tokushima University, Tokushima, Japan
| | - Yasuhiko Nishioka
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences (H.O., Y.N.), Tokushima University, Tokushima, Japan
| | - Koji Amano
- Department of Palliative Medicine, National Cancer Center Hospital (K.A.), Tokyo, Japan
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health (J.Y.), University of Manchester, Manchester M13 9PL, and The Christie NHS Foundation Trust, Manchester, United Kingdom
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20
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Konishi N, Kumagai H, Sawatari H, Hoshino T, Murase Y, Yamaguchi M, Urabe A, Kiyohara Y, Arita A, Baku M, Sasanabe R, Shiomi T. Efficacy of a Combination Therapy for Difficulties Waking Up in Non-School-Attending Students. J Clin Med 2022; 11:jcm11123271. [PMID: 35743342 PMCID: PMC9225467 DOI: 10.3390/jcm11123271] [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: 04/28/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
School non-attendance due to difficulties waking up is increasing in Japan, and affected students are commonly diagnosed with orthostatic dysregulation (OD); however, OD-associated sleep problems are overlooked. To date, no sleep-medicine-based treatment for wake-up difficulties in non-school-attending students has been established. This study aimed to assess the efficacy of a novel combination therapy for these students. We assessed the combined effect of sleep hygiene guidance, low-dose aripiprazole administration (3 mg/day), and blue-light exposure on wake-up difficulty in 21 non-school-attending teenage patients. The patients were evaluated using sleep studies and questionnaires before and after treatment. The average subjective total sleep time calculated from sleep diaries before treatment in the patients was 10.3 h. The therapy improved wake-up difficulty by 85.7% and further improved school non-attendance by 66.7%. The subjective sleep time significantly decreased by 9.5 h after treatment (p = 0.0004). The self-rating Depression Scale and mental component summary of the 36-item Short-Form Health Survey significantly improved after treatment (p = 0.002 and p = 0.01, respectively). Wake-up difficulties were caused by the addition of a delayed sleep phase to the patients’ long sleep times. The novel combination therapy was effective in improving wake-up difficulty and mental quality of life in non-school-attending teenage students.
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Affiliation(s)
- Noriyuki Konishi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Correspondence: ; Tel.: +81-82-257-1922
| | - Hiroyuki Sawatari
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Yoko Murase
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Maiko Yamaguchi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Ayako Urabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Yuka Kiyohara
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Aki Arita
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Masayo Baku
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Toshiaki Shiomi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
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Ahmed R, Sawatari H, Deshpande SA, Somers V, Padmanabhan D, Khanji M, Chahal AA. HF-564-01 READMISSION OUTCOMES IN PATIENTS WITH CARDIAC SARCOIDOSIS. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Deshpande SA, Sawatari H, Ahmed R, Khanji M, Somers V, Gopinathannair R, Chahal AA, Padmanabhan D. CA-537-04 INTRACARDIAC ECHOCARDIOGRAPHY USE AND IMPACT ON OUTCOMES FOR ATRIAL FIBRILLATION CATHETER ABLATION. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Sawatari H, Yoshimura C, Amagase H, Takewaka M, Nakashima K, Imaoka C, Obama H, Miyanaga N, Ando SI. Relationship between Restless legs syndrome associated symptoms and presence of depression during pregnancy. Women Health 2022; 62:265-271. [DOI: 10.1080/03630242.2022.2055698] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chikara Yoshimura
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | | | | | | | - Hirotsugu Obama
- Department of Obstetrics and Gynecology, Izuchi Hospital, Fukuoka, Japan
| | | | - Shin-ichi Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
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24
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Ahmed R, Sawatari H, Deshpande S, Khan H, Rui P, Padmanabhan D, Somers VK, Chahal A, Khanji M. UTILITY OF CHA2DS2-VASC SCORE AS A PREDICTOR OF READMISSION AND RESOURCE UTILIZATION IN CORONARY ARTERY BYPASS GRAFTING PATIENTS WITHOUT ATRIAL FIBRILLATION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01938-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Deshpande SA, Sawatari H, Padmanabhan D, Krishnappa D, Chahal A. B-PO04-197 COMPARISON OF POST-PROCEDURE CARDIAC TAMPONADE IN CORONARY INTERVENTIONS AND CARDIAC ELECTROPHYSIOLOGICAL PROCEDURES. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Hill EA, Sawatari H, Nishizaka MK, Fairley DM, Chishaki A, Funakoshi K, Riha RL, Ando SI. A Cross-Sectional Comparison of the Prevalence of Obstructive Sleep Apnea Symptoms in Adults With Down Syndrome in Scotland and Japan. Am J Intellect Dev Disabil 2020; 125:260-273. [PMID: 32609806 DOI: 10.1352/1944-7558-125.4.260] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 11/04/2019] [Indexed: 06/11/2023]
Abstract
Small studies in Western populations report a high prevalence of obstructive sleep apnea (OSA) in adults with Down syndrome. To date, ethnic differences have not been explored. A questionnaire sent to 2,752 adults with Down syndrome aged ≥16 years in Scotland and Japan (789 valid responses) estimated OSA prevalence based on reported symptoms. Symptoms were common in both countries, with snoring (p = 0.001) and arousals (p = 0.04) more prevalent in Japan. Estimated OSA prevalence in adults with Down syndrome was similar in the two countries, and raised in comparison with the general adult population (19.6% in Scotland and 14.3% in Japan; p = 0.08), though BMI was a confounder. Identification and treatment of OSA is recommended in adults with Down syndrome, regardless of ethnicity.
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Affiliation(s)
- Elizabeth A Hill
- The University of Edinburgh and NHS Lothian, Edinburgh, United Kingdom
| | - Hiroyuki Sawatari
- Kyushu University, Fukuoka, Japan, and Hiroshima University, Hiroshima, Japan
| | - Mari K Nishizaka
- Kyushu University Hospital and Kyushu University, Fukuoka, Japan
| | | | | | | | - Renata L Riha
- The University of Edinburgh, Edinburgh, United Kingdom
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Asano S, Sawatari H, Mentani H, Shimada Y, Takahashi M, Fudano K, Sasaki K, Niitani M, Tanabe K, Kataoka T. Taste Disorders: Effect of Education in Patients With Breast Cancer Receiving Chemotherapy. Clin J Oncol Nurs 2020; 24:265-271. [PMID: 32441675 DOI: 10.1188/20.cjon.265-271] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND For patients with breast cancer treated with certain chemotherapy regimens, taste disorders associated with those regimens can negatively affect quality of life. OBJECTIVES This study evaluated the effects of taste disorder-related education on meal satisfaction and sense of taste in Japanese women with breast cancer undergoing chemotherapy. METHODS A sample of 53 newly diagnosed women with breast cancer scheduled for chemotherapy treatment were randomly assigned to the control or intervention (nurse-provided education about chemotherapy-associated taste disorders) group. Meal satisfaction and sense of taste were assessed using a visual analog scale. FINDINGS The proportions of patients with meal dissatisfaction and impaired sense of taste were lower in the intervention group than in the control group. Although meal dissatisfaction and impaired sense of taste recovered in the intervention group two months after protocol completion, they did not recover in the control group. Providing education to women with breast cancer scheduled for chemotherapy treatment can affect patients' experience of treatment-associated taste disorders.
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Affiliation(s)
| | | | | | | | | | - Kazumi Fudano
- Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital
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28
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Sawatari H, Chishaki A, Nishizaka M, Miyazono M, Tokunou T, Magota C, Yamamoto U, Handa SS, Ando SI. Accumulated nocturnal hypoxemia predict arterial endothelial function in patients with sleep-disordered breathing with or without chronic heart failure. Heart Vessels 2020; 35:800-807. [PMID: 31965227 DOI: 10.1007/s00380-020-01557-5] [Citation(s) in RCA: 2] [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: 09/10/2019] [Accepted: 01/10/2020] [Indexed: 11/26/2022]
Abstract
ABTSRACT Sleep-disordered breathing (SDB) is often accompanied with the chronic heart failure (CHF). Hypoxemia due to pulmonary congestion from CHF and concurrent SDB might synergistically impair endothelial function and worsen the prognosis. However, the main factors affecting deterioration of endothelial function are unknown and whether the influence of hypoxemia differs in SDB patients with and without CHF remains unclear. Fifty-three patients (CHF group, n = 23; non-CHF group, n = 30) underwent polysomnography to evaluate their SDB and flow-mediated vasodilation (FMD) measurements to assess arterial endothelial function. We examined the relationships between FMD and SDB-related parameters, including our original index of accumulated hypoxemia by SDB throughout one-night sleep: the time desaturation summation index (TDS), calculated as follows: (100% - averaged arterial oxygen saturation during sleep) × total sleep time. The mean age in the CHF and non-CHF groups was 59.0 ± 13.5 and 57.7 ± 11.4 years, respectively. Although the FMD in the 2 groups were not significantly different, well-known adverse factors for FMD such as serum lipid profiles, blood pressure levels, and conventional indices of SDB were worse in the non-CHF group. Only the TDS was not significantly different between 2 groups and associated with FMD as shown by the univariate analysis (CHF: p < 0.05, non-CHF: p < 0.01) and multivariate analysis (CHF: p < 0.05, non-CHF: p < 0.01). Accumulated hypoxemia (TDS) rather than the frequency of hypoxemia might more influence on the endothelial function irrespective of the cardiac state. Removal of accumulation of nocturnal hypoxemia might be a target for treatment equally in the patients with and without CHF.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
- Department of Health Care for Adult, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Mari Nishizaka
- Department of Cardiovascular Medicine, Kimura Hospital, Fukuoka, Japan
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Mami Miyazono
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
- Department of Nursing, Faculty of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Tomotake Tokunou
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Chie Magota
- School of Nursing, Kurume University, Fukuoka, Japan
| | - Umpei Yamamoto
- Sleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, Japan
- Department of Cardiology, General Internal Medicine, Onga Hospital, Fukuoka, Japan
| | - Sakiko Shimizu Handa
- Sleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, Japan
- Kirameki Projects Career Support Center, Kyushu University Hospital, Fukuoka, Japan
| | - Shin-Ichi Ando
- Sleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, Japan.
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Yamasaki K, Sawatari H, Konagai N, Kamiya CA, Yoshimatsu J, Muneuchi J, Watanabe M, Fukuda T, Mizuno A, Sakamoto I, Yamamura K, Ohkusa T, Tsutsui H, Niwa K, Chishaki A. Peripartum Management of Pregnant Women With Congenital Heart Disease. Circ J 2019; 83:2257-2264. [PMID: 31462608 DOI: 10.1253/circj.cj-19-0369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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 The average maternal age at delivery, and thus the associated maternal risk are increasing including in women with congenital heart disease (CHD). A comprehensive management approach is therefore required for pregnant women with CHD. The present study aimed to investigate the factors determining peripartum safety in women with CHD.Methods and Results:We retrospectively collected multicenter data for 217 pregnant women with CHD (age at delivery: 31.4±5.6 years; NYHA classifications I and II: 88.9% and 7.4%, respectively). CHD severity was classified according to the American College of Cardiology/American Heart Association guidelines as simple (n=116), moderate complexity (n=69), or great complexity (n=32). Cardiovascular (CV) events (heart failure: n=24, arrhythmia: n=9) occurred in 30 women during the peripartum period. Moderate or great complexity CHD was associated with more CV events during gestation than simple CHD. CV events occurred earlier in women with moderate or great complexity compared with simple CHD. Number of deliveries (multiparity), NYHA functional class, and severity of CHD were predictors of CV events. CONCLUSIONS This study identified not only the severity of CHD according to the ACC/AHA and NYHA classifications, but also the number of deliveries, as important predictive factors of CV events in women with CHD. This information should be made available to women with CHD and medical personnel to promote safe deliveries.
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Affiliation(s)
- Keiko Yamasaki
- Faculty of Health Sciences, Department of Nursing, Ube Frontier University
| | - Hiroyuki Sawatari
- Department of Health Care for Adults, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Nao Konagai
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
| | - Jun Muneuchi
- Department of Pediatrics, Community Healthcare Organization Kyushu Hospital
| | - Mamie Watanabe
- Department of Pediatrics, Community Healthcare Organization Kyushu Hospital
| | - Terunobu Fukuda
- Department of Cardiology, Cardiovascular Center, St. Luke's International University Hospital
| | - Atsushi Mizuno
- Department of Cardiology, Cardiovascular Center, St. Luke's International University Hospital
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Kenichiro Yamamura
- Department of Pediatrics, Kyushu University Graduate School of Medical Sciences
| | - Tomoko Ohkusa
- Faculty of Health Sciences, Department of Nursing, Ube Frontier University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Koichiro Niwa
- Department of Cardiology, Cardiovascular Center, St. Luke's International University Hospital
| | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences
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Rahmawati A, Chishaki A, Miyazono M, Sawatari H, Hashiguchi N, Tsuchihashi-Makaya M, Nakai M, Sakurada H, Takemoto M, Mukai Y, Inoue S, Chishaki H. Sex disparities on psychological responses among implantable cardioverter defibrillator patients with underlying heart diseases. J Electrocardiol 2019. [DOI: 10.1016/j.jelectrocard.2019.01.041] [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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31
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Rahmawati A, Chishaki A, Miyazono M, Sawatari H, Hashiguchi N, Tsuchihashi-Makaya M, Nakai M, Sakurada H, Takemoto M, Mukai Y, Inoue S, Chishaki H. Sex disparities on psychological responses among implantable cardioverter defibrillator patients with underlying heart diseases. J Electrocardiol 2018. [DOI: 10.1016/j.jelectrocard.2018.10.040] [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: 11/25/2022]
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32
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Kang M, Sakamoto I, Sawatari H, Kouho T, Yamasaki K, Umemoto S, Abe K, Hiasa K, Ide T, Nishizaka M, Yamamura K, Kodama Y, Ishikawa S, Shinbara R, Chishaki H, Tsutsui H, Chishaki A. Serial electrocardiographic changes after transcatheter closure of atrial septal defects. J Electrocardiol 2018. [DOI: 10.1016/j.jelectrocard.2018.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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33
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Yamasaki K, Sawatari H, Konagai N, Kamiya C, Yoshimatsu J, Muneuchi J, Watanabe M, Fukuda T, Mizuno A, Sakamoto I, Yamamura K, Ohkusa T, Tsutsui H, Niwa K, Chishaki A. P5475Predictors of cardiovascular events in pregnant women with congenital heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Yamasaki
- Ube Frontier University, Nursing, Faculty of Health Sciences, Ube, Japan
| | - H Sawatari
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Health Care for Adults, Hiroshima, Japan
| | - N Konagai
- National cerebral and Cardiovascular Center, Perinatology and Gynecology, Osaka, Japan
| | - C Kamiya
- National cerebral and Cardiovascular Center, Perinatology and Gynecology, Osaka, Japan
| | - J Yoshimatsu
- National cerebral and Cardiovascular Center, Perinatology and Gynecology, Osaka, Japan
| | - J Muneuchi
- Japan Community Healthcare Organization Kyushu Hospital, Pediatrics, Kitakyushu, Japan
| | - M Watanabe
- Japan Community Healthcare Organization Kyushu Hospital, Pediatrics, Kitakyushu, Japan
| | - T Fukuda
- St. Luke's International University Hospital, Cardiology Cardiovascular Center, Tokyo, Japan
| | - A Mizuno
- St. Luke's International University Hospital, Cardiology Cardiovascular Center, Tokyo, Japan
| | - I Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Yamamura
- Kyushu University Graduate School of Medical Sciences, Pediatrics, Fukuoka, Japan
| | - T Ohkusa
- Ube Frontier University, Nursing, Faculty of Health Sciences, Ube, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Niwa
- St. Luke's International University Hospital, Cardiology Cardiovascular Center, Tokyo, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Health Sciences, Fukuoka, Japan
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Moriyama N, Sawatari H, Chishaki A, Rahmawati A, Nishizaka M, Hashiguchi N, Kuroda H, Ando S. 0772 Age And Sex Impact On Symptoms Of Sleep-disordered Breathing In People With Down Syndrome -a Nation-wide Study In Japan-. Sleep 2018. [DOI: 10.1093/sleep/zsy061.771] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Moriyama
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - H Sawatari
- Department of Health Care for Adults, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JAPAN
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - A Rahmawati
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - M Nishizaka
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fufuoka, JAPAN
- Department of Cardiovascular Medicine, Kimura Hospital, Fukuoka, JAPAN
| | - N Hashiguchi
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - H Kuroda
- Faculty of Fundamentals of Nursing, Japanese Red Cross Kyushu International College of Nursing, Fukuoka, JAPAN
| | - S Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, JAPAN
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35
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Kuroda H, Sawatari H, Ando S, Ohkusa T, Rahmawati A, Ono J, Nishizaka M, Hashiguchi N, Matsuoka F, Chishaki A. A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome. J Intellect Disabil Res 2017; 61:656-667. [PMID: 28378398 DOI: 10.1111/jir.12379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 04/23/2016] [Revised: 01/04/2017] [Accepted: 03/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with Down syndrome (DS) often have sleep-disordered breathing (SDB). Unusual sleep postures, such as leaning forward and sitting, are observed in people with DS. This study aimed to clarify the prevalence of unusual sleep postures and their relationships with SDB-related symptoms (SDB-RSs), such as snoring, witnessed apnoea, nocturnal awakening and excessive daytime sleepiness. METHODS A questionnaire, including demographic characteristics and the presence of unusual sleep postures, as well as SDB-RSs, was completed by 1149 parents of people with DS from Japan. RESULTS Unusual sleep postures were recorded in 483 (42.0%) people with DS. These participants were significantly younger and had a history of low muscle tone more frequently than people without unusual sleep postures. In all ages, the leaning forward posture was more frequent than sitting. People with DS with unusual sleep postures suffered from SDB-RSs. Those who slept in the sitting posture had more frequent SDB-RSs than did those who slept with the leaning forward posture. Snoring, witnessed apnoea and nocturnal awakening were observed in 73.6, 27.2 and 58.2% of participants, respectively. Snoring increased with aging. Witnessed apnoea was more common in males and in those with hypothyroidism than in females and in those without hypothyroidism. CONCLUSIONS Our study shows that there is a close relationship between unusual sleep postures and SDB-RSs. We recommend that all people with DS with unusual sleep postures should be checked for the presence of SDB.
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Affiliation(s)
- H Kuroda
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - S Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
| | - T Ohkusa
- Faculty of Health Sciences, Ube Frontier University, Ube, Japan
| | - A Rahmawati
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - J Ono
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - M Nishizaka
- Kirameki Projects Career Support Center, Kyushu University Hospital, Fukuoka, Japan
| | - N Hashiguchi
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - F Matsuoka
- Department of Medicine, Kyushu University School of Medicine, Fukuoka, Japan
| | - A Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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36
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Magota C, Sawatari H, Ando SI, Nishizaka MK, Tanaka K, Horikoshi K, Hoashi I, Nobuko H, Ohkusa T, Chishaki A. Seasonal ambient changes influence inpatient falls. Age Ageing 2017; 46:513-517. [PMID: 28057622 DOI: 10.1093/ageing/afw254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/06/2016] [Accepted: 12/22/2016] [Indexed: 11/13/2022] Open
Abstract
Background falls by inpatients often result in serious injuries and deterioration in a patient's physical abilities and quality of life, especially among older individuals. Although various factors have been found to be associated with falls, the combined effects of behavioural and ambient factors are not fully evaluated. Objective we investigated the influence of both behavioural and ambient factors on inpatient falls, focusing on seasonal and diurnal variations. Design retrospective study. Methods we surveyed the incident reports related to falls from April 2010 to March 2014 and examined the relationship between the incidents and seasonal and diurnal variations in behavioural and ambient factors, including the sunrise time, the night-time length and temperature. Results we identified 464 fallers from 3,037 incident reports. The average fall-rate of the study population was 1.4 ± 0.5/1,000 occupied bed-days. The seasonal and diurnal variations in falls were compared. The number of falls around dawn in October-February was higher than that in April-September. Toileting was the behaviour most frequently related to the falls (56.9%, n = 264), and 57.1% of the falls occurred at night. A multivariate analysis showed that the night-time length was significantly related to an increase in night-time falls (P = 0.047). Conclusion these results suggested that the inpatient falls increased in the early morning from November to March and tended to be related to toileting activities. Considering these results, additional attention and support during the higher risk hours and seasons, especially in relation to toileting activities, might help to reduce the incidence of falls. Clinical trial name, URL and registration number N/A (Because of retrospective nature).
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Affiliation(s)
- Chie Magota
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
- Faculty of Medical Technology, Teikyo University, Fukuoka, Japan
| | - Hiroyuki Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shin-Ichi Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
- Saiseikai Futsukaichi Hospital, Fukuoka, Japan
| | - Mari K Nishizaka
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | | | | | - Hashiguchi Nobuko
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomoko Ohkusa
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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37
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Ono J, Hashiguchi N, Sawatari H, Ohkusa T, Miyazono M, Son SY, Magota C, Tochihara Y, Chishaki A. Effect of water bath temperature on physiological parameters and subjective sensation in older people. Geriatr Gerontol Int 2017; 17:2164-2170. [PMID: 28421715 DOI: 10.1111/ggi.13053] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 01/27/2017] [Accepted: 02/20/2017] [Indexed: 11/29/2022]
Abstract
AIM In Japan, the incidence of water bathing-related cardiopulmonary accidents among older people is high in winter. The purpose of the present study was to investigate alterations in physiological characteristics and subjective thermal sensations of older people when bathing in a cool environment. METHODS We assessed the skin temperature, rectal temperature, blood pressure, pulse rate, body fluid loss (sweat and urine), and subjective thermal responses of 11 older healthy male and 10 young male volunteers throughout 42°C and 39°C bathing in a room at 20°C with 50% humidity. RESULTS At 42°C bathing, the rectal temperature during bathing and in the post-bathing period were significantly lower in the older men than in the young men, and skin temperature during the post-bathing period decreased gradually in the older men. Systolic blood pressure and pulse rate immediately increased just after entering 42°C water and decreased during bathing in the older men. With the activities of dressing, systolic blood pressure increased followed by a decrease during the post-bathing period. Thus, double product (pulse rate × systolic blood pressure) increased during the bathing period. Although there was no significant difference in body fluid loss between the older and younger men in 42°C water, the older men produced significantly less sweat. The older men also reported feeling less warm after 42°C bathing, and feeling less cold during the post-bathing period after 39°C bathing. CONCLUSIONS These results suggest that hot water bathing during cold seasons might induce more serious physiological changes in older people. Geriatr Gerontol Int 2017; 17: 2164-2170.
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Affiliation(s)
- Junji Ono
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Nobuko Hashiguchi
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroyuki Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomoko Ohkusa
- Faculty of Health Science, Ube Frontier University, Yamaguchi, Japan.,Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
| | - Mami Miyazono
- School of Nursing, Fukuoka Prefectural University, Fukuoka, Japan
| | - Su-Young Son
- National Institute of Occupational Safety and Health, Tokyo, Japan
| | - Chie Magota
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.,Faculty of Medical Technology, Teikyo University, Fukuoka, Japan
| | - Yutaka Tochihara
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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38
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Izukura R, Imada H, Hashiguchi N, Sawatari H, Ohguri T, Miyazono M, Ohta S, Takakura C, Yamasaki K, Magota C, Fujita K, Kuroda H, Hirata H, Ohkusa T, Chishaki A. Cardiac and respiratory effects of deep regional hyperthermia using an 8 MHz radiofrequency-capacitive device on patients with cancer. Int J Hyperthermia 2017; 33:428-434. [PMID: 28093005 DOI: 10.1080/02656736.2017.1283064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/20/2022] Open
Abstract
PURPOSE Hyperthermia (HT), an adjuvant therapy for variable cancers, may cause physiological changes in the patients, which may lead to cardiovascular problems. Among various HT treatments, the physiological effects of deep regional HT are still unclear. We examined the physiological alterations throughout deep regional HT to improve the HT safety. MATERIALS AND METHODS Thirty-one patients (age: 61 ± 12 years) with cancer received HT in the thoracic or upper abdominal regions using an 8-MHz radiofrequency-capacitive-device for 50 min. Rectal temperature (Trec), systolic and diastolic blood pressures (SBP and DBP), pulse rate (PR), respiratory rate (RR), percutaneous oxygen saturation (SpO2) and sweating volume were evaluated throughout HT. RESULTS At 50 min after starting HT, Trec, PR and RR were significantly increased compared with the baseline values (Trec: 38.2 ± 1.4 vs. 36.3 ± 0.8 °C, p < 0.001, PR: 104 ± 15 vs. 85 ± 16 bpm, p < 0.05, RR: 23 ± 3 vs. 21 ± 3/min, p < 0.05). Although the average SBP and DBP were both stable during HT in a recumbent position, these values dropped significantly in a standing position (SBP: 113 ± 16 vs. 127 ± 18 mmHg, p < 0.001, DBP: 70 ± 12 vs. 75 ± 13 mmHg, p < 0.01). The total amount of sweating was 356 ± 173 g/m2 on average. CONCLUSIONS Deep regional HT increased the deep body temperature and resulted in an increase of sweating with peripheral vasodilatation. Consequently, a significant reduction in BP would be induced on standing after HT. Careful attention is needed for patients receiving HT, especially when standing after HT.
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Affiliation(s)
- Rieko Izukura
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Hajime Imada
- b Cancer Treatment Center , Tobata Kyoritsu Hospital , Kitakyushu , Japan
| | - Nobuko Hashiguchi
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Hiroyuki Sawatari
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Takayuki Ohguri
- c Department of Radiology , University of Occupational and Environmental Health , Kitakyushu , Japan
| | - Mami Miyazono
- d School of Nursing , Fukuoka Prefectural University , Fukuoka , Japan
| | - Shin Ohta
- b Cancer Treatment Center , Tobata Kyoritsu Hospital , Kitakyushu , Japan
| | - Chiduko Takakura
- b Cancer Treatment Center , Tobata Kyoritsu Hospital , Kitakyushu , Japan
| | - Keiko Yamasaki
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Chie Magota
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Kanae Fujita
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Hiromi Kuroda
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
| | - Hideki Hirata
- e Department of radiotherapy , St. Mary's Hospital , Kurume , Japan
| | - Tomoko Ohkusa
- f Sleep Apnea Center, Kyushu University Hospital , Fukuoka , Japan.,g Faculty of Health Sciences , Ube Frontier University , Yamaguchi , Japan
| | - Akiko Chishaki
- a Department of Health Sciences , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan
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Sawatari H, Chishaki A, Ando SI. The Epidemiology of Sleep Disordered Breathing and Hypertension in Various Populations. Curr Hypertens Rev 2016; 12:12-7. [PMID: 26778203 DOI: 10.2174/1573402112666160114093307] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/10/2016] [Indexed: 11/22/2022]
Abstract
Hypertension is prevalent in patients with sleep disordered breathing (SDB). Since hypertension significantly relates to cardiovascular diseases, the treatment and prevention of SDB could be targets for the prevention of cardiovascular diseases. In this article, we summarize about epidemiology of SDB and hypertension in various populations. General population based studies on the prevalence of SDB reported that 24 to 47% male and 9 to 30% female had SDB. Furthermore, the prevalence of hypertension in individuals with SDB was high, ranging from 36 to 57%. American and Korean based studies reported that the severity of SDB related to increase of blood pressure and hypertension. In the elderly, however, the severity of SDB did not relate to increase in blood pressure and hypertension, but to dipping pattern of blood pressure. With respect to children, the severity of SDB also related to increase in blood pressure, but the trend was inconstant in children with habitual snoring. In addition to the sexual differences, the severity of SDB related to hypertension in males. On the other hand, there was no relationship between the severity of SDB and hypertension in females. SDB was prevalent in the general population, regardless of race, and affected blood pressure. We should pay attention to the subjects' individual character when we interrupt the outcome.
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Affiliation(s)
| | | | - Shin-ich Ando
- Sleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan.
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Sawatari H, Ohkusa T, Rahamawati A, Ishikawa K, Tsuchihashi-Makaya M, Ohtsuka Y, Nakai M, Miyazono M, Hashiguchi N, Chishaki H, Sakurada H, Mukai Y, Inoue S, Sunagawa K, Chishaki A. Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients With Implantable Cardioverter-Defibrillators. Clin Cardiol 2016; 39:263-8. [PMID: 27153459 DOI: 10.1002/clc.22521] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Received: 11/06/2015] [Revised: 01/07/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Implantable cardioverter-defibrillators (ICD) have provided effective therapy for fatal arrhythmia. However, ICD patients are known to develop psychological problems, such as posttraumatic stress disorder (PTSD), if they have experienced potentially fatal arrhythmia and ICD shocks. Little is known about the factors influencing PTSD in ICD patients. HYPOTHESIS Echocardiographic cardiac-function parameters might relate to psychological problems, especially PTSD, in ICD patients. METHODS A total of 128 outpatients with ICD implantation completed the Impact of Event Scale Revised (IES-R) questionnaire as a measurement of PTSD. Demographic and clinical characteristic data were collected from medical records. RESULTS The mean age of the ICD patients was 59 ± 16 years; 103 were male; and the mean left ventricular ejection fraction (LVEF) by echocardiography was 52.4% ± 18.3%. In the ICD patients, female sex and impaired LVEF were related to lower IES-R scores or led to PTSD (P = 0.01 and P = 0.03, respectively). Impaired LVEF also worsened 2 symptoms of PTSD, intrusion (P = 0.02) and hyperarousal (P = 0.03). In patients with LVEF <35%, there was a significant negative correlation between LVEF level and IES-R score (P = 0.045). CONCLUSIONS This study showed that LVEF was related to the severity of PTSD, especially in the ICD patients with LVEF of <35%. We should pay more attention to ICD patients with severely impaired left ventricular function to prevent psychological problems.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoko Ohkusa
- Center for Clinical and Translational Research, Kyushu University, Fukuoka, Japan
| | - Anita Rahamawati
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsuhiko Ishikawa
- Institutional Research Office for Education, Education Promotion Center, Prefectural University of Kumamoto, Kumamoto, Japan
| | | | - Yuko Ohtsuka
- Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Mori Nakai
- Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan
| | - Mami Miyazono
- School of Nursing, Fukuoka Prefectural University, Fukuoka, Japan
| | - Nobuko Hashiguchi
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Chishaki
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Healthcare Management, College of Healthcare Management, Fukuoka, Japan
| | - Harumizu Sakurada
- Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenji Sunagawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Healthcare Management, College of Healthcare Management, Fukuoka, Japan
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Sawatari H, Chishaki A, Nishizaka M, Tokunou T, Adachi S, Yoshimura C, Ohkusa T, Ando SI. Cumulative Hypoxemia During Sleep Predicts Vascular Endothelial Dysfunction in Patients With Sleep-Disordered Breathing. Am J Hypertens 2016; 29:458-63. [PMID: 26286866 DOI: 10.1093/ajh/hpv135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 05/09/2015] [Accepted: 07/20/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) is associated with repeated intermittent hypoxemia, and it is known as one of the risk factors for cardiovascular diseases. Previous studies assessing the effects of frequency and depth of hypoxemia on cardiovascular diseases have shown conflicting results. The aim of the current study was to clarify what SDB-related parameters most predict endothelial dysfunction to better understand the pathogenesis of endothelial dysfunction in patients with SDB. METHODS We conducted polysomnography (PSG) and measured flow-mediated vasodilation response (%FMD) in 50 outpatients suspected of SDB. Evaluated indices included: apnea-hypopnea index (AHI), 3% oxygen desaturation index (3%ODI), averaged arterial oxygen saturation (averaged SpO2), lowest arterial oxygen saturation (lowest SpO2), ratio of arterial oxygen saturation <90% (<SpO2 90%), and averaged time desaturation summation index (TDS: [100%-averaged SpO2] × total sleep time). RESULTS Significant differences were observed only in the TDS between the first and third (P = 0.03) and between the first and forth (P = 0.04) quartile groups, stratified by %FMD. The %FMD showed a significant relationship with TDS (β = -0.47, P = 0.001), even after adjusting for confounding factors (β = -0.33, P = 0.02). In contrast, AHI, 3%ODI, averaged SpO2, lowest SpO2, and <SpO2 90% showed no significant relationships. CONCLUSIONS This study shows the validity of TDS in predicting endothelial damage in patients with SDB. Cumulative hypoxemia, rather than the frequency of hypoxemic events presented as AHI, may be a greater contributing factor in causing endothelial dysfunction. A simple index like TDS may be a useful and novel indicator of the influence of SDB on the vasculature.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Mari Nishizaka
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan; Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomotake Tokunou
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Sonomi Adachi
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan; Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | | | - Tomoko Ohkusa
- Kirameki Projects Career Support Center, Kyushu University Hospital, Fukuoka, Japan
| | - Shin-ichi Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan;
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Sawatari H, Ando S, Nishizaka M, Miyazono M, Sakamoto T, Chishaki H, Ohkusa T, Magota C, Sunagawa K, Chishaki A. Accumulated nocturnal hypoxemia was a better predicting factor in vascular endothelial dysfunction in patients with chronic heart failure and sleep disordered breathing. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rahmawati A, Chishaki A, Ohkusa T, Sawatari H, Tsuchihashi-Makaya M, Ohtsuka Y, Nakai M, Miyazono M, Hashiguchi N, Sakurada H, Takemoto M, Mukai Y, Inoue S, Sunagawa K, Chishaki H. Influence of primary and secondary prevention indications on anxiety about the implantable cardioverter-defibrillator. J Arrhythm 2015; 32:102-7. [PMID: 27092190 PMCID: PMC4823574 DOI: 10.1016/j.joa.2015.10.002] [Citation(s) in RCA: 9] [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] [Received: 08/28/2015] [Revised: 09/29/2015] [Accepted: 10/05/2015] [Indexed: 11/21/2022] Open
Abstract
Background Implantable cardioverter-defibrillators (ICDs) have been established for primary and secondary prevention of fatal arrhythmias. However, little is known about the influence of ICD indications on quality of life (QOL) and psychological disturbances. This study aimed to examine whether there were differences in QOL and psychological distress in patients that have an ICD for primary or secondary prevention of fatal arrhythmias. Methods A multicenter survey of 179 consecutive outpatients (29.1% primary prevention) with ICD implantations completed the Short Form-8 (SF-8), Beck Depression Inventory (BDI), Impact of Event Scale-Revised (IES-R), State-Trait Anxiety Inventory (STAI), and Worries about ICD (WAICD). Results Patients with an ICD for primary prevention had a higher trait anxiety score and worries about ICD score than patients with an ICD for secondary prevention (41.7±12.4 vs. 34.7±12.3, p=0.001 and 39.6±18.0 vs. 30.0±18.9, p=0.002, respectively), even after adjusting for demographic and clinical characteristics. In multivariable analysis of variance, primary prevention ICD recipients reported a poorer QOL on the vitality subscale of the SF-8. Conclusions In our study population, which mostly consisted of New York Heart Association (NYHA) class I and II subjects, primary prevention ICD recipients were more prone to experience worries about their ICD, anxiety, and a poorer QOL compared to secondary prevention ICD recipients. In clinical practice, primary prevention ICD patients should be closely monitored. If warranted, they should be offered psychological intervention, as anxiety and low QOL were predictors of mortality.
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Affiliation(s)
- Anita Rahmawati
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomoko Ohkusa
- Kirameki Project Carrier Support Center, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroyuki Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Yuko Ohtsuka
- Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan
| | - Mori Nakai
- Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan
| | - Mami Miyazono
- School of Nursing, Fukuoka Prefectural University, Fukuoka, Japan
| | - Nobuko Hashiguchi
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Harumizu Sakurada
- Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan
| | - Masao Takemoto
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shujirou Inoue
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kenji Sunagawa
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroaki Chishaki
- Department of Healthcare Management, College of Healthcare Management, Fukuoka, Japan
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Rahmawati A, Chishaki A, Ohkusa T, Sawatari H, Tsuchihashi-Makaya M, Ohtsuka Y, Nakai M, Miyazono M, Hashiguchi N, Sakurada H, Takemoto M, Mukai Y, Inoue S, Chishaki H. Psychological Issues in Heart Failure Patients Who Received Implantable Cardioverter-Defibrillator. J Card Fail 2015. [DOI: 10.1016/j.cardfail.2015.08.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ono J, Chishaki A, Ohkusa T, Sawatari H, Nishizaka M, Ando SI. Obstructive sleep apnea-related symptoms in Japanese people with Down syndrome. Nurs Health Sci 2015. [DOI: 10.1111/nhs.12206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Junji Ono
- Faculty of Health Science; Ube Frontier University; Ube Japan
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Akiko Chishaki
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Tomoko Ohkusa
- Kirameki Project Career Support Center; Fukuoka Japan
- Sleep Apnea Center; Kyushu University Hospital; Fukuoka Japan
| | - Hiroyuki Sawatari
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Mari Nishizaka
- Sleep Apnea Center; Kyushu University Hospital; Fukuoka Japan
- Department of Cardiovascular Medicine; Faculty of Medicine; Kyushu University Graduate School; Fukuoka Japan
| | - Shin-ichi Ando
- Sleep Apnea Center; Kyushu University Hospital; Fukuoka Japan
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Rahmawati A, Chishaki A, Ohkusa T, Sawatari H, Hashiguchi N, Ono J, Kuroda H, Nishizaka MK, Ando SI. Relationship between sleep postures and sleep-disordered breathing parameters in people with Down syndrome in Japan. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anita Rahmawati
- Department of Cardiovascular Medicine; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Akiko Chishaki
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Tomoko Ohkusa
- Kirameki Project Carrier Support Center; Kyushu University Hospital; Fukuoka Japan
- Sleep Apnea Center; Kyushu University Hospital; Fukuoka Japan
| | - Hiroyuki Sawatari
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Nobuko Hashiguchi
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Junji Ono
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Hiromi Kuroda
- Department of Health Sciences; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Mari K Nishizaka
- Department of Cardiovascular Medicine; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
- Sleep Apnea Center; Kyushu University Hospital; Fukuoka Japan
| | - Shin-ichi Ando
- Sleep Apnea Center; Kyushu University Hospital; Fukuoka Japan
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Sawatari H, Chishaki A, Nishizaka M, Matsuoka F, Yoshimura C, Kuroda H, Rahmawati A, Hashiguchi N, Miyazono M, Ono J, Ohkusa T, Ando SI. A nationwide cross-sectional study on congenital heart diseases and symptoms of sleep-disordered breathing among Japanese Down's syndrome people. Intern Med 2015; 54:1003-8. [PMID: 25948338 DOI: 10.2169/internalmedicine.54.3989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/06/2022] Open
Abstract
OBJECTIVE It is well known that people with Down's syndrome (DS) frequently complicate with congenital heart diseases (CHDs). Patients with heart diseases often have sleep-disordered breathing as a co-morbidity (SDB) which worsens the heart diseases. However, the relationship between SDB and CHDs in DS people has not yet been fully elucidated. The aim of this study was to establish the association between SDB and CHDs in DS people using data from a large nationwide questionnaire survey in Japan. METHODS We conducted a cross-sectional questionnaire survey of a randomly selected sample of 2,000 DS people and their caregivers throughout Japan to examine the associations between observed signs of SDB and CHDs in DS people. The questionnaire included the presence of SDB symptoms (snoring, apnea, arousal, nocturia, and napping) and CHDs (the presence and types of CHDs). RESULTS Of the 1,222 replies received from the caregivers, 650 reported complications of some type of CHDs. The observed apnea tended to be higher among DS people with CHDs than those without CHDs (OR=1.28, 95% CI=0.97-1.70, p=0.09). DS people with tetralogy of Fallot reported significantly more frequent apnea than those without CHDs (OR=3.10, 95% CI=1.36-7.05, p<0.01). CONCLUSION SDB prevailed among DS people with severe CHDs, such as tetralogy of Fallot. Careful attention to the signs of SDB in such patients may lead to earlier clinical intervention removing the vicious cycle between SDB and CHDs.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, 2) Research Fellow of the Japan Society for the Promotion of Science, Japan
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Sawatari H, Chishaki A, Miyazono M, Hashiguchi N, Maeno Y, Chishaki H, Tochihara Y. Different Physiological and Subjective Responses to the Hyperthermia Between Young and Older Adults: Basic Study for Thermal Therapy in Cardiovascular Diseases. J Gerontol A Biol Sci Med Sci 2014; 70:912-6. [PMID: 25528016 DOI: 10.1093/gerona/glu224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/05/2013] [Accepted: 11/12/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Thermal therapy has been used as adjuvant therapy in patients with cardiovascular disease. However, little is known about responses to thermal stress in older adults. We examined the effects of thermal stress in younger and older healthy Japanese individuals. METHODS The study included 12 young (mean age, 22 years) and 12 older (mean age, 68 years) healthy adults and was performed under strict temperature and humidity control to minimize confounding. Participants lay supine throughout three consecutive 30-minute phases: Phase I (heating at 70°C in a dome-shaped sauna), Phase II (insulation in the sauna), and Phase III (cool down). Physiological parameters and subjective thermal sensations were compared within and between two age groups. RESULTS Mean skin temperature increased significantly in both age groups (Phase I) and after the first 10 minutes was higher among older adults (by 6.8°C vs 6.0°C among younger; p < .01). Mean rectal temperature increased by 0.6°C in both groups (Phase II). Mean heart rate increased significantly in both age groups (Phase II) and was higher among younger adults (by 21.4 vs 11.3 beats/min among older adults; p < .05). Both systolic (by 15.1 mmHg) and diastolic (by 10.5 mmHg) blood pressure dropped significantly among older adults (Phase I), returning to baseline in Phase III; no changes were noted among those younger. There was no between-group difference in fluid loss or thermal sensations. CONCLUSIONS Compared with younger adults, older adults are more likely to drop blood pressure in response to thermal stress but had similar fluid loss and subjective responses.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
| | - Mami Miyazono
- Department of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Nobuko Hashiguchi
- Department of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Yukari Maeno
- Department of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Hiroaki Chishaki
- Department of Healthcare Management, College of Healthcare Management, Miyama, Japan
| | - Yutaka Tochihara
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
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Nakashima T, Ohkusa T, Nao T, Ueyama T, Kobayashi S, Ikeda Y, Sawatari H, Chishaki A, Ando SI, Yano M. Analysis of Correlation between Sleep Disordered Breathing Indexes and Cardiac Functional Parameter in Chronic Heart Failure Patients. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.126] [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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Sawatari H, Miyazono M, Nishizaka M, Ando S, Sunagawa K, Chishaki A. Leg thermal therapy improved sleep structure and subjective sleep quality in chronic heart failure. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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