1
|
Vinograd I, Souliou SM, Haghighirad AA, Lacmann T, Caplan Y, Frachet M, Merz M, Garbarino G, Liu Y, Nakata S, Ishida K, Noad HML, Minola M, Keimer B, Orgad D, Hicks CW, Le Tacon M. Using strain to uncover the interplay between two- and three-dimensional charge density waves in high-temperature superconducting YBa 2Cu 3O y. Nat Commun 2024; 15:3277. [PMID: 38627407 PMCID: PMC11021565 DOI: 10.1038/s41467-024-47540-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
Uniaxial pressure provides an efficient approach to control charge density waves in YBa2Cu3Oy. It can enhance the correlation volume of ubiquitous short-range two-dimensional charge-density-wave correlations, and induces a long-range three-dimensional charge density wave, otherwise only accessible at large magnetic fields. Here, we use x-ray diffraction to study the strain dependence of these charge density waves and uncover direct evidence for a form of competition between them. We show that this interplay is qualitatively described by including strain effects in a nonlinear sigma model of competing superconducting and charge-density-wave orders. Our analysis suggests that strain stabilizes the 3D charge density wave in the regions between disorder-pinned domains of 2D charge density waves, and that the two orders compete at the boundaries of these domains. No signatures of discommensurations nor of pair density waves are observed. From a broader perspective, our results underscore the potential of strain tuning as a powerful tool for probing competing orders in quantum materials.
Collapse
Affiliation(s)
- I Vinograd
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
- 4th Physical Institute - Solids and Nanostructures, University of Göttingen, D-37077, Göttingen, Germany
| | - S M Souliou
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
| | - A-A Haghighirad
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
| | - T Lacmann
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
| | - Y Caplan
- Racah Institute of Physics, The Hebrew University, Jerusalem, 91904, Israel
| | - M Frachet
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
| | - M Merz
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
- Karlsruhe Nano Micro Facility (KNMFi), Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany
| | - G Garbarino
- ESRF, The European Synchrotron, 71, avenue des Martyrs, CS 40220, F-38043, Grenoble Cedex 9, France
| | - Y Liu
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, D-70569, Stuttgart, Germany
| | - S Nakata
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, D-70569, Stuttgart, Germany
| | - K Ishida
- Max Planck Institute for Chemical Physics of Solids, Nöthnitzer Str. 40, D-01187, Dresden, Germany
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - H M L Noad
- Max Planck Institute for Chemical Physics of Solids, Nöthnitzer Str. 40, D-01187, Dresden, Germany
| | - M Minola
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, D-70569, Stuttgart, Germany
| | - B Keimer
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, D-70569, Stuttgart, Germany
| | - D Orgad
- Racah Institute of Physics, The Hebrew University, Jerusalem, 91904, Israel
| | - C W Hicks
- Max Planck Institute for Chemical Physics of Solids, Nöthnitzer Str. 40, D-01187, Dresden, Germany
- School of Physics and Astronomy, University of Birmingham, Birmingham, B15 2TT, UK
| | - M Le Tacon
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, Kaiserstr. 12, D-76131, Karlsruhe, Germany.
| |
Collapse
|
2
|
Tokunaga Y, Sakai H, Kambe S, Opletal P, Tokiwa Y, Haga Y, Kitagawa S, Ishida K, Aoki D, Knebel G, Lapertot G, Krämer S, Horvatić M. Longitudinal Spin Fluctuations Driving Field-Reinforced Superconductivity in UTe_{2}. Phys Rev Lett 2023; 131:226503. [PMID: 38101342 DOI: 10.1103/physrevlett.131.226503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 12/17/2023]
Abstract
Our measurements of ^{125}Te NMR relaxations reveal an enhancement of electronic spin fluctuations above μ_{0}H^{*}∼15 T, leading to their divergence in the vicinity of the metamagnetic transition at μ_{0}H_{m}≈35 T, below which field-reinforced superconductivity appears when a magnetic field (H) is applied along the crystallographic b axis. The NMR data evidence that these fluctuations are dominantly longitudinal, providing a key to understanding the peculiar superconducting phase diagram in H∥b, where such fluctuations enhance the pairing interactions.
Collapse
Affiliation(s)
- Y Tokunaga
- ASRC, Japan Atomic Energy Agency Tokai, Ibaraki 319-1195, Japan
| | - H Sakai
- ASRC, Japan Atomic Energy Agency Tokai, Ibaraki 319-1195, Japan
| | - S Kambe
- ASRC, Japan Atomic Energy Agency Tokai, Ibaraki 319-1195, Japan
| | - P Opletal
- ASRC, Japan Atomic Energy Agency Tokai, Ibaraki 319-1195, Japan
| | - Y Tokiwa
- ASRC, Japan Atomic Energy Agency Tokai, Ibaraki 319-1195, Japan
| | - Y Haga
- ASRC, Japan Atomic Energy Agency Tokai, Ibaraki 319-1195, Japan
| | - S Kitagawa
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - K Ishida
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - D Aoki
- IMR, Tohoku University, Ibaraki 311-1313, Japan
- Université Grenoble Alpes, CEA, Grenoble-INP, IRIG, Pheliqs, 38000 Grenoble, France
| | - G Knebel
- Université Grenoble Alpes, CEA, Grenoble-INP, IRIG, Pheliqs, 38000 Grenoble, France
| | - G Lapertot
- Université Grenoble Alpes, CEA, Grenoble-INP, IRIG, Pheliqs, 38000 Grenoble, France
| | - S Krämer
- Laboratoire National des Champs Magnétiques Intenses, LNCMI-CNRS (UPR3228), EMFL, Université Grenoble Alpes, UPS and INSA Toulouse, Boîte Postale 166, 38042 Grenoble Cedex 9, France
| | - M Horvatić
- Laboratoire National des Champs Magnétiques Intenses, LNCMI-CNRS (UPR3228), EMFL, Université Grenoble Alpes, UPS and INSA Toulouse, Boîte Postale 166, 38042 Grenoble Cedex 9, France
| |
Collapse
|
3
|
Noad HML, Ishida K, Li YS, Gati E, Stangier V, Kikugawa N, Sokolov DA, Nicklas M, Kim B, Mazin II, Garst M, Schmalian J, Mackenzie AP, Hicks CW. Giant lattice softening at a Lifshitz transition in Sr 2RuO 4. Science 2023; 382:447-450. [PMID: 37883549 DOI: 10.1126/science.adf3348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 09/16/2023] [Indexed: 10/28/2023]
Abstract
The interplay of electronic and structural degrees of freedom in solids is a topic of intense research. More than 60 years ago, Lifshitz discussed a counterintuitive possibility: lattice softening driven by conduction electrons at topological Fermi surface transitions. The effect that he predicted, however, was small and has not been convincingly observed. Using a piezo-based uniaxial pressure cell to tune the ultraclean metal strontium ruthenate while measuring the stress-strain relationship, we reveal a huge softening of the Young's modulus at a Lifshitz transition of a two-dimensional Fermi surface and show that it is indeed driven entirely by the conduction electrons of the relevant energy band.
Collapse
Affiliation(s)
- H M L Noad
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - K Ishida
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - Y-S Li
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - E Gati
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - V Stangier
- Institut für Theorie der Kondensierten Materie, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
| | - N Kikugawa
- National Institute for Materials Science, Tsukuba, Ibaraki 305-0003, Japan
| | - D A Sokolov
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - M Nicklas
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - B Kim
- Department of Physics, Kunsan National University, Gunsan 54150, Korea
- Department of Physics, Kyungpook National University, Daegu 41566, Korea
| | - I I Mazin
- Department of Physics and Astronomy, George Mason University, Fairfax, VA 22030, USA
- Quantum Science and Engineering Center, George Mason University, Fairfax, VA 22030, USA
| | - M Garst
- Institut für Theoretische Festkörperphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
- Institut für QuantenMaterialien und Technologien, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
| | - J Schmalian
- Institut für Theorie der Kondensierten Materie, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
- Institut für QuantenMaterialien und Technologien, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
| | - A P Mackenzie
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
- Scottish Universities Physics Alliance, School of Physics and Astronomy, University of St Andrews, St Andrews KY16 9SS, UK
| | - C W Hicks
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
- School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, UK
| |
Collapse
|
4
|
Kamijo K, Ishida K, Oide S, Anan K, Taito S, Kataoka Y, Chikazawa K. Efficacy and Safety of the Surgery-First Approach Compared to the Chemotherapy-First Approach for Treating Low-Risk Gestational Trophoblastic Neoplasia: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e45726. [PMID: 37868570 PMCID: PMC10590247 DOI: 10.7759/cureus.45726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
For gestational trophoblastic neoplasia (GTN) affecting women of reproductive age, the chemotherapy-first approach is often preferred over the surgery-first approach. Low-risk GTN is treated with a chemotherapy-first approach, but the number of courses required can affect fertility. A surgery-first approach may decrease the number of chemotherapy courses, but its efficacy and safety compared to a chemotherapy-first approach are unclear. Thus, we investigated the efficacy and safety of the surgery-first approach compared to the chemotherapy-first approach in treating low-risk GTN. We searched the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform databases for relevant articles in July 2023. A systematic review and meta-analysis of outcome measures were conducted using a random-effects model. The primary outcomes were remission, the mean number of chemotherapy courses required to cure, and adverse events. The certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. This study protocol was registered in the Open Science Framework (https://osf.io/kysvn/). Studies for low-risk GTN included a qualitative synthesis (with 2,192 participants and ten studies, eight of which were about second uterine curettage and two about hysterectomy) and a meta-analysis (with 138 participants and two randomized controlled trials (RCTs) that compared first-line treatments of second uterine curettage and chemotherapy). Second uterine curettage may result in little to no difference in remission (risk ratio: 1.00, 95% confidence interval: 0.96-1.05; low certainty) and a slight reduction in adverse events (risk ratio: 0.87, 95% confidence interval: 0.47-1.60; low certainty). The evidence is very uncertain on the mean number of chemotherapy courses (mean difference: 2.84 lower, 95% confidence interval: 7.31 lower to 1.63 higher; very low certainty). Based on clinical outcomes, second uterine curettage can be comparable to the chemotherapy-first approach as a first-line treatment option for low-risk GTN; however, the overall certainty of the evidence was low or very low.
Collapse
Affiliation(s)
- Kyosuke Kamijo
- Obstetrics and Gynecology, Nagano Manicipal Hospital, Nagano, JPN
- Department of Obstetrics and Gynecology, Nagano Prefectural Kiso Hospital, Kiso-gun, JPN
- Department of Systematic Reviewers, Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, JPN
| | - Kentaro Ishida
- Department of Obstetrics and Gynaecology, Osaka Red Cross Hospital, Osaka, JPN
- Department of Systematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, JPN
| | - Shiho Oide
- Urogynecology Center, Kameda Medical Center, Chiba, JPN
- Department of Systematic Reviewers, Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, JPN
| | - Keisuke Anan
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, JPN
- Department of Systematic Reviewers, Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, JPN
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JPN
| | - Shunsuke Taito
- Division of Rehabilitation, Hiroshima University Hospital, Hiroshima, JPN
- Department of Systematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, JPN
| | - Yuki Kataoka
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JPN
- Department of Internal Medicine, Kyoto Min-iren Asukai Hospital, Kyoto, JPN
- Department of Systematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, JPN
- Department of Community Medicine, Kyoto University Graduate School of Medicine/Section of Clinical Epidemiology, Kyoto, JPN
| | - Kenro Chikazawa
- Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama, JPN
| |
Collapse
|
5
|
Inda-Webb ME, Jimenez M, Liu Q, Phan NV, Ahn J, Steiger C, Wentworth A, Riaz A, Zirtiloglu T, Wong K, Ishida K, Fabian N, Jenkins J, Kuosmanen J, Madani W, McNally R, Lai Y, Hayward A, Mimee M, Nadeau P, Chandrakasan AP, Traverso G, Yazicigil RT, Lu TK. Sub-1.4 cm 3 capsule for detecting labile inflammatory biomarkers in situ. Nature 2023; 620:386-392. [PMID: 37495692 DOI: 10.1038/s41586-023-06369-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/26/2023] [Indexed: 07/28/2023]
Abstract
Transient molecules in the gastrointestinal tract such as nitric oxide and hydrogen sulfide are key signals and mediators of inflammation. Owing to their highly reactive nature and extremely short lifetime in the body, these molecules are difficult to detect. Here we develop a miniaturized device that integrates genetically engineered probiotic biosensors with a custom-designed photodetector and readout chip to track these molecules in the gastrointestinal tract. Leveraging the molecular specificity of living sensors1, we genetically encoded bacteria to respond to inflammation-associated molecules by producing luminescence. Low-power electronic readout circuits2 integrated into the device convert the light emitted by the encapsulated bacteria to a wireless signal. We demonstrate in vivo biosensor monitoring in the gastrointestinal tract of small and large animal models and the integration of all components into a sub-1.4 cm3 form factor that is compatible with ingestion and capable of supporting wireless communication. With this device, diseases such as inflammatory bowel disease could be diagnosed earlier than is currently possible, and disease progression could be more accurately tracked. The wireless detection of short-lived, disease-associated molecules with our device could also support timely communication between patients and caregivers, as well as remote personalized care.
Collapse
Affiliation(s)
- M E Inda-Webb
- Synthetic Biology Group, MIT Synthetic Biology Center, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - M Jimenez
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Liu
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA
| | - N V Phan
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J Ahn
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - C Steiger
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Wentworth
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Riaz
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA
| | - T Zirtiloglu
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA
| | - K Wong
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - K Ishida
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - N Fabian
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Comparative Medicine, MIT, Cambridge, MA, USA
| | - J Jenkins
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J Kuosmanen
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - W Madani
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R McNally
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y Lai
- Synthetic Biology Group, MIT Synthetic Biology Center, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A Hayward
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Division of Comparative Medicine, MIT, Cambridge, MA, USA
| | - M Mimee
- Department of Microbiology, Biological Sciences Division and Pritzker School of Molecular Engineering, The University of Chicago, Chicago, IL, USA
| | | | - A P Chandrakasan
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, USA
| | - G Traverso
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - R T Yazicigil
- Electrical and Computer Engineering Department, Boston University, Boston, MA, USA.
| | - T K Lu
- Synthetic Biology Group, MIT Synthetic Biology Center, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Senti Biosciences, South San Francisco, CA, USA.
| |
Collapse
|
6
|
Aoyama D, Miyazaki S, Hasegawa K, Nomura R, Kakehashi S, Mukai M, Miyoshi M, Yamaguchi J, Sato Y, Shiomi Y, Ikeda H, Ishida K, Uzui H, Tada H. Atrial fibrillation activation patterns predict freedom from arrhythmias after catheter ablation: utility of ExTRa mapping™. Front Cardiovasc Med 2023; 10:1161691. [PMID: 37576113 PMCID: PMC10416434 DOI: 10.3389/fcvm.2023.1161691] [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: 02/08/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Mechanisms underlying atrial fibrillation (AF) are widely complex and vary tremendously among individuals. Objectives This retrospective study aimed to investigate the association between AF activation patterns and clinical outcomes post-ablation. Methods Fifty-five AF patients (64.0 ± 12.9 years; 41 men; 17 paroxysmal) underwent bi-atrial endocardial driver mapping during AF pre-ablation with a real-time phase mapping system (ExTRa Mapping). The nonpassively activated ratio (%NP) of meandering rotors and multiple wavelets relative to the recording time was evaluated in 26 atrial segments [15 in the left atrium (LA) and 11 in the right atrium]. Irrespective of the mapping results, all patients underwent standard AF ablation via cryoballoons and/or radiofrequency catheters. Results In a median follow-up interval of 27(14-30) months, 69.1% of patients were free from recurrent arrhythmias and antiarrhythmic drugs at one year post-procedure. Patients with recurrent AF were more likely to have non-paroxysmal AF, a significantly larger LA size, and higher LA maximal %NP(LAmax%NP) and LA anterior wall %NP(LAAW%NP) than those without recurrent AF. A multivariate Cox regression analysis showed that both an LAmax%NP (hazard ratio [HR] = 1.075; 95% confidence interval [CI] = 1.02-1.14, p = 0.012) and LAAW%NP (HR = 1.061; 95% CI = 1.01-1.11, p = 0.013) were independent predictors of atrial arrhythmia recurrence. The optimal cutoff points for the LAmax%NP and LAAW%NP for predicting AF recurrence were 64.5% and 60.0%, respectively. A Kaplan-Meier analysis demonstrated that both an LAmax%NP > 64.5% (p = 0.0062) and LAAW%NP > 60.0% (p = 0.014) were associated with more frequent AF recurrences. Conclusion Baseline AF activation pattern mapping may aid in predicting freedom from arrhythmias after standard AF ablation procedures.
Collapse
Affiliation(s)
- Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ryohei Nomura
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shota Kakehashi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Machiko Miyoshi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yusuke Sato
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
7
|
Čulo M, Licciardello S, Ishida K, Mukasa K, Ayres J, Buhot J, Hsu YT, Imajo S, Qiu MW, Saito M, Uezono Y, Otsuka T, Watanabe T, Kindo K, Shibauchi T, Kasahara S, Matsuda Y, Hussey NE. Expanded quantum vortex liquid regimes in the electron nematic superconductors FeSe 1-xS x and FeSe 1-xTe x. Nat Commun 2023; 14:4150. [PMID: 37438333 DOI: 10.1038/s41467-023-39730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/21/2023] [Indexed: 07/14/2023] Open
Abstract
The quantum vortex liquid (QVL) is an intriguing state of type-II superconductors in which intense quantum fluctuations of the superconducting (SC) order parameter destroy the Abrikosov lattice even at very low temperatures. Such a state has only rarely been observed, however, and remains poorly understood. One of the key questions is the precise origin of such intense quantum fluctuations and the role of nearby non-SC phases or quantum critical points in amplifying these effects. Here we report a high-field magnetotransport study of FeSe1-xSx and FeSe1-xTex which show a broad QVL regime both within and beyond their respective electron nematic phases. A clear correlation is found between the extent of the QVL and the strength of the superconductivity. This comparative study enables us to identify the essential elements that promote the QVL regime in unconventional superconductors and to demonstrate that the QVL regime itself is most extended wherever superconductivity is weakest.
Collapse
Affiliation(s)
- M Čulo
- High Field Magnet Laboratory (HFML-EMFL) and Institute for Molecules and Materials, Radboud University, Toernooiveld 7, 6525, ED, Nijmegen, Netherlands.
- Institut za fiziku, Bijenička cesta 46, HR-10000, Zagreb, Croatia.
| | - S Licciardello
- High Field Magnet Laboratory (HFML-EMFL) and Institute for Molecules and Materials, Radboud University, Toernooiveld 7, 6525, ED, Nijmegen, Netherlands
| | - K Ishida
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - K Mukasa
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - J Ayres
- H. H. Wills Physics Laboratory, University of Bristol, Tyndall Avenue, Bristol, BS8 1TL, UK
| | - J Buhot
- H. H. Wills Physics Laboratory, University of Bristol, Tyndall Avenue, Bristol, BS8 1TL, UK
| | - Y-T Hsu
- High Field Magnet Laboratory (HFML-EMFL) and Institute for Molecules and Materials, Radboud University, Toernooiveld 7, 6525, ED, Nijmegen, Netherlands
- Center for Theory and Computation, National Tsing Hua University, No. 101, Section. 2, Kuang-Fu Road, Hsinchu, 30013, Taiwan
| | - S Imajo
- Institute for Solid State Physics, University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - M W Qiu
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - M Saito
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - Y Uezono
- Graduate School of Science and Technology, Hirosaki University, Hirosaki, Aomori, 036-8561, Japan
| | - T Otsuka
- Graduate School of Science and Technology, Hirosaki University, Hirosaki, Aomori, 036-8561, Japan
| | - T Watanabe
- Graduate School of Science and Technology, Hirosaki University, Hirosaki, Aomori, 036-8561, Japan
| | - K Kindo
- Institute for Solid State Physics, University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - T Shibauchi
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - S Kasahara
- Research Institute for Interdisciplinary Science, Okayama University, 3-1-1 Tsushimanaka, Kita-Ku, Okayama, 700-8530, Japan
| | - Y Matsuda
- Department of Physics, Kyoto University, Sakyo-Ku, Kyoto, 606-8502, Japan
| | - N E Hussey
- High Field Magnet Laboratory (HFML-EMFL) and Institute for Molecules and Materials, Radboud University, Toernooiveld 7, 6525, ED, Nijmegen, Netherlands.
- H. H. Wills Physics Laboratory, University of Bristol, Tyndall Avenue, Bristol, BS8 1TL, UK.
| |
Collapse
|
8
|
Saito N, Inoue M, Ishida K, Taguchi H, Haga M, Shimoda E, Morimoto K, Takahama J, Tanaka T. A Case of Refractory Esophageal Varices Caused by an Inferior Mesenteric Arteriovenous Malformation with All Portal System Occlusion Successfully Treated via Transarterial Embolization. Interv Radiol (Higashimatsuyama) 2023; 8:83-87. [PMID: 37485479 PMCID: PMC10359167 DOI: 10.22575/interventionalradiology.2022-0032] [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] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/22/2022] [Indexed: 07/25/2023]
Abstract
Inferior mesenteric arteriovenous fistulas/malformations are rare, reported in only 40 cases as of 2021. Their main manifestations include portal hypertension and ischemic bowel disease. We report the case of a 50-year-old man with refractory esophageal varices caused by this condition that was successfully treated with transarterial embolization. Computed tomography revealed an inferior mesenteric arteriovenous malformation and ascending blood flow into the esophageal varices through a remarkably dilated marginal vein. All portal systems were occluded, possibly because of the myointimal hyperplasia of the inferior mesenteric vein. The patient recovered without hemorrhagic events after transarterial embolization and endoscopic injection sclerotherapy. This is the first report of an inferior mesenteric arteriovenous malformation resulting in refractory esophageal varices with all-portal system occlusion successfully treated with transarterial embolization.
Collapse
Affiliation(s)
- Natsuhiko Saito
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Masayoshi Inoue
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Kentaro Ishida
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Hidehiko Taguchi
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Masayo Haga
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Emiko Shimoda
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Kengo Morimoto
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Junko Takahama
- Department of Radiology, Higashiosaka City Medical Center, Japan
| | - Toshihiro Tanaka
- Department of Diagnostic and Interventional Radiology, Nara Medical University, Japan
| |
Collapse
|
9
|
Ishida K, Ashihara T, So M, Minamiguchi S, Matsumura N, Nonogaki T. Synchronous ovarian and uterine mesonephric-like carcinoma that potentially arose from endometrioid adenofibroma: A case report. J Obstet Gynaecol Res 2023; 49:1052-1056. [PMID: 36597276 DOI: 10.1111/jog.15539] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/07/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023]
Abstract
Mesonephric-like carcinoma histologically resembles mesonephric adenocarcinoma (MA) of the cervix. MA arises from mesonephric duct remnants. However, the origin of mesonephric-like carcinoma is not extensively studied because of its rarity. Here, we present a case of synchronous ovarian and uterine mesonephric-like carcinoma that potentially arose from endometrioid adenofibroma. A 69-year-old woman presented with an abdominal mass with no genital bleeding. She underwent simple total abdominal hysterectomy and bilateral adnexal resection. Histological and immunohistochemical analyses were consistent with mesonephric-like carcinoma involving both ovaries and the uterus. Endometrioid adenofibroma was present in both ovaries, while adenomyosis was observed in the uterus. The glandular duct of the endometrioid adenofibroma in the right ovary had areas suggestive of precursor lesions of mesonephric-like carcinoma. All tumors exhibited the KRAS G12D mutation. These findings suggest that the origin of the mesonephric-like carcinoma was the Müllerian duct, and that the ovarian and uterine tumors were monoclonal.
Collapse
Affiliation(s)
- Kentaro Ishida
- Department of Obstetrics and Gynecology, Osaka Red Cross Hospital, Osaka, Japan
| | - Takahito Ashihara
- Department of Obstetrics and Gynecology, Osaka Red Cross Hospital, Osaka, Japan
| | - Makiko So
- Department of Obstetrics and Gynecology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriomi Matsumura
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takafumi Nonogaki
- Department of Obstetrics and Gynecology, Osaka Red Cross Hospital, Osaka, Japan
| |
Collapse
|
10
|
Aoyama D, Miyazaki S, Tsuji T, Nomura R, Kakehashi S, Mukai M, Ikeda H, Ishida K, Uzui H, Tada H. Low troponin I levels predict the presence of arrhythmia-induced cardiomyopathy in patients with atrial fibrillation and left ventricular systolic dysfunction. Heart Vessels 2023; 38:929-937. [PMID: 36823474 DOI: 10.1007/s00380-023-02242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
Successful atrial fibrillation (AF) ablation can improve reduced left ventricular ejection fraction (LVEF) with AF, which is defined as arrhythmia-induced cardiomyopathy (AIC). However, it is difficult to pre-procedurally predict the presence of AIC. We aimed to explore the pre-procedural predictors of AIC in patients with AF and reduced LVEF. This study included 60 patients with a reduced LVEF (LVEF < 50%; 69.1 ± 8.8 years; 45 men) who underwent successful AF ablation. Responders were defined as patients whose LVEF post-procedurally improved to the normal range (≥ 50%). Multivariate analysis revealed that the log-transformed pre-procedural troponin I (TnI) levels (odds ratio [OR] = 0.059; 95% confidence interval [CI] = 0.0052-0.42, p = 0.003) and age (OR = 0.91; 95% CI = 0.82-1.00, p = 0.044) were independent predictors of post-procedural LVEF recovery; further, low TnI levels (< 11.1 pg/ml) predicted LVEF recovery (sensitivity, 79.1%; specificity, 76.5%; positive predictive value, 89.5%; and negative predictive value, 59.1%). There were no significant differences in TnI levels between the baseline and 1 month after the procedure. However, four patients with high baseline TnI levels showed a > 50% reduction in the TnI levels post-procedurally, with three of these patients showing LVEF recovery. Low pre-procedural TnI levels can predict LVEF recovery after successful AF ablation in patients with reduced LVEF.
Collapse
Affiliation(s)
- Daisetsu Aoyama
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan.
| | - Shinsuke Miyazaki
- The Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshihiko Tsuji
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Ryohei Nomura
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Shota Kakehashi
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- The Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| |
Collapse
|
11
|
Yashi M, Suzuki I, Ishida K, Imasato N, Shimoda H, Nakamura G, Hidetoshi K, Takei K, Nishihara D, Kijima T, Kamai T. Nodal tumor burden provides independent predictive value for biochemical recurrence in patients with node-positive prostate cancer after definitive surgery. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00708-x] [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: 02/12/2023]
|
12
|
Aoyama D, Uzui H, Sekihara T, Eguchi T, Hasegawa K, Tsuji T, Kataoka T, Nagao M, Kakehashi S, Mukai M, Aiki T, Yamaguchi J, Shiomi Y, Tama N, Fukuoka Y, Ishida K, Tada H. Declines in serum uric acid level after catheter ablation of atrial fibrillation. Heart Vessels 2022; 37:2049-2058. [PMID: 35790552 DOI: 10.1007/s00380-022-02108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few studies have examined whether catheter ablation for AF patients improves biomarkers other than serum levels of brain natriuretic peptide (BNP) and renal function. This study was to explore whether catheter ablation for atrial fibrillation (AF) patients affects uric acid (UA), glucose and lipid metabolism. METHODS AND RESULTS A total of 206 patients (66.6 ± 10.4 years; 132 men) who underwent initial AF ablation without changes to oral medications were included. Baseline BNP and UA levels significantly decreased at 1 year after ablation (p < 0.05 each). Changes in UA level correlated significantly with pre-procedural UA level (r = 0.57). In multivariable logistic regression modeling, pre-procedural UA level, persistent AF, and hemoglobin A1c (p < 0.05 each) were independent predictors of post-procedural UA level decline. Significant improvements in both persistent and paroxysmal AF patients were identified, and the magnitude of post-procedural serum UA level decline after ablation (ΔUA) was significantly greater in patients with persistent AF (0.8 ± 1.0 mg/dl) than in those with paroxysmal AF (0.2 ± 0.8 mg/dl, p < 0.001). Of the 48 patients with high UA level before procedure, 28 patients showed improvement in UA level to normal range. CONCLUSIONS Catheter ablation for AF patients significantly improved serum UA levels without obvious influences of heart failure, renal function, or inflammation, suggesting that AF ablation may be effective for AF patients with hyperuricemia. Trial registration The study was approved by the Research Ethics Committee of University of Fukui (no. 20210132) and clinical trial registration (UMIN000044669).
Collapse
Affiliation(s)
- Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Takayuki Sekihara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Tomoya Eguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Toshihiko Tsuji
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Tatsuhiro Kataoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Moeko Nagao
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Shota Kakehashi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Takayoshi Aiki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| |
Collapse
|
13
|
Kinjo K, Manago M, Kitagawa S, Mao ZQ, Yonezawa S, Maeno Y, Ishida K. Superconducting spin smecticity evidencing the Fulde-Ferrell-Larkin-Ovchinnikov state in Sr 2RuO 4. Science 2022; 376:397-400. [PMID: 35446631 DOI: 10.1126/science.abb0332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Translational symmetry breaking is antagonistic to static fluidity but can be realized in superconductors, which host a quantum-mechanical coherent fluid formed by electron pairs. A peculiar example of such a state is the Fulde-Ferrell-Larkin-Ovchinnikov (FFLO) state, induced by a time-reversal symmetry-breaking magnetic field applied to spin-singlet superconductors. This state is intrinsically accompanied by the superconducting spin smecticity, spin density-modulated fluidity with spontaneous translational-symmetry breaking. Detection of such spin smecticity provides unambiguous evidence for the FFLO state, but its observation has been challenging. Here, we report the characteristic "double-horn" nuclear magnetic resonance spectrum in the layered superconductor Sr2RuO4 near its upper critical field, indicating the spatial sinusoidal modulation of spin density that is consistent with superconducting spin smecticity. Our work reveals that Sr2RuO4 provides a versatile platform for studying FFLO physics.
Collapse
Affiliation(s)
- K Kinjo
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - M Manago
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto, Japan
| | | | - Z Q Mao
- Department of Physics, Pennsylvania State University, State College, PA, USA
| | - S Yonezawa
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - Y Maeno
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - K Ishida
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto, Japan
| |
Collapse
|
14
|
Aoki D, Brison JP, Flouquet J, Ishida K, Knebel G, Tokunaga Y, Yanase Y. Unconventional superconductivity in UTe 2. J Phys Condens Matter 2022; 34:243002. [PMID: 35203074 DOI: 10.1088/1361-648x/ac5863] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
The novel spin-triplet superconductor candidate UTe2was discovered only recently at the end of 2018 and already attracted enormous attention. We review key experimental and theoretical progress which has been achieved in different laboratories. UTe2is a heavy-fermion paramagnet, but following the discovery of superconductivity, it has been expected to be close to a ferromagnetic instability, showing many similarities to the U-based ferromagnetic superconductors, URhGe and UCoGe. This view might be too simplistic. The competition between different types of magnetic interactions and the duality between the local and itinerant character of the 5fUranium electrons, as well as the shift of the U valence appear as key parameters in the rich phase diagrams discovered recently under extreme conditions like low temperature, high magnetic field, and pressure. We discuss macroscopic and microscopic experiments at low temperature to clarify the normal phase properties at ambient pressure for field applied along the three axis of this orthorhombic structure. Special attention will be given to the occurrence of a metamagnetic transition atHm= 35 T for a magnetic field applied along the hard magnetic axisb. Adding external pressure leads to strong changes in the magnetic and electronic properties with a direct feedback on superconductivity. Attention is paid on the possible evolution of the Fermi surface as a function of magnetic field and pressure. Superconductivity in UTe2is extremely rich, exhibiting various unconventional behaviors which will be highlighted. It shows an exceptionally huge superconducting upper critical field with a re-entrant behavior under magnetic field and the occurrence of multiple superconducting phases in the temperature-field-pressure phase diagrams. There is evidence for spin-triplet pairing. Experimental indications exist for chiral superconductivity and spontaneous time reversal symmetry breaking in the superconducting state. Different theoretical approaches will be described. Notably we discuss that UTe2is a possible example for the realization of a fascinating topological superconductor. Exploring superconductivity in UTe2reemphasizes that U-based heavy fermion compounds give unique examples to study and understand the strong interplay between the normal and superconducting properties in strongly correlated electron systems.
Collapse
Affiliation(s)
- D Aoki
- IMR, Tohoku University, Oarai, Ibaraki, 311-1313, Japan
| | - J-P Brison
- Univ. Grenoble Alpes, CEA, Grenoble INP, IRIG, PHELIQS, F-38000 Grenoble, France
| | - J Flouquet
- Univ. Grenoble Alpes, CEA, Grenoble INP, IRIG, PHELIQS, F-38000 Grenoble, France
| | - K Ishida
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - G Knebel
- Univ. Grenoble Alpes, CEA, Grenoble INP, IRIG, PHELIQS, F-38000 Grenoble, France
| | - Y Tokunaga
- ASRC, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - Y Yanase
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
- Institute for Molecular Science, Okazaki 444-8585, Japan
| |
Collapse
|
15
|
Hasegawa K, Gao J, Ohno S, Ishida K, Miyazaki S, Makiyama T, Horie M, Uzui H, Tada H. Oral Adrenergic Agents Produced Ventricular Fibrillation and QT Prolongation in an Elderly Patient Carrying an RYR2 Variant. Int Heart J 2022; 63:398-403. [PMID: 35354758 DOI: 10.1536/ihj.21-543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mutant cardiac ryanodine receptor channels (RyR2) are "leaky," and spontaneous Ca2+ release through these channels causes delayed afterdepolarizations that can deteriorate into ventricular fibrillation. Some patients carrying RYR2 mutations in type 1 catecholaminergic polymorphic ventricular tachycardia exhibit QT prolongation and are initially diagnosed with long QT syndrome. However, none have been reported to cause drug-induced ventricular fibrillation in patients with RYR2 variants. We describe the first case of an elderly woman with drug-induced QT prolongation and ventricular fibrillation who carried a novel RYR2 variant but no other mutations related to long QT syndrome. Oral adrenergic agents might induce QT prolongation and subsequent ventricular fibrillation in patients carrying an RYR2 variant. Screening for RYR2 could be valuable in patients with suspected drug-induced long QT syndrome.
Collapse
Affiliation(s)
- Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Jingshan Gao
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| |
Collapse
|
16
|
Miyazaki S, Hasegawa K, Yamao K, Ishikawa E, Mukai M, Aoyama D, Nodera M, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Iesaka Y, Tada H. Mapping and ablation of left atrial roof-dependent tachycardias using an ultra-high resolution mapping system. BMC Cardiovasc Disord 2022; 22:57. [PMID: 35172730 PMCID: PMC8851727 DOI: 10.1186/s12872-022-02505-z] [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: 04/08/2021] [Accepted: 02/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Left atrial roof-dependent tachycardias (LARTs) are common macroreentrant atrial tachycardias (ATs). We sought to characterize clinical LARTs using an ultra-high resolution mapping system. METHODS This study included 22 consecutive LARTs in 21 patients who underwent AT mapping/ablation using Rhythmia systems. RESULTS Three, 13, 4, and 2 LART patients were cardiac intervention naïve (Group-A), post-roof line ablation (Group-B), post-atrial fibrillation ablation without linear ablation (Group-C), and post-cardiac surgery (Group-D), respectively. The mean AT cycle length was 244 ± 43 ms. Coronary sinus activation was proximal-to-distal or distal-to-proximal in 16 (72.7%) ATs. The activation map revealed 13 (59.1%) clockwise and 9 (40.9%) counter-clockwise LARTs. A 12-lead synchronous isoelectric interval was observed in 10/19 (52.6%) LARTs. The slow conduction area was identified on the LA roof, anterior/septal wall, and posterior wall in 18, 6, and 2 ATs, respectively. Twenty concomitant ATs among 13 procedures were also eliminated, and peri-mitral AT coexisted in 7 of 9 non-group-B patients. In group-B, the conduction gap was predominantly located on the mid-roof. Sustained LARTs were terminated by a single application and linear ablation in 6 (27.3%) and 9 (40.9%), while converting to other ATs in 7 (31.8%) LARTs. Complete linear block was created without any complications in all, however, ablation at the mid-posterior wall was required to achieve block in 4 (18.2%) procedures. During 14.0 (6.5-28.5) months of follow-up, 17 (81.0%) and 19 (90.5%) patients were free from any atrial tachyarrhythmias after single and last procedures. CONCLUSIONS The LART mechanisms were distinct in individual patients, and elimination of all concomitant ATs was required for the management.
Collapse
Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kazuya Yamao
- Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshito Iesaka
- Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| |
Collapse
|
17
|
Hasegawa K, Uzui H, Fukuoka Y, Miyanaga D, Shiomi Y, Tama N, Ikeda H, Ishida K, Miyazaki S, Sekijima Y, Naiki H, Tada H. Abdominal Fat Pad Fine-Needle Aspiration for Diagnosis of Cardiac Amyloidosis in Patients with Non-Ischemic Cardiomyopathy. Int Heart J 2022; 63:49-55. [DOI: 10.1536/ihj.21-430] [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: 11/18/2022]
Affiliation(s)
- Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Dai Miyanaga
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Yoshiki Sekijima
- Department of Medicine (Neurology and Rheumatology), Shinshu University
| | - Hironobu Naiki
- Department of Molecular Pathology, Faculty of Medical Sciences, University of Fukui
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| |
Collapse
|
18
|
Shimizu T, Uzui H, Sato Y, Miyoshi M, Shiomi Y, Hasegawa K, Ikeda H, Tama N, Fukuoka Y, Morishita T, Ishida K, Miyazaki S, Tada H. Association between Changes in the Systolic Blood Pressure from Evening to the Next Morning and Night Glucose Variability in Heart Disease Patients. Intern Med 2021; 60:3543-3549. [PMID: 34092728 PMCID: PMC8666227 DOI: 10.2169/internalmedicine.6784-20] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectve To assess the impact of glycemic variability on blood pressure in hospitalized patients with cardiac disease. Methods In 40 patients with cardiovascular disease, the glucose levels were monitored by flash continuous glucose monitoring (FGM; Free-Style Libre™ or Free-Style Libre Pro; Abbott, Witney, UK) and self-monitoring blood glucose (SMBG) for 14 days. Blood pressure measurements were performed twice daily (morning and evening) at the same time as the glucose level measurement using SMBG. Results The detection rate of hypoglycemia using the FGM method was significantly higher than that with the 5-point SMBG method (77.5% vs. 5.0%, p<0.001). Changes in the systolic blood pressure from evening to the next morning [morning - evening (ME) difference] were significantly correlated with night glucose variability (r=0.63, P<0.001). A multiple regression analysis showed that night glucose variability using FGM was more closely correlated with the ME difference [r=0.62 (95% confidence interval, 0.019-0.051); p<0.001] than with the age, body mass index, or smoking history. Night glucose variability was also more closely associated with the ME difference in patients with unstable angina pectoris (UAP) than in those with acute myocardial infarction (AMI) or heart failure (HF) (r=0.83, p=0.058). Conclusion Night glucose variability is associated with the ME blood pressure difference, and FGM is more accurate than the 5-point SMBG approach for detecting such variability.
Collapse
Affiliation(s)
- Tomohiro Shimizu
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yusuke Sato
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Machiko Miyoshi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| |
Collapse
|
19
|
Kakehashi S, Miyazaki S, Hasegawa K, Nodera M, Mukai M, Aoyama D, Nagao M, Sekihara T, Eguchi T, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Ishida K, Uzui H, Tada H. Safety and durability of cavo-tricuspid isthmus linear ablation in the current era: Single-center 9-year experience from 1078 procedures. J Cardiovasc Electrophysiol 2021; 33:40-45. [PMID: 34676946 DOI: 10.1111/jce.15281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/17/2021] [Accepted: 08/31/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cavo-tricuspid isthmus (CTI) linear ablation is performed not only for atrial flutter (AFL) but empirically during atrial fibrillation (AF) ablation in real-world practice. PURPOSE: We sought to evaluate the safety and durability of the CTI ablation. METHODS: This retrospective study included 1078 consecutive patients who underwent a CTI ablation. AFL was documented before or during the procedure in 249 (23.1%) patients, and an empirical CTI and AF ablation were performed in 829 (76.9%) patients. RESULTS: CTI block was successfully created in 1051 (97.5%) patients with a 10.3 ± 6.6 min total radiofrequency time. Repeat procedures were performed for recurrent arrhythmias in 187 (17.3%) patients at a median of 11.0 (5.0-30.0) months postprocedure, and conduction resumption was identified in 68/174 (39.1%). Among those undergoing a CTI ablation with an AF ablation, the durability was significantly higher in those with than without documented AFL (78.1% vs. 58.2%, p = .031). The total radiofrequency time was significantly shorter (9.0 ± 5.3 vs. 10.0 ± 6.4 [mins], p = .024) and durability significantly higher (78.1 vs. 58.7[%], p = .043) in the large-tip than irrigated-tip catheter group. Iatrogenic AFL was observed after the empiric CTI ablation in 11 (1.3%) patients. Procedure-related complications occurred in 15 (1.4%) patients. Eight patients experienced coronary artery spasms, including one with ventricular fibrillation following ST elevation on the ward. The other six patients experienced transient atrioventricular block and one experienced cardiac tamponade requiring drainage. CONCLUSIONS: Despite a high acute CTI ablation success, the conduction block durability was relatively low after the empiric ablation. An empiric CTI ablation at the time of the AF ablation is not recommended.
Collapse
Affiliation(s)
- Shota Kakehashi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moeko Nagao
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takayuki Sekihara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tomoya Eguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
20
|
Miyoshi M, Uzui H, Shimizu T, Aiki T, Shiomi Y, Nodera M, Ikeda H, Tama N, Hasegawa K, Morishita T, Ishida K, Miyazaki S, Tada H. Significance of day-to-day glucose variability in patients after acute coronary syndrome. BMC Cardiovasc Disord 2021; 21:490. [PMID: 34629051 PMCID: PMC8504044 DOI: 10.1186/s12872-021-02303-z] [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: 03/19/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Several studies have recently addressed the importance of glycemic variability (GV) in patients with acute coronary syndrome (ACS). Although daily GV measures, such as mean amplitude of glycemic excursions, are established predictors of poor prognosis in patients with ACS, the clinical significance of day-to-day GV remains to be fully elucidated. We therefore monitored day-to-day GV in patients with ACS to examine its significance. Methods In 25 patients with ACS, glucose levels were monitored for 14 days using a flash continuous glucose monitoring system. Mean of daily differences (MODD) was calculated as a marker of day-to-day GV. N-terminal pro-brain natriuretic peptide (NT-proBNP) was evaluated within 4 days after hospitalization. Cardiac function (left ventricular end-diastolic volume, left ventricular ejection fraction, stroke volume) was assessed by echocardiography at 3–5 days after admission and at 10–12 months after the disease onset. Results Of the 25 patients, 8 (32%) were diagnosed with diabetes, and continuous glucose monitoring (CGM)-based MODD was high (16.6 to 42.3) in 17 patients (68%). Although MODD did not correlate with max creatine kinase (CK), there was a positive correlation between J-index, high blood glucose index, and NT-proBNP (r = 0.83, p < 0.001; r = 0.85, p < 0.001; r = 0.41, p = 0.042, respectively). Conclusions In patients with ACS, MODD was associated with elevated NT-proBNP. Future studies should investigate whether day-to-day GV in ACS patients can predict adverse clinical events such as heart failure.
Collapse
Affiliation(s)
- Machiko Miyoshi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan.
| | - Tomohiro Shimizu
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Takayoshi Aiki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-Cho, Fukui, 910-1193, Japan
| |
Collapse
|
21
|
Matsumoto T, Takayama K, Ishida K, Hayashi S, Hashimoto S, Kuroda R. Corrigenda. Bone Joint J 2021; 103-B:1641. [PMID: 34587812 DOI: 10.1302/0301-620x.103b10.bjj-2021-00021] [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: 11/05/2022]
|
22
|
Mita M, Sugawara I, Harada K, Ito M, Takizawa M, Ishida K, Ueda H, Kitaguchi T, Tsuboi T. Development of red genetically encoded biosensor for visualization of intracellular glucose dynamics. Cell Chem Biol 2021; 29:98-108.e4. [PMID: 34197723 DOI: 10.1016/j.chembiol.2021.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 05/19/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022]
Abstract
Glucose is the main source of energy for organisms, and it is important to understand the spatiotemporal dynamics of intracellular glucose. Single fluorescent protein-based glucose indicators, named "Red Glifons" have been developed that apply to live-cell and dual-color imaging. These indicators exhibited more than 3-fold increase in fluorescence intensity in the presence of 10 mM glucose. The two Red Glifons developed have different half-maximal effective concentration (EC50) values for glucose (300 μM and 3,000 μM) and are able to monitor a wide range of glucose dynamics. Red Glifon combined with green indicators allowing visualization of the interplay between glucose and ATP, lactate, or pyruvate. Glucose influx in the pharyngeal muscle of Caenorhabditis elegans, enteroendocrine cells, and human iPS cell-derived cardiac myocytes was observed using the Red Glifons. Thus these red glucose indicators serve as a multi-color imaging toolkit for investigating complex interactions in energy metabolism.
Collapse
Affiliation(s)
- Marie Mita
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan
| | - Izumi Sugawara
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Kazuki Harada
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan
| | - Motoki Ito
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Mai Takizawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan
| | - Kentaro Ishida
- Myoridge Co. Ltd., 46-29 Yoshidashimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Hiroshi Ueda
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8503, Japan
| | - Tetsuya Kitaguchi
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8503, Japan.
| | - Takashi Tsuboi
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan; Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan.
| |
Collapse
|
23
|
Kurose R, Satoh T, Murakami K, Kurose A, Satoh YI, Ishibashi Y, Ishida K, Ogasawara K, Morikawa A, Sawai T. AB0045 THE RELATIONSHIP BETWEEN CD14 AND VIMENTIN-POSITIVE SYNOVIAL DENDRITIC-SHAPED CELLS AND SYNOVITIS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Inflammation in rheumatoid arthritis (RA) is caused by multiple cell types, including infiltrating inflammatory cells, such as lymphocytes, neutrophils, macrophages, and spindle-shaped fibroblasts. Especially, we are focusing on fibroblast-like synoviocytes (FLSs). In our previous study, we have reported that FLSs were positive for multiple markers including CD14, CD68 and HLA-DR, and were dendritic-shaped cells constituting nursing phenomenon between lymph or plasma cells. In addition, in our recent study, we found that CD14+FLSs were positive for vimentin (VIM), which is a marker for mesenchymal cells. There are still many issues to be discussed regarding CD14+VIM+ cells.Objectives:To investigate the relationship between CD14+VIM+ cells and the degree of synovitis in rheumatoid arthritis.Methods:Synovial tissues collected from RA patients who underwent joint surgeries were prepared for this study. First, the proportions of CD14+ cells in RA synovial tissue and control were analyzed using flow cytometry and the concentrations of inflammatory cytokines released by CD14+ cells in RA synovial tissue and control were examined by ELISA. Next, the proportions of CD14+VIM+ cells in RA synovial tissue and control were examined immunohistologically and then we analyzed the results using image analysis software. Also, we statistically analyzed the relationship between the proportion of CD14+VIM+ cells, the degree of synovitis, and clinical data.Results:Results of flow cytometry showed that CD14+ cells were frequently observed in RA synovial tissue than control. Cultured CD14+ cells released more inflammatory cytokines than cultured CD14- cells. Also, results of immunohistological staining showed that many CD14+VIM+ cells were observed in RA synovial tissue than in control. The proportion of CD14+VIM+ cells was correlated with Krenn synovitis score. High proportion cases significantly showed high level of CRP and MMP-3.Conclusion:CD14+VIM+ cells might be involved in the mechanism of chronic immunological inflammation in RA and the proportion of these cells might influence the clinical data.References:[1]Ochi T, Yoshikawa H, Toyosaki-Maeda T, Lipsky PE. Mesenchymal stromal cells. Nurse-like cells reside in thesynovial tissue and bone marrow in rheumatoid arthritis. Arthritis Research&Therapy 2007; 9(1): 201.[2]Ochi T, Sawai T, Murakami K, Kamataki A, Uzuki M, Tomita T, et al. Nurse-like cells in rheumatoid arthritis: Formation of survival niches cooperating between the cell types. Mod Rheum 2018; 29: 1-5.[3]Krenn V, Morawietz L, Burmester GR, Kinne RW, Muller-Ladner U, Muller B, Haupl T. Synovitis score: discrimination between chronic low-grade and high-grade synovitis. Histopathology 2006; 49: 358-64.Disclosure of Interests:None declared
Collapse
|
24
|
Katagiri K, Ozaki N, Ohmura S, Albertazzi B, Hironaka Y, Inubushi Y, Ishida K, Koenig M, Miyanishi K, Nakamura H, Nishikino M, Okuchi T, Sato T, Seto Y, Shigemori K, Sueda K, Tange Y, Togashi T, Umeda Y, Yabashi M, Yabuuchi T, Kodama R. Liquid Structure of Tantalum under Internal Negative Pressure. Phys Rev Lett 2021; 126:175503. [PMID: 33988455 DOI: 10.1103/physrevlett.126.175503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/09/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
In situ femtosecond x-ray diffraction measurements and ab initio molecular dynamics simulations were performed to study the liquid structure of tantalum shock released from several hundred gigapascals (GPa) on the nanosecond timescale. The results show that the internal negative pressure applied to the liquid tantalum reached -5.6 (0.8) GPa, suggesting the existence of a liquid-gas mixing state due to cavitation. This is the first direct evidence to prove the classical nucleation theory which predicts that liquids with high surface tension can support GPa regime tensile stress.
Collapse
Affiliation(s)
- K Katagiri
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - N Ozaki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Ohmura
- Research Center for Condensed Matter Physics, Department of Environmental and Civil Engineering, Hiroshima Institute of Technology, Hiroshima 731-5193 Japan
| | - B Albertazzi
- LULI, CNRS, CEA, Ecole Polytechnique, UPMC, Université Paris 06: Sorbonne Universites, Institut Polytechnique de Paris, F-91128 Palaiseau cedex, France
| | - Y Hironaka
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
- Open and Transdisciplinary Research Initiative, OTRI, Osaka University, Osaka 565-0871, Japan
| | - Y Inubushi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - K Ishida
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - M Koenig
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
- LULI, CNRS, CEA, Ecole Polytechnique, UPMC, Université Paris 06: Sorbonne Universites, Institut Polytechnique de Paris, F-91128 Palaiseau cedex, France
| | - K Miyanishi
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - H Nakamura
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - M Nishikino
- Kansai Photon Science Institute, National Institutes for Quantum and Radiological Science and Technology, Kyoto 619-0215, Japan
| | - T Okuchi
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Osaka 590-0494, Japan
| | - T Sato
- Graduate School of Science, Hiroshima University, Hiroshima 739-8526, Japan
| | - Y Seto
- Graduate School of Science, Kobe University, Hyogo 657-0013, Japan
| | - K Shigemori
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Sueda
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Y Tange
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - T Togashi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Y Umeda
- Institute for Planetary Materials, Okayama University, Tottori 682-0193, Japan
| | - M Yabashi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - T Yabuuchi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - R Kodama
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| |
Collapse
|
25
|
Komatsu H, Ishida K, Matsui Y, Amano S, Hashimoto M, Sasaki A. Treatment strategy for locally advanced breast cancer in our department. Breast 2021. [DOI: 10.1016/s0960-9776(21)00151-x] [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: 10/21/2022] Open
|
26
|
Miyazaki S, Hasegawa K, Mukai M, Aoyama D, Nodera M, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Ishida K, Uzui H, Tada H. Superior vena cava isolation using a novel ablation catheter incorporating local impedance monitoring. J Interv Card Electrophysiol 2021; 64:291-300. [PMID: 33755817 DOI: 10.1007/s10840-021-00980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND A novel technology able to measure the local impedance (LI) during radiofrequency ablation has become available for clinical use. We investigated the change in the LI characteristics during superior vena cava isolations (SVCIs) using a novel catheter equipped with mini-electrodes. METHODS Twenty paroxysmal atrial fibrillation patients (68 ± 9 years; 14 males) underwent an SVCI by targeting breakthroughs. Subsequently, dormant conduction provoked by adenosine triphosphate (ATP) was evaluated. RESULTS Electrical SVCIs were successfully achieved in all with 7.2 ± 3.0 radiofrequency applications (RFA) without any complications. The procedure and fluoroscopic times were 13.1 ± 8.1 and 2.8 ± 2.3 min. No ablation was required at the anteroseptal SVC in 19 (95.0%) patients. The baseline LI and generator impedance (GI) were 125 ± 23 and 105 ± 14Ω. LI drops during RFA were significantly greater than GI drops (17 ± 12 vs. 4 ± 4Ω, p < 0.001). The correlation between the LI drops and GI drops was relatively high (R = 0.69, p < 0.001). LI drops were highest at the septal SVC and lowest at the lateral followed by antero-lateral SVC. The baseline electrogram amplitude between the mini-electrodes and tip-ring electrodes was 1.2 ± 1.4 and 0.8 ± 0.6 mV. The mini-electrode amplitude is more sharply attenuated with a greater magnitude than the tip-ring amplitude (p < 0.001). ATP-provoked dormant conduction was exposed in 10/17 (58.8%) patients and antero-lateral SVC gap locations in 7. Antero-lateral SVC LI drops were similar between patients with and without dormancy. CONCLUSIONS The LI drop magnitude during RFA significantly differed among the SVC segments. Antero-lateral SVC ATP-provoked dormant conduction was often exposed, and additional applications are recommended following the isolation for a robust SVCI.
Collapse
Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| |
Collapse
|
27
|
Miyazaki S, Hasegawa K, Ishikawa E, Mukai M, Aoyama D, Nodera M, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Tada H. The mechanisms of left septal and anterior wall reentrant atrial tachycardias analyzed with ultrahigh resolution mapping: The role of functional block in the circuit. J Cardiovasc Electrophysiol 2021; 32:1305-1319. [PMID: 33682247 DOI: 10.1111/jce.14983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/04/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Low voltage areas (LVAs) are most commonly observed on the left atrial (LA) septal/anterior wall. OBJECTIVE We explored the mechanisms of LA septal/anterior wall reentrant tachycardias (LASARTs) using ultrahigh resolution mapping. METHODS This study included seven consecutive LASARTs in six patients (75 [62.2-82.8] years, 4 women) who underwent atrial tachycardia (AT) mapping and ablation using Rhythmia systems. RESULTS The AT cycle length was 266 (239-321) ms. During ATs, 11.0 (9.0-12.9) cm2 of LVAs were identified in all, and 0.8 (0.7-1.7) cm2 of dense scar was identified in four patients. Five ATs rotated around dense scar, while two rotated around functional linear block, which was confirmed during atrial pacing after AT termination. The AT circuit length was 8.7 ± 2.1 cm with a conduction velocity of 30.4 ± 3.7 cm/s. A median of 3.0 (2.0-4.0) slow conduction areas per circuit were identified, and 17/23 (73.9%) areas were present in LVAs, while they were at the border of the LVA and normal voltage areas in the remaining 6/23 (26.1%). Global activation histograms facilitated the identification of the critical isthmus in all. Tailor-made ablation at critical isthmuses successfully eliminated all ATs. However, one patient with AT related to functional linear block experienced recurrent AT related to dense scar, which progressed after the procedure. During a mean 14 ± 13 month follow-up after the last procedure, no patients experienced recurrent ATs without any complications. CONCLUSION LASARTs consist of not only fixed conduction blocks but also functional conduction blocks. Ultrahigh resolution mapping is highly useful to decide the optimal tailor-made ablation strategy based on the mechanisms.
Collapse
Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
28
|
Hasegawa K, Ito H, Kaseno K, Miyazaki S, Shiomi Y, Tama N, Ikeda H, Ishida K, Uzui H, Ohno S, Horie M, Yokoyama O, Tada H. Impact of Medical Castration on Malignant Arrhythmias in Patients With Prostate Cancer. J Am Heart Assoc 2021; 10:e017267. [PMID: 33599136 PMCID: PMC8174268 DOI: 10.1161/jaha.120.017267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/06/2023]
Abstract
Background Medical castration, gonadotropin‐releasing hormone agonists, and antiandrogens have been widely applied as a treatment for prostate cancer. Sex steroid hormones influence cardiac ion channels. However, few studies have examined the proarrhythmic properties of medical castration. Methods and Results This study included 149 patients who underwent medical castration using gonadotropin‐releasing hormones with/without antiandrogen for prostate cancer. The changes in the ECG findings during the therapy and associations of the electrocardiographic findings with malignant arrhythmias were studied. The QT and corrected QT (QTc) intervals prolonged during the therapy compared with baseline (QT, 394±32 to 406±39 ms [P<0.001]; QTc, 416±27 to 439±31 ms [P<0.001]). The QTc interval was prolonged in 119 (79.9%) patients during the therapy compared with baseline. In 2 (1.3%) patients who had no structural heart disease, torsade de pointes (TdP) and ventricular fibrillation (VF) occurred ≥6 months after starting the therapy. In patients with TdP/VF, the increase in the QTc interval from the pretreatment value was >80 ms. However, in patients without TdP/VF, the prevalence of an increase in the QTc interval from the pretreatment value of >50 ms was 11%, and an increase in the QTc interval from the pretreatment value >80 ms was found in only 4 (3%) patients. Conclusions Medical castration prolongs the QT/QTc intervals in most patients with prostate cancer, and it could cause TdP/VFs even in patients with no risk of QT prolongation before the therapy. An increase in the QTc interval from the pretreatment value >50 ms might become a predictor of TdP/VF. Much attention should be paid to the QTc interval throughout all periods of medical castration to prevent malignant arrhythmias.
Collapse
Affiliation(s)
- Kanae Hasegawa
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Hideaki Ito
- Department of Urology Faculty of Medical Science University of Fukui Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine Shiga University of Medical Science Otsu Japan
| | - Osamu Yokoyama
- Department of Urology Faculty of Medical Science University of Fukui Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine Faculty of Medical Science University of Fukui Japan
| |
Collapse
|
29
|
Miyazaki S, Hasegawa K, Mukai M, Aoyama D, Nodera M, Shiomi Y, Tama N, Ikeda H, Ishida K, Uzui H, Tada H. The advantages and disadvantages of the novel fourth-generation cryoballoon as compared to the second-generation cryoballoon in the current short freeze strategy. J Interv Card Electrophysiol 2021; 63:143-152. [PMID: 33575920 DOI: 10.1007/s10840-021-00957-5] [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: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The novel fourth-generation cryoballoon (4th-CB) is characterized by a shorter-tip that potentially facilitates better time-to-isolation (TTI) monitoring. We sought to clarify the advantages and disadvantages of the 4th-CB compared to the second-generation cryoballoon (2nd-CB) in pulmonary vein isolation (PVI). METHODS Forty-one and 49 consecutive atrial fibrillation patients underwent 2nd-CB and 4th-CB PVIs using 28-mm balloons and short freeze strategies. When effective freezing was not obtained, the CB was switched to the other CB. RESULTS The rate of successful PVIs was significantly higher for 2nd-CBs than 4th-CBs (162/162[100%] vs. 178/193[92.2%] PVs, p < 0.0001). The difference was significant for lower PVs, especially right inferior PVs (RIPVs)(p = 0.005). In a total of 15 PVs in 11 patients, 4th-CBs were switched to 2nd-CBs, and 14/15(93.3%) PVs were successfully isolated. The balloon temperature tended to reach -55℃ more frequently with 2nd-CBs than 4th-CBs during RIPV ablations (15/41[36.6%] vs. 12/49[24.5%], p = 0.21). The TTI monitoring capability was significantly higher with 4th-CBs than 2nd-CBs (131/188[69.7%] vs. 83/160[51.9%] PVs, p = 0.0007). The difference was significant for right superior and left inferior PVs, but not for left superior PVs. Even if PVs requiring crossover were excluded, the total freeze duration (715±152 vs. 755±215 seconds, p = 0.31) tended to be shorter for 2nd-CBs than 4th-CBs. The incidence of phrenic nerve injury was similar for 2nd-CB and 4th-CB ablation (0/41 vs. 2/49, p = 0.12) CONCLUSIONS: The 4th-CB's shorter balloon tip enabled a significantly higher capability of TTI monitoring; however, it resulted in significantly lower rates of successful PVIs than the 2nd-CB, especially for the RIPVs.
Collapse
Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| |
Collapse
|
30
|
Kaseno K, Hasegawa K, Miyazaki S, Mukai M, Aoyama D, Nodera M, Hirano K, Otake M, Nomura R, Miyahara K, Ishikawa R, Matsui A, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Tada H. Discrepancy between CARTO and Rhythmia maps for defining the left atrial low-voltage areas in atrial fibrillation ablation. Heart Vessels 2021; 36:1027-1034. [PMID: 33507357 DOI: 10.1007/s00380-021-01773-7] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/08/2021] [Indexed: 11/25/2022]
Abstract
Reported mapping procedures of left atrial (LA) low-voltage areas (LVAs) vary widely. This study aimed to compare the PentaRay®/CARTO®3 (PentaRay map) and Orion™/Rhythmia™ (Orion map) systems for LA voltage mapping. This study included 15 patients who underwent successful pulmonary vein isolation (PVI) for atrial fibrillation. After PVI, PentaRay and Orion maps created for all patients were compared. LVAs were defined as sites with ≥ 3 adjacent low-voltage points < 0.5 mV. LVAs were indicated in 8 (53%) among 15 patients, and the average values of the measured LVAs was comparable between the systems (PentaRay map = 5.4 ± 8.7 cm2; Orion map = 4.3 ± 6.4 cm2, p = 0.69). However, in 2 of 8 patients with LVAs, the Orion map indicated LVAs at the septum and posterolateral sites of the LA, respectively, whereas the PentaRay map indicated no LVAs. In those patients, sharp electrograms of > 0.5 mV were properly recorded at the septum and posterolateral sites during appropriate beats in the PentaRay map. The PentaRay map had a shorter procedure time than the Orion map (12 ± 3 min vs. 23 ± 8 min, respectively; p < 0.01). Our study results showed a discrepancy in the LVA evaluation between the PentaRay and Orion maps. In 2 of 15 patients, the Orion map indicated LVAs at the sites where > 0.5-mV electrograms were properly recorded in the PentaRay map.
Collapse
Affiliation(s)
- Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan.
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Koudai Hirano
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Mika Otake
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Ryouhei Nomura
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Kousuke Miyahara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Rie Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Akira Matsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, yoshida-gun, Fukui, 910-1193, Japan
| |
Collapse
|
31
|
Sato Y, Uzui H, Aiki Y, Aoyama D, Yamaguchi J, Nodera M, Shiomi Y, Hasegawa K, Ikeda H, Tama N, Fukuoka Y, Morishita T, Ishida K, Miyazaki S, Tada H. Effects of PCSK9 inhibitor on adverse limb outcomes in patients with critical limb ischemia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2375] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9-I), evolocumab, reduced the risk of cardiovascular event in patients with peripheral artery disease in FOURIER trial. However, the effects of evolocumab on favorable limb outcomes in patients with critical limb ischemia (CLI) is still unclear.
Purpose
The aim of this study was to evaluate the impacts of evolocumab on favorable limb outcomes and lipid profile in patients with CLI.
Methods
This was a single center, prospective observational study. A total of 39 patients with CLI were enrolled between November 2016 to May 2019. The subjects were divided into 2 groups based on evolocumab administration: evolocumab-treated group: E group (mean 69.4±11.7 years, n=14) and evolocumab non-treated group: Non-E group (mean 74.0±8.8 years, n=25). Baseline characteristics were assessed at admission. Lipid profile was evaluated at admission, 1, 3, 6, 12 and 18 months. The primary outcome was defined 18-month amputation-free survival (AFS). The secondary outcomes were defined 18-month overall survival (OS) and wound-free limb salvage. Mean follow-up period was 18±11 months.
Results
The patients in E group had greater reduction in levels of LDL cholesterol and non-HDL cholesterol than those in Non-E group over time. The reduction in MDA-LDL level was maintained at 1, 3, 6, 12 months, respectively. The 18-month AFS rate in the E-group was significantly higher than those in the Non-E group (log-rank p=0.02). The patients receiving evolocumab had a lower hazard regarding AFS (hazard ratio, 0.12; 95% confidence interval, 0.02–0.94; P=0.043) and a higher proportion of wound-free limb salvage at 12 months (E group [92%] vs Non-E group [57%], P=0.034) and 18 months (92% vs 52%, P=0.03). Otherwise, evolocumab administration was not associated with 18-month OS (log-rank p=0.053).
Conclusions
Evolocumab administration may be associated with the favorable outcome of 18-month AFS in the patients with CLI. Additionally, long-term administration of evolocumab over 12 months may improve wound-free limb salvage.
Effects of evolocumab on limb outcomes
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- Y Sato
- University of Fukui, Fukui, Japan
| | - H Uzui
- University of Fukui, Fukui, Japan
| | - Y Aiki
- University of Fukui, Fukui, Japan
| | - D Aoyama
- University of Fukui, Fukui, Japan
| | | | - M Nodera
- University of Fukui, Fukui, Japan
| | - Y Shiomi
- University of Fukui, Fukui, Japan
| | | | - H Ikeda
- University of Fukui, Fukui, Japan
| | - N Tama
- University of Fukui, Fukui, Japan
| | | | | | - K Ishida
- University of Fukui, Fukui, Japan
| | | | - H Tada
- University of Fukui, Fukui, Japan
| |
Collapse
|
32
|
Miyazaki S, Ishikawa E, Mukai M, Aoyama D, Nodera M, Hasegawa K, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Tada H. Ultra-high resolution mapping and ablation of accessory pathway conduction. J Interv Card Electrophysiol 2020; 62:309-318. [PMID: 33098524 DOI: 10.1007/s10840-020-00900-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/24/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Detailed mapping studies of accessory pathway (AP) conduction have not been previously performed using ultra-high resolution mapping systems. We sought to evaluate the clinical utility of ultra-high resolution mapping systems and the novel "Lumipoint" algorithm in AP ablation. METHODS This study included 17 patients who underwent AP mapping using minielectrode basket catheters and Rhythmia systems. Ablation was performed with 4-mm irrigated-tip catheters. RESULTS Antegrade and retrograde AP conduction was observed in 6 and 16 patients. Atrial activation map was obtained during orthodromic tachycardia and ventricular pacing in 13 (76.5%) and 14 (82.3%) patients, and the earliest activation area was identical. Ventricular activation maps were created during atrial pacing in 3 patients. All maps showed focal activation patterns on global activation histograms, and the valley on the histogram highlighted the earliest activation area. "Complex activation" features further highlighted limited areas with continuous electrical activity during the time period in the majority. APs were located at the mitral and tricuspid annuli in 15 and 2 patients, and all were successfully eliminated with 3.4 ± 0.6 s applications. No patients had recurrences during a median follow-up of 15 [10.5-22.5] months. At successful ablation sites, the local atrial and ventricular electrogram amplitudes and ratio tended to be greater, and fusion or continuous electrical activity between the atrial and ventricular components was more frequently observed on the minielectrode than ablation catheter (17/17 vs. 12/17, p = 0.005). CONCLUSIONS Ultra-high resolution activation mapping and a novel algorithm facilitated the AP localization. The local electrogram characteristics differed between the minielectrode and ablation catheters.
Collapse
Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| |
Collapse
|
33
|
Miyazaki S, Hasegawa K, Yamao K, Ishikawa E, Mukai M, Aoyama D, Nodera M, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Iesaka Y, Tada H. Mapping and ablation of clinical spontaneous perimitral atrial tachycardias using an ultra-high-resolution mapping system. Heart Rhythm 2020; 18:189-198. [PMID: 33007441 DOI: 10.1016/j.hrthm.2020.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/19/2020] [Accepted: 09/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Perimitral atrial tachycardias (PMATs) are common atrial tachycardias (ATs), yet their mechanisms vary. OBJECTIVE The purpose of this study was to characterize clinical spontaneous PMATs using an ultra-high-resolution (UHR) mapping system. METHODS The study included 32 consecutive PMATs in 31 patients who had undergone AT mapping/ablation using a UHR mapping system. RESULTS Six, 10, 11, and 5 PMATs occurred in cardiac intervention-naïve (group A), post-lateral/posterior mitral isthmus linear ablation (group B), post-atrial fibrillation ablation without mitral isthmus linear ablation (group C), and post-cardiac surgery (group D) patients, respectively. Group A patients tended to be older, more likely were female, and had sinus node or atrioventricular conduction disturbances more frequently. A 12-lead synchronous isoelectric interval was observed in 15 PMATs (46.9%). Coronary sinus activation was proximal to distal or distal to proximal except in 3 PMATs with straight patterns due to epicardial gaps. Left atrial anterior/septal wall (LAASW) low-voltage areas were smallest in group B. Slow conduction areas (SCAs) were identified in 26 PMATs (81.2%) and were located on the LAASW in all group A and group D patients. Conduction velocity in the SCAs was slowest in group B. In group B, all PMATs were terminated by single applications, and the gaps were located epicardially in 5 of 10 (50%). Anterior (n = 23) or lateral/posterior (n = 9) mitral isthmus linear block was successfully created without any complications in all. Twenty-five concomitant ATs among 18 patients (58.1%) also were eliminated. During a median of 20.0 (11.0-40.0) months of follow-up, 28 patients (90.3%) were free from any atrial tachyarrhythmias. CONCLUSION An UHR mapping-guided approach with identification of the individual tachycardia mechanism should be the preferred strategy given the distinct and complex arrhythmia mechanisms.
Collapse
Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan.
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Kazuya Yamao
- Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| | - Yoshito Iesaka
- Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan
| |
Collapse
|
34
|
Sato Y, Uzui H, Morishita T, Fukuoka Y, Hasegawa K, Ikeda H, Tama N, Ishida K, Miyazaki S, Tada H. Effects of PCSK9 Inhibitor on Favorable Limb Outcomes in Patients with Chronic Limb-Threatening Ischemia. J Atheroscler Thromb 2020; 28:754-765. [PMID: 32981918 PMCID: PMC8265925 DOI: 10.5551/jat.57653] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim:
The aim of this study was to examine the effects of evolocumab on favorable limb events in patients with chronic limb-threatening ischemia (CLTI).
Methods:
A single-center, prospective observational study was performed on 30 patients with CLTI. The subjects were divided into 2 groups based on evolocumab administration: evolocumab-treated (E) group (
n
=14) and evolocumab non-treated (non-E) group (
n
=16). The primary outcome was 12-month freedom from major amputation. The secondary outcomes were 12-month amputation-free survival (AFS), overall survival (OS), and wound-free limb salvage. The mean follow-up period was 18±11 months.
Results:
No significant difference was detected between the two groups for the 12-month freedom from major amputation (log-rank
p
=0.15), while the 12-month AFS rate was significantly higher in the E group than that in the non-E group (log-rank
p
=0.02). The 12-month OS rate in the E group was shown a tendency for improvement, as compared with that in the non-E group (log-rank
p
=0.056). Evolocumab administration was not associated with a significant change in freedom from major amputation (HR, 0.23, 95% CI, 0.03-2.07,
p
=0.19). However, evolocumab administration was related to a tendency for improvement of AFS and OS (HR, 0.13, 95% CI, 0.02-1.06,
p
=0.056; HR, 0.16, 95% CI, 0.02-1.37,
p
=0.09, respectively). Moreover, The E group had a higher proportion of wound-free limb salvage at 12 months (92% vs. 42%,
p
=0.03).
Conclusion:
Evolocumab administration was associated with a better AFS outcome in patients with CLTI. Long-term administration of evolocumab over 12 months contributed to improving proportion of wound-free limb salvage.
Collapse
Affiliation(s)
- Yusuke Sato
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| |
Collapse
|
35
|
Arai S, Lloyd K, Takahashi T, Mammoto K, Miyazawa T, Tamura K, Kaneko T, Ishida K, Moriyama Y, Mitsui T. Dynamic Properties of Heart Fragments from Different Regions and Their Synchronization. Bioengineering (Basel) 2020; 7:E81. [PMID: 32751255 PMCID: PMC7552607 DOI: 10.3390/bioengineering7030081] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/17/2020] [Accepted: 07/23/2020] [Indexed: 12/29/2022] Open
Abstract
The dynamic properties of the heart differ based on the regions that effectively circulate blood throughout the body with each heartbeat. These properties, including the inter-beat interval (IBI) of autonomous beat activity, are retained even in in vitro tissue fragments. However, details of beat dynamics have not been well analyzed, particularly at the sub-mm scale, although such dynamics of size are important for regenerative medicine and computational studies of the heart. We analyzed the beat dynamics in sub-mm tissue fragments from atria and ventricles of hearts obtained from chick embryos over a period of 40 h. The IBI and contraction speed differed by region and atrial fragments retained their values for a longer time. The major finding of this study is synchronization of these fragment pairs physically attached to each other. The probability of achieving this and the time required differ for regional pairs: atrium-atrium, ventricle-ventricle, or atrium-ventricle. Furthermore, the time required to achieve 1:1 synchronization does not depend on the proximity of initial IBI of paired fragments. Various interesting phenomena, such as 1:n synchronization and a reentrant-like beat sequence, are revealed during synchronization. Finally, our observation of fragment dynamics indicates that mechanical motion itself contributes to the synchronization of atria.
Collapse
Affiliation(s)
- Shin Arai
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Kento Lloyd
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Tomonori Takahashi
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Kazuki Mammoto
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Takashi Miyazawa
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Kei Tamura
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Tomoyuki Kaneko
- Department of Frontier Bioscience, Hosei University, Koganei, Tokyo 184-8584, Japan;
| | - Kentaro Ishida
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Yuuta Moriyama
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| | - Toshiyuki Mitsui
- Department of Physics and Mathematics, College of Science and Engineering, Aoyama Gakuin University, Kanagawa 252-5258, Japan; (S.A.); (K.L.); (T.T.); (K.M.); (T.M.); (K.T.); (K.I.); (Y.M.)
| |
Collapse
|
36
|
Hisazaki K, Hasegawa K, Kaseno K, Miyazaki S, Aoyama D, Mukai M, Nodera M, Shiomi Y, Tama N, Ikeda H, Ishida K, Uzui H, Tada H. Idiopathic right ventricular arrhythmias requiring additional ablation from the left-sided outflow tract: ECG characteristics and efficacy of an anatomical approach. J Cardiovasc Electrophysiol 2020; 31:2653-2664. [PMID: 32639637 DOI: 10.1111/jce.14658] [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: 04/25/2020] [Revised: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Despite the characteristic electrocardiogram (ECG) findings of early activation during ventricular tachyarrhythmias (VAs) and/or excellent pacemapping in the right ventricular outflow tract (RVOT), some VAs may require additional, left-sided ablation for a cure. METHODS AND RESULTS This study included five patients with idiopathic VAs whose QRS morphologies were highly suggestive of an RVOT origin. The ECG characteristics and intracardiac electrocardiograms during catheter ablation were assessed. In all patients, the clinical VAs had an LBBB QRS morphology and inferior axis with a precordial R/S transition through leads V3-V5, and negative components in lead I. The earliest activation during the VAs (local electrogram-QRS interval = -34 ± 6.8 ms) and excellent pacemapping were obtained at the posterior portion of the RVOT just beneath the pulmonary valve. However, ablation at those sites failed, and the QRS morphology of the VAs changed. During left-sided OT mapping, the earliest activation was found at sites just contralateral to the initially ablated sites of the RVOT (junction of the left and right coronary cusps = 2, left coronary cusp = 3). In spite of the late activation time and poor pacemapping scores, catheter ablation at those sites cured the VAs. Those successful sites were also near the transitional zone from the great cardiac vein to the anterior interventricular vein (GCV-AIV). CONCLUSIONS Some VAs, highly suggestive of having RVOT origins, require catheter ablation in the left-sided OT near the initially ablated RVOT site. Those VAs have the same ECG characteristics and might have intramural origins in the superobasal LV surrounded by the RVOT, LVOT, and GCV-AIV.
Collapse
Affiliation(s)
- Kaori Hisazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| |
Collapse
|
37
|
Ishikawa E, Miyazaki S, Mukai M, Aoyama D, Nodera M, Hasegawa K, Kaseno K, Miyahara K, Matsui A, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Tada H. Femoral vascular complications after catheter ablation in the current era: The utility of computed tomography imaging. J Cardiovasc Electrophysiol 2020; 31:1385-1393. [PMID: 32249492 DOI: 10.1111/jce.14468] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few studies have examined the characteristics of catheter ablation vascular complications, and recently physicians increasingly use computed tomography angiography (CTA) for diagnosing. OBJECTIVE We sought to investigate the incidence of femoral vascular complications in catheter ablation and factors associated with complications in the current era. METHODS This single-center observational study consisted of 311 consecutive (atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, and ventricular arrhythmias in 222 [71.4%], 7 [2.3%], 43 [13.8%], and 39 [12.5%]) patients who underwent catheter ablation. The detailed patient data and clinical outcomes were obtained from the medical records. RESULTS Emergent CTA was performed in a total of 8 (2.6%) patients at a median of 4.5 (2.0-12.5) days postprocedure, and the precise diagnosis was obtained in all. Among them, pseudoaneurysms, arteriovenous fistulae (AVF), and actively bleeding hematomas were identified in two, one, and one patient, respectively, and all required readmissions after discharge. AVF was diagnosed by a Doppler ultrasound examination in another patient. In total, 5 (1.6%) patients exhibited major femoral vascular complications including two pseudoaneurysms, two AVFs, and one active bleeding hematoma. The pseudoaneurysms and AVFs were successfully eliminated by direct compression, and extravasation from the femoral circumflex artery required coil embolization. Antiplatelet therapy and the use of larger arterial sheaths (≥7-Fr) increased the major femoral arterial complications, but atrial fibrillation ablation under uninterrupted anticoagulation therapy or the use of larger venous sheaths did not. CONCLUSION Vascular complications are still not negligible procedure-related complications during catheter ablation in the current era. CTA provides a rapid and precise diagnosis for optimal treatment strategies.
Collapse
Affiliation(s)
- Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kosuke Miyahara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akira Matsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
38
|
Aoyama D, Miyazaki S, Hasegawa K, Kaseno K, Ishikawa E, Mukai M, Nodera M, Miyahara K, Matsui A, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter. J Am Heart Assoc 2020; 9:e015126. [PMID: 32200728 PMCID: PMC7428643 DOI: 10.1161/jaha.119.015126] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Left ventricular (LV) systolic dysfunction is reversible in some patients once the arrhythmia is controlled. However, identifying this arrhythmia‐induced cardiomyopathy among patients with LV systolic dysfunction is challenging. We explored the factors predicting the reversibility of the LV ejection fraction (LVEF) after catheter ablation of atrial fibrillation and/or atrial flutter in patients with LV systolic dysfunction. Methods and Results Forty patients with a reduced LVEF (LVEF <50%; 66.2±10.7 years; 32 men) who underwent atrial fibrillation/atrial flutter ablation were included. Transthoracic echocardiography was performed before and during the early (<4 days) and late phases (>3 months) after the ablation. Responders were defined as having a normalized LVEF (≥50%) during the late phase after the ablation. The LVEF improved from 39.8±8.8 to 50.9±10.9% at 1.2±0.6 days after the procedure, and to 56.2±12.2% at 9.6±8.0 months after the procedure (both for P<0.001). Thirty (75.0%) patients were responders. The preprocedural echocardiographic parameters were comparable between the responders and nonresponders. In the multivariate analysis, the preprocedural high‐sensitivity troponin T was the only independent predictor of the recovery of the LV dysfunction during the late phase after ablation (odds ratio, 1.17; 95% CI, 1.06–1.33; P=0.001), and a level of ≤12 pg/mL predicted recovery of the LV dysfunction with a high accuracy (sensitivity, 90.0%; specificity, 76.7%; positive predictive value, 56.3%; and negative predictive value, 95.8%). Conclusions Preprocedural high‐sensitivity troponin T levels might be a simple and useful parameter for predicting the reversibility of the LV systolic dysfunction after atrial fibrillation/atrial flutter ablation in patients with a reduced LVEF.
Collapse
Affiliation(s)
- Daisetsu Aoyama
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Eri Ishikawa
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Kosuke Miyahara
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Akira Matsui
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan
| |
Collapse
|
39
|
Mukai M, Miyazaki S, Hasegawa K, Ishikawa E, Aoyama D, Nodera M, Kaseno K, Miyahara K, Matsui A, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Ishida K, Uzui H, Tada H. Cryothermal atrial linear ablation in patients with atrial fibrillation: An insight from the comparison with radiofrequency atrial linear ablation. J Cardiovasc Electrophysiol 2020; 31:1075-1082. [PMID: 32108407 DOI: 10.1111/jce.14420] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/03/2020] [Accepted: 02/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Atrial linear lesions are generally created with radiofrequency energy. We sought to evaluate the feasibility of cryothermal atrial linear ablation. METHODS AND RESULTS Twenty-one atrial fibrillation (AF) patients underwent linear ablation on the left atrial (LA) roof, mitral isthmus (MI), and cavotricuspid isthmus (CTI) with 8-mm-tip cryocatheters following pulmonary vein isolation. The data were compared with those of 31 patients undergoing linear ablation with irrigated-tip radiofrequency catheters. Conduction block was successfully created in 18 of 20 (90%), 9 of 21 (43%), and 20 of 20 (100%) on the LA roof, MI, and CTI by endocardial cryoablation alone with 19.0 (12.0-24.0), 30.0 (23.0-34.0), and 14.0 (14.0-16.0) minute cryo applications, respectively. The presence of either an interposed circumflex artery or pouch at the MI was significantly associated with failed MI block (P = .04). Conduction block was created in 25 of 31 (83.9%), 27 of 31 (87.1%), and 30 of 31 (96.8%) on the roof, MI, and CTI, respectively, by radiofrequency ablation. During the 17.5 (13.0-31.7) months of follow-up, freedom from AF/atrial tachycardia (AT) was significantly higher in the cryo group (P = .05); especially, recurrent AT was more frequent in the RF group (8/31 vs 1/21; P = .03). Conduction block across the roof, MI, and CTI was durable in 6 of 12 (50.0%), 4 of 12 (33.3%), and 9 of 12 (75.0%) patients during second procedures. All nine patients (except one) with recurrent ATs had at least one roof or MI conduction resumption. CONCLUSIONS Cryoablation is effective for creating a roof and CTI linear block, however, creating MI block by endocardial ablation alone was often challenging. Conduction resumption of LA linear block is common and recurrent arrhythmias, especially iatrogenic ATs, are more frequently observed after radiofrequency linear ablation.
Collapse
Affiliation(s)
- Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kosuke Miyahara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akira Matsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
40
|
Aoyama D, Morishita T, Uzui H, Miyazaki S, Ishida K, Kaseno K, Hasegawa K, Fukuoka Y, Tama N, Ikeda H, Shiomi Y, Tada H. Sequential organ failure assessment score on admission predicts long-term mortality in acute heart failure patients. ESC Heart Fail 2020; 7:244-252. [PMID: 31905270 PMCID: PMC7083430 DOI: 10.1002/ehf2.12563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/09/2019] [Accepted: 11/04/2019] [Indexed: 12/27/2022] Open
Abstract
Aims The sequential organ failure assessment (SOFA) score has been a widely used predictor of outcomes in the intensive care unit, whereas short‐term and long‐term survivals of heart failure (HF) patients are predicted by the American Heart Association Get With the Guidelines–Heart Failure (GWTG‐HF) risk score. The purpose of present study was to examine whether the SOFA score on admission is more useful for predicting long‐term mortality in acute HF patients than the GWTG‐HF risk score. Methods and results A total of 269 patients (mean age, 78.5 ± 10.9 years; all‐cause mortality, 53.9%) seen in a single facility from January 2007 to December 2016 were enrolled retrospectively. They were followed up for a mean of 32.1 ± 22.3 months. All‐cause death was associated with higher SOFA and GWTG‐HF risk scores. However, no significant difference was observed in the area under the curve value between the scores. Kaplan–Meier survival analysis indicated that higher SOFA scores (P < 0.001) and GWTG‐HF risk scores (P < 0.001) were related to increased probabilities of all‐cause death. On multivariate Cox proportional hazard model analysis, the SOFA score (P < 0.001) and GWTG‐HF (P < 0.001) score were independent predictors of all‐cause death. Incorporating the SOFA score into the GWTG‐HF risk score yielded a significant net reclassification improvement and integrated discrimination improvement. On decision curve analysis, the net benefit of the SOFA score model when compared with the reference model was greater across the range of threshold probabilities. Conclusions In acute HF patients, long‐term all‐cause mortality can be predicted by the SOFA score. Discriminative performance metrics, such as net reclassification improvement, integrated discrimination improvement, and decision curve analysis, for predicting mortality were improved when the SOFA score was incorporated.
Collapse
Affiliation(s)
- Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
41
|
Aoyama D, Miyazaki S, Hasegawa K, Kaseno K, Ishikawa E, Mukai M, Miyahara K, Aiki T, Matsui A, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Feasibility of Uninterrupted Direct Oral Anticoagulants with Temporary Switching to Dabigatran ("Dabigatran Bridge") for Catheter Ablation of Atrial Fibrillation. Int Heart J 2019; 60:1315-1320. [DOI: 10.1536/ihj.19-143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kosuke Miyahara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Takayoshi Aiki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Akira Matsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Junya Yamaguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| |
Collapse
|
42
|
Muramatsu Y, Minami Y, Ishida K, Kato A, Katsura A, Sato T, Kakizaki R, Nemoto T, Hashimoto T, Fujiyoshi K, Meguro K, Shimohama T, Ako J. P686Cancer is not associated with increased cardiac and bleeding events after 2nd- and 3rd-generation drug-eluting stents implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous studies demonstrated the impact of concomitant cancer on the increased risk of adverse cardiac and bleeding events after percutaneous coronary intervention (PCI). However, the impact in this 2nd- and 3rd-generation drug-eluting stent (DES) era remains to be elucidated.
Purpose
To clarify the impact of cancer on clinical outcomes in patients after 2nd- or 3rd -generation DES implantation.
Methods
A total of 932 patients who underwent PCI with 2nd- or 3rd -generation DES were included. Patients who were diagnosed with cancer after PCI were excluded from the present cohort. The incidence of major adverse cardiac events (MACE) including cardiac death, myocardial infarction and target or non-target vessel revascularization, and bleeding events was compared between the patients with cancer or the history of treatment for cancer (cancer group, n=140) and the patients without cancer (no cancer group, n=792). Bleeding events were evaluated according to the Thrombolysis in Myocardial Infarction definition. Further comparisons were performed between the 2 groups (cancer group, n=126; no cancer group, n=252) after the adjustment of baseline clinical characteristics using 1:2 propensity score-matching analysis.
Results
The incidence of MACE at median 577 [340–1043] days after the PCI was comparable between the 2 groups in both unadjusted (15.0% vs. 15.0%, p=0.984) (Panel A) and adjusted cohorts (14.3 vs. 13.1%, p=0.796), although the incidence of all cause death in the cancer group was significantly greater than the no cancer group (15.1 vs. 9.5%, p=0.007, in the adjusted cohort). The increased risk of MACE was not observed in any types of cancer or treatment (Panel B). The incidence of bleeding events was also comparable between the 2 groups (4.0 vs. 2.0%, p=0.297, in the adjusted cohort).
Conclusion
The increased incidence of MACE and bleeding events in patients with cancer was not demonstrated after the 2nd- or 3rd-generation DES implantation. Further studies are required to clarify the safety and efficacy of PCI in patients with cancer.
Collapse
Affiliation(s)
- Y Muramatsu
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Y Minami
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Ishida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Kato
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Katsura
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Sato
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - R Kakizaki
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Nemoto
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Fujiyoshi
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Meguro
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Shimohama
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| |
Collapse
|
43
|
Masuda N, Ohtani S, Nagai S, Takashima S, Yamaguchi M, Tsuneizumi M, Komoike Y, Osako T, Ito Y, Ikeda M, Ishida K, Nakayama T, Takashima T, Asakawa T, Matsumoto S, Shimizu D, Takahashi M. Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer: Results of single arm phase IV COMACHI study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
44
|
Ishida K, Ohara N, Ercan A, Jang S, Trinh T, Kavvas ML, Carr K, Anderson ML. Impacts of climate change on snow accumulation and melting processes over mountainous regions in Northern California during the 21st century. Sci Total Environ 2019; 685:104-115. [PMID: 31174110 DOI: 10.1016/j.scitotenv.2019.05.255] [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: 03/28/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
A point-location-based analysis of future climate change impacts on snow accumulation and melting processes was conducted over three study watersheds in Northern California during a 90-year future period by means of snow regime projections. The snow regime projections were obtained by means of a physically-based snow model with dynamically downscaled future climate projections. Then, atmospheric and snow-related variables, and their interrelations during the 21st century were investigated to reveal future climate change impacts on snow accumulation and melting processes. The analysis shows large reductions in snow water equivalent (SWE), snowfall to precipitation (S/P) ratio, and snowmelt through the 21st century. Timing of the peak of the SWE and snowmelt will also change in the future. Meanwhile, the analysis in this study shows that air temperature rise will affect, but will not dominate the future change in snowmelt over the study watersheds. This result implies the importance of considering atmospheric variables other than air temperature, such as precipitation, shortwave radiation, relative humidity, and wind speed even if these variables will not clearly change during the 21st century.
Collapse
Affiliation(s)
- K Ishida
- Faculty of Advanced Science and Technology, Kumamoto University, 2-39-1 Kurokami, Kumamoto 860-8555, Japan.
| | - N Ohara
- Civil and Architectural Engineering, University of Wyoming, Laramie, WY 82071, USA.
| | - A Ercan
- J.Amorocho Hydraulics Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - S Jang
- Korea Institute of Water and Environment, Korea Water Resources Corporation, Daejeon 305-730, South Korea.
| | - T Trinh
- Hydrologic Research Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - M L Kavvas
- J.Amorocho Hydraulics Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA; Hydrologic Research Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - K Carr
- J.Amorocho Hydraulics Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - M L Anderson
- California Department of Water Resources, Division of Flood Management, 3310 El Camino Ave Rm 200, Sacramento, CA 95821, USA.
| |
Collapse
|
45
|
Morishita T, Uzui H, Ikeda H, Amaya N, Kaseno K, Ishida K, Fukuoka Y, Tada H. Effects of Sitagliptin on the Coronary Flow Reserve, Circulating Endothelial Progenitor Cells and Stromal Cell-derived Factor-1alpha. Intern Med 2019; 58:2773-2781. [PMID: 31243210 PMCID: PMC6815900 DOI: 10.2169/internalmedicine.2616-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective Circulating endothelial progenitor cells (EPCs) are regulated by stromal cell-derived factor-1alpha (SDF-1α) and are reduced in type 2 diabetes mellitus (DM). SDF-1α is a substrate of dipeptidyl-peptidase-4 (DPP-4), so we investigated whether or not DPP-4-inhibitors modulate EPC levels in type 2 DM patients with coronary artery disease (CAD). Methods Thirty patients with CAD and type 2 DM treated using an ordinary regimen were enrolled. EPC and SDF-1α levels were compared between those receiving additional 24-week treatment with a DPP-4-inhibitor (n=11) and no additional treatment (n=19). We determined the HbA1c, 1.5-Anhydro-D-glucitol (1,5-AG), coronary flow reserve (CFR), brain natriuretic peptide (BNP), E/e', and circulating EPC proportion and SDF-1α levels at baseline and the end of follow-up. The CFR was assessed using a dual-sensor-equipped guidewire. The primary endpoints were changes in the EPC count, SDF-1α levels, and CFR from baseline to the end of follow-up. The secondary endpoints were changes in the HbA1c and 1,5-AG, which are useful clinical markers of postprandial hyperglycemia, as well as the BNP and E/e'. Results After the 6-month follow-up, compared with ordinary regimen subjects, the patients receiving a DPP-4-inhibitor showed no significant increase in the EPC proportion (-0.01±0.50 vs. 0.02±0.77%, p=0.87), SDF-1α level (-600.4±653.6 vs. -283.2±543.1 pg/mL, p=0.18), or CFR (0.0±0.2 vs. 0.1±0.6, p=0.20), whereas both the 1.5-AG level (2.4±4.6 vs. -0.7±2.5 μg/dL, p=0.07) and HbA1c (-0.8±1.8 vs. 0.0±0.7%, p=0.02) were improved. There were no significant differences between the two groups in changes in the BNP and E/e'. Conclusion DPP-4 inhibition with sitagliptin did not increase or decrease the EPC proportion, SDF-1α level, or CFR, although the glycemic control was improved.
Collapse
Affiliation(s)
- Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Naoki Amaya
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| |
Collapse
|
46
|
Aoyama D, Morishita T, Yamaguchi J, Shiomi Y, Ikeda H, Tama N, Fukuoka Y, Hasegawa K, Kaseno K, Ishida K, Miyazaki S, Uzui H, Tada H. P6339Sequential organ failure assessment score on admission predicts long-time mortality of the patients with acute heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite the remarkable advances in the treatment options of acute heart failure (HF), prognosis assessment remains an ongoing challenge. Previous studies revealed only a moderate accuracy of models predicting mortality. Sequential Organ Failure Assessment (SOFA) Score are widely used in the intensive care unit (ICU) to predict outcome and predicted higher long-time mortality in unselected patients in cardiac ICU. In addition, the American Heart Association Get With the Guidelines–Heart Failure (GWTG-HF) risk score allows for risk stratification of 30-day outcome for patients hospitalized with HF. The purpose of this study was to evaluate whether SOFA score on admission is useful for long-time mortality prediction in acute HF patients and also to assess the discriminative performance as compared with GWTG-HF risk score.
Methods
This was a single-centre, retrospective cohort study. Between January 2007 and December 2016, we screened eligible 661 consecutive patients with acute HF administered at our hospital. SOFA score on admission of 294 patients was able to calculate retrospectively. We enrolled 269 patients who could complete follow up evaluation for more than 1 year. Endpoint was all-cause mortality after admission. Additive information of SOFA score was evaluated by area under the curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI) and decision curve analysis (DCA).
Results
The 269 patients were included in this study (78.5±10.9 years; 136 men; left ventricular ejection fraction [EF], 49.8±16.6%) during a mean follow-up of 32.1±22.3 months. Patients with all-cause death had higher SOFA score (4.2±2.3 versus 2.8±1.8, p<0.001; AUC, 0.689) and GWTG-HF risk score (44.0±7.6 versus 38.1±7.9, P<0.001, AUC, 0.692).
Kaplan-Meier survival analysis demonstrated higher SOFA scores (P<0.001) and GWTG-HF risk scores (P<0.001) appears to be related to increase probabilities of all cause death. A multivariate Cox proportional hazard model were made with adjustment for SOFA score, GWTG-HF risk score, age, gender and ejection fraction. As a result, SOFA score (hazard ratio [HR] 1.227; 95% confidence interval [CI], 1.130 to 1.326; P<0.001), GWTG-HF (HR, 1.054; 95% CI, 1.029 to 1.078; P<0.001) and age (HR, 1.069; 95% CI 1.048 to 1.092; P<0.001) were independent predictors of all cause death and HR of SOFA score was the highest in these parameters. Incorporating SOFA score into GWTG-HF score yielded a significant NRI (0.528 (95% CI 0.291 to 0.765) and IDI (0.046 (95% CI 0.020 to 0.072). In DCA, compared with the reference model, the net benefit for SOFA score model was greater across the range of threshold probabilities.
Conclusions
The SOFA score, simple and validated mortality risk score can predict long-term all-cause mortality in patients with acute HF. Discriminative performance metrics such as NRI, IDI and DCA were improved on incorporation of the SOFA score for prediction of mortality.
Collapse
Affiliation(s)
- D Aoyama
- University of Fukui Hospital, Fukui, Japan
| | | | | | - Y Shiomi
- University of Fukui Hospital, Fukui, Japan
| | - H Ikeda
- University of Fukui Hospital, Fukui, Japan
| | - N Tama
- University of Fukui Hospital, Fukui, Japan
| | - Y Fukuoka
- University of Fukui Hospital, Fukui, Japan
| | - K Hasegawa
- University of Fukui Hospital, Fukui, Japan
| | - K Kaseno
- University of Fukui Hospital, Fukui, Japan
| | - K Ishida
- University of Fukui Hospital, Fukui, Japan
| | - S Miyazaki
- University of Fukui Hospital, Fukui, Japan
| | - H Uzui
- University of Fukui Hospital, Fukui, Japan
| | - H Tada
- University of Fukui Hospital, Fukui, Japan
| |
Collapse
|
47
|
Kanda K, Fujimoto K, Mochizuki R, Ishida K, Lee B. Development and validation of the comprehensive assessment scale for chemotherapy-induced peripheral neuropathy in survivors of cancer. BMC Cancer 2019; 19:904. [PMID: 31506070 PMCID: PMC6734590 DOI: 10.1186/s12885-019-6113-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 08/30/2019] [Indexed: 12/13/2022] Open
Abstract
Background Appropriate assessment is essential for the management of chemotherapy-induced peripheral neuropathy (CIPN), an intractable symptom that cannot yet be palliated, which is high on the list of causes of distress for cancer patients. However, objective assessment by medical staff makes it easy to underestimate the symptoms and effects of CIPN in cancer survivors. As a result, divergence from subjective evaluation of cancer survivors is a significant problem. Therefore, there is an urgent need to develop a subjective scale with high accuracy and applicability that reflects the experiences of cancer patients. We developed a comprehensive assessment scale for CIPN in cancer survivors, named the Comprehensive Assessment Scale for Chemotherapy-Induced Peripheral Neuropathy in Survivors of Cancer (CAS-CIPN), and demonstrated its reliability and validity. Methods We developed a questionnaire based on qualitative studies of peripheral neuropathy in Japanese cancer patients and literature review. Twelve cancer experts confirmed the content validity of the questionnaire. A draft version comprising 40 items was finalized by a pilot test on 100 subjects. The participants in the present study were 327 Japanese cancer survivors. Construct validity was determined by factor analysis, and internal validity by confirmation factor analysis and Cronbach’s α. Results Factor analysis showed that the structure consisted of 15 items in four dimensions: “Threatened interference in daily life by negative feelings”, “Impaired hand fine motor skills”, “Confidence in choice of treatment/management,” and “Dysesthesia of the palms and soles.” The CAS-CIPN internal consistency reliability was 0.826, and the reliability coefficient calculated using the Spearman-Brown formula [q = 2r/(1 + r)] was 0.713, confirming high internal consistency and stability. Scores on this scale were strongly correlated with Gynecologic Oncology Group-Neurotoxicity scores (r = 0.714, p < 0.01), confirming its criterion-related validity. Conclusions The CAS-CIPN is an assessment tool with high reliability and validity for the comprehensive evaluation of CIPN in cancer survivors. The CAS-CIPN is simple to use, and can be used by medical professionals for appropriate situational assessment and intervention.
Collapse
Affiliation(s)
- K Kanda
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaoruimachi, Takasakishi, Gunma, 370-0033, Japan.
| | - K Fujimoto
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaoruimachi, Takasakishi, Gunma, 370-0033, Japan
| | - R Mochizuki
- The Jikei University School of Medicine, School of Nursing, 8-3-1, Kokuryocho, Chofu, Tokyo, 182-8570, Japan
| | - K Ishida
- Niigata College of Nursing, 240 Shinnancho, Joetsu, Nigata, 943-0147, Japan
| | - B Lee
- Department of Occupation, Gunma University Graduate School of Health Sciences, 3-39-22, Showamachi, Maebashi, Gunma, 371-8514, Japan
| |
Collapse
|
48
|
Sugiyama M, Fukaya T, Moon JY, Ishida K, Matsushita A, Kim SY, Yeo SH. Analysis and enhancement of the ethanol resistance of Pichia kudriavzevii N77-4, a strain newly isolated from the Korean traditional fermentation starter Nuruk, for improved fermentation performance. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1742-6596/1282/1/012062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
49
|
Hasegawa K, Miyazaki S, Kaseno K, Hisazaki K, Amaya N, Miyahara K, Aiki T, Ishikawa E, Mukai M, Matsui A, Aoyama D, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Pressure-guided second-generation cryoballoon pulmonary vein isolation: Prospective comparison of the procedural and clinical outcomes with the conventional strategy. J Cardiovasc Electrophysiol 2019; 30:1841-1847. [PMID: 31328311 DOI: 10.1111/jce.14080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 05/06/2019] [Revised: 06/05/2019] [Accepted: 06/13/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The utility of pressure waveform analyses to assess pulmonary vein (PV) occlusions has been reported in cryoballoon PV isolation (CB-PVI) using first-generation CBs. This prospective randomized study compared the procedural and clinical outcomes of pressure-guided and conventional CB-PVI. METHODS AND RESULTS Sixty patients with paroxysmal atrial fibrillation underwent CB-PVI with 28-mm second-generation CBs. PV occlusions were assessed either by real-time pressure waveforms without contrast utilization (pressure-guided group) or contrast injections (conventional group) and randomly assigned. Before the randomization, 24 patients underwent pressure-guided CB-PVIs. In the derivation study, a vein occlusion was obtained in 88/96 (91.7%) PVs among which 86 (97.7%) were successfully isolated by the application. In the validation study, the nadir balloon temperature and total freezing time did not significantly differ per PV between the two groups. The positive predictive value of the vein occlusion for predicting successful acute isolations was similar (93 of 103 [90.2%] and 89 of 98 [90.8%] PVs; P = 1.000), but the negative predictive value was significantly higher in pressure-guided than angiographical occlusions (14 of 17 [82.3%] vs 7 of 22 [31.8%]; P = .003). Both the procedure (57.7 ± 14.2 vs 62.6 ± 15.8 minutes; P = .526) and fluoroscopic times (16.3 ± 6.4 vs 20.1 ± 6.1; P = .732) were similar between the two groups, however, the fluoroscopy dose (130.6 ± 97.7 vs 353.2 ± 231.4 mGy; P < .001) and contrast volume used (0 vs 17.5 ± 7.7 mL; P < .001) were significantly smaller in the pressure-guided than conventional group. During 27.8 (5-39) months of follow-up, the single procedure arrhythmia freedom was similar between the two groups (P = .438). CONCLUSIONS Pressure-guided second-generation CB-PVIs were similarly effective and as safe as conventional CB-PVIs. This technique required no contrast utilization and significantly reduced radiation exposure more than conventional CB-PVIs.
Collapse
Affiliation(s)
- Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kaori Hisazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoki Amaya
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kosuke Miyahara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Aiki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Eri Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akira Matsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
50
|
Sato Y, Uzui H, Mukai M, Shiomi Y, Hasegawa K, Ikeda H, Tama N, Fukuoka Y, Morishita T, Ishida K, Kaseno K, Miyazaki S, Nakano A, Tada H. Efficacy and Safety of Tolvaptan in Patients More Than 90 Years Old With Acute Heart Failure. J Cardiovasc Pharmacol Ther 2019; 25:47-56. [PMID: 31280620 DOI: 10.1177/1074248419861962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/15/2022]
Abstract
BACKGROUND The oral vasopressin-2 receptor antagonist, tolvaptan, causes aquaresis and improves symptoms in patients with congestive heart failure. However, few studies have explored the effect of tolvaptan in acute heart failure (AHF) patients ≥90 years old. METHODS This study enrolled 106 AHF patients treated with tolvaptan added to standard therapy. The subjects were divided into 2 groups: ≥90-year-old patients (over-90 group, mean 92 ± 2 years, n = 45) and <90-year-old patients (under-90 group, mean 76 ± 11 years, n = 61). Patients' characteristics were assessed, and efficacy and safety were compared between the 2 groups. RESULTS The over-90 group had a lower proportion of male patients, lower body weight, and higher ejection fraction. The under-90 group had significantly higher prevalence of ischemic heart disease and diabetes mellitus. There were no significant differences between the 2 groups in total urine volume at 24 and 48 hours (1934 ± 983 mL vs 1816 ± 1028 mL, P = 0.58 and 3806 ± 1444 mL vs 4078 ± 1851 mL, P=0.47, respectively), the mean change in body weight (-3.0 ± 2.7 kg vs -2.6 ± 2.6 kg, P = 0.50), improvement of congestive symptoms, changes in serum sodium and creatinine levels, the incidences of hypernatremia (n = 0, 0% vs n = 1, 1.6%, P = 0.63), and worsening renal function (n = 9, 20% vs n = 17, 28%, P = 0.48). CONCLUSION The efficacy and safety of tolvaptan in AHF patients aged more than 90 years were comparable to those of <90 years old. Tolvaptan provides a complementary therapeutic option for AHF patients aged more than 90 years.
Collapse
Affiliation(s)
- Yusuke Sato
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Depatment of Cardiology, Hikone Municipal Hospital, Shiga, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Depatment of Cardiology, Hikone Municipal Hospital, Shiga, Japan
| | - Yuichiro Shiomi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoto Tama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshitomo Fukuoka
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentaro Ishida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akira Nakano
- Depatment of Cardiology, Hikone Municipal Hospital, Shiga, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|