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Ishii M, Marume K, Nakai M, Ogata S, Kaichi R, Ikebe S, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Ogawa H, Iwanaga Y, Miyamoto Y, Yamamoto N, Tsujita K. Risk Prediction Score for Cancer Development in Patients With Acute Coronary Syndrome. Circ J 2024; 88:234-242. [PMID: 34078839 DOI: 10.1253/circj.cj-21-0071] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cancer is a known prognostic factor in patients with acute coronary syndrome (ACS), but few risk assessments of cancer development after ACS have been established.Methods and Results:Of the 573 consecutive ACS admissions between January 2015 and March 2018 in Nobeoka City, Japan, 552 were analyzed. Prevalent cancer was defined as a treatment history of cancer, and incident cancer as post-discharge cancer incidence. The primary endpoint was post-discharge cancer incidence, and the secondary endpoint was all-cause death during follow-up. All-cause death occurred in 9 (23.1%) patients with prevalent cancer, and in 17 (3.5%) without cancer. In the multivariable analysis, prevalent cancer was associated with all-cause death. To develop the prediction model for cancer incidence, 21 patients with incident cancer and 492 without cancer were analyzed. We compared the performance of D-dimer with that of the prediction model, which added age (≥65 years), smoking history, and high red blood cell distribution width to albumin ratio (RAR) to D-dimer. The areas under the receiver-operating characteristics curves of D-dimer and the prediction model were 0.619 (95% confidence interval: 0.512-0.725) and 0.774 (0.676-0.873), respectively. Decision curve analysis showed superior net benefits of the prediction model. CONCLUSIONS By adding elderly, smoking, and high RAR to D-dimer to the prediction model it became clinically useful for predicting cancer incidence after ACS.
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Affiliation(s)
- Masanobu Ishii
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | | | | | - Ryota Kaichi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Sou Ikebe
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Takayuki Mori
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Soichi Komaki
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Hiroaki Kusaka
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Reiko Toida
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kazumasa Kurogi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | | | | | | | - Nobuyasu Yamamoto
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Kumamoto University Hospital
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2
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Usuku H, Yamamoto E, Sueta D, Imamura K, Oike F, Marume K, Ishii M, Hanatani S, Arima Y, Takashio S, Oda S, Kawano H, Ueda M, Matsui H, Tsujita K. Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy. Int J Cardiol Heart Vasc 2023; 47:101227. [PMID: 37416484 PMCID: PMC10320495 DOI: 10.1016/j.ijcha.2023.101227] [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: 04/11/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 07/08/2023]
Abstract
Background Left ventricular (LV) apical sparing by transthoracic echocardiography (TTE) has not been widely accepted to diagnose transthyretin amyloid cardiomyopathy (ATTR-CM), because it is time consuming and requires a level of expertise. We hypothesized that automatic assessment may be the solution for these problems. Methods-and-Results We enrolled 63 patients aged ≥70 years who underwent 99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy on suspicion of ATTR-CM and performed TTE by EPIQ7G, and had enough information for two-dimensional speckle tracking echocardiography at Kumamoto University Hospital from January 2016 to December 2019. LV apical sparing was described as a high relative apical longitudinal strain (LS) index (RapLSI). Measurement of LS was repeated using the same apical images with three different measurement packages as follows: (1) full-automatic assessment, (2) semi-automatic assessment, and (3) manual assessment. The calculation time for full-automatic assessment (14.7 ± 1.4 sec/patient) and semi-automatic assessment (66.7 ± 14.4 sec/patient) were significantly shorter than that for manual assessment (171.2 ± 59.7 sec/patient) (p < 0.01 for both). Receiver operating characteristic curve analysis showed that the area under curve of the RapLSI evaluated by full-automatic assessment for predicting ATTR-CM was 0.70 (best cut-off point; 1.14 [sensitivity 63%, specificity 81%]), by semi-automatic assessment was 0.85 (best cut-off point; 1.00 [sensitivity, 66%; specificity, 100%]) and by manual assessment was 0.83 (best cut-off point; 0.97 [sensitivity, 72%; specificity, 97%]). Conclusion There was no significant difference between the diagnostic accuracy of RapLSI estimated by semi-automatic assessment and that estimated by manual assessment. Semi-automatically assessed RapLSI is useful to diagnose ATTR-CM in terms of rapidity and diagnostic accuracy.
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Affiliation(s)
- Hiroki Usuku
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Kanako Imamura
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroaki Kawano
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
| | - Mitsuharu Ueda
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto
| | - Hirotaka Matsui
- Department of Molecular Laboratory Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan
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3
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Marume K, Mugele H, Ueno R, Amin SB, Lesmana HS, Possnig C, Hansen AB, Simpson LL, Lawley JS. The impact of leg position on muscle blood flow and oxygenation during low-intensity rhythmic plantarflexion exercise. Eur J Appl Physiol 2023; 123:1091-1099. [PMID: 36645478 PMCID: PMC10119266 DOI: 10.1007/s00421-022-05117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 12/12/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE Resistance training (RT) is an effective countermeasure to combat physical deconditioning whereby localized hypoxia within the limb increases metabolic stress eliciting muscle adaptation. The current study sought to examine the influence of gravity on muscle oxygenation (SmO2) alongside vascular hemodynamic responses. METHODS In twelve young healthy adults, an ischemic occlusion test and seven minutes of low-intensity rhythmic plantarflexion exercise were used alongside superficial femoral blood flow and calf near-infrared spectroscopy to assess the microvascular vasodilator response, conduit artery flow-mediated dilation, exercise-induced hyperemia, and SmO2 with the leg positioned above or below the heart in a randomized order. RESULTS The microvascular vasodilator response, assessed by peak blood flow (798 ± 231 mL/min vs. 1348 ± 290 mL/min; p < 0.001) and reperfusion slope 10 s of SmO2 after cuff deflation (0.75 ± 0.45%.s-1 vs.2.40 ± 0.94%.s-1; p < 0.001), was attenuated with the leg above the heart. This caused a blunted dilatation of the superficial femoral artery (3.0 ± 2.4% vs. 5.2 ± 2.1%; p = 0.008). Meanwhile, blood flow area under the curve was comparable (above the heart: 445 ± 147 mL vs. below the heart: 474 ± 118 mL; p = 0.55) in both leg positions. During rhythmic exercise, the increase in femoral blood flow was lower in the leg up position (above the heart: 201 ± 94% vs. below the heart: 292 ± 114%; p = 0.001) and contributed to a lower SmO2 (above the heart: 41 ± 18% vs. below the heart 67 ± 5%; p < 0.001). CONCLUSION Positioning the leg above the heart results in attenuated peak vascular dilator response and exercise-induced hyperemia that coincided with a lower SmO2 during low-intensity plantarflexion exercise.
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Affiliation(s)
- Kyohei Marume
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.
| | - Hendrik Mugele
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Ryo Ueno
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Sachin B Amin
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Carmen Possnig
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Alexander B Hansen
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Lydia L Simpson
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Justin S Lawley
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
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4
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Mugele H, Marume K, Amin SB, Possnig C, Kühn LC, Riehl L, Pieper R, Schabbehard EL, Oliver SJ, Gagnon D, Lawley JS. Control of blood pressure in the cold: differentiation of skin and skeletal muscle vascular resistance. Exp Physiol 2023; 108:38-49. [PMID: 36205383 PMCID: PMC10092517 DOI: 10.1113/ep090563] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/30/2022] [Indexed: 01/03/2023]
Abstract
NEW FINDINGS What is the central question of this study? Why does blood pressure increases during cold air exposure? Specifically, what is the contribution of skin and skeletal muscle vascular resistance during whole body versus isolated face cooling? What is the main finding and its importance? Whole-body cooling caused an increase in blood pressure through an increase in skeletal muscle and cutaneous vascular resistance. However, isolated mild face cooling caused an increase in blood pressure predominately via an increase in cutaneous vasoconstriction. ABSTRACT The primary aim of this investigation was to determine the individual contribution of the cutaneous and skeletal muscle circulations to the cold-induced pressor response. To address this, we examined local vascular resistances in the cutaneous and skeletal muscle of the arm and leg. Thirty-four healthy individuals underwent three different protocols, whereby cold air to clamp skin temperature (27°C) was passed over (1) the whole-body, (2) the whole-body, but with the forearm pre-cooled to clamp cutaneous vascular resistance, and (3) the face. Cold exposure applied to the whole body or isolated to the face increased mean arterial pressure (all, P < 0.001) and total peripheral resistance (all, P < 0.047) compared to thermal neutral baseline. Whole-body cooling increased femoral (P < 0.005) and brachial artery resistance (P < 0.003) compared to thermoneutral baseline. Moreover, when the forearm was pre-cooled to remove the contribution of cutaneous resistance (P = 0.991), there was a further increase in lower arm vasoconstriction (P = 0.036) when whole-body cooling was superimposed. Face cooling also caused a reflex increase in lower arm cutaneous (P = 0.009) and brachial resistance (P = 0.050), yet there was no change in femoral resistance (P = 0.815) despite a reflex increase in leg cutaneous resistance (P = 0.010). Cold stress causes an increase in blood pressure through a change in total peripheral resistance that is largely due to cutaneous vasoconstriction with face cooling, but there is additional vasoconstriction in the skeletal muscle vasculature with whole-body cooling.
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Affiliation(s)
- Hendrik Mugele
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Kyohei Marume
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Sachin B Amin
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Carmen Possnig
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Lucie C Kühn
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Lydia Riehl
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Robin Pieper
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Eva-Lotte Schabbehard
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria
| | - Samuel J Oliver
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Daniel Gagnon
- Montreal Heart Institute, Montréal, Canada.,School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Justin S Lawley
- Department of Sport Science, Division of Performance Science and Prevention, University Innsbruck, Innsbruck, Austria.,Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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5
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Kaichi R, Ishii M, Marume K, Takae M, Mori T, Komaki S, Toida R, Kurogi K, Nagamine Y, Nishikawa S, Matsuyama M, Yamaguchi T, Yano T, Tsujita K, Yamamoto N. Prediction of intracerebral hemorrhage in patients with out-of-hospital cardiac arrest using post-resuscitation electrocardiogram: An observational cohort study. Resusc Plus 2022; 12:100337. [PMCID: PMC9712767 DOI: 10.1016/j.resplu.2022.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022] Open
Abstract
Aim We evaluated the characteristics of patients with intracerebral hemorrhage in nontraumatic out-of-hospital cardiac arrests (OHCA) after return of spontaneous circulation (ROSC) to identify patients who required brain computed tomography as the next diagnostic workup. Methods We conducted a retrospective cohort study on 1303 consecutive patients with nontraumatic OHCA who were admitted to Miyazaki Prefectural Nobeoka Hospital between 2008 and 2020. Among these, 454 patients achieved sustained ROSC. We excluded 126 patients with obvious extracardiac causes. Clinical and demographic characteristics of patients and post-resuscitation 12-lead electrocardiogram were compared. Patients were categorized into the intracerebral hemorrhage (n = 32, 10%) and no intracerebral hemorrhage group (n = 296). All causes of intracerebral hemorrhage were diagnosed based on brain computed tomography images by board-certified radiologists. Results We included 328 patients (mean age, 74 years; women, 36%) who achieved ROSC. Logistic regression analyses showed that female sex, younger age (<75 years), no shockable rhythm changes, tachycardia (≥100 bpm), lateral ST-segment elevation, and inferior ST-segment depression on post-resuscitation electrocardiogram were independently associated with intracerebral hemorrhage. We developed a new predictive model for intracerebral hemorrhage by considering 1 point for each of the six factors. The odds ratio for intracerebral hemorrhage increased 2.36 for each 1-point increase (P < 0.001). A score ≥ 4 had 43.7% sensitivity, 90.8% specificity, 34.1% positive predictive value, and 93.7% negative predictive value. Conclusion Our new predictive model might be useful for risk stratification of intracerebral hemorrhage in patients with OHCA who achieved ROSC.
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Affiliation(s)
- Ryota Kaichi
- Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan,Corresponding author at: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan,Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Takayuki Mori
- Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Soichi Komaki
- Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Reiko Toida
- Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | | | | | | | | | | | - Takao Yano
- Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan
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6
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Amin SB, Hansen AB, Mugele H, Simpson LL, Marume K, Moore JP, Cornwell WK, Lawley JS. High intensity exercise and passive hot water immersion cause similar post intervention changes in peripheral and cerebral shear. J Appl Physiol (1985) 2022; 133:390-402. [PMID: 35708700 DOI: 10.1152/japplphysiol.00780.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Passive hot water immersion (PHWI) provides a peripheral vasculature shear stimulus comparable to low intensity exercise within the active skeletal muscle, whereas moderate and high intensity exercise elicit substantially greater shear rates in the peripheral vasculature, likely conferring greater vascular benefits. Few studies have compared post intervention shear rates in the peripheral and cerebral vasculature following high intensity exercise and PHWI, especially considering that the post intervention recovery period represents a key window in which adaptation occurs. Therefore, we aimed to compare shear rates in the internal carotid artery (ICA), vertebral artery (VA) and common femoral artery (CFA) between high intensity exercise and PHWI for up to 80 minutes post intervention. Fifteen healthy (27 ± 4 years), moderately trained individuals underwent three-time matched interventions in a randomised order which included 30 minutes of whole-body immersion in a 42°C hot bath, 30 minutes of treadmill running and 5x4 minute high intensity intervals (HIIE). There were no differences in ICA (P= 0.4643) and VA (P=0.1940) shear rates between PHWI and exercise (both continuous and HIIE) post intervention. All three interventions elicited comparable increases in CFA shear rate post intervention (P=0.0671), however, CFA shear rate was slightly higher 40 minutes post threshold running (P=0.0464) and, slightly higher, although not statically for HIIE (P=0.0565) compared with PHWI. Our results suggest that time and core temperature matched high intensity exercise and PHWI elicit limited changes in cerebral shear and comparable increases in peripheral vasculature shear rates when measured for up to 80 minutes post intervention.
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Affiliation(s)
- Sachin B Amin
- University Innsbruck, Department Sport Science, Innsbruck, Austria
| | | | - Hendrik Mugele
- University Innsbruck, Department Sport Science, Innsbruck, Austria
| | - Lydia L Simpson
- University Innsbruck, Department Sport Science, Innsbruck, Austria
| | - Kyohei Marume
- University Innsbruck, Department Sport Science, Innsbruck, Austria
| | - Jonathan P Moore
- School of Sport, Health and Exercise Science, Bangor University, Bangor, United Kingdom
| | - William K Cornwell
- Department of Medicine - Cardiology, University of Colorado Anschutz Medical Campus, Aurora CO, United States.,Clinical and Translational Research Center, University of Colorado Anschutz Medical Campus, Aurora CO, United States
| | - Justin S Lawley
- University Innsbruck, Department Sport Science, Innsbruck, Austria
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7
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Oike F, Usuku H, Yamamoto E, Marume K, Takashio S, Ishii M, Tabata N, Fujisue K, Yamanaga K, Sueta D, Hanatani S, Arima Y, Araki S, Oda S, Kawano H, Soejima H, Matsushita K, Ueda M, Fukui T, Tsujita K. Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis. ESC Heart Fail 2022; 9:1976-1986. [PMID: 35338611 PMCID: PMC9065867 DOI: 10.1002/ehf2.13909] [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: 10/27/2021] [Revised: 02/13/2022] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
Aims To clarify the usefulness of left atrial (LA) function and left ventricular (LV) function obtained by two‐dimensional (2D) speckle tracking echocardiography to diagnose concomitant transthyretin amyloid cardiomyopathy (ATTR‐CM) in patients with aortic stenosis (AS). Methods and results We analysed 72 consecutive patients with moderate to severe AS who underwent 99mTc‐pyrophosphate (PYP) scintigraphy at Kumamoto University Hospital from January 2012 to September 2020. We divided these 72 patients into 2 groups based on their 99mTc‐PYP scintigraphy positivity or negativity. Among 72 patients, 16 patients (22%) were positive, and 56 patients (78%) were negative for 99mTc‐PYP scintigraphy. In clinical baseline characteristics, natural logarithm troponin T was significantly higher in the 99mTc‐PYP scintigraphy‐positive than scintigraphy‐negative group (−2.9 ± 0.5 vs. −3.5 ± 0.8 ng/mL, P < 0.05). In conventional echocardiography, the severity of AS was not significantly different between these two groups. In 2D speckle tracking echocardiography, the relative apical longitudinal strain (LS) index (RapLSI) [apical LS/ (basal LS + mid LS)] was significantly higher (1.09 ± 0.49 vs. 0.78 ± 0.23, P < 0.05) and the peak longitudinal strain rate (LSR) in LA was significantly lower in the 99mTc‐PYP scintigraphy‐positive than scintigraphy‐negative group (0.36 ± 0.14 vs. 0.55 ± 0.20 s−1, P < 0.05). Multivariable logistic analysis revealed the peak LSR in LA and RapLSI were significantly associated with 99mTc‐PYP scintigraphy positivity. Receiver operating characteristic analysis showed that the area under the curve (AUC) of the peak LSR in LA for 99mTc‐PYP scintigraphy positivity was 0.79 and that the best cut‐off value of the peak LSR in LA was 0.47 s−1 (sensitivity: 78.6% and specificity: 72.3%). The AUC of RapLSI for 99mTc‐PYP scintigraphy positivity was 0.69, and the cut‐off value of RapLSI was decided as 1.00 (sensitivity: 43.8% and specificity: 87.5%) according to the previous report. The 99mTc‐PYP scintigraphy positivity in patients with RapLSI ≥ 1.0 and the peak LSR in LA ≤ 0.47 s−1 was 83.3% (5/6), and the 99mTc‐PYP scintigraphy negativity in patients with RapLSI < 1.0 and the peak LSR in LA > 0.47 s−1 was 96.6% (28/29). Conclusions Left atrial and LV strain analysis were significantly associated with 99mTc‐PYP scintigraphy positivity in ATTR‐CM patients with moderate to severe AS. The combination of the peak LSR in LA and RapLSI might be a useful predictor of the presence of ATTR‐CM in patients with moderate to severe AS.
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Affiliation(s)
- Fumi Oike
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.,Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Noriaki Tabata
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenshi Yamanaga
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Araki
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroaki Kawano
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirofumi Soejima
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Matsushita
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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8
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Marume K, Ogata S, Kaichi R, Nakai M, Ishii M, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Iwanaga Y, Miyamoto Y, Yamamoto N. Incidence Rate of Hospitalization for Heart Failure in a Japanese City ― An Updated Reference for Japan’s Aging Society ―. Circ Rep 2022; 4:116-122. [PMID: 35342838 PMCID: PMC8901245 DOI: 10.1253/circrep.cr-21-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 11/21/2022] Open
Abstract
Background:
The prevalence of heart failure (HF) is increasing in aging societies, such as Japan. The current incidence rate (IR) of HF hospitalization in Japan is unknown. Methods and Results:
We conducted a regional population-based study assessing the IR of HF hospitalization in Nobeoka City. Data were collected over a period of 3 years from all patients with HF admitted for the first time to hospitals and clinics. 406 HF hospitalizations were registered (54% female; mean age 82 years). The IR of HF hospitalization was 129/100,000 person-years. The difference in the IR between women and men was not significant (131 vs. 127/100,000 person-years, respectively; P=0.767). The age-adjusted IR in the 2015 Japanese population was 105/100,000 person-years. According to 5-year age bands, the IR of HF hospitalization gradually increased up to 60–70 years of age, then increased rapidly in those aged ≥95 years for both sexes. The IR ratio compared with age <65 years was higher in women than men in each older age group. Conclusions:
In this population-based study, the current IR of HF hospitalization in a region of Japan was higher than the IR from another study conducted in a different region in early 2000. By presenting detailed age-related data, the research findings will contribute to estimating the number of HF hospitalizations in other areas of Japan.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Ryota Kaichi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Takayuki Mori
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Soichi Komaki
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Hiroaki Kusaka
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Reiko Toida
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kazumasa Kurogi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Yoshitaka Iwanaga
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Yoshihiro Miyamoto
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Nobuyasu Yamamoto
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
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9
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Kaichi R, Marume K, Nakai M, Ishii M, Ogata S, Iwanaga Y, Ikebe S, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Miyamoto Y, Yamamoto N. Relationship Between Heart Failure Hospitalization Costs and Left Ventricular Ejection Fraction in an Advanced Aging Society. Circ Rep 2022; 4:48-58. [PMID: 35083388 PMCID: PMC8710639 DOI: 10.1253/circrep.cr-21-0134] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background:
Left ventricular ejection fraction (LVEF) is a basic clinical index that determines the heart failure (HF) treatment strategy. We aimed to evaluate the association between hospitalization costs for HF patient and LVEF in an advanced aging society in a region in Japan. Methods and Results:
Consecutive HF patients admitted to Miyazaki Prefectural Nobeoka Hospital between January 2015 and March 2018 were included in the study. The 346 HF patients (mean age 78 years) were divided into 2 groups: HF with reduced ejection fraction (HFrEF; LVEF <40%; n=129) and HF with preserved ejection fraction (HFpEF; LVEF ≥40%; n=217). Median hospitalization costs (in 2017 US dollars) were higher in the HFrEF than HFpEF group, but the difference was not statistically significant ($7,128 vs. $6,580; P=0.189). However, in older adults (age ≥75 years; n=252), median hospitalization costs were significantly higher in the HFrEF than HFpEF group ($7,240 vs. $6,471; P=0.014), and LVEF was an independent factor of hospitalization costs (β=−0.0301, P=0.006). Median hospitalization costs were significantly lower in the older than younger HFpEF group ($6,471 vs. $7,250; P=0.011), but there was no significant difference in costs between the older and younger HFrEF groups ($7,240 vs. $6,760; P=0.351). Conclusions:
The relationship between LVEF and hospitalization costs became more pronounced with age, and LVEF was a negative independent factor for hospitalization costs in the older population.
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Affiliation(s)
| | | | | | | | | | | | - Sou Ikebe
- Miyazaki Prefectural Nobeoka Hospital
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10
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Amin SB, Mugele H, Dobler FE, Marume K, Moore JP, Lawley JS. Intra-rater reliability of leg blood flow during dynamic exercise using Doppler ultrasound. Physiol Rep 2021; 9:e15051. [PMID: 34617675 PMCID: PMC8496156 DOI: 10.14814/phy2.15051] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/24/2022] Open
Abstract
Developing an exercise model that resembles a traditional form of aerobic exercise and facilitates a complete simultaneous assessment of multiple parameters within the oxygen cascade is critically for understanding exercise intolerances in diseased populations. Measurement of muscle blood flow is a crucial component of such a model and previous studies have used invasive procedures to determine blood flow kinetics; however, this may not be appropriate in certain populations. Furthermore, current models utilizing Doppler ultrasound use isolated limb exercise and while these studies have provided useful data, the exercise model does not mimic the whole-body physiological response to continuous dynamic exercise. Therefore, we aimed to measure common femoral artery blood flow using Doppler ultrasound during continuous dynamic stepping exercise performed at three independent workloads to assess the within day and between-day reliability for such an exercise modality. We report a within-session coefficient of variation of 5.8% from three combined workloads and a between-day coefficient of variation of 12.7%. These values demonstrate acceptable measurement accuracy and support our intention of utilizing this noninvasive exercise model for an integrative assessment of the whole-body physiological response to exercise in a range of populations.
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Affiliation(s)
- Sachin B. Amin
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
| | - Hendrik Mugele
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
| | - Florian E. Dobler
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
| | | | | | - Justin S. Lawley
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
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11
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Marume K, Noguchi T, Kamakura T, Tateishi E, Morita Y, Miura H, Nakaoku Y, Nishimura K, Yamada N, Tsujita K, Izumi C, Kusano K, Ogawa H, Yasuda S. Prognostic impact of multiple fragmented QRS on cardiac events in idiopathic dilated cardiomyopathy. Europace 2021; 23:287-297. [PMID: 33212485 DOI: 10.1093/europace/euaa193] [Citation(s) in RCA: 6] [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: 02/12/2020] [Accepted: 07/09/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS To evaluate the prognostic impact of fragmented QRS (fQRS) on idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS We conducted a prospective observational study of 290 consecutive patients with DCM (left ventricular ejection fraction ≤ 40%) and narrow QRS who underwent cardiac magnetic resonance. We defined fQRS as the presence of various RSR' patterns in ≥2 contiguous leads representing the anterior (V1-V5), inferior (II, III, and aVF), or lateral (I, aVL, and V6) myocardial segments. Multiple fQRS was defined as the presence of fQRS in ≥2 myocardial segments. Patients were divided into three groups: no fQRS, single fQRS, or multiple fQRS. The primary endpoint was a composite of hard cardiac events consisting of heart failure death, sudden cardiac death (SCD), or aborted SCD. The secondary endpoints were all-cause death and arrhythmic event. During a median follow-up of 3.8 years (interquartile range, 1.8-6.2), 31 (11%) patients experienced hard cardiac events. Kaplan-Meier analysis showed that the rates of hard cardiac events and all-cause death were similar in the single-fQRS and no-fQRS groups and higher in the multiple-fQRS group (P = 0.004 and P = 0.017, respectively). Multivariable Cox regression identified that multiple fQRS is a significant predictor of hard cardiac events (hazard ratio, 2.23; 95% confidence interval, 1.07-4.62; P = 0.032). The multiple-fQRS group had the highest prevalence of a diffuse late gadolinium enhancement pattern (no fQRS, 21%; single fQRS, 22%; multiple fQRS, 39%; P < 0.001). CONCLUSION Multiple fQRS, but not single fQRS, is associated with future hard cardiac events in patients with DCM.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan.,Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
| | - Emi Tateishi
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshiaki Morita
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Naoaki Yamada
- Department of Radiology, Osaka Neurological Institute, Toyonaka, Osaka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan
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12
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Mikami T, Ishii M, Yamamoto N, Marume K, Nakai M, Ogata S, Kaichi R, Ikebe S, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Iwanaga Y, Ogawa H, Miyamoto Y, Tsujita K. Association of early administration of furosemide with improved oxygenation in patients with acute heart failure. ESC Heart Fail 2021; 8:3354-3359. [PMID: 34132503 PMCID: PMC8318445 DOI: 10.1002/ehf2.13379] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/05/2021] [Accepted: 04/08/2021] [Indexed: 01/28/2023] Open
Abstract
Aims Optimal pharmacological treatment for chronic heart failure has been established. However, treatments that can improve the prognosis of acute heart failure (AHF) are controversial. Although intravenous diuretics may be one optimal treatment option, little evidence has shown the effect of early administration of diuretics on clinical outcomes in patients with AHF. The aim of this study was to evaluate the association between door‐to‐furosemide (D2F) time, improved oxygenation, and in‐hospital mortality in patients hospitalized for AHF. Methods and results We screened 494 patients hospitalized for AHF in Miyazaki Prefectural Nobeoka Hospital. AHF patients who were treated with intravenous furosemide within 24 h of arrival at the hospital were included in this study. D2F time was defined as the time from patient arrival at the hospital to the first intravenous dose of furosemide. The early administration group was defined as those with D2F time ≤60 min, whereas the non‐early group was defined as those with D2F time >60 min. The primary outcome was the rate of improved oxygenation at Day 1. The secondary outcomes were in‐hospital mortality and cardiac death. There were 219 patients treated with the first intravenous dose of furosemide within 24 h analysed after the exclusion of 275 patients. The median D2F time was 55 min (interquartile range: 30–120 min) in the final cohort. The early administration group included 121 patients (55.3%). The rate of improved oxygenation was higher in the early group than the non‐early group [median 16.7% (interquartile range: 0.0–40.0) vs. 0.0% (0.0–20.6), respectively, P < 0.001]. During the study period, there were six patients (5.0%) with in‐hospital mortality in the early group and nine patients (9.2%) in the non‐early group (P = 0.218). Cardiac death was observed less frequently in the early group than in the non‐early group, but without statistical significance (3.3% and 9.2%, respectively) (P = 0.067). The univariable logistic regression analyses showed that early administration of furosemide was associated with improved oxygenation [odds ratio (OR): 2.26; 95% confidence interval (CI): 1.31–3.91; P = 0.004], but not with in‐hospital mortality (OR: 0.52; 95% CI: 0.18–1.50; P = 0.225) or cardiac death (OR: 0.34; 95% CI: 0.10–1.13; P = 0.079). In multivariable analyses adjusted for risk score or relevant variables, early administration of furosemide was consistently associated with improvement of oxygenation. Conclusions The present study showed that in AHF patients, the early administration of furosemide was associated with improved oxygenation.
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Affiliation(s)
- Takafumi Mikami
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Masanobu Ishii
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Nobuyasu Yamamoto
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Kyohei Marume
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | | | - Soshiro Ogata
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ryota Kaichi
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Sou Ikebe
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Takayuki Mori
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Soichi Komaki
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Hiroaki Kusaka
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Reiko Toida
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Kazumasa Kurogi
- Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | | | - Hisao Ogawa
- National Cerebral and Cardiovascular Center, Suita, Japan
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13
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Ogata S, Marume K, Nakai M, Kaichi R, Ishii M, Ikebe S, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Iwanaga Y, Yano T, Yamamoto N, Miyamoto Y. Incidence Rate of Acute Coronary Syndrome Including Acute Myocardial Infarction, Unstable Angina, and Sudden Cardiac Death in Nobeoka City for the Super-Aged Society of Japan. Circ J 2021; 85:1722-1730. [PMID: 34121054 DOI: 10.1253/circj.cj-20-1207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to calculate incidence rates (IR) of acute coronary syndrome (ACS) including acute myocardial infarction (AMI), unstable angina (UAP), and sudden cardiac death (SCD) in Nobeoka city, Japan.Methods and Results:This was an observational study based on a city-wide comprehensive registration between 2015 and 2017 in Nobeoka city, Japan, using 2 databases: all patients with cardiogenic out-of-hospital cardiac arrest in Nobeoka city and hospitalized ACS patients from Miyazaki Prefectural Nobeoka Hospital in which all ACS patients in Nobeoka city were hospitalized except for possible rare cases of patients highly unlikely to be hospitalized elsewhere. The IRs of ACS based on the population size of Nobeoka city (125,000 persons), and their age-adjusted IRs by using the direct method and the 2015 model population of Japan were calculated. There were 260 eligible patients hospitalized with first-onset ACS (age [SD]=71.1 [12.4], 34.2% women) and 107 eligible SCD patients. Crude IRs of hospitalized ACS and SCD patients, and hospitalized AMI and SCD patients, respectively, were 130.2 (183.3 for men, 85.6 for women) and 107.5 (148.4 for men, 73.2 for women) per 100,000. Crude IRs of hospitalized ACS, AMI, and UAP patients, respectively, were 92.3 (132.8 for men, 58.1 for women), 69.6 (97.9 for men, 45.7 for women), and 22.7 (35.0 for men, 12.4 for women) per 100,000. CONCLUSIONS The calculated IRs can be useful in building a health strategy for treating ACS.
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Affiliation(s)
- Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Kyohei Marume
- Miyazaki Prefectural Nobeoka Hospital.,Department of Sport Science, University of Innsbruck
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | | | | | - Sou Ikebe
- Miyazaki Prefectural Nobeoka Hospital
| | | | | | | | | | | | - Yoshitaka Iwanaga
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | | | | | - Yoshihiro Miyamoto
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
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14
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Hansen AB, Lawley JS, Rickards CA, Howden EJ, Sarma S, Cornwell WK, Amin SB, Mugele H, Marume K, Possnig C, Whitworth LA, Williams MA, Levine BD. Reducing intracranial pressure by reducing central venous pressure: assessment of potential countermeasures to spaceflight-associated neuro-ocular syndrome. J Appl Physiol (1985) 2020; 130:283-289. [PMID: 33270516 DOI: 10.1152/japplphysiol.00786.2020] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Spaceflight-associated neuro-ocular syndrome (SANS) involves unilateral or bilateral optic disc edema, widening of the optic nerve sheath, and posterior globe flattening. Owing to posterior globe flattening, it is hypothesized that microgravity causes a disproportionate change in intracranial pressure (ICP) relative to intraocular pressure. Countermeasures capable of reducing ICP include thigh cuffs and breathing against inspiratory resistance. Owing to the coupling of central venous pressure (CVP) and intracranial pressure, we hypothesized that both ICP and CVP will be reduced during both countermeasures. In four male participants (32 ± 13 yr) who were previously implanted with Ommaya reservoirs for treatment of unrelated clinical conditions, ICP was measured invasively through these ports. Subjects were healthy at the time of testing. CVP was measured invasively by a peripherally inserted central catheter. Participants breathed through an impedance threshold device (ITD, -7 cmH2O) to generate negative intrathoracic pressure for 5 min, and subsequently, wore bilateral thigh cuffs inflated to 30 mmHg for 2 min. Breathing through an ITD reduced both CVP (6 ± 2 vs. 3 ± 1 mmHg; P = 0.02) and ICP (16 ± 3 vs. 12 ± 1 mmHg; P = 0.04) compared to baseline, a result that was not observed during the free breathing condition (CVP, 6 ± 2 vs. 6 ± 2 mmHg, P = 0.87; ICP, 15 ± 3 vs. 15 ± 4 mmHg, P = 0.68). Inflation of the thigh cuffs to 30 mmHg caused no meaningful reduction in CVP in all four individuals (5 ± 4 vs. 5 ± 4 mmHg; P = 0.1), coincident with minimal reduction in ICP (15 ± 3 vs. 14 ± 4 mmHg; P = 0.13). The application of inspiratory resistance breathing resulted in reductions in both ICP and CVP, likely due to intrathoracic unloading.NEW & NOTEWORTHY Spaceflight causes pathological changes in the eye that may be due to the absence of gravitational unloading of intracranial pressure (ICP) under microgravity conditions commonly referred to as spaceflight-associated neuro-ocular syndrome (SANS), whereby countermeasures aimed at lowering ICP are necessary. These data show that impedance threshold breathing acutely reduces ICP via a reduction in central venous pressure (CVP). Whereas, acute thigh cuff inflation, a popular known spaceflight-associated countermeasure, had little effect on ICP and CVP.
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Affiliation(s)
- Alexander B Hansen
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Justin S Lawley
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Caroline A Rickards
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Erin J Howden
- The Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - William K Cornwell
- Division of Cardiology, Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sachin B Amin
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hendrik Mugele
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Kyohei Marume
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Carmen Possnig
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Michael A Williams
- Departments of Neurology and Neurological Surgery, University of Washington School of Medicine, Seattle, Washington
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
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15
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Usuku H, Takashio S, Yamamoto E, Kinoshita Y, Nishi M, Oike F, Marume K, Hirakawa K, Tabata N, Oda S, Misumi Y, Ueda M, Kawano H, Kaikita K, Matsushita K, Ando Y, Matsui H, Tsujita K. Usefulness of relative apical longitudinal strain index to predict positive 99m Tc-labeled pyrophosphate scintigraphy findings in advanced-age patients with suspected transthyretin amyloid cardiomyopathy. Echocardiography 2020; 37:1774-1783. [PMID: 33145817 DOI: 10.1111/echo.14892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/09/2020] [Accepted: 09/25/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND We previously reported that a high score (2 or 3 points) according to the Kumamoto criteria, a combination of high-sensitivity cardiac troponin T (hs-cTnT) ≥0.308 ng/mL, the length of QRS ≥ 120 ms in electrocardiogram, and left ventricular (LV) posterior wall thickness ≥ 13.6 mm, increases the pretest probability of 99m Tc-labeled pyrophosphate (99m Tc-PYP) scintigraphy in patients with suspected transthyretin amyloid cardiomyopathy (ATTR-CM). However, some patients with a low score (0 or 1 point) show positive findings on 99m Tc-PYP scintigraphy. Therefore, we evaluated the usefulness of additional examinations, including echocardiographic assessment of myocardial strain, to raise the pretest probability of 99m Tc-PYP scintigraphy for these patients. METHODS AND RESULTS We examined 109 consecutive patients aged ≥70 years with low scores according to the Kumamoto criteria who underwent 99m Tc-PYP scintigraphy. Nineteen patients (17%) had positive 99m Tc-PYP scintigraphy findings. The relative apical longitudinal strain (LS) index (apical LS/ basal LS + mid LS) (RapLSI) was significantly higher in patients with positive than negative 99m Tc-PYP scintigraphy findings (1.04 ± 0.37 vs 0.70 ± 0.28, P < .01). Multivariable logistic regression analysis revealed that a high RapLSI (≥1.04) was significantly associated with 99m Tc-PYP positivity (odds ratio, 14.14; 95% confidence interval, 3.36-59.47; P < .01). The sensitivity, specificity, and accuracy of the diagnostic model using the RapLSI for identification of 99m Tc-PYP positivity were 53%, 94%, and 87%, respectively. CONCLUSIONS A high RapLSI can raise the pretest probability of 99m Tc-PYP scintigraphy in patients with a low score according to the Kumamoto criteria. The RapLSI can assist clinicians in determining strategies for these patients.
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Affiliation(s)
- Hiroki Usuku
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan.,Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Yui Kinoshita
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Masato Nishi
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Noriaki Tabata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yohei Misumi
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroaki Kawano
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Kenichi Matsushita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirotaka Matsui
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan.,Department of Molecular Laboratory Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Center of Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
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16
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Marume K, Noguchi T, Tateishi E, Morita Y, Miura H, Nishimura K, Ohta-Ogo K, Yamada N, Tsujita K, Izumi C, Kusano K, Ogawa H, Yasuda S. Prognosis and Clinical Characteristics of Dilated Cardiomyopathy With Family History via Pedigree Analysis. Circ J 2020; 84:1284-1293. [PMID: 32624524 DOI: 10.1253/circj.cj-19-1176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The clinical characteristics and prognostic outcomes of dilated cardiomyopathy (DCM) with a familial history (FHx) via pedigree analysis are unclear.Methods and Results:We conducted a prospective observational study of 514 consecutive Japanese patients with DCM. FHx was defined as the presence of DCM in ≥1 family member within 2-degrees relative based on pedigree analysis. The primary endpoint was a composite of major cardiac events (sudden cardiac death and pump failure death). The prevalence of FHx was 7.4% (n=38). During a median follow-up of 3.6 years, 77 (15%) patients experienced a major cardiac event. Multivariable Cox regression analysis identified FHx as independently associated with major cardiac events (hazard ratio [HR] 4.32; 95% confidence interval [CI], 2.04-9.19; P<0.001) compared with conventional risk factors such as age, QRS duration, and left ventricular volume. In the propensity score-matched cohort (n=38 each), the FHx group had a significantly higher incidence of major cardiac events (HR, 4.48; 95% CI, 1.25-16.13; P=0.022). In addition, the FHx group had a higher prevalence of a diffuse late gadolinium enhancement (LGE) pattern than the no-FHx group (32% vs. 17%, P=0.022). CONCLUSIONS DCM patients with FHx had a worse prognosis, which was associated with a higher prevalence of a diffuse LGE pattern, than patients without FHx.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.,Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Emi Tateishi
- Department of Radiology, National Cerebral and Cardiovascular Center
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center.,Department of Radiology, Tohoku University Hospital
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kunihiro Nishimura
- Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center
| | - Keiko Ohta-Ogo
- Department of Pathology, National Cerebral and Cardiovascular Center
| | - Naoaki Yamada
- Department of Radiology, Osaka Neurological Institute
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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17
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Takashio S, Marume K, Nishi M, Kaikita K, Tsujita K. Utility of Kumamoto Criteria in Diagnosing Transthyretin Cardiac Amyloidosis in Real-World Practice ― Reply ―. Circ J 2020; 84:681-682. [DOI: 10.1253/circj.cj-20-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Center for Metabolic Regulation of Healthy Aging, Kumamoto University
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Center for Metabolic Regulation of Healthy Aging, Kumamoto University
| | - Masato Nishi
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Center for Metabolic Regulation of Healthy Aging, Kumamoto University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Center for Metabolic Regulation of Healthy Aging, Kumamoto University
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Center for Metabolic Regulation of Healthy Aging, Kumamoto University
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18
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Kurogi K, Ishii M, Sakamoto K, Komaki S, Marume K, Kusaka H, Yamamoto N, Arima Y, Yamamoto E, Kaikita K, Tsujita K. Persistent Renal Dysfunction in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction. J Am Heart Assoc 2019; 8:e014096. [PMID: 31766973 PMCID: PMC6912980 DOI: 10.1161/jaha.119.014096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The long-term prognosis of patients with acute myocardial infarction who develop persistent renal dysfunction (RD) remains unclear. We investigated risk factors and prognostic implications of persistent RD after contrast-induced nephropathy (CIN) in patients with acute myocardial infarction after primary percutaneous coronary intervention. Methods and Results We enrolled 952 consecutive patients who underwent primary percutaneous coronary intervention for acute myocardial infarction. CIN was defined as an increase in serum creatinine levels ≥0.5 mg/dL or ≥25% from baseline within 72 hours after percutaneous coronary intervention. Persistent RD was defined as residual impairment of renal function over 2 weeks, and transient RD was defined as recovery of renal function within 2 weeks, after CIN. The overall incidence of CIN was 8.8% and that of persistent CIN was 3.1%. A receiver-operator characteristic curve showed that the optimal cutoff value of the contrast volume/baseline estimated glomerular filtration rate ratio for persistent CIN was 3.45. In multivariable logistic analysis, a contrast volume/baseline estimated glomerular filtration rate >3.45 was an independent correlate of persistent RD. At 3 years, the incidence of death was significantly higher in patients with persistent RD than in those with transient RD (P=0.001) and in those without CIN (P<0.001). Cox regression analysis showed that persistent RD (hazard ratio, 4.99; 95% CI, 2.30-10.8; P<0.001) was a significant risk factor for mortality. A similar trend was observed for the combined end points, which included mortality, hemodialysis, stroke, and acute myocardial infarction. Conclusions Persistent RD, but not transient RD, is independently associated with long-term mortality. A contrast volume/baseline estimated glomerular filtration rate >3.45 is an independent predictor of persistent RD.
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Affiliation(s)
- Kazumasa Kurogi
- Department of Cardiovascular Medicine Miyazaki Prefectural Nobeoka Hospital Miyazaki Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine Miyazaki Prefectural Nobeoka Hospital Miyazaki Japan
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Soichi Komaki
- Department of Cardiovascular Medicine Miyazaki Prefectural Nobeoka Hospital Miyazaki Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine Miyazaki Prefectural Nobeoka Hospital Miyazaki Japan
| | - Hiroaki Kusaka
- Department of Cardiovascular Medicine Miyazaki Prefectural Nobeoka Hospital Miyazaki Japan
| | - Nobuyasu Yamamoto
- Department of Cardiovascular Medicine Miyazaki Prefectural Nobeoka Hospital Miyazaki Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
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19
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Marume K, Noguchi T, Tateishi E, Morita Y, Kamakura T, Ishibashi K, Noda T, Miura H, Nishimura K, Nakai M, Yamada N, Tsujita K, Anzai T, Kusano K, Ogawa H, Yasuda S. Mortality and Sudden Cardiac Death Risk Stratification Using the Noninvasive Combination of Wide QRS Duration and Late Gadolinium Enhancement in Idiopathic Dilated Cardiomyopathy. Circ Arrhythm Electrophysiol 2019; 11:e006233. [PMID: 29654132 DOI: 10.1161/circep.117.006233] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/26/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study was to investigate whether the combination of QRS duration ≥120 ms (wide QRS duration [wQRS]) and late gadolinium enhancement (LGE) is a precise prognostic indicator for dilated cardiomyopathy. METHODS AND RESULTS We investigated the association between the combination of LGE plus wQRS and the primary end point (all-cause death) and a composite of sudden cardiac death (SCD) or aborted SCD in 531 patients with dilated cardiomyopathy. We also analyzed the association between the combination of LGE and wQRS and these end points among patients with a class I indication for implantable cardioverter defibrillator implantation. We divided study patients into 3 groups according to LGE status and QRS duration: 2 negative indices (LGE negative and narrow QRS), 1 positive index (LGE positive or wQRS), or 2 positive indices (LGE positive and wQRS), and followed them for 3.8 years. Multivariable Cox regression analysis identified 2 positive indices as a significant predictor of all-cause death (hazard ratio, 4.29 [1.19-15.47]; P=0.026). Among 317 patients with a class I indication for implantable cardioverter defibrillator, the 5-year event rate of SCD or aborted SCD was the lowest in the 2 negative indices group (1.4%). With propensity score-matching cohorts, the 2 negative indices group had a significantly lower event rate of SCD or aborted SCD than the other 2 groups (hazard ratio, 0.12 [0.01-0.97]; P=0.046). CONCLUSIONS The combination of LGE and wQRS provides additional prognostic stratification compared with LGE status alone and might improve the appropriate use of implantable cardioverter defibrillator therapy in patients with dilated cardiomyopathy.
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Affiliation(s)
- Kyohei Marume
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Teruo Noguchi
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan.
| | - Emi Tateishi
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Yoshiaki Morita
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Tsukasa Kamakura
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Kohei Ishibashi
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Takashi Noda
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Hiroyuki Miura
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Kunihiro Nishimura
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Michikazu Nakai
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Naoaki Yamada
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Kenichi Tsujita
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Toshihisa Anzai
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Kengo Kusano
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Hisao Ogawa
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Satoshi Yasuda
- Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), National Cerebral and Cardiovascular Center, Suita, Japan. Department of Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical Sciences, Kumamoto University, Japan
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20
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Marume K, Takashio S, Nishi M, Hirakawa K, Yamamoto M, Hanatani S, Oda S, Utsunomiya D, Shiraishi S, Ueda M, Yamashita T, Sakamoto K, Yamamoto E, Kaikita K, Izumiya Y, Yamashita Y, Ando Y, Tsujita K. Combination of Commonly Examined Parameters Is a Useful Predictor of Positive 99 mTc-Labeled Pyrophosphate Scintigraphy Findings in Elderly Patients With Suspected Transthyretin Cardiac Amyloidosis. Circ J 2019; 83:1698-1708. [PMID: 31189791 DOI: 10.1253/circj.cj-19-0255] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A recent study revealed a high prevalence of transthyretin (TTR) cardiac amyloidosis (CA) in elderly patients. 99 mTc-labeled pyrophosphate (99 mTc-PYP) scintigraphy is a remarkably sensitive and specific modality for TTR-CA, but is only available in specialist centres; thus, it is important to raise the pretest probability. The aim of this study was to evaluate the characteristics of patients with 99 mTc-PYP positivity and make recommendations about patient selection for 99 mTc-PYP scintigraphy.Methods and Results:We examined 181 consecutive patients aged ≥70 years who underwent 99 mTc-PYP scintigraphy at Kumamoto University Hospital between January 2012 and December 2018. Logistic regression analyses showed that high-sensitivity cardiac troponin T (hs-cTnT) ≥0.0308 ng/mL, left ventricular posterior wall thickness ≥13.6 mm, and wide QRS (QRS ≥120 ms) were strongly associated with 99 mTc-PYP positivity. We developed a new index for predicting 99 mTc-PYP positivity by adding 1 point for each of the 3 factors. The 99 mTc-PYP positive rate increased by a factor of 4.57 for each 1-point increase (P<0.001). Zero points corresponded to a negative predictive value of 87% and 3 points corresponded to a positive predictive value of 96% for 99 mTc-PYP positivity. CONCLUSIONS The combination of biochemical (hs-cTnT), physiological (wide QRS), and structural (left ventricular posterior wall thickness) findings can raise the pretest probability for 99 mTc-PYP scintigraphy. It can assist clinicians in determining management strategies for elderly patients with suspected CA.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Masato Nishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Masahiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Science, Kumamoto University
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Graduate School of Medical Science, Kumamoto University
| | - Shinya Shiraishi
- Department of Diagnostic Radiology, Graduate School of Medical Science, Kumamoto University
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Science, Kumamoto University
| | - Taro Yamashita
- Department of Neurology, Graduate School of Medical Science, Kumamoto University
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Medical Science, Kumamoto University
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Science, Kumamoto University
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
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21
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Marume K, Takashio S, Nakanishi M, Kumasaka L, Fukui S, Nakao K, Arakawa T, Yanase M, Noguchi T, Yasuda S, Goto Y. Efficacy of Cardiac Rehabilitation in Heart Failure Patients With Low Body Mass Index. Circ J 2019; 83:334-341. [PMID: 30651408 DOI: 10.1253/circj.cj-18-0852] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Low body mass index (BMI) is a relevant prognostic factor for heart failure (HF), but HF patients with low BMI are reported to be at risk of not receiving optimal drug treatment. We sought to evaluate the efficacy of cardiac rehabilitation (CR) in patients with low vs. normal BMI. Methods and Results: We studied 152 consecutive patients (low BMI, n=32; normal BMI, n=119) who participated in a 3-month CR program. Low BMI was defined as <18.5 kg/m2and normal BMI, as 18.5≤BMI<25 kg/m2. All patients underwent cardiopulmonary exercise testing and muscle strength testing at the beginning and end of the 3-month CR program. After CR, a significantly greater proportion of HF patients with low BMI had a positive change in peak V̇O2than in the normal BMI group (91% vs. 70%; P=0.010). Average percent change in peak V̇O2was significantly greater in patients with low vs. normal BMI (17.1±2.8% vs. 7.8±1.5%; P<0.001). In addition, on multivariable logistic regression, low BMI was an independent predictor of a positive change in peak V̇O2after CR (OR, 3.97; 95% CI: 1.10-14.31; P=0.035). CONCLUSIONS CR has a greater effect in patients with low than normal BMI, and low BMI is an independent predictor of a positive change in peak V̇O2. Thus, CR should be strongly recommended for HF patients with low BMI.
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Affiliation(s)
- Kyohei Marume
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.,Division of Cardiovascular Medicine, Graduate School of Medicine, Kumamoto University
| | - Seiji Takashio
- Division of Cardiovascular Medicine, Graduate School of Medicine, Kumamoto University
| | - Michio Nakanishi
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Leon Kumasaka
- Department of Cardiovascular Medicine, Saitama Sekishinkai Hospital
| | - Shigefumi Fukui
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kazuhiro Nakao
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tetsuo Arakawa
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Teruo Noguchi
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Division of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoichi Goto
- Department of Cardiovascular Medicine, Yoka Hospital
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22
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Marume K, Takashio S, Nagai T, Tsujita K, Saito Y, Yoshikawa T, Anzai T. Effect of Statins on Mortality in Heart Failure With Preserved Ejection Fraction Without Coronary Artery Disease - Report From the JASPER Study. Circ J 2018; 83:357-367. [PMID: 30416189 DOI: 10.1253/circj.cj-18-0639] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/09/2022]
Abstract
BACKGROUND Statins might be associated with improved survival in patients with heart failure with preserved ejection fraction (HFpEF). The effect of statins in HFpEF without coronary artery disease (CAD), however, remains unclear. Methods and Results: From the JASPER registry, a multicenter, observational, prospective cohort with Japanese patients aged ≥20 years requiring hospitalization with acute HF and LVEF ≥50%, 414 patients without CAD were selected for outcome analysis. Based on prescription of statins at admission, we divided patients into the statin group (n=81) or no statin group (n=333). We followed them for 25 months. The association between statin use and primary (all-cause mortality) and secondary (non-cardiac death, cardiac death, or rehospitalization for HF) endpoints was assessed in the entire cohort and in a propensity score-matched cohort. In the propensity score-matched cohort, 3-year mortality was lower in the statin group (HR, 0.21; 95% CI: 0.06-0.72; P=0.014). The statin group had a significantly lower incidence of non-cardiac death (P=0.028) and rehospitalization for HF (P<0.001), but not cardiac death (P=0.593). The beneficial effect of statins on mortality did not have any significant interaction with cholesterol level or HF severity. CONCLUSIONS Statin use has a beneficial effect on mortality in HFpEF without CAD. The present findings should be tested in an adequately powered randomized clinical trial.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.,Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Yoshihiko Saito
- First Department of Internal Medicine, Nara Medical University
| | | | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.,Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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23
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Kurogi K, Sakamoto K, Marume K, Kusaka H, Yamamoto N, Tsujita K. Successful removal of side branch-jailed stent struts by reused balloon. Cardiol J 2018; 25:644-645. [PMID: 30394516 DOI: 10.5603/cj.2018.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | | | | | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto City, Japan.
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24
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Marume K, Ishibashi K, Noda T, Ohta-Ogo K, Yasuda S, Kusano K. Short coupled Torsade de pointes with myocardial injury: A possible sequela of myocarditis. J Cardiol Cases 2018; 19:62-65. [PMID: 31193697 DOI: 10.1016/j.jccase.2018.10.004] [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] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/27/2018] [Accepted: 10/20/2018] [Indexed: 12/19/2022] Open
Abstract
A 44-year-old woman with previous myocarditis underwent several syncopal events due to self-terminated ventricular fibrillation (VF) with hypokalemia. Electrocardiogram showed a normal QT duration and premature ventricular contraction with a short coupling interval (280 ms), and the R-on-T phenomenon induced Torsade de pointes (TdP) that deteriorated into VF, a condition known as short coupled TdP (ScTdP). Cardiac magnetic resonance imaging showed left ventricular dilatation and diffuse high T2 signal intensity, and endomyocardial biopsy exhibited a failing myocardium. This is a rare case of ScTdP accompanied by a failing myocardium. Some instances of ScTdP may be associated not only with an electrical disorder but also with a structural myocardial disorder. <Leaning Objective: Any cases with short coupled Torsade de pointes (ScTdP) have not reported structural disorders, and ScTdP has been categorized as an idiopathic arrhythmia. This is the first case of ScTdP accompanied by a failing myocardium, which was identified by cardiac magnetic resonance imaging and both light and electron microscopic examination. According to this case, some cases of ScTdP may be associated not only with electrical disorders, but also structural myocardial abnormalities.>.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Ohta-Ogo
- Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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25
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Hirakawa K, Takashio S, Marume K, Yamamoto M, Hanatani S, Yamamoto E, Sakamoto K, Izumiya Y, Kaikita K, Oda S, Utsunomiya D, Shiraishi S, Ueda M, Yamashita T, Yamashita Y, Ando Y, Tsujita K. Non-Val30Met mutation, septal hypertrophy, and cardiac denervation in patients with mutant transthyretin amyloidosis. ESC Heart Fail 2018; 6:122-130. [PMID: 30284755 PMCID: PMC6352919 DOI: 10.1002/ehf2.12361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 04/03/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 11/20/2022] Open
Abstract
Aims Mutant transthyretin (ATTRm) amyloidosis is a systemic disease caused by the deposition of amyloid fibrils derived from mutated transthyretin. Although cardiac involvement impacts the prognosis of patients with ATTRm amyloidosis, the incidence of cardiac events, such as bradyarrhythmia, ventricular tachycardia, and heart failure, has not been fully elucidated. The aim of this study was to evaluate the prognosis and predictors of clinical outcomes, including cardiac events, in patients with ATTRm amyloidosis in Japan. Methods and results We evaluated 90 consecutive patients with ATTRm amyloidosis at Kumamoto University. ATTRm amyloidosis was diagnosed by the observation of both amyloid fibril deposition on tissue biopsy and a transthyretin mutation on sequential analysis. Sympathetic nerve activity was evaluated in 59 patients using 123‐iodine metaiodobenzylguanidine (123I‐MIBG) imaging. The endpoint was a composite of all‐cause death, hospitalization for heart failure, and implantation of a pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization therapy defibrillator. Sixty‐seven patients had the Val30Met mutation (74%). The composite endpoint occurred in 23 patients (26%): all‐cause death (n = 6), hospitalization for worsening heart failure (n = 1), and implantation of an implantable cardioverter defibrillator (n = 6), cardiac resynchronization therapy defibrillator (n = 3), or pacemaker (n = 7). The 5‐year incident rate for clinical outcomes was 19%. In a multivariate Cox hazard analysis, age [hazard ratio (HR): 1.07, 95% confidence interval (95% CI): 1.01–1.12, P = 0.015], PQ interval (HR: 1.01, 95% CI: 1.00–1.02, P = 0.042), interventricular septum thickness in diastole (HR: 1.25, 95% CI: 1.09–1.42, P = 0.001), and non‐Val30Met mutation (HR: 4.31, 95% CI: 1.53–12.16, P = 0.006) were independent predictive factors of clinical outcomes. Kaplan–Meier analysis demonstrated a significantly higher probability of the composite endpoint in the non‐Val30Met group than in the Val30Met group (log‐rank test: P = 0.002) and in patients with left ventricular hypertrophy than in patients without left ventricular hypertrophy (log‐rank test: P < 0.001). In patients who underwent 123I‐MIBG imaging, a delayed heart‐to‐mediastinum (HM) ratio <1.6 was a significant predictive factor of the composite endpoint (HR: 4.98, 95% CI: 1.73–14.37, P = 0.003) in the univariate Cox hazard analyses. Kaplan–Meier curve analysis showed that a delayed HM ratio <1.6 was associated with a poor prognosis (log‐rank test: P = 0.001). Conclusions Non‐Val30Met mutation, septal hypertrophy, and a delayed HM ratio are useful predictors of clinical outcomes in patients with ATTRm amyloidosis in Japan. These results suggest that it is important to evaluate cardiac involvement in terms of morphological (left ventricular hypertrophy) and functional (cardiac denervation) perspectives using echocardiography and 123I‐MIBG imaging, respectively.
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Affiliation(s)
- Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masahiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinya Shiraishi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Taro Yamashita
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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26
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Hamatani Y, Nakashima J, Ohta-Ogo K, Amaki M, Koga M, Aoyama D, Marume K, Sawada K, Nakashima Y, Shibata A, Okada A, Takahama H, Hasegawa T, Sugano Y, Kanzaki H, Ikeda Y, Yasuda S, Ishibashi-Ueda H, Anzai T. Mitral Regurgitation and Heart Failure as the First Presentation in a Patient with Features of Two Connective Tissue Disorders: A Rare Combination of Mucopolysaccharidosis and Osteogenesis Imperfecta? Intern Med 2018; 57:2209-2215. [PMID: 29225276 PMCID: PMC6120827 DOI: 10.2169/internalmedicine.9763-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Connective tissue disorders sometimes involve cardiovascular systems. This report describes the case of a middle-aged man with mitral regurgitation and heart failure. He had distinctive features of mucopolysaccharidosis type (MPS) III, but no gene mutations that were known to be associated with MPS. Meanwhile, he had a COL1A2 gene mutation that is associated with osteogenesis imperfecta (OI), and had some features that were compatible with OI. The patient might have had a rare connective tissue disorder with the characteristics of MPS III and OI, which was initially detected as a result of the cardiovascular manifestations.
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Affiliation(s)
- Yasuhiro Hamatani
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Junko Nakashima
- Department of Pathology, National Cerebral and Cardiovascular Center, Japan
| | - Keiko Ohta-Ogo
- Department of Pathology, National Cerebral and Cardiovascular Center, Japan
| | - Makoto Amaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Masashi Koga
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kenichiro Sawada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yasuteru Nakashima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Atsushi Shibata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Atsushi Okada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Hiroyuki Takahama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Takuya Hasegawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yasuo Sugano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | | | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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27
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Marume K, Takashio S, Nagai T, Tsujita K, Saito Y, Yoshikawa T, Anzai T. P6501The effect of statin on mortality in patients with heart failure with preserved ejection fraction without coronary artery disease - a report from the JASPER study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Marume
- Kumamoto University Hospital, Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan
| | - S Takashio
- Kumamoto University Hospital, Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan
| | - T Nagai
- Hokkaido University, cardiovascular medicine, Sapporo, Japan
| | - K Tsujita
- Kumamoto University Hospital, Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Y Saito
- Nara Medical University, First Department of Internal Medicine, Nara, Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
| | - T Anzai
- Hokkaido University, cardiovascular medicine, Sapporo, Japan
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28
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Marume K, Fukui S, Shimamoto K, Ohuchi H, Tsuji A, Ogo T, Nakanishi N, Yasuda S. Coexistence of a Double-Chambered Right Ventricle With Ebstein-Like Anomaly and Right Ventricular Apical Hypoplasia ― Usefulness of Multimodality Imaging ―. Circ J 2018; 82:1215-1217. [DOI: 10.1253/circj.cj-17-0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shigefumi Fukui
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideo Ohuchi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Akihiro Tsuji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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29
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Takashio S, Yamamuro M, Izumiya Y, Hirakawa K, Marume K, Yamamoto M, Ueda M, Yamashita T, Ishibashi-Ueda H, Yasuda S, Ogawa H, Ando Y, Anzai T, Tsujita K. Diagnostic utility of cardiac troponin T level in patients with cardiac amyloidosis. ESC Heart Fail 2017; 5:27-35. [PMID: 28869340 PMCID: PMC5793964 DOI: 10.1002/ehf2.12203] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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] [Received: 09/28/2016] [Revised: 06/23/2017] [Accepted: 07/14/2017] [Indexed: 01/15/2023] Open
Abstract
AIM The aim of this study was to evaluate the diagnostic utility of high-sensitivity cardiac troponin T (hs-cTnT) levels in discriminating cardiac amyloidosis from patients with cardiac hypertrophy caused by aetiologies other than cardiac amyloidosis. METHODS AND RESULTS Serum hs-cTnT levels were measured in 96 patients with cardiac amyloidosis (light chain: 23, wild-type transthyretin amyloidosis: 40, and mutated transthyretin amyloidosis: 33), and 91 patients with other causes of cardiac hypertrophy who were confirmed to have no cardiac amyloidosis by endomyocardial biopsy (control group). The diagnostic utility and cut-off value of hs-cTnT were evaluated by receiver operating characteristic analysis. The median hs-cTnT levels were higher in cardiac amyloidosis than the control group [0.048 (0.029-0.073) vs. 0.016 (0.010-0.031) ng/mL; P < 0.001]. High levels of hs-cTnT were suggestive of cardiac amyloidosis (cut-off value: 0.0312 ng/mL, sensitivity: 0.74, specificity: 0.76, area under the curve: 0.788; 95% confidence interval: 0.723-0.854, P < 0.001), compared with brain natriuretic peptide and E/e' ratio. The hs-cTnT levels were also useful in differentiating each type of amyloidosis from the control group. Multivariate analysis identified log hs-cTnT as an independent diagnostic factor for cardiac amyloidosis (odds ratio: 2.22; 95% confidence interval: 1.30-3.80; P = 0.004). CONCLUSIONS High serum levels of hs-cTnT are highly suggestive of cardiac amyloidosis, allowing its differentiation from cardiac hypertrophy of other aetiologies. Further refined diagnostic approaches that include imaging modalities and histopathological examination are needed for these patients to avoid underdiagnosis of cardiac amyloidosis.
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Affiliation(s)
- Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Megumi Yamamuro
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masahiro Yamamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Taro Yamashita
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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30
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Marume K, Hokimoto S, Tabata N, Akasaka T, Tsujita K, Sakamoto K, Yamamoto E, Yamamuro M, Kaikita K, Oniki K, Nakagawa K, Ogawa H. Intraprocedural thrombotic event during coronary intervention depends on CYP2C19 genotype and is a predictor of future clinical event. Int J Cardiol 2015; 187:231-3. [PMID: 25838219 DOI: 10.1016/j.ijcard.2015.03.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 03/21/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seiji Hokimoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
| | - Noriaki Tabata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomonori Akasaka
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Megumi Yamamuro
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kentaro Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Medical and Pharmaceutical Sciences, Center for Clinical Pharmaceutical Sciences, Kumamoto, Japan
| | - Kazuko Nakagawa
- Division of Pharmacology and Therapeutics, Graduate School of Medical and Pharmaceutical Sciences, Center for Clinical Pharmaceutical Sciences, Kumamoto, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Marume K, Arima Y, Igata M, Nishikawa T, Yamamoto E, Yamamuro M, Tsujita K, Tanaka T, Kaikita K, Hokimoto S, Ogawa H. Prolonged hyponatremia due to hypopituitarism in a patient with non-ST-elevation myocardial infarction. J Cardiol Cases 2014; 10:226-230. [DOI: 10.1016/j.jccase.2014.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022] Open
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