1
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Malatesta P, Kyriakidis K, Hada M, Ikeda H, Takahashi A, Saganti PB, Georgakilas AG, Michalopoulos I. Differential Gene Expression in Human Fibroblasts Simultaneously Exposed to Ionizing Radiation and Simulated Microgravity. Biomolecules 2024; 14:88. [PMID: 38254688 PMCID: PMC10812944 DOI: 10.3390/biom14010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/23/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
During future space missions, astronauts will be exposed to cosmic radiation and microgravity (μG), which are known to be health risk factors. To examine the differentially expressed genes (DEG) and their prevalent biological processes and pathways as a response to these two risk factors simultaneously, 1BR-hTERT human fibroblast cells were cultured under 1 gravity (1G) or simulated μG for 48 h in total and collected at 0 (sham irradiated), 3 or 24 h after 1 Gy of X-ray or Carbon-ion (C-ion) irradiation. A three-dimensional clinostat was used for the simulation of μG and the simultaneous radiation exposure of the samples. The RNA-seq method was used to produce lists of differentially expressed genes between different environmental conditions. Over-representation analyses were performed and the enriched biological pathways and targeting transcription factors were identified. Comparing sham-irradiated cells under simulated μG and 1G conditions, terms related to response to oxygen levels and muscle contraction were identified. After irradiation with X-rays or C-ions under 1G, identified DEGs were found to be involved in DNA damage repair, signal transduction by p53 class mediator, cell cycle arrest and apoptosis pathways. The same enriched pathways emerged when cells were irradiated under simulated μG condition. Nevertheless, the combined effect attenuated the transcriptional response to irradiation which may pose a subtle risk in space flights.
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Affiliation(s)
- Polina Malatesta
- Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece; (P.M.); (K.K.)
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 15780 Athens, Greece
| | - Konstantinos Kyriakidis
- Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece; (P.M.); (K.K.)
- Laboratory of Pharmacology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- UC Santa Cruz Genomics Institute, Santa Cruz, CA 95060, USA
| | - Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA; (M.H.); (P.B.S.)
| | - Hiroko Ikeda
- Department of Life Science, Faculty of Science and Engineering, Kindai University, Higashiosaka 577-8502, Japan;
| | - Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, Maebashi 371-8511, Japan;
| | - Premkumar B. Saganti
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA; (M.H.); (P.B.S.)
| | - Alexandros G. Georgakilas
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 15780 Athens, Greece
| | - Ioannis Michalopoulos
- Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece; (P.M.); (K.K.)
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2
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Huff JL, Poignant F, Rahmanian S, Khan N, Blakely EA, Britten RA, Chang P, Fornace AJ, Hada M, Kronenberg A, Norman RB, Patel ZS, Shay JW, Weil MM, Simonsen LC, Slaba TC. Galactic cosmic ray simulation at the NASA space radiation laboratory - Progress, challenges and recommendations on mixed-field effects. Life Sci Space Res (Amst) 2023; 36:90-104. [PMID: 36682835 DOI: 10.1016/j.lssr.2022.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 06/17/2023]
Abstract
For missions beyond low Earth orbit to the moon or Mars, space explorers will encounter a complex radiation field composed of various ion species with a broad range of energies. Such missions pose significant radiation protection challenges that need to be solved in order to minimize exposures and associated health risks. An innovative galactic cosmic ray simulator (GCRsim) was recently developed at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL). The GCRsim technology is intended to represent major components of the space radiation environment in a ground analog laboratory setting where it can be used to improve understanding of biological risks and serve as a testbed for countermeasure development and validation. The current GCRsim consists of 33 energetic ion beams that collectively simulate the primary and secondary GCR field encountered by humans in space over the broad range of particle types, energies, and linear energy transfer (LET) of interest to health effects. A virtual workshop was held in December 2020 to assess the status of the NASA baseline GCRsim. Workshop attendees examined various aspects of simulator design, with a particular emphasis on beam selection strategies. Experimental results, modeling approaches, areas of consensus, and questions of concern were also discussed in detail. This report includes a summary of the GCRsim workshop and a description of the current status of the GCRsim. This information is important for future advancements and applications in space radiobiology.
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Affiliation(s)
- Janice L Huff
- NASA Langley Research Center, Hampton, VA, 23681, United States of America.
| | - Floriane Poignant
- National Institute of Aerospace, Hampton, VA, 23666, United States of America
| | - Shirin Rahmanian
- National Institute of Aerospace, Hampton, VA, 23666, United States of America
| | - Nafisah Khan
- National Institute of Aerospace, Hampton, VA, 23666, United States of America
| | - Eleanor A Blakely
- Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, United States of America
| | - Richard A Britten
- Department of Radiation Oncology, Department of Microbiology and Molecular Cell Biology, Leroy T Canoles Jr. Cancer Center, School of Medicine, Eastern Virginia Medical School, Norfolk, VA, 23507, United States of America
| | - Polly Chang
- SRI International, Menlo Park, CA, 94025, United States of America
| | - Albert J Fornace
- Georgetown University, Washington, DC, 20057, United States of America
| | - Megumi Hada
- Prairie View A&M University, Prairie View, TX, 77446, United States of America
| | - Amy Kronenberg
- Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, United States of America
| | - Ryan B Norman
- NASA Langley Research Center, Hampton, VA, 23681, United States of America
| | - Zarana S Patel
- KBR Inc., Houston, TX, 77058, United States of America; NASA Johnson Space Center, Houston, TX, 77058, United States of America
| | - Jerry W Shay
- University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States of America
| | - Michael M Weil
- Colorado State University, Fort Collins, CO, 80523, United States of America
| | - Lisa C Simonsen
- NASA Headquarters, Washington, DC, 20546, United States of America
| | - Tony C Slaba
- NASA Langley Research Center, Hampton, VA, 23681, United States of America
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3
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Souli MP, Nikitaki Z, Puchalska M, Brabcová KP, Spyratou E, Kote P, Efstathopoulos EP, Hada M, Georgakilas AG, Sihver L. Clustered DNA Damage Patterns after Proton Therapy Beam Irradiation Using Plasmid DNA. Int J Mol Sci 2022; 23:ijms232415606. [PMID: 36555249 PMCID: PMC9779025 DOI: 10.3390/ijms232415606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Modeling ionizing radiation interaction with biological matter is a major scientific challenge, especially for protons that are nowadays widely used in cancer treatment. That presupposes a sound understanding of the mechanisms that take place from the early events of the induction of DNA damage. Herein, we present results of irradiation-induced complex DNA damage measurements using plasmid pBR322 along a typical Proton Treatment Plan at the MedAustron proton and carbon beam therapy facility (energy 137-198 MeV and Linear Energy Transfer (LET) range 1-9 keV/μm), by means of Agarose Gel Electrophoresis and DNA fragmentation using Atomic Force Microscopy (AFM). The induction rate Mbp-1 Gy-1 for each type of damage, single strand breaks (SSBs), double-strand breaks (DSBs), base lesions and non-DSB clusters was measured after irradiations in solutions with varying scavenging capacity containing 2-amino-2-(hydroxymethyl)propane-1,3-diol (Tris) and coumarin-3-carboxylic acid (C3CA) as scavengers. Our combined results reveal the determining role of LET and Reactive Oxygen Species (ROS) in DNA fragmentation. Furthermore, AFM used to measure apparent DNA lengths provided us with insights into the role of increasing LET in the induction of highly complex DNA damage.
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Affiliation(s)
- Maria P Souli
- Atominstitut, Technische Universität Wien, 1020 Vienna, Austria
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 15780 Athens, Greece
| | - Zacharenia Nikitaki
- Atominstitut, Technische Universität Wien, 1020 Vienna, Austria
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 15780 Athens, Greece
| | | | | | - Ellas Spyratou
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11517 Athens, Greece
| | - Panagiotis Kote
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 15780 Athens, Greece
| | - Efstathios P Efstathopoulos
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11517 Athens, Greece
| | - Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA
| | - Alexandros G Georgakilas
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 15780 Athens, Greece
| | - Lembit Sihver
- Atominstitut, Technische Universität Wien, 1020 Vienna, Austria
- Nuclear Physics Institute, Czech Academy of Sciences, Na Truhlářce 39/64, 180 86 Prague, Czech Republic
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. the diagnostic value of left-anterior-descending artery velocity assessed by transthoracic Doppler echocardiography for microvascular dysfunction in stenotic left-anterior-descending artery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Index of microcirculatory resistance (IMR) has been used as a clinical measure of microvascular function. Transthoracic Doppler echocardiography (TDE) can provide information on the functional status of coronary artery circulation. This study aims to assess the diagnostic value of left-anterior-descending artery (LAD) flow velocity by TDE for microvascular dysfunction.
Methods
Consecutive patients who were scheduled for elective percutaneous coronary intervention (PCI) for LAD lesions were prospectively enrolled in the single tertiary-care center between April 2020 and July 2021. Pre-PCI LAD diastolic peak velocity (DPV) by TDE at rest and hyperemia were measured. By invasive coronary angiography, quantitative coronary angiography and invasive wire-based physiological indices including fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured.
Results
A total of 104 patients were studied. Median FFR and IMR values were 0.70 (0.60–0.74) and 20.68 (14.92–31.69), respectively. No significant relationship was observed between FFR and IMR. The prevalence of microvascular dysfunction defined as IMR≥25 was 39.4%. Basal DPV was 25 (20–33) cm/sec, and hyperemic DPV was 51 (41–67) cm/sec. In lesions with IMR≥25, reference diameter (RD) was significantly greater [2.63 (2.22–3.19) mm vs 2.39 (2.09–2.66) mm, p=0.019], basal DPV was lower [26 (18–29) cm/sec vs 29 (22–37) cm/sec, p=0.022)] and hyperemic DPV was lower [49 (19–54) cm/sec vs 56 (42–70) cm/sec, p=0.023] compared to lesions with IMR<25. ROC analysis showed basal DPV and RD are significant predictors of IMR≥25 [basal DPV: AUC 0.633 (0.525–0.742), best cutoff 29cm/sec RD: AUC 0.636 (0.523–0.750), best cutoff 2.84mm]. Multivariable logistic regression analysis showed basal DPV<29cm/sec and RD>2.84mm are independent predictors for IMR≥25 [Odds ratio: 3.08 (1.22–7.78), p=0.017; odds ratio 4.40 (1.55–12.50), p=0.005].
Conclusion
Basal DPV by non-invasive pre-PCI TDE and reference diameter can predict lesions with coexisting microvascular dysfunction in LAD territory with functionally significant lesions without the need of vasodilator-induced hyperemia and a wire-based invasive physiological measurement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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5
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Nogami K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Yamaguchi M, Nagamine T, Teng Y, Ueno H, Matsuda K, Sayama K, Kakuta T. Prognostic implications of unrecognized myocardial infarction before elective percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A non-negligible proportion of myocardial infarction (MI) is not clinically recognized and unrecognized myocardial infarction (UMI) is associated with adverse outcomes.
Purpose
To determine the prevalence and prognostic significance of UMI by delayed-enhancement cardiac magnetic resonance (DE-CMR) before elective percutaneous coronary intervention (PCI).
Methods
In this prospective, single-center study, 236 patients with stable coronary artery disease undergoing elective and uncomplicated PCI were studied. All patients underwent DE-CMR before PCI. The prevalence of UMI was evaluated and the association of clinical and CMR-derived variables with primary MACE, defined as cardiovascular death, nonfatal MI, hospitalization for heart failure, unplanned late revascularization, and ischemic stroke was investigated.
Results
In the final analysis of 213 patients, 63 patients (29.6%) showed UMI. Target territory UMI was observed in 38 (17.8% of total, 60.3% of patients with UMI). UMI was significantly associated with sex, diabetes mellitus, left ventricular ejection fraction, SYNTAX score and fractional flow reserve in target vessels. During follow-up periods (median, 23 months), MACE was observed in 17 (27.0%) of patients with UMI, and 17 (11.3%) without (P=0.001). In a multivariable model, UMI (hazard ratio [HR] 2.18, 95% confidential interval, 1.10–4.33, P=0.001) remained as an independent predictor of MACE. Kaplan–Meier analysis indicated that the presence of UMI was significantly associated with higher incidence of MACE.
Conclusions
The prevalence of UMI in patients undergoing elective PCI was 29.6%. UMI was independently associated with an increased risk of MACE after successful PCI. Given the non-negligible prevalence and potential clinical significance of UMI, clinical studies comparing PCI and guideline directed medical therapy (GDMT) versus GDMT only strategy might have to take the presence of UMI into consideration.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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6
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Sayama K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Nagamine T, Nogami K, Teng Y, Ueno H, Matsuda K, Yonetsu T, Kakuta T. Prognostic implication of unrecognized myocardial infarction in patients with non-ST-segment-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prognostic value of unrecognized non-infarct-related territory (non-IR) myocardial infarction (UMI) in patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) remains to be elucidated.
Purpose
This study sought to evaluate the prevalence of non-IR UMI and its prognostic value in patients with first NSTE-ACS presentation.
Methods
This retrospective single-center analysis was conducted in patients with NSTE-ACS without prior history of coronary artery disease, who underwent uncomplicated urgent percutaneous coronary intervention (PCI) within 48 hours of admission between August 2014 and January 2018. All patients underwent postprocedural cardiac magnetic resonance imaging (CMR) within 30 days after PCI. Non-IR UMI was defined as the presence of non-IR delayed gadolinium enhancement with an ischemic distribution pattern. We investigated the association of non-IR UMI, other CMR findings and baseline clinical characteristics with major adverse cardiac events (MACE), defined as all-cause death, non-fatal myocardial infarction, ischemic stroke, late revascularization and hospitalization for congestive heart failure.
Results
A total of 168 NSTE-ACS patients were included (124 males (73.8%); 66±11 years). Non-IR UMI was detected in 28 patients (16.7%). During a median follow-up of 32 months (15–58), MACE occurred in 10 (35.7%) patients with non-IR UMI, and 20 (14.3%) patients without (P=0.013). Patients with MACE showed higher frequency of non-IR UMI in RCA territory and multi vessel disease, higher level of NT-proBNP at admission, higher Genisini score, and greater extent of UMI. Cox's proportional hazards analysis showed that the presence of non-IR UMI was an independent predictor of MACE (HR 2.34, 95% CI 1.02–5.37, P=0.045), after adjusting confounding factors, such as multi vessel disease and serum levels of NT-proBNP at admission. The discriminant efficacy (IDI and NRI) of predicting MACE was significantly improved when the presence of non-IR UMI added to the reference clinical risk model. Kaplan-Meier analysis revealed that patients with non-IR UMI were significantly associated with poor prognosis. (Figure 1).
Conclusions
In patients with NSTE-ACS undergoing urgent PCI, the prevalence of non-IR UMI was 16.7%. Non-IR UMI provided prognostic information independent of conventional risk factors.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Division of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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7
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Nagamine T, Hoshino M, Matsuda K, Misawa T, Sugiyama T, Sasano T, Sayama S, Ueno H, Hada M, Yonetsu T, Kakuta T. Identification of coronary plaque rupture or erosion by preprocedural computed tomography angiography in patients with non-st-segment elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The frequent pathological cause of acute coronary thrombosis is plaque rupture or erosion. A previous CT angiographic study failed to discriminate OCT-defined intact fibrous cap culprit lesions (IFC lesions) from those with ruptured fibrous cap (RFC group) in patients with acute coronary syndrome (ACS) and chronic coronary syndrome.
Objectives
This study aimed to evaluate the diagnostic efficacy of preprocedural coronary CT imaging to identify optical coherence tomography (OCT)-defined plaque rupture or erosion at culprit lesions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
Methods
Consecutive patients with suspected NSTE-ACS who underwent preprocedural non-contrast CT and CT angiography (CCTA) were studied. Patients with at least one lesion with more than 50% stenosis at the proximal segment on CCTA were subsequently assessed by invasive coronary angiography and OCT. ALL CT and OCT examination were performed within 24 hours from presentation. The diagnosis of intact fibrous cap or ruptured fibrous cap was made by OCT for the angiographically most severely stenosed lesion. Cases of ambiguous OCT diagnosis such as massive thrombosis or calcified nodule precluding the fibrous cap assessment were excluded from the final analysis.
Results
In the final analysis of 176 patients, OCT identified 87 RFC plaques and 89 IFC plaques for the culprit lesions, respectively. In IFC group, lower prevalence of diabetes mellitus (24.7% vs. 41.4%, P=0.025) and lower peak cardiac marker elevation (CPK, 159 vs. 272 U/L, P<0.001) were observed. On CT, the prevalence of low attenuation plaque, positive remodeling, napkin ring sign, spotty calcification, calcium score (CAC), and culprit vessel pericoronary adipose tissue attenuation (FAI) were all significantly low in IFC group. Multivariate regression analysis to predict IFC at culprit lesions revealed that the absence of low attenuation plaque, the absence of napkin ring sign, zero CAC, and low FAI were independent predictors of IFC. When stratified by the number of these 4 CT factors, the presence of IFC were stratified as 0%, 23.6%, 50%, 77.8%, and 100% (P<0.001), respectively. Adding non-contrast CT factor of zero CAC to the reference model including age, sex, DM, EF, low attenuation plaque, napkin ring sign, and FAI, can increase the incremental discriminatory and reclassification performance for the prediction of IFC (C-statistic 0.828 NRI: 0.37, 95% CI: 0.095–0.646, P=0.008 and IDI: 0.042, 95% CI: 0.012–0.071, P=0.005).
Conclusions
Preprocedural comprehensive CT imaging including CAC and pericoronary adipose tissue inflammation could identify IFC or RFC culprit lesions defined by OCT. Further studies are needed to confirm our preliminary results and if CT imaging in NSTE-ACS provides prognostic information or specific therapeutic approach such as conservative therapy or non-stenting strategy before invasive angiography.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - S Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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8
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Diagnostic value of computed tomography myocardial perfusion to detect coexisting microvascular dysfunction in patients with obstructive epicardial coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The usefulness of computed tomography myocardial perfusion (CTP) to assess hemodynamically significant epicardial coronary artery lesions has been previously reported. However, the diagnostic value of quantitative evaluation of absolute coronary flow by CTP to detect microvascular dysfunction remains unknown.
Purpose
The aim of study is to assess the diagnostic value of CTP to evaluate coronary microvascular dysfunction (CMD) in patients with significant epicardial coronary stenosis, and to analyze the predicting factors for lesions with CMD.
Methods
Sixty-eight chronic coronary syndrome patients with de novo single functionally significant stenosis (Fractional flow reserve [FFR] <0.80) were investigated. CMD was defined by the index of microcirculatory resistance (IMR) ≥25. Clinical characteristics and CTP findings were compared between the two groups with and without CMD (CMD, n=29, non-CMD, n=39, respectively). The computed tomography angiography (CCTA) assessment included CTP findings and quantitative and qualitative assessment of plaques.
Results
In wire-based analysis, FFR, coronary flow reserve (CFRwire) and IMR were 0.68 (0.59–0.74), 1.71 (1.24–2.88), and 22.6 (15.1–34.5), respectively.
In CTP analysis, culprit territory regional absolute myocardial blood flow (MBF) at rest (rest-MBF) and hyperemia (hyperemic-MBF) were evaluated semi-automatically. CTP-derived CFR (CFRCTP) was calculated as hyperemic-MBF divided by rest-MBF. Rest and hyperemic-MBF and CFRCTP were 0.83 (0.64–1.03) ml/min/g, 2.14 (1.30–2.92) ml/min/g, and 2.19 (1.44–3.37).
In the lesions with CMD, hyperemic-MBF was significantly lower than those without CMD (1.68 [0.84–2.44] vs 2.31 [1.67–3.34] ml/min/g, p=0.015) and the prevalence of CFRCTP<2.0 was higher in the lesions with CMD than those without CMD (62.1% vs 28.2%, p=0.007).
CCTA analysis showed that fibrofatty and necrotic core component (FFNC) volume was greater in the lesions with CMD than in the lesions without CMD (31.8 [19.0–48.9] vs 25.1 [17.2–32.1] mm3, p=0.045). The multivariable logistic regression analysis, hyperemic-MBF and FFNC volume were independent predictors for lesions with CMD (Odds ratio [OR] 0.583 [0.355–0.958], p=0.033 and OR 1.040 [1.010–1.070], p=0.018).
Conclusion
Quantitative assessment of absolute coronary flow by CTP and comprehensive plaque analysis by CCTA may help detect coexisting subtended microvascular dysfunction in patients with functionally significant epicardial coronary lesions. Further studies are needed to elucidate the clinical significance of coexisting CMD in CCS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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9
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Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Multimodality coronary imaging to predict non-culprit territory unrecognized myocardial infarction assessed by cardiac magnetic resonance in non-ST-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
This study sought to assess the predictors of coherence tomography (OCT) and coronary computed tomography angiographic (CCTA) findings for non-infarct-related (non-IR) territory unrecognized myocardial infarction (UMI) in patients with first non-ST-elevation acute coronary syndrome (NSTE-ACS) presentation.
Background
UMI detected by cardiac magnetic resonance (CMR) is associated with adverse outcomes in patients with both acute coronary syndrome and chronic coronary syndrome. However, the association between the presence of UMI and findings of multimodality coronary imaging remains unknown.
Methods
We investigated 69 patients with a first clinical episode of NSTE-ACS, who underwent pre-PCI 320-slice CCTA, uncomplicated urgent percutaneous coronary intervention (PCI) with OCT assessment within 48 hours of admission, and post-PCI CMR. UMI was assessed on late gadolinium enhancement (LGE-CMR) by identifying regions of hyperenhancement with an ischemic distribution pattern in non-IR territories (non-IR UMI).
Results
Non-IR UMI was detected in 11 patients (15.9%). ROC analysis revealed the optimal cut-off value of PCATA in culprit vessel for predicting the presence of non-IR UMI were −71.3. Lower ejection fraction, higher Gensini score, high pericoronary inflammation (>−71.3), OCT-defined culprit lesion plaque rupture (OCT-PR), and OCT-defined culprit lesion cholesterol crystal (OCT-CC) were significantly associated with the presence of non-IR UMI (Figure 1A). OCT findings are shown in Figure 1B. Patients with non-IR UMI had a higher prevalence of OCT-PR and OCT-CC than those without. Compared with patients without non-IR UMI, the prevalence of high pericoronary inflammation was higher in patients with non-IR UMI (Figure 1C). When the total cohort was divided into four groups according to the numbers of aforementioned OCT-derived risk factors and PCATA, patients with all of these UMI risk factors showed 46.2% (6/13) prevalence of non-IR UMI, whereas none of 15 patients without these factors showed non-IR UMI (Figure 1D).
Conclusions
When culprit lesion showed OCT-PR, OCT-CC, and high PCATA, about half of these patients are likely to have non-IR UMI. The integrated CCTA and OCT assessment may help identify the presence of non-IR UMI, potentially providing prognostic information in first NSTE-ACS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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10
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Ueno H, Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Nogami K, Sayama K, Matsuda K, Yonetsu T, Sasano T, Kakuta T. Prognostic implications of fractional flow reserve and coronary flow reserve after newer-generation drug-eluting stent implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
FFR after percutaneous coronary intervention (PCI) has been reported to provide prognostic information. However, limited data are available regarding the prognostication by CFR in patients treated with elective PCI using newer generation DES.
Purpose
This study aimed to assess the prognostic value of post-procedural fractional flow reserve (FFR) and coronary flow reserve (CFR) after newer-generation drug-eluting stent implantation (DES).
Methods
A total of 466 stenoses in 466 patients underwent FFR-guided PCI. FFR and CFR measurements before and after PCI by a pressure-temperature sensor-tipped wire were performed. Follow-up data were studied to determine the predictors of target vessel failure (TVF), defined as death, target vessel-related nonfatal myocardial infarction, and unplanned clinically driven target vessel late revascularization. Prognostic value of post-PCI CFR was compared with that of FFR or FFR/CFR combination.
Results
After PCI completion, 13.7% showed post-PCI FFR ≤0.80 and 44.2% exhibited post-PCI CFR <2.5. Discordant results were observed in 42.5% (198/466). During 2.7 (1.8–3.3) years follow-up, 57 (12.2%) TVF were documented. The multivariable Cox proportional hazard regression analysis revealed that post-PCI FFR and post-PCI CFR were independent prognostic factors. ROC analysis revealed that the optimal cut-off values of post-PCI FFR and CFR values were 0.85 and 2.26, respectively. Significant differences in TVF were detected according to post-PCI FFR (≤0.85 vs >0.85: 17.8% vs 8.9%, P<0.05) and post-PCI CFR (≤2.26 vs >2.26: 20.5% vs 7.2%, P<0.01), although the reclassification ability for TVF was improved only with post-PCI CFR (net reclassification index 0.598; P<0.01; integrated discrimination index 0.038; P<0.01), but not with post-PCI FFR, in comparison with the clinical model. Compared with patients with FFR >0.85, those with post-PCI FFR ≤0.85 and CFR ≤2.26 showed significantly higher risk of TVF (8.9% vs 28.9%, P<0.01, HR 4.24, 95% CI 2.40–7.50, P<0.01), whereas those with post-PCI FFR <0.85 and CFR >2.26 had similar TVF risk (8.9% vs 9.2%, P=1.00, HR 1.01, 95% CI 0.47–2.16, P=0.97).
Conclusions
After PCI completion with newer-generation DES, discordant results between FFR and CFR were observed in 42.5%. Compared with post-PCI CFR, post-PCI FFR provided limited reclassification ability for TVF. Among patients with lower post-PCI FFR, only patients with lower post-PCI CFR showed significantly higher risk of TVF than those with higher post-PCI FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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11
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Nagamine T, Masahiro H, Sayama K, Matsuda K, Ueno H, Misawa T, Hada M, Sugiyama T, Yonetsu T, Sasano T, Kakuta T. Prevalence and culprit lesion plaque characteristics on optical coherence tomography in patients with non-st-segment elevation acute coronary syndrome with zero coronary calcification on coronary CTA. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
CAC evaluated by non-contrast computed tomography is a marker of atherosclerosis. However, the characteristic features of CCTA and optical coherence tomography (OCT) of culprit lesions in patients with NSTE-ACS showing zero CAC remain unknown.
Objectives
This study aimed to assess the prevalence and characteristic features of culprit lesions on coronary CT angiography (CCTA) and optical coherence tomography (OCT) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) showing zero coronary artery calcium (CAC).
Methods
A total of 176 consecutive patients with NSTE-ACS who underwent preprocedural CCTA and OCT were studied. Patients were divided into two groups according to their CAC (zero-CAC and non-zero-CAC groups). Baseline characteristics, CCTA and OCT findings were compared between these two groups.
Results
The prevalence of patients with zero-CACS was 15.9% (28/176). Patients in zero CAC group were younger (mean age, 55 vs. 65 years, P<0.001) and had a lower prevalence of diabetes (10.7 vs 37.2%, P=0.012) than non-zero CAC group. In zero CAC group, the lower prevalence of napkin ring sign (3.5% vs. 28.4%, P=0.028), smaller LV mass index (77.7 vs. 83.9, P=0.04), lower prevalence on spotty calcification (0 vs. 83.8%, P<0.001), lower epicardial fat volume (111.3 vs. 142.6 cm3, P=0.025), and lower pericoronary adipose tissue attenuation (−71.5 vs. −70.2 HU, P=0.07) on CCTA were observed. On OCT, the frequency of plaque erosion (82.1 vs. 44.6%, P<0.001) was significantly higher in zero-CACS group. The prevalence of lipid-rich plaque (46.4 vs. 86.5%, P<0.001), thin-cap fibroatheroma (17.9 vs. 46%, P=0.006), macrophage accumulation (46.4 vs. 81.8%, P<0.001) and cholesterol crystal (7 vs. 41.9%, P<0.001) were all significantly lower in zero-CAC group.
Conclusions
Zero CAC NSTE-ACS was not rare. Zero-CAC NSTE-ACS was characterized by specific phenotypes defined by the combined assessment of CCTA and OCT. Further studies are warranted if these characteristics of NSTE-ACS on preprocedural imaging studies provide prognostic information or guidance of a specific therapeutic approach.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Masahiro
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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12
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Sugiyama T, Kanaji Y, Hoshino M, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Relationship between OCT-derived plaque characteristics, CTA-derived coronary inflammation, and CMR-derived global coronary flow reserve in patients with acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The presence of layered plaque is suggestive of recurrent thrombotic events. However, the impact of layered plaque detected by optical coherence tomography (OCT) on coronary inflammation and coronary flow reserve remains unclear.
Purpose
We aimed to investigate the association of OCT-derived layered plaque with pericoronary adipose tissue inflammation assessed by coronary computed tomography angiography (cCTA) and global coronary flow reserve (G-CFR) assessed by cardiac magnetic resonance imaging (CMR) in patients with acute coronary syndrome (ACS).
Methods
We investigated 88 patients with first ACS who underwent preprocedural cCTA and OCT imaging of the culprit lesion, and CMR after percutaneous coronary intervention (PCI). All patients were divided into four groups according to the OCT-derived culprit plaque characteristics: layered vs. non-layered plaque; and plaque rupture vs. plaque erosion. Coronary inflammation was assessed by the mean value of pericoronary adipose tissue (PCAT) attenuation (−190 to −30 HU) of the three major coronary vessels. G-CFR was obtained by quantifying absolute coronary sinus flow at rest and during maximum hyperemia. CCTA and CMR findings were compared between the groups.
Results
In a total of 88 patients, layered plaque [L] with plaque rupture [PR] was observed in 25 patients, layered plaque with plaque erosion [PE] was observed in 26 patients, non-layered plaque [NL] with PR was observed in 23 patients, and non-layered plaque with PE was observed in 14 patients, respectively. Three-vessel-PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −68.13±6.18 vs. −69.01±6.72 vs. −69.76±4.04 vs. −74.61±5.63 HU, P=0.009) and culprit vessel PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −66.39±7.38 vs. −68.94±8.06 vs. −70.01±5.76 vs. −75.45±6.60 HU, P=0.003) showed the graded difference between the four groups. G-CFR value also showed the graded difference between the four groups (L-PR vs. L-PE vs. NL-PR vs. NL-PE; 2.26 [1.80–2.87] vs. 2.24 [1.72–3.13] vs. 2.97 [2.24–3.83] vs. 3.18 [2.67–4.08], P=0.022).
Conclusions
The presence of layered plaque at the culprit lesion was associated with high PCATA and low G-CFR in patients with ACS. Detection of layered plaque may indicate increased pericoronary inflammation and impaired coronary flow reserve, potentially providing the risk stratification in patients with ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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13
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Ju Z, Thomas TN, Chiu YJ, Yamanouchi S, Yoshida Y, Abe JI, Takahashi A, Wang J, Fujiwara K, Hada M. Adaptation and Changes in Actin Dynamics and Cell Motility as Early Responses of Cultured Mammalian Cells to Altered Gravitational Vector. Int J Mol Sci 2022; 23:ijms23116127. [PMID: 35682810 PMCID: PMC9181735 DOI: 10.3390/ijms23116127] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 02/05/2023] Open
Abstract
Cultured mammalian cells have been shown to respond to microgravity (μG), but the molecular mechanism is still unknown. The study we report here is focused on molecular and cellular events that occur within a short period of time, which may be related to gravity sensing by cells. Our assumption is that the gravity-sensing mechanism is activated as soon as cells are exposed to any new gravitational environment. To study the molecular events, we exposed cells to simulated μG (SμG) for 15 min, 30 min, 1 h, 2 h, 4 h, and 8 h using a three-dimensional clinostat and made cell lysates, which were then analyzed by reverse phase protein arrays (RPPAs) using a panel of 453 different antibodies. By comparing the RPPA data from cells cultured at 1G with those of cells under SμG, we identified a total of 35 proteomic changes in the SμG samples and found that 20 of these changes took place, mostly transiently, within 30 min. In the 4 h and 8 h samples, there were only two RPPA changes, suggesting that the physiology of these cells is practically indistinguishable from that of cells cultured at 1 G. Among the proteins involved in the early proteomic changes were those that regulate cell motility and cytoskeletal organization. To see whether changes in gravitational environment indeed activate cell motility, we flipped the culture dish upside down (directional change in gravity vector) and studied cell migration and actin cytoskeletal organization. We found that compared with cells grown right-side up, upside-down cells transiently lost stress fibers and rapidly developed lamellipodia, which was supported by increased activity of Ras-related C3 botulinum toxin substrate 1 (Rac1). The upside-down cells also increased their migratory activity. It is possible that these early molecular and cellular events play roles in gravity sensing by mammalian cells. Our study also indicated that these early responses are transient, suggesting that cells appear to adapt physiologically to a new gravitational environment.
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Affiliation(s)
- Zhenlin Ju
- Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Tamlyn N. Thomas
- Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.N.T.); (J.-i.A.)
- Aab Cardiovascular Research Institute, University of Rochester Medical School, Rochester, NY 14642, USA;
| | - Yi-Jen Chiu
- Aab Cardiovascular Research Institute, University of Rochester Medical School, Rochester, NY 14642, USA;
| | - Sakuya Yamanouchi
- Gunma University Heavy Ion Medical Center, Maebashi 371-8511, Japan; (S.Y.); (Y.Y.); (A.T.)
| | - Yukari Yoshida
- Gunma University Heavy Ion Medical Center, Maebashi 371-8511, Japan; (S.Y.); (Y.Y.); (A.T.)
| | - Jun-ichi Abe
- Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.N.T.); (J.-i.A.)
| | - Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, Maebashi 371-8511, Japan; (S.Y.); (Y.Y.); (A.T.)
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
- Correspondence: (J.W.); (K.F.); Tel.: +1-713-794-4190 (J.W.); +1-585-490-0613 (K.F.)
| | - Keigi Fujiwara
- Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.N.T.); (J.-i.A.)
- Correspondence: (J.W.); (K.F.); Tel.: +1-713-794-4190 (J.W.); +1-585-490-0613 (K.F.)
| | - Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA;
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14
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Beheshti A, McDonald JT, Hada M, Takahashi A, Mason CE, Mognato M. Genomic Changes Driven by Radiation-Induced DNA Damage and Microgravity in Human Cells. Int J Mol Sci 2021; 22:ijms221910507. [PMID: 34638848 PMCID: PMC8508777 DOI: 10.3390/ijms221910507] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 12/13/2022] Open
Abstract
The space environment consists of a complex mixture of different types of ionizing radiation and altered gravity that represents a threat to humans during space missions. In particular, individual radiation sensitivity is strictly related to the risk of space radiation carcinogenesis. Therefore, in view of future missions to the Moon and Mars, there is an urgent need to estimate as accurately as possible the individual risk from space exposure to improve the safety of space exploration. In this review, we survey the combined effects from the two main physical components of the space environment, ionizing radiation and microgravity, to alter the genetics and epigenetics of human cells, considering both real and simulated space conditions. Data collected from studies on human cells are discussed for their potential use to estimate individual radiation carcinogenesis risk from space exposure.
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Affiliation(s)
- Afshin Beheshti
- KBR, NASA Ames Research Center, Space Biosciences Division, Moffett Field, CA 94035, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Correspondence: or (A.B.); (M.M.)
| | - J. Tyson McDonald
- Department of Radiation Medicine, Georgetown University School of Medicine, Washington, DC 20007, USA;
| | - Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA;
| | - Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-Machi, Maebashi 371-8511, Gunma, Japan;
| | - Christopher E. Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA;
- The World Quant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10065, USA
| | - Maddalena Mognato
- Department of Biology, University of Padova, Via U. Bassi 58/B, 35131 Padova, Italy
- Correspondence: or (A.B.); (M.M.)
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15
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Slaba TC, Plante I, Ponomarev A, Patel ZS, Hada M. Determination of Chromosome Aberrations in Human Fibroblasts Irradiated by Mixed Fields Generated with Shielding. Radiat Res 2020; 194:246-258. [PMID: 32942302 DOI: 10.1667/rr15366.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/14/2020] [Indexed: 11/03/2022]
Abstract
To better study biological effects of space radiation using ground-based facilities, the NASA Space Radiation Laboratory (NSRL) at the Brookhaven National Laboratory has been upgraded to rapidly switch ions and energies. This has allowed investigators to design irradiation protocols comprising a mixture of ions and energies more indicative of the galactic cosmic ray (GCR) environment. Despite these advancements, beam selection and delivery schemes should be optimized against facility and experimental constraints and validated to ensure such irradiations are a suitable representation of the space environment. Importantly, since experiments are time consuming and expensive, models capable of predicting biological outcomes over a range of irradiation conditions (single ion, sequential multi ion or mixed fields) are needed to support such efforts. In this work, human fibroblasts were placed behind 20 g/cm2 aluminum and 10.345 g/cm2 polyethylene and irradiated separately by 344 MeV hydrogen, 344 MeV/n helium, 450 MeV/n oxygen and 950 MeV/n iron ions at various doses. The fluorescence in situ hybridization (FISH) whole chromosome painting technique was then used to assess the cells for chromosome aberrations (CAs), notably simple exchanges. A multi-scale modeling approach was also developed to predict the formation of chromosome aberrations in these experiments. The Geant4 simulation toolkit was used to determine the spectra of particles and energies produced by interactions between the incident beams and shielding. The simulated mixed field generated by shielding was then transferred into the track structure code, RITRACKS (relativistic ion tracks), to generate three-dimensional (3D) voxelized dose maps at the nanometer scale. Finally, these voxel dose maps were input into the new damage and repair model, RITCARD (radiation-induced tracks, chromosome aberrations, repair and damage), to predict the formation of various CAs. The multi-scale model described herein is a significant advancement for the computational tools used to predict biological outcomes in cells exposed to highly complex, mixed ion fields related to the GCR environment. Results show that the simulation and experimental data are in good agreement for the complex radiation fields generated by all ions incident on shielding for most data points. The differences between model predictions and measurements are discussed. Although improvements are needed, the model extends current capabilities for evaluating beam selection and delivery schemes at the NSRL ground-based GCR simulator and for informing NASA risk projection models in the future.
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Affiliation(s)
- Tony C Slaba
- NASA Langley Research Center, Hampton, Virginia 23681
| | | | | | | | - Megumi Hada
- Prairie View A&M University, Prairie View, Texas 77446
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16
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Takahashi A, Yamanouchi S, Takeuchi K, Takahashi S, Tashiro M, Hidema J, Higashitani A, Adachi T, Zhang S, Guirguis FNL, Yoshida Y, Nagamatsu A, Hada M, Takeuchi K, Takahashi T, Sekitomi Y. Combined Environment Simulator for Low-Dose-Rate Radiation and Partial Gravity of Moon and Mars. Life (Basel) 2020; 10:life10110274. [PMID: 33172150 PMCID: PMC7694743 DOI: 10.3390/life10110274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 12/25/2022] Open
Abstract
Deep space exploration by humans has become more realistic, with planned returns to the Moon, travel to Mars, and beyond. Space radiation with a low dose rate would be a constant risk for space travelers. The combined effects of space radiation and partial gravity such as on the Moon and Mars are unknown. The difficulty for such research is that there are no good simulating systems on the ground to investigate these combined effects. To address this knowledge gap, we developed the Simulator of the environments on the Moon and Mars with Neutron irradiation and Gravity change (SwiNG) for in vitro experiments using disposable closed cell culture chambers. The device simulates partial gravity using a centrifuge in a three-dimensional clinostat. Six samples are exposed at once to neutrons at a low dose rate (1 mGy/day) using Californium-252 in the center of the centrifuge. The system is compact including two SwiNG devices in the incubator, one with and one without radiation source, with a cooling function. This simulator is highly convenient for ground-based biological experiments because of limited access to spaceflight experiments. SwiNG can contribute significantly to research on the combined effects of space radiation and partial gravity.
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Affiliation(s)
- Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
- Correspondence: ; Tel.: +81-27-220-7917
| | - Sakuya Yamanouchi
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
| | - Kazuomi Takeuchi
- Matsuo Industries, Inc., 27-1, Ida, Kitasaki-machi, Obu, Aichi 474-0001, Japan; (K.T.); (S.T.); (K.T.); (T.T.); (Y.S.)
| | - Shogo Takahashi
- Matsuo Industries, Inc., 27-1, Ida, Kitasaki-machi, Obu, Aichi 474-0001, Japan; (K.T.); (S.T.); (K.T.); (T.T.); (Y.S.)
| | - Mutsumi Tashiro
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
| | - Jun Hidema
- Division for the Establishment of Frontier Sciences of the Organization for Advanced Studies, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi 980-8577, Japan;
- Graduate School of Life Sciences, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi 980-8577, Japan;
| | - Atsushi Higashitani
- Graduate School of Life Sciences, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi 980-8577, Japan;
| | - Takuya Adachi
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
| | - Shenke Zhang
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
| | - Fady Nagy Lotfy Guirguis
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
| | - Yukari Yoshida
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; (S.Y.); (M.T.); (T.A.); (S.Z.); (F.N.L.G.); (Y.Y.)
| | - Aiko Nagamatsu
- Japan Aerospace Exploration Agency, Tsukuba Space Center, 2-1-1 Sengen, Tsukuba, Ibaraki 305-8505, Japan;
| | - Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA;
| | - Kunihito Takeuchi
- Matsuo Industries, Inc., 27-1, Ida, Kitasaki-machi, Obu, Aichi 474-0001, Japan; (K.T.); (S.T.); (K.T.); (T.T.); (Y.S.)
| | - Tohru Takahashi
- Matsuo Industries, Inc., 27-1, Ida, Kitasaki-machi, Obu, Aichi 474-0001, Japan; (K.T.); (S.T.); (K.T.); (T.T.); (Y.S.)
| | - Yuji Sekitomi
- Matsuo Industries, Inc., 27-1, Ida, Kitasaki-machi, Obu, Aichi 474-0001, Japan; (K.T.); (S.T.); (K.T.); (T.T.); (Y.S.)
- Material Solutions Center, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi 980-8577, Japan
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17
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Hoshino M, Yang S, Sugiyama T, Zhang J, Kanaji Y, Yamaguchi M, Hada M, Sumino Y, Nogami K, Ueno H, Misawa T, Yonetsu T, Koo B, Kakuta T. Prognostic value of peri-coronary adipose tissue attenuation and whole vessel and lesion plaque quantification on Coronary Computed Tomography Angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Peri-coronary adipose tissue attenuation expressed by fat attenuation index (FAI) on coronary CT angiography (CCTA) reflects peri-coronary inflammation and is associated with cardiac mortality. CCTA also provides two-dimensional and three-dimensional quantification of the individual component of atherosclerotic plaque and entire vessel. The atherosclerotic burden or disease extent in entire epicardial coronary arteries provides prognostic information in patients with coronary artery disease.
Purpose
This study sought to explore the prognostic significance of FAI values and whole vessel and lesion plaque quantification on CCTA in stable patients with intermediate epicardial stenosis evaluated by fractional flow reserve (FFR).
Methods
A total of 277 patients (277 lesions) with intermediate coronary stenosis who underwent FFR measurement and CCTA were studied. FAI was assessed by the crude analysis of the mean CT attenuation value (−190 to −30 Hounsfield units; higher values indicating inflammation) on CCTA. CT findings including whole vessel and lesion plaque quantification, and target vessel myocardial mass were investigated. Major adverse cardiovascular outcome (MACE) was defined as all cause death, cardiac death, myocardial infarction, unplanned revascularization, and heart failure requiring admission. Survivals from MACE were assessed.
Results
The mean FAI and the median FFR values were −71.6 and 0.77, respectively. FFR values were weakly albeit significantly correlated with FAI values. (r=−0.016, P=0.008.) MACE was occurred 43 (15.5%) patients during 5 years F-up. ROC analyses revealed that best cut-off value of FAI to predict MACE was −73.1. Kaplan-Meier analysis revealed that lesions with FAI ≥−73.1 had a significantly higher risk of MACE. (Chi-square 5.5, P=0.019) FFR values and the percutaneous coronary intervention were not predictive of MACE. Multivariate COX proportional hazards regression analysis revealed that age, remodeling index, and lesions with FAI ≥−73.1 were independent predictors of MACE.
Conclusion
The peri-coronary inflammation evaluated by FAI and CT remodeling index enhances cardiac risk prediction in chronic coronary syndrome patients with intermediate lesions. Non-invasive comprehensive CT assessment may help identify high risk patients of subsequent clinical events and provide enhanced patient management.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): This study was supported in part by an unrestricted research grant from St. Jude Medical (Abbot Vascular, Santa Clara, CA, USA). The company had no role in study design, conduct, data analysis or manuscript preparation.
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - S Yang
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - J Zhang
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - B Koo
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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18
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Nogami K, Kanaji Y, Sugiyama T, Hoshino M, Yamaguchi M, Hada M, Sumino Y, Misawa T, Hirano H, Ueno H, Kakuta T. Prognostic value of unrecognized myocardial infarction and hyperemic coronary sinus flow in patients undergoing elective percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac magnetic resonance (CMR) imaging is a useful instrument for the assessment of pathological and functional conditions without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Both unrecognized myocardial infarction (UMI) and impaired global myocardial blood flow (g-MBF) have been reported to be strongly associated with worse outcome in patients with cardiovascular disease. However, their combined efficacy remains undetermined.
Purpose
We sought to assess the prognostic value of the presence of UMI and pre-procedural hyperemic g-MBF evaluated by phase-contrast cine magnetic resonance imaging (PC-CMR) in patients with chronic coronary syndrome who underwent elective percutaneous coronary intervention (PCI).
Methods
A total of 177 patients with de novo functionally significant stenosis who underwent pre-PCI CMR and PCI between September, 2016 and March, 2019 were retrospectively studied. UMI was defined as a scar detected by late gadolinium enhancement (LGE) without previously diagnosed MI. g-MBF was assessed by quantifying coronary sinus flow using PC-CMR at rest and hyperemic state. The predictors of major adverse cardiac events (MACE; cardiac death, nonfatal myocardial infarction, clinically driven unplanned revascularization, or hospitalization for congestive heart failure) during follow-up were investigated.
Results
UMI was detected in 40 (27.7%) patients and rest and maximal hyperemic g-MBF evaluated by the coronary sinus flow obtained by PC-CMR were 0.95 ml/min/g and 2.26 ml/min/g, respectively. During the median follow-up of 26 months, cardiovascular death occurred in 1 patient (0.6%), nonfatal myocardial infarction occurred in 4 patients (2.3%), and clinically driven revascularization and hospitalization due to congestive heart failure occurred in 25 patients (14.1%) and 3 patients (1.7%) patients, respectively. In patients with MACE, hyperemic g-MBF was significantly lower and the prevalence of UMI were significantly higher compared with those without MACE (1.94 ml/min/g vs 2.36 ml/min/g P=0.014; 48.3% vs 23.6%, P=0.011). Cox proportional hazards model indicated that impaired hyperemic g-MBF (<2.00 ml/min/g) and the presence of UMI were significant predictors of MACE (HR 2.22, 95% CI 1.060–4.640, P=0.034; HR 2.660, 95% CI 1.290–5.470, P=0.008). During follow-up, cardiac event-free survival was significantly worse in patients with impaired hyperemic g-MBF (<2.00 ml/min/g) and UMI (log-rank χ2=11.0, P=0.010).
Conclusion
In patients with chronic coronary syndrome undergoing elective PCI, the combined assessment of UMI and hyperemic g-MBF obtained by preprocedural noninvasive CMR may provide significant prognostic information.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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19
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Hada M, Kanaji Y, Ueno H, Nogami K, Misawa T, Sumino Y, Yamaguchi M, Sugiyama T, Yonetsu T, Kakuta T. Diagnostic value of myocardial perfusion CT to detect coexisting microvascular dysfunction in patients with obstructive epicardial coronary disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The usefulness of computed tomography myocardial perfusion (CTP) to assess hemodynamically significant coronary artery lesions has been previously reported. However, the diagnostic value of quantitative evaluation of regional absolute coronary flow by CTP to detect microvascular dysfunction remains unknown.
Purpose
The aim of study is to assess the diagnostic value of preprocedural CTP to detect coexisting microvascular dysfunction with functionally significant epicardial stenosis in patients with chronic coronary syndromes.
Methods and results
Thirty-three chronic coronary syndrome patients with de novo single functionally significant stenosis (Fractional flow reserve [FFR]<0.80) who underwent noncomplicated PCI were investigated. In CTP analysis, regional myocardial blood flow (MBF) at rest (rest-MBF) and hyperemia (hyperemic-MBF) were evaluated semi-automatically. Clinical characteristics, pressure-temperature sensor-chipped wire-based information and CTP findings were compared between groups with and without microvascular dysfunction defined by the index of microcirculatory resistance (IMR) (IMR≥25, n=17, IMR<25, n=16, respectively).
The determinants of coexistence of microvascular dysfunction and functional epicardial stenosis were determined. In invasive wire-based analysis, FFR, coronary flow reserve (CFRwire) and IMR were 0.68 (0.57–0.72), 1.61 (1.00–1.98), and 26.7 (19.3–39.4) respectively.
In CTP analysis, rest and hyperemic-MBF and CFR derived from CTP (CFRCTP; calculated as hyperemic-MBF/rest-MBF) were 2.00 (1.31–2.35) ml/min/g, 4.03 (2.11–5.44) ml/min/g, and 2.09 (1.49–2.09) respectively.
In the lesions with IMR>25, hyperemic-MBF was significantly lower than that in IMR<25 (3.42 [1.89–4.34] vs 4.50 [3.44–5.99], p=0.031), although there was no significant difference in regional rest-MBF and CFRCTP (1.75 [1.31–2.24] vs 2.05 [1.35–2.46], p=0.439, and 1.83 [1.21–2.11] vs 2.61 [1.91–2.91], p=0.101 respectively). Receiver operating characteristic curve analysis of hyperemic-MBF detecting IMR>25 showed area under the curve of 0.72 (0.54–0.90), sensitivity of 47% and specificity of 94%.
Conclusion
Quantitative assessment of absolute coronary flow by CTP may help detect coexisting microvascular dysfunction in patients with significant epicardial stenotic lesions.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
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20
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Sugiyama T, Kanaji Y, Hoshino M, Yamaguchi M, Hada M, Misawa T, Sumino Y, Nogami K, Ueno H, Kakuta T. Prognostic value of fat attenuation index of pericoronary adipose tissue surrounding left anterior descending artery on coronary computed tomography angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent studies reported the association between elevated fat attenuation index (FAI) of pericoronary adipose tissue (PCAT) on coronary computed tomography angiography (CTA) and worse cardiac outcomes.
Purpose
We investigated the prognostic value of increased FAI-defined coronary inflammation status in patients with coronary artery disease.
Methods
Three-hundred fifty-eight patients (127 acute coronary syndromes [ACS], 231 stable coronary artery disease) with left anterior descending artery (LAD) as a culprit vessel who underwent coronary CTA were retrospectively studied. The FAI defined as the mean CT attenuation value of PCAT (−190 to −30 Hounsfield Unit [HU]) was measured at the proximal 40-mm segment of LAD. All subjects were divided into two groups according to the median value of FAI in the LAD. The association between the incidence of major adverse cardiac events (MACE) including all-cause death, myocardial infarction, heart failure, target and non-target vessel revascularization were evaluated.
Results
In a total of 358 patients, median FAI values surrounding the LAD was −71.46 (interquartile range, −77.10 to −66.34) HU. Thirty-eight patients (10.6%) experienced MACE during the follow-up period (median, 818 days). Kaplan-Meier analysis revealed that high FAI-LAD (>−71.46 HU [median]) was significantly associated with the incidence of MACE (log-rank test, chi-square = 4.183, P=0.041) (Figure).
Conclusions
In patients with coronary artery disease with culprit LAD lesions, elevated FAI of PCAT surrounding the LAD was associated with worse clinical outcomes. Assessment of FAI may have a potential for potential for non-invasive risk-stratification by coronary CTA.
Kaplan-Meier analysis for MACE
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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21
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Sumino Y, Yonetsu T, Ueno H, Nogami K, Misawa T, Hada M, Yamaguchi M, Hoshino M, Kanaji Y, Sugiyama T, Kakuta T. Impact of neoatherosclerosis observed at very late phase after coronary stent implantation on subsequent adverse events. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite the reduction in late thrombotic events with newer generation coronary stents, late stent failure remains a concern following stent implantation. Neoatherosclerosis (NA) is a cause of in-stent restenosis and acute thrombotic occlusion originating from the stented segment by disruption of the in-stent atheroma. Although the clinical impact of NA at 1 year has been reported, clinical significance of NA observed at very later phase remains to be determined. We sought to investigate the association between optical coherence tomography (OCT) findings at very late phase after stenting and subsequent clinical outcomes.
Methods
A total of 195 patients with 316 stents (including 74 bare metal stents, 48 first-generation DES, and 194 second-generation DES) without stent failure who underwent OCT examination at >3 years (4.9 [3.9- 5.8] years) after stent implantation according to the prespecified protocol were investigated. OCT analysis included the presence of lipid-laden neointima, macrophage, malapposition, thrombus, and plaque rupture within the stents. NA was defined as having lipid-laden neointima. The criteria for the diagnosis of NA were signal-poor region in continuous flames, lipid length longer than 0.3 mm, and invisible stent strut at NA site. Quantitative OCT measurement included lipid length (LL), lipid arc, minimum lumen area (MLA) at the stented segment and minimum stent area (MSA). Major adverse cardiac events (MACE) including all-cause death, non-fatal myocardial infarction, and clinically driven revascularization were assessed. MACE-free survival rate was compared between patients with stent showing NA (NA group) and those without NA (non-NA group). Furthermore, in per-stent basis analysis, stent failure including remote revascularization and stent thrombosis of the stent after follow-up OCT examination was assessed.
Results
NA was identified in 50 stents (15.8%) in 38 patients (19.5%). During the median follow-up period of 2.1 [1.0- 2.8] years after OCT examination, 15 MACEs (7.7%) were captured in the total cohort, of which stent failure was observed in 5 stents (5/316, 1.6%). In patient-based analysis, patients with NA had more frequent MACE than those without (18.0% vs 5.1%, p=0.01). Kaplan-Meier analysis revealed that significantly higher MACE rate was detected in NA group than in non-NA group (χ2=5.4, Log-rank p=0.02). In stent-based analysis, NA stents had more frequent stent failure than those without (8.0% vs 0.4%, p=0.002)
Conclusions
NA observed by OCT at >3 years after implantation were associated with subsequent worse clinical outcomes in both patient and stent-based analysis. NA at the very late phase after stenting might be the therapeutic target of secondary prevention and OCT examination at very late phase after stenting may help identify high risk patients of subsequent MACE.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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22
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Kanaji Y, Sugiyama T, Hoshino M, Ueno H, Nogami K, Hada M, Misawa T, Sumino Y, Yamaguchi M, Yonetsu T, Kakuta T. Prognostic value of coronary flow capacity assessed by coronary sinus flow obtained by phase contrast cine-magnetic resonance imaging in patients with acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The concept of coronary flow capacity (CFC) originated from positron emission tomography has been reported to provide prognostic information. Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying global coronary sinus flow (CSF) and global coronary flow reserve (g-CFR) without the need for ionizing radiation, radioactive tracers, or intravascular catheterization.
Purpose
We evaluated the prognostic value of postprocedural CFC by quantifying CSF using PC-CMR in patients with acute coronary syndrome (ACS) treated with primary or urgent percutaneous coronary intervention (PCI).
Methods
This study prospectively but nonconsecutively enrolled 569 ACS patients who underwent uncomplicated primary (for ST-segment elevation myocardial infarction (STEMI)) or urgent PCI within 48 hours of symptom onset (for non-ST elevation acute coronary syndrome (NSTE-ACS)). Breath-hold PC-CMR images of CS were acquired to assess absolute CSF at rest and during maximum hyperemia within 30 days after culprit lesion PCI and revascularization of functionally significant non-culprit lesions. The entire cohort was stratified by the CFC according to the thresholds of hyperemic CSF and g-CFR. Impaired CFC was defined as a severely-reduced CFC in the present study. The association of CFC and baseline clinical characteristics with major adverse cardiac events (all-cause death, nonfatal myocardial infarction, hospitalization for congestive heart failure or stroke) was investigated.
Results
In the final analysis of 502 patients (Male 417 (83.1%), mean age was 67 [58, 73]) and 310 patients (82.3%) with STEMI and 192 patients (38.2%) with NSTE-ACS were studied. In a total cohort, rest and maximal hyperemic CSF and corrected G-CFR were 0.93 [0.68, 1.24] ml/min/g, 2.08 [1.44, 2.77] ml/min/g, and 2.21 [1.58, 3.05], respectively. During a median follow-up of 28 months, MACE occurred in 53 patients (all-cause death: 19, nonfatal myocardial infarction: 16, late revascularization: 59, hospitalization for congestive heart failure: 9, stroke: 9). Cox proportional hazards analysis showed that corrected G-CFR and impaired CFC were both independent predictors of MACE. (hazard ratio (HR), 0.61, 95% confidence interval (CI): 0.45–0.82, p=0.001; HR, 3.51, 95% CI: 1.79–6.86, p≤0.001, respectively). Cardiac event-free survival was significantly worse in patients with impaired CFC (log-rank χ2=22.9, P<0.001). Net reclassification index (NRI) and integrated discrimination improvement (IDI) were both significantly improved when impaired CFC was added to the clinical risk model for predicting MACE.
Conclusions
In ACS patients successfully revascularized with primary or urgent PCI, CFC categorization stratified by noninvasive PC-CMR provided significant prognostic information independent of infarction size, conventional risk factors and g-CFR.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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23
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Yamaguchi M, Hoshino M, Nogami K, Ueno H, Misawa T, Sumino Y, Hada M, Kanaji Y, Sugiyama T, Yonetsu T, Kakuta T. Association between near-infrared spectroscopy defined lipid rich plaque and pericoronary adipose tissue inflammation on computed tomography angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A recent study has shown that lipid-rich plaque (LRP) detected by near-infrared spectroscopy (NIRS) is a significant predictor of future adverse events. Pericoronary adipose tissue inflammation (FAI; fat attenuation index) evaluated by computed tomography angiography (CTA) has also been reported to be linked with cardiac events. The relationship between NIRS-defined LRP and FAI remains to be determined.
Methods
A total of 82 de novo culprit lesions in 82 patients with chronic coronary syndromes (CCS) who underwent perprocedural CTA and NIRS was retrospectively studied. FAI was assessed by the crude analysis of the mean CT attenuation value (−190 to −30 Hounsfield units; higher values indicating inflammation) of pericoronary adipose tissue. Plaque morphology was assessed by coronary CTA and grey-scale intravascular ultrasound (IVUS). NIRS-defined LRP was defined as a maximum lipid core burden index (LCBI) in 4 mm ≥400. Relationship between NIRS-defined LRP, CTA/grey-scale IVUS findings, and FAI was assessed. Univariate and multivariate logistic regression analyses were performed to determine the predictors for NIRS-derived LRP.
Results
NIRS-defined LRP was observed in 35 (42.6%) patients. Maximum LCBI showed modest correlations both with FAI (r=0.29, p-value=0.007) and CT-derived remodeling index (r=0.51, p<0.001). Receiver operating characteristic (ROC) curve analysis revealed that the best cut-off values of FAI and CT-derived remodeling index for predicting NIRS-defined LRP were −70.7 (AUC: 0.65, 95% CI: 0.53–0.71, P<0.05) and 1.11 (AUC: 0.74, 95% CI: 0.63–0.86, P<0.01), respectively. Multivariate logistic regression analysis showed FAI ≥−70.7 (odds ratio [OR]: 4.27; 95% CI: 1.28–14.3; p-value = 0.02) and CT-derived remodeling index (OR: 10.7; 95% CI: 2.99–32.2; p-value <0.001) were independent predictors of the presence of NIRS-defined LRP, whereas there was no statistically significant and independent predictor of IVUS-derived factors for NIRS-defined LRP. When stratified according to the presence or absence of FAI ≥−70.7 and CT-derived remodeling index ≥1.11, 93% of the lesions showed NIRS-derived LRP when both factors were present, and NIRS-derived LRP was safely ruled out (88%) when both factors were absent.
Conclusions
FAI of the culprit lesion in CCS was an independent predictor of NIRS-defined LRP, supporting the notion that local pericoronary adipose tissue inflammation may correlate to the presence of LRP. Comprehensive assessment of coronary CTA including FAI evaluation may provide a highly accurate information with high sensitivity and specificity for identifying high risk lesions potentially leading to future cardiac events.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
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Yamaguchi M, Hoshino M, Nogami K, Ueno H, Misawa T, Sumino Y, Hada M, Kanaji Y, Sugiyama T, Yonetsu T, Kakuta T. Clinical significance of the periaortic adipose tissue inflammation in patients with abdominal aortic aneurysms. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent studies have reported the association between periaortic adipose tissue volumes identified by multi-detector computed tomography (MDCT) and the periaortic adipose tissue inflammation (PATI) identified by positron emission tomography, which may suggest the link between perivascular inflammation and aortic dilation. However, clinical significance of the PATI identified by MDCT remains elusive in patients with asymptomatic abdominal aortic aneurysm (AAA).
Methods
A total of 77 patients with AAA (diameter >30mm) who underwent the initial and follow-up MDCT examinations were studied retrospectively. PATI was assessed by the crude analysis of the mean CT attenuation value (−190 to −30 Hounsfield units; higher values indicating inflammation). The AAA progression (AP) was defined as the growth of AAA diameter >5.0mm/year from the initial to follow-up. Univariate and multivariate logistic regression analysis were performed to determine the predictors for AP.
Results
AP was observed in 19 (24.7%) patient, the median initial AAA diameter was 38.9 (32.7–42.9) mm, and the median progression of AAA diameter was 3.1 (1.5–4.9) mm/year. The initial AAA diameter (odds ratio [OR]: 1.16; 95% confidence interval [CI]: 1.05–1.28; p-value=0.001) and the initial PATI (OR: 1.12; 95% CI: 1.05–1.20; p-value=0.004) were independent predictors of AP. PATI of −71.08 at initial MDCT and the initial AAA diameter of 37.7mm were the best cut-off value to predict AP. Receiver operating characteristic curve analysis revealed that the best cut-off values of PATI at initial MDCT and the initial AAA diameter for predicting AP were −71.08 (AUC: 0.68, 95% CI: 0.50–0.82) and 37.7 (AUC: 0.71, 95% CI: 0.59–0.84), respectively. Addition of the initial AAA diameter to PATI at initial MDCT significantly increased the accuracy for discriminating AP (net reclassification improvement; 95% CI: 0.67 [0.17–1.17]; p-value = 0.007, integrated discrimination improvement; 95% CI: 0.14 [0.04–0.24]; p-value =0.007).
Conclusions
PATI was an independent and significant predictor of aortic dilation, supporting the notion that local adipose tissue inflammation may contribute to aortic remodeling. Comprehensive assessment of MDCT including PATI evaluation may provide a highly accurate information for identifying high risk lesions potentially leading to future AAA rupture.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
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Misawa T, Sugiyama T, Kanaji Y, Hoshino M, Yamaguchi M, Hada M, Sumino Y, Ueno H, Nogami K, Kakuta T. Impact of pericoronary inflammation assessed by coronary computed tomography angiography on the progression of aortic valve calcification. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Aortic valve calcification (AVC) has been known as an independent predictor for adverse cardiovascular events and all-cause mortality. Previous studies demonstrated that AVC was associated with aortic valve inflammation and atherosclerosis. However, the relationship between the progression of AVC and pericoronary inflammation remains undetermined.
Purpose
The purpose of this study was to evaluate the impact of the pericoronary inflammation on the progression of AVC.
Methods
A total of 107 patients with suspected or known chronic coronary syndromes who underwent clinically indicated serial 320-slice coronary computed tomography angiography (CTA) at Tsuchiura Kyodo General Hospital from January 2011 to June 2019 were retrospectively studied. Pericoronary inflammation was assessed by pericoronary adipose tissue attenuation (PCATA) defined as the mean CT attenuation value of PCATA (−190 to −30 Hounsfield units [HU]) on proximal 40 mm segments of coronary arteries. AVC was quantified by Agatston score on CTA. The mean aortic attenuation (HU Aorta) and the standard deviation (SD) in the region of interest at the level of the sinotubular junction was measured. AVC was defined as the threshold for calcium detection (mean HU Aorta + 2SD). AVC index was calculated as follows: (follow-up/baseline) AVC divided by follow-up period. AVC progression was defined as newly-developed AVC at follow-up or an increased AVC index during follow-up. All patients were divided into two groups according to the presence or absence of AVC progression, and clinical characteristics and CT findings were compared between these two groups.
Results
AVC progression was observed in 26 patients (24.3%) between 2 serial CT examinations (median, 34 months). There was no significant difference in age, gender and the prevalence of other cardiovascular risk factors between the 2 groups. Patients in AVC progression group were associated with higher prevalence of elevated PCATA-LAD, higher LV mass index at baseline and the initial AVC presence. Receiver-operating characteristic curve analysis revealed that the optimal cut off value of PCATA-LAD for predicting AVC progression was −68.26 HU (area under the curve 0.605; 95% confidence interval [CI], 0.465–0.745). Multivariable logistic regression analysis revealed that baseline PCATA-LAD ≥−68.26 HU (odds ratio [OR], 3.12; 95% CI, 1.04–9.35, p=0.042) and the presence of baseline positive AVC (OR, 6.84; 95% CI, 2.34–20.0, p=0.0004) were independent predictors of AVC progression.
Conclusions
The increased pericoronary inflammation and the presence of AVC may help identify patients with high risk for future AVC progression.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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Yamanouchi S, Rhone J, Mao JH, Fujiwara K, Saganti PB, Takahashi A, Hada M. Simultaneous Exposure of Cultured Human Lymphoblastic Cells to Simulated Microgravity and Radiation Increases Chromosome Aberrations. Life (Basel) 2020; 10:E187. [PMID: 32927618 PMCID: PMC7555395 DOI: 10.3390/life10090187] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 12/22/2022] Open
Abstract
During space travel, humans are continuously exposed to two major environmental stresses, microgravity (μG) and space radiation. One of the fundamental questions is whether the two stressors are interactive. For over half a century, many studies were carried out in space, as well as using devices that simulated μG on the ground to investigate gravity effects on cells and organisms, and we have gained insights into how living organisms respond to μG. However, our knowledge on how to assess and manage human health risks in long-term mission to the Moon or Mars is drastically limited. For example, little information is available on how cells respond to simultaneous exposure to space radiation and μG. In this study, we analyzed the frequencies of chromosome aberrations (CA) in cultured human lymphoblastic TK6 cells exposed to X-ray or carbon ion under the simulated μG conditions. A higher frequency of both simple and complex types of CA were observed in cells exposed to radiation and μG simultaneously compared to CA frequency in cells exposed to radiation only. Our study shows that the dose response data on space radiation obtained at the 1G condition could lead to the underestimation of astronauts' potential risk for health deterioration, including cancer. This study also emphasizes the importance of obtaining data on the molecular and cellular responses to irradiation under μG conditions.
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Affiliation(s)
- Sakuya Yamanouchi
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan;
| | - Jordan Rhone
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA; (J.R.); (P.B.S.)
| | - Jian-Hua Mao
- Biological Systems & Engineering Division, Lawrence Berkeley Laboratory, Berkeley, CA 94720, USA;
| | - Keigi Fujiwara
- Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Premkumar B. Saganti
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA; (J.R.); (P.B.S.)
| | - Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan;
| | - Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA; (J.R.); (P.B.S.)
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27
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Usui E, Yonetsu T, Kanaji Y, Hoshino M, Yamaguchi M, Hada M, Fukuda T, Ohya H, Sumino Y, Hamaya R, Kanno Y, Murai T, Lee T, Kakuta T. Corrigendum to ‘Relationship between optical coherence tomography-derived morphological criteria and functional relevance as determined by fractional flow reserve’ [J. Cardiol. 71 (2018) 359–366/4]. J Cardiol 2020; 76:226-227. [DOI: 10.1016/j.jjcc.2020.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Sugiyama T, Kanno Y, Hamaya R, Hoshino M, Usui E, Kanaji Y, Yamaguchi M, Hada M, Ohya H, Sumino Y, Hirano H, Yuki H, Horie T, Yonetsu T, Kakuta T. P3578Determinants of visual-functional mismatches as assessed by coronary angiography and 3-D angiography-based quantitative flow ratio. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0439] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Quantitative flow ratio (QFR) is a novel three-dimensional quantitative coronary angiography (QCA)-based computational index that can estimate fractional flow reserve (FFR) without pharmacologically induced hyperemia or the use of a pressure wire.
Purpose
We aimed to evaluate the determinants of visual-functional mismatches between conventional two-dimensional QCA and QFR.
Methods
A total of 504 de novo intermediate-to-severe lesions from 504 patients with stable angina who underwent angiographical and physiological assessments were analyzed. All lesions were divided into four groups based on the significance of visual (QCA-diameter stenosis [DS] >50% and ≤50%) and functional (QFR <0.80 and ≥0.80) stenosis severity. Patient characteristics, angiographic findings, QFR computations, and physiological indices were compared among the four groups.
Results
Among 504 lesions, 153 lesions (30.4%) showed concordantly negative (DS ≤50% and QFR >0.80) and 170 lesions (33.7%) showed concordantly positive (DS >50% and QFR ≤0.80) visual and functional assessments. Among 181 lesions (35.9%) with discordant results, 75 lesions (14.9%) showed a mismatch (DS >50% and QFR >0.80) and 106 lesions (21.0%) showed a reverse mismatch (DS ≤50% and QFR ≤0.80), respectively. Reverse mismatch was associated with smaller reference diameter (odds ratio [OR] 0.561; P=0.036), greater DS (OR 1.039, P=0.013), lower coronary flow reserve (CFR) (OR 0.571, P<0.001, non-diabetes mellitus (OR 2.141, P=0.013) and lower ejection fraction (OR 0.961, P=0.011). Mismatch was associated with smaller DS (OR 0.914, P<0.001), shorter lesion length (OR 0.894, P=0.001), higher CFR (OR 1,633, P<0.001), and lower estimated glomerular filtration rate (OR, 0.968, P=0.001). Lesion location and the index of microcirculatory resistance was not associated with the prevalence of reverse mismatch or mismatch.
Conclusions
There was a high prevalence of visual-functional mismatches between QCA-DS and QFR, and CFR was an important functional factor of mismatches. Our results suggested the difference between predictors of reported visual-functional mismatches of QCA/FFR and those of QCA/QFR.
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - R Hamaya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - E Usui
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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29
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Kanno Y, Hoshio M, Sugiyama T, Kanaji Y, Yamaguchi M, Hada M, Ohya H, Sumino Y, Hirano H, Horie T, Yuki H, Yonetsu T, Kakuta T. P2705Hybrid QFR-FFR decision making strategy for revascularization. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1022] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Measurement of the fractional flow reserve (FFR) has become a standard practice for revascularization decision-making in evaluating the functional significance of angiographically intermediate epicardial coronary stenosis. The quantitative flow ratio (QFR) is a novel method for rapid computational estimation of FFR without pressure wire and vasodilator drugs.
Purpose
Nevertheless, the evidence was shown the clinical better outcome of coronary revascularization stratified by FFR, the adoption of FFR remains low. We hypothesized that combined QFR and FFR hybrid strategy could improve the physiological assessment without pressure wire and drugs.
Methods and results
We performed a post-hocanalysis of 549 vessels with angiographically intermediate stenosis in 549 patients who underwent measurement of FFR. The median FFR and QFR values were 0.81 (0.73–0.87) and 0.79 (0.74–0.87), respectively.The ischemic threshold was defined as 0.80 for both QFR and FFR measures. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the QFR for predicting an FFR of ≤0.80 were 86.2%, 71.9%, 78.9%, 74.5%, and 84.5%, respectively. The area under the receiver operating characteristic curve using the cut-off threshold of ≤0.80 for the FFR was 0.85 (95% confidence interval [CI], 0.81–0.88) for the QFR.In total, 433 (78.9%) and 116 (21.1%) lesions showed concordant and discordant FFR and QFR functional classifications, respectively. A hybrid QFR-FFR strategy was developed, by allowing deferral when QFR values providing negative predictive value greater than 90% and treat others when QFR values greater than that showing 90% positive predictive value, with adenosine being given only to patients with QFR in between those values. For the FFR cut-off (0.8), an QFR of <0.73 could be used to confirm treatment (PPV of 90.7%), while an QFR value of >0.83 could be used to defer revascularization (NPV of 90.0%). When QFR values fall between 0.73 and 0.84, adenosine is given for hyperemic induction and the FFR cut-off of 0.8 is used to guide revascularization. This hybrid QFR-FFR approach has a 95% agreement with an FFR-only decision making, and 285 lesions (51.9%) would have obviated the need of a pressure wire and adenosine.
Hybrid QFR-FFR strategy
Conclusions
A hybrid QFR-FFR strategy for coronary revascularization could reduce the need of a pressure wire and vasodilator drugs, which may increase the penetration of functional assessment of coronary lesions.
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Affiliation(s)
- Y Kanno
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hoshio
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
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30
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Hoshino M, Kanaji Y, Sugiyama T, Yamaguchi M, Ohya H, Sumino Y, Hada M, Kanno Y, Hirano H, Horie T, Yonetsu T, Kakuta T. P5619Comparison of different resting physiological indices: are diastolic pressure ratio and resting full-cycle ratio equal? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous reports showed all diastolic resting indexes tested were virtually identical to the instantaneous wave-free ratio (iFR). Although RFR has been also reported to be diagnostically equivalent to iFR, no comparisons have been reported about the prevalence and characteristics of discordance in diagnosis between diastolic pressure ratio (dPR) and resting full-cycle ratio (RFR).
Purpose
This study sought to determine the coronary pressure characteristics of lesions classified as discordant between dPR and RFR in angiographically intermediate stenoses.
Methods
We recruited 532 patients with 668 intermediate (angiographically stenosis between 30% to 70% severity) coronary lesions undergoing FFR assessment and analyzed DICOM pressure tracings of resting state (dPR and RFR) using a fully automated off-line software algorithm in a blind fashion. Diagnostic performance of dPR and RFR was evaluated using FFR as a reference. Furthermore, we investigated similarity and difference between dPR and RFR.
Results
Median FFR was 0.81 with an interquartile range of 0.74 to 0.87. RFR was highly correlated to dPR (R2=0.94, p<0.001), with a mean bias of 0.012 (95% limits of agreement −0.008 to 0.031). The diagnostic performance of RFR versus dPR was diagnostic accuracy 95.4%, sensitivity 100.0%, specificity 91.6%, positive predictive value 90.6%, negative predictive value 100.0%). Using the binary cut-off of dPR ≤0.89 as a cut-off value, RFR showed near identical agreement according to ROC curve analysis (AUC: 0.996, 95% CI: 0.994–0.999, p<0.001). Although dPR and RFR demonstrated equivalent performance against FFR ≤0.8 (79.5% vs. 79.3% accuracy; p=0.960; area under the receiver-operating characteristic curve: 0.869 vs. 0.870; p=0.528), RFR disagreed with dPR in 4.6% (31 of 668). When all lesions (668 vessels) were divided into groups according to the concordance and discordance between dPR and RFR: RFR+/dPR+ (298 vessels, n=240), RFR+/dPR– (31 vessels, n=31 patients), RFR-/dPR- (339 vessels, n=259). There was no lesion showing RFR-/dPR+. The prevalence of ischemia was tended to be higher in lesions evaluated by RFR (49.3% vs 44.6%, P=0.100) when using FFR ≤0.80 as a reference standard. An overall significant difference in the prevalence of FFR ≤0.80 and the FFR values were detected among these 3 groups. Furthermore, pairwise comparison also revealed the prevalence of FFR >0.80 and the FFR values were significantly lower in RFR+/dPR– than in RFR-/dPR-, and significantly higher in RFR+/dPR– than in RFR+/dPR+. (P<0.001 and P<0.001, respectively)
Conclusion
Significant difference in FFR values was observed according to dPR/RFR agreement and disagreement. Revascularization decision making might defer according to the resting index used. Compared with RFR, lesions might be more frequently deferred when dPR was used to assess physiological significance.
Acknowledgement/Funding
None
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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31
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Hirano H, Kanaji Y, Horie T, Yuki H, Kanno Y, Ohya H, Hada M, Sumino Y, Yamaguchi M, Hoshino M, Sugiyama T, Yonetsu T, Kakuta T. P2704The association between global coronary flow reserve and coronary inflammation assessed by attenuation index on computed tomography in patients with stable angina pectoris. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Impaired global coronary flow reserve (G-CFR) is known to predict worse outcomes in patients with coronary artery disease. Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying coronary sinus flow (CSF) and G-CFR without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Although G-CFR impairment is previously reported to be linked with endothelium dysfunction and progression of atherosclerosis, the association of perivascular adipose tissue inflammation with myocardial coronary flow remains to be determined.
Purpose
We evaluated the association between G-CFR by quantifying CSF using PC-CMR and the extent of coronary inflammation evaluated by perivascular adipose tissue inflammatory status using CT to assess if coronary inflammation is linked with G-CFR in patients with stable angina pectoris (SAP) treated with elective percutaneous coronary intervention (PCI).
Methods
The study enrolled 74 SAP patients with single denovo lesion who underwent coronary CT angiography and PC-CMR within 90 days before coronary intervention. Proximal 40-mm segments of all three major epicardial coronary vessels were traced and examined. Coronary inflammation was assessed by the CT fat attenuation index of perivascular adipose tissue (FAI-PVAT) defined as the mean attenuation of the perivascular adipose tissue (−190 to −30 Hounsfield units (HU)) in a layer of tissue within a radial distance from the outer coronary artery wall equal to the diameter of the vessel. CMR images were also acquired to assess absolute CSF at rest and during maximum hyperemia before elective PCI. The patients were divided into 4 groups according to the number of inflamed vessels as defined by showing FAI ≥−70.1 HU.
Results
In the final analysis of 69 patients (mean age 67, Male 45 (65.2%)), 18, 19, 20, 12 patients exhibited none, 1, 2, 3 inflamed vessels with FAI ≥−70.1 HU, respectively. Rest and maximal hyperemic CSF and corrected G-CFR were 1.28 [0.76,1.55] vs 1.47 [1.11, 1.81] vs 1.30 [0.94, 1.64] vs 1.27 [1.11, 2.00] ml/min/g; P=0.49, 3.50 [2.84, 5.25] vs 3.28 [2.62, 4.31] vs 3.11 [2.16, 3.63] vs 2.37 [1.40, 2.98] ml/min/g; P=0.049, 3.57 [2.17, 4.54] vs 2.25 [1.73, 3.49] vs 2.26 [1.64, 3.38] vs 1.89 [0.89, 2.32]; P=0.023, respectively. G-CFR and hyperemic CSF were both significantly lower in the group with larger number of inflamed vessels.
Conclusions
In SAP patients with significant coronary artery stenosis, G-CFR obtained by PC-CMR significantly associated with the prevalence of inflamed vessels detected by coronary CT. The extent of coronary inflammation may influence global coronary endothelium dysfunction, resulting in decreased G-CFR.
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Affiliation(s)
- H Hirano
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | | | - M Hoshino
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
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32
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Horie T, Hoshino M, Hirano H, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Kanaji Y, Sugiyama T, Yonetsu T, Kakuta T. P5617Repeatability of instantaneous wave-free ratio in comparison with fractional flow reserve. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Instantaneous wave-free ratio (iFR) has been recently introduced as an adenosine free alternative for fractional flow reserve (FFR) to assess the functional significance of epicardial coronary stenosis. Little is known, however, regarding the repeatability and stability of iFR in comparison with FFR.
Purpose
The aim of this study was to evaluate the repeatability of iFR and compare it to that of FFR.
Methods
Patients with stable coronary artery disease who underwent physiological assessment twice within 90 days were enrolled. Repeated measurements were performed at diagnostic and therapeutic catheterization in about 70% of studied population. The remaining patients were measured twice for non-culprit lesion assessment at primary PCI and subsequent non-culprit and ischemia-documented lesion PCI. The calculation of iFRmatlab from DICOM pressure tracing data of resting state was performed using a fully automated off-line software algorithm in a blind fashion. FFR values were also measured by a fully automated algorithm in the same core laboratory by using hyperemic pressure tracing data. The repeatability of the two indices were evaluated and compared. The inter-rater agreement between iFRmatlab and FFR values of two measurements was assessed by κ coefficient. The pressure rate product during each assessment was also documented and evaluated.
Results
Ninety-three lesions from 92 patients were included in the study. The time interval between the two assessments was 38.4±19.0 days. iFRmatlab and FFR both showed significant correlation within the two assessments (iFRmatlab: r=0.75, 95% confidence interval, 0.64 to 0.83; mean difference, −0.006 [−0.18 to −0.01], FFR: r=0.86, 95% confidence interval, 0.79 to 0.90; mean difference, 0.004 [−0.07 to 0.03]). The inter-rater agreement of functional ischemia for iFRmatlab and FFR were κ=0.449 and κ=0.732, respectively. Although the prevalence of functional ischemia during the first and second assessment were consistent for both indices (iFRmatlab: 70.0%/67.7%, FFR: 86.0%/ 86.0%), significant difference was observed in the prevalence of clinical disagreement on the diagnosis of functional ischemia (FFR=0.80, iFR=0.89 used as cut-off values, respectively) between the first and second assessment among the two indices (iFRmatlab: 6.5%, FFR: 23.7%, p=0.002). iFRmatlab was significantly associated with pressure rate product during the examination compared to FFR (iFRmatlab: r= −0.25, 95% confidence interval, −0.43 to −0.04, P=0.018, FFR: r=−0.08, 95% confidence interval, −0.28 to −0.13, p=0.467).
Conclusion
Our results suggested that iFRmatlab showed lower repeatability and reliability for decision making compared to FFR. The instability of iFRmatlab potentially derives at least in part from its association with heart rate and blood pressure product.
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Affiliation(s)
- T Horie
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiology, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
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33
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Kanno Y, Hoshino M, Sugiyama T, Kanaji Y, Yamaguchi M, Hada M, Ohya H, Sumino Y, Hirano H, Horie T, Yonetsu T, Kakuta T. P2703Impact of subtended myocardial mass on the assessment of functional ischemia as evaluated by FFR and QFR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The fractional flow reserve (FFR) becomes a standard practice for revascularization decision-making in evaluating the functional significance of angiographically intermediate epicardial coronary stenosis. The quantitative flow ratio (QFR) is a novel method for rapid computational estimation of FFR without pressure wire and hyperemic induction. FFR has been reported to be associated with not only epicardial stenosis but also subtended myocardial mass (Vsub). In contrast, the relationship between QFR and Vsub has not been clarified.
Purpose
We sought to examine if subtended myocardial mass (Vsub) assessed by coronary computed tomography showed a significant relationship with QFR in comparison with FFR.
Methods and results
We performed a post-hoc analysis of 152 territories (LAD 116, RCA 25 and LCX 11 lesions) with angiographically intermediate-to-severe stenosis in 152 patients who underwent FFR assessment. The median FFR and QFR values were 0.76 (0.64–0.84) and 0.76 (0.72–0.83), respectively. The median diameter stenosis (%DS) and minimum lumen diameter (MLD) were 54.5 (43.9–64.2) and 1.2 (0.9–1.6), respectively. In total, 123 (80.9%) and 29 (19.1%) lesions showed concordant and discordant FFR and QFR functional classifications, respectively. The ability of Vsub/MLD2 to discriminate lesions with FFR≤0.80 and QFR≤0.80 was assessed compared with QCA data. FFR values were associated with Vsub (R=0.37, P<0.001). In contrast, a trend albeit no significant linear relationshipwas detected between QFR and Vsub (R=0.15, P=0.060). The area under the curve (AUC) of Vsub/MLD2 predicting FFR≤0.80 (0.88: 95% confidence interval [CI], 0.83–0.94)was significantly better than that of MLD (0.80: 95% [CI], 0.72–0.88) (P<0.001). On the other hand, the AUC of Vsub/MLD2 predicting QFR≤0.80 (0.82: 95% [CI], 0.75–0.90) was similar to that of MLD (0.80: 95% [CI], 0.72–0.87) (P=0.276). Multivariate analysis showed that the value of Vsub/MLD2 was an independent predictor of FFR≤0.80 (odds ratio [OR]: 1.09, 95% [CI]: 1.03–1.15, P=0.002), whereas it was not an independent predictor of QFR≤0.80.
Conclusions
Subtended cardiac mass volume derived from CT segmentation improved the diagnostic performance of angiography-derived parameters to identify ischemia-producing lesions when FFR used as a reference standard, whereas QFR showed non-significant relationship with subtended cardiac mass.
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Affiliation(s)
- Y Kanno
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
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Hoshino M, Yonetsu T, Kanaji Y, Sugiyama T, Yamaguchi M, Hada M, Ohya H, Sumino Y, Kanno Y, Hirano H, Horie T, Murai T, Koo BK, Escaned J, Kakuta T. 6113Gender differences in long-term outcomes in patients with deferred revascularization following fractional flow reserve assessment: international collaboration registry of physiologic evaluation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Studies of sex differences in fractional flow reserve (FFR) measurements have shown that in comparison with men, angiographic lesions of similar visual severity are less likely to be ischemia producing in women. Gender specific differences may influence revascularization decision making and prognosis after deferred revascularization following FFR measurement.
Purpose
This study sought to investigate the gender difference in long-term prognosis of patients of deferred revascularization following FFR assessment.
Methods
A total of 879 patients (879 vessels) with deferred revascularization with FFR >0.75 who underwent FFR and CFR measurements were enrolled from 3 countries (Korea, Japan, and Spain). Long-term outcomes were assessed in 649 men and 230 women by the patient-oriented composite outcome (POCO, a composite of any death, any myocardial infarction [MI], and any revascularization). We applied inverse-probability weighting (IPW) based on propensity scores to account for differences at baseline between women and men (age, hypertension, hyperlipidemia, diabetes mellitus, lesion location, clinical status, FFR, Reference diameter, Diameter stenosis, lesion length). The median follow-up duration was 1855 days (745–1855 days).
Results
Median FFR values were 0.88 (0.83–0.93) in men and 0.89 (0.85–0.94) in women, respectively. The occurrences of POCO were significantly high in men compared with that in women (10.5% vs 4.2%, P=0.007). Kaplan–Meier analysis revealed that women had a significantly lower risk of POCO (χ2=7.2, P=0.007). Multivariate COX regression analysis revealed that age, male, diabetes mellitus, diameter stenosis, lesion length, and coronary flow reserve were independent predictors of POCO. After applying IPW, the hazard ratio of male for POCO was 2.20 (95% confidence interval: 1.12 to 4.33, P=0.023).
Conclusion
This large multinational study reveals that long-term outcome differs between women and men in favour of women after FFR-guided revascularization deferral.
Acknowledgement/Funding
None
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Murai
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - B K Koo
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - J Escaned
- Hospital Clinic San Carlos, Madrid, Spain
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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35
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Kanaji Y, Sugiyama T, Hoshino M, Hirano H, Horie T, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Yuki H, Yonetsu T, Kakuta T. P2239The association between global coronary flow reserve and coronary inflammation assessed by fat attenuation index on computed tomography in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Impaired global coronary flow reserve (G-CFR) is known to predict worse outcomes in patients with coronary artery disease. Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying coronary sinus flow (CSF) and global coronary flow reserve (G-CFR) without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Although G-CFR impairment has been previously reported to be linked with endothelium dysfunction and subsequent atherosclerosis, the relationship between coronary inflammation and absolute coronary blood flow volume or coronary flow reserve remains elusive.
Purpose
We evaluated the association between G-CFR by quantifying CSF using PC-CMR and the extent of coronary inflammation in patients with ACS treated with emergent percutaneous coronary intervention (PCI).
Methods
The study enrolled 107 ACS patients who underwent uncomplicated emergent PCI within 48 hours of symptom onset and coronary CT angiography were performed before PCI. Proximal 40-mm segments of all three major epicardial coronary vessels were examined. Coronary inflammation was assessed by the CT fat attenuation index of perivascular adipose tissue (FAI−PVAT) defined as the mean attenuation of the perivascular adipose tissue (−190 to −30 Hounsfield units (HU)) in a layer of tissue within a radial distance from the outer coronary artery wall equal to the diameter of the vessel, as previously reported. CMR images were acquired to assess absolute CSF at rest and during maximum hyperemia within 30 days after emergent PCI and revascularization of non-culprit significant lesions. The patients were divided into 4 groups according to the number of inflamed vessels (defined as 0, 1, 2, 3 vessels with FAI ≥−70.1 HU).
Results
In the final analysis of 102 patients (mean age 64, Male 65 (63.7%)) including 77 patients with non-ST-segment elevation myocardial infarction (NSTEMI) (75.5%) and 25 patients with unstable angina pectoris (UAP), 25, 30, 26, 21 patients exhibited none, 1, 2, 3 inflamed vessels with FAI ≥−70.1 HU, respectively. Rest and maximal hyperemic CSF and corrected G-CFR were 1.17 [0.63, 1.71] vs 1.36 [1.05, 1.67] vs 1.21 [0.83, 1.94] vs 1.35 [0.96, 1.67] ml/min/g; P=0.61, 3.26 [2.62, 2.99] vs 3.50 [2.60, 4.03] vs 3.34 [1.78, 4.20] vs 2.48 [1.54, 3.43]; P=0.061, 2.95 [2.05, 4.30] vs 2.63 [1.80, 3.56] vs 2.15 [1.37, 2.91] vs 2.18 [1.46, 2.42]; P=0.018, respectively. G-CFR was significantly lower in group with increased number of inflamed vessels.
Conclusions
In ACS patients successfully revascularized within 48 hours of onset, G-CFR obtained by noninvasive PC-CMR significantly associated with the prevalence of inflamed vessels detected by coronary CT. Further large population study is warranted to test the hypothesis that the extent of coronary inflammation before coronary revascularization in patients with ACS might provide prognostic information.
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Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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36
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Kanaji Y, Sugiyama T, Hoshino M, Hirano H, Yuki H, Horie T, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Yonetsu T, Kakuta T. P5251Prognostic value of unrecognized myocardial infarction detected by cardiac magnetic resonance imaging in patients presenting with first acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Unrecognized myocardial infarction (UMI) has been reported to be strongly associated with worse outcome in patients with cardiovascular disease. Cardiac magnetic resonance (CMR) imaging is a useful instrument for the assessment of pathological and functional conditions.
Purpose
This study sought to evaluate the prognostic value of the presence of unrecognized non-infarct-related late gadolinium enhancement (non-IR LGE) evaluated by cardiac magnetic resonance imaging in patients presenting with a first acute myocardial infarction (AMI).
Methods
We studied 311 AMI patients including 213 STEMI and 98 NSTEMI patients without the history of prior MI who underwent uncomplicated primary or emergent PCI within 48 hours of symptom onset between October, 2012 and June, 2017. CMR images were acquired at 28 [21, 32] days after primary/emergent PCI. UMI was defined as having LGE separately in the different and remote area from the perfused territory by infarct-related artery. In case of multiple LGE areas of infarction, the coronary angiography findings were used to support identification of the area corresponding to the culprit artery of AMI. The association of CMR variables and other clinical characteristics with major adverse cardiac events (cardiac death, nonfatal myocardial infarction, nonfatal stroke) were investigated.
Results
Forty-six patients (14.8%) showed UMI defined by the presence of non-IR LGE (27 STEMI and 19 NSTEMI). During the follow up for 830 [385, 1309] days, cardiovascular death occurred in 7 patients (2.3%), and non-fatal MI and non-fatal stroke occurred in 10 and 1 patients, respectively (3.2%, 0.3%, respectively). There was no significant difference in the prevalence of UMI and incidence of MACE between the patients with STEMI and NSTEMI (p=0.13, p=0.11, respectively). Event-free survival was significantly worse in patients with UMI (log-rank χ2=16.3, P=0.001) in a total cohort. Cox proportional hazards analysis showed that UMI was independent predictors of adverse cardiac events during follow-up in patients with first MI (hazard ratio, 7.60, 95% confidence interval, 2.78–20.8, p=0.0001).
Conclusions
In first AMI patients, UMI defined by non-IR LGE obtained by noninvasive CMR provides significant prognostic information. Early detection of UMI by CMR may help risk stratification of patients with AMI and support adjunctive aggressive patient management such as strong statin therapy and life style intervention.
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Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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Sugiyama T, Hoshino M, Kanaji Y, Horie T, Yuki H, Hirano H, Kanno Y, Hada M, Ohya H, Sumino Y, Yamaguchi M, Yonetsu T, Kakuta T. P6393Differences in coronary inflammation between the culprit and non-culprit vessels assessed by fat attenuation index on computed tomography in patients with acute coronary syndromes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Inflammation is linked with progression of coronary atherosclerosis. Recent studies have reported the association between elevated perivascular fat attenuation index (FAI) on computed tomography (CT) and worse cardiac outcomes in patients with coronary artery disease.
Purpose
We aimed to investigate the differences in FAI-defined peri-coronary inflammation status between the culprit and non-culprit vessels in patients with acute coronary syndromes (ACS).
Methods
A total of 78 ACS patients with left anterior descending coronary arteries (LAD) as a culprit vessel who underwent coronary CT angiography and invasive coronary angiography were studied. Proximal 40-mm segments of the LAD and the right coronary artery (RCA) were traced. Coronary inflammation was assessed by the FAI defined as the mean CT attenuation value of perivascular adipose tissue (−190 to −30 Hounsfield units [HU]) in a layer of tissue within a radial distance from the outer coronary artery wall equal to the diameter of the vessel. All patients were divided into two groups according to the values of FAI in the LAD: high FAI group (FAI-LAD > median; n=39) and low FAI group (FAI-LAD ≤ median; n=39). Patient characteristics, angiographic and CT findings were compared between the two groups.
Results
In a total of 78 patients, median FAI in the LAD was −70.20 (interquartile range, −74.81 to −64.58) HU. High FAI group was associated with male sex and lower left ventricular ejection fraction compared with Low FAI group. Minimal lumen diameter, reference diameter, diameter stenosis, and lesion length on quantitative coronary angiography analysis and coronary artery calcium score on CT was not different between the groups. FAI in the RCA was also higher in High FAI group than that in Low FAI group (−67.64±8.31 vs. −76.47±6.25 HU, P<0.001). Paired t-test comparison demonstrated that culprit vessel showed higher FAI than the non-culprit vessel (−69.85±7.74 vs. −72.11±8.54 HU, P=0.013).
Conclusions
In ACS patients with culprit LAD lesions, FAI-defined peri-coronary inflammation status is higher in the culprit vessel than in the non-culprit vessel.
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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Kanaji Y, Sugiyama T, Hoshino M, Hirano H, Horie T, Yuki H, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Yonetsu T, Kakuta T. P3585Prognostic value of the assessment of coronary sinus flow by phase contrast cine-magnetic resonance imaging in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying global coronary sinus flow (CSF) and global coronary flow reserve (G-CFR) without the need for ionizing radiation, radioactive tracers, or intravascular catheterization.
Purpose
We evaluated the prognostic value of G-CFR by quantifying CSF using PC-CMR in patients with ACS treated with primary or emergent percutaneous coronary intervention (PCI).
Methods
The study prospectively enrolled 387 ACS patients who underwent uncomplicated primary or emergent PCI within 48 hours of symptom onset. Breath-hold PC-CMR images of CS were acquired to assess absolute CSF at rest and during maximum hyperemia within 30 days after primary PCI and revascularization of functionally significant non-culprit lesions of ACS. The association of G-CFR and baseline clinical characteristics with major adverse cardiac events (cardiac death, nonfatal myocardial infarction, late revascularization, or hospitalization for congestive heart failure) was investigated.
Results
In the final analysis of 366 patients (Male 294 (80.3%), mean age 65) including 233 patients (63.7%) with ST-segment elevation myocardial infarction (STEMI) and 133 patients (36.3%) with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), rest and maximal hyperemic CSF and corrected G-CFR were 1.24 [0.83, 1.71] ml/min/g, 2.56 [1.87, 3.66] ml/min/g, and 2.20 [1.53, 3.17], respectively. During a median follow-up of 16 months, MACE occurred in 84 patients (cardiac death: 9, nonfatal myocardial infarction: 11, late revascularization: 59, hospitalization for congestive heart failure: 5). Cardiac event-free survival was significantly worse in patients with a corrected G-CFR <2.00 (log-rank χ2=20.2, P<0.001). Cox proportional hazards analysis showed that corrected G-CFR were independent predictors of adverse cardiac events during follow-up in patients with STEMI (hazard ratio, 0.66, 95% confidence interval, 0.51–0.85, p=0.001) and NSTE-ACS (hazard ratio, 0.64, 95% confidence interval, 0.43–0.95, p=0.026), respectively.
Conclusions
In ACS patients successfully revascularized within 48 hours of onset, G-CFR obtained by noninvasive PC-CMR provided significant prognostic information independent of infarction size and conventional risk scores.
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Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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Hada M, Saganti PB, Cucinotta FA. Nitric Oxide Is Involved in Heavy Ion-Induced Non-Targeted Effects in Human Fibroblasts. Int J Mol Sci 2019; 20:ijms20184327. [PMID: 31487843 PMCID: PMC6769611 DOI: 10.3390/ijms20184327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/28/2019] [Revised: 08/19/2019] [Accepted: 08/30/2019] [Indexed: 11/16/2022] Open
Abstract
Previously, we investigated the dose response for chromosomal aberration (CA) for exposures corresponding to less than one particle traversal per cell nucleus by high energy and charge (HZE) particles, and showed that the dose responses for simple exchanges for human fibroblast irradiated under confluent culture conditions were best fit by non-linear models motivated by a non-targeted effect (NTE). Our results suggested that the simple exchanges in normal human fibroblasts have an important NTE contribution at low particle fluence. Nitric oxide (NO) has been reported as a candidate for intercellular signaling for NTE in many studies. In order to estimate the contribution of NTE components in induced CA, we measured CA with and without an NO scavenger in normal skin fibroblasts cells after exposure to 600 MeV/u and 1 GeV/u 56Fe ions, less than one direct particle traversal per cell nucleus. Yields of CA were significantly lower in fibroblasts exposed to the NO scavenger compared to controls, suggesting involvement of NO in cell signaling for induction of CA. Media transferred from irradiated cells induced CA in non-irradiated cells, and this effect was abrogated with NO scavengers. Our results strongly support the importance of NTE contributions in the formation of CA at low-particle fluence in fibroblasts.
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Affiliation(s)
- Megumi Hada
- Chancellor's Research Initiative, Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA.
| | - Premkumar B Saganti
- Chancellor's Research Initiative, Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA
| | - Francis A Cucinotta
- Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
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Uchida M, Hada M, Yamada M, Inma D, Ariyoshi S, Aoki K, Inoue S, Shimazoe T, Mitsuiki K, Haraguchi T. Impact of a systematic education model for palliative care in cancer. Pharmazie 2019; 74:499-504. [PMID: 31526444 DOI: 10.1691/ph.2019.9417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In clinical practice, pharmacists are continually required to improve their knowledge and expertise; however, the postgraduate education system for professional development cannot be confidently stated to be well established. The establishment of a systematic and multifaceted educational curriculum should be useful to improve home care and pharmacists' contribution; therefore, we developed a curriculum in collaboration with the university faculty of pharmaceutical sciences, department of pharmacy in hospital, and the Fukuoka Pharmaceutical Association. Class topics were extracted from the "Kanwa-Iryou-Yakugaku", edited by the Japanese Society for Pharmaceutical Palliative Care and Sciences. The items are necessary to perform palliative care as a pharmacist. A class schedule of 6 days (24 classes in total) was formulated. Questionnaires on comprehension degree before and after each class were provided to the participants. Comprehension was assessed on a scale of 1 to 10, where "I do not understand at all" was 1 and "I understand enough" was 10. The average recovery rates of questionnaires from each class were 92.6 % and 88.9 % before and after class, respectively. The average number of participants who completely answered the questionnaire before and after class was 45.6; therefore, these data were analyzed. Comprehension degree on each topic had significantly increased after attendance of all classes (p < 0.01). The comprehension degree of participants of the medical science of palliative care did greatly improve. Consequently, it is clear that the standard education model constructed was meaningful for the professional development of pharmacists in palliative care medicine.
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Abstract
Chromosome aberrations (CAs) are one of the effects of radiation exposure and can have implications for human health in the space environment, since they are related to cancer risk. In radiation research, chromosome aberrations are a convenient biomarker for carcinogenesis. To shed light on the formation and quality of chromosome aberrations in the space environment, many experiments and simulations have been performed using chromosome aberrations in human cells, induced by heavy ions, which are present in galactic cosmic rays (GCRs). In this work, the new simulation program, radiation-induced tracks, chromosome aberrations, repair and damage (RITCARD), is presented. This software program is based on the algorithm used in the NASA Radiation Track Image (NASARTI) model with some improvements. NASARTI and RITCARD are both comprised of four parts: a random walk (RW) algorithm for simulating chromosomes in a nucleus; a deoxyribonucleic acid (DNA) damage algorithm; a break repair process; and a function to assess and count chromosome aberrations. Prior to running RITCARD, the code, relativistic ion tracks (RITRACKS), is used to simulate detailed radiation track structure and calculate time-dependent differential voxel dose maps in a parallelepiped centered on a cell nucleus. The RITCARD program reads the pre-calculated voxel dose and locates the intersections between the voxels and the chromosomes that were simulated by random walk. Radiation-induced breaks occur strictly at these intersections with a probability that is a function of the voxel dose. When a break occurs in the random walk, the corresponding chromosome piece is cut into two fragments where each has a free end at the position of the break. RITCARD generates a collection of all fragments, free ends, and enlists free end pairs. In the next step, the algorithm simulates the time-dependent rejoining of free end pairs, using different probabilities for pairs originating from a given break (proper) or from different breaks (improper), which results in the formation of fragment sequences. By grouping these sequences, the program determines the number and types of aberrations, based on the same criteria used in our experiment. The new program is used to assess the yields of various types of chromosome aberrations in human fibroblast cells for several ions (1H+, 4He2+, 12C6+, 16O8+, 20Ne10+, 28Si14+, 48Ti22+ and 56Fe26+) with energies varying from 10 to 1,000 MeV/n. The results show linear and linear-quadratic dose dependence for most chromosome aberrations types. The calculation results were compared with those obtained by fluorescence in situ hybridization (FISH) experiments that were performed by our group. The simulations and experiments are in better agreement at lower LET. Regarding the simulation results, the coefficient of the linear part of the dose-dependence curve also peaks at an LET value of approximately 100 keV/lm, which evokes a relative biological effectiveness (RBE) peak found by other researchers.
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Affiliation(s)
| | | | | | - Tony Slaba
- NASA Langley Research Center, Hampton, Virginia 23681
| | - Megumi Hada
- Prairie View A&M University, Prairie View, Texas 77446
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Risal P, Adhikari B, Shrestha R, Manandhar S, Bhatt RD, Hada M. Analysis of Factors Associated with Thyroid Dysfunction: A Hospital Based Study. Kathmandu Univ Med J (KUMJ) 2019; 17:88-92. [PMID: 32632053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background Thyroid dysfunction (TD) is one of the major public health concerns in Nepal. This study intends to identify factors in association with thyroid dysfunction and its hospital based prevalence. Objective To determine hospital-based prevalence of thyroid dysfunction and to identify and analyze factors in association with thyroid dysfunction. Method A retroprospective cross-sectional study was conducted among patients attending Dhulikhel Hospital-Kathmandu University Hospital (DH,KUH) from January to December, 2015 with prospective part carried out from July to December 2015 in the patients visiting Dhulikhel hospital for health check-up and requested for Thyroid Function Tests (TFTs). Thyroid Function Tests of 1530 subjects were performed in the biochemistry laboratory and semi-structured questionnaire were introduced to 312 participants with convenient sampling method and their anthropometric measurements were taken. Chi-square test, Pearson's correlation and student-t test were used as a measure to analyze factors. Result Out of total 1530 subjects, 35.3% were having thyroid dysfunction with the prevalence of overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism and subclinical hypothyroidism to be 2.5%, 2.4%, 5.6% and 24.8% respectively. The distribution of thyroid dysfunction was preponderant among females and among older age. The prevalence of thyroid dysfunction was highest among Terai/Madhesi (40.0%) and lowest among Newars (28.5%) with higher fraction of hypothyroidism in each ethnic group. There were significant correlation between Thyroid Stimulating Hormone (TSH) with waist-hip ratio (p<0.05) and weight (kg) with free thyroxine (fT4) (p<0.05). Direct pesticide exposure (p<0.05) was significantly associated with hypothyroidism. The serum fT4 was significantly different (p<0.05) among vegetarian and non-vegetarian whereas TSH and free triiodothyronine (fT3) were not significantly different. Smoking, alcoholism, dietary food habits, diabetes and hypertension were not significantly associated with thyroid dysfunction. Conclusion Thyroid dysfunction was highly prevalent among participants with higher proportion of subclinical hypothyroidism. Besides, direct pesticide exposure found to be factor in association with hypothyroidism, this study could not find significance relation with other established risk factors.
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Affiliation(s)
- P Risal
- Department of Clinical Biochemistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Adhikari
- Department of Natural Science-Human Biology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R Shrestha
- Department of Natural Science-Human Biology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Manandhar
- Department of Natural Science-Human Biology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R D Bhatt
- Department of Clinical Biochemistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - M Hada
- Department of Clinical Biochemistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Hada M, Ikeda H, Rhone JR, Beitman AJ, Plante I, Souda H, Yoshida Y, Held KD, Fujiwara K, Saganti PB, Takahashi A. Increased Chromosome Aberrations in Cells Exposed Simultaneously to Simulated Microgravity and Radiation. Int J Mol Sci 2018; 20:E43. [PMID: 30583489 PMCID: PMC6337712 DOI: 10.3390/ijms20010043] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022] Open
Abstract
Space radiation and microgravity (μG) are two major environmental stressors for humans in space travel. One of the fundamental questions in space biology research is whether the combined effects of μG and exposure to cosmic radiation are interactive. While studies addressing this question have been carried out for half a century in space or using simulated μG on the ground, the reported results are ambiguous. For the assessment and management of human health risks in future Moon and Mars missions, it is necessary to obtain more basic data on the molecular and cellular responses to the combined effects of radiation and µG. Recently we incorporated a μG⁻irradiation system consisting of a 3D clinostat synchronized to a carbon-ion or X-ray irradiation system. Our new experimental setup allows us to avoid stopping clinostat rotation during irradiation, which was required in all other previous experiments. Using this system, human fibroblasts were exposed to X-rays or carbon ions under the simulated μG condition, and chromosomes were collected with the premature chromosome condensation method in the first mitosis. Chromosome aberrations (CA) were quantified by the 3-color fluorescent in situ hybridization (FISH) method. Cells exposed to irradiation under the simulated μG condition showed a higher frequency of both simple and complex types of CA compared to cells irradiated under the static condition by either X-rays or carbon ions.
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Affiliation(s)
- Megumi Hada
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA.
| | - Hiroko Ikeda
- Gunma University Initiative for Advanced Research, Gunma University, Maebashi, Gunma 371-8511, Japan.
| | - Jordan R Rhone
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA.
| | - Andrew J Beitman
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA.
| | - Ianik Plante
- KBRwyle, 2400 NASA Parkway, Houston, TX 77508, USA.
| | - Hikaru Souda
- Heavy Ion Medical Center, Gunma University, Maebashi, Gunma 371-8511, Japan.
| | - Yukari Yoshida
- Heavy Ion Medical Center, Gunma University, Maebashi, Gunma 371-8511, Japan.
| | - Kathryn D Held
- Gunma University Initiative for Advanced Research, Gunma University, Maebashi, Gunma 371-8511, Japan.
- Department of Radiation Oncology, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA.
| | - Keigi Fujiwara
- Department of Cadiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Premkumar B Saganti
- Radiation Institute for Science & Engineering, Prairie View A&M University, Prairie View, TX 77446, USA.
| | - Akihisa Takahashi
- Heavy Ion Medical Center, Gunma University, Maebashi, Gunma 371-8511, Japan.
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Kaneko T, Kono N, Mochizuki Y, Hada M, Sunakawa T, Ikegami H, Musha Y. The influence of compressive forces across the patellofemoral joint on patient-reported outcome after bi-cruciate stabilized total knee arthroplasty. Bone Joint J 2018; 100-B:1585-1591. [PMID: 30499324 DOI: 10.1302/0301-620x.100b12.bjj-2018-0693.r1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIMS Patellofemoral problems are a common complication of total knee arthroplasty. A high compressive force across the patellofemoral joint may affect patient-reported outcome. However, the relationship between patient-reported outcome and the intraoperative patellofemoral contact force has not been investigated. The purpose of this study was to determine whether or not a high intraoperative patellofemoral compressive force affects patient-reported outcome. PATIENTS AND METHODS This prospective study included 42 patients (42 knees) with varus-type osteoarthritis who underwent a bi-cruciate stabilized total knee arthroplasty and in whom the planned alignment was confirmed on 3D CT. Of the 42 patients, 36 were women and six were men. Their mean age was 72.3 years (61 to 87) and their mean body mass index (BMI) was 24.4 kg/m 2 (18.2 to 34.3). After implantation of the femoral and tibial components, the compressive force across the patellofemoral joint was measured at 10°, 30°, 60°, 90°, 120°, and 140° of flexion using a load cell (Kyowa Electronic Instruments Co., Ltd., Tokyo, Japan) manufactured in the same shape as the patellar implant. Multiple regression analyses were conducted to investigate the relationship between intraoperative patellofemoral compressive force and patient-reported outcome two years after implantation. RESULTS No patient had anterior knee pain after total knee arthroplasty. The compressive force across the patellofemoral joint at 140°of flexion was negatively correlated with patient satisfaction (R 2 = 0.458; β = -0.706; p = 0. 041) and Forgotten Joint Score-12 (FJS-12; R 2 = .378; β = -0.636; p = 0. 036). The compressive force across the patellofemoral joint at 60° of flexion was negatively correlated with the patella score (R 2 = 0.417; β = -0.688; p = 0. 046). CONCLUSION Patient satisfaction, FJS-12, and patella score were affected by the patellofemoral compressive force at 60° and 140° of flexion. Reduction of the patellofemoral compressive forces at 60° and 140° of flexion angle during total knee arthroplasty may improve patient-reported outcome, but has no effect on anterior knee pain.
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Affiliation(s)
- T Kaneko
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
| | - N Kono
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
| | - Y Mochizuki
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
| | - M Hada
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
| | - T Sunakawa
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
| | - H Ikegami
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
| | - Y Musha
- Department of Orthopedic Surgery (Ohashi), Toho University School of Medicine, Tokyo, Japan
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Hamaya R, Hoshino M, Kanno Y, Yamaguchi M, Fukuda T, Ohya H, Sumino Y, Kanaji Y, Usui E, Hada M, Yuki H, Yonetsu T, Kakuta T. P4596Prognostic implication of three-vessel three-dimensional quantitative coronary angiography-based contrast-flow quantitative flow ratio in patients with stable coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4596] [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: 11/13/2022] Open
Affiliation(s)
- R Hamaya
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - T Fukuda
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - E Usui
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
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Hoshino M, Yonetsu T, Kanaji Y, Usui E, Yamaguchi M, Hada M, Fukuda T, Ohya H, Hamaya R, Kakuta T. P3648Prevalence of thin-cap fibroatheroma in relation to the physiological stenosis severity determined by fractional flow reserve and instantaneous wave-free ratio. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3648] [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: 11/12/2022] Open
Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Yonetsu
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - E Usui
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Fukuda
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - R Hamaya
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
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Hoshino M, Yonetsu T, Kanaji Y, Usui E, Yamaguchi M, Hada M, Fukuda T, Ohya H, Hamaya R, Kakuta T. P4624Clinical significance of the fractional flow reserve measurement position after elective percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4624] [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)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Yonetsu
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - E Usui
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Fukuda
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - R Hamaya
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
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48
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Sumino Y, Yonetsu T, Yuki H, Kannno Y, Hamaya R, Fukuda T, Ooya H, Hada M, Yamaguchi M, Hoshino M, Usui E, Kanaji Y, Kakuta T. P6489Comparison of morphological parameters between 40MHz and 60MHz intravascular ultrasound during percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6489] [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: 11/13/2022] Open
Affiliation(s)
- Y Sumino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Kannno
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - R Hamaya
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Fukuda
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Ooya
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - E Usui
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
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49
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Hoshino M, Yonetsu T, Kanaji Y, Usui E, Yamaguchi M, Hada M, Fukuda T, Ohya H, Hamaya R, Kakuta T. P2272Clinical significance of lipid-rich plaque without plaque rupture detected by optical coherence tomography in the culprit lesion of acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2272] [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)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Yonetsu
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - E Usui
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Fukuda
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - R Hamaya
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Cardiovascular Medicine, Tsuchiura-Shi, Japan
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50
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Usui E, Yonetsu T, Kanaji Y, Hoshino M, Yamaguchi M, Sumino Y, Hada M, Ohya H, Fukuda T, Hamaya R, Kanno Y, Yuki H, Kakuta T. P6494Predictors of optical coherence tomography-defined thin-cap fibroatheroma using near-infrared spectroscopy and intravascular ultrasound. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6494] [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: 11/12/2022] Open
Affiliation(s)
- E Usui
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - T Fukuda
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - R Hamaya
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of Cardiology, Tsuchiura, Japan
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