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Kubota K, Fujioka T, Tateishi U, Mori M, Yashima Y, Yamaga E, Katsuta L, Yamaguchi K, Tozaki M, Sasaki M, Uematsu T, Monzawa S, Isomoto I, Suzuki M, Satake H, Nakahara H, Goto M, Kikuchi M. Investigation of imaging features in contrast-enhanced magnetic resonance imaging of benign and malignant breast lesions. Jpn J Radiol 2024:10.1007/s11604-024-01551-1. [PMID: 38503998 DOI: 10.1007/s11604-024-01551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/20/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This study aimed to enhance the diagnostic accuracy of contrast-enhanced breast magnetic resonance imaging (MRI) using gadobutrol for differentiating benign breast lesions from malignant ones. Moreover, this study sought to address the limitations of current imaging techniques and criteria based on the Breast Imaging Reporting and Data System (BI-RADS). MATERIALS AND METHODS In a multicenter retrospective study conducted in Japan, 200 women were included, comprising 100 with benign lesions and 100 with malignant lesions, all classified under BI-RADS categories 3 and 4. The MRI protocol included 3D fast gradient echo T1- weighted images with fat suppression, with gadobutrol as the contrast agent. The analysis involved evaluating patient and lesion characteristics, including age, size, location, fibroglandular tissue, background parenchymal enhancement (BPE), signal intensity, and the findings of mass and non-mass enhancement. In this study, univariate and multivariate logistic regression analyses were performed, along with decision tree analysis, to identify significant predictors for the classification of lesions. RESULTS Differences in lesion characteristics were identified, which may influence malignancy risk. The multivariate logistic regression model revealed age, lesion location, shape, and signal intensity as significant predictors of malignancy. Decision tree analysis identified additional diagnostic factors, including lesion margin and BPE level. The decision tree models demonstrated high diagnostic accuracy, with the logistic regression model showing an area under the curve of 0.925 for masses and 0.829 for non-mass enhancements. CONCLUSION This study underscores the importance of integrating patient age, lesion location, and BPE level into the BI-RADS criteria to improve the differentiation between benign and malignant breast lesions. This approach could minimize unnecessary biopsies and enhance clinical decision-making in breast cancer diagnostics, highlighting the effectiveness of gadobutrol in breast MRI evaluations.
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Affiliation(s)
- Kazunori Kubota
- Department of Radiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamiko-Shigaya, Koshigaya, Saitama, 343-8555, Japan
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Mio Mori
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Yuka Yashima
- Department of Radiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamiko-Shigaya, Koshigaya, Saitama, 343-8555, Japan
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Emi Yamaga
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Leona Katsuta
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Ken Yamaguchi
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga City, Saga, 849-8501, Japan
| | - Mitsuhiro Tozaki
- Department of Radiology, Sagara Hospital, 3-31 Matsubara-Cho, Kagoshima City, Kagoshima, 892-0833, Japan
| | - Michiro Sasaki
- Department of Radiology, Sagara Hospital, 3-31 Matsubara-Cho, Kagoshima City, Kagoshima, 892-0833, Japan
| | - Takayoshi Uematsu
- Division of Breast Imaging and Breast Interventional Radiology, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, 411-8777, Japan
| | - Shuichi Monzawa
- Department of Diagnostic Radiology, Shinko Hospital, 1-4-47, Wakinohama-Cho, Chuo-Ku, Kobe City, Hyogo, 651-0072, Japan
| | - Ichiro Isomoto
- Department of Radiology, St. Francis Hospital, 9-20, Kominemachi, Nagasaki City, Nagasaki, 852-8125, Japan
| | - Mizuka Suzuki
- Department of Diagnostic Radiology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-Ku, Tokyo, 113-8677, Japan
| | - Hiroko Satake
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Hiroshi Nakahara
- Department of Radiology, Sagara Hospital Miyazaki, 2-112-1 Maruyama, Miyazaki City, Miyazaki, 880-0052, Japan
| | - Mariko Goto
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto City, 602-8566, Japan
| | - Mari Kikuchi
- Department of Imaging Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan
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Miwa T, Mori E, Sekine R, Kimura Y, Kobayashi M, Shiga H, Tsuzuki K, Suzuki M, Kondo K, Suzaki I, Inokuchi G, Aiba T, Chujo K, Yagi-Nakanishi S, Tsukatani T, Nakanishi H, Nishijo M, Iinuma Y, Yokoyama A. Olfactory and taste dysfunctions caused by COVID-19: a nationwide study. Rhinology 2023; 61:552-560. [PMID: 37690065 DOI: 10.4193/rhin23.034] [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: 09/12/2023]
Abstract
BACKGROUND Olfactory dysfunctions (OD) and taste dysfunctions (TD) are widely recognized as characteristic symptoms of COVID-19; however, the frequency and mode of occurrence has varied depending on the viral mutation. The prevalence and characteristics of OD/TD in Japan have not been definitively investigated. The purpose of this study is to assess the prevalence of OD/TD in Japan during the Alpha variant epidemic, and measure symptom prolongation at 6 months and 1 year later following initial infection. METHODS Patients treated for COVID-19 between February to May 2021 were evaluated for OD/TD symptoms and provided with a QOL questionnaire. Olfactory tests and taste tests were performed using Open Essence and Taste Strips, respectively. RESULTS Among the 251 COVID-19 patients who participated, 119 underwent both olfactory and taste tests. Prevalence of subjective OD and TD at the time of survey was 57.8% and 40.2%, respectively. After 12 months, the prevalence fell to 5.8% for OD and 3.5% for TD. Among the OD/TD patients, 36.6% experienced parosmia, and 55.4% experienced parageusia. Prevalence of parosmia and parageusia was higher at 6 and 12 months than at the time of survey. Patients with long-lasting disease reported qualitative dysfunctions and scored significantly higher in food-related QOL problems. Most patients who were aware of their hyposmia had low scores on the olfactory test (83.1%). In contrast, only 26.7% of patients who were aware of their hypogeusia had low scores on the taste test. CONCLUSIONS The prevalence of COVID-19-related OD and TD at the time of survey was 57.8% and 40.2%, respectively. Subjective symptoms of OD and TD persisted for one year in 5.8% and 3.5% of patients, respectively. More than half of the patients with OD or TD complained of qualitative dysfunction and a decrease in their QOL related to eating and drinking. Most patients with TD did not have true TD, but rather developed flavour disorders associated with OD. This conclusion is supported by the finding that patients with subjective OD had low scores on the olfactory test, whereas most patients with subjective TD had normal scores on the taste test.
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Affiliation(s)
- T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - R Sekine
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Y Kimura
- Department of Otolaryngology, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
| | - M Kobayashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - H Shiga
- Department of Otorhinolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - K Tsuzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Hyogo Medical University, Hyogo, Japan
| | - M Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University, Aichi, Japan
| | - K Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - I Suzaki
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - G Inokuchi
- Department of Otolarygology, Head and Neck Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - T Aiba
- Department of Otorhinolaryngology, Osaka City Juso Hospital, Osaka, Japan
| | - K Chujo
- Department of Otorhinolaryngology, St. Luke s International Hospital, Tokyo, Japan
| | - S Yagi-Nakanishi
- Department of Otorhinolaryngology, Kanazawa Municipal Hospital, Ishikawa, Japan
| | - T Tsukatani
- Department of Otorhinolaryngology, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - H Nakanishi
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University, Aichi, Japan
| | - M Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Y Iinuma
- Department of Infectious Diseases, Kanazawa Medical University, Ishikawa, Japan
| | - A Yokoyama
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kochi, Japan
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Ueno K, Seyama Y, Okinaga H, Takao M, Harada N, Nakahodo J, Chiba K, Okuya T, Suzuki M, Horiguchi S. [A Case of a Two-Stage Robotic-Assisted Surgery for a Neuroendocrine Tumor of the Pancreatic Tail with Simultaneous Single Liver Metastasis]. Gan To Kagaku Ryoho 2023; 50:1662-1664. [PMID: 38303375] [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: 02/03/2024]
Abstract
As medical insurance coverage for robotic surgery has been expanded in the field of gastrointestinal surgery in Japan, the number of cases undergoing robotic surgery for hepato-biliary-pancreatic disease has been increasing. Therefore, cases with malignant tumors and metastatic lesions tend to undergo robotic operation for both primary tumors and metastases. Herein, we report a case of neuroendocrine tumor(NET)in the pancreatic tail with simultaneous single liver metastasis, which was treated with two-stage robotic-assisted surgery. A 67-year-old female underwent a computed tomography scan and a hypovascularized tumor in the pancreatic tail region and liver was found. A biopsy of the pancreatic tumor by endoscopic ultrasound-guided fine needle aspiration demonstrated a NET G1-2. The liver lesion was diagnosed as a metastatic tumor, considering the other examinations. The patient underwent a robotic distal pancreatectomy(RDP)and was histopathologically diagnosed as NET G2. Sixty-three days after the RDP, a two-stage partial liver resection for the metastatic tumor was performed under robotic assistance. Curative resection was achieved through two-stage robot-assisted surgery, there were no postoperative complications.
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Affiliation(s)
- Kohdai Ueno
- Dept. of Hepato-Biliary-Pancreatic Surgery, Tokyo Metropolitan Komagome Hospital
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Takagi M, Seyama Y, Takao M, Nakahodo J, Chiba K, Okuya T, Suzuki M, Horiguchi S, Okinaga H, Harada N. [Curative Resection after Chemotherapy for Advanced Extensive Cholangiocarcinoma-A Case Report]. Gan To Kagaku Ryoho 2023; 50:1630-1632. [PMID: 38303364] [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: 02/03/2024]
Abstract
A 73-year-old, male patient presented with the chief complaint of epigastric pain and received the diagnosis of extensive cholangiocarcinoma after a close examination. Extensive extension of the malignancy into the right and left hepatic ducts precluded a curative resection, and the patient received GC therapy. After 11 courses of GC over about 1 year, no new lesions or tumor progression was observed, and a bile duct mapping biopsy was performed to investigate the possibility of resection conversion. The results showed a marked decrease in atypia, and reactive atypia was diagnosed. A pancreaticoduodenectomy was performed, and histopathologically negative margins were obtained. The response to treatment was Grade Ⅱa according to the Evans classification. At 23 months after the start of treatment and 12 months after surgery, the patient is recurrence-free without adjuvant chemotherapy. Although the evidence for conversion surgery for biliary tract cancer has not been established, the long-term outcomes may be favorable.
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Affiliation(s)
- Maki Takagi
- Dept. of Hepato-Biliary-Pancreatic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
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Suzuki M, Watari T. Blue toe syndrome caused by spontaneous cholesterol embolization syndrome. QJM 2023; 116:936-937. [PMID: 37471693 DOI: 10.1093/qjmed/hcad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Indexed: 07/22/2023] Open
Affiliation(s)
- M Suzuki
- Department of General Internal Medicine, National Hospital Organization Sendai Medical Center, Miyagi, Japan
| | - T Watari
- Department of Internal Medicine, University of Michigan Medical School, MI, USA
- General Medicine Centre, Shimane University Hospital, Shimane, Japan
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Kawamura Y, Itou H, Kida A, Sunakawa H, Suzuki M, Kawamura K. Percutaneous shunt vessel embolisation with Amplatzer vascular plugs II and IV in the treatment of dogs with splenophrenic shunts: four cases (2019-2022). J Small Anim Pract 2023; 64:710-717. [PMID: 37817531 DOI: 10.1111/jsap.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 04/23/2023] [Accepted: 06/10/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES To describe the treatment of four dogs with splenophrenic shunts using percutaneous shunting vessel embolisation with Amplatzer vascular plugs II and IV and provide information on their clinical outcomes. MATERIALS AND METHODS Dogs with splenophrenic shunts treated at a veterinary hospital from January 2019 to December 2022 were identified through a medical record search. RESULTS Six dogs with splenophrenic shunts were identified. Two dogs were excluded because they were treated with laparoscopic surgery. Four underwent percutaneous shunting vessel embolization with Amplatzer vascular plugs and were included in the case series. A sheath was placed in the left external jugular vein and a balloon catheter was advanced to the shunting vessel under fluoroscopy. Portal vein pressure was confirmed to be within an acceptable range during temporary balloon occlusion. Based on preoperative CT angiography and intraoperative contrast examination, Amplatzer vascular plugs II were selected for two dogs and IV were selected for two dogs. Under fluoroscopy, the plug was deployed into the shunting vessel, and angiography confirmed occlusion. In all cases, the increase in portal pressure after temporary occlusion was within the acceptable range, and complete occlusion of blood flow was possible with a single plug. There were no major procedure-related complications. No dogs developed post-ligation seizures or signs of portal hypertension. In addition, improvements in ammonia values were observed in all cases. CLINICAL SIGNIFICANCE Percutaneous splenophrenic shunt embolisation using Amplatzer vascular plugs II and IV is technically feasible in dogs, and assessed by intra-procedure angiography, a single plug completely obstructed blood flow in all dogs. Based on the literature search, this is the first report describing Amplatzer vascular plugs for the treatment of splenophrenic shunts.
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Affiliation(s)
- Y Kawamura
- Kawamura Animal Hospital, 1-1-6 Kamikido, Higashi-ku, Niigata City, Niigata, 950-0891, Japan
| | - H Itou
- Kawamura Animal Hospital, 1-1-6 Kamikido, Higashi-ku, Niigata City, Niigata, 950-0891, Japan
| | - A Kida
- Kawamura Animal Hospital, 1-1-6 Kamikido, Higashi-ku, Niigata City, Niigata, 950-0891, Japan
| | - H Sunakawa
- Kawamura Animal Hospital, 1-1-6 Kamikido, Higashi-ku, Niigata City, Niigata, 950-0891, Japan
| | - M Suzuki
- Kawamura Animal Hospital, 1-1-6 Kamikido, Higashi-ku, Niigata City, Niigata, 950-0891, Japan
| | - K Kawamura
- Kawamura Animal Hospital, 1-1-6 Kamikido, Higashi-ku, Niigata City, Niigata, 950-0891, Japan
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Murakami S, Nagawa K, Inui T, Yamamoto A, Suzuki M, Koga F, Motoi T, Takaki Y. Case Reports of TFE3-Rearranged Renal Cell Carcinoma: FDG-PET Uptake Might Help Diagnosis. J Kidney Cancer VHL 2023; 10:61-68. [PMID: 37789903 PMCID: PMC10542702 DOI: 10.15586/jkcvhl.v10i3.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 09/10/2023] [Indexed: 10/05/2023] Open
Abstract
Translocation and transcription factor E3 (TFE3)-rearranged renal cell carcinoma (RCC) is a rare subtype of RCCs characterised by the fusion of the TFE3 transcription factor genes on chromosome Xp11.2 with one of the multiple genes. TFE3-rearranged RCC occurs mainly in children and adolescents, although middle-aged cases are also observed. As computed tomography (CT)/magnetic resonance imaging (MRI) findings of TFE3-rearranged RCC overlap with those of other RCCs, differential diagnosis is often challenging. In the present case reports, we highlighted the features of the fluorine-18-labelled fluorodeoxyglucose positron emission tomography with CT (FDG PET-CT) in TFE3-rearranged RCCs. Due to the rarity of the disease, FDG PET-CT features of TFE3-rearranged RCC have not yet been reported. In our cases, FDG PET-CT showed high standardised uptake values (SUVmax) of 7.14 and 6.25 for primary tumours. This might imply that TFE3-rearranged RCC has high malignant potential. This is conceivable when the molecular background of the disease is considered in terms of glucose metabolism. Our cases suggest that a high SUVmax of the primary tumour is a clinical characteristic of TFE3-rearranged RCCs.
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Affiliation(s)
- Sho Murakami
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Keita Nagawa
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Takanori Inui
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Aya Yamamoto
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Mizuka Suzuki
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Fumitaka Koga
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yasunobu Takaki
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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Suzuki M, Miyano Y, Sato F, Shinkai K. Surface Properties of Resin Composites and CAD/CAM Blocks After Simulated Toothbrushing. Oper Dent 2023; 48:575-587. [PMID: 37635455 DOI: 10.2341/22-123-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES This study aimed to evaluate the surface gloss, surface roughness, and color change of restorative materials after a three-body wear abrasion. METHODS AND MATERIALS Four resin composites with different filler particle size (Gracefil Flo [GFF, 0.7 μm], Gracefil LoFlo [GFL, 0.25 μm], Gracefil ZeroFlo [GFZ, 0.15 μm], and Gracefil Putty [GFP, 0.3 μm]), two CAD/CAM resin composite blocks with different filler particle size (Cerasmart 300 [CS3, 0.7 μm] and Cerasmart Prime [CSP, 0.3 μm], GC), and one CAD/CAM lithium disilicate glass-ceramic block (Initial LiSi Block [ILS], GC) as a control were evaluated. Twenty slab-shaped specimens were obtained from each material. Ten specimens were subjected to 80,000 toothbrushing strokes and measured for surface gloss (Gloss Unit, GU), surface roughness (Ra, μm), and color (L*, a*, and b* values) before toothbrushing and at every 20,000 strokes. Color differences (ΔL*, Δa*, Δb*, and ΔE00) before and after toothbrushing were calculated. After 80,000 strokes, abraded surfaces were observed using scanning electron microscopy. The other 10 specimens were measured for Vickers microhardness (VHN). RESULTS After 80,000 toothbrushing strokes, the mean GU ranged from 60.43 to 16.12 (the highest for ILS and lowest for GFL), and the mean Ra ranged from 0.079 to 4.085 (the lowest for ILS and highest for GFL). At all measuring stages, the calculated ΔE00 values ranged from 0.31 to 0.92 for all materials. The mean VHN ranged from 632.34 to 39.08 (the highest for ILS and lowest for GFZ). The resin composite containing the largest filler particle (GFF) showed significantly lower Ra and higher VHN than other resin composites (GFL, GFZ, and GFP). The CAD/CAM resin composite block containing a smaller filler particle (CSP) retained significantly higher GU than that containing a larger filler particle (CS3). A negative correlation between GU and Ra was detected. CONCLUSIONS Based on the findings, toothbrush abrasion induced a decrease in GU and an increase in Ra for all resin-based materials tested. Resin-based materials with larger filler size tended to show lower Ra, while resin-based materials with smaller filler size tended to show a smaller reduction in GU. These were more pronounced for light-cure resin composites than for resin composite blocks for CAD/CAM.
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Affiliation(s)
- M Suzuki
- *Masaya Suzuki, DDS, PhD, Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata
| | - Y Miyano
- Yuko Miyano, DDS, Advanced Operative Dentistry-Endodontics, The Nippon Dental University Graduate School of Life Dentistry at Niigata
| | - F Sato
- Fumiaki Sato, DDS, PhD, Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata
| | - K Shinkai
- Koichi Shinkai, DDS, PhD, Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata
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Yoshiyasu N, Matsuki R, Sato M, Urushiyama H, Toda E, Terasaki Y, Suzuki M, Shinozaki-Ushiku A, Terashima Y, Nakajima J. Anti-Alcohol Drug to Target Macrophages Attenuates Acute Rejection in Rat Lung Allografts. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kikuyama M, Nakahodo J, Honda G, Suzuki M, Horiguchi SI, Chiba K, Tabata H, Ome Y, Uemura SI, Kawamoto Y, Kamisawa T. Pancreatic duct epithelial malignancy suggested by large focal pancreatic parenchymal atrophy in cystic diseases of the pancreas. Pancreatology 2023:S1424-3903(23)00066-2. [PMID: 37003856 DOI: 10.1016/j.pan.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/23/2023] [Accepted: 03/12/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND /Objectives: A cystic lesion is common in the pancreas. Focal pancreatic parenchymal atrophy (FPPA) has been reported as a sign of high-grade pancreatic intraepithelial neoplasia/carcinoma in situ (HGP/CIS). Some cystic lesions accompany FPPA. However, the relationship between a cystic lesion, FPPA, and the histopathological background of the pancreatic duct is unknown. METHODS We retrospectively evaluated the data of 98 patients with a cystic lesion who underwent serial pancreatic juice aspiration cytologic examination (SPACE) because of accompanying FPPA, increased size of the cystic lesion, and pancreatic duct stricture at the base. RESULTS The clinical diagnosis of a cystic lesion was intraductal papillary mucinous neoplasia (IPMN) and cysts in 72 (73.5%) and 26 (26.5%) patients, respectively. Ninety of the 98 patients (91.8%) had FPPA. Positive results (adenocarcinoma and suspicion) on SPACE were observed in 56 of all cases (57.1%), 48 of IPMN (66.7%), 8 of cysts (30.8%), and 54 of FPPA (59.3%), and were significantly associated with IPMN (p = 0.002) and the large FPPA (>269.79 mm2,p = 0.0001); moreover, these disorders are considerably related (p = 0.0003). Fifty patients (51.0%) with positive results on SPACE underwent surgery, with the histopathological diagnosis of epithelial malignancy in 42 patients (42.9%, 42/50, 84%). Many cystic lesions clinically diagnosed as IPMN were dilated branches covered by pancreatic intraepithelial neoplasia. CONCLUSIONS Positive results on SPACE were significantly associated with the clinical diagnosis of IPMN and the large FPPA. Moreover, these disorders are significantly related. Surgery owing to positive results could lead to the histopathological diagnosis of HGP/CIS.
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Affiliation(s)
- Masataka Kikuyama
- Department of Gastroenterology, Tokyo Women's Medical Hospital, Tokyo, Japan; Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
| | - Jun Nakahodo
- Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Goro Honda
- Department of Surgery, Tokyo Women's Medical Hospital, Tokyo, Japan
| | - Mizuka Suzuki
- Department of Radiology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | | | - Kazuro Chiba
- Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Hiroki Tabata
- Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Yusuke Ome
- Department of Surgery, Tokyo Women's Medical Hospital, Tokyo, Japan
| | | | - Yusuke Kawamoto
- Department of Surgery, Tokyo Women's Medical Hospital, Tokyo, Japan
| | - Terumi Kamisawa
- Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
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Nomura S, Eguchi A, Ghaznavi C, Yamasaki L, Rauniyar SK, Tanoue Y, Kawashima T, Yoneoka D, Kohsaka S, Suzuki M, Hashizume M. Changes in cerebrovascular disease-related deaths and their location during the COVID-19 pandemic in Japan. Public Health 2023; 218:176-179. [PMID: 37060737 PMCID: PMC10011032 DOI: 10.1016/j.puhe.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/23/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023]
Abstract
Objective The COVID-19 pandemic placed an enormous strain on healthcare systems and raised concerns for delays in the management of patients with acute cerebrovascular events. In this study, we investigated cerebrovascular excess deaths in Japan. Study design Vital mortality statistics from January 2012 to May 2022 were obtained from the Japanese Ministry of Health, Labour and Welfare. Methods Using quasi-Poisson regression models, we estimated the expected weekly number of cerebrovascular deaths in Japan from January 2020 through May 2022 by place of death. Estimates were calculated for deaths in all locations, as well as for deaths in hospitals, in geriatric health service facilities, and at home. The age subgroups of ≥75 and <75 years were also considered. Weeks with a statistically significant excess of cerebrovascular deaths were determined when the weekly number of observed deaths exceeded the upper bound of 97.5% prediction interval. Results Excess deaths were noted in June 2021 and became more pronounced from February 2022 onwards. The trend was notable among those aged ≥75 years and for those who died in hospitals. With respect to the location of deaths, the excess was significant in geriatric health services facilities from April 2020 to June 2021, while no evidence of excess hospital deaths was observed during the same period. Conclusions Beginning in late 2021, excess cerebrovascular deaths coincided with the spread of the Omicron variant and may be associated with increased healthcare burden. In 2020, COVID-19 altered the geography of cerebrovascular deaths, with fewer people dying in hospitals and more dying in geriatric health service facilities and at home.
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Affiliation(s)
- S Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan.
| | - A Eguchi
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - C Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Medical Education Program, Washington University School of Medicine in St Louis, Saint Louis, United States
| | - L Yamasaki
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; School of Medicine, Nagasaki University, Nagasaki, Japan
| | - S K Rauniyar
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Ocean Policy Research Institute, Sasakawa Peace Foundation, Tokyo, Japan
| | - Y Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - T Kawashima
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - D Yoneoka
- Infectious Disease Surveillance Center at the National Institute of Infectious Diseases, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
| | - S Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - M Suzuki
- Infectious Disease Surveillance Center at the National Institute of Infectious Diseases, Tokyo, Japan
| | - M Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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12
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Kimura S, Suzuki M, Nakamaru Y, Kano S, Watanabe M, Honma A, Nakazono A, Tsushima N, Hatakeyama S, Homma A. TRIM27 expression is associated with poor prognosis in sinonasal mucosal melanoma. Rhinology 2023:3062. [PMID: 36891983 DOI: 10.4193/rhin22.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND Tripartite motif-containing 27 (TRIM27) has been implicated in the progression of various cancers. However, the role of TRIM27 in sinonasal mucosal melanoma (SNMM) remains poorly understood. MATERIALS & METHODS We retrospectively examined 28 patients with SNMM treated with between 2003 and 2021. We undertook immunohistochemical analysis of TRIM27, Ki-67, and p-Akt1 expression in SNMM tissues. We also investigated the relationship between TRIM27 expression and clinical characteristics, prognosis, Ki-67 as a tumor growth potential marker, and p-Akt1 as one of the prognostic factors in mucosal melanoma. RESULTS TRIM27 expression was significantly higher in T4 disease than in T3 disease and was higher in stage IV than in stage III. Patients with high-TRIM27 SNMM had a significantly poorer prognosis in terms of overall survival (OS) and disease-free survival.There was also a significantly higher rate of distant metastasis. Univariate analysis for OS revealed that TRIM27 and T classification were significant poor prognostic factors. In addition, the Ki-67 positive score and the p-Akt1 total staining score were significantly higher in the high-TRIM27 group than in the low-TRIM27 group. CONCLUSIONS High TRIM27 expression in SNMM was associated with advanced T classification, poor prognosis and distant metastasis. We suggest that TRIM27 has potential as a novel biomarker for prognosis in SNMM.
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Affiliation(s)
- S Kimura
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Y Nakamaru
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - S Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Watanabe
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - A Honma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - A Nakazono
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - N Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - S Hatakeyama
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - A Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
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13
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Nakahodo J, Kikuyama M, Fukumura Y, Horiguchi SI, Chiba K, Tabata H, Suzuki M, Kamisawa T. Focal pancreatic parenchyma atrophy is a harbinger of pancreatic cancer and a clue to the intraductal spreading subtype. Pancreatology 2022; 22:1148-1158. [PMID: 36273992 DOI: 10.1016/j.pan.2022.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND/OBJECTIVES Radiological evidence of focal pancreatic parenchymal atrophy (FPPA) may presage early pancreatic ductal adenocarcinoma (PDAC) development. We aimed to clarify the incidence of FPPA and the clinicopathological features of PDAC with FPPA before diagnosis. METHODS Data on endoscopic ultrasound-guided fine-needle biopsies and surgical samples from 170 patients with pancreatic cancer histologically diagnosed between 2014 and 2019 were extracted from the pathology database of Komagome Hospital and Juntendo University hospital and retrospectively evaluated together with 51 patients without PDAC. RESULTS FPPA was identified in 47/170 (28%) patients before PDAC diagnosis and in 2/51 (4%) patients in the control group (P < 0.01). The median duration from FPPA detection to diagnosis was 35 (interquartile range [IQR]:16-63) months. In 24/47 (51%) patients with FPPA, the atrophic area resolved. The lesion was in the head and body/tail in 7/40 and 67/56 of the patients with (n = 47) and without FPPA (n = 123), respectively (P < 0.001). Histopathologically confirmed non-invasive lesions in the main pancreatic duct and a positive surgical margin in the resected specimens occurred in 53% vs. 21% (P = 0.078) and 29% vs. 3% (P = 0.001) of the groups, respectively. The PDAC patients with FPPA accompanied by a malignant pancreatic resection margin had high-grade pancreatic intraepithelial neoplasia. CONCLUSIONS FPPA occurred in 28% of the PDAC group at 35 months prediagnosis. The FPPA area resolved before PDAC onset. Benchmarking previous images of the pancreas with the focus on FPPA may enable prediction of PDAC. PDAC with FPPA involves widespread high-grade pancreatic intraepithelial neoplasia requiring a wide surgical margin for surgical excision.
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Affiliation(s)
- Jun Nakahodo
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan; Department of Human Pathology, Juntendo University, Bunkyo-Ku, Tokyo, Japan; Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Japan.
| | - Masataka Kikuyama
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan; Department of Gastroenterology, Tokyo Women's Medical University Hospital, Shinjuku-Ku, Tokyo, Japan
| | - Yuki Fukumura
- Department of Human Pathology, Juntendo University, Bunkyo-Ku, Tokyo, Japan
| | - Shin-Ichiro Horiguchi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan
| | - Kazuro Chiba
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan
| | - Hiroki Tabata
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan
| | - Mizuka Suzuki
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan
| | - Terumi Kamisawa
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan
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14
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Seto I, Yamaguchi H, Takagawa Y, Suzuki M, Takayama K, Tominaga T, Machida M, Murakami M. Retrospective Clinical Outcomes of Proton Beam Therapy for Unresectable Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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15
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Murakami M, Kato T, Yamaguchi H, Seto I, Takayama K, Tominaga T, Takagawa Y, Suzuki M, Machida M, Kikuchi Y. Proton Beam Re-Irradiation for In-Field Recurrent Non-Small Cell Lung Cancer after Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Kono A, Yoshioka R, Hawke P, Iwashina K, Inoue D, Suzuki M, Narita C, Haruta K, Miyake A, Yoshida H, Tosaka N. Correction to: A case of severe interstitial lung disease after COVID-19 vaccination. QJM 2022; 115:705. [PMID: 35312768 PMCID: PMC9383578 DOI: 10.1093/qjmed/hcac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Kono
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - R Yoshioka
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - P Hawke
- School of Pharmaceutical Sciences, University of Shizuoka, 51-1 Yada Suruga ward, Shizuoka 422-8526, Japan
| | - K Iwashina
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - D Inoue
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - M Suzuki
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - C Narita
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - K Haruta
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - A Miyake
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - H Yoshida
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
| | - N Tosaka
- Department of Emergency Medicine, Shizuoka General Hospital, 4-27-1 Kitaando Aoi ward, Shizuoka 420-0881, Japan
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17
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Matsuda M, Suzuki M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Iguchi M, Abe M, Akao M, Hasegawa K, Wada H. Involvement of growth differentiation factor 15 in paradoxical relationship between body mass index and mortality in patients with suspected or known coronary artery disease; The ANOX Study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2391] [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
Obesity is a well-established risk factor for type 2 diabetes mellitus, hypertension and dyslipidemia, leading to coronary artery disease (CAD). Nevertheless, body mass index (BMI) is inversely associated with cardiovascular (CV) mortality in patients with cardiac disorders, termed “obesity paradox”. However, the underlying mechanism remains unclear.
Purpose
To clarify important factors involved in the pathogenesis of obesity paradox.
Methods
Using data from a multicenter, prospective cohort of 2,418 patients with suspected or known CAD enrolled in the ANOX study, we assessed the relationship between BMI at baseline and the incidence of CV death over 3 years, and investigated the involvement of several endocrine factors which were previously reported to have some roles in obesity and heart diseases, such as adiponectin, N-terminal pro-brain natriuretic peptide (NT-proBNP) and growth differentiation factor 15 (GDF-15), in the relationship between BMI and CV death.
Results
In Kaplan-Meier analyses, the lower quartiles of BMI and the higher quartiles of adiponectin levels were paradoxically associated with the higher cumulative incidence of CV death. To clarify the important factors involved in the paradoxical association between BMI or adiponectin and mortality, we first investigated independent determinants for BMI and adiponectin levels respectively, using multiple stepwise regression analyses among many clinical factors, and then narrow down the prognostic factors commonly associated with BMI and adiponectin, which were age, hemoglobin and NT-proBNP. Interestingly, circulating levels of GDF15 were significantly correlated with NT-proBNP levels, and the presence of anemia raised the gradient of the correlation line in a scatter plot (without anemia, r=0.139, p<0.0001; with anemia, r=0.228, p<0.0001). Moreover, the highest GDF15 quartile showed significantly lower BMI and higher adiponectin levels compared to the lower quartiles (p<0.001 and p<0.001, respectively, by Student t-test). In Cox proportional hazard models, hazard ratios (HRs) of BMI (per 1-unit increase) were 0.90 (95% confidence interval [CI], 0.85–0.96) for CV death. Additional adjustment for hemoglobin, NT-proBNP, adiponectin or GDF15 diminished the statistical significance (HR, 0.92 [95% CI, 0.87–0.99], 0.95 [0.89–1.01], 0.92 [0.87–0.99], or 0.93 [0.87–0.99], respectively).
Conclusions
The lower BMI and the higher adiponectin levels were paradoxically associated with the higher incidence of CV death in patients with CAD. This paradox may be mediated by cardiac endocrine factors induced by cardiac stresses, including GDF-15 in addition to natriuretic peptides.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital , Sagamihara , Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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18
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Vascular endothelial factor C and D in patients with heart failure with preserved, mildly reduced, and reduced ejection fraction: the PREHOSP-CHF study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.916] [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 lymphatic system has been suggested to play an important role in cardiovascular diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and D (VEGF-D) are key regulators of lymphangiogenesis, and we recently reported the association of low VEGF-C with the risk of all-cause death and high VEGF-D with the risk of HF hospitalization in patients with HF.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with HF with preserved ejection fraction (EF) (HFpEF: EF≥50%), mildly reduced EF (HFmrEF: EF, 40–49%), and reduced EF (HFrEF: EF<40%).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in HF. A total of 1,024 patients (mean age 75.5±12.6 years; 58.7% male) admitted to acute decompensated HF were included in the analyses. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitivity C reactive protein, were measured at the time of discharge. Patients were followed-up over two years.
Results
The numbers of HFpEF, HFmrEF, and HFrEF were 429 (41.9%), 186 (18.2%), and 409 (39.9%), respectively. HFpEF patients were older, more likely to be female, and had more hypertension, atrial fibrillation, and anemia, but less coronary artery disease. NT-proBNP and hs-cTnI levels increased with decreasing EF. VEGF-C levels decreased with increasing EF (median [interquartile range]: HFpEF, 4508 [3318–5919] pg/ml; HFmrEF, 4719 [3663–6203] pg/ml; HFrEF, 5023 [3804–6382] pg/ml), whereas VEGF-D levels were comparable among the three EF groups (HFpEF, 404.6 [293.1–560.3] pg/ml; HFmrEF, 386.0 [298.5–556.3] pg/ml; HFrEF, 414.2 [296.1–557.3] pg/ml). In multivariate stepwise logistic regression analyses, anemia and high NT-proBNP were independently associated with low VEGF-C levels, and high NT-proBNP was independently associated with high VEGF-D levels, across all the EF groups. During the follow-up, incidences of all-cause death and HF hospitalizations were similar among the three EF groups (log-rank P=0.6 for all-cause death, and log-rank P=0.3 for HF hospitalization). On multivariate Cox proportional hazard analyses including established risk factors and cardiovascular biomarkers, VEGF-C levels tended to be inversely associated with the incidence of all-cause death in patients with HFpEF and HFrEF (Figure). On the contrary, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization in patients with HFpEF, and tended to be positively associated with it in patients with HFmrEF and HFrEF (Figure).
Conclusions
Low VEGF-C was associated with the risk of all-cause death in patients with HFpEF and HFrEF, while high VEGF-D was associated with the risk of HF hospitalization especially in HFpEF.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Saitama , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center , Fukuoka , Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center , Ibaraki , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center , Hiroshima , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - K Kotani
- Jichi Medical University , Tochigi , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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19
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Wada K, Kotani K, Abe M, Akao M, Hasegawa K. Associations of soluble fms-like tyrosine kinase-1 with cardiovascular events and stroke in patients with atrial fibrillation and suspected or known coronary artery disease: the EXCEED-J study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.544] [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
Atrial fibrillation (AF) increases the risk of stroke. Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction, which are associated with both AF and coronary artery disease (CAD). Recently, we demonstrated that sFlt-1 is independently associated with major adverse cardiovascular (CV) events (MACE) in patients with suspected or known CAD. However, the prognostic utility of sFlt-1 in patients with AF remains unknown.
Methods
Using data from a multicenter, prospective cohort of 3255 patients with suspected or known CAD, we investigated whether AF modifies the prognostic utility of sFlt-1. Heparin-free serum levels of sFlt-1, N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin-I, high-sensitivity C-reactive protein, cystatin C, neutrophil gelatinase-associated lipocalin, VEGF, and placental growth factor were measured in 324 patients with AF and 2931 patients without AF. The primary outcome was MACE defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, stroke, heart failure (HF) hospitalization, and coronary/peripheral artery revascularization. The biomarkers were natural log-transformed for use as continuous variables.
Results
After adjustment for potential clinical confounders including anticoagulant drug use, sFlt-1 was significantly associated with MACE (hazard ratio for 1 standard deviation increase [HR], 1.55; 95% confidence interval [CI], 1.14–2.08), CV death (HR, 1.68; 95% CI, 1.10–2.48), and stroke (HR, 1.89; 95% CI, 1.16–3.10), but not with all-cause death (HR, 1.32; 95% CI, 0.99–1.73), HF hospitalization (HR, 0.97; 95% CI, 0.73–1.25), or revascularization (HR, 0.99; 95% CI, 0.74–1.28) in patients with AF, whereas sFlt-1 was significantly associated with MACE (HR, 1.19; 95% CI, 1.02–1.37), all-cause death (HR, 1.19; 95% CI, 1.05–1.34), CV death (HR, 1.26; 95% CI, 1.03–1.48), and HF hospitalization (HR, 1.26; 95% CI, 1.11–1.42), but not with stroke (HR, 1.06; 95% CI, 0.81–1.33) or revascularization (HR, 1.01; 95% CI, 0.95–1.07) in patients without AF. Among other biomarkers, only VEGF was significantly associated with MACE (HR, 1.55; 95% CI, 1.02–2.44), and no biomarkers were significantly associated with CV death or stroke in patients with AF. sFlt-1 added incremental prognostic information for MACE (P=0.005 for net reclassification improvement [NRI], P=0.026 for integrated discrimination improvement [IDI]) and stroke (P=0.034 for NRI, P=0.018 for IDI), but not for CV death (P=0.021 for NRI, P=0.134 for IDI), to the model with potential clinical confounders in patients with AF.
Conclusions
sFlt-1 independently predicted MACE and stroke in patients with AF and suspected or known CAD. sFlt-1 may serve as a novel prognostic biomarker to stratify the risk of MACE and stroke in patients with AF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008)
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital , Sagamihara , Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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20
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Matsumura M, Honda G, Tani K, Nemoto S, Ome Y, Hayakawa S, Suzuki M, Horiguchi S, Kikuyama M, Seyama Y. The outcome of a multidisciplinary approach incorporating neoadjuvant chemoradiotherapy with
S1
for resectable pancreatic ductal adenocarcinoma. Ann Gastroenterol Surg 2022; 7:306-317. [PMID: 36998294 PMCID: PMC10043772 DOI: 10.1002/ags3.12624] [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] [Received: 06/27/2022] [Accepted: 09/14/2022] [Indexed: 04/01/2023] Open
Abstract
Aim This study was performed to evaluate the efficacy of a multidisciplinary approach incorporating neoadjuvant chemoradiotherapy with S1 (S1-NACRT) for resectable pancreatic ductal adenocarcinoma. Methods The medical records of 132 patients who received S1-NACRT for resectable pancreatic ductal adenocarcinoma from 2010 to 2019 were reviewed. The S1-NACRT regimen consisted of S1 at a dose of 80-120 mg/body/day together with 1.8 Gy of radiation in 28 fractions. The patients were re-evaluated 4 weeks after S1-NACRT completion, and a pancreatectomy was then considered. Results Adverse events of S1-NACRT ≥grade 3 occurred in 22.7% of the patients, and 1.5% discontinued therapy. Of the 112 patients who underwent a pancreatectomy, 109 underwent R0 resection. Adjuvant chemotherapy with relative dose intensity ≥50% was administered to 74.1% of the patients who underwent resection. The median overall survival of all patients was 47 months, and the median overall survival and recurrence-free survival of patients who underwent resection was 71 and 32 months, respectively. According to the multivariate analyses of prognostic factors for overall survival in patients who underwent resection, negative margin status (hazard ratio: 0.182; P = 0.006) and relative dose intensity of adjuvant chemotherapy ≥50% (hazard ratio 0.294; P < 0.001) were independent prognostic factors of overall survival. Conclusions A multidisciplinary approach incorporating S1-NACRT for resectable pancreatic ductal adenocarcinoma demonstrated acceptable tolerability and good local control and resulted in comparable survival benefits.
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Affiliation(s)
- Masaru Matsumura
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Goro Honda
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
- Department of Surgery, Institute of GastroenterologyTokyo Women's Medical UniversityTokyoJapan
| | - Keigo Tani
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Satoshi Nemoto
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Yusuke Ome
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
- Department of Surgery, Institute of GastroenterologyTokyo Women's Medical UniversityTokyoJapan
| | - Sara Hayakawa
- Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Mizuka Suzuki
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Shin‐ichiro Horiguchi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Masataka Kikuyama
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Yasuji Seyama
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
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21
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Suzuki M, Kotani K, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada M, Abe M, Akao M, Hasegawa K, Wada H. Serum amyloid A-low-density-lipoprotein complex and mortality in patients with suspected or known coronary artery disease: the ANOX study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1161] [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
Serum amyloid A-low-density-lipoprotein (SAA-LDL) is a complex formed from the oxidative interaction between SAA and LDLs. A relatively small-scale study has shown that circulating SAA-LDL levels may serve as a prognostic marker in patients with stable coronary artery disease (CAD). However, the prognostic value of SAA-LDL should be confirmed in a larger-scale cohort study.
Methods
Using data from a multicenter, prospective cohort of 2416 patients with suspected or known CAD enrolled in the ANOX (Development of Novel Biomarkers Related to Angiogenesis or Oxidative Stress to Predict Cardiovascular Events) study, we assessed the prognostic value of serum levels of SAA-LDL. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Patients were followed up over 3 years.
Results
Stepwise regression analysis including baseline data on potential clinical confounders (i.e., age, sex, body mass index, hypertension, dyslipidemia, diabetes, current smoking, estimated glomerular filtration rate, the Gensini score, previous myocardial infarction, previous stroke, previous heart failure hospitalization, atrial fibrillation, malignancies, anemia, antihypertensive drug use, statin use, and aspirin use) and established cardiovascular biomarkers (i.e., N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin I [hs-cTnI], and high-sensitivity C-reactive protein [hs-CRP]) revealed that independent determinants of SAA-LDL levels were female sex, dyslipidemia, the Gensini score, absence of statin use, hs-cTnI, and hs-CRP. After adjusting for potential clinical confounders and established cardiovascular biomarkers, the highest quartile of SAA-LDL levels (vs. the lowest quartile) was significantly associated with the incidence of all-cause death (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.02–2.26), but not with that of cardiovascular death (HR, 1.11; 95% CI, 0.59–2.10) or MACE (HR, 1.57; 95% CI, 0.97–2.57). Stratified analyses revealed that this association was pronounced in patients with low hs-cTnI (<75th percentile) (HR, 1.85; 95% CI, 1.06–3.30) and in patients with low hs-CRP levels (≤1.0 mg/L) (HR, 2.30; 95% CI, 1.17–4.79).
Conclusions
Elevated SAA-LDL levels were independently associated with the risk of all-cause death in patients with suspected or known CAD. The SAA-LDL level appears to serve as a prognostic biomarker for risk stratification in relatively low-risk patients with low hs-cTnI (<75th percentile) or low hs-CRP (≤1.0 mg/L).
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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22
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Murayama Y, Kitasato L, Ishizue N, Suzuki M, Mitani Y, Saito D, Matsuura G, Sato T, Kobayashi S, Nakamura H, Oikawa J, Kishihara J, Fukaya H, Niwano S, Ako J. Evaluation of the direct protective effects of Canagliflozin on the Isoproterenol-induced cell injury in rat cardiomyocytes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2927] [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
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are agents that act by inhibiting glucose and sodium reabsorption in the proximal renal tubule which promotes urinary glucose excretion. More recently, significant benefit data of SGLT2 inhibitors in patients with heart failure, independent of the presence of type 2 diabetes has been reported. We have previously demonstrated that Canagliflozin (Cana), a SGLT2 inhibitor, reduced the ventricular effective refractory period in isoproterenol (ISP)-induced myocardial injury rat model accompanied with the suppression of reactive oxygen species and the elevation of ketone bodies, suggesting the effect of Cana on electrical cardiac remodeling. The direct effect of Cana to the cardiomyocytes and its underlying molecular mechanism was remained to be clarified. We therefore established an ISP-induced neonatal rat ventricular cardiomyocyte (NRVCM) in vitro model, pretreated with Cana and/or ketone bodies.
Methods
Primary NRVCM were isolated from Wistar rats, were pretreated by Cana with or without βOHB (the most abundant ketone body in circulation), followed by a stimulation of ISP (10μM). Cells without drug or ketone body pretreatment were used as control. We then analyzed its effect on cell viability, apoptosis, and mitochondrial membrane potential using MTT assay, TUNEL assay, and mitochondrial membrane potential assay, respectively. MTT assay was also performed with or without PI3k inhibitor, LY294002. The end-labeling of DNA fragmentation were labelled with FITC, followed by the nuclei counterstain with DAPI and were observed with confocal microscope. The apoptotic index was defined as the percentage of TUNEL positive cells / total nuclei.
Results
Cana rescued the reduction of NRVCM cell viability induced by ISP stimulation for 24 hours which was inhibited by LY294002 compared to cells without pretreatment. Interestingly, pretreatment of βOHB with or without Cana improved also the NRCVM cell viability whereas there was no significant difference between these two conditions or with cells treated with Cana only, suggesting the direct protective effect of Cana. In 48 hours of ISP stimulation, the apoptotic index intends to decrease in Cana and/or βOHB compared to cells without pretreatment (Figure 1). Although the mitochondrial function was maintained in Cana-pretreated cells compared to cells without pretreatment, there was no significant difference in βOHB-pretreated cells.
Conclusions
Cana has a direct protective effect on cardiomyocytes cell viability, apoptosis as well as the mitochondrial function impaired by ISP through the cell survival signaling PI3K/Akt pathway. This brings a new insight to the therapeutic target of cardiovascular disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Murayama
- Kitasato University School of Medicine , Sagamihara , Japan
| | - L Kitasato
- Kitasato University School of Medicine , Sagamihara , Japan
| | - N Ishizue
- Kitasato University School of Medicine , Sagamihara , Japan
| | - M Suzuki
- Kitasato University School of Medicine , Sagamihara , Japan
| | - Y Mitani
- Kitasato University School of Medicine , Sagamihara , Japan
| | - D Saito
- Kitasato University School of Medicine , Sagamihara , Japan
| | - G Matsuura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - T Sato
- Kitasato University School of Medicine , Sagamihara , Japan
| | - S Kobayashi
- Kitasato University School of Medicine , Sagamihara , Japan
| | - H Nakamura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Oikawa
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Kishihara
- Kitasato University School of Medicine , Sagamihara , Japan
| | - H Fukaya
- Kitasato University School of Medicine , Sagamihara , Japan
| | - S Niwano
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
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Takeda T, Yamano S, Suzuki M. P19-03 Comparative analysis of pathogenesis and search for biomarkers using a rat model of pneumoconiosis caused by toxic particulate matters. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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24
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Yanagiba Y, Takeda T, Yamano S, Amamoto T, Yamada M, Kubota H, Suzuki M, Saito M, Umeda Y, Wang RS, Koda S. P19-05 Challenges in developing a novel accelerated silicosis rat model by single intratracheal instillation of high-purity crystalline silica particles. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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25
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Morioka S, Tsuzuki S, Suzuki M, Terada M, Akashi M, Osanai Y, Kuge C, Sanada M, Tanaka K, Maruki T, Takahashi K, Saito S, Hayakawa K, Teruya K, Hojo M, Ohmagari N. Post COVID-19 condition of the Omicron variant of SARS-CoV-2. J Infect Chemother 2022; 28:1546-1551. [PMID: 35963600 PMCID: PMC9365517 DOI: 10.1016/j.jiac.2022.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/18/2022] [Accepted: 08/04/2022] [Indexed: 12/12/2022]
Abstract
Objectives To investigate the prevalence of post coronavirus disease (COVID-19) condition of the Omicron variant in comparison to other strains. Study design A single-center cross-sectional study. Methods Patients who recovered from Omicron COVID-19 infection (Omicron group) were interviewed via telephone, and patients infected with other strains (control group) were surveyed via a self-reporting questionnaire. Data on patients’ characteristics, information regarding the acute-phase COVID-19, as well as presence and duration of COVID-19-related symptoms were obtained. Post COVID-19 condition in this study was defined as a symptom that lasted for at least 2 months, within 3 months of COVID-19 onset. We investigated and compared the prevalence of post COVID-19 condition in both groups after performing propensity score matching. Results We conducted interviews for 53 out of 128 patients with Omicron and obtained 502 responses in the control group. After matching cases with controls, 18 patients from both groups had improved covariate balance of the factors: older adult, female sex, obesity, and vaccination status. There were no significant differences in the prevalence of each post COVID-19 condition between the two groups. The number of patients with at least one post COVID-19 condition in the Omicron and control groups were 1 (5.6%) and 10 (55.6%) (p = 0.003), respectively. Conclusions The prevalence of post Omicron COVID-19 conditions was less than that of the other strains. Further research with a larger sample size is needed to investigate the precise epidemiology of post COVID-19 condition of Omicron, and its impact on health-related quality of life and social productivity.
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Affiliation(s)
- S Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
| | - S Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - M Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - M Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Akashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Y Osanai
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - C Kuge
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - M Sanada
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Tanaka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - T Maruki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Takahashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - S Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - M Hojo
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
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Harigai A, Saito AI, Inoue T, Suzuki M, Namba Y, Suzuki Y, Makino F, Nagashima O, Sasaki S, Sasai K. The prognostic value of 18F-FDG PET/CT taken immediately after completion of radiotherapy for lung cancer treated with concurrent chemoradiotherapy: A pilot study. Cancer Radiother 2022; 26:711-716. [PMID: 35715357 DOI: 10.1016/j.canrad.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/10/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The prognostic value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) taken immediately after completion of radiotherapy in lung cancer patients is not well known. The purpose of this study is to assess the prognostic value of PET/CT taken immediately after completion of radiotherapy in lung cancer patients. MATERIALS AND METHODS Patients with primary lung cancer planned to undergo concurrent chemoradiotherapy were enrolled. Patients underwent PET/CT scans at 3 time points: before radiotherapy, within 24hours of completing radiotherapy (im-PET/CT), and 2-9 months after radiotherapy (post-PET/CT). Maximum standardized uptake value (SUVmax) was obtained. A post-PET/CT-SUVmax cut-off of 2.5 was determined as radiotherapy success. RESULTS Nineteen patients were enrolled. im-PET/CT-SUVmax for patients in the high post-PET/CT-SUVmax group was significantly higher than that of the low group (P=0.004). Receiver operator curve analysis indicated that im-PET/CT-SUVmax of 4.35 was an optimal cut-off value to discriminate between the two groups. Multivariable analysis showed that a high im-PET/CT-SUVmax was significantly associated with a high post-PET/CT-SUVmax (P=0.003). CONCLUSION PET/CT-SUVmax taken immediately following radiotherapy was associated with that evaluated 2-9 months after radiotherapy.
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Affiliation(s)
- A Harigai
- Clinical training center, Juntendo university, Urayasu hospital, 2-1-1 Tomioka Urayasushi, Chiba, Japan
| | - A I Saito
- Department of radiation oncology, Juntendo university, faculty of medicine, Tokyo, Japan.
| | - T Inoue
- Department of radiation oncology, Juntendo university, faculty of medicine, Tokyo, Japan
| | - M Suzuki
- Department of radiology, Juntendo Tokyo Koto geriatric medical center, Tokyo, Japan
| | - Y Namba
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - Y Suzuki
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - F Makino
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - O Nagashima
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - S Sasaki
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - K Sasai
- Department of radiation oncology, Juntendo university, faculty of medicine, Tokyo, Japan
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Abe S, Ezaki O, Suzuki M. Effects of Timing of Medium-Chain Triglycerides (8:0 and 10:0) Supplementation during the Day on Muscle Mass, Function and Cognition in Frail Elderly Adults. J Frailty Aging 2022; 11:100-108. [PMID: 35122097 DOI: 10.14283/jfa.2021.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Supplementation with 6 g/day of medium-chain triglycerides (MCTs) at dinnertime increases muscle function and cognition in frail elderly adults relative to supplementation with long-chain triglycerides. However, suitable timing of MCT supplementation during the day is unknown. DESIGN We enrolled 40 elderly nursing home residents (85.9 ± 7.7 years) in a 1.5-month randomized intervention trial. Participants were randomly allocated to two groups: one received 6 g/day of MCTs at breakfast (breakfast group) as a test group and the other at dinnertime (dinner group) as a positive control group. MEASUREMENTS Muscle mass, strength, function, and cognition were monitored at baseline and 1.5 months after initiation of intervention. RESULTS Thirty-seven participants completed the study and were included in the analysis. MCT supplementation in breakfast and dinner groups respectively increased right arm muscle area from baseline by 1.1 ± 0.8 cm2 (P<0.001) and 1.6 ± 2.5 cm2 (P<0.001), left arm muscle area by 1.1 ± 0.7 cm2 (P<0.001) and 0.9 ± 1.0 cm2 (P<0.01), right knee extension time by 39 ± 42 s (P<0.01) and 20 ± 32 s (P<0.05), leg open and close test time by 1.74 ± 2.00 n/10 s (P<0.01) and 1.67 ± 2.01 n/10 s (P<0.01), and Mini-Mental State Examination score by 1.5 ± 3.0 points (P=0.06) and 1.0 ± 2.1 points (P=0.06). These increases between two groups did not differ statistically significantly. CONCLUSION Supplementation with 6 g MCTs/day for 1.5 months, irrespective of ingestion at breakfast or dinnertime, could increase muscle mass and function, and cognition in frail elderly adults.
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Affiliation(s)
- S Abe
- Osamu Ezaki, M.D. Institute of Women's Health Science, Showa Women's University, 1-7-57 Taishido, Setagaya-ku, Tokyo 154-8533, Japan, Tel: +81-3-3411-7450; Fax: +81-3-3411-7450, E-mail:
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Shimizu M, Miyazaki H, Cho S, Misu Y, Tateishi R, Yamaguchi M, Yamakami Y, Shimada H, Manno T, Isshiki A, Kimura S, Fujii H, Suzuki M, Nishizaki M, Sasano T. Prognostic value of machine learning for acute heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.050] [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
Funding Acknowledgements
Type of funding sources: None.
Background
At onset of acute heart failure (AHF), various clinical fundamental parameters including vital sign, laboratory data, or initial treatment were investigated, and we can roughly estimate the prognosis. However, machine learning method for prediction of the prognosis was not studied.
Purpose
To elucidate prognostic value of machine learning for AHF comparing conventional statistical model.
Methods
We enrolled consecutive 300 patients with AHF (79.5 ± 12.1 years, 158 Males). Patients with acute coronary syndrome, mechanical circulatory support cases, and cardio-pulmonary arrest cases were excluded. The patients were randomly divided into 80% (240 cases) and 20% (60 cases), and the former was used as train data, and the latter as validation data. Objective variable was set as cardiac death in one year. First, logistic regression analysis with Akaike’s information criterion (AIC) was performed, and extracted predictive parameters. The predictive model for the cardiac prognosis was constructed by cut-off value of ROC curve analysis of propensity score was calculated. Next, machine learning (random forest method and deep learning) to build predictive model was performed with the predictors. Finally, accuracy of each predictive model was compared.
Results
Thirty cases showed cardiac death in one year. Logistic regression with AIC extracted 8 predictors, and the cut off-value of propensity score with the 6 parameters was 0.110. The accuracy was 0.714 and area under ROC (AUROC) was 0.836. Conversely, random forest method demonstrated the accuracy as 0.927, AUROC 0.860. On deep learning, the accuracy was 0.937 and AUROC 0.901.
The top 4 high feature importance of random forest were Cl/red blood cell count/pH/Anion Gap. However, accuracy of those predictors was lower than that of machine learning.
Conclusion
Machine learning was a powerful tool to predict cardiac prognosis of AHF, comparing with conventional statistical model. Abstract Figure. Statistical model
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Affiliation(s)
- M Shimizu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Miyazaki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - S Cho
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Misu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - R Tateishi
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Yamaguchi
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Manno
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - A Isshiki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | | | - T Sasano
- Tokyo Medical And Dental University, Tokyo, Japan
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Kitabatake T, Takayama K, Tominaga T, Hayashi Y, Seto I, Yamaguchi H, Suzuki M, Wada H, Kikuchi Y, Murakami M, Mitsudo K. Treatment outcomes of proton beam therapy combined with retrograde intra-arterial infusion chemotherapy for locally advanced oral cancer in the elderly. Int J Oral Maxillofac Surg 2022; 51:1264-1272. [DOI: 10.1016/j.ijom.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/04/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
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Seki S, Suzuki M, Ishibashi M, Takagi R, Khanh ND, Shiota Y, Shibata K, Koshibae W, Tokura Y, Ono T. Direct visualization of the three-dimensional shape of skyrmion strings in a noncentrosymmetric magnet. Nat Mater 2022; 21:181-187. [PMID: 34764432 DOI: 10.1038/s41563-021-01141-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 09/23/2021] [Indexed: 05/21/2023]
Abstract
Magnetic skyrmions are topologically stable swirling spin textures that appear as particle-like objects in two-dimensional (2D) systems. Here, utilizing scalar magnetic X-ray tomography under applied magnetic fields, we report the direct visualization of the three-dimensional (3D) shape of individual skyrmion strings in the room-temperature skyrmion-hosting non-centrosymmetric compound Mn1.4Pt0.9Pd0.1Sn. Through the tomographic reconstruction of the 3D distribution of the [001] magnetization component on the basis of transmission images taken at various angles, we identify a skyrmion string running through the entire thickness of the sample, as well as various defect structures, such as the interrupted and Y-shaped strings. The observed point defect may represent the Bloch point serving as an emergent magnetic monopole, as proposed theoretically. Our tomographic approach with a tunable magnetic field paves the way for direct visualization of the structural dynamics of individual skyrmion strings in 3D space, which will contribute to a better understanding of the creation, annihilation and transfer of these topological objects.
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Affiliation(s)
- S Seki
- Department of Applied Physics, University of Tokyo, Tokyo, Japan.
- Institute of Engineering Innovation, University of Tokyo, Tokyo, Japan.
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Japan.
- PRESTO, Japan Science and Technology Agency (JST), Kawaguchi, Japan.
| | - M Suzuki
- Japan Synchrotron Radiation Research Institute, Sayo, Japan.
- School of Engineering, Kwansei Gakuin University, Sanda, Japan.
| | - M Ishibashi
- Institute for Chemical Research, Kyoto University, Uji, Japan
| | - R Takagi
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
- Institute of Engineering Innovation, University of Tokyo, Tokyo, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Japan
- PRESTO, Japan Science and Technology Agency (JST), Kawaguchi, Japan
| | - N D Khanh
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Japan
| | - Y Shiota
- Institute for Chemical Research, Kyoto University, Uji, Japan
| | - K Shibata
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - W Koshibae
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Japan
| | - Y Tokura
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Japan
- Tokyo College, University of Tokyo, Tokyo, Japan
| | - T Ono
- Institute for Chemical Research, Kyoto University, Uji, Japan.
- Center for Spintronics Research Network, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan.
- Center for Spintronics Research Network, Institute for Chemical Research, Kyoto University, Uji, Japan.
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Kono A, Yoshioka R, Hawk P, Iwashina K, Inoue D, Suzuki M, Narita C, Haruta K, Miyake A, Yoshida H, Tosaka N. A case of severe interstitial lung disease after COVID-19 vaccination. QJM 2022; 114:805-806. [PMID: 34618126 PMCID: PMC8522437 DOI: 10.1093/qjmed/hcab263] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Kono
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
- Corresponding author contact information. Akira KONO, Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881). Mail: , TEL: +81-70-6557-8674
| | - R Yoshioka
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - P Hawk
- University of Shizuoka, 51-1 Yada Suruga ward, Shizuoka, Japan (zip code 422-8526)
| | - K Iwashina
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - D Inoue
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - M Suzuki
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - C Narita
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - K Haruta
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - A Miyake
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - H Yoshida
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
| | - N Tosaka
- Department of Emergency medicine, Shizuoka general hospital, 4-27-1 Kitaando Aoi ward, Shizuoka, Japan (zip code 420-0881)
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32
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Shimizu Y, Suzuki M, Hata Y, Sakaki T. Influence of Perceived Ageism on Older Adults: Focus on Attitudes toward Young People and Life Satisfaction. Adv Gerontol 2022. [PMCID: PMC9774065 DOI: 10.1134/s2079057022040142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The world’s population is aging, and intergenerational conflicts between older adults and young people are becoming more serious. This study focused on ageism as a cause of intergenerational conflicts and older adults’ diminished mental health status. We conducted an online survey of older Japanese participants (n = 1.096). Our results indicated that older adults who perceived more ageism directed toward them (1) had more negative attitudes toward young people and (2) had lower life satisfaction, which persisted even after controlling for variables such as old age identity and depressive tendencies. Accordingly, we suggest that ageism may reinforce intergenerational conflicts between older adults and young people and compromise older adults’ mental health status. The findings of this study can aid gerontological and psychological research aimed at reducing ageism.
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Affiliation(s)
- Y. Shimizu
- The University of Tokyo, 7-3-1 Hongo, 113-0033 Bunkyo-ku, Tokyo Japan ,Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, 102-0083 Tokyo, Japan
| | - M. Suzuki
- Sompo Holdings, Inc., 1-26-1 Nishi-Shinjyuku, Shinjyuku-ku, 160-8338 Tokyo, Japan
| | - Y. Hata
- SAT Laboratory LLC, 3-20 Matsunouchi-cho, 659-0094 Ashiya, Hyogo Japan
| | - T. Sakaki
- SAT Laboratory LLC, 3-20 Matsunouchi-cho, 659-0094 Ashiya, Hyogo Japan
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33
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Otobe Y, Kimura Y, Suzuki M, Koyama S, Kojima I, Yamada M. Factors Associated with Increased Caregiver Burden of Informal Caregivers during the COVID-19 Pandemic in Japan. J Nutr Health Aging 2022; 26:157-160. [PMID: 35166308 PMCID: PMC8783575 DOI: 10.1007/s12603-022-1730-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
This study's objective was to explore the association between various factors and the increased caregiver burden of informal caregivers during the COVID-19 pandemic. On February, 2021, 700 informal caregivers completed an online survey. We assessed the change in caregiver burden during the COVID-19 pandemic. Among all caregiver participants, 287 (41.0%) complained of an increased caregiver burden due to the COVID-19 pandemic. The factors associated with increased caregiver burden were depressive symptoms in caregivers [odds ratio (OR), 2.20; 95% confidence interval (CI), 1.50-3.23], dementia (OR, 2.48; 95%CI, 1.07-5.73) and low Barthel Index scores (OR, 2.01; 95%CI, 1.39-2.90) in care receivers, care days (OR, 1.09; 95%CI, 1.01-1.17) and times (OR, 1.06; 95%CI, 1.01-1.10), and use of home care service (OR, 1.46; 95%CI, 1.01-2.10) and visiting care service (OR, 1.71; 95%CI, 1.20-2.45). These findings suggest we need to pay attention to the physical and mental health of both the care receivers and caregivers.
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Affiliation(s)
- Y Otobe
- Yuhei Otobe, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan, Tel: +81-29-853-2111, E-mail:
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34
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Tokisawa H, Aruga T, Kumaki Y, Iwamoto N, Yonekura R, Ishiba T, Honda Y, Suzuki M. Metastasis of breast cancer to liver through direct lymphatic drainage: a case report. J Int Med Res 2021; 49:3000605211064793. [PMID: 34918986 PMCID: PMC8721733 DOI: 10.1177/03000605211064793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Breast cancer liver metastasis (BCLM) is considered to occur by hematogenous spread of primary breast cancer cells. We herein present a case of lymphatic BCLM that was confirmed by preoperative imaging for sentinel lymph node biopsy (SLNB). A woman in her early 70s was diagnosed with clinical stage T2N0M0 invasive lobular cancer of the left breast. She underwent mastectomy with SLNB. Preoperative lymphoscintigraphy showed intense accumulation of isotope in the upper abdomen, corresponding to segment IV of the liver on single-photon emission computed tomography/computed tomography (SPECT/CT). However, no abnormalities were detected on magnetic resonance imaging. At 2.5 years postoperatively, the patient’s serum CA15-3 concentration was elevated, and positron emission tomography/computed tomography (PET/CT) showed a solitary liver metastasis. The PET/CT findings were similar to the SPECT/CT findings obtained 2.5 years earlier, indicating that the BCLM had developed lymphatically. To the best of our knowledge, this is the first case report of lymphatic BCLM proven by imaging examination.
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Affiliation(s)
- Hiromi Tokisawa
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Tomoyuki Aruga
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Yuichi Kumaki
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Naoko Iwamoto
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Rika Yonekura
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Toshiyuki Ishiba
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Yayoi Honda
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Mizuka Suzuki
- Department of Radiological Diagnosis, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
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35
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Nomura S, Eguchi A, Tanoue Y, Yoneoka D, Kawashima T, Suzuki M, Hashizume M. Excess deaths from COVID-19 in Japan and 47 prefectures from January through June 2021. Public Health 2021; 203:15-18. [PMID: 35016070 PMCID: PMC8742134 DOI: 10.1016/j.puhe.2021.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/12/2021] [Accepted: 11/27/2021] [Indexed: 11/18/2022]
Abstract
Objectives In Japan, several studies have reported no excess all-cause deaths (the difference between the observed and expected number of deaths) during the coronavirus disease 2019 (COVID-19) pandemic in 2020. This study aimed to estimate the weekly excess deaths in Japan's 47 prefectures for 2021 until June 27. Study design Vital statistical data on deaths were obtained from the Ministry of Health, Labour and Welfare of Japan. For this analysis, we used data from January 2012 to June 2021. Methods A quasi-Poisson regression was used to estimate the expected weekly number of deaths. Excess deaths were expressed as the range of differences between the observed and expected number of all-cause deaths and the 95% upper bound of the one-sided prediction interval. Results Since January 2021, excess deaths were observed for the first time in the week corresponding to April 12–18 and have continued through mid-June, with the highest excess percentage occurring in the week corresponding to May 31–June 6 (excess deaths: 1431–2587; excess percentage: 5.95–10.77%). Similarly, excess deaths were observed in consecutive weeks from April to June 2021 in 18 of 47 prefectures. Conclusions For the first time since February 2020, when the first COVID-19 death was reported in Japan, excess deaths possibly related to COVID-19 were observed in April 2021 in Japan, during the fourth wave. This may reflect the deaths of non-infected people owing to the disruption that the pandemic has caused.
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Affiliation(s)
- S Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan.
| | - A Eguchi
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Y Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - D Yoneoka
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
| | - T Kawashima
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - M Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - M Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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36
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Ishimoto K, Hatanaka N, Otani S, Maeda S, Xu B, Yasugi M, Moore JE, Suzuki M, Nakagawa S, Yamasaki S. Tea crude extracts effectively inactivate severe acute respiratory syndrome coronavirus 2. Lett Appl Microbiol 2021; 74:2-7. [PMID: 34695222 PMCID: PMC8661916 DOI: 10.1111/lam.13591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/03/2021] [Accepted: 10/19/2021] [Indexed: 12/29/2022]
Abstract
It is well known that black and green tea extracts, particularly polyphenols, have antimicrobial activity against various pathogenic microbes including viruses. However, there is limited data on the antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which emerged rapidly in China in late 2019 and which has been responsible for coronavirus disease 2019 (COVID‐19) pandemic globally. In this study, 20 compounds and three extracts were obtained from black and green tea and found that three tea extracts showed significant antiviral activity against SARS‐CoV‐2, whereby the viral titre decreased about 5 logs TCID50 per ml by 1·375 mg ml−1 black tea extract and two‐fold diluted tea bag infusion obtained from black tea when incubated at 25°C for 10 s. However, when concentrations of black and green tea extracts were equally adjusted to 344 µg ml−1, green tea extracts showed more antiviral activity against SARS‐CoV‐2. This simple and highly respected beverage may be a cheap and widely acceptable means to reduce SARS‐CoV‐2 viral burden in the mouth and upper gastrointestinal and respiratory tracts in developed as well as developing countries.
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Affiliation(s)
- K Ishimoto
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,Global Center for Medical Engineering and Informatic, Osaka University, Osaka, Japan
| | - N Hatanaka
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Asian Health Science Research Institute, Osaka Prefecture University, Izumisano, Osaka, Japan.,Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - S Otani
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,R&D Group, Mitsui Norin Co. Ltd, Fujieda, Shizuoka, Japan
| | - S Maeda
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,R&D Group, Mitsui Norin Co. Ltd, Fujieda, Shizuoka, Japan
| | - B Xu
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - M Yasugi
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Asian Health Science Research Institute, Osaka Prefecture University, Izumisano, Osaka, Japan.,Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - J E Moore
- Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK
| | - M Suzuki
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,R&D Group, Mitsui Norin Co. Ltd, Fujieda, Shizuoka, Japan
| | - S Nakagawa
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,Global Center for Medical Engineering and Informatic, Osaka University, Osaka, Japan.,Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - S Yamasaki
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Asian Health Science Research Institute, Osaka Prefecture University, Izumisano, Osaka, Japan.,Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Izumisano, Osaka, Japan
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Distinct association of VEGF-C and VEGF-D with prognosis in patients with chronic heart failure: the PREHOSP-CHF study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0868] [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: 11/14/2022] Open
Abstract
Abstract
Background
The lymphatic system has been suggested to play an important role in cardiovascular (CV) diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and VEGF-D are key regulators of lymphoangiogenesis.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with chronic HF (CHF).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in CHF. A total of 1,024 patients (mean age, 75.5±12.6 years; male, 58.7%) admitted to acute decompensated HF were included in the analyses. The primary outcome was MACE defined as a composite of CV death or HF hospitalization. The secondary outcomes were all-cause death, CV death, and HF hospitalizations. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitive C reactive protein (hs-CRP), VEGF, and soluble VEGF receptor-2 (sVEGFR-2) were measured at the time of discharge. Patients were followed-up over two years.
Results
Median [interquartile range] of VEGF-C and VEGF-D levels were 4821 [3633–6131] pg/ml and 404 [296–559] pg/ml, respectively. In multivariate stepwise regression analysis, independent determinants of VEGF-C levels were younger age, female gender, absence of prior HF hospitalization, chronic kidney disease, and anemia, lower ejection fraction, lower NT-proBNP levels, higher VEGF levels, and higher sVEGFR-2 levels, while those of VEGF-D levels were lower body mass index, presence of diabetes and atrial fibrillation, and higher NT-proBNP levels. During the follow-up, a total of 209 (20.4%) all-cause deaths, 112 (10.9%) CV deaths, and 309 (30.2%) HF hospitalizations occurred. After adjusting for established risk factors and CV biomarkers, VEGF-C levels were significantly and inversely associated with the incidence of MACE and non-CV death (Fig.1, model 4). On the other hand, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization (Fig. 1, model 4). When we divided the patients into 4 groups based on the median of VEGF-C and VEGF-D levels, patients with low VEGF-C and high VEGF-D showed significantly higher incidence of MACE, all-cause death, CV death, and HF hospitalization compared to those with high VEGF-C and low VEGF-D (Fig. 2).
Conclusions
Among patients with CHF, VEGF-C and VEGF-D had different characteristic and association with the incidence of adverse events. VEGF-C levels were inversely associated with the incidence of MACE and non-CV death, and VEGF-D levels were positively associated with the incidence of HF hospitalization. These results suggests different effects of VEGF-C and VEGF-D in CHF. Combination of VEGF-C and VEGF-D enables us to make good risk stratification in patients with CHF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization Figure 1Figure 2
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Kotani
- Jichi Medical University, Tochigi, Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
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Shimizu M, Miyazaki H, Cho S, Misu Y, Tateishi R, Yamaguchi M, Yamakami Y, Shimada H, Manno T, Isshiki A, Kimura S, Fujii H, Suzuki M, Nishizaki M, Sasano T. Diagnostic performance of deep learning on 12-leads electrocardiography for recurrence after pulmonary vein isolation in patients with persistent atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0490] [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
Several patients with persistent atrial fibrillation (per-AF) suffer from recurrence after pulmonary vein isolation (PVI). Various methods to predict the recurrence were tried, but deep learning on 12-leads electrocardiography (ECG) after PVI was not studied.
Purpose
To elucidate diagnostic performance of deep learning on 12-leads ECG after PVI in patients with per-AF
Methods
We enrolled consecutive 109 patients with per-AF who underwent PVI (68.8±10.0 years, 83 males) excluding failure cases. We defined recurrence in 3–12 months after PVI. From the ECG just after PVI, five beats of each lead were sampled separately. Deep learning (convolutional neural network on bitmap ECG image) was performed by transfer learning of Inception-Resnet-V2 model. Gradient weighted class activation color mapping (GradCam) was performed to detect convolutional importance in the lead.
Results
Thirty-six patients showed recurrence in the period. Lead II (accuracy 0.701), aVR (0.690) were the top 2 leads of prediction, which showed larger accuracy than statistical accuracies of Non PV foci = SVC (accuracy = 0.541) and left atrial diameter >50mm (0.596). In lead II, GradCam spotlighted strong convolution of latter half of P wave in recurrent case, and former half of P wave and T wave in no-recurrent case.
Conclusions
Deep learning on ECG was a powerful tool to predict recurrence of per-AF after PVI.
Funding Acknowledgement
Type of funding sources: None. Results of deep learningResults of GradCam
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Affiliation(s)
- M Shimizu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Miyazaki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - S Cho
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Misu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - R Tateishi
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Yamaguchi
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Manno
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - A Isshiki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | | | - T Sasano
- Tokyo Medical and Dental University, Tokyo, Japan
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Saito M, Nakao Y, Inoue K, Higaki R, Yokomoto Y, Ogimoto A, Suzuki M, Kawakami H, Hiasa G, Okayama H, Ikeda S, Yamaguchi O. Exploration of electrocardiographic and echocardiographic findings to screen transthyretin amyloid cardiomyopathy in patients with mild left ventricular hypertrophy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.010] [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: 11/15/2022] Open
Abstract
Abstract
Background
The transthyretin amyloid cardiomyopathy (ATTR-CM), a common condition in the elderly, is a life-threatening disease; however, it is treatable. The early accurate diagnosis is, therefore, an important key to improve the patient's outcomes. Electrocardiography and echocardiography are instant diagnostic tools with red flags for the screening of the ATTR-CM. In fact, ATTR-CM often mimics left ventricular hypertrophy (LVH), and the differential diagnosis is difficult to establish. Thus, the characteristics of cardiac amyloidosis may be obscured in ATTR-CM patients with mild LVH, possibly making the disease difficult to diagnose. Therefore, in this study, the effect of LVH on the occurrence of electrocardiographic and echocardiographic parameters for ATTR-CM was investigated, and their incremental value over the age for the screening of ATTR-CM in the patients with mild LVH was recorded.
Methods
This study retrospectively studied 319 consecutive nonischemic LVH patients with a sinus rhythm who underwent detailed diagnostic tests. The light chain-associated amyloidosis was an exclusion criterion. The mean left ventricular wall thickness (MWT) <12 mm was defined as mild LVH, while MWT ≥12 mm was defined as moderate to severe LVH. The ATTR-CM was diagnosed with biopsy or 99 mTc-PYP scintigraphy. The elderly were defined as people aged ≥65 years in males and ≥70 years in females, according to the literature. Each electrocardiographic and echocardiographic parameter was binarized with an external cut-off point to increase the external validity, being the incremental benefit of each parameter over age for identifying ATTR-CM assessed using a receiver operating characteristic curve analysis and comparisons of the area under the curve (AUC).
Results
Fourteen patients (8%) among the 170 patients with mild LVH had ATTR-CM, while 27 patients (18%) among the 149 patients with moderate to severe LVH had ATTR-CM. The patients with mild LVH had fewer electrocardiographic and echocardiographic parameters, showing a significant difference between ATTR-CM and non-ATTR-CM patients than those with moderate to severe LVH (Table 1). Among several binarized parameters, the voltage-to-mass ratio, E/A ratio, the global longitudinal strain, and also the relative apical sparing pattern demonstrated additive value for identifying the ATTR-CM over aging (Table 2). In addition, the discriminative ability of the propensity score calculated from these four variables and age was considered excellent for the screening of ATTR-CM (AUC = 0.98).
Conclusion
The patients with mild LVH appear to have fewer electrocardiographic and echocardiographic specific findings of the ATTR-CM compared to patients with moderate to severe LVH. However, several red flags may be useful for screening ATTR-CM even in patients with a mild LVH.
Funding Acknowledgement
Type of funding sources: None. Table 1Table 2
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Affiliation(s)
- M Saito
- Kitaishikai Hospital, Ozu, Japan
| | - Y Nakao
- Ehime University, Cardiology, Toon, Japan
| | - K Inoue
- Ehime University, Cardiology, Toon, Japan
| | - R Higaki
- Kitaishikai Hospital, Ozu, Japan
| | - Y Yokomoto
- Uwajima City Hospital, Cardiology, Uwajima, Japan
| | - A Ogimoto
- Uwajima City Hospital, Cardiology, Uwajima, Japan
| | - M Suzuki
- Ehime Prefectural Imabari Hospital, Cardiology, Imabari, Japan
| | - H Kawakami
- Ehime Prefectural Imabari Hospital, Cardiology, Imabari, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Cardiology, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Cardiology, Matsuyama, Japan
| | - S Ikeda
- Ehime University, Cardiology, Toon, Japan
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Yonezawa K, Kotani K, Abe M, Akao M, Hasegawa K. Impact of atrial fibrillation on soluble fms-like tyrosine kinase-1 and cardiovascular events in patients with suspected or known coronary artery disease: the EXCEED-J study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1390] [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
Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction. Circulating sFlt-1 levels are associated with adverse outcomes in patients with preeclampsia, chronic kidney disease, and heart failure. Atrial fibrillation (AF) and coronary artery disease (CAD) are both associated with endothelial dysfunction. However, whether sFlt-1 can predict cardiovascular (CV) events and whether AF modifies the relationship between sFlt-1 and CV events in patients with suspected or known CAD are unknown.
Methods
We performed a nationwide, multicenter, prospective cohort study to determine the prognostic value of sFlt-1 and other biomarkers in patients with suspected or known CAD undergoing elective angiography. Heparin-free fasting serum was collected from the peripheral vein to determine levels of sFlt-1, VEGF, placental growth factor, cystatin C, neutrophil gelatinase-associated lipocalin, N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin-I (hs-cTnI), and high-sensitivity C-reactive protein (hs-CRP). The primary outcome was 3-point major adverse CV events (3P-MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, and 5P-MACE defined as a composite of 3P-MACE, heart failure hospitalization, and coronary/peripheral artery revascularization.
Results
3311 patients were consecutively enrolled between Nov 2013 and May 2017. After excluding 56 ineligible patients, 3255 patients (324 AF and 2931 non-AF) were followed up over 3 years (follow-up rate, 99%). During the follow-up, 156 patients developed 3P-MACE, 215 died from any cause, 82 died from cardiovascular disease, and 1361 developed 5P-MACE. The sFlt-1 level was significantly higher in AF compared to non-AF patients (p<0.001). Stepwise regression analysis revealed that the sFlt-1 level was independently associated with AF. After adjusting for potential clinical confounders, serum levels of sFlt-1, NT-proBNP, hs-cTnI and cystatin C, but not other biomarkers, were significantly associated with 3P-MACE in the entire cohort. These associations were still significant in non-AF patients, whereas only the sFlt-1 level was significantly associated with 3P-MACE in AF patients. Serum levels of sFlt-1, but not other biomarkers, were also significantly associated with CV death in AF patients. Among the biomarkers, only the hs-CRP level was significantly associated with all-cause death, and no biomarker was significantly associated with 5P-MACE in AF patients. Furthermore, sFlt-1 provided an incremental prognostic information for 3P-MACE to the model with potential clinical confounders in AF, but not in non-AF patients.
Conclusions
Serum levels of sFlt-1 were significantly associated with 3P-MACE in patients with suspected or known CAD. This association was pronounced in AF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The EXCEED-J study is supported by Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008) and Grant-in-Aid for Clinical Research from the National Hospital Organization (2018-2020).
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - K Kotani
- Jichi Medical University,, Shimotsuke, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Sone M, Takenaka Y, Miyabe C, Suzuki M, Nakao M, Hagiwara N, Ishiguro N. Ischaemic skin ulcers with neurofibromatosis 1 successfully treated with stent implantation. Clin Exp Dermatol 2021; 47:459-461. [PMID: 34551137 DOI: 10.1111/ced.14939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/10/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Sone
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Y Takenaka
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - C Miyabe
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - M Suzuki
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - M Nakao
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - N Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - N Ishiguro
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
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Yagishita S, Nishikawa T, Yoshida H, Shintani D, Sato S, Miwa M, Suzuki M, Yasuda M, Yonemori K, Hasegawa K, Hamada A. 1767P Co-clinical PDX study of trastuzumab deruxtecan in HER2-positive uterine carcinosarcoma (STATICE trial, NCCH1615). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mizutani K, Takamizawa T, Ishii R, Shibasaki S, Kurokawa H, Suzuki M, Tsujimoto A, Miyazaki M. Flexural Properties and Polished Surface Characteristics of a Structural Colored Resin Composite. Oper Dent 2021; 46:E117-E131. [PMID: 34370032 DOI: 10.2341/20-154-l] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to determine the flexural properties and surface characteristics of a structural colored resin composite after different finishing and polishing methods, in comparison to those of conventional resin composites. METHODS AND MATERIALS A structural color resin composite, Omnichroma (OM, Tokuyama Corp, Chiyoda City, Tokyo, Japan), and two comparison resin composites, Filtek Supreme Ultra (FS, 3M, St Paul, MN, USA) and Tetric EvoCeram (TE, Ivoclar Vivadent, Schaan, Liechtenstein), were used. The flexural properties of the resin composites were determined in accordance with the ISO 4049 specifications. For surface properties, 70 polymerized specimens of each resin composite were prepared and divided into seven groups of 10. Surface roughness (Sa), gloss (GU), and surface free energy (SFE) were investigated after the following finishing and polishing methods. Three groups of specimens were finished with a superfine-grit diamond bur (SFD), and three with a tungsten carbide bur (TCB). After finishing, one of the two remaining groups was polished with a one-step silicone point (CMP), and the other with an aluminum oxide flexible disk (SSD). A group ground with SiC 320-grit was set as a baseline. RESULTS The average flexural strength ranged from 116.6 to 142.3 MPa in the following order with significant differences between each value: FS > TE > OM. The average E ranged from 6.8 to 13.2 GPa in the following order with significant differences between each value: FS > TE > OM. The average R ranged from 0.77 to 1.01 MJ/mm3 in the following order: OM > FS > TE. The Sa values of the OM groups polished with CMP and SSD were found to be significantly lower than those of the other resin composites, regardless of the finishing method. The GU values appeared to be dependent on the material and the finishing method used. The OM specimens polished with SSD showed significantly higher GU values than those polished with CMP. Most of the resin composites polished with SSD demonstrated significantly higher γS values compared to the other groups. Extremely strong negative correlations between Sa and GU in the combined data from the three resin composites and each resin composite and between Sa and γS in the OM specimens were observed; GU showed a strong positive correlation with γS in the same material. CONCLUSION These findings indicate that both flexural and surface properties are material dependent. Furthermore, the different finishing and polishing methods used in this study were observed to affect the Sa, GU, and SFE of the resin composites.
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Cho H, Kishikawa T, Tokita Y, Suzuki M, Takemoto N, Hanamoto A, Fukusumi T, Yamamoto M, Fujii M, Ohno Y, Inohara H. Corrigendum to "Prevalence of human papillomavirus in oral gargles and tonsillar washings" [Oral Oncol. 105 (2020) 104669]. Oral Oncol 2021; 120:105478. [PMID: 34366245 DOI: 10.1016/j.oraloncology.2021.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- H Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Kishikawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Tokita
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan; Department of Nursing, Kyoto Tachibana University, Kyoto, Japan.
| | - M Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - N Takemoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - A Hanamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Fukusumi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Fujii
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Ohno
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - H Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
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Setta K, Matsuda T, Sasaki M, Chiba T, Fujiwara S, Kobayashi M, Yoshida K, Kubo Y, Suzuki M, Yoshioka K, Ogasawara K. Diagnostic Accuracy of Screening Arterial Spin-Labeling MRI Using Hadamard Encoding for the Detection of Reduced CBF in Adult Patients with Ischemic Moyamoya Disease. AJNR Am J Neuroradiol 2021; 42:1403-1409. [PMID: 34016589 DOI: 10.3174/ajnr.a7167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Adult patients with ischemic Moyamoya disease are advised to undergo selective revascularization surgery based on cerebral hemodynamics. The purpose of this study was to determine the diagnostic accuracy of arterial spin-labeling MR imaging using Hadamard-encoded multiple postlabeling delays for the detection of reduced CBF in such patients. MATERIALS AND METHODS Thirty-seven patients underwent brain perfusion SPECT and pseudocontinuous arterial spin-labeling MR imaging using standard postlabeling delay (1525 ms) and Hadamard-encoded multiple postlabeling delays. For Hadamard-encoded multiple postlabeling delays, based on data obtained from the 7 sub-boluses with combinations of different labeling durations and postlabeling delays, CBF corrected by the arterial transit time was calculated on a voxel-by-voxel basis. Using a 3D stereotaxic template, we automatically placed ROIs in the ipsilateral cerebellar hemisphere and 5 MCA territories in the symptomatic cerebral hemisphere; then, the ratio of the MCA to cerebellar ROI was calculated. RESULTS The area under the receiver operating characteristic curve for detecting reduced SPECT-CBF ratios (<0.686) was significantly greater for the Hadamard-encoded multiple postlabeling delays-CBF ratios (0.885) than for the standard postlabeling delay-CBF ratios (0.786) (P = .001). The sensitivity and negative predictive value for the Hadamard-encoded multiple postlabeling delays-CBF ratios were 100% (95% confidence interval, 100%-100%) and significantly higher than the sensitivity (95% CI, 44%-80%) and negative predictive value (95% CI, 88%-97%) for the standard postlabeling delay-CBF ratio, respectively. CONCLUSIONS ASL MR imaging using Hadamard-encoded multiple postlabeling delays may be applicable as a screening tool because it can detect reduced CBF on brain perfusion SPECT with 100% sensitivity and a 100% negative predictive value in adult patients with ischemic Moyamoya disease.
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Affiliation(s)
- K Setta
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - T Matsuda
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (T.M., M. Sasaki), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - M Sasaki
- Department of Radiology (M. Suzuki, K. Yoshioka) Institute for Biomedical Sciences (TM, MS), Iwate Medical University School of Medicine, Yahaba-cho, Japan.,Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (T.M., M. Sasaki), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - T Chiba
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - S Fujiwara
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - M Kobayashi
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - K Yoshida
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan.,Department of Radiology (M. Suzuki, K. Yoshioka) Institute for Biomedical Sciences (TM, MS), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - Y Kubo
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | | | - K Yoshioka
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan.,Department of Radiology (M. Suzuki, K. Yoshioka) Institute for Biomedical Sciences (TM, MS), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - K Ogasawara
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
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Artisyuk V, Suzuki M, Saito M, Fujii-e Y. The potential of accelerator driven cores in a self-consistent nuclear energy system / Die Möglichkeiten unterkritischer Spaltzonen mit Beschleunigerbetrieb in einem sich selbst erhaltenden Kernenergiesystem. KERNTECHNIK 2021. [DOI: 10.1515/kern-1996-612-315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Batbayar K, Ye K, Waldman S, Marsh A, Shi M, Siddiqui T, Suzuki M, Desai A, Patel D, Patel J, Dobkin J, Sadoughi A, Shah C, Yakov P, Vijig J, Spivack S. P58.02 Bronchial Field Progenitor Basal Cells Show Methylome-Wide Characteristics Reflective of Lung Cancer Case-Control, Age, and Smoking Status. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shono A, Matsumoto K, Yamada N, Kusunose K, Suzuki M, Sumimoto K, Tanaka Y, Yamashita K, Shibata N, Yokota S, Suto M, Dokuni K, Tanaka H, Hirata K. Impaired preload reserve is an important haemodynamic characteristics that discriminates between physiological ageing and overt heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.211] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Ageing process per se is a major risk factor for heart failure (HF). In fact, the incidence of HF with preserved ejection fraction (HFpEF) dramatically increases with age. Although ageing plays a central role in the development of HFpEF, not all the elderly patients develop clinical HFpEF. Multiple abnormalities in the cardiovascular system have been proposed to contribute to the development of HFpEF. However, the pathophysiology that discriminates between physiological ageing and overt HFpEF is incompletely understood.
Purpose
The purpose of this study was to assess the effects of ageing on the cardiac structures and haemodynamics. Moreover, we evaluated the determinant factor that discriminates between physiological ageing and overt HFpEF by non-invasive preload increasing manoeuvre using leg-positive pressure (LPP) stress echocardiography.
Methods
A total of 91 subjects were prospectively recruited in this study: 22 patients with HFpEF and 69 healthy controls. Normal controls were further stratified into 3 age groups: young (n = 19, 20-40 years of age), middle-aged (N = 25, 40-65 years) and elderly (n = 25, >65 years). All subjects underwent LPP stress with a continuous external pressure of 90 mmHg around both lower limbs using dedicated airbags (Fig.).
Results
The left ventricular mass index (LVMI; young, 68 ± 19 g/m²; middle-age, 70 ± 18 g/m²; elderly, 84 ± 21 g/m²) and also the relative wall thickness (RWT; young, 0.34 ± 0.09; middle-age, 0.41 ± 0.06; elderly 0.55 ± 0.10) increased with ageing, which was accelerated in HFpEF (LVMI: 111 ± 32 g/m², RWT; 0.63 ± 0.19, ANOVA P < 0.001, respectively). Although baseline LV ejection fraction and cardiac output were quite comparable between groups, E/e’ ratio significantly increased with with ageing (ANOVA P < 0.001, Fig.). During LPP stress, E/e’ ratio significantly increased in the middle-aged and elderly groups (from 8.8 ± 2.7 to 9.7 ± 3.3, and from 11.4 ± 2.4 to 13.0 ± 2.2, P < 0.05, respectively), which was further deteriorated in HFpEF (from 16.8 ± 5.8 to 18.0 ± 7.6, P < 0.05). On the other hand, stroke volume index (SVi) significantly increased in each healthy group during LPP stress (young; from 45 ± 10 to 50 ± 11 mL/m², middle-age; from 39 ± 7 to 44 ± 6 mL/m² and elderly; from 37 ± 7 to 43 ± 8 mL/m², all P < 0.001), while SVi failed to increase in the HFpEF group (from 45 ± 13 to 45 ± 14 mL/m², P = 0.60). In a multivariate logistic regression analysis, LVMI (hazard ratio; HR 1.055, P < 0.05), baseline E/e’ (HR 1.444; P < 0.05), and ΔSVi (HR 0.755; P < 0.05) during LPP stress were the independent parameters that characterised overt HFpEF.
Conclusions
Striking parallels between structure-function alterations were observed in the physiological cardiovascular ageing process, which was further accelerated in patients with HFpEF. Not only structural remodeling and impaired diastolic function, but also impaired systolic reserve during preload stress is important haemodynamic feature that characterise the pathophysiology of HFpEF.
Abstract Figure.
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Affiliation(s)
- A Shono
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Yamada
- Tokushima University Hospital, Tokushima, Japan
| | - K Kusunose
- Tokushima University Hospital, Tokushima, Japan
| | - M Suzuki
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Sumimoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Tanaka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Yamashita
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Shibata
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Yokota
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Suto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Dokuni
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Kobe, Japan
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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Shibata N, Yokota S, Suto M, Dokuni K, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.020] [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
Funding Acknowledgements
Type of funding sources: None.
Background
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity.
Purpose
Our purpose was to investigate the impact of baseline risk factors on left ventricular (LV) function in patients with preserved LV ejection fraction (LVEF) who have undergone chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59 ± 13 years and LVEF was 67 ± 5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥ 240mg/m², (2) age ≥ 65-year-old, (3) body mass index ≥ 30kg/m², (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥ 100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (-9.3 ± 10.8% vs. -2.2 ± 10.2%; p = 0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p = 0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3 ± 29.0g/m² vs. 83.2 ± 21.0g/m², p < 0.001), lower global longitudinal strain (18.4 ± 2.8% vs. 20.0 ± 2.6%, p = 0.06) and higher E/e’ (10.4 (8.9-13.0) vs. 9.0 (7.4-10.9), p = 0.06) compared to those without.
Furthermore, receiver-operator characteristics curve analysis showed that an optimal cut off value of a cumulative total doxorubicin dose for developing LV dysfunction in patients with more than any of four risk factors was lower than that in those without (180 mg/m² vs. 280 mg/m²).
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Abstract Figure.
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Affiliation(s)
| | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | - M Suto
- Kobe University, Kobe, Japan
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Shibata N, Matsumoto K, Shiraki H, Yamauchi Y, Yoshigai Y, Shono A, Sumimoto K, Suzuki M, Tanaka Y, Yamashita K, Yokota S, Suto M, Dokuni K, Tanaka H, Hirata K. Preload stress echocardiography by using dynamic postural alteration can identify high risk patients with heart failure with reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.209] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Haemodynamic assessment during stress testing is not commonly performed for patients with heart failure with reduced ejection fraction (HFrEF) due to its invasiveness, less feasibility, and safety concerns. Passive leg-lifting (PLL) manoeuvres have been introduced as a simple alternative for non-invasive preload stress testing; however, the haemodynamic load imposed on the cardiovascular system is unsatisfactory, which precludes the accurate assessment of the preload reserve for patients with HF.
Purpose
The purpose of this study was to assess the haemodynamic characteristics of patients with HFrEF in response to a preload stress during dynamic postural alterations by combining the semi-sitting position (SSP) and PLL. We also evaluated whether combined postural stress could be used for risk stratification for these patients.
Methods
For this study, 101 patients with HFrEF and 35 age- and sex-matched normal controls were prospectively recruited. At each postural position (i.e., baseline, SSP, and PLL), all standard echocardiographic and Doppler variables were obtained. Adverse cardiac events were prespecified as the combined endpoints of death from or hospitalisation for deteriorated HF, or sudden cardiac death. Clinical follow-up was conducted for a median of 7 months.
Results
During PLL stress, the stroke volume index (SVi) significantly increased in both controls (from 40 ± 6 to 43 ± 6 mL/m², P = 0.03) and HFrEF patients (from 31 ± 9 to 34 ± 10 mL/m², P = 0.03). Conversely, during SSP stress, the SVi significantly decreased for both controls (from 40 ± 6 to 37 ± 6 mL/m², P = 0.03) and HFrEF patients (31 ± 9 to 28 ± 8 mL/m², P = 0.03). During the follow-up period, 16 patients developed cardiac events. In patients without events, the Frank-Starling mechanism was well preserved (Fig. A). Namely, the SVi significantly increased from 31 ± 9 to 35 ± 10 mL/m² (P = 0.02) during PLL stress, while the SVi significantly decreased from 31 ± 8 to 28 ± 8 mL/m² (P = 0.02) during SSP stress. In contrast, for patients with cardiac events, the SVi did not change during postural alterations (n.s), which indicated that the failing heart operates on the flat portion of the Frank-Starling curve (Fig. A). When patients were divided into three equal sub-groups based on the total difference in the SVi during dynamic postural stress, patients with impaired preload reserve (third trimester, ΔSVi ≤ 3.0 mL/m²) showed significantly worse event-free survival than the other two sub-groups (Fig. B; P < 0.001). In a Cox proportional-hazard analysis, baseline LVEF (hazard ratio 0.93; P = 0.04), and ΔSVi during postural stress (hazard ratio 0.76; P = 0.004) were predictors of future cardiac events.
Conclusions
The combined assessment of dynamic postural stress during PLL and SPP is a simple, time-saving, and easy-to-use clinical tool for the assessment of preload reserve for patients with HFrEF. Moreover, postural stress echocardiography proved to contribute to the risk stratification for these patients.
Abstract Figure.
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | | | - M Suto
- Kobe University, Kobe, Japan
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