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Fukuda I, Hirayama A, Kawasugi K, Kobayashi T, Maeda H, Nakamura M, Nakanishi N, Yamada N, Tajima T, Iwashiro S, Okayama Y, Sunaya T, Hirano K, Hayasaki T. Design and Baseline Data for a Prospective Observational Study of Rivaroxaban in Patients with Venous Thromboembolism in Japan (XASSENT). TH Open 2021; 5:e521-e532. [PMID: 34877450 PMCID: PMC8639284 DOI: 10.1055/a-1664-1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background
The efficacy and safety of rivaroxaban have been demonstrated in phase 3 trials of patients with venous thromboembolism (VTE; pulmonary embolism [PE] and deep vein thrombosis [DVT]). Data regarding rivaroxaban treatment of VTE in routine Japanese clinical practice remain limited.
Objectives
XASSENT will evaluate rivaroxaban treatment of VTE in real-world Japanese clinical practice. We report the study design and baseline patient characteristics.
Methods
XASSENT (NCT02558465) is an open-label, prospective observational, post-marketing surveillance cohort study in patients receiving rivaroxaban treatment for VTE. Enrolment took place between November 2015 and March 2018. XASSENT will follow patients for up to 2 years. Primary outcome variables: major bleeding and symptomatic recurrent VTE. Statistical analyses are exploratory and descriptive.
Results
Baseline patient characteristics at June 2020 (
n
= 2,299) are presented (58.2% female; mean age 66.7 years; mean weight 60.9 kg). The population encompasses patients with wide-ranging characteristics including older age, low weight, and renal dysfunction. Most participants (67.6%) had a history of VTE risk factors at baseline. Half of the population (50.4%) had DVT only; 41.4% had DVT with PE; 8.2% had PE only. Overall, 68.4% were inpatients and 77.1% had symptomatic VTE. Rivaroxaban was prescribed for initial treatment in 84.6% of patients and maintenance treatment in 15.4%. Most were prescribed the approved dose of rivaroxaban for initial (30 mg daily; 84.4%) or maintenance (15 mg daily; 81.9%) treatment of VTE in Japan. The most common reason for selecting non-recommended dose was ‘elderly’.
Conclusions
Results from XASSENT will complement phase 3 trial data and inform clinical practice.
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Affiliation(s)
- Ikuo Fukuda
- Department of Cardiovascular Surgery, Suita Tokushukai Hospital, Suita, Japan
| | | | - Kazuo Kawasugi
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | | | - Hideaki Maeda
- Division of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | | | | | - Norikazu Yamada
- Department of Cardiology, Kuwana City Medical Center, Kuwana, Japan
| | - Tsubasa Tajima
- Medical Affairs Cardiovascular and Nephrology, Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Sanghun Iwashiro
- Medical Affairs Cardiovascular and Nephrology, Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Yutaka Okayama
- Pharmacovigilance Monitoring and Governance, Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Toshiyuki Sunaya
- Statistics and Data Insights, Data Sciences and Analytics, Research and Development Japan, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Kazufumi Hirano
- Pharmacovigilance Monitoring and Governance, Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Takanori Hayasaki
- Medical Affairs Cardiovascular and Nephrology, Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
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Kuyama N, Kaikita K, Mitsuse T, Fujisue K, Nakanishi N, Tabata N, Yamanaga K, Sueta D, Kanazawa H, Takashio S, Araki S, Arima Y, Yamamoto E, Matsushita K, Tsujita K. Total thrombus-formation analysis system (T-TAS) can predict target lesion revascularization in patients undergoing endovascular therapy for critical limb ischemia. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Despite of the development of endovascular therapy (EVT), the frequency of target lesion revascularization (TLR) after EVT in patients with critical limb ischemia (CLI) is still high. Recent histrogical study suggested the possibility of thromboembolic phenomenon in the development of CLI; however, there is few monitoring system of total thrombogenicity in perioperative period of EVT in CLI patients. The total thrombus-formation analysis system (T-TAS), a novel system for quantitatively analyzing thrombus formation using microchips with thrombogenic surfaces (collagen plus tissue factor, atheroma [AR]-chip), is validated and can evaluate the total thrombogenicity.
Purpose
To investigate the utility of T-TAS parameters in predicting TLR after EVT in CLI patients.
Methods
We analyzed 27 CLI patients (45 lesions; aortoiliac 20%, femoropopliteal 40%, infrapopliteal 40%) who underwent EVT at our institution between January 2018 and December 2020. Patients undergoing hemodialysis were excluded. Blood sample was collected on the day of EVT and was used in T-TAS to compute the thrombus formation area under the curve (AUC; AUC for the first 30 minutes for AR tested at flow rate of 10 lL/min [AR10-AUC30]). We investigated the relationship between the AR10-AUC30 level and the occurrence of clinically-driven TLR, and the predictors of TLR among CLI patients.
Results
Study population had a mean age of 77 years, and 56% were male. During the follow-up period (mean 1.0±0.7 years), 11 lesions (24%) required clinically-driven TLR. The AR10-AUC30 level was significantly higher in patients requiring TLR than those without TLR (1783±121 vs. 1587±205; p<0.01). The frequency of TLR significantly increased in association with a tertile of the AR10-AUC30 level (Figure 1, p for trend=0.003). As shown in Figure 2, univariate logistic regression analysis demonstrated male sex and the third tertile of the AR10-AUC30 level compared to its first or second tertiles were significantly associated with TLR in patients with CLI, whereas platelet count, PT-INR, APTT, and atherosclerotic risk factors including glycated hemoglobin, low-density lipoprotein cholesterol, and renal function were not. Multivariate logistic regression analysis also revealed that the AR10-AUC30 level ≥1707 (=its third tertile) as an independent predictor for TLR, even after adjusted by age and sex (OR=6.28, 95% CI=1.18–33.3, p=0.03).
Conclusions
In patients with CLI, the AR10-AUC30 level measured by the T-TAS may be a potential predictor to identify the high-risk patients requiring TLR after EVT. This finding suggests the hypercoagulability in CLI patients and that an anticoagulant agent following EVT may be useful in preventing a restenosis in CLI patients. Further study with a larger sample size is warranted to validate this finding.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- N Kuyama
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - T Mitsuse
- Arao Municipal Hospital, Cardiology, Arao, Japan
| | - K Fujisue
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - N Nakanishi
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - N Tabata
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Yamanaga
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - D Sueta
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - H Kanazawa
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - S Takashio
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - S Araki
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - Y Arima
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Matsushita
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Cardiovascular medicine, Kumamoto, Japan
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3
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Tomita S, Nakanishi N, Ogata T, Suga T, Tsuji Y, Sakamoto A, Higuchi Y, Matoba S. Cavin-1 modulates BMP/Smad signaling through the interaction of Caveolin-1 with BMPRII in pulmonary artery endothelial cells. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary hypertension (PH) is a progressive disease associated with poor outcomes. Caveolin-1 (Cav1) and Cavin-1 are components of caveolae, and Cav1 is identified as a related gene of pulmonary arterial hypertension (PAH). Gene mutations of bone morphogenetic protein type II receptor (BMPRII) is the most common cause of PAH. BMPRII is localized in caveolae and associates with Cav1. However, the role of the Caveolin-Cavin system on the BMP/Smad signaling and the PAH progression has not been well-known.
Purpose
Our study aims to investigate the relationship between Caveolin-Cavin system and BMP/Smad signaling pathway in pulmonary artery endothelial cells (PAECs). [Methods] Cav1 knockout mice were used to assess PH, and caveolae in PAECs were observed by electron microscope. After knocking down Cav1 and/or Cavin-1 in human PAECs (hPAECs) using siRNA, we evaluated the phosphorylation of Smad by Western blotting. Apoptosis was explored by flow cytometry. To assess the interaction between Cav1 and BMPRII, and the effect of Cavin-1 for this interaction and BMP/Smad signaling, we performed immunoprecipitation, Co-immunostaining, Proximal Ligation Assay (PLA), GST pulldown assay, and Western blotting.
Results
As in previous reports, Cav1 knockout mice exhibited PH with pulmonary vascular remodeling and right ventricular hypertrophy and PAECs isolated from Cav1 knockout mice showed caveolae disappearance. Cav1 knockdown in hPAECs reduced BMPRII at the plasma membrane and Smad 1/5/9 phosphorylation. Cav1 knockdown also significantly increased hypoxia-induced apoptosis in hPAECs. Co-immunostaining revealed that Cav1 was associated with BMPRII at the membrane of hPAECs. Cavin-1 inhibited the interaction of BMPRII with Cav1 and reduced BMPRII localization on the membrane of hPAECs. GST pulldown assay revealed that Cavin-1 and BMPRII were associated with Cav1 through the scaffolding domain in Cav1. These findings suggest that Cavin-1 and BMPRII are competitively associated with Cav1. Cavin-1 knockdown improved the interaction between Cav1 and BMPRII and inhibited both BMPRII reduction at the plasma membrane and Smad 1/5/9 dephosphorylation.
Conclusions
Cavin-1 affects the interaction of Cav1 with BMPRII at the plasma membrane and modulates BMP/Smad signaling in PAECs. The binding of Cavin-1 to Cav1 enhances the interaction between BMPR2 and Cav1, resulting in stabilization of BMPRII localization at the plasma membrane in PAECs and prevention of BMP/Smad signaling attenuation, which is important for PAH development.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Tomita
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Ogata
- Kyoto Prefectural University of Medicine, Department of Pathology and Cell Regulation, Graduate School of Medical Science, Kyoto, Japan
| | - T Suga
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Tsuji
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - A Sakamoto
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Higuchi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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4
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Tomita S, Nakanishi N, Ogata T, Tsuji Y, Sakamoto A, Higuchi Y, Matoba S. Cavin-1 regulates BMP/Smad signaling through the interaction of Caveolin-1 with BMPRII in pulmonary artery endothelial cells. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary hypertension (PH) is a progressive disease associated with poor outcome. Caveolin-1 (Cav1) is a component of caveolae and classified as a related gene of pulmonary arterial hypertension (PAH). Gene mutations of bone morphogenetic protein type II receptor (BMPRII) is a most common cause of PAH. BMPRII is localized in caveolae and associates with Cav1. However, the role of the Caveolin-Cavin system on the BMP/Smad signaling and the PAH progression has not been well-known.
Purpose
The aim of our study is to investigate the relationship between Caveolin-Cavin system and BMP/Smad signaling pathway and explore the mechanism of downstream signal transduction of BMP signaling by the interaction between Caveolin and BMPRII.
Methods
Cav1 knockout mice were used to assess PH and caveolae in pulmonary artery endothelial cells were observed by electron microscope. Cav1 and Cavin-1, which is a component of caveolae and form a complex with Cav1, were knocked-down in human pulmonary artery endothelial cell (hPAEC) using siRNA and phosphorylation of Smad signal was evaluated. Apoptosis of these cells was explored by flow cytometry. We investigated the interaction between Cav1 and BMPRII, and evaluated whether Cavin-1 affects this interaction and signal transduction of BMP signaling.
Results
As previously described, deletion of Cav1 revealed disappearance of caveolae in pulmonary artery endothelial cells (PAECs), and Cav1 knockout mice exhibited PH with pulmonary vascular remodeling and right ventricular hypertrophy. We then examined roles of Cav1 in human PAECs (hPAECs). Cav1 knockdown in hPAECs reduced phosphorylation of Smad 1/5/9. In addition, Cav1 knockdown significantly increased hypoxia-induced apoptosis in hPAEC. Knockdown of Cavin-1 reversed phosphorylation of Smad 1/5/9 decreased by Cav1 knockdown in BMP9 stimulation. Cavin-1 reversed the expression of BMPRII decreased by overexpression of Cav1. Cav1 was associated with Cavin-1 at the plasma membrane in PAECs. Cav1 also associated with BMPRII at the membrane of hPAECs that was inhibited by Cavin-1, and Cavin-1 reduced the localization of BMPRII to the membrane of hPAECs. These results suggest that BMPRII interacts with Cav1 via Cavin-1-associated localization at the plasma membrane in hPAECs, resulting in regulating BMP/Smad signaling pathway and involving in the development of PAH.
Conclusions
Cavin-1 affects the interaction of Cav1 with BMPRII at the membrane of PAECs, and regulates BMP/Smad signaling. These results reveal a previously undescribed function of Cavin-Caveolin system in the development of PAH through regulation of BMP/Smad signaling.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Tomita
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Ogata
- Kyoto Prefectural University of Medicine, Department of Pathology and Cell Regulation, Graduate School of Medical Science, Kyoto, Japan
| | - Y Tsuji
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - A Sakamoto
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Higuchi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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5
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Sakamoto A, Ogata T, Nakanishi N, Higuchi Y, Tsuji Y, Tomita S, Matoba S. SDPR/Cavin-2 loss inhibits monocyte adhesion to endothelial cells in abdominal aortic aneurysm via suppressing the expression of adhesion molecules. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3794] [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
Abdominal aortic aneurysm (AAA) is a common and life-threatening vascular disease. The initial phase of AAA progression is vascular inflammation. Inflammation sites present adhesion molecules, such as vascular cell adhesion molecule-1 (VCAM-1) and intracellular cell adhesion molecule-1 (ICAM-1). These molecules play a crucial role in recruiting inflammatory cells to endothelial cells through NF-κB signaling. Endothelial cells express serum deprivation response (SDPR)/Cavin-2 localized in caveolae on the cell membrane. Although Cavin-2 is involved in such as cell proliferation, migration, and signal transduction, the role of Cavin-2 in vascular inflammation in the development of AAA is still unclear.
Purpose
To assess the influence of Cavin-2 deficiency in AAA development and clarify the role of Cavin-2 in the regulation of inflammatory cell adhesion in endothelial cells.
Methods
CaCl2-induced AAAs were induced by the periaortic application of 0.5 M CaCl2 in male SDPR-knockout (KO) and wild-type (WT) mice at 8–10 weeks of age. Angiotensin II (Ang II)-induced AAAs were created by 4-week-subcutaneous drug infusion in male ApoE-KO and ApoE/Cavin-2-double KO (DKO) mice at 24 weeks of age. Inflammatory response and cell adhesion were evaluated using human aortic endothelial cells (HAECs) and human monocytes (THP-1 cells).
Results
Six weeks after CaCl2 treatment, Cavin-2 deficiency significantly attenuated the development of AAAs. Elastin degradation was markedly suppressed and F4/80-positive macrophages infiltration in aortic walls were decreased in Cavin-2-KO mice. Although Ang II infusion for 4 weeks formed AAAs in ApoE KO mice and ApoE/Cavin-2-DKO mice, ApoE/Cavin-2-DKO mice exhibited the suppression of AAA formation independently of blood pressure. Immunohistochemical staining showed VCAM-1 expression on endothelial cells was suppressed in ApoE/Cavin-2-DKO mice. Further, in vitro co-culture experiment, the number of THP-1 cells adhered to TNF-treated SDPR-knockdown HAECs was decreased compared with that to control HAECs. Moreover, mRNA expression of VCAM-1 and ICAM-1 was decreased in TNFα-treated SDPR-knockdown HAECSs. Protein expression of VCAM-1 was also suppressed in TNFα-treated SDPR-knockdown HAECSs. The activity of NF-κB p65, an upstream regulator of VCAM-1 and ICAM-1,tended to be suppressed in TNFα-treated SDPR-knockdown HAECs.
Conclusion
In this study, we revealed that SDPR/Cavin-2 loss attenuated AAA development with the suppression of elastin degradation and macrophage infiltration. Our findings suggest that SDPR/Cavin-2 in the endothelial cells regulates the expression of adhesion molecules via NF-κB signaling and promotes the adhesion and infiltration of inflammatory cells to the aortic wall.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Sakamoto
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Ogata
- Kyoto Prefectural University of Medicine, Department of Pathology and Cell Regulation, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Higuchi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y Tsuji
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Tomita
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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Wakana N, Zen K, Yanishi K, Nakanishi N, Nakamura T, Yamada H, Matoba S. The efficacy of a PCSK9 inhibitor for the plaque stabilization in the non-culprit lesion of ACS patients by using near-infrared intravascular ultrasonography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1432] [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 and purpose
In acute coronary syndrome (ACS) patients, major cardiovascular events during follow-up were equally attributable to recurrence at the site of culprit lesions and to non-culprit lesions, and mostly occurred within one year. Recent studies showed that Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitor significantly reduces the risk of cardiovascular events. However, the rigorous effects of PCSK9 inhibitor in patients with ACS, especially for the stabilization of plaque in the non-culprit lesions has not been identified. The purpose of this study was to evaluate the efficacy of a PCSK9 inhibitor for the plaque stabilization in the non-culprit lesion of ACS patients.
Methods
We retrospectively analyzed the 10 ACS patients (STEMI:5 cases, NSTEMI:1 case, and UAP:4 cases) who had non-culprit lesions and were injected with a PCSK9 inhibitor. We analyzed 11 non-culprit lesions before and after PSCK9 injections by using a near-infrared intravascular ultrasonography (NIRS-IVUS).
Results
The follow up intervals were 229.4±82.9 days. Major cardiovascular events did not occur in all patients. The serum low-density lipoprotein (LDL) cholesterol levels were significantly decreased form 128±36.7 mg/dl to 26.7±7.4 mg/dl (P<0.01; Figure 1A). There were no significant changes in percent atheroma volume before and after PCSK9 injections. However, the max lipid core burden index (LCBI) were significantly improved from 392.5±155.8 to 209.4±116 (P<0.01; Figure 1B). Although the lesion characteristics did not change in the images, by IVUS, the LCBI of the lesion was significantly decreased after PCSK9 injections. This study suggested that NIRS-IVUS had the possibility of detection for the slight changes in the plaque characteristics, which could not be detected by only an IVUS.
Conclusion
This study suggested that the plaque morphology can be altered by the aggressive lipid lowering therapy by using a PCSK9 inhibitor, and NIRS-IVUS can detect these plaque stabilizations of non-culprit lesion in ACS patients.
The authors have no financial conflicts of interest to disclose concerning the presentation.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Wakana
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - K Zen
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - K Yanishi
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - T Nakamura
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - H Yamada
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
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Nakanishi N, Kaikita K, Mitsuse T, Tsujita K. The usefulness of total thrombus-formation analysis system for predicting high bleeding risk in coronary artery disease patients taking anticoagulants who underwent percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3372] [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
Although anticoagulants are widely used for prevention of cerebral infarction in patients with atrial fibrillation (AF), venous thrombosis, and valvular disease, it is possible that anticoagulants increase bleeding events in daily medical practices. Recently, we reported that the total thrombus-formation analysis system (T-TAS) was useful for evaluating bleeding risk in coronary artery disease (CAD) patients.
Aim
We examined whether T-TAS was practical for predicting bleeding risk in CAD patients taking anticoagulants who underwent percutaneous coronary intervention (PCI).
Methods
This study was the retrospective analysis of the 500 consecutive CAD patients who underwent PCI. Blood samples obtained on the day of PCI were used in T-TAS to compute the thrombus formation area under the curve (AUC) (AR10-AUC30, AUC for AR chip). We divided the total number of study patients into two groups according to the presence of anticoagulants; 53 CAD patients with triple therapy (TT) and 447 CAD patients with dual antiplatelet therapy (DAPT). We compared clinical characteristics and prognosis between the two groups. The primary endpoint was 1-year bleeding events that were defined by ISTH bleeding criteria. We excluded the CAD patients who underwent emergency PCI, and who were treated for hemodialysis.
Results
All patients took aspirin and clopidogrel, or aspirin and prasugrel at baseline. Compared to the patients with DAPT, the patients with TT had atrial fibrillation and history of stroke. The AR10-AUC30 levels were significantly lower in the patients with TT than the patients with DAPT (median [interquartile range] 1402.6 [1095.1–1609.8] vs. 1679.8 [1526.4–1783.3], p<0.001). Thirty-five patients (7%) had bleeding events during follow-up [11 cases (20.8%) in the patients with TT, 24 cases (5.4%) in the patients with DAPT]. Kaplan-Meier curve analysis showed a worse 1-year bleeding event-free survival rate in the patients with TT compared with the patients with DAPT (p<0.001). Receiver operating characteristic analysis showed that AR10-AUC30 levels significantly predicted bleeding events (AUC 0.653, 95% CI 0.555–0.751; p=0.003) and the cut-off point was 1586.4 by Youden index in the present study. In multivariate Cox hazards analysis, low AR10-AUC30 level (≤1586.4) (hazard ratio 2.99; 95% CI 1.46–6.11; p=0.003) and taking warfarin (hazard ratio 3.02; 95% CI 1.24–7.34; p=0.015) were significant predictors for 1-year bleeding events.
Conclusions
The present findings suggested that the AR10-AUC30 level determined by T-TAS could be a useful marker for predicting high bleeding risk in CAD patients taking anticoagulants who underwent PCI.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - T Mitsuse
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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8
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Tanabe N, Fukuda K, Matsubara H, Nakanishi N, Tahara N, Ikeda S, Kishi T, Satoh T, Hirata KI, Inoue T, Kimura H, Okano Y, Okazaki O, Sata M, Tsujino I, Ueno S, Yamada N, Yao A, Kuriyama T. Selexipag for Chronic Thromboembolic Pulmonary Hypertension in Japanese Patients - A Double-Blind, Randomized, Placebo-Controlled, Multicenter Phase II Study. Circ J 2020; 84:1866-1874. [PMID: 32879152 DOI: 10.1253/circj.cj-20-0438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Selexipag is an oral prostacyclin receptor (IP receptor) agonist with a non-prostanoid structure. This study examined its efficacy and safety in Japanese patients with non-operated or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH).Methods and Results:This Phase II study was a randomized, double-blind, placebo-controlled parallel-group comparison. The primary endpoint was a change in pulmonary vascular resistance (PVR) from baseline to week 17. The main analysis involved a per-protocol set group of 28 subjects. The change in PVR (mean±SD) after 17 weeks of treatment in the selexipag group was -104±191 dyn·s/cm5, whereas that in the placebo group was 26±180 dyn·s/cm5. Thus, the treatment effect after 17 weeks of selexipag treatment was calculated as -130±189 dyn·s/cm5(P=0.1553). Although the primary endpoint was not met, for the group not concomitantly using a pulmonary vasodilator the PVR in the selexipag group was significantly decreased compared with placebo group (P=0.0364). The selexipag group also showed improvement in total pulmonary resistance and cardiac index. CONCLUSIONS Selexipag treatment improved pulmonary hemodynamics in Japanese patients with CTEPH, but PVR did not show a significant difference between the selexipag and placebo groups. (Trial registration: JAPIC Clinical Trials Information [JapicCTI-111667]).
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Affiliation(s)
- Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Hiromi Matsubara
- Director of Entire Medical Departments, National Hospital Organization Okayama Medical Center
| | | | - Nobuhiro Tahara
- Department of Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Takuya Kishi
- Department of Cardiology, Graduate School of Medical Sciences, International University of Health and Welfare
| | - Toru Satoh
- Department of Cardiovascular Medicine, Kyorin University Hospital
| | - Ken-Ichi Hirata
- Cardiovascular Medicine, Kobe University Graduate School of Medicine
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | | | - Yoshiaki Okano
- Department of Intermal Medicine, Hanwa Dai-ni Senboku Hospital
| | - Osamu Okazaki
- Department of Cardiology, National Center for Global Health and Medecine
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Ichizo Tsujino
- The First Department of Medicine, Hokkaido University School of Medicine
| | - Shuichi Ueno
- Department of Internal Medicine Division of Cardiovascular Medicine, Jichi Medical University School of Medicine.,Ueno Clinic
| | | | - Atsushi Yao
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
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9
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Tahara N, Dobashi H, Fukuda K, Funauchi M, Hatano M, Ikeda S, Joho S, Kihara Y, Kondo T, Matsushita M, Minamino T, Nakanishi N, Okano Y, Ozaki Y, Saji T, Sakai S, Tanabe N, Watanabe H, Yamada H, Yoshioka K, Hatta M, Sasayama S. Long-term treatment of pulmonary arterial hypertension with macitentan in Japanese patients. Curr Med Res Opin 2020; 36:921-928. [PMID: 32298185 DOI: 10.1080/03007995.2020.1756234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: Macitentan, a novel dual endothelin receptor antagonist, was approved for the treatment of pulmonary arterial hypertension (PAH) in Japan. However, long-term effects in Japanese patients of macitentan are currently unavailable. This study sought to assess the long-term efficacy and safety of macitentan in Japanese patients with PAH.Methods: In this multicenter, open-label, clinical extension study (JapicCTI-121986), efficacy was evaluated based on the change from baseline at 24, 48, 72, 96 and 120-week in the 6-minute walk distance (6MWD), World Health Organization (WHO) functional class, and serum N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels. In addition, the time to a hospitalization related to PAH and a morbidity/mortality event was determined. As for safety, the incidence of adverse events and changes in laboratory data and vital signs were assessed.Results: Macitentan was administered at a once-daily dose of 10 mg in 30 PAH patients with a median treatment period of 2.4 years (range, 229-1037 days). The improvements in 6MWD, WHO functional class and NT-pro-BNP at week 24 were maintained throughout the long-term follow-up. Hospitalization related to PAH occurred in 2 patients. Levels of liver enzyme and hemoglobin remained unchanged throughout the study period.Conclusions: This study suggests that the long-term use of macitentan is well tolerated and effective in Japanese patients with PAH. We concluded that macitentan can be a possible approach to reduce morbidity/mortality in Japanese PAH patients.
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Affiliation(s)
- Nobuhiro Tahara
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroaki Dobashi
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masanori Funauchi
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shuji Joho
- Second department of internal medicine, Toyama University Hospital, Toyama, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Takahisa Kondo
- Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masakazu Matsushita
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Norifumi Nakanishi
- Endowed Department of Pulmonary Hypertension and Pulmonary Vascular Medicine, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Yoshiaki Okano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Internal Medicine, Hanwa Dai-ni Senboku Hospital, Osaka, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University School of Medicine, Aichi, Japan
| | - Tsutomu Saji
- Advanced and Integrated Cardiovascular Research Course in the Young and Adolescence, Toho University, Tokyo, Japan
| | - Satoshi Sakai
- Cardiovascular Division, Department of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroshi Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hidehiro Yamada
- Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Koichiro Yoshioka
- Department of Cardiovascular Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Motonori Hatta
- Data Management & Biometry, Actelion Pharmaceuticals Japan, Tokyo, Japan
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10
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Katsuragi S, Kamiya C, Yamanaka K, Neki R, Miyoshi T, Iwanaga N, Horiuchi C, Tanaka H, Yoshimatsu J, Niwa K, Takagi Y, Ogo T, Nakanishi N, Ikeda T. Corrigendum to "Maternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome" [Taiwan J Obstet Gynecol 58 (2019) 183-187]. Taiwan J Obstet Gynecol 2020; 59:171. [PMID: 32039794 DOI: 10.1016/j.tjog.2019.12.001] [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: 11/20/2022] Open
Affiliation(s)
- Shinji Katsuragi
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Japan; Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan.
| | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Kaoru Yamanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Hiroaki Tanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Koichiro Niwa
- Department of Cardiology, St. Luke's International Hospital, Japan
| | - Yaemi Takagi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Japan
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11
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Nakanishi N, Kaikita K, Ishii M, Oimatsu Y, Mitsuse T, Tsujita K. P2563Effects of rivaroxaban on cardiac remodeling after experimental myocardial infarction in mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0891] [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
Rivaroxaban, a direct activated factor X (FXa) inhibitor, has been established for prevention and treatment of arterial and venous thrombosis. Although FXa plays an important role in thrombosis, FXa also involves in inflammation via the protease-activated receptor (PAR)-1 and PAR-2 pathway. We assessed the hypothesis that rivaroxaban might protect cardiac remodeling after myocardial infarction (MI) in mice.
Methods
MI was induced in wild-type mice by permanent ligation of the left anterior descending coronary artery. At 1 day after MI, mice were randomly assigned to the rivaroxaban and vehicle groups. In the rivaroxaban group, the mice were provided with regular chow diet including rivaroxaban (2400ppm) after the randomization. We evaluated the cardiac function by echocardiography, expression of mRNA and protein in the infarcted and non-infarcted area 7 days after MI. Furthermore, we measured infarct size, infiltration of inflammatory cells by pathological analysis 7 days after MI.
Results
The fractional shortening (%FS) and Interventricular Septal thickness in diastole (IVSTd) was significantly improved 7 days after MI in the rivaroxaban group compared with the vehicle group (%FS, p=0.01; IVSTd, p=0.013). As for pathological analysis, rivaroxaban decreased infarct size (p=0.026) and the number of infiltrated macrophages in the non-infarcted area (p=0.011) compared with vehicle. The mRNA expression in tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β in the infarcted area and atrial natriuretic peptide (ANP) in the non-infarcted area was significantly lower in the rivaroxaban group compared with the vehicle (TNF-α, p=0.015; TGF-β, p=0.019; ANP, p=0.012). PAR-1 and PAR-2 mRNA expression in the infarcted area significantly decreased 7 days after MI in the rivaroxaban group compared with the vehicle (PAR-1, p=0.005; PAR-2, p=0.037). Furthermore, western blot analysis demonstrated that the phosphorylation of Extracellular Signal-regulated Kinase (ERK) and c-Jun N-terminal Kinase (JNK) in the non-infarcted area significantly decreased 7 days after MI in the rivaroxaban group compared with the vehicle (ERK, p=0.015; JNK, p=0.002).
Conclusions
The present study showed that rivaroxaban protected against cardiac dysfunction, probably due to the suppression of PAR-mediated increase of pro-inflammatory cytokines post-MI. Rivaroxaban might be potentially effective for improving the cardiac remodeling after MI.
Acknowledgement/Funding
This study was supported in part by trust-research grant from Bayer Yakuhin, Ltd.
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Affiliation(s)
| | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - M Ishii
- Kumamoto University, Kumamoto, Japan
| | - Y Oimatsu
- Kumamoto University, Kumamoto, Japan
| | - T Mitsuse
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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12
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Katsurahgi S, Kamiya C, Yamanaka K, Neki R, Miyoshi T, Iwanaga N, Horiuchi C, Tanaka H, Yoshimatsu J, Niwa K, Takagi Y, Ogo T, Nakanishi N, Ikeda T. Maternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome. Taiwan J Obstet Gynecol 2019; 58:183-187. [PMID: 30910135 DOI: 10.1016/j.tjog.2019.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The goal of the study was to clarify the risk factors for pregnancy complicated with Eisenmenger syndrome (ES). MATERIALS AND METHODS A retrospective study was performed in 15 patients with ES who were managed throughout pregnancy at one institution from 1982 to 2013. Cases associated with congenital heart diseases other than atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) were excluded. RESULTS The congenital heart diseases in ES included ASD (n = 3), VSD (n = 9), and PDA (n = 3). Ten women chose termination and 5 continued with their pregnancies. In the 5 continuation cases (PDA 1, VSD 4), worsening of cyanosis, exertional fatigue and dyspnea appeared between 25 and 30 weeks gestation and cesarean section was performed at 30 (28-33) weeks. LVEF, PaO2, and SpO2 decreased and heart rate increased significantly from before pregnancy to 25-30 weeks gestation. From before to during the pregnancy, there were no significant changes in mean PABP or pulmonary vascular resistance (PVR) in four cases with data (582-592, 885 to 868, 1280 to 1291, 1476-1522 dyn × s/cm2). PVR at conception had a negative relationship with delivery weeks. NYHA classes before, during and 1 year after pregnancy were II, III and II. In one recent case, epoprostenol and tadalafil were administered during pregnancy. CONCLUSIONS Pregnancy with ES has a high risk due to hypooxygenation, cyanosis, and cardiac failure, which can appear as common complications as early as the 2nd trimester. Early interventions with meticulous care are required for these complications during pregnancy and delivery.
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Affiliation(s)
- Shinji Katsurahgi
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Japan; Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan.
| | - Chizuko Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Kaoru Yamanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Reiko Neki
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Takekazu Miyoshi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Chinami Horiuchi
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Hiroaki Tanaka
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Koichiro Niwa
- Department of Cardiology, St. Luke's International Hospital, Japan
| | - Yaemi Takagi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, Pulmonary Circulation Group, National Cerebral and Cardiovascular Center, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Japan
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13
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Fukuda K, Date H, Doi S, Fukumoto Y, Fukushima N, Hatano M, Ito H, Kuwana M, Matsubara H, Momomura SI, Nishimura M, Ogino H, Satoh T, Shimokawa H, Yamauchi-Takihara K, Tatsumi K, Ishibashi-Ueda H, Yamada N, Yoshida S, Abe K, Ogawa A, Ogo T, Kasai T, Kataoka M, Kawakami T, Kogaki S, Nakamura M, Nakayama T, Nishizaki M, Sugimura K, Tanabe N, Tsujino I, Yao A, Akasaka T, Ando M, Kimura T, Kuriyama T, Nakanishi N, Nakanishi T, Tsutsui H. Guidelines for the Treatment of Pulmonary Hypertension (JCS 2017/JPCPHS 2017). Circ J 2019; 83:842-945. [PMID: 30853682 DOI: 10.1253/circj.cj-66-0158] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University
| | - Shozaburo Doi
- Department of Pediatrics, Perinatal and Maternal Medicine, Graduate School, Tokyo Medical and Dental University
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masaru Hatano
- Department of Cardiovascular Medicine/Therapeutic Strategy for Heart Failure, The University of Tokyo Hospital
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Field of Functional Physiology, Okayama University Graduate School of Medicine
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School
| | - Hiromi Matsubara
- Department of Clinical Science, National Hospital Organization Okayama Medical Center
| | - Shin-Ichi Momomura
- Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Toru Satoh
- Internal Medicine II, Kyorin University School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Keiko Yamauchi-Takihara
- Health and Counseling Center and Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University
| | | | | | - Shunji Yoshida
- Department of Rheumatology and Infectious Diseases, Fujita Health University Hospital
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Kyushu University Hospital
| | - Aiko Ogawa
- Department of Clinical Science, National Hospital Organization Okayama Medical Center
| | - Takeshi Ogo
- Division of Pulmonary Circulation, Department of Cardiovascular Medicine/Department of Advanced Medicine for Pulmonary Hypertension, National Cerebral and Cardiovascular Center
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine
| | | | | | - Shigetoyo Kogaki
- Department of Pediatrics and Neonatology, Osaka General Medical Center
| | | | - Tomotaka Nakayama
- Department of Pediatrics, Toho University Medical Center Omori Hospital
| | - Mari Nishizaki
- Department of Rehabilitation, National Hospital Organization, Okayama Medical Center
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Nobuhiro Tanabe
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
| | - Ichizo Tsujino
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Atsushi Yao
- Division for Health Service Promotion, The University of Tokyo
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Motomi Ando
- Daiyukai General Hospital Cardiovascular Center
| | - Takeshi Kimura
- Department Cardiovascular Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | | | | | - Toshio Nakanishi
- Department of Pediatric Cardiology, Tokyo Women's Medical University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
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14
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Ishii M, Kaikita K, Sato K, Nakanishi N, Mitsuse T, Oimatsu Y, Takashio S, Izumiya Y, Yamamoto E, Kojima S, Tsujita K. P1684Prognostic impact of variant angina in patients with coronary spasm. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Ishii
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sato
- Kumamoto City Hospital, Kumamoto, Japan
| | - N Nakanishi
- Kumamoto University Hospital, Kumamoto, Japan
| | - T Mitsuse
- Kumamoto University Hospital, Kumamoto, Japan
| | - Y Oimatsu
- Kumamoto University Hospital, Kumamoto, Japan
| | - S Takashio
- Kumamoto University Hospital, Kumamoto, Japan
| | - Y Izumiya
- Kumamoto University Hospital, Kumamoto, Japan
| | - E Yamamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - S Kojima
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
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15
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Wakana N, Zen K, Yanishi K, Nakanishi N, Nakamura T, Matoba S. P2721Serum levels of remnant-like particle cholesterol play an important role in the pathogenesis of coronary spasm. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Wakana
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - K Zen
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - K Yanishi
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - T Nakamura
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cadiology, Kyoto, Japan
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16
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Nishi M, Ogata T, Nakanishi N, Higuchi Y, Sakamoto A, Matoba S. P1683MURC/Cavin-4 deletion protects murine heart from ischemia-reperfusion injury. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Nishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - T Ogata
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Y Higuchi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - A Sakamoto
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
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17
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Tanabe N, Kawakami T, Satoh T, Matsubara H, Nakanishi N, Ogino H, Tamura Y, Tsujino I, Ogawa A, Sakao S, Nishizaki M, Ishida K, Ichimura Y, Yoshida M, Tatsumi K. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: A systematic review. Respir Investig 2018; 56:332-341. [PMID: 30008295 DOI: 10.1016/j.resinv.2018.03.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/16/2018] [Accepted: 03/30/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Balloon pulmonary angioplasty (BPA) has been performed for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or residual pulmonary hypertension after pulmonary endarterectomy (PEA). We performed a systematic review to assess the efficacy and safety of BPA, especially compared to medical treatment or PEA. METHODS We reviewed all studies investigating pre- and post-treatment pulmonary hemodynamics, mortality, or complications from three electronic databases (PubMed, Cochrane Library, Japan Medical Abstracts Society) prior to February 2017. From 26 studies retrieved, we selected 13 studies (493 patients): the 10 most recent ones including complete data from each institution, one study of residual pulmonary hypertension, and two studies comparing BPA with medical treatment or PEA. RESULTS No randomized controlled or prospective controlled studies comparing BPA with medical treatment or PEA were reported. The early mortality of BPA ranged from 0% to 14.3%; lung injury occurred in 7.0% to 31.4% (average sessions, 2.5-6.6). Mean pulmonary arterial pressure decreased from 39.4-56 to 20.9-36 mm Hg, and the 6-min walk distance increased from 191-405 to 359-501 m. The 2-year mortality of 80 patients undergoing BPA was significantly lower compared to 68 patients receiving medical treatment (1.3% vs. 13.2%); the risk ratio was 0.14 (95% confidence interval: 0.03-0.76). No significant difference was observed in the 2-year mortality between BPA (n=97) and PEA (n=63) patients. CONCLUSIONS This systematic review suggests that BPA improves hemodynamics, has acceptable early mortality, and may improve long-term survival compared with medical treatment in inoperable CTEPH patients.
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Affiliation(s)
- Nobuhiro Tanabe
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Takashi Kawakami
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
| | - Toru Satoh
- Division of Cardiology Department of Medicine, Kyorin University Hospital, Mitaka, Japan.
| | - Hiromi Matsubara
- Department of Clinical Science, National Hospital Organization, Okayama Medical Center, Okayama, Japan.
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, Minami Osaka Hospital, Osaka, Japan.
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Yuichi Tamura
- Division of Cardiovascular Internal Medicine, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
| | - Ichizo Tsujino
- First Department of Medicine, Hokkaido University Hospital, Sapporo, Japan.
| | - Aiko Ogawa
- Department of Clinical Science, National Hospital Organization, Okayama Medical Center, Okayama, Japan.
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Mari Nishizaki
- Department of Rehabilitation, National Hospital Organization, Okayama Medical Center, Okayama, Japan.
| | - Keiichi Ishida
- Department of Cardiovascular Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Yasunori Ichimura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Narita, Japan.
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
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18
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Nakamura T, Ogo T, Tahara N, Fukui S, Tsuji A, Ueda J, Fukumoto Y, Nakanishi N, Ogawa H, Yasuda S. Thalidomide for Hereditary Hemorrhagic Telangiectasia With Pulmonary Arterial Hypertension. Circ J 2018; 82:1205-1207. [DOI: 10.1253/circj.cj-17-0299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tomohisa Nakamura
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Nobuhiro Tahara
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine
| | - Shigefumi Fukui
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akihiro Tsuji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Jin Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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Marume K, Fukui S, Shimamoto K, Ohuchi H, Tsuji A, Ogo T, Nakanishi N, Yasuda S. Coexistence of a Double-Chambered Right Ventricle With Ebstein-Like Anomaly and Right Ventricular Apical Hypoplasia ― Usefulness of Multimodality Imaging ―. Circ J 2018; 82:1215-1217. [DOI: 10.1253/circj.cj-17-0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shigefumi Fukui
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideo Ohuchi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Akihiro Tsuji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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20
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Tatebe S, Sugimura K, Aoki T, Yamamoto S, Yaoita N, Suzuki H, Sato H, Kozu K, Konno R, Satoh K, Fukuda K, Adachi O, Saito R, Nakanishi N, Morisaki H, Oyama K, Saiki Y, Okada Y, Shimokawa H. The Efficacy of a Genetic Analysis of the BMPR2 Gene in a Patient with Severe Pulmonary Arterial Hypertension and an Atrial Septal Defect Treated with Bilateral Lung Transplantation. Intern Med 2017; 56:3193-3197. [PMID: 29021450 PMCID: PMC5742392 DOI: 10.2169/internalmedicine.8686-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Severe pulmonary arterial hypertension (PAH) rarely develops in children with an atrial septal defect (ASD), even those with a large defect. We herein report the case of a 27-year-old man with a moderate-sized secundum ASD and right ventricular failure due to severe PAH, which developed in his early teens. He was diagnosed as having a genetic mutation of the bone morphogenetic protein receptor-2 (BMPR2) gene and was successfully treated with bilateral lung transplantation with ASD path closure. In patients with congenital heart disease, a genetic analysis may provide information about the lifetime risk of developing PAH.
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Affiliation(s)
- Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Saori Yamamoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Nobuhiro Yaoita
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hideaki Suzuki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Haruka Sato
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Katsuya Kozu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Ryo Konno
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Koji Fukuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Osamu Adachi
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Japan
| | - Ryoko Saito
- Department of Pathology, Tohoku University School of Medicine, Japan
| | - Norifumi Nakanishi
- Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Hiroko Morisaki
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Japan
- Department of Medical Genetics, Sakakibara Heart Institute, Japan
| | - Kotaro Oyama
- Department of Pediatrics, Iwate Medical University, Japan
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
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21
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Yanishi K, Nakanishi N, Zen K, Ogata T, Nakamura T, Yamano T, Shiraishi H, Shirayama T, Matoba S. P5194Long-term clinical outcome of therapeutic angiogenesis by cell transplantation in patients with critical limb ischemia. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Nishi M, Ogata T, Nakanishi N, Kasahara T, Higuchi Y, Matoba S. P1094Myocardial ischemia-reperfusion injury is reduced in MURC/Cavin-4-deficeint mice. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Hirashiki A, Adachi S, Nakano Y, Kamimura Y, Ogo T, Nakanishi N, Morisaki T, Morisaki H, Shimizu A, Toba K, Murohara T, Kondo T. Left main coronary artery compression by a dilated main pulmonary artery and left coronary sinus of Valsalva aneurysm in a patient with heritable pulmonary arterial hypertension and FLNA mutation. Pulm Circ 2017; 7:734-740. [PMID: 28660794 PMCID: PMC5841897 DOI: 10.1177/2045893217716107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Left main coronary artery (LMCA) disease due to external compression by a dilated main pulmonary artery (MPA) is an uncommon clinical entity. Here, we describe a 52-year-old woman with pulmonary arterial hypertension (PAH) and anteroseptal old myocardial infarction (OMI). The cause of the OMI was external compression of the LMCA by the dilated MPA and aneurysm of the left coronary sinus of Valsalva. The patient’s sister (aged 56 years) had also been diagnosed with PAH and both women had a novel heterozygous splicing mutation, IVS2-2A > G (c.374-2A > G in NM_001456), in the filamin A (FLNA) gene. To our knowledge, this is the first report of HPAH which is likely to be due to FLNA mutation and compression of the LMCA between a dilated MPA and aneurysm of the left coronary sinus of Valsalva.
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Affiliation(s)
- Akihiro Hirashiki
- 1 Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan.,2 Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Shiro Adachi
- 3 Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshihisa Nakano
- 2 Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshihiro Kamimura
- 2 Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Takeshi Ogo
- 4 Department of Advanced Medical Research for Pulmonary Hypertension, Division of Pulmonary Circulation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Norifumi Nakanishi
- 4 Department of Advanced Medical Research for Pulmonary Hypertension, Division of Pulmonary Circulation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takayuki Morisaki
- 5 Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan.,6 Department of Clinical Engineering, Tokyo University of Technology School of Health Sciences, Tokyo, Japan
| | - Hiroko Morisaki
- 5 Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan.,7 Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan
| | - Atsuya Shimizu
- 1 Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- 1 Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Toyoaki Murohara
- 2 Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Takahisa Kondo
- 3 Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Aichi, Japan
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Kurosawa T, Nakao N, Nakamura T, Uwamino Y, Shibata T, Nakanishi N, Fukumura A, Murakami K. Measurements of Secondary Neutrons Produced from Thick Targets Bombarded by High-Energy Helium and Carbon Ions. NUCL SCI ENG 2017. [DOI: 10.13182/nse98-53] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Kurosawa
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki Sendai-shi, 980-8578, Japan
| | - N. Nakao
- High-Energy Accelerator Research Organization, Tanashi Branch 3-2-1, Midori-cho, Tanashi-shi, Tokyo, 188-8501, Japan
| | - T. Nakamura
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki Sendai-shi, 980-8578, Japan
| | - Y. Uwamino
- The Institute of Physical and Chemical Research, 2-1, Hirosawa, Wako Saitama, 351-0198, Japan
| | - T. Shibata
- High-Energy Accelerator Research Organization, Tanashi Branch 3-2-1, Midori-cho, Tanashi-shi, Tokyo, 188-8501, Japan
| | - N. Nakanishi
- The Institute of Physical and Chemical Research, 2-1, Hirosawa, Wako Saitama, 351-0198, Japan
| | - A. Fukumura
- National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku Chiba-shi, Chiba, 263-8555, Japan
| | - K. Murakami
- National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku Chiba-shi, Chiba, 263-8555, Japan
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25
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Kim E, Nakamura T, Konno A, Uwamino Y, Nakanishi N, Imamura M, Nakao N, Shibata S, Tanaka S. Measurements of Neutron Spallation Cross Sections of12C and209Bi in the 20- to 150-MeV Energy Range. NUCL SCI ENG 2017. [DOI: 10.13182/nse98-a1977] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- E. Kim
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Aoba-ku, Sendai 980, Japan
| | - T. Nakamura
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Aoba-ku, Sendai 980, Japan
| | - A. Konno
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Aoba-ku, Sendai 980, Japan
| | - Y. Uwamino
- Institute of Physical and Chemical Research, Hirosawa, Wako, Saitama 351-01, Japan
| | - N. Nakanishi
- Institute of Physical and Chemical Research, Hirosawa, Wako, Saitama 351-01, Japan
| | - M. Imamura
- University of Tokyo, Institute for Nuclear Study, 3-2-1, Midori-cho, Tanashi, Tokyo 188, Japan
| | - N. Nakao
- University of Tokyo, Institute for Nuclear Study, 3-2-1, Midori-cho, Tanashi, Tokyo 188, Japan
| | - S. Shibata
- University of Tokyo, Institute for Nuclear Study, 3-2-1, Midori-cho, Tanashi, Tokyo 188, Japan
| | - S. Tanaka
- Japan Atomic Energy Research Institute, Takasaki Research Establishment 1233 Watanuki-cho, Takasaki, Gunma 370-12, Japan
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26
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Daimon A, Kamiya CA, Iwanaga N, Ikeda T, Nakanishi N, Yoshimatsu J. Management of pulmonary vasodilator therapy in three pregnancies with pulmonary arterial hypertension. J Obstet Gynaecol Res 2017; 43:935-938. [DOI: 10.1111/jog.13279] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 10/05/2016] [Accepted: 12/09/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Atsushi Daimon
- Department of Perinatology and Gynecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Chizuko A. Kamiya
- Department of Perinatology and Gynecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Naoko Iwanaga
- Department of Perinatology and Gynecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology; Mie University School of Medicine; Tsu, Mie Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Jun Yoshimatsu
- Department of Perinatology and Gynecology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
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27
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Shiba M, Fukui S, Ohuchi H, Ueda J, Tsuji A, Morita Y, Miyazaki A, Ogo T, Yasuda S, Shiraishi I, Nakanishi N. Congenitally Corrected Transposition of the Great Arteries and Situs Inversus in an Octogenarian With Systemic Right Ventricular Failure. Int Heart J 2017; 58:151-154. [PMID: 27818476 DOI: 10.1536/ihj.16-101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/18/2022]
Abstract
Systemic right ventricular (RV) failure in patients with congenitally corrected transposition of the great arteries (ccTGA), a major cause of mortality in the long-term follow-up, is usually induced by concomitant severe morphologically tricuspid regurgitation (TR) with/without Ebstein's anomaly or progressive conduction tissue disturbances. However, whether or not myocardial fibrosis is a common cause of systemic RV failure in patients with ccTGA remains unclear. Here, we describe an 82-year-old man who had been diagnosed previously as having uncomplicated ccTGA and situs inversus and recently developed systemic RV failure, which was neither associated with severe TR nor advanced conduction tissue abnormalities. Cardiovascular magnetic resonance (CMR) with delayed-enhancement imaging clearly detected extensive myocardial scars (presumably fibrosis) in the RV wall as well as prominent dilatation, hypertrophy, and systolic dysfunction of the systemic RV. These findings suggest that myocardial fibrosis can cause systemic RV failure in elderly patients with uncomplicated ccTGA despite the absence of severe TR or advanced conduction tissue abnormalities and that CMR may be a useful examination to accurately detect systemic RV failure associated with myocardial fibrosis and to subsequently clarify the prognosis in these patients.
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Affiliation(s)
- Mikio Shiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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28
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Tsuji A, Ogo T, Ueda J, Fukui S, Morita Y, Fukuda T, Nakanishi N, Ogawa H, Yasuda S. Predictors of residual pulmonary hypertension after balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. Int J Cardiol 2017; 226:118-120. [DOI: 10.1016/j.ijcard.2016.09.132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
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29
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Takaoka A, Sasaki M, Nakanishi N, Kurihara M, Ohi A, Bamba S, Ban H, Andoh A. SUN-P052: Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn’s Disease. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30395-8] [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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30
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Takemura Y, Sasaki M, Goto K, Takaoka A, Ohi A, Kurihara M, Nakanishi N, Nakano Y, Hanaoka J. PT08.3: Proinflammatory Cytokine IL-6, But Not TNF-α, Affects Energy Metabolism and Nutritional Status in Patients with Lung Cancer. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30328-4] [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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31
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Fukui S, Ogo T, Takaki H, Ueda J, Tsuji A, Morita Y, Kumasaka R, Arakawa T, Nakanishi M, Fukuda T, Yasuda S, Ogawa H, Nakanishi N, Goto Y. Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Heart 2016; 102:1403-9. [PMID: 27220694 PMCID: PMC5013094 DOI: 10.1136/heartjnl-2015-309230] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/14/2016] [Indexed: 11/13/2022] Open
Abstract
Objective To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. Methods Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. Results No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO2), per cent predicted peak VO2 (70.7±9.4% to 78.2±12.8%, p<0.01), peak workload, and oxygen pulse significantly improved in the CR group compared with the non-CR group, with a tendency towards improvement in mental health-related QOL. Quadriceps strength and heart failure (HF) symptoms (WHO functional class, 2.2–1.8, p=0.01) significantly improved within the CR group. During the CR, no patient experienced adverse events or deterioration of right-sided HF or haemodynamics as confirmed via catheterisation. Conclusions The combination of BPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile.
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Affiliation(s)
- Shigefumi Fukui
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Takeshi Ogo
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hiroshi Takaki
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Jin Ueda
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Akihiro Tsuji
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Yoshiaki Morita
- The Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Reon Kumasaka
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Tetsuo Arakawa
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Michio Nakanishi
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Tetsuya Fukuda
- The Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Satoshi Yasuda
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hisao Ogawa
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Norifumi Nakanishi
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Yoichi Goto
- The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
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Tahara N, Dobashi H, Fukuda K, Funauchi M, Hatano M, Ikeda S, Joho S, Kihara Y, Kimura T, Kondo T, Matsushita M, Minamino T, Nakanishi N, Ozaki Y, Saji T, Sakai S, Tanabe N, Watanabe H, Yamada H, Yoshioka K, Sasayama S. Efficacy and Safety of a Novel Endothelin Receptor Antagonist, Macitentan, in Japanese Patients With Pulmonary Arterial Hypertension. Circ J 2016; 80:1478-83. [PMID: 27180890 DOI: 10.1253/circj.cj-15-1305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Macitentan is a novel, dual endothelin receptor antagonist with sustained receptor binding, used for the long-term treatment of pulmonary arterial hypertension (PAH). In the present study, we assessed the efficacy and safety of macitentan in Japanese patients with PAH. METHODS AND RESULTS Macitentan was administered at a once-daily dose of 10 mg in 30 patients. The primary endpoint was change in pulmonary vascular resistance (PVR) from baseline to week 24. Change to week 24 in the other hemodynamic parameters, 6-min walk distance (6MWD), World Health Organization (WHO) functional class, and plasmaN-terminal pro-brain natriuretic peptide (NT-pro-BNP), as well as time to clinical deterioration up to week 52 were also assessed as secondary endpoints. In the 28 patients on per-protocol analysis, PVR decreased from 667±293 to 417±214 dyn·sec·cm(-5)(P<0.0001). 6MWD increased from 427±128 to 494±116 m (P<0.0001). WHO functional class improved in 13 patients (46.4%) and was maintained in 15 patients (53.6%), and NT-pro-BNP was reduced by 18% (P<0.0001). The favorable treatment effect on PVR was apparent regardless of concomitant therapy for PAH. CONCLUSIONS Macitentan was efficacious and well tolerated and improved the hemodynamic parameters, exercise capacity, symptoms, and clinical biomarkers in Japanese PAH patients. Macitentan can be a valuable therapeutic option for Japanese patients with PAH. ( TRIAL REGISTRATION JAPIC Clinical Trials Information [JapicCTI-121986].) (Circ J 2016; 80: 1478-1483).
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Affiliation(s)
- Nobuhiro Tahara
- Department of Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine
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Tsuji A, Ogo T, Fukui S, Fukuda T, Ueda J, Nakanishi N. Clinical Determinant Factor Predicting Post-Balloon Pulmonary Angioplasty Mean Pulmonary Arterial Pressure Less Than 30 mmhg in Patients With Chronic Thromboembolic Pulmonary Hypertension. Chest 2016. [DOI: 10.1016/j.chest.2016.02.519] [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: 10/22/2022] Open
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34
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Fukuda T, Ogo T, Nakanishi N, Ueda J, Sanda Y, Morita Y, Sugiyama M, Fukui S, Tsuji A, Naito H. Evaluation of organized thrombus in distal pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension using cone-beam computed tomography. Jpn J Radiol 2016; 34:423-31. [PMID: 27012964 DOI: 10.1007/s11604-016-0538-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/14/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE Balloon pulmonary angioplasty (BPA) is an emerging treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) patients. However, the approach to use to identify distal thrombi suitable for BPA has not yet been established. The purpose of this work was therefore to evaluate distal chronic thromboembolic lesions for BPA using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Thirty-two patients (men/women: 9/23) with CTEPH who underwent CBCT before BPA were enrolled. We assessed representative forms of chronic thromboembolic lesions in 94 segmental and/or 208 subsegmental branches according to CBCT and compared the results to the findings of selective angiography during BPA. RESULTS We classified CTEPH lesions into five subtypes as follows: type 1a (11.1 %), webs; type 1b (14.4 %), web with severe narrowing of the subsegmental artery; type 2, (58.2 %) web and slits; type 3 (2.4 %), slits; and type 4 (13.9 %), pouch defect with incomplete obstruction of subsegmental branches or complete occlusion. In our study, 92.6 % of the CTEPH lesions diagnosed by CBCT were highly consistent with the findings of selective angiography during BPA. CONCLUSION CBCT clearly revealed and classified distal lesions in CTEPH patients. The CBCT findings for distal lesions were highly consistent with those of selective angiography during BPA. CBCT could be a useful modality to detect target lesions before BPA.
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Affiliation(s)
- Tetsuya Fukuda
- Department of Radiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Jin Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Yoshihiro Sanda
- Department of Radiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Munehiro Sugiyama
- Department of Radiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Shigefumi Fukui
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Akihiro Tsuji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Hiroaki Naito
- Department of Radiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
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Nakamura T, Ogo T, Tsuji A, Fukui S, Fukuda T, Tahara N, Fukumoto Y, Yasuda S, Ogawa H, Nakanishi N. Successful balloon pulmonary angioplasty with gadolinium contrast media for a patient with chronic thromboembolic pulmonary hypertension and iodine allergy. Respir Med Case Rep 2016; 17:75-82. [PMID: 27141436 PMCID: PMC4821363 DOI: 10.1016/j.rmcr.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 01/24/2016] [Accepted: 02/01/2016] [Indexed: 12/13/2022] Open
Abstract
A 28-year-old male was referred to our hospital with dyspnea. He was diagnosed as having chronic thromboembolic pulmonary hypertension, and a pulmonary endarterectomy (PEA) was performed. However, exertional dyspnea remained because of residual pulmonary hypertension; therefore, the patient was re-admitted to our hospital 1 year after PEA. We performed computed tomography and pulmonary angiography and found web and band lesions in the distal pulmonary artery with a high pulmonary artery pressure. Although further management was complicated because the patient had an anaphylactic shock to iodine-based contrast media, we eventually completed five sessions of balloon pulmonary angioplasty (BPA) using gadolinium contrast medium. His symptoms and hemodynamics dramatically improved after a series of BPA. After 15 months, mean pulmonary arterial pressure reduced from 67 mmHg to 20 mmHg, and subjective symptoms improved from stage Ⅳ to I as per the WHO classification system. BPA is a potential procedure for residual pulmonary hypertension after PEA and could be safely performed using gadolinium contrast medium for patients with iodine allergy.
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Affiliation(s)
- Tomohisa Nakamura
- Department of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akihiro Tsuji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shigefumi Fukui
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tetsuya Fukuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nobuhiro Tahara
- Department of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
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Tazumi A, Nakajima T, Sekizuka A, Arikawa K, Nakanishi N, Hayashi H, Tasaki T, Moore M, Millar B, Matsuda M. Biochemical characterisation of urease from urease-positive thermophilic Campylobacter (UPTC). Br J Biomed Sci 2016; 69:1-5. [DOI: 10.1080/09674845.2012.11669913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A. Tazumi
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - T. Nakajima
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - A. Sekizuka
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - K. Arikawa
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - N. Nakanishi
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - H. Hayashi
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - T. Tasaki
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
| | - M. Moore
- School of Biomedical Sciences, University of Ulster, Coleraine
- Department of Bacteriology, Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, Northern Ireland, UK
| | - B.C. Millar
- Department of Bacteriology, Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, Northern Ireland, UK
| | - M. Matsuda
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, Sagamihara, Japan
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Konishi H, Miyoshi T, Neki R, Fukuda T, Ishibashi-Ueda H, Ogo T, Nakanishi N, Yoshimatsu J. Intrapartum temporary inferior vena cava filters are rarely indicated in pregnant women with deep venous thromboses. J Vasc Surg Venous Lymphat Disord 2015; 3:370-375. [DOI: 10.1016/j.jvsv.2015.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/28/2015] [Indexed: 11/24/2022]
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Shigyo H, Tsuji A, Ueda J, Fukui S, Ogo T, Sanda Y, Morita Y, Fukuda T, Yasuda S, Ogawa H, Nakanishi N. EFFECT OF BALLOON PULMONARY ANGIOPLASTY FOR INOPERABLE PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION IN WHOM MEAN PULMONARY ARTERIAL PRESSURE WAS LESS THAN 30MMHG. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fukui S, Ogo T, Goto Y, Ueda J, Tsuji A, Sanda Y, Kumasaka R, Arakawa T, Nakanishi M, Fukuda T, Takaki H, Yasuda S, Ogawa H, Nakanishi N. Exercise intolerance and ventilatory inefficiency improve early after balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Int J Cardiol 2014; 180:66-8. [PMID: 25438215 DOI: 10.1016/j.ijcard.2014.11.187] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/23/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Shigefumi Fukui
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Takeshi Ogo
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan.
| | - Yoichi Goto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Jin Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Akihiro Tsuji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Yoshihiro Sanda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Reon Kumasaka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Tetsuo Arakawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Tetsuya Fukuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hiroshi Takaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan
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Narishige Y, Fukui S, Tsuji A, Ogo T, Nakanishi N. A Case of Takayasu's Artitis Which Presented as Total Occlusion of Right Pulmonary Artery. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.161] [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: 11/30/2022]
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Nishimura S, Sasaki M, Iwakawa H, Kurihara M, Nakanishi N. PP219-MON: Usefulness of Semi-Solid Enteral Formula Containing Partially Hydrolyzed Guar Gum in Patients with Percutaneous Endoscopic Gastrostomy. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50553-5] [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: 10/24/2022]
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Tsuji A, Ogo T, Demachi J, Ono Y, Sanda Y, Morita Y, Fukuda T, Nakanishi N. Rescue balloon pulmonary angioplasty in a rapidly deteriorating chronic thromboembolic pulmonary hypertension patient with liver failure and refractory infection. Pulm Circ 2014; 4:142-7. [PMID: 25006430 DOI: 10.1086/675643] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 11/16/2013] [Indexed: 12/17/2022] Open
Abstract
Pulmonary endarterectomy (PEA) is the standard therapy for chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) is an alternative therapy for such patients. Here we report the case of a 60-year-old woman who presented with severe CTEPH resulting in low cardiac output and liver failure. Her clinical status rapidly deteriorated after she developed a respiratory infection that was refractory to antibiotic treatment. PEA was risky because of her unstable hemodynamics, uncontrolled infection, and liver failure with jaundice. We thus performed rescue BPA. After 3 BPA procedures, her cardiac symptoms improved from World Health Organization functional class IV to II, and her jaundice resolved. The day after her final BPA procedure, her hemodynamics dramatically improved, and she continued to show improvement 3 months later. We thus suggest that BPA is a good treatment option in CTEPH patients with rapidly deteriorating heart failure and uncontrolled comorbidities.
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Affiliation(s)
- Akihiro Tsuji
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takeshi Ogo
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Jun Demachi
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yusuke Ono
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshihiro Sanda
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshihiro Morita
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tetsuya Fukuda
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Norifumi Nakanishi
- Departments of Cardiology and Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism. CTEPH results from persistent obstruction of pulmonary arteries and progressive vascular remodelling. Not all patients presenting with CTEPH have a history of clinically overt pulmonary embolism. The diagnostic work-up to detect or rule out CTEPH should include ventilation-perfusion scintigraphy, which has high sensitivity and a negative predictive value of nearly 100%. CT angiography usually reveals typical features of CTEPH, including mosaic perfusion, part or complete occlusion of pulmonary arteries, and intraluminal bands and webs. Patients with suspected CTEPH should be referred to a specialist centre for right-heart catheterisation and pulmonary angiography. Surgical pulmonary endarterectomy remains the treatment of choice for CTEPH and is associated with excellent long-term results and a high probability of cure. For patients with inoperable CTEPH, various medical and interventional therapies are being developed.
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Affiliation(s)
- Marius M Hoeper
- Department of Respiratory Medicine, Hannover Medical School and German Centre for Lung Research (DZL), Hannover, Germany.
| | - Michael M Madani
- Department of Cardiothoracic Surgery, University of California, San Diego, CA, USA
| | - Norifumi Nakanishi
- Department of Cardiovascular Medicine, National Cardiovascular Centre, Osaka, Japan
| | - Bernhard Meyer
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Serghei Cebotari
- Department of Cardiovascular, Thoracic and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - Lewis J Rubin
- Department of Respiratory Medicine, University of California, San Diego, CA, USA
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Handa T, Okano Y, Nakanishi N, Morisaki T, Morisaki H, Mishima M. BMPR2 gene mutation in pulmonary arteriovenous malformation and pulmonary hypertension: a case report. Respir Investig 2014; 52:195-198. [PMID: 24853021 DOI: 10.1016/j.resinv.2013.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 07/14/2013] [Accepted: 08/02/2013] [Indexed: 06/03/2023]
Abstract
The transforming growth factor-β superfamily signaling pathway is thought to be involved in the pathogenesis of pulmonary arteriovenous malformation (PAVM). However, the association between bone morphogenetic protein receptor type 2 (BMPR2) gene mutations and PAVM remains unclear. We present a case of concurrent PAVM and pulmonary arterial hypertension (PAH), with a deletion mutation in exon 6 and exon 7 of the BMPR2 gene. Drug treatment for PAH improved the patient's hemodynamics and exercise capacity, but worsened oxygenation. This case suggests that BMPR2 gene mutation may be associated with the complex presentation of PAVM combined with PAH.
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Affiliation(s)
- Tomohiro Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Yoshiaki Okano
- Department of Internal Medicine, Hanwa Daini Senboku Hospital, Sakai, Japan.
| | - Norifumi Nakanishi
- Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Takayuki Morisaki
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan.
| | - Hiroko Morisaki
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan.
| | - Michiaki Mishima
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Sugiyama M, Fukuda T, Sanda Y, Morita Y, Higashi M, Ogo T, Tsuji A, Demachi J, Nakanishi N, Naito H. Organized thrombus in pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension; imaging with cone beam computed tomography. Jpn J Radiol 2014; 32:375-82. [PMID: 24760203 DOI: 10.1007/s11604-014-0319-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [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: 02/07/2014] [Accepted: 04/06/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE To assess the usefulness of cone-beam CT (CBCT) during pulmonary angiography for the evaluation of organized thrombus at segmental or subsegmental arteries in patients with chronic thromboembolic pulmonary hypertension (CTEPH). MATERIALS AND METHODS The segmental and/or subsegmental pulmonary arteries of 13 patients with CTEPH were evaluated by CBCT. We classified representative forms of organized thrombus into 4 types (type 1: webs, type 2: web and slits, type 3: slits, and type 4: narrowing or complete occlusion), and the distribution and frequency of the organized thrombus were evaluated. The relative detectability of these lesions using CBCT was compared with that in contrast-enhanced CT pulmonary angiography (CTPA). RESULTS Type 1 lesions were most frequently observed in both segmental (30/65 = 46 %) and subsegmental branches (72/156 = 46 %). Type 2 lesions were relatively less frequent than type 1, but subsegmental branches were frequently involved (29/156 = 19 %). Type 3 lesions observed as a thin flap in 9/156 subsegmental branches (6 %). Comparing with CTPA, all 40 lesions in segmental branches were detectable in CTPA, whereas only 62 lesions among 90 lesions (69 %) in subsegmental branches could be observed by CTPA. CONCLUSION CBCT is found to be useful for the treatment planning of balloon pulmonary angioplasty distal to segmental arteries.
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Affiliation(s)
- Munehiro Sugiyama
- Department of Radiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan,
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Fukui S, Ogo T, Morita Y, Tsuji A, Tateishi E, Ozaki K, Sanda Y, Fukuda T, Yasuda S, Ogawa H, Nakanishi N. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J 2014; 43:1394-402. [PMID: 24627536 DOI: 10.1183/09031936.00012914] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Balloon pulmonary angioplasty (BPA) has been reported to improve haemodynamics and functional capacity, with an acceptable risk, in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are not candidates for pulmonary endarterectomy. However, right ventricular (RV) function, an important predictor in CTEPH, remains to be elucidated. We aimed to examine the impact of BPA on RV remodelling and dysfunction relative to haemodynamic improvements in patients with inoperable CTEPH. 20 consecutive patients with inoperable CTEPH who underwent BPA with cardiovascular magnetic resonance before and after BPA were retrospectively studied. BPA led to significant amelioration of the mean pulmonary arterial pressure, cardiac index and pulmonary vascular resistance (PVR), without death or major complications. Furthermore, BPA significantly ameliorated right-sided heart failure symptoms and signs, and exercise capacity. Cardiovascular magnetic resonance revealed a marked improvement in RV end-diastolic and end-systolic volume index, with concomitant improvements in RV ejection fraction, mass and interventricular septal bowing after BPA. Changes in RV volumes strongly correlated with changes in cardiac index and PVR. BPA induced RV reverse remodelling and improved systolic dysfunction safely by ameliorating haemodynamics in patients with inoperable CTEPH. Evaluating RV function with cardiovascular magnetic resonance may be effective for noninvasively monitoring BPA efficacy.
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Nakamura M, Sakuma M, Yamada N, Tanabe N, Nakanishi N, Miyahara Y, Kuriyama T, Kunieda T, Shirato K, Sugimoto T, Nakano T. Risk factors of acute pulmonary thromboembolism in Japanese patients hospitalized for medical illness: results of a multicenter registry in the Japanese society of pulmonary embolism research. J Thromb Thrombolysis 2014; 21:131-5. [PMID: 16622608 DOI: 10.1007/s11239-006-5205-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although the prophylaxis of acute pulmonary thromboembolism (APTE) in hospitalized patients has been improving in Japan, there is no report concerning APTE of Japanese medical patients. Therefore, the present study was designed to investigate the characteristics of APTE in Japanese patients hospitalized for medical illness, through a retrospective study. METHODS In a total of 1,438 registry patients with pulmonary thromboembolism for recent 10 years, 1,027 patients with APTE were analyzed with respect to underlying diseases or predisposing factors, and clinical course. RESULTS A hundred thirty three patients hospitalized for medical illness developed APTE, among 433 in-hospital APTE patients. The prevalence of APTE in women was more than in men. The mean age of the patients at diagnosis was 61 +/- 17 years. Main risk factors were a prolonged immobilization, stroke, cancer, indwelling central venous catheter. Fifty-four patients had 3 or more risk factors. In-hospital mortality rate was 23%. CONCLUSIONS Japanese patients in this registry had almost the same findings as in western patients, except for some points that had the possibility of demonstrating a difference between westerners and Japanese in the development of APTE. Our results will be available for establishing the prevention of APTE in medical patients in Japan.
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Affiliation(s)
- Mashio Nakamura
- Department of Cardiology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.
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Ishiwata T, Terada J, Tanabe N, Abe M, Sugiura T, Tsushima K, Tada Y, Sakao S, Kasahara Y, Nakanishi N, Morisaki H, Tatsumi K. Pulmonary arterial hypertension as the first manifestation in a patient with hereditary hemorrhagic telangiectasia. Intern Med 2014; 53:2359-63. [PMID: 25318803 DOI: 10.2169/internalmedicine.53.2850] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 17-year-old Japanese girl visited our hospital for an evaluation of exertional dyspnea. A diagnosis of pulmonary arterial hypertension (PAH) was confirmed based on the findings of right heart catheterization. Detailed questioning revealed a family history of hereditary hemorrhagic telangiectasia (HHT), and a genetic mutation analysis disclosed a mutation in the activin receptor-like kinase 1 gene (ACVRL1). The patient was finally diagnosed with HHT according to the Curaçao diagnostic criteria eight years after the diagnosis of PAH. This case supports previous reports indicating that signs of PAH can be the first manifestation of disease in ACVRL1 mutation carriers.
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Affiliation(s)
- Tsukasa Ishiwata
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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Ogo T, Fukui S, Tsuji A, Nakanishi N. Efficacy of oral triple upfront combination therapy (long-acting prostacyclin analogue, endothelin receptor antagonist, phosphodiesterase 5 inhibitor) in the patients with idiopathic/heritable pulmonary arterial hypertension. Life Sci 2013. [DOI: 10.1016/j.lfs.2013.12.168] [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: 10/25/2022]
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Mizuno A, Niwa K, Matsuo K, Kawada M, Miyazaki A, Mori Y, Nakanishi N, Ohuchi H, Watanabe M, Yao A, Inai K. Survey of reoperation indications in tetralogy of fallot in Japan. Circ J 2013; 77:2942-7. [PMID: 24042321 DOI: 10.1253/circj.cj-13-0673] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although the survival rate for repaired Tetralogy of Fallot (TOF) is dramatically improving, anatomical and functional residua and sequelae followed by arrhythmias and sudden death are still challenging issues to be resolved. Reoperation can reduce the incidence of arrhythmias and sudden death, but there is no consensus on the indications of reoperation for patients with TOF, especially in Japan. METHODS AND RESULTS A cross-sectional questionnaire survey of reoperation indications in patients with TOF was performed through a Japanese multicenter study. The questionnaire, which focused on the number of repaired TOF patients aged >15 years old, reoperation indications and management, was sent to the institutions belonging to Japanese Society for Adult Congenital Heart Disease. In total, 41.5% (78/188) of the institutions replied. The total number of repaired TOF patients was 4,010, and sudden cardiac death was observed in 45.236/4,010 (5.9%) experienced reoperation. Pulmonary stenosis (32%) and pulmonary regurgitation (29%) were the most common reasons for reoperation. There were only 2 implantable cardioverter defibrillator or resynchronization therapy defibrillator implantations. The physiological/anatomical indications of reoperation differed among the hospitals. CONCLUSIONS Approximately 1.1% of patients suffered sudden death and 6% of repaired TOF patients had reoperation. The indications of reoperation, however, varied among the institutions. Therefore, detailed information for each case of sudden death or reoperation should be collected and analyzed in order to establish guidelines for reoperation.
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Affiliation(s)
- Atsushi Mizuno
- Research Committee, Japanese Society for Adult Congenital Heart Disease, ST. Luke's International Hospital
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