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Nishiike S, Michiba T, Ito R, Ashida N, Kato H, Kuki A, Ogawa K, Tamura K, Uetsuka S. Quantitative measurement of airborne particles during endoscopic and microscopic ear surgery in the operating room. J Laryngol Otol 2024; 138:405-409. [PMID: 37646247 DOI: 10.1017/s0022215123001433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE This study aimed to quantitatively investigate airborne particle load in the operating room during endoscopic or microscopic epitympanectomy or mastoidectomy. METHOD In the transcanal endoscopic ear surgery group, drilling was performed underwater. A particle counter was used to measure the particle load before, during and after drilling during transcanal endoscopic ear surgery or microscopic ear surgery. The device counted the numbers of airborne particles of 0.3, 0.5 or 1.0 μm in diameter. RESULTS The particle load during drilling was significantly higher in the microscopic ear surgery group (n = 5) than in the transcanal endoscopic ear surgery group (n = 11) for all particle sizes (p < 0.01). In the transcanal endoscopic ear surgery group, no significant differences among the particle load observed before, during and after drilling were seen for any of the particle sizes. CONCLUSION Bone dissection carries a lower risk of airborne infection if it is performed using the endoscopic underwater drilling technique.
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Affiliation(s)
- S Nishiike
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - T Michiba
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - R Ito
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - N Ashida
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - H Kato
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - A Kuki
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - K Ogawa
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - K Tamura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - S Uetsuka
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Rosai Hospital, Osaka, Japan
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Noda S, Hanai S, Ito R, Kobayashi Y, Nakagomi D. Isolated thoracic aortitis following mRNA vaccination against SARS-CoV-2. QJM 2023; 116:875-876. [PMID: 37294845 DOI: 10.1093/qjmed/hcad126] [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] [Received: 06/05/2023] [Indexed: 06/11/2023] Open
Affiliation(s)
- S Noda
- Department of Rheumatology and Department of Diabetes and Endocrinology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - S Hanai
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - R Ito
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - Y Kobayashi
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - D Nakagomi
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Ito R, Suzuki S, Nishiyama N. Restrictive Ventilatory Impairment as a Poor Prognostic Factor in Patients Who Undergo Surgical Resection for Metachronous Second Primary Lung Cancer. Ann Thorac Cardiovasc Surg 2023; 29:185-191. [PMID: 36740271 PMCID: PMC10466115 DOI: 10.5761/atcs.oa.22-00182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate the prognostic impact of restrictive ventilatory impairment in patients who undergo pulmonary resection of metachronous second primary lung cancer. METHODS The clinical characteristics and surgical outcomes of 70 patients with metachronous second primary lung cancer were analyzed. RESULTS The surgical procedures consisted of wedge resection in 40 patients, segmentectomy in 17, lobectomy in 12, and completion pneumonectomy in one. Patients who underwent ipsilateral pulmonary resection developed more perioperative complications (p = 0.0339). Three-year and 5-year overall survival rates were 78.2% and 69.2%, respectively. In univariate analysis, sex, restrictive ventilatory impairment, and histology of second primary lung cancer were significantly poor prognostic factors (all p <0.05). Multivariate analysis identified restrictive ventilatory impairment to be an independent predictor of a poor prognosis (p = 0.0193). In the 22 patients who died, the cause of death was lung cancer in 11 and other diseases, including pneumonia and respiratory failure, in 11. Death from another disease was significantly more common in patients with restrictive ventilatory impairment (p = 0.0216). CONCLUSION Restrictive ventilatory impairment was an independent predictor of a poor prognosis in patients with a second primary lung cancer. Restrictive ventilatory impairment as a result of repeated thoracic surgery may increase the likelihood of death from another disease.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Ito R, Suzuki S, Nishiyama N. Elevation of the Neutrophil-to-Lymphocyte Ratio Is a Significant Postoperative Poor Prognostic Factor in Patients With Clinical T3-4 Centrally Located Primary Lung Cancer. Anticancer Res 2023; 43:1631-1636. [PMID: 36974781 DOI: 10.21873/anticanres.16313] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 03/29/2023]
Abstract
BACKGROUND/AIM In centrally located non-small cell lung cancer (CLNSCLC) surgery, large tumors and extension to neighboring structures prevent the attainment of adequate surgical fields and make operations more difficult, and some patients have extremely poor outcomes. This study aimed to identify novel postoperative prognostic factors in patients with advanced CLNSCLC. PATIENTS AND METHODS CLNSCLC was defined as a tumor requiring pneumonectomy or sleeve lobectomy for complete removal. We retrospectively investigated the clinical courses of 35 patients with cT3-4 CLNSCLC. RESULTS This study included 21 patients with cT3 and 14 with cT4 lung cancer. Nine patients underwent pneumonectomy and 26 underwent sleeve lobectomy. Univariate analysis revealed that a high neutrophil-to-lymphocyte ratio (NLR, p=0.005) and carcinoembryonic antigen (CEA) positivity (p=0.028) were significant poor prognostic factors. Only high NLR (p=0.020) was a significant independent predictor in multivariate analysis. Nine of 16 patients with high NLR (56%) experienced disease recurrence, whereas 6 of 19 patients without high NLR (32%) had recurrent disease. CONCLUSION High NLR and CEA positivity were significant poor prognostic factors in patients with cT3-4 CLNSCLC, and only high NLR was an independent predictor. Our findings may be helpful in selecting optimal treatments for advanced CLNSCLC.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Ito R, Suzuki S, Nishiyama N. Surgical Outcomes After Pulmonary Resection With Typical or Atypical Bronchoplasty in Patients With Primary Lung Cancer. Anticancer Res 2023; 43:1719-1724. [PMID: 36974784 DOI: 10.21873/anticanres.16324] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 01/13/2023] [Accepted: 02/15/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND/AIM Atypical bronchoplasty is essential for complete tumor removal and preservation of peripheral lung tissue. This study compared surgical outcomes after atypical or typical bronchoplasty in patients who underwent pulmonary sleeve resection with bronchoplasty. PATIENTS AND METHODS Typical bronchoplasty was defined as that after one-lobe sleeve resection; atypical bronchoplasty was defined as that after sleeve bilobectomy or sleeve removal of one lobe plus segments. Double-barreled bronchoplasty was also included in the atypical group. Surgical outcomes were retrospectively investigated according to type of bronchoplasty. RESULTS Fifty-one patients underwent typical bronchoplasty and 20 atypical bronchoplasty. Recurrence was seen in 17 out of 51 (33%) patients after typical bronchoplasty and 10 out of 20 patients (50%) after atypical bronchoplasty. The recurrence-free survival rate was significantly poorer in the atypical bronchoplasty group (p=0.038). However, patients in the atypical bronchoplasty group were able to receive anticancer treatment for tumor recurrence, and there was no significant difference in overall survival rates between the groups. CONCLUSION Preservation of pulmonary function by atypical bronchoplasty might contribute to tolerability of anticancer treatment for tumor recurrence. Pulmonary resection with atypical bronchoplasty is reliably beneficial for overall survival.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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Hanai S, Kobayashi Y, Ito R, Harama K, Nakagomi D. Thrombotic microangiopathy with refractory lupus nephritis successfully treated by combining rituximab with belimumab. Scand J Rheumatol 2023; 52:227-229. [PMID: 36409225 DOI: 10.1080/03009742.2022.2140483] [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: 11/23/2022]
Affiliation(s)
- S Hanai
- Department of Rheumatology, University of Yamanashi Hospital, Yamanashi, Japan
| | - Y Kobayashi
- Department of Rheumatology, University of Yamanashi Hospital, Yamanashi, Japan
| | - R Ito
- Department of Rheumatology, University of Yamanashi Hospital, Yamanashi, Japan
| | - K Harama
- Department of Rheumatology, University of Yamanashi Hospital, Yamanashi, Japan
| | - D Nakagomi
- Department of Rheumatology, University of Yamanashi Hospital, Yamanashi, Japan
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Ito R, Yashiro M, Tsukioka T, Izumi N, Komatsu H, Inoue H, Yamamoto Y, Nishiyama N. GLUT1 and PKM2 may be useful prognostic predictors in patients with non‑small cell lung cancer following curative R0 resection. Oncol Lett 2023; 25:129. [PMID: 36844619 PMCID: PMC9950336 DOI: 10.3892/ol.2023.13715] [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: 09/19/2022] [Accepted: 01/24/2023] [Indexed: 02/12/2023] Open
Abstract
Lung cancer has a poor prognosis despite recent progresses being made regarding its treatment. In addition, there is a paucity of reliable and independent prognostic predictors for non-small cell lung cancer (NSCLC) following curative resection. Glycolysis is associated with the malignancy and proliferation of cancer cells. Glucose transporter 1 (GLUT1) promotes glucose uptake, whereas pyruvate kinase M2 (PKM2) promotes anaerobic glycolysis. The present study aimed to evaluate the relationship between the expression of GLUT1 and PKM2 and the clinicopathological features of patients with NSCLC, and to identify a reliable prognostic factor for NSCLC following curative resection. Patients with NSCLC who underwent curative surgery were retrospectively enrolled to the present study. GLUT1 and PKM2 expression was assessed using immunohistochemistry. Subsequently, the association between the clinicopathological features of patients with NSCLC and the expression of GLUT1 and PKM2 was assessed. Of the 445 patients with NSCLC included in the present study, 65 (15%) were positive for both GLUT1 and PKM2 expression (G+/P+ group). GLUT1 and PKM2 positivity was significantly associated with sex, absence of adenocarcinoma, lymphatic invasion and pleural invasion. Furthermore, patients with NSCLC in the G+/P+ group presented significantly poorer survival rates than those expressing other markers. G+/P+ expression was significantly associated with poor disease-free survival. In conclusion, the findings of the present study indicated that the combination of GLUT1 and PKM2 may be considered a reliable prognostic factor for patients with NSCLC following curative resection, especially in patients with stage I NSCLC.
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Affiliation(s)
- Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Masakazu Yashiro
- Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan,Cancer Center for Translational Research, Osaka Metropolitan University, Osaka 545-8585, Japan,Correspondence to: Dr Masakazu Yashiro, Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan, E-mail:
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Yurie Yamamoto
- Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan,Cancer Center for Translational Research, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka 545-8585, Japan
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Kitagawa M, Sugawara M, Chiba T, Ryuzaki S, Yoshino Y, Kobayashi Y. Prognosis of hypertrophic cardiomyopathy in Japanese patients with an implantable cardioverter defibrillator -focus on apical hypertrophic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.663] [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
Patients with hypertrophic cardiomyopathy (HCM) are at high risk of lethal arrhythmias, and implantable cardioverter defibrillators (ICD) are widely used for prevention of sudden cardiac death (SCD). Apical HCM is a phenotype variant of HCM, with hypertrophy predominantly affecting apex, that was initially described 30 years ago. Apical HCM patients may have different clinical prognosis compared with other subsets of HCM. In previous studies, apical HCM patients seem to have a more benign prognosis than other types of HCM. However, little is known about the long-term outcomes of apical HCM patients and there are many unclear points. Moreover, there are few reports about the clinical prognosis in apical HCM patients with an ICD.
Objective
The aim of this study is to identify the difference between the prognosis of apical and the other types of HCM patients with an ICD.
Methods
We retrospectively analyzed the database of our ICD clinic. All subjects underwent ICD implantation between October 2006 and September 2018. We classified HCM patients into LV outflow tract obstruction (LVOTO) and midventricular obstruction (MVO), apical HCM and other non-obstructive types. We divided all the patients into apical and other types of HCM, and examined their background, incidence of appropriate ICD therapies, hospitalization for heart failure, electrical storm and death.
Results
A total of consecutive 64 Japanese HCM patients with an ICD (follow-up period, 86±24 months; age, 65±14 years; male sex, 83%; left ventricular ejection fraction, 56±14%; LV max wall-thickness, 19±7mm; LV apical aneurysm, 9.4%; 5-year risk of SCD, 4.4±2.1) were enrolled in this study. We classified them into 14 apical HCM and 50 other types of HCM patients. The clinical characteristics and major clinical events of these patients are shown in the Table 1. During the follow-up periods, there were no significant differences in the incidence of electrical storm, hospitalization for heart failure and death between the 2 groups (p=0.11; p=0.60; p=0.39). Appropriate ICD therapies occurred in 6 of 14 (43%) patients with apical HCM and 5 of 50 (10%) patients with other types of HCM (p=0.010). The risk factors of patients with apical HCM patients are shown in Table 2.
Conclusions
Appropriate ICD therapy was more prevalent in patients with apical HCM, compared to patients with other types of HCM. Aggressive intervention such as catheter ablation for ventricular tachycardia and ventricular fibrillation may be considered in patients with apical HCM and higher score of 5-year risk of SCD. Further studies are needed to clarify the manifestations and long-term outcome of apical HCM patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics , Chiba , Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics , Chiba , Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - S Ryuzaki
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - Y Yoshino
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
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Sugawara M, Kondo Y, Yoshino Y, Ryuzaki S, Chiba T, Kitagawa M, Ito R, Nakano MI, Kajiyama T, Nakano MA, Kobayashi Y. Long-term clinical course and prognostic factors of heart failure with reduced ejection fraction (HFrEF) patients underwent primary prophylactic implantable cardioverter defibrillator (ICD). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.380] [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
For decades, ICD is a well-established therapy for improving prognosis of structural heart disease with severe cardiac dysfunction, and ICD for primary prophylaxis against sudden cardiac death were routinely provided. However, long-term prognosis and clinical course are different in each individual patient with an ICD, and it is moreover unclear what kind of factors might have influences on their clinical outcomes.
Purpose
The aim of this study is to clarify long-term prognosis and predictors of future major adverse cardiac events (MACEs) in HFrEF patients with an ICD as primary prophylaxis in Japanese population.
Methods
We retrospectively analyzed our ICD database. Patients underwent primary prophylactic ICD implantation from 2006 to 2020 at our institute and met the criteria of ICD recommendation of the latest Japanese guideline. Its requirements are receiving optimal medication therapy, symptomatic heart failure (New York Heart Association classification II or greater), and severe cardiac dysfunction (left ventricular ejection fraction (LVEF) is 35% or less). Additionally, prior NSVT is considered Class I ICD recommendation. In the case of ischemic cardiomyopathy (ICM), ICD implantation was done at least 40 days after myocardial infarction and at least 90 days after revascularization. MACEs were defined as composite outcome of cardiovascular death, heart failure hospitalization, and appropriate ICD therapies.
Results
A total of 148 consecutive patients were enrolled (male, 120 (81%); age, 62.1±11.8 years; LVEF, 23.0±5.86%; left ventricular end-diastolic diameter (LVDd), 67.6±9.26mm; paroxysmal or persistent atrial fibrillation (AF), 38 (26%); NSVT, 113 (76%); use of class III antiarrhythmic drugs, 48 (32%); ICM, 49 (33%); cardiac resynchronization therapy (CRT), 63 (43%)). One hundred twenty patients (81%) were programmed with a shock-only zone over 200 beats per minute. The median follow-up duration was 58.5 months. Among those 148 patients, MACEs were occurred to 60 patients (41%). As a result of dividing all patients into two groups by the occurrence of MACE, LVEF and LVDd were worse in MACE(+) group, whereas, MACE(−) had greater number of co morbidities. The results of cox-regression analysis showed LVDd (HR: 1.07, 95% CI: 1.03–1.12, p<0.001), AF (HR: 2.88, 95% CI: 1.56–5.31, p<0.001) and ICM (HR: 1.78, 95% CI: 1.00–3.16, p=0.049) were the independent predictors of MACEs (Table). However, initial ICD programming was not related to the occurrence of MACE.
Conclusions
The incidence of MACEs in patients with an ICD and severe HFrEF was substantially high in this Japanese population. Etiology of ICM, left ventricle size, and AF were the potential risk factors for future MACEs.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Sugawara
- Chiba University Hospital , Chiba , Japan
| | - Y Kondo
- Chiba University Hospital , Chiba , Japan
| | - Y Yoshino
- Chiba University Hospital , Chiba , Japan
| | - S Ryuzaki
- Chiba University Hospital , Chiba , Japan
| | - T Chiba
- Chiba University Hospital , Chiba , Japan
| | - M Kitagawa
- Chiba University Hospital , Chiba , Japan
| | - R Ito
- Chiba University Hospital , Chiba , Japan
| | - M I Nakano
- Chiba University Hospital , Chiba , Japan
| | - T Kajiyama
- Chiba University Hospital , Chiba , Japan
| | - M A Nakano
- Chiba University Hospital , Chiba , Japan
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Ito R, Suzuki S, Nishiyama N. Lung cancer surgery after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment. Surg Case Rep 2022; 8:173. [PMID: 36129588 PMCID: PMC9490712 DOI: 10.1186/s40792-022-01531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
Background The spread of COVID-19 infection increased the number of patients who underwent pulmonary resection for lung cancer after COVID-19 infection. It is unclear how previous infection with COVID-19 affects perioperative complications and acute exacerbation of interstitial pneumonia after surgery in patients with interstitial pneumonia. Case presentation An 80-year-old man was referred to our hospital because of a tumor in his left lung. Chest computed tomography showed a 28-mm nodule in the lower lobe of the left lung and usual interstitial pneumonia in bilateral lungs. Bronchoscopic examination was performed, which diagnosed squamous cell carcinoma. Pulmonary function testing revealed restrictive ventilatory impairment, and we planned to perform basal segmentectomy of the left lung. However, before the planned surgery, the patient contracted symptomatic COVID-19. Chest computed tomography revealed ground-glass opacities owing to COVID-19. The patient was admitted for surgery 7 weeks after COVID-19 infection. Preoperatively, pulmonary function testing was repeated, which revealed decreased % vital capacity (%VC) and % diffusing capacity for carbon monoxide (%DLco). The 6-min walk test indicated a distance of 500 m, and the percutaneous oxygen saturation at the end of the test was 94%. Basal segmentectomy of the left lung was performed by video-assisted thoracoscopic surgery. The patient’s postoperative course was favorable, and he was discharged without the need for oxygen inhalational therapy 12 days after the surgery. Pathological examination of the resected specimen revealed usual interstitial pneumonia in the non-cancerous areas of the lung. Additionally, the infiltration of immature fibroblasts in the alveoli and perivascular infiltration of inflammatory cells were observed, which were consistent with fibrotic change after inflammation owing to COVID-19. Three months after the surgery, the patient was alive without recurrence or acute exacerbation of the interstitial pneumonia. Pulmonary function testing 6 weeks after surgery revealed decreased %VC and %DLco. Testing 12 weeks after surgery revealed persistently decreased %VC and improved %DLco (Table 1).Pulmonary function test results before and after COVID-19 infection and 6 and 12 weeks after surgery | VC (ml) | %VC (%) | %DLco (%) |
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Before COVID-19 infection | 2070 | 71.9 | 74.9 | 7 weeks after COVID-19 infection | 1700 | 59.6 | 51.9 | 6 weeks after surgery | 1500 | 52.6 | 53.1 | 12 weeks after surgery | 1510 | 53.0 | 61.7 |
%VC % vital capacity, %DLco % diffusing capacity for carbon monoxide Conclusion We successfully performed basal segmentectomy of the left lung for lung cancer 7 weeks after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment.
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Ito R, Suzuki S, Nishiyama N. Large Tumor Size and High Neutrophil-to-lymphocyte Ratio Predicts Poor Prognosis After Pneumonectomy or Sleeve Lobectomy in Patients With Non-small-cell Lung Cancer. Anticancer Res 2022; 42:3029-3034. [PMID: 35641275 DOI: 10.21873/anticanres.15788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are useful biomarkers in non-small cell lung cancer (NSCLC). The aim of this study was to identify novel prognostic factors after pneumonectomy or sleeve lobectomy. PATIENTS AND METHODS The clinical courses of 68 patients with NSCLC who underwent pneumonectomy or sleeve lobectomy were retrospectively investigated. RESULTS High NLR (p=0.002) and PLR (p=0.006), and large tumor (>40 mm) (p=0.024) were indicative of poor prognosis in univariate analysis. High NLR (p=0.021) and large tumor (>40 mm) (p=0.017) remained independent factors indicating poor prognosis in multivariate analysis. Eighteen patients with both high NLR and large tumor (>40 mm) had significantly poorer prognoses than the remaining patients, 10 of them having recurrences within a short time after surgery. CONCLUSION A high NLR and large tumor size indicate a poor prognosis after pneumonectomy or sleeve lobectomy. Our findings may be helpful in selecting optimal treatments for this subgroup of patients.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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12
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Chiba T, Kajiyama T, Yutaka Y, Ryuzaki S, Sugawara M, Kitagawa M, Ito R, Nakano M, Nakano M, Kondo Y, Kobayashi Y. Association between right ventricular dysfunction and appropriate icd therapy. Europace 2022. [DOI: 10.1093/europace/euac053.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Right ventricular fractional area change (RVFAC) as right ventricular function is recently referred as an independent predictor of sudden cardiac death (SCD). The purpose of this study was to evaluate the association of RVFAC and appropriate ICD therapy in order to determine the cut-off value of RVFAC.
Methods
Consecutive patients who underwent initial ICD implantation for any diseases except for non-dilated phase hypertrophic cardiomyopathy and channelopathy were retrospectively enrolled from 2012 to 2018. Primary endpoint was an initial appropriate ICD therapy. Transthoracic echocardiographic parameters before ICD implantation were evaluated by one physician and one echocardiologist to be validated. Right ventricular dimensions and function were also measured to be analyzed.
Results
In total, 172 patients (60.3±13.6 years, 131 males) including 63 ischemic cardiomyopathy were enrolled. Ninety patients received an ICD as a secondary prophylaxis. Mean LVEF and RVFAC were 38.3±14.3% and 35.8±8.82%, respectively. There was little correlation between RVFAC and LVEF (correlation coefficient =0.274). Regarding appropriate ICD therapy events, the best cut-off value of RVFAC was 34.8%. The odds ratio of low RVFAC was 2.731 (95%CI: 1.456-5.121, P=0.00174). Secondary prophylactic cohort with low RVFAC showed highest incidence of appropriate ICD therapy as shown in the figure. In multivariate analysis, only low RVFAC is an independent predictor of appropriate ICD therapy (HR: 3.53, 95%CI:1.78- 6.99, P=0.0003).
Conclusion
Low RVFAC seemed independently associated with increased appropriate ICD therapy.
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Affiliation(s)
- T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Yutaka
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - S Ryuzaki
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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13
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Sugawara M, Kondo Y, Ryuzaki S, Yoshino Y, Chiba T, Kitagawa M, Ito R, Nakano MI, Kajiyama T, Nakano MA, Kobayashi Y. Negative prognostic implications of non-sustained ventricular tachycardias in patients after prophylactic defibrillator implantation. Europace 2022. [DOI: 10.1093/europace/euac053.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Non-sustained ventricular tachycardia (NSVT) is frequent phenomenon in severe heart failure with reduced ejection fraction (HFrEF) patients, and causes any negative impacts on such patients. In the Japanese Circulation Society (JCS) and Japanese Heart Rhythm Society (JHRS) guidelines, NSVT is regarded as a major component of indication for implantable cardioverter defibrillator (ICD) implantation. However, the long-term prognostic significance of NSVT in severe HFrEF is incompletely resolved.
Purpose
The aim of this study is to investigate the relation between prior NSVT episodes and major adverse cardiac events (MACEs) in HFrEF patients with an ICD as primary prophylaxis.
Methods
We retrospectively analyzed our ICD database. Patients underwent primary prophylactic ICD implantation from 2007 to 2018 following ICD recommendation of JCS and JHRS guidelines. Patients met the criteria of receiving optimal medication therapy, symptomatic heart failure (New York Heart Association classification II or greater), and severe cardiac dysfunction (left ventricular ejection fraction (LVEF) is 35% or less). In the case of ischemic cardiomyopathy (ICM), implantation of ICD was done at least 40 days after myocardial infarction and at least 90 days after revascularization. Incidence of NSVT episodes were identified through daily electrocardiogram (ECG), Holter ECG or monitor ECG in the hospital. MACEs were defined as composite outcome of cardiovascular death, heart failure hospitalization, and appropriate ICD therapies.
Results
A total of 148 consecutive patients were enrolled (male, 120 (81%); age, 62.1±11.8 years; LVEF, 23.0±5.86%; left ventricular end-diastolic diameter (LVDd), 67.6±9.26mm; paroxysmal or persistent atrial fibrillation (AF), 38 (26%); NSVT, 113 (76%); use of class III antiarrhythmic drugs, 48 (32%); ICM, 49 (33%); cardiac resynchronization therapy (CRT), 63 (43%)). The median follow-up duration was 58.5 months. As a result of comparison of the Kaplan-Meier curve between NSVT group (n=113) and non-NSVT group (n=35), cardiovascular death, heart failure hospitalization, and appropriate ICD therapy were not statistically different (Figures). Of those, MACEs were occurred to 60 patients (41%). The results of cox-regression analysis showed LVDd (HR: 1.07, 95% CI: 1.03-1.12, p<0.001), AF (HR: 2.88, 95% CI: 1.56-5.31, p<0.001) and ICM (HR: 1.78, 95% CI: 1.00-3.16, p=0.049) were the independent predictors of MACEs, however NSVT was not (Table).
Conclusions
In this Japanese population, the long-term prognosis of severe HFrEF patients is considered to be comparable regardless of prior NSVT episodes. However, the incidence of MACEs in patients with severe HFrEF after ICD implantation was substantially high. ICM, left ventricle size, and atrial fibrillation were the potential risk factors for MACEs as the previous reports showed.
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Affiliation(s)
| | - Y Kondo
- Chiba University Hospital, Chiba, Japan
| | - S Ryuzaki
- Chiba University Hospital, Chiba, Japan
| | - Y Yoshino
- Chiba University Hospital, Chiba, Japan
| | - T Chiba
- Chiba University Hospital, Chiba, Japan
| | | | - R Ito
- Chiba University Hospital, Chiba, Japan
| | - MI Nakano
- Chiba University Hospital, Chiba, Japan
| | | | - MA Nakano
- Chiba University Hospital, Chiba, Japan
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14
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Affiliation(s)
- S Hanai
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - Y Kobayashi
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - R Ito
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - Y Maejima
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
| | - D Nakagomi
- Department of Rheumatology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan
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15
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Ito R, Nishiyama N. Surgical Techniques of Y-Sleeve Lobectomy in Patients With Primary Lung Cancer. In Vivo 2022; 36:350-354. [PMID: 34972733 DOI: 10.21873/invivo.12709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/27/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The directions of distal and proximal airway stumps were different in Y-sleeve lobectomy. This difference might make Y-sleeve lobectomy a difficult procedure. In this article, we present our surgical techniques and analyse short-term outcomes of Y-sleeve lobectomy. PATIENTS AND METHODS Right middle and lower, left lower, and left lower and lingular segment sleeve lobectomies are categorized in Y-sleeve lobectomy. We retrospectively investigated the clinical courses of 17 patients who underwent Y-sleeve lobectomy from January 2017 to December 2020. RESULTS No treatment-related deaths occurred. One patient developed a bronchopleural fistula. Four patients developed pneumonia and were cured by repeated bronchoscopies and antibiotic therapy. Three patients had retention of pleural effusion, and two had prolonged air leakage. One patient had empyema after prolonged air leakage and was cured by thoracic drainage and antibiotic therapy. CONCLUSION A major complication was observed only in one patient. Y-sleeve lobectomy is a reliable surgical method to avoid pneumonectomy.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
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16
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Ito R, Tsukioka T, Izumi N, Komatsu H, Inoue H, Kimura T, Kishimoto K, Nishiyama N. Lymph Node Metastasis Location and Postoperative Adjuvant Chemotherapy in Patients With pN1 Stage IIB Non-small Cell Lung Cancer. In Vivo 2022; 36:355-360. [PMID: 34972734 DOI: 10.21873/invivo.12710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The benefit of adjuvant chemotherapy for patients with pN1 non-small cell lung cancer (NSCLC) according to the location of lymph node (LN) metastases remains unclear. In this study, we examined the location of LN metastasis and prognosis to identify the significance of adjuvant chemotherapy. PATIENTS AND METHODS Thirty-five patients with pathological T1a-2bN1M0 NSCLC who underwent curative resection between 2010 and 2016 were enrolled in the study. We defined patients with LN metastasis extending in stations 10-12 as the hilar group (n=22), and only in stations 13-14 as the intralobar group (n=13). RESULTS There was a significant difference in the overall survival (OS) (p=0.042) and disease-free survival (DFS) rates (p=0.021) between the intralobar and hilar groups. In the intralobar group, there were no significant differences in the OS and DFS rates according to adjuvant chemotherapy. However, patients without adjuvant chemotherapy had a poorer OS (p<0.001) and DFS rates (p<0.001) in the hilar group. CONCLUSION Prognosis significantly differed according to adjuvant chemotherapy in the hilar group.
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Affiliation(s)
- Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Kazuya Kishimoto
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
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17
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Ito R, Nishiyama N. Completion lower lobectomy after basal segmentectomy for pulmonary sclerosing pneumocytoma with lymph node metastasis. J Surg Case Rep 2021; 2021:rjab492. [PMID: 34804480 PMCID: PMC8598114 DOI: 10.1093/jscr/rjab492] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022] Open
Abstract
A 20-year-old man was referred to our hospital because of a tumor in his left lung. Chest computed tomography showed a 35-mm nodule in the left lower lung lobe. Bronchoscopic examination and cryobiopsy were performed, which revealed suspicion for sclerosing pneumocytoma. We performed basal segmentectomy, and intraoperative-frozen pathological examination revealed no metastases in the segmental lymph nodes. However, the postoperative pathological diagnosis revealed metastasis in these nodes. We performed additional resection of segment 6 (completion lower lobectomy) and hilar and mediastinal lymph node dissection 2 weeks after the first surgery. The postoperative course was favorable, and the patient was discharged 13 days after the second surgery. Pathological examination of the additional resected specimens revealed lymph node metastases in the interlobar and mediastinal lymph nodes. Pulmonary sclerosing pneumocytoma with lymph node metastasis is extremely rare, and its prognosis is unclear. Recurrence has been reported rarely, and long-term follow-up is required.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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18
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Ito R, Yashiro M, Tsukioka T, Izumi N, Komatsu H, Inoue H, Yamamoto Y, Nishiyama N. Pyruvate dehydrogenase E1α represents a reliable prognostic predictor for patients with non-small cell lung cancer resected via curative operation. J Thorac Dis 2021; 13:5691-5700. [PMID: 34795919 PMCID: PMC8575853 DOI: 10.21037/jtd-21-1463] [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: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 12/04/2022]
Abstract
Background Lung cancer is associated with a high morbidity and mortality rate worldwide; however, no reliable and independent prognostic predictor for non-small cell lung cancer (NSCLC) after curative surgery is available. Glucose metabolism is correlated with cancer cell proliferation. Pyruvate dehydrogenase E1α (PDH-E1α) catalyzes the conversion of pyruvate to acetyl-CoA and promotes aerobic glucose metabolism. In this study, we examined the relationship between PDH-E1α expression and clinicopathological factors associated with NSCLC to identify a reliable prognostic predictor of NSCLC after curative surgery. Methods A total of 445 patients with NSCLC who underwent curative resection were enrolled in this study. PDH-E1α expression was evaluated via immunohistochemistry. We analyzed the correlation between PDH-E1α expression and clinicopathological features of the patients. Results In total, 248 (56%) of the 445 patients with NSCLC were PDH-E1α-positive, and 197 patients were PDH-E1α-negative. PDH-E1α positivity was significantly correlated with the presence of adenocarcinoma (P<0.001) compared to the PDH-E1α-negative group. Patients with NSCLC showing PDH-E1α-negative expression had a significantly poorer overall survival rate (P=0.007) than those showing PDH-E1α-positive expression, especially at stage II. Patients with PDH-E1α negative expression also showed a poorer disease-free survival rate (P=0.02). Multivariate analysis revealed that PDH-E1α negativity (P=0.037) and male sex (P<0.001) were significantly correlated with a poor overall survival. Conclusions PDH-E1α may represent a reliable prognostic predictor for NSCLC in patients that have recently undergone curative resection, especially at stage II.
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Affiliation(s)
- Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Masakazu Yashiro
- Molecular Oncology and Therapeutics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Yurie Yamamoto
- Molecular Oncology and Therapeutics, Osaka City University Graduate School of Medicine, Osaka, Japan
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19
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Hida S, Fujita Y, Hatano T, Morishima T, Yamashita J, Murata N, Ito R, Chikamori T. Diagnostic value of simultaneous 99mTc-sestamibi/123I-BMIPP imaging parameters for predicting the improvement of left ventricular wall motion after acute myocardial infarction using CZT SPECT system. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0253] [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
Although the presence of 99mTc-sestamibi/123I-BMIPP-mismatch, the reverse redistribution (RR) of 99mTc-sestamibi and RR of 123I-BMIPP in patients with acute myocardial infarction (AMI) are known to significant markers for predicting the improvement of LV wall motion in the infarcted territory in chronic phase, few studies were performed to analyze them by simultaneous dual-isotope imaging using cadmium-zinc-telluride (CZT) SPECT system.
Purpose
The purpose of this study was to evaluate whether the presence of 99mTc-sestamibi/123I-BMIPP-mismatch or RR of 99mTc-sestamibi, RR of 123I-BMIPP make better prediction of the improvement of LV wall motion in the infarcted territory.
Methods
We evaluated 42 consecutive patients with AMI who had undergone both dual-isotope SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. The presence of 99mTc-sestamibi/123I-BMIPP-mismatch, RR of 99mTc-sestamibi and RR of 123I-BMIPP were determined using traditional definition. The improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was assessed using QGS.
Results
Of 42 patients, the improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was found in 29 patients. The presence of 99mTc-sestamibi/123I-BMIPP-mismatch and RR of 99mTc-sestamibi and RR of 123I-BMIPP were significantly linked to predict the improvement of LV wall motion (p=0.0001, p=0.0001 and p=0.002, respectively). To predict the improvement of LV wall motion in the infarcted territory in chronic phase, the presence of 99mTc-sestamibi/123I-BMIPP-mismatch showed sensitivity of 93%, specificity of 85% and accuracy of 91%, while RR of 99mTc-sestamibi and RR of 123I-BMIPP had sensitivities of 72%, 48%, specificities of 85%, 100% and accuracies of 76%, 64%, respectively. The multivariate discriminant analysis revealed that the combination of 99mTc-sestamibi/123I-BMIPP-mismatch, RR of 99mTc-sestamibi and RR of 123I-BMIPP best predicted the improvement of LV wall motion in the infarcted territory in chronic phase with sensitivity of 93%, specificity of 85% and accuracy of 91% (chi-square=40.6), compared with RR of 99mTc-sestamibi and RR of 123I-BMIPP only (sensitivity 79%, specificity 85% and accuracy of 81%, chi-square=16.9).
Conclusions
The addition of 99mTc-sestamibi/123I-BMIPP-mismatch on RR of 99mTc-sestamibi and RR of 123I-BMIPP in patients with AMI, help better predict the improvement of LV wall motion in the infarcted territory in chronic phase.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Hida
- Tokyo Medical University, Tokyo, Japan
| | - Y Fujita
- Tokyo Medical University, Tokyo, Japan
| | - T Hatano
- Tokyo Medical University, Tokyo, Japan
| | | | | | - N Murata
- Tokyo Medical University, Tokyo, Japan
| | - R Ito
- Tokyo Medical University, Tokyo, Japan
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20
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Takahira H, Kitagawa M, Sugawara M, Chiba T, Kobayashi Y. Prognosis of apical hypertrophic cardiomyopathy in patients with an implantable cardioverter defibrillator. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0627] [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
Prophylactic use of implantable cardioverter-defibrillators (ICDs) to prevent sudden cardiac death (SCD) is widely spread all over the world in patients with hypertrophic cardiomyopathy (HCM). Apical HCM is a phenotype variant of HCM, with hypertrophy predominantly affecting apex, that was initially described 30 years ago. Apical HCM patients may have different clinical prognosis compared with other subsets of HCM. In previous studies, apical HCM patients seem to have a more benign prognosis than other types of HCM. However, little is known about the long-term outcomes of apical HCM and there are many unclear points. Moreover, there are few reports about the clinical prognosis in apical HCM patients with an ICD.
Objective
The aim of this study is to identify the difference between the prognosis of apical and the other HCM patients with an ICD.
Methods
We retrospectively analyzed the database of our ICD clinic. All subjects had been implanted with an ICD from October 2006 to August 2017. We classified HCM patients into LV outflow tract obstruction (LVOTO) and midventricular obstruction (MVO), apical HCM and other non-obstructive types. We divided all the patients into apical and other types of HCM, and examined their background, incidence of appropriate ICD therapies, hospitalization for heart failure, electrical storm and death.
Results
A total of consecutive 62 Japanese HCM patients with an ICD (follow-up period, 86±25 months; age, 67±14 years; male sex, 85%; left ventricular ejection fraction, 57±12%; LV max wall-thickness, 19±5mm; LV apical aneurysm, 9.7%; HCM Risk-SCD, 4.4±3.0) were enrolled in this study. We classified them into 14 apical HCM and 48 other types of HCM patients. The clinical characteristics and major events of these patients are shown in the Figure. During the follow-up periods, there were no significant differences in the incidence of hospitalization for heart failure, electrical storm and death between the 2 groups (p=0.40; p=0.22; p=0.23). Appropriate therapies occurred in 5 of 14 (36%) patients with apical HCM and 4 of 48 (8.3%) patients with other types of HCM (p=0.022).
Conclusions
Appropriate ICD therapy was more prevalent in patients with apical HCM, compared to patients with other types of HCM. However, the incidences of hospitalization for heart failure, electrical storm and death were not significantly different between two groups.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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21
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Takahira H, Kitagawa M, Sugawara M, Chiba T, Kobatashi Y. Risk stratification for ischemic stroke and major bleeding in patients without atrial fibrillation – application of CHA2DS2-VASc and HAS-BLED scores. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most common arrhythmia. AF-related stroke tends to be more severe, and the mortality rate is higher compared with stroke without AF. Recent cardiac implantable electronic devices (CIEDs) have led to an improvement in the early detection of AF episodes. Previous studies showed that AF episodes detected by CIEDs are associated with ischemic stroke. However, little is known about the relationship between new-onset AF and ischemic stroke events in Japanese patients with CIEDs who have no prior AF and take no anticoagulant therapy. ESC guidelines for the management of AF recommend the use of CHA2DS2-VASc score as class I to predict the risk of ischemic stroke in patients with AF. However, the validity of the CHA2DS2-VASc and HAS-BLED scores to predict ischemic stroke and major bleeding events in patients without AF remains unclear.
Objective
The purpose of this study was to identify the incidence of ischemic stroke and major bleeding events in CIEDs patients without AF and assess the validity of CHA2DS2-VASc and HAS-BLED scores in this population.
Methods
We retrospectively analyzed the database of our CIEDs clinic. Every 6 months, CIEDs were checked using remote monitoring system. We examined the characteristics and incidence of ischemic stroke and bleeding events. In addition, we investigated the relationship between CHA2DS2-VASc and HAS-BLED scores and the incidence of these events.
Results
We enrolled 620 consecutive patients who were followed up at our CIED clinic. We excluded patients who had a history of AF or had received anticoagulant therapies, 348 patients (follow-up period, 65±58 months; age, 70±16 years; male sex; 64%; defibrillator, 55%) were included in this study. The mean CHA2DS2-VASc and HAS-BLED scores were 2.8±1.5 points and 1.7±1.6 points, respectively. During the follow-up, 23 (6.6%) and 12 (3.4%) of 348 patients had ischemic stroke and major bleeding events, respectively. The incidence of ischemic stroke and major bleeding events stratified by the CHA2DS2-VASc and HAS-BLED scores were shown in Figure 1.
Conclusion
The risk stratification for ischemic stroke and major bleeding using the CHA2DS2-VASc and HAS-BLED scores is valid in patients without AF.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobatashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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22
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Ono R, Kajiyama T, Ito R, Kobayashi Y. CO sign after mitral valve plasty and tricuspid annuloplasty. QJM 2021; 114:419-420. [PMID: 33580252 DOI: 10.1093/qjmed/hcab032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Ono
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - T Kajiyama
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - R Ito
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Y Kobayashi
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
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23
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Ito R, Matsuda Y, Nishiyama N. Peripheral pulmonary mucous gland adenoma with a cavity mimicking lung cancer. Gen Thorac Cardiovasc Surg 2021; 70:92-95. [PMID: 34528157 DOI: 10.1007/s11748-021-01705-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/04/2021] [Indexed: 11/28/2022]
Abstract
A 71-year-old woman presented to our hospital because of a 10 mm nodule with a cavity in right lower lobe on chest computed tomography. Fluorodeoxyglucose-positron emission tomography showed slight accumulation in the nodule (maximum standard uptake value 2.08). Her serum carcinoembryonic antigen concentration was 5.4 ng/mL. Wedge resection of the tumor was performed for diagnostic and treatment purposes. Findings on intraoperative pathological examination of a frozen section were suspicious for adenocarcinoma. We, therefore, performed a right lower lobectomy and mediastinal lymph node dissection. Postoperative histological examination revealed a mucous gland adenoma. The patient's postoperative course was favorable and she was discharged 7 days after surgery. Four months later, the serum carcinoembryonic antigen concentration had decreased to 3.1 ng/mL. Pulmonary mucous gland adenomas are rarely located peripherally. These benign tumors should be considered, even in the presence of high serum carcinoembryonic antigen concentrations or increased fluorodeoxyglucose uptake on fluorodeoxyglucose-positron emission tomography.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yumi Matsuda
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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24
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Matsuda Y, Ito R, Kimura T, Miki Y, Nishiyama N. Changes in pedicle pericardial fat tissue around the anastomotic site after tracheobronchoplasty. Surg Today 2021; 52:414-419. [PMID: 34468845 DOI: 10.1007/s00595-021-02370-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/10/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Pericardial fat is appropriate tissue to cover the bronchial anastomotic site because its harvesting is minimally invasive. We investigated the changes in pericardial fat tissue around the anastomotic site after pulmonary resection with tracheobronchoplasty. METHODS The subjects of this study were 43 lung cancer patients who underwent pulmonary resection with tracheobronchoplasty. We measured the maximum cross-sectional area and average computed tomography (CT) values of the pedicle pericardial fat pad around the anastomotic site 1 week and then 6 months after the operation. RESULTS The average volume of the residual pedicle pericardial fat pad 6 months postoperatively was 61%. A body mass index (BMI) < 21.2 kg/m2 (P = 0.031) and a blood albumin level < 3.4 g/dl (P = 0.005) were significant predictors of pedicle flap shrinkage. Patients with fat tissue shrinkage had significantly elevated CT values 6 months postoperatively (P = 0.029), whereas those without shrinkage maintained low CT values. CONCLUSIONS Preoperative nutritional conditions, reflected in high BMI and blood albumin levels, correlated with a high residual pedicle pericardial fat pad. Conversely, patients with pedicle flap shrinkage had significantly increased CT values, suggesting that the fat might have taken on another form such as scar tissue.
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Affiliation(s)
- Takuma Tsukioka
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Nobuhiro Izumi
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiroaki Komatsu
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hidetoshi Inoue
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yumi Matsuda
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Ryuichi Ito
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Takuya Kimura
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Noritoshi Nishiyama
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
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25
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Matsuda Y, Ito R, Kimura T, Nishiyama N. Surgical Outcomes in Patients With Centrally Located Non-small Cell Lung Cancer. In Vivo 2021; 35:2815-2820. [PMID: 34410973 DOI: 10.21873/invivo.12568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIM Identification of prognostic factors is helpful in selecting optimal treatment for centrally-located non-small cell lung cancer (NSCLC). This study aimed to detect prognostic factors in patients with centrally-located NSCLC. PATIENTS AND METHODS NSCLCs in the hilar area requiring pneumonectomy or sleeve lobectomy for complete removal are defined as centrally-located NSCLCs. We retrospectively investigated the clinical courses of 45 patients with such lesions. RESULTS Sleeve lobectomies were performed on 33 patients and pneumonectomies on 12. Three and five-year survival rates were 72% and 62%, respectively. Presence of comorbidities (p=0.013), severe symptoms (p=0.001), high white cell count (p=0.001), and pathological T3-4 stage (p=0.004) were identified as independent predictors of poor prognosis. Operative procedures did not correlate with outcomes (p=0.722). CONCLUSION Presence of comorbidities, severe symptoms, high white cell counts, and pathological T stage are independent predictors of poor prognosis. These data can contribute in selecting appropriate treatments for such lesions.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Yumi Matsuda
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
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Ito R, Tsukioka T, Izumi N, Komatsu H, Inoue H, Miyamoto H, Kimura T, Yamamoto S, Nishiyama N. [Sleeve Lobectomy for Right Middle Lobe and S6 Segment Lung Cancer:Report of a Case]. Kyobu Geka 2021; 74:469-471. [PMID: 34059595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 76-year-old man showed an abnormal chest shadow at the follow-up of treated gastric cancer. Chest computed tomography revealed mass lesions in the right middle and left upper lobes, and bronchoscopy revealed a nodular lesion at the entrance of the right B6. The right middle lobe and B6 lesions were diagnosed as lung cancer, and sleeve resection for the right middle lobe and S6 segment was performed. On postoperative day 98, partial resection of the left lung lesion was performed, and the pathological diagnosis was also lung cancer.
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Affiliation(s)
- Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University, Osaka, Japan
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Chiba T, Kajiyama T, Sugawara M, Kitagawa M, Takahira H, Ito R, Nakano M, Nakano M, Kondo Y, Kobayashi Y. Right ventricular function as a predictor of appropriate therapy of implantable cardioverter defibrillator. Europace 2021. [DOI: 10.1093/europace/euab116.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aim
The purpose of this study was to evaluate the association of RV function and appropriate therapy of ICD.Methods: This study was a single-center retrospective cohort study. Consecutive patients who underwent ICD implantation for any diseases were enrolled except for non-dilated phase hypertrophic cardiomyopathy and channelopathy. Transthoracic echocardiographic parameters including left ventricular ejection fraction (LVEF), RV basal diameter, RV end-diastolic area, and right ventricular fractional area change (RVFAC) were evaluated. RV systolic dysfunction was defined as RVFAC <35%. Cox regression analysis was used to analyze the effects of those parameters on appropriate ICD therapy after the implantation.
Results
In total, 151 patients (60.9 ± 13.6 years, 117 males) consisting of 67 old myocardial infarction, 34 dilated cardiomyopathy, 19 cardiac sarcoidosis, and 31 others were enrolled. Eighty patients received an ICD as a secondary prophylaxis. Mean LVEF and RVFAC were 37.8 ± 13.9% and 33.2 ± 10.8%, respectively. RV systolic dysfunction was present in 86 (57.0%) patients, which was significantly associated with ICD therapy (odds ratio 2.313; 95% confidence interval 1.067-5.014; P = 0.034) according to a univariate analysis. There was no correlation between RVFAC and LVEF (correlation coefficient =0.064). Regarding the subjects LVEF > 35%, RV systolic dysfunction was an independent predictor of ICD therapy in a multivariate analysis.
Conclusion
RV systolic dysfunction was independently associated with increased ICD therapy despite of relatively preserved LVEF.
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Affiliation(s)
- T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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28
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Miyamoto H, Ito R, Kimura T, Nishiyama N. Surgical outcomes of primary lung cancers following esophagectomy for primary esophageal carcinoma. Jpn J Clin Oncol 2021; 51:786-792. [PMID: 33442741 DOI: 10.1093/jjco/hyaa254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/22/2020] [Accepted: 12/06/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this retrospective study is to evaluate the perioperative complications and prognosis of patients with a history of resected esophageal carcinoma who subsequently underwent pulmonary resection of a primary lung cancer. METHODS The study cohort comprised 23 patients who had undergone curative resection of a primary lung cancer following esophagectomy for a primary esophageal carcinoma. Clinical characteristics and surgical outcomes were analyzed. RESULTS The initial treatment for esophageal carcinoma was esophagectomy by thoracotomy in 10 patients and video assisted thoracoscopic surgery in 13. The treatments for lung cancer comprised wedge resection in three patients, segmentectomy in seven and lobectomy in 13. The pulmonary resections were performed by thoracotomy in six and video assisted thoracoscopic surgery in 17. The average operating time for the lung cancer surgeries was 202 min and average blood loss 122 ml. There were no perioperative deaths or severe complications. Three- and Five-year overall survival rates were 78.0% and 68.2%. According to univariate survival analysis, age, restrictive ventilatory impairment and histology of lung cancer were significant predictors of poor prognosis (all P < 0.05). Significantly more of the patients with than without restrictive ventilatory impairment died of other diseases (P = 0.0036). CONCLUSIONS Pulmonary resection for primary lung cancers following esophagectomy for esophageal carcinoma is acceptable in selected patients. Such surgery requires caution concerning intrathoracic adhesions and postoperative prolonged air leakage. Patients with restrictive ventilatory impairment had a poorer prognosis, and the indication for surgery in these patients should be carefully considered.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Miyamoto H, Ito R, Kimura T, Nishiyama N. Tumor Size and N2 Lymph Node Metastasis Are Significant Risk Factors for Early Recurrence in Completely Resected Centrally Located Primary Lung Cancer Patients. Anticancer Res 2021; 41:2165-2169. [PMID: 33813428 DOI: 10.21873/anticanres.14989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM In centrally-located lung cancer treatment, it is difficult to attain a sufficient resection margin. It is important to investigate recurrent styles in centrally-located lung cancer patients. PATIENTS AND METHODS Primary lung cancer located at the hilar area that requires pneumonectomy or sleeve lobectomy is defined as centrally-located lung cancer. Early recurrence was defined as that within 1 year after surgery. RESULTS This study included 43 centrally-located lung cancer patients. Ten patients underwent pneumonectomy and 33 underwent sleeve lobectomy. Eleven patients experienced early recurrence. Non-squamous cell carcinoma (p=0.012), tumor size>64 mm (p<0.001) and pathological N2 (p=0.012) were significant predictors for early recurrence by univariate analysis. Also, tumor size >64 mm (p=0.006) and pathological N2 (p=0.019) were independent predictors by multivariate analysis. CONCLUSION Non-squamous cell carcinoma, tumor size and pathological N2 were significant predictors of early recurrence in centrally-located lung cancer. The type of surgical procedure did not affect recurrence development.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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30
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Muto Y, Narita S, Hatakeyama S, Maita S, Chiba S, Kubo K, Aoyama Y, Ito R, Takahashi Y, Takahashi S, Nakamura K, Honma N, Sato H, Koizumi A, Igarashi R, Okane K, Ishida T, Horikawa Y, Kumazawa T, Akihama S, Shimoda J, Suzuki T, Ohyama C, Habuchi T. Short-term outcomes of risk-adapted upfront docetaxel administration in patients with metastatic hormone-sensitive prostate cancer: a multicenter prospective study in Japan. Med Oncol 2021; 38:37. [PMID: 33713196 DOI: 10.1007/s12032-021-01480-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/13/2021] [Indexed: 01/22/2023]
Abstract
We conducted a risk-adapted upfront docetaxel (DOC) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Here, we reported an interim analysis of the study. The study enrolled 68 patients with newly diagnosed mHSPC between 2016 and 2018. According to the presence of visceral metastasis, an EOD score ≥ 3, or prostate-specific antigen (PSA) level at 3 months of ≥ 1 ng/mL, patients were divided into low- and high-risk groups. Patients were treated with androgen deprivation therapy (ADT) with or without bicalutamide; those in the high-risk group received upfront treatment involving six cycles of DOC (70 mg/m2). Short-term treatment effect, adverse events, and quality of life (QOL) were evaluated. Fifty (73.5%) were classified in the high-risk group, and 46 (67%) received upfront ADT + DOC. In the ADT + DOC group, 43.5% (20/46) patients achieved a PSA level ≤ 0.2 ng/mL. PSA nadir and time to PSA nadir were 0.291 ng/mL and 288 days, respectively. In the ADT + DOC group, 76.1% (35/42) patients had adverse events (AEs) of grade ≥ 3. During a median follow-up of 18.5 months, 36.4% (8/22) patients in the ADT group and 43.5% (20/46) in the ADT + DOC group had CRPC. Two QOL scores including the physical status and appetite loss at 6 months significantly worsened in the ADT + DOC group but was resolved by 12 months. Upfront DOC achieved high PSA responses without long-term QOL deterioration. However, the short-term outcomes were limited. Longer follow-up is needed to determine the survival advantage.
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Affiliation(s)
- Yumina Muto
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Shintaro Narita
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Shinya Maita
- Department of Urology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Shuji Chiba
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Kyohei Kubo
- Department of Urology, Hiraka General Hospital, Yokote, Japan
| | - Yuu Aoyama
- Department of Urology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Ryuichi Ito
- Department of Urology, Yuri Kumiai General Hospital, Yurihonjo, Japan
| | | | | | | | - Naoko Honma
- Department of Urology, Akita Kousei Medical Center, Akita, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Atsushi Koizumi
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Ryoma Igarashi
- Department of Urology, Yokote Municipal Hospital, Akita, Japan
| | - Katsumi Okane
- Department of Urology, Akita Kousei Medical Center, Akita, Japan
| | - Toshiya Ishida
- Department of Urology, Akita City Hospital, Akita, Japan
| | - Yohei Horikawa
- Department of Urology, Akita Red Cross Hospital, Akita, Japan
| | - Teruaki Kumazawa
- Department of Urology, Omagari Kousei Medical Center, Akita, Japan
| | - Susumu Akihama
- Department of Urology, Yuri Kumiai General Hospital, Yurihonjo, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Takehiro Suzuki
- Department of Urology, Hiraka General Hospital, Yokote, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Ito R, Takada S, Ludwig A, Wieck AD, Tarucha S, Yamamoto M. Coherent Beam Splitting of Flying Electrons Driven by a Surface Acoustic Wave. Phys Rev Lett 2021; 126:070501. [PMID: 33666445 DOI: 10.1103/physrevlett.126.070501] [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] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
We develop a coherent beam splitter for single electrons driven through two tunnel-coupled quantum wires by surface acoustic waves (SAWs). The output current through each wire oscillates with gate voltages to tune the tunnel coupling and potential difference between the wires. This oscillation is assigned to coherent electron tunneling motion that can be used to encode a flying qubit and is well reproduced by numerical calculations of time evolution of the SAW-driven single electrons. The oscillation visibility is currently limited to about 3%, but robust against decoherence, indicating that the SAW electron can serve as a novel platform for a solid-state flying qubit.
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Affiliation(s)
- R Ito
- Center for Emergent Matter Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Takada
- National Institute of Advanced Industrial Science and Technology, National Metrology Institute of Japan, 1-1-1 Umezono, Tsukuba, Ibaraki 305-8563, Japan
| | - A Ludwig
- Angewandte Festkörperphysk, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - A D Wieck
- Angewandte Festkörperphysk, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - S Tarucha
- Center for Emergent Matter Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Yamamoto
- Center for Emergent Matter Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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32
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Miyamoto H, Ito R, Kimura T, Nishiyama N. Influence of caliber mismatch on patients' clinical course after sleeve lobectomy. Gen Thorac Cardiovasc Surg 2021; 69:1079-1085. [PMID: 33507486 DOI: 10.1007/s11748-020-01582-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/25/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Respiratory complications are critical events after sleeve lobectomy. A caliber mismatch is an important factor in wound healing at the anastomotic site. This study aimed to determine the influence of caliber mismatches on patients' clinical courses after sleeve lobectomy. METHODS We investigated the clinical courses of 56 patients with primary lung cancer who underwent pulmonary resection with end-to-end bronchoplasty. Anastomoses between the main bronchus and the segmental, right upper or middle bronchus, and between the trunks intermedius and the segmental or middle bronchus are categorized as an "anastomosis with caliber mismatch". RESULTS Among the 56 patients, 22 underwent bronchoplasty with caliber mismatch. There were no in-hospital deaths, and the mortality rates at the 30- and 90-day evaluations were zero. Respiratory complications (n = 10, 52%, p = 0.005), such as pneumonia (n = 7, 32%, p = 0.029), retention of pleural effusion (n = 6, 27%, p = 0.026) and bronchopleural fistula (n = 3, 14%, p = 0.027), were significantly increased after bronchoplasty with caliber mismatch. Lower body mass index (BMI) is a significant risk factor for respiratory complications after sleeve lobectomy with caliber mismatch (median value; 23.2 vs 21.2, p = 0.036). CONCLUSIONS Significant respiratory complications are apparent after bronchoplasty with caliber mismatch, especially patients with low BMI have a high risk of respiratory complications. Appropriate patient selection and cautious perioperative management are mandatory for this type of lung-preserving surgery.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
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Hida S, Fujita Y, Igarashi Y, Hatano T, Morishima T, Yamashita J, Murata N, Ito R, Chikamori T. Prediction of the improvement of left ventricular wall motion after acute myocardial infarction by simultaneous dual-isotope imaging with 99mTc-sestamibi/123I-BMIPP using cadmium-zinc-telluride SPECT. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0281] [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/Introduction
Although both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and the reverse redistribution of 99mTc-sestamibi in patients with acute myocardial infarction (AMI) are known to significant markers for predicting the improvement of left ventricular (LV) wall motion in the infarcted territory in chronic phase, few studies evaluated them by simultaneous dual-isotope (99mTc-sestamibi/123I-BMIPP) imaging using cadmium-zinc-telluride (CZT) SPECT system.
Purpose
The purpose of this study was to evaluate whether the presence of 99mTc-sestamibi/123I-BMIPP mismatch or the reverse redistribution of 99mTc-sestamibi make better prediction of the improvement of LV wall motion in the infarcted territory.
Methods
We evaluated 30 consecutive patients with AMI who had undergone both dual-isotope (99mTc-sestamibi/123I-BMIPP) SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. Both 99mTc-sestamibi/123I-BMIPP mismatch and reverse redistribution of 99mTc-sestamibi were determined using traditional definition. The improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was assessed using QGS.
Results
Of 30 patients, the improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was found in 20 patients. Both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and reverse redistribution of 99mTc-sestamibi were significantly linked to predict the improvement of LV wall motion (p=0.0001, p=0.011, respectively). The respective sensitivities, specificities and accuracies in the prediction of the improvement of LV wall motion in the infarcted territory were 90%, 90% and 90% with 99mTc-sestamibi/123I-BMIPP mismatch, and 60%, 90%, 70% with reverse redistribution of 99mTc-sestamibi.
Conclusions
In the simultaneous 99mTc-sestamibi/123I-BMIPP dual-isotope imaging using CZT SPECT system, both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and the reverse redistribution of 99mTc-sestamibi in acute phase are useful for predicting the improvement of LV wall motion in chronic phase, but the presence of 99mTc-sestamibi/123I-BMIPP mismatch is superior to the reverse redistribution of 99mTc-sestamibi for it.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Hida
- Tokyo Medical University, Tokyo, Japan
| | - Y Fujita
- Tokyo Medical University, Tokyo, Japan
| | | | - T Hatano
- Tokyo Medical University, Tokyo, Japan
| | | | | | - N Murata
- Tokyo Medical University, Tokyo, Japan
| | - R Ito
- Tokyo Medical University, Tokyo, Japan
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34
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Asano T, Mitsuhashi Y, Yamashita J, Ito R, Saji M, Wakabayashi K, Yahagi K, Shinke T, Mase T, Miyachi H, Higuchi S, Miyauchi K, Yamamoto T, Nagao K, Takayama M. Relationship between age and the impact of revascularization on mortality in patients with non-ST-elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1766] [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
It is known that the early coronary revascularization in patients with non-ST-elevation myocardial infarction (NSTEMI) was associated with favorable clinical outcomes. However, it is still unclear whether this efficacy is equivalent over all the ages of the patients.
Methods
Patients with NSTEMI were screened from the database of the Tokyo CCU network registry. Of those, the patients treated without revascularization (medical treatment) were matched with the patients receiving revascularization by propensity score matching. The probabilities of in-hospital death were calculated in the logistic regression model. In two subgroups stratified according to median of the age (elderly and non-elderly subgroups), the odds ratios of revascularization for in-hospital death were calculated.
Results
In the patients registered between 2013 and 2017, 4,851 patients with NSTEMI were identified. After the screening, 370 patients with medical treatment were matched with 370 patients treated with revascularization. The incidence of in-hospital death was significantly higher in the patients with medical treatment (20.3% vs 13.0%, P=0.01). The two probability curves of in-hospital death in patients with and without revascularization converged as age increased. In the elderly subgroup, the revascularization was not significantly associated with favorable outcome of mortality, whereas it had a significant impact on mortality in the non-elderly subgroup (odds ratio: 0.47 [95% CI 0.23–0.95]).
Conclusion
The impact of revascularization on short-term mortality in patients with NSTEMI tended to be reduced as age increased.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Asano
- Tokyo CCU Network, Tokyo, Japan
| | | | | | - R Ito
- Tokyo CCU Network, Tokyo, Japan
| | - M Saji
- Tokyo CCU Network, Tokyo, Japan
| | | | | | | | - T Mase
- Tokyo CCU Network, Tokyo, Japan
| | | | | | | | | | - K Nagao
- Tokyo CCU Network, Tokyo, Japan
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35
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Kawamori J, Itasawa T, Fukushima S, Ito R, Haga C, Yamauchi H, Sekiguchi K. PO-0926: Derma-QOL after heparinoid moisturizer for radiation damage in breast-conserving surgery patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00943-9] [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]
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36
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Fujita Y, Hida S, Igarashi Y, Hatano T, Morishima T, Yamashita J, Murata N, Ito R, Chikamori T. Prediction of myocardial viability in chronic phase in patients with acute myocardial infarction by simultaneous dual-isotope imaging with 99mTc-sestamibi/123I-BMIPP SPECT using CZT camera system. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The objective of this study was to determine the optimal cut-off value of % uptake of simultaneous dual-isotope (99mTc-sestamibi/123I-BMIPP) SPECT in patients with acute myocardial infarction (AMI) for prediction of myocardial viability in chronic phase.
Methods
We evaluated 30 consecutive patients with AMI who had undergone both dual-SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. Regional % uptake with a 17-segment model was obtained using QPS software. The presence of myocardial viability was defined when regional % uptake ≥50% in 99mTc SPECT at rest in chronic phase was observed. Receiver operating characteristic (ROC) curves were analyzed to determine the optimal cutoff values of regional % uptake in both left anterior descending artery (LAD) territory and non-LAD coronary territory in acute phase to predict the myocardial viability in chronic phase.
Results
The cutoff values for prediction of viable myocardium were %uptake ≥47% for 99mTc-sestamibi, %uptake ≥31% for 123I-BMIPP in acute phase in LAD territory and %uptake ≥52% for 99mTc-sestamibi, %uptake ≥48% for 123I-BMIPP in non-LAD territory. The respective sensitivities, specificities and the area under the ROC curve (AUC) values in the prediction of myocardial viability were 92%, 92% and 0.94 with 99mTc-sestamibi, 90%, 85%, 0.92 with 123I-BMIPP in LAD territory, and 81%, 93% and 0.92 with 99mTc-sestamibi, 81%, 90%, 0.92 with 123I-BMIPP in non-LAD territory. There were no significant differences in AUC values between 99mTc-sestamibi and 123I-BMIPP in both LAD territory and non-LAD coronary territory.
Conclusions
In the simultaneous 99mTc-sestamibi/123I-BMIPP dual-isotope imaging in patients with AMI, these results suggest that not only 99mTc-sestamibi SPECT, but also 123I-BMIPP SPECT may be possible to predict the presence of myocardial viability in chronic phase. But it should be noted that the optimal cutoff values of regional % uptake in acute phase to predict the myocardial viability may differ for LAD territory and non-LAD coronary territory.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Fujita
- Tokyo Medical University, Tokyo, Japan
| | - S Hida
- Tokyo Medical University, Tokyo, Japan
| | | | - T Hatano
- Tokyo Medical University, Tokyo, Japan
| | | | | | - N Murata
- Tokyo Medical University, Tokyo, Japan
| | - R Ito
- Tokyo Medical University, Tokyo, Japan
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Ito R, Oshima S, Ishii H, Takahashi H, Umemoto N, Sakakibara T, Murohara T. Long term clinical outcome after self-expandable nitinol stent implantation for femoropopliteal occlusive disease in hemodialysis patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2394] [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
Endovascular therapy (EVT) using self-expandable bare nitinol stent (BNS) has been commonly accepted in patients with symptomatic femoropopliteal (FP) occlusive disease. However, poor clinical outcomes in hemodialysis (HD) patients are major problems. We investigated the impact of HD on clinical outcome after EVT in patients with FP disease.
Methods
A total of 427 consecutive HD patients undergoing successful EVT with BNS for FP disease were enrolled with 157 non-HD patients as a control group. They were followed-up for 5 years. We collected data on target lesion revascularization (TLR) rate, and limb salvage rate as well as survival rate. Propensity-score matching analysis was performed to investigate the true impact of HD on the outcome.
Results
Critical limb ischemia was observed in 44.0% of overall population (43.0% in HD group vs. 46.8% in non-HD group, p=0.42). Rates of diabetes (67.1% vs. 58.1%, p=0.045) and coronary artery disease (73.5% vs. 58.3%, p=0.0008) were higher, while age (70±10 years old vs. 76±10 years old, p<0.0001) and TASC2 C/D lesion (27.9% vs. 44.6%, p=0.0002) were lower in HD group compared to non-HD group. Pre-procedural C-reactive protein level (0.4mg/l vs. 0.3mg/l, p=0.045) was higher and serum albumin level (3.6g/dl vs. 3.8g/dl, p=0.0045) was lower in HD group than those in non-HD group. The freedom rate from TLR at 5 years was significantly lower in HD group than in non-HD group [47.2% vs. 65.2%, hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.23–2.64, p=0.0017]. The limb salvage rate was comparable between the groups (93.3% vs. 97.1%, HR 1.57, 95% CI 0.58–5.47, p=0.41), while the survival rate was significantly lower in HD group compared to non-HD group (60.6% vs. 86.0%, HR 2.53, 95% CI 1.56–4.36, p=0.0002). After propensity-score analysis, 250 patients (125 in each group) were matched without any difference of clinical characteristics in both groups. In the matched cohort, the freedom rate from TLR was still lower in HD group compared to non-HD group (46.7% vs. 66.6%, HR 2.25, 95% CI 1.35–3.87, p=0.0019). The adjusted limb salvage rate was consistently similar between the groups (95.4% vs. 97.3%, HR 1.10, 95% CI 0.20–5.94, p=0.91). Also, the adjusted survival rate was lower in HD group than in non-HD group (47.6% vs. 89.9%, HR 3.60, 95% CI 1.89–7.44, p<0.0001).
Conclusion
The freedom rate from TLR at 5 years after BNS implantation for FP disease were significantly lower in HD group than in non-HD group, though the limb salvage rate was similar between the groups. The survival rate was consistently lower in HD group compared to non-HD group. HD status had a great impact on TLR and mortality after EVT with BNS in patients with FP disease.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Ito
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - S Oshima
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - H Ishii
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - H Takahashi
- Fujita Health University School of Medicine, Department of Nephrology, Toyoake, Japan
| | - N Umemoto
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Japan
| | - T Sakakibara
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Miyamoto H, Ito R, Kimura T, Nishiyama N. Combined sleeve lobectomy for centrally located primary lung cancer and lung cancer with hilar lymph node metastasis. Jpn J Clin Oncol 2020; 50:794-799. [PMID: 32211775 DOI: 10.1093/jjco/hyaa037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/10/2020] [Accepted: 03/02/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Centrally located lung cancer or metastatic hilar lymph nodes can invade the airway and other hilar structures, and they must be removed to achieve complete resection. METHODS We retrospectively assessed the clinical course of 47 patients with centrally located lung cancer or metastatic hilar lymph nodes who underwent sleeve lobectomy from January 2010 to December 2017. RESULTS The invaded structure other than the airway was the pulmonary artery in 21 patients, chest wall in 3, esophageal muscular wall in 2, vagus nerve in 2, pericardium in 2, left atrium in 1, phrenic nerve in 1 and superior vena cava in 1. Twenty-four patients were treated with sleeve lobectomy alone (simple sleeve lobectomy), and 23 patients were treated with sleeve lobectomy with additional methods (combined sleeve lobectomy). Adverse events occurred in 10 patients (48%) in the simple sleeve lobectomy group and 7 patients (30%) in the combined sleeve lobectomy group. During the follow-up period, 15 patients developed recurrent disease and 12 patients died. Patients in the combined sleeve lobectomy group had significantly shorter overall survival (P = 0.004) and disease-free survival periods (P = 0.013). Combined sleeve lobectomy was a significantly poor prognostic factor in the univariate and multivariate analyses. Patients who underwent sleeve lobectomy with an additional method other than angioplasty had a significantly poorer prognosis. However, no patient developed recurrent disease in the hilar area. CONCLUSIONS Combined sleeve lobectomy has acceptable adverse events and good local controllability. However, combined sleeve lobectomy is associated with a significantly poorer prognosis than simple sleeve lobectomy in terms of overall survival and disease-free survival.
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Affiliation(s)
- Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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Mizuguchi S, Takahama M, Nakajima R, Inoue H, Ito R, Yamamoto R. Rapid Progression of Tracheoesophageal Fistula Caused by Immunotherapy Administered after Tracheal Stent Placement. Biomed Hub 2020; 4:1-5. [PMID: 31993425 PMCID: PMC6985888 DOI: 10.1159/000501157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/23/2019] [Indexed: 11/19/2022] Open
Abstract
Development of a tracheoesophageal fistula (TEF) is a serious complication of treatment for esophageal or lung cancer, especially following radiation therapy. However, development of a TEF as a complication of chemotherapy or tracheal stenting after surgical debulking is quite uncommon. We herein report a rare case involving a patient with advanced adenocarcinoma invading the mediastinum who rapidly developed a TEF after placement of a tracheal stent and administration of nivolumab immunotherapy. A 55-year-old heavy ex-smoker was diagnosed with lung adenocarcinoma with mediastinal invasion. Nine months after first-line therapy (chemotherapy and radiation therapy), he underwent treatment with nivolumab (3 mg/kg) as fourth-line therapy. Two weeks after the first dose, he underwent mechanical debulking of the tumor with tracheal stenting because of the rapid development of paraesophageal lymph node swelling and severe tracheal stenosis. He received a second dose of nivolumab 2 weeks later; however, imaging studies 12 days after this second dose revealed a huge fistula between the upper trachea and esophagus through a metastatic lymph node. Neither an additional stent nor replacement of the stent was considered because of the fistula site expansion and suffocation risk. Despite further treatment, the patient died of his primary disease 2 months later. Our findings will be of great interest to the readers, especially those involved in the clinical treatment of patients with advanced lung cancer treated by immunotherapy. The knowledge of potentially devastating TEF formation in the presence of transmural tracheal metastasis/invasion will allow clinicians to provide the best possible care for their patients.
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Affiliation(s)
- Shinjiro Mizuguchi
- Department of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Makoto Takahama
- Department of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Ryu Nakajima
- Department of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Ryoji Yamamoto
- Department of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
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Yamabe S, Ito R, Sakakibara T, Yamada A, Ohshima S, Ozaki Y. 1043 Association of left ventricular global longitudinal strain with myocardial perfusion evaluated by 13N-ammonia positron emission tomography in hemodialysis patients with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.635] [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
Global longitudinal strain (GLS) is an echocardiographic marker to detect subclinical left ventricular systolic dysfunction prior to the appearance of reduced left ventricular ejection fraction (LVEF). Reduced GLS identified in patients with maintenance hemodialysis (HD) has been reported to be a predictor of their higher mortality and cardiovascular events. On the other hand, pharmacological stress 13N-ammonia positron emission tomography (13N-NH3-PET) has been an established and reliable imaging modality to evaluate myocardial perfusion expressed as coronary flow reserve (CFR) or maximal stress myocardial blood flow (MBF). CFR and MBF are powerful parameters to detect coronary artery disease and to predict cardiovascular events and mortality. However, association between GLS and those myocardial perfusion parameters are not fully understood.
Purpose:The aim of this study was to evaluate the relationship between GLS and the myocardial perfusion parameters of 13N-NH3-PET in HD patients with preserved LVEF.
Methods
We studied 24 HD patients (mean age 67 years, 67% male) who underwent ATP stress 13N-NH3-PET as well as transthoracic echocardiography including 2-dimensional speckle tracking imaging for suspected ischemic heart disease. Exclusion criteria were as follows: LVEF <50%, moderate to severe valvular diseases, and atrial fibrillation. Myocardial perfusion abnormality (MPA) was defined as CFR <2.0 and/or stress MBF <2.0.
Results
Mean GLS in all patients was -16.2 ± 3.6%. The patients were divided into 2 groups based on GLS: patients with reduced GLS (<-16%) (Group A, N = 11) and those with preserved GLS (≧-16%) (Group B, N = 14). There were no significant differences between 2 groups in age, gender, body mass index, left ventricular mass index, and average E/e’. Nevertheless, Group A had significantly lower stress MBF than Group B (1.7 ± 0.41 vs 2.0 ± 0.33, p = 0.031). In addition, Group A showed more frequent MPA compared with Group B (81.8% vs 42.9%, p = 0.043). There was a moderate correlation between GLS and stress MBF (r = 0.62, p = 0.0012), whereas no significant correlation was noted between GLS and CFR (r = 0.079, p = 0.71).
Conclusion
Reduced GLS was significantly associated MPA. MPA may be one of the major contributors to the reduction in GLS in HD patients with preserved LVEF.
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Affiliation(s)
- S Yamabe
- Fujita Health University, Toyoake, Japan
| | - R Ito
- Kyoritsu Hospital, Nagoya, Japan
| | | | - A Yamada
- Fujita Health University, Toyoake, Japan
| | | | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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Ito R, Takayama M, Yamashita J, Yahagi K, Shinke T, Mase T, Abe K, Miyaji H, Higuchi S, Tanaka H, Yamazaki M, Miyauchi K, Yamamoto T, Nagao K, Chikamori T. P850Clinical difference of recent myocardial infarction compared with acute myocardial infarction - Insights from Tokyo CCU network multicenter registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0448] [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
Although the patient's characteristics and outcome of acute myocardial infarction (AMI) have been sufficiently investigated and primary percutaneous coronary intervention (PCI) has been recognized as established treatment strategy, those of recent myocardial infarction (RMI) have not been fully evaluated.
Purpose
The purpose of the present study was to clarify clinical characteristics and in-hospital outcomes of RMI patients from the database of the Tokyo CCU network multicenter registry.
Methods
In Tokyo CCU network multicenter registry database from 2013 to 2016, 15788 consecutive patients were registered as AMI (within 24 hours from onset) and RMI (within 2–30 days from onset). However 1246 patients were excluded because of inadequate data. And we excluded 66 cases because of out of onset period and 129 cases that strongly suspected of involvement of vasospastic events. Therefore, remaining 14347 patients were categorized to RMI group (n=1853) and AMI group (n=12494), and analyzed.
Results
Compared with AMI group, average age was older (70.4±12.9 vs 68.0±13.4 years, p<0.001), male was less (72.4 vs 76.4%, p<0.001), chest pain as chief complaint was less (75.2 vs 83.6%, p<0.001), prevalence of diabetes mellitus was higher (35.9 vs 31.0%, p<0.001), multi-vessel coronary disease was more (54.7 vs 44.6%, p<0.001), patients undergoing PCI was less (79.0 vs 91.2%, p<0.001), and the incidence of mechanical complication was more in RMI group (3.0 vs 1.5%, p<0.001). Although 30-day mortality was equivalent between 2 groups (5.3 vs 5.8%, p=0.360), the major cause of death in AMI group was cardiogenic shock, while in the RMI group it was a mechanical complication. On Kaplan-Meier analysis, the 2 groups had significantly different cumulative incidence of death due to cardiogenic shock (p=0.006, Log-rank test) and mechanical complication (p=0.021, Log-rank test). Furthermore death due to mechanical complication in AMI group was plateau after about 1 week from hospitalization, whereas in RMI group it continued to increase.
Kaplan-Meier analysis
Conclusions
RMI patients had distinctive clinical features in backgrounds and treatment strategies compared with AMI patients, and the major cause of death of RMI patients was different from that of AMI patients. Furthermore, even though treatment during hospitalization of RMI patients was well done, death due to mechanical complications continued to increase.
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Affiliation(s)
- R Ito
- Tokyo Medical University, Department of Cardiology, Tokyo, Japan
| | | | | | | | | | - T Mase
- Tokyo CCU Network, Tokyo, Japan
| | - K Abe
- Tokyo CCU Network, Tokyo, Japan
| | | | | | | | | | | | | | - K Nagao
- Tokyo CCU Network, Tokyo, Japan
| | - T Chikamori
- Tokyo Medical University, Department of Cardiology, Tokyo, Japan
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Okamoto R, Hashizume R, Ito R, Suzuki N, Kiyonari H, Ito M. P5437The BNP reporter mouse by knock-in technology is useful for the analysis of mechanism in reactivation of BNP in adult heart. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0393] [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
It has been thought BNP is induced by undetermined stretch-activated receptors, however, which receptor is associated remains unknown. The stretch-activated receptors include mechanically gated channels, which can be activated by a mechanical stimulus alone, and mechanically modulated channels, which require nonmechanical stimuli such as agonists. It has been recently shown that 1.1kb segment of mouse NPPB promoter dose not reproduce the pattern of reactivation of BNP in adult heart, although it could monitor the expression of BNP in neonatal cardiomyocytes.
Purpose
Our aim is to develop a true BNP reporter mouse and examine whether this mouse is useful or not for the investigation of BNP reactivation mechanism in adult heart and for the measurement of serum-induced BNP expression in patients with heart failure.
Methods
We generated the BNP reporter mice by knocking luciferase cDNA in the initiation site of NPPB. In vivo imaging of luciferase was performed in the BNP reporter mice after the intraperitoneal injection of luciferin. The luciferase activity was examined in neonatal cardiomyocyte, isolated adult cardiomyocytes, adult cardiac dissected tissue with or without 120–150% stretch or angiotensin II stimulation. Left anterior descending (LAD) coronary artery was ligated to study myocardial infarction. Cardiac dissected tissue segments from the BNP reporter mouse were incubated for 8 hours with 20% serum from patients with or without heart failure and the luciferase activity was measured after homogenization.
Results
The in vivo imaging system showed the activity of BNP was high in 1 day-old neonates and the reactivation of BNP in the adult heart after LAD ligation could be monitored by the luciferase activity (figure). The treatment of Ang II could increase the activity of pBNP more than ten folds in heart tissue from adult mice. On the other hand, the 120–150% stretch did not show any effect on the activity of pBNP in this system. We could not observe any activation of pBNP in cultured neonatal or adult cardiomyocytes demonstrated by immunostain with antibodies against luciferase after 120–150% stretch. Interestingly, the luciferase activity was extensively higher in cultured heart tissue segments from the BNP reporter mice after the treatment of serum from patients with heart failure than without heart failure.
In vivo imaging of BNP reporter mice
Conclusion
These results indicate the BNP reporter mouse by knock-in technology is useful for the analysis of mechanism in reactivation of BNP in adult heart and the elevation of BNP in patients of heart failure partly due to the serum-derived induction of BNP from heart.
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Affiliation(s)
- R Okamoto
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - R Hashizume
- Mie University Graduate School of Medicine, Department of Pathology and Matrix Biology, Tsu, Japan
| | - R Ito
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - N Suzuki
- Mie University Life Science Research Center, Department of Animal Genomics, Functional Genomics Institute, Tsu, Japan
| | - H Kiyonari
- RIKEN Center for Life Science Technologies, Animal Resource Development Unit and Genetic Engineering Team, Kobe, Japan
| | - M Ito
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
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Kumada Y, Ishii H, Oshima T, Sakakibara T, Ito R, Takahashi H, Murohara T. P1959Impact of hemodialysis in patients undergoing bypass surgery for peripheral arterial disease - 10-year follow-up study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0706] [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
Although lower extremities bypass surgery has been commonly performed as the standard option to treat peripheral artery disease (PAD) even in patients on hemodialysis (HD) as well as general population, poorer prognosis still remains major problems in this specific population. In this 10-year follow-up study, we investigated the impact of HD after surgical revascularization in patients with PAD.
Methods
A total of 660 patients undergoing successfully bypass surgery were enrolled. Patients with acute limb ischemia were excluded. We compared 392 HD patients with 428 limbs and 268 non-HD (NHD) patients with 296 limbs during 10 years follow-up period. Primary endpoint was defined as major adverse cardiovascular events (MACE) including all-cause death, non-fatal myocardial infarction and stroke. Second endpoint was major adverse limb events (MALE) including any revascularization and major amputation. To minimize the differences of clinical characteristics between the two groups, propensity score adjusting with all baseline variables was performed.
Results
Prevalence of diabetes (53.3% vs. 35.2%), critical limb ischemia (77.5% vs. 52.1%) and infra-popliteal artery (48.2% vs. 19.6%) were higher in HD group compared to NHD group (p<0.0001 in all), inversely, age was younger in HD group than in NHD group (67±9 years vs. 71±9 years, p<0.0001). The 30-day mortality rate was comparable (3.1% in HD group vs. 1.5% in NHD group, p=0.19). The 10-year event-free survival rate for MACE was significantly lower in HD group compared to NHD group (45.3% vs. 67.4%, p<0.0001) and for MALE (60.0% vs. 80.0%, p=0.0007), respectively. After propensity score adjustment, the freedom rate from MACE was still lower in HD group compared to NHD group [45.6% vs. 67.6%, hazard ratio (HR) 1.89, 95% confidence interval (CI) 1.33–2.72, p=0.0003], however, the rate from MALE was statistically comparable between the two group (65.7% vs. 76.9%, 1.27, 95% CI 0.87–1.90, p=0.21). Furthermore, although the 10-year limb salvage rate was crudely lower in HD group compared to NHD group (80.6% vs. 91.6%, HR 1.57, 95% CI 1.05–2.40, p=0.0027), it was comparable after propensity score adjustment (89.4% vs. 90.1%, HR 1.09, 95% CI 0.59–1.88, p=0.79). Also, the mortality rate was consistently lower in HD patients (adjusted HR 2.37, 95% CI 1.62–3.50, p<0.0001).
Conclusion
The long-term freedom rate from MACE and mortality was markedly lower in HD patients compared to non-HD patients. However, the rate from MALE, especially limb salvage rate was similar between HD and NHD after adjustment for clinical characteristics. These results suggest that detection at the early stage of PAD may potentially improve the poor outcomes in this high risk population.
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Affiliation(s)
- Y Kumada
- Matsunami General Hospital, Cardiovascular Surgery, Kasamatsu, Japan
| | - H Ishii
- Nagoya University Graduate School of medicine, Cardiology, Nagoya, Japan
| | - T Oshima
- Nagoya Kyoritsu Hospital, Cardiology, Nagoya, Japan
| | - T Sakakibara
- Nagoya Kyoritsu Hospital, Cardiology, Nagoya, Japan
| | - R Ito
- Nagoya Kyoritsu Hospital, Cardiology, Nagoya, Japan
| | - H Takahashi
- Fujita Health University, School of Medical Science, Toyoake, Japan
| | - T Murohara
- Nagoya University Graduate School of medicine, Cardiology, Nagoya, Japan
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Hayashi T, Ito R, Takahira H, Kobayashi Y. P5649Impact of atrial fibrillation detected by implantable cardioverter-defibrillators on future stroke events in patients with heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0592] [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
Atrial fibrillation (AF) is the most common type of arrhythmia. AF-related stroke tends to be more severe, and the mortality rate is higher compared with stroke without AF. The definition of AF in patients with implanted cardioverter-defibrillators (ICDs) is not clear and the appropriate treatment guideline for patients with AF episode has not established yet. Recent ICDs have led to an improvement in the early detection of AF episodes, especially in patients who are asymptomatic. Previous studies showed that atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices are associated with embolic stroke events. However, little is known about the incidence of AF and stroke events in Japanese heart failure patients with an ICD.
Objective
The purpose of this study was to identify the incidence of embolic stroke events in heart failure patients with and without AF events detected by ICDs and examine the risk factors of embolic stroke events.
Methods
We retrospectively analyzed the database of our hospital. Every 6 months, AF events were checked by ICDs. AF30 was defined as AF episodes lasting for ≥30 seconds detected by ICDs. We examined the characteristics and incidence of embolic stroke events and investigated the relationship between AF30 and the incidence of embolic stroke events.
Results
We enrolled 215 consecutive patients who had no prior AF and took no anticoagulant in this study (follow-up period, 58±35 months; age, 62±15 years; male sex, 75%). The mean CHADS2 score and CHA2DS2-VASc score were 2.4±0.8 points and 3.8±1.2 points, respectively. The mean HAS-BLED score was 2.1±1.0 points. During the follow-up, 14 of 215 patients (6.5%) had embolic stroke events. Nine patients (5.8%/year) and 5 patients (0.65%/year) had embolic stroke events with and without AF30, respectively. The comparison of characteristics among patients with and without embolic stroke events was shown in Table. In multivariate logistic regression analysis, independent predictors for embolic stroke events were new-onset episode of AF30 (odd ratio [OR] 21, 95% confidence interval [CI] 4.8–120, P<0.0001) and an enlarged left atrium ≥40mm (OR 14, 95% CI 2.2–304, P=0.0029).
Conclusions
Embolic stroke events were common in Japanese heart failure patients with an ICD. AF30 and enlarged left atrium were the risk factors of embolic stroke events in this population. Therefore, when physicians detect new-onset AF in patients with an ICD, they should consider a comprehensive assessment of the risk and benefit of prescribing an anticoagulant.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Hayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Hayashi T, Ito R, Takahira H, Kobayashi Y. P3705Impact of subclinical atrial fibrillation detected by cardiac implantable electronic devices on the risk of future embolic stroke events from Far East. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0559] [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
Atrial fibrillation (AF) is the most common type of arrhythmia. AF-related stroke tends to be more severe, and the mortality rate is higher compared with stroke without AF. The definition of AF in patients with cardiac implantable electronic devices (CIEDs) is not clear and the appropriate treatment guideline for patients with AF episode has not established yet. Recent CIEDs have led to an improvement in the early detection of AF episodes, especially in patients who are asymptomatic. Previous studies showed that atrial high-rate episodes (AHREs) detected by CIEDs are associated with embolic stroke events. However, little is known about the incidence of AF and stroke events in Japanese patients with CIEDs who have no prior AF and take no anticoagulant.
Objective
The purpose of this study was to identify the incidence of embolic stroke events in patients with and without AF events detected by CIEDs and examine the risk factors of embolic stroke events.
Methods
We retrospectively analyzed the database of our hospital. Every 6 months, AF events were checked by CIEDs. AF30 was defined as AF episodes lasting for ≥30 seconds detected by CIEDs. We examined the characteristics and incidence of embolic stroke events and investigated the relationship between AF30 and the incidence of embolic stroke events.
Results
We enrolled 348 consecutive patients who had no prior AF and took no anticoagulant in this study (follow-up period, 65±58 months; age, 70±16 years; male sex; 64%; defibrillator, 55%). The mean CHADS2 score and CHA2DS2-VASc score were 1.8±1.1 points and 2.8±1.5 points, respectively. The mean HAS-BLED score was 1.7±1.2 points. During the follow-up, 23 of 348 patients (6.6%) had embolic stroke events. Thirteen patients (4.1%/year) and 10 patients (0.63%/year) had embolic stroke events with and without AF30, respectively. The comparison of characteristics among patients with and without embolic stroke events was shown in Table. In multivariate logistic regression analysis, independent predictors for embolic stroke events were new-onset episode of AF30 (odd ratio [OR] 5.3, 95% confidence interval [CI] 2.2–13, P=0.0003) and an enlarged left atrium ≥40mm (OR 3.1, 95% CI 1.2–7.9, P=0.016).
Conclusions
Embolic stroke events were common in Japanese patients with CIEDs. AF30 and enlarged left atrium were risk factors of embolic stroke events in this population. Therefore, when physicians detect new-onset AF in patients with CIEDs, they should consider a comprehensive assessment of the risk and benefit of prescribing an anticoagulant.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Hayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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Ito R, Oshima S, Ishii H, Sakakibara T, Yamabe S, Umemoto N, Murohara T. P1583The association of carotid atherosclerosis, protein-energy wasting and inflammation status with mortality in patients on haemodialysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0343] [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
Carotid atherosclerosis such as increased intima-media thickness (IMT) is associated with poor cardiovascular outcome. On the other hand, protein-energy wasting (PEW) or malnutrition, currently considered to be due to inflammatory process rather than poor nutritional intake, is highly prevalent in in chronic kidney disease (CKD) patients, particularly those on haemodialysis (HD). We investigated the association of carotid atherosclerosis, PEW and inflammation, and their joint role with prediction of mortality in chronic HD patients.
Methods
Carotid ultra-sound was performed in a total of 774 CKD patients stably undergoing HD therapy. Carotid atherosclerosis is defined as IMT>0.8mm as median value with hyperechoic plaque. Geriatric nutritional risk index (GNRI) which calculated from serum albumin levels, body weight and height as a surrogate marker of the PEW, and C-reactive protein (CRP) were measured at the same point. Patients were followed-up for 7 years.
Results
Declined GNRI and elevated CRP levels were independently associated with carotid atherosclerosis [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.93–0.98, p=0.0082 and OR 1.30, 95% CI 1.04–1.64, p=0.019, respectively] accompanied with age (OR 1.03, 95% CI 1.01–1.05, p=0.0024) and hypertension (OR 1.78, 95% CI 1.12–2.91, p=0.013). During follow-up period (median of 67 months), 180 patients (23.3%) died. Carotid atherosclerosis [62.7% vs. 79.3% for 7-year survival rate, hazard ratio (HR) 1.57, 95% CI 1.12–2.16, p=0.0078], GNRI<91.2 as an established cut-off value (58.8% vs. 83.7%, HR 1.87, 95% CI 1.35–2.59, p=0.0002) and CRP>1.1 mg/l as a median value (65.8% vs. 88.6%, HR 2.87, 95% CI 2.00–4.22, p<0.0001) were identified as independent predictors of mortality after adjustment for other confounders. When patients were divided into groups according to number of these three risk factors, 7-year Kaplan-Meier survival rate was 92.7%, 91.1%, 56.8% and 37.2% among groups with no risk factor, any 1 risk factor, any 2 risk factors and all risk factors, respectively (p<0.0001 for trend). After adjustment for other confounders, patients with any 1, any 2 and all risk factors had 2.21-fold (95% CI 1.26–4.14), 5.44-fold (95% CI 3.13–10.1) and 7.19-fold (95% CI 3.67–14.6) higher risk for mortality compared to those without any risk factor, respectively (p<0.0001 for trend).
Conclusions
Presence of carotid atherosclerosis was closely associated with both declined GNRI and elevated CRP levels in CKD patients on HD. Combination of these predictors was also additively associated with an increasing risk of mortality. These results clearly manifested the so-called malnutrition, inflammation and atherosclerosis (MIA) syndrome in this high-risk population.
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Affiliation(s)
- R Ito
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - S Oshima
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - H Ishii
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Sakakibara
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - S Yamabe
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - N Umemoto
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
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Kajiyama T, Kondo Y, Nakano MA, Nakano MI, Hayashi T, Ito R, Takahira H, Kobayashi Y. P6552Is it possible to recognize free-wall implantation of leadless pacemakers from an ECG? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1142] [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
Leadless pacemaker (Micra, Medtronic, US) is a effective treatment for bradycardia and eliminates any malfunctions related to intravenous leads. However, some cases exhibit pericardial effusion, presumably associated to device implantation to right ventricular free-wall.
Objectives
The present study was carried out to find ECG features during ventricular pacing by Micra, which enabled to distinguish free-wall implantation from septal implantation without imaging modalities.
Methods
Consecutive 21 patients who received implantation of Micra in our facility were enrolled. Location of device in the right ventricle was evaluated using echocardiography or computed tomography in order to determine whether the device was implanted on the septum or the freewall. The difference of 12-lead ECG during ventricular pacing from Micra were analyzed between the septum group and the free wall group.
Results
According to the imaging investigation, body of Micra was clearly identifiable in 17 patients. The locations of device were classified into septum in 11 patients, free-wall in 4 patients, and indeterminate but apex in 2 patients. Further analysis regarding ECG was performed exclusively between the septum group and the free-wall group. In lead V1, peak deflection index (PDI) was significantly larger in free-wall group than septum group (0.64±0.06 vs. 0.45±0.10, P=0.005), whereas there was no difference of QRS duration, transitional zone and QRS pattern.
PDI of V1 and Location of LPM
Conclusion
PDI of V1 could be useful to predict implantation of Micra to free-wall and may potentially stratify the risk of postprocedural pericardial effusion.
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Affiliation(s)
- T Kajiyama
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - Y Kondo
- Chiba University Hospital, Departemnt of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M A Nakano
- Chiba University Hospital, Departemnt of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M I Nakano
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - T Hayashi
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
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Takahashi H, Ishii H, Kumada Y, Oshima T, Sakakibara T, Ito R, Murohara T, Ozaki Y. P1582Prognostic value of C-reactive protein/albumin ratio for cardiovascular morbidity and mortality in end-stage renal disease patients with incident haemodialysis therapy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0342] [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
Hypoalbuminemia, a manifestation of protein-energy wasting or malnutrition, is commonly observed in patients with end-stage renal disease (ESRD), and is associated with chronic inflammation and increasing cardiovascular (CV) risk. Recently, C-reactive protein (CRP)/albumin ratio at discharge is reportedly a well-predictor of mortality in severe sepsis or cancer patients.
We investigated prognostic value of the CRP/albumin ratio at just starting haemodialysis (HD) therapy for CV morbidity and mortality in patients with ESRD.
Methods
A total of 1,548 ESRD patients were enrolled and were divided into quartiles according to CRP/albumin levels at initiation of HD; quartile 1 (Q1): <0.22, Q2: 0.23–0.54, Q3: 0.55–1.83 and Q4: >1.84. They were followed up for 10-year after starting HD therapy. Primary endpoint was CV events defined as hospitalization due to CV events such as cardiac disease, stroke and peripheral artery disease and CV death. We also evaluated the incremental value with C-index when CRP alone, albumin alone and the CRP/albumin ratio were added into a model with established risk factors.
Results
During follow-up period (median: 59 months), 512 cases experienced CV events (33.1%) including 165 cases of CV deaths (10.7%). Kaplan-Meier analysis shows that CV event-free survival rates for 10 years were 63.5%, 53.8%, 47.5% and 31.9% in Q1, Q2, Q3 and Q4, and that CV survival rates were 90.4%, 83.9%, 77.2% and 64.6% in Q1, Q2, Q3 and Q4, respectively (p<0.0001 in both). After adjustment for all baseline variables, elevated CRP/albumin ratio was identified as an independent predictor for CV events [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.11–2.07, p=0.0093 for Q2 vs. Q1, HR 1.79, 95% CI 1.33–2.42, p<0.0001 for Q3 vs. Q1and HR 2.27, 95% CI 1.70–3.07, p<0.0001 for Q4 vs. Q1, respectively]. As to CV mortality, similar results were obtained (HR 1.80, 95% CI 0.98–3.44, p=0.056 for Q2 vs. Q1, HR 2.56, 95% CI 1.45–4.71, p=0.0009 for Q3 vs. Q1 and HR 2.66, 95% CI 1.53–4.86, p=0.0004 for Q4 vs. Q1, respectively). Furthermore, adding the CRP/albumin ratio to a baseline model with established risk factors improved the C-index greater than that of CRP alone or albumin alone, respectively (0.715 from 0.692, p=0.0095 and from 0.683, p=0.0019)
Conclusion
The CRP/albumin ratio, which easily available from daily practice, could strongly stratify the risk of future CV morbidity and mortality in ESRD patients who need HD therapy.
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Affiliation(s)
- H Takahashi
- Fujita Health University School of Medicine, Cardiology, Toyoake, Japan
| | - H Ishii
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya, Japan
| | - Y Kumada
- Matsunami General Hospital, Cardiovascular Surgery, Kasamatsu, Japan
| | - T Oshima
- Nagoya Kyoritsu Hospital, Cardiology, Nagoya, Japan
| | - T Sakakibara
- Nagoya Kyoritsu Hospital, Cardiology, Nagoya, Japan
| | - R Ito
- Nagoya Kyoritsu Hospital, Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya, Japan
| | - Y Ozaki
- Fujita Health University School of Medicine, Cardiology, Toyoake, Japan
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Mizuguchi S, Takahama M, Nakajima R, Inoue H, Ito R, Nomura N, Yamamoto R. P1.05-10 Usefulness of Respiratory Dilatation Balloon in Tracheobronchial Stenosis Requiring Silicone Y-Stent Treatment. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.762] [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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50
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Ito R, Oshima S, Ishii H, Sakakibara T, Yamabe S, Umemoto N, Murohara T. P6376Drug-coated balloon versus drug-eluting stent after rotational atherectomy for calcified coronary lesions. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6376] [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)
- R Ito
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - S Oshima
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - H Ishii
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Sakakibara
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - S Yamabe
- Nagoya Kyoritsu Hospital, Department of Cardiology, Nagoya, Japan
| | - N Umemoto
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
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