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Sugane H, Asaumi Y, Ogata S, Kimura M, Kanaya T, Hoshi T, Sato A, Miura H, Tomishima Y, Morita Y, Nakao K, Otsuka F, Kataoka Y, Kawasaki T, Nishimura K, Narula J, Yasuda S, Noguchi T. Evaluation of fractional flow reserve and atherosclerotic plaque characteristics on coronary non-contrast T1-weighted magnetic resonance imaging. Atherosclerosis 2024; 392:117530. [PMID: 38583287 DOI: 10.1016/j.atherosclerosis.2024.117530] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/05/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND AND AIMS The relationship between high-risk coronary plaque characteristics regardless of the severity of lesion stenosis and myocardial ischemia remains unsettled. High-intensity plaques (HIPs) on non-contrast T1-weighted magnetic resonance imaging (T1WI) have been characterized as high-risk coronary plaques. We sought to elucidate whether the presence of coronary HIPs on T1WI influences fractional flow reserve (FFR) in the distal segment of the vessel. METHODS We retrospectively analyzed 281 vessels in 231 patients with chronic coronary syndrome who underwent invasive FFR measurement and coronary T1WI using a multicenter registry. The plaque-to-myocardial signal intensity ratio (PMR) of the most stenotic lesion was evaluated; a coronary plaque with PMR ≥1.4 was defined as a HIP. RESULTS The median PMR of coronary plaques on T1WI in vessels with FFR ≤0.80 was significantly higher than that of plaques with FFR >0.80 (1.17 [interquartile range (IQR): 0.99-1.44] vs. 0.97 [IQR: 0.85-1.09]; p < 0.001). Multivariable analysis showed that an increase in PMR of the most stenotic segment was associated with lower FFR (beta-coefficient, -0.050; p < 0.001). The presence of coronary HIPs was an independent predictor of FFR ≤0.80 (odds ratio (OR), 6.18; 95% confidence interval (CI), 1.93-19.77; p = 0.002). Even after adjusting for plaque composition characteristics based on computed tomography angiography, the presence of coronary HIPs was an independent predictor of FFR ≤0.80 (OR, 4.48; 95% CI, 1.19-16.80; p = 0.026). CONCLUSIONS Coronary plaques with high PMR are associated with low FFR in the corresponding vessel, indicating that plaque morphology might influence myocardial ischemia severity.
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Affiliation(s)
- Hiroki Sugane
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Cardiology, Chikamori Hospital, Kochi-city, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michito Kimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Cardiovascular Medicine, Dokkyo Medical Univeristy, Mibu, Japan
| | - Tomoya Hoshi
- Department of Cardiovascular Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akira Sato
- Second Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshiyuki Tomishima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Fumiyuku Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | | | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Jagat Narula
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Aikawa Y, Ogata S, Honda S, Nagai T, Murata S, Morii I, Anzai T, Nishimura K, Noguchi T. Prolonged delirium during hospitalization is associated with worse long-term and short-term outcomes in patients with acute heart failure. Int J Cardiol 2024; 399:131776. [PMID: 38216062 DOI: 10.1016/j.ijcard.2024.131776] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND The association between prolonged delirium during hospitalization and long-term prognosis in patients with acute heart failure (AHF) admitted to the cardiac intensive care unit (CICU) has not been fully elucidated. METHODS We conducted a prospective registry study of patients with AHF admitted to the CICU at 2 hospitals from 2013 to 2021. We divided study patients into 3 groups according to the presence or absence of delirium and prolonged delirium as follows: no delirium, resolved delirium, or prolonged delirium. Main outcomes were in-hospital mortality and 3-year mortality after discharge. RESULTS A total of 1555 patients with AHF (median age, 80 years) were included in the analysis. Of these, 406 patients (26.1%) developed delirium. We divided patients with delirium into 2 groups: the resolved delirium group (n = 201) or the prolonged delirium group (n = 205). Multivariate Cox proportional hazards models for long-term prognosis demonstrated that the prolonged delirium group had a higher incidence of all-cause death (hazard ratio [HR], 1.52; 95% CI, 1.08 to 2.14) and non-cardiovascular death (HR, 1.84; 95% CI, 1.21 to 2.78) than the resolved delirium group. Regarding in-hospital outcomes, multivariate logistic regression modeling showed that prolonged delirium is associated with all-cause death (odds ratio [OR], 9.55; 95% confidential interval [CI], 2.99 to 30.53) and cardiovascular death (OR, 13.02; 95% CI, 2.86 to 59.27) compared with resolved delirium. CONCLUSIONS Prolonged delirium is associated with worse long-term and short-term outcomes than resolved delirium in patients with AHF.
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Affiliation(s)
- Yukio Aikawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cardiology, Hokusetsu General Hospital, Takatsuki, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Isao Morii
- Department of Cardiology, Hokusetsu General Hospital, Takatsuki, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Egashira S, Tanaka T, Yamashiro T, Saito S, Abe S, Yoshimoto T, Fukuma K, Ishiyama H, Yamaguchi E, Hattori Y, Ogata S, Nishimura K, Koga M, Toyoda K, Debette S, Ihara M. High pillow and spontaneous vertebral artery dissection: A case-control study implicating "Shogun pillow syndrome". Eur Stroke J 2024:23969873231226029. [PMID: 38284382 DOI: 10.1177/23969873231226029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
INTRODUCTION The underlying causes of spontaneous vertebral artery dissection (sVAD) remain insufficiently understood. This study aimed to determine whether high-pillow usage is associated with an increased risk of sVAD and evaluate the frequency of sVAD attributable to high-pillow usage. PATIENTS AND METHODS This case-control study identified patients with sVAD and age- and sex-matched non-sVAD controls (case-to-control ratio: 1:1) treated at a certified comprehensive stroke center in Japan between 2018 and 2023. The pillow height used at the onset of the index disease was measured and classified into three categories between 12 and 15 cm boundaries. Univariable logistic regression was performed to assess the odds ratio (OR) with a 95% confidence interval (CI) of high-pillow usage for sVAD development. A subgroup of sVAD attributable to high-pillow usage was defined with the following three conditions: high-pillow usage (⩾12 or ⩾15 cm); no minor preceding trauma; and wake-up onset. RESULTS Fifty-three patients with sVAD and 53 non-sVAD controls (42% women, median age: 49 years) were identified. High-pillow usage (⩾12 and ⩾15 cm) was more common in the sVAD group than in the non-sVAD group (34 vs 15%; OR = 2.89; 95%CI = 1.13-7.43 and 17 vs 1.9%; OR = 10.6; 95%CI = 1.30-87.3, respectively). The subgroup of sVAD attributed to high-pillow usage (⩾12 and ⩾15 cm) was found in 11.3% (95%CI = 2.7%-19.8%) and 9.4% (95%CI = 1.5%-17.3%), respectively. CONCLUSION High-pillow usage was associated with an increased risk of sVAD and accounted for approximately 10% of all sVAD cases. This tentative subgroup of sVAD may represent a distinct spectrum of disease-Shogun pillow syndrome.
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Affiliation(s)
- Shuhei Egashira
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takayuki Yamashiro
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Soichiro Abe
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Yoshimoto
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuki Fukuma
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hiroyuki Ishiyama
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Eriko Yamaguchi
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Stéphanie Debette
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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Morinaga M, Yoshitani K, Ogata S, Fukushima S, Matsuda H. Association between intraoperative blood salvage and coagulation disorder after cardiopulmonary bypass. JA Clin Rep 2024; 10:5. [PMID: 38270666 PMCID: PMC10810763 DOI: 10.1186/s40981-024-00689-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND This study investigated whether intraoperative blood salvage was associated with coagulation disorder diagnosed by conventional coagulation tests and thromboelastography (TEG) after cardiopulmonary bypass (CPB). STUDY DESIGN AND METHODS This was a prospective, observational study. Ninety-two patients who underwent cardiovascular surgery with CPB were enrolled. We evaluated coagulation function in patients with or without cell salvage blood transfusion at the following time points: before CPB, just after protamine administration, and 1 h after protamine administration. We evaluated platelet count, fibrinogen concentration, and TEG parameters. Patients were considered to have coagulation disorder if one or more of the following criteria were present: (1) residual heparin, (2) low platelet count, (3) low fibrinogen level, (4) low clotting factor level, and (5) hyperfibrinolysis. RESULTS Fifty-three of 92 patients (57.6%) received intraoperative cell salvage. Coagulation disorder was observed in 56 of 92 patients (60.9%) after CPB. There was no significant difference between patients with or without intraoperative blood salvage in terms of the incidence of coagulation disorder (p = 0.542) or the total volume of blood from the drain after CPB (p = 0.437). Intraoperative blood salvage was not associated with coagulation disorder diagnosed by either TEG or conventional coagulation tests (odds ratio 1.329, 95% confidence interval: 0.549-3.213, p = 0.547). There were no significant interactions between patients with or without intraoperative blood salvage regarding coagulation parameters derived from TEG. CONCLUSIONS The incidence of coagulation disorder and the total blood volume from the drain after CPB did not differ significantly between patients with or without intraoperative blood salvage.
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Affiliation(s)
- Masahiro Morinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenji Yoshitani
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
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Ishii M, Marume K, Nakai M, Ogata S, Kaichi R, Ikebe S, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Ogawa H, Iwanaga Y, Miyamoto Y, Yamamoto N, Tsujita K. Risk Prediction Score for Cancer Development in Patients With Acute Coronary Syndrome. Circ J 2024; 88:234-242. [PMID: 34078839 DOI: 10.1253/circj.cj-21-0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cancer is a known prognostic factor in patients with acute coronary syndrome (ACS), but few risk assessments of cancer development after ACS have been established.Methods and Results:Of the 573 consecutive ACS admissions between January 2015 and March 2018 in Nobeoka City, Japan, 552 were analyzed. Prevalent cancer was defined as a treatment history of cancer, and incident cancer as post-discharge cancer incidence. The primary endpoint was post-discharge cancer incidence, and the secondary endpoint was all-cause death during follow-up. All-cause death occurred in 9 (23.1%) patients with prevalent cancer, and in 17 (3.5%) without cancer. In the multivariable analysis, prevalent cancer was associated with all-cause death. To develop the prediction model for cancer incidence, 21 patients with incident cancer and 492 without cancer were analyzed. We compared the performance of D-dimer with that of the prediction model, which added age (≥65 years), smoking history, and high red blood cell distribution width to albumin ratio (RAR) to D-dimer. The areas under the receiver-operating characteristics curves of D-dimer and the prediction model were 0.619 (95% confidence interval: 0.512-0.725) and 0.774 (0.676-0.873), respectively. Decision curve analysis showed superior net benefits of the prediction model. CONCLUSIONS By adding elderly, smoking, and high RAR to D-dimer to the prediction model it became clinically useful for predicting cancer incidence after ACS.
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Affiliation(s)
- Masanobu Ishii
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kyohei Marume
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | | | | | - Ryota Kaichi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Sou Ikebe
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Takayuki Mori
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Soichi Komaki
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Hiroaki Kusaka
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Reiko Toida
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kazumasa Kurogi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | | | | | | | - Nobuyasu Yamamoto
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Kumamoto University Hospital
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Inaguma D, Tatematsu Y, Okamoto N, Ogata S, Kawai H, Watanabe E, Yuzawa Y, Hasegawa M, Tsuboi N. Multicentre, open-label, randomised, controlled trial to compare early intervention with calcimimetics and conventional therapy in preventing coronary artery calcification in patients with secondary hyperparathyroidism (UPCOMING): a study protocol. BMJ Open 2024; 14:e076962. [PMID: 38267238 PMCID: PMC10823999 DOI: 10.1136/bmjopen-2023-076962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Coronary artery and heart valve calcification is a risk factor for cardiovascular death in haemodialysis patients, so calcification prevention should be started as early as possible. Treatment with concomitant calcimimetics and low-dose vitamin D receptor activators (VDRAs) is available, but not enough evidence has been obtained on the efficacy of this regimen, particularly in patients with short dialysis duration. Therefore, this study will evaluate the efficacy and safety of early intervention with upacicalcet, a calcimimetic used to prevent coronary artery calcification in this patient population. METHODS AND ANALYSIS This multicentre, open-label, randomised, parallel-group controlled study will compare an early intervention group, which received upacicalcet and a low-dose VDRA, with a conventional therapy group, which received a VDRA. The primary endpoint is a change in log coronary artery calcium volume score from baseline to 52 weeks. The main inclusion criteria are as follows: (1) age 18 years or older; (2) dialysis is planned or dialysis duration is less than 60 months; (3) intact parathyroid hormone (PTH) >240 pg/mL or whole PTH level>140 pg/mL; (4) serum-corrected calcium≥8.4 mg/dL and (5) Agatston score >30. The main exclusion criteria are as follows: (1) history of parathyroid intervention or fracture in the past 12 weeks; (2) history of myocardial infarction, stroke or leg amputation in the past 12 weeks; (3) history of coronary angioplasty and (4) heart failure of New York Heart Association class III or worse. ETHICS AND DISSEMINATION The study will comply with the Declaration of Helsinki and the Japanese Clinical Trials Act. The study protocol has been approved by the Fujita Health University Certified Review Board (file no. CR22-052). Written informed consent will be obtained from all participants. Study results will be presented in academic meetings and peer-reviewed academic journals. TRIAL REGISTRATION NUMBER jRCTs041220126.
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Affiliation(s)
- Daijo Inaguma
- Nephrology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | | | - Naoki Okamoto
- Nephrology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Soshiro Ogata
- Preventive Medicine & Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hideki Kawai
- Cardiology, Fujita Health University, Toyoake, Japan
| | - Eiichi Watanabe
- Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Yukio Yuzawa
- Nephrology, Fujita Health University, Toyoake, Japan
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Morris K, Takegami M, Teramoto K, Murata S, Nakatsuka K, Ogata S, Nishimura K. Cognitive transitions based on functional status in older adults with heart failure: a population-based study. ESC Heart Fail 2023; 10:3454-3462. [PMID: 37706364 PMCID: PMC10682903 DOI: 10.1002/ehf2.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023] Open
Abstract
AIMS Cognitive impairment and functional status are both important determinants of poor outcomes in heart failure (HF). However, little is known about how functional status impacts the changes in cognitive status during the disease course. This study aimed to describe the cognitive transitions in patients with HF and assess the relationship of these transitions to functional status, which was assessed by the dependency of activities of daily living (ADL). METHODS AND RESULTS This retrospective cohort study included 1764 patients with an International Classification of Diseases-10 code of HF (≥65 years, mean age 82.3 ± 7.9 years, 39% male) from a long-term care and medical insurance database from Nobeoka city, a rural city of south-western Japan. Cognitive status at baseline and 6, 12, 18, and 24 month time points was collected, and participants were stratified based on ADL status at baseline. Generalized estimating equations and multi-state modelling were used to examine associations between ADL dependency and cognitive changes/mortality. Transition probabilities were estimated using multi-state modelling. At baseline, there were 1279 (73%) and 485 (27%) patients with independent and dependent ADL, respectively. In overall patients, 1656 (93.9%) patients had normal/mild cognitive status and 108 (6%) patients had a moderate/severe cognitive status at baseline. The majority [104 (96%) patients] of patients with moderate/severe cognitive status at baseline had dependent ADL. In patients with moderate/severe cognitive status, the number of patients with dependent ADL always outnumbered that of the independent ADL throughout the follow-up. Multi-state modelling estimated that patients with dependent ADL and normal/mild cognitive status at baseline had 47% probability of maintaining the same cognitive status at 24 months, while the probability of maintaining the same cognitive status was 86% for those with independent ADL. Patients with normal/mild cognitive status in the dependent ADL group at baseline had a higher risk of experiencing a transition to moderate/severe cognitive status at any time point during 24 months compared with those with independent ADL [hazard ratio 5.24 (95% confidence interval 3.47-7.90)]. CONCLUSIONS In older patients with HF, the prevalence of cognitive impairment was always higher for those with reduced functional status. Despite having a normal/mild cognitive status at baseline, patients with dependent ADL are at high risk of experiencing cognitive decline over 24 months with substantially less chance of maintaining their cognitive status. ADL dependency was an important risk factor of cognitive decline in patients with HF.
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Affiliation(s)
- Kensuke Morris
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Misa Takegami
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
- Department of Public Health and Health Policy, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Kanako Teramoto
- Department of BiostatisticsNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Shunsuke Murata
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
- Department of Public Health, Graduate School of Health SciencesKobe UniversityKobeJapan
- Japan Society for the Promotion of ScienceTokyoJapan
| | - Kiyomasa Nakatsuka
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
- Department of Public Health, Graduate School of Health SciencesKobe UniversityKobeJapan
| | - Soshiro Ogata
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
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8
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Fukuma K, Tojima M, Tanaka T, Kobayashi K, Kajikawa S, Shimotake A, Kamogawa N, Ikeda S, Ishiyama H, Abe S, Morita Y, Nakaoku Y, Ogata S, Nishimura K, Koga M, Toyoda K, Matsumoto R, Takahashi R, Ikeda A, Ihara M. Periodic discharges plus fast activity on electroencephalogram predict worse outcomes in poststroke epilepsy. Epilepsia 2023; 64:3279-3293. [PMID: 37611936 DOI: 10.1111/epi.17760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Postseizure functional decline is a concern in poststroke epilepsy (PSE). However, data on electroencephalogram (EEG) markers associated with functional decline are scarce. Thus, we investigated whether periodic discharges (PDs) and their specific characteristics are associated with functional decline in patients with PSE. METHODS In this observational study, patients admitted with seizures of PSE and who had scalp EEGs were included. The association between the presence or absence of PDs and postseizure short-term functional decline lasting 7 days after admission was investigated. In patients with PD, EEG markers were explored for risk stratification of short-term functional decline, according to the American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology. The association between EEG markers and imaging findings and long-term functional decline at discharge and 6 months after discharge, defined as an increase in the modified Rankin Scale score compared with the baseline, was evaluated. RESULTS In this study, 307 patients with PSE (median age = 75 years, range = 35-97 years, 64% males; hemorrhagic stroke, 47%) were enrolled. Compared with 247 patients without PDs, 60 patients with PDs were more likely to have short-term functional decline (12 [20%] vs. 8 [3.2%], p < .001), with an adjusted odds ratio (OR) of 4.26 (95% confidence interval [CI] = 1.44-12.6, p = .009). Patients with superimposed fast-activity PDs (PDs+F) had significantly more localized (rather than widespread) lesions (87% vs. 58%, p = .003), prolonged hyperperfusion (100% vs. 62%, p = .023), and a significantly higher risk of short-term functional decline than those with PDs without fast activity (adjusted OR = 22.0, 95% CI = 1.87-259.4, p = .014). Six months after discharge, PDs+F were significantly associated with long-term functional decline (adjusted OR = 4.21, 95% CI = 1.27-13.88, p = .018). SIGNIFICANCE In PSE, PDs+F are associated with sustained neuronal excitation and hyperperfusion, which may be a predictor of postseizure short- and long-term functional decline.
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Affiliation(s)
- Kazuki Fukuma
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Maya Tojima
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Katsuya Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shunsuke Kajikawa
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naruhiko Kamogawa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shuhei Ikeda
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroyuki Ishiyama
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soichiro Abe
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Riki Matsumoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Yokoyama C, Yoshitnai K, Ogata S, Fukushima S, Matsuda H. Effect of postoperative delirium after cardiovascular surgery on 5-year mortality. JA Clin Rep 2023; 9:66. [PMID: 37831211 PMCID: PMC10575819 DOI: 10.1186/s40981-023-00658-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
INTRODUCTION Postoperative delirium is a common complication after cardiovascular surgery. A meta-analysis revealed that postoperative delirium was associated with cognitive decline and dementia, which may affect long-term mortality. However, few studies have reported the association between postoperative delirium after cardiovascular surgery and long-term postoperative mortality. Therefore, we investigated the effect of postoperative delirium on 5-year survival rates of patients who underwent cardiovascular surgery. METHODS We retrospectively reviewed the records of patients who underwent cardiovascular surgery with cardiopulmonary bypass from January 2016 to December 2019. Postoperative delirium was defined as an Intensive Care Delirium Screening score ≥ 3, which might include subclinical delirium. Cox proportional hazards modeling was performed to assess the association between postoperative delirium and mortality. Postoperative mortality in patients with and without delirium was assessed using the Kaplan-Meier method and compared using the log-rank test. RESULTS Postoperative delirium was observed in 562 (31.9%) of 1731 patients. There were more elderly patients, more emergent surgery procedures, longer operative time, and larger transfusion volume in the postoperative delirium group. Cox regression analyses showed that delirium (hazard ratio (HR), 1.501; 95% confidence interval (CI), 1.053-2.140; p = 0.025) and emergent surgery (HR, 3.380; 95% CI, 2.231-5.122; p < 0.001) are significantly associated with 5-year mortality. Among patients who underwent elective surgery, postoperative delirium (HR, 1.987; 95% CI, 1.135-3.481; p = 0.016) is significantly associated with 5-year mortality. Kaplan-Meier survival analysis revealed that patients with postoperative delirium had significantly higher 5-year mortality. CONCLUSIONS Patients with postoperative delirium after cardiovascular surgery have significantly higher 5-year mortality.
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Affiliation(s)
- Chisaki Yokoyama
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1, Kishibeshinmachi, Suita, Osaka, Japan
| | - Kenji Yoshitnai
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1, Kishibeshinmachi, Suita, Osaka, Japan.
| | - Soshiro Ogata
- Department of, Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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10
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Aikawa H, Fujino M, Murai K, Iwai T, Sawada K, Matama H, Miura H, Honda S, Yoneda S, Takagi K, Otsuka F, Kataoka Y, Asaumi Y, Tahara Y, Ogata S, Nishimura K, Tsujita K, Noguchi T. In-hospital adverse events and recurrence in hospitalized patients with acute pericarditis. J Cardiol 2023; 82:268-273. [PMID: 36906259 DOI: 10.1016/j.jjcc.2023.03.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/04/2023] [Accepted: 02/16/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Acute pericarditis occasionally requires invasive treatment, and may recur after discharge. However, there are no studies on acute pericarditis in Japan, and its clinical characteristics and prognosis are unknown. METHODS This was a single-center, retrospective cohort study of clinical characteristics, invasive procedures, mortality, and recurrence in patients with acute pericarditis hospitalized from 2010 to 2022. The primary in-hospital outcome was adverse events (AEs), a composite of all-cause mortality and cardiac tamponade. The primary outcome in the long-term analysis was hospitalization for recurrent pericarditis. RESULTS The median age of all 65 patients was 65.0 years [interquartile range (IQR), 48.0-76.0 years], and 49 (75.3 %) were male. The etiology of acute pericarditis was idiopathic in 55 patients (84.6 %), collagenous in 5 (7.6 %), bacterial in 1 (1.5 %), malignant in 3 (4.6 %), and related to previous open-heart surgery in 1 (1.5 %). Of the 8 patients (12.3 %) with in-hospital AE, 1 (1.5 %) died during hospitalization and 7 (10.8 %) developed cardiac tamponade. Patients with AE were less likely to have chest pain (p = 0.011) but were more likely to have symptoms lasting 72 h after treatment (p = 0.006), heart failure (p < 0.001), and higher levels of C-reactive protein (p = 0.040) and B-type natriuretic peptide (p = 0.032). All patients complicated with cardiac tamponade were treated with pericardial drainage or pericardiotomy. We analyzed 57 patients for recurrent pericarditis after excluding 8 patients: 1 with in-hospital death, 3 with malignant pericarditis, 1 with bacterial pericarditis, and 3 lost to follow-up. During a median follow-up of 2.5 years (IQR 1.3-3.0 years), 6 patients (10.5 %) had recurrences requiring hospitalization. The recurrence rate of pericarditis was not associated with colchicine treatment or aspirin dose or titration. CONCLUSIONS In acute pericarditis requiring hospitalization, in-hospital AE and recurrence were each observed in >10 % of patients. Further large studies on treatment are warranted.
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Affiliation(s)
- Hirohiko Aikawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan.
| | - Kota Murai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamasa Iwai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Kenichiro Sawada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Kensuke Takagi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, NCVC, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, NCVC, Suita, Osaka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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11
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Ogata S, Manson JE, Kang JH, Buring JE, Lee IM, Nishimura K, Sakata Y, Danik JS, D’Agostino D, Mora S, Albert CM, Cook NR. Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease: A Novel Analysis of the VITAL Trial Using Win Ratio and Hierarchical Composite Outcomes. Nutrients 2023; 15:4235. [PMID: 37836519 PMCID: PMC10574231 DOI: 10.3390/nu15194235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to investigate whether n-3 fatty acid supplementation reduced cardiovascular disease (CVD) events in a novel analysis using hierarchical composite CVD outcomes based on win ratio in the VITamin D and OmegA-3 TriaL (VITAL). This was a secondary analysis of our VITAL randomized trial, which assessed the effects of marine n-3 fatty acids (1 g/day) and vitamin D3 on incident CVD and cancer among healthy older adults (n = 25,871). The primary analysis estimated win ratios of a composite of major CVD outcomes prioritized as fatal coronary heart disease, other fatal CVD including stroke, non-fatal myocardial infarction (MI), and non-fatal stroke, comparing n-3 fatty acids to placebo. The primary result was a nonsignificant benefit of this supplementation for the prioritized primary CVD outcome (reciprocal win ratio [95% confidence interval]: 0.90 [0.78-1.04]), similar to the 0.92 (0.80-1.06) hazard ratio in our original time-to-first event analysis without outcome prioritization. Its benefits came from reducing MI (0.71 [0.57-0.88]) but not stroke (1.01 [0.80 to 1.28]) components. For the primary CVD outcome, participants with low fish consumption at baseline benefited (0.79 [0.65-0.96]) more than those with high consumption (1.05 [0.85-1.30]). These results are consistent with, but slightly stronger than, those without outcome prioritization.
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Affiliation(s)
- Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
| | - Jae H. Kang
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
| | - Julie E. Buring
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
| | - I-Min Lee
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Jacqueline Suk Danik
- Division of Cardiovascular Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA;
| | - Denise D’Agostino
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
| | - Samia Mora
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
| | - Christine M. Albert
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
- Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Nancy R. Cook
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.M.); (J.H.K.); (J.E.B.); (I.-M.L.); (D.D.); (S.M.); (C.M.A.); (N.R.C.)
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12
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Shrestha RM, Inoue Y, Yamamoto S, Fukunaga A, Sampei M, Okubo R, Morisaki N, Ohmagari N, Funaki T, Ishizuka K, Yamaguchi K, Sasaki Y, Takeda K, Miyama T, Kojima M, Nakagawa T, Nishimura K, Ogata S, Umezawa J, Tanaka S, Inoue M, Konishi M, Miyo K, Mizoue T. The association between experience of COVID-19-related discrimination and psychological distress among healthcare workers for six national medical research centers in Japan. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1421-1429. [PMID: 36928546 PMCID: PMC10020069 DOI: 10.1007/s00127-023-02460-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Discrimination is an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan. METHODS This cross-sectional study conducted a health survey among 5703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress (≥ 13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified factors associated with discrimination. RESULTS Of the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.28-1.55), had high vs. low viral exposure (AOR = 2.31, 95% CI = 1.81-2.93), and worked for 11 or more hours/day vs. 8 or less hours/day (AOR = 1.42, 95% CI = 1.35-1.49) were more likely to have experienced COVID-19-related discrimination. The AOR (95% CI) of severe psychological distress was 1.83 (1.29-2.59) among those who experienced discrimination. In the stratified analysis by sociodemographic and job-related factors, all the interactions did not reach statistical significance (p for interaction > 0.20). CONCLUSION Experience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.
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Affiliation(s)
- Rachana Manandhar Shrestha
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan.
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Makiko Sampei
- Department of Health Science, Health Promotion, Nippon Sport Science University, Tokyo, Japan
| | - Ryo Okubo
- Clinical Research and Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Science, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takanori Funaki
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kazue Ishizuka
- Department of Social Science, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Koushi Yamaguchi
- Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yohei Sasaki
- Clinical Research and Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kazuyoshi Takeda
- Clinical Research and Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takeshi Miyama
- National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masayo Kojima
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Takeshi Nakagawa
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Jun Umezawa
- Division of Cohort Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Shiori Tanaka
- Division of Prevention, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Manami Inoue
- Division of Prevention, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Kengo Miyo
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
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13
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Ogata S, Nakai S. Response to "Association Between Dietary Potassium Intake and Serum Potassium in CKD". Kidney Int Rep 2023; 8:1480. [PMID: 37441485 PMCID: PMC10334392 DOI: 10.1016/j.ekir.2023.04.020] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 07/15/2023] Open
Affiliation(s)
- Soshiro Ogata
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Shigeru Nakai
- Faculty of Nursing, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
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14
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Tagaya T, Hayashi H, Ogata S, Takahashi K, Koide S, Inaguma D, Hasegawa M, Yuzawa Y, Tsuboi N. Tolvaptan's Association with Low Risk of Acute Kidney Injury in Patients with Advanced Chronic Kidney Disease and Acute Decompensated Heart Failure. Am J Nephrol 2023; 54:319-328. [PMID: 37385233 DOI: 10.1159/000531692] [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: 03/16/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Furosemide, a loop diuretic, is often empirically used to treat acute decompensated heart failure (ADHF) initially. Conversely, decongestion using tolvaptan, an aquaretic, is thought to maintain renal function compared to furosemide. However, it has not been investigated in patients with advanced chronic kidney disease (CKD) at high risk of developing acute kidney injury (AKI). This study aimed to investigate AKI incidence using tolvaptan add-on treatment, compared to increased furosemide treatment for patients with ADHF complicated by advanced CKD. METHODS We retrospectively studied patients with advanced CKD (estimated glomerular filtration rate [eGFR] <45 mL/min/1.73 m2) who developed ADHF under outpatient furosemide treatment. The exposure was set to tolvaptan add-on treatment, and the control was set to increased furosemide treatment. RESULTS Of the 163 patients enrolled, 79 were in the tolvaptan group and 84 in the furosemide group. The mean age was 71.6 years, the percentage of males was 63.8%, the mean eGFR was 15.7 mL/min/1.73 m2, and patients with CKD stage G5 were 61.9%. AKI incidence was 17.7% in the tolvaptan group and 42.9% in the furosemide group (odds ratio [95% confidence interval]: 0.34 [0.13-0.86], p = 0.023 in multivariate logistic regression analysis). Persistent AKI incidence was 11.8% in the tolvaptan group and 32.9% in the furosemide group (odds ratio [95% confidence interval]: 0.34 [0.10-1.06], p = 0.066 in the multinomial logit analysis). CONCLUSION This study suggests that tolvaptan may be better than furosemide in patients with ADHF experiencing complicated advanced CKD.
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Affiliation(s)
- Tomoki Tagaya
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Soshiro Ogata
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuo Takahashi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Biomedical Molecular Sciences, Fujita Health University school of Medicine, Toyoake, Japan
| | - Shigehisa Koide
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Daijo Inaguma
- Department of Internal Medicine, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Midori Hasegawa
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yukio Yuzawa
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Naotake Tsuboi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
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15
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Akema S, Mameno T, Nakagawa T, Inagaki H, Fukutake M, Hatta K, Murotani Y, Tsujioka Y, Hagino H, Higashi K, Takahashi T, Wada M, Maeda Y, Gondo Y, Kamide K, Kabayama M, Ishizaki T, Masui Y, Ogata S, Ikebe K. Relationship between occlusal force and psychological frailty in Japanese community-dwelling older adults: The Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. J Am Geriatr Soc 2023; 71:1819-1828. [PMID: 36691687 DOI: 10.1111/jgs.18239] [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: 06/06/2022] [Revised: 12/05/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Frailty increases the risk of negative health-related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross-sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community-dwelling older adults. METHODS Psychological frailty was defined as a World Health Organization-5 scale (WHO-5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA-J) score of <23, and psychological robustness was defined as a WHO-5 score of ≥13 and a MoCA-J score of ≥23. We used a cross-sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. RESULTS After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = -72.7, 95% confidence interval: -126.3 to -19.1). CONCLUSIONS Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community-dwelling older adults participating in our study.
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Affiliation(s)
- Suzuna Akema
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takeshi Nakagawa
- National Center for Geriatrics and Gerontology, Research Institute, Aichi, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motoyoshi Fukutake
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kodai Hatta
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Murotani
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshitaka Tsujioka
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiromasa Hagino
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Higashi
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toshihito Takahashi
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masahiro Wada
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Kei Kamide
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Division of Health Sciences, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Tatsuro Ishizaki
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yukie Masui
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
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Katasako A, Yoshikawa Y, Noguchi T, Ogata S, Nishimura K, Tsujita K, Kusano K, Yonemoto N, Ikeda T, Nakashima T, Tahara Y. Changes in neurological outcomes of out-of-hospital cardiac arrest during the COVID-19 pandemic in Japan: a population-based nationwide observational study. Lancet Reg Health West Pac 2023:100771. [PMID: 37360869 PMCID: PMC10152207 DOI: 10.1016/j.lanwpc.2023.100771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/21/2023] [Accepted: 04/02/2023] [Indexed: 06/28/2023]
Abstract
Background There is growing interest in the indirect negative effects of coronavirus disease 2019 (COVID-19) on mortality. We aimed to assess its indirect effect on out-of-hospital cardiac arrest (OHCA) outcomes. Methods We analysed a prospective nationwide registry of 506,935 patients with OHCA between 2017 and 2020. The primary outcome was favourable neurological outcome (Cerebral Performance Category 1 or 2) at 30 days. The secondary outcomes were public access defibrillation (PAD) and bystander-initiated chest compression. We performed an interrupted time series (ITS) analysis to assess changes in the trends of these outcomes around the declaration of a state of emergency (April 7 - May 25, 2020). We also performed a subgroup analysis stratified by infection spread status. Findings We identified 21,868 patients with OHCA witnessed by a bystander who had an initial shockable heart rhythm. ITS analysis showed a drastic decline in PAD use (relative risk [RR], 0.60; 95% confidence interval [CI], 0.49-0.72; p < 0.0001) and a reduction in favourable neurological outcomes (RR, 0.79; 95% CI, 0.68-0.91; p = 0.0032) all over Japan after the state of emergency was declared when compared with the equivalent time period in previous years. The decline in favourable neurological outcomes was more pronounced in areas with COVID-19 spread than in areas without spread (RR, 0.70; 95% CI, 0.58-0.86 vs. RR, 0.87; 95% CI, 0.72-1.03; p for effect modification = 0.019). Interpretation COVID-19 is associated with worse neurological outcomes and less PAD use in patients with OHCA. Funding None.
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Affiliation(s)
- Aya Katasako
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yusuke Yoshikawa
- Department of Biostatistics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kunihiro Nishimura
- Department of Biostatistics, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Naohiro Yonemoto
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Takahiro Nakashima
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Emergency Medicine and Michigan, Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, United States
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Hattori Y, Saito S, Nakaoku Y, Ogata S, Hattori M, Nakatsuji M, Nishimura K, Ihara M. Taxifolin for Cognitive Preservation in Patients with Mild Cognitive Impairment or Mild Dementia. J Alzheimers Dis 2023; 93:743-754. [PMID: 37092223 DOI: 10.3233/jad-221293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND The development of numerous disease-modifying drugs for age-related dementia has been attempted based on the amyloid-β (Aβ) hypothesis without much success. Taxifolin (TAX), a natural bioactive flavonoid, shows pleiotropic neuroprotective effects with inhibition of Aβ aggregation, production, and glycation, antiinflammatory effects, and amelioration of the waste clearance system. We hypothesized that TAX intake is associated with the suppression of cognitive deterioration. OBJECTIVE To investigate associations between TAX intake and cognitive changes. METHODS We retrospectively identified patients who orally took TAX 300 mg/day and regularly underwent Alzheimer's Disease Assessment Scale-Cognitive Subscale 13 (ADAS-Cog) and Montreal Cognitive Assessment (MoCA) and compared the temporal changes in ADAS-Cog and MoCA between the non-treatment (pre-TAX) period (180±100 days) and following treatment (on-TAX) period (180±100 days) from June 2020 to November 2021. Since some additional patients underwent the Mini-Mental State Examination (MMSE) instead of the MoCA at the beginning of the pre-TAX period, the same comparison was performed using the MoCA total score converted from MMSE as a sensitivity analysis. RESULTS Sixteen patients were identified. TAX intake was associated with significantly higher interval changes in the MoCA subscale scores of visuospatial/executive function (p = 0.016), verbal fluency (p = 0.02), and the total score (p = 0.034), but not with ADAS-Cog (total score, p = 0.27). In the sensitivity analysis, 29 patients were included. TAX intake was associated with a significantly higher interval change in the total MoCA score (p = 0.004) but not with ADAS-Cog (p = 0.41). CONCLUSION Our findings provide a basis for TAX as a novel strategy for maintaining brain health during aging. A prospective cohort study is required to confirm these findings.
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Affiliation(s)
- Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masashi Hattori
- Next Generation Business Development Department, Business Development Division, Towa Pharmaceutical Co., Ltd, Kadoma, Osaka, Japan
| | - Mio Nakatsuji
- Scientific Research and Business Development Department, Towa Pharmaceutical Co., Ltd, Settsu, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Yagyu T, Noguchi T, Asano Y, Ida K, Ogata S, Nishimura K, Matsuda H. Association Between Genetic Diagnosis and Clinical Outcomes in Patients With Heritable Thoracic Aortic Disease. J Am Heart Assoc 2023; 12:e028625. [PMID: 37042257 DOI: 10.1161/jaha.122.028625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Differences in the clinical course of heritable thoracic aortic disease based on the disease-causing gene have not been fully evaluated. To clarify the clinical relevance of causative genes in heritable thoracic aortic disease, we assessed the clinical course of patients categorized based on genetic diagnosis. Methods and Results We investigated cardiovascular events and mortality in 518 genetically diagnosed patients in 4 groups: Group 1, FBN1 (n=344); Group 2, TGFBR1, TGFBR2, SMAD3, or TGFB2 (n=74); Group 3, COL3A1 (n=60); and Group 4, ACTA2 or MYH11 (n=40). The median age at the first cardiovascular event ranged from 30.0 to 35.5 years (P=0.36). Patients with gene variants related to transforming growth factor-β signaling had a significantly higher rate of subsequent events than those with FBN1 variants (adjusted hazard ratio, 2.33 [95% CI, 1.60-3.38]; P<0.001). Regarding the incidence of aortic dissection, there were no significant differences among the 4 groups in male patients (36.3%, 34.3%, 21.4%, and 54.2%, respectively; P=0.06). Female patients with COL3A1 variants had a significantly lower incidence than female patients in the other 3 groups (34.2%, 59.0%, 3.1%, and 43.8%, respectively; P<0.001). Conclusions Gene variants related to transforming growth factor-β signaling are associated with a higher incidence of subsequent cardiovascular events than FBN1 variants. COL3A1 variants might be related to a lower incidence of aortic dissection than other gene variants in women only. Identifying the genetic background of patients with heritable thoracic aortic disease is important for determining appropriate treatment.
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Affiliation(s)
- Takeshi Yagyu
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
- Department of Genomic Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
- Department of Genomic Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Yoshihiro Asano
- Department of Genomic Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Kazufumi Ida
- Department of Genomic Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology National Cerebral and Cardiovascular Center Research Institute Suita Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology National Cerebral and Cardiovascular Center Research Institute Suita Japan
| | - Hitoshi Matsuda
- Department of Cardiovascular Surgery National Cerebral and Cardiovascular Center Suita Japan
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19
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Kurogi R, Kada A, Ogasawara K, Nishimura K, Kitazono T, Iwama T, Matsumaru Y, Sakai N, Shiokawa Y, Miyachi S, Kuroda S, Shimizu H, Yoshimura S, Osato T, Horie N, Nagata I, Nozaki K, Date I, Hashimoto Y, Hoshino H, Nakase H, Kataoka H, Ohta T, Fukuda H, Tamiya N, Kurogi AI, Ren N, Nishimura A, Arimura K, Shimogawa T, Yoshimoto K, Onozuka D, Ogata S, Hagihara A, Saito N, Arai H, Miyamoto S, Tominaga T, Iihara K. National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study. BMJ Open 2023; 13:e068642. [PMID: 37037619 PMCID: PMC10111904 DOI: 10.1136/bmjopen-2022-068642] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
OBJECTIVES To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan. DESIGN Retrospective study. SETTING Six hundred and thirty-one primary care institutions in Japan. PARTICIPANTS Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database. PRIMARY AND SECONDARY OUTCOME MEASURES Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3-6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1-25 points). RESULTS In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality. CONCLUSIONS The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era.
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Affiliation(s)
- Ryota Kurogi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Kada
- Department of Clinical Research Management, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Yanagido, Japan
| | - Yuji Matsumaru
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, University of Tsukuba, Tsukuba, Japan
| | - Nobuyuki Sakai
- Department of Neurosurgery, Kobe City General Hospital, Kobe, Japan
| | | | - Shigeru Miyachi
- Department of Neurosurgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - Satoshi Kuroda
- Department of Neurosurgery, Toyama University, Toyama, Japan
| | - Hiroaki Shimizu
- Department of Neurosurgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Shinichi Yoshimura
- Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan
| | - Toshiaki Osato
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Izumi Nagata
- Department of Neurosurgery, Kokura Memorial Hospital, Kita-kyushu, Japan
| | - Kazuhiko Nozaki
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan
| | | | - Haruhiko Hoshino
- Department of Neurology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Hiroyuki Nakase
- Department of Neurosurgery, Nara Medical University, Nara, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsuyoshi Ohta
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hitoshi Fukuda
- Department of Neurosurgery, Kochi Medical School, Nankoku, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - A I Kurogi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nice Ren
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takafumi Shimogawa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Onozuka
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akihito Hagihara
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hajime Arai
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koji Iihara
- Director General, National Cerebral and Cardiovascular Center Hospital, Suita, Japan
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Kawarada O, Otsuka F, Miki K, Ikutomi M, Okada K, Ogata S, Nishimura K, Fitzgerald PJ, Honda Y. Heterogeneous vascular response after implantation of bare nitinol self-expanding stents in the swine femoropopliteal artery. Cardiovasc Interv Ther 2023; 38:210-222. [PMID: 36255689 PMCID: PMC10020252 DOI: 10.1007/s12928-022-00889-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Mechanism of femoropopliteal in-stent restenosis has been underappreciated. AIM The aim of this animal study was to elucidate vascular response after femoropopliteal bare nitinol self-expanding stents (SESs) implantation. METHODS Misago, Smart Flex, or Innova stent was randomly implanted in 36 swine femoropopliteal arteries. At week 4, quantitative vessel analysis (QVA) was performed on 36 legs, of which 18 underwent histological evaluation after angiography. The remaining 18 legs underwent QVA and histological evaluation at week 13. RESULTS Fibrin deposition was excessive at week 4. Internal elastic lamina (IEL) progressively enlarged over time, and vessel injury developed from mild level at week 4 to moderate level at week 13. Vessel inflammatory reaction was mild to moderate at week 4, and was moderate to severe at week 13. Increased fibrin deposition was an early-acting, IEL enlargement and increased vessel inflammation were long-acting, and increased vessel injury and giant cells infiltration were late-acting contributors to neointimal hyperplasia (NIH). Stent type altered time-dependent process of vessel injury, vessel inflammation, eosinophils and giant cells infiltration. Misago had less fibrin deposition and vessel enlargement, and less progressive vessel injury, vessel inflammation, and eosinophils and giant cells infiltration. Net lumen as assessed by percent diameter stenosis or minimum lumen diameter was preserved with Misago, but was not preserved with the other stents. CONCLUSIONS In the context of bare nitinol SES platform with less progressive mechanical stress and inflammatory reaction, the advantage of less NIH outweighed the disadvantage of less vessel enlargement, leading to net lumen preservation.
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Affiliation(s)
- Osami Kawarada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita city, Osaka, 564-8565, Japan.
- Kawarada Cardio Foot Vascular Clinic, Osaka, Japan.
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita city, Osaka, 564-8565, Japan
| | - Kojiro Miki
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Masayasu Ikutomi
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Kozo Okada
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Peter J Fitzgerald
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Yasuhiro Honda
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Suzuki T, Fujino M, Murai K, Iwai T, Sawada K, Matama H, Miura H, Honda S, Yoneda S, Takagi K, Otsuka F, Asaumi Y, Kataoka Y, Tahara Y, Ogata S, Nishimura K, Tsujita K, Noguchi T. Urinary catheterization prior to PCI worsens clinical outcomes in patients with acute myocardial infarction. J Cardiol 2023; 81:373-377. [PMID: 36565996 DOI: 10.1016/j.jjcc.2022.12.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Indwelling urethral catheters (IUCs) are used to measure urine volume, keep patients on bed rest, or keep the groin area clean in patients with acute myocardial infarction (AMI). However, the association between IUC use and in-hospital urinary-related complications is unknown. METHODS This was a single-center retrospective analysis of 303 patients admitted to our hospital in 2018-2020 who had AMI without cardiogenic shock. An IUC was inserted in the emergency room upon initiation of invasive catheter treatment and removed as soon as possible. The primary outcome was in-hospital adverse urinary event (IHAUE), which consisted of in-hospital urinary tract infection and in-hospital gross hematuria. RESULTS Of 303 patients, 243 patients (80.2 %) underwent IUC insertion. A lower proportion of patients with IUCs were male (72 % vs. 85 %, p = 0.044). A higher proportion had Killip classification 2 or 3 (13 % vs. 0 %, p = 0.003) or ST-elevation myocardial infarction (65 % vs. 32 %, p < 0.001). IHAUEs occurred significantly more commonly in patients with IUCs than without IUCs (11 % vs. 2 %, p = 0.023). Kaplan-Meier analysis showed that IHAUEs occurred more frequently in patients with IUCs than patients without IUCs (log-rank test p = 0.033). Furthermore, IUC use longer than the median of 2 days was associated with a higher odds ratio (OR) for IHAUE when compared with those without IUC use (OR, 3.65; 95 % confidence interval, 1.28-10.4; p = 0.015). There were no significant differences in in-hospital mortality by IUC status. CONCLUSIONS IUC use is associated with a higher risk of IHAUEs in patients with uncomplicated AMI. Routine IUC use might not be recommended.
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Affiliation(s)
- Toshiaki Suzuki
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan.
| | - Kota Murai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamasa Iwai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Kenichiro Sawada
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Kensuke Takagi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Soshiro Ogata
- Department of Clinical Research and Development, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Clinical Research and Development, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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22
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Yoshitani K, Ogata S, Kato S, Tsukinaga A, Takatani T, Kin N, Ezaka M, Shimizu J, Furuichi Y, Uezono S, Kida K, Seo K, Kakumoto S, Miyawaki H, Kawamata M, Tanaka S, Kakinohana M, Izumi S, Uchino H, Kakinuma T, Nishiwaki K, Hasegawa K, Matsumoto M, Ishida K, Yamashita A, Yamakage M, Yoshikawa Y, Morimoto Y, Saito H, Goto T, Masubuchi T, Kawaguchi M, Tsubaki K, Mizobuchi S, Obata N, Inagaki Y, Funaki K, Ishiguro Y, Sanui M, Taniguchi K, Nishimura K, Ohnishi Y. Effect of cerebrospinal fluid drainage pressure in descending and thoracoabdominal aortic repair: a prospective multicenter observational study. J Anesth 2023; 37:408-415. [PMID: 36944824 DOI: 10.1007/s00540-023-03179-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed. We hypothesize that CSFD at higher pressures is effective for preventing motor deficits. METHODS This prospective observational study included 14 hospitals that are members of the Japanese Society of Cardiovascular Anesthesiologists. Patients who underwent thoracic and thoracoabdominal aortic repair were divided into four groups: Group 1, CSF pressure around 10 mmHg; Group 2, CSF pressure around 15 mmHg; Group 3, CSFD initiated when motor evoked potential amplitudes decreased; and Group 4, no CSFD. We assessed the association between the CSFD group and motor deficits using mixed-effects logistic regression with a random intercept for the institution. RESULTS Of 1072 patients in the study, 84 patients (open surgery, 51; thoracic endovascular aortic repair, 33) had motor deficits at discharge. Groups 1 and 2 were not associated with motor deficits (Group 1, odds ratio (OR): 1.53, 95% confidence interval (95% CI): 0.71-3.29, p = 0.276; Group 2, OR: 1.73, 95% CI: 0.62-4.82) when compared with Group 4. Group 3 was significantly more prone to motor deficits than Group 4 (OR: 2.56, 95% CI: 1.27-5.17, p = 0.009). CONCLUSION CSFD is not associated with motor deficits in thoracic and thoracoabdominal aortic repair with CSF pressure around 10 or 15 mmHg.
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Affiliation(s)
- Kenji Yoshitani
- Department of Transfusion, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Osaka, 564-8565, Japan.
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Shinya Kato
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akito Tsukinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Department of Anesthesiology, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tsunenori Takatani
- Division of Central Clinical Laboratory, Nara Medical University, Kashihara, Nara, Japan
| | - Nobuhide Kin
- Department of Anesthesia, New Tokyo Hospital, Matsudo, Japan
| | - Mariko Ezaka
- Department of Anesthesia, New Tokyo Hospital, Matsudo, Japan
| | - Jun Shimizu
- Department of Anesthesiology, Sakakibara Heart Institute, Futyu, Japan
| | - Yuko Furuichi
- Department of Anesthesiology, Sakakibara Heart Institute, Futyu, Japan
| | - Shoichi Uezono
- Department of Anesthesiology, The Jikei University School of Medicine, Minato-ku, Japan
| | - Kotaro Kida
- Department of Anesthesiology, The Jikei University School of Medicine, Minato-ku, Japan
| | - Katsuhiro Seo
- Department of Emergency, Kokura Memorial Hospital, Fukuoka, Japan
| | - Shinichi Kakumoto
- Department of Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Hiroshi Miyawaki
- Department of Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Mikito Kawamata
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Manabu Kakinohana
- Department of Anesthesiology, Faculty of Medicine, University of Ryukyu, Nishihara, Japan
| | - Shunsuke Izumi
- Department of Anesthesiology, Faculty of Medicine, University of Ryukyu, Nishihara, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Japan
| | - Takayasu Kakinuma
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Japan
| | - Kimitoshi Nishiwaki
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuko Hasegawa
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mishiya Matsumoto
- Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kazuyoshi Ishida
- Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Atsuo Yamashita
- Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yusuke Yoshikawa
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yuji Morimoto
- Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hitoshi Saito
- Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takahisa Goto
- Department of Anesthesiology, School of Medicine, Yokohama City University, Yokohama, Japan
- Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Tetsuhito Masubuchi
- Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Kosuke Tsubaki
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Satoshi Mizobuchi
- Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Norihiko Obata
- Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimi Inagaki
- Division of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazumi Funaki
- Division of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiki Ishiguro
- Department of Anesthesiology, The Jikei University School of Medicine, Minato-ku, Japan
- Department of Anesthesiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masamitsu Sanui
- Department of Anesthesiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | | | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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23
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Hayashi C, Ogata S, Toyoda H, Tanemura N, Okano T, Umeda M, Mashino S. Risk factors for fracture by same-level falls among workers across sectors: a cross-sectional study of national open database of the occupational injuries in Japan. Public Health 2023; 217:196-204. [PMID: 36907029 DOI: 10.1016/j.puhe.2023.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES The hospitalisation rate for work-related injuries among older workers is double that of younger workers; however, the risk factors for same-level fall fractures sustained during industrial accidents remain unclear. This study aimed to estimate the influence of worker age, time of day and weather conditions on the risk of same-level fall fractures in all industrial sectors in Japan. STUDY DESIGN This was a cross-sectional study. METHODS This study used the population-based national open database of worker death and injury reports in Japan. In total, 34,580 reports of occupational same-level falls between 2012 and 2016 were used in this study. Multiple logistic regression analysis was performed. RESULTS In primary industries, workers aged ≥55 years had a 1.684 times greater risk of fracture (95% confidence interval [CI]: 1.167-2.430) compared with workers aged ≤54 years. In tertiary industries, relative to the odds ratio (OR) of injuries recorded at 0:00-2:59 a.m., the ORs recorded at 6:00-8:59 p.m., 6:00-8:59 a.m., 9:00-11:59 p.m. and 0:00-2:59 p.m. were 1.516 (95% CI: 1.202, 1.912), 1.502 (95% CI: 1.203-1.876), 1.348 (95% CI: 1.043-1.741) and 1.295 (95% CI: 1.039-1.614), respectively. The risk of fracture increased with a 1-day increase in the number of snowfall days were per month in secondary (OR = 1.056, 95% CI: 1.011-1.103) and tertiary (OR = 1.034, 95% CI: 1.009-1.061) industries. The risk of fracture decreased with every 1-degree increase in the lowest temperature in primary (OR = 0.967, 95% CI: 0.935-0.999) and tertiary (OR = 0.993, 95% CI: 0.988-0.999) industries. CONCLUSIONS With the increasing number of older workers and changing environmental conditions, the risk of falls in the tertiary sector industries is increasing, particularly just before and just after shift change hours. These risks may be associated with environmental obstacles during work migration. It is also important to consider the weather-associated risks of fracture.
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Affiliation(s)
- C Hayashi
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo, 673-8588, Japan.
| | - S Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - H Toyoda
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka, 545-8585, Japan; Department of General Practice, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan
| | - N Tanemura
- National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan
| | - T Okano
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka, 545-8585, Japan
| | - M Umeda
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo, 673-8588, Japan
| | - S Mashino
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo, 673-8588, Japan
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24
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Ogata S, Akashi Y, Kato S, Oka Y, Suda A, Yoshizaki S, Maeda Y, Nishimura K, Maeda K, Nakai S. Association Between Dietary Potassium Intake Estimated From Multiple 24-Hour Urine Collections and Serum Potassium in Patients With CKD. Kidney Int Rep 2023; 8:584-595. [PMID: 36938093 PMCID: PMC10014441 DOI: 10.1016/j.ekir.2022.12.005] [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: 11/01/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Limited and inconclusive evidence for the association of dietary potassium intake with serum potassium in chronic kidney disease (CKD) patients have been shown, though restricting dietary potassium has been recommended for CKD patients to prevent hyperkalemia. Multiple 24-hour urine collections are necessary to adequately assess potassium intake. We investigated associations of 24-hour urinary potassium excretion (UKV) with serum potassium in CKD outpatients based on multiple 24-hour urine collections. Methods This retrospective cohort study was based on outpatients with CKD stages G3 to G5, median age of 72.0 years; and median follow-up of 3.9 months and 8.9 months, respectively, for analyses using 3-time measurement (N = 290 and 870 observations) and 7-time measurements (N = 220 and 1540 observations). The outcome was serum potassium. Results Multivariable-adjusted mean difference in serum potassium (mEq/l) and odds ratio of hyperkalemia per 10 mEq/d increase in UKV were, respectively, 0.12 (95% confidence interval [CI]: 0.09-0.15) and 2.15 (1.70-2.73) in generalized estimating equations (GEEs) with 3-time measurements. The mean difference became more pronounced as CKD stages progressed: 0.08 (0.05-0.12), 0.12 (0.08-0.16), and 0.16 (0.12-0.20) for CKD G3, G4, and G5. Similar results were obtained from analyses using 7-time measurements and hierarchical Bayesian measurement error models treating measurement error of UKV adequately. Conclusion We suggest significant but weak associations (R2: 0.08, 0.14, and 0.18 for CKD G3, G4, and G5) between serum potassium and dietary potassium intake estimated by multiple 24-hour urine collections in CKD patients. Further studies are needed to validate nutritional and clinical aspects of the associations.
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Affiliation(s)
- Soshiro Ogata
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuumi Akashi
- Faculty of Nursing, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | - Satoshi Kato
- HU Group Research Institute GK, Akiruno, Tokyo, Japan
| | - Yuma Oka
- HU Group Research Institute GK, Akiruno, Tokyo, Japan
| | - Akari Suda
- HU Group Research Institute GK, Akiruno, Tokyo, Japan
| | | | - Yuko Maeda
- Daiko-Sunadabashi Clinic, Nagoya, Aichi, Japan
| | - Kunihiro Nishimura
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenji Maeda
- Daiko-Sunadabashi Clinic, Nagoya, Aichi, Japan
| | - Shigeru Nakai
- Faculty of Nursing, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
- Correspondence: Shigeru Nakai, Faculty of Nursing, Fujita Health University School of Health Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
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25
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Yang LT, Lee CC, Su CH, Amano M, Nabeshima Y, Kitano T, Tsai CM, Hung CL, Nakaoku Y, Nishimura K, Ogata S, Lo HY, Hsu RB, Chen YS, Chen WJ, Mankad R, Pellikka PA, Ho YL, Takeuchi M, Izumi C. Analysis of Left Ventricular Indexes and Mortality Among Asian Adults With Hemodynamically Significant Chronic Aortic Regurgitation. JAMA Netw Open 2023; 6:e234632. [PMID: 36961461 DOI: 10.1001/jamanetworkopen.2023.4632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Importance Chronic hemodynamically significant aortic regurgitation (AR) is associated with excess risk of death, yet data for Asian patients are lacking, and whether Asian patients can abide by Western guidelines as to when aortic valve surgery should be performed is unknown. Objective To assess AR presentation and cutoffs of left ventricular ejection fraction (LVEF), LV end-systolic dimension index (LVESDi), and LV end-systolic volume index (LVESVi) that are associated with risk of death in Asian patients with AR. Design, Setting, and Participants This retrospective cohort study included consecutive patients with chronic, moderately severe to severe AR from 3 tertiary referral centers (2 in Japan and 1 in Taiwan) from June 11, 2008, through November 19, 2020, with follow-up through November 11, 2021. Exposures Aortic regurgitation severity, graded by a comprehensive integrated approach. Main Outcomes and Measures The primary outcome was the association between volume-derived LVEF, LVESDi, and LVESVi and all-cause death (ACD). The secondary outcome was the association of these LV indexes with cardiovascular death (CVD). Clinical and echocardiographic data were analyzed retrospectively. A de novo disk-summation method was used to derive LV volumes and volume-derived LVEF. Results Of 1259 patients (mean [SD] age, 64 [17] years; 934 [74%] male), 515 (41%) were Japanese and 744 (59%) were Taiwanese. The median follow-up was 4.1 years (IQR, 1.56-7.24 years). The mean (SD) body surface area was 1.67 (0.21) m2; LVEF, 55% (11%); LVESDi, 24.7 (5.7) mm/m2; LVESVi, 50.1 (28.0) mL/m2; and indexed mid-ascending aorta size, 24.7 (5.5) mm/m2. Aortic valve surgery occurred in 483 patients (38%); 240 patients (19%) died during follow-up. Overall mean (SD) 8-year survival was 74% (2%). Separate multivariate models adjusted for covariates demonstrated independent associations of LVEF, LVESDi, and LVESVi with ACD (LVEF: hazard ratio [HR] per 10%, 0.80; 95% CI, 0.70-0.92; P = .002; LVESDi: HR, 1.04; 95% CI, 1.01-1.06; P = .002; LVESVi: HR per 10 mL/m2, 1.11; 95% CI, 1.05-1.17; P < .001) and CVD (LVEF: HR per 10%, 0.69; 95% CI, 0.56-0.85; P < .001; LVESDi: HR, 1.05; 95% CI, 1.01-1.09; P = .01; LVESVi per 10 mL/m2: HR, 1.15; 95% CI, 1.06-1.24; P < .001). In the total cohort, spline curves showed that mortality started to increase for an LVEF of 53% or less, LVESDi of 22 mm/m2 or greater, and LVESVi of 46 mL/m2 or greater for both ACD and CVD. Early surgery was beneficial in 3 strata of LVESDi (<20, 20 to <25, and ≥25 mm/m2) and 2 strata of LVESVi (<46 and ≥46 mL/m2). Conclusions and Relevance This multicenter cohort study of Asian patients with hemodynamically significant AR found cutoff values of LVEF, LVESDi, and LVESVi that were associated with increased risk of death. These findings suggest that Western guidelines seem applicable in Asian patients and, most importantly, that indexed LV parameters with a lower cutoff could be used in discriminating patients with excess mortality risk.
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Affiliation(s)
- Li-Tan Yang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Intelligent Healthcare, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Hua Su
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Masashi Amano
- Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yosuke Nabeshima
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tetsuji Kitano
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Chieh-Mei Tsai
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-Lieh Hung
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hao-Yun Lo
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ron-Bin Hsu
- Cardiovascular Center and Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yih-Sharng Chen
- Cardiovascular Center and Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Jone Chen
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Rekha Mankad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Yi-Lwun Ho
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Chisato Izumi
- Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
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26
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Tanaka T, Fukuma K, Abe S, Matsubara S, Ikeda S, Kamogawa N, Ishiyama H, Hosoki S, Kobayashi K, Shimotake A, Nakaoku Y, Ogata S, Nishimura K, Koga M, Toyoda K, Matsumoto R, Takahashi R, Ikeda A, Ihara M. Association of Cortical Superficial Siderosis with Post-Stroke Epilepsy. Ann Neurol 2023; 93:357-370. [PMID: 36053955 PMCID: PMC10087209 DOI: 10.1002/ana.26497] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 08/06/2022] [Accepted: 08/29/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess whether post-stroke epilepsy (PSE) is associated with neuroimaging findings of hemosiderin in a case-control study, and whether the addition of hemosiderin markers improves the risk stratification models of PSE. METHODS We performed a post-hoc analysis of the PROgnosis of POST-Stroke Epilepsy study enrolling PSE patients at National Cerebral and Cardiovascular Center, Osaka, Japan, from November 2014 to September 2019. PSE was diagnosed when one unprovoked seizure was experienced >7 days after the index stroke, as proposed by the International League Against Epilepsy. As controls, consecutive acute stroke patients with no history or absence of any late seizure or continuing antiseizure medications at least 3 months after stroke were retrospectively enrolled during the same study period. We examined cortical microbleeds and cortical superficial siderosis (cSS) using gradient-echo T2*-weighted images. A logistic regression model with ridge penalties was tuned using 10-fold cross-validation. We added the item of cSS to the existing models (SeLECT and CAVE) for predicting PSE and evaluated performance of new models. RESULTS The study included 180 patients with PSE (67 women; median age 74 years) and 1,183 controls (440 women; median age 74 years). The cSS frequency was higher in PSE than control groups (48.9% vs 5.7%, p < 0.0001). Compared with the existing models, the new models with cSS (SeLECT-S and CAVE-S) demonstrated significantly better predictive performance of PSE (net reclassification improvement 0.63 [p = 0.004] for SeLECT-S and 0.88 [p = 0.001] for CAVE-S at the testing data). INTERPRETATION Cortical superficial siderosis was associated with PSE, stratifying stroke survivors at high risk of PSE. ANN NEUROL 2023;93:357-370.
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Affiliation(s)
- Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuki Fukuma
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soichiro Abe
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soichiro Matsubara
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shuhei Ikeda
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Naruhiko Kamogawa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroyuki Ishiyama
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Hosoki
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Katsuya Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Shimotake
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuriko Nakaoku
- Departments of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Departments of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Departments of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
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27
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Kiyoshige E, Ogata S, O'Flaherty M, Capewell S, Takegami M, Iihara K, Kypridemos C, Nishimura K. Projections of future coronary heart disease and stroke mortality in Japan until 2040: a Bayesian age-period-cohort analysis. Lancet Reg Health West Pac 2023; 31:100637. [PMID: 36879780 PMCID: PMC9985054 DOI: 10.1016/j.lanwpc.2022.100637] [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] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/19/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022]
Abstract
Background We aimed to estimate the future burden of coronary heart disease (CHD) and stroke mortalities by sex and all 47 prefectures of Japan until 2040 while accounting for effects of age, period, and cohort and integrating them to be at the national level to account for regional differences among prefectures. Methods We estimated future CHD and stroke mortality projections, developing Bayesian age-period-cohort (BAPC) models in population and the number of CHD and stroke by age, sex, and all 47 prefectures observed from 1995 to 2019; then applying these to official future population estimates until 2040. The present participants were all men and women aged over 30 years and were residents of Japan. Findings In the BAPC models, the predicted number of national-level cardiovascular deaths from 2020 to 2040 would decrease (39,600 [95% credible interval: 32,200-47,900] to 36,200 [21,500-58,900] CHD deaths in men, and 27,400 [22,000-34,000] to 23,600 [12,700-43,800] in women; and 50,400 [41,900-60,200] to 40,800 [25,200-67,800] stroke deaths in men, and 52,200 [43,100-62,800] to 47,400 [26,800-87,200] in women). Interpretation After adjusting these factors, future CHD and stroke deaths will decline until 2040 at the national level and in most prefectures. Funding This research was supported by the Intramural Research Fund of Cardiovascular Diseases of the National Cerebral and Cardiovascular Center (21-1-6, 21-6-8), JSPS KAKENHI Grant Number JP22K17821, and the Ministry of Health, Labour and Welfare Comprehensive Research on Life-Style Related (Diseases Cardiovascular Diseases and Diabetes Mellitus Program), Grant Number 22FA1015.
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Affiliation(s)
- Eri Kiyoshige
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Simmachi, Suita, Osaka 564-8565, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Simmachi, Suita, Osaka 564-8565, Japan
| | - Martin O'Flaherty
- Department of Public Health, Policy and Systems, University of Liverpool, L69 3GB, Brownlow Street, Liverpool, UK
| | - Simon Capewell
- Department of Public Health, Policy and Systems, University of Liverpool, L69 3GB, Brownlow Street, Liverpool, UK
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Simmachi, Suita, Osaka 564-8565, Japan
| | - Koji Iihara
- Director General, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan
| | - Chris Kypridemos
- Department of Public Health, Policy and Systems, University of Liverpool, L69 3GB, Brownlow Street, Liverpool, UK
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Simmachi, Suita, Osaka 564-8565, Japan
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28
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Kawarada O, Zen K, Hozawa K, Obara H, Matsubara K, Yamamoto Y, Doijiri T, Tamai N, Ito S, Higashimori A, Kawasaki D, Doi H, Matsushita K, Tsukahara K, Noda K, Shimpo M, Tsuda Y, Sonoda S, Taniguchi T, Waseda K, Munehisa M, Taguchi E, Kinjo T, Sasaki Y, Yuba K, Yamaguchi S, Nakagami T, Ayabe S, Sakamoto S, Yagyu T, Ogata S, Nishimura K, Motomura H, Noguchi T, Ishihara M, Ogawa H, Yasuda S. Characteristics, Antithrombotic Patterns, and Prognostic Outcomes in Claudication and Critical Limb-Threatening Ischemia Undergoing Endovascular Therapy. J Endovasc Ther 2022:15266028221134886. [DOI: 10.1177/15266028221134886] [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: 11/24/2022]
Abstract
Purpose: The underlying difference between intermittent claudication (IC) and critical limb-threatening ischemia (CLTI) still remains unclear. This prospective multicenter observational study aimed to clarify differences in clinical features and prognostic outcomes between IC and CLTI, and prognostic factors in patients undergoing endovascular therapy (EVT). Materials and Methods: A total of 692 patients with 808 limbs were enrolled from 20 institutions in Japan. The primary measurements were the 3-year rates of major adverse cardiovascular event (MACE) and reintervention. Results: Among patients, 79.0% had IC and 21.0% had CLTI. Patients with CLTI were more frequently women and more likely to have impaired functional status, undernutrition, comorbidities, hypercoagulation, hyperinflammation, distal artery disease, short single antiplatelet and long anticoagulation therapies, and late cilostazol than patients with IC. Aortoiliac and femoropopliteal diseases were dominant in patients with IC and infrapopliteal disease was dominant in patients with CLTI. Patients with CLTI underwent less frequently aortoiliac intervention and more frequently infrapopliteal intervention than patients with IC. Longitudinal change of ankle-brachial index (ABI) exhibited different patterns between IC and CLTI (pinteraction=0.002), but ABI improved after EVT both in IC and in CLTI (p<0.001), which was sustained over time. Dorsal and plantar skin perfusion pressure in CLTI showed a similar improvement pattern (pinteraction=0.181). Distribution of Rutherford category improved both in IC and in CLTI (each p<0.001). Three-year MACE rates were 20.4% and 42.3% and 3-year reintervention rates were 22.1% and 46.8% for patients with IC and CLTI, respectively (log-rank p<0.001). Elevated D-dimer (p=0.001), age (p=0.043), impaired functional status (p=0.018), and end-stage renal disease (p=0.019) were independently associated with MACE. After considering competing risks of death and major amputation for reintervention, elevated erythrocyte sedimentation rate (p=0.003) and infrainguinal intervention (p=0.002) were independently associated with reintervention. Patients with CLTI merely showed borderline significance for MACE (adjusted hazard ratio 1.700, 95% confidence interval 0.950–3.042, p=0.074) and reintervention (adjusted hazard ratio 1.976, 95% confidence interval 0.999–3.909, p=0.05). Conclusions: The CLTI is characterized not only by more systemic comorbidities and distal disease but also by more inflammatory coagulation disorder compared with IC. Also, CLTI has approximately twice MACE and reintervention rates than IC, and the underlying inflammatory coagulation disorder per se is associated with these outcomes. Clinical Impact The underlying difference between intermittent claudication (IC) and critical limb-threatening ischemia (CLTI) still remains unclear. This prospective multicenter observational study, JPASSION study found that CLTI was characterized not only by more systemic comorbidities and distal disease but also by more inflammatory coagulation disorder compared to IC. Also, CLTI had approximately twice major adverse cardiovascular event (MACE) and reintervention rates than IC. Intriguingly, the underlying inflammatory coagulation disorder per se was independently associated with MACE and reintervention. Further studies to clarify the role of anticoagulation and anti-inflammatory therapies will contribute to the development of post-interventional therapeutics in the context of peripheral artery disease.
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Affiliation(s)
- Osami Kawarada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Kawarada Cardio Foot Vascular Clinic, Osaka, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Cardiology, Omihachiman Community Medical Center, Omihachiman, Japan
| | - Koji Hozawa
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshito Yamamoto
- Department of Cardiology, Iwaki City Medical Center, Iwaki, Japan
| | - Tatsuki Doijiri
- Department of Cardiology, Yamato Seiwa Hospital, Yamato, Japan
| | - Nozomu Tamai
- Division of Cardiology, Nagoya City University East Medical Center, Nagoya, Japan
| | - Shigenori Ito
- Division of Cardiology, Nagoya City University East Medical Center, Nagoya, Japan
| | | | - Daizo Kawasaki
- Department of Cardiology, Morinomiya Hospital, Osaka, Japan
| | - Hideki Doi
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Japan
| | - Kensuke Matsushita
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kengo Tsukahara
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsuo Noda
- Division of Cardiology, Kumamoto Central Hospital, Kumamoto, Japan
| | - Masahisa Shimpo
- Division of Cardiovascular Medicine, Department of Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yuki Tsuda
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shinjo Sonoda
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Cardiology, Saga University, Saga, Japan
| | - Takuya Taniguchi
- Department of Cardiovascular Medicine, North Medical Center, Kyoto Prefectural University of Medicine, Yosa-gun, Kyoto, Japan
| | - Katsuhisa Waseda
- Department of Cardiology, Aichi Medical University, Nagakute, Japan
| | - Masato Munehisa
- Department of Cardiology, Yuri Kumiai General Hospital, Yurihonjo, Japan
| | - Eiji Taguchi
- Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Tatsuya Kinjo
- Department of Cardiology, Chidoribashi Hospital, Fukuoka, Japan
| | - Yohei Sasaki
- Department of Cardiology, Chidoribashi Hospital, Fukuoka, Japan
| | - Kenichiro Yuba
- Department of Cardiology, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Shinichiro Yamaguchi
- Department of Cardiology, Omihachiman Community Medical Center, Omihachiman, Japan
| | - Takuo Nakagami
- Department of Cardiology, Omihachiman Community Medical Center, Omihachiman, Japan
| | - Shinobu Ayabe
- Department of Plastic Surgery, Yao Tokushukai General Hospital, Yao, Japan
| | - Shingo Sakamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Yagyu
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hisashi Motomura
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masaharu Ishihara
- Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan
| | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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29
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Ohyama Y, Yamaguchi H, Ogata S, Chiurlia S, Cox SN, Kouri NM, Stangou MJ, Nakajima K, Hayashi H, Inaguma D, Hasegawa M, Yuzawa Y, Tsuboi N, Renfrow MB, Novak J, Papagianni AA, Schena FP, Takahashi K. Racial heterogeneity of IgA1 hinge-region O-glycoforms in patients with IgA nephropathy. iScience 2022; 25:105223. [PMID: 36277451 PMCID: PMC9583103 DOI: 10.1016/j.isci.2022.105223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/22/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Galactose (Gal)-deficient IgA1 (Gd-IgA1) is involved in IgA nephropathy (IgAN) pathogenesis. To reflect racial differences in clinical characteristics, we assessed disease- and race-specific heterogeneity in the O-glycosylation of the IgA1 hinge region (HR). We determined serum Gd-IgA1 levels in Caucasians (healthy controls [HCs], n = 31; IgAN patients, n = 63) and Asians (HCs, n = 20; IgAN patients, n = 60) and analyzed profiles of serum IgA1 HR O-glycoforms. Elevated serum Gd-IgA1 levels and reduced number of Gal residues per HR were observed in Caucasians. Reduced number of N-acetylgalactosamine (GalNAc) residues per HR and elevated relative abundance of IgA1 with three HR O-glycans were common features in IgAN patients; these features were associated with elevated blood pressure and reduced renal function. We speculate that the mechanisms underlying the reduced GalNAc content in IgA1 HR may be relevant to IgAN pathogenesis.
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Affiliation(s)
- Yukako Ohyama
- Department of Biomedical Molecular Sciences, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Hisateru Yamaguchi
- Department of Nursing, Yokkaichi Nursing and Medical Care University, Yokkaichi, Mie 512-8045, Japan
| | - Soshiro Ogata
- Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan
| | - Samantha Chiurlia
- University of Bari and Schena Foundation, Valenzano, Bari 70010, Italy
| | - Sharon N. Cox
- University of Bari and Schena Foundation, Valenzano, Bari 70010, Italy
| | - Nikoletta-Maria Kouri
- Department of Nephrology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - Maria J. Stangou
- Department of Nephrology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - Kazuki Nakajima
- Institute for Glyco-core Research, Gifu University, Gifu, Gifu 501-1193, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Daijo Inaguma
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Midori Hasegawa
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Yukio Yuzawa
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Naotake Tsuboi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Matthew B. Renfrow
- Departments of Biochemistry and Molecular Genetics and Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jan Novak
- Departments of Biochemistry and Molecular Genetics and Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | | | - Kazuo Takahashi
- Department of Biomedical Molecular Sciences, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
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30
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Tsukinaga A, Yoshitani K, Ozaki T, Takahashi JC, Ogata S, Ohnishi Y. Quantitative regional cerebral blood flow measurement using near-infrared spectroscopy and indocyanine green in patients undergoing superficial temporal to middle cerebral artery bypass for moyamoya disease: a novel method using a frequency filter. J Clin Monit Comput 2022; 37:421-429. [PMID: 36167879 DOI: 10.1007/s10877-022-00916-z] [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: 06/30/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Abstract
Measuring regional cerebral blood flow (rCBF) after revascularization for moyamoya disease, as a type of ischemic cerebrovascular disease, is crucial. This study aims to validate our novel technology that combines near-infrared spectroscopy (NIRS) with a frequency filter to extract the arterial component. We measured rCBF before and after revascularization for moyamoya disease and at the end of the surgery using NIRO-200NX (Hamamatsu Photonics, Japan) and indocyanine green (ICG). rCBF was calculated using Fick's principle, change in arterial ICG concentrations, and maximum arterial ICG concentration. rCBF measured with NIRS (rCBF_N) was compared with pre- and postoperative rCBF measured with SPECT (rCBF_S). Thirty-four procedures were analyzed. rCBF_N increased from baseline to end of the surgery (mean difference (MD), 2.99 ml/min/100 g; 95% confidence interval (CI), 0.40-5.57 ml/min/100 g on the diseased side; MD, 4.94 ml/min/100 g; 95% CI, 2.35-7.52 ml/min/100 g on the non-diseased side). Similar trends were observed for rCBF_S (MD, 3.98 ml/min/100 g; 95% CI, 2.30-5.67 ml/min/100 g on the diseased side; MD, 2.77 ml/min/100 g; 95% CI, 1.09-4.45 ml/min/100 g on the non-diseased side). Intraclass correlations 3 (ICC3s) between rCBF_N and rCBF_S were weak on the diseased side (ICC3, 0.25; 95% CI, -0.03-0.5; p = 0.07) and the non-diseased side (ICC3, 0.24; 95% CI, -0.05-0.5; p = 0.08). rCBF measurements based on this novel method were weakly correlated with rCBF measurements with SPECT.
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Affiliation(s)
- Akito Tsukinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, SuitaOsaka, 564-8565, Japan
| | - Kenji Yoshitani
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, SuitaOsaka, 564-8565, Japan.
| | - Takeo Ozaki
- Systems Division, Hamamatsu Photonics K.K, Hamamatsu, Japan
| | - Jun C Takahashi
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, SuitaOsaka, 564-8565, Japan
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31
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Fujimoto W, Toh R, Takegami M, Imanishi J, Hamana T, Odajima S, Takemoto M, Kuroda K, Hatani Y, Yamashita S, Iwasaki M, Inoue T, Okamoto H, Todoroki T, Okuda M, Hayashi T, Konishi A, Tanaka H, Shinohara M, Nagao M, Murata S, Ogata S, Nishimura K, Hirata K. Aetiology of chronic heart failure in patients from a super-aged society: the KUNIUMI registry chronic cohort. ESC Heart Fail 2022; 10:100-110. [PMID: 36151724 PMCID: PMC9871726 DOI: 10.1002/ehf2.14162] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/25/2022] [Accepted: 09/10/2022] [Indexed: 01/29/2023] Open
Abstract
AIMS With the rapidly increasing ageing population, heart failure is an urgent challenge, particularly in developed countries. The study aimed to investigate the main aetiologies of chronic heart failure in a super-aged society. METHODS AND RESULTS The KUNIUMI registry chronic cohort is a community-based, prospective, observational study of chronic heart failure in Awaji Island, Japan. Inhabitants of this island aged ≥65 years accounted for 36.3% of the population. In the present study, data from patients with symptomatic heart failure were extracted from the registry. A total of 1646 patients were enrolled from March 2019 to March 2021, accounting for ~1.3% of the inhabitants of Awaji Island. We analysed 852 patients with symptomatic heart failure. The mean age was high (78.7 ± 11.1 years), with 357 patients (41.9%) being female. The proportion of women increased significantly with advancing age and constituted more than half of the patients aged 85 years and older (P < 0.01). The prevalence of atrial fibrillation, and in particular long-standing persistent atrial fibrillation, increased at 70 years of age (P < 0.01). The proportion of patients with heart failure with preserved ejection fraction increased to ~60% when age was over 75 years. Although ischaemic heart disease accounted for 35.0% of chronic heart failure aetiologies, valvular heart disease was the most common cause of chronic heart failure (49.8%). The major types of valvular heart disease were mitral regurgitation and tricuspid regurgitation (27.2% and 21.7%, respectively), both of which increased significantly with age (P < 0.01). The incidence of aortic valve stenosis increased markedly over the age of 85 years (P < 0.01). Atrial functional mitral regurgitation increased with age and was the major cause of mitral regurgitation in patients aged >75 years. Patients with atrial functional mitral regurgitation had a higher prevalence of atrial fibrillation (especially long-standing persistent atrial fibrillation) and a larger left atrial volume index when compared with patients with other types of mitral regurgitation (P < 0.001, respectively). CONCLUSIONS The KUNIUMI registry chronic cohort showed a change in heart failure aetiology to valvular heart disease in a super-aged society. Effective and comprehensive countermeasures are required to prepare for the rapid rise in heart failure incidence in a super-aged society.
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Affiliation(s)
- Wataru Fujimoto
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan,Division of Cardiovascular MedicineKobe University Graduate School of MedicineKobeJapan
| | - Ryuji Toh
- Division of Evidence‐based Laboratory MedicineKobe University Graduate School of Medicine7‐5‐1 Kusunoki‐cho, Chuo‐kuKobe650‐0017Japan
| | - Misa Takegami
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular Center6‐1 Kishibeshin‐machiSuitaOsaka564‐8565Japan
| | - Junichi Imanishi
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Tomoyo Hamana
- Division of Cardiovascular MedicineKobe University Graduate School of MedicineKobeJapan
| | - Susumu Odajima
- Division of Cardiovascular MedicineKobe University Graduate School of MedicineKobeJapan
| | - Makoto Takemoto
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Koji Kuroda
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Yutaka Hatani
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Soichiro Yamashita
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Masamichi Iwasaki
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Takumi Inoue
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Hiroshi Okamoto
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Takafumi Todoroki
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Masanori Okuda
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Takatoshi Hayashi
- Department of CardiologyHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Akihide Konishi
- Clinical & Translational Research CenterKobe University HospitalKobeJapan
| | - Hidekazu Tanaka
- Division of Cardiovascular MedicineKobe University Graduate School of MedicineKobeJapan
| | - Masakazu Shinohara
- Division of EpidemiologyKobe University Graduate School of MedicineKobeJapan
| | - Manabu Nagao
- Division of Evidence‐based Laboratory MedicineKobe University Graduate School of Medicine7‐5‐1 Kusunoki‐cho, Chuo‐kuKobe650‐0017Japan
| | - Shunsuke Murata
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular Center6‐1 Kishibeshin‐machiSuitaOsaka564‐8565Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular Center6‐1 Kishibeshin‐machiSuitaOsaka564‐8565Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular Center6‐1 Kishibeshin‐machiSuitaOsaka564‐8565Japan
| | - Ken‐ichi Hirata
- Division of Cardiovascular MedicineKobe University Graduate School of MedicineKobeJapan,Division of Evidence‐based Laboratory MedicineKobe University Graduate School of Medicine7‐5‐1 Kusunoki‐cho, Chuo‐kuKobe650‐0017Japan
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32
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Ren N, Ogata S, Kiyoshige E, Nishimura K, Nishimura A, Matsuo R, Kitazono T, Higashi T, Ogasawara K, Iihara K. Associations Between Adherence to Evidence-Based, Stroke Quality Indicators and Outcomes of Acute Reperfusion Therapy. Stroke 2022; 53:3359-3368. [PMID: 35971841 PMCID: PMC9586826 DOI: 10.1161/strokeaha.121.038483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Quality indicators (QIs) are an accepted tool for measuring a hospital’s performance in routine care. We examined national trends in adherence to the QIs developed by the Close The Gap-Stroke program by combining data from the health insurance claims database and electronic medical records, and the association between adherence to these QIs and early outcomes in patients with acute ischemic stroke in Japan.
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Affiliation(s)
- Nice Ren
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan (N.R., S.O., E.K., K.N.).,Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.R., A.N.)
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan (N.R., S.O., E.K., K.N.)
| | - Eri Kiyoshige
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan (N.R., S.O., E.K., K.N.)
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan (N.R., S.O., E.K., K.N.)
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.R., A.N.)
| | - Ryu Matsuo
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. (R.M.)
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. (T.K.)
| | - Takahiro Higashi
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center, Tokyo (T.H.)
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan (K.O.)
| | - Koji Iihara
- Director General, National Cerebral and Cardiovascular Center Hospital, Suita, Japan (K.I.)
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Nakashima T, Ogata S, Noguchi T, Nishimura K, Hsu CH, Sefa N, Haas NL, Bĕlohlávek J, Pellegrino V, Tonna JE, Haft J, Neumar RW. Association of intentional cooling, achieved temperature and hypothermia duration with in-hospital mortality in patients treated with extracorporeal cardiopulmonary resuscitation: An analysis of the ELSO Registry. Resuscitation 2022; 177:43-51. [PMID: 35788020 DOI: 10.1016/j.resuscitation.2022.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 03/07/2022] [Revised: 05/29/2022] [Accepted: 06/26/2022] [Indexed: 12/12/2022]
Abstract
AIM To investigate whether intentional cooling, achieved temperature and hypothermia duration were associated with in-hospital death in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest. METHODS This is a retrospective analysis of the Extracorporeal Life Support Organization Registry. Patients 18-79 years of age who received ECPR between 2010 and 2019 were included. We compared outcomes for intentional cooling versus no intentional cooling. Then, among those who completed intentional cooling, we compared the outcomes between i) achieved temperature ≤34℃, 34-36℃, and >36℃, and ii) duration ≤36℃ for <12 hours, 12-48 hours, and ≥48 hours. The primary outcome was in-hospital mortality within 90 days. Cox proportional hazard models were generated with adjustment for covariates. RESULTS Among 4,214 ECPR patients, 1,511 patients were included in the final analysis. After multivariable adjustment, there was no significant difference in in-hospital mortality between patients with intentional cooling and no intentional cooling (hazard ratio [HR], 1.06 [95% CI 0.92-1.21]; p=0.395). In the 609 patients who completed intentional cooling, temperature at 34-36℃ had a significantly lower adjusted HR for in-hospital mortality compared with >36℃ (HR, 0.73 [0.55-0.96]; p=0.025). Moreover, temperature ≤36℃ for 12-48 hours had a significantly lower adjusted HR for in-hospital mortality compared with ≤36℃ for <12 hours (HR, 0.69 [0.53-0.90]; p=0.005). CONCLUSION Intentional cooling was not associated with lower in-hospital mortality in ECPR patients. However, among patients with intentional cooling, achieving temperature of 34-36℃ for 12-48 hours was associated with lower in-hospital mortality.
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Affiliation(s)
- Takahiro Nakashima
- Department of Emergency Medicine and the Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, United States; Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Centre, Suita, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Cindy H Hsu
- Department of Emergency Medicine and the Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, United States
| | - Nana Sefa
- Department of Emergency Medicine and the Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, United States
| | - Nathan L Haas
- Department of Emergency Medicine and the Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, United States
| | - Jan Bĕlohlávek
- 2nd Department of Internal Medicine, Cardiovascular Medicine, General University Hospital, Prague, Czech Republic
| | | | - Joseph E Tonna
- Department of Surgery, University of Utah, Salt Lake City, United States
| | - Jonathan Haft
- Department of Thoracic Surgery, University of Michigan, Ann Arbor, United States
| | - Robert W Neumar
- Department of Emergency Medicine and the Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, United States
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34
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Murata S, Takegami M, Ogata S, Ono R, Nakatsuka K, Nakaoku Y, Iihara K, Hagihara A, Nishimura K. Joint effect of cognitive decline and walking ability on incidence of wandering behavior in older adults with dementia: A cohort study. Int J Geriatr Psychiatry 2022; 37. [PMID: 35451122 DOI: 10.1002/gps.5714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/04/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Wandering behavior is one of the most troublesome behavioral disturbances in dementia. Inconsistent associations between physical function and wandering behavior were reported, and the effect of cognitive decline may be different according to walking ability. The purposes of this study are to investigate whether high walking ability is a risk factor for wandering behavior and to investigate the interaction of walking ability and cognitive function with wandering behavior in older adults with dementia. METHODS This retrospective cohort study included 3979 elderly adults with dementia. The association of cognitive function and walking ability with incidence of wandering behavior during a 5-year follow-up period were examined using a generalized linear model, and relative excess risk due to interaction (RERI) was calculated. RESULTS Severe cognitive decline and high walking ability were associated with a higher risk for wandering behavior. Additionally, some joint effects of cognitive decline and walking ability decline were higher than the sum of its individual effects (RERI [95% confidence interval], severe cognitive decline × 'walk with help': 1.58 [0.35, 2.81]; severe cognitive decline × 'independent': 3.09 [1.05, 5.14]). CONCLUSIONS Effects of cognitive decline and walking ability on incidence of wandering behavior were observed, and the effects varied depending on their combination.
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Affiliation(s)
- Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan.,Department of Public Health, Kobe University, Graduate School of Health Sciences, Kobe, Hyogo, Japan.,Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Rei Ono
- Department of Public Health, Kobe University, Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Kiyomasa Nakatsuka
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan.,Department of Public Health, Kobe University, Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Koji Iihara
- Director General, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan
| | - Akihito Hagihara
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
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35
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Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, Lee IM, D'Agostino D, Buring JE, Cook NR, Grodstein F, Manson JE. Marine n-3 fatty acids and cognitive change among older adults in the VITAL randomized trial. Alzheimers Dement (N Y) 2022; 8:e12288. [PMID: 35415212 PMCID: PMC8984093 DOI: 10.1002/trc2.12288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 12/19/2022]
Abstract
Introduction : Few large, randomized trials have evaluated marine n‐3 supplements and cognition in healthy older adults. Methods : Healthy community‐dwelling participants aged 60+ years (mean [standard deviation] = 70.9 [5.8] years) in VITAL (randomized trial of n‐3 fats [1 g/day, including 840 mg of eicosapentaenoic acid + docosahexaenoic acid] and vitamin D) were included: 3424 whose cognition was assessed by phone (VITAL‐Cog; eight neuropsychological tests; 2.8 years) and 794 evaluated in person (CTSC‐Cog; nine tests; 2.0 years). The primary outcome was a global score (average of test z‐scores) of change over two assessments. We used multivariable‐adjusted linear mixed models; substudy‐specific results were meta‐analyzed. Results : We observed no significant effect of n‐3 supplementation: the mean difference in annual rate of cognitive change for the n‐3 versus placebo group was –0.01 standard units (95% confidence interval [CI]: –0.02, 0.003) in VITAL‐Cog and –0.002 (95% CI: –0.04, 0.03) in CTSC‐Cog; the pooled difference was –0.01 (95% CI: –0.02, 0.003; P = .15). Discussion : Marine n‐3 supplementation (1 g/day) did not confer cognitive benefits over 2 to 3 years in community‐dwelling older adults.
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Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA
| | - Chirag M Vyas
- Department of Psychiatry Massachusetts General Hospital/Harvard Medical School Boston Massachusetts USA
| | - Olivia I Okereke
- Channing Division of Network Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA.,Department of Psychiatry Massachusetts General Hospital/Harvard Medical School Boston Massachusetts USA.,Department of Epidemiology Harvard T. H. Chan School of Public Health Boston Massachusetts USA
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology National Cerebral and Cardiovascular Center Suita Japan
| | - Michelle Albert
- University of California at San Francisco School of Medicine San Francisco California USA
| | - I-Min Lee
- Department of Epidemiology Harvard T. H. Chan School of Public Health Boston Massachusetts USA.,Division of Preventive Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA
| | - Denise D'Agostino
- Division of Preventive Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA
| | - Julie E Buring
- Division of Preventive Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA
| | - Nancy R Cook
- Department of Epidemiology Harvard T. H. Chan School of Public Health Boston Massachusetts USA.,Division of Preventive Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago Illinois USA
| | - JoAnn E Manson
- Department of Epidemiology Harvard T. H. Chan School of Public Health Boston Massachusetts USA.,Division of Preventive Medicine Brigham and Women's Hospital/Harvard Medical School Boston Massachusetts USA
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36
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Ohta-Ogo K, Sugano Y, Ogata S, Nakayama T, Komori T, Eguchi K, Dohi K, Yokokawa T, Kanamori H, Nishimura S, Nakamura K, Ikeda Y, Nishimura K, Takemura G, Anzai T, Hiroe M, Hatakeyama K, Ishibashi-Ueda H, Imanaka-Yoshida K. Myocardial T-Lymphocytes as a Prognostic Risk-Stratifying Marker of Dilated Cardiomyopathy - Results of the Multicenter Registry to Investigate Inflammatory Cell Infiltration in Dilated Cardiomyopathy in Tissues of Endomyocardial Biopsy (INDICATE Study). Circ J 2022; 86:1092-1101. [PMID: 35264513 DOI: 10.1253/circj.cj-21-0529] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) associated with inflammation is diagnosed by endomyocardial biopsy; patients with this have a poorer prognosis than patients without inflammation. To date, standard diagnostic criteria have not been established.Methods and Results:This study analyzed clinical records and endomyocardial biopsy samples of 261 patients with DCM (201 males, median left ventricular ejection fraction; 28%) from 8 institutions in a multicenter retrospective study. Based on the European Society of Cardiology criteria and CD3 (T-lymphocytes) and CD68 (macrophages) immunohistochemistry, 48% of patients were categorized as having inflammatory DCM. For risk-stratification, we divided patients into 3 groups using Akaike Information Criterion/log-rank tests, which can determine multiple cut-off points: CD3+-Low, <13/mm2(n=178, 68%); CD3+-Moderate, 13-24/mm2(n=58, 22%); and CD3+-High, ≥24/mm2(n=25, 10%). The survival curves for cardiac death or left ventricular assist device implantation differed significantly among the 3 groups (10-year survival rates: CD3+-Low: 83.4%; CD3+-Moderate: 68.4%; CD3+-High: 21.1%; Log-rank P<0.001). Multivariate Cox analysis revealed CD3+count as a potent independent predictive factor for survival (fully adjusted hazard ratio: CD3+-High: 5.70,P<0.001; CD3+-Moderate: 2.64, P<0.01). CD3+-High was also associated with poor left ventricular functional and morphological recovery at short-term follow up. CONCLUSIONS Myocardial CD3+T-lymphocyte infiltration has a significant prognostic impact in DCM and a 3-tiered risk-stratification model could be helpful to refine patient categorization.
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Affiliation(s)
- Keiko Ohta-Ogo
- Department of Pathology, National Cerebral and Cardiovascular Center
| | | | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Takafumi Nakayama
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Takahiro Komori
- Department of Cardiovascular Medicine, Jichi Medical University School of Medicine
| | - Kazuo Eguchi
- Department of General Internal Medicine, Saitama Red Cross Hospital
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine, Fukushima Medical University
| | | | - Shigeyuki Nishimura
- Department of Cardiology, Saitama Medical University International Medical Center
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceuticals
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Genzou Takemura
- Department of Internal Medicine, Asahi University School of Dentistry
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.,Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Michiaki Hiroe
- Department of Cardiology, National Center for Global Health and Medicine
| | - Kinta Hatakeyama
- Department of Pathology, National Cerebral and Cardiovascular Center
| | | | - Kyoko Imanaka-Yoshida
- Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine
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37
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Hitomi S, Hatta K, Murotani Y, Takahashi T, Gondo Y, Kamide K, Masui Y, Ishizaki T, Kabayama M, Ogata S, Matsuda K, Mihara Y, Fukutake M, Hagino H, Higashi K, Akema S, Kitamura M, Murakami S, Maeda Y, Ikebe K. Predictive factors for tooth loss in older adults vary according to occlusal support: A 6-year longitudinal survey from the SONIC study. J Dent 2022; 121:104088. [DOI: 10.1016/j.jdent.2022.104088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/18/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022] Open
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38
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Marume K, Ogata S, Kaichi R, Nakai M, Ishii M, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Iwanaga Y, Miyamoto Y, Yamamoto N. Incidence Rate of Hospitalization for Heart Failure in a Japanese City ― An Updated Reference for Japan’s Aging Society ―. Circ Rep 2022; 4:116-122. [PMID: 35342838 PMCID: PMC8901245 DOI: 10.1253/circrep.cr-21-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 11/21/2022] Open
Abstract
Background:
The prevalence of heart failure (HF) is increasing in aging societies, such as Japan. The current incidence rate (IR) of HF hospitalization in Japan is unknown. Methods and Results:
We conducted a regional population-based study assessing the IR of HF hospitalization in Nobeoka City. Data were collected over a period of 3 years from all patients with HF admitted for the first time to hospitals and clinics. 406 HF hospitalizations were registered (54% female; mean age 82 years). The IR of HF hospitalization was 129/100,000 person-years. The difference in the IR between women and men was not significant (131 vs. 127/100,000 person-years, respectively; P=0.767). The age-adjusted IR in the 2015 Japanese population was 105/100,000 person-years. According to 5-year age bands, the IR of HF hospitalization gradually increased up to 60–70 years of age, then increased rapidly in those aged ≥95 years for both sexes. The IR ratio compared with age <65 years was higher in women than men in each older age group. Conclusions:
In this population-based study, the current IR of HF hospitalization in a region of Japan was higher than the IR from another study conducted in a different region in early 2000. By presenting detailed age-related data, the research findings will contribute to estimating the number of HF hospitalizations in other areas of Japan.
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Affiliation(s)
- Kyohei Marume
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Ryota Kaichi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Takayuki Mori
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Soichi Komaki
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Hiroaki Kusaka
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Reiko Toida
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Kazumasa Kurogi
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
| | - Yoshitaka Iwanaga
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Yoshihiro Miyamoto
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Nobuyasu Yamamoto
- Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
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39
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Kaichi R, Marume K, Nakai M, Ishii M, Ogata S, Iwanaga Y, Ikebe S, Mori T, Komaki S, Kusaka H, Toida R, Kurogi K, Miyamoto Y, Yamamoto N. Relationship Between Heart Failure Hospitalization Costs and Left Ventricular Ejection Fraction in an Advanced Aging Society. Circ Rep 2022; 4:48-58. [PMID: 35083388 PMCID: PMC8710639 DOI: 10.1253/circrep.cr-21-0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background:
Left ventricular ejection fraction (LVEF) is a basic clinical index that determines the heart failure (HF) treatment strategy. We aimed to evaluate the association between hospitalization costs for HF patient and LVEF in an advanced aging society in a region in Japan. Methods and Results:
Consecutive HF patients admitted to Miyazaki Prefectural Nobeoka Hospital between January 2015 and March 2018 were included in the study. The 346 HF patients (mean age 78 years) were divided into 2 groups: HF with reduced ejection fraction (HFrEF; LVEF <40%; n=129) and HF with preserved ejection fraction (HFpEF; LVEF ≥40%; n=217). Median hospitalization costs (in 2017 US dollars) were higher in the HFrEF than HFpEF group, but the difference was not statistically significant ($7,128 vs. $6,580; P=0.189). However, in older adults (age ≥75 years; n=252), median hospitalization costs were significantly higher in the HFrEF than HFpEF group ($7,240 vs. $6,471; P=0.014), and LVEF was an independent factor of hospitalization costs (β=−0.0301, P=0.006). Median hospitalization costs were significantly lower in the older than younger HFpEF group ($6,471 vs. $7,250; P=0.011), but there was no significant difference in costs between the older and younger HFrEF groups ($7,240 vs. $6,760; P=0.351). Conclusions:
The relationship between LVEF and hospitalization costs became more pronounced with age, and LVEF was a negative independent factor for hospitalization costs in the older population.
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Affiliation(s)
| | | | | | | | | | | | - Sou Ikebe
- Miyazaki Prefectural Nobeoka Hospital
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40
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Murotani Y, Hatta K, Takahashi T, Gondo Y, Kamide K, Kabayama M, Masui Y, Ishizaki T, Matsuda KI, Mihara Y, Fukutake M, Nishimura Y, Akema S, Hagino H, Higashi K, Togawa H, Maeda Y, Ogata S, Moynihan P, Ikebe K. Oral Functions Are Associated with Muscle Strength and Physical Performance in Old-Old Japanese. Int J Environ Res Public Health 2021; 18:ijerph182413199. [PMID: 34948808 PMCID: PMC8702148 DOI: 10.3390/ijerph182413199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/25/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022]
Abstract
Grip strength and walking speed are considered to be important indicators of physical frailty. However, no study has contemporaneously examined any association of multiple oral functions with grip strength and walking speed. The purpose of this study was to examine which oral functions are associated with muscle strength (grip strength), physical performance (walking speed) or both. The study participants were 511 community-dwelling people (254 men and 257 women) aged 77–81 years old. Six oral functions—oral wetness, occlusal force, tongue-lip motor function, tongue pressure, masticatory performance and swallowing function—were measured. Grip strength and walking speed were also measured. A partial correlation analysis, adjusted for gender, showed that occlusal force, tongue-lip motor function, masticatory performance and swallowing function were significantly associated with both grip strength and walking speed. In addition, tongue pressure was significantly associated with grip strength. A general linear model showed that tongue pressure and occlusal force were significantly associated with grip strength. Swallowing function and tongue-lip motor function were significantly associated with walking speed. It is suggested that there are different oral function measures for muscle strength and physical performance, and these oral function measures could be a useful proxy for physical frailty.
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Affiliation(s)
- Yuki Murotani
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Kodai Hatta
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
- Correspondence:
| | - Toshihito Takahashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Suita 565-0871, Japan;
| | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine, Suita 565-0871, Japan;
| | - Mai Kabayama
- Integrated General Nursing Science, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan;
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (T.I.)
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (T.I.)
| | - Ken-ichi Matsuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Yusuke Mihara
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Motoyoshi Fukutake
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Yuichi Nishimura
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Suzuna Akema
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Hiromasa Hagino
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Kotaro Higashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Hitomi Togawa
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan;
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
| | - Soshiro Ogata
- National Cerebral and Cardiovascular Center, Department of Preventive Medicine and Epidemiology, Suita 564-8565, Japan;
| | - Paula Moynihan
- Faculty of Health and Medical Sciences, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005, Australia;
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (Y.M.); (T.T.); (K.-i.M.); (Y.M.); (M.F.); (Y.N.); (S.A.); (H.H.); (K.H.); (Y.M.); (K.I.)
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Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, Lee IM, D'Agostino D, Buring JE, Cook NR, Grodstein F, Manson JE. Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized trial. Sci Rep 2021; 11:23253. [PMID: 34853363 PMCID: PMC8636504 DOI: 10.1038/s41598-021-02485-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
Low vitamin D levels have been associated with cognitive decline; however, few randomized trials have been conducted. In a trial, we evaluated vitamin D3 supplementation on cognitive decline. We included participants aged 60+ years (mean[SD] = 70.9[5.8] years) free of cardiovascular disease and cancer in two substudies in the VITAL 2 × 2 randomized trial of vitamin D3 (2000 IU/day of cholecalciferol) and fish oil supplements: 3424 had cognitive assessments by phone (eight neuropsychologic tests; 2.8 years follow-up) and 794 had in-person assessments (nine tests; 2.0 years follow-up). The primary, pre-specified outcome was decline over two assessments in global composite score (average z-scores of all tests); substudy-specific results were meta-analyzed. The pooled mean difference in annual rate of decline (MD) for vitamin D3 versus placebo was 0.01 (95% CI - 0.01, 0.02; p = 0.39). We observed no interaction with baseline 25-hydroxyvitamin-D levels (p-interaction = 0.84) and a significant interaction with self-reported race (p-interaction = 0.01). Among Black participants (19%), those assigned vitamin D3 versus placebo had better cognitive maintenance (MD = 0.04, 95% CI 0.01, 0.08, similar to that observed for Black participants 1.2 years apart in age). Thus, vitamin D3 (2000 IU/day cholecalciferol) supplementation was not associated with cognitive decline over 2-3 years among community-dwelling older participants but may provide modest cognitive benefits in older Black adults, although these results need confirmation.Trial registration ClinicalTrials.gov; VITAL (NCT01169259), VITAL-DEP (NCT01696435) and VITAL-Cog (NCT01669915); the date the registration for the parent trial (NCT01169259) was submitted to the registry: 7/26/2010 and the date of first patient enrollment in either of the ancillary studies for cognitive function in a subset of eligible VITAL participants: 9/14/2011.
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Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA.
| | - Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michelle Albert
- University of California at San Francisco School of Medicine, San Francisco, CA, USA
| | - I-Min Lee
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Denise D'Agostino
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Julie E Buring
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Nancy R Cook
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Francine Grodstein
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - JoAnn E Manson
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
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Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, Lee I, D'Agostino D, Buring JE, Cook NR, Grodstein F, Manson JE. Marine n‐3 fatty acids and cognitive change among older adults in the VITAL randomized trial. Alzheimers Dement 2021. [DOI: 10.1002/alz.055393] [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: 11/12/2022]
Affiliation(s)
- Jae Hee Kang
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health Boston MA USA
| | - Soshiro Ogata
- National Cerebral and Cardiovascular Center Suita Japan
| | - Michelle Albert
- University of California at San Francisco School of Medicine San Francisco CA USA
| | - I‐Min Lee
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | | | - Julie E Buring
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Nancy R Cook
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Fran Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
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Ogata S, Akashi Y, Sakusabe T, Yoshizaki S, Maeda Y, Nishimura K, Maeda K, Nakai S. A multiple 24-hour urine collection study indicates that kidney function decline is related to urinary sodium and potassium excretion in patients with chronic kidney disease. Kidney Int 2021; 101:164-173. [PMID: 34774553 DOI: 10.1016/j.kint.2021.10.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 04/05/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022]
Abstract
Multiple 24-hour urine collections are necessary to adequately assess sodium and potassium intake. Here, we assessed kidney function decline for four years after baseline in relation to seven-time averaged 24-hour urinary sodium and potassium excretion (UNaV, UKV), their UNaV/UKV ratio, and their categorical combination in outpatients with chronic kidney disease (CKD). This retrospective cohort study was based on 240 outpatients with baseline CKD stages 3-5, baseline age 20 years or more (median age 72.0 years), and a median follow-up (with interquartile range) of 2.9 (1.4-4.0) years. Outcome was the percentage change in annual slope of estimated glomerular filtration rate (delta eGFR per year). In linear mixed models, percentage changes in delta eGFR per year were -3.26% (95% confidence interval -5.85 to -0.60), +5.20% (2.34 to 8.14), and -5.20% (-7.64 to -2.69), respectively, per one standard deviation increase in the seven-time averaged UNaV and UKV, and their UNaV/UKV ratio. Additionally, percentage changes per year in delta eGFR per year were -16.27% (-23.57 to -8.27) in the middle-to-high UNaV and low UKV group, compared with the low UNaV and middle-to high UKV group. Thus, our study reinforces the observation of opposite associations between GFR decline and urinary excretion rates of sodium (positive) and potassium (negative), respectively. Whether changes in dietary sodium and potassium intake slow GFR decline still requires further study.
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Affiliation(s)
- Soshiro Ogata
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuumi Akashi
- Faculty of Nursing, Fujita Health University School of Health Sciences, Aichi, Japan
| | - Takaya Sakusabe
- Faculty of Clinical Engineering, Fujita Health University School of Medical Sciences, Aichi, Japan
| | | | | | - Kunihiro Nishimura
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Shigeru Nakai
- Faculty of Clinical Engineering, Fujita Health University School of Medical Sciences, Aichi, Japan.
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Hatta K, Murotani Y, Takahashi T, Gondo Y, Kamide K, Masui Y, Ishizaki T, Ogata S, Matsuda KI, Mihara Y, Fukutake M, Nishimura Y, Hagino H, Higashi K, Maeda Y, Ikebe K. Decline of oral functions in old-old adults and their relationship with age and sex: The SONIC study. J Am Geriatr Soc 2021; 70:541-548. [PMID: 34719784 DOI: 10.1111/jgs.17535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/09/2021] [Accepted: 10/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many physical functions decline with aging, but it is not known whether oral functions vary according to sex or decline with aging, as it occurs with physical functions. The present study aimed to examine the association of sex, age, and elapsed years with occlusal force and tongue pressure using a generalized linear mixed-effect model (GLMM) over a 3-year period among old-old Japanese adults. METHODS Participants were community-dwelling older adults who participated in a survey (June 2014-March 2017) and a follow-up survey (July 2017-December 2019) after 3 years (n = 951: 70-year group, n = 466; 80-year group, n = 391; 90-year group, n = 94). Dental examinations including the number of teeth, occlusal force, and tongue pressure were conducted, and a GLMM was used to estimate the association of sex, age, and elapsed years with occlusal force and tongue pressure, adjusting for the number of teeth. RESULTS The GLMM showed that occlusal force was significantly associated with sex (reference; male, non-standardized coefficient: B = -66.9 [female], p < 0.001), age (reference; 70-year group, B = -81.7 [80-year group], p < 0.001, B = -87.2 [90-year group], p < 0.001), and the number of teeth (B = 13.8, p < 0.001), but did not significantly decrease with elapsed years. Tongue pressure was significantly associated with sex (reference; male, B = -0.94 [female], p = 0.034) and age (reference; 70-year group, B = -1.78 [80-year group], p < 0.001, B = -5.47 [90-year group], p < 0.001). Tongue pressure decreased significantly with elapsed years (B = -0.82, p < 0.001). CONCLUSIONS These findings suggest that tongue pressure significantly decreased over time, but occlusal force did not. Tongue-related muscles may be more susceptible to aging than masticatory muscles.
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Affiliation(s)
- Kodai Hatta
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Murotani
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toshihito Takahashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yukie Masui
- Research Team for Human Care, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Research Team for Human Care, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ken-Ichi Matsuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yusuke Mihara
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Motoyoshi Fukutake
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuichi Nishimura
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiromasa Hagino
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Higashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
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Hayashi C, Toyoda H, Ogata S, Okano T, Mashino S. Long-term participation in community-based group resistance exercises delays the transition from robustness to frailty in older adults: a retrospective cohort study. Environ Health Prev Med 2021; 26:105. [PMID: 34670491 PMCID: PMC8529757 DOI: 10.1186/s12199-021-01028-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/04/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND How community-based group resistance exercises affect the transition from robustness to frailty remains unclear. Thus, we conducted a retrospective cohort study to determine whether the trajectory from robustness to frailty over age differed depending on the duration of participation in group exercises. METHODS We analyzed the Kihon Checklist (KCL) score of community-dwelling elderly residents of Sumoto city, Hyogo prefecture, who participated in community-based group resistance exercises between April 2010 and December 2019. Finally, 2567 older individuals were analyzed using multilevel modeling. The explanatory variables of interest were the frailty score measured using the KCL for each individual, where 0-3, 4-7, and ≥8 points denoted robustness, pre-frailty, and frailty, respectively. We considered age, sex, systolic blood pressure, pulse, duration of participation, and change in KCL score from baseline as possible confounders. Participants were classified as follows based on the duration of participation in the exercises: <3 times, short-term participation group; 4-6 times; mid-term participation group; and 7-13 times, long-term participation group. The mean duration from the baseline physical test for the total sample was 2.35 years (SD=2.51). RESULTS The participants' mean total KCL score at baseline was 4.9±3.7. Multilevel modeling analysis revealed that the KCL scores changed by 0.82 points for each additional year of age (p<0.001) and changed by - 0.93 points for long-term participate group (p<0.001). The Estimated Marginal Means (EMM) of the KCL score was 3.98 (95%CI: 3.69, 4.28) points in the short-term participation group and was significantly worse than that of the long-term participation group at 70 years of age (p=0.001). The EMM was 4.49 (95%CI: 4.24, 4.74) at 75 years of age in the mid-term participation group and was significantly worse than that of the long-term participation group. The EMM was 3.87 (95%CI: 3.57, 4.16) in the long-term participation group and significantly better than that of the short-term (p<0.001) and mid-term (p=0.002) participation groups. CONCLUSION Participation in community-based group resistance exercises prolongs the transition from robustness to frailty. The improved KCL scores at baseline in the long-term participation group remained in the robust range at 75 years of age, which suggests the importance of initiating participation before the onset of functional decline.
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Affiliation(s)
- Chisato Hayashi
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo, 673-8588, Japan.
| | - Hiromitsu Toyoda
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka, 545-8585, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Tadashi Okano
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka, 545-8585, Japan
| | - Sonoe Mashino
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo, 673-8588, Japan
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Nishio S, Tsuchiya K, Nakatani S, Muto S, Mochizuki T, Kawano H, Hanaoka K, Hidaka S, Ichikawa D, Ishikawa E, Uchiyama K, Koshi-Ito E, Hayashi H, Makabe S, Ogata S, Mitobe M, Sekine A, Suwabe T, Kataoka H, Kai H, Kaneko Y, Kurashige M, Seta K, Shimazu K, Hama T, Miura K, Nakanishi K, Horie S, Furuichi K, Okada H, Narita I. A digest from evidence-based Clinical Practice Guideline for Polycystic Kidney Disease 2020. Clin Exp Nephrol 2021; 25:1292-1302. [PMID: 34564792 DOI: 10.1007/s10157-021-02097-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Saori Nishio
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan
| | - Shinya Nakatani
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Satoru Muto
- Departments of Urology and Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan
| | - Toshio Mochizuki
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan
| | - Haruna Kawano
- Departments of Urology and Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan
| | - Kazushige Hanaoka
- Department of General Internal Medicine, The Jikei University, Tokyo, Japan
| | - Sumi Hidaka
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Daisuke Ichikawa
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kanagawa, Japan
| | - Eiji Ishikawa
- Department of Internal Medicine, Saiseikai Matsusaka General Hospital, Mie, Japan
| | - Kiyotaka Uchiyama
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eri Koshi-Ito
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Shiho Makabe
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan
| | - Soshiro Ogata
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Michihiro Mitobe
- Department of Nephrology, Takeda General Hospital, Fukushima, Japan
| | - Akinari Sekine
- Department of Nephrology, Toranomon Hospital, Tokyo, Japan
| | - Tatsuya Suwabe
- Department of Nephrology, Toranomon Hospital, Tokyo, Japan
| | - Hiroshi Kataoka
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan
| | - Hirayasu Kai
- Pathophysiology of Renal Diseases, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Yoshikatsu Kaneko
- Niigata University, Division of Clinical Nephrology and Rheumatology, Niigata University, Niigata, Japan
| | - Mahiro Kurashige
- Nephrology & Hypertension, Department of Internal Medicine, The Jikei University, Tokyo, Japan
| | - Koichi Seta
- Department of Nephrology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Keiji Shimazu
- Department of Nephrology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Taketsugu Hama
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Kenichiro Miura
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichi Nakanishi
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shigeo Horie
- Departments of Urology and Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan
| | - Kengo Furuichi
- Department of Nephrology, Kanazawa Medical University, Ishikawa, Japan
| | - Hirokazu Okada
- Department of Nephrology, Saitama Medical University, Saitama, Japan.
| | - Ichiei Narita
- Niigata University, Division of Clinical Nephrology and Rheumatology, Niigata University, Niigata, Japan
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Fujimoto W, Toh R, Takegami M, Hayashi T, Kuroda K, Hatani Y, Yamashita S, Imanishi J, Iwasaki M, Inoue T, Okamoto H, Okuda M, Konishi A, Shinohara M, Murata S, Ogata S, Nishimura K, Hirata KI. Estimating Incidence of Acute Heart Failure Syndromes in Japan - An Analysis From the KUNIUMI Registry. Circ J 2021; 85:1860-1868. [PMID: 33678754 DOI: 10.1253/circj.cj-20-1154] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few registries have provided precise information concerning incidence rates for acute heart failure syndrome (AHFS) in Japan.Methods and Results:All hospitals with acute care beds in Awaji Island participated in the Kobe University heart failure registry in Awaji Medical Center (KUNIUMI Registry), a retrospective, population-based AHFS registration study, enabling almost every patient with AHFS in Awaji Island to be registered. From 1 January 2015 to 31 December 2017, 743 patients with de novo AHFS had been registered. Mean age was 82.1±11.5 years. Using the general population of Japan as of 2015 as a standard, age- and sex-adjusted incidence rates for AHFS were 133.8 per 100,000 person-years for male and 120.0 for female. In 2015, there were an estimated 159,702 new-onset patients with AHFS, which was predicted to increase to 252,153 by 2040, and reach a plateau. The proportion of patients aged >85 years accounted for 42.6% in 2015, which was predicted to increase up to 62.5% in 2040. The proportion of patients with heart failure with preserved ejection fraction was estimated at 52.0% in 2015, which was predicted to increase gradually to 57.3% in 2055. CONCLUSIONS The present analysis suggested that the number of patients with de novo AHFS keeps increasing with progressive aging in Japan. Establishment of countermeasures against the expanding burden of HF is urgently required.
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Affiliation(s)
- Wataru Fujimoto
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center.,Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
| | - Ryuji Toh
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | | | - Koji Kuroda
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center
| | - Yutaka Hatani
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center
| | | | - Junichi Imanishi
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center
| | | | - Takumi Inoue
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center
| | - Hiroshi Okamoto
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center
| | - Masanori Okuda
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center
| | - Akihide Konishi
- Clinical & Translational Research Center, Kobe University Hospital
| | | | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine.,Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine
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Nakaoku Y, Ogata S, Murata S, Nishimori M, Ihara M, Iihara K, Takegami M, Nishimura K. AI-Assisted In-House Power Monitoring for the Detection of Cognitive Impairment in Older Adults. Sensors (Basel) 2021; 21:s21186249. [PMID: 34577455 PMCID: PMC8473035 DOI: 10.3390/s21186249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/23/2022]
Abstract
In-home monitoring systems have been used to detect cognitive decline in older adults by allowing continuous monitoring of routine activities. In this study, we investigated whether unobtrusive in-house power monitoring technologies could be used to predict cognitive impairment. A total of 94 older adults aged ≥65 years were enrolled in this study. Generalized linear mixed models with subject-specific random intercepts were used to evaluate differences in the usage time of home appliances between people with and without cognitive impairment. Three independent power monitoring parameters representing activity behavior were found to be associated with cognitive impairment. Representative values of mean differences between those with cognitive impairment relative to those without were −13.5 min for induction heating in the spring, −1.80 min for microwave oven in the winter, and −0.82 h for air conditioner in the winter. We developed two prediction models for cognitive impairment, one with power monitoring data and the other without, and found that the former had better predictive ability (accuracy, 0.82; sensitivity, 0.48; specificity, 0.96) compared to the latter (accuracy, 0.76; sensitivity, 0.30; specificity, 0.95). In summary, in-house power monitoring technologies can be used to detect cognitive impairment.
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Affiliation(s)
- Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (Y.N.); (S.O.); (S.M.); (M.T.)
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (Y.N.); (S.O.); (S.M.); (M.T.)
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (Y.N.); (S.O.); (S.M.); (M.T.)
| | - Makoto Nishimori
- Division of Epidemiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan;
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Koji Iihara
- National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (Y.N.); (S.O.); (S.M.); (M.T.)
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (Y.N.); (S.O.); (S.M.); (M.T.)
- Correspondence: ; Tel.: +81-6-6170-1070
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Murata S, Takegami M, Ogata S, Ono R, Nakaoku Y, Hagihara A, Nishimura K. 1383Interaction of cognitive decline and walking ability to influence wandering behavior: a cohort study. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.465] [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
Background
Wandering behavior is one of the most troublesome behavioral disturbances in dementia. Though cognitive decline leads to wandering behavior, its effects may vary across walking ability. The purpose of this study was to investigate the joint effect of cognitive decline and walking ability on wandering behavior.
Methods
This retrospective cohort study in community analyzed 3920 elderly adults with dementia. The association of cognitive function and walking ability with an incidence of wandering behavior during a 5-year follow-up period were examined using a generalized linear model, and relative excess risk due to interaction was calculated.
Results
Compared to ‘walk independently’, adjusted risk ratios (95% confidence intervals) for ‘walk with help’ and ‘unable to walk’ were 0.51 (0.42, 0.63) and 0.21 (0.16, 0.28), respectively (P for trend < 0.001). Compared to mild cognitive decline, adjusted risk ratios (95% confidence intervals) for moderate and severe cognitive decline were 1.44 (1.17, 1.77) and 1.73 (1.36, 2.18), respectively (P for trend < 0.001). Additionally, some joint effects of cognitive decline and walking ability decline were lower than the sum of its individual effects (relative excess risk due to interaction (95% confidence interval), moderate cognitive decline × ‘walk with help’: -0.45 (-0.98, -0.01); severe cognitive decline × ‘unable to walk’: -0.95 (-1.71, -0.37)).
Conclusions
Effects of cognitive decline and walking ability on incidence of wandering behavior were observed, and the effects varied depending on their combination.
Key messages
Our results help clinicians to predict and manage wandering behavior.
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Affiliation(s)
- Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
- Department of Public Health, Kobe University, Graduate School of Health Sciences, Kobe, Japan
- Japan Society for the Promotion of Science, Chiyoda, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Rei Ono
- Department of Public Health, Kobe University, Graduate School of Health Sciences, Kobe, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Akihito Hagihara
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
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50
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Ishikawa T, Kimoto H, Mishima H, Yamagata K, Ogata S, Aizawa Y, Hayashi K, Morita H, Nakajima T, Nakano Y, Nagase S, Murakoshi N, Kowase S, Ohkubo K, Aiba T, Morimoto S, Ohno S, Kamakura S, Nogami A, Takagi M, Karakachoff M, Dina C, Schott JJ, Yoshiura KI, Horie M, Shimizu W, Nishimura K, Kusano K, Makita N. Functionally validated SCN5A variants allow interpretation of pathogenicity and prediction of lethal events in Brugada syndrome. Eur Heart J 2021; 42:2854-2863. [PMID: 34219138 DOI: 10.1093/eurheartj/ehab254] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/09/2021] [Accepted: 04/14/2021] [Indexed: 02/06/2023] Open
Abstract
AIMS The prognostic value of genetic variants for predicting lethal arrhythmic events (LAEs) in Brugada syndrome (BrS) remains controversial. We investigated whether the functional curation of SCN5A variations improves prognostic predictability. METHODS AND RESULTS Using a heterologous expression system and whole-cell patch clamping, we functionally characterized 22 variants of unknown significance (VUSs) among 55 SCN5A mutations previously curated using in silico prediction algorithms in the Japanese BrS registry (n = 415). According to the loss-of-function (LOF) properties, SCN5A mutation carriers (n = 60) were divided into two groups: LOF-SCN5A mutations and non-LOF SCN5A variations. Functionally proven LOF-SCN5A mutation carriers (n = 45) showed significantly severer electrocardiographic conduction abnormalities and worse prognosis associated with earlier manifestations of LAEs (7.9%/year) than in silico algorithm-predicted SCN5A carriers (5.1%/year) or all BrS probands (2.5%/year). Notably, non-LOF SCN5A variation carriers (n = 15) exhibited no LAEs during the follow-up period. Multivariate analysis demonstrated that only LOF-SCN5A mutations and a history of aborted cardiac arrest were significant predictors of LAEs. Gene-based association studies using whole-exome sequencing data on another independent SCN5A mutation-negative BrS cohort (n = 288) showed no significant enrichment of rare variants in 16 985 genes including 22 non-SCN5A BrS-associated genes as compared with controls (n = 372). Furthermore, rare variations of non-SCN5A BrS-associated genes did not affect LAE-free survival curves. CONCLUSION In vitro functional validation is key to classifying the pathogenicity of SCN5A VUSs and for risk stratification of genetic predictors of LAEs. Functionally proven LOF-SCN5A mutations are genetic burdens of sudden death in BrS, but evidence for other BrS-associated genes is elusive.
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Affiliation(s)
- Taisuke Ishikawa
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Hiroki Kimoto
- Department of Molecular Physiology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 8528523, Japan
| | - Hiroyuki Mishima
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 8528523, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Yoshiyasu Aizawa
- Department of Cardiovascular Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 2860048, Japan
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa 9208641, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 7008558, Japan
| | - Tadashi Nakajima
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showamachi, Maebashi 3710034, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University, 1-2-3 Kasumi, Hiroshima 7348551, Japan
| | - Satoshi Nagase
- Department of Advanced Arrhythmia and Translational Medical Science, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Nobuyuki Murakoshi
- Department of Cardiology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 3058575, Japan
| | - Shinya Kowase
- Department of Heart Rhythm Management, Yokohama Rosai Hospital, 3211 Kozukue-Cho, Yokohama 2220036, Japan
| | - Kimie Ohkubo
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Tokyo 1738610, Japan
| | - Takeshi Aiba
- Department of Clinical Laboratory, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 8528501, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Shiro Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Akihiko Nogami
- Department of Cardiology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 3058575, Japan
| | - Masahiko Takagi
- Division of Cardiac Arrhythmia, Kansai Medical University, 10-15 Fumizonomachi, Moriguchi 5708507, Japan
| | - Matilde Karakachoff
- L'institut du Thorax, CHU Nantes, 1 Place Alexis-Ricordeau, Nantes 44007, France
| | - Christian Dina
- L'institut du Thorax, INSERM, CNRS, UNIV Nantes, 8 Quai Moncousu, Nantes 44007, France
| | - Jean-Jacques Schott
- L'institut du Thorax, INSERM, CNRS, UNIV Nantes, 8 Quai Moncousu, Nantes 44007, France
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 8528523, Japan
| | - Minoru Horie
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Setatsukiwa-cho, Ohtsu 5202192, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Tokyo 1138603, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
| | - Naomasa Makita
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita 5648565, Japan
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