1
|
Nishimura T, Hirata Y, Ise T, Iwano H, Izutani H, Kinugawa K, Kitai T, Ohno T, Ohtani T, Okumura T, Ono M, Satomi K, Shiose A, Toda K, Tsukamoto Y, Yamaguchi O, Fujino T, Hashimoto T, Higashi H, Higashino A, Kondo T, Kurobe H, Miyoshi T, Nakamoto K, Nakamura M, Saito T, Saku K, Shimada S, Sonoda H, Unai S, Ushijima T, Watanabe T, Yahagi K, Fukushima N, Inomata T, Kyo S, Minamino T, Minatoya K, Sakata Y, Sawa Y. JCS/JSCVS/JCC/CVIT 2023 Guideline Focused Update on Indication and Operation of PCPS/ECMO/IMPELLA. Circ J 2024:CJ-23-0698. [PMID: 38583962 DOI: 10.1253/circj.cj-23-0698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- Takashi Nishimura
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine
| | - Yasutaka Hirata
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | | | - Hironori Izutani
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine
| | | | - Takeshi Kitai
- Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center
| | - Takayuki Ohno
- Division of Cardiovascular Surgery, Mitsui Memorial Hospital
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Takahiro Okumura
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Minoru Ono
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo
| | - Kazuhiro Satomi
- Department of Cardiovascular Medicine, Tokyo Medical University Hospital
| | - Akira Shiose
- Department of Cardiovascular Surgery, Kyushu University Hospital
| | - Koichi Toda
- Department of Thoracic and Cardiovascular Surgery, Dokkyo Medical University Saitama Medical Center
| | - Yasumasa Tsukamoto
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Osamu Yamaguchi
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine
| | - Takeo Fujino
- Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Haruhiko Higashi
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine
| | | | - Toru Kondo
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Hirotsugu Kurobe
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine
| | - Toru Miyoshi
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine
| | - Kei Nakamoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Makiko Nakamura
- Second Department of Internal Medicine, University of Toyama
| | - Tetsuya Saito
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
| | - Keita Saku
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center
| | - Shogo Shimada
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | - Hiromichi Sonoda
- Department of Cardiovascular Surgery, Kyushu University Hospital
| | - Shinya Unai
- Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic
| | - Tomoki Ushijima
- Department of Cardiovascular Surgery, Kyushu University Hospital
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | | | | | - Takayuki Inomata
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Shunei Kyo
- Tokyo Metropolitan Institute for Geriatrics and Gerontology
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Kenji Minatoya
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | |
Collapse
|
2
|
Kondo M, Nagasue T, Torisu T, Miyazono S, Matsuno Y, Nagahata T, Hashimoto T, Fujino T, Shiose A, Kitazono T. Use of endoscopic hand-suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device. DEN Open 2024; 4:e369. [PMID: 38638286 PMCID: PMC11024503 DOI: 10.1002/deo2.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/30/2024] [Accepted: 04/06/2024] [Indexed: 04/20/2024]
Abstract
We herein describe a 49-year-old man with severe heart failure due to fulminant myocarditis who underwent left ventricular assist device implantation and received clopidogrel and warfarin as antithrombotic agents. The patient developed anemia secondary to chronic bleeding gastric hyperplastic polyps, necessitating endoscopic mucosal resection. Despite attempts to manage post-endoscopic mucosal resection bleeding from a gastric ulcer by endoscopic hemostasis using hemostatic forceps, local hemostatic agents, and polyglycolic acid sheets, the bleeding persisted. Hemostasis of the refractory bleeding was finally achieved by endoscopic hand-suturing of the ulcer. One month later, the ulcer was almost completely scarred. This case has important clinical value in that it demonstrates the efficacy of endoscopic hand-suturing even in challenging cases such as refractory bleeding gastric ulcers in patients with left ventricular assist devices.
Collapse
Affiliation(s)
- Masahiro Kondo
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Tomohiro Nagasue
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takehiro Torisu
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Satoshi Miyazono
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yuichi Matsuno
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takahisa Nagahata
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Toru Hashimoto
- Department of Cardiovascular MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takeo Fujino
- Department of Advanced Cardiopulmonary FailureGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Akira Shiose
- Department of Cardiovascular SurgeryGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takanari Kitazono
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| |
Collapse
|
3
|
Matoba T, Nakano Y, Katsuki S, Ide T, Matsushima S, Fujino T, Hashimoto T, Shinohara K, Abe K, Hosokawa K, Sakamoto T, Sakamoto I, Kakino T, Ishikita A, Nishizaki A, Sakamoto K, Takase S, Nagayama T, Tohyama T, Nagata T, Kinugawa S, Tsutsui H. Overview of the 87 th Annual Scientific Meeting of the Japanese Circulation Society (JCS2023) - New Challenge With Next Generation. Circ J 2024; 88:615-619. [PMID: 38448007 DOI: 10.1253/circj.cj-24-0127] [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] [Indexed: 03/08/2024]
Abstract
The 87thAnnual Meeting of the Japanese Circulation Society (JCS2023) was held in March 2023 in Fukuoka, Japan, marking the first in-person gathering after the COVID-19 pandemic. With the theme of "New Challenge With Next Generation" the conference emphasized the development of future cardiovascular leaders and technologies such as artificial intelligence (AI). Notable sessions included the Mikamo Lecture on heart failure and the Mashimo Lecture on AI in medicine. Various hands-on sessions and participatory events were well received, promoting learning and networking. Post-event surveys showed high satisfaction among participants, with positive feedback on face-to-face interactions and the overall experience. JCS2023, attended by 17,852 participants, concluded successfully, marking a significant milestone in post-pandemic meetings, and advancing cardiovascular medicine.
Collapse
Affiliation(s)
- Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kazuya Hosokawa
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takafumi Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takamori Kakino
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Ayako Ishikita
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Akiko Nishizaki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| |
Collapse
|
4
|
Watanabe T, Tohyama T, Ikeda M, Fujino T, Hashimoto T, Matsushima S, Kishimoto J, Todaka K, Kinugawa S, Tsutsui H, Ide T. Development of deep-learning models for real-time anaerobic threshold and peak VO2 prediction during cardiopulmonary exercise testing. Eur J Prev Cardiol 2024; 31:448-457. [PMID: 38078901 DOI: 10.1093/eurjpc/zwad375] [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: 06/17/2023] [Revised: 09/27/2023] [Accepted: 12/03/2023] [Indexed: 01/26/2024]
Abstract
AIMS Exercise intolerance is a clinical feature of patients with heart failure (HF). Cardiopulmonary exercise testing (CPET) is the first-line examination for assessing exercise capacity in patients with HF. However, the need for extensive experience in assessing anaerobic threshold (AT) and the potential risk associated with the excessive exercise load when measuring peak oxygen uptake (peak VO2) limit the utility of CPET. This study aimed to use deep-learning approaches to identify AT in real time during testing (defined as real-time AT) and to predict peak VO2 at real-time AT. METHODS AND RESULTS This study included the time-series data of CPET recorded at the Department of Cardiovascular Medicine, Kyushu University Hospital. Two deep neural network models were developed to: (i) estimate the AT probability using breath-by-breath data and (ii) predict peak VO2 using the data at the real-time AT. The eligible CPET contained 1472 records of 1053 participants aged 18-90 years and 20% were used for model evaluation. The developed model identified real-time AT with 0.82 for correlation coefficient (Corr) and 1.20 mL/kg/min for mean absolute error (MAE), and the corresponding AT time with 0.86 for Corr and 0.66 min for MAE. The peak VO2 prediction model achieved 0.87 for Corr and 2.25 mL/kg/min for MAE. CONCLUSION Deep-learning models for real-time CPET analysis can accurately identify AT and predict peak VO2. The developed models can be a competent assistant system to assess a patient's condition in real time, expanding CPET utility.
Collapse
Affiliation(s)
- Tatsuya Watanabe
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Takeshi Tohyama
- Centre for Advanced Medical Open Innovation, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582, Japan
| | - Masataka Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Junji Kishimoto
- Centre for Clinical and Translational Research of Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582, Japan
| | - Koji Todaka
- Centre for Advanced Medical Open Innovation, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582, Japan
- Centre for Clinical and Translational Research of Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- School of Medicine and Graduate School, International University of Health and Welfare, 141-11 Sakami, Okawa-shi, Fukuoka 831-0016, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| |
Collapse
|
5
|
Sakamoto K, Tohyama T, Ide T, Mukai Y, Enzan N, Nagata T, Ikeda M, Takase S, Nagayama T, Fujino T, Matsushima S, Tsutsui H. Efficacy of Early Catheter Ablation for Atrial Fibrillation After Admission for Heart Failure. JACC Clin Electrophysiol 2023; 9:1948-1959. [PMID: 37480855 DOI: 10.1016/j.jacep.2023.05.038] [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] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Advances in catheter ablation (CA) for atrial fibrillation (AF) have improved the prognosis of patients with heart failure (HF) and AF. However, its optimal timing remains to be fully elucidated. OBJECTIVES The aim of this study was to investigate the prognostic impact of early CA in patients with HF and AF hospitalized for worsening HF. METHODS From JROADHF (Japanese Registry of Acute Decompensated Heart Failure) (n = 13,238), patients with HF and AF who underwent CA within 90 days after admission for HF (early CA; n = 103) and those who did not (control; n = 2,683) were identified. Mortality was compared between these groups in the crude cohort, as well as in the propensity-matched cohort (n = 83 in each group). RESULTS In the crude cohort, all-cause mortality was significantly lower in the early CA group than in the control group (log-rank P < 0.001; HR: 0.38; 95% CI: 0.24-0.60). In the matched cohort, all-cause mortality was likewise significantly lower in the early CA group (log-rank P = 0.014; HR: 0.47; 95% CI: 0.25-0.88). Cardiovascular death and HF mortality were significantly lower in both cohorts (crude: Gray' test: P < 0.001 and P = 0.005; subdistribution HR: 0.28 [95% CI: 0.13-0.63] and HR: 0.31 [95% CI: 0.13-0.75]; matched: Gray's test: P = 0.006 and P = 0.017; subdistribution HR: 0.24 [95% CI: 0.08-0.70] and HR: 0.28 [95% CI: 0.09-0.84], respectively). CONCLUSIONS In a nationwide representative real-world cohort, CA for AF within 90 days after admission for HF was associated with improved long-term outcomes, including cardiovascular and HF death in patients with HF and AF.
Collapse
Affiliation(s)
- Kazuo Sakamoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yasushi Mukai
- Division of Cardiology, Japanese Red-Cross Fukuoka Hospital, Fukuoka, Japan
| | - Nobuyuki Enzan
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masataka Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Advanced Cardiopulmonary Failure, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; School of Medicine and Graduate School, International University of Health and Welfare, Otawara, Japan
| |
Collapse
|
6
|
Yokota T, Fukushima A, Tsuchihashi-Makaya M, Abe T, Takada S, Furihata T, Ishimori N, Fujino T, Kinugawa S, Ohta M, Kakinoki S, Yokota I, Endoh A, Yoshino M, Tsutsui H. The AppCare-HF randomized clinical trial: a feasibility study of a novel self-care support mobile app for individuals with chronic heart failure. Eur Heart J Digit Health 2023; 4:325-336. [PMID: 37538146 PMCID: PMC10393880 DOI: 10.1093/ehjdh/ztad032] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 04/23/2023] [Accepted: 05/09/2023] [Indexed: 08/05/2023]
Abstract
Aims We evaluated a self-care intervention with a novel mobile application (app) in chronic heart failure (HF) patients. To facilitate patient-centred care in HF management, we developed a self-care support mobile app to boost HF patients' optimal self-care. Methods and results We conducted a multicentre, randomized, controlled study evaluating the feasibility of the self-care support mobile app designed for use by HF patients. The app consists of a self-monitoring assistant, education, and automated alerts of possible worsening HF. The intervention group received a tablet personal computer (PC) with the self-care support app installed, and the control group received a HF diary. All patients performed self-monitoring at home for 2 months. Their self-care behaviours were evaluated by the European Heart Failure Self-Care Behaviour Scale. We enrolled 24 outpatients with chronic HF (ages 31-78 years; 6 women, 18 men) who had a history of HF hospitalization. During the 2 month study period, the intervention group (n = 13) showed excellent adherence to the self-monitoring of each vital sign, with a median [interquartile range (IQR)] ratio of self-monitoring adherence for blood pressure, body weight, and body temperature at 100% (92-100%) and for oxygen saturation at 100% (91-100%). At 2 months, the intervention group's self-care behaviour score was significantly improved compared with the control group (n = 11) [median (IQR): 16 (16-22) vs. 28 (20-36), P = 0.02], but the HF Knowledge Scale, the General Self-Efficacy Scale, and the Short Form-8 Health Survey scores did not differ between the groups. Conclusion The novel mobile app for HF is feasible.
Collapse
Affiliation(s)
- Takashi Yokota
- Corresponding author. Tel: +81 11 706 6001, Fax: +81 11 706 7613,
| | - Arata Fukushima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
- Asabu Heart and Gastrointestinal Clinic, 1-1, Kita-40 Nishi-4, Kita-Ku, Sapporo 001-0040, Japan
| | - Miyuki Tsuchihashi-Makaya
- School of Nursing, Kitasato University, 2-1-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0329, Japan
| | - Takahiro Abe
- Department of Rehabilitation, Hokkaido University Hospital, Kita-14 Nishi-5, Kita-Ku, Sapporo 060-8648, Japan
| | - Shingo Takada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
| | - Takaaki Furihata
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
| | - Naoki Ishimori
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
| | - Masayuki Ohta
- Research and Development Group, Hitachi, Ltd., 1-280, Higashi-Koigakubo, Kokubunji, Tokyo 185-8601, Japan
| | - Shigeo Kakinoki
- Department of Cardiology, Otaru Kyokai Hospital, 6-15, 1-Chome, Suminoe, Otaru, Hokkaido 047-8510, Japan
| | - Isao Yokota
- Department of Biostatistics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
| | - Akira Endoh
- Department of Medical Informatics, Hokkaido University Hospital, Kita-14 Nishi-5, Kita-Ku, Sapporo 060-8648, Japan
| | - Masanori Yoshino
- Center of Innovation, Hokkaido University, Kita-21 Nishi-11, Kita-Ku, Sapporo 001-0021, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
| |
Collapse
|
7
|
Fujino T, Takakura S, Chinone Y, Hasegawa M, Hazumi M, Katayama N, Lee AT, Matsumura T, Minami Y, Nishino H. Characterization of a half-wave plate for cosmic microwave background circular polarization measurement with POLARBEAR. Rev Sci Instrum 2023; 94:064502. [PMID: 37862532 DOI: 10.1063/5.0140088] [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] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/03/2023] [Indexed: 10/22/2023]
Abstract
A half-wave plate (HWP) is often used as a modulator to suppress systematic error in the measurements of cosmic microwave background (CMB) polarization. A HWP can also be used to measure circular polarization (CP) through its optical leakage from CP to linear polarization. The CP of the CMB is predicted from various sources, such as interactions in the Universe and extension of the standard model. Interaction with supernova remnants of population III stars is one of the brightest CP sources. Thus, the observation of the CP of CMB is a new tool for searching for population III stars. In this paper, we demonstrate the improved measurement of the leakage coefficient using the transmission measurement of an actual HWP in the laboratory. We measured the transmittance of linearly polarized light through the HWP used in Polarbear in the frequency range of 120-160 GHz. We evaluate the properties of the HWP by fitting the data with a physical model using the Markov Chain Monte Carlo method. We then estimate the band-averaged CP leakage coefficient using the physical model. We find that the leakage coefficient strongly depends on the spectra of CP sources. We thus calculate the maximum fractional leakage coefficient from CP to linear polarization as 0.133 ± 0.009 in the Rayleigh-Jeans spectrum. The nonzero value shows that Polarbear has a sensitivity to CP. Additionally, because we use the bandpass of detectors installed in the telescope to calculate the band-averaged values, we also consider systematic effects in the experiment.
Collapse
Affiliation(s)
- T Fujino
- Graduate School of Engineering Science, Yokohama National University, Yokohama 240-8501, Japan
| | - S Takakura
- Department of Astrophysical and Planetary Sciences, University of Colorado Boulder, Boulder, Colorado 80309, USA
| | - Y Chinone
- International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (QUP), High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Hasegawa
- International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (QUP), High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- The Graduate University for Advanced Studies (SOKENDAI), Miura District, Kanagawa, Hayama 240-0115, Japan
| | - M Hazumi
- International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (QUP), High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- The Graduate University for Advanced Studies (SOKENDAI), Miura District, Kanagawa, Hayama 240-0115, Japan
- Japan Aerospace Exploration Agency (JAXA), Institute of Space and Astronautical Science (ISAS), Sagamihara, Kanagawa 252-5210, Japan
| | - N Katayama
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A T Lee
- International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (QUP), High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Department of Physics, University of California, Berkeley, California 94720, USA
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - T Matsumura
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Minami
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Nishino
- Research Center for the Early Universe, School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| |
Collapse
|
8
|
Enzan N, Matsushima S, Kaku H, Tohyama T, Nezu T, Higuchi T, Nagatomi Y, Fujino T, Hashimoto T, Ide T, Tsutsui H. Propensity-Matched Study of Early Cardiac Rehabilitation in Patients With Acute Decompensated Heart Failure. Circ Heart Fail 2023; 16:e010320. [PMID: 37026462 PMCID: PMC10101139 DOI: 10.1161/circheartfailure.122.010320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND The impact of early implementation of cardiac rehabilitation (CR) in heart failure (HF) patients remains to be elucidated. This study sought to determine whether CR during HF hospitalization could improve prognostic outcomes in patients with acute decompensated HF. METHODS We analyzed patients with HF enrolled in the JROADHF (Japanese Registry of Acute Decompensated Heart Failure) registry, a retrospective, multicenter, nationwide registry of patients hospitalized for acute decompensated HF. Eligible patients were divided into 2 groups according to CR during hospitalization. The primary outcome was a composite of cardiovascular death or rehospitalization due to cardiovascular event after discharge. The secondary outcomes were cardiovascular death and cardiovascular event rehospitalization. RESULTS Out of 10 473 eligible patients, 3210 patients underwent CR. Propensity score matching yielded 2804 pairs. Mean age was 77±12 years and 3127 (55.8%) were male. During a mean follow-up of 2.8 years, the CR group had lower incidence rates of the composite outcome (291 versus 327 events per 1000 patient-years; rate ratio, 0.890 [95% CI, 0.830-0.954]; P=0.001) and rehospitalization due to cardiovascular event (262 versus 295 events per 1000 patient-years; rate ratio, 0.888 [95% CI, 0.825-0.956]; P=0.002) than the no CR group. In-hospital CR was associated with an improvement in Barthel index for activities of daily living (P=0.002). Patients with very low Barthel index at admission were benefited by CR in comparison with patients with independent Barthel index (very low; hazard ratio, 0.834 [95% CI, 0.742-0.938]: independent; hazard ratio, 0.985 [95% CI, 0.891-1.088]; P for interaction=0.035). CONCLUSIONS CR implementation during hospitalization was associated with better long-term outcomes in patients with acute decompensated HF. These data support the need for a randomized, controlled, adequately powered trial to definitively test the role of early physical rehabilitation in hospitalized patients with HF.
Collapse
Affiliation(s)
- Nobuyuki Enzan
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.F., T. Hashimoto, T.I., H.T.)
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.I., H.T.)
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.F., T. Hashimoto, T.I., H.T.)
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.I., H.T.)
| | - Hidetaka Kaku
- Department of Cardiology, Japan Community Healthcare Organization, Kyushu Hospital, Fukuoka, Japan (H.K.)
| | - Takeshi Tohyama
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan. (T.T.)
| | - Tomoyuki Nezu
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan. (T.N., T. Higuchi, Y.N.)
| | - Tae Higuchi
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan. (T.N., T. Higuchi, Y.N.)
| | - Yuta Nagatomi
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan. (T.N., T. Higuchi, Y.N.)
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.F., T. Hashimoto, T.I., H.T.)
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.F., T. Hashimoto, T.I., H.T.)
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.F., T. Hashimoto, T.I., H.T.)
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.I., H.T.)
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.F., T. Hashimoto, T.I., H.T.)
- Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. (N.E., S.M., T.I., H.T.)
| |
Collapse
|
9
|
Nagai T, Inomata T, Kohno T, Sato T, Tada A, Kubo T, Nakamura K, Oyama-Manabe N, Ikeda Y, Fujino T, Asaumi Y, Okumura T, Yano T, Tajiri K, Matsuura H, Baba Y, Sunami H, Tsujinaga S, Ota Y, Ohta-Ogo K, Ishikawa Y, Matama H, Nagano N, Sato K, Yasuda K, Sakata Y, Kuwahara K, Minamino T, Ono M, Anzai T. JCS 2023 Guideline on the Diagnosis and Treatment of Myocarditis. Circ J 2023; 87:674-754. [PMID: 36908170 DOI: 10.1253/circj.cj-22-0696] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Takashi Kohno
- Department of Cardiovascular Medicine, Kyorin University Faculty of Medicine
| | - Takuma Sato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Atsushi Tada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center
| | - Takeo Fujino
- Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takahiro Okumura
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Kazuko Tajiri
- Department of Cardiology, National Cancer Center Hospital East
| | | | - Yuichi Baba
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University
| | - Haruki Sunami
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Yasutoshi Ota
- Department of Radiology, National Cerebral and Cardiovascular Center
| | - Keiko Ohta-Ogo
- Department of Pathology, National Cerebral and Cardiovascular Center
| | - Yusuke Ishikawa
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Kazushi Yasuda
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Minoru Ono
- Department of Cardiac Surgery, University of Tokyo Hospital, The University of Tokyo
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | | |
Collapse
|
10
|
Yoshida D, Hashimoto T, Katsuki M, Ishikita A, Ishikawa Y, Fujino T, Shinohara K, Matsushima S, Kinugawa S, Nakano Y, Katsuki S, Matoba T, Hayashidani S, Tsutsui H. Histologic Diagnosis of Coronary Amyloidosis Using Percutaneous Transluminal Directional Atherectomy. CJC Open 2022; 5:99-102. [PMID: 36700181 PMCID: PMC9869350 DOI: 10.1016/j.cjco.2022.11.009] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Daisuke Yoshida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Corresponding author: Dr Toru Hashimoto, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Tel.: +81-92-642-5360; fax: +81-92-642-5374.
| | - Masato Katsuki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihito Ishikita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunji Hayashidani
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
11
|
Belkin MN, Imamura T, Rodgers D, Kanelidis AJ, Henry MP, Fujino T, Kagan V, Meehan K, Okray J, Creighton S, LaBuhn C, Song T, Ota T, Jeevanandam V, Nguyen AB, Chung BB, Smith BA, Kalantari S, Grinstein J, Sarswat N, Pinney SP, Sayer G, Kim G, Uriel N. Postoperative tolvaptan use in left ventricular assist device patients: The TOLVAD randomized pilot study. Artif Organs 2022; 46:10.1111/aor.14375. [PMID: 36574590 PMCID: PMC10227625 DOI: 10.1111/aor.14375] [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: 06/09/2022] [Revised: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Tolvaptan, a selective vasopressin type-2 antagonist, has been shown to increase serum sodium (Na) and urine output in hyponatremic left ventricular assist device (LVAD) patients in retrospective studies. In this prospective randomized pilot study, we aimed to assess the efficacy of tolvaptan in this population. METHODS We conducted a prospective, randomized, non-blinded pilot study of LVAD recipients with post-operative hyponatremia (Na < 135 mEq/L) (NCT05408104). Eligible participants were randomized to receive tolvaptan 15 mg daily in addition to usual care versus usual care alone. The primary outcome was a change in Na level and estimated glomerular filtration rate (eGFR), from the first post-operative day of hyponatremia (the day of randomization) to discharge. RESULTS A total of 33 participants were enrolled, and 28 underwent randomization (median age 55 [IQR 50-62]), 21% women, 54% Black, 32% ischemic cardiomyopathy, median baseline Na 135 (IQR 134-138). Fifteen participants were randomized to tolvaptan (TLV) and 13 were randomized to usual care alone (No-TLV). Mean change in Na from randomization to discharge in the TLV group was 2.7 mEq/L (95%CI 0.7-4.7, p = 0.013) and 1.8 (95%CI 0.5-4.0, p = 0.11) in the No-TLV group, though baseline and final Na levels were similar between groups. The mean change in eGFR was 2.6 ml/min/1.73 m2 (95%CI 10.1-15.3, p = 0.59) in TLV versus 7.5 ml/min/1.73 m2 (95%CI 5.2-20.2, p = 0.15) in No-TLV. TLV participants had significantly more urine output than No-TLV patients during their first 24 h after randomization (3294 vs 2155 ml, p = 0.043). CONCLUSION TLV significantly increases urine output, with nominal improvement in Na level, in hyponatremic post-operative LVAD patients without adversely impacting renal function.
Collapse
Affiliation(s)
| | - Teruhiko Imamura
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Daniel Rodgers
- Cardiac Surgery, UChicago Medicine, Chicago, Illinois, USA
| | | | | | | | | | - Karen Meehan
- Cardiac Surgery, UChicago Medicine, Chicago, Illinois, USA
| | - Justin Okray
- Cardiac Surgery, UChicago Medicine, Chicago, Illinois, USA
| | | | - Colleen LaBuhn
- Cardiac Surgery, UChicago Medicine, Chicago, Illinois, USA
| | - Tae Song
- Cardiac Surgery, UChicago Medicine, Chicago, Illinois, USA
| | - Takeyoshi Ota
- Cardiac Surgery, UChicago Medicine, Chicago, Illinois, USA
| | | | - Ann B. Nguyen
- Cardiology, UChicago Medicine, Chicago, Illinois, USA
| | - Ben B. Chung
- Cardiology, UChicago Medicine, Chicago, Illinois, USA
| | | | | | | | | | | | - Gabriel Sayer
- Columbia University Irving Medical Center, Weill Cornell Medicine, New York, New York, USA
| | - Gene Kim
- Cardiology, UChicago Medicine, Chicago, Illinois, USA
| | - Nir Uriel
- Columbia University Irving Medical Center, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
12
|
Fujino T, Suda K, Koga T, Hamada A, Ohara S, Chiba M, Shimoji M, Takemoto T, Soh J, Mitsudomi T. EP08.02-146 Proposal of Foretinib as Second-Line TKI after Capmatinib/Tepotinib Treatment Failure in NSCLC with MET Exon 14 Mutation. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
Suda K, Fujino T, Hamada A, Ohara S, Soh J, Mitsudomi T. EP08.02-085 In vitro Activity and Potential Resistance Mutations Against BI-4020, a 4th-generation EGFR-TKI. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Kimura M, Hashimoto T, Noda E, Ishikawa Y, Ishikita A, Fujino T, Matsushima S, Ide T, Kinugawa S, Nagaoka K, Ushijima T, Shiose A, Tsutsui H. Fulminant necrotizing eosinophilic myocarditis after COVID-19 vaccination survived with mechanical circulatory support. ESC Heart Fail 2022; 9:2732-2737. [PMID: 35616026 PMCID: PMC9288782 DOI: 10.1002/ehf2.13962] [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: 01/25/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 01/05/2023] Open
Abstract
A 69‐year‐old man was hospitalized for heart failure 7 days after coronavirus disease 2019 (COVID‐19) mRNA vaccination. Electrocardiography showed ST‐segment elevation and echocardiography demonstrated severe left ventricular dysfunction. Venoarterial extracorporeal membrane oxygenation and Impella 5.0 were instituted because of cardiogenic shock and ventricular fibrillation. Endomyocardial biopsy demonstrated necrotizing eosinophilic myocarditis (NEM). Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) PCR test was negative. He had no infection or history of new drug exposure. NEM was likely related to COVID‐19 vaccination. He was administered 10 mg/kg of prednisolone following methylprednisolone pulse treatment (1000 mg/day for 3 days). Left ventricular function recovered and he was weaned from mechanical circulatory support (MCS). Follow‐up endomyocardial biopsy showed no inflammatory cell infiltration. This is the first report of biopsy‐proven NEM after COVID‐19 vaccination survived with MCS and immunosuppression therapy. It is a rare condition but early, accurate diagnosis and early aggressive intervention can rescue patients.
Collapse
Affiliation(s)
- Mitsukuni Kimura
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eri Noda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihito Ishikita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuhiro Nagaoka
- Department of Cardiovascular Medicine, St. Mary's Hospital, Fukuoka, Japan
| | - Tomoki Ushijima
- Department of Cardiovascular Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Shiose
- Department of Cardiovascular Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
15
|
Nagatomi Y, Ide T, Higuchi T, Nezu T, Fujino T, Tohyama T, Nagata T, Higo T, Hashimoto T, Matsushima S, Shinohara K, Yokoyama T, Eguchi A, Ogusu A, Ikeda M, Ishikawa Y, Yamashita F, Kinugawa S, Tsutsui H. Home-based cardiac rehabilitation using information and communication technology for heart failure patients with frailty. ESC Heart Fail 2022; 9:2407-2418. [PMID: 35534907 PMCID: PMC9288767 DOI: 10.1002/ehf2.13934] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/30/2022] [Accepted: 04/04/2022] [Indexed: 12/30/2022] Open
Abstract
AIMS Cardiac rehabilitation (CR) is an evidence-based, secondary preventive strategy that improves mortality and morbidity rates in patients with heart failure (HF). However, the implementation and continuation of CR remains unsatisfactory, particularly for outpatients with physical frailty. This study investigated the efficacy and safety of a comprehensive home-based cardiac rehabilitation (HBCR) programme that combines patient education, exercise guidance, and nutritional guidance using information and communication technology (ICT). METHODS AND RESULTS This study was a single-centre, open-label, randomized, controlled trial. Between April 2020 and November 2020, 30 outpatients with chronic HF (New York Heart Association II-III) and physical frailty were enrolled. The control group (n = 15) continued with standard care, while the HBCR group (n = 15) also received comprehensive, individualized CR, including ICT-based exercise and nutrition guidance using ICT via a Fitbit® device for 3 months. The CR team communicated with each patient in HBCR group once a week via the application messaging tool and planned the training frequency and intensity of training individually for the next week according to each patient's symptoms and recorded pulse data during exercise. Dietitians conducted a nutritional assessment and then provided individual nutritional advice using the picture-posting function of the application. The primary outcome was the change in the 6 min walking distance (6MWD). The participants' mean age was 63.7 ± 10.1 years, 53% were male, and 87% had non-ischaemic heart disease. The observed change in the 6MWD was significantly greater in the HBCR group (52.1 ± 43.9 m vs. -4.3 ± 38.8 m; P < 0.001) at a 73% of adherence rate. There was no significant change in adverse events in either group. CONCLUSIONS Our comprehensive HBCR programme using ICT for HF patients with physical frailty improved exercise tolerance and improved lower extremity muscle strength in our sample, suggesting management with individualized ICT-based programmes as a safe and effective approach. Considering the increasing number of HF patients with frailty worldwide, our approach provides an efficient method to keep patients engaged in physical activity in their daily life.
Collapse
Affiliation(s)
- Yuta Nagatomi
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.,Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tae Higuchi
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.,Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Tomoyuki Nezu
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.,Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Tomiko Yokoyama
- Department of Nutrition, Kyushu University Hospital, Fukuoka, Japan
| | - Aika Eguchi
- Department of Nutrition, Kyushu University Hospital, Fukuoka, Japan
| | - Ayumi Ogusu
- Department of Nutrition, Kyushu University Hospital, Fukuoka, Japan
| | - Masataka Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Fumika Yamashita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
16
|
Ono M, Yamaguchi O, Ohtani T, Kinugawa K, Saiki Y, Sawa Y, Shiose A, Tsutsui H, Fukushima N, Matsumiya G, Yanase M, Yamazaki K, Yamamoto K, Akiyama M, Imamura T, Iwasaki K, Endo M, Ohnishi Y, Okumura T, Kashiwa K, Kinoshita O, Kubota K, Seguchi O, Toda K, Nishioka H, Nishinaka T, Nishimura T, Hashimoto T, Hatano M, Higashi H, Higo T, Fujino T, Hori Y, Miyoshi T, Yamanaka M, Ohno T, Kimura T, Kyo S, Sakata Y, Nakatani T. JCS/JSCVS/JATS/JSVS 2021 Guideline on Implantable Left Ventricular Assist Device for Patients With Advanced Heart Failure. Circ J 2022; 86:1024-1058. [PMID: 35387921 DOI: 10.1253/circj.cj-21-0880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo
| | - Osamu Yamaguchi
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, Faculty of Medicine, University of Toyama
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Yoshiki Sawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
| | - Akira Shiose
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kenji Yamazaki
- Advanced Medical Research Institute, Hokkaido Cardiovascular Hospital
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Masatoshi Akiyama
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Teruhiko Imamura
- Second Department of Internal Medicine, Faculty of Medicine, University of Toyama
| | - Kiyotaka Iwasaki
- Cooperative Major in Advanced Biomedical Sciences, Graduate School of Advanced Science and Engineering, Waseda University
| | - Miyoko Endo
- Department of Nursing, The University of Tokyo Hospital
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center
| | - Takahiro Okumura
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Koichi Kashiwa
- Department of Medical Engineering, The University of Tokyo Hospital
| | - Osamu Kinoshita
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | - Kaori Kubota
- Department of Transplantation Medicine, Osaka University Graduate School of Medicine
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Koichi Toda
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
| | - Hiroshi Nishioka
- Department of Clinical Engineering, National Cerebral and Cardiovascular Center
| | - Tomohiro Nishinaka
- Department of Artificial Organs, National Cerebral and Cardiovascular Center
| | - Takashi Nishimura
- Department of Cardiovascular and Thoracic Surgery, Ehime University Hospital
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Kyushu University Hospital
| | - Masaru Hatano
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
| | - Haruhiko Higashi
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Hospital
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Kyushu University Hospital
| | - Yumiko Hori
- Department of Nursing and Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Toru Miyoshi
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine
| | | | - Takayuki Ohno
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | | | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | | |
Collapse
|
17
|
Li Z, Yu D, Cruz J, Siddiqi U, Patel A, Rasheed N, Hoang R, Hu K, Rodgers D, Belkin M, Grinstein J, Jeevanandam V, Fujino T. Omega-3 Therapy is Not Associated with Reduced Gastrointestinal Bleeding in HeartMate 3 Left Ventricular Assist Device Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
18
|
Okuda T, Nishimura A, Arimura K, Iwaki K, Fujino T, Ushijima T, Sonoda H, Tanoue Y, Shiose A, Yoshimoto K. Endovascular therapy for intracranial infectious aneurysms associated with a left ventricular assist device: illustrative case. Journal of Neurosurgery: Case Lessons 2022; 3:CASE21559. [PMID: 36209407 PMCID: PMC9379626 DOI: 10.3171/case21559] [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] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/09/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Cerebrovascular events and infection are among the most common complications of left ventricular assist device (LVAD) therapy. The authors reported on a patient with an infectious intracranial aneurysm (IIA) associated with LVAD infection that was successfully occluded by endovascular therapy. OBSERVATIONS A 37-year-old man with severe heart failure received an implantable LVAD. He was diagnosed with candidemia due to driveline infection 44 months after LVAD implantation, and empirical antibiotic therapy was started. After 4 days of antibiotic treatment, the patient experienced sudden dizziness. Computed tomography (CT) revealed subarachnoid hemorrhage in the right frontal lobe, and CT angiography revealed multiple aneurysms in the peripheral lesion of the anterior cerebral artery (ACA) and middle cerebral artery. Two weeks and 4 days after the first bleeding, aneurysms on the ACA reruptured. Each aneurysm was treated with endovascular embolization using n-butyl cyanoacrylate. Subsequently, the patient had no rebleeding of IIAs. The LVAD was replaced, and bloodstream infection was controlled. He received a heart transplant and was independent 2 years after the heart transplant. LESSONS LVAD-associated IIAs have high mortality and an increased risk of surgical complications. However, endovascular obliteration may be safe and thus improve prognosis.
Collapse
Affiliation(s)
| | | | | | | | | | - Tomoki Ushijima
- Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiromichi Sonoda
- Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihisa Tanoue
- Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Shiose
- Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | |
Collapse
|
19
|
Wada R, Shinohara M, Yao S, Yano K, Akitsu K, Koike H, Kinoshita T, Yuzawa H, Nakanishi R, Fujino T, Ikeda T. Significance of mitral L wave to predict late recurrence of atrial fibrillation after radiofrequency catheter ablation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mitral L wave, prominent mid-diastolic filling wave in echocardiographic examinations, is associated with severe left ventricular diastolic dysfunction, and that has been reported to predict recurrent atrial fibrillation (AF) after cardioversion. However, association between mitral L wave and the outcome of AF after radiofrequency catheter ablation (RFCA) has not been established.
Objective
The aim of this study is to evaluate the predictive value of mitral L wave on AF recurrence after RFCA.
Methods
250 patients including 164 paroxysmal AF (65.6%) and 86 non-paroxysmal AF (34.4%) who received RFCA in single center from January 2015 to December 2016 were enrolled consecutively. Echocardiographic examinations before RFCA were recorded, and the mitral L wave was defined as a distinct mid-diastolic flow velocity with a peak velocity ≥20 cm/s following the E wave. Systematic follow-up was conducted after RFCA. Univariate and multivariate analyses were carried out to determine the factors predicting late recurrence of AF (LRAF) which means AF recurrence after 3 months. Enrolled patients were divided into groups with the L wave (L-group; n=57) or without the L wave (NL-group; n=193) based on the findings of echocardiographic examinations.
Results
During a follow-up of 35.0±17.6 months, the ratio of LRAF in the L-group was significantly higher than that in the NL-group (32 (56.1%) vs. 41 (21.2%), Hazard ratio [HR]: 3.55, 95% confidence interval [CI]: 2.33 - 5.42, p<0.001). Among the clinical factors, presence of mitral L wave, BNP value, non-paroxysmal AF and moderate-severe mitral regurgitation were related to LRAF. A multivariate analysis using a Cox proportional hazard model found that presence of mitral L wave (HR: 2.67, 95% CI: 1.30 - 5.48, p=0.007) was significantly associated with LRAF.
Conclusion
This study revealed that mitral L wave predicts late recurrence of AF after RFCA.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- R Wada
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - M Shinohara
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - S Yao
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - K Yano
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - K Akitsu
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - H Koike
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - T Kinoshita
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - H Yuzawa
- Toho University Faculty of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Tokyo, Japan
| | - R Nakanishi
- Toho University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Fujino
- Toho University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Ikeda
- Toho University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| |
Collapse
|
20
|
Suda K, Rivard C, Yu H, Fujino T, Koga T, Soh J, Hirsch F, Mitsudomi T. P68.12 Inter-Tumor Heterogeneity of CD44 Expression in Non-Small Cell Lung Cancers / EGFR Mutated Lung Adenocarcinomas. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
21
|
Belkin M, Imamura T, Kanelidis A, Henry M, Fujino T, Kagan V, Meehan K, Okray J, Creighton S, LaBuhn C, Song T, Ota T, Jeevanandam V, Nguyen A, Chung B, Smith B, Kalantari S, Grinstein J, Sarswat N, Pinney S, Sayer G, Kim G, Uriel N. Postoperative Tolvaptan Use in Left Ventricular Assist Device Implantation Patients: The TOLVAD Study. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
22
|
Kai T, Ono Y, Matsushima S, Shinohara K, Nakashima R, Kawahara T, Katsuki M, Fujino T, Hashimoto T, Higo T, Tsutsui H. Undiagnosed Cardiac Sarcoidosis Causing Refractory Heart Failure After Acute Myocardial Infarction due to Thromboembolism. Int Heart J 2021; 62:437-440. [PMID: 33731532 DOI: 10.1536/ihj.20-586] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 61-year-old woman suffered chest pain and was admitted to a nearby hospital emergency department. She was diagnosed with acute myocardial infarction probably due to thromboembolism in the left anterior descending coronary artery and aspiration thrombectomy was performed. Afterwards, she developed refractory heart failure with severe global left ventricular dysfunction and was transferred to our hospital. An 18F-FDG-PET/CT scan revealed abnormal 18F-FDG uptake in non-infarcted regions of the left ventricle. Non-caseating granulomas were detected by biopsy from a skin eruption. She was diagnosed with cardiac sarcoidosis. In cases of refractory heart failure which cannot be explained only by myocardial infarction, evaluation of other undiagnosed cardiomyopathies is important for optimal management.
Collapse
Affiliation(s)
- Takashi Kai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Yoshiyasu Ono
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University.,Department of Cardiology, Munakata Suikokai General Hospital
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Keisuke Shinohara
- Department of Experimental and Clinical Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Ryosuke Nakashima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Takuro Kawahara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Masato Katsuki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University.,Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University
| | - Taiki Higo
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| |
Collapse
|
23
|
Sato T, Hashimoto T, Ishikawa Y, Fujino T, Sakamoto I, Higo T, Shiose A, Tsutsui H. Bidirectional Dynamic Change in Shunt Flow Across a Small Ventricular Septal Defect in a Patient With a Left Ventricular Assist Device. CJC Open 2021; 3:984-985. [PMID: 34401705 PMCID: PMC8348322 DOI: 10.1016/j.cjco.2021.03.004] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tasuku Sato
- Echocardiography Laboratory, Kyushu University Hospital Heart Center, Fukuoka, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Kyushu University Hospital Heart Center, Fukuoka, Japan.,Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Ishikawa
- Department of Cardiovascular Medicine, Kyushu University Hospital Heart Center, Fukuoka, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Kyushu University Hospital Heart Center, Fukuoka, Japan
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Hospital Heart Center, Fukuoka, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Hospital Heart Center, Fukuoka, Japan
| | - Akira Shiose
- Echocardiography Laboratory, Kyushu University Hospital Heart Center, Fukuoka, Japan.,Department of Cardiovascular Surgery, Kyushu University Hospital Heart Center, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Hospital Heart Center, Fukuoka, Japan
| |
Collapse
|
24
|
Ohara S, Mitsudomi T, Suda K, Fujino T, Koga T, Soh J, Takemoto T, Shimoji M, Nishino M, Chiba M, Hamada A. P76.71 RYK Confers Drug Tolerance to Osimertinib in Lung Cancer Cells with EGFR Mutations. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
25
|
Fujino T, Kumai Y, Yang B, Kalantari S, Rodgers D, Henriksen K, Chang A, Husain A, Kim G, Sayer G, Uriel N. Discordance between immunofluorescence and immunohistochemistry C4d staining and outcomes following heart transplantation. Clin Transplant 2021; 35:e14242. [PMID: 33539043 DOI: 10.1111/ctr.14242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Capillary deposition of C4d is an important marker of antibody-mediated rejection (AMR) following heart transplantation (HT). There are two immunopathologic assay methods for detecting C4d: frozen-tissue immunofluorescence (IF) and paraffin immunohistochemistry (IHC). The clinical significance of discrepancy between the results of IF and IHC has not been understood. METHODS AND RESULTS We reviewed 2187 biopsies from 142 HT recipients who had biopsies with assessment of both IF and IHC staining. Among them, 103 (73%) patients had negative IF and IHC C4d staining (Negative Group) and 32 (23%) patients had positive IF but negative IHC staining (Discordant Group). At the time of positive biopsy, 6 (19%) Discordant patients had graft dysfunction, compared to 5 (5%) Negative patients (p = .022). Cumulative incidence of cellular rejection at 1 year was comparable (31% vs. 29%, p = .46); however, cumulative incidence of AMR was significantly higher in the Discordant group (21% vs. 4%, p = .004). Overall 1-year survival was comparable (90% vs. 96%, p = .24); however, freedom from heart failure (HF) was significantly lower in the Discordant group (70% vs. 96%, p < .001). CONCLUSION The Discordant group showed higher rates of graft dysfunction, AMR and HF admission than the Negative group.
Collapse
Affiliation(s)
- Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Yuto Kumai
- Cardiology Division, Columbia University, New York, NY, USA
| | - Benjamin Yang
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Sara Kalantari
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Kammi Henriksen
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA
| | - Anthony Chang
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA
| | - Aliya Husain
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Gabriel Sayer
- Cardiology Division, Columbia University, New York, NY, USA
| | - Nir Uriel
- Cardiology Division, Columbia University, New York, NY, USA
| |
Collapse
|
26
|
Holzhauser L, Clerkin KJ, Fujino T, Alenghat FJ, Raikhelkar J, Kim G, Sayer G, Uriel N. Donor-derived cell-free DNA is associated with cardiac allograft vasculopathy. Clin Transplant 2021; 35:e14206. [PMID: 33368611 PMCID: PMC10040222 DOI: 10.1111/ctr.14206] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/21/2020] [Revised: 11/20/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The role of donor-derived cell-free DNA (dd-cfDNA) in screening for cardiac allograft vasculopathy (CAV) is unknown. We hypothesized that dd-cfDNA correlates with CAV, markers of inflammation, and angiogenesis in stable heart transplant (HT) recipients. METHODS Sixty-five HT recipients ≥2 years post-transplant, without recent rejection, were stratified by high (≥0.12%) versus low levels (<0.12%) of dd-cfDNA. A targeted amplification, next-generation sequencing assay (AlloSure® ; CareDx, Inc.) was used to detect dd-cfDNA. Peripheral blood inflammatory and angiogenesis markers were assessed using a multiplex immunoassay system (Bioplex® ). RESULTS Of 65 patients, 58 patients had a known CAV status and were included. Thirty had high levels of dd-cfDNA (≥0.12%), and 28 had low levels (<0.12%). CAV was present in 63% of patients with high dd-cfDNA vs. 35% with low dd-cfDNA (p = .047). Donor-specific antibodies were present in 25% of patients with high dd-cfDNA vs. 3.8% in those with low dd-cfDNA (p = .03). There were no differences in rejection episodes, inflammatory, or angiogenesis markers. Importantly, dd-cfDNA levels were not different when stratified by time post-transplant. CONCLUSIONS Higher dd-cfDNA levels were associated with CAV in stable chronic HT recipients. Further studies are warranted to investigate a possible association between dd-cfDNA levels and CAV severity and whether dd-cfDNA can predict CAV progression.
Collapse
Affiliation(s)
- Luise Holzhauser
- Department of Cardiology, University of Chicago, Chicago, IL, USA
| | - Kevin J Clerkin
- Department of Medicine, Milstein Division of Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Takeo Fujino
- Department of Cardiology, University of Chicago, Chicago, IL, USA
| | | | - Jayant Raikhelkar
- Department of Medicine, Milstein Division of Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Gene Kim
- Department of Cardiology, University of Chicago, Chicago, IL, USA
| | - Gabriel Sayer
- Department of Medicine, Milstein Division of Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Nir Uriel
- Department of Medicine, Milstein Division of Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| |
Collapse
|
27
|
Kubota K, Hanawa H, Yokoyama M, Kita S, Hirata K, Fujino T, Kokubun T, Ishibashi T, Kanemura N. Usefulness of Muscle Synergy Analysis in Individuals With Knee Osteoarthritis During Gait. IEEE Trans Neural Syst Rehabil Eng 2020; 29:239-248. [PMID: 33301406 DOI: 10.1109/tnsre.2020.3043831] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To clarify whether there are any muscle synergy changes in individuals with knee osteoarthritis, and to determine whether muscle synergy analysis could be applied to other musculoskeletal diseases. METHODS Subjects in this study included 11 young controls (YC), 10 elderly controls (EC), and 10 knee osteoarthritis patients (KOA). Gait was assessed on a split-belt treadmill at 3 km/h. A non-negative matrix factorization (NNMF) was applied to the electromyogram data matrix to extract muscle synergies. To assess the similarity of each module, we performed the NNMF analysis assuming four modules for all of the participants. Further, we calculated joint angles to compare the kinematic data between the module groups. RESULTS The number of muscle modules was significantly lower in the EC (2-3) and KOA (2-3) groups than in the YC group (3-4), which reflects the merging of late swing and early stance modules. The EC and KOA groups also showed greater knee flexion angles in the early stance phase. Contrarily, by focusing on the module structure, we found that the merging of early and late stance modules is characteristic in KOA. CONCLUSION The lower number of modules in the EC and KOA groups was due to the muscle co-contraction with increased knee flexion angle. Contrarily, the merging of early and late stance modules are modular structures specific to KOA and may be biomarkers for detecting KOA. SIGNIFICANCE Describing the changes in multiple muscle control associated with musculoskeletal degeneration can serve as a fundamental biomarker in joint disease.
Collapse
|
28
|
Kinoshita T, Yuzawa H, Wada R, Yano K, Yao S, Akitsu K, Koike H, Shinohara M, Abe A, Fujino T, Ogata H, Ikeda T. Electrocardiographic evaluation of depolarization and repolarization abnormalities in breast cancer patients with HER2-inhibitor related cardiac dysfunction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The arrhythmic substrates of the myocardium such as depolarization and repolarization abnormalities are thought to reflect cardiac dysfunction prior to the morphologic left ventricular dysfunction. Activation time (AT), recovery time (RT) and T wave peek-end interval dispersion (Tpe-dispersion) are useful indicators of the arrhythmic substrate. We examined the appearance of depolarization and repolarization abnormalities in patients with cancer therapeutics-related cardiac dysfunction (CTRCD) using AT, RT and Tpe-dispersion.
Methods
We conducted a standardized case-control study of CTRCD with 40 patients who developed breast cancer and treated with trastuzumab (13 cases and 27 controls). We assessed the relation between electrocardiographic indexes, including AT, RT and corrected Tpe-dispersion, and CTRCD. QT intervals were measured by Fridericia method, and QT observer 3 software were used for the measurement of all electrocardiographic indexes.
Results
LVEF in case and control group were 45.7±8% and 69.2±6%, respectively. AT in aVR lead was significantly higher in case group compared with control (28.8±7ms vs 22.8±5ms, P=0.02). corrected Tpe-dispersion tended to be higher in case group than that of control group (43.2±19ms vs 31.9±10ms, P=0.06). QT dispersion and RT dispersion were not different between case and control group.
Conclusions
Our study demonstrated that AT in aVR may predict cardiac dysfunction in breast cancer patients with HER2-inhibitor related cardiac dysfunction. More detailed studies using other modalities which can detect depolarization and repolarization abnormalities, including ventricular late potentials and T wave alternans, are needed.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- T Kinoshita
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Yuzawa
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - R Wada
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Yano
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Yao
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Akitsu
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Koike
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Shinohara
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - A Abe
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Fujino
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Ogata
- Toho University Faculty of Medicine, Division of Breast and Endocrine Surgery (Omori), Department of Surgery, Tokyo, Japan
| | - T Ikeda
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| |
Collapse
|
29
|
Imamura T, Narang N, Kim G, Nitta D, Fujino T, Nguyen A, Grinstein J, Rodgers D, Ota T, Raikhelkar J, Jeevanandam V, Sayer G, Uriel N. Impact of worsening of aortic insufficiency during HeartMate 3 LVAD support. Artif Organs 2020; 45:297-302. [PMID: 33098153 DOI: 10.1111/aor.13825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 11/29/2022]
Abstract
Aortic insufficiency remains a difficult to treat and highly morbid condition even in the era of HeartMate 3 left ventricular assist devices (LVADs). The prognostic nature of the longitudinal progression of aortic insufficiency, however, remains unknown. We prospectively collected data on patients who received HeartMate 3 LVAD implantation, who had assessments of aortic insufficiency using a novel Doppler echocardiography obtained at outflow graft at three (baseline) and 6 months postimplant. Patients with moderate or greater aortic insufficiency at baseline were excluded. The risk of aortic insufficiency progression on 1-year death and readmission for heart failure was investigated. In total, 41 patients (median 51 years old and 29 males) were included. All patients had less than moderate aortic insufficiency at baseline. Of them, 22 patients had worsening aortic insufficiency for 3 months following baseline assessments, which was associated with a significantly higher risk of 1-year death or heart failure readmission rate (41% vs. 11%, P = .023) with a hazard ratio of 3.24 (95% confidence interval 1.02-18.5, P = .038) adjusted for device speed at baseline and destination therapy indication. In patients with HeartMate 3 LVADs, progressive aortic insufficiency may be associated with a higher risk of 1-year death or readmission for heart failure. Close monitoring of patients with baseline aortic insufficiency should be considered as a measure to risk-stratify those for future adverse events.
Collapse
Affiliation(s)
- Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.,Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Nikhil Narang
- Division of Advocate Christ Medical Center, Oak Lawn, IL, USA
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Daisuke Nitta
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Ann Nguyen
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Jonathan Grinstein
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Takeyoshi Ota
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - Jayant Raikhelkar
- Cardiology Division, Columbia University Medical Center, New York, NY, USA
| | | | - Gabriel Sayer
- Cardiology Division, Columbia University Medical Center, New York, NY, USA
| | - Nir Uriel
- Cardiology Division, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
30
|
Kondo T, Iwatani Y, Matsuoka K, Fujino T, Umemoto S, Yokomaku Y, Ishizaki K, Kito S, Sezaki T, Hayashi G, Murakami H. Antibody-like proteins that capture and neutralize SARS-CoV-2. Sci Adv 2020; 6:sciadv.abd3916. [PMID: 32948512 PMCID: PMC7556756 DOI: 10.1126/sciadv.abd3916] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/28/2020] [Indexed: 05/10/2023]
Abstract
To combat severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and any unknown emerging pathogens in the future, the development of a rapid and effective method to generate high-affinity antibodies or antibody-like proteins is of critical importance. We here report high-speed in vitro selection of multiple high-affinity antibody-like proteins against various targets including the SARS-CoV-2 spike protein. The sequences of monobodies against the SARS-CoV-2 spike protein were successfully procured within only 4 days. Furthermore, the obtained monobody efficiently captured SARS-CoV-2 particles from the nasal swab samples of patients and exhibited a high neutralizing activity against SARS-CoV-2 infection (half-maximal inhibitory concentration, 0.5 nanomolar). High-speed in vitro selection of antibody-like proteins is a promising method for rapid development of a detection method for, and of a neutralizing protein against, a virus responsible for an ongoing, and possibly a future, pandemic.
Collapse
MESH Headings
- Amino Acid Sequence
- Angiotensin-Converting Enzyme 2
- Antibodies, Immobilized/chemistry
- Antibodies, Immobilized/immunology
- Antibodies, Neutralizing/chemistry
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/metabolism
- Betacoronavirus/genetics
- Betacoronavirus/immunology
- Betacoronavirus/isolation & purification
- COVID-19
- Cell Surface Display Techniques/methods
- Coronavirus Infections/pathology
- Coronavirus Infections/virology
- Dimerization
- Humans
- Kinetics
- Pandemics
- Peptides/chemistry
- Peptides/immunology
- Peptidyl-Dipeptidase A/chemistry
- Peptidyl-Dipeptidase A/immunology
- Peptidyl-Dipeptidase A/metabolism
- Pneumonia, Viral/pathology
- Pneumonia, Viral/virology
- Protein Domains/immunology
- Protein Subunits/chemistry
- Protein Subunits/immunology
- Protein Subunits/metabolism
- RNA, Viral/metabolism
- SARS-CoV-2
- Single-Domain Antibodies/chemistry
- Single-Domain Antibodies/immunology
- Single-Domain Antibodies/metabolism
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/immunology
Collapse
Affiliation(s)
- T Kondo
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - Y Iwatani
- Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Division of Basic Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - K Matsuoka
- Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - T Fujino
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - S Umemoto
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - Y Yokomaku
- Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - K Ishizaki
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - S Kito
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - T Sezaki
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - G Hayashi
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
- Japan Science and Technology Agency (JST), PRESTO, Saitama, Japan
| | - H Murakami
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan.
- Institute of Nano-Life-Systems, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
| |
Collapse
|
31
|
Fujino T, Kumai Y, Nitta D, Holzhauser L, Nguyen A, Lourenco L, Rodgers D, Raikhelkar J, Kim G, Sayer G, Uriel N. Hypogammaglobulinemia following heart transplantation: Prevalence, predictors, and clinical importance. Clin Transplant 2020; 34:e14087. [PMID: 32955148 DOI: 10.1111/ctr.14087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/09/2020] [Accepted: 09/08/2020] [Indexed: 01/14/2023]
Abstract
Hypogammaglobulinemia (HGG) can occur following solid organ transplantation. However, there are limited data describing the prevalence, risk factors, and clinical outcomes associated with HGG following heart transplantation. We retrospectively reviewed data of 132 patients who had undergone heart transplantation at our institution between April 2014 and December 2018. We classified patients into three groups based on the lowest serum IgG level post-transplant: normal (≥700 mg/dL), mild HGG (≥450 and <700 mg/dL), and severe HGG (<450 mg/dL). We compared clinical outcomes from the date of the lowest IgG level. Mean age was 57 (47, 64) years, and 94 (71%) patients were male. Prevalence of severe HGG was the highest (27%) at 3-6 months following heart transplantation and then decreased to 5% after 1 year. Multivariate analysis showed that older age and Caucasian race were independent risk factors for HGG. Overall survival was comparable between the groups; however, survival free of infection was 73%, 60%, and 45% at 1 year in the normal, mild HGG, and severe HGG groups, respectively (P = .013). In conclusion, there is a high prevalence of HGG in the early post-heart transplant period that decreases over time. HGG is associated with an increased incidence of infection.
Collapse
Affiliation(s)
- Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Yuto Kumai
- Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Daisuke Nitta
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Luise Holzhauser
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Ann Nguyen
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Laura Lourenco
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Jayant Raikhelkar
- Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Gabriel Sayer
- Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Nir Uriel
- Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
32
|
Imamura T, Narang N, Nitta D, Fujino T, Nguyen A, Chung B, Holzhauser L, Kim G, Raikhelkar J, Kalantari S, Smith B, Juricek C, Rodgers D, Ota T, Song T, Jeevanandam V, Sayer G, Uriel N. HeartWare Ventricular Assist Device Cannula Position and Hemocompatibility-Related Adverse Events. Ann Thorac Surg 2020; 110:911-917. [PMID: 32035046 PMCID: PMC7416438 DOI: 10.1016/j.athoracsur.2019.12.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/25/2019] [Accepted: 12/17/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND HeartWare ventricular assist device (HVAD) cannula position is associated with hemodynamics and heart failure readmissions. However, its impact on hemocompatibility-related adverse events (HRAEs) remains uncertain. METHODS HVAD patients were followed for 1 year after index hospitalization, when cannula coronal angle was quantified from chest x-ray film. Invasive right heart catheterization and transthoracic echocardiography were performed. One-year occurrences of each HRAE were compared between those with and without a cannula coronal angle of greater than 65 degrees. RESULTS Among 63 HVAD patients (median age 60 years, 63% male), 10 (16%) had a cannula coronal angle greater than 65 degrees. The wide-angle group had elevated intracardiac pressures and lower pulmonary artery pulsatility index (P < .05). They also had reduced right ventricular function by echocardiography. Freedom from HRAEs tended to be lower in the wide-angle group (24% vs 62%; P = .11). The rate of gastrointestinal bleeding was significantly higher in the greater than 65 degrees group (0.90 events/year vs 0.40 events/year; P = .013). The rates of stroke and pump thrombosis were statistically comparable irrespective of cannula angle (P > .05). CONCLUSIONS HVAD cannula coronal angle was associated with reduced right ventricular function and HRAEs. Prospective studies evaluating surgical techniques to ensure optimal device positioning and its effects on HRAEs are warranted.
Collapse
Affiliation(s)
- Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois; Second Department of Medicine, University of Toyama, Toyama, Japan.
| | - Nikhil Narang
- Advocate Heart Institute, Advocate Christ Medical Center, Oak Lawn, Illinois
| | - Daisuke Nitta
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ann Nguyen
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ben Chung
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Luise Holzhauser
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Jayant Raikhelkar
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Sara Kalantari
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Bryan Smith
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Colleen Juricek
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Takeyoshi Ota
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Tae Song
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | | | - Gabriel Sayer
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Nir Uriel
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
33
|
Kashihara S, Ohtani K, Sato T, Nishizaki A, Shojima Y, Deguchi Y, Fujino T, Hashimoto T, Higo T, Tsutsui H. A Rare Manifestation of Right Ventricular Dysfunction in an Adult Patient With Mucolipidosis Type III α/β. Can J Cardiol 2020; 36:1978.e1-1978.e3. [PMID: 32818557 DOI: 10.1016/j.cjca.2020.07.239] [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] [Received: 05/06/2020] [Revised: 07/11/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022] Open
Abstract
Mucolipidosis type III α/β is an autosomal recessive lysosomal storage disease, caused by the deficient activity of UDP-N-acetyl glucosamine-1-phosphotransferase. The resultant intralysosomal accumulation of partly degraded mucopolysaccharides and sphingolipids causes multiple-organ damage, including the heart. The most documented cardiac manifestation is the thickening and insufficiency of mitral and aortic valves, but there are very few reports about the myocardial involvement. We report a case with mucolipidosis type III α/β complicated by marked dilatation and dysfunction of the right ventricle, which is quite rare and further broadens the clinical spectrum of the disease.
Collapse
Affiliation(s)
- Soichiro Kashihara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kisho Ohtani
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Cardiovascular Medicine, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
| | - Tasuku Sato
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Nishizaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoko Shojima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuko Deguchi
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
34
|
Imamura T, Narang N, Nitta D, Fujino T, Nguyen A, Kim G, Raikhelkar J, Rodgers D, Ota T, Jeevanandam V, Sayer G, Uriel N. Optimal cannula positioning of HeartMate 3 left ventricular assist device. Artif Organs 2020; 44:e509-e519. [PMID: 32557769 DOI: 10.1111/aor.13755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 12/30/2022]
Abstract
Cannula position in HeartMate II and HeartWare left ventricular assist devices (LVADs) is associated with clinical outcome. This study aimed to investigate the clinical implication of the device positioning in HeartMate 3 LVAD cohort. Consecutive patients who underwent HeartMate 3 LVAD implantation were followed for one year from index discharge. At index discharge, chest X-ray parameters were measured: (a) cannula coronal angle, (b) height of pump bottom, (c) cannula sagittal angle, and (d) cannula lumen area. The association of each measurement of cannula position with one-year clinical outcomes was investigated. Sixty-four HeartMate 3 LVAD patients (58 years old, 64% male) were enrolled. In the multivariable Cox regression model, the cannula coronal angle was a significant predictor of death or heart failure readmission (hazard ratio 1.27 [1.01-1.60], P = .045). Patients with a cannula coronal angle ≤28° had lower central venous pressure (P = .030), lower pulmonary capillary wedge pressure (P = .027), and smaller left ventricular size (P = .019) compared to those with the angle >28°. Right ventricular size and parameters of right ventricular function were also better in the narrow angle group, as was one-year cumulative incidence of death or heart failure readmission (10% vs. 50%, P = .008). Narrow cannula coronal angle in patients with HeartMate 3 LVADs was associated with improved cardiac unloading and lower incidence of death or heart failure readmission. Larger studies to confirm the implication of optimal device positioning are warranted.
Collapse
Affiliation(s)
- Teruhiko Imamura
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA.,Second Department of Internal Medicine, University of Toyama, Toyama, Toyama, Japan
| | - Nikhil Narang
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | - Daisuke Nitta
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | - Takeo Fujino
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | - Ann Nguyen
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | - Gene Kim
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | - Jayant Raikhelkar
- Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| | - Daniel Rodgers
- Division of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | - Takeyoshi Ota
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | | | - Gabriel Sayer
- Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| | - Nir Uriel
- Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
35
|
Affiliation(s)
- Takeo Fujino
- Department of Medicine, Section of Cardiology, University of Chicago Medicine
| | | | | |
Collapse
|
36
|
Adachi S, Aguilar Faúndez MAO, Akiba Y, Ali A, Arnold K, Baccigalupi C, Barron D, Beck D, Bianchini F, Borrill J, Carron J, Cheung K, Chinone Y, Crowley K, El Bouhargani H, Elleflot T, Errard J, Fabbian G, Feng C, Fujino T, Goeckner-Wald N, Hasegawa M, Hazumi M, Hill CA, Howe L, Katayama N, Keating B, Kikuchi S, Kusaka A, Lee AT, Leon D, Linder E, Lowry LN, Matsuda F, Matsumura T, Minami Y, Namikawa T, Navaroli M, Nishino H, Peloton J, Pham ATP, Poletti D, Puglisi G, Reichardt CL, Segawa Y, Sherwin BD, Silva-Feaver M, Siritanasak P, Stompor R, Tajima O, Takatori S, Tanabe D, Teply GP, Vergès C. Internal Delensing of Cosmic Microwave Background Polarization B-Modes with the POLARBEAR Experiment. Phys Rev Lett 2020; 124:131301. [PMID: 32302154 DOI: 10.1103/physrevlett.124.131301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/20/2019] [Accepted: 02/26/2020] [Indexed: 06/11/2023]
Abstract
Using only cosmic microwave background polarization data from the polarbear experiment, we measure B-mode polarization delensing on subdegree scales at more than 5σ significance. We achieve a 14% B-mode power variance reduction, the highest to date for internal delensing, and improve this result to 22% by applying for the first time an iterative maximum a posteriori delensing method. Our analysis demonstrates the capability of internal delensing as a means of improving constraints on inflationary models, paving the way for the optimal analysis of next-generation primordial B-mode experiments.
Collapse
Affiliation(s)
- S Adachi
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M A O Aguilar Faúndez
- Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Maryland 21218, USA
- Departamento de Física, FCFM, Universidad de Chile, Blanco Encalada 2008, Santiago, Chile
| | - Y Akiba
- SOKENDAI (The Graduate University for Advanced Studies), Shonan Village, Hayama, Kanagawa 240-0193, Japan
| | - A Ali
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K Arnold
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - C Baccigalupi
- International School for Advanced Studies (SISSA), Via Bonomea 265, 34136 Trieste, Italy
- Institute for Fundamental Physics of the Universe (IFPU), Via Beirut 2, 34014 Trieste, Italy
- National Institute for Nuclear Physics (INFN), via Valerio 2, 34127 Trieste, Italy
| | - D Barron
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - D Beck
- AstroParticule et Cosmologie (APC), Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, 75013 Paris, France
| | - F Bianchini
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - J Borrill
- Computational Cosmology Center, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Space Sciences Laboratory, University of California, Berkeley, California 94720, USA
| | - J Carron
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - K Cheung
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - Y Chinone
- Department of Physics, University of California, Berkeley, California 94720, USA
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), Berkeley Satellite, the University of California, Berkeley, California 94720, USA
| | - K Crowley
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H El Bouhargani
- AstroParticule et Cosmologie (APC), Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, 75013 Paris, France
| | - T Elleflot
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - J Errard
- AstroParticule et Cosmologie (APC), Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, 75013 Paris, France
| | - G Fabbian
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - C Feng
- Department of Physics, University of Illinois at Urbana-Champaign, 1110 West Green Street, Urbana, Illinois 61801, USA
| | - T Fujino
- Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - N Goeckner-Wald
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Hazumi
- SOKENDAI (The Graduate University for Advanced Studies), Shonan Village, Hayama, Kanagawa 240-0193, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Institute of Space and Astronautical Science (ISAS), Japan Aerospace Exploration Agency (JAXA), Sagamihara, Kanagawa 252-0222, Japan
| | - C A Hill
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - L Howe
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - N Katayama
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - B Keating
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - S Kikuchi
- Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - A Kusaka
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), Berkeley Satellite, the University of California, Berkeley, California 94720, USA
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
- Research Center for the Early Universe, School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - A T Lee
- Department of Physics, University of California, Berkeley, California 94720, USA
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Radio Astronomy Laboratory, University of California, Berkeley, California 94720, USA
| | - D Leon
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - E Linder
- Space Sciences Laboratory, University of California, Berkeley, California 94720, USA
| | - L N Lowry
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - F Matsuda
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - T Matsumura
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), UTIAS, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Minami
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Namikawa
- DAMTP, University of Cambridge, Cambridge CB3 0WA, United Kingdom
| | - M Navaroli
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - H Nishino
- Research Center for the Early Universe, School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - J Peloton
- Laboratoire de l'Accélérateur Linéaire, Université Paris-Sud, CNRS/IN2P3, 91400 Orsay, France
| | - A T P Pham
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - D Poletti
- International School for Advanced Studies (SISSA), Via Bonomea 265, 34136 Trieste, Italy
- Institute for Fundamental Physics of the Universe (IFPU), Via Beirut 2, 34014 Trieste, Italy
- National Institute for Nuclear Physics (INFN), via Valerio 2, 34127 Trieste, Italy
| | - G Puglisi
- Department of Physics, Stanford University, Stanford, California 94305, USA
- Kavli Institute for Particle Astrophysics and Cosmology, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - C L Reichardt
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - Y Segawa
- SOKENDAI (The Graduate University for Advanced Studies), Shonan Village, Hayama, Kanagawa 240-0193, Japan
| | - B D Sherwin
- Kavli Institute for Cosmology Cambridge, Cambridge CB3 OHA, United Kingdom
| | - M Silva-Feaver
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - P Siritanasak
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - R Stompor
- AstroParticule et Cosmologie (APC), Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, 75013 Paris, France
| | - O Tajima
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Takatori
- SOKENDAI (The Graduate University for Advanced Studies), Shonan Village, Hayama, Kanagawa 240-0193, Japan
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - D Tanabe
- SOKENDAI (The Graduate University for Advanced Studies), Shonan Village, Hayama, Kanagawa 240-0193, Japan
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - G P Teply
- Department of Physics, University of California, San Diego, California 92093-0424, USA
| | - C Vergès
- AstroParticule et Cosmologie (APC), Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, 75013 Paris, France
| |
Collapse
|
37
|
Kaku H, Funakoshi K, Ide T, Fujino T, Matsushima S, Ohtani K, Higo T, Nakai M, Sumita Y, Nishimura K, Miyamoto Y, Anzai T, Tsutsui H. Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan - An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC. Circ J 2020; 84:742-753. [PMID: 32238643 DOI: 10.1253/circj.cj-19-0759] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the relationship between these factors and 7-day, 30-day, and in-hospital mortality among HF patients in Japan.Methods and Results:We analyzed the records of 198,861 patients admitted to 683 certified hospitals of the Japanese Circulation Society between 2012 and 2014. Records were obtained from the nationwide database of the Japanese Registry Of All cardiac and vascular Diseases-Diagnostic Procedure Combination (JROAD-DPC). Using exploratory factor analysis, 90 hospital survey items were grouped into 5 factors, according to their collinearity: "Interventional cardiology", "Cardiovascular surgery", "Pediatric cardiology", "Electrophysiology" and "Cardiac rehabilitation". Multivariable logistic regression analysis was performed to determine the association between these factors and mortality. The 30-day mortality was 8.0%. Multivariable logistic regression analysis showed the "Pediatric cardiology" (odds ratio (OR) 0.677, 95% confidence interval [CI]: 0.628-0.729, P<0.0001), "Electrophysiology" (OR 0.876, 95% CI: 0.832-0.923, P<0.0001), and "Cardiac rehabilitation" (OR 0.832, 95% CI: 0.792-0.873, P<0.0001) factors were associated with lower mortality. In contrast, "Interventional cardiology" (OR 1.167, 95% CI: 1.070-1.272, P<0.0001) was associated with higher mortality. CONCLUSIONS Hospital factors, including various cardiovascular therapeutic practices, may be associated with the early death of HF patients.
Collapse
Affiliation(s)
- Hidetaka Kaku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Kouta Funakoshi
- Center for Clinical and Translational Research, Kyushu University Hospital
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Kisho Ohtani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Taiki Higo
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Yoko Sumita
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Kunihiro Nishimura
- 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
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| |
Collapse
|
38
|
Mehta N, Fujino T, Dela Cruz M, Holzhauser L, Rodgers D, Kalantari S, Smith B, Sarswat N, Nguyen A, Chung B, Uriel N, Raikhelkar J, Sayer G, Ota T, Song T, Jeevanandam V, Kim G, Grinstein J. Absence of Aortic Valve Opening after Hemodynamic Ramp Optimization Study Does Not Impact LVAD Morbidity of Mortality. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
39
|
Fujino T, Kumai Y, Nitta D, Lourenco L, Nguyen A, Chung B, Rodgers D, Raikhelkar J, Kim G, Sayer G, Uriel N. Hypogammaglobulinemia Following Heart Transplantation - Prevalence and Clinical Importance. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
40
|
Mehta N, Fujino T, Belkin M, DelaCruz M, Yu D, Holzhauser L, Rodgers D, Smith B, Kalantari S, Sarswat N, Chung B, Nguyen A, Uriel N, Raikhelkar J, Sayer G, Song T, Ota T, Jeevanandam V, Kim G, Grinstein J. Prognostication of Residual Mitral Regurgitation or Aortic Insufficiency after Invasive Hemodynamic Ramp Optimization. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
41
|
Mazzone S, Fujino T, Nguyen A, Chung B, Smith B, Raikhelkar J, Kim G, Sayer G, Uriel N. Post-Heart Transplant Diabetes Mellitus: Incidence, Prevalence and Outcomes. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
42
|
Imamura T, Nitta D, Fujino T, Nguyen A, Narang N, Chung B, Holzhauser L, Kim G, Raikhelkar J, Rodgers D, Ota T, Jeevanandam V, Burkhoff D, Sayer G, Uriel N. Optimal Cannula Positioning of Heart Mate 3 Left Ventricular Assist Device. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
43
|
Belkin MN, Imamura T, Fujino T, Kanelidis AJ, Holzhauser L, Ebong I, Narang N, Blair JE, Nathan S, Paul JD, Shah AP, Chung BB, Nguyen A, Smith B, Kalantari S, Raikhelkar J, Ota T, Jeevanandam V, Kim G, Burkhoff D, Sayer G, Uriel N. Transcatheter Aortic Valve Replacement in Left Ventricular Assist Device Patients with Aortic Regurgitation. Structural Heart 2020. [DOI: 10.1080/24748706.2019.1706793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
44
|
Fujino T, Imamura T, Nitta D, Kim G, Smith B, Kalantari S, Nguyen A, Chung B, Narang N, Holzhauser L, Juricek C, Rodgers D, Song T, Ota T, Jeevanandam V, Burkhoff D, Sayer G, Uriel N. Effect of Concomitant Tricuspid Valve Surgery With Left Ventricular Assist Device Implantation. Ann Thorac Surg 2020; 110:918-924. [PMID: 32035052 DOI: 10.1016/j.athoracsur.2019.12.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/24/2019] [Accepted: 12/17/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tricuspid regurgitation (TR) is common in advanced heart failure (HF) patients. However, the effect of concomitant tricuspid valve repair or replacement (tricuspid valve intervention [TVI]) with left ventricular assist device (LVAD) implantation is controversial. The aim of this study was to investigate the longitudinal trend of TR after LVAD implantation and the effect of TVI on the TR trend and clinical outcomes. METHODS We retrospectively reviewed patients at our institution who underwent LVAD implantation between April 2014 and August 2018. We evaluated the grade of TR by echocardiography before and after LVAD implantation. Moderate or greater TR was defined as significant. RESULTS Among 199 consecutive patients, 194 had at least 2 echocardiographic TR assessments before and after LVAD implantation. Of these patients, 108 were included in the TVI-positive (TVI+) group and 86 in the TVI-negative (TVI-) group. In the TVI+ group, the prevalence of significant TR decreased from 52% to about 20% in the first 6 months after implantation (P < .01). Overall survival and HF readmission-free survival were comparable between the TVI+ and TVI- patients. In contrast, patients in both groups who had significant postoperative TR during early follow-up had worse 2-year HF readmission-free survival (36% in patients with significant postoperative TR vs 55% in those without significant postoperative TR; P = .028). CONCLUSIONS Concomitant TVI with LVAD implantation improved TR in most patients but did not have an impact on clinical outcomes. Significant postoperative TR after LVAD implantation, in patients with and without TVI, was associated with worse HF-free outcomes.
Collapse
Affiliation(s)
- Takeo Fujino
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Teruhiko Imamura
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Daisuke Nitta
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Gene Kim
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Bryan Smith
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Sara Kalantari
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ann Nguyen
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ben Chung
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Nikhil Narang
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Luise Holzhauser
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Colleen Juricek
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Rodgers
- Departments of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Tae Song
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Takeyoshi Ota
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | | | - Daniel Burkhoff
- Columbia University Medical Center and Cardiovascular Research Foundation, New York, New York
| | - Gabriel Sayer
- Department of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Nir Uriel
- Department of Cardiology, Columbia University Irving Medical Center, New York, New York.
| |
Collapse
|
45
|
Fujino T, Sayer A, Nitta D, Imamura T, Narang N, Nguyen A, Rodgers D, Raikhelkar J, Smith B, Kim G, LaBuhn C, Jeevanandam V, Burkhoff D, Sayer G, Uriel N. Longitudinal Trajectories of Hemodynamics Following Left Ventricular Assist Device Implantation. J Card Fail 2020; 26:383-390. [PMID: 32027961 DOI: 10.1016/j.cardfail.2020.01.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 08/02/2019] [Revised: 01/15/2020] [Accepted: 01/28/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Continuous-flow left ventricular assist devices (LVADs) improve the hemodynamics of patients with advanced heart failure. However, the longitudinal trajectories of hemodynamics in patients after LVAD implantation remain unknown. The aim of this study was to investigate the trends of hemodynamic parameters following LVAD implantation. METHODS AND RESULTS We retrospectively reviewed patients who underwent LVAD implantation between April 2014 and August 2018. We collected hemodynamic parameters from right heart catheterizations. Of 199 consecutive patients, we enrolled 150 patients who had both pre- and postimplant right heart catheterizations. They had 3 (2, 4) postimplant right heart catheterizations during a follow-up of 2.3 (1.3, 3.1) years. The mean age was 57 ± 13 years, and 102 patients (68%) were male. Following LVAD implantation, pulmonary arterial pressure and pulmonary capillary wedge pressure decreased, and cardiac index increased significantly, then remained unchanged throughout follow-up. Right atrial pressure decreased initially and then gradually increased to preimplant values. The pulmonary artery pulsatility index decreased initially and returned to preimplant values, then progressively decreased over longer follow-up. Subgroup analysis showed significant differences in the trajectories of the pulmonary artery pulsatility index based on gender. CONCLUSIONS Despite improvement in left-side filling pressures and cardiac index following LVAD implantation, right atrial pressure increased and the pulmonary artery pulsatility index decreased over time, suggesting progressive right ventricular dysfunction.
Collapse
Affiliation(s)
- Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Aline Sayer
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Daisuke Nitta
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Nikhil Narang
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Ann Nguyen
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Jayant Raikhelkar
- Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Bryan Smith
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Colleen LaBuhn
- Department of Cardiology, Columbia University Irving Medical Center, 622 W. 168th Street, New York, NY 10032, USA
| | - Valluvan Jeevanandam
- Department of Cardiology, Columbia University Irving Medical Center, 622 W. 168th Street, New York, NY 10032, USA
| | - Daniel Burkhoff
- Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Gabriel Sayer
- Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Nir Uriel
- Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA; Columbia University Medical Center, and Cardiovascular Research Foundation, 1700 Broadway, New York, NY 10019, USA.
| |
Collapse
|
46
|
Imamura T, Narang N, Rodgers D, Nitta D, Grinstein J, Fujino T, Kim G, Nguyen A, Jeevanandam V, Sayer G, Uriel N. HVAD Flow Waveform Estimates Left Ventricular Filling Pressure. J Card Fail 2020; 26:342-348. [PMID: 31981696 DOI: 10.1016/j.cardfail.2020.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/15/2019] [Accepted: 01/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND HVAD left ventricular assist device flow waveforms provides graphical real-time information linking device performance with invasive hemodynamics. Previous studies have demonstrated a good correlation between the slopes of the ventricular filling phase slope (VFPS) and directly measured pulmonary capillary wedge pressure (PCWP). We aimed to validate the utility of VFPS to estimate PCWP and predict clinical outcomes. METHODS In this prospective blinded study, screenshots from the HVAD monitor and simultaneous invasive hemodynamic measurements were obtained. Each screenshot was digitized and the VFPS was calculated by 2 independent reviewers who were blinded to the hemodynamic results. The equation PCWP = 7.053 +1.365 × (VFPS) was derived from a previously published dataset and the estimated PCWP was correlated to the actually measured PCWP. RESULTS One hundred thirty-one sets of simultaneous measurements (VFPS and PCWP) were obtained from 27 HVAD patients (mean age 55 years, 47% male). A previously proposed cutoff of VFPS ≥5.8 L/min/s predicted PCWP ≥ 18 mmHg with 91.5% sensitivity and 95.2% specificity with the area under curve of 0.987. The estimated PCWP significantly correlated with measured PCWP (R2 = 0.65, P < .001) and showed acceptable agreement with measured PCWP. Patients with VFPS ≥ 5.8 L/min/s experienced significantly higher heart failure readmission rates than those without (0.24 vs 0.05 events/y, P < .001). CONCLUSIONS VFPS of the HVAD flow waveform is a novel noninvasive parameter that can estimate PCWP.
Collapse
Affiliation(s)
- Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois; Second Department of Medicine, University of Toyama, Toyama, Japan
| | - Nikhil Narang
- Advocate Heart Institute, Advocate Christ Medical Center, Oak Lawn, Illinois
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Daisuke Nitta
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Jonathan Grinstein
- Division of Cardiology, MedStar Heart and Vascular Institute Advanced Heart Failure and Cardiac Transplantation, NW, Washington, DC
| | - Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ann Nguyen
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | | | - Gabriel Sayer
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Nir Uriel
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York.
| |
Collapse
|
47
|
Imamura T, Nitta D, Fujino T, Smith B, Kalantari S, Nguyen A, Narang N, Holzhauser L, Rodgers D, Song T, Ota T, Jeevanandam V, Kim G, Sayer G, Uriel N. Deep Y-Descent in Right Atrial Waveforms Following Left Ventricular Assist Device Implantation. J Card Fail 2020; 26:360-367. [PMID: 31935459 DOI: 10.1016/j.cardfail.2020.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/17/2019] [Accepted: 01/02/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Characterization of right heart catheterization (RHC) waveforms provides diagnostic and clinical information in heart failure patients. We aimed to investigate the implication of RHC waveforms, specifically the y-descent, in patients with left ventricular assist device (LVAD). METHODS AND RESULTS Patients underwent RHC and waveforms were quantified prior to and 6 months after LVAD implantation. The impact of a deep y-descent (>3 mmHg) on echocardiographic measures of right heart function and 1-year hemocompatibility-related adverse event rates were investigated. Eighty-nine patients (median 59 years old, 65 male) underwent RHC. RHC waveform showed unique changes following LVAD implantation, particularly an increase in the steepness of the y-descent. A post-LVAD deep y-descent was associated with reduced right ventricular function and enlarged right heart. Patients with post-LVAD deep y-descent had higher rates of gastrointestinal bleeding (0.866 vs 0.191 events/year) and stroke (0.199 vs 0 events/year) compared with those without (P< .05 for both). CONCLUSION RHC waveforms characterized by deep y-descent on RHC waveform during LVAD support was associated with impaired right ventricular function and worse clinical outcomes.
Collapse
Affiliation(s)
- Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.
| | - Daisuke Nitta
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Takeo Fujino
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Bryan Smith
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Sara Kalantari
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Ann Nguyen
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Nikhil Narang
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Luise Holzhauser
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Rodgers
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Tae Song
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Takeyoshi Ota
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | | | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Gabriel Sayer
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Nir Uriel
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| |
Collapse
|
48
|
Kinoshita T, Yuzawa H, Wada R, Yao S, Yano K, Akitsu K, Shinohara M, Koike H, Suzuki T, Abe A, Fujino T, Ikeda T. P93 The usefulness of dual cardiac autonomic nervous modulation assessment for prediction of mortality in patients with relatively preserved left ventricular ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Recent guidelines have stated that reduced left ventricular ejection fraction (LVEF) is the gold standard marker for identifying patients at risk for cardiac mortality. Although reduced LVEF identifies patients at an increased risk of cardiac arrest, sudden cardiac deaths (SCDs) occur considerably more often in patients with relatively preserved LVEF. Current guidelines on SCDs risk stratification do not adequately cover this general population pool. Heart rate variability (HRV) and heart rate turbulence (HRT) are non-invasive electrocardiography (ECG)-based techniques capable of providing relevant information on the cardiac autonomic nervous modulation. Although a large body of evidence about autonomic nervous modulation markers has been reported, the usefulness of HRV and HRT parameters for risk stratification in such patients with relatively preserved LVEF has not yet been elucidated.
Purpose
This study aimed to evaluate HRV and HRT parameters for predicting cardiac mortality in patients with structural heart disease (SHD), including ischemic heart disease, dilated cardiomyopathy and valvular heart disease, who have mid-range left ventricular dysfunction (LVD).
Methods
We prospectively enrolled 229 patients (187 men, age 63 ± 13 years) with SHD who have mid-range LVD (LVEF > 40%). HRV and HRT parameters based on 24-hour ambulatory ECG recordings (Fukuda Denshi Co., Ltd., Tokyo, Japan) were evaluated as follows; SDNN, triangular index, high and low frequency HRV, turbulence onset and slope. The primary endpoint was all-cause mortality. Univariate and multivariate Cox regression analysis were used to assess the association between these cardiac autonomic nervous modulation and mortality.
Results
During a mean follow-up of 21 ± 11 months, all-cause mortality was seen in 11 (4.8%) patients. Univariate Cox regression analysis showed that reduced SDNN (<50ms), reduced triangular index (<20ms) and HRT category 2 were significantly associated with the primary endpoint (P < 0.05). When HRT category 2 combined with reduced SDNN, Multivariate Cox regression analysis revealed that this combination more strongly associates with the primary endpoint (hazard ratio =7.91, 95%CI, 1.82-34.2; P = 0.006).
Conclusion
Dual cardiac autonomic nervous modulation assessment which combined HRT and HRV could be a superior technique to predict mortality in patients with relatively preserved LVEF.
Collapse
Affiliation(s)
- T Kinoshita
- Toho University Faculty of Medicine, Tokyo, Japan
| | - H Yuzawa
- Toho University Faculty of Medicine, Tokyo, Japan
| | - R Wada
- Toho University Faculty of Medicine, Tokyo, Japan
| | - S Yao
- Toho University Faculty of Medicine, Tokyo, Japan
| | - K Yano
- Toho University Faculty of Medicine, Tokyo, Japan
| | - K Akitsu
- Toho University Faculty of Medicine, Tokyo, Japan
| | - M Shinohara
- Toho University Faculty of Medicine, Tokyo, Japan
| | - H Koike
- Toho University Faculty of Medicine, Tokyo, Japan
| | - T Suzuki
- Toho University Faculty of Medicine, Tokyo, Japan
| | - A Abe
- Toho University Faculty of Medicine, Tokyo, Japan
| | - T Fujino
- Toho University Faculty of Medicine, Tokyo, Japan
| | - T Ikeda
- Toho University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
49
|
Imamura T, Narang N, Rodgers D, Nitta D, Fujino T, Kalantari S, Smith B, Kim G, Nguyen A, Chung B, Holzhauser L, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Estimation of the Severity of Aortic Insufficiency by HVAD Flow Waveform. Ann Thorac Surg 2019; 109:945-949. [PMID: 31756319 DOI: 10.1016/j.athoracsur.2019.09.077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/04/2019] [Accepted: 09/23/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Aortic insufficiency (AI) significantly affects morbidity and mortality in patients with left ventricular assist devices. Although AI may be commonly assessed by echocardiography, expert techniques are required for accurate quantification of AI severity. DESCRIPTION In this prospective blinded study, screenshots from the HVAD (Medtronic, Framingham, MA) display and simultaneous echocardiographic measurements were obtained. Each screenshot was digitized and the early diastolic phase slope was calculated, with blinding to the echocardiographic results. The regurgitant fraction of AI was quantified by Doppler echocardiography of the outflow graft. EVALUATION A total of 30 patients (median, 57 years old; 57% male) were enrolled. A cutoff of -17.6 L/min/s for the early diastolic phase slope had a sensitivity of 0.92 and a specificity of 0.53 to estimate significant AI with a regurgitant fraction of 30% or greater, and it significantly stratified patients into a low regurgitant faction group (0.3%) and a high regurgitant fraction group (33.0%) (P = .009). The early diastolic phase slope had a moderate correlation with the actually measured regurgitant fraction (r = .50). CONCLUSIONS The early diastolic phase slope of the HVAD flow waveform may be a parameter that can estimate the presence of clinically significant AI.
Collapse
Affiliation(s)
- Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.
| | - Nikhil Narang
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Rodgers
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Daisuke Nitta
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Takeo Fujino
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Sara Kalantari
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Bryan Smith
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Gene Kim
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ann Nguyen
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Ben Chung
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Luise Holzhauser
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Tae Song
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | - Takeyoshi Ota
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
| | | | - Gabriel Sayer
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Nir Uriel
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| |
Collapse
|
50
|
Shinohara M, Wada R, Akitsu K, Kinoshita T, Yuzawa H, Fujino T, Ikeda T. P3754Comparison of the transdermal bisoprolol patch with the oral bisoprolol fumarate administration as a therapeutic agent for idiopathic frequent premature ventricular contractions. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The transdermal bisoprolol patch (TB) was designed to maintain a sustained concentration of bisoprolol in plasma by higher trough concentration than the oral bisoporolol fumarate administration (OB). It is unclear whether the TB is as effective in treating idiopathic premature ventricular contractions (PVCs) as the OB.
Purpose
We compared the efficacy between the TB and OB in treating idiopathic PVCs while considering their duration of action.
Methods
Among 198 patients with a PVC count of ≥3,000 beats/24 hours, 84 patients were divided into groups treated with TB 4mg (n=50) or OB 2.5mg (n=34). The PVCs were divided into positive heart rate (HR)-dependent PVCs (P-PVCs) and non-positive HR-dependent PVCs (NP-PVCs) based on the relationship between the hourly PVCs density and hourly mean HR. To evaluate the efficacy, PVC counts by 24-hour Holter electrocardiograms were measured at baseline and at 1 month after the initiation of the therapy.
Results
There were no significant between-group differences for the mean HR, PVC count, or type of PVCs. Both the TB (from 16,692±9,737 to 10,442±10,711 beats/24 hours, P<0.001) and OB (from 19,633±16,298 to 9,235±12,124 beats/24 hours, P<0.001) significantly decreased the total PVC count after the initiation of therapy, and a comparison between the two drugs showed no significant difference (P=0.46). In the P-PVC group, both the TB and OB significantly decreased the total PVC count (P<0.001, P=0.022 respectively), PVC count during the day-time (P<0.001, P=0.030 respectively), and PVC count during the night-time (P=0.0038, P=0.022 respectively). In contrast, in the NP-PVC group, neither the TB nor OB made any significantly change in the total PVC count (P=0.079, P=0.10 respectively), PVC count during the day-time (P=0.35, P=0.12 respectively), or PVC count during the night-time (P=0.11, P=0.12 respectively). The TB exhibited a significant reduction during each time period regarding the changes within 24-hours in the P-PVC count from baseline, while the OB did not significantly reduce the P-PVC count from baseline during each time period between 0 and 5 o'clock.
Conclusions
Compared with the OB, the TB could be used with the same efficacy for reducing the PVC count. The TB could be a more useful therapeutic agent for idiopathic P-PVCs during a 24-hour period than the OB.
Collapse
Affiliation(s)
- M Shinohara
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - R Wada
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Akitsu
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Kinoshita
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Yuzawa
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Fujino
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Ikeda
- Toho University Faculty of Medicine, Cardiovascular Medicine, Tokyo, Japan
| |
Collapse
|