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Fujimoto K, Hisanaga S, Kuroda S, Kodama K, Sugiyama F, Kikuchi M, Kita T, Yamashita A, Nagai T, Kamimura T, Kaikita K, Imamura T, Fujimoto S. A case of primary aldosteronism with excessive secretion of renin that was unmasked by kidney transplantation. CEN Case Rep 2024; 13:1-8. [PMID: 37010722 PMCID: PMC10834915 DOI: 10.1007/s13730-023-00784-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 03/10/2023] [Indexed: 04/04/2023] Open
Abstract
A 42-year-old man showed marked hypokalemia after kidney transplantation. He was diagnosed with hypertension and suffered from acute myocardial infarction at 33 and 38 years of age. At 40 years of age, hemodialysis was introduced. A left adrenal tumor was noted and suspected as a non-functional adrenal adenoma at that time. Therefore, he received a living-donor kidney transplant at 42 years of age. After kidney transplantation, the serum creatinine level dropped. His blood pressure remained high, and the serum potassium level decreased. The PRA and PAC were elevated, and ARR was not elevated. Based on the results of various confirmatory tests and vein sampling, he was diagnosed with excessive secretion of renin from the native kidneys that was complicated by primary aldosteronism (PA), and left nephrectomy and adrenalectomy were performed. The overproduction of aldosterone in the resected adrenal adenoma and over secretion of renin in the kidney with arteriolosclerosis were immunohistologically confirmed. After surgery, the PAC decreased, but the PRA did not decrease. The postoperative serum potassium level improved, and the blood pressure was well controlled with a small dose of medication. This is the first reported case of PA with hyperreninemia after kidney transplantation. It should be noted that PA in dialysis patients and kidney transplant recipients may not fulfill the usual diagnostic criteria of an elevated ARR. In such patients, PA should be suspected based on the absolute value of the PAC and responsiveness to ACTH stimulation, and adrenal and renal vein sampling is required for a definitive diagnosis.
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Affiliation(s)
- Kenta Fujimoto
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan, 1749-1 Sudaki, Ikeuchi, 880-0041.
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
| | - Shuichi Hisanaga
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan, 1749-1 Sudaki, Ikeuchi, 880-0041
| | - Sayaka Kuroda
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan, 1749-1 Sudaki, Ikeuchi, 880-0041
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kotoko Kodama
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan, 1749-1 Sudaki, Ikeuchi, 880-0041
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Fumiko Sugiyama
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan, 1749-1 Sudaki, Ikeuchi, 880-0041
| | - Masao Kikuchi
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Toshihiro Kita
- Department of Projects Research, Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan
| | - Atsushi Yamashita
- Pathophysiology Section, Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takahiro Nagai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Toshio Kamimura
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Koichi Kaikita
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takuroh Imamura
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan, 1749-1 Sudaki, Ikeuchi, 880-0041
| | - Shouichi Fujimoto
- Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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2
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Imamura T, Hori M, Kinugawa K. Lung fluid levels estimated by remote dielectric sensingTM values and invasive hemodynamic measurements. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Remote dielectric sensing (ReDSTM) is a recently introduced non-invasive electromagnetic-based technology to quantify lung fluid levels (Figure 1A). The association between ReDS values and invasively measured hemodynamics, particularly among those with small body size, remains uncertain.
Methods
Consecutive patients with chronic heart failure who were admitted to our institute and underwent right heart catheterization as well as simultaneous ReDS measurement at clinically stable conditions between Sep and Nov 2021 were prospectively included. The correlation between ReDS values and PCWP was investigated.
Results
A total of 30 patients (median 79 [73, 84] years old, 13 men) were included. Median ReDS value was 26% (22%, 28%). ReDS values had a moderate correlation with PCWP (r=0.698, p<0.001; Figure 1B), even among those with a height <155 cm. ReDS values with a cutoff 28% predicted a PCWP >15 mmHg with sensitivity 0.70 and specificity 0.75.
Conclusions
A non-invasive electromagnetic-based technology ReDS might be a promising tool to estimate cardiac pressure in patients with heart failure, even among those with smaller body size.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Imamura
- University of Toyama , Toyama , Japan
| | - M Hori
- University of Toyama , Toyama , Japan
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3
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Shiiba T, Sekikawa Y, Tateoka S, Shinohara N, Inoue Y, Kuroiwa Y, Tanaka T, Kihara Y, Imamura T. Verification of the effect of acquisition time for SwiftScan on quantitative bone single-photon emission computed tomography using an anthropomorphic phantom. EJNMMI Phys 2022; 9:48. [PMID: 35907090 PMCID: PMC9339048 DOI: 10.1186/s40658-022-00477-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background SwiftScan single-photon emission computed tomography (SPECT) is a recently released scanning technique with data acquired when the detector is stationary and when it moves from one view to the next. The influence of scan time for using SwiftScan on quantitative bone SPECT remains unclear. This study aimed to clarify the effect of the scan time for SwiftScan SPECT on the image quality and quantification of bone SPECT compared to step and shoot mode (SSM) using 99mTc-filled anthropomorphic phantom (SIM2 bone phantom). Materials and methods Phantom SPECT/computed tomography (CT) images were acquired using Discovery NM/CT 860 (GE Healthcare) with a low-energy high-resolution sensitivity collimator. We used the fixed parameters (subsets 10 and iterations 5) for reconstruction. The coefficient of variation (CV), contrast-to-noise ratio (CNR), full width at half maximum (FWHM), and quantitative value of SwiftScan SPECT and SSM were compared at various acquisition times (5, 7, 17, and 32 min). Results In the short-time scan (< 7 min), the CV and CNR of SwiftScan SPECT were better than those of SSM, whereas in the longtime scan (> 17 min), the CV and CNR of SwiftScan SPECT were similar to those of SSM. The FWHMs for SwiftScan SPECT (13.6–14.8 mm) and SSM (13.5–14.4 mm) were similar. The mean absolute errors of quantitative values at 5, 7, 17, and 32 min were 38.8, 38.4, 48.8, and 48.1, respectively, for SwiftScan SPECT and 41.8, 40.8%, 47.2, and 49.8, respectively, for SSM. Conclusions SwiftScan on quantitative bone SPECT provides improved image quality in the short-time scan with quantification similar to or better than SSM. Therefore, in clinical settings, using SwiftScan SPECT instead of the SSM scan protocol in the short-time scan might provide higher-quality diagnostic images than SSM. Our results could provide vital information on the use of SwiftScan SPECT.
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Affiliation(s)
- Takuro Shiiba
- Department of Molecular Imaging, School of Medical Sciences, Fujita Health University, 1-98, Dengakubo, Kutsukake-cho, Aichi, 470-1192, Toyoake, Japan.
| | - Yuya Sekikawa
- Department of Radiological Technology, Faculty of Fukuoka Medical Technology, Teikyo University, 6-22 Misakimachi, Omuta-shi, Fukuoka, 836-8505, Japan
| | - Shinji Tateoka
- Department of Radiological Technology, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan
| | - Nobutaka Shinohara
- Department of Radiological Technology, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan
| | - Yuuki Inoue
- Department of Radiological Technology, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan
| | - Yasuyoshi Kuroiwa
- Department of Radiological Technology, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan.,Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Takashi Tanaka
- Department of Radiology, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan
| | - Yasushi Kihara
- Department of Radiology, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan
| | - Takuroh Imamura
- Department of Internal Medicine, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki-shi, Miyazaki, 880-0041, Japan
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4
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Raju V, Hiner E, Imamura T, Singh A, Monaco J, Kabbany M, Pillarella J, Joshi A, Sciamanna C, Andrade A, Dia M, Pauwaa S, Macaluso G, Cotts W, Coyle L, Cross C, Alexander P, Pappas P, Tatooles A, Chau V, Narang N. Adverse Events of Temporary Extracorporeal Right Ventricular Assist Devices Placed with Durable Left Ventricular Assist Devices. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1175] [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
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Imamura T, Oshima A, Kinugawa K. Implication of Mineralocorticoid Receptor Antagonist Esaxerenone in Patients with HFpEF. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1108] [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] Open
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6
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Imamura T, Sobajima M, Tanaka S, Ushijima R, Fukuda N, Ueno H, Kinugawa K. Decoupling Between Pulmonary Artery Diastolic and Wedge Pressure Following TAVR. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1466] [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
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7
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Imamura T, Oshima A, Onoda H, Tanaka S, Ushijima R, Sobajima M, Fukuda N, Ueno H, Kinugawa K. Clinical implications of troponin-T elevations following TAVR. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Baseline and post-procedural elevations in serum troponin-T levels are associated with increased morbidity and mortality following transcatheter aortic valve replacement (TAVR). However, the prognostic impact of change in serum troponin-T level following TAVR remains unknown.
Methods
Among the patients with severe aortic stenosis who underwent TAVR, those with baseline serum troponin-T level ≥51.5 ng/L were excluded. The impact of increases in serum troponin-T level to an abnormally high range (≥51.5 ng/L) following TAVR on 2-year cardiovascular death or heart failure readmissions was investigated.
Results
Among 189 included patients (median 86 years old, 28% men), serum troponin-T level increased in 79 patients following TAVR. An increase in serum troponin-T was associated with a higher rate of 30-day adverse events, predominantly due to pacemaker implantation for complete atrio-ventricular block, and a higher 2-year cumulative incidence of the primary endpoint (hazard ratio 3.97, 95% confidence interval 1.51-10.4, p = 0.005) adjusted for the use of balloon-expandable valve and post-TAVR pacemaker implantation (Figure 1).
Conclusion
Post-procedural increase in serum troponin-T level was associated with adverse clinical outcomes following TAVR. Abstract Figure. Cumulative incidence of endpoint
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Affiliation(s)
| | - A Oshima
- University of Toyama, Toyama, Japan
| | - H Onoda
- University of Toyama, Toyama, Japan
| | - S Tanaka
- University of Toyama, Toyama, Japan
| | | | | | - N Fukuda
- University of Toyama, Toyama, Japan
| | - H Ueno
- University of Toyama, Toyama, Japan
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8
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Nakamura M, Imamura T, Kinugawa K. Pulmonary artery pulsatility index and hemolysis during Impella support. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Impella-related hemolysis is a well-known complication, which we sometimes experience in the clinical practice depending on various hemodynamic status including right ventricular impairment.
Methods
We enrolled consecutive patients with cardiogenic shock who received Impella support between March 2018 and December 2020. The association between pulmonary artery pulsatility index (PAPi) immediately after Impella insertion and the occurrence of hemolysis was investigated. Hemolytic event was defined as detection of hemoglobinuria and elevated lactate dehydrogenase level over 2.5 folds of upper normal range.
Results
Among 38 patients (median 71 y; men 61%; LVEF 29%) included in this study, hemolysis occurred in 18 patients (47%). Incidence of hemolysis was significantly higher in the low PAPi group (< 1.3) compared with the normal PAPi group (≥ 1.3) (67% vs. 33%, p = 0.0176; Figure 1). The low PAPi (<1.3) was significantly associated with the occurrence of hemolysis with a hazard ratio of 5.71 (95% confidence interval 1.09–29.91, p = 0.0313) adjusted for other clinically significant variables.
Conclusions
In patients with right ventricular impairment with lower PAPi, it might be encouraged to be aware of the risk of hemolysis, maintaining volume status and considering inotropes administration. Abstract Figure.
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9
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Kuroiwa Y, Kusumoto K, Shimata K, Yamashita A, Hibi T, Asada Y, Imamura T. MRI diffusion-weighted imaging detects a fresh portal vein thrombus as a high intensity lesion in a patient with a liver transplant: A case report. Acta Radiol Open 2022; 10:20584601211069557. [PMID: 34992794 PMCID: PMC8725224 DOI: 10.1177/20584601211069557] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/09/2021] [Indexed: 11/23/2022] Open
Abstract
Portal vein thrombosis is one of the most serious complications after liver
transplantation. It is important to determine the age of the thrombus for management of
portal vein thrombosis. We present a case report of histologically confirmed heterogenous
fresh portal vein thrombus which was depicted heterogenous high signal intensity on
magnetic resonance diffusion weighted imaging. The sequence may be a useful imaging tool
for detecting fresh thrombus components in the portal vein thrombosis.
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Affiliation(s)
- Yasuyoshi Kuroiwa
- Department of Radiological Technology,
Internal Medicine, Koga General Hospital, Miyazaki, Japan
- Department of Pathology, Faculty of
Medicine, University of Miyazaki, Miyazaki, Japan
| | | | - Keita Shimata
- Department of Pediatric Surgery and
Transplantation, Kumamoto University Graduate School of Medical
Sciences, Kumamoto, Japan
| | - Atsushi Yamashita
- Department of Pathology, Faculty of
Medicine, University of Miyazaki, Miyazaki, Japan
- Atsushi Yamashita, Department of Pathology, Faculty
of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
| | - Taizo Hibi
- Department of Pediatric Surgery and
Transplantation, Kumamoto University Graduate School of Medical
Sciences, Kumamoto, Japan
| | - Yujiro Asada
- Department of Pathology, Faculty of
Medicine, University of Miyazaki, Miyazaki, Japan
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10
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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
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11
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Lee YJ, García Muñoz A, Imamura T, Yamada M, Satoh T, Yamazaki A, Watanabe S. Brightness modulations of our nearest terrestrial planet Venus reveal atmospheric super-rotation rather than surface features. Nat Commun 2020; 11:5720. [PMID: 33184258 PMCID: PMC7665209 DOI: 10.1038/s41467-020-19385-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
Terrestrial exoplanets orbiting within or near their host stars’ habitable zone are potentially apt for life. It has been proposed that time-series measurements of reflected starlight from such planets will reveal their rotational period, main surface features and some atmospheric information. From imagery obtained with the Akatsuki spacecraft, here we show that Venus’ brightness at 283, 365, and 2020 nm is modulated by one or both of two periods of 3.7 and 4.6 days, and typical amplitudes <10% but occasional events of 20–40%. The modulations are unrelated to the solid-body rotation; they are caused by planetary-scale waves superimposed on the super-rotating winds. Here we propose that two modulation periods whose ratio of large-to-small values is not an integer number imply the existence of an atmosphere if detected at an exoplanet, but it remains ambiguous whether the atmosphere is optically thin or thick, as for Earth or Venus respectively. Multi-wavelength and long temporal baseline observations may be required to decide between these scenarios. Ultimately, Venus represents a false positive for interpretations of brightness modulations of terrestrial exoplanets in terms of surface features. Establishing diagnostics for terrestrial exoplanets are crucial for their characterization. Here, the authors show brightness modulations of Venus are caused by planetary-scale waves superimposed on the super-rotating winds can be used to detect existence of an atmosphere if detected at an exoplanet.
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Affiliation(s)
- Y J Lee
- Technische Universität Berlin, Berlin, Germany.
| | | | - T Imamura
- GSFS, Univ. of Tokyo, Kashiwa, Japan
| | - M Yamada
- Planetary Exploration Research Center (PERC), Narashino, Japan
| | - T Satoh
- Institute of Space and Astronautical Science (ISAS/JAXA), Sagamihara, Japan
| | - A Yamazaki
- Institute of Space and Astronautical Science (ISAS/JAXA), Sagamihara, Japan.,Graduate School of Science, Univ. of Tokyo, Tokyo, Japan
| | - S Watanabe
- Hokkaido Information University, Ebetsu, Japan
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12
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Yamamoto Y, Makiyama T, Wuriyanghai Y, Kohjitani H, Gao J, Kashiwa A, Hai H, Aizawa T, Imamura T, Ishikawa T, Yoshida Y, Ohno S, Horie M, Makita N, Kimura T. Preclinical proof-of-concept study: antisense-mediated knockdown of CALM as a therapeutic strategy for calmodulinopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Calmodulin (CaM) is a ubiquitous Ca2+ sensor molecule encoded by three distinct calmodulin genes, CALM1–3, and has an important role for cardiac ion channel function. Recently, heterozygous missense mutations in CALM genes were reported to cause a new category of life-threatening genetic arrhythmias such as long-QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT), which is called as “calmodulinopathy”. The patients with calmodulinopathy show poor prognosis and there is no effective treatment for them.
Purpose
Considering the dominant-negative effect of mutant calmodulin proteins produced by heterozygous missense mutations in CALMs, we aimed to prove the concept of antisense-based therapy to treat calmodulinopathy using human iPS cell-derived cardiomyocyte (hiPSC-CM) model.
Methods
We designed multiple locked nucleic acid (LNA) gapmer-antisense oligonucleotides (ASOs) targeting CALM2 and analyzed the silencing efficiency and toxicity in cultured cells to select the most potent ASO. Using CMs differentiated from hiPSCs which were generated form a 12-year-old boy with LQTS carrying a heterozygous CALM2-N98S mutation, CALM2 expression and action potentials (APs) were analyzed to evaluate the efficacy of ASOs.
Results
We identified several ASOs which reduced CALM2 expression without affecting cell viability in human cultured cells (HepG2) (ASO 50 nM, n=2; Figure 1A). Considering further experiments in vivo mouse model, we investigated the CALM2 silencing activity in mouse cultured cells (3T3-L1) without transfection (free-uptake) (ASO 1 μM, n=2; †ASOs have homologous sequence between human and mouse; Figure B). After free-uptake CALM2 silencing analysis in 3T3-L1 cells, we identified that ASO #2 has the most potent CALM2 silencing activity and low cytotoxicity (Figure 1B). ASO #2 effectively reduced CALM2 expression even in hiPSC-CMs (ASO(−): n=3, lipofection: n=4, free-uptake: n=3; P<0.05; Figure 1C). In action potential recordings, we demonstrated that ASO #2 ameliorated prolonged AP durations (APD90) in N98S-hiPSC-CMs at 0.5 Hz pacing (ASO(−): 666±123 ms (n=7), lipofection: 329±21 ms (n=8), free-uptake: 388±34 ms (n=12); P<0.05; Figure 1D).
Conclusion
Our results using patient-derived hiPSC-CM model suggest that ASO-based therapy might be a promising strategy for the treatment of calmodulinopathy.
Figure 1
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Nissan Chemical Corporation
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Affiliation(s)
- Y Yamamoto
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - T Makiyama
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - Y Wuriyanghai
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - H Kohjitani
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - J Gao
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - A Kashiwa
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - H Hai
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - T Aizawa
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - T Imamura
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
| | - T Ishikawa
- National Cerebral & Cardiovascular Center, Omics Research Center, Suita, Japan
| | - Y Yoshida
- Kyoto University, Center for iPS Cell Research and Application, Kyoto, Japan
| | - S Ohno
- National Cerebral & Cardiovascular Center, Department of Bioscience and Genetics, Suita, Japan
| | - M Horie
- Shiga University of Medical Science, Center for Epidemiologic Research in Asia, Otsu, Japan
| | - N Makita
- National Cerebral & Cardiovascular Center, Omics Research Center, Suita, Japan
| | - T Kimura
- Kyoto University, Cardiovascular Medicine, Kyoto, Japan
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Nakamura M, Imamura T, Ueno H, Kinugawa K. Impact of the angle between aortic and mitral annulus on the occurrence of hemolysis during Impella support. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hemolysis of Impella is known as a major comorbidity and adequate device positioning and optimization of volume status are recommended. However, we have sometimes experienced hemolysis refractory to these adjustments and anatomical feature appears to be crucial in such cases.
Methods
We enrolled 26 patients (median 71 y; BSA 1.6 m2; LVEF 27%) with cardiogenic shock who received Impella insertion from March 2018 to November 2019. The angle of the aortic and mitral annulus which was drawn at the apical 3-chamber view on echocardiography, just before or after Impella insertion was measured (Figure). Hemolytic event was defined as follows; (1) Gross dark red urine and elevation of serum LDH level after initiation of Impella support were seen and subsequently required to lower the support level of Impella under P6. (2) Blood sample data indicating hemolysis (i.e. elevation of LDH level over 1.5 fold of normal range, anemia complicated with decreased haptoglobin, the elevation of total bilirubin level accompanied indirect bilirubin elevation) was found and subsequently required to initiate continuous hemodiafiltration.
Results
The freedom from hemolytic event was significantly lower in the narrow angle group (<126.5 degrees, Figure A) compared with the wide angle group (≥126.5 degrees, Figure B) (18% vs 83%, p<0.0001). The narrow angle was a significant risk factor of hemolytic event with an unadjusted hazard ratio 13.9 (95% confidence interval 2.88–67.2, p=0.0499) and a hazard ratio 15.5 (95% confidence interval 3.15–76.3, p=0.0008) adjusted for lower pulmonary artery pulsatility index, which was another risk factor significant in the univariate analyses. Furthermore, 30-day survival rate was significantly lower in the narrow angle group compared with the wide angle group (63% vs 100%, p=0.0116).
Conclusions
The narrow angle (<126.5 degrees) was an independent risk factor of hemolytic event and 30-day survival was lower compared with the wide angle group.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - H Ueno
- University of Toyama, Toyama, Japan
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14
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Imamura T, Makiyama T, Huang H, Aizawa T, Gao J, Kashiwa A, Wuriyanghai Y, Yamamoto Y, Kohjitani Y, Kato K, Ohno S, Sumitomo N, Horie M. Clinical aspects of pediatric Brugada syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Brugada syndrome (BrS) is an inherited arrhythmia characterized by a coved-type ST elevation and sudden death, especially in middle-aged males and more common in Asia. Mutations in SCN5A are detected in 15–20% and reported to be associated with poor prognosis. Among children, BrS is rare and the risk factors in pediatric BrS are unknown, especially in Asian population.
Purpose
The purpose of this study is to elucidate the risk factors for fatal arrhythmic events in Japanese pediatric patients with BrS.
Methods
We enrolled 52 Japanese children with BrS younger than 20 years, and performed genetic analysis and collected the clinical information.
Results
The mean age of initial symptoms was 10.7±5.5 years, and the mean follow-up period was 3.9±5.5 years. Ninety percent of patients were probands. No subjective symptom was confirmed in 28 of the patients, but aborted cardiac arrest (ACA) in 4, ventricular tachycardia in 4, ventricular fibrillation in 1, and syncope in 11. We identified mutations in SCN5A in 63%. There was no significant gender difference in ≤10 years, but a significant male predominance appeared in >10 years. And no gender difference was confirmed in the incidence of severe cardiac events in ≤10 years.
Conclusion
No gender difference was confirmed in ≤10 years in this study about Asian children. And being girls did not reduce the risk in ≤10 years. The frequency of SCN5A mutations was higher than adults, but decreased from childhood (68%) to adolescence (59%). In BrS, genetical and environmental factors may be more effective in childhood and adulthood, respectively.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Imamura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Makiyama
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - H Huang
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Aizawa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - J Gao
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - A Kashiwa
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Wuriyanghai
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Kohjitani
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Kato
- Shiga University of Medical Science, Department of Cardiology, Otsu, Japan
| | - S Ohno
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - N Sumitomo
- Saitama Medical University International Medical Center, Department of Pediatric Cardiology, Hidaka, Japan
| | - M Horie
- Shiga University of Medical Science, Center for Epidemiologic Research in Asia, Shiga, Japan
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15
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Kohjitani H, Kashiwa A, Makiyama T, Toyoda F, Yamamoto Y, Wuriyanghai Y, Ohno S, Aizawa T, Imamura T, Shizuta S, Kimura T. Usefulness of collaboration between mathematical models and cell engineering for elucidating complex disease mechanisms and discover effective drugs. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A missense mutation, CACNA1C-E1115K, located in the cardiac L-type calcium channel (LTCC), was recently reported to be associated with diverse arrhythmias. Several studies reported in-vivo and in-vitro modeling of this mutation, but actual mechanism and target drug of this disease has not been clarified due to its complex ion-mechanisms.
Objective
To reveal the mechanism of this diverse arrhythmogenic phenotype using combination of in-vitro and in-silico model.
Methods and results
Cell-Engineering Phase: We generated human induced pluripotent stem cell (hiPSC) from a patient carrying heterozygous CACNA1C-E1115K and differentiated into cardiomyocytes. Spontaneous APs were recorded from spontaneously beating single cardiomyocytes by using the perforated patch-clamp technique.
Mathematical-Modeling Phase: We newly developed ICaL-mutation mathematical model, fitted into experimental data, including its impaired ion selectivity. Furthermore, we installed this mathematical model into hiPSC-CM simulation model.
Collaboration Phase: Mutant in-silico model showed APD prolongation and frequent early afterdepolarization (EAD), which are same as in-vitro model. In-silico model revealed this EAD was mostly related to robust late-mode of sodium current occurred by Na+ overload and suggested that mexiletine is capable of reducing arrhythmia. Afterward, we applicated mexiletine onto hiPSC-CMs mutant model and found mexiletine suppress EADs.
Conclusions
Precise in-silico disease model can elucidate complicated ion currents and contribute predicting result of drug-testing.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science, Grant-in-Aid for Young Scientists
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Affiliation(s)
| | - A Kashiwa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | | | - F Toyoda
- Shiga University of Medical Science, Department of Physiology, Otsu, Japan
| | | | | | - S Ohno
- National Cerebral and Cardiovascular Center Hospital, Department of Bioscience and Genetics, Osaka, Japan
| | - T Aizawa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Imamura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Shizuta
- Kyoto University Hospital, Kyoto, Japan
| | - T Kimura
- Kyoto University Hospital, Kyoto, Japan
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16
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Imamura T, Combs P, Siddiqi U, Mirzai S, Stonebraker C, Bullard H, Simone P, Jeevanandam V. Sex difference in the impact of smoking on Clinical outcomes following LVAD implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Smoking would have a negative impact on clinical outcomes following left ventricular assist device (LVAD) implantation. However, its impact on male and female cohorts separately remains uninvestigated.
Purpose
We aimed to investigate the association between smoking and post-LVAD outcomes among male and female cohorts separately.
Methods
Data of consecutive patients who received LVAD implantation at our institute between Jan 2013 and Sep 2018 were retrospectively reviewed. Clinical outcomes were compared between the never smokers and the current smokers among male and female cohorts separately. Those with former smoking were excluded.
Results
Of all, 85 male patients (median 56 years old) and 45 female patients (median 56 years old) were included. Among the male cohort, total readmission rate was higher in the current smokers than never smokers (incidence rate ratio 1.51, p=0.09). Rates of gastrointestinal bleeding, stroke, and hemolysis trended to be higher in current smokers (Figure 1A). Among the female cohort, these rates were not different irrespective of the smoking status (Figure 1B). Survival was not different irrespective of smoking status among both male and female cohorts.
Conclusion
The impact of smoking on post-LVAD outcomes seems to be different between males and females. Different therapeutic strategy might be required for the LVAD candidates with active smoking between male and female cohort.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - P Combs
- University of Chicago Medical Center, Chicago, United States of America
| | - U Siddiqi
- University of Chicago Medical Center, Chicago, United States of America
| | - S Mirzai
- University of Chicago Medical Center, Chicago, United States of America
| | - C Stonebraker
- University of Chicago Medical Center, Chicago, United States of America
| | - H Bullard
- University of Chicago Medical Center, Chicago, United States of America
| | - P Simone
- University of Chicago Medical Center, Chicago, United States of America
| | - V Jeevanandam
- University of Chicago Medical Center, Chicago, United States of America
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17
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Gi T, Kuroiwa Y, Yamashita A, Mizutani Y, Asanuma T, Miyati T, Maekawa K, Aman M, Imamura T, Asada Y. High Signal Intensity on Diffusion-Weighted Images Reflects Acute Phase of Deep Vein Thrombus. Thromb Haemost 2020; 120:1463-1473. [PMID: 32746467 PMCID: PMC7511261 DOI: 10.1055/s-0040-1714280] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The effects of antithrombotic therapy on deep vein thrombosis (DVT) can be affected by thrombus age, which cannot be reliably determined by noninvasive imaging modalities. We investigated whether magnetic resonance (MR) diffusion-weighted imaging (DWI) can localize and determine the age of venous thrombus in patients with DVT, animal models, and human blood in vitro. Signal intensity (SI) on DWI and the apparent diffusion coefficient (ADC) of thrombi were assessed in eight patients with DVT using a 1.5-T MR imaging (MRI) system. We assessed the organizing processes as venous thrombus developed in the rabbit jugular vein using a 3.0-T MRI system over time. We also assessed MRI signals of human blood in vitro using the 1.5-T MRI system. Venous thrombi were detected by DWI as areas of high or mixed high and iso SI in all patients. The ADCs were lower in the proximal, than in the distal portion of the thrombi. The thrombi of rabbit jugular veins histologically organized in a time-dependent manner, with high SI on DWI at 4 hours, mixed high and iso SI at 1 and 2 weeks, and iso SI at 3 weeks. The ADC correlated negatively with erythrocyte content, and positively with smooth muscle cells, macrophages, hemosiderin, and collagen content. MRI signals of human blood in vitro showed that ADCs were affected by erythrocyte content, but not by blood clotting. MR-DWI can detect venous thrombus, and high SI on DWI accompanied by a low ADC might reflect erythrocyte-rich, acute-phase thrombi.
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Affiliation(s)
- Toshihiro Gi
- Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yasuyoshi Kuroiwa
- Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.,Department of Radiological Technology, Koga General Hospital, Miyazaki, Japan
| | - Atsushi Yamashita
- Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yuko Mizutani
- Division of Radiology, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Taketoshi Asanuma
- Development of Veterinary Medicine, Faculty of Veterinary Medicine, Imabari Campus, Okayama University of Science, Imabari, Japan
| | - Tosiaki Miyati
- Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Kazunari Maekawa
- Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Murasaki Aman
- Department of Diagnostic Pathology, University of Miyazaki Hospital, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takuroh Imamura
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan
| | - Yujiro Asada
- Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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18
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Kuga N, Kuroiwa Y, Sakamoto T, Yamashita A, Gi T, Doi S, Kinoshita T, Tanaka T, Kihara Y, Asada Y, Imamura T. Signal Change of Jugular Vein Thrombus on Diffusion-Weighted Magnetic Resonance Imaging. Circ Rep 2020; 2:455-456. [PMID: 33693269 PMCID: PMC7819652 DOI: 10.1253/circrep.cr-20-0039] [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] [Indexed: 11/16/2022] Open
Affiliation(s)
- Naoya Kuga
- Department of Radiological Technology, Koga General Hospital Miyazaki Japan
| | - Yasuyoshi Kuroiwa
- Department of Radiological Technology, Koga General Hospital Miyazaki Japan.,Department of Pathology, Faculty of Medicine, University of Miyazaki Miyazaki Japan
| | | | - Atsushi Yamashita
- Department of Pathology, Faculty of Medicine, University of Miyazaki Miyazaki Japan
| | - Toshihiro Gi
- Department of Pathology, Faculty of Medicine, University of Miyazaki Miyazaki Japan
| | - Shogo Doi
- Department of Radiological Technology, Koga General Hospital Miyazaki Japan
| | - Tomoki Kinoshita
- Department of Radiological Technology, Koga General Hospital Miyazaki Japan
| | - Takashi Tanaka
- Department of Radiology, Koga General Hospital Miyazaki Japan
| | - Yasushi Kihara
- Department of Radiology, Koga General Hospital Miyazaki Japan
| | - Yujiro Asada
- Department of Pathology, Faculty of Medicine, University of Miyazaki Miyazaki Japan
| | - Takuroh Imamura
- Department of Internal Medicine, Koga General Hospital Miyazaki Japan
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19
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Gomi T, Imamura T. Comprehensive histological investigation of age-related changes in dermal extracellular matrix and muscle fibers in the upper lip vermilion. Int J Cosmet Sci 2020; 42:359-368. [PMID: 32274802 PMCID: PMC7496161 DOI: 10.1111/ics.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Few histological studies have directly examined age-related changes within the lips, although non-invasive investigations of such changes are increasing. Therefore, this study aimed to provide histological and molecular data on age-dependent alterations in the vermilion. METHODS Upper vermilion specimens from 15 female Caucasian cadavers (age range, 27-78 years) were investigated histologically or immunohistochemically. RESULTS Histologically, age-dependent decreases in areas occupied by hyaluronan and collagenous fibres in the dermis of upper vermilion were demonstrated. Elastic fibre content varied widely between individuals. The area occupied by muscle fibres in the orbicularis oris muscle region within the vermilion also correlated negatively with age. Immunohistochemically, signals of four proteins were attenuated in vermilion from older individuals compared with young individuals: procollagen type I, hyaluronan synthase (HAS)1, myosin heavy chain (MYH)2 (a component of fast-twitch oxidative muscle fibres) and MYH7 (a component of slow-twitch muscle fibres). In contrast, signals of cell migration inducing hyaluronidase 1 (CEMIP) were intensified in vermilion from older individuals. No marked differences between young and older individuals were seen in procollagen type III, HAS2, HAS3, hyaluronidase (HYAL)1, HYAL2, MYH1 or MYH4. CONCLUSION Age-dependent decreases of hyaluronan in the dermis of vermilion were prominent, possibly due to both the decrease in synthesis (HAS1) and the increase in degradation (CEMIP). Furthermore, age-dependent decreases in collagenous fibres and two types of muscle fibre in the vermilion were also identified histologically. Type I collagen, MYH2 and MYH7 appear to represent the molecules responsible for these respective decrements.
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Affiliation(s)
- T Gomi
- Cell Regulation Laboratory, Bionics Program, Tokyo University of Technology, Graduate School of Bionics, Computer and Media Science, 1404-1 Katakura, Hachioji, Tokyo, 192-0982, Japan.,Frontier Research Center, POLA Chemical Industries Inc, 560 Kashio-cho, Totsuka-ku, Yokohama, Kanagawa, 244-0812, Japan
| | - T Imamura
- Cell Regulation Laboratory, Bionics Program, Tokyo University of Technology, Graduate School of Bionics, Computer and Media Science, 1404-1 Katakura, Hachioji, Tokyo, 192-0982, Japan
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20
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Nguyen A, Rodgers D, Imamura T, Besser S, Holzhauser L, Chung B, Smith B, Kalantari S, Sarswat N, Kim G, Sayer G, Uriel N. Prevalence of BK Virus Infection in a Large Heart Transplant Population. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.037] [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
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21
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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
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22
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Imamura T, Yamamoto Y, Sugiura T, Okamura Y, Ito T, Ashida R, Ohgi K, Todaka A, Fukutomi A, Aramaki T, Uesaka K. Prognostic role of the length of tumour-vein contact at the portal-superior mesenteric vein in patients having surgery for pancreatic cancer. Br J Surg 2019; 106:1649-1656. [PMID: 31626342 DOI: 10.1002/bjs.11328] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/15/2019] [Accepted: 07/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The length of tumour-vein contact between the portal-superior mesenteric vein (PV/SMV) and pancreatic head cancer, and its relationship to prognosis in patients undergoing pancreatic surgery, remains controversial. METHODS Patients diagnosed with pancreatic head cancer who were eligible for pancreatoduodenectomy between October 2002 and December 2016 were analysed. The PV/SMV contact was assessed retrospectively on CT. Using the minimum P value approach based on overall survival after surgery, the optimal cut-off value for tumour-vein contact length was identified. RESULTS Among 491 patients included, 462 underwent pancreatoduodenectomy for pancreatic head cancer. PV/SMV contact with the tumour was detected on preoperative CT in 248 patients (53·7 per cent). Overall survival of patients with PV/SMV contact exceeding 20 mm was significantly worse than that of patients with a contact length of 20 mm or less (median survival time (MST) 23·3 versus 39·3 months; P = 0·012). Multivariable analysis identified PV/SMV contact longer than 20 mm as an independent predictor of poor survival, whereas PV/SMV contact greater than 180° was not a predictive factor. Among patients with a PV/SMV contact length exceeding 20 mm on pretreatment CT, those receiving neoadjuvant therapy had significantly better overall survival than patients who had upfront surgery (MST not reached versus 21·6 months; P = 0·002). CONCLUSION The length of PV/SMV contact predicts survival, and may be used to suggest a role for neoadjuvant therapy to improve prognosis.
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Affiliation(s)
- T Imamura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - Y Yamamoto
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - T Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - Y Okamura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - T Ito
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - R Ashida
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - K Ohgi
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
| | - A Todaka
- Division of Gastrointestinal Oncology, Shizuoka Cancer Centre, Shizuoka, Japan
| | - A Fukutomi
- Division of Gastrointestinal Oncology, Shizuoka Cancer Centre, Shizuoka, Japan
| | - T Aramaki
- Division of Interventional Radiology, Shizuoka Cancer Centre, Shizuoka, Japan
| | - K Uesaka
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Centre, Shizuoka, Japan
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23
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Muraji S, Sumitomo N, Imamura T, Yasuda K, Nishihara E, Iwamoto M, Tateno S, Doi S, Hata T, Kogaki S, Horigome H, Ohno S, Ichida F, Nagashima M, Yoshinaga M. P4654Clinical and electrocardiographic features of restrictive cardiomyopathy in children. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Restrictive cardiomyopathy (RCM) is a rare myocardial disease with an impaired diastolic function and poor prognosis. The mean survival duration after a diagnosis of RCM is reported to be around 2 years in children and most need heart transplantations.
Purpose
This study aimed to determine the 12-lead electrocardiogram (ECG) diagnostic criteria of RCM based on the initial diagnostic electrocardiogram.
Methods
ECGs in pediatric cardiomyopathy patients were collected from 15 institutes in Japan between 1979 and 2013. We compared the ECG findings, especially of the P wave, in RCM patients between the cardiomyopathy group and healthy children group separately for each gender and the age. The ECGs in the healthy group were obtained from school heart screening in Japan of first-graders, and seventh-graders. Statistical significance was determined as p<0.001.
Results
Among 376 registered cardiomyopathy patients, 63 had hypertrophic cardiomyopathy (HCM) (36%), 91 (24%) dilated cardiomyopathy (DCM), 106 (28%) a left ventricular myocardial noncompaction (LVNCs), 25 (7%) restrictive cardiomyopathy (RCM), 14 (4%) arrhythmogenic right ventricular cardiomyopathy (ARVC), and 5 (1%) other cardiomyopathies. Of the 25 RCM patients (9.9±3.4 years old, F:M=11:14), 36% were discovered during school heart screening. The first onset was an abnormal ECG in 9, symptoms of heart failure in 6, respiratory tract infections in 3, syncope in 1, and 6 with other. Of those patients, 2 (8%) had a family history of RCM, 24 (92%) no family history. A genetic diagnosis was performed in 5 of the 25 cases, and 3 had genetic abnormalities related to RCM. The mean follow-up period was 65±95 months (mean±standard deviation). During follow up, 19 patients (76%) survived, 6 (24%) died, 7 (28%) had heart transplantations, and 3 (12%) were waiting for heart transplantations with a left ventricular assist device.
The P wave was bimodal in lead I or biphasic in lead V1 in 15 patients (93%), and 13 (81%) patients had both variations. We evaluated the duration and amplitude of the first and second component of the P wave as P1 and P2. The number of control and RCM patients (control/RCM), duration of P1+P2, and sum total absolute value of the amplitude of P1+P2 in lead V1 were 8350/5, 90±9/116±10ms, and 72±28/528±278μV in first grade boys, 8423/3, 91±10/120±22ms, and 66±28/326±229μV in first grade girls, 8943/1, 97±1/100ms, and 71±31/328μV in seventh grade boys, and 9183/5, 98±11/112±10ms, and 55±27/315±56μV in seventh grade girls. Although the number of patients in the RCM group was small, sum total absolute value of the amplitude of P1+P2 in lead V1 showed a significant difference in any group.
Conclusion
The ECG in children with RCM exhibits P wave abnormalities in almost all patients. In particular, not the P wave interval but P wave shape in I and V1 and the sum total absolute value of the amplitude of P1+P2 in lead V1 were observed differences.
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Affiliation(s)
- S Muraji
- Saitama International Medical Center, Pediatric cardiology, Hidaka, Japan
| | - N Sumitomo
- Saitama International Medical Center, Pediatric cardiology, Hidaka, Japan
| | - T Imamura
- Saitama International Medical Center, Pediatric cardiology, Hidaka, Japan
| | - K Yasuda
- Aichi Children's Medical Center, Cardiology, Obu, Japan
| | - E Nishihara
- Ogaki Municipal Hospital, Pediatric Cardiology, Ogaki, Japan
| | - M Iwamoto
- Saiseikai Yokohama City Eastern Hospital, Pediatrics, Yokohama, Japan
| | - S Tateno
- Chiba Cerebral and Cardiovascular Center, Pediatrics, Chiba, Japan
| | - S Doi
- Tokyo Medical and Dental University, Pediatrics, Tokyo, Japan
| | - T Hata
- Fujita Health University, Toyoake, Japan
| | - S Kogaki
- Osaka General Medical Center, Pediatrics, Osaka, Japan
| | - H Horigome
- Ibaraki Children's Hospital, Pediatric Cardiology, Mito, Japan
| | - S Ohno
- National Cerebral and Cardiovascular Center, Bioscience and Genetics, Osaka, Japan
| | - F Ichida
- University of Toyama, Toyama, Japan
| | - M Nagashima
- Aichi Saiseikai Rehabilitation Hospital, Nagoya, Japan
| | - M Yoshinaga
- National Hospital Organization Kagoshima Medical Center, Pediatrics, Kagoshima, Japan
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24
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Miyazaki T, Zhao Z, Ichihara Y, Yoshino D, Imamura T, Sawada K, Hayano S, Kamioka H, Mori S, Hirata H, Araki K, Kawauchi K, Shigemoto K, Tanaka S, Bonewald LF, Honda H, Shinohara M, Nagao M, Ogata T, Harada I, Sawada Y. Mechanical regulation of bone homeostasis through p130Cas-mediated alleviation of NF-κB activity. Sci Adv 2019; 5:eaau7802. [PMID: 31579816 PMCID: PMC6760935 DOI: 10.1126/sciadv.aau7802] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 09/03/2019] [Indexed: 05/07/2023]
Abstract
Mechanical loading plays an important role in bone homeostasis. However, molecular mechanisms behind the mechanical regulation of bone homeostasis are poorly understood. We previously reported p130Cas (Cas) as a key molecule in cellular mechanosensing at focal adhesions. Here, we demonstrate that Cas is distributed in the nucleus and supports mechanical loading-mediated bone homeostasis by alleviating NF-κB activity, which would otherwise prompt inflammatory processes. Mechanical unloading modulates Cas distribution and NF-κB activity in osteocytes, the mechanosensory cells in bones. Cas deficiency in osteocytes increases osteoclastic bone resorption associated with NF-κB-mediated RANKL expression, leading to osteopenia. Upon shear stress application on cultured osteocytes, Cas translocates into the nucleus and down-regulates NF-κB activity. Collectively, fluid shear stress-dependent Cas-mediated alleviation of NF-κB activity supports bone homeostasis. Given the ubiquitous expression of Cas and NF-κB together with systemic distribution of interstitial fluid, the Cas-NF-κB interplay may also underpin regulatory mechanisms in other tissues and organs.
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Affiliation(s)
- T. Miyazaki
- Department of Geriatric Medicine, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan
- Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan
- Corresponding author. (T.M.); (Y.S.)
| | - Z. Zhao
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
- Department of Biological Sciences, National University of Singapore, 14 Science Drive 4, Singapore 117543, Singapore
| | - Y. Ichihara
- Department of Rehabilitation for Motor Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan
- Division of Pharmacology, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - D. Yoshino
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
- Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - T. Imamura
- Division of Pharmacology, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - K. Sawada
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
- Laboratory for Mechanical Medicine, Nadogaya Research Institute, Nadogaya Hospital, Kashiwa, Chiba 277-0032, Japan
| | - S. Hayano
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama 700-8525, Japan
| | - H. Kamioka
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama 700-8525, Japan
| | - S. Mori
- Department of Geriatric Medicine, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan
| | - H. Hirata
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
| | - K. Araki
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
| | - K. Kawauchi
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
| | - K. Shigemoto
- Department of Geriatric Medicine, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan
| | - S. Tanaka
- Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - L. F. Bonewald
- Indiana Center for Musculoskeletal Health, School of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - H. Honda
- Field of Human Disease Models, Institute of Laboratory Animals, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - M. Shinohara
- Department of Rehabilitation for Motor Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan
- Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency (JST), Saitama 332-0012, Japan
| | - M. Nagao
- Department of Rehabilitation for Motor Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan
| | - T. Ogata
- Department of Rehabilitation for Motor Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan
| | - I. Harada
- Laboratory for Mechanical Medicine, Nadogaya Research Institute, Nadogaya Hospital, Kashiwa, Chiba 277-0032, Japan
| | - Y. Sawada
- Mechanobiology Institute, National University of Singapore, Level 10, T-Lab, 5A Engineering Drive 1, Singapore 117411, Singapore
- Department of Rehabilitation for Motor Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan
- Laboratory for Mechanical Medicine, Nadogaya Research Institute, Nadogaya Hospital, Kashiwa, Chiba 277-0032, Japan
- Department of Clinical Research, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan
- Corresponding author. (T.M.); (Y.S.)
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Doi S, Kuroiwa Y, Kusumoto K, Yamashita A, Furukoji E, Tai H, Kihara Y, Hirai T, Asada Y, Imamura T. Therapeutic response of immunoglobulin 4-related aortitis and pancreatitis demonstrated by diffusion-weighted MRI. Radiol Case Rep 2019; 14:1132-1135. [PMID: 31360274 PMCID: PMC6637269 DOI: 10.1016/j.radcr.2019.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/08/2019] [Accepted: 06/27/2019] [Indexed: 01/13/2023] Open
Abstract
Immunoglobulin (IgG) 4-related disease is a systemic inflammatory disease, and it affects vascular system as aortitis, periaortitis, or aneurysm. However, due to a lack of serum biomarker on aortic damage and the multiorgan involvement, it is difficult to assess aortic inflammatory activity of IgG4-related disease. We described a case of IgG4-related pancreatitis and aortitis, which was visualized with magnetic resonance merged image of diffusion weighted and T1 weighted images. The aortic signal intensity or apparent diffusion coefficient value reduced or increased after oral prednisone administration, respectively. Magnetic resonance diffusion weighted image and apparent diffusion coefficient may be a useful imaging tool for assessment of vascular inflammation in IgG4-related aortitis.
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Affiliation(s)
- Shogo Doi
- Department of Radiological Technology, Koga General Hospital, Miyazaki, Japan
| | - Yasuyoshi Kuroiwa
- Department of Radiological Technology, Koga General Hospital, Miyazaki, Japan.,Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Kazunori Kusumoto
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan
| | - Atsushi Yamashita
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Eiji Furukoji
- Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hiroshi Tai
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan
| | - Yasushi Kihara
- Department of Radiology, Koga General Hospital, Miyazaki, Japan
| | - Toshinori Hirai
- Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yujiro Asada
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Takuroh Imamura
- Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan
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Combs P, Imamura T, Stonebraker C, Bullard H, Simone P, LaBuhn C, Chung B, Ota T, Onsager D, Song T, Lammy T, Kim G, Smith B, Kalantari S, Nguyen A, Raikhelkar J, Sarswat N, Sayer G, Jeevanandam V, Uriel N. Opioid Use in LVAD Patients is Associated with Increased GI Bleed and Sepsis. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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27
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Imamura T, Nitta D, Rodgers D, Grinstein J, Kalantari S, Smith B, Raikhelkar J, Kim G, Nguyen A, Narang N, Chung B, Ebong I, Holzhauser L, Fujino T, Juricek C, Combs P, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Estimation of Pulmonary Capillary Wedge Pressure from the HVAD Waveform and Its Prognostic Implications. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.195] [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: 10/27/2022] Open
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28
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Nitta D, Imamura T, Chung B, Nguyen A, Raikhelkar J, Sarswat N, Lourenco L, Smith B, Holzhauser L, Kim G, Ebong I, Fujino T, Narang N, Murks C, Riley T, Powers J, Jeevanandam V, Sayer G, Uriel N. Correlation of ImmuKnow Assay Levels with Rejection and Infection after Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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29
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Yang B, Kanelidis A, Narang N, Holzhauser L, Nguyen A, Chung B, Raikhelkar J, Smith B, Sarswat N, Ebong I, Rodgers D, Imamura T, Murks C, Riley T, Powers J, Riley M, Jeevanandam V, Sayer G, Uriel N. Psychosocial Contraindications to Heart Transplant Listing in an Urban Academic Medical Center. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1016] [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: 10/27/2022] Open
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30
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Nitta D, Imamura T, Fujino T, Rodgers D, Nguyen A, Holzhauser L, Ebong I, Narang N, Chung B, Song T, Ota T, Juricek C, Jeevanandam V, Raikhelkar J, Kim G, Sayer G, Uriel N. Lower Pulmonary Artery Pulsatility Index after Left Ventricular Assist Device Implantation is Associated with Worse Heart Failure Free Survival. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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31
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Imamura T, Raikhelkar J, Kim G, Smith B, Kalantari S, Nguyen A, Narang N, Chung B, Ebong I, Holzhauser L, Grinstein J, Nitta D, Fujino T, Juricek C, Rodgers D, Combs P, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Aortic Insufficiency is Associated with Hemocompatibility-Related Adverse Events in LVAD Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.159] [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] Open
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32
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Narang N, Imamura T, Blair J, Holzhauser L, Ebong I, Belkin M, Kanelidis A, Oehler A, Yu D, Fujino T, Nitta D, Chung B, Nguyen A, Smith B, Raikhelkar J, Sarswat N, Kim G, Jeevanandam V, Sayer G, Uriel N. Ratio of Systolic Blood Pressure to Pulmonary Capillary Wedge Pressure Ratio: A Novel Prognostic Marker in Chronic Heart Failure. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.333] [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] Open
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33
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Belkin M, Imamura T, Kanelidis A, Holzhauser L, Ebong I, Narang N, Blair J, Nathan S, Paul J, Shah A, Chung B, Nguyen A, Smith B, Kalantari S, Raikhelkar J, Sarswat N, Kim G, Sayer G, Uriel N. TAVI in LVAD Patients with Aortic Insufficiency. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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34
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Imamura T, Smith B, Raikhelkar J, Rodgers D, Kim G, Kalantari S, Nguyen A, Narang N, Chung B, Ebong I, Holzhauser L, Nitta D, Fujino T, Juricek C, Combs P, Onsager D, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Right Heart Function Worsens in LVAD Patients with Decoupling between Pulmonary Artery and Wedge Pressures. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.563] [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: 10/27/2022] Open
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35
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Imamura T, Nguyen A, Nitta D, Rodgers D, Kalantari S, Smith B, Raikhelkar J, Narang N, Chung B, Ebong I, Holzhauser L, Fujino T, Juricek C, Combs P, Onsager D, Song T, Ota T, Jeevanandam V, Kim G, Sayer G, Uriel N. Worsening of Right Heart Function Following Left Ventricular Assist Device Implantation - Right Heart Catheter Waveform Analyses. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1166] [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: 10/27/2022] Open
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36
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Kuroiwa Y, Uchida A, Yamashita A, Miyati T, Maekawa K, Gi T, Noguchi T, Yasuda S, Imamura T, Asada Y. Coronary high-signal-intensity plaques on T 1-weighted magnetic resonance imaging reflect intraplaque hemorrhage. Cardiovasc Pathol 2019; 40:24-31. [PMID: 30797186 DOI: 10.1016/j.carpath.2019.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/03/2018] [Accepted: 01/07/2019] [Indexed: 01/01/2023] Open
Abstract
Coronary high-signal-intensity plaques (HIPs) detected by T1-weighted magnetic resonance imaging are associated with future cardiovascular events. This study aimed to identify pathological findings reflecting HIPs in coronary arteries obtained from autopsy cases. Formalin-fixed hearts were imaged with noncontrast T1-weighted imaging with a 1.5-T magnetic resonance system. We defined HIPs or non-HIPs as a coronary plaque to myocardial signal intensity ratio (PMR) of ≥1.4 or <1.4, respectively. We found HIPs in 4 of 37 (10.8%) hearts and analyzed 7 hearts in detail. The corresponding sections to HIPs (n=11) or non-HIPs (n=25) were histologically and immunohistochemically analyzed. We calculated the T1 relaxation time of human venous blood in vitro. Plaque and necrotic core areas, and the frequency of intraplaque hemorrhage in HIPs were significantly larger/higher than those in non-HIPs. HIPs were immunopositive for CD68 (11/11), glycophorin A (10/11), and fibrin (11/11). Glycophorin-A-, matrix metalloprotease 9 (MMP9)-, and tissue factor-immunopositive areas were larger in HIPs than in non-HIPs. The PMR was positively correlated with glycophorin-A-, fibrin-, MMP9-, and tissue factor-immunopositive areas. Blood coagulation shortened the T1 relaxation time of the blood and plasma, and the T1 relaxation times in coagulated whole blood and erythrocyte-rich blood were significantly shorter than those in plasma. Coronary HIPs may reflect intraplaque hemorrhage and may be a novel marker for plaque instability and thrombogenic potential.
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Affiliation(s)
- Yasuyoshi Kuroiwa
- Department of Radiological Technology, Koga General Hospital, 1749-4 Sudaki, Ikeuchi, Miyazaki 880-0041, Japan; Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Akiko Uchida
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Atsushi Yamashita
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan
| | - Kazunari Maekawa
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Toshihiro Gi
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Takuroh Imamura
- Department of Internal Medicine, Koga General Hospital, 1749-4 Sudaki, Ikeuchi, Miyazaki 880-0041, Japan
| | - Yujiro Asada
- Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
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Kaneko M, Sato M, Ogasawara K, Imamura T, Hashimoto K, Momoi N, Hosoya M. Serum cytokine concentrations, chorioamnionitis and the onset of bronchopulmonary dysplasia in premature infants. J Neonatal Perinatal Med 2018; 10:147-155. [PMID: 28409755 DOI: 10.3233/npm-171669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the relationships between serum cytokine concentrations and chorioamnionitis (CAM) and CAM-related bronchopulmonary dysplasia (BPD) in premature infants. METHODS Serum was collected at 0 and 7 days after birth from 36 premature infants born at <32 weeks of gestation. We examined the relationships between 30 cytokine concentrations and CAM, BPD, and other perinatal factors. RESULTS On day 0, GM-CSF, IL-15, IL-17, IL-2, IL-2R, VEGF, and MIG concentrations were significantly higher in the CAM group (n = 17) than in the non-CAM group (n = 19). These concentrations had decreased by day 7 and were similar in both groups. The IL-12p70 concentration on day 0 was significantly lower in the BPD group (n = 16) than in the non-BPD group (n = 15). BPD incidence was similar between the CAM and non-CAM groups. CONCLUSIONS These data support the hypothesis that intrauterine inflammation is not a primary risk factor for BPD. The immunological environment at birth or soon after, rather than intrauterine fetal inflammation (e.g., CAM), is a primary risk factor for BPD onset in preterm infants. Decreased inflammatory responses are particularly relevant, as indicated by the relationship between BPD and low serum IL-12p70 concentrations on day 0.
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Yamashita A, Kuroiwa Y, Uchida A, Maekawa K, Gi T, Imamura T, Asada Y. Abstract 236: Magnetic Resonance T1 High Signal Intensity in Coronary Atherosclerotic Plaques Reflects Intraplaque Hemorrhage-derived Erythrocyte Content. Arterioscler Thromb Vasc Biol 2018. [DOI: 10.1161/atvb.38.suppl_1.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective:
Acute myocardial infarction is triggered by plaque disruption and thrombus formation, therefore, it is important to detect high thrombotic risk plaque non-invasively. Coronary high signal intensity plaque (HIP) on T1 weighted magnetic resonance imaging (T1WI) was associated with future coronary events. The aim of this study is to identify pathological findings reflecting HIPs using hearts obtained from autopsy cases and blood samples.
Approach and Results:
Formalin-fixed hearts (n=7) were imaged with non-contrast T1WI with a 1.5 T magnetic resonance system. We defined HIPs (n=11) or non-HIPs (n=25) as a coronary plaque to myocardial signal intensity ratio (PMR) of √ 1.4 or √ 1.4, respectively. The corresponding histological sections were histologically and immunohistochemically analyzed. Plaque and necrotic core areas or frequency of intraplaque hemorrhage in HIPs were significantly larger or higher than those in non-HIPs. The high intensity portion in large coronary plaque was immunopositive for CD68, CD163, glycophorin A, and fibrin. Glycophorin A-, matrix metalloprotease (MMP) 9-, tissue factor-immunopositive areas were larger in HIPs than those in non-HIPs. Glycophorin A-, fibrin-, MMP9-, and tissue factor-immunopositive areas were positively correlated with PMR. We calculated T1 relaxation time of venous blood, plasma, and erythrocyte-rich blood in vitro. Blood coagulation shortened T1 relaxation time of the blood and plasma, and T1 relaxation times in coagulated whole blood and erythrocyte-rich blood were significantly shorter than those in plasma.
Conclusions:
Majority of coronary HIPs may reflect intraplaque hemorrhage-derived erythrocyte content, and may be a novel marker for plaque instability and thrombogenic potential.
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Ohshio G, Yamaki K, Imamura T, Suwa H, Chang CY, Wada H, Sueno Y, Imamura M. Distribution of the Carbohydrate Antigens, Du-Pan-2 and Ca19-9, in Tumors of the Lung. Tumori 2018; 81:67-73. [PMID: 7754546 DOI: 10.1177/030089169508100116] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The carbohydrate chains of malignant cells appear to be related to oncofetal differentiation. The serum levels of CA19-9 have been reported to be evaluated in some patients with lung carcinomas, however, the distribution of carbohydrate antigens were not precisely described. We have investigated in this study the distribution of DU-PAN-2 and CA19-9 antigens in lung tumors. Methods Ninety five specimens of lung tumors were selected from surgical specimens. The expression of DU-PAN-2 and CA19-9 were studied by immunohystochemical techniques. The relationship between the expression of these antigens and the classification or the differentiation degree of the tumors were examined. Results DU-PAN-2 or CA19-9 antigens were detected in 41 (54%) and 45 (59%) cases of the 76 malignant epithelial tumors investigated. These antigens were detected in all types of malignant epithelial tumors, including squamous cell carcinomas, where they were mainly localized to the entire cell surface of malignant cells. In adenocarcinomas, large cell carcinomas and small cell carcinomas, however, these antigens were commonly detected both on the cell membrane and in the cytoplasm. There was positive correlation between the degree of differentiation and DU-PAN-2, but not CA19-9 expression. Among the non-epithelial tumors investigated, those antigens were detected in pulmonary blastomas but not in mesotheliomas. Conclusions Immunohistochemical studies for DU-PAN-2 and CA19-9 are useful for defining characteristics of the lung tumors. DU-PAN-2 could be a marker for differentiating between malignant epithelial tumors and mesotheliomas.
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Affiliation(s)
- G Ohshio
- Department of Surgery and Thoracic Surgery, Kyoto University, Japan
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Imamura T, Murks C, Riley T, Powers J, Chung B, Nguyen A, Rodgers D, Raikhelkar J, Kalantari S, Costanzo M, Jorde U, Ota T, Song T, Onsager D, Juricek C, Jeevanandam V, Kim G, Sayer G, Uriel N. Comparison of Survival and Readmission Rates in Patients 65 and Older Undergoing Heart Transplantation or LVAD Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.817] [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: 11/17/2022] Open
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41
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Imamura T, Raikhelkar J, Sarswat N, Rodgers D, Kalantari S, Nguyen A, Chung B, Narang N, Kim G, Juricek C, Murks C, Ota T, Song T, Costanzo M, Burkhoff D, Jorde U, Jeevanandam V, Sayer G, Uriel N. Optimal Hemodynamics During LVAD Support Are Associated With Reduced Readmission Rate. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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42
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Imamura T, Rodgers D, Kim G, Raikhelkar J, Sarswat N, Kalantari S, Nguyen A, Chung B, Juricek C, Burkhoff D, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Estimation of Central Venous Pressure by Pacemaker Lead Impedances in LVAD Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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43
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Imamura T, Juricek C, Song T, Ota T, Onsager D, Bryant B, Sarswat N, Kim G, Raikhelkar J, Kalantari S, Sayer G, Jeevanandam V, Uriel N. Reverse Remodeling Following Ambulatory Counterpulsation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.816] [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: 11/17/2022] Open
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44
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Imamura T, Rodgers D, Kim G, Raikhelkar J, Sarswat N, Kalantari S, Nguyen A, Chung B, Juricek C, Burkhoff D, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Decoupling Between Diastolic Pulmonary Artery and Pulmonary Capillary Wedge Pressures at Incremental LVAD Speeds is a Poor Prognostic Factor Following LVAD Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1264] [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: 10/17/2022] Open
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45
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Mehta P, Imamura T, Belkin M, Rodgers D, Sarswat N, Kim G, Raikhelkar J, Kalantari S, Murks C, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Neurohormonal Blockade Reduces Adverse Events During LVAD Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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46
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Holzhauser L, Arnold K, Schroeder A, Imamura T, Nguyen A, Chung B, Narang N, Costanzo M, Jeevanandam V, Murks C, Riley T, Powers J, Sarswat N, Kalantari S, Raikhelkar J, Sayer G, Kim G, Uriel N, Alenghat F. Circulating Monocyte Subtypes Correlate with Cardiac Allograft Vasculopathy and Differ from Atherosclerotic Disease: A Tool for Monitoring? J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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47
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Imamura T, Raikhelkar J, Sarswat N, Kalantari S, Murks C, Rodgers D, Juricek C, Kim G, Costanzo M, Ota T, Song T, Jeevanandam V, Jorde U, Burkhoff D, Sayer G, Uriel N. Optimal Hemodynamics During LVAD Support Are Associated with Reduced Hemocompatibility-related Adverse Events. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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48
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Narang N, Chung B, Nguyen A, Rodgers D, Imamura T, Kalantari S, Raikhelkar J, Sarswat N, Kim G, Jeevanandam V, Sayer G, Uriel N. Prediction of Mortality in Decompensated Heart Failure by Invasive Hemodynamics Compared to Clinical Assessment. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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49
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Imamura T, Rodgers D, Kim G, Raikhelkar J, Sarswat N, Kalantari S, Nguyen A, Chung B, Juricek C, Burkhoff D, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. Omega-3 Reduces Gastrointestinal Bleeding in Patients With Continuous-flow Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.397] [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: 10/17/2022] Open
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50
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Narang N, Laffin L, Kalathiya R, Chung B, Nguyen A, Costanzo M, Imamura T, Kalantari S, Kim G, Raikhelkar J, Sarswat N, Jeevanandam V, Sayer G, Uriel N. Normal Serum Lactic Acid is Discordant with Shock in Advanced Heart Failure Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.151] [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: 10/17/2022] Open
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