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Chatani R, Yamashita Y, Morimoto T, Muraoka N, Shioyama W, Shibata T, Nishimoto Y, Ogihara Y, Doi K, Oi M, Shiga T, Sueta D, Kim K, Tanabe Y, Koitabashi N, Takada T, Ikeda S, Nakagawa H, Mitsuhashi T, Shoji M, Sakamoto J, Hisatake S, Ogino Y, Fujita M, Nakanishi N, Dohke T, Hiramori S, Nawada R, Kaneda K, Mushiake K, Yamamoto H, Kadota K, Ono K, Kimura T. Home Treatment for Active Cancer Patients With Low-Risk Pulmonary Embolism - A Predetermined Companion Report From the ONCO PE Trial. Circ J 2024:CJ-24-0004. [PMID: 38462535 DOI: 10.1253/circj.cj-24-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
BACKGROUND Patients with appropriately selected low-risk pulmonary embolism (PE) can be treated at home, although it has been controversial whether applies to patients with cancer, who are considered not to be at low risk.Methods and Results: The current predetermined companion report from the ONCO PE trial evaluated the 3-month clinical outcomes of patients with home treatment and those with in-hospital treatment. The ONCO PE trial was a multicenter, randomized clinical trial among 32 institutions in Japan investigating the optimal duration of rivaroxaban treatment in cancer-associated PE patients with a score of 1 using the simplified version of the Pulmonary Embolism Severity Index (sPESI). Among 178 study patients, there were 66 (37%) in the home treatment group and 112 (63%) in the in-hospital treatment group. The primary endpoint of a composite of PE-related death, recurrent venous thromboembolism (VTE) and major bleeding occurred in 3 patients (4.6% [0.0-9.6%]) in the home treatment group and in 2 patients (1.8% [0.0-4.3%]) in the in-hospital treatment group. In the home treatment group, there were no cases of PE-related death or recurrent VTE, but major bleeding occurred in 3 patients (4.6% [0.0-9.6%]), and 2 patients (3.0% [0.0-7.2%]) required hospitalization due to bleeding events. CONCLUSIONS Active cancer patients with PE of sPESI score=1 could be potential candidates for home treatment.
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Affiliation(s)
- Ryuki Chatani
- Department of Cardiovascular Medicine, Kurashiki Central Hospital
| | - Yugo Yamashita
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | | | - Nao Muraoka
- Division of Cardiology, Shizuoka Cancer Center
| | - Wataru Shioyama
- Department of Cardiovascular Medicine, Shiga University of Medical Science
| | - Tatsuhiro Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | | | - Yoshito Ogihara
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Kosuke Doi
- Department of Cardiology, National Hospital Organization Kyoto Medical Center
| | - Maki Oi
- Department of Cardiology, Japanese Red Cross Otsu Hospital
| | - Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Kitae Kim
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
| | - Yasuhiro Tanabe
- Department of Cardiology, St. Marianna University School of Medicine
| | - Norimichi Koitabashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine
| | - Takuma Takada
- Department of Cardiology, Tokyo Women's Medical University
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | | | | | - Masaaki Shoji
- Department of Cardiovascular Medicine, National Cancer Center Hospital
| | | | - Shinji Hisatake
- Division of Cardiovascular Medicine, Toho University Omori Medical Center
| | - Yutaka Ogino
- Department of Cardiology, Yokohama City University
| | - Masashi Fujita
- Department of Onco-Cardiology, Osaka International Cancer Institute
| | - Naohiko Nakanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | | | | | - Ryuzo Nawada
- Department of Cardiology, Shizuoka City Shizuoka Hospital
| | - Kazuhisa Kaneda
- Department of Cardiovascular Medicine, Mitsubishi Kyoto Hospital
| | | | - Hiromi Yamamoto
- Department of Cardiovascular Medicine, Kurashiki Central Hospital
| | - Kazushige Kadota
- Department of Cardiovascular Medicine, Kurashiki Central Hospital
| | - Koh Ono
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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2
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Wang X, Nakano K, Shiga T, Ohmoto A, Oyakawa T, Ebihara A, Sato Y, Fukuda N, Nishizawa M, Urasaki T, Ono M, Yunokawa M, Tomomatsu J, Takahashi S. Assessment of Pazopanib-Related Heart Failure in Patients With Advanced Soft Tissue Sarcoma - A Single Institute Analysis. Circ J 2024; 88:228-233. [PMID: 35314578 DOI: 10.1253/circj.cj-21-0808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Heart failure (HF) is one of the potential adverse events of pazopanib treatment for soft tissue sarcoma (STS), but detailed reports of such HF cases are scarce. This study determined the incidence and risk factors of HF following pazopanib treatment for STS at our Institute and the clinical outcomes.Methods and Results:This study retrospectively analyzed the cases of STS patients treated with pazopanib (n=151) between 2012 and 2020. HF occurred in 6 patients (3.9%) at the median onset of 137 (range 14-468) days after the treatment initiation. When their HF was diagnosed, pazopanib was interrupted in all 6 patients. No patients experienced HF-related death, and HF development was not a significant factor for poor overall survival. The cumulative doses of anthracyclines (>225 mg/m2) before pazopanib initiation (83% vs. 37%, P=0.031), pazopanib initiation at age ≥60 years (83% vs. 35%, P=0.026), and the baseline B-type natriuretic peptide (BNP) concentration (≥50 pg/mL) before pazopanib (67% vs. 11%, P=0.002) initiation were predictive factors for post-pazopanib treatment HF. CONCLUSIONS The study findings highlight the effect of past anthracycline exposure and baseline BNP for pazopanib-associated HF. Although the study patients' clinical outcomes were generally favorable, periodic monitoring of cardiac function using ultrasonic echocardiography or serum markers is essential to detect events early and begin therapeutic intervention appropriately under a cardiologist's instructions.
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Affiliation(s)
- Xiaofei Wang
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Kenji Nakano
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Akihiro Ohmoto
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Takuya Oyakawa
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Aya Ebihara
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Yasuyoshi Sato
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Naoki Fukuda
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Masatoshi Nishizawa
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
- Next Generation Development of Genome and Cellular Therapy Program, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Tsuya Urasaki
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Makiko Ono
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Mayu Yunokawa
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Junichi Tomomatsu
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
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Imura M, Katada J, Shiga T. Correction to: Epidemiological Study Regarding the Incidence of Venous Thromboembolism in Patients After Cancer Remission. Cardiol Ther 2023; 12:749. [PMID: 37755611 DOI: 10.1007/s40119-023-00330-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Affiliation(s)
- Miki Imura
- Medical Affairs, Internal Medicine, Pfizer Biopharmaceuticals Group, Pfizer Japan Inc, 3-22-7 Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan.
| | - Jun Katada
- Medical Affairs, Internal Medicine, Pfizer Biopharmaceuticals Group, Pfizer Japan Inc, 3-22-7 Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | - Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Imura M, Katada J, Shiga T. Epidemiological Study Regarding the Incidence of Venous Thromboembolism in Patients After Cancer Remission. Cardiol Ther 2022; 11:611-623. [PMID: 36319831 PMCID: PMC9652192 DOI: 10.1007/s40119-022-00285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The time course of reduction in the risk of venous thromboembolism (VTE) in patients who were diagnosed with cancer, treated with anticancer therapy, and in remission is unclear. We hypothesized that the risk of VTE will decrease over time after cancer remission. METHODS We conducted a retrospective analysis using claims data for cancer remission in Japan. Background information of patients who developed VTE after cancer remission was collected, and the VTE incidence rate after cancer remission was analyzed. Subgroup analysis based on VTE history, cancer type, and the presence or absence of surgery during hospitalization was conducted. RESULTS A total of 638,908 patients were eligible for the analysis. VTE occurred in 5533 of 638,908 cases, pulmonary embolism occurred in 779 cases, and deep vein thrombosis occurred in 5084 cases after cancer remission. The mean age of patients who developed VTE was 70.1 ± 12.5 years, and the proportion of men was 47.5%. All comorbidities and medications were higher in the VTE group (P < 0.001) than in the non-VTE group after cancer remission. The incidence of VTE was 2.4% per year in the first 30 days, 1.35% per year in 31-60 days, and gradually decreased to 0.48% per year in 181-360 days, becoming almost constant (annual rate 0.3%) 2 years after cancer remission. CONCLUSION Risk of developing VTE decreased to the same level as that in patients without cancer 2 years after cancer remission. Although the guidelines do not specify the duration of anticoagulant prophylaxis for new onset or recurrent VTE after cancer remission and the appropriate duration of such prophylaxis may vary depending on VTE risk factors, determining the period of high risk of VTE for each patient and preventing VTE is considered important.
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Affiliation(s)
- Miki Imura
- Medical Affairs, Internal Medicine, Pfizer Biopharmaceuticals Group, Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-Ku, Tokyo, 151-8589 Japan
| | - Jun Katada
- Medical Affairs, Internal Medicine, Pfizer Biopharmaceuticals Group, Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-Ku, Tokyo, 151-8589 Japan
| | - Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550 Japan
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Sonoda K, Nagase S, Aiba T, Kato K, Shiga T, Kusano K, Horie M, Ohno S. Different prognosis of ARVC patients between DSG2 and PKP2 variant carriers. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1753] [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
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy mainly caused by desmosomal gene variants. In Europe and North America, pathogenic variants in PKP2 were identified in most of the ARVC patients. On the other hand, we have reported that the genetic backgrounds of ARVC in Japanese were different from those in European; pathogenic variants in DSG2 were predominant in Japanese. Genotype-phenotype correlations, however, have not been clarified yet.
Purpose
In this study, we aimed to examine whether the genotype affect the phenotype and outcome in Japanese ARVC patients.
Methods and results
This study included 167 Japanese ARVC patients who received genetic testing (128 males [77%]). Their median age at diagnosis was 44 [24–55] years old and median follow-up duration was 10 [4–21] years. We found 90 patients with pathogenic variants: 52 in DSG2 (31%), 30 in PKP2 (18%), 3 in DSP (1.8%), 1 in DSC (0.6%), 1 in JUP (0.6%) and 3 in DES (1.8%). The age of the first sustained ventricular arrhythmia (SVT) were older in the patients with DSG2 than those with PKP2 variants (48±15 years vs. 35±15 years, P=0.008) but younger in DSG2 variant carriers at the first hospitalization for heart failure (41 [22–61] years vs. 67 [61–74] years, P=0.03). The left ventricular ejection fractions of DSG2 variant carriers were significantly lower at diagnosis than that of PKP2 (52 [41–60] % vs. 61 [56–66] %, P=0.002). Kaplan-Meier survival curve for lethal arrhythmic events including SVT, ventricular fibrillation and sudden death revealed that the event rate of DSG2 variant carriers was significantly lower than that of PKP2 (log-rank test, P=0.02) (Fig. 1).
Among 11 patients who had both SVT and hospitalizations for HF, 7 PKP2 variant carriers had SVT first, then, hospitalized for HF (48 [35–53] years and 67 [55–71] years, P=0.02). Contrary, the clinical course of 4 DSG2 variants carriers were different from those with PKP2 (54 [40–68] years for SVT and 65 [56–70, P=0.1] years for HF) (Fig. 2).
Conclusion
The patients with DSG2, which is the major causative gene for ARVC in Japanese, show different phenotype and outcome from those with PKP2. We should examine the effect of variants on the prognosis of ARVC patients in more large population including various ethnics.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Sonoda
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Kato
- Shiga University of Medical Science, Department of Cardiovascular and Respiratory Medicine , Shiga , Japan
| | - T Shiga
- Tokyo Women's Medical University , Tokyo , Japan
| | - K Kusano
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - M Horie
- Shiga University of Medical Science, Center for Epidemiologic Research in Asia , Otsu , Japan
| | - S Ohno
- National Cerebral & Cardiovascular Center , Suita , Japan
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6
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Oyakawa T, Fukumitsu M, Ebihara A, Shiga T. Relevance of Non-Bridging Therapy with Heparin during Temporary Interruption of Direct Oral Anticoagulants in Patients with Cancer-Associated Venous Thromboembolism. Ann Vasc Dis 2022; 15:121-125. [PMID: 35860816 PMCID: PMC9257392 DOI: 10.3400/avd.oa.22-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/21/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives: To evaluate the relevance of non-bridging therapy with unfractionated heparin during the temporary, pre-procedural interruption of direct oral anticoagulants (DOACs) in patients with cancer-associated venous thromboembolism (VTE). Materials and Methods: This retrospective study included 142 patients with cancer and VTE who required temporary interruption of DOACs before invasive procedures. Data, including rates of VTE recurrence, non-major bleeding, and major bleeding, were compared between patients who received or not received alternative therapy with unfractionated heparin during interruption. Results: Sixty-eight patients were prescribed heparin, while 74 were not. There were no differences in age, body mass index, white blood cell count, hemoglobin level, or platelet count between the groups. VTE recurrence was observed in four (6%) and one (1%) patient in the heparin bridging and non-bridging groups, respectively (risk ratio [RR]: 4.4, 95% confidence interval [CI]: 0.50–38.0, p=0.19). Non-major bleeding occurred in three (4%) and two (3%) patients in the bridging and non-bridging groups (RR: 1.6, 95%CI: 0.28–9.48, p=0.67), while major bleeding occurred in 0 (0%) and three patients (4%) (p=0.25), respectively. Conclusion: Our findings confirm the relevance of non-bridging therapy with unfractionated heparin for reducing VTE risk during DOAC interruption in patients with cancer.
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Affiliation(s)
- Takuya Oyakawa
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Masafumi Fukumitsu
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Aya Ebihara
- Department of Clinical Examination Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
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Takeda K, Nakano K, Udagawa S, Fukuda N, Nishizawa A, Ono M, Urasaki T, Tomomatsu J, Mochizuki T, Shiga T, Kogawa T, Takahashi S, Kitano S. Chilblain lupus-like cutaneous reaction associated with systemic lupus erythematosus induced by immune checkpoint inhibitor. Rheumatology (Oxford) 2021; 61:e13-e14. [PMID: 34463707 DOI: 10.1093/rheumatology/keab670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Koichi Takeda
- Department of Onco-Rheumatology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Infectious Diseases, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kenji Nakano
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shohei Udagawa
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoki Fukuda
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Aya Nishizawa
- Department of Dermatology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Ono
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tetsuya Urasaki
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junichi Tomomatsu
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshiaki Mochizuki
- Department of Emergency Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Taro Shiga
- Department of Onco-Cardiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takahiro Kogawa
- Division of Early Clinical Development for Cancer, Advanced Medical Development Center; The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shigehisa Kitano
- Division of Cancer Immunotherapy Development, Advanced Medical Development Center; The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Abstract
For the past 20 years, S-1 has been used in the treatment of many types of cancer. However, the clinical importance of myocardial dysfunction attributed to S-1 remains to be unclear. Thus, in this study, we report on a patient with myocardial dysfunction associated with S-1.S-1 postoperative chemotherapy for gastric cancer was included as a treatment for a 65-year-old man. On day 8, S-1 treatment was discontinued after the patient developed an oral ulcer. He was then admitted to the hospital because of diarrhea caused by S-1. At approximately the same time, he developed dyspnea, and his chest X-rays revealed perihilar vascular engorgement and cardiac enlargement. Although his brain natriuretic peptide was 595.8 pg/mL, troponin I and creatine phosphokinase were unremarkable. Electrocardiograms showed no change in atrial fibrillations or new ST-T wave change. As per his transthoracic echocardiogram, noted were expansion of the left ventricle, global hypokinesis, and reduced left ventricular ejection fraction (approximately 40%). The patient was then diagnosed with S-1-related myocardial dysfunction. Furosemide, human atrial natriuretic peptide, dobutamine, enalapril, spironolactone, and bisoprolol were administered. Thirteen days after being diagnosed with heart failure, his symptoms disappeared, his echocardiogram showed that the left ventricular ejection fraction had increased to 65%, and the cardiothoracic ratio improved to 47% according to his chest X-rays.S-1-related myocardial dysfunction may be reversible, as it can improve after approximately 2 weeks.
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Affiliation(s)
- Takuya Oyakawa
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital, Japanese Foundation for Cancer Research
| | - Zhensheng Hua
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital, Japanese Foundation for Cancer Research
| | - Aya Ebihara
- Department of Clinical Examination Center, The Cancer Institute Hospital, Japanese Foundation for Cancer Research
| | - Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital, Japanese Foundation for Cancer Research
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9
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Abstract
OPINION STATEMENT Fluoropyrimidine (FP) is used to treat a wide range of cancers; however, it is associated with drug-induced vascular toxicity, as well as angina pectoris and coronary spasm. FP has been administered for many years, although the incidence, mechanisms, and appropriate methods for managing its associated cardiovascular toxicities have not been clarified, and the management of these complications has not been standardized. This lack of evidence is not limited to FP. Many trials of anticancer agents have been conducted, excluding patients with heart diseases. Hence, there is a paucity of epidemiological data on cardiovascular adverse events caused by anticancer agents. There have been remarkable improvements in cancer treatment in recent years, with consequent improvements in prognosis. In this context, new cardiovascular toxicities related to new drugs have emerged. We are now compelled to respond to cardiovascular adverse events despite the lack of evidence regarding optimal management. The result has been establishment and rapid maturation of the new academic field of cardio-oncology. Despite the relative lack of evidence, we must review small pieces of evidence that have accumulated to date and make the utmost efforts to provide patients with effective evidence-based medical care. Simultaneously, we urgently need randomized clinical trials to build strong evidence.
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Affiliation(s)
- Taro Shiga
- Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital Of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Makoto Hiraide
- Department of Pharmacy, The Cancer Institute Hospital Of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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10
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Hiraide M, Minowa Y, Nakano Y, Suzuki K, Shiga T, Miyoshi J, Takahashi H, Hama T. [Effects of Seven Tyrosine Kinase Inhibitors on the Anticoagulation Activity of Warfarin]. Gan To Kagaku Ryoho 2019; 46:1733-1739. [PMID: 31748483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Several studies have reported increased anticoagulation effect of warfarin(WF)when combined with tyrosine kinase inhibitors(TKIs), such as gefitinib and erlotinib. However, effects of TKIs other than gefitinib and erlotinib on the anticoagulation effect of WF have not been clarified. To assess the degree and onset of prothrombin time-international normalized ratio (PT-INR)elevation and changes in WF daily doses in patients additionally receiving TKIs, this retrospective, single-center observational study compared PT-INR values and WF daily doses during WF treatment in the absence and presence of TKIs. Seven different TKIs(afatinib, alectinib, axitinib, crizotinib, pazopanib, regorafenib, and vandetanib)were prescribed during treatment with WF of venous thromboembolism in 10 cancer patients. Compared to baseline PT-INR, significant PT-INR elevations were observed in all patients during the combination therapy. The median PT-INR increased 1.6-fold from the baseline in the presence of TKIs(p<0.01), and the onset of PT-INR elevation was observed at a median of 18 days. As all patients receiving WF with the 7 TKIs showed PT-INR elevation, enhancement of the anticoagulation effect of WF in the presence of TKIs appears to be highly frequent. PT-INR should be carefully monitored, and adjusting the WF dosage may become necessary during the WF and TKI combination therapy.
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Affiliation(s)
- Makoto Hiraide
- Dept. of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research
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11
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Kikuchi N, Yamamoto E, Nagao M, Momose M, Hattori H, Suzuki A, Shiga T, Niinami H, Hagiwara N, Nunoda S. P3359Myocardial flow reserve using 13N ammonia PET for detection of cardiac allograft vasculopathy in heart transplant patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0235] [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
Purpose
Risk stratification and early detection of cardiac allograft vasculopathy (CAV) are essential in heart transplantation patients. CAV is associated with poor outcome in the chronic phase after heart transplantation. CAV presents a diffuse vascular involvement and has been difficult to noninvasively diagnose by the lack of a sensitive method to detect developing vascular pathology in the allograft. The present study investigates the ability of 13N-ammonia PET for detection of CAV in heart transplant patients.
Methods
Data of adenosine-stress 13N-ammonia PET imaging for thirty-one patients (mean age, 39 years-old) after 11 + 7 years from transplant was analyzed. Five patients had undergone percutaneous coronary intervention (PCI), and the remaining 26 patients had no history of definite myocardial ischemia. Myocardial flow was generated from the time activity curve of left ventricle input and myocardial uptake using 3-compartment model and the first 2 minutes' dataset of list-mode acquisition. Global - myocardial flow reserve (MFR) was calculated by stress to rest flow ratio. Patient with global-MFR <2.0 was defined as significant decrease. Summed difference score (SDS) was used as an estimate for the extent of ischemia, and the patient showing SDS >2 was identified as those having significant ischemia.
Results
The mean Global-MFR of our subjects were 2.3 (1.2 to 3.9). MFR using 13N-ammonia PET significantly decreases in one third of heart transplant patients in chronic stage. Eleven patients with Global-MFR <2.0 (35%) were observed, and eight of them had no history of clinical myocardial ischemia. The proportion of patients with a history of PCI is 18% in patients with Global-MFR <2.0 (vs 5%, p=0.210). Moreover, there were eight patients with SDS >2 (26%) including three patients having a history of PCI. The proportion of patients with a history of PCI tends to be high with SDS >2 (38% vs 9%, p=0.056).
Conclusion
This modality using 13N ammonia PET is useful for easily detection of CAV before manifestation of symptomatic myocardial ischemia in heart transplant patients.
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Affiliation(s)
- N Kikuchi
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - E Yamamoto
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - M Nagao
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - M Momose
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - H Hattori
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - A Suzuki
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - T Shiga
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - H Niinami
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - S Nunoda
- Tokyo Women's Medical University, Shinjuku-ku, Japan
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12
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Sekiguchi H, Ishida I, Suzuki A, Shiga T, Hagiwara N. P5745The Impact Of Brain Atrophy In The Young Patientwith Severe Heart Failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0685] [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
Recently, several reports recognized the heart failure (HF) effected the brain impairment by impaired vascular blood flow and brain atrophy. However, there are no report mentioned the relationship brain atrophy and the mortality in young patient with severe HF.
Methods
A total 368 patients with severe HF form 2009 to 2014. We analyzed 117 patients aged under 55 years old without past history of cerebral artery disease. We evaluated the brain atrophy using head CT data by AZE VitualPlace and compared their clinical background, cardiac function, and the mortality.
Results
The mean age was 41±10 years (male 80%) and the average LVEF was 39±8%. The median follow-up period was 1.264 days. During the observations, we observed a total of 12 all cause death. The ROC analysis revealed that 10.2% of atrophy area was cut-off and the sensitivity was 80%, specificity was 69.5% and the area under the curve was 0.71. In univariate analysis, severe NYHA class, low LVEF, large brain atrophy (>10%) were significant factors as predictor of mortality (P<0.05). Interestingly, as a result of multiple analysis, only the large brain atrophy was independent predictor of mortality. Kaplan-Meier analysis resulted that the patients with the large brain atrophy as over 10% were statistically significant worse mortality than the other patients (P=0.02).
Conclusion
This is a first report to evaluate the brain atrophy area by CT in young severe HF patients. HF patients with ≥10% of brain atrophy have higher mortality.
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Affiliation(s)
- H Sekiguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - I Ishida
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Suzuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Shiga
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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13
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Tsukamoto K, Suzuki A, Shiga T, Sakai MW, Tanaka Y, Kouno E, Osada A, Matsuura J, Hayashi N, Nagara K, Ogiso MW, Nomura H, Kikuchi N, Hagiwara N. P3541Change in left ventricular ejection fraction and outcome in heart failure patients with mid-range ejection fraction: from the HIJ-HF prospective study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0404] [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
Heart failure (HF) is categorized on the basis of the eft ventricular ejection fraction (LVEF). The European Society of Cardiology has proposed mid-range EF (HFmrEF) as a new category of HF that includes patients with an LVEF of 40–49%. However, the clinical characteristics, change in LVEF following treatment, and outcome of patients with HFmrEF remain clear.
Methods
We conducted a prospective observational study of Japanese hospitalized HF patients between 2015 and 2018 at a single-center (HIJ-HF III). HFmrEF was defined as 40–49% of LVEF on echocardiography at admission. We followed these patients and performed echocardiography to assess LVEF per year after hospital discharge. Clinical outcome was death from any cause.
Methods and results
We studied 138 patients with HFmrEF (median age 71 years, 69% male). They had 32% of ischemic heart disease, 9% of New York Heart Association functional class III or IV at discharge. During median follow-up of 20 [13–28] months, we assessed change in LVEF for 110 patients with HFmrEF. One year after hospital discharge, 49 patients (44%) improved LVEF (≥50%) and 21 patients (19%) reduced LVEF (<40%). HFmrEF patients who reduced LVEF (<40%) were significantly higher mortality rate than those who improved LVEF (≥50%) (14% vs. 2%, p<0.05) (Figure).
Conclusions
This study demonstrated that 44% of HFmrEF patients improved LVEF following treatment but 19% patients reduced LVEF. Reduced LVEF was associated with poor prognosis.
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Affiliation(s)
- K Tsukamoto
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Suzuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Shiga
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M W Sakai
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - Y Tanaka
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Kouno
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Osada
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - J Matsuura
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hayashi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Nagara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M W Ogiso
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Nomura
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Kikuchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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14
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Sakai M, Suzuki A, Shiga T, Tanaka Y, Kouno E, Osada A, Matsuura J, Hayashi N, Matsui Y, Hagiwara N. 4332Benefit of sinus rhythm restoration in acute decompensated heart failure patients with atrial tachyarrhythmia treated with landiolol. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0169] [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
Atrial tachyarrhythmias (ATA), such as atrial fibrillation / atrial tachycardia are frequently observed in patients with acute decompensated heart failure (ADHF). Because ATA leads to clinical deterioration and worsen HF, the conversion and prevention of ATA is important of ADHF with ATA. Landiolol, an ultrashort-acting intravenous beta-1 blocker, was developed and has been used for the treatment of ATA.
Purpose
We evaluated the acute effect of landiolol treatment on heart rate or blood pressure (BP), also the rates and benefits of sinus rhythm (SR) restoration among AHF patients with ATA treated with landiolol.
Methods
We studied 67 consecutive HF patients with ATA (age: 67±12 years, 36 male) treated with landiolol from 2015 to December 2017 at our University Hospital. They were compared with 50 paired subjects, matched for gender, age and baseline BP who developed HF with ATA from HIJ-HF 2 study (consisted of HF patients hospitalized between 2013 and 2014).
Results
At the start of landiolol treatment, mean left ventricular ejection fraction (LVEF) was 41±14%. The median maintenance dose of landiolol was 3.0 (1.0–12.0) μ/kg/min and the median treatment duration of landiolol was 5 (1–24) days. After 6 hours from administration of landiolol, mean HR decreased significantly from 140±18 to 100±21 bpm (p<0.05), whereas BP was not difference during landiolol treatment. Sinus rhythm was restored spontaneously in 15 (22%), and by electrical or pharmacological cardioversion in 5 (7%) during a treatment with intravenous landiolol. Furthermore, sinus rhythm was restored in 22 patients using additional rhythm control treatment, such as amiodarone or catheter ablation after intravenous landiolol treatement. Eight patients experienced in-hospital death. Forty-one (69%) of 59 patients discharged alive were in SR. During the follow-up period of 16±12 months, 4 patients died and 12 patients experienced rehospitalization due to worsening HF after hospital discharge. There was a significant higher rate of death or HF rehospitalization in patients without SR restoration than patients with SR restoration (44% vs. 20%, p<0.05) (Figure A). Compared with 50 paired subjects from HIJ-HF 2 study, those who treated with landiolol developed a significant higher rate of SR restoration (68% vs. 20%, p<0.05) (Figure B).
Figure 1
Conclusion
This study demonstrated that landiolol treatment was effective for both rate control and conversion to sinus rhythm in ADHF patient with ATA. We should consider that the benefits of rhythm control in ADHF patients with ATA during and after landiolol treatment.
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Affiliation(s)
- M Sakai
- Tokyo Womens Medical University, Tokyo, Japan
| | - A Suzuki
- Tokyo Womens Medical University, Tokyo, Japan
| | - T Shiga
- Tokyo Womens Medical University, Tokyo, Japan
| | - Y Tanaka
- Tokyo Womens Medical University, Tokyo, Japan
| | - E Kouno
- Tokyo Womens Medical University, Tokyo, Japan
| | - A Osada
- Tokyo Womens Medical University, Tokyo, Japan
| | - J Matsuura
- Tokyo Womens Medical University, Tokyo, Japan
| | - N Hayashi
- Tokyo Womens Medical University, Tokyo, Japan
| | - Y Matsui
- Tokyo Womens Medical University, Tokyo, Japan
| | - N Hagiwara
- Tokyo Womens Medical University, Tokyo, Japan
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15
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Hiraide M, Minowa Y, Nakano Y, Yoshioka H, Suzuki K, Shiga T, Takahashi H, Hama T. [Effects of Tyrosine Kinase Inhibitors on Control of PT-INR in Patients Receiving Warfarin]. Gan To Kagaku Ryoho 2019; 46:1413-1419. [PMID: 31530781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Few studies have evaluated the influence of anticancer drugs on the anticoagulation response to warfarin(WF). This retrospective, single-center, observationalstudy evaluated the changes in prothrombin time-internationalnormal ized ratio (PT-INR)in patients receiving a combination of WF and anticancer drugs. We compared(a)PT-INR changes between groups receiving WF and concomitantly started on either tyrosine kinase inhibitors(TKI)(WF+TKI group: n=14)or anticancer drugs other than TKI(WF+non-TKI group: n=20)and(b)PT-INR changes between groups that were started on WF concomitantly while receiving either TKI(TKI+WF group: n=16)or anticancer drugs other than TKI(non-TKI+WF group: n=13). (a)PT-INR changes were significantly larger in the WF+TKI group than in the WF+non-TKI group(2.23 vs 0.42, p<0.001). In the WF+TKI group, the WF dose was reduced after all 14 patients(100.0%)showed increased PT-INR.(b)PT-INR changes during the WF induction period were significantly larger in the TKI+WF group than in the non-TKI+WF group(2.18 vs 0.68, p<0.001). In the TKI+WF group, the WF dose was reduced after 12 patients(75.0%)showed increased PT-INR. It might be necessary to consider a reduction in WF dose when WF is administered in combination with TKIs.
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Affiliation(s)
- Makoto Hiraide
- Dept. of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research
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16
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Kikuchi N, Yamamoto E, Hattori H, Nagao M, Momose M, Shiga T, Hagiwara N, Niinami H, Nunoda S. Myocardial Flow Reserve Using 13N Ammonia PET for Detection of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.704] [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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17
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Yasuda K, Takao S, Matsuo Y, Yoshimura T, Tamura M, Minatogawa H, Dekura Y, Matsuura T, Onimaru R, Shiga T, Shimizu S, Umegaki K, Shirato H. Intensity-Modulated Proton Therapy with Dose Painting based on Hypoxia Imaging for Nasopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1125] [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]
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18
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Oguri T, Hiraide M, Shiga T, Yasuda C, Nishio M, Takahashi S. Safety and efficacy of direct oral anticoagulants vs warfarin for Japanese lung cancer patients with thromboembolism in real world settings. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy444.023] [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: 11/14/2022] Open
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19
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Shiga T. An overview of cancer-associated thrombosis (CAT). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy359.002] [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: 11/14/2022] Open
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20
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Hiraide M, Minowa Y, Nakano Y, Suzuki K, Shiga T, Nishio M, Miyoshi J, Takahashi H, Hama T. Drug interactions between tyrosine kinase inhibitors (gefitinib and erlotinib) and warfarin: Assessment of international normalized ratio elevation characteristics and in vitro CYP2C9 activity. J Oncol Pharm Pract 2018; 25:1599-1607. [PMID: 30253730 DOI: 10.1177/1078155218801061] [Citation(s) in RCA: 5] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Elevation of the international normalized ratio and bleeding complications has been reported in patients taking warfarin concomitantly with tyrosine kinase inhibitors such as gefitinib and erlotinib. OBJECTIVE To assess the frequency, degree, and onset of international normalized ratio elevation in patients receiving warfarin with gefitinib or erlotinib, and changes in vitro cytochrome P450 2C9 activity. METHODS This retrospective, single-center, observational study compared international normalized ratio values during the treatment with warfarin in the absence and presence of the tyrosine kinase inhibitors, gefitinib, and erlotinib. In addition, the inhibitory effect of tyrosine kinase inhibitors on cytochrome P450 2C9 activity was screened in an in vitro study. RESULTS Compared with international normalized ratio at the baseline significant (P < 0.05) international normalized ratio elevations were observed in the majority of the patients (5/6 patients with gefitinib, 83.3%; 6/7 patients with erlotinib, 85.7%) during concurrent therapy. The international normalized ratio was increased 1.8- and 1.6-fold relative to the baseline value, on median, in the presence of gefitinib and erlotinib, respectively, and the onset of international normalized ratio elevation was observed at a median of seven days and nine days, respectively. In vitro (S)-warfarin 7-hydroxylation activity was inhibited by 36% in the presence of 1 µM gefitinib and 27% by 10 µM erlotinib, which are comparable to the steady-state plasma levels of these tyrosine kinase inhibitors after standard dosing. CONCLUSION In most patients, international normalized ratio elevation was observed within two weeks of the start of concomitant therapy with warfarin and gefitinib or erlotinib. To avoid excessive anticoagulant response by warfarin, international normalized ratio should be carefully monitored weekly and dosage adjustment of warfarin might be recommended during the first month after the start of concurrent tyrosine kinase inhibitor therapy.
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Affiliation(s)
- Makoto Hiraide
- 1 Department of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.,2 Department of Biopharmaceutics, Meiji Pharmaceutical University, Kiyose-city, Tokyo, Japan
| | - Yuichi Minowa
- 1 Department of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Yasuhiro Nakano
- 1 Department of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Kenichi Suzuki
- 1 Department of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Taro Shiga
- 3 Departments of General Medicine and Cardiology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Makoto Nishio
- 4 Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Junya Miyoshi
- 2 Department of Biopharmaceutics, Meiji Pharmaceutical University, Kiyose-city, Tokyo, Japan
| | - Harumi Takahashi
- 2 Department of Biopharmaceutics, Meiji Pharmaceutical University, Kiyose-city, Tokyo, Japan
| | - Toshihiro Hama
- 1 Department of Pharmacy, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
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21
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Fujima N, Hirata K, Shiga T, Li R, Yasuda K, Onimaru R, Tsuchiya K, Kano S, Mizumachi T, Homma A, Kudo K, Shirato H. Integrating quantitative morphological and intratumoural textural characteristics in FDG-PET for the prediction of prognosis in pharynx squamous cell carcinoma patients. Clin Radiol 2018; 73:1059.e1-1059.e8. [PMID: 30245069 DOI: 10.1016/j.crad.2018.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/24/2018] [Indexed: 12/15/2022]
Abstract
AIM To assess potential prognostic factors in pharynx squamous cell carcinoma (SCC) patients by quantitative morphological and intratumoural characteristics obtained by 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). MATERIALS AND METHODS The cases of 54 patients with pharynx SCC who underwent chemoradiation therapy were analysed retrospectively. Using their FDG-PET data, the quantitative morphological and intratumoural characteristics of 14 parameters were calculated. The progression-free survival (PFS) and overall survival (OS) information was obtained from patient medical records. Univariate and multivariate analyses were performed to assess the 14 quantitative parameters as well as the T-stage, N-stage, and tumour location data for their relation to PFS and OS. When an independent predictor was suggested in the multivariate analysis, the parameter was further assessed using the Kaplan-Meier method. RESULTS In the assessment of PFS, the univariate and multivariate analyses indicated the following as independent predictors: the texture parameter of homogeneity and the morphological parameter of sphericity. In the Kaplan-Meier analysis, the PFS rate was significantly improved in the patients who had both a higher value of homogeneity (p=0.01) and a higher value of sphericity (p=0.002). With the combined use of homogeneity and sphericity, the patients with different PFS rates could be divided more clearly. CONCLUSION The quantitative parameters of homogeneity and sphericity obtained by FDG-PET can be useful for the prediction of the PFS of pharynx SCC patients, especially when used in combination.
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Affiliation(s)
- N Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14 W5, Kita-Ku, Sapporo 0608638, Japan.
| | - K Hirata
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - T Shiga
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - R Li
- Department of Radiation Oncology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA 94305-5847, USA; The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, N15 W8, Kita-Ku, Sapporo 0608638, Japan
| | - K Yasuda
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, N15 W8, Kita-Ku, Sapporo 0608638, Japan; Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - R Onimaru
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - K Tsuchiya
- Department of Radiation Oncology, Otaru General Hospital, Wakamatsu1-1-1, Otaru 0478550, Japan
| | - S Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - T Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - A Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - K Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14 W5, Kita-Ku, Sapporo 0608638, Japan
| | - H Shirato
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, N15 W8, Kita-Ku, Sapporo 0608638, Japan; Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
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22
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Koyanagawa K, Naya M, Aikawa T, Manabe O, Ohira H, Tsujino I, Shiga T, Anzai T. P2759Phase SD and bandwidth on myocardial perfusion imaging were increased in patients with cardiac sarcoidosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Koyanagawa
- Hokkaido University, Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - M Naya
- Hokkaido University, Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - O Manabe
- Hokkaido University, Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Ohira
- Hokkaido University, First Department of Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - I Tsujino
- Hokkaido University, First Department of Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - T Shiga
- Hokkaido University, Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
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23
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Kikuchi N, Yoshimura A, Suzuki A, Shiga T, Hattori H, Nishinaka T, Saito S, Yamazaki K, Niinami H, Hagiwara N, Nunoda S. 3277Impact of congestion in worsening renal failure after implantation of a centrifugal, continuous-flow left ventricular device. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Kikuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - A Yoshimura
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - A Suzuki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Shiga
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Hattori
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Nishinaka
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - S Saito
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - K Yamazaki
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - H Niinami
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Nunoda
- Tokyo Women's Medical University, Therapeutic Strategy for Severe Heart Failure, Tokyo, Japan
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24
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Sato J, Kitagawa Y, Watanabe S, Asaka T, Ohga N, Hirata K, Shiga T, Satoh A, Tamaki N. Hypoxic volume evaluated by 18 F-fluoromisonidazole positron emission tomography (FMISO-PET) may be a prognostic factor in patients with oral squamous cell carcinoma: preliminary analyses. Int J Oral Maxillofac Surg 2018; 47:553-560. [DOI: 10.1016/j.ijom.2017.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 08/03/2017] [Accepted: 09/18/2017] [Indexed: 11/25/2022]
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25
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Funakoshi H, Sugawara S, Nakashima Y, Homma Y, Mizobe M, Takahashi J, Inoue T, Shiga T, Yasunaga H. 268 The Effectiveness of Fasudil Hydrochloride Administration to Prevent Cerebral Vasospasm After Intervention for Subarachnoid Hemorrhage. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.246] [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]
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26
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Serizawa N, Fukushima K, Momose M, Shiga T, Hagiwara N. P4341Detection of undiagnosed cardiac sarcoidosis by FDG-PET and SPECT among patients with Atrioventricular Block routinely followed in a pacemaker outpatient clinic. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Serizawa N, Momose M, Fukushima K, Nomura A, Shiga T, Hagiwara N. 4783The incidence and clinical significance of 18F-fluorodeoxyglucose re-uptake on cardiac positron emission tomography in patient with cardiac sarcoidosis after receiving corticosteroid therapy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.4783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Kikuchi N, Shiga T, Minami Y, Suzuki A, Nomura A, Serizawa N, Ejima K, Shoda M, Hagiwara N. P6395Short-term prevalence of fatal ventricular arrhythmic events in patients with newly diagnosed reduced left ventricular ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abe T, Fukada I, Shiga T, Morizono H, Ikebata K, Shibayama T, Kobayashi K, Iwase T, Ohno S, Ito Y. A Case of Recurrent Breast Cancer Identified by Pulmonary Tumor Thrombotic Microangiopathy. Case Rep Oncol 2017; 10:620-626. [PMID: 28868021 PMCID: PMC5567112 DOI: 10.1159/000477842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/29/2017] [Accepted: 05/29/2017] [Indexed: 11/19/2022] Open
Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare, cancer-related, pulmonary complication that causes hypoxia and pulmonary hypertension. We report on a 42-year-old woman who was diagnosed with recurrent breast cancer that was detected due to the presence of PTTM. Eleven months after surgery for heterochronous bilateral cancer of the left breast, she developed progressive dyspnea but computerized tomography showed no pulmonary thromboembolism, and a transthoracic echocardiography revealed mild pulmonary hypertension. She was diagnosed with PTTM by cytology from pulmonary artery catheterization and perfusion lung scintigraphy. Also, the patients complained of back pain after admission, bone scintigraphy showed multiple bone metastases. Despite the early diagnosis of PTTM, her platelet count decreased, her performance status rapidly deteriorated, and her dyspnea worsened. Thus, we could not treat her with chemotherapy. She died due to respiratory failure 19 days after admission. To the best of our knowledge, this is the first report of recurrent breast cancer identified by the manifestation of PTTM. Although PTTM is a rare phenomenon, it should be considered in the differential diagnosis of acute dyspnea or pulmonary hypertension in patients with breast cancer. Furthermore, upon diagnosis, the patient should be referred to a cardiologist as soon as possible.
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Affiliation(s)
- Tomomi Abe
- Department of Breast Surgery, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Breast Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ippei Fukada
- Department of Breast Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Taro Shiga
- Department of General Medicine, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hidetomo Morizono
- Department of Breast Surgery, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Koichi Ikebata
- Department of Cytology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomoko Shibayama
- Department of Breast Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kokoro Kobayashi
- Department of Breast Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takuji Iwase
- Department of Breast Surgery, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinji Ohno
- Department of Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinori Ito
- Department of Breast Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
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Ishimoto T, Kataoka S, Shiga T, Takaishi M, Sano S. 572 Intralesional blood, an easy-to-access tool for determination of diffusible mediators by skin lesions. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.594] [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]
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31
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Nakajima K, Hashida Y, Shiga T, Nakajima H, Daibata M, Sano S. 278 High burden of Merkel cell polyomavirus DNA in the nonlesional, sun-exposed skin of patients with Merkel cell carcinoma. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.298] [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]
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Affiliation(s)
- Taro Shiga
- Department of General Medicine, Cardiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
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33
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Nishikawa Y, Yasuda K, Okamoto S, Ito Y, Mori T, Onimaru R, Shiga T, Tsuchiya K, Watanabe S, Takeuchi W, Katoh N, Kuge Y, Tamaki N, Shirato H. The Voxel-based Analysis of FMISO-PET Image in Patients With Local Recurrence of Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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34
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Inoue T, Okamoto S, Watanabe S, Yasuda K, Katoh N, Harada K, Onimaru R, Shiga T, Tamaki N, Kuge Y, Shirato H. Respiration-gated 18F-fluoromisonidazole PET/CT for Stage I Non-Small Cell Lung Cancer Treated by Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Sato J, Kitagawa Y, Watanabe S, Asaka T, Ohga N, Miyakoshi M, Hata H, Okamoto S, Shiga T, Shindoh M, Tamaki N. FMISO-PET reflects not only hypoxia but also cell proliferation in oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.777] [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]
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36
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Hoshijima H, Kuratani N, Hirabayashi Y, Takeuchi R, Shiga T, Masaki E. Pentax Airway Scope® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta-analysis. Anaesthesia 2014; 69:911-8. [PMID: 24820205 DOI: 10.1111/anae.12705] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2014] [Indexed: 12/01/2022]
Abstract
The Pentax Airway Scope(®) is a single-use optical videolaryngoscope designed to assist with difficult tracheal intubation. We systematically reviewed the efficacy of the Pentax Airway Scope with that of a conventional laryngoscope for tracheal intubation in adults with 'normal' and 'difficult' airways. We included 17 randomised controlled trials with a total of 1801 participants. We used the DerSimonian and Laird random-effects model to calculate pooled relative risk or weighted mean differences. The relative risk (95% CI) of a Cormack-Lehane grade-1 laryngeal view was 2.40 (1.76-2.49) with the Pentax Airway Scope compared with the Macintosh laryngoscope, p < 0.00001. We found no other differences between the two laryngoscopes. Despite a superior laryngeal view, the Pentax Airway Scope provides little clinical benefit over the conventional laryngoscope.
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Affiliation(s)
- H Hoshijima
- Division of Dento-Oral Anaesthesiology, Tohoku University Graduate School of Dentistry, Miyagi, Japan
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37
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Kato N, Kinugawa K, Nakayama E, Tsuji T, Kumagai Y, Imamura T, Maki H, Shiga T, Hatano M, Yao A, Miura C, Komuro I, Nagai R. Insufficient self-care is an independent risk factor for adverse clinical outcomes in Japanese patients with heart failure. Int Heart J 2014; 54:382-9. [PMID: 24309448 DOI: 10.1536/ihj.54.382] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 11/18/2022]
Abstract
Self-care is a cornerstone for the successful management of heart failure (HF). The purpose of this study was to examine the impacts of HF self-care on prognosis in Japanese patients with HF. A total of 283 HF outpatients (age 64 ± 14, 70% male, 52% HFrEF) were enrolled. We asked patients to answer about their adhevence to 5 self-care behaviors (medication, eating a low-sodium diet, regular exercise, daily weight check, and treatment seeking behavior). On the basis of the results, we classified patients into a good self-care group and a poor self-care group. The primary outcome was HF hospitalization and/or cardiac death. In total, 65% of patients were classified into the poor self-care group. During a median follow-up of 2 years, cardiac events occurred more frequently in the poor self-care group (22% versus 9.6%, P = 0.013). Poor self-care was an independent risk factor for cardiac events in Cox regression analysis adjusted for clinical parameters (hazard ratio = 2.86, P = 0.005). Poor self-care was also associated with an increased number of HF hospitalizations as well as an extended length of hospital stay for HF. Poor knowledge about HF was an independent determinant for poor self-care in multivariate logistic regression analysis (odds ratio = 0.92, P = 0.019). Insufficient self-care is an independent risk factor for cardiac events in Japanese patients with HF.
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Affiliation(s)
- Naoko Kato
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine
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38
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Nozaki Y, Kinoshita K, Yano T, Shiga T, Hino S, Niki K, Kishimoto K, Funauchi M, Matsumura I. Estimation of kidney injury molecule-1 (Kim-1) in patients with lupus nephritis. Lupus 2014; 23:769-77. [DOI: 10.1177/0961203314526292] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 02/04/2014] [Indexed: 02/01/2023]
Abstract
Objective Biomarkers of disease activity in lupus nephritis (LN) are needed. Ideally, such biomarkers would be capable of detecting early sub-clinical disease and could be used to gauge response to therapy, thus obviating the need for serial renal biopsies. Much of the focus in the search for LN biomarkers has been on the measurement of urinary chemokines and cytokines in LN patients. However, these have yet to be widely implemented in clinical practice. Kidney injury molecule-1 (Kim-1) is expressed in damaged tubules, but whether urinary (u) and tubular (t)-Kim-1 could serve as a biomarker of active LN is unknown. To investigate the disease activity and histological findings in LN, we evaluated u-Kim-1 levels and t-Kim-1 cells in patients with systemic lupus erythematosus (SLE). Method We measured u-Kim-1 levels and stained t-Kim-1 expression in 57 patients with LN using an ELISA and immunohistochemistry staining. Patients were classified into two groups (active LN, n = 37; inactive LN, n = 20) based on the presence of active renal disease according to the renal SLE disease activity index. correlations of clinical, laboratory data, and histological findings with urinary and t-Kim-1 expression were assessed. Result The u-Kim-1 levels were significantly correlated with the expression of t-Kim-1 ( R = 0.64; P = 0.004) in the SLE patients. The active LN patients exhibited elevated u-Kim-1 levels compared to the inactive LN patients. The number of t-Kim-1 cells was also correlated with histological findings (both glomerular and interstitial inflammation). The u-Kim-1 levels were also correlated with proteinuria and tubular damage in the active LN group. The number of t-Kim-1 cells at baseline was significantly correlated with the estimated glomerular filtration rate ( R = 0.72; P = 0.005) and serum creatinine ( R = 0.53; P = 0.005) after 6–8 months of treatment. Conclusion These data suggest the potential use of the u-Kim-1 levels to screen for active LN and for the estimation of t-Kim-1 expression in renal biopsies to predict renal damage, ongoing glomerular nephritis and tubulointerstitial inflammation, and tubular atrophy.
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Affiliation(s)
- Y Nozaki
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - K Kinoshita
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - T Yano
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - T Shiga
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - S Hino
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - K Niki
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - K Kishimoto
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - M Funauchi
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
| | - I Matsumura
- Department of Hematology and Rheumatology, Kinki University School of Medicine, Osaka, Japan
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Shiga T, Watanabe N, Sugita M, Kamada Y, Inoue S, Kubo T. Two cases of osteochondromatosis which developed in the iliopectineal bursa of an osteoarthritic hip. Mod Rheumatol 2014; 11:360-2. [PMID: 24383786 DOI: 10.3109/s10165-001-8072-0] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Abstract Two osteoarthritis patients had osteochondromatosis in the iliopectineal bursa which communicated with the hip joint space. They received surgical resection of the cystic mass and total hip arthroplasty and had good clinical outcomes. The authors consider that these patients' osteochondromatosis was a secondary development on the synovium of the iliopectineal bursa due to chronic inflammation caused by osteoarthritis.
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Affiliation(s)
- T Shiga
- Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine , Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566 , Japan
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40
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Yamada A, Shiraishi Y, Miura H, Yambe T, Omran MH, Shiga T, Tsuboko Y, Homma D, Yamagishi M. Peristaltic hemodynamics of a new pediatric circulatory assist system for Fontan circulation using shape memory alloy fibers. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:683-6. [PMID: 24109779 DOI: 10.1109/embc.2013.6609592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fontan procedure is one of the common surgical treatments of congenital heart diseases. Patients with Fontan circulation have single ventricle in the systemic circulation with the total cavopulmonary connection. We have been developing a pulmonary circulatory assist device using shape memory alloy fibers for Fontan circulation with total cavopulmonary connection. It consisted of the shape memory alloy fibers, the diameter of which are 100 µm. The fibers could wrap the ePTFE conduit for Fontan TCPC connection from the outside. We designed the sequential motion control system for sophisticated pulmonary hemodynamics by the pulsatile flow generation. In order to achieve pulsatile flow assistance in pulmonary arterial system, we fabricated a mechanical structure by sequential contraction of shape memory alloy fibers. Then, we developed a sequential contraction controller for the assist system, which could reproduce the wall contractile velocity at 6.0 to 20.0 cm/sec. We examined hemodynamic characteristic of its function using a mock circulatory system, which consisted of two overflow tanks representing venous and pulmonary arterial pressures in Fontan circulation. As a result, the pulmonary circulation assist device with sequential contraction could achieve effective promotion of the pulsatility in pulmonary arterial flow.
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41
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Funakoshi H, Iwasaki T, Mori K, Nakashima Y, Homma Y, Takahashi J, Kamura H, Toda H, Shiga T. Can We Appropriately Triage Emergency Patients Using the Simplified Japan Triage and Acuity Scale-Based Triage Scale?: Validation of a Triage Scale Emphasizing Physiologic Variables or Mechanism of Injuries. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.099] [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]
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42
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Yasuda K, Tsuchiya K, Okamoto S, Onimaru R, Shiga T, Harada K, Suzuki R, Kuge Y, Tamaki N, Shirato H. The Impact of FMISO-PET Before Treatment in Nasopharyngeal Cancer Patients. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1706] [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: 10/26/2022]
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43
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Harima Y, Ikeda K, Utsunomiya K, Komemushi A, Kanno S, Shiga T, Tanigawa N. Prediction of Outcome for the Patients With Advanced Cervical Cancers After Chemoradiation Therapy Using MicroRNA Analysis. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.244] [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: 10/26/2022]
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44
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Homma Y, Shiga T, Funakoshi H, Ohde S, Miyazaki D, Tahara Y, Nagao K, Yaguchi A, Morimura N. Comparison of Advanced Airways in the Initial Airway Management of Out-of-Hospital Cardiac Arrest–Are There Any Differences?: SOS-KANTO 2012 Study Interim Report. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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45
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Gaididei YB, Gorria C, Berkemer R, Kawamoto A, Shiga T, Christiansen PL, Sørensen MP, Starke J. Controlling traffic jams by time modulating the safety distance. Phys Rev E Stat Nonlin Soft Matter Phys 2013; 88:042803. [PMID: 24229222 DOI: 10.1103/physreve.88.042803] [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: 09/27/2012] [Revised: 06/25/2013] [Indexed: 06/02/2023]
Abstract
The possibility of controlling traffic dynamics by applying high-frequency time modulation of traffic flow parameters is studied. It is shown that the region of the car density where the uniform (free) flow is unstable changes in the presence of time modulation compared with the unmodulated case. This region shrinks when the speed-up of cars does not exceed some critical value and expands in the opposite case. The flux of the time-modulated flow is an increasing function of the amplitude of the modulation for traffic flows whose density is larger than 1/h where h is the safety distance in the nonmodulated case, while it is a decreasing function in the opposite case. In other words, the safety distance time modulation facilitates car propagation in the case when the mean distance between cars in the congestive traffic is less than h and hinders it when the neighboring cars in the flow are well separated. A link between a microscopic description and the macroscopic fundamental diagram is established.
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Affiliation(s)
- Yu B Gaididei
- Bogolyubov Institute for Theoretical Physics, Metrologichna str. 14 B, 03680, Kiev, Ukraine
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46
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Ono M, Nishimura T, Kinoshita O, Shiga T, Kinugawa K, Nagai R, Kyo S. Improved Survival in Patients with Continuous-Flow Ventricular Assist Device for Bridge to Heart Transplantation. Transplant Proc 2013; 45:2017-8. [DOI: 10.1016/j.transproceed.2013.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 01/15/2013] [Indexed: 11/26/2022]
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47
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Maki H, Hatano M, Yao A, Imamura T, Inaba T, Shiga T, Kinugawa K, Nagai R. THU0248 Efficacy of imatinib mesylate on scleroderma associated pulmonary arterial hypertension. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2213] [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: 11/03/2022]
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48
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Imamura T, Kinugawa K, Kato N, Minatsuki S, Muraoka H, Inaba T, Maki H, Shiga T, Hatano M, Yao A, Kyo S, Ono M, Komuro I. Successful conversion from thiazide to tolvaptan in a patient with stage d heart failure and chronic kidney disease before heart transplantation. Int Heart J 2013; 54:48-50. [PMID: 23428925 DOI: 10.1536/ihj.54.48] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Chronic kidney disease (CKD) is often complicated with advanced heart failure because of not only renal congestion and decreased renal perfusion but also prolonged use of diuretics at higher doses, which sometimes results in hyponatremia. Preoperative CKD is known to be associated with poor prognosis after heart transplantation (HTx). We experienced a stage D heart failure patient with CKD and hyponatremia who was switched from trichlormethiazide to tolvaptan. His hyponatremia was normalized, and his renal function was improved after conversion to tolvaptan. In patients with stage D heart failure, it may be useful to administer tolvaptan with a concomitant reduction in the dose of diuretics in order to preserve renal function and avoid hyponatremia before HTx.
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Affiliation(s)
- Teruhiko Imamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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49
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Imamura T, Kinugawa K, Hatano M, Kato N, Minatsuki S, Muraoka H, Inaba T, Maki H, Kimura M, Kinoshita O, Shiga T, Yao A, Kyo S, Ono M, Komuro I. Acute pulmonary vasoreactivity test with sildenafil or nitric monoxide before left ventricular assist device implantation. J Artif Organs 2013; 16:389-92. [PMID: 23559349 DOI: 10.1007/s10047-013-0706-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 03/21/2013] [Indexed: 10/27/2022]
Abstract
There has been no established medical therapy to ameliorate pulmonary hypertension (PH) owing to left heart disease (LHD-PH). It has recently been shown that the left ventricular assist device (LVAD) can improve LHD-PH and therefore has the potential to become a major bridge tool for heart transplantation (HTx). However, some patients still have persistent PH even after LVAD treatment. It is essential to demonstrate the reversibility of end-organ dysfunction, including PH, prior to implantable LVAD treatment, especially in Japan, because implantable LVAD treatment is indicated only as bridge to transplantation. Here we report a patient with LHD-PH whose PH was demonstrated to be reversible by the acute pulmonary vasoreactivity test (APVT) with nitrogen monoxide (NO) and the phosphodiesterase-5 inhibitor sildenafil. Both inhaled NO and sildenafil reduced pulmonary vascular resistance, but pulmonary capillary wedge pressure was increased by NO, which was conversely decreased under increased cardiac output by sildenafil. After the patient was listed as an HTx recipient, pulmonary vascular resistance recovered down to an acceptable range with LVAD treatment. Based on these findings, we suggest that the APVT with sildenafil may be a useful and safe tool to predict improvement of PH after LVAD treatment.
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Affiliation(s)
- Teruhiko Imamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan,
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50
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Amiya E, Watanabe M, Takeda N, Saito T, Shiga T, Hosoya Y, Nakao T, Imai Y, Manabe I, Nagai R, Komuro I, Maemura K. Angiotensin II impairs endothelial nitric-oxide synthase bioavailability under free cholesterol-enriched conditions via intracellular free cholesterol-rich membrane microdomains. J Biol Chem 2013; 288:14497-14509. [PMID: 23548909 DOI: 10.1074/jbc.m112.448522] [Citation(s) in RCA: 16] [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] [Indexed: 01/13/2023] Open
Abstract
Vascular endothelial function is impaired in hypercholesterolemia partly because of injury by modified LDL. In addition to modified LDL, free cholesterol (FC) is thought to play an important role in the development of endothelial dysfunction, although the precise mechanisms remain to be elucidated. The aim of this study was to clarify the mechanisms of endothelial dysfunction induced by an FC-rich environment. Loading cultured human aortic endothelial cells with FC induced the formation of vesicular structures composed of FC-rich membranes. Raft proteins such as phospho-caveolin-1 (Tyr-14) and small GTPase Rac were accumulated toward FC-rich membranes around vesicular structures. In the presence of these vesicles, angiotensin II-induced production of reactive oxygen species (ROS) was considerably enhanced. This ROS shifted endothelial NOS (eNOS) toward vesicle membranes and vesicles with a FC-rich domain trafficked toward perinuclear late endosomes/lysosomes, which resulted in the deterioration of eNOS Ser-1177 phosphorylation and NO production. Angiotensin II-induced ROS decreased the bioavailability of eNOS under the FC-enriched condition.
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Affiliation(s)
- Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Norihiko Takeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Tetsuya Saito
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Taro Shiga
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Yumiko Hosoya
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoko Nakao
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Yasushi Imai
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Ichiro Manabe
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Ryozo Nagai
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan; Jichi Medical University, Shimotsuke 329-0498, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan; Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan.
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