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Matsuo Y, Murofushi K, Kokubo M, Sakamoto T, Morita S, Hiraoka M, Nakamura M, Mizowaki T. Long-Term Results of a Multi-Institutional Study of Dynamic Tumor Tracking-Stereotactic Body Radiotherapy for Lung Tumors. Int J Radiat Oncol Biol Phys 2023; 117:S31. [PMID: 37784474 DOI: 10.1016/j.ijrobp.2023.06.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We had conducted a multi-institutional phase II study to evaluate the safety and efficacy of dynamic tumor tracking-stereotactic body radiotherapy (DTT-SBRT) for lung tumors. The primary endpoint was 2-year local control, which was reported to be 95.2%. After the initial evaluation of the primary endpoint, the study was extended as an observational study which was designed to evaluate 5-year survival and late toxicities. We present the long-term results of DTT-SBRT for lung tumors. MATERIALS/METHODS The main eligibility criteria for the study were as follows: (1) primary or metastatic lung cancer with a diameter of 5 cm or less, and up to 3 lesions without any extrapulmonary lesions; (2) ineligibility to standard surgery, or patient's refusal of surgery; (3) ECOG-PS of 0 to 2; and (4) expected range of respiratory motion of 10 mm or more. The study included 48 patients from four institutions with the median age of 80 years (range, 49-90 years). Forty-two patients had primary non-small-cell lung cancer, and 6 patients had metastatic lung tumors. Forty-eight tumors (median diameter, 23.5 mm; range, 5-47 mm) in 48 patients were targeted for DTT-SBRT using a gimbal-mounted linear accelerator. Prior to treatment planning, spherical gold markers were placed around the tumor to detect internal tumor motion using fluoroscopy. The prescribed dose was 50 Gy in four fractions. Treatment beams were delivered with DTT according to a 4D model that predicts internal tumor motion with abdominal wall motion. DTT-SBRT was successfully delivered to all but one patient who had poor correlation between abdominal wall and tumor motion. RESULTS Median follow-up period at data cutoff was 5.0 years (interquartile range, 3.1-6.3 years). Twenty-nine patients died; the causes of death were cancer-specific in 10 patients, comorbidity in 14 patients (pulmonary disease, renal failure, cerebral infarction, other malignancies, etc.), and unknown in 5 patients without cancer recurrence. Overall survival at 5 years was 51.5% (95% confidence interval [CI], 36.5-64.6%). Progression-free survival and local control at 5 years were 41.0% (95% CI, 27.0-54.5%) and 92.6% (95% CI, 78.7-97.6%), respectively. There were no grade 4-5 toxicities. One patient (2%) developed grade 3 radiation pneumonitis at 3 months. Grade 2 toxicities were observed in 9 patients (19%), including dyspnea, radiation pneumonitis, pleural effusion, rib fracture, and dermatitis. CONCLUSION Dynamic tumor tracking SBRT achieved the long-term efficacy with low incidence of severe toxicities in lung tumors with respiratory motion. In this elderly patient cohort, non-cancer deaths were observed more than cancer-specific deaths.
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Affiliation(s)
- Y Matsuo
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Murofushi
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - M Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Sakamoto
- Department of Radiation Oncology, Kyoto Katsura Hospital, Kyoto, Japan
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Hiraoka
- Department of Radiation Oncology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - M Nakamura
- Department of Advanced Medical Physics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Kokubo M, Kishi N, Matsuo Y, Ogura M, Araki N, Fujii K, Okumura S, Nakamatsu K, Kishi T, Atsuta T, Sakamoto T, Otsu S, Katagiri T, Narabayashi M, Fujishiro S, Iizuka Y, Ozasa H, Hirai T, Mizowaki T. Major Cardiovascular Events after Chemoradiotherapy with or without Durvalumab in Patients with Stage III Non-Small Cell Lung Cancer: Supplementary Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e30-e31. [PMID: 37785096 DOI: 10.1016/j.ijrobp.2023.06.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) RTOG 0617 showed that cardiac events are relatively common after high-dose thoracic radiotherapy. The aim of this study was to investigate the incidence and risk of major cardiovascular events (MACE) after concurrent chemoradiotherapy (CCRT) with or without durvalumab in patients with stage III non-small cell lung cancer (NSCLC) using the data from a multi-institutional study in Japan. MATERIALS/METHODS Patients who received CCRT for stage III NSCLC between July 2018 and July 2019 were enrolled in a multi-institutional study in Japan. MACE was defined as follows: symptomatic pericardial effusion, acute coronary syndrome, pericarditis, significant arrhythmia, and heart failure. The cumulative incidence of MACE, accounting for death as a competing risk, was calculated. Pre-existing coronary heart disease (CHD) included coronary artery disease, congestive heart failure, peripheral vascular disease, stroke, and extensive coronary artery calcification. The association between patient/treatment-related factors and MACE was assessed by multivariate analysis. RESULTS Among 178 patients with a median follow-up period of 42.5 months, 13 patients developed MACEs. The 3-year cumulative incidence of MACE was 6.9% (95% confidence interval [CI], 4.0-11.9%). Univariate analysis showed that female sex and mean heart dose (MHD) were marginally associated (3-year cumulative incidence, male 5.6% vs. female 12.1%; P = 0.12; MHD ≥ 6.3 Gy 4.8% vs. < 6.3 Gy 9.1%; P = 0.13), and pre-existing CHD was significantly associated with an increased risk of MACE (no CHD 4.3% vs. CHD 16.8%; P = 0.026). Consolidation durvalumab was not associated with an increased risk of MACE (no durvalumab 5.2% vs. durvalumab 7.4%; P = 0.89). Multivariate analysis showed that pre-existing CHD was significantly associated with MACE (hazard ratio, 4.22; 95% CI, 1.30-13.7; P = 0.016). CONCLUSION The incidence of MACE based on the real-world data in Japan was lower than previously reported. Pre-existing CHD was associated with an increased risk of MACE after CCRT in patients with stage III NSCLC, whereas the administration of consolidation durvalumab was not associated with an increased risk of MACE.
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Affiliation(s)
- M Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Kishi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Matsuo
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Ogura
- Department of Radiation Oncology, Kishiwada City Hospital, Kishiwada, Japan
| | - N Araki
- Department of Radiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Fujii
- Department of Radiation Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - S Okumura
- Department of Radiation Oncology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - K Nakamatsu
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, Osaka, Japan
| | - T Atsuta
- Department of Radiology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - T Sakamoto
- Department of Radiation Oncology, Kyoto Katsura Hospital, Kyoto, Japan
| | - S Otsu
- Department of Radiation Oncology, Kyoto City Hospital, Kyoto, Japan
| | - T Katagiri
- Department of Radiation Oncology, Tenri Hospital, Tenri, Japan
| | - M Narabayashi
- Department of Radiology, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - S Fujishiro
- Department of Radiation Oncology, Shinko Hospital, Kobe, Japan
| | - Y Iizuka
- Department of Radiation Oncology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - H Ozasa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Kishi N, Matsuo Y, Ogura M, Kokubo M, Araki N, Fujii K, Okumura S, Nakamatsu K, Kishi T, Atsuta T, Sakamoto T, Otsu S, Katagiri T, Narabayashi M, Fujishiro S, Iizuka Y, Ozasa H, Hirai T, Mizowaki T. Real-World Study of Overall Survival in Patients with Stage III Non-Small Cell Lung Cancer Treated with Chemoradiotherapy with or without Durvalumab and an Exploratory Analysis of Effective Radiation Dose to the Immune Cells. Int J Radiat Oncol Biol Phys 2023; 117:e29-e30. [PMID: 37785070 DOI: 10.1016/j.ijrobp.2023.06.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To investigate the real-world data on overall survival (OS) in patients with stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (CCRT) with or without consolidation durvalumab, and to perform an exploratory analysis on effective radiation dose to the immune cells (EDIC). MATERIALS/METHODS In our multi-institutional retrospective study, patients who received CCRT between July 2018 and July 2019 for stage III NSCLC in Japan were investigated. EDIC was estimated using mean lung dose, mean heart dose, body volume, body mean dose, and body weight, as reported in the secondary analysis of RTOG 0617. The cut-off value of EDIC was calculated using the maximally selected log-rank statistics. RESULTS One hundred and seventy-eight patients were eligible for the analysis (136 patients, CCRT with consolidation durvalumab [CCRT+D] cohort; 42 patients, CCRT cohort). The median follow-up period was 42.5 months. Three-year OS rates were 59.8% in the overall cohort: 60.5% in the CCRT+D cohort, and 58.0% in the CCRT cohort with no significant difference (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.45-1.27; P = 0.29). Univariate analysis showed that ECOG-PS, smoking history, histology, EGFR mutational status, gross tumor volume and EDIC were significantly associated with OS. Multivariate analysis showed that ECOG-PS 2, gross tumor volume ≥ 57 cm3 and EDIC ≥ 4.4 Gy were associated with poor OS. Among 21 EGFR-mutated patients, 3 year-OS rates were 64.7% in the CCRT+D cohort and 100% in the CCRT cohort, while 3 year-OS rates were 68.8% and 58.7% among 90 EGFR wild-type patients. Three-year OS rates were 64.6% and 47.6% for EDIC < 4.4 Gy and EDIC ≥ 4.4 Gy in the overall cohort (HR, 1.82; 95% CI, 1.14-2.90; P = 0.015). In the subgroup analysis, 66.3% vs. 44.4% in the CCRT+D cohort (HR, 2.01; 95% CI, 1.17-3.47; P = 0.016), and 59.0% vs. 56.1% in the CCRT cohort (HR, 1.20; 95% CI, 0.48-3.01; P = 0.70), respectively. CONCLUSION Our real-world data in Japan showed that there was no significant difference in OS between the CCRT+D cohort and the CCRT cohort. High EDIC could be a risk for poor OS in patients treated with CCRT and consolidation durvalumab compared with those treated with CCRT.
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Affiliation(s)
- N Kishi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Matsuo
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Ogura
- Department of Radiation Oncology, Kishiwada City Hospital, Kishiwada, Japan
| | - M Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Araki
- Department of Radiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Fujii
- Department of Radiation Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - S Okumura
- Department of Radiation Oncology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - K Nakamatsu
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, Osaka, Japan
| | - T Atsuta
- Department of Radiology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - T Sakamoto
- Department of Radiation Oncology, Kyoto Katsura Hospital, Kyoto, Japan
| | - S Otsu
- Department of Radiation Oncology, Kyoto City Hospital, Kyoto, Japan
| | - T Katagiri
- Department of Radiation Oncology, Tenri Hospital, Tenri, Japan
| | - M Narabayashi
- Department of Radiology, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - S Fujishiro
- Department of Radiation Oncology, Shinko Hospital, Kobe, Japan
| | - Y Iizuka
- Department of Radiation Oncology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - H Ozasa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Shimojima Y, Kishida D, Ichikawa T, Kida T, Yajima N, Omura S, Nakagomi D, Abe Y, Masatoshi K, Takizawa N, Nomura A, Kukida Y, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Yamasaki A, Nishioka R, Takata T, Moriyama M, Takatani A, Ito T, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Kawahito Y, Sekijima Y. POS0822 HYPERTROPHIC PACHYMENINGITIS IN ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS: A MULTICENTER SURVEY IN JAPAN. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundHypertrophic pachymeningitis (HP), characterized by an inflammatory disorder indicating intracranial or spinal thickening of dura mater, is found to develop as a neurological involvement in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Meanwhile, the previous studies focusing on HP in AAV have been reported as a single-institution study, and the analyses were performed in a small number of patients because HP is a rare neurological disorder. Therefore, neither etiological nor clinical characteristics of HP in AAV have been adequately elucidated.ObjectivesThis study clarified the characteristics of HP in AAV by analyzing the information of multicenter study in Japan (Japan collaborative registry of ANCA-associated vasculitis: J-CANVAS).MethodsWe analyzed the clinical information from 541 Asian patients with AAV enrolled in J-CANVAS. Of them, newly diagnosed and relapsed AAV were included in 448 and 93, respectively. The epidemiological and clinical findings were compared between patients with and without HP. Clinical manifestations related to AAV were evaluated based on the Birmingham Vasculitis Activity Score version 3. To elucidate independent factors in HP development, logistic regression analyses were additionally performed.ResultsOf the total 541 patients (mean age: 71±14 years, M:F = 1:1.2), HP was demonstrated in 28 (5.17%), including 17 (3.79%) in newly diagnosed AAV and 11 (11.8%) in relapsed AAV. The classification of granulomatosis with polyangiitis (GPA) was significantly higher in patients with HP than those without HP (50% vs. 21%, p = 0.0007). In newly diagnosed AAV, patients with HP significantly had higher GPA classification and higher positivity for PR3-ANCA than those without HP (53% vs. 17%, p = 0.001; 29% vs. 9%, p = 0.015, respectively). Conversely, positivity for MPO-ANCA was significantly higher in patients with HP than those without HP in relapsed AAV (91% vs. 55%, p = 0.025), despite not significantly different in the classification of AAV. Headache and cranial neuropathies were significant neurological symptoms in patients with HP compared to those without HP (82% vs. 6.6%, p < 0.0001; 32% vs. 2.9%, p < 0.0001, respectively). Besides, ear, nose and throat (ENT) and mucous membranes/eyes were significantly higher involvements in patients with HP than in those without HP (54% vs. 26%, p = 0.003; 29% vs. 9%, p = 0.003, respectively). Moreover, higher complications of “conjunctive hearing loss” and “sudden visual loss”, which are included in the categories of ENT and mucous membranes/eyes involvement, respectively, were significantly indicated in patients with HP than those without HP (39% vs. 7.2%, p < 0.0001; 21% vs. 1.2%, p < 0.0001, respectively). Multivariable logistic regression analysis identified that ENT (odds ratio [OR] 1.28, 95% confident interval [CI] 1.09 to 1.49, p = 0.002) and mucous membranes/eyes involvement (OR 1.37, CI 1.14 to 1.65, p = 0.0006), as well as conjunctive hearing loss (OR 4.52, CI 1.56 to 13.05, p = 0.005) and sudden visual loss (OR 1.84, CI 1.12 to 3.00, p = 0.015), were independent related factors in patients with HP.ConclusionGPA could be significantly classified in patients with HP. Notably, patients with HP significantly showed higher positivity for PR3-ANCA than those without HP in newly diagnosed AAV. Furthermore, sudden visual loss and conjunctive hearing loss might be implicated in HP development.Disclosure of InterestsNone declared
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Kawamori K, Oguro N, Kida T, Omura S, Nakagomi D, Masatoshi K, Takizawa N, Nomura A, Yuji K, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Shimojima Y, Nishioka R, Yamasaki A, Takata T, Ito T, Moriyama M, Takatani A, Miyawaki Y, Kawahito Y, Ito-Ihara T, Kawaguchi T, Yajima N. AB0625 Association between Cytomegalovirus Reactivation and Renal Prognosis during Remission Induction Therapy for ANCA-Associated Vasculitis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCytomegalovirus (CMV) has been associated with atherosclerosis in patients with chronic renal failure, and may cause secondary nephrotic syndrome. Therefore, we hypothesized that the reactivation of CMV by immunosuppressive therapy in patients with vasculitis may affect renal function.ObjectivesThe purpose of this study was to investigate relationships between CMV infection and renal function during ANCA-associated vasculitis remission induction therapy.MethodsThis retrospective cohort study enrolled microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis patients at 25 sites in Japan who had a first or severe relapse between January 2017 and June 2020. Of these, patients with MPA or GPA who had a positive renal lesion score on BVAS (version 3) at baseline, or vasculitis findings on renal biopsy, CMV assayed by 48 weeks of treatment, were included. Patients were divided into two groups based on the presence or absence of a positive CMV antigen test during the remission induction phase (0–48 weeks of treatment). Outcomes were the rate of change in estimated glomerular filtration rate (eGFR) at 48 weeks after initiation of treatment in both groups, as determined by (eGFR at 48 weeks - eGFR at the initiation of treatment)/eGFR at the initiation of treatment; where lower values were associated with worse renal function. General linear models adjusted for age, gender, presence of diabetes or chronic kidney disease, and the use of rituximab or cyclophosphamide were generated.ResultsA total of 387 patients had CMV antigen measured during ANCA-associated vasculitis treatment, of which 164 had renal involvement and eGFR measured at 48 weeks. Seventy-seven (47.0%) were male and the median age was 75 years (range 69–80 years). CMV reactivation was observed in 44 patients (26.8%). The beta coefficient of multiple regression analysis with CMV positive as 1 and negative as 0 was 0.08 (95% confidence interval -0.13 to 0.29) (p = 0.47). The rate of change in eGFR was higher in the CMV positive group, but not statistically significantly.ConclusionContrary to our hypothesis, renal prognoses tended to be better when CMV reactivation was observed. The patients in the CMV reactivation group may have been treated more aggressively, and some patients with a poor prognosis who were not followed up for 48 weeks dropped out. Further research investigating the adjustment of treatment methods is required.Disclosure of InterestsNone declared
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Nishioka R, Mizushima I, Kida T, Omura S, Nakagomi D, Masatoshi K, Takizawa N, Nomura A, Yuji K, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Shimojima Y, Yamasaki A, Takata T, Ito T, Moriyama M, Takatani A, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Yajima N, Kawahito Y, Kawano M. POS0247 GLUCOCORTICOID TAPERING STRATEGY FOR ANCA-ASSOCIATED VASCULITIS: ADDRESSING THE GAP BETWEEN RECOMMENDATIONS AND REAL-WORLD PRACTICE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAntineutrophil cytoplasmic antibody -associated vasculitis (AAV) is usually treated with combination of high-dose glucocorticoid (GC) and immunosuppressive agents, followed by tapering GC dose. Although the European League Against Rheumatism (EULAR) has specific recommendations for tapering the GC dose, clinicians often taper it slower than recommended due to concerns of potential disease relapse. However, such slower taper may prolong GC exposure for the patients, increasing the risk of adverse events, particularly infection.ObjectivesThe aims of our study were (1) to clarify GC dose tapering in the treatment of AAV in a real-world setting, in contrast to the EULAR recommendation of 2015 and (2) to compare the incidence of AAV relapse and severe infection between patients underdoing EULAR-recommended tapering and those undergoing slower tapering than the recommendation.MethodsIn this multicenter (25 sites in Japan), observational, retrospective study of AAV, 541 patients who had initial or severe relapse were enrolled between January 2017 and June 2020. Of these, 349 patients with microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) who entered in GC tapering phase after successful induction treatment were included. These patients were then grouped on the pace of GC tapering, defined as the GC dose at 12 weeks after treatment initiation: (1) EULAR group: 7.5-10 mg/day of GC, according to the EULAR recommendation of 2015, and (2) SLOWER group: >10 mg/day of GC. Their baseline characteristics and clinical outcomes were compared. Primary outcome was defined as relapse-free days from treatment initiation, whereas secondary outcome included the incidence of infectious events requiring hospitalization within 48 weeks from treatment initiation. Multivariable analysis was performed to assess the relationship between tapering pace and clinical outcomes.ResultsThere were 44 patients (12.6%) in the EULAR group and 290 (83.2%) in the SLOWER group. Regarding baseline characteristics, compared with the EULAR group, the SLOWER group had significantly higher serum C-reactive protein level (EULAR, 5.89 ± 6.89 mg/dL vs SLOWER, 7.56 ± 6.01 mg/dL; p = 0.03), as well as a trend toward higher Birmingham Vasculitis Activity Score (version 3) (EULAR, 11.80 ± 7.01 SLOWER, 13.93 ± 7.06; p = 0.08) We did not observe any significant differences in the frequency of relapses between the two groups (EULAR, 8/44, 18.2% vs SLOWER, 55/290, 19.0%; p = 0.63). Multivariable Cox proportional hazard analysis revealed no relationship GC dose at 12 weeks from treatment initiation and incidence of relapse. However, upon logistic regression analysis, the SLOWER group was found to have significant higher risk of a severe infectious event within 48 weeks from treatment initiation (p = 0.046; hazard ratio, 1.27; 95% confidence interval, 1.004 – 1.601).ConclusionOur finding indicates that clinicians tended to taper GC slower for patients with higher disease activity. However, slower GC taper was not found to reduce the frequency of relapse. In addition, slower GC taper was found to increase the risk of a severe infection. Hence, clinicians should pay attention not only relapsing but also late GC taper resulting in the risk of serious infection, especially in patients with higher disease activity of AAV.References[1]Eur J Clin Invest 2015;45 (3): 346–368.[2]Rheumatology (Oxford). 2021 Dec 24;61(1):205-212.[3]Arthritis Res Ther. 2021 Mar 20;23(1):90.[4]Scand J Rheumatol. 2022 Jan 20;1-13.[5]J Rheumatol. 2018 Apr;45(4):521-528.[6]Rheumatol Adv Pract. 2021 Mar 9;5(3):rkab018.[7]Ann Rheum Dis. 2016 Sep;75(9):1583-94.Figure 1.AcknowledgementsWe would like to thank Editage (www.editage.com) for English language editing.Disclosure of InterestsNone declared
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Kishi N, Matsuo Y, Shintani T, Ogura M, Mitsuyoshi T, Araki N, Fujii K, Okumura S, Nakamatsu K, Kishi T, Atsuta T, Sakamoto T, Otsu S, Katagiri T, Narabayashi M, Fujishiro S, Iizuka Y, Ozasa H, Mizowaki T. PO-1279 PFS and recurrence patterns after CCRT with durvalumab for stage III and recurrent NSCLC. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03243-1] [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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Fujimoto K, Fujii K, Kanamori T, Murai K, Tomura T, Tsutsumi R, Teramoto T, Nonaka Y, Sakaue H, Matsuo Y, Murayama N. Randomized, double-blind, crossover, placebo-controlled clinical trial to evaluate the effects of chicken hot water extract on insulin secretion. Eur Rev Med Pharmacol Sci 2022; 26:2422-2430. [PMID: 35442497 DOI: 10.26355/eurrev_202204_28476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Essence of chicken (EOC), a hot water extract of chicken, is widely consumed in Southeast Asia as a beverage. EOC has an inhibitory effect on the elevation of blood glucose levels and a secretagogue effect on insulin. However, the mechanism by which EOC promotes insulin secretion is unknown. We aimed to verify the postprandial hyperglycemic inhibitory effect and the insulin secretory effect of EOC in healthy adults under appropriate placebo settings. In addition, we aimed to understand the mechanism underlying the insulin secretory effect of EOC. PATIENTS AND METHODS Thirty-four healthy Japanese adults were fed 68 mL of EOC or control food, followed by 200 g of cooked rice. Blood glucose and plasma insulin levels were measured at 30, 45, 60, 90, and 120 min after the participants ate cooked rice. The trial had a randomized, double-blind, crossover, placebo-controlled design. RESULTS The ingestion of EOC induced an increase in the maximum blood concentration (Cmax) of insulin and shortened the time required to reach the maximum blood concentration following rice consumption. Ingestion of the test beverage resulted in a significantly higher insulinogenic index than that obtained after ingestion of the control beverage. No side effects were observed in this study. Mechanistic experiments revealed that EOC stimulated significant (p < 0.05) secretion of GLP-1 from NCI-H716 human intestinal L cells at 0.1, 1, and 10 mg/mL. CONCLUSIONS Consuming EOC when eating rice supports pancreatic function. Daily consumption of EOC could elevate the early-phase insulin response; therefore, it could prevent diabetes in Asians with low insulin secretion.
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Affiliation(s)
- K Fujimoto
- Research Institute, Suntory Global Innovation Center Limited, Kyoto, Japan.
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Kito S, Mukumoto N, Nakamura M, Tanabe H, Karasawa K, Kokubo M, Sakamoto T, Yoshimura M, Matsuo Y, Hiraoka M, Mizowaki T. Theoretical Calculation of Population-Based Margins in Fiducial Marker-Based Real-time Tumor Tracking. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1485] [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: 11/26/2022]
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Ueki K, Matsuo Y, Takeda A, Morita S, Kishi N, Hanazawa H, Tsurugai Y, Mizowaki T. OA11.04 Impact of Local Control on Cause-Specific Survival After SBRT for Early-Stage NSCLC: Dynamic Prediction With Landmarking. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.071] [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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11
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Miyazawa Y, Oka D, Nakayama H, Miyao T, Nakamura T, Takezawa Y, Shimizu N, Matsuo Y, Haruyuki O, Takei T, Sekine Y, Arai S, Suzuki K. Prospective study of the relationship between clinical outcomes of enzalutamide and serum androgen levels measured by LC-MS/MS in CRPC patients. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01230-6] [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: 10/20/2022]
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12
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Kishi N, Matsuo Y, Menju T, Hamaji M, Nakakura A, Hanazawa H, Takehana K, Date H, Mizowaki T. P05.08 A Propensity Score-Weighted Analysis for SBRT, Lobectomy and Sublobar Resection in Elderly Patients with cStage I NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Matsuo Y, Hiraoka M, Karasawa K, Kokubo M, Sakamoto T, Nakamura M, Morita S, Inokuchi H, Mizowaki T. A Multi-institutional Phase II Study of Dynamic Tumor Tracking SBRT for the Lung. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.608] [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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14
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Hiraoka S, Nakajima A, Kishi N, Takehana K, Hanazawa H, Matsuo Y, Mizowaki T. Efficacy Of Metastasis-Directed Therapy For Recurrent Uterine Cervical Cancer After Definitive Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Iizuka Y, Matsuo Y, Nakamura M, Mizowaki T. Reduction Of Kidney Doses Using Dynamic Wave-Arc Therapy For Spinal Metastases To The Lower Thoracic And Upper Lumbar Vertebra Indicated For Spinal Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.050] [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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16
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Yoshimura M, Hiraoka M, Kokubo M, Sakamoto T, Karasawa K, Matsuo Y, Nakamura M, Goto Y, Morita S, Mizowaki T. A Multi-institutional Phase II Study of Dynamic Tumor Tracking IMRT for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.898] [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: 10/23/2022]
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17
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Hozumi T, Morimoto J, Nishi T, Takemoto K, Fujita S, Wada T, Shimamura K, Kashiawagi M, Shiono Y, Kuroi A, Matsuo Y, Ino Y, Kubo T, Tanaka A, Akasaka T. P1518 Relationship between post-operative asymptomatic status and reverse remodeling of large left atrium in patients with aortic stenosis who underwent aortic valve replacement. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.942] [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
Recently, we have reported that large left atrial volume (minimum left atrial volume index : LAVImin ≥30ml/m²) at end-diastole determined by direct exposure of left ventricular (LV) end-diastolic pressure can predict post-operative symptomatic status after aortic valve replacement (AVR) in aortic stenosis (AS) patients with high sensitivity and modest specificity. Reverse remodeling of large LAVImin after AVR may contribute to false positive for the prediction of post-operative symptomatic status in patients with AS.
Purpose
The purpose of this study was to evaluate relationship between post-operative symptomatic status and reverse remodeling of large LAVImin in patients with AS who underwent AVR.
Methods
The study population consisted of 75 patients with AS who underwent AVR and were followed up for 600 days after AVR, after the exclusion of the followings; atrial fibrillation, significant coronary artery disease, significant mitral valve disease, pacemaker rhythm, and inadequate echocardiographic images. We measured LAVImin by biplane Simpson"s method before and after AVR. Preoperative large LAVImin (≥30ml/m²) according to the previous study was observed in 32 (43%) of 75 patients. We divided these 32 patients into two groups according to the post-operative symptomatic status during the follow-up period.
Results
There was no significant difference in pre-operative LAVImin between patients with and without post-operative symptom (46.5 ± 13.4 vs 40.4 ± 8.6 ml/m²). On the other hand, post-operative LAVImin in patients without post-operative symptom was significantly smaller than that in patients with post-operative symptom (31.5 ± 8.6 vs 54.8 ± 14.0 ml/m², p < 0.01). While significant regression in LAVImin after AVR was observed in patients without post-operative symptom (40.4 ± 8.6 to 31.5 ± 8.6 ml/m², p < 0.05), no regression in LAVImin after AVR was observed in patients with post-operative symptom (46.5 ± 13.4 to 54.8 ± 14.0 ml/m²).
Conclusions
Reverse remodeling of large LAVmin in patients with AS who underwent AVR was observed in post-operative asymptomatic group, but not in symptomatic group. These results suggest that reverse remodeling of large LAVImin after AVR could contribute to the post-operative asymptomatic status in patients with AS who underwent AVR.
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Affiliation(s)
- T Hozumi
- Wakayama Medical University, Wakayama, Japan
| | - J Morimoto
- Wakayama Medical University, Wakayama, Japan
| | - T Nishi
- Wakayama Medical University, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Wakayama, Japan
| | - S Fujita
- Wakayama Medical University, Wakayama, Japan
| | - T Wada
- Wakayama Medical University, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Wakayama, Japan
| | | | - Y Shiono
- Wakayama Medical University, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Wakayama, Japan
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18
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Teraguchi I, Hozumi T, Emori H, Takemoto K, Maniwa N, Kashiwagi M, Shimamura K, Shiono Y, Kuroi A, Matsuo Y, Ino Y, Kitabata H, Kubo T, Tanaka A, Akasaka T. P91 Prognostic value of tissue-tracking mitral annular displacement by speckle-tracking echocardiography in asymptomatic patients with aortic stenosis with preserved left ventricular ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Management of asymptomatic severe aortic stenosis (AS) patients with preserved left ventricular (LV) ejection fraction (EF) remains controversial. Recent studies using have shown that decreased LV longitudinal deformation assessed by global longitudinal strain analysis can predict adverse cardiac events in AS patients with preserved EF. Tissue-tracking mitral annular displacement (TMAD) by speckle-tracking echocardiography provides rapid and simple assessment of LV longitudinal deformation even when the acoustic window is poor (Fig.1).
Purpose
The purpose of this study was to examine the value of TMAD to predict occurrence of the cardiac events in asymptomatic severe AS patients with preserved EF.
Methods
We studied 103 patients with severe AS and preserved EF [aortic velocity >4m/s or aortic valve area (AVA) <1.0 cm2, EF >50%]in whom TMAD was measured, and a total of 44 patients were included in the final data setaccording to the exclusion criteria. Using TMAD analysis software, the base-to-apex displacement of automatically defined mid-point of mitral annular line in four-chamber view was quickly assessed, and the percentage of its displacement to LV length at end-diastole (%TMAD) was calculated (Fig.1). We investigated the association between %TMAD and the cardiac events including implementation of hospitalization due to heart failure, decreased EF (< 50%), aortic valve replacement or transcatheter aortic valve implantation due to appearance of symptoms and cardiac death,
Results
In all the final study patients, %TMAD was successfully and quickly (within 10 seconds) evaluated. During a follow-up, the cardiac events developed in 16 (36%) of 44 patients. Tableshows echocardiographic parameters in patients with and without the cardiac events. %TMAD was significantly impaired in patients with the cardiac events compared with those without the cardiac events (9.6 ± 0.6 vs 12.1 ± 0.4%, p= 0.002). The other parameters were not involved in the event occurrence; age, LV mass index, EF, aortic velocity, AVA, tricuspid regurgitation pressure gradient (TR-PG), early diastolic /atrial filling velocity (E/A), early diastolic velocity of the mitral valve annulus (e’) and E/e’. In multiple variable analysis, %TMAD was an independentpredictor of the cardiac events (HR; 12.1, p= 0.001). ROC analysis revealed that the area under the curve of %TMAD was 0.81 for the cardiac events. Kaplan-Meier analysis showed %TMAD (cut-off: 11.9) provides a significant difference in the cardiac event (Fig. 2). Conclusions. The present results suggests that TMAD easily and rapidly estimated by speckle-tracking echocardiography can be used as a simple method to predict occurrence of the cardiac events in asymptomatic severe AS patients with preserved EF.
Abstract P91 Figure 1,2 and Table
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Affiliation(s)
- I Teraguchi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - H Emori
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - N Maniwa
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
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19
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Matsuo Y, Nakai K, Sakuma I, Akutsu K, Tatsuta N, Ishiyama M, Higuchi T, Ryuda N, Ueno D. Estimation of Polychlorinated Biphenyls Intake through Fish Oil-Derived Dietary Supplements and Prescription Drugs in the Japanese Population. JFQHC 2019. [DOI: 10.18502/jfqhc.6.4.1992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Oily fish and their extracted oils may be a source of polychlorinated biphenyls (PCBs) which can induce toxic effects on the consumers. The main aim of this survey was estimation of PCBs intake through fish oil-derived dietary supplements and prescription drugs in the Japanese population. Methods: PCBs levels were determined in 20 fish oil-derived dietary supplements and 6 oil-derived prescription drugs from the Japanese market using Gas Chromatography-Mass Spectrometry. Then, the daily exposure to PCBs was estimated. Data were statistically analyzed using JMP software suite. Results: Totally, 17 of the 26 fish oil-derived products were contaminated with PCBs. The median PCB concentrations in the total set of fish oil-derived products was 2.2 ng/g oil wt. with a range of <MDL-720 ng/g oil wt. The average total daily intake of PCBs was estimated to be ranged from 770 to 2800 ng/day in the Japanese population. Conclusion: PCBs intakes through fish oil-derived dietary supplements and prescription drugs in the Japanese adults were much lower than tolerable daily intake
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20
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Emori H, Kubo T, Tanigaki T, Kawase Y, Shiono Y, Shimamura K, Sobue Y, Matsuo Y, Hirata T, Kitabata H, Ota H, Ino Y, Okubo M, Matsuo H, Akasaka T. P1252Diagnostic performance of quantitative flow ratio from coronary angiography versus fractional flow reserve from computed tomography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
QFR and FFRCT are recently developed, less-invasive techniques for functional assessment of coronary artery disease.
Objectives
We compared the diagnostic performance between fractional flow reserve derived from computed tomography (FFRCT) and quantitative flow ratio (QFR) derived from coronary angiography, using FFR as the standard reference.
Methods
We measured FFRCT, QFR and FFR in 152 patients (233 vessels) with stable coronary artery disease.
Results
QFR was highly correlated with FFR (r=0.78, p<0.001), while FFRCT was moderately correlated with FFR (r=0.63, p<0.001). Both QFR and FFRCT showed good agreements with FFR, presenting small values of mean difference and root-mean-squared deviation (FFR -QFR: 0.02±0.09 and FFR -FFRCT: 0.03±0.11). The AUC of QFR was significantly greater than that of 3D-QCA-derived %DS (0.93 vs. 0.78; difference: 0.15; 95% CI: 0.09 to 0.20; p<0.001). The AUC of FFRCTwas significantly greater than that of CCTA-derived %DS (0.82 vs. 0.70; difference: 0.12; 95% CI: 0.05 to 0.19; p<0.001). The AUC of QFR was significantly greater than that of FFRCT (0.93 vs. 0.82; difference: 0.11; 95% CI: 0.05 to 0.16; p<0.001). The sensitivity, specificity, positive predictive value, and negative predictive valueof QFR ≤0.80 for predicting FFR ≤0.80 were 90%, 82%, 81%, and 90%, respectively. Those of FFRCT ≤0.80 for predicting FFR ≤0.80 were 82%, 70%, 70%, and 82%, respectively. The diagnostic accuracy of QFR ≤0.80 for predicting FFR ≤0.80 was 85% [95% confidence interval: 81% to 89%], while that of FFRCT≤0.80 for predicting FFR ≤0.80was 76% [95% confidence interval: 70% to 80%].
Figure 1. Comparison of FFR ≤0.80 predictors
Conclusions
Both QFR and FFRCTpossessed the ability to accurately evaluate the functional severity of coronary stenosis.
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Affiliation(s)
- H Emori
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | | | | | - Y Shiono
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - Y Sobue
- Gifu Heart Center, Gifu, Japan
| | - Y Matsuo
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | | | - H Kitabata
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - H Ota
- Gifu Heart Center, Gifu, Japan
| | - Y Ino
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - M Okubo
- Gifu Heart Center, Gifu, Japan
| | | | - T Akasaka
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
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21
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Wada T, Shiono Y, Higashioka D, Kashiwagi M, Shimamura K, Kuroi A, Honda K, Matsuo Y, Kitabata H, Ino Y, Kubo T, Tanaka A, Hozumi T, Nishimura Y, Akasaka T. P2700Impact of instantaneous wave-free ratio on graft failure after coronary artery bypass graft surgery. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
It has been reported that preoperative fractional flow reserve (FFR) is associated with graft patency after coronary artery bypass graft (CABG) and the patency is excellent when a bypass graft is anastomosed on a vessel with positive FFR. However, the association with graft patency has not yet been investigated in its novel counterpart, instantaneous wave-free ratio (iFR), and iFR sometimes contradicts FFR results.
Purpose
The purpose of this study is to assess an impact of preoperative iFR on a graft failure after CABG in patients with coronary arteries showing positive FFR (≤0.80).
Methods
We retrospectively identified patients who had undergone preoperative coronary angiography in conjunction with resting and hyperemic intra-coronary pressure measurements, CABG, and graft evaluation by coronary computed tomography angiography. After excluding vessels with negative FFR (>0.80), vessels were divided into two groups: negative iFR group (iFR >0.89) and positive iFR group (iFR ≤0.89). The rate of graft failure within 1 year after CABG was compared between the two groups.
Results
We analyzed 131 vessels in 89 patients (35 vessels in the negative iFR group and 96 vessels in the positive iFR group). The negative iFR group showed significantly higher iFR (0.92±0.02 vs. 0.74±0.13, P<0.0001) and FFR (0.72±0.06 vs. 0.63±0.09, P<0.0001) than the positive iFR group, although percent diameter stenosis (%DS) was comparable (57±10 vs. 56±9, P=0.47). The graft failure significantly often occurred in the negative iFR group than in the positive iFR group (28.6% vs. 8.3%, P=0.0029). In order to reduce the imbalance in the baseline characteristics except for iFR, 70 vessels were selected by using propensity score matching (n=35 in each group). The propensity score matched vessels also demonstrated significantly higher rate of graft failure in the negative iFR group than in the positive iFR group (28.6% vs. 5.7%, p=0.026) despite much more balanced FFR (0.72±0.06 vs. 0.69±0.07, p=0.02) and %DS (57±10 vs. 57±9, p=1.000).
Conclusions
Even when FFR is positive, the graft failure is likely to occur when a bypass graft is anastomosed on a vessel with negative iFR compared to a vessel with positive iFR.
Acknowledgement/Funding
None
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Affiliation(s)
- T Wada
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - D Higashioka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - K Honda
- Wakayama Medical University, Department of Thoracic and Cardiovascular Surgery, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Nishimura
- Wakayama Medical University, Department of Thoracic and Cardiovascular Surgery, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
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22
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Matsuo Y, Kumakura H, Shirakura T, Ichikawa K, Funada R, Yagi H, Iwasaki T, Ichikawa S, Kurabayashi M. P1956Geriatric nutritional risk index as predictor for long-term survival and cardiovascular or limb events in peripheral arterial disease patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The geriatric nutritional risk index (GNRI) is a simple tool to assess the nutritional risk and associated with mortality. However, there are no reports focusing GNRI in peripheral artery disease (PAD) patients.
Purpose
The purpose of this study was to examine the effects of GNRI for long-term survival, cardiovascular and limb events in PAD patients.
Methods
A prospective cohort study was performed in 1219 PAD patients. Baseline GNRI was calculated from serum albumin level and body-mass-index. The patients were divided into four groups by GNRI level (G1: >98; G2: 92–98; G3: 82–91; G4: <82). The endpoints were overall survival (OS) and freedom from major adverse cardiovascular and limb events (MACE and MACLE).
Results
The median follow-up was 73 months. There were 626 deaths (51.4%) during follow-up. The rate of cardiovascular death among dead was 51.3%. The OS rates markedly depended on GNRI level (p<0.01). The 5-year OS rates were G1: 80.8%, G2: 62.0%, G3: 40.0%, G4: 23.3%, respectively. In multivariate analyses, GNRI, age, low ankle brachial pressure index (ABI), low estimated glomerular filtration rate (eGFR), and high C-reactive protein (CRP) levels were independent factors associated with OS (<0.05). GNRI, age, low ABI, diabetes mellitus, coronary artery disease, lower eGFR and higher CRP levels were associated with MACE and MACLE (p<0.05, respectively). Besides, statins improved OS, MACE, and MACLE (<0.01, respectively).
Conclusions
GNRI was an independent predictor for OS, MACE, and MACLE in PAD patients. Furthermore,statins improved OS, MACE and MACLE in patients with PAD.
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Affiliation(s)
- Y Matsuo
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - H Kumakura
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - T Shirakura
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - K Ichikawa
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - R Funada
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - H Yagi
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - T Iwasaki
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - S Ichikawa
- Kitakanto Cardiovascular Hospital, Cardiology, Shibukawa, Japan
| | - M Kurabayashi
- Gunma University School of Medicine, Department of Cardiovascular Medicine, Maebashi, Japan
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23
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Katayama Y, Tanaka A, Kitabata H, Kashiwagi M, Terada K, Emori H, Shiono Y, Kuroi A, Matsuo Y, Ino Y, Kubo T, Hozumi T, Akasaka T. P3387Cholesterol crystals in superficial plaque layer detected by optical coherence tomography as a new morphological feature for plaque rupture. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0263] [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
While plaque rupture (PR) is the leading cause of acute myocardial infarction (AMI), other etiologies are also involved in the onset of AMI. Cholesterol crystals (CCs) are usually present abundantly in atherosclerotic plaques, especially in the culprit site of AMI. However, the relationship between in vivo CCs and PR is unclear. Optical coherence tomography (OCT) is a high-resolution imaging technique that allows for the in vivo identification of various plaque characteristics including PR and CCs.
Purpose
The aim of this study was to investigate prevalence and distribution of CCs between patients with AMI with PR, AMI without PR, and SAP.
Method
This study consisted of 146 patients with coronary artery disease (AMI with PR; n=64, AMI without PR; n=41, and SAP; n=41) who underwent OCT prior to percutaneous coronary intervention. Plaque characteristics in OCT images were assessed according to the consensus document. We classified the distribution of CCs as follows; superficial type CCs were defined by any of the CCs invading the fibrous cap and remaining CCs as deep type CCs.
Result
There was no statistical difference in clinical characteristics among the three groups. The % diameter stenosis was significantly smaller in the SAP group than others (AMI with PR 91±12% vs. AMI without PR 86±13% vs. SAP 65±9%, p<0.001). The prevalence of CCs was significantly higher in the AMI with PR group than others (AMI with PR 78% vs. AMI without PR 41% vs. SAP 39%, p<0.001). The prevalence of superficial type CCs was significantly different among the groups (AMI with PR 72% vs. AMI without PR 24% vs. SAP 7%, p<0.001). Multivariable logistic analysis demonstrated that lipid plaque (OR 84.5, 95% CI [6.30–11332.33], p<0.001) and superficial type CC (OR 9.5, 95% CI [2.61–34.89], p<0.001) were independent predictors of PR.
Conclusion
Plaque with CCs invading the fibrous cap is frequently associated with PR in patients with AMI, suggesting. In vivo CC detection is a new morphological feature for plaque rupture.
Acknowledgement/Funding
This study was supported by a grant from JSPS KAKENHI (17K09557).
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Affiliation(s)
- Y Katayama
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - K Terada
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - H Emori
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
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24
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Hozumi T, Nozawa Y, Takemoto K, Nishi T, Wada T, Maniwa N, Kashiwagi K, Shimamura K, Kuroi A, Matsuo Y, Kitabata H, Ino Y, Kubo T, Tanaka A, Akasaka T. P3365Relationship between early diastolic intra-ventricular pressure gradient shortly after aortic valve closure estimated by vector flow mapping and left ventricular diastolic untwisting rate in humans. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0241] [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
Early diastolic suction is an important determinant of early diastolic function. Previous studies using color Doppler M-mode and speckle-tracking echocardiography have shown left ventricular (LV) early diastolic LV untwisting rate is directly related to LV intra-ventricular pressure gradient (IVPG) between LV base and apex during early diastole. Recent introduction of vector flow mapping (VFM) using combination of color Doppler and speckle-tracking echocardiography provides noninvasive and feasible assessment of early diastolic IVPG shortly after aortic valve closure including isovolmic relaxation period (ED-IVPG) in humans. However, relationship between VFM–derived ED-IVPG and early diastolic LV untwisting rate has not been well investigated.
Purpose
The purpose of this study was to examine relationship between ED-IVPG estimated by VFM and LV untwisting rate by speckle-tracking echocardiography.
Methods
The study population consists of 66 patients without segmental wall motion abnormality, significant valvular diseases, and atrial fibrillation who underwent echocardiography for evaluation of LV function (age: 60±15 years, LVEF: 49±16%). From the apical long-axis views by color Doppler echocardiography, we analyzed peak ED-IVPG between LV base and apex just after aortic valve closure (figure) using commercially available VFM analysis software (DAS-RS1, Hitachi). We assessed peak early diastolic LV untwisting rate and LV torsion from LV basal and apical short-axis view by speckle-tracking echocardiography. We evaluated correlation between ED-IVPG and LV untwisting rate. We also evaluated correlation between ED-IVPG and peak systolic LV torsion, LV end-diastolic (EDV) and end-systolic volumes (ESV), ejection fraction (EF), early diastolic velocity (E) of LV inflow, average early diastolic velocity (e') of mitral annulus, and average E/e'.
Results
In all the study patients, ED-IVPG was successfully and quickly evaluated. 1) ED-IVPG correlated well with peak LV untwisting rate (r=0.64, p<0.0001). 2) ED-IVPG significantly correlated with LV torsion, LVEDV, LVESV, and LVEF (r=0.47, r=−0.48, r=−0.46, and r=0.48, respectively, p<0.001). 3) There were no significant correlations between ED-IVPG and other indexes including E, average e', and average E/e'. According to receiver operating characteristic analysis, the best cut-off value of ED-IVPG for determining impaired LV untwisting rate (<80 degrees/s) was found at 0.42 mmHg (sensitivity 81%, specificity 76%, and area under the curve 0.86)
ED-IVPG measurement by VFM
Conclusions
The present results showed that noninvasive VFM-derived peak ED-IVPG shortly after aortic valve closure is related to early diastolic peak LV untwisting rate. ED-IVPG easily and quickly estimated by VFM may be used as an additional index for LV diastolic function.
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Affiliation(s)
- T Hozumi
- Wakayama Medical University, Wakayama, Japan
| | - Y Nozawa
- Wakayama Medical University, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Wakayama, Japan
| | - T Nishi
- Wakayama Medical University, Wakayama, Japan
| | - T Wada
- Wakayama Medical University, Wakayama, Japan
| | - N Maniwa
- Wakayama Medical University, Wakayama, Japan
| | - K Kashiwagi
- Wakayama Medical University, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Wakayama, Japan
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25
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Shiomi K, Ichinoe M, Jiang S, Naito M, Mikubo M, Matsui Y, Tamagawa S, Mitsui A, Hayashi S, Satoh Y, Matsuo Y. P2.09-20 The Possible Clinical Significances of Infiltration of CD8+ Lymphocytes in Non-Small Cell Lung Cancers. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1669] [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: 11/15/2022]
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26
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Nakao R, Nagao M, Momose M, Kasuga N, Matsuo Y, Fukushima K, Watanabe E, Sakai A, Hagiwara N. P3354Papillary muscle ischemia and global myocardial flow reserve: assessment by high-resolution cine imaging of 13N ammonia PET. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0230] [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
Purpose
Papillary muscle ischemia (PMI) is caused by micro-vessels' occlusion in the broad endocardium because papillary muscle perfusion is supply from micro-vessels of peripheral coronary arteries and is easy to fail by the increase in peripheral vascular resistance. However, the clinical significant is not understood because PMI could not be detected by existing perfusion imaging such as SPECT and MRI. We propose the detection method of PMI using 13N-ammonia PET (NH3-PET), and investigate the association with the global myocardial flow reserve (Global-MFR) reflecting coronary microvascular dysfunction.
Methods
Data of adenosine-stress NH3-PET for consecutive 260 patients with coronary artery disease (CAD) or suspected CAD was retrospectively analyzed. Using high-resolution cine imaging derived from NH3-PET, PMI was defined as the absence of the PM accumulation at stress conditions. 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 images. Global-MFR was calculated by stress to rest flow ratio. Summed stress score (SSS) was used as an estimate of the extent of myocardial ischemia. 150 out of 260 patients (58%) with SSS ≥4 or with the past history of coronary artery diseases were classified as ischemic group, and 110 patients (42%) with SSS<4 were classified as non-ischemic group.
Results
PMI was seen in 68 of 260 patients (26.6%). The frequency of PMI was higher in the ischemic group than the non-ischemic group (37.8% vs. 10.1%, p<0.0001). Global-MFR was significantly lower in patients with PMI than those without (1.87±0.55 vs. 2.39±0.80, p<0.0001). In both ischemic and non-ischemic group, global-MFR was significantly reduced in patients with PMI. (Ischemic group: 1.83±0.56 vs. 2.12±0.52, p=0.0043, Non-ischemic group: 2.06±0.45 vs. 2.63±0.91, p=0.040).
Typical case of PMI
Conclusion
High-resolution cine imaging derived from NH3-PET makes it possible to detect PMI in about a quarter of patients with CAD or suspected CAD. PMI associates with reduced Global-MFR regardless of the presence of myocardial ischemia, suggesting that PMI is an important sign of early ischemia confined to the papillary muscle or the broad microvascular injury.
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Affiliation(s)
- R Nakao
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nagao
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - M Momose
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - N Kasuga
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - Y Matsuo
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - K Fukushima
- Saitama International Medical Center, Department of Nuclear Medicine, Cardiology, Hidaka, Japan
| | - E Watanabe
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
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27
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Hozumi T, Morimoto J, Takemoto K, Wada T, Maniwa N, Kashiwagi M, Shimamura K, Shiono Y, Kuroi A, Matsuo Y, Kitabata H, Ino Y, Kubo T, Tanaka A, Akasaka T. P2453Value of pre-operative left atrial minimum volume as a surrogate for post-operative symptoms in patients with aortic stenosis who underwent aortic valve replacement. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Previous reports have shown that symptoms after aortic valve replacement (AVR) are not uncommon depending on severity of myocardial fibrosis in patients with severe aortic stenosis (AS). Pre-operative minimum left atrial volume (LAVmin) at end-diastole determined by direct exposure of left ventricular end-diastolic pressure may be used as a surrogate for post-operative symptoms in patients with severe AS undergoing AVR.
Purpose
The purpose of this study was to examine the value of pre-operative echocardiographic LAVmin index (LAVImin) to predict post-operative symptomatic status after AVR in patients with severe AS.
Methods
The study population consisted of 219 patients with severe AS who underwent AVR and were followed up for 1000 days after AVR. Pre-operative maximum LAV index (LAVImax), LAVImin, LA emptying fraction (LAEF), LV volume indexes, LV ejection fraction (LVEF) by biplane Simpson's method, aortic valve area index (AVAI), mean aortic valve pressure gradient (mAV-PG), E/A, mean E/e' from LV inflow and mitral annular velocity, and pulmonary artery systolic pressure (PASP) were evaluated by Doppler echocardiography.
Results
After exclusion of 136 patients who met the exclusion criteria (atrial fibrillation, significant coronary artery disease, significant mitral valve diseases, pacemaker rhythm, and inadequate echocardiographic images), the final study population consisted of 75 patients (75±7 years old, 46 female). During a follow-up, 19 patients (25%) complained post-operative symptoms. There were no significant differences in pre-operative serum hemoglobin, creatinine, BNP, chronic obstructive pulmonary disease, hypertension, diabetes, LV volume indexes, LVEF, AVA, mAV-PG between patients with and without post-operative symptoms. There were significant differences in pre-operative LAVImax, LAVImin, and LAEF between patients with and without post-operative symptoms. (60±15 vs 47±15 ml/m2, 45±15 vs 28±1 ml/m2, and 29±12 vs 42±11 ml/m2, respectively). E/A, mean E/e', and PASP in patients with symptoms were significantly greater compared with patients without symptoms (1.0±0.3 vs 0.7±0.2, 25±3 vs 18±2, 44±17 vs 32±9 mmHg, respectively). In the multivariate analysis, pre-operative LAVImin was the independent predictor of the post-operative symptomatic status after AVR (odds ratio: 1.11, 95% confidence interval: 1.04 - 1.18). Receiver operating characteristic analysis revealed that area under the curve (AUC) of LAVImin (cutoff: 30ml/m2) for post-operative symptoms was the largest (0.84) among the other echocardiographic parameters, and significantly larger than that of mean E/e' (0.67, *p<0.01) and LVEF (0.53, **p<0.05) (figure).
Figure 1. ROC analysis
Conclusions
The present results suggest that pre-operative echocardiographic LAVImin may be used as a surrogate for post-operative symptomatic status after AVR in patients with severe AS.
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Affiliation(s)
- T Hozumi
- Wakayama Medical University, Wakayama, Japan
| | - J Morimoto
- Wakayama Medical University, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Wakayama, Japan
| | - T Wada
- Wakayama Medical University, Wakayama, Japan
| | - N Maniwa
- Wakayama Medical University, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Wakayama, Japan
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28
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Terada K, Kubo T, Matsuo Y, Ino Y, Kitabata H, Emori H, Katayama Y, Khalifa A, Shimamura K, Shiono Y, Tanaka A, Hozumi T, Akasaka T. 102Diagnosis of coronary plaque rupture, plaque erosion, and calcified nodule by using near-infrared spectroscopy intravascular ultrasound. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0030] [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
Objectives
This study sought to investigate the ability of near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) to differentiate among plaque rupture (PR), plaque erosion (PE), and calcified nodule (CN) in acute myocardial infarction (AMI) using an optical coherence tomography (OCT) diagnosis as a reference standard.
Background
In vivo, precise differentiation among PR, PE and CN is a major challenge for intravascular imaging.
Methods
The study enrolled 156 AMI patients who had a de novo culprit lesion in a native coronary artery. The culprit lesions were assessed by both NIRS-IVUS and OCT.
Results
OCT identified 112 PR, 29 PE, and 15 CN. IVUS-detected plaque ulceration showed a high specificity (100%) to identify OCT-PR although the sensitivity (62%) was intermediate. IVUS-detected convex calcium showed a high sensitivity (93%) and specificity (100%) to identify OCT-CN. In NIRS, the maximum lipid core burden index in 4 mm (maxLCBI4mm) was greatest in OCT-PR (values are median [interquartile range]) (671 [530 to 853]), followed by OCT-CN (355 [303 to 432]) and OCT-PE (283 [89 to 357]) (p<0.001). MaxLCBI4mm of <422 was the best cut-off to discriminate OCT-PE from OCT-PR and OCT-CN. The NIRS-IVUS classification algorithm using plaque ulceration, convex calcium, and maxLCBI4mm <422 showed a sensitivity and specificity of 96% and 95% for identifying OCT-PR, 93% and 95% for OCT-PE, and 93% and 100% for OCT-CN, respectively.
NIRS-IVUS classification algorism
Conclusion
Lipid component assessed by NIRS-IVUS was different among OCT-PR, OCT-PE and OCT-CN. The NIRS-IVUS classification algorism was highly sensitive and specific for differentiating these unstable lesion types in AMI.
Acknowledgement/Funding
None
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Affiliation(s)
- K Terada
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - H Emori
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - Y Katayama
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - A Khalifa
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, cardiovascular medicine, Wakayama, Japan
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Nishi T, Hozumi T, Takemoto K, Wada T, Maniwa N, Kashiwagi M, Shimamura K, Shiono Y, Kuroi A, Matsuo Y, Kitabata H, Ino Y, Kubo T, Tanaka A, Akasaka T. P4349Simple and rapid estimation of left ventricular longitudinal deformation by tissue-tracking mitral annular displacement in single apical view. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Noninvasive assessment of left ventricular (LV) deformation using global longitudinal strain (GLS) has prognostic value in patients with and without preserved ejection fraction (EF). Application of speckle-tracking technology to the mitral annulus provides rapid and easy assessment of displacement of septal and lateral mitral annulus and mid-point of mitral annular line in single apical view (TMAD) even in poor echo-image quality. TMAD may be used as a simple index of LV longitudinal deformation in patients with and without preserved EF (Figure).
Purpose
The purpose of this study was to examine whether TMAD can be used as a simple index of LV longitudinal deformation in patients with and without preserved EF.
Methods
The study population consists of 95 patients without segmental wall motion abnormality, significant valvular diseases, and atrial fibrillation in whom both TMAD and GLS measurements were applied by QLAB software (Philips). We estimated GLS from apical 4- and 2-chamber views and apical longitudinal views, and TMAD from apical 4-chamber view. TMAD was automatically and quickly evaluated as the base-to-apex displacement of septal (TMADsep), lateral (TMADlat), and mid-point of annular line (TMADmid) (Figure). The percentage of M-TMAD to LV length from the mid-point of mitral annuls to the apex at end-diastole (%TMADmid) was also calculated. We compared each TMAD values with GLS values by linear regression analysis, and evluated TMAD values by a receiver operating characteristic (ROC) analysis to detect impaired LV longitudinal deformation (|GLS|<12.0%).
Results
TMAD was successfully assessed in 94 of 95 patients (99%) while GLS was measured in 84 of 95 patients (87%, p=0.0082 vs TMAD). There were good correlations between each TMAD index and |GLS| (TMADsep:r=0.77, TMADlat:r=0.81, TMADmid:r=0.82, %TMADmid:r=0.87). According to ROC curve, the best cut-off values for TMADsep, TMADlat, TMADmid, and %TMADmid in determining LV longitudinal deformation were 6.8mm, 8.0mm, 7.8mm, and 9.5% respectively (Table).
Conclusions
The present results suggest that rapid and easy assessment of TMAD in single apical view may be used as a simple index of LV longitudinal deformation.
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Affiliation(s)
- T Nishi
- Wakayama Medical University, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Wakayama, Japan
| | - T Wada
- Wakayama Medical University, Wakayama, Japan
| | - N Maniwa
- Wakayama Medical University, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Wakayama, Japan
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Onishi H, Shioyama Y, Matsuo Y, Takayama K, Miyakawa A, Yamashita H, Nomiya T, Matsumo Y, Matsushita H, Kimura T, Murakami N, Ishiyama H, Uno T, Takanaka T, Katoh N, Takeda A, Nakata K, Ogawa K, Nihei K, Aoki M, Kuriyama K, Komiyama T, Marino K, Araya M, Aoki S, Saito R, Maehata Y, Tominaga R, Nonaka H, Oguri M, Matsuda M, Yamada T, Akita T, Hiraoka M. Prognosis after Local Recurrence or Metastases in Medically Operable Stage I Non-Small Cell Lung Cancer Patients Treated By Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Kishi N, Nakamura M, Hirashima H, Mukumoto N, Takehana K, Uto M, Matsuo Y, Mizowaki T. EP-1829 Clinical validation of knowledge-based planning for multiple brain metastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32249-2] [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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32
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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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33
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Onishi H, Imai T, Ito Y, Matsumo Y, Onimaru R, Shioyama Y, Yoshitake T, Kokubo M, Takayama K, Yamashita H, Matsuo Y, Matsushita H, Karasawa K, Kuriyama K, Komiyama T, Shirato H. Single Nucleotide Polymorphisms of Inflammation-Related Genes As Predictive Risk Factors of Radiation Pneumonitis after Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1882] [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: 10/28/2022]
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34
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Matsuo Y, Chen-Yoshikawa T, Hamaji M, Mitsuyoshi T, Shintani T, Iizuka Y, Sonobe M, Date H, Mizowaki T. P1.16-25 A Propensity Score Model for Appropriate Treatment Selection (Sublobar Resection vs. SBRT) In Patients With cStage I NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Teraguchi I, Hozumi T, Emori H, Takemoto K, Kuroi A, Kameyama T, Yamano T, Matsuo Y, Kitabata H, Ino Y, Yamaguchi T, Kubo T, Tanaka A, Akasaka T. P1755Assessment of systolic dysfunction in asymptomatic patients with severe aortic stenosis and preserved ejection fraction using tissue mitral annular displacement by speckle-tracking echocardiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1755] [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: 11/13/2022] Open
Affiliation(s)
- I Teraguchi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - H Emori
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Kameyama
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Yamano
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Yamaguchi
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Department of Cardiovascular Medicine, Wakayama, Japan
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36
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Hozumi T, Nozawa Y, Teraguchi I, Takemoto K, Ota S, Kashiwagi M, Shimamura K, Kuroi A, Kamayama T, Matsuo Y, Kitabata H, Ino Y, Kubo T, Tanaka A, Akasaka T. P861Relationship between noninvasive assessment of left ventricular intra-ventricular pressure gradients estimated by vector flow mapping and left ventricular systolic and diastolic function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p861] [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: 11/13/2022] Open
Affiliation(s)
- T Hozumi
- Wakayama Medical University, Wakayama, Japan
| | - Y Nozawa
- Wakayama Medical University, Wakayama, Japan
| | - I Teraguchi
- Wakayama Medical University, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Wakayama, Japan
| | - S Ota
- Wakayama Medical University, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Wakayama, Japan
| | - T Kamayama
- Wakayama Medical University, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Wakayama, Japan
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Emori H, Kubo T, Ino Y, Matsuo Y, Kitabata H, Tanaka A, Hozumi T, Akasaka T. P4638Diagnostic accuracy of quantitative flow ratio for assessing myocardial ischemia in prior myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4638] [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: 11/13/2022] Open
Affiliation(s)
- H Emori
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Division of Cardiovascular Medicine, Wakayama, Japan
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Katayama Y, Tanaka A, Emori H, Taruya A, Wada T, Maniwa N, Kashiwagi M, Shimamura K, Shiono Y, Matsuo Y, Kitabata H, Ino Y, Kubo T, Hozumi T, Akasaka T. P784Association between cholesterol crystals piercing fibrous cap and plaque rupture in patients with acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p784] [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)
- Y Katayama
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - H Emori
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - A Taruya
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Wada
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - N Maniwa
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Cardiovasculer medicine, Wakayama, Japan
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Higashioka D, Shiono Y, Shimamura K, Kuroi A, Kameyama T, Matsuo Y, Kitabata H, Ino Y, Kubo T, Tanaka A, Hozumi T, Akasaka T. P4594The reproducibility of physiological mapping of coronary vessels by angio-coregistration with instantaneous wave-free ratio pullback. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4594] [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: 11/13/2022] Open
Affiliation(s)
| | - Y Shiono
- Wakayama Medical University, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Wakayama, Japan
| | - T Kameyama
- Wakayama Medical University, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Wakayama, Japan
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Maniwa N, Hozumi T, Takemoto K, Ota S, Kashiwagi M, Shimamura K, Shiono Y, Kuroi A, Kameyama T, Matsuo Y, Ino Y, Kitabata H, Kubo T, Tanaka A, Akasaka T. P4667Value of speckle-tracking echocardiographic tricuspid annular displacement for the assessment of right ventricular systolic dysfunction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4667] [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: 11/13/2022] Open
Affiliation(s)
- N Maniwa
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - K Takemoto
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - S Ota
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - M Kashiwagi
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - Y Shiono
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - A Kuroi
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - T Kameyama
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - Y Matsuo
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - Y Ino
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - H Kitabata
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - A Tanaka
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Cardiovascular medicine, Wakayama, Japan
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Abstract
In an In vitro study using a human monocytic leukemia cell line, U-937, the effects of interferon-γ (IFN-γ) in combination with the antifolate methotrexate and the role of thymidine introduced as a biochemical modulator were investigated. Methotrexate alone or in combination with INF-γ was found to enhance the induction of morphologic and functional monocytic differentiation in the U-937 cell line. Various cellular effects with the addition of thymidine to the medium with methotrexate and IFN-γ were studied. Enhanced inhibition of cell growth and perturbation of the cell cycle were noted when methotrexate and IFN-γ were used in combination, but not when methotrexate was used alone. The reduction of cellular folate by methotrexate was also enhanced in combination with IFN-γ. Cell cycle delay, resulting in cell growth inhibition of folate depletion, caused the induction of differentiation in U-937 cells, which was found to be greater with methotrexate + IFN-γ than with methotrexate alone. Cellular differentiation, as assessed by nitroblue tetrazolium reduction assay, indirect immunofluorescence and morphology, showed better effects towards the differentiation of U-937 cells when the agents were used in combination. However, addition of thymidine to the medium was found to cancel all the aforementioned effects. The addition of thymidine to the medium also caused reversal of the inhibitory effect of methotrexate and IFN-γ on cell growth and repletion of the endogenous folate level. Repletion of the folate level by exogenous thymidine is a new possibility for the role of the thymidine in cellular growth.
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Affiliation(s)
- P Sur
- Fujisaki Cell Center, Hayashibara Biochemical Laboratories, Okayama, Japan
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Mitsuyoshi T, Matsuo Y, Shintani T, Iizuka Y, Ueki N, Mizowaki T. P2.05-002 A Pilot Study on the Safety and the Efficacy of Dose Escalation in Stereotactic Body Radiotherapy for Peripheral Lung Tumor. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.11.029] [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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Hitoshi I, Matsuo Y, Ohtsu S, Sakamoto T, Mizowaki T. P2.14-007 Histological Difference in Outcomes of Definitive Chemoradiotherapy for non-small cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1379] [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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Iizuka Y, Matsuo Y, Mitsuyoshi T, Shintani T, Mizowaki T. Comparison of Target Delineation Methods in Dynamic Tumor Tracking Radiation Therapy for Lung Tumors Based on Internal Fiducial Markers. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2222] [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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Tawara N, Yamashita S, Zhang X, Zhang Z, Doki T, Matsuo Y, Nakane S, Maeda Y, Ando Y. Predominant atrophy in type 2 myofibers of sporadic inclusion body myositis with anti-cn1a autoantibody. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3046] [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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Zhang Z, Yamashita S, Tawara N, Kawakami K, Doki T, Matsuo Y, Zhang X, Maeda Y, Ando Y. Mitochondrial analysis in wild-type TDP-43 transgenic mice mimicking sporadic inclusion body myositis. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.221] [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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Satoshi Y, Matsuo Y, Tawara N, Zhang X, Zhang Z, Doki T, Ando Y. CYLD is involved in the pathogenesis of inclusion body myositis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3028] [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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Ota S, Ozaki Y, Kuroi A, Kameyama T, Yamano T, Yamaguchi T, Matsuo Y, Kitabata H, Ino Y, Takemoto K, Kubo T, Tanaka A, Hozumi T, Akasaka T. P3327The pattern of myocardial fibrosis detected by cardiovascular magnetic resonance imaging provides prognostic information in patients with idiopathic dilated cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3327] [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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49
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Nishiguchi T, Kubo T, Tanimoto T, Ino Y, Katayama Y, Emori H, Teraguchi I, Taruya A, Terada K, Kameyama T, Yamano T, Matsuo Y, Tanaka A, Hozumi T, Akasaka T. P1783Obesity, and low high-density lipoprotein are residual cardiovascular risks despite optimal low-density lipoprotein reduction with statins: a substudy of the ESCORT trial. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1783] [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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50
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Teraguchi I, Hozumi T, Takemoto K, Ota S, Ozaki Y, Kuroi A, Kameyama T, Yamano T, Yamaguchi T, Matsuo Y, Kitabata H, Ino Y, Tanaka A, Kubo T, Akasaka T. P3541Assessment of systolic dysfunction in asymptomatic patients with mitral regurgitation and preserved ejection fraction using tissue mitral annular displacement by speckle-tracking echocardiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3541] [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: 11/14/2022] Open
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