1
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Kurokawa Y, Nakaoka H, Nishimura Y, Nishida K, Nakaoka Y, Imai RI, Seki SI, Kubokawa SI, Kawai K, Hamashige N, Doi Y. Reversal of Myocardial Metastasis From Primary Lung Cancer After Successful Chemotherapy. Circ Rep 2023; 5:267-268. [PMID: 37305792 PMCID: PMC10247352 DOI: 10.1253/circrep.cr-23-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
| | - Hiroshi Nakaoka
- Department of Pulmonary Medicine, Chikamori Hospital Kochi Japan
| | - Yuki Nishimura
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | - Koji Nishida
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | - Yoko Nakaoka
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | | | - Shu-Ichi Seki
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | | | - Kazuya Kawai
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | | | - Yoshinori Doi
- Department of Cardiology, Chikamori Hospital Kochi Japan
- Cardiomyopathy Institute, Chikamori Hospital Kochi Japan
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Yamaguchi H, Nishimura YK, Nakaoka Y, Komatsu J, Sugane H, Hosoda H, Imai RI, Nishida K, Seki SI, Kubokawa SI, Kawai K, Hamashige N, Doi Y. Intracardiac Thrombosis and Systemic Embolism in a Patient with Cardiac Amyloidosis in Sinus Rhythm. Int Heart J 2023:22-448. [PMID: 37197918 DOI: 10.1536/ihj.22-448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Intracardiac thrombosis formation in patients in sinus rhythm is a rare phenomenon. An 84-year-old woman was admitted because of worsening dyspnea on exertion. An electrocardiogram showed sinus rhythm, left atrial overload, marked left axis deviation, low voltage, and poor r-wave progression in leads V1-4. An echocardiogram showed relatively preserved left ventricular ejection fraction with minimal wall thickening. Her serum level of B-type natriuretic peptide (931 pg/mL) was markedly elevated and a diagnosis of worsening heart failure was made. During the course of treatment for heart failure, she was complicated by acute abdominal aortic thromboembolism together with left atrial thrombus. An emergency abdominal aortic thrombectomy was followed by the removal of a left atrial thrombus 2 days later. Left ventricular biopsy performed during the surgery revealed amyloid deposits in the myocardial interstitium. Immunohistochemical study confirmed the diagnosis of transthyretin cardiac amyloidosis. It is postulated that the risk of intracardiac thrombosis and systemic embolism is increased even in sinus rhythm in patients with cardiac amyloidosis.
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Affiliation(s)
| | | | - Yoko Nakaoka
- Department of Medicine and Cardiology Chikamori Hospital
| | - Junya Komatsu
- Department of Medicine and Cardiology Chikamori Hospital
| | - Hiroki Sugane
- Department of Medicine and Cardiology Chikamori Hospital
| | - Hayato Hosoda
- Department of Medicine and Cardiology Chikamori Hospital
| | | | - Koji Nishida
- Department of Medicine and Cardiology Chikamori Hospital
| | - Shu-Ichi Seki
- Department of Medicine and Cardiology Chikamori Hospital
| | | | - Kazuya Kawai
- Department of Medicine and Cardiology Chikamori Hospital
| | | | - Yoshinori Doi
- Department of Medicine and Cardiology Chikamori Hospital
- Cardiomyopathy Institute, Chikamori Hospital
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3
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Nishimura YK, Komatsu J, Sugane H, Hosoda H, Imai RI, Nakaoka Y, Nishida K, Seki SI, Kubo T, Yamasaki N, Kitaoka H, Kubokawa SI, Kawai K, Hamashige N, Doi Y. Unilateral Pulmonary Edema in Patients With Acute Mitral Regurgitation Caused by Chordal Rupture. Circ Rep 2022; 4:571-578. [PMID: 36530837 PMCID: PMC9726524 DOI: 10.1253/circrep.cr-22-0090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 08/03/2023] Open
Abstract
Background: Cardiogenic unilateral pulmonary edema (UPE) has been reported as an unusual condition and to occur in association with severe mitral regurgitation (MR). However, the prevalence of UPE in patients with severe MR remains unknown. Methods and Results: Among 143 consecutive patients with chordal rupture and significant MR, 38 patients with acute severe MR were studied. The prevalence of UPE was 50% (19 patients); all these patients had right-sided UPE. Eight (21%) patients had bilateral pulmonary edema (BPE). All 8 patients with BPE and 18 of 19 patients with UPE had chordal rupture of the posterior leaflet. All patients with UPE and BPE had severe MR with similar left atrial size. Chest radiographs taken ≤48 h from symptom onset diagnosed UPE in 15 of 19 (79%) patients and BPE in 3 of 8 (38%) patients (P=0.037). Chest radiographs taken >48 h from symptom onset diagnosed UPE in 4 (21%) patients and BPE in 5 (62%) patients (P=0.037). Conclusions: The prevalence of UPE was estimated as 50%; it was most frequently right sided and almost always associated with chordal rupture of the posterior leaflet. UPE is not rare, but common, particularly shortly after the development of acute severe MR caused by chordal rupture.
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Affiliation(s)
- Yu-Ki Nishimura
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Junya Komatsu
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Hiroki Sugane
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Hayato Hosoda
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Ryu-Ichiro Imai
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Yoko Nakaoka
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Koji Nishida
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Shu-Ichi Seki
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Toru Kubo
- Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan
| | - Naohito Yamasaki
- Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan
| | - Sho-Ichi Kubokawa
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Kazuya Kawai
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Naohisa Hamashige
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Yoshinori Doi
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
- Cardiomyopathy Institute, Chikamori Hospital Kochi Japan
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4
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Iida O, Soga Y, Seki SI, Kawasaki D, Anzai H, Ando H, Nakama T, Shinozaki N, Kozuki A, Ishihara M, Urasawa K, Toi S, Tsujita H, Tobita K, Ogata K, Horie K, Hayakawa N, Mori S, Fujihara M, Ohki T, Yuba K, Mano T, Nakamura M. Twelve-month safety and effectiveness of TCD-17187 drug-coated balloon for the treatment of atherosclerotic lesions in the superficial femoral and proximal popliteal artery. Catheter Cardiovasc Interv 2022; 100:1100-1109. [PMID: 36177551 DOI: 10.1002/ccd.30408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/29/2022] [Accepted: 09/06/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE The aim of this preapproval trial was to evaluate the 12-month safety and effectiveness of the TCD-17187 drug-coated balloon (DCB) for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and/or proximal popliteal artery (PA). METHODS This was a prospective, multicenter, core laboratory adjudicated, single-arm trial. From October 2019 to November 2020, a total of 121 symptomatic peripheral artery disease patients with SFA and/or proximal PA lesions were enrolled. The primary effectiveness endpoint was 12-month primary patency defined as freedom from restenosis as determined by duplex ultrasonography in the absence of clinically driven target lesion revascularization (CD-TLR). The safety endpoint was the major adverse event (MAE) rate defined as freedom from a composite of device- and procedure-related death within 30 days, and index limb major amputation and/or CD-TLR through follow-up. RESULTS Average age was 74.5 ± 7.3 years and the frequency of diabetes mellitus was 67.5%. Average lesion length and vessel diameter were 106.0 ± 52.6 and 5.2 ± 0.8 mm, respectively. The frequency of chronic total occlusion and bilateral calcification was 17.5% and 50.8% of patients, respectively. The 12-month primary patency rate calculated by Kaplan-Meier analysis was 81.1%, while 12-month freedom from CD-TLR was 95.8%. The MAE rate at 30 days was 1.7% and all events comprised CD-TLR. There were no instances of device- or procedure-related deaths, major amputations, or thrombosis throughout the 12-month evaluation period. CONCLUSION This preapproval trial confirmed the safety and effectiveness of TCD-17187 DCB in the treatment of atherosclerotic lesions in the SFA and/or proximal PA.
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Affiliation(s)
- Osamu Iida
- Department of Cardiology, Cardiovascular Center, Kansai Rosai Hospital, Hyogo, Japan
| | - Yoshimitsu Soga
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Shu-Ichi Seki
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Daizo Kawasaki
- Department of Cardiology, Morinomiya Hospital, Osaka, Japan
| | - Hitoshi Anzai
- Department of Cardiology, SUBARU Health Insurance Ota Memorial Hospital, Gunma, Japan
| | - Hiroshi Ando
- Heart Center, Kasukabe Chuo General Hospital, Saitama, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Chiba, Japan
- Department of Surgery, Division of Vascular Surgery, Jikei University School of Medicine, Tokyo, Japan
| | | | - Amane Kozuki
- Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Masaharu Ishihara
- Division of Cardiovascular Medicine and Coronary Artery Disease, Hyogo College of Medicine, Hyogo, Japan
| | - Kazushi Urasawa
- Department of Cardiology, Cardiovascular Center, Tokeidai Memorial Hospital, Hokkaido, Japan
| | - Satoru Toi
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Hiroaki Tsujita
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kazuki Tobita
- Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Kenji Ogata
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
| | - Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Chiba, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Masahiko Fujihara
- Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
| | - Takao Ohki
- Department of Surgery, Division of Vascular Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Kenichiro Yuba
- Department of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan
| | - Toshiaki Mano
- Department of Cardiology, Cardiovascular Center, Kansai Rosai Hospital, Hyogo, Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
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5
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Nishimura YK, Kubokawa SI, Imai RI, Nakaoka Y, Nishida K, Seki SI, Kubo T, Yamasaki N, Kitaoka H, Kawai K, Hamashige N, Doi Y. Takotsubo Syndrome in Octogenarians and Nonagenarians. Circ Rep 2021; 3:724-732. [PMID: 34950798 PMCID: PMC8651470 DOI: 10.1253/circrep.cr-21-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 12/25/2022] Open
Abstract
Background:
Takotsubo syndrome (TTS) in the very elderly is poorly understood. We sought to clarify the characteristics of octogenarians and nonagenarians with TTS. Methods and Results:
From 148 patients with TTS who underwent coronary angiography, 68 very elderly patients aged ≥80 years (octogenarians/nonagenarians) were compared with 80 younger patients aged ≤79 years. Emotional triggers of TTS were less frequent (7% vs. 19%; P=0.043), whereas physical triggers were more frequent (69% vs. 46%; P=0.005), in octogenarians/nonagenarians than in patients aged ≤79 years. As initial clues to the diagnosis, electrocardiogram changes were more frequent (71% vs. 46%; P=0.003) and chest pain and/or dyspnea were less common (25% vs. 51%; P=0.001) in octogenarians/nonagenarians than in patients aged ≤79 years. Twenty-nine patients had acute heart failure (AHF) as a complication. AHF was more frequently found in octogenarians/nonagenarians than in patients aged ≤79 years (29% vs. 11%, respectively; P=0.006). Cardiac death occurred in 2 octogenarians/nonagenarians; non-cardiac death occurred in 3 octogenarians/nonagenarians and in 2 patients aged ≤79 years. Conclusions:
Emotional triggers of TTS were infrequent in octogenarians/nonagenarians with TTS. AHF was common and there was significant in-hospital all-cause mortality among octogenarians/nonagenarians.
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Affiliation(s)
- Yu-Ki Nishimura
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Sho-Ichi Kubokawa
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Ryu-Ichiro Imai
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Yoko Nakaoka
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Koji Nishida
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Shu-Ichi Seki
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Toru Kubo
- Department of Cardiology and Aging Science, Kochi Medical School Kochi Japan
| | - Naohito Yamasaki
- Department of Cardiology and Aging Science, Kochi Medical School Kochi Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Aging Science, Kochi Medical School Kochi Japan
| | - Kazuya Kawai
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Naohisa Hamashige
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan
| | - Yoshinori Doi
- Department of Medicine and Cardiology, Chikamori Hospital Kochi Japan.,Cardiomyopathy Institute, Chikamori Hospital Kochi Japan
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6
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Takahashi M, Okamoto N, Nishida K, Nakaoka Y, Imai RI, Seki SI, Kubo T, Yamasaki N, Kitaoka H, Kubokawa SI, Kawai K, Hamashige N, Doi Y. Progressive deterioration of frailty is associated with poor outcomes in patients with transthyretin cardiac amyloidosis. Geriatr Gerontol Int 2021; 21:967-969. [PMID: 34427979 DOI: 10.1111/ggi.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/10/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Makoto Takahashi
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Nao Okamoto
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Koji Nishida
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Yoko Nakaoka
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Ryu-Ichiro Imai
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Shu-Ichi Seki
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Toru Kubo
- Department of Cardiology and Aging Science, Kochi Medial School, Nankoku, Japan
| | - Naohito Yamasaki
- Department of Cardiology and Aging Science, Kochi Medial School, Nankoku, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Aging Science, Kochi Medial School, Nankoku, Japan
| | - Sho-Ichi Kubokawa
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Kazuya Kawai
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Naohisa Hamashige
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan
| | - Yoshinori Doi
- Department of Medicine and Cardiology, Chikamori Hospital, Kochi, Japan.,Cardiomyopathy Institute, Chikamori Hospital, Kochi, Japan
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7
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Komatsu J, Imai RI, Nakaoka Y, Nishida K, Seki SI, Kubo T, Yamasaki N, Kitaoka H, Kubokawa SI, Kawai K, Hamashige N, Doi YL. Importance of Paroxysmal Atrial Fibrillation and Sex Differences in the Prevention of Embolic Stroke in Hypertrophic Cardiomyopathy. Circ Rep 2021; 3:273-278. [PMID: 34007941 PMCID: PMC8099667 DOI: 10.1253/circrep.cr-20-0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background:
Although atrial fibrillation (AF) is a well-known risk factor for embolic stroke in hypertrophic cardiomyopathy (HCM), there is a paucity of information derived from HCM patients who have experienced embolic stroke. Methods and Results:
From 141 consecutive HCM patients who had been hospitalized between 2000 and 2018, the clinical characteristics and management of 86 patients with AF were analyzed retrospectively. The incidence of embolic stroke was 36% (n=31 patients). The median (interquartile range) age of embolic stroke was younger in male than female HCM patients (71 [64–80] vs. 83 [77–87] years, respectively; P=0.009). The prevalence of paroxysmal AF (74%) was significantly higher than that of chronic AF (26%) in 31 patients with embolic stroke (P=0.007). The CHADS2
score in patients with embolic stroke was not particularly useful in predicting the occurrence of embolic stroke. Conclusions:
One-third of HCM patients with AF developed embolic stroke, and male HCM patients were younger at the time of the embolic stroke than female HCM patients. The prevalence of paroxysmal AF was significantly higher than that of chronic AF in patients with AF and embolic stroke. Early introduction of anticoagulation therapy is recommended at the first documentation of paroxysmal AF.
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Affiliation(s)
- Junya Komatsu
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | | | - Yoko Nakaoka
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | - Koji Nishida
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | - Shu-Ichi Seki
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | - Toru Kubo
- Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan
| | - Naohito Yamasaki
- Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan
| | | | - Kazuya Kawai
- Department of Cardiology, Chikamori Hospital Kochi Japan
| | | | - Yoshinori L Doi
- Department of Cardiology, Chikamori Hospital Kochi Japan.,Cardiomyopathy Institute, Chikamori Hospital Kochi Japan
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8
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Machida A, Funaki T, Nishida K, Imai RI, Nakaoka Y, Seki SI, Baba YI, Kubo T, Yamasaki N, Kitaoka H, Kubokawa SI, Sakaeda H, Kawai K, Hamashige N, Doi Y. Premature Onset Aortic Stenosis in Systemic Sclerosis: A Report of a Series of Cases. Intern Med 2020; 59:3177-3181. [PMID: 32788545 PMCID: PMC7807118 DOI: 10.2169/internalmedicine.5226-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/22/2020] [Indexed: 11/06/2022] Open
Abstract
Although cardiovascular involvement is a well-known complication correlated with a poor prognosis in patients with systemic sclerosis, there are few reports on valvular heart disease. Forty patients with systemic sclerosis were retrospectively analyzed. Valvular heart disease was found in six patients, five of whom had severe tri-leaflet aortic stenosis. Three of these 5 patients were ≤71 years old. Two frail elderly patients who underwent transcatheter aortic valve replacement died within two years. Premature-onset aortic stenosis is not uncommon in patients with systemic sclerosis. When considering mechanical intervention, the evaluation of frailty is important.
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Affiliation(s)
| | - Takashi Funaki
- Department of Medicine, Chikamori Hospital, Japan
- Department of Cardiology and Aging Science, Kochi Medical School, Japan
| | - Koji Nishida
- Department of Medicine, Chikamori Hospital, Japan
| | | | - Yoko Nakaoka
- Department of Medicine, Chikamori Hospital, Japan
| | | | - Yu-Ichi Baba
- Department of Cardiology and Aging Science, Kochi Medical School, Japan
| | - Toru Kubo
- Department of Cardiology and Aging Science, Kochi Medical School, Japan
| | - Naohito Yamasaki
- Department of Cardiology and Aging Science, Kochi Medical School, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Aging Science, Kochi Medical School, Japan
| | | | | | - Kazuya Kawai
- Department of Medicine, Chikamori Hospital, Japan
| | | | - Yoshinori Doi
- Department of Medicine, Chikamori Hospital, Japan
- Cardiomyopathy Institute, Chikamori Hospital, Japan
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9
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Inotani S, Kubokawa SI, Nakaoka Y, Kotani T, Matsuda H, Yamamoto S, Seki SI, Kawai K, Hamashige N, Doi Y. Unilateral cardiogenic pulmonary edema. J Cardiol Cases 2017; 17:85-88. [PMID: 30279862 DOI: 10.1016/j.jccase.2017.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022] Open
Abstract
A 45-year-old man presented with fatigue for the previous two days. Because of severe hypoxemia and chest radiograph showing severe consolidation only in the right lung field, he was admitted to a near-by district hospital under the diagnosis of acute pneumonia. Since his respiratory condition rapidly deteriorated, he was transferred to our hospital. The diagnosis of unilateral cardiogenic pulmonary edema was made based upon the echocardiographic examination which showed severe mitral regurgitation secondary to chordal rupture of the posterior mitral valve leaflet (P2). After successful intensive medical treatment with diuretics and extracorporeal membrane oxygenation, mitral valve repair was performed with quadrangular resection of the posterior mitral leaflet (P2) and insertion of 28 mm Cosgrove ring. It is important to recognize acute and severe mitral regurgitation as a main cause of unilateral cardiogenic pulmonary edema. Prompt differentiation from acute pneumonia is critical to save lives of the patients. <Learning objective: Unilateral cardiogenic pulmonary edema is an unusual condition and may often be misdiagnosed as acute pneumonia, resulting in an increased risk of mortality. A correct differentiation from pneumonia is critical to save lives of the patients. It is important to recognize acute and severe mitral regurgitation as a main cause of this unusual condition.>.
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Affiliation(s)
- Satoshi Inotani
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Sho-Ichi Kubokawa
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Yoko Nakaoka
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Toshiaki Kotani
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Hideyuki Matsuda
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Satoshi Yamamoto
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Shu-Ichi Seki
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Kazuya Kawai
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Naohisa Hamashige
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
| | - Yoshinori Doi
- The Department of Medicine & Cardiology, Chikamori Hospital, Kochi, Japan
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10
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Abstract
Membrane vesicles of wild-type Halobacterium sp. mex strain show a wavy absorbance change which has not been so far reported in halophilic archaebacteria. A white mutant strain lacking carotenoids did not show the wavy absorbance change. The wavy absorbance change in the range of 440-590 nm was induced by a red flash (600-640 nm), which photoexcited electrogenic ion pumps, mex bacteriorhodopsin and mex halorhodopsin but not carotenoids. The wavy change was also caused by K+ diffusion potentials without light. These results suggest that the wavy absorbance change in the membrane vesicles is the voltage-dependent absorbance change of the carotenoids.
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Affiliation(s)
- S I Seki
- Institute of Physical and Chemical Research (RIKEN) Wako, Japan
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