27 results on '"Miyashita, K."'
Search Results
2. Antifibrotics and mortality in idiopathic pulmonary fibrosis: external validity and avoidance of immortal time bias.
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Hozumi H, Miyashita K, Nakatani E, Inoue Y, Yasui H, Suzuki Y, Karayama M, Furuhashi K, Enomoto N, Fujisawa T, Inui N, and Suda T
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- Humans, Male, Female, Aged, Middle Aged, Time Factors, Japan epidemiology, Bias, Pyridones therapeutic use, Reproducibility of Results, Databases, Factual trends, Survival Rate trends, Treatment Outcome, Indoles, Idiopathic Pulmonary Fibrosis drug therapy, Idiopathic Pulmonary Fibrosis mortality, Idiopathic Pulmonary Fibrosis diagnosis, Antifibrotic Agents therapeutic use
- Abstract
Background and Objective: Pooled analyses of previous randomized controlled trials reported that antifibrotics improved survival in patients with idiopathic pulmonary fibrosis (IPF), but the results were only based on short-term outcome data from selected patients who met strict criteria. Observational studies/meta-analyses also suggested that antifibrotics improve survival, but these studies failed to control for immortal time bias that considerably exaggerates drug effects. Therefore, whether antifibrotics truly improve long-term survival in patients with IPF in the real world remains undetermined and requires external validity., Methods: We used data from the Japanese National Claims Database to estimate the intention-to-treat effect of antifibrotics on mortality. To address immortal time bias, we employed models treating antifibrotic initiation as a time-dependent covariate and target trial emulation (TTE), both incorporating new-user designs for antifibrotics and treating lung transplantation as a competing event., Results: Of 30,154 patients with IPF, 14,525 received antifibrotics. Multivariate Fine-Gray models with antifibrotic initiation as a time-dependent covariate revealed that compared with no treatment, nintedanib (adjusted hazard ratio [aHR], 0.85; 95% confidence interval [CI], 0.81-0.89) and pirfenidone (aHR, 0.89; 95% CI, 0.86-0.93) were associated with reduced mortality. The TTE model also replicated the associations of nintedanib (aHR, 0.69; 95% CI, 0.65-0.74) and pirfenidone (aHR, 0.81; 95% CI, 0.78-0.85) with reduced mortality. Subgroup analyses confirmed this association regardless of age, sex, and comorbidities, excluding certain subpopulations., Conclusions: The results of this large-scale real-world analysis support the generalizability of the association between antifibrotics and improved survival in various IPF populations., (© 2024. The Author(s).)
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- 2024
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3. Long-term outcomes following bioresorbable vascular scaffolds.
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Miyashita K, Ninomiya K, Tobe A, Masuda S, Kotoku N, Kageyama S, Revaiah PC, Tsai TY, Wang B, Garg S, Serruys PW, and Onuma Y
- Abstract
Introduction: The higher scaffold thrombosis rates observed with the first-generation bioresorbable scaffolds (BRSs) compared to conventional drug-eluting stents were likely due in part to bioresorbable polymers having insufficient radial strength, necessitating larger strut profiles. Meta-analysis of the long-term outcomes from the first-generation Absorb bioresorbable vascular scaffold (BVS) showed that this period of excess risk ended at 3 years. Therefore, current attention has been focused on improving early outcomes by increasing the scaffold's tensile strength and reducing strut thickness., Areas Covered: This review summaries the lessons learned from the first-generation BRS. It updates the long-term clinical outcomes of trials evaluating the ABSORB BVS and metallic alloy-based BRS. In addition, it reviews the next-generation BRSs manufactured in Asia., Expert Opinion: Critical areas to improve the performance and safety of biodegradable scaffolds include further development in material science, surface modification, delivery systems, and long-term follow-up studies.
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- 2024
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4. Cardiac computed tomography-derived coronary artery volume to myocardial mass in patients with severe coronary artery disease.
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Kageyama S, Taylor CA, Updegrove A, Garg S, Masuda S, Revaiah PC, Kageyama M, Tsai TY, Miyashita K, Tobe A, Tanaka K, De Mey J, La Meir M, Schneider U, Doenst T, Teichgräber U, Saima M, Pompilio G, Andreini D, Pontone G, Puskas JD, Gupta H, Morel MA, Serruys PW, and Onuma Y
- Abstract
Background: Coronary artery lumen volume (V) to myocardial mass (M) ratio (V/M) can show the mismatch between epicardial coronary arteries and the underlying myocardium., Methods: The V, M and V/M were obtained from the coronary computed tomography angiography (CCTA) of patients in the FAST-TRACK CABG study, the first-in-human trial of coronary artery bypass grafting (CABG) guided solely by CCTA and fractional flow reserve derived from CCTA (FFR
CT ) in patients with complex coronary artery disease (CAD). The correlations between V/M ratios and baseline characteristics were determined and compared with those from the ADVANCE registry, an unselected cohort of historical controls with chronic CAD., Results: The V/M ratio was obtained in 106 of the 114 pre-CABG CCTAs. Mean age was 65.6 years and 87% of them were male. The anatomical SYNTAX score from CCTA was significantly higher than the functional SYNTAX score derived using FFRCT [43.1 (15.2) vs 41.1 (16.5), p < 0.001]. Mean V, M, and V/M were 2204 mm3 , 137 g, and 16.5 mm3 /g, respectively. There were weak negative correlations between V and anatomical and functional SYNTAX scores (Pearson's r = -0.26 and -0.34). V and V/M had a strong correlation (r = 0.82). The V/M ratio in the current study was significantly lower than that in the ADVANCE registry (median 16.1 vs. 24.8 [1st quartile 20.1])., Conclusion: Systematically smaller V/M ratios were found in this population with severe CAD requiring CABG compared to an unselected cohort with chronic CAD. The V/M ratio could provide additional non-invasive assessment of CAD especially when combined with FFRCT ., Competing Interests: Declaration of competing interest Dr Serruys has received consultancy fees from Philips/Volcano, SMT, Novartis, Xeltis, Merillife. Dr Garg receives consulting fee from Biosensors. Dr Puskas reports consulting fees from Medtronic, Atricure, Medistim, Edwards Life Science, and royalty payments from Scanlan. Dr Gupta reports an institutional grant from Siemens Health Solutions. Dr Garg reported consulting fees from Biosensors. Dr Taylor and Dr Rogers are employees of HeatFlow Inc. including salary and equity. Dr Thomsen is an employee of GE HealthCare. Dr Pontone reports grants and consultant fees from GE HealthCare, Bracco, and HeartFlow, Payment honoraria from GE HealthCare and HeartFlow, and payment for expert testimony from GE HealthCare. All other authors have no conflict of interest to declare. All other authors have no conflict of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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5. Ammonia decomposition mediated at nitrogen vacancies on NaCl-type binary metal nitrides supporting transition metal nanoparticles.
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Miyazaki M, Ogasawara K, Takekoshi Y, Miyashita K, Abe H, Niwa Y, Hosono H, and Kitano M
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The ability of NaCl-type binary transition metal nitrides (incorporating La, Ce, Y, Zr or Hf) to act as catalytic supports facilitating ammonia decomposition was examined. The effect of nitrogen vacancies formed on nitrides can be understood in terms of the ionic radii of the metal cations. A clear correlation between the N
2 desorption temperature and catalytic activity was found.- Published
- 2024
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6. Fucoxanthin alleviates lipopolysaccharide-induced intestinal barrier injury in mice.
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Du L, Chen C, Yang YH, Zheng Y, Li H, Wu ZJ, Wu H, Miyashita K, and Su GH
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- Animals, Mice, Male, Apoptosis drug effects, NF-kappa B metabolism, Permeability, Mice, Inbred C57BL, Tight Junction Proteins metabolism, Cytokines metabolism, Xanthophylls pharmacology, Intestinal Mucosa drug effects, Intestinal Mucosa metabolism, Lipopolysaccharides adverse effects
- Abstract
The aim of this study was to evaluate the preventive role and underlying mechanisms of fucoxanthin (Fx) on lipopolysaccharide (LPS)-induced intestinal barrier injury in mice. Our results demonstrated that the oral administration of Fx (50 and 200 mg per kg body weight per day) for consecutive 7 days significantly alleviated the severity of LPS-induced intestinal barrier injury in mice, as evidenced by attenuating body weight loss, improving intestinal permeability, and ameliorating intestinal morphological damage such as reduction in the ratio of the villus length to the crypt depth ( V / C ), intestinal epithelium distortion, goblet cell depletion, and low mucin 2 (MUC2) expression. Fx also significantly mitigated LPS-induced excessive apoptosis of intestinal epithelial cells (IECs) and curbed the decrease of tight junction proteins including claudin-1, occludin, and zonula occludens-1 in the ileum and colon. Additionally, Fx effectively alleviated LPS-induced extensive infiltration of macrophages and neutrophils into the intestinal mucosa, the overproduction of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin 1beta (IL-1β) and IL-6, and gasdermin D (GSDMD)-mediated pyroptosis of IECs. The underlying mechanisms might be associated with inhibiting the activation of nuclear factor-kappa B (NF-κB), mitogen-activated protein kinases (MAPKs) and nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome signaling pathways. Moreover, Fx also notably restrained intestinal reactive oxygen species (ROS), malondialdehyde and protein carbonylation levels in LPS-treated mice, and it might be mediated by activating the nuclear factor-erythroid 2 related factor 2 (Nrf2) signaling pathway. Overall, these findings indicated that Fx might be developed as a potential effective dietary supplement to prevent intestinal barrier injury.
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- 2024
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7. First Report of Klebsiella pneumoniae subsp. ozaenae Meningitis in Japan.
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Hosono Honda N, Harada S, Suzuki M, Akaiwa Y, Miyashita K, Miyamoto T, and Haruki K
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- Aged, Female, Humans, Community-Acquired Infections microbiology, Community-Acquired Infections diagnosis, Japan epidemiology, Klebsiella Infections diagnosis, Klebsiella Infections microbiology, Klebsiella Infections complications, Klebsiella pneumoniae isolation & purification, Meningitis, Bacterial diagnosis, Meningitis, Bacterial microbiology
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Although the frequency of community-acquired infections caused by Klebsiella pneumoniae subsp. ozaenae (K. ozaenae) is low, they are often detected in sputum specimens. In addition, lung abscesses, necrotizing pneumonia, and urinary tract infections caused by K. ozaenae have also been reported. We herein report the first detection of K. ozaenae as an etiological agent of bacterial meningitis in Japan. Cases of K. ozaenae meningitis complicated by diabetes mellitus and sinusitis have been reported elsewhere. When Klebsiella pneumoniae is detected in such cases, it is important to use other detection methods in addition to mass spectrometry for correct identification.
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- 2024
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8. [Business continuity capabilities for disaster preparedness: A comparative study of different industries in Wakayama Prefecture].
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Morioka I, Takeshita T, Miyashita K, Fujiyoshi A, Tanaka T, Ikuta Z, and Hirabayashi A
- Abstract
Objectives: This study aimed to elucidate the status of business continuity plan (BCP) formulation in businesses, focusing on different industries. It examined their preparation for natural disasters, such as earthquakes and tsunamis, and crisis events, such as emerging infectious diseases., Methods: A total of 1,583 businesses in Wakayama Prefecture, Japan, were randomly selected from the Wakayama Occupational Health Support Center workplace list. Anonymous self-administered questionnaires were distributed by mail. The questionnaire comprised questions on the business, awareness and formulation status of BCP, and business continuity capabilities in preparation for natural disasters and crisis events. It also explored reasons for the lack of progress in BCP formulation. Businesses were categorized into three groups based on the type of industry: manufacturing (114 companies), lifeline (66 companies), and others (207 companies)., Results: Questionnaires were collected from 412 businesses, and 387 of those that responded to the type of industry were analyzed (valid response rate: 24.3%). More than 50% of businesses in all industries were aware of BCP. Regarding the status of BCP formulation, 39.5% of the manufacturing, 34.8% of the lifeline, and 41.5% of others had already formulated or were formulating a BCP. Many lifeline businesses had not taken any measures to prepare facilities and allocate funds for emergencies. Additionally, 49% were at high risk of being forced to close down due to disasters. As the background to the lack of progress in formulating a BCP, 60.9% of lifeline businesses did not know what to develop or how to consider it. In addition, 44.2% of others had to secure the time and human resources necessary for formulation., Conclusions: Although awareness of BCPs is increasing, their formulation has not progressed significantly. In particular, BCP formulation has been delayed in lifeline industries, resulting in low business continuity capabilities. Given that many businesses do not know the contents or methods of formulating BCPs, it is suggested that educating relevant parties about using templates is necessary. This approach can reduce the time required for formulation and enable the creation of a BCP even without detailed human resources.
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- 2024
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9. Mutation spectra of the BRCA1/2 genes in human breast and ovarian cancer and germline.
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Koi Y, Watanabe A, Kawasaki A, Ideo S, Matsutani N, Miyashita K, Shioi S, Tokunaga E, Shimokawa M, Nakatsu Y, Kuraoka I, and Oda S
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- Humans, Female, BRCA1 Protein genetics, BRCA2 Protein genetics, Mutation, Missense, Genes, BRCA1, Genes, BRCA2, Breast Neoplasms genetics, Germ-Line Mutation genetics, Ovarian Neoplasms genetics
- Abstract
Annotating genomic sequence alterations is sometimes a difficult decision, particularly in missense variants with uncertain pathogenic significance and also in those presumed as germline pathogenic variants. We here suggest that mutation spectrum may also be useful for judging them. From the public databases, 982 BRCA1/1861 BRCA2 germline missense variants and 294 BRCA1/420 BRCA2 somatic missense variants were obtained. We then compared their mutation spectra, i.e., the frequencies of two transition- and four transversion-type mutations, in each category. Intriguingly, in BRCA1 variants, A:T to C:G transversion, which was relatively frequent in the germline, was extremely rare in somatic, particularly breast cancer, cells (p = .03). Conversely, A:T to T:A transversion was most infrequent in the germline, but not rare in somatic cells. Thus, BRCA1 variants with A:T to T:A transversion may be suspected as somatic, and those with A:T to C:G as being in the germline. These tendencies of mutation spectrum may also suggest the biological and chemical origins of the base alterations. On the other hand, unfortunately, variants of uncertain significance (VUS) were not distinguishable by mutation spectrum. Our findings warrant further and more detailed studies., (© 2024 The Author(s). Environmental and Molecular Mutagenesis published by Wiley Periodicals LLC on behalf of Environmental Mutagenesis and Genomics Society.)
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- 2024
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10. Retroperitoneal leiomyosarcoma mimicking an ovarian tumor diagnosed using a negative ovarian pedicle sign.
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Mitsuo K, Kaneko H, Tsukamoto M, Asami Y, Miyazawa A, Miyashita K, Onoda G, Yamashita H, Hatano M, Kamiyama M, and Okuda S
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Retroperitoneal leiomyosarcoma (RPLMS) is rare and usually presents as a large abdominal mass with poor clinical symptoms. Radiological findings of an RPLMS arising in the pelvis of a woman resemble those of adnexal tumors. Herein, we present a case of RPLMS mimicking an adnexal tumor which was differentiated from having an ovarian origin as the right ovarian vein was passing through the tumor but there was no direct vascular connection with the tumor. Therefore, it is important to identify the ovarian vein to distinguish between these tumors., (© 2024 The Authors.)
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- 2024
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11. Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3).
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Ueno A, Onishi Y, Mise K, Yamaguchi S, Kanno A, Nojima I, Higuchi C, Uchida HA, Shikata K, Miyamoto S, Nakatsuka A, Eguchi J, Hida K, Katayama A, Watanabe M, Nakato T, Tone A, Teshigawara S, Matsuoka T, Kamei S, Murakami K, Shimizu I, Miyashita K, Ando S, Nunoue T, and Wada J
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- Humans, Male, Female, Middle Aged, Aged, Prognosis, Disease Progression, Follow-Up Studies, Diabetic Nephropathies blood, Diabetic Nephropathies etiology, Diabetic Nephropathies diagnosis, Angiotensin-Converting Enzyme 2 blood, Biomarkers blood, Glomerular Filtration Rate, Peptidyl-Dipeptidase A blood
- Abstract
Introduction: ACE cleaves angiotensin I (Ang I) to angiotensin II (Ang II) inducing vasoconstriction via Ang II type 1 (AT1) receptor, while ACE2 cleaves Ang II to Ang (1-7) causing vasodilatation by acting on the Mas receptor. In diabetic kidney disease (DKD), it is still unclear whether plasma or urine ACE2 levels predict renal outcomes or not., Research Design and Methods: Among 777 participants with diabetes enrolled in the Urinary biomarker for Continuous And Rapid progression of diabetic nEphropathy study, the 296 patients followed up for 9 years were investigated. Plasma and urinary ACE2 levels were measured by the ELISA. The primary end point was a composite of a decrease of estimated glomerular filtration rate (eGFR) by at least 30% from baseline or initiation of hemodialysis or peritoneal dialysis. The secondary end points were a 30% increase or a 30% decrease in albumin-to-creatinine ratio from baseline to 1 year., Results: The cumulative incidence of the renal composite outcome was significantly higher in group 1 with lowest tertile of plasma ACE2 (p=0.040). Group 2 with middle and highest tertile was associated with better renal outcomes in the crude Cox regression model adjusted by age and sex (HR 0.56, 95% CI 0.31 to 0.99, p=0.047). Plasma ACE2 levels demonstrated a significant association with 30% decrease in ACR (OR 1.46, 95% CI 1.044 to 2.035, p=0.027) after adjusting for age, sex, systolic blood pressure, hemoglobin A1c, and eGFR., Conclusions: Higher baseline plasma ACE2 levels in DKD were protective for development and progression of albuminuria and associated with fewer renal end points, suggesting plasma ACE2 may be used as a prognosis marker of DKD., Trial Registration Number: UMIN000011525., Competing Interests: Competing interests: JW receives speaker honoraria from AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Kyowa Kirin, Novo Nordisk, and Mitsubishi Tanabe, and receives grant support from Bayer, Chugai, Kyowa Kirin, Otsuka, Shionogi, Sumitomo, and Mitsubishi Tanabe., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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12. The Impact of Microvascular Resistance Reserve on the Outcome of Patients With STEMI.
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Tsai TY, Aldujeli A, Haq A, Knokneris A, Briedis K, Hughes D, Unikas R, Renkens M, Revaiah PC, Tobe A, Miyashita K, Sharif F, Garg S, Onuma Y, and Serruys PW
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- Humans, Male, Female, Prospective Studies, Aged, Middle Aged, Treatment Outcome, Time Factors, Risk Factors, Prevalence, Coronary Vessels physiopathology, Coronary Vessels diagnostic imaging, Risk Assessment, ST Elevation Myocardial Infarction physiopathology, ST Elevation Myocardial Infarction therapy, ST Elevation Myocardial Infarction mortality, ST Elevation Myocardial Infarction diagnosis, Microcirculation, Vascular Resistance, Predictive Value of Tests, Coronary Circulation, Percutaneous Coronary Intervention adverse effects, Thermodilution, Coronary Artery Disease physiopathology, Coronary Artery Disease therapy, Coronary Artery Disease mortality, Coronary Artery Disease diagnosis
- Abstract
Background: Microvascular resistance reserve (MRR) can characterize coronary microvascular dysfunction (CMD); however, its prognostic impact in ST-segment elevation myocardial infarction (STEMI) patients remains undefined., Objectives: This study sought to investigate the prevalence of CMD in STEMI patients and to elucidate the prognostic performance of MRR., Methods: This prospective cohort study enrolled 210 STEMI patients with multivessel disease who underwent successful revascularization and returned at 3 months for coronary physiology assessments with bolus thermodilution. The prevalence of CMD (MRR <3) and the association between MRR and major adverse cardiovascular and cerebrovascular events (MACCEs) at 12 months were investigated., Results: The median age of patients was 65 years, and 59.5% were men. At the 3-month follow-up, 56 patients (27%) had CMD (MRR <3.0). The number of MACCEs at 12 months was higher in patients with vs without CMD (48.2% vs 11.0%; P < 0.001). MRR was independently associated with 12-month MACCEs (HR: 0.45 per unit increase; 95% CI: 0.31-0.67; P < 0.001) and with stroke, heart failure, and poorer recovery in left ventricular systolic function. The areas under the receiver-operating characteristic curves for predicting MACCEs at 12 months with fractional flow reserve, coronary flow reserve (CFR), the index of microvascular resistance (IMR), and MRR were 0.609, 0.762, 0.781, and 0.743, respectively. The prognostic performance of CFR, IMR, and MRR were all comparable., Conclusions: The novel parameter MRR is a prognostic marker of MACCEs in STEMI patients with a comparable performance to CFR and IMR. (Impact of TMAO Serum Levels on Hyperemic IMR in STEMI Patients [TAMIR]; NCT05406297)., Competing Interests: Funding Support and Author Disclosures The study was sponsored by the Lithuanian University of Health Sciences. Dr Aldujeli recently held shares in Pfizer Inc. Dr Unikas is the President of the National Interventional Cardiology Association of Lithuania. Dr Tobe has received research grants from the Fukuda Foundation for Medical Technology. Dr Miyashita has received research grants from OrbusNeich Medical K.K. outside the submitted work. Dr Sharif has received grants from SFI Infrastructure 17/RI/5353. Dr Garg has received consulting fees from Biosensors outside the submitted work. Dr Serruys has received consulting fees from SMT, Novartis, Xeltis, Merillife, and Philips outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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13. Frequency of periprocedural myocardial injury and infarction stratified by cardiac troponin I and cardiac troponin T.
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Revaiah PC, Tsai TY, Wang B, Renkens M, Kageyama S, Wlodarczak A, Lemoine J, Mollmann H, Sabate M, Sharif F, Zaman A, Wykrzykowska J, Benit E, Qiang HX, Miyashita K, Tobe A, Muramatsu T, Tanabe K, Ozaki Y, Garg S, McEvoy JW, Neumann FJ, Baumbach A, Smits PC, Stone G, Onuma Y, and Serruys PW
- Abstract
Background: There are different definitions of periprocedural myocardial infarction (PPMI) both in terms of thresholds for cardiac biomarkers and the ancillary criteria for myocardial ischemia. Cardiac Troponin I (cTnI) and cardiac Troponin T (cTnT) are used interchangeably to diagnose PPMI., Objectives: This study evaluated the frequency of periprocedural myocardial injury and infarction as defined by the Society of Cardiovascular Angiography & Interventions (SCAI), the Academic Research Consortium-2 (ARC-2), and the 4th Universal definition of MI (4UDMI) stratified using cTnT versus cTnI, among patients with chronic coronary syndrome (CCS) and unstable angina., Results: Among 830 patients, PPMI rates according to the SCAI, ARC2 and 4UDMI criteria were 4.34 %, 2.05 %, and 4.94 % respectively, with higher rates seen for all definitions when using cTnI versus cTnT (SCAI: 9.84 % vs. 1.91 %, p < 0.001; ARC 2: 3.15 % vs. 1.56 %, p = 0.136; and 4UDMI 5.91 % vs. 4.51 %, p = 0.391). Minor and major periprocedural myocardial injury was respectively observed in 58.31 % and 27.10 % of patients, with rates of both significantly higher when using cTnI versus cTnT (Minor: 69.29 % vs. 53.47 %, p < 0.001, Major: 49.21 % vs. 17.36 %, p < 0.001)., Conclusions: Among patients with CCS and unstable angina, PPMIs defined by SCAI occurred more frequently when using cTnI as opposed to cTnT, whereas the type of troponin had no impact on the incidence of PPMIs according to the ARC-2 and 4UDMI., Competing Interests: Declaration of competing interest Dr. Ninomiya reports a grant from Abbott Medical Japan outside the submitted work. Dr. Kotoku has received a grant for studying overseas from Fukuda Foundation for Medical Technology. Dr. Serruys reports institutional grants from Sinomedical Sciences Technology, SMT (Sahajanand Medical technologies), Meril Life sciences, Philips/Volcano, Xeltis, and HeartFlow, outside the submitted work. Dr. Onuma reports institutional grants from Sinomedical Sciences Technology, SMT (Sahajanand Medical technologies), Meril Life sciences, Philips/Volcano, Xeltis, and HeartFlow, outside the submitted work. Dr. Sabate is a consultant for Abbott vascular and iVascular outside the submitted work. Dr. Mollmann is a consultant for Abbott vascular, Boston Scientific, Medtronic and SMT outside the submitted work., (Copyright © 2024. Published by Elsevier Inc.)
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- 2024
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14. Calibration of commercial fisheries echo sounders using seabed backscatter for the estimation of fishery resources.
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Zhu Y, Kenji M, Tokeshi T, Nishiyama Y, Kasai A, Matsuura M, Horie H, and Miyashita K
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- Calibration, Animals, Acoustics instrumentation, Fishes physiology, Conservation of Natural Resources methods, Fisheries
- Abstract
Acoustic methods are often used for fisheries resource surveys to investigate fish stocks in a wide area. Commercial fisheries echo sounders, which are installed on most small fishing vessels, are used to record a large amount of data during fishing trips. Therefore, it can be used to collect the basic information necessary for stock assessment for a wide area and frequently. To carry out the quantification for the fisheries echo sounder, we devised a simple method using the backscattering strength of the seabed to perform calibration periodically and easily. In this study, seabed secondary reflections were used instead of primary reflection because the fisheries echo sounders were not equipped with a time-varied gain (TVG) function, and the primary backscattering strength of the seabed was saturated. It was also necessary to use standard values of seabed backscattering strength averaged over a certain area for calibration to eliminate some of the effects of differences in seabed sediment and vessel motions. By using standard values of the seabed secondary reflections, the fisheries echo sounder was calibrated accurately. Our study can provide a reliable framework to calibrate commercial fisheries echo sounders, to improve the estimation and management of fishery resources., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zhu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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15. Quantitative coronary computed tomography assessment for differentiating between total occlusions and severe stenoses.
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Masuda S, Revaiah PC, Kageyama S, Tsai TY, Miyashita K, Tobe A, Puskas JD, Teichgräber U, Schneider U, Doenst T, Tanaka K, De Mey J, La Meir M, Mushtaq S, Bartorelli AL, Pompilio G, Garg S, Andreini D, Onuma Y, and Serruys PW
- Abstract
Backgrounds: The impact of quantitative assessment to differentiate total occlusions (TOs) from severe stenoses on coronary computed tomography angiography (CCTA) remains unknown., Objective: This study investigated whether quantitative characteristics assessed on CCTA could help differentiate a TO from a severe stenosis on invasive coronary angiography (ICA)., Methods: This study is a sub-analysis of the FASTTRACK CABG (NCT04142021) in which both CCTA and ICA were routinely performed. Quantitative analysis was performed with semi-automated CCTA plaque-analysis software. Blinded analysts compared TOs on CCTA, defined as a complete lack of contrast opacification within the coronary occlusion, with corresponding ICA., Results: Eighty-four TOs were seen on CCTA in 59 of the 114 patients enrolled in the trial. The concordance in diagnosing a TO between ICA and CCTA was 56.0% (n = 47). Compared to severe stenoses, TOs had a significantly longer lesion length (25.1 ± 23.0 mm vs 9.4 ± 11.2 mm, P < 0.001). The best cut-off value to differentiate a TO from severe stenosis was a lesion length of 5.5 mm (area under the curve 0.77, 95% CI: 0.66-0.87), with a 91.1% sensitivity and 61.1% specificity. Dense calcium percentage atheroma volume (PAV) was significantly higher in TOs compared to severe stenoses (18.7 ± 19.6% vs. 6.6 ± 13.0%, P < 0.001), whilst the opposite was seen for fibro-fatty PAV (31.3 ± 14.2% vs. 19.5 ± 10.5%, P < 0.001). On a multivariable logistic regression analysis, lesion length (>5.5 mm) was the only parameter associated with differentiating a TO from a severe stenosis., Conclusion: In quantitative CCTA analysis, a lesion length >5.5 mm was the only independent predictor differentiating a TO from a severe stenosis., Nct Registration Number: NCT04142021., Competing Interests: Declaration of competing interest Dr. Masuda received a grant from TERUMO corporation outside the submitted work. Dr. Miyashita received research grants from OrbusNeich Medical K.K., outside the submitted work. Dr. Tobe received a grant from the Fukuda foundation for medical technology. Dr. Scot received consultancy fees from Biosensors. Dr. P.W.S. reported consulting fees from SMT, Novartis, Meril Life, Philips, and Xeltis. All other authors have nothing to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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16. Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature.
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Obata Y, Takemoto M, Sakaue TA, Kawata S, Mukai K, Miyashita K, Kozawa J, Nishizawa H, and Shimomura I
- Abstract
Immune checkpoint inhibitor (ICI)-related type 1 diabetes is an immune-related adverse event (irAE), occurring in slightly less than 1% of patients undergoing ICI therapy. Most cases develop during ICI treatment, with occurrences long after discontinuation being extremely rare. A 76-year-old woman, with no history of glucose tolerance issues, was diagnosed with lung adenocarcinoma with pleural invasion and underwent chemotherapy, including atezolizumab, an anti-programmed death-ligand 1 antibody. This treatment was discontinued due to disease progression, although she continued with other chemotherapy regimens. Approximately 5.5 months (166 days) after her last atezolizumab dose, she developed diabetic ketoacidosis, fulfilling the diagnostic criteria for fulminant type 1 diabetes. Anti-glutamic acid decarboxylase antibodies were positive. The patient carried susceptibility human leukocyte antigen (HLA) haplotypes, which are associated with type 1 diabetes. To date, including our patient, only nine cases of ICI-related type 1 diabetes developed after ICI discontinuation have been precisely reported. Eight cases originated from East Asia, with six exhibiting fulminant type 1 diabetes, and seven tested negative for islet-related autoantibodies. The reported cases were independent of ICI types, cycle number, or HLA haplotypes. Median time from the last ICI administration to diabetes onset was 4 months (range: 2-7 months). Although reports of cases occurring after ICI discontinuation are currently limited, their frequency may increase with the wider use of ICIs and improved survival rates of patients post-treatment. Therefore, it is crucial to remain vigilant for the development of ICI-related type 1 diabetes, not only during ICI administration, but also long after discontinuation., Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-024-00719-4., Competing Interests: Conflict of interestThe authors declare that they have no conflicts of interest., (© The Japan Diabetes Society 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
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- 2024
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17. Quantification of lipoprotein lipase in mouse plasma with a sandwich enzyme-linked immunosorbent assay.
- Author
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Kimura T, Miyashita K, Fukamachi I, Fukamachi K, Ogura K, Yokoyama E, Tsunekawa K, Nagasawa T, Ploug M, Yang Y, Song W, Young SG, Beigneux AP, Nakajima K, and Murakami M
- Subjects
- Animals, Mice, Rats, Receptors, Lipoprotein metabolism, Receptors, Lipoprotein genetics, Mice, Knockout, Lipoprotein Lipase metabolism, Lipoprotein Lipase blood, Enzyme-Linked Immunosorbent Assay methods, Antibodies, Monoclonal immunology
- Abstract
To support in vivo and in vitro studies of intravascular triglyceride metabolism in mice, we created rat monoclonal antibodies (mAbs) against mouse LPL. Two mAbs, mAbs 23A1 and 31A5, were used to develop a sandwich ELISA for mouse LPL. The detection of mouse LPL by the ELISA was linear in concentrations ranging from 0.31 ng/ml to 20 ng/ml. The sensitivity of the ELISA made it possible to quantify LPL in serum and in both pre-heparin and post-heparin plasma samples (including in grossly lipemic samples). LPL mass and activity levels in the post-heparin plasma were lower in Gpihbp1
-/- mice than in wild-type mice. In both groups of mice, LPL mass and activity levels were positively correlated. Our mAb-based sandwich ELISA for mouse LPL will be useful for any investigator who uses mouse models to study LPL-mediated intravascular lipolysis., Competing Interests: Conflict of interest The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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18. Editorial: Are inflammatory biomarkers following bioresorbable scaffold or drug-eluting stent implantation directly linked to outcomes?
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Serruys PW, Miyashita K, Garg S, and Onuma Y
- Subjects
- Humans, Absorbable Implants, Everolimus, Biomarkers, Drug-Eluting Stents, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease surgery
- Published
- 2024
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19. A novel class of inhibitors that disrupts the stability of integrin heterodimers identified by CRISPR-tiling-instructed genetic screens.
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Mattson NM, Chan AKN, Miyashita K, Mukhaleva E, Chang WH, Yang L, Ma N, Wang Y, Pokharel SP, Li M, Liu Q, Xu X, Chen R, Singh P, Zhang L, Elsayed Z, Chen B, Keen D, Pirrotte P, Rosen ST, Chen J, LaBarge MA, Shively JE, Vaidehi N, Rockne RC, Feng M, and Chen CW
- Subjects
- Humans, Cell Membrane, Clustered Regularly Interspaced Short Palindromic Repeats genetics
- Abstract
The plasma membrane is enriched for receptors and signaling proteins that are accessible from the extracellular space for pharmacological intervention. Here we conducted a series of CRISPR screens using human cell surface proteome and integrin family libraries in multiple cancer models. Our results identified ITGAV (integrin αV) and its heterodimer partner ITGB5 (integrin β5) as the essential integrin α/β pair for cancer cell expansion. High-density CRISPR gene tiling further pinpointed the integral pocket within the β-propeller domain of ITGAV for integrin αVβ5 dimerization. Combined with in silico compound docking, we developed a CRISPR-Tiling-Instructed Computer-Aided (CRISPR-TICA) pipeline for drug discovery and identified Cpd_AV2 as a lead inhibitor targeting the β-propeller central pocket of ITGAV. Cpd_AV2 treatment led to rapid uncoupling of integrin αVβ5 and cellular apoptosis, providing a unique class of therapeutic action that eliminates the integrin signaling via heterodimer dissociation. We also foresee the CRISPR-TICA approach to be an accessible method for future drug discovery studies., (© 2024. The Author(s).)
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- 2024
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20. Spot urinary sodium-to-potassium ratio is associated with blood pressure levels in healthy adolescents: the Wakayama Study.
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Zhang Y, Miyai N, Utsumi M, Miyashita K, and Arita M
- Subjects
- Male, Female, Middle Aged, Humans, Adolescent, Aged, Blood Pressure physiology, Sodium urine, Sodium Chloride, Potassium urine, Sodium Chloride, Dietary adverse effects, Hypertension diagnosis, Hypertension epidemiology
- Abstract
The spot urinary sodium-to-potassium (Na/K) ratio is a simple measure of salt loading and has been shown to be associated with elevated blood pressure (BP) in middle-aged and older adults. This study aimed to evaluate the association between the spot urinary Na/K ratio and BP in 457 healthy adolescents aged 12-15 years in a school-based setting. The mean urinary Na/K ratio was 4.99 ± 2.76, and no significant difference was found between the boys and girls. When the participants were stratified based on urinary Na/K ratio quartile, age- and sex-adjusted systolic and diastolic BP gradually increased as Na/K ratio increased (systolic BP: 106.1, 106.9, 108.2, and 111.5 mmHg, P
trend < 0.001; diastolic BP: 62.0, 62.4, 63.1, 64.3 mmHg, Ptrend = 0.022). The systolic and diastolic BP were more closely associated with urinary Na/K ratio than with Na and K levels, as well as estimated daily salt intake. In the multiple regression analysis, the urinary Na/K ratio was significantly associated with systolic BP (β = 0.144, P < 0.001) and diastolic BP (β = 0.114, P = 0.015) independent of potential confounding factors. An additional subgroup analysis revealed that the BP of the group with both high salt intake (≥8.5 g/day) and high Na/K ratio (≥6.60) was significantly higher than that of the group with high salt intake alone (systolic BP, 115.0 vs. 109.1 mmHg, P < 0.001; diastolic BP, 66.0 vs. 62.5 mmHg, P = 0.017). These results suggest that the urinary Na/K ratio is associated with BP levels in healthy adolescents and may be useful for assessing salt loading and its effects on BP elevation., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)- Published
- 2024
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21. Fucoxanthin Alleviates Dextran Sulfate Sodium-Induced Colitis and Gut Microbiota Dysbiosis in Mice.
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Yang YH, Chen C, Zheng Y, Wu ZJ, Zhou MQ, Liu XY, Miyashita K, Duan DL, and Du L
- Subjects
- Mice, Animals, Dextran Sulfate adverse effects, Dysbiosis chemically induced, Dysbiosis drug therapy, Colon metabolism, Mice, Inbred C57BL, Disease Models, Animal, Gastrointestinal Microbiome, Colitis chemically induced, Colitis drug therapy, Colitis metabolism, Xanthophylls
- Abstract
The purpose of this study was to evaluate the preventive role and underlying mechanisms of fucoxanthin (Fx) on dextran sulfate sodium (DSS)-induced colitis in mice. The present data demonstrated that oral administration of Fx (50 and 200 mg/kg body weight/day) for 36 days significantly alleviated the severity of colitis in DSS-treated mice, as evidenced by attenuating body weight loss, bloody stool, diarrhea, shortened colon length, colonic epithelium distortion, a thin mucus layer, goblet cell depletion, damaged crypts, and extensive infiltration of inflammatory cells in the colonic mucosa. Additionally, Fx notably relieved DSS-induced intestinal epithelial barrier dysfunction via maintaining the tight junction function and preventing excessive apoptosis of colonic epithelial cells. Moreover, Fx effectively diminished colonic inflammation and oxidative stress in DSS-treated mice, and its mechanisms might be due to blunting the activation of NF-κB and NLRP3 inflammasome signaling pathways. Furthermore, Fx also modulates DSS-induced gut microbiota dysbiosis via recovering the richness and diversity of gut microbiota and reshaping the structure of gut microbiota, such as increasing the Firmicutes and Bacteroidota (F/B) ratio and elevating the relative abundance of some potential beneficial bacteria, including Lactobacillaceae and Lachnospiraceae . Overall, Fx might be developed as a promising functional ingredient to prevent colitis and maintain intestinal homeostasis.
- Published
- 2024
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22. Impact of preexisting interstitial lung disease on mortality in COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study.
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Miyashita K, Hozumi H, Furuhashi K, Nakatani E, Inoue Y, Yasui H, Suzuki Y, Karayama M, Enomoto N, Fujisawa T, Inui N, Ojima T, and Suda T
- Subjects
- Adult, Humans, Pandemics, COVID-19 Vaccines, SARS-CoV-2, Retrospective Studies, Lung Neoplasms, COVID-19 complications, Lung Diseases, Interstitial diagnosis, Lung Diseases, Interstitial epidemiology, Lung Diseases, Interstitial complications
- Abstract
Background: COVID-19 patients with preexisting interstitial lung disease (ILD) were reported to have a high mortality rate; however, this was based on data from the early stages of the pandemic. It is uncertain how their mortality rates have changed with the emergence of new variants of concern as well as the development of COVID-19 vaccines and treatments. It is also unclear whether having ILD still poses a risk factor for mortality. As COVID-19 continues to be a major concern, further research on COVID-19 patients with preexisting ILD is necessary., Methods: We extracted data on COVID-19 patients between January 2020-August 2021 from a Japanese nationwide insurance claims database and divided them into those with and without preexisting ILD. We investigated all-cause mortality of COVID-19 patients with preexisting ILD in wild-type-, alpha-, and delta-predominant waves, to determine whether preexisting ILD was associated with increased mortality., Results: Of the 937,758 adult COVID-19 patients, 7,333 (0.8%) had preexisting ILD. The proportion of all COVID-19 patients who had preexisting ILD in the wild-type-, alpha-, and delta-predominant waves was 1.2%, 0.8%, and 0.3%, respectively, and their 60-day mortality was 16.0%, 14.6%, and 7.5%, respectively. The 60-day mortality significantly decreased from the alpha-predominant to delta-predominant waves (difference - 7.1%, 95% confidence intervals (CI) - 9.3% to - 4.9%). In multivariable analysis, preexisting ILD was independently associated with increased mortality in all waves with the wild-type-predominant, odds ratio (OR) 2.10, 95% CI 1.91-2.30, the alpha-predominant wave, OR 2.14, 95% CI 1.84-2.50, and the delta-predominant wave, OR 2.10, 95%CI 1.66-2.66., Conclusions: All-cause mortality rates for COVID-19 patients with preexisting ILD decreased from the wild-type- to the more recent delta-predominant waves. However, these patients were consistently at higher mortality risk than those without preexisting ILD. We emphasize that careful attention should be given to patients with preexisting ILD despite the change in the COVID-19 environment., (© 2024. The Author(s).)
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- 2024
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23. Spatial and economic quantification of provisioning service by eelgrass beds in Lake Notoro, Hokkaido, Japan.
- Author
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Ito K, Sonoki S, Minami K, Chiba S, Shirakawa H, Kawajiri T, Zhu Y, and Miyashita K
- Subjects
- Animals, Japan, Lakes, Fisheries, Ecosystem, Pandalidae
- Abstract
Eelgrass beds provide a habitat for many high-value fishery resources, and provisioning services, one of the ecosystem services, need to be quantified. However, few examples have been evaluated spatially. We determined the distribution of eelgrass beds in Lake Notoro, a marine lagoon in Hokkaido, Japan, and quantified the provisioning services by the eelgrass beds in relation to Pandalus latirostris, a fishery resource. Acoustic measurement surveys of the eelgrass beds and catch surveys of the shrimp were conducted in July and August 2015. The relationship between catch per unit effort (CPUE) of shrimp and the distribution of eelgrass beds was shown. The estimated distribution area of eelgrass beds was 7.07 km
2 . Shrimp was frequently caught at water depths of 3-5 m, approximately 200 m from the edge of the eelgrass beds. The expected catch of shrimp in the fishing area of Lake Notoro in 2015 was 25.37 tons and US$ 463.6 thousand. Eelgrass beds were found to affect the fisheries production not only on the inside but also at the edge and outside. The entire coastal space should be evaluated, while considering the effect of the distribution of eelgrass beds, to quantify the provisioning services., (© 2024. The Author(s).)- Published
- 2024
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24. Multiple Lymphaticovenular Anastomoses for Chyluria in Klippel-Trenaunay Syndrome.
- Author
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Miyashita K, Kadota H, Hanada M, Inatomi Y, Oryoji C, Morishita A, Yoshida S, Oda Y, and Kinoshita I
- Subjects
- Humans, Female, Child, Aged, Hematuria complications, Lower Extremity blood supply, Serum Albumin, Klippel-Trenaunay-Weber Syndrome complications, Klippel-Trenaunay-Weber Syndrome surgery, Klippel-Trenaunay-Weber Syndrome diagnosis, Lymphedema surgery, Lymphedema complications, Fistula complications
- Abstract
Abstract: Klippel-Trenaunay syndrome (KTS) is characterized by port-wine stains, mixed vascular malformations, and soft tissue and bone hypertrophy. Klippel-Trenaunay syndrome is occasionally complicated by chyluria, for which there is no effective treatment currently. We report a case of KTS complicated by intractable chyluria and hematuria due to a lymphatic-ureteral fistula. The patient was successfully treated with multiple lymphaticovenular anastomoses (LVAs).A 66-year-old woman with an enlarged left lower extremity since childhood was diagnosed with KTS. At 60 years of age, she developed chyluria (urine albumin, 2224 μg/mL) and hematuria. Lymphoscintigraphy showed a lymphatic-ureteral fistula near the ureterovesical junction. Conservative treatment was ineffective. She also developed left lower extremity lymphedema, which gradually worsened. Leg cellulitis and purulent pericarditis developed because of hypoalbuminemia (minimum serum albumin level, 1.3 g/dL).We performed 14 LVAs in 2 surgeries to reduce lymphatic fluid flow through the lymphatic-ureteral fistula. The chyluria and hematuria resolved soon after the second operation, and the urine albumin level decreased (3 μg/mL). After 28 months, she had no chyluria or hematuria recurrence and her serum albumin level improved (3.9 g/dL). Multiple LVAs can definitively treat chyluria caused by a lymphatic-ureteral fistula in patients with KTS., Competing Interests: Conflicts of interest and sources of funding: The authors received no grants for the research, authorship, and/or publication of this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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25. Evaluation of changes in glycemic control and diabetic complications over time and factors associated with the progression of diabetic complications in Japanese patients with juvenile-onset type 1 diabetes mellitus.
- Author
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Masuda T, Katakami N, Watanabe H, Taya N, Miyashita K, Takahara M, Kato K, Kuroda A, Matsuhisa M, and Shimomura I
- Subjects
- Humans, Adolescent, Young Adult, Adult, Glycated Hemoglobin, Carotid Intima-Media Thickness, Ankle Brachial Index adverse effects, Glycemic Control adverse effects, Glycated Serum Albumin, Japan, Pulse Wave Analysis adverse effects, Cholesterol, Risk Factors, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 2, Diabetes Complications complications, Diabetic Nephropathies complications
- Abstract
Background: This study aimed to evaluate the changes in glycemic control and diabetic complications over time in Japanese patients with juvenile-onset type 1 diabetes mellitus and to clarify the factors associated with the progression of diabetic complications., Methods: We tracked 129 patients with type 1 diabetes mellitus (21.8 ± 4.1 years old [mean ± SD] with a diabetes duration of 12.6 ± 5.7 years) for up to 19 years and analyzed data on glycated hemoglobin (HbA1c) and indicators related to the severity of diabetic complications (estimated glomerular filtration rate [eGFR], urinary albumin excretion rate [UAE], carotid intima-media thickness [CIMT], and brachial-ankle pulse wave velocity [baPWV]) using linear mixed model and decision tree analysis., Results: Although the HbA1c and UAE levels improved over time, the eGFR, CIMT, and baPWV worsened. Decision tree analysis showed that HbA1c and the glycoalbumin/HbA1c ratio for eGFR; HbA1c and systolic blood pressure for UAE; low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio, glycoalbumin/HbA1c ratio, and body mass index (BMI) for CIMT; and HbA1c for baPWV were associated factors., Conclusions: In this retrospective observational study, glycemic control and albuminuria improved; however, renal function and arteriosclerosis worsened over time. HbA1c levels, glycemic excursion, and blood pressure are associated with nephropathy progression. HbA1c levels, glycemic excursion, lipid levels, and BMI are associated with the progression of atherosclerosis., (© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
- Published
- 2024
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26. Viscosity-Induced Emission of 5-(Diarylmethylene)imidazolone with Extended Conjugation via Attachment of N-Methylpyrrole at the 2-Position.
- Author
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Ikejiri M, Yoshimizu A, Shiota F, Nagayama A, Fujisaka A, Kuboki Y, and Miyashita K
- Subjects
- Viscosity, Molecular Structure, Lipid Bilayers chemistry, Green Fluorescent Proteins chemistry, Pyrroles chemistry, Pyrroles chemical synthesis, Imidazoles chemistry, Imidazoles chemical synthesis
- Abstract
We have developed a series of 2-monoaryl-5-diarylmethylene analogs of the green fluorescent protein chromophore to study their viscosity-induced emission (VIE) properties. The analogs were synthesized by a condensation with methyl imidate and N-(diarylmethylene)glycinate. Among the analogs, the N-methylpyrrol-2-yl-substituted analog 1h induced the most remarkable VIE behavior in triglyceride and lipid bilayers probably due to the high π-electron-rich property of the pyrrole ring. The pyrrole substituent in imidazolone analogs can be expected to become a common template for introducing VIE behavior.
- Published
- 2024
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27. Murray law-based quantitative flow ratio to assess left main bifurcation stenosis: selecting the angiographic projection matters.
- Author
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Kotoku N, Ninomiya K, Ding D, O'Leary N, Tobe A, Miyashita K, Masuda S, Kageyama S, Garg S, Leipsic JA, Mushtaq S, Andreini D, Tanaka K, de Mey J, Wijns W, Tu S, Piazza N, Onuma Y, and Serruys PW
- Subjects
- Humans, Constriction, Pathologic, Predictive Value of Tests, Coronary Angiography methods, Computed Tomography Angiography methods, Coronary Vessels diagnostic imaging, Severity of Illness Index, Coronary Artery Disease diagnostic imaging, Fractional Flow Reserve, Myocardial physiology, Coronary Stenosis diagnostic imaging
- Abstract
Murray law-based quantitative flow ratio (µQFR) assesses fractional flow reserve (FFR) in bifurcation lesions using a single angiographic view, enhancing the feasibility of analysis; however, accuracy may be compromised in suboptimal angiographic projections. FFR
CT is a well-validated non-invasive method measuring FFR from coronary computed tomographic angiography (CCTA). We evaluated the feasibility of µQFR in left main (LM) bifurcations, the impact of the optimal/suboptimal fluoroscopic view with respect to CCTA, and its diagnostic concordance with FFRCT . In 300 patients with three-vessel disease, the values of FFRCT and µQFR were compared at distal LM, proximal left anterior descending artery (pLAD) and circumflex artery (pLCX). The optimal viewing angle of LM bifurcation was defined on CCTA by 3-dimensional coordinates and converted into a 2-dimensional fluoroscopic view. The best fluoroscopic projection was considered the closest angulation to the optimal viewing angle on CCTA. µQFR was successfully computed in 805 projections. In the best projections, µQFR sensitivity was 88.2% (95% CI 76.1-95.6) and 84.8% (71.1-93.7), and specificity was 96.8% (93.8-98.6) and 97.2% (94.4-98.9), in pLAD and pLCX, respectively, with regard to FFRCT . The AUC of µQFR for predicting FFRCT ≤ 0.80 tended to be improved using the best versus suboptimal projections (0.94 vs. 0.89 [p = 0.048] in pLAD; 0.94 vs. 0.88 [p = 0.075] in pLCX). Computation of µQFR in LM bifurcations using a single angiographic view showed high feasibility from post-hoc analysis of coronary angiograms obtained for clinical purposes. The fluoroscopic viewing angle influences the diagnostic performance of physiological assessment using a single angiographic view., (© 2023. The Author(s).)- Published
- 2024
- Full Text
- View/download PDF
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