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1. Comparison of Effectiveness Among Different Sodium‐Glucose Cotransoporter‐2 Inhibitors According to Underlying Conditions: A Network Meta‐Analysis of Randomized Controlled Trials

Author

Ryoma Kani, Atsuyuki Watanabe, Yoshihisa Miyamoto, Kentaro Ejiri, Masao Iwagami, Hisato Takagi, Leandro Slipczuk, Yusuke Tsugawa, Tadao Aikawa, and Toshiki Kuno

Subjects
CKD, cardiovascular death or hospitalizations for HF, diabetes, network meta‐analysis, SGLT2 inhibitors, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background To investigate the individual profile of each SGLT2 (sodium‐glucose cotransoporter‐2) inhibitor in patients with different backgrounds. Methods and Results This study included 21 placebo‐controlled randomized controlled trials with a total of 96 196 participants, investigating empagliflozin, ertugliflozin, dapagliflozin, canagliflozin, and sotagliflozin. The primary efficacy end point was the composite of cardiovascular death and hospitalizations for heart failure. The secondary efficacy end points were all‐cause death, cardiovascular death, hospitalizations for heart failure, kidney disease progression, and acute kidney injury. We conducted subgroup analyses based on the underlying comorbidities, including diabetes and chronic kidney disease. Safety end points were also assessed among SGLT2 inhibitors in the overall cohort. In the overall cohort, there were no significant differences in the primary efficacy outcome among the SGLT2 inhibitors, while empagliflozin (hazard ratio [HR], 0.70 [95% CI, 0.53–0.92]) and dapagliflozin (HR, 0.73 [95% CI, 0.56–0.96]) were associated with lower risk of acute kidney injury than sotagliflozin. The presence or absence of diabetes did not alter the results. In patients with chronic kidney disease, there were no differences in the efficacy outcomes among SGLT2 inhibitors, while in patients without chronic kidney disease, empagliflozin was associated with lower risk of the primary outcome compared with ertugliflozin (HR, 0.77 [95% CI, 0.60–0.98]). For safety outcomes, no significant differences were observed in amputation, urinary tract infection, genital infection, hypoglycemia, and diabetic ketoacidosis. Conclusions The differences in reducing cardiovascular and kidney outcomes as well as safety profiles across SGLT2 inhibitors were not consistently significant, although empagliflozin might be preferred in patients without chronic kidney disease. Further investigations are needed to better understand the mechanism and clinical effectiveness of each SGLT2 inhibitor in certain populations.

Published
2024
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2. Transcatheter Aortic Valve Replacement in Patients With or Without Active Cancer

Author

Tadao Aikawa, Toshiki Kuno, Aaqib H. Malik, Alexandros Briasoulis, Dhaval Kolte, Polydoros N. Kampaktsis, and Azeem Latib

Subjects
active cancer, bleeding, mortality, readmission, transcatheter aortic valve replacement, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Data on clinical outcomes after transcatheter aortic valve replacement (TAVR) in specific cancer types or the presence of metastatic disease remain sparse. This study aimed to investigate the impact of active cancer on short‐term mortality, complications, and readmission rates after TAVR across different cancer types. Methods and Results The authors assessed the Nationwide Readmissions Database for TAVR cases from 2012 to 2019. Patients were stratified by specific cancer types. Primary outcome was in‐hospital mortality. Secondary outcomes included bleeding requiring blood transfusion and readmissions at 30, 90, and 180 days after TAVR. Overall, 122 573 patients undergoing TAVR were included in the analysis, of whom 8013 (6.5%) had active cancer. After adjusting for potential confounders, the presence of active cancer was not associated with increased in‐hospital mortality (adjusted odds ratio [aOR], 1.06 [95% CI, 0.89–1.27]; P=0.523). However, active cancer was associated with an increased risk of readmission at 30, 90, and 180 days after TAVR and increased risk of bleeding requiring transfusion at 30 days. Active colon and any type of metastatic cancer were individually associated with readmissions at 30, 90, and 180 days after TAVR. At 30 days after TAVR, colon (aOR, 2.51 [95% CI, 1.68–3.76]; P

Published
2023
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5. Left ventricular outflow tract velocity time integral in hospitalized heart failure with preserved ejection fraction

Author

Kazunori Omote, Toshiyuki Nagai, Hiroyuki Iwano, Shingo Tsujinaga, Kiwamu Kamiya, Tadao Aikawa, Takao Konishi, Takuma Sato, Yoshiya Kato, Hirokazu Komoriyama, Yuta Kobayashi, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, and Toshihisa Anzai

Subjects
Heart failure with preserved ejection fraction, Left ventricular outflow tract velocity time integral, Prognosis risk stratification, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Aims The prognostic implication of left ventricular outflow tract velocity time integral (LVOT‐VTI) on admission in hospitalized heart failure with preserved ejection fraction (HFpEF) patients has not been determined. We sought to investigate whether LVOT‐VTI on admission is associated with worse clinical outcomes in hospitalized patients with HFpEF. Methods and results We studied consecutive 214 hospitalized HFpEF patients who had accessible LVOT‐VTI data on admission, from a prospective HFpEF‐specific multicentre registry. The primary outcome of interest was the composite of all‐cause death and readmission due to heart failure. During a median follow‐up period of 688 (interquartile range 162–810) days, the primary outcome occurred in 83 patients (39%). The optimal cut‐off value of LVOT‐VTI for the primary outcome estimated by receiver operating characteristic analysis was 15.8 cm. Lower LVOT‐VTI was significantly associated with the primary outcome compared with higher LVOT‐VTI (P = 0.005). Multivariable Cox regression analyses revealed that lower LVOT‐VTI was an independent determinant of the primary outcome (hazard ratio 0.94, 95% confidence interval 0.91–0.98). In multivariable linear regression, haemoglobin level was the strongest independent determinant of LVOT‐VTI among clinical parameters (β coefficient = −0.61, P = 0.007). Furthermore, patients with lower LVOT‐VTI and anaemia had the worst clinical outcomes among the groups (P < 0.001). Conclusions Lower admission LVOT‐VTI was an independent determinant of worse clinical outcomes in hospitalized HFpEF patients, indicating that LVOT‐VTI on admission might be useful for categorizing a low‐flow HFpEF phenotype and risk stratification in hospitalized HFpEF patients.

Published
2020
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6. Effects of Therapeutic Hypothermia on Normal and Ischemic Heart

Author

Kelly P. Yamada, Taro Kariya, Tadao Aikawa, and Kiyotake Ishikawa

Subjects
hypothermia, myocardial infarction, infarct size, endovascular, physiology, cardiac function, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Therapeutic hypothermia has been used for treating brain injury after out-of-hospital cardiac arrest. Its potential benefit on minimizing myocardial ischemic injury has been explored, but clinical evidence has yet to confirm positive results in preclinical studies. Importantly, therapeutic hypothermia for myocardial infarction is unique in that it can be initiated prior to reperfusion, in contrast to its application for brain injury in resuscitated cardiac arrest patients. Recent advance in cooling technology allows more rapid cooling of the heart than ever and new clinical trials are designed to examine the efficacy of rapid therapeutic hypothermia for myocardial infarction. In this review, we summarize current knowledge regarding the effect of hypothermia on normal and ischemic hearts and discuss issues to be solved in order to realize its clinical application for treating acute myocardial infarction.

Published
2021
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7. Procedural Volume and Outcomes After Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease—Report From the National Clinical Data (J‐PCI Registry)

Author

Tadao Aikawa, Kyohei Yamaji, Toshiyuki Nagai, Shun Kohsaka, Kiwamu Kamiya, Kazunori Omote, Taku Inohara, Yohei Numasawa, Kenichi Tsujita, Tetsuya Amano, Yuji Ikari, and Toshihisa Anzai

Subjects
mortality/survival, percutaneous coronary intervention, revascularization, unprotected left main coronary artery disease, volume‐outcome relationship, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background There is a limited evidence base to support the volume‐outcome relationship in patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery disease (UPLMD). This study aimed to evaluate the relationship between institutional and operator volume and in‐hospital outcomes in patients undergoing PCI for unprotected left main coronary artery disease. Methods and Results We analyzed characteristics and clinical outcomes of 24 320 patients undergoing PCI for unprotected left main coronary artery disease at 1102 hospitals by 7244 operators using data from the Japanese nationwide J‐PCI Registry (National PCI Data Registry) between January 2014 and December 2017. We classified institutions and operators into quartiles based on the mean annual volume of PCI. A generalized linear mixed‐effects model was used to evaluate the association between institutional and operator PCI volume and in‐hospital outcomes. Among the 24 320 patients, 4027 (16.6%), 6147 (25.3%), and 14 146 (58.2%) presented with ST‐segment–elevation myocardial infarction, non–ST‐segment–elevation acute coronary syndrome, and stable ischemic heart disease; their crude in‐hospital mortality was 15%, 3.1%, and 0.3%, respectively. Compared with patients in the lowest quartile of institutional volume (1–216 PCIs/y), the adjusted odds ratio of in‐hospital death in patients in the second (217–323 PCIs/y), third (324–487 PCIs/y), and fourth (488–3015 PCIs/y) quartile of institutional volume was 0.75 (95% CI, 0.51–1.10; P=0.14), 0.87 (95% CI, 0.57–1.34; P=0.54), and 0.51 (95% CI, 0.30–0.86; P=0.01), respectively. These findings were consistent in rates of in‐hospital death or any complication. Conversely, operator PCI volume was not significantly associated with in‐hospital outcomes. Conclusions Institutional rather than operator‐based PCI volume was associated with better in‐hospital outcomes in patients undergoing PCI for unprotected left main coronary artery disease.

Published
2020
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8. Which is the proper reference tissue for measuring the change in FDG PET metabolic volume of cardiac sarcoidosis before and after steroid therapy?

Author

Sho Furuya, Osamu Manabe, Hiroshi Ohira, Kenji Hirata, Tadao Aikawa, Masanao Naya, Ichizo Tsujino, Kazuhiro Koyanagawa, Toshihisa Anzai, Noriko Oyama-Manabe, and Tohru Shiga

Subjects
Cardiac sarcoidosis, 18F-Fluorodeoxyglucose, PET, Metabolic cardiac volume, Steroid therapy, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Abstract Background Cardiac sarcoidosis (CS) is a rare but potentially life-threatening disease that causes conduction disturbance, systolic dysfunction, and, most notably, sudden cardiac death. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) plays important roles not only in diagnosing CS but also in evaluating the effects of anti-inflammatory therapy. A volume-based analysis of parameters measured by FDG PET, so-called cardiac metabolic volume (CMV), has emerged as a new assessment tool. CMV is measured as the volume within the boundary determined by a reference tissue such as the liver and the blood pool uptake. However, there is a possibility that oral steroid therapy could lead to variations of the liver and the blood pool uptake. Here, we attempted to evaluate the steroid effects on the liver and the blood pool uptake. A total of 38 CS patients who underwent FDG PET/CT before and during steroid therapy were retrospectively enrolled. Volumes of interest (VOIs) were placed in the right lobe of the liver and descending aorta (DA). The maximum standardized uptake value (SUVmax), SUVmean, and SUVpeak of the liver and DA were compared between time points before and during steroid therapy. Results The SUVmax, SUVmean, and SUVpeak of the liver during steroid therapy significantly increased from the time point before the therapy (SUVmax 3.5 ± 0.4 vs. 3.8 ± 0.6, p = 0.014; SUVmean 2.7 ± 0.3 vs. 3.0 ± 0.5, p = 0.0065; SUVpeak 3.0 ± 0.4 vs. 3.4 ± 0.6, p = 0.006). However, the SUVmax, SUVmean, and SUVpeak in the DA did not significantly change (SUVmax 2.2 ± 0.3 vs. 2.2 ± 0.4, p = 0.46; SUVmean 1.9 ± 0.3 vs. 2.0 ± 0.4, p = 0.56; SUVpeak 2.0 ± 0.3 vs. 2.0 ± 0.3, p = 0.70). Conclusions We measured FDG uptake in the liver and blood pool before and during steroid therapy. Steroid therapy increased the liver uptake but not the blood pool uptake. Our findings suggested that the DA uptake is a more suitable threshold than liver uptake to evaluate therapeutic effects using volume-based analysis of cardiac FDG PET.

Published
2018
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9. PET/CT scanning with 3D acquisition is feasible for quantifying myocardial blood flow when diagnosing coronary artery disease

Author

Osamu Manabe, Masanao Naya, Tadao Aikawa, Masahiko Obara, Keiichi Magota, Markus Kroenke, Noriko Oyama-Manabe, Kenji Hirata, Daiki Shinyama, Chietsugu Katoh, and Nagara Tamaki

Subjects
Myocardial blood flow, Coronary flow reserve, Positron emission tomography, 15O-water, Three-dimensional data acquisition, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Abstract Background The quantification of myocardial blood flow (MBF) and coronary flow reserve (CFR) are useful approaches for evaluating the functional severity of coronary artery disease (CAD). 15O-water positron emission tomography (PET) is considered the gold standard method for MBF quantification. However, MBF measurements in 15O-water PET with three-dimensional (3D) data acquisition, attenuation correction using computed tomography (CT), and time of flight have not been investigated in detail or validated. We conducted this study to evaluate the diagnostic potential of MBF measurements using PET/CT for a comparison of a control group and patients suspected of having CAD. Results Twenty-four patients with known or suspected CAD and eight age-matched healthy volunteers underwent rest and pharmacological stress perfusion studies with 15O-water PET/CT. The whole and three regional (left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) territory) MBF values were estimated. The CFR was computed as the ratio of the MBF during adenosine triphosphate-induced stress to the MBF at rest. The inter-observer variability was assessed by two independent observers. PET/CT using a 15O-water dose of 500 MBq and 3D data acquisition showed good image quality. A strong inter-observer correlation was detected in both the whole MBF analysis and the regional analysis with high intra-class correlation coefficients (r > 0.90, p

Published
2017
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11. Distribution of cardiomyocyte-selective adeno-associated virus serotype 9 vectors in swine following intracoronary and intravenous infusion

Author

Jinliang Li, Shannon C. Kelly, Jan R. Ivey, Pamela K. Thorne, Kelly P. Yamada, Tadao Aikawa, Renata Mazurek, James R. Turk, Kleiton Augusto Santos Silva, Amira R. Amin, Darla L. Tharp, Christina M. Mueller, Hrishikesh Thakur, Emily V. Leary, Timothy L. Domeier, R. Scott Rector, Kenneth Fish, Federico Cividini, Kiyotake Ishikawa, Craig A. Emter, and Michael S. Kapiloff

Subjects
Swine, Physiology, Genetic Vectors, Gene Transfer Techniques, Genetics, Animals, Myocytes, Cardiac, Tissue Distribution, Dependovirus, Infusions, Intravenous, Serogroup, Research Article
Abstract

Limited reports exist regarding adeno-associated virus (AAV) biodistribution in swine. This study assessed biodistribution following antegrade intracoronary and intravenous delivery of two self-complementary serotype 9 AAV (AAV9sc) biologics designed to target signaling in the cardiomyocyte considered important for the development of heart failure. Under the control of a cardiomyocyte-specific promoter, AAV9sc.shmAKAP and AAV9sc.RBD express a small hairpin RNA for the perinuclear scaffold protein muscle A-kinase anchoring protein β (mAKAPβ) and an anchoring disruptor peptide for p90 ribosomal S6 kinase type 3 (RSK3), respectively. Quantitative PCR was used to assess viral genome (vg) delivery and transcript expression in Ossabaw and Yorkshire swine tissues. Myocardial viral delivery was 2–5 × 105 vg/µg genomic DNA (gDNA) for both infusion techniques at a dose ∼1013 vg/kg body wt, demonstrating delivery of ∼1–3 viral particles per cardiac diploid genome. Myocardial RNA levels for each expressed transgene were generally proportional to dose and genomic delivery, and comparable with levels for moderately expressed endogenous genes. Despite significant AAV9sc delivery to other tissues, including the liver, neither biologic induced toxic effects as assessed using functional, structural, and circulating cardiac and systemic markers. These results indicate successful targeted delivery of cardiomyocyte-selective viral vectors in swine without negative side effects, an important step in establishing efficacy in a preclinical experimental setting.

Published
2022
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12. Diagnostic values of delayed additional FDG PET/CT scan in the evaluation of cardiac sarcoidosis

Author

Osamu Manabe, Keiko Takahashi, Hiroki Kawakami, Akira Ohtsuka, Tadao Aikawa, Hisataka Maki, Tatsuro Ibe, Hideo Fujita, and Noriko Oyama-Manabe

Abstract

Objective This study aimed to compare the contribution of 18F-fluorodepxyglucose (FDG) positron (PET)/ computed tomography (CT) acquisition of early and delayed scan in patients with cardiac sarcoidosis (CS). Methods Twenty-three patients with CS (median age: 69 years; 11 women) were retrospectively evaluated using dual-phase FDG PET/CT. All patients were instructed to consume a low-carbohydrate diet followed by fasting for 18 h before FDG injection to reduce physiological myocardial uptake. PET/CT was acquired at 60 min (early) and 100 min (delayed) after FDG administration. Focal and focal on diffuse uptake on visual analysis was considered positive for CS. A semi-quantitative analysis was performed using the maximum standardized uptake value (SUVmax) of the cardiac lesion and the mean SUV (SUV mean) of the blood pool. Results Significant myocardial FDG uptake was observed in 21 patients (91.3%) in the early acquisition group and in 23 patients in the delayed scan group (100%). Compared to the early scan, the delayed scan showed a significantly higher SUVmax of cardiac lesion (median, 4.0; IQR [interquartile range, 2.9 to 7.0] vs. 5.8 [IQR 3.7 to 10.1]; P = 0.0030) and a significantly lower SUVmean of blood pool (median, 1.3 [IQR, 1.2 to 1.4] vs. 1.1 [IQR, 0.9 to 1.2]; P

Published
2023
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17. Elevated Natriuretic Peptides in Patients With Severe or Critical COVID-19: A Meta-Analysis

Author

Benjamin Benhuri, Tadao Aikawa, Hisato Takagi, Daniel Benhuri, and Toshiki Kuno

Subjects
SARS-CoV-2, Natriuretic Peptide, Brain, COVID-19, Humans, Review, Natriuretic Peptides, Cardiology and Cardiovascular Medicine, Pandemics, Biomarkers, Peptide Fragments, Retrospective Studies
Abstract

Background The worldwide COVID-19 pandemic caused by SARS-CoV-2 has resulted in an extraordinary increase in the number of patients who are severely critically ill. For many of these patients, cardiovascular risk factors are key contributors to the development of severe illness. Laboratory markers for cardiac damage and failure, such as natriuretic peptides, are reported to be elevated in patients with severe COVID-19. Methods We conducted a systematic review and meta-analysis to compare natriuretic peptide levels in patients with severe COVID-19 vs those with nonsevere COVID-19. PubMed and medRxiv were searched through April 7, 2020. The outcome of interest was the difference in B-type natriuretic peptide (BNP) or N-terminal-proBNP levels in patients with severe vs nonsevere COVID-19. Results We identified 9 retrospective cohort studies that had a total of 1,575 patients with COVID-19 who had their natriuretic peptides measured and were classified by disease severity. All studies were conducted in China. Patients with severe COVID-19 had significantly higher BNP levels than patients with nonsevere COVID-19 (mean difference, 69.56 pg/mL; 95% CI, 1.77–137.35 pg/mL; P = .04, I2 = 83%). Similarly, patients with severe COVID-19 had significantly higher N-terminal-proBNP levels than patients with nonsevere COVID-19 (mean difference, 518.65 pg/mL; 95% CI, 152.40–884.90 pg/mL; P = .006, I2 = 86%). Conclusions In this study, Chinese patients with severe COVID-19 had higher natriuretic peptide levels than those with nonsevere COVID-19. Studies from all countries affected by the virus will help to further delineate whether the cause is directly or indirectly of cardiac origin and whether preexisting heart failure has an influence on this disparity.

Published
2022
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19. Functional Assessment of Coronary Artery Disease by Myocardial Flow Reserve Versus Pressure-wire Based Assessment

Author

Noriko Oyama-Manabe, Shiro Miura, Osamu Manabe, Masanao Naya, and Tadao Aikawa

Subjects
Cultural Studies, History, medicine.medical_specialty, Literature and Literary Theory, business.industry, Review Article, medicine.disease, Pressure wire, Coronary artery disease, Flow (mathematics), Internal medicine, medicine, Cardiology, business
Abstract

Positron emission tomography (PET) permits the noninvasive quantification of myocardial blood flow (MBF). Myocardial flow reserve (MFR), calculated by dividing stress MBF by rest MBF is a reliable index for the functional information of coronary artery disease. A pressure-derived physiological index, such as fractional flow reserve (FFR) is also an important measurement. Both MFR and FFR values are used to evaluate coronary physiology; however, but they are not interchangeable because each test has certain discrepancies. In this systematic review, we provide an overview of coronary physiology with PET compared to pressure-derived physiological indices.

Published
2021
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20. Interatrial septal 99mTc-pyrophosphate uptake and reduced strain in wild-type transthyretin amyloid cardiomyopathy

Author

Noriko Oyama-Manabe, Hisataka Maki, Tatsuro Ibe, Osamu Manabe, and Tadao Aikawa

Subjects
Transthyretin, Strain (chemistry), biology, business.industry, Wild type, biology.protein, 99mTc-Pyrophosphate, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Amyloid cardiomyopathy, business, Molecular biology
Published
2021
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23. Vasospastic Angina: A Cause of Post-acute COVID-19 Syndrome

Author

Tadao Aikawa, Jiro Ogino, Noriko Oyama-Manabe, and Naohiro Funayama

Subjects
Angina Pectoris, Variant, Post-Acute COVID-19 Syndrome, Internal Medicine, COVID-19, Coronary Vasospasm, Humans, General Medicine, Angina Pectoris
Published
2022

24. The Role of Multimodality Imaging in Cardiac Sarcoidosis

Author

Tadao Aikawa, Osamu Manabe, Satonori Tsuneta, and Noriko Oyama-Manabe

Subjects
medicine.medical_specialty, Cardiac sarcoidosis, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Cardiac magnetic resonance imaging, Internal Medicine, medicine, State of the Art Review, 030212 general & internal medicine, cardiovascular diseases, medicine.diagnostic_test, business.industry, medicine.disease, Positron emission tomography, Heart failure, Etiology, cardiovascular system, Cardiac Imaging Techniques, Radiology, Sarcoidosis, Cardiology and Cardiovascular Medicine, business, Active inflammation, 18F-FDG PET
Abstract

Author's summary Cardiac sarcoidosis (CS) is significantly associated with a poor prognosis due to the associated congestive heart failure, arrhythmias (such as an advanced atrioventricular block), and ventricular tachyarrhythmia. Novel imaging modalities are now available to detect CS lesions secondary to active inflammation, granuloma formation, and fibrotic changes such as 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and cardiac magnetic resonance imaging (CMR). Systematic review revealed both modalities showed high sensitivity to detect CS, while FDG PET and CMR provide different aspects of the pathophysiology of CS., The etiology and the progression of sarcoidosis remain unknown. However, cardiac sarcoidosis (CS) is significantly associated with a poor prognosis due to the associated congestive heart failure, arrhythmias (such as an advanced atrioventricular block), and ventricular tachyarrhythmia. Novel imaging modalities are now available to detect CS lesions secondary to active inflammation, granuloma formation, and fibrotic changes. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and cardiac magnetic resonance imaging (CMR) play essential roles in diagnosing and monitoring patients with confirmed or suspected CS. The following focused review will highlight the emerging role of non-invasive cardiac imaging techniques, including FDG PET/CT and CMR.

Published
2021

26. Safety and feasibility of same-day discharge in patients receiving pulmonary vein isolation—systematic review and a meta-analysis

Author

Alexandros Briasoulis, Toshiki Kuno, Yuki Sahashi, Tadao Aikawa, Iwanari Kawamura, and Hisato Takagi

Subjects
business.industry, medicine.medical_treatment, Catheter ablation, Atrial fibrillation, Perioperative, 030204 cardiovascular system & hematology, medicine.disease, Confidence interval, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Meta-analysis, Anesthesia, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Complication, Prospective cohort study, business
Abstract

The purpose of this systematic review and meta-analysis was to evaluate the feasibility and safety of a same-day discharge protocol following pulmonary vein isolation (PVI). PubMed and Embase were systematically investigated from the inception to 20 July 2020. Studies on safety and feasibility of PVI for atrial fibrillation (AF) were included. Study-specific estimates were combined using one-group meta-analysis with a random-effects model. Seven observational studies investigating the safety and feasibility of same-day discharge protocols were identified. Of a total of 3656 patients who have undergone PVI for AF, the overall complication rate was 0.80% (95% confidence interval [CI], 0.20–1.40%). The readmission within 30-day following same-day discharge protocol occurred at a pooled rate of 3.6% (95% CI, 0.0–8.4%). Frequent complications following the procedure were complications related to vascular access (0.38%; 95% CI, 0.18–0.58%), and phrenic nerve injury (0.19%; 95% CI, 0.05–0.33%). The reported complications in SDD group were mainly based on results among patients without perioperative complications. The introduction of same-day discharge strategies might be safe and feasible in selected patients given the reported complication and re-admission rates in the current practice. Further prospective studies are needed to confirm these findings.

Published
2021
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27. Prognostic value of phase analysis on gated single photon emission computed tomography in patients with cardiac sarcoidosis

Author

Toshihisa Anzai, Ichizo Tsujino, Nagara Tamaki, Tadao Aikawa, Masato Kuzume, Osamu Manabe, Kazuhiro Koyanagawa, Hiroshi Ohira, and Masanao Naya

Subjects
Male, Sarcoidosis, Gated SPECT, Electrocardiography-gated single-photon emission computed tomography, Cardiac sarcoidosis, 030204 cardiovascular system & hematology, Single-photon emission computed tomography, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Predictive Value of Tests, Positron Emission Tomography Computed Tomography, Phase analysis, Medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, Major adverse cardiac events, Aged, Retrospective Studies, Ejection fraction, medicine.diagnostic_test, business.industry, F-18, Myocardial Perfusion Imaging, Stroke Volume, Middle Aged, Prognosis, fluorideoxyglucose positron emission tomography-computed tomography, Female, Radiopharmaceuticals, Cardiology and Cardiovascular Medicine, Nuclear medicine, business, Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography, Cardiomyopathies, Perfusion, Mace
Abstract

Background We aimed to determine the correlation between phase analysis, reflecting the heterogeneity of perfusion defects, and the dyssynchrony of the left ventricle wall motion, and adverse cardiac events in cardiac sarcoidosis (CS) patients. Methods Fifty-seven consecutive patients with diagnosed CS (64 [IQR 55-71] years old, 14 males), who underwent F-18-FDG PET/CT and ECG-gated SPECT, were studied. FDG PET was analysed to measure cardiac metabolic volume (CMV), and total lesion glycolysis (TLG). The SPECT findings, such as LVEF, Summed Rest Score (SRS), bandwidth (BW) were evaluated. Results The median of BW was 56 degrees (IQR 40-95). BW showed a strong inverse correlation with LVEF (r = - 0.60, P < 0.0001), and positive correlation with SRS (r = 0.82, P < 0.0001). However, there were no significant correlations between BW and CMV or TLG. The Kaplan-Meier curves revealed a significantly higher rate of MACE in the high BW group (BW > 56 degrees) than the low BW group (BW

Published
2021

28. Myocardial T1-mapping and Extracellular Volume Quantification in Patients and Putative Carriers of Muscular Dystrophy: Early Experience

Author

Satonori Tsuneta, Toshiyuki Nagai, Hideaki Shiraishi, Tadao Aikawa, Toshihisa Anzai, Noriko Oyama-Manabe, Atsuhito Takeda, Kazuhiro Koyanagawa, Yuta Kobayashi, and Hiroyuki Iwano

Subjects
musculoskeletal diseases, Pathology, medicine.medical_specialty, Extracellular volume fraction, business.industry, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Male patient, Extracellular fluid, medicine, Radiology, Nuclear Medicine and imaging, Myocardial fibrosis, In patient, Muscular dystrophy, business, 030217 neurology & neurosurgery
Abstract

To assess myocardial fibrosis associated with muscular dystrophy, T1-mapping and extracellular volume fraction (ECV) quantification was prospectively performed using cardiovascular MR (CMR) imaging in 6 male patients with muscular dystrophy and 5 female putative carriers of Duchenne or Becker muscular dystrophy. Five patients and all putative carriers had an elevated ECV (>29.5% for men and >35.2% for women), suggesting that ECV has a potential to detect diffuse fibrotic changes in patients and putative carriers of muscular dystrophy.

Published
2021
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29. Impaired left ventricular global longitudinal strain is associated with elevated left ventricular filling pressure after myocardial infarction

Author

Olympia Bikou, Tadao Aikawa, Satoshi Miyashita, Taro Kariya, Serena Tharakan, Kenneth Fish, Kelly P. Yamada, and Kiyotake Ishikawa

Subjects
Male, medicine.medical_specialty, Longitudinal strain, Physiology, Hemodynamic measurements, Sus scrofa, Echocardiography, Three-Dimensional, Myocardial Infarction, Strain (injury), 030204 cardiovascular system & hematology, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Physiology (medical), Internal medicine, Ventricular Pressure, medicine, Animals, 030212 general & internal medicine, Myocardial infarction, business.industry, Stroke Volume, medicine.disease, Disease Models, Animal, Cardiology, Female, Cardiology and Cardiovascular Medicine, Ventricular filling, business, Research Article
Abstract

Left ventricular (LV) global longitudinal strain (GLS) has emerged as a significant prognostic marker in patients after myocardial infarction (MI). Although elevated LV filling pressure after MI might alter GLS, direct evidence for this is lacking. This study aimed to clarify the association between GLS and LV filling pressure in a large animal MI model. A total of 104 Yorkshire pigs underwent both echocardiographic and hemodynamic assessments 1–4 wk after induction of large anterior MI. GLS was measured in the apical four-chamber view using a semiautomated speckle-tracking software. LV pressure-volume relationship was invasively measured using a high-fidelity pressure-volume catheter. GLS >−14% was considered impaired. Compared with pigs with LV ejection fraction (LVEF) >40% and preserved GLS (n = 29), those with LVEF >40% and impaired GLS (n = 37) and those with LVEF ≤40% (n = 38) had significantly higher LV end-diastolic pressure (15.5 ± 5.5 vs. 19.7 ± 5.8 and 19.6 ± 6.6 mmHg; P = 0.008 and P = 0.026, respectively) and higher LV mean diastolic pressure (7.1 ± 2.9 vs. 10.4 ± 4.5 and 11.1 ± 5.4 mmHg; P = 0.013 and P = 0.002, respectively). GLS was modestly correlated with τ (r = 0.21, P = 0.039) and slope of LV end-diastolic pressure–volume relationship (r = 0.43, P < 0.001). Impaired GLS was associated with higher LV end-diastolic and mean-diastolic pressures after adjusting for LVEF and baseline characteristics (P = 0.026 and P = 0.001, respectively). Impaired GLS assessed by speckle-tracking echocardiography was associated with elevated LV filling pressure after MI. GLS has an incremental diagnostic value for detecting elevated LV filling pressure and may be particularly useful for evaluating post-MI patients with preserved LVEF. NEW & NOTEWORTHY Strain analysis was performed in 104 pigs after MI, and its relationship to invasive hemodynamic measurements was studied. Impaired longitudinal strain was associated with high ventricular filling pressure independent of LVEF in post-MI setting. Global longitudinal strain is a potential prognostic marker after MI.

Published
2020
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30. Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

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Andrew J. Einstein, Cole Hirschfeld, Michelle C. Williams, Joao V. Vitola, Nathan Better, Todd C. Villines, Rodrigo Cerci, Leslee J. Shaw, Andrew D. Choi, Sharmila Dorbala, Ganesan Karthikeyan, Bin Lu, Valentin Sinitsyn, Alexey A. Ansheles, Takashi Kudo, Chiara Bucciarelli-Ducci, Bjarne Linde Nørgaard, Pál Maurovich-Horvat, Roxana Campisi, Elisa Milan, Lizette Louw, Adel H. Allam, Mona Bhatia, Lorenzo Sewanan, Eli Malkovskiy, Yosef Cohen, Michael Randazzo, Jagat Narula, Olga Morozova, Thomas N.B. Pascual, Yaroslav Pynda, Maurizio Dondi, Diana Paez, Gerd Hinterleitner, Yao Lu, Zhuoran Xu, Cole B. Hirschfeld, Ikenna Erinne, Mrinali Shetty, Andrew Choi, Juan Lopez-Mattei, Purvi Parwani, Artan Goda, Ervina Shirka, Salah Bouyoucef, Lydia Chelghoum, Farouk Mansouri, Abdelkader Medjahedi, Qais Naili, Mokhtar Ridouh, Diego Alasia, Lucia Alberghina, Natalia Aramayo, Diego Buchara, Franco Gabriel Busso, Jose Javier Bustos Rivadero, Jorge Camilletti, Hugo Campanelli, Ricardo Belisario Castro, Mariana Daicz, Horacio del Riego, Laura Dragonetti, Diego Echazarreta, Juan Erriest, Fernando Faccio, Adolfo Facello, Hugo Gallegos, Ricardo Geronazzo, Horacio Glait, Victor Hasbani, Victor Jäger, Julio Manuel Lewkowicz, Jose Lotti, Neiva Maciel, Osvaldo Masoli, Edgardo Mastrovito, Maria Medus, Maria Fernanda Merani, Susana Molteni, Marcos Montecinos, Gustavo Parisi, Claudio Pereyra Sueldo, Diego Perez de Arenaza, Luis Quintana, Alejandro Radzinschi, Marcela Redruello, Marina Rodríguez, Horacio Rojas, Arturo Romero Acuña, Daniel Schere, Sonia Traverso, Gustavo Vazquez, Susana Zeffiro, Mari Sakanyan, Scott Beuzeville, Raef Boktor, Michael Crowley, D'Arne Downie, Girish Dwivedi, Barry Elison, Omar Farouque, Kim Jasper, Subodh Joshi, Joseph Lee, Kenneth Lee, Elaine Lui, Peter Mcconachie, Joanne Meaker, Dee Nandurkar, Johanne Neill, Edward O'Rourke, Patricia O'Sullivan, George Pandos, Manuja Premaratne, David Prior, Natalie Rutherford, Connor Saunders, Kim Taubman, Andrew Tauro, Andrew Taylor, James Theuerle, Paul Thomas, Jonathan Tow, Anthony Upton, Shankar Vamadevan, Victor Wayne, Eva Alina Wegner, David Wong, John Younger, Dietrich Beitzke, Gudrun Feuchtner, Oliver Sommer, Konrad Weiss, Natallia Maroz-Vadalazhskaya, Uladzimir Tserakhau, Filip Homans, Caroline M. Van De Heyning, Raúl Araujo, Valentina Soldat-Stankovic, Sinisa Stankovic, Augusto Almeida, Carlos Anselmi, Guilherme S.A. Azevedo, Marcio Sommer Bittencourt, Diego Bromfman Pianta, Estevan Cabeda, Lara Carreira, Igor Coelho, Fernando de Amorim Fernandes, Andrea de Lorenzo, Roberta Delgado, Fernanda Erthal, Fabio Fernandes, Juliano Fernandes, Thiago Ferreira de Souza, Murilo Foppa, Wilson Furlan Matos Alves, Cibele Gontijo, Ilan Gottlieb, Gabriel Grossman, Maria Helena Albernaz Siqueira, Cesar Higa Nomura, Katia Hiromoto Koga, Ronaldo Lima, Rafael Lopes, Hugo Humberto Marçal Filho, Paulo Masiero, Luiz Mastrocola, Maria Eduarda Menezes de Siqueira, Claudio Mesquita, Danilo Naves, Filipe Penna, Ibraim Pinto, Thércio Rocha, Juliana Leal Rocha, Alfredo Rodrigues, Leila Salioni, Adelina Sanches, Marcelo Santos, Leonardo Sara Da Silva, Paulo Schvartzman, Cristina Sebastião Matushita, Tiago Senra, Marcelo Silva, Carlos Eduardo Soares, Bernardo Spiro, Carlos Eduardo Suaide Silva, Rafael Torres, Guilherme Urpia Monte, Andrea Vilela, Alexandre Volney Villa, Joao Vitola, Themissa Voss, Roberto Waltrick, Marcello Zapparoli, Hamid Naseer, Marina Garcheva-Tsacheva, Tiémégna Florence Ouattara, Sarameth Thou, Soley Varoeun, Gad Abikhzer, Rob Beanlands, Michael Chetrit, Dominique Dabreo, Carole Dennie, Matthias Friedrich, Mohmmed Nassoh Hafez, Kate Hanneman, Robert Miller, Anastasia Oikonomou, Idan Roifman, Gary Small, Vikas Tandon, Adwait Trivedi, James White, Katherine Zukotynski, Rita Alay, Carmen Concha, Teresa Massardo, Pedro Abad, Kelly Anzola, Harold Arturo, Luis Benitez, Alberto Cadena, Carlos Caicedo Zamudio, Antonio Calderón, Claudia T. Gutierrez Villamil, Claudia Jaimes, Juan L. Londono, Nelson Lopez, Sonia Merlano-Gaitan, Ramon Murgieitio-Cabrera, Manuel Valencia, Damiana Vergel, Alejandro Zuluaga Santamaria, Felix Solis, Tonci Batinic, Maja Franceschi, Maja Hrabak Paar, Marina Prpic, Cuba: Juan Felipe Batista, Lazaro Omar Cabrera, Amalia Peix, Yamilé Peña, Luis Manuel Rochela Vázquez, Ioannis Ntalas, Milan Kaminek, Vladimir Kincl, Otto Lang, Jawdat Abdulla, Morten Bøttcher, Martin Busk, Uka Geisler, Lars C. Gormsen, Nicolaj Hansson, Søren Hess, Jens Hove, Lars Thorbjoern Jensen, Magnus T. Jensen, Kristian Hay Kragholm, Bjarne L. 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Rutherford, N, Saunders, C, Taubman, K, Tauro, A, Taylor, A, Theuerle, J, Thomas, P, Tow, J, Upton, A, Vamadevan, S, Wayne, V, Wegner, E, Wong, D, Younger, J, Beitzke, D, Feuchtner, G, Sommer, O, Weiss, K, Maroz-Vadalazhskaya, N, Tserakhau, U, Homans, F, Van De Heyning, C, Araujo, R, Soldat-Stankovic, V, Stankovic, S, Almeida, A, Anselmi, C, Azevedo, G, Bittencourt, M, Pianta, D, Cabeda, E, Carreira, L, Coelho, I, de Amorim Fernandes, F, de Lorenzo, A, Delgado, R, Erthal, F, Fernandes, F, Fernandes, J, Ferreira de Souza, T, Foppa, M, Matos Alves, W, Gontijo, C, Gottlieb, I, Grossman, G, Albernaz Siqueira, M, Nomura, C, Koga, K, Lima, R, Lopes, R, Marcal Filho, H, Masiero, P, Mastrocola, L, Menezes de Siqueira, M, Mesquita, C, Naves, D, Penna, F, Pinto, I, Rocha, T, Rocha, J, Rodrigues, A, Salioni, L, Sanches, A, Santos, M, Da Silva, L, Schvartzman, P, Matushita, C, Senra, T, Silva, M, Soares, C, Spiro, B, Suaide Silva, C, Torres, R, Monte, G, Vilela, A, Villa, A, Voss, T, Waltrick, R, Zapparoli, M, Naseer, H, Garcheva-Tsacheva, M, Ouattara, T, Thou, S, Varoeun, S, Abikhzer, G, Beanlands, R, Chetrit, M, Dabreo, D, Dennie, C, Friedrich, M, Hafez, M, Hanneman, K, Miller, R, Oikonomou, A, Roifman, I, Small, G, Tandon, V, Trivedi, A, White, J, Zukotynski, K, Alay, R, Concha, C, Massardo, T, Abad, P, Anzola, K, Arturo, H, Benitez, L, Cadena, A, Zamudio, C, Calderon, A, Gutierrez Villamil, C, Jaimes, C, Londono, J, Lopez, N, Merlano-Gaitan, S, Murgieitio-Cabrera, R, Valencia, M, Vergel, D, Santamaria, A, Solis, F, Batinic, T, Franceschi, M, Paar, M, Prpic, M, Felipe Batista, C, Cabrera, L, Peix, A, Pena, Y, Rochela Vazquez, L, Ntalas, I, Kaminek, M, Kincl, V, Lang, O, Abdulla, J, Bottcher, M, Busk, M, Geisler, U, Gormsen, L, Hansson, N, Hess, S, Hove, J, Jensen, L, Jensen, M, Kragholm, K, Ovrehus, K, Rasmussen, J, Ronnow Sand, N, Sondergaard, H, Zaremba, T, Speckter, H, Amores, N, Velez, M, Alrahman, T, Elsamad, S, Abdelfattah, A, Elkaffas, S, Hassan, M, Hussein, E, Ibrahim, A, Kandeel, A, Ali, M, Shaaban, M, Flores, C, Gomez Leiva, V, Liiver, A, Larikka, M, Uusitalo, V, Agostini, D, Berger, C, Dietz, M, Hyafil, F, Ohana, M, Prigent, K, Regaieg, H, Sarda-Mantel, L, H-Ici, D, Ayetey, H, Angelidis, G, Fragkaki, C, Fragkiadaki, C, Georgoulias, P, Koutelou, M, Kyrozi, E, Lama, N, Prassopoulos, V, Spartalis, M, Zaglavara, T, Gonzalez, C, Gutierrez, G, Maldonado, A, Martinez, Y, Kovacs, A, Szilveszter, B, Banthia, N, Bhat, V, Choudhury, P, Chowdekar, V, Christopher, J, Garg, T, Goyal, N, Gupta, R, Gupta, A, Hephzibah, J, Jain, S, Krupa, J, Kumar, P, Kumar, S, Lalchandani, A, Mishra, A, Mishra, V, Mohan, P, Ozair, A, Pandey, S, Parameswaran, R, Patel, C, Patel, T, Patel, S, Vimala, L, Kumar Sarangi, D, Sengupta, S, Sethi, A, Sharma, A, Sharma, P, Shrigiriwar, A, Singh, S, Singh, H, Sood, A, Verma, A, Vyas, A, Soeriadi, E, Bun, E, Hutomo, F, Syawaluddin, H, Yudistiro, R, Albadr, A, Assadi, M, Emami, F, Emami-Ardekani, A, Farzanehfar, S, Jafari, R, Manafi-Farid, R, Tajik, M, Arnson, Y, Fuchs, S, Goldkorn, R, Kennedy, J, Leitman, M, Shalev, A, Acampa, W, Albano, D, Alongi, P, Arnone, G, Assante, R, Baritussio, A, Bauckneht, M, Bianco, F, Bonfiglioli, R, Bovenzi, F, Bruno, I, Bruno, A, Busnardo, E, Califaretti, E, Casoni, R, Censullo, V, Chierichetti, F, Chiocchi, M, Cittanti, C, Clemente, A, Cuocolo, A, De Rimini, M, De Vincentis, G, Della Tommasina, V, Dellegrottaglie, S, Erba, P, Evangelista, L, Faggi, L, Faragasso, E, Florimonte, L, Frantellizzi, V, Gatti, M, Gaudiano, A, Gelardi, F, Gerali, A, Gimelli, A, Guglielmo, M, Leccisotti, L, Liga, R, Liguori, C, Longo, G, Maffione, M, Marcassa, C, Matassa, G, Mele, D, Mircoli, L, Paccagnella, A, Pacella, S, Padovano, F, Pellegrini, D, Pergola, V, Pugliese, L, Quartuccio, N, Rampin, L, Ricci, F, Rubini, G, Russo, V, Sambuceti, G, Scatteia, A, Sciagra, R, Spidalieri, G, Stefanelli, A, Tedeschi, C, Ventroni, G, Baugh, D, Madu, E, Aikawa, T, Asano, H, Fujimoto, S, Fujise, K, Fukushima, Y, Fukuyama, K, Ichikawa, Y, Ideguchi, R, Iguchi, N, Imai, M, Ishimura, H, Isobe, S, Ito, K, Izawa, Y, Kadokami, T, Kasai, T, Kato, T, Kawamoto, T, Kiryu, S, Kumita, S, Manabe, O, Maruno, H, Matsumoto, N, Miyagawa, M, Moroi, M, Nagamachi, S, Nakajima, K, Nakazato, R, Nanasato, M, Naya, M, Norikane, T, Ohta, Y, Otomi, Y, Otsuka, H, Oyama-Manabe, N, Saito, M, Sarai, M, Sato, J, Sato, D, Shiraishi, S, Takanami, K, Takehana, K, Taniguchi, Y, Teragawa, H, Tomizawa, N, Umeji, K, Wakabayashi, Y, Yamada, S, Yamazaki, S, Yoneyama, T, Rawashdeh, M, Dautov, T, Makhdomi, K, Abass, M, Garashi, M, Siraj, Q, Kalnina, M, Haidar, M, Komiagiene, R, Kviecinskiene, G, Vajauskas, D, Karim, N, Doucoure, M, Reichmuth, L, Samuel, A, Dieng, M, Naojee, A, Hernandez, E, Alducin Tellez, C, Alexanderson-Rosas, E, Barragan, E, Cabada, M, Calderon, D, Carvajal-Juarez, I, Esparza, J, Gama-Moreno, M, Quinto, V, Gonzalez, N, Herrera-Zarza, M, Meave, A, Medina Verdugo, J, Melendez, G, Morales Murguia, R, Navarro Quiroz, C, Ornelas, M, Preciado-Anaya, A, Preciado-Gutierrez, O, Puente, A, Salazar, A, Rosales Uvera, S, Rosales-Uvera, S, Serna Macias, J, Sierra-Galan, L, Tirado Alderete, J, Vallejo, E, Faraggi, M, Sereegotov, E, Ben Rais, N, Alaoui, N, Kyiphyu, T, Oo, S, Win, S, Zar, H, Ghimire, R, Neupane, M, Glaudemans, A, Slart, R, Verschure, D, Allen, B, Edmond, J, Mckenzie, C, Tie, S, Van Pelt, N, Worthington, K, Young, C, Soli, I, Kana, S, Onubogu, U, Sani, M, Braten, A, Jorgensen, A, Vassbotn, H, Al Dhuhli, H, Jawa, Z, Tag, N, Fatima, S, Imran, M, Younis, M, Saadullah, M, Malo, Y, Lenturut-Katal, D, Castillo, M, Ortellado, J, Akhter, A, Cader, F, Hussain, R, Khan, S, Mandal, T, Nasreen, F, An, Y, Cao, D, Gong, L, Hou, Y, Jia, C, Li, T, Li, C, Liu, H, Liu, W, Liu, J, Ng, M, Shi, H, Tang, C, Wang, X, Wang, Z, Wang, Y, Wu, J, Yi, Y, Yuan, L, Zhang, T, Zhang, L, Chavez, E, Cruz, C, Llontop, C, Morales, R, Abrihan, P, Bustos-Barroso, A, Duldulao-Ogbac, M, Eduarte, C, Obaldo, J, Quinon, A, San Juan, B, San Juan, C, Sauler-Gomez, M, Uy, M, Kostkiewicz, M, Kunikowska, J, Teresinska, A, Urbanik, T, Bettencourt, N, Fontes-Carvalho, R, Gavina, C, Goncalves, L, Macedo, F, Moreno, N, Sousa, C, Timoteo, A, Vidigal, M, Al Heidous, M, Ramanathan, S, Arnous, S, Aytani, S, Byrne, A, Gleeson, T, Kerins, D, O'Brien, J, Bang, J, Bom, H, Cheon, M, Cheon, G, Cho, S, Hong, C, Jeong, Y, Kang, W, Kang, Y, Kim, J, Oh, S, So, Y, Song, H, Won, K, Yoo, S, Mitevska, I, Vavlukis, M, Salobir, B, Stalc, M, Benedek, T, Pop, M, Stan, C, Dariy, O, Gagarina, N, Itskovich, I, Karalkin, A, Kokov, A, Marina, G, Migunova, E, Pospelov, V, Ryzhkova, D, Sayfullina, G, Sergienko, V, Shurupova, I, Vakhromeeva, M, Valiullina, N, Zavadovsky, K, Zhuravlev, K, Abazid, R, Al Garni, T, Alasnag, M, Aljizeeri, A, Amer, H, Amro, A, Hamdy, H, Smettei, O, Saranovic, D, Vlajkovic, M, Keng, F, See, J, Berecova, Z, Mistinova, J, Evbuomwan, O, Govender, N, Hack, J, Hadebe, B, Hlongwa, K, Kaplan, M, Lakhi, H, Milos, K, Modiselle, M, More, S, Muambadzi, N, Scholtz, L, Barreiro-Perez, M, Blanco, I, Broncano, J, Camarero, A, Casans-Tormo, I, De Haro, J, Flotats, A, Garcia, E, Mendiguchia, C, Jimenez-Heffernan, A, Leta, R, Diaz, J, Vega, L, Manovel-Sanchez, A, Monzonis, A, Patrut, B, Pubul, V, Perez, R, Zeidan, N, Nanayakkara, D, Suliman, A, Engblom, H, Murtadha, M, Ostenfeld, E, Simonsson, M, Alkadhi, H, Buechel, R, Burger, P, Grani, C, Kamani, C, Kawel-Bohm, N, Klaeser, B, Manka, R, Prior, J, Kaewchur, T, Khiewvan, B, Kositwattanarerk, A, Namwongprom, S, Thientunyakit, T, Sayman, H, Yuksel, M, Sebikali, M, Okello, E, Korol, P, Noverko, I, Satyr, M, Ahmad, T, Alfakih, K, Andrade, I, Buckingham, S, Bularga, A, Carpenter, J, Cole, G, Cusack, D, David, S, Davis, P, Fairbairn, T, Ghosh, A, Ramkumar, P, Hamilton, M, Haque, F, Hudson, B, Johnstone, A, Karthikeyan, V, Kay, M, Khan, M, Kitt, J, Low, C, Mcalindon, E, Mccreavy, D, Morrissey, B, Motwani, M, Na, D, Nicol, E, Patel, D, Rodrigues, J, Rofe, C, Schofield, R, Semple, T, Sheikh, A, Sinha, A, Subedi, D, Topping, W, Tweed, K, Underwood, S, Weir-Mccall, J, Zuhairy, H, Abbasi, T, Abohashem, S, Abramson, S, Al-Mallah, M, Kumar, M, Balmer-Swain, M, Berman, D, Bernheim, A, Bhatti, S, Biederman, R, Bieging, E, Bingham, S, Bloom, S, Blue, S, Borges, A, Branch, K, Bravo, P, Buddhe, S, Budoff, M, Bullock-Palmer, R, Cahill, M, Candela, C, Cao, J, Chatterjee, S, Chatzizisis, Y, Chaudhuri, N, Cheezum, M, Chelliah, A, Chen, T, Chen, M, Chen, L, Chokshi, A, Chung, J, Danciu, S, Desisto, W, Dilorenzo, M, Doukky, R, Duvall, W, Ferencik, M, Foster, C, Fuisz, A, Gannon, M, German, D, Gerson, M, Geske, J, Hage, F, Haider, A, Haider, S, Hamirani, Y, Hassen, K, Hendel, R, Henkel, J, Horgan, S, Hyun, M, Janardhanan, R, Jerome, S, Kalra, D, Kassop, D, Kinkhabwala, M, Kinzfogl, G, Koch, B, Koweek, L, Krepp, J, Kwon, Y, Layer, J, Lesser, J, Leung, S, Lisske, B, Magurany, K, Markowitz, J, Mccullough, B, Moalemi, A, Moffitt, C, Montanez, J, Moore, W, Morayati, S, Mossa-Basha, M, Mrsic, Z, Murthy, V, Nagpal, P, Nelson, K, Nijjar, P, O'Quinn, R, Passen, E, Patil, P, Pursnani, A, Quachang, N, Rabbat, M, Ranjan, P, Lozano, P, Schemmer, M, Seifried, R, Shah, N, Shah, A, Shanbhag, S, Sharma, G, Skotnicki, R, Sobczak, M, Soman, P, Sorrell, V, Srichai, M, Streeter, J, Strickland, L, Suliman, S, Tebyanian, N, Thomas, D, Thompson, R, Uretsky, S, Vallurupalli, S, Vandyck-Acquah, M, Verma, V, Weinstein, J, Wolinsky, D, Zareba, K, Zgaljardic, M, Beretta, M, Ferrando, R, Kapitan, M, Mut, F, Djuraev, O, Rozikhodjaeva, G, Vera, L, Duc, B, Nguyen, X, Hiep Nguyen, P, Einstein, Andrew J, Hirschfeld, Cole, Williams, Michelle C, Vitola, Joao V, Better, Nathan, Villines, Todd C, Cerci, Rodrigo, Shaw, Leslee J, Choi, Andrew D, Dorbala, Sharmila, Karthikeyan, Ganesan, Lu, Bin, Sinitsyn, Valentin, Ansheles, Alexey A, Kudo, Takashi, Bucciarelli-Ducci, Chiara, Nørgaard, Bjarne Linde, Maurovich-Horvat, Pál, Campisi, Roxana, Milan, Elisa, Louw, Lizette, Allam, Adel H, Bhatia, Mona, Sewanan, Lorenzo, Malkovskiy, Eli, Cohen, Yosef, Randazzo, Michael, Narula, Jagat, Morozova, Olga, Pascual, Thomas N B, Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, and Cuocolo, Alberto

Subjects
cardiac testing, Health Personnel, delivery of health care, coronavirus, COVID-19, global health, 610 Medicine & health, cardiovascular disease, health personnel, humans, pandemics, surveys and questionnaires, coronaviru, Surveys and Questionnaires, Humans, Cardiology and Cardiovascular Medicine, Delivery of Health Care, Pandemics, COVID-19/epidemiology
Abstract

BACKGROUND: The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES: The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS: Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS: Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing.

Published
2022
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31. Endobronchial Aerosolized AAV1.SERCA2a Gene Therapy in a Pulmonary Hypertension Pig Model: Addressing the Lung Delivery Bottleneck

Author

Olympia Bikou, Serena Tharakan, Kelly P. Yamada, Taro Kariya, Jaume Aguero, Alexandra Gordon, Renata Mazurek, Tadao Aikawa, Erik Kohlbrenner, Kenneth M. Fish, Roger J. Hajjar, and Kiyotake Ishikawa

Subjects
Swine, Hypertension, Pulmonary, Genetic Vectors, Genetics, Gene Transfer Techniques, Molecular Medicine, Animals, Genetic Therapy, Dependovirus, Molecular Biology, Lung, Research Articles, Sarcoplasmic Reticulum Calcium-Transporting ATPases
Abstract

A disappointing number of new therapies for pulmonary hypertension (PH) have been successfully translated to the clinic. Adeno-associated viral (AAV) gene therapy has the potential to treat the underlying pathology of PH, but the challenge remains in efficient and safe delivery. The aims of this study were (1) to test the efficacy of endobronchial aerosolization delivery for AAV1-mediated sarcoplasmic/endoplasmic reticulum Ca(2+) ATPase 2a (SERCA2a) gene therapy in a PH pig model and (2) to identify the most efficient airway administration modality for in-lung gene therapy in PH. We hypothesized that delivery to the distal bronchi increases lung viral uptake and avoids virus loss in off-target compartments. In part 1 of the study, PH was induced in pigs by surgically banding the pulmonary veins. Two months postsurgery, 1 × 10(13) viral genomes (vg) of AAV1.SERCA2a or saline was endobronchially aerosolized using a bronchoscope. Two months after aerosolization, high vg copies (vgc) were detected in the lungs, accompanied by functional and morphometrical amelioration of PH. In part 2 of the study, we directly compared the endobronchial aerosolization gene delivery to the intratracheal aerosolization in PH pigs. Endobronchial delivery demonstrated higher viral expression (6,719 ± 927 vs. 1,444 ± 402 vgc/100 ng DNA, p = 0.0017), suggesting this delivery modality is a promising method for clinical AAV gene therapy for PH.

Published
2022

34. Left ventricular outflow tract velocity time integral in hospitalized heart failure with preserved ejection fraction

Author

Toshihisa Anzai, Kiwamu Kamiya, Shingo Tsujinaga, Yuta Kobayashi, Yoshiya Kato, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Tadao Aikawa, Hiroyuki Iwano, Takao Konishi, Kazunori Omote, Toshiyuki Nagai, Takuma Sato, and Hirokazu Komoriyama

Subjects
Male, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, Ventricular Function, Left, Angiotensin Receptor Antagonists, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Interquartile range, Original Research Articles, Internal medicine, Prognosis risk stratification, medicine, Humans, Ventricular outflow tract, Original Research Article, Prospective Studies, 030212 general & internal medicine, Heart Failure, Proportional hazards model, business.industry, Hazard ratio, Stroke Volume, medicine.disease, Confidence interval, Left ventricular outflow tract velocity time integral, Heart failure with preserved ejection fraction, lcsh:RC666-701, Heart failure, Cardiology, Velocity time integral, Cardiology and Cardiovascular Medicine, business
Abstract

Aims The prognostic implication of left ventricular outflow tract velocity time integral (LVOT‐VTI) on admission in hospitalized heart failure with preserved ejection fraction (HFpEF) patients has not been determined. We sought to investigate whether LVOT‐VTI on admission is associated with worse clinical outcomes in hospitalized patients with HFpEF. Methods and results We studied consecutive 214 hospitalized HFpEF patients who had accessible LVOT‐VTI data on admission, from a prospective HFpEF‐specific multicentre registry. The primary outcome of interest was the composite of all‐cause death and readmission due to heart failure. During a median follow‐up period of 688 (interquartile range 162–810) days, the primary outcome occurred in 83 patients (39%). The optimal cut‐off value of LVOT‐VTI for the primary outcome estimated by receiver operating characteristic analysis was 15.8 cm. Lower LVOT‐VTI was significantly associated with the primary outcome compared with higher LVOT‐VTI (P = 0.005). Multivariable Cox regression analyses revealed that lower LVOT‐VTI was an independent determinant of the primary outcome (hazard ratio 0.94, 95% confidence interval 0.91–0.98). In multivariable linear regression, haemoglobin level was the strongest independent determinant of LVOT‐VTI among clinical parameters (β coefficient = −0.61, P = 0.007). Furthermore, patients with lower LVOT‐VTI and anaemia had the worst clinical outcomes among the groups (P < 0.001). Conclusions Lower admission LVOT‐VTI was an independent determinant of worse clinical outcomes in hospitalized HFpEF patients, indicating that LVOT‐VTI on admission might be useful for categorizing a low‐flow HFpEF phenotype and risk stratification in hospitalized HFpEF patients.

Published
2020

37. Myopericarditis After COVID-19 mRNA Vaccination Among Adolescents and Young Adults

Author

Jun Yasuhara, Kaihei Masuda, Tadao Aikawa, Takuro Shirasu, Hisato Takagi, Simon Lee, and Toshiki Kuno

Subjects
Pediatrics, Perinatology and Child Health
Abstract

ImportancePublished data on COVID-19 mRNA vaccine–associated myopericarditis in adolescents and young adults have been derived from small case series, national population-based studies, or passive reporting systems. Pooled evidence from a larger, international cohort is scarce.ObjectiveTo investigate the clinical features and early outcomes associated with myopericarditis after COVID-19 mRNA vaccination in a heterogeneous population of adolescents and young adults.Data SourcesPubMed and EMBASE were searched through August 2022. Language restrictions were not applied.Study SelectionObservational studies and case series describing COVID-19 vaccine–associated myopericarditis in adolescents and young adults aged 12 to 20 years and reporting clinical characteristics and early outcomes were included.Data Extraction and SynthesisTwo independent investigators extracted relevant data from each study. One-group meta-analysis in a random effects model was performed. The Preferred Reporting Items for Systematic Reviews and Meta-analysis and Meta-analysis of Observational Studies in Epidemiology reporting guidelines were followed.Main Outcomes and MeasuresThe primary outcomes were clinical features and early outcomes for COVID-19 mRNA vaccine–associated myopericarditis, including incident rate, cardiac findings, hospitalization, intensive care unit (ICU) admission, and in-hospital mortality.ResultsA total of 23 observational studies were identified, including 854 individuals (mean age, 15.9 [95% CI, 15.5-16.2] years) with COVID-19 vaccine–associated myopericarditis. Male sex was predominant, at 90.3% (95% CI, 87.3%-93.2%) of individuals. The incident rate was higher after the second dose than the first dose, with 74.4% (95% CI, 58.2%-90.5%) of events occurring after the second dose. Most patients (84.4% [95% CI, 80.5%-88.3%] of patients) had preserved left ventricular (LV) function. Of the 15.6% (95% CI, 11.7%-19.5%) of patients with LV systolic dysfunction (LV ejection fraction [LVEF] Conclusions and RelevanceThis systematic review and meta-analysis found low incidence rate and largely favorable early outcomes of COVID-19 mRNA vaccine–associated myopericarditis in adolescents and young adults from a wide range of populations. These findings are reassuring but continued follow-up is warranted.

Published
2023
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38. 18F-FMISO PET/CT detects hypoxic lesions of cardiac and extra-cardiac involvement in patients with sarcoidosis

Author

Nagara Tamaki, Toshihisa Anzai, Noriko Oyama-Manabe, Kohsuke Kudo, Kenji Hirata, Hiroshi Ohira, Keiichi Magota, Osamu Manabe, Sho Furuya, Masanao Naya, Tadao Aikawa, Ichizo Tsujino, Yuji Kuge, Tohru Shiga, and Kazuhiro Koyanagawa

Subjects
PET-CT, 18F-Fluoromisonidazole, Lung, medicine.diagnostic_test, business.industry, Standardized uptake value, 030204 cardiovascular system & hematology, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Positron emission tomography, medicine, Radiology, Nuclear Medicine and imaging, Sarcoidosis, Cardiology and Cardiovascular Medicine, Nuclear medicine, business, Prospective cohort study, FMISO
Abstract

18F-fluoromisonidazole (FMISO) is a hypoxia positron emission tomography (PET) tracer. Here, we evaluated cardiac and extra-cardiac sarcoidosis using both FMISO and 18F-fluorodeoxyglucose (FDG) PET/CT in a prospective cohort of patients with sarcoidosis. Ten consecutive sarcoidosis patients with suspected cardiac involvement were prospectively enrolled. Each patient fasted overnight (for ≥ 18 hours) preceded by a low-carbohydrate diet before FDG PET/CT but not given special dietary instructions before the FMISO PET/CT scan. We visually and semiquantitatively assessed the uptakes of FMISO and FDG using the maximal standardized uptake value (SUVmax). The metabolic volume (MV) of FDG was calculated as the volume within the boundary determined by the threshold (mean SUV of blood pool × 1.5). Nine patients showed focal FDG uptake in the myocardium and were diagnosed with cardiac sarcoidosis. Among the patients with extra-cardiac lesions, FDG uptake was seen in 8 lymph nodes and 3 lung lesions. FMISO uptake was seen in the 7 cardiac (77.8%) and 6 extra-cardiac (54.5%) lesions. None of the patients showed physiological FMISO uptake in the myocardium. The SUVmax values of the lesions with FMISO uptake were higher than those of the lesions without FMISO uptake in both the cardiac (SUVmax: 9.9, IQR: 8.4-10.0 vs 7.3, IQR: 6.3-8.2) and non-cardiac lesions (SUVmax: 17.6, IQR: 14.5-19.3 vs 6.1, IQR: 5.9-6.2; P = 0.006). The MV values of the lesions with FMISO uptake were significantly higher than those of the lesions without FMISO uptake (111.3, IQR: 78.3-135.7 vs 6.4, IQR: 1.9-23.3; P = 0.0009). FMISO showed no physiological myocardial uptake and did not require special preparation. FMISO PET has the potential to detect hypoxic lesions in patients with sarcoidosis.

Published
2019
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39. Long-term Prognostic Significance of Admission Tricuspid Regurgitation Pressure Gradient in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction: A Report From the Japanese Real-World Multicenter Registry

Author

Toshiyuki Nagai, Hirokazu Komoriyama, Kazunori Omote, Kiwamu Kamiya, Shingo Tsujinaga, Toshihisa Anzai, Kazuhiro Yamamoto, Yoshihiko Saito, Yoshiya Kato, Tadao Aikawa, Tsutomu Yoshikawa, and Hiroyuki Iwano

Subjects
Male, medicine.medical_specialty, Hospitalized patients, Blood Pressure, Regurgitation (circulation), 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Japan, Internal medicine, medicine.artery, medicine, Humans, Prospective Studies, Pulmonary Wedge Pressure, Registries, 030212 general & internal medicine, Pulmonary wedge pressure, Aged, Aged, 80 and over, Heart Failure, Ejection fraction, business.industry, Stroke Volume, Prognosis, medicine.disease, Pulmonary hypertension, Tricuspid Valve Insufficiency, Hospitalization, Blood pressure, Pulmonary artery, Cardiology, Female, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business
Abstract

Doppler-estimated peak systolic tricuspid regurgitation pressure gradient (TRPG) is a representative noninvasive parameter for evaluating pulmonary artery systolic pressure, which can be a determinant of adverse outcomes in chronic heart failure with preserved ejection fraction (HFpEF). However, the prognostic implications of TRPG at admission for hospitalized patients with HFpEF are undetermined.We examined 469 consecutive hospitalized patients with decompensated HFpEF (left ventricular ejection fraction ≥ 50%) who underwent TRPG measurement at admission in our HFpEF multicenter registry. The primary outcome of interest was all-cause death. Admission TRPG was significantly correlated with estimated pulmonary capillary wedge pressure and left atrial dimension (r = 0.24, P0.001 and r = 0.21, P0.001, respectively). During a median follow-up period of 748 (IQR 540-820) days, 83 patients died. Higher TRPG was significantly associated with higher mortality compared to lower TRPG (log-rank; P = 0.007). Multivariable analysis revealed that elevated TRPG was an independent determinant of mortality (HR 1.02, 95% CI 1.01-1.04, P = 0.008) after adjustment for prespecified confounders and renal function.Elevated TRPG at admission was an independent determinant of mortality in hospitalized patients with HFpEF, indicating that TRPG at admission could be a useful marker for risk stratification in these patients.

Published
2019
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43. Right ventricular involvement of cardiac sarcoidosis: A comprehensive evaluation using cardiovascular magnetic resonance imaging and positron emission tomography

Author

Noriko Oyama-Manabe, Tatsuro Ibe, Osamu Manabe, and Tadao Aikawa

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Positron emission tomography, medicine, MEDLINE, Radiology, Nuclear Medicine and imaging, Magnetic resonance imaging, Cardiac sarcoidosis, Radiology, Cardiology and Cardiovascular Medicine, business
Published
2021
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44. Catheter ablation for atrial fibrillation in elderly patients: Systematic review and a meta-analysis

Author

Iwanari Kawamura, Tadao Aikawa, Hisato Takagi, Yujiro Yokoyama, and Toshiki Kuno

Subjects
medicine.medical_specialty, medicine.medical_treatment, Subgroup analysis, Catheter ablation, Postoperative Complications, Recurrence, Internal medicine, Atrial Fibrillation, medicine, Humans, Aged, Aged, 80 and over, business.industry, Incidence (epidemiology), Hazard ratio, Atrial fibrillation, social sciences, General Medicine, medicine.disease, humanities, Confidence interval, Relative risk, Catheter Ablation, Cardiology and Cardiovascular Medicine, Complication, business
Abstract

AIMS Catheter ablation (CA) is established therapy for patients with atrial fibrillation (AF); however, there is a limited understanding of CA in elderly patients. We studied the long-term efficacy and periprocedural safety of radiofrequency and cryoballoon CA for elderly patients with AF. METHODS PubMed and Embase were searched through April 2021 to investigate the comparative outcomes between elderly and non-elderly patients who underwent CA for AF. The primary efficacy and safety endpoints were AF recurrence and procedure-related complications, respectively. Subgroup analyses were performed by procedure type of CA. RESULTS The search identified 20 observational studies with 110,606 patients, including 8,009 elderly patients (7.2%). The risk of AF recurrence was not significantly different between elderly and non-elderly patients (hazard ratio, 1.37; 95% confidence interval [CI], 0.94-2.00; P = 0.10, I2 = 70%). However, relative to the non-elderly, elderly patients had significantly higher major complications (risk ratio [RR], 1.32; 95% CI, 1.14-1.54], P

Published
2021

45. Myocardial microthrombi after COVID-19 mRNA vaccination

Author

Tadao Aikawa, Yuichi Kita, Naohiro Funayama, and Jiro Ogino

Subjects
Messenger RNA, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Myocardium, Vaccination, COVID-19, Thrombosis, Virology, Medicine, Humans, AcademicSubjects/MED00200, Cardiovascular Flashlight, RNA, Messenger, Cardiology and Cardiovascular Medicine, business
Published
2021

46. Delayed

Author

Sakura, Kato, Tadao, Aikawa, Tatsuro, Ibe, Osamu, Manabe, and Noriko, Oyama-Manabe

Published
2021

47. Microvascular thrombi in recurrent myocardial injury after coronavirus disease 2019 infection

Author

Noriko Oyama-Manabe, Jiro Ogino, Tadao Aikawa, and Aina Hirofuji

Subjects
2019-20 coronavirus outbreak, Heart Injury, Coronavirus disease 2019 (COVID-19), business.industry, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Thrombosis, medicine.disease, Virology, Heart Injuries, medicine, Humans, AcademicSubjects/MED00200, Cardiovascular Flashlight, Thrombus, Cardiology and Cardiovascular Medicine, business
Published
2021

48. Clinical Applications of 4D Flow MR Imaging in Aortic Valvular and Congenital Heart Disease

Author

Satonori Tsuneta, Noriko Oyama-Manabe, Tadao Aikawa, and Osamu Manabe

Subjects
Heart Defects, Congenital, medicine.medical_specialty, Heart disease, business.industry, Hemodynamics, Blood flow, medicine.disease, Magnetic Resonance Imaging, Intracardiac injection, Shunt (medical), Aortic valvular disease, Imaging, Three-Dimensional, Flow (mathematics), Internal medicine, Coronary artery anomaly, cardiovascular system, Cardiology, Medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, business, Blood Flow Velocity, Retrospective Studies
Abstract

4D flow MRI allows time-resolved 3D velocity-encoded phase-contrast imaging for 3D visualization and quantification of aortic and intracardiac flow. Radiologists should be familiar with the principles of 4D flow MRI and methods for evaluating blood flow qualitatively and quantitatively. The most substantial benefits of 4D flow MRI are that it enables the simultaneous comprehensive assessment of different vessels, and that retrospective analysis can be achieved in all vessels in any direction in the field of view, which is especially beneficial for patients with complicated congenital heart disease (CHD). For aortic valvular diseases, new parameters such as wall shear stress and energy loss may provide new prognostic values for 4D flow MRI. In this review, we introduce the clinical applications of 4D flow MRI for the visualization of blood flow and quantification of hemodynamic metrics in the setting of aortic valvular disease and CHD, including intracardiac shunt and coronary artery anomaly.

Published
2021

49. Interatrial septal

Author

Tadao, Aikawa, Hisataka, Maki, Tatsuro, Ibe, Osamu, Manabe, and Noriko, Oyama-Manabe

Subjects
Diphosphates, Amyloid Neuropathies, Familial, Technetium Tc 99m Pyrophosphate, Humans, Prealbumin, Cardiomyopathies
Published
2021

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