302 results on '"Tomoko Ishizu"'
Search Results
2. Metabolic remodeling and calcium handling abnormality in induced pluripotent stem cell-derived cardiomyocytes in dilated phase of hypertrophic cardiomyopathy with MYBPC3 frameshift mutation
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Haruka Mori, Dongzhu Xu, Yuzuno Shimoda, Zixun Yuan, Yoshiko Murakata, Binyang Xi, Kimi Sato, Masayoshi Yamamoto, Kazuko Tajiri, Tomoko Ishizu, Masaki Ieda, and Nobuyuki Murakoshi
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Dilated phase of hypertrophic cardiomyopathy ,Induced pluripotent stem cells ,Myosin binding protein C ,Cardiomyocytes ,Energy metabolism ,Medicine ,Science - Abstract
Abstract Hypertrophic cardiomyopathy (HCM) is an inherited disorder characterized by left ventricular hypertrophy and diastolic dysfunction, and increases the risk of arrhythmias and heart failure. Some patients with HCM develop a dilated phase of hypertrophic cardiomyopathy (D-HCM) and have poor prognosis; however, its pathogenesis is unclear and few pathological models exist. This study established disease-specific human induced pluripotent stem cells (iPSCs) from a patient with D-HCM harboring a mutation in MYBPC3 (c.1377delC), a common causative gene of HCM, and investigated the associated pathophysiological mechanisms using disease-specific iPSC-derived cardiomyocytes (iPSC-CMs). We confirmed the expression of pluripotent markers and the ability to differentiate into three germ layers in D-HCM patient-derived iPSCs (D-HCM iPSCs). D-HCM iPSC-CMs exhibited disrupted myocardial sarcomere structures and an increased number of damaged mitochondria. Ca2+ imaging showed increased abnormal Ca2+ signaling and prolonged decay time in D-HCM iPSC-CMs. Cell metabolic analysis revealed increased basal respiration, maximal respiration, and spare-respiratory capacity in D-HCM iPSC-CMs. RNA sequencing also showed an increased expression of mitochondrial electron transport system-related genes. D-HCM iPSC-CMs showed abnormal Ca2+ handling and hypermetabolic state, similar to that previously reported for HCM patient-derived iPSC-CMs. Although further studies are required, this is expected to be a useful pathological model for D-HCM.
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- 2024
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3. Genetic testing and human leukocyte antigen in patients with hypertrophic cardiomyopathy and connective tissue diseases
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Daigo Hiraya, Nobuyuki Murakoshi, Miyako Igarashi, DongZhu Xu, and Tomoko Ishizu
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hypertrophic cardiomyopathy ,genetic mutations ,human leukocyte antigen ,rheumatoid arthritis ,connective tissue diseases ,Genetics ,QH426-470 - Abstract
Hypertrophic cardiomyopathy (HCM) is caused by myocardial hypertrophy, often due to mutations in cardiac sarcomere protein genes such as beta-myosin heavy chain (MYH7) and myosin-binding protein C (MYBPC3). However, a significant proportion of HCM cases lack identified genetic mutations, and genotype-phenotype correlations remain unclear. Concurrently, potential associations between HCM and human leukocyte antigen (HLA) types, as well as connective tissue diseases, have been proposed. In this single-center study, we aimed to investigate the genetic and HLA profiles of patients with obstructive hypertrophic cardiomyopathy (HOCM) and connective tissue diseases, particularly focusing on the prevalence of genetic variants and HLA types. We conducted a detailed analysis of five patients with HOCM and connective tissue diseases and sarcoidosis, identifying rare variants in causative genes for HCM in two cases and observing specific HLA types that were relatively common. Notably, 15% of all HOCM cases presented with connective tissue diseases, mainly rheumatoid arthritis. These findings underscore the complexity of HCM etiology and suggest potential implications for both diagnostic strategies and therapeutic approaches in patients with concomitant inflammatory conditions.
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- 2024
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4. Association Between Right Bundle Branch Block and Ventricular Arrhythmia in Patients With Cardiac Sarcoidosis
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Yu Yamada, MD, Kimi Sato, MD, PhD, Masayoshi Yamamoto, MD, PhD, Takeru Nabeta, MD, PhD, Yoshihisa Naruse, MD, PhD, Tatsunori Taniguchi, MD, PhD, Takeshi Kitai, MD, PhD, Kenji Yoshioka, MD, PhD, Hidekazu Tanaka, MD, PhD, Takahiro Okumura, MD, PhD, Yuichi Baba, MD, PhD, Yudai Fujimoto, MD, Yuya Matsue, MD, PhD, Yuki Komatsu, MD, PhD, Akihiko Nogami, MD, PhD, and Tomoko Ishizu, MD, PhD
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cardiac sarcoidosis ,interventricular septum thinning ,late gadolinium enhancement ,right bundle branch block ,ventricular arrhythmia ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Background: Ventricular arrhythmia (VA) is a life-threatening condition associated with cardiac sarcoidosis (CS). Right bundle branch block (RBBB) is a common conduction disorder in CS; however, its association with VA remains unknown. Objectives: This study aimed to investigate the relationship between RBBB and VA in patients with CS. Methods: This was a post hoc analysis of ILLUMINATE-CS (Illustration of the Management and Prognosis of Japanese Patients with Cardiac Sarcoidosis), a multicenter, retrospective, and observational study that evaluated the clinical characteristics and prognosis of CS. Eligible patients were divided into two groups based on the presence or absence of RBBB at the time of diagnosis. The primary outcome was serious ventricular arrhythmia events (SVAEs), defined as a combination of sudden cardiac death and documented ventricular fibrillation, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator therapy. Results: Overall, 312 patients were studied, with 155 (49.7%) patients presenting with RBBB (RBBB group). Patients in the RBBB group had a higher prevalence of basal interventricular septum (IVS) thinning and prominent late gadolinium enhancement in the basal IVS on cardiac magnetic resonance imaging than those in the non-RBBB group. During a median follow-up of 3.0 years (IQR: 1.6-6.0 years), 66 patients experienced SVAE. In multivariable Cox regression analysis, the RBBB group was independently associated with a higher incidence of SVAEs (HR: 1.93 [95% CI: 1.14-3.28]; P = 0.015). Conclusions: In patients with CS, RBBB was an independent predictor of SVAEs, which might reflect the specific scar distribution that is predominant in the IVS.
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- 2024
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5. Impact of cancer in patients with aortic stenosis undergoing transcatheter aortic valve replacement: A systematic review and meta-analysis
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Takumi Osawa, Kazuko Tajiri, Tomoya Hoshi, Masaki Ieda, and Tomoko Ishizu
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Cardio-oncology ,TAVI ,TAVR ,Onco-cardiology ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Owing to the minimally invasive nature of transcatheter aortic valve replacement (TAVR), TAVR seems to be preferred in patients with cancer; however, related research on the clinical efficacy and safety of TAVR in patients with cancer and severe aortic stenosis is limited, and conclusions are controversial. This study aimed to evaluate the clinical outcomes of patients with cancer who underwent TAVR. Method and results: We conducted a systematic review and meta-analysis to investigate the clinical outcomes in patients with and without cancer who underwent TAVR. We systematically reviewed and analyzed 15 studies (195,658 patients) published in PubMed and Cochrane Library databases between January 2022 and January 2023. The primary outcomes were short-term (in-hospital or 30-day) and long-term (≥12 months) mortality. The prevalence of current or previous cancer in the patients undergoing TAVR was 19.8 % (38,695 patients). Patients with cancer had a lower risk of short-term mortality (odds ratio [OR] 0.69, 95 % confidence interval [CI] 0.61–0.77, P
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- 2024
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6. Impact of Transcatheter Aortic Valve Replacement on Cardiac Reverse Remodeling and Prognosis in Mixed Aortic Valve Disease
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Yoshihito Saijo, Kenya Kusunose, Tomonori Takahashi, Hirotsugu Yamada, Masataka Sata, Kimi Sato, Noor Albakaa, Tomoko Ishizu, and Yoshihiro Seo
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aortic regurgitation ,aortic stenosis ,mixed aortic valve disease ,reverse remodeling ,transcatheter aortic valve replacement ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The management of mixed aortic valve disease (MAVD), defined as the concomitant presence of aortic stenosis (AS) and aortic regurgitation, remains a clinical challenging. The present study assessed the impact of transcatheter aortic valve replacement (TAVR) on cardiac geometry and prognosis in patients with MAVD. Methods and Results A retrospective multicenter TAVR registry was conducted, including patients who underwent TAVR for severe symptomatic AS between January 2015 and March 2019. Patients were subdivided into 2 groups according to concomitant presence of moderate or more severe aortic regurgitation as the MAVD group, and with mild or less severe aortic regurgitation as the isolated AS group. The primary outcome was a composite of cardiovascular death and rehospitalization due to cardiovascular causes. A total of 1742 patients (isolated AS, 1522 patients; MAVD, 220 patients) were included (84.0±5.2 years). Although MAVD exhibited significantly larger left ventricular volumes and higher left ventricular mass index at the TAVR procedure than isolated AS (respectively, P
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- 2024
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7. Factors associated with carotid intima-media thickness progression in patients with asymptomatic hyperuricemia: insights from the PRIZE study
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Yuichi Saito, Atsushi Tanaka, Tomoko Ishizu, Hisako Yoshida, Yoshiaki Kubota, Mamoru Nanasato, Munehide Matsuhisa, Yusuke Ohya, Yoshio Kobayashi, Koichi Node, and the PRIZE Study Investigators
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Medicine ,Science - Abstract
Abstract Hyperuricemia is reportedly associated with the progression of carotid intima-media thickness (IMT), a surrogate of cardiovascular risks and events. However, factors associated with carotid IMT progression in patients with asymptomatic hyperuricemia are largely unknown. In this post-hoc analysis of the multicenter, randomized PRIZE study, we analyzed data from a total of 326 patients who underwent carotid ultrasonography in a blind manner at baseline and 24 months to evaluate carotid IMT. Mean and maximum IMT at the common carotid artery (CCA) were measured at a central core laboratory. Factors related to the absolute change in mean and maximum IMT from baseline to 24 months were explored. Overall, the adjusted mean [0.0032 (− 0.0214 to 0.0278) mm] and maximum [0.0011 (− 0.0327 to 0.0351) mm] CCA-IMT increased numerically from baseline to 24 months. Multivariable analysis identified higher body mass index, history of atherosclerotic cardiovascular disease (ASCVD), and lower mean CCA-IMT at baseline as significant factors associated with the increase in mean CCA-IMT. In addition, older age and lower mean CCA-IMT at baseline were significant factors for an increased absolute change in the maximum CCA-IMT at 24 months. The present sub-analysis of the PRIZE study showed higher body mass index, history of ASCVD, and older age as significant factors associated with CCA-IMT progression in patients with asymptomatic hyperuricemia. These factors may be considered when identifying the possible risk of atherosclerotic progression in this specific patient population of hyperuricemia. Trial registration: UMIN000012911 and UMIN000041322.
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- 2023
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8. Clinical outcomes of takotsubo syndrome in patients with cancer: a systematic review and meta-analysis
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Takumi Osawa, Kazuko Tajiri, Masaki Ieda, and Tomoko Ishizu
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stress cardiomyopathy ,apical ballooning ,broken heart syndrome ,stress-induced cardiomyopathy ,cardio-oncology ,onco-cardiology ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundRecent studies suggested a relationship between Takotsubo syndrome (TTS) and malignancy. However, clinical outcomes of TTS associated with cancer have not been assessed completely. This study was aimed to investigate the outcomes of patients with TTS and cancer.MethodsWe performed a systematic review and meta-analysis to evaluate the clinical outcomes of TTS in patients with and without malignancy. We systematically reviewed and analyzed 14 studies (189,210 patients) published in PubMed and Cochrane Library databases until December 2022. The primary outcome was all-cause mortality at the longest follow-up.ResultsThe prevalence of current or previous malignancy in patients with TTS was 8.7% (16,461 patients). Patients with TTS and malignancy demonstrated a higher risk of mortality at the longest follow-up than those with TTS alone (odds ratio [OR], 2.41; 95% confidence interval [CI]; 1.95–2.98; P
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- 2023
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9. Cardiac Reversibility and Survival After Transcatheter Aortic Valve Implantation in Patients With Low‐Gradient Aortic Stenosis
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Kimi Sato, Yoshihiro Seo, Tomoko Ishizu, Noor K. Albakaa, Masaki Izumo, Atsushi Okada, Chisato Izumi, Shu Inami, Yasuharu Takeda, Toshinari Onishi, Yuki Izumi, Akiko Kumagai, Tomoko Fukuda, Naohiko Takahashi, Takeshi Kitai, Hiroyuki Iwano, Shigeo Sugawara, Kazumi Akasaka, Kenji Harada, Yoshiko Masaoka, Kenya Kusunose, Kazuaki Tanabe, Takahiro Sakamoto, Takeshi Takamura, and Masaki Ieda
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low‐flow, low‐gradient AS ,low‐gradient AS ,normal‐flow, low‐gradient AS ,TAVI ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Prognostic implications of transcatheter aortic valve implantation (TAVI) in low‐gradient (LG) aortic stenosis (AS) remain controversial. The authors hypothesized that differences in cardiac functional recovery may solve this ongoing controversy. The aim was to evaluate clinical outcomes and the response of left ventricular (LV) function following TAVI in patients with LG AS. Methods and Results This multicenter retrospective study included 1742 patients with severe AS undergoing TAVI between January 2015 and March 2019. Patients were subdivided into low‐flow (LF) LG, normal‐flow (NF) LG, LF high‐gradient, and NF high‐gradient AS groups according to the mean gradient of the aortic valve (LG
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- 2023
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10. Reduced reactive hyperemia of the brachial artery in diabetic patients assessed by repeated measurements: The FMD‐J B study
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Nobuyuki Masaki, Takeshi Adachi, Hirofumi Tomiyama, Takahide Kohro, Toru Suzuki, Tomoko Ishizu, Shinichiro Ueda, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Teruo Inoue, Shinji Koba, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka Ishibashi, Koichi Node, Koji Maemura, Yusuke Ohya, Taiji Furukawa, Hiroshi Ito, Yukihito Higashi, Akira Yamashina, and Bonpei Takase
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clinical study ,diabetes mellitus ,endothelial function ,hyperglycemia ,reactive hyperemia ,Physiology ,QP1-981 - Abstract
Abstract Type 2 diabetes mellitus (T2DM) is a major cause of microvascular dysfunction. However, its effect on blood flow patterns during ischemic demand has not been adequately elucidated. In this study, we investigated the hypothesis that microvascular dysfunction in patients with T2DM manifests as brachial reactive hyperemia (BRH), defined as the ratio of peak blood flow velocities in a brachial artery before and after forearm cuff occlusion. The study enrolled 943 subjects (men, n = 152 [T2DM] and n = 371 [non‐T2DM]; women, n = 107 [T2DM] and n = 313 [non‐T2DM], respectively) with no history of cardiovascular disease. Semiautomatic measurements were obtained three times at 1.5‐year intervals to confirm the reproducibility of factors involved in BRH for each sex. An age‐adjusted mixed model demonstrated attenuated BRH in the presence of T2DM in both men (p = 0.022) and women (p = 0.031) throughout the study period. Post hoc analysis showed that the estimated BRH was significantly attenuated in patients with T2DM regardless of sex, except at baseline in women. In multivariate regression analysis, T2DM was a negative predictor of BRH at every measurement in men. For women, BRH was more strongly associated with alcohol consumption. Repeated measurements analysis revealed that T2DM was associated with attenuated postocclusion reactive hyperemia.
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- 2023
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11. THEFIS Test Simulation to Validate a Freezing Model of ASTERIA-SFR Core Disruptive Accident Analysis Code
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Tomoko Ishizu, Hiroki Sonoda, and Satoshi Fujita
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fast reactor ,core disruptive accident ,melt freezing ,model validation ,THEFIS test ,penetration length ,Nuclear engineering. Atomic power ,TK9001-9401 - Abstract
The mechanical consequences of core disruptive accidents (CDAs) are a major safety concern in sodium-cooled fast reactors. Once core disruption occurs, liquefied core materials rapidly disperse vertically and radially. The dispersed materials penetrate the pin bundles and control rod guide tubes (CRGTs) before freezing at the edge of the penetration zone as heat is transferred to surrounding structures. Such freezing phenomena can suppress the negative reactivity feedback of fuel dispersion. The discharge of core materials can be impeded, resulting in a molten core pool formation when tight blockages occur inside CRGTs due to frozen material. Accordingly, freezing phenomena of core materials play a key role in governing the mechanical consequences of a CDA. To validate a freezing model implemented in our CDA analysis code, ASTERIA-SFR, a preliminary simulation of the THEFIS RUN#1 test, was performed. The calculation results show that freezing on the structural wall and crust formation were key phenomena affecting the penetration behavior, and the structural heat transfer is an important parameter. A remarkable reduction of the heat transfer coefficient was required to reproduce the penetration length observed in the experiment. This suggests that the momentum exchange and flow regime at the leading edge as well as heat transfer should be well modeled to predict the freezing phenomena in rapidly evolving CDAs.
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- 2023
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12. Utility of Updated Japanese Circulation Society Guidelines to Diagnose Isolated Cardiac Sarcoidosis
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Kimi Sato, Naoto Kawamatsu, Masayoshi Yamamoto, Tomoko Machino‐Ohtsuka, Tomoko Ishizu, and Masaki Ieda
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echocardiography ,FDG‐PET ,isolated cardiac sarcoidosis ,multimodality imaging ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background In the population with cardiac sarcoidosis (CS), approximately one third lacks extracardiac involvement and is considered to have isolated CS. Recently, the Japanese Circulation Society updated the diagnostic criteria for CS, providing a methodology for diagnosing isolated CS. We aimed to assess the characteristics of isolated CS diagnosed using a multimodal imaging approach according to the updated Japanese Circulation Society guidelines. Methods and Results We retrospectively identified 161 consecutive patients who underwent 18F‐fluorodeoxyglucose positron emission tomography for suspected CS between 2012 and 2019. According to the guidelines, patients were classified as having CS with extracardiac involvement, isolated CS, or no CS. We compared the characteristics of multimodality imaging and the prevalence of major adverse cardiovascular events. The Japanese Circulation Society criteria classified 28 patients (17%) as having CS with 4 (2%) with histological confirmation, 21 (13%) as isolated CS, and 112 (70%) as no CS. Compared with CS, isolated CS showed higher left ventricular volume and reduced left ventricular ejection fraction (P
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- 2022
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13. Association between serum urate level and carotid atherosclerosis: an insight from a post hoc analysis of the PRIZE randomised clinical trial
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Atsushi Tanaka, Shinichiro Ueda, Teruo Inoue, Koichi Node, Toru Kato, Shigeru Toyoda, Hisako Yoshida, Shuichi Hamasaki, Masato Watarai, and Tomoko Ishizu
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Medicine - Published
- 2022
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14. 3-Dimensional Speckle-Tracking Echocardiography-Derived Interventricular Activation Imaging in a Patient With Repaired Tetralogy of Fallot
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Tomoko Ishizu, MD, PHD, Yoshihiro Seo, MD, PHD, Yuki Komatsu, MD, PHD, Nobuyuki Ohte, MD, PHD, and Masaki Ieda, MD, PHD
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activation imaging system ,tetralogy of Fallot ,3-dimensional speckle-tracking echocardiography ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Using 3-dimensional speckle-tracking echocardiography-derived activation imaging system, we visualized interventricular dyssynchrony in a repaired tetralogy of Fallot case with pacing-induced left ventricular dysfunction. The activation imaging system visualized interventricular dyssynchrony and resynchronization after cardiac resynchronization therapy and may be useful to assess electromechanical disturbance in complicated congenital heart diseases. (Level of Difficulty: Intermediate.)
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- 2020
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15. Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: A randomized, controlled trial.
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Atsushi Tanaka, Isao Taguchi, Hiroki Teragawa, Nobukazu Ishizaka, Yumiko Kanzaki, Hirofumi Tomiyama, Masataka Sata, Akira Sezai, Kazuo Eguchi, Toru Kato, Shigeru Toyoda, Ryoichi Ishibashi, Kazuomi Kario, Tomoko Ishizu, Shinichiro Ueda, Koji Maemura, Yukihito Higashi, Hirotsugu Yamada, Mitsuru Ohishi, Kotaro Yokote, Toyoaki Murohara, Jun-Ichi Oyama, Koichi Node, and PRIZE study investigators
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Medicine - Abstract
BackgroundAn elevated level of serum uric acid (SUA) is associated with an increased risk of cardiovascular disease. Pharmacological intervention with urate-lowering agents, such as the conventional purine analogue xanthine oxidase (XO) inhibitor, allopurinol, has been used widely for a long period of time in clinical practice to reduce SUA levels. Febuxostat, a novel non-purine selective inhibitor of XO, has higher potency for inhibition of XO activity and greater urate-lowering efficacy than conventional allopurinol. However, clinical evidence regarding the effects of febuxostat on atherosclerosis is lacking. The purpose of the study was to test whether treatment with febuxostat delays carotid intima-media thickness (IMT) progression in patients with asymptomatic hyperuricemia.Methods and findingsThe study was a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial undertaken at 48 sites throughout Japan between May 2014 and August 2018. Adults with both asymptomatic hyperuricemia (SUA >7.0 mg/dL) and maximum IMT of the common carotid artery (CCA) ≥1.1 mm at screening were allocated equally using a central web system to receive either dose-titrated febuxostat (10-60 mg daily) or as a control-arm, non-pharmacological lifestyle modification for hyperuricemia, such as a healthy diet and exercise therapy. Of the 514 enrolled participants, 31 were excluded from the analysis, with the remaining 483 people (mean age 69.1 years [standard deviation 10.4 years], female 19.7%) included in the primary analysis (febuxostat group, 239; control group, 244), based on a modified intention-to-treat principal. The carotid IMT images were recorded by a single sonographer at each site and read in a treatment-blinded manner by a single analyzer at a central core laboratory. The primary endpoint was the percentage change from baseline to 24 months in mean IMT of the CCA, determined by analysis of covariance using the allocation adjustment factors (age, gender, history of type 2 diabetes, baseline SUA, and baseline maximum IMT of the CCA) as the covariates. Key secondary endpoints included changes in other carotid ultrasonographic parameters and SUA and the incidence of clinical events. The mean values (± standard deviation) of CCA-IMT were 0.825 mm ± 0.173 mm in the febuxostat group and 0.832 mm ± 0.175 mm in the control group (mean between-group difference [febuxostat - control], -0.007 mm [95% confidence interval (CI) -0.039 mm to 0.024 mm; P = 0.65]) at baseline; 0.832 mm ± 0.182 mm in the febuxostat group and 0.848 mm ± 0.176 mm in the control group (mean between-group difference, -0.016 mm [95% CI -0.051 mm to 0.019 mm; P = 0.37]) at 24 months. Compared with the control group, febuxostat had no significant effect on the primary endpoint (mean percentage change 1.2% [95% CI -0.6% to 3.0%] in the febuxostat group (n = 207) versus 1.4% [95% CI -0.5% to 3.3%] in the control group (n = 193); mean between-group difference, -0.2% [95% CI -2.3% to 1.9%; P = 0.83]). Febuxostat also had no effect on the other carotid ultrasonographic parameters. The mean baseline values of SUA were comparable between the two groups (febuxostat, 7.76 mg/dL ± 0.98 mg/dL versus control, 7.73 mg/dL ± 1.04 mg/dL; mean between-group difference, 0.03 mg/dL [95% CI -0.15 mg/dL to 0.21 mg/dL; P = 0.75]). The mean value of SUA at 24 months was significantly lower in the febuxostat group than in the control group (febuxostat, 4.66 mg/dL ± 1.27 mg/dL versus control, 7.28 mg/dL ± 1.27 mg/dL; mean between-group difference, -2.62 mg/dL [95% CI -2.86 mg/dL to -2.38 mg/dL; P < 0.001]). Episodes of gout arthritis occurred only in the control group (4 patients [1.6%]). There were three deaths in the febuxostat group and seven in the control group during follow-up. A limitation of the study was the study design, as it was not a placebo-controlled trial, had a relatively small sample size and a short intervention period, and only enrolled Japanese patients with asymptomatic hyperuricemia.ConclusionsIn Japanese patients with asymptomatic hyperuricemia, 24 months of febuxostat treatment did not delay carotid atherosclerosis progression, compared with non-pharmacological care. These findings do not support the use of febuxostat for delaying carotid atherosclerosis in this population.Trial registrationUniversity Hospital Medical Information Network Clinical Trial Registry UMIN000012911.
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- 2020
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16. Diagnostic Criteria of Flow‐Mediated Vasodilation for Normal Endothelial Function and Nitroglycerin‐Induced Vasodilation for Normal Vascular Smooth Muscle Function of the Brachial Artery
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Tatsuya Maruhashi, Masato Kajikawa, Shinji Kishimoto, Haruki Hashimoto, Yuji Takaeko, Takayuki Yamaji, Takahiro Harada, Yiming Han, Yoshiki Aibara, Farina Mohamad Yusoff, Takayuki Hidaka, Yasuki Kihara, Kazuaki Chayama, Ayumu Nakashima, Chikara Goto, Hirofumi Tomiyama, Bonpei Takase, Takahide Kohro, Toru Suzuki, Tomoko Ishizu, Shinichiro Ueda, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Teruo Inoue, Shinji Koba, Kentaro Watanabe, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka Ishibashi, Koichi Node, Koji Maemura, Yusuke Ohya, Taiji Furukawa, Hiroshi Ito, Hisao Ikeda, Akira Yamashina, and Yukihito Higashi
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diagnostic criteria ,endothelial function ,flow‐mediated vasodilation ,nitroglycerin‐induced vasodilation ,vascular smooth muscle function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Diagnostic criteria of flow‐mediated vasodilation (FMD), an index of endothelial function, and nitroglycerin‐induced vasodilation (NID), an index of vascular smooth muscle function, of the brachial artery have not been established. The purpose of this study was to propose diagnostic criteria of FMD and NID for normal endothelial function and normal vascular smooth muscle function. Methods and Results We investigated the cutoff values of FMD and NID in subjects with (risk group) and those without cardiovascular risk factors or cardiovascular diseases (no‐risk group) in 7277 Japanese subjects (mean age 51.4±10.8 years) from the Flow‐Mediated Dilation Japan study and the Flow‐Mediated Dilatation Japan Registry study for analysis of the cutoff value of FMD and in 1764 Japanese subjects (62.2±16.1 years) from the registry of Hiroshima University Hospital for analysis of the cutoff value of NID. Receiver‐operator characteristic curve analysis of FMD to discriminate subjects in the no‐risk group from patients in the risk group showed that the optimal cutoff value of FMD to diagnose subjects in the no‐risk group was 7.1%. Receiver‐operator characteristic curve analysis of NID to discriminate subjects in the no‐risk group from patients in the risk group showed that the optimal cutoff value of NID to diagnose subjects in the no‐risk group was 15.6%. Conclusions We propose that the cutoff value for normal endothelial function assessed by FMD of the brachial artery is 7.1% and that the cutoff value for normal vascular smooth muscle function assessed by NID of the brachial artery is 15.6% in Japanese subjects. Clinical Trial Registration www.umin.ac.jp Unique identifiers: UMIN000012950, UMIN000012951, UMIN000012952, and UMIN000003409
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- 2020
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17. Brachial‐Ankle Pulse Wave Velocity Versus Its Stiffness Index β‐Transformed Value as Risk Marker for Cardiovascular Disease
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Hirofumi Tomiyama, Toshiaki Ohkuma, Toshiharu Ninomiya, Hiroki Nakano, Chisa Matsumoto, Alberto Avolio, Takahide Kohro, Yukihito Higashi, Tatsuya Maruhashi, Bonpei Takase, Toru Suzuki, Tomoko Ishizu, Shinichiro Ueda, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Teruo Inoue, Shinji Koba, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka Ishibashi, Koichi Node, Koji Maemura, Yusuke Ohya, Taiji Furukawa, Hiroshi Ito, Taishiro Chikamori, and Akira Yamashina
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arterial stiffness ,blood pressure ,hypertension ,organ damage ,stiffness index β ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The difference in the predictive ability of the brachial‐ankle pulse wave velocity (baPWV) and its stiffness index β‐transformed value (β‐baPWV, ie, baPWV adjusted for the pulse pressure) for the development of pathophysiological abnormalities related to cardiovascular disease or future occurrence of cardiovascular disease was examined. Methods and Results In study 1, a 7‐year prospective observational study in cohorts of 3274 men and 3490 men, the area under the curve in the receiver operator characteristic curve analysis was higher for baPWV than for β‐baPWV for predicting the development of hypertension (0.73, 95% CI=0.70 to 0.75 versus 0.59, 95% CI=0.56 to 0.62; P
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- 2019
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18. Embolization of the Deep Vein Thrombus During Ultrasound Examination
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Noor K. Albakaa, MD, Tomoko Ishizu, MD, PhD, Noriko Iida, PhD, Kazuko Tajiri, MD, PhD, and Masaki Ieda, MD, PhD
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deep vein thrombosis ,echocardiography ,lung adenocarcinoma ,right atrium thrombus ,ultrasound examination ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Thrombus embolization is a rare consequence of ultrasonographic examination of the vessels of the lower limbs. We present a case of a 77-year-old woman with lung cancer who developed pulmonary embolism originating from the right femoral deep vein thrombus during the compression maneuver of the ultrasonographic examination of the lower limbs. (Level of Difficulty: Beginner.)
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- 2020
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19. Rationale, Design, and Feasibility of a Prospective Multicenter Registry Study of Anthracycline-Induced Cardiotoxicity (AIC Registry)
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Keiko Inoue, Noriko Iida, Kazuko Tajiri, Hiroko Bando, Shigeru Chiba, Nobutaka Tasaka, Kenji Nagashio, Rumi Sasamura, Hiroyuki Naito, Momoko Murata, Siqi Li, Tomoko Ishizu, Yoko Nakazawa, Ikuo Sekine, and Masaki Ieda
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anthracycline ,cardiotoxicity ,cardiomyopathy ,onco-cardiology ,cardio-oncology ,echocardiography ,Medicine - Abstract
As the number of cancer survivors increases, cardiac management in anthracycline-treated patients has become more important. We planned to conduct a prospective multicenter registry study for comprehensive echocardiographic and biomarker data collection and an evaluation of the current practice in terms of diagnosis and management of anthracycline-induced cardiotoxicity (AIC registry). To examine the feasibility of this registry study, we analyzed the 1-year follow-up data of 97 patients registered during the first year of this registry. The AIC registry was launched in July 2016. Data on echocardiographic parameters (e.g., two-and three-dimensional [(2- and 3-D) left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS)) and biomarkers (e.g., troponin T and brain natriuretic peptide) were collected before anthracycline treatment, every 3 months during the first year after starting anthracycline, and every 6 months during the second year. Eighty-three patients (86%) completed a 1-year follow-up. The measurable rates of 2D LVEF, 3D LVEF, and GLS on each visit were nearly optimal (100%, 86–93%, and 84–94%, respectively). During the 1-year follow-up, 5 patients (6.0%) developed cardiotoxicity (a reduction in LVEF ≥ 10 percentage points from baseline and
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- 2021
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20. Endothelial Dysfunction, Increased Arterial Stiffness, and Cardiovascular Risk Prediction in Patients With Coronary Artery Disease: FMD‐J (Flow‐Mediated Dilation Japan) Study A
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Tatsuya Maruhashi, Junko Soga, Noritaka Fujimura, Naomi Idei, Shinsuke Mikami, Yumiko Iwamoto, Akimichi Iwamoto, Masato Kajikawa, Takeshi Matsumoto, Nozomu Oda, Shinji Kishimoto, Shogo Matsui, Haruki Hashimoto, Yoshiki Aibara, Farina Mohamad Yusoff, Takayuki Hidaka, Yasuki Kihara, Kazuaki Chayama, Kensuke Noma, Ayumu Nakashima, Chikara Goto, Hirofumi Tomiyama, Bonpei Takase, Takahide Kohro, Toru Suzuki, Tomoko Ishizu, Shinichiro Ueda, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Teruo Inoue, Shinji Koba, Kentaro Watanabe, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka Ishibashi, Koichi Node, Koji Maemura, Yusuke Ohya, Taiji Furukawa, Hiroshi Ito, Hisao Ikeda, Akira Yamashina, and Yukihito Higashi
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arterial stiffness ,coronary artery disease ,endothelial function ,flow‐induced dilation ,pulse wave velocity ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The usefulness of vascular function tests for management of patients with a history of coronary artery disease is not fully known. Methods and Results We measured flow‐mediated vasodilation (FMD) and brachial–ankle pulse wave velocity (baPWV) in 462 patients with coronary artery disease for assessment of the predictive value of FMD and baPWV for future cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow‐up period of 49.2 months, the first primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver‐operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio, 0.27; 95% confidence interval, 0.06–0.74; P=0.008) and second (hazard ratio, 0.32; 95% confidence interval, 0.09–0.79; P=0.01) primary outcomes. baPWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (hazard ratio, 1.86; 95% confidence interval, 1.01–3.44; P=0.04) and second (hazard ratio, 2.19; 95% confidence interval, 1.23–3.90; P=0.008) primary outcomes. Among 4 groups stratified according to the combination of cutoff values of FMD and baPWV, stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed. Conclusions In patients with coronary artery disease, both FMD and baPWV were significant predictors of cardiovascular events. The combination of FMD and baPWV provided further cardiovascular risk stratification. Clinical Trial Registration URL: www.umin.ac.jp. Unique identifier: UMIN000012950.
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- 2018
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21. A Long-Term Survivor with Tetralogy of Fallot Treated Only with the Classical Blalock-Taussig Shunt
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Yu Yamada, Tomoko Ishizu, Hidekazu Tsuneoka, Yutaka Eki, and Hitoshi Horigome
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The prognosis of tetralogy of Fallot (TOF) treated only with Blalock-Taussig shunt (BTS) operation is unclear. A woman with TOF underwent classic BTS operation at 10 years of age. Despite no medication, she delivered two children and worked without apparent heart failure. At 72 years of age, she complained of dyspnea on exertion and leg edema. The cardiac angiogram revealed a well-patent BTS and severely stenotic right ventricular outflow tract. Right heart catheterization showed adequately maintained pulmonary blood flow with slight pulmonary arterial hypertension. Her unexpected yet favorable outcome reaffirms the importance of structural and functional self-adaptation even with cyanosis. If she had undergone a valve-sparing corrective surgery in adolescence, much better quality of life and outcome could have been expected.
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- 2018
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22. Incremental Value of Speckle Tracking Echocardiography to Predict Cardiac Resynchronization Therapy (CRT) Responders
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Yoshihiro Seo, Tomoko Ishizu, Tomoko Machino‐Ohtsuka, Masayoshi Yamamoto, Takeshi Machino, Kenji Kuroki, Hiro Yamasaki, Yukio Sekiguchi, Akihiko Nogami, and Kazutaka Aonuma
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cardiac resynchronization therapy ,heart failure ,speckle training echocardiography ,statistics ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundSpeckle tracking echocardiography (STE) is reported as a useful method to predict cardiac resynchronization therapy (CRT) responders. This study aimed to identify the incremental value of a STE parameter to predict CRT responders. Methods and ResultsWe enrolled 171 patients from the Speckle Tracking imaging for the Assessment of cardiac Resynchronization Therapy (START) study. CRT responders were defined as patients with ≥15% reduction of left ventricular (LV) end‐systolic volume at 6 months post‐CRT. Based on multivariable logistic regression analysis, incremental values of STE were assessed by c‐statistics, net reclassification improvement (NRI)/integrated discrimination improvement (IDI), and decision curve analysis. Six parameters (left bundle branch block or right ventricular pacing, use of beta‐blocker, blood urea nitrogen ≤3.0 mg/dL, LV end‐systolic diameter ≤50 mm, mitral regurgitation index ≤40%, and STE parameter standard deviation of time from QRS onset to first peak on the circumferential strain curves [TSD] ≥116 ms) were identified as the determinants. Compared to the multivariable logistic regression model without TSD (model 1), that with TSD (model 2) showed significant improvement to predict CRT responders: c‐statistic (0.86 vs 0.77; P
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- 2016
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23. The Effect of Sitagliptin on Carotid Artery Atherosclerosis in Type 2 Diabetes: The PROLOGUE Randomized Controlled Trial.
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Jun-Ichi Oyama, Toyoaki Murohara, Masafumi Kitakaze, Tomoko Ishizu, Yasunori Sato, Kazuo Kitagawa, Haruo Kamiya, Masayoshi Ajioka, Masaharu Ishihara, Kazuoki Dai, Mamoru Nanasato, Masataka Sata, Koji Maemura, Hirofumi Tomiyama, Yukihito Higashi, Kohei Kaku, Hirotsugu Yamada, Munehide Matsuhisa, Kentaro Yamashita, Yasuko K Bando, Naoki Kashihara, Shinichiro Ueda, Teruo Inoue, Atsushi Tanaka, Koichi Node, and PROLOGUE Study Investigators
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Medicine - Abstract
BackgroundExperimental studies have suggested that dipeptidyl peptidase-4 (DPP-4) inhibitors provide cardiovascular protective effects. We performed a randomized study to evaluate the effects of sitagliptin added on to the conventional therapy compared with conventional therapy alone (diet, exercise, and/or drugs, except for incretin-related agents) on the intima-media thickness (IMT) of the carotid artery, a surrogate marker for the evaluation of atherosclerotic cardiovascular disease, in people with type 2 diabetes mellitus (T2DM).Methods and findingsWe used a multicenter PROBE (prospective, randomized, open label, blinded endpoint) design. Individuals aged ≥30 y with T2DM (6.2% ≤ HbA1c < 9.4%) were randomly allocated to receive either sitagliptin (25 to 100 mg/d) or conventional therapy. Carotid ultrasound was performed at participating medical centers, and all parameters were measured in a core laboratory. Of the 463 enrolled participants with T2DM, 442 were included in the primary analysis (sitagliptin group, 222; conventional therapy group, 220). Estimated mean (± standard error) common carotid artery IMT at 24 mo of follow-up in the sitagliptin and conventional therapy groups was 0.827 ± 0.007 mm and 0.837 ± 0.007 mm, respectively, with a mean difference of -0.009 mm (97.2% CI -0.028 to 0.011, p = 0.309). HbA1c level at 24 mo was significantly lower with sitagliptin than with conventional therapy (6.56% ± 0.05% versus 6.72% ± 0.05%, p = 0.008; group mean difference -0.159, 95% CI -0.278 to -0.041). Episodes of serious hypoglycemia were recorded only in the conventional therapy group, and the rate of other adverse events was not different between the two groups. As it was not a placebo-controlled trial and carotid IMT was measured as a surrogate marker of atherosclerosis, there were some limitations of interpretation.ConclusionsIn the PROLOGUE study, there was no evidence that treatment with sitagliptin had an additional effect on the progression of carotid IMT in participants with T2DM beyond that achieved with conventional treatment.Trial registrationUniversity Hospital Medical Information Network Clinical Trials Registry UMIN000004490.
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- 2016
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24. Successful Treatment of Malignant Lymphoma Following Transcatheter Aortic Valve Replacement.
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Takumi Osawa, Kazuko Tajiri, Tomoya Hoshi, Masaki Ieda, and Tomoko Ishizu
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- 2024
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25. Efficacy and Safety of Long-Term Administration of Esomeprazole in Japanese Pediatric Patients Aged 1-14 Years with Chronic Gastric Acid-Related Disease.
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Masaaki Mori, Yoshiko Nakayama, Shigeo Nishimata, Tadafumi Yokoyama, Ryo Matsuoka, Reiko Hatori, Masaki Shimizu, Katsuhiro Arai, Yuri Etani, Tsuyoshi Sogo, Tomoko Ishizu, Masahiro Nii, Ryosuke Nakashima, and Toshiaki Shimizu
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CHILD patients ,GASTRIC diseases ,ESOMEPRAZOLE ,GASTROESOPHAGEAL reflux ,DUODENAL ulcers ,ANTI-inflammatory agents - Abstract
Purpose: To evaluate prolonged esomeprazole use in Japanese pediatric patients for reflux esophagitis (RE) maintenance therapy and prevention of gastric (GU) and/or duodenal ulcers (DU) while using non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin (LDA). Methods: This multicenter, open-label, parallel-group, phase III study (NCT03553563) included patients who were administered esomeprazole according to body weight (10 mg/day [Groups 1 and 3] and up to 20 mg/day [Groups 2 and 4] for patients weighing 10-20 kg and ≥20 kg, respectively). Efficacy outcomes for Groups 1 and 2 (maintenance therapy for healed RE) and Groups 3 and 4 (prevention of long-term NSAID/LDA use-associated GU/DU) were the presence/absence of RE relapse and GU/DU recurrence, respectively. Results: Esomeprazole as maintenance therapy was associated with a low RE recurrence rate, independent of body weight or dosage. Recurrence rates of RE were 0.0% and 5.3% for Groups 1 and 2, respectively. In patients previously diagnosed with GU and/or DU due to long-term NSAID/LDA use, the recurrence rates of GU/DU during weeks 0-32 were 11.1% and 0.0% in Groups 3 and 4, respectively. Conclusion: Long-term use of 10- or 20-mg, once-daily esomeprazole demonstrated a favorable benefit-risk balance in preventing RE and suppressing recurrence of GU and/or DU secondary to NSAID or LDA therapy in Japanese pediatric patients. No new safety concerns were identified. Esomeprazole may be a viable option for managing RE and preventing GU and DU in Japanese pediatric patients. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Long-QT Syndrome with Peripartum Cardiomyopathy Causing Fatal Ventricular Arrhythmia after Delivery
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Tomofumi Nakatsukasa, Tomoko Ishizu, Toru Adachi, Hiromi Hamada, Akihiko Nogami, and Masaki Ieda
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
27. Successful surgical epicardial cryoablation of refractory atrial tachycardia in a patient with repaired tetralogy of Fallot after multiple failed endocardial ablations
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Qasim J. Naeemah, Miyako Igarashi, Muneaki Matsubara, Tomoko Ishizu, Akihiko Nogami, and Masaki Ieda
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Cardiology and Cardiovascular Medicine - Published
- 2023
28. Association between right ventricular longitudinal strain and cardiovascular events in patients with cardiac sarcoidosis
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Noor K, Albakaa, Kimi, Sato, Noriko, Iida, Masayoshi, Yamamoto, Tomoko, Machino-Ohtsuka, Tomoko, Ishizu, and Masaki, Ieda
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Myocarditis ,Sarcoidosis ,Heart Ventricles ,Ventricular Dysfunction, Right ,Ventricular Function, Right ,Humans ,Contrast Media ,Gadolinium ,Prognosis ,Cardiology and Cardiovascular Medicine - Abstract
While right ventricular (RV) involvement is commonly observed in patients with cardiac sarcoidosis (CS), the utility of strain imaging to detect RV involvement is unclear. We aimed to investigate the association between RV free wall longitudinal strain (RVFWLS) and cardiovascular events in patients with CS.We studied 51 patients with CS who were diagnosed between 2012 and 2020. All patients underwent comprehensive echocardiographic evaluation, and RVFWLS was assessed using 2-dimensional speckle tracking echocardiography. The primary outcome was major adverse cardiovascular events (MACEs).During a median follow-up duration of 548 days, 11 patients exhibited MACEs. In the univariable Cox proportional hazards model, the baseline RVFWLS was associated with MACEs (hazard ratio: 1.29, p = 0.008). The addition of RVFWLS to the conventional echocardiographic parameters exhibited a significant incremental value associated with MACEs. Patients with reduced RVFWLS showed a higher prevalence of late gadolinium enhancement on cardiac magnetic resonance imaging in RV wall (p = 0.02) and trends toward higher prevalence of fluorodeoxyglucose uptake in RV (p = 0.06). A serial echocardiographic evaluation revealed that patients with events showed a worsening in RVFWLS, while others showed a trend toward improvement.Impaired RVFWLS at baseline was associated with MACEs in patients with CS. RVFWLS could be an important surrogate of disease activity and prognosis by detecting active RV involvement in CS.
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- 2022
29. Status of adult outpatients with congenital heart disease in Japan: The Japanese Network of Cardiovascular Departments for Adult Congenital Heart Disease Registry
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Atsushi, Yao, Ryo, Inuzuka, Atsushi, Mizuno, Hiroyuki, Iwano, Shunsuke, Tatebe, Yasumasa, Tsukamoto, Ichiro, Sakamoto, Hiroyuki, Watanabe, Nobuyuki, Fukuda, Fumie, Takechi, Shiro, Adachi, Yusuke, Akazawa, Koichiro, Kuwahara, Kaoru, Dohi, Tomoko, Ishizu, Makoto, Miyake, Norimichi, Koitabashi, Saki, Hasegawa-Tamba, Seiichi, Sato, Takanari, Fujii, Eiji, Ehara, Tohru, Minamino, Hirotsugu, Yamada, Eiji, Yamashita, Naoto, Kawamatsu, Keita, Masuda, Katsura, Soma, Isao, Shiraishi, Ryozo, Nagai, and Koichiro, Niwa
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Adult ,Heart Defects, Congenital ,Japan ,Transposition of Great Vessels ,Outpatients ,Humans ,Adult congenital heart disease ,Prospective Studies ,Registries ,Cardiology and Cardiovascular Medicine ,Lifelong care ,JNCVD-ACHD - Abstract
BackgroundThe Japanese Network of Cardiovascular Departments for Adult Congenital Heart Disease (JNCVD-ACHD) was founded in 2011 for the lifelong care of adult patients with congenital heart disease (ACHD patients). This network maintains the first Japanese ACHD registry.Methods and resultsFrom 2011 to 2019, the JNCVD-ACHD registered 54 institutions providing specialized care for ACHD patients in 32 of the 47 prefectures in Japan. The registry collected data on the disease profile for 24,048 patients from 50 institutions and the patient characteristics for 9743 patients from 24 institutions. The most common ACHDs were atrial septal defect (20.5 %), ventricular septal defect (20.5 %), tetralogy of Fallot (12.9 %), and univentricular heart (UVH)/single ventricle (SV; 6.6 %). ACHD patients without biventricular repair accounted for 37.0 % of the population. Also examined were the serious anatomical and/or pathophysiological disorders such as pulmonary arterial hypertension (3.0 %) including Eisenmenger syndrome (1.2 %), systemic right ventricle under biventricular circulation (sRV-2VC; 2.8 %), and Fontan physiology (6.0 %). The sRV-2VC cases comprised congenitally corrected transposition of the great arteries without anatomical repair (61.9 %) and transposition of the great arteries with atrial switching surgery (38.1 %). The primary etiology (86.4 %) for Fontan physiology was UVH/SV. In addition, developmental/chromosomal/genetic disorders were heterotaxy syndromes (asplenia, 0.9 %; polysplenia, 0.7 %), trisomy 21 (4.0 %), 22q11.2 deletion (0.9 %), Turner syndrome (0.2 %), and Marfan syndrome (1.1 %).ConclusionsAlthough the specific management of ACHD has systematically progressed in Japan, this approach is still evolving. For ideal ACHD care, the prospective goals for the JNCVD-ACHD are to create local networks and provide a resource for multicenter clinical trials to support evidence-based practice.
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- 2022
30. Effect of ipragliflozin on carotid intima-media thickness in type 2 diabetes patients
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Atsushi, Tanaka, Masataka, Sata, Yosuke, Okada, Hiroki, Teragawa, Kazuo, Eguchi, Michio, Shimabukuro, Isao, Taguchi, Kazuo, Matsunaga, Yumiko, Kanzaki, Hisako, Yoshida, Tomoko, Ishizu, Shinichiro, Ueda, Masafumi, Kitakaze, Toyoaki, Murohara, Koichi, Node, Yoshihiko, Nishio, Mitsuru, Ohishi, Kazuomi, Kario, Wataru, Shimizu, Hideaki, Jinnouchi, Hirofumi, Tomiyama, Koji, Maemura, Makoto, Suzuki, Shinichi, Ando, Haruo, Kamiya, Tomohiro, Sakamoto, Mamoru, Nanasato, Munehide, Matsuhisa, Junya, Ako, Yoshimasa, Aso, Masaharu, Ishihara, Kazuo, Kitagawa, Akira, Yamashina, Yumi, Ikehara, Ayako, Takamori, Miki, Mori, Kaori, Yamaguchi, Machiko, Asaka, Tetsuya, Kaneko, Masashi, Sakuma, Shigeru, Toyoda, Takahisa, Nasuno, Michiya, Kageyama, Jojima, Teruo, Iijima, Toshie, Haruka, Kishi, Hirotsugu, Yamada, Kenya, Kusunose, Daiju, Fukuda, Shusuke, Yagi, Koji, Yamaguchi, Takayuki, Ise, Yutaka, Kawabata, Akio, Kuroda, Yuichi, Akasaki, Mihoko, Kurano, Satoshi, Hoshide, Takahiro, Komori, Tomoyuki, Kabutoya, Yukiyo, Ogata, Yuji, Koide, Hiroaki, Kawano, Satoshi, Ikeda, Satoki, Fukae, Seiji, Koga, Yukihito, Higashi, Shinji, Kishimoto, Masato, Kajikawa, Tatsuya, Maruhashi, Yoshiaki, Kubota, Yoshisato, Shibata, Nehiro, Kuriyama, Ikuko, Nakamura, Kanemitsu, Hironori, Bonpei, Takase, Yuichi, Orita, Chikage, Oshita, Yuko, Uchimura, Ruka, Yoshida, Yukihiko, Yoshida, Hirohiko, Suzuki, Yasuhiro, Ogura, Mayuho, Maeda, Masaki, Takenaka, Takumi, Hayashi, Mirai, Hirose, Itaru, Hisauchi, Toshiaki, Kadokami, Ryo, Nakamura, Junji, Kanda, Masaaki, Hoshiga, Koichi, Sohmiya, Arihiro, Koyosue, Hiroki, Uehara, Naoto, Miyagi, Toshiya, Chinen, Kentaro, Nakamura, Chikashi, Nago, Suguru, Chiba, Sho, Hatano, Yoshikatsu, Gima, Masami, Abe, Masayoshi, Ajioka, Hiroshi, Asano, Yoshihiro, Nakashima, Hiroyuki, Osanai, Takahiro, Kanbara, Yusuke, Sakamoto, Mitsutoshi, Oguri, Shiou, Ohguchi, Kunihiko, Takahara, Kazuhiro, Izumi, Kenichiro, Yasuda, Akihiro, Kudo, Noritaka, Machii, Ryota, Morimoto, Yasuko, Bando, Takahiro, Okumura, Toru, Kondo, Shin-Ichiro, Miura, Yuhei, Shiga, Joji, Mirii, Makoto, Sugihara, Tadaaki, Arimura, Junko, Nakano, Kazuhisa, Kodama, Nobuyuki, Ohte, Tomonori, Sugiura, Kazuaki, Wakami, Yasuhiko, Takemoto, Minoru, Yoshiyama, Taichi, Shuto, Kazuo, Fukumoto, Kenichi, Tanaka, Satomi, Sonoda, Akemi, Tokutsu, Takashi, Otsuka, Fumi, Uemura, Kenji, Koikawa, Megumi, Miyazaki, Maiko, Umikawa, Manabu, Narisawa, Machi, Furuta, Hiroshi, Minami, Masaru, Doi, Kazuhiro, Sugimoto, Susumu, Suzuki, Akira, Kurozumi, and Kosuke, Nishio
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Ipragliflozin ,Type 2 diabetes ,Pharmacology (medical) ,Carotid intima-media thickness ,Atherosclerosis ,Cardiology and Cardiovascular Medicine - Abstract
Aims To examine the effects of a 24-month treatment with ipragliflozin on carotid intima-media thickness (IMT) in type 2 diabetes patients. Methods and results In this multicenter, prospective, randomized, open-label, and blinded-endpoint investigator-initiated clinical trial, adults with type 2 diabetes and haemoglobin A1C (HbA1c) of 6.0–10.0% (42–86 mmol/mol) were randomized equally to ipragliflozin (50 mg daily) and non-sodium-glucose cotransporter-2 (SGLT2) inhibitor use of standard-care (control group) for type 2 diabetes and were followed-up to 24 months. The primary endpoint was the change in mean common carotid artery IMT (CCA-IMT) from baseline to 24 months. A total of 482 patients were equally allocated to the ipragliflozin (N = 241) and control (N = 241) groups, and 464 patients (median age 68 years, female 31.7%, median type 2 diabetes duration 8 years, median HbA1c 7.3%) were included in the analyses. For the primary endpoint, the changes in the mean CCA-IMT from baseline to 24 months were 0.0013 [95% confidence interval (CI), −0.0155–0.0182] mm and 0.0015 (95% CI, −0.0155–0.0184) mm in the ipragliflozin and control groups, respectively, with an estimated group difference (ipragliflozin-control) of −0.0001 mm (95% CI, −0.0191–0.0189; P = 0.989). A group difference in HbA1c change at 24 months was also non-significant between the treatment groups [−0.1% (95% CI, −0.2–0.1); P = 0.359]. Conclusion Twenty-four months of ipragliflozin treatment did not affect carotid IMT status in patients with type 2 diabetes recruited in the PROTECT study, relative to the non-SGLT2 inhibitor-use standard care for type 2 diabetes.
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- 2022
31. Effect of Novel Stratified Lipid Risk by 'LDL-Window' and Flow-Mediated Dilation on the Prognosis of Coronary Artery Disease Using the FMD-J Study A Data
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Shichiro, Abe, Yasuo, Haruyama, Gen, Kobashi, Shigeru, Toyoda, Teruo, Inoue, Hirofumi, Tomiyama, Tomoko, Ishizu, Takahide, Kohro, Yukihito, Higashi, Bonpei, Takase, Toru, Suzuki, Shinichiro, Ueda, Tsutomu, Yamazaki, Tomoo, Furumoto, Kazuomi, Kario, Shinji, Koba, Yasuhiko, Takemoto, Takuzo, Hano, Masataka, Sata, Yutaka, Ishibashi, Koichi, Node, Koji, Maemura, Yusuke, Ohya, Taiji, Furukawa, Hiroshi, Ito, and Akira, Yamashina
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Lipoproteins ,Cholesterol, HDL ,Cholesterol, LDL ,General Medicine ,Prognosis ,Dilatation ,Coronary artery disease ,Triglyceride ,Flow-mediated dilation ,Non-high-density lipoprotein cholesterol ,Cholesterol ,Risk Factors ,Humans ,Cardiology and Cardiovascular Medicine ,Lipid risk stratification ,Triglycerides - Abstract
Background: Elevated levels of triglyceride (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) are regarded as a residual lipid risk in low-density lipoprotein cholesterol (LDL-C)-lowering therapy. This study investigated the association between lipid risk stratified by TG and non-HDL-C and the prognosis of patients with coronary artery disease (CAD), and the association between stratified lipid risk and flow-mediated dilatation (FMD) index. Methods and Results: The 624 CAD patients enrolled in flow-mediated dilation (FMD)-J study A were divided into 4 groups: low-risk group (n=413) with TG
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- 2022
32. Using computed tomography fusion imaging as learning data for sonographer training in identification of left ventricular endocardial boundaries
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Yoshiki Shiina, Tomoko Ishizu, Satomi Nesaki, Hideki Nakajima, Noriko Iida, Naoto Kawamatsu, Kimi Sato, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Masaki Ieda, and Yasushi Kawakami
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Cardiology and Cardiovascular Medicine - Published
- 2023
33. Echocardiography image quality of global longitudinal strain in cardio-oncology: a prospective real-world investigation
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Noriko Iida, Kazuko Tajiri, Tomoko Ishizu, Rumi Sasamura-Koshizuka, Hideki Nakajima, Naoto Kawamatsu, Kimi Sato, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Hiroko Bando, Ikuo Sekine, Yasushi Kawakami, and Masaki Ieda
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Adult ,Ventricular Dysfunction, Left ,Echocardiography ,Humans ,Reproducibility of Results ,Breast Neoplasms ,Female ,Stroke Volume ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Middle Aged ,Ventricular Function, Left - Abstract
Left-ventricular (LV) global longitudinal strain (GLS) has been reported to be a robust and sensitive marker of chemotherapy-induced cardiac damage. Image quality is paramount for accurate GLS measurements. In real-world cardio-oncology settings, the incidence of suboptimal echocardiography quality and its significance in clinical decision-making have not been well investigated. This prospective study examined the incidence and impact of suboptimal echocardiographic image quality on detecting subtle myocardial damage by chemotherapy.Seventy-seven consecutive patients with breast cancer (age, 52 ± 12 years, 76 women, 33 with left-sided breast cancer) were included in this study. Echocardiography was performed at 3-month intervals 1 year before and after chemotherapy initiation. We classified the image quality of each echocardiographic acquisition into three groups: optimal, suboptimal, or inadequate for speckle tracking.Among the 376 examinations obtained during the cardiac monitoring, the image quality in 194 (52%) was optimal, suboptimal in 159 (42%), and inadequate in 23 (6%). The interobserver reproducibility was 0.91 in the optimal and 0.21 in the suboptimal group. In contrast, the optimal group showed progressive impairment in both GLS (p = 0.001) and LV ejection fraction (LVEF) (p 0.001) during follow-up, and the suboptimal group showed a progressive decrease in LVEF (p = 0.006), but not in GLS (p = 0.13). Left-sided mammotomy and/or reconstruction surgery and high body mass index were significant determinants of suboptimal image quality.Even in cases of minor image quality impairment, the physician should assess GLS carefully to avoid errors in crucial clinical decision-making.
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- 2022
34. PO-01-011 EFFECT OF TRANSVENOUS SYSTEMIC RIGHT VENTRICULAR PACING FOR HEART FAILURE IN ADDITION TO MANAGING ARRHYTHMIAS IN THE PATIENT WITH UNREPAIRED D-TGA
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Miyako Igarashi, Tomoko Mahino-Ohtsuka, Yoshiki Aono, Qasim J. Naeemah, YUTO IIOKA, Yuka Mashimo, Chihiro Ota, Yuichi Hanaki, Kojiro Ogawa, Akira Kimata, Yuki Komatsu, Hiro Yamasaki, Tomoko Ishizu, Akihiko Nogami, and Masaki Ieda
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
35. Left atrial regional strain assessed by novel dedicated three-dimensional speckle tracking echocardiography
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Ayako Kuraoka, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Miho Sato, Miyako Igarashi, Masaki Ieda, Tomoko Ishizu, and Kimi Sato
- Subjects
Male ,medicine.medical_specialty ,Paroxysmal atrial fibrillation ,Segmental analysis ,Echocardiography, Three-Dimensional ,Computed tomography ,Speckle tracking echocardiography ,Left atrial ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Heart Atria ,medicine.diagnostic_test ,Strain (chemistry) ,business.industry ,Mean age ,Middle Aged ,Global strain ,Echocardiography ,Cardiology ,Atrial Function, Left ,Female ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business - Abstract
BACKGROUND Left atrial (LA) global strain has been studied as an early marker of LA dysfunction, followed by LA dilatation. Recently, a novel dedicated software for LA 3-dimensional speckle tracking echocardiography (LA-3DSTE) has allowed us to assess anatomy-based six-segmental LA deformation. This study aimed to assess the accuracy of LA-3DSTE software in measuring LA volume and to reveal the characteristics of regional LA reservoir strain. METHODS Fifty patients with paroxysmal atrial fibrillation who underwent computed tomography (CT) and 3D-STE were enrolled. The LA volumes obtained by 3D-STE and CT were compared, and regional LA strain was analyzed. Six LA segments (anterior, septal, inferior, lateral, roof, and posterior) were determined on the basis of LA anatomy. RESULTS In 50 patients (mean age, 64 years; 62% male), the 3D-STE-derived LA volume index (LAVI) showed good correlation with the CT-derived index, (r = 0.78, p < 0.001) with an underestimate bias of 10.5 ± 11.0 ml/m2 (p < 0.001). The lateral LA strain was negatively correlated with LAVI and emptying fraction, while the anterior and septal strains were not. In the 1st quantile LA volume group, the segmental LA strain was heterogeneous, that is, the lateral and inferior strains were greater than the anterior strain. While in the 3rd quantile LA volume group, the lateral and inferior strains were decreased, and there was no regional difference. CONCLUSION LA volume obtained by 3D-STE and CT showed a good correlation. LA segmental analysis by 3D-STE enables early identification of how LA dysfunction affects lateral and inferior LA strains, consistent with anatomical features.
- Published
- 2021
36. The determinants of plasma brain natriuretic peptide level in severe aortic valve stenosis patients undergoing transcatheter aortic valve implantation
- Author
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Tomoya Hoshi, Yoshihiro Seo, Naomi Nakazawa, Yasushi Kawakami, Kimi Sato, Nobuyuki Ohte, Masayoshi Yamamoto, Masaki Ieda, Akira Sato, Tomoko Machino-Ohtsuka, and Tomoko Ishizu
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Transcatheter aortic ,medicine.drug_class ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Lv dysfunction ,Natriuretic Peptide, Brain ,Natriuretic peptide ,Humans ,Medicine ,030212 general & internal medicine ,Aged ,Subclinical infection ,Cardiac catheterization ,Aged, 80 and over ,Brain natriuretic peptide level ,business.industry ,Stroke Volume ,Aortic Valve Stenosis ,medicine.disease ,Treatment Outcome ,Aortic Valve ,Aortic valve stenosis ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Brain or B-type natriuretic peptide (BNP) is an objective marker to diagnose the presence of heart failure (HF) and assess its severity. However, the determinants of serum BNP level in elderly patients with severe aortic valve stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) have not been well investigated.We prospectively studied 106 AS patients who underwent TAVI. Cardiac catheterization, transesophageal echocardiography, and blood collection for plasma BNP level measurements were performed simultaneously just before the TAVI procedures.Ninety-nine patients (83.9±5.0 years, 33% male) were studied. The natural logarithm of BNP (lnBNP) level was 5.4±0.9 pg/mL. Significant correlations with lnBNP level were observed in: 1) the history of syncope, prior HF medication, and New York Heart Association class III or IV (R=0.255, p=0.011) (R=0.210, p=0.037) (R=0.402, p0.001), 2) albumin and hemoglobin level (R=-0.289, p=0.004) (R=0.263, p=0.009), 3) Left ventricular (LV) ejection fraction and global longitudinal strain (LVGLS) (R=-0.338, p0.001) (R=0.447, p0.001), 4) LV end-diastolic volume index (EDVI), LV mass index, and left atrial volume index (R=0.280, p=0.005) (R=0.366, p0.001) (R=0.337, p0.001), 5) the catheter-measured pressure gradient across the aortic valve (AVPG) (R=0.365, p0.001). Note that LV wall stress was not significantly correlated with lnBNP level. LVGLS, AVPG, hemoglobin level, and LVEDVI were independently correlated with ln BNP level (R=0.652, LVGLS; β=0.395, p0.006, AVPG; β=0.291, p=0.001, hemoglobin level; β=-0.216, p=0.011, and LVEDVI; β=0.203, p=0.016, respectively).In severe AS patients candidate for TAVI, multiple factors, including the severities of AS and HF conditions and subclinical LV dysfunction determined by LVGLS affects plasma BNP level.
- Published
- 2021
37. JCS 2021 Guideline on the Clinical Application of Echocardiography
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Nobuyuki, Ohte, Tomoko, Ishizu, Chisato, Izumi, Hiroshi, Itoh, Shiro, Iwanaga, Hiroyuki, Okura, Yutaka, Otsuji, Yasushi, Sakata, Toshihiko, Shibata, Toshiro, Shinke, Yoshihiro, Seo, Masao, Daimon, Masaaki, Takeuchi, Kazuaki, Tanabe, Satoshi, Nakatani, Masaki, Nii, Kazuhiro, Nishigami, Takeshi, Hozumi, Satoshi, Yasukochi, Hirotsugu, Yamada, Kazuhiro, Yamamoto, Masaki, Izumo, Katsuji, Inoue, Hiroyuki, Iwano, Atsushi, Okada, Akihisa, Kataoka, Shuichiro, Kaji, Kenya, Kusunose, Akiko, Goda, Yasuharu, Takeda, Hidekazu, Tanaka, Kaoru, Dohi, Hirotoshi, Hamaguchi, Hidekatsu, Fukuta, Satoshi, Yamada, Nozomi, Watanabe, Makoto, Akaishi, Takashi, Akasaka, Takeshi, Kimura, Masami, Kosuge, and Tohru, Masuyama
- Subjects
Japan ,Echocardiography ,Humans ,General Medicine ,Cardiology and Cardiovascular Medicine ,Societies, Medical - Published
- 2022
38. Intraoperative Imaging Strategy Unique to Japan for Transcatheter Closure of Atrial Septal Defects
- Author
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Tomoko Machino-Ohtsuka, Tomoko Ishizu, and Yasushi Kawakami
- Subjects
General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
39. Right bundle branch block and risk of cardiovascular mortality: the Ibaraki Prefectural Health Study
- Author
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Takuji Tomizawa, Akihiko Nogami, Dongzhu Xu, Kimi Sato, Fujiko Irie, Hiroyasu Iso, Yasushi Kawakami, Hitoshi Ota, Kazumasa Yamagishi, Naoto Kawamatsu, Naomi Nakazawa, Tomofumi Nakatsukasa, Nobuyuki Murakoshi, Daishi Nakagawa, Masayoshi Yamamoto, Tomoko Machino-Otsuka, Toshimi Sairenchi, Kazutaka Aonuma, Tomoko Ishizu, and Masaki Ieda
- Subjects
Male ,medicine.medical_specialty ,Bundle-Branch Block ,Population ,Cardiovascular System ,Asymptomatic ,Cohort Studies ,Electrocardiography ,Japan ,Internal medicine ,Epidemiology ,medicine ,Humans ,education ,Aged ,education.field_of_study ,Proportional hazards model ,business.industry ,Hazard ratio ,Middle Aged ,Right bundle branch block ,medicine.disease ,Confidence interval ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
Historically, a right bundle branch block has been considered a benign finding in asymptomatic individuals. However, this conclusion is based on a few old studies with small sample sizes. We examined the association between a complete right bundle branch block (CRBBB) and subsequent cardiovascular mortality in the general population in Japan. In this large community-based cohort study, data of 90,022 individuals (mean age, 58.5 ± 10.2 years; 66.2% women) who participated in annual community-based health check-ups were assessed. Subjects were followed up from 1993 to the end of 2016. Cox proportional hazards’ models and log-rank tests were used for the data analysis. CRBBB was documented in 1,344 participants (1.5%). Among all included participants, CRBBB was associated with an increased risk of cardiovascular mortality after adjustment for all potential confounders (hazard ratio [HR] 1.21; 95% confidence interval [CI] 1.06–1.38). The increased risk of cardiovascular mortality was particularly evident in women aged
- Published
- 2021
40. JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair
- Author
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Hideo, Ohuchi, Masaaki, Kawata, Hideki, Uemura, Teiji, Akagi, Atsushi, Yao, Hideaki, Senzaki, Shingo, Kasahara, Hajime, Ichikawa, Hirohiko, Motoki, Morio, Syoda, Hisashi, Sugiyama, Hiroyuki, Tsutsui, Kei, Inai, Takaaki, Suzuki, Kisaburo, Sakamoto, Syunsuke, Tatebe, Tomoko, Ishizu, Yumi, Shiina, Shigeru, Tateno, Aya, Miyazaki, Norihisa, Toh, Ichiro, Sakamoto, Chisato, Izumi, Yoshiko, Mizuno, Atsuko, Kato, Koichi, Sagawa, Ryota, Ochiai, Fukiko, Ichida, Takeshi, Kimura, Hikaru, Matsuda, and Koichiro, Niwa
- Subjects
Heart Defects, Congenital ,Humans - Published
- 2022
41. Sodium Glucose Co-Transporter 2 Inhibitors Improve Renal Congestion and Left Ventricular Fibrosis in Rats With Hypertensive Heart Failure
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Tomofumi Nakatsukasa, Tomoko Ishizu, Masumi Ouchi, Nobuyuki Murakoshi, Kimi Sato, Masayoshi Yamamoto, Kunio Kawanishi, Yoshihiro Seo, and Masaki Ieda
- Subjects
Heart Failure ,Heart Ventricles ,Stroke Volume ,General Medicine ,Kidney ,Fibrosis ,Ventricular Function, Left ,Rats ,Furosemide ,Hypertension ,Animals ,Canagliflozin ,Cardiology and Cardiovascular Medicine ,Sodium-Glucose Transporter 2 Inhibitors - Abstract
Elevated central venous pressure (CVP) in heart failure causes renal congestion, which deteriorates prognosis. Sodium glucose co-transporter 2 inhibitor (SGLT2-i) improves kidney function and heart failure prognosis; however, it is unknown whether they affect renal congestion. This study investigated the effect of SGLT2-i on the kidney and left ventricle using model rats with hypertensive heart failure.Methods and Results: Eight rats were fed a 0.3% low-salt diet (n=7), and 24 rats were fed an 8% high-salt diet, and they were divided into 3 groups of untreated (n=6), SGLT2-i (canagliflozin; n=6), and loop diuretic (furosemide; n=5) groups after 11 weeks of age. At 18 weeks of age, CVP and renal intramedullary pressure (RMP) were monitored directly by catheterization. We performed contrast-enhanced ultrasonography to evaluate intrarenal perfusion. In all high-salt fed groups, systolic blood pressure was elevated (P=0.287). The left ventricular ejection fraction did not differ among high-salt groups. Although CVP decreased in both the furosemide (P=0.032) and the canagliflozin groups (P=0.030), RMP reduction (P=0.003) and preserved renal medulla perfusion were only observed in the canagliflozin group (P=0.001). Histological analysis showed less cast formation in the intrarenal tubule (P=0.032), left ventricle fibrosis (P0.001), and myocyte thickness (P0.001) in the canagliflozin group than in the control group.These results suggest that SGLT2-i causes renal decongestion and prevents left ventricular hypertrophy, fibrosis, and dysfunction.
- Published
- 2022
42. PO-04-150 ATRIAL TACHYCARDIA IN PATIENTS WITH REPAIRED TETRALOGY OF FALLOT: ITS CHARACTERISTICS AND THE EFFICACY OF CATHETER ABLATION
- Author
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Qasim J. Naeemah, Miyako Igarashi, Noor K. Albakaa, YUTO IIOKA, Yuka Mashimo, Yuichi Hanaki, Chihiro Ota, Akira Kimata, Kojiro Ogawa, Yuki Komatsu, Naoto Kawamatsu, Tomoko Machino, Hiro Yamasaki, Tomoko Ishizu, Akihiko Nogami, and Masaki Ieda
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
43. Visualization of an Accessory Pathway by 3D High-Density Mapping: A Case of Ebstein Anomaly With Atrioventricular Re-entrant Tachycardia
- Author
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Chihiro Ota, Tomoko Ishizu, Akihiko Nogami, Kazutaka Aonuma, Masaki Ieda, and Miyako Igarashi
- Subjects
Tachycardia ,medicine.medical_specialty ,business.industry ,High density ,Case Report ,Accessory pathway ,3d mapping ,EBSTEIN ANOMALY ,Radiofrequency catheter ablation ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,Re entrant ,cardiovascular diseases ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Radiofrequency catheter ablation (RFCA) is the primary choice for treating patients with an accessory pathway and atrioventricular re-entrant tachycardia. However, using RFCA to treat a right-sided accessory pathway in a patient with Ebstein anomaly can be difficult owing to challenges in locating the electrophysiological atrioventricular groove. We report a case of atrioventricular re-entrant tachycardia in a patient with Ebstein anomaly and a right-sided accessory pathway that was successfully treated using RFCA and 3-dimensional (3D) high-density mapping. RFCA and 3D mapping may be useful in the management of such cases and may aid in improving prognoses of patients.
- Published
- 2021
44. Acute influences of tennis services on cardiac output and brachial hemodynamics in young male tennis players
- Author
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Shoya Mori, Keisei Kosaki, Ryohei Tagata, Kayoko Kon, Risa Yasuda, Natsumi Nishitani, Tomoko Ishizu, and Seiji Maeda
- Subjects
Male ,Brachial Artery ,Tennis ,Arm ,Hemodynamics ,Humans ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,Cardiac Output - Abstract
This study aimed to examine the influences of tennis service exercise on cardiac output (CO) and bilateral brachial hemodynamics in young tennis players.Experimental study.Ten young male tennis players (21 ± 2 years of age) participated. Each performed 100 tennis services without a return shot for experimental tennis exercise. Cardiovascular hemodynamic variables, including bilateral brachial blood flow (BF), shear rate (SR), blood pressure, and CO, were collected under three conditions: 1) baseline, 2) immediately after the tennis services (post), and 3) 1 h after the tennis services (1-hour). The positive incremental area under the curve (iAUC) for brachial hemodynamic variables was calculated.Immediately after the 100 tennis services, CO, brachial BF, SR, and brachial vascular conductance (VC) in the dominant and non-dominant arms increased (p 0.05). At the 1-hour condition, CO returned to baseline; the brachial BF, SR, and VC in the non-dominant arm returned to baseline levels, whereas the same variables in the dominant arm remained increased. The iAUC for brachial BF and VC in the dominant arm was higher than that in the non-dominant arm. Furthermore, the brachial BF/CO ratio index in the dominant arm increased at the post and 1-hour conditions, whereas that in the non-dominant arm was unchanged.Tennis service exercise specifically increases brachial BF, SR, and VC in the dominant arm, independent of increased CO. Our findings contribute to unveiling the underlying mechanisms of brachial artery adaptations in tennis players.
- Published
- 2022
45. Additional diagnostic value of electron microscopic examination in endomyocardial biopsy in patients with suspected non-ischemic cardiomyopathy
- Author
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Masayoshi Yamamoto, Kimi Sato, Nobuyuki Murakoshi, Yu Yamada, Daishi Nakagawa, Tomofumi Nakatsukasa, Tomoko Ishizu, and Masaki Ieda
- Subjects
Microscopy, Electron ,Heart Diseases ,Myocardium ,Biopsy ,Humans ,Fabry Disease ,Electrons ,Amyloidosis ,Cardiology and Cardiovascular Medicine ,Cardiomyopathies - Abstract
Electron microscopy enables a finely detailed analysis of ultra-structural features, and hence, it generally has an added diagnostic value to light microscopy alone. However, no studies have verified the additional diagnostic value of electron microscopic examination in patients with suspected non-ischemic cardiomyopathy.A total of 294 consecutive patients with non-ischemic cardiomyopathy who underwent endomyocardial biopsy were prospectively enrolled. Patients were divided into three groups according to left ventricular morphology assessed using echocardiography. Myocardial specimens were collected from the right ventricular septum and examined by light microscopy. Electron microscopy was performed subsequently to evaluate the additional diagnostic value.Altogether, 294 patients were analyzed, including 160 (55 %), 96 (33 %), and 35 (12 %) patients who were diagnosed with primary, secondary, and unclassified cardiomyopathy, respectively. In patients with dilated cardiomyopathy-like morphology, the detection rate of disease-specific histological findings was relatively low compared to that in patients with other cardiac morphologies. The additional diagnostic value of electron microscopy was observed in eight patients, including five with Fabry disease, one with cardiac amyloidosis, one with mitochondrial cardiomyopathy, and one with triglyceride deposit cardiomyovasculopathy. Among the 18 cardiac amyloidosis cases, electron microscopy detected amyloid fibrils in all patients, whereas light microscopy could not detect amyloid deposition in 1 patient. Among one of five patients with Fabry disease, light microscopy did not show obvious vacuolated cardiomyocytes, but zebra bodies were detected by electron microscopy, leading to the diagnosis of cardiac Fabry disease. The diagnostic value of electron microscopic examination in patients with cardiac sarcoidosis was not observed.The additional diagnostic value of electron microscopy was observed in patients with secondary cardiomyopathy, in whom light microscopy did not show disease-specific histological findings. Electron microscopy should be performed in cases where secondary cardiomyopathy is strongly suspected with no disease-specific findings by light microscopy.
- Published
- 2022
46. REVERSIBILITY OF CARDIAC FUNCTION PREDICTS OUTCOME AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENTS WITH LOW-FLOW LOW-GRADIENT AORTIC STENOSIS
- Author
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Kimi Sato, Noor Albakaa, Tomoya Hoshi, Tomoko Ishizu, Yoshihiro Seo, and Masaki Ieda
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
47. Proton Beam Therapy for Hepatocellular Carcinoma after the Fontan Procedure
- Author
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Kazunori Ishige, Toshiyuki Okumura, Hideyuki Sakurai, Masashi Mizumoto, Naoyuki Hasegawa, Nobuyoshi Fukumitsu, Kuniaki Fukuda, Haruko Numajiri, Katsutoshi Tokushige, and Tomoko Ishizu
- Subjects
Radical treatment ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Lung metastasis ,General Medicine ,medicine.disease ,Metastasis ,Radiation therapy ,Fontan procedure ,Hepatocellular carcinoma ,Medicine ,In patient ,Radiology ,business ,Transcatheter arterial chemoembolization - Abstract
Background: Hepatocellular carcinoma (HCC) is more likely to occur in patients with a history of Fontan surgery, possibly due to long-term liver congestion. Proton beam therapy (PBT) may be effective for HCC that develops after Fontan surgery. Methods: Six lesions in 5 patients (3 females, 2 males) received PBT. The median age of the patients was 33 (range 21 - 42) years, and the median age at the time of the Fontan procedure was 6 (5 - 13) years. Four patients had multiple HCC at the time of PBT. The median tumor size was 57 (22 - 80) mm and 4 patients were classified as Child-Pugh B. Two patients received transcatheter arterial chemoembolization before PBT. The schedule of PBT was 66 Gy (RBE) in 10 fractions for 2 lesions, 72.6 Gy (RBE) in 22 fractions for 2 lesions, and 74 GyE (RBE) in 37 fractions for 2 lesions. Results: The median follow-up period was 31 (10 - 46) months, and the numbers of survivors, deaths from primary diseases, and deaths from other diseases were 3, 1, and 1, respectively. There were no local recurrences, one intrahepatic metastasis, one lung metastasis, and one intrathoracic metastasis. Conclusion: Although experiences on a small number of patients cannot conclude things, we believe that PBT can be a reasonable choice of radical treatment for HCC occurring after the Fontan procedure.
- Published
- 2021
48. Dramatic Recovery from Cardiovascular Collapse: Paclitaxel as an Urgent Treatment for Primary Cardiac Angiosarcoma
- Author
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Masayuki Noguchi, Kazuko Tajiri, Yoshiyuki Yamamoto, Ikuo Sekine, Tomoko Ishizu, Hideo Suzuki, Masaki Ieda, Noriaki Sakamoto, Yasuhiro Fujisawa, Yuji Hiramatsu, and Toshio Suzuki
- Subjects
medicine.medical_specialty ,cardio-oncology ,Circulatory collapse ,medicine.medical_treatment ,Hemangiosarcoma ,Vital signs ,Case Report ,030204 cardiovascular system & hematology ,chemotherapy ,Heart Neoplasms ,paclitaxel ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Biopsy ,Internal Medicine ,medicine ,Humans ,Angiosarcoma ,neoplasms ,cardiac angiosarcoma ,Collapse (medical) ,rare malignant tumor ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,Shock ,General Medicine ,hemodynamic instability ,medicine.disease ,digestive system diseases ,Surgery ,Paclitaxel ,chemistry ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Hemodynamic instability - Abstract
We herein report three patients with cardiac angiosarcoma who were directly admitted to the intensive-care unit for hemodynamic instability with circulatory collapse. Using a multidisciplinary cardio-oncologic approach, we diagnosed their condition as angiosarcoma by an invasive biopsy and urgently started weekly paclitaxel administration despite their poor performance status. Their vital signs were soon stabilized, leading to the patients’ discharge from the hospital. Although no treatment guidelines for cardiac angiosarcoma have been established, chemotherapy with paclitaxel can be an option for cases presenting with hemodynamic instability.
- Published
- 2021
49. Obstetric venous thromboembolism: Evaluation of prophylactic approach based on risk scores, D-dimer levels, and ultrasonography findings in a tertiary hospital in Japan
- Author
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Mana Obata‐Yasuoka, Rena Ohara, Yoshihiko Hosokawa, Keiko Nishida, Haruna Abe, Miyuki Mayumi, Tomoko Ishizu, Naho Endo‐Kawamura, Hiromi Hamada, and Toyomi Satoh
- Subjects
Venous Thrombosis ,Infant, Newborn ,Obstetrics and Gynecology ,Venous Thromboembolism ,Fibrin Fibrinogen Degradation Products ,Tertiary Care Centers ,Japan ,Pregnancy ,Risk Factors ,Humans ,Female ,Pulmonary Embolism ,Retrospective Studies ,Ultrasonography - Abstract
Pulmonary embolism remains a leading cause of maternal mortality in developed countries despite developments in venous thromboembolism prophylaxis strategies. This study aimed to evaluate the effectiveness of our approach involving risk-scoring, D-dimer level assessment, and ultrasonography for obstetric venous thromboembolism.This retrospective cohort study included women who delivered at 22-41 weeks of gestation in The University of Tsukuba Hospital, Japan between January and December 2020. Venous thromboembolism risk (determined according to Japanese guidelines) and D-dimer levels were evaluated within 20 weeks of gestation, 30-34 weeks of gestation, and during the pre-delivery period (36 weeks of gestation or any time before preterm delivery). Compression and color Doppler ultrasonography for lower extremity deep vein thrombosis were performed if D-dimer levels were ≥3.2 μg/mL (for those undergoing cesarean delivery, 1.0 μg/mL).Of 1026 women, 6 women had deep vein thrombosis during pregnancy and 1 during the puerperium period. Pulmonary embolism was not observed. The D-dimer screening result was positive for 8 women (2%) within 20 weeks of gestation (deep vein thrombosis was confirmed in 3 of them), 87 women (10%) (no deep vein thrombosis) at 30-34 weeks of gestation, and 367 women (36%) during the pre-delivery period (asymptomatic deep vein thrombosis in one). Based on the Japanese guidelines, 1%, 11%, 33%, and 55% of women had high, intermediate, low, and no postpartum risk factors, respectively.Our approach appears useful for antenatal venous thromboembolism screening in the first trimester. For postpartum prophylaxis, more cost-effective strategies are needed.
- Published
- 2022
50. Doppler-Derived Intrarenal Venous Flow Mirrors Right-Sided Heart Hemodynamics in Patients With Cardiovascular Disease
- Author
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Noriko Iida, Yoshihiro Seo, Tomoko Ishizu, Nobuyuki Ohte, Masaki Ieda, and Masayoshi Yamamoto
- Subjects
Adult ,Male ,Cardiac Catheterization ,medicine.medical_specialty ,Ventricular Dysfunction, Right ,Diastole ,Hemodynamics ,Atrial Function, Right ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,Kidney ,Renal Circulation ,03 medical and health sciences ,Atrial Pressure ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Heart Atria ,030212 general & internal medicine ,Ultrasonography, Doppler, Color ,Systole ,Aged ,Retrospective Studies ,Aged, 80 and over ,Heart Failure ,Pulmonary Arterial Hypertension ,Cardiac cycle ,business.industry ,Central venous pressure ,Atrial fibrillation ,General Medicine ,Middle Aged ,medicine.disease ,Tricuspid Valve Insufficiency ,Pathophysiology ,Cross-Sectional Studies ,Echocardiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Background Interruption in Doppler intrarenal venous flow (IRVF) has been used in assessing renal congestion and in the prediction of prognosis of cardiovascular diseases. However, there is a paucity of pathophysiological knowledge, so we aimed to clarify the determinants of IRVF interruption.Methods and Results:Intrarenal Doppler studies were performed within 24 h before right-side catheterization studies. The interruption in IRVF in 73 patients was divided into a continuous pattern, and 4 discontinuous types based on the timing of interruption. Type 1, with an interruption in early systole, was associated with a-wave elevation of right atrial pressure (RAP). Type 2, with an interruption in early diastole, was associated with v-wave elevation, tricuspid regurgitation (TR), and right ventricular dysfunction. Both Type 1 and 2 were observed even in the normal range of mean RAP. Type 3, with an interruption throughout systole, was observed in advanced right heart failure patients with markedly elevated RAP, particularly elevated x-descend and atrial fibrillation. Finally, Type 4, with limited flow at systole, was observed in 2 of the patients with pulmonary arterial hypertension. Conclusions IRVF interruption was closely related to RAP elevation at each specific point of the cardiac cycle rather than to mean RAP levels, suggesting that the characteristics of IRVF mirror right-sided heart hemodynamics, not mean RAP.
- Published
- 2020
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