235 results on '"Tomoko Ishizu"'
Search Results
2. Successful surgical epicardial cryoablation of refractory atrial tachycardia in a patient with repaired tetralogy of Fallot after multiple failed endocardial ablations
- Author
-
Qasim J. Naeemah, Miyako Igarashi, Muneaki Matsubara, Tomoko Ishizu, Akihiko Nogami, and Masaki Ieda
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
3. Association between right ventricular longitudinal strain and cardiovascular events in patients with cardiac sarcoidosis
- Author
-
Noor K, Albakaa, Kimi, Sato, Noriko, Iida, Masayoshi, Yamamoto, Tomoko, Machino-Ohtsuka, Tomoko, Ishizu, and Masaki, Ieda
- Subjects
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.
- Published
- 2022
4. Effect of ipragliflozin on carotid intima-media thickness in type 2 diabetes patients
- Author
-
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
- Subjects
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.
- Published
- 2022
5. Using computed tomography fusion imaging as learning data for sonographer training in identification of left ventricular endocardial boundaries
- Author
-
Yoshiki Shiina, Tomoko Ishizu, Satomi Nesaki, Hideki Nakajima, Noriko Iida, Naoto Kawamatsu, Kimi Sato, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Masaki Ieda, and Yasushi Kawakami
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
6. Echocardiography image quality of global longitudinal strain in cardio-oncology: a prospective real-world investigation
- Author
-
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
- Subjects
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.
- Published
- 2022
7. 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
- Author
-
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
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
8. Left atrial regional strain assessed by novel dedicated three-dimensional speckle tracking echocardiography
- Author
-
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
9. The determinants of plasma brain natriuretic peptide level in severe aortic valve stenosis patients undergoing transcatheter aortic valve implantation
- Author
-
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
10. JCS 2021 Guideline on the Clinical Application of Echocardiography
- Author
-
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
11. Intraoperative Imaging Strategy Unique to Japan for Transcatheter Closure of Atrial Septal Defects
- Author
-
Tomoko Machino-Ohtsuka, Tomoko Ishizu, and Yasushi Kawakami
- Subjects
General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
12. Right bundle branch block and risk of cardiovascular mortality: the Ibaraki Prefectural Health Study
- Author
-
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
13. JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair
- Author
-
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
14. Sodium Glucose Co-Transporter 2 Inhibitors Improve Renal Congestion and Left Ventricular Fibrosis in Rats With Hypertensive Heart Failure
- Author
-
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
15. PO-04-150 ATRIAL TACHYCARDIA IN PATIENTS WITH REPAIRED TETRALOGY OF FALLOT: ITS CHARACTERISTICS AND THE EFFICACY OF CATHETER ABLATION
- Author
-
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
16. Visualization of an Accessory Pathway by 3D High-Density Mapping: A Case of Ebstein Anomaly With Atrioventricular Re-entrant Tachycardia
- Author
-
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
17. Utility of Updated Japanese Circulation Society Guidelines to Diagnose Isolated Cardiac Sarcoidosis
- Author
-
Kimi Sato, Naoto Kawamatsu, Masayoshi Yamamoto, Tomoko Machino‐Ohtsuka, Tomoko Ishizu, and Masaki Ieda
- Subjects
Myocarditis ,Japan ,Sarcoidosis ,Fluorodeoxyglucose F18 ,Positron-Emission Tomography ,Humans ,Stroke Volume ,Radiopharmaceuticals ,Cardiology and Cardiovascular Medicine ,Cardiomyopathies ,Ventricular Function, Left ,Retrospective Studies - 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 P =0.036) was independently associated with major adverse cardiovascular events after adjusting for reduced left ventricular ejection fraction and steroid. In the subgroup of 41 patients with serial 18F‐fluorodeoxyglucose positron emission tomography evaluation, only updated CS criteria were associated with improvement in myocardial inflammation on 18F‐fluorodeoxyglucose positron emission tomography. Conclusions Isolated CS detected using the updated Japanese Circulation Society guidelines was associated with poor event‐free survival and should be managed with caution.
- Published
- 2022
18. Acute influences of tennis services on cardiac output and brachial hemodynamics in young male tennis players
- Author
-
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
19. Additional diagnostic value of electron microscopic examination in endomyocardial biopsy in patients with suspected non-ischemic cardiomyopathy
- Author
-
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
20. Obstetric venous thromboembolism: Evaluation of prophylactic approach based on risk scores, D-dimer levels, and ultrasonography findings in a tertiary hospital in Japan
- Author
-
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
21. Proton Beam Therapy for Hepatocellular Carcinoma after the Fontan Procedure
- Author
-
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
22. REVERSIBILITY OF CARDIAC FUNCTION PREDICTS OUTCOME AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENTS WITH LOW-FLOW LOW-GRADIENT AORTIC STENOSIS
- Author
-
Kimi Sato, Noor Albakaa, Tomoya Hoshi, Tomoko Ishizu, Yoshihiro Seo, and Masaki Ieda
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
23. Doppler-Derived Intrarenal Venous Flow Mirrors Right-Sided Heart Hemodynamics in Patients With Cardiovascular Disease
- Author
-
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
24. Cardiology consultation in oncology practice: a 5-year survey
- Author
-
Keiko Inoue, Rumi Sasamura, Momoko Murata, Siqi Li, Hiroyuki Naito, Hideki Nakajima, Kazuko Tajiri, Tomoko Ishizu, Nobuyuki Murakoshi, Junya Honda, Ikuo Sekine, Masaki Ieda, Noriko Iida, and Kenji Nagashio
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Adolescent ,Cardiology ,Psychological intervention ,Cancer therapy ,Antineoplastic Agents ,030204 cardiovascular system & hematology ,Medical Oncology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Neoplasms ,Surveys and Questionnaires ,Internal medicine ,Cardiovascular problems ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardio oncology ,Child ,Referral and Consultation ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Cancer ,Atrial fibrillation ,General Medicine ,Middle Aged ,medicine.disease ,Cancer treatment ,Oncology ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Female ,business ,Venous thromboembolism - Abstract
Objective Onco-cardiology services are expanding rapidly in Japan. To provide a better service, it is important to consider the needs of oncologists. However, little is known regarding specific needs for which oncologists should consult cardiologists to manage cardiovascular problems of their patients. We analysed cardiology consultations sought by oncologists to evaluate the role of cardiologists in cancer treatment. Method We retrospectively investigated consecutive 2064 cardiology consultations of cancer patients in the University of Tsukuba Hospital, Tsukuba, Japan, between January 2014 and December 2018. Results The most common timing of cardiology consultation was before the commencement of cancer treatment (n = 1355; 65.7%), followed by after the commencement of cancer treatment (n = 686; 33.2%). Among the 361 consultations before the administration of anticancer drugs, 235 (65.1%) were for anthracycline-based regimens. There were 506 (24.5%) consultations for the management of cardiovascular emergencies developing after the commencement of cancer treatment; venous thromboembolism was the most frequent (n = 125; 24.7%), followed by atrial fibrillation (n = 110; 21.7%) and heart failure (n = 74; 14.6%). There were marked differences in the types of cardiovascular emergencies depending on the type of cancer. Conclusions This survey revealed the various cardiovascular problems for which oncologists sought interventions by cardiologists. A multidisciplinary approach in an onco-cardiology service is essential to achieve optimal long-term outcomes.
- Published
- 2020
25. Usefulness of the SAGE score to predict elevated values of brachial-ankle pulse wave velocity in Japanese subjects with hypertension
- Author
-
Hiroki Nakano, Taiji Furukawa, Hiroshi Ito, Toshiharu Ninomiya, Toshiaki Ohkuma, Kazuki Shiina, Toru Suzuki, Masataka Sata, Shinji Koba, Koichi Node, Tomoko Ishizu, Taishiro Chikamori, Tsutomu Yamazaki, Panagiotis Xaplanteris, Takuzo Hano, Teruo Inoue, Koji Maemura, Akira Yamashina, Takahide Kohro, Yukihito Higashi, Shin ichiro Ueda, Yusuke Ohya, Charalambos Vlachopoulos, Hirofumi Tomiyama, Atsushi Tanaka, Tomoo Furumoto, Yasuhiko Takemoto, Yutaka Ishibashi, Bonpei Takase, and Kazuomi Kario
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physiology ,Population ,Pulse Wave Analysis ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,Internal Medicine ,medicine ,Health Status Indicators ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,education ,Pulse wave velocity ,Aged ,education.field_of_study ,Receiver operating characteristic ,business.industry ,Area under the curve ,Odds ratio ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Blood pressure ,Hypertension ,Cohort ,cardiovascular system ,Cardiology ,Arterial stiffness ,Female ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology - Abstract
The score based on the office systolic blood pressure, age, fasting blood glucose level, and estimated glomerular filtration rate (SAGE score) has been proposed as a useful marker to identify elevated values of carotid-femoral pulse wave velocity (PWV). The present cross-sectional study was conducted to examine whether the SAGE score is also a useful marker to identify subjects with elevated brachial-ankle PWV values in Japanese subjects with hypertension. We measured the brachial-ankle PWV and calculated the SAGE score in a total of 1019 employees of a Japanese company with hypertension and 817 subjects with hypertension derived from a multicenter study cohort. The analyses in this study were based on data from these two study groups as well as on a composite population of the two (n = 1836). The receiver operating characteristic curve analysis showed that the area under the curve to identify subjects with brachial-ankle PWV values of ≥1800 cm/s was over 0.70 in each of the three study groups. Even after adjustments, a SAGE score ≥7 had a significant odds ratio for identifying subjects with brachial-ankle PWV values ≥1800 cm/s in the 1836 study subjects from the composite occupational and multicenter study cohort (odds ratio = 2.1, 95% confidence interval = 1.4–3.0, P
- Published
- 2020
26. Increased arterial stiffness and cardiovascular risk prediction in controlled hypertensive patients with coronary artery disease: post hoc analysis of FMD-J (Flow-mediated Dilation Japan) Study A
- Author
-
Teruo Inoue, Yiming Han, Nozomu Oda, Kazuaki Chayama, Yumiko Iwamoto, Haruki Hashimoto, Kentaro Watanabe, Hiroshi Ito, Yusuke Ohya, Toru Suzuki, Takahiro Harada, Masataka Sata, Masato Kajikawa, Yoshiki Aibara, Yutaka Ishibashi, Bonpei Takase, Takuzo Hano, Shinsuke Mikami, Koji Maemura, Koichi Node, Shinji Kishimoto, Yuji Takaeko, Kazuomi Kario, Tomoko Ishizu, Takayuki Hidaka, Hisao Ikeda, Taiji Furukawa, Junko Soga, Hirofumi Tomiyama, Yasuhiko Takemoto, Chikara Goto, Yukihito Higashi, Ayumu Nakashima, Yasuki Kihara, Tomoo Furumoto, Tsutomu Yamazaki, Tatsuya Maruhashi, Takahide Kohro, Kensuke Noma, Takeshi Matsumoto, Akira Yamashina, Farina Mohamad Yusoff, Naomi Idei, Shogo Matsui, Shinichiro Ueda, Noritaka Fujimura, Akimichi Iwamoto, Takayuki Yamaji, and Shinji Koba
- Subjects
Male ,medicine.medical_specialty ,Physiology ,Blood Pressure ,Coronary Artery Disease ,Pulse Wave Analysis ,030204 cardiovascular system & hematology ,Risk Assessment ,Sudden death ,Coronary artery disease ,03 medical and health sciences ,Vascular Stiffness ,0302 clinical medicine ,Japan ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Ankle Brachial Index ,030212 general & internal medicine ,Pulse wave velocity ,Stroke ,Aged ,business.industry ,Hazard ratio ,Middle Aged ,medicine.disease ,Vasodilation ,Blood pressure ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Heart failure ,Hypertension ,Cardiology ,Arterial stiffness ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
The usefulness of brachial-ankle pulse wave velocity (baPWV), an index of arterial stiffness, is not fully known for the management of treated hypertensive patients with a history of coronary artery disease (CAD) who have blood pressure less than 130/80 mmHg, a recommended blood pressure target in the updated major hypertension guidelines. We analyzed data for 447 treated hypertensive patients with CAD enrolled in FMD-J Study A for assessment of the predictive value of baPWV for future cardiovascular events. The primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow-up period of 47.6 months, the primary outcome occurred in 64 patients. Blood pressure less than 130/80 mmHg was significantly associated with a lower risk of the composite outcome independent of other cardiovascular risk factors in treated hypertensive patients with CAD (hazard ratio, 0.59; 95% confidence interval (CI), 0.35-0.99; P = 0.04). In treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, baPWV above the cutoff value of 1731 cm/s, derived from receiver-operator characteristic curve analysis for the composite outcome was significantly associated with a higher risk of the composite outcome independent of conventional risk factors (hazard ratio, 2.83; 95% CI, 1.02-7.91; P = 0.04). baPWV was an independent predictor of cardiovascular events in treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, for whom measurement of baPWV is recommended for cardiovascular risk assessment.
- Published
- 2020
27. The impact of right bundle branch block on right ventricular size and function assessed by three-dimensional speckle-tracking echocardiography
- Author
-
Yoshihiro Seo, Yasushi Kawakami, Kimi Sato, Tomoko Machino-Ohtsuka, Masayoshi Yamamoto, Yuji Hiramatsu, Naoto Kawamatsu, Naomi Nakazawa, Tomoko Ishizu, Masaki Ieda, and Hitoshi Horigome
- Subjects
Adult ,Male ,medicine.medical_specialty ,Systole ,Heart Ventricles ,Bundle-Branch Block ,Echocardiography, Three-Dimensional ,Speckle tracking echocardiography ,030204 cardiovascular system & hematology ,Free wall ,Electrocardiography ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Diastole ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,End-systolic volume ,Retrospective Studies ,Ejection fraction ,Ventricular size ,business.industry ,Stroke Volume ,Middle Aged ,Right bundle branch block ,medicine.disease ,Cardiac surgery ,Cross-Sectional Studies ,Ventricular Function, Right ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
To determine the influence of right bundle branch block (RBBB) on right ventricular (RV) size and function, we investigated the association between complete RBBB (CRBBB) and RV volume, function, and dyssynchrony by three-dimensional echocardiography. In this retrospective, cross-sectional study, 103 consecutive patients with adequate three-dimensional echocardiographic images were divided into the CRBBB, middle-range QRS, and narrow QRS group. RV volumetric and functional data were compared between the three groups. Among the 103 patients (44.8 ± 18.7 years, 50 men), the CRBBB group comprised 26 (25%) patients and the middle-range QRS group comprised 48 (47%). The CRBBB group showed a significant contraction delay in the RV inlet free wall and outflow tract; larger RV end-diastolic and systolic volume index (RV-EDVI, RV-ESVI); and lower RV systolic function. On dividing the CRBBB patients into two (with or without mechanical dyssynchrony), those with RV dyssynchrony showed larger RV-EDVI (121 ± 45 vs. 85 ± 25 mL/m2, P = 0.019) and RV-ESVI (93 ± 42 vs. 56 ± 20 mL/m2, P = 0.009) and smaller RV ejection fraction (24 ± 11 and 34 ± 11%, P = 0.026) than those without RV dyssynchrony. RV dyssynchrony in CRBBB patients might have an adverse effect on RV volume and function. Three-dimensional speckle-tracking echocardiography could provide additional and beneficial data during assessment of RV dyssynchrony.
- Published
- 2019
28. Survey results: status report on problems caused by sexual mismatch between sonographer and patient during echocardiography-a 2020 report of the Japanese Society of Echocardiography
- Author
-
Mai Iwataki, Mitsushige Murata, Masashi Fujita, Hiroyuki Toide, Kazumi Akasaka, Takako Iino, Akiko Goda, Kohta Takei, Norihisa Toh, Yoko Miyasaka, Michiyo Yamano, Tomoko Ishizu, Satoshi Nakatani, and Kazuhiro Yamamoto
- Subjects
Radiology, Nuclear Medicine and imaging - Abstract
Ultrasonography is an essential examination performed in various clinical fields. The number of clinical sonographers has been increasing. However, the working environments and conditions at each facility are different, leading to diverse problems. Among them, the emerging issue is the sexual disagreement between the sonographer and patient at the time of echocardiography. Since the patient must expose their breast during echocardiography, female patients may refuse to undergo the examination when conducted by a male sonographer. This study aimed to conduct a questionnaire survey to understand the measures for sonographer-patient gender mismatch at different facilities.A questionnaire on the implementation of echocardiography by male sonographers for female patients was answered by representatives and specialist technicians of the Japanese Society of Echocardiography.Questionnaire responses were obtained from 50 facilities (59 participants). A total of 70% of the facilities restricted male sonographers from conducting echocardiography examinations for female patients. Among them, 81% of the facilities serviced female patients aged 60 years or younger.It has become clear that the gender selection of echocardiographic examiners varies from facility to facility, and providing a sufficient explanation before echocardiographic examination is necessary to avoid causing uncomfortable situations for female patients.
- Published
- 2021
29. Differential effect of a xanthine oxidase inhibitor on arterial stiffness and carotid atherosclerosis: a subanalysis of the PRIZE study
- Author
-
Kazuki, Shiina, Hirofumi, Tomiyama, Atsushi, Tanaka, Hisako, Yoshida, Kazuo, Eguchi, Kazuomi, Kario, Toru, Kato, Hiroki, Teragawa, Shigeru, Toyoda, Mitsuru, Ohishi, Yoshihiro, Fukumoto, Bonpei, Takase, Tomoko, Ishizu, and Koichi, Node
- Subjects
Carotid Artery Diseases ,Xanthine Oxidase ,Febuxostat ,Vascular Stiffness ,Awards and Prizes ,Humans ,Ankle Brachial Index ,Hyperuricemia ,Prospective Studies ,Enzyme Inhibitors ,Pulse Wave Analysis ,Atherosclerosis ,Uric Acid - Abstract
Atherosclerosis and arterial stiffness are phenotypes of atherosclerotic vascular damage. Atherosclerosis originates from endothelial vascular damage and forms focal morphological lesions; arterial stiffness originates from diffuse medial-layer damage in the arterial tree. Thus, the two phenomena reflect different facets of atherosclerotic vascular damage, and they both gradually progress. We conducted a subanalysis to compare the long-term effects of febuxostat on atherosclerosis and arterial stiffness in the PRIZE study (a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial to examine the effect of febuxostat on carotid atherosclerosis). Among 514 study participants, arterial stiffness parameters (brachial-ankle pulse wave velocity or cardio-ankle vascular index) were obtained at baseline, 12 months, and 24 months in 100 subjects. Among them, 48 subjects were allocated to the control group (i.e., nonpharmacological lifestyle modification for hyperuricemia), and 52 subjects were allocated to the febuxostat treatment group. While the decrease in serum uric acid was greater in the febuxostat group than in the control group, the adjusted percentage decrease in arterial stiffness parameters at month 24 was greater in the febuxostat group than in the control group, with a mean between-group difference (febuxostat - control) of -5.099% (95% confidence interval (CI) -10.009% to -0.188%, p = 0.042). Thus, long-term treatment with febuxostat may exert beneficial effects on arterial stiffness without improving carotid atherosclerosis. A long-term study to examine the effect of febuxostat on cardiovascular outcomes related to increased arterial stiffness is warranted.
- Published
- 2021
30. Pathophysiological role of right ventricular function and interventricular functional mismatch in the development of pulmonary edema in acute heart failure
- Author
-
Masayoshi Yamamoto, Tomoko Ishizu, Yoshihiro Seo, Daishi Nakagawa, Kimi Sato, Naoto Kawamatsu, Tomoko Machino-Ohtsuka, Yoshie Hamada-Harimura, Seika Sai, Akinori Sugano, Isao Nishi, and Masaki Ieda
- Subjects
Heart Failure ,Echocardiography ,Ventricular Dysfunction, Right ,Ventricular Function, Right ,Humans ,Pulmonary Edema ,Cardiology and Cardiovascular Medicine - Abstract
Parameters of cardiac function related to the development of pulmonary edema (PE) in acute heart failure (AHF), including right ventricular (RV) function and a mismatch of interventricular function, are not fully elucidated. The aim of this study was to verify the hypothesis that a relatively preserved RV function compared with left ventricular function may be associated with the development of PE by using two-dimensional speckle tracking echocardiography (2DSTE).Hospitalized patients with AHF at 11 institutions were enrolled. PE was defined as lung congestion on chest X-ray with hypoxemia. Patients with systolic blood pressure ≥140 mmHg on admission were defined to have hypertensive AHF. Echocardiographic analyses, including 2DSTE, were performed prior to discharge. The index of mismatch between RV and left ventricular systolic function was assessed by interventricular longitudinal strain difference (IVLSD) which was defined as RV free wall longitudinal strain and left ventricular global longitudinal strain.Of 610 patients with AHF, 422 (69.2%) had PE. In patients with PE, IVLSD (p = 0.007) and RV fractional area change ratio (p0.001) was significantly higher than those in patients without PE. In patients with non-hypertensive AHF, RV fractional area change ratio, age, ischemic etiology, and serum brain natriuretic peptide (BNP) levels were independent predictors of PE. In patients with hypertensive AHF, IVLSD, age, and serum BNP levels were independent predictors of PE.Preserved RV function might be one of the underlying mechanisms of the development of PE in AHF. Furthermore, interventricular functional mismatch might be related to the development of PE in hypertensive AHF.
- Published
- 2021
31. Successful surgical resection plus surgical cryoablation for the treatment of a large left ventricular fibroma
- Author
-
Ryuhei Yamamoto, Muneaki Matsubara, Hideyuki Kato, Tomoko Ishizu, Bryan J. Mathis, and Yuji Hiramatsu
- Subjects
Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2022
32. Prognostic Value of Apical Sparing of Longitudinal Strain in Patients with Symptomatic Aortic Stenosis
- Author
-
Chia-Hung, Yang, Masaaki, Takeuchi, Yosuke, Nabeshima, Eiji, Yamashita, Masaki, Izumo, Tomoko, Ishizu, and Yoshihiro, Seo
- Subjects
Original Article - Abstract
BACKGROUND: Older patients with aortic stenosis (AS) have a higher incidence of wild-type transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to determine whether apical sparing of longitudinal strain (LS) could help diagnose ATTR-CA and provide useful prognostic information in symptomatic AS. METHODS: We performed vendor-independent two-dimensional speckle-tracking analysis of regional and global left ventricular LS in 16 patients with ATTR-CA and 31 patients with non-obstructive hypertrophic cardiomyopathy to determine the best cutoff value of the apical sparing ratio (APSR) for diagnosing ATTR-CA. We then determined the prevalence in patients who had an APSR higher than the best cutoff value and investigated its prognostic value in 230 patients with symptomatic AS. To determine the natural history of symptomatic AS, patients who had aortic valve replacement were censored at the time of surgery. RESULTS: The best cutoff value of APSR was 0.76. APSR ≥ 0.76 was observed in 108 patients with symptomatic AS (48%). The prevalence was not different among the four AS subgroups. During a median follow-up period of 5.7 months, 47 patients had cardiac events. Cox proportional hazards analysis revealed that neither APSR nor APSR ≥ 0.76 was significantly associated with future cardiac events. CONCLUSIONS: Apical sparing was frequently observed in patients with symptomatic AS, and it was not a useful predictor of future adverse outcomes. Our results suggest that the underlying cause of apical sparing in AS may not be related to the presence of ATTR-CA.
- Published
- 2021
33. Relationships between maintenance of sinus rhythm and clinical outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation
- Author
-
Tomoko Machino-Ohtsuka, Yoshihiro Seo, Masaki Ieda, Takeshi Machino, Yoshie Hamada-Harimura, Kazutaka Aonuma, Yukio Sekiguchi, Masayoshi Yamamoto, Hiro Yamasaki, Tomoko Ishizu, and Akihiko Nogami
- Subjects
Male ,medicine.medical_specialty ,Exacerbation ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Lower risk ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Heart Conduction System ,Risk Factors ,Cause of Death ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Sinus rhythm ,030212 general & internal medicine ,Propensity Score ,Aged ,Retrospective Studies ,Sinoatrial Node ,Heart Failure ,business.industry ,Hazard ratio ,Stroke Volume ,Atrial fibrillation ,Middle Aged ,Prognosis ,medicine.disease ,Hospitalization ,Heart failure ,Catheter Ablation ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Heart failure with preserved ejection fraction ,business ,Anti-Arrhythmia Agents - Abstract
Background Although atrial fibrillation (AF) is associated with exacerbation of heart failure with preserved ejection fraction (HFpEF), the relationships between maintenance of sinus rhythm (SR) and clinical outcomes in HFpEF is unknown. We investigated whether maintenance of SR was associated with better prognosis compared with rate control in patients with concomitant HFpEF and AF. Methods We conducted a retrospective, observational study of 283 patients with HFpEF and AF. Of these, 107 patients achieved maintenance of SR by catheter ablation and/or antiarrhythmic drugs (rhythm control) and 176 were treated with rate control. The propensity score (PS) for each patient in both treatment groups was estimated, resulting in selectively matched subgroups of 79 patients each. All-cause death and a composite of cardiovascular death or hospitalization for heart failure (HF) were analyzed. Results During a median follow-up period of 24 months, all-cause mortality was comparable between groups; however, maintenance of SR was significantly associated with a lower incidence of the composite endpoint [adjusted hazard ratio (HR), 0.30; 95% confidence interval, 0.18–0.98; p = 0.04] in the PS-matched cohort. The PS-adjusted multivariable analysis based on 283 pre-matched patients also revealed that rhythm control was associated with a lower rate of the composite endpoint (adjusted HR, 0.27; 95% CI, 0.12–0.61; p = 0.002). Subgroup analyses suggested that rhythm control was consistently related to the composite endpoint across a wide spectrum of HFpEF patients. Conclusions Maintenance of SR was associated with a lower risk of composite of cardiovascular death or hospitalization for HF in patients with HFpEF and AF. A randomized trial is necessary to confirm this result.
- Published
- 2019
34. Symptomatic paradoxical low gradient severe aortic stenosis: A possible link to heart failure with preserved ejection fraction
- Author
-
Yasufumi Nagata, Tomoko Ishizu, Masaki Izumo, Yutaka Otsuji, Yoshihiro J. Akashi, Masaaki Takeuchi, Yoshihiro Seo, Hidehiro Namisaki, and Eiji Yamashita
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,Heart Ventricles ,Echocardiography, Three-Dimensional ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Asymptomatic ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Natriuretic Peptide, Brain ,Natriuretic peptide ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Propensity Score ,Aged ,Aged, 80 and over ,Heart Failure ,business.industry ,Stroke Volume ,Aortic Valve Stenosis ,Stroke volume ,Middle Aged ,medicine.disease ,Stenosis ,Heart failure ,Ventricular fibrillation ,Cohort ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Heart failure with preserved ejection fraction ,business - Abstract
Background There is an ongoing debate regarding optimal management of patients with paradoxical low gradient severe aortic stenosis (PLG-SAS). We hypothesized that the presence of symptoms is closely associated with future adverse outcome. We aimed to determine the relation between symptoms and outcome in patients with PLG-SAS. Methods We prospectively enrolled 222 patients with PLG-SAS. Left ventricular (LV) volumes, mass, and strain were measured by three-dimensional echocardiography. The primary end-point was cardiac events including cardiac death, ventricular fibrillation, and heart failure leading to hospitalization. Results There were 65 cases of symptomatic PLG-SAS and 157 cases of asymptomatic PLG-SAS. Patients with symptomatic PLG-SAS received beta-blockers, angiotensin blockers, and diuretics more frequently and showed higher levels of B-type natriuretic peptide than patients with asymptomatic PLG-SAS. Although LV chamber parameters were not different, patients with symptomatic PLG-SAS had significantly higher E-wave velocity and E/A ratio than patients with asymptomatic PLG-SAS. During the median follow-up of 18 months, 20 patients reached the primary end-point. Patients with symptomatic PLG-SAS had significantly worse prognosis than patients with asymptomatic PLG-SAS. A similar trend was observed while comparing with the propensity-score-matched cohort after adjusting for age, sex, stroke volume index, and severity of AS. Conclusions Symptomatic PLG-SAS is associated with poorer prognosis even after adjusting for flow status and severity of AS. Therefore, presence of symptoms is not always related to the severity of AS itself but might be related to the underlying comorbidities. Our results suggest a possible link between PLG-SAS and heart failure with preserved ejection fraction in some symptomatic patients.
- Published
- 2019
35. Modelling and capability of severe accident simulation code, AZORES to analyze In-Vessel Retention for a loop-type sodium-cooled fast reactor
- Author
-
Hiroki Watanabe, Toshihisa Yamamoto, Tomoko Ishizu, Masahiko Ariyoshi, and Tsuyoshi Okawa
- Subjects
020209 energy ,Nuclear engineering ,Control rod ,Energy Engineering and Power Technology ,02 engineering and technology ,010501 environmental sciences ,Corium ,Scram ,01 natural sciences ,Coolant ,Sodium-cooled fast reactor ,Nuclear Energy and Engineering ,0202 electrical engineering, electronic engineering, information engineering ,Environmental science ,Light-water reactor ,Decay heat ,Safety, Risk, Reliability and Quality ,Waste Management and Disposal ,Core catcher ,0105 earth and related environmental sciences - Abstract
Research and development of the physical models and codes of safety analyses have been promoted for loop-type Sodium-cooled Fast Reactors (SFRs). A severe accident code, AZORES has been developing for the evaluation of molten corium behavior and integrity of reactor and containment vessels. AZORES enables the simulation of plant equipment behavior under severe accident conditions. In recent years, much attention regarding the mitigation of severe accident progression has been attracted to In-Vessel Retention (IVR) of SFRs, which has relatively less existing experimental and analysis results than that of the Light Water Reactor (LWR). This paper describes the status of development for main physical models and preliminary verification for IVR simulation mainly with AZORES. For a verification process, the simulation has been conducted for representative Post-Accident Material Relocation (PAMR)/Post-Accident Heat Removal (PAHR) phases subsequent to an Anticipated Transients Without Scram (ATWS) to evaluate the impact of initial conditions on severe accident progression. From the study, it was found that the mass of molten corium and capability of decay heat removal were key parameters for the attainment of IVR. Furthermore, this paper describes the results of Computational Fluid Dynamics (CFD) simulations which have been conducted for molten corium relocation in a control rod assembly and for corium coolability with sodium coolant on the core catcher for the purpose of enhancing the related AZORES physical models.
- Published
- 2019
36. Target of Triglycerides as Residual Risk for Cardiovascular Events in Patients With Coronary Artery Disease ― Post Hoc Analysis of the FMD-J Study A ―
- Author
-
Hisao Ikeda, Taiji Furukawa, Takuzo Hano, Yasuhiko Takemoto, Teruo Inoue, Masato Kajikawa, Yusuke Ohya, Kazuaki Chayama, Hirofumi Tomiyama, Masataka Sata, Shogo Matsui, Yutaka Ishibashi, Kazuomi Kario, Bonpei Takase, Akira Yamashina, Yukihito Higashi, Kensuke Noma, Kentaro Watanabe, Chikara Goto, Koji Maemura, Toru Suzuki, Shinichiro Ueda, Yuji Takaeko, Tatsuya Maruhashi, Tomoo Furumoto, Takahide Kohro, Shinji Kishimoto, Haruki Hashimoto, Tomoko Ishizu, Farina Mohamad Yusoff, Koichi Node, Shinji Koba, Hiroshi Ito, Tsutomu Yamazaki, Yasuki Kihara, and Ayumu Nakashima
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Disease-Free Survival ,Cardiovascular events ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Post-hoc analysis ,medicine ,Humans ,030212 general & internal medicine ,Acute Coronary Syndrome ,Triglycerides ,Aged ,Triglyceride ,business.industry ,Surrogate endpoint ,Hypertriglyceridemia ,Confounding ,General Medicine ,Middle Aged ,Atherosclerosis ,medicine.disease ,Stroke ,Survival Rate ,Residual risk ,chemistry ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Follow-Up Studies - Abstract
Background: Circulating triglyceride (TG) levels are a current focus as a residual risk for cardiovascular (CV) events. We evaluated the relationship between circulating TG levels and future CV events in patients with coronary artery disease (CAD) who were treated with conventional therapy. Methods and Results: We analyzed data for 652 patients who were enrolled in the FMD-J Study A. We investigated the associations between serum TG levels and first major CV events (death from CV cause, nonfatal acute coronary syndrome (ACS), nonfatal stroke, and CAD) for a 3-year follow-up period. Patients were divided into 4 groups based on serum TG level: low-normal (
- Published
- 2019
37. Association between serum urate level and carotid atherosclerosis: an insight from a post hoc analysis of the PRIZE randomised clinical trial
- Author
-
Atsushi Tanaka, Shigeru Toyoda, Toru Kato, Hisako Yoshida, Shuichi Hamasaki, Masato Watarai, Tomoko Ishizu, Shinichiro Ueda, Teruo Inoue, and Koichi Node
- Subjects
Adult ,Carotid Artery Diseases ,Febuxostat ,Rheumatology ,Immunology ,Awards and Prizes ,cardiovascular system ,Humans ,Immunology and Allergy ,Hyperuricemia ,Carotid Intima-Media Thickness ,Uric Acid - Abstract
ObjectivesElevated serum urate (SU) levels are associated with arterial atherosclerosis and subsequent cardiovascular events. However, an optimal therapeutic target SU level for delaying atherosclerotic progression in patients with hyperuricaemia remains uncertain. The aim of this analysis was to assess an association between changes in SU level and carotid intima–media thickness (IMT) to examine whether an optimal SU concentration exists to delay atherosclerotic progression.MethodsThis was a post hoc analysis of the PRIZE (programme of vascular evaluation under uric acid control by xanthine oxidase inhibitor, febuxostat: multicentre, randomised controlled) study of Japanese adults with asymptomatic hyperuricaemia. The primary endpoint of this analysis was an association between changes in SU levels and mean common carotid artery IMT (CCA-IMT) after 24 months of febuxostat treatment.ResultsAmong subjects treated with febuxostat (n=239), a total of 204 who had both data on SU and mean CCA-IMT at baseline and 24 months were included in this analysis. The mean baseline SU level was 7.7±1.0 mg/dL, and febuxostat treatment significantly reduced SU concentrations at 24 months (estimated mean change ‒3.051 mg/dL, 95% CI ‒3.221 to ‒2.882). A multivariable linear regression analysis revealed that a reduction in SU level was associated with changes in mean CCA-IMT values at 24 months (p=0.025). In contrast, the achieved SU concentrations were not associated with changes in mean CCA-IMT at 24 months.ConclusionA greater reduction in SU, but not its achieved concentrations, may be associated with delayed progression of carotid IMT in patients with asymptomatic hyperuricaemia treated with febuxostat.Trial registration numberUMIN000012911
- Published
- 2022
38. Renoprotective effects of tolvaptan in hypertensive heart failure rats depend on renal decongestion
- Author
-
Yoshihiro Seo, Tomoko Ishizu, Mikiko Namekawa, Kazutaka Aonuma, Seika Sai, and Hiroki Chiba
- Subjects
Male ,medicine.medical_specialty ,Central Venous Pressure ,Physiology ,Tolvaptan ,Urology ,Renal function ,Hemodynamics ,030204 cardiovascular system & hematology ,Protective Agents ,03 medical and health sciences ,0302 clinical medicine ,Internal Medicine ,medicine ,Animals ,030212 general & internal medicine ,Ultrasonography ,Heart Failure ,Kidney Medulla ,Rats, Inbred Dahl ,Ejection fraction ,business.industry ,Central venous pressure ,Sodium, Dietary ,Stroke Volume ,medicine.disease ,Fibrosis ,Rats ,Blood pressure ,Heart failure ,Hypertension ,Kidney Diseases ,Vascular Resistance ,Cardiology and Cardiovascular Medicine ,business ,Perfusion ,Antidiuretic Hormone Receptor Antagonists ,medicine.drug - Abstract
The vasopressin type 2 receptor antagonist tolvaptan may have renoprotective effects in patients with heart failure (HF). This study aimed to reveal the renoprotective effect of tolvaptan from the viewpoint of hemodynamic combined with catheter and ultrasound examinations in a hypertensive HF model. Dahl salt-sensitive rats (n = 24) were fed an 8% high-salt diet after the age of 6 weeks and were treated with tolvaptan (n = 16) or vehicle (control group; n = 8). The tolvaptan-treated rats were divided into two groups: a low-dose group (0.01% tolvaptan diet; Low-Tol) and a high-dose group (0.05% tolvaptan diet; High-Tol). At 24 weeks, catheterizations to measure central venous pressure (CVP) and renal medullary pressure (RMP) were performed, followed by intrarenal Doppler (IRD) studies and contrast-enhanced ultrasonography (CEUS) to evaluate renal medullary perfusion. The tolvaptan diet reduced CVP (7.7 ± 1.5, 9.0 ± 1.1, and 12.2 ± 0.8 mmHg in the High-Tol, Low-Tol, and control groups, respectively; p < 0.001) and RMP (7.7 ± 0.8, 9.4 ± 1.3, and 13.7 ± 1.2 mmHg in the High-Tol, Low-Tol, and control groups, respectively; p < 0.001). Tolvaptan also reduced the venous impedance index (VII) in the IRD analysis (0.18 ± 0.03, 0.26 ± 0.04, and 0.40 ± 0.08 in the High-Tol, Low-Tol, and control groups, respectively; p < 0.001), and the time to peak intensity in CEUS (6.0 ± 0.5, 7.3 ± 1.3, 9.8 ± 1.8 s in the High-Tol, Low-Tol, and control groups, respectively; p < 0.001). Creatinine clearance (Ccr) was preserved in both the High-Tol and Low-Tol groups compared to the control group (4.80 ± 1.9, 4.24 ± 0.8, and 1.35 ± 0.3 mg/min, respectively; p = 0.001). Ccr was negatively correlated with RMP (R = -0.76, P < 0.001), the venous impedance index (R = -0.70, p < 0.001), time to peak intensity (R = -0.75, P < 0.001), and renal fibrosis (R = -0.70, p < 0.001). In contrast, Ccr had modest correlations with systolic blood pressure (R = -0.50, P = 0.02) and left ventricular ejection fraction (R = 0.48, P = 0.03). This study revealed that the renoprotective effects of tolvaptan in a hypertensive HF model depended on renal decongestion.
- Published
- 2018
39. Cross-sectional and longitudinal associations between serum uric acid and endothelial function in subjects with treated hypertension
- Author
-
Koji Maemura, Masataka Sata, Atsushi Tanaka, Tsutomu Yamazaki, Hiroshi Ito, Tomoo Furumoto, Kazuomi Kario, Atsushi Kawaguchi, Hirofumi Tomiyama, Toru Suzuki, Yutaka Ishibashi, Bonpei Takase, Takuzo Hano, Yukihito Higashi, Shinji Koba, Shinichiro Ueda, Koichi Node, Taiji Furukawa, Teruo Inoue, Akira Yamashina, Yusuke Ohya, Tomoko Ishizu, Chisa Matsumoto, and Yasuhiko Takemoto
- Subjects
Male ,medicine.medical_specialty ,Vasodilation ,Pulse Wave Analysis ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Humans ,Medicine ,Longitudinal Studies ,cardiovascular diseases ,030212 general & internal medicine ,Common carotid artery ,Pulse wave velocity ,Aged ,Flow mediated vasodilatation ,business.industry ,Serum uric acid ,Middle Aged ,Pathophysiology ,Uric Acid ,Cross-Sectional Studies ,Treatment Outcome ,chemistry ,Hypertension ,cardiovascular system ,Cardiology ,Uric acid ,Female ,Endothelium, Vascular ,Cardiology and Cardiovascular Medicine ,business ,Vascular function ,Biomarkers ,Follow-Up Studies - Abstract
Objectives The endothelial dysfunction-arterial stiffness-atherosclerosis continuum plays an important pathophysiological role in hypertension. The aim of this study was to investigate the cross-sectional association between serum uric acid (SUA) and vascular markers related to this continuum, and to assess the longitudinal association between SUA and endothelial function that represents the initial step of the continuum. Methods We evaluated the baseline associations between SUA levels and vascular markers that included flow-mediated vasodilatation (FMD), brachial-ankle pulse wave velocity (baPWV), and common carotid artery intima-media thickness (CCA-IMT) in 648 subjects receiving antihypertensive treatment. The longitudinal association between baseline SUA levels and FMD measured at 1.5 and 3 yr of follow-up was also investigated. Results At baseline, modest, but significant correlations were observed between SUA and FMD in females (r = −0.171), baPWV in males with SUA >368.78 μmol/L (r = −0.122) and in females with a SUA level ≤ 362.83 μmol/L (r = 0.217), mean CCA-IMT in females with a SUA level ≤ 333.09 μmol/L (r = 0.139), and max CCA-IMT in females with SUA level ≤ 333.09 μmol/L (r = 0.138). A longitudinal association between SUA and FMD was less observed in males. In females, the baseline SUA was associated significantly with FMD values at 1.5 yr (r = −0.211), and SUA levels >237.92 μmol/L were associated significantly and independently with FMD values at 3 yr (r = −0.166). Conclusions Lower SUA levels were associated with better vascular markers of the continuum, especially in females. Furthermore, we observed a longitudinal association between SUA and endothelial function, suggesting SUA level may be a potential marker of the continuum in hypertension.
- Published
- 2018
40. Sitagliptin on carotid intima-media thickness in type 2 diabetes patients receiving primary or secondary prevention of cardiovascular disease: A subgroup analysis of the PROLOGUE study
- Author
-
Kohei Kaku, Koichi Node, Mamoru Nanasato, Koji Maemura, Makoto Saito, Jun-ichi Oyama, Ryoji Ishiki, Hisako Yoshida, Teruo Inoue, Masayoshi Ajioka, Yukihito Higashi, Atsushi Tanaka, Tomoko Ishizu, Toyoaki Murohara, and Yoshisato Shibata
- Subjects
Male ,medicine.medical_specialty ,Subgroup analysis ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,Diabetes mellitus ,Post-hoc analysis ,Secondary Prevention ,Humans ,Medicine ,Single-Blind Method ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Common carotid artery ,Aged ,Aged, 80 and over ,Dipeptidyl-Peptidase IV Inhibitors ,business.industry ,Sitagliptin Phosphate ,Middle Aged ,medicine.disease ,Primary Prevention ,Diabetes Mellitus, Type 2 ,Intima-media thickness ,Cardiovascular Diseases ,Sitagliptin ,cardiovascular system ,Cardiology ,Female ,Internal carotid artery ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background Whether a dipeptidyl peptidase-4 (DPP-4) inhibitor can attenuate atherosclerosis is still controversial. Some clinical trials reported that DPP-4 inhibitors in diabetes patients without a previous history of cardiovascular (CV) events could reduce carotid intima-media thickness (IMT). However, in the PROLOGUE study, which enrolled diabetes patients both with and without previous CV events, sitagliptin failed to slow the progression of carotid IMT relative to conventional therapy. Aim and methods We hypothesized that the effect of DPP-4 inhibitors on carotid atherosclerosis might be different between the primary and secondary prevention groups. We performed a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in carotid IMT in subgroups with or without previous CV events. Results No significant difference in the IMT changes between the treatment groups was found in the secondary prevention subgroup (sitagliptin, N = 102; conventional, 111). However, in the primary prevention subgroup (sitagliptin, 120; conventional, 109), we found significant inhibitory effects of sitagliptin on mean and max internal carotid artery IMT [estimated group difference: −0.096 mm (95% CI −0.175 to −0.018, p = 0.017) and −0.162 mm (95% CI −0.272 to −0.052, p = 0.004), respectively], although there was no significant difference in the common carotid artery IMT. Conclusions Our data suggest that there is a favorable effect of DPP-4 inhibitor treatment on carotid atherosclerosis in diabetes patients without previous CV events.
- Published
- 2018
41. Differential effect of concomitant antidiabetic agents on carotid atherosclerosis: a subgroup analysis of the PROLOGUE study
- Author
-
Jun-ichi Oyama, Shigetaka Kuroki, Atsushi Kawaguchi, Toyoaki Murohara, Kohei Kaku, Taizo Kondo, Atsushi Tanaka, Tomoko Ishizu, Koichi Node, Yukihito Higashi, Jun Fukui, Mamoru Nanasato, Hiroshi Ito, and Teruo Inoue
- Subjects
Carotid Artery Diseases ,Male ,medicine.medical_specialty ,Time Factors ,Combination therapy ,Carotid Artery, Common ,medicine.drug_class ,Subgroup analysis ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Post-hoc analysis ,Humans ,Hypoglycemic Agents ,Medicine ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Thiazolidinedione ,Aged ,Dose-Response Relationship, Drug ,business.industry ,Biguanide ,Sitagliptin Phosphate ,Middle Aged ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Intima-media thickness ,Concomitant ,Sitagliptin ,Disease Progression ,cardiovascular system ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,medicine.drug - Abstract
Accumulated evidence shows that some antidiabetic agents attenuate the progression of carotid atherosclerosis assessed as intima-media thickness (IMT). Although some studies have demonstrated an inhibitory effect of dipeptidyl peptidase-4 inhibitors on carotid IMT progression, in the PROLOGUE study sitagliptin failed to slow progression relative to conventional therapy for 24 months. We hypothesized that differences in the concomitant antidiabetic agents between the groups have influenced the progression of carotid IMT. We performed a post hoc analysis of the PROLOGUE study using subgroups stratified by concomitant antidiabetic agents. Although no subgroup with any combination of agents in the overall patients showed a significant difference between sitagliptin group and conventional therapy group in the changes from baseline in mean common carotid artery (CCA)-IMT at 24 months, a significant attenuation of mean CCA-IMT progression was observed in the sitagliptin group relative to conventional therapy group only in three combination subgroups aged
- Published
- 2018
42. Tissue Tracking
- Author
-
Tomoko Ishizu, Yasuhiko Abe, and Yoshihiro Seo
- Published
- 2020
43. Clinical Usefulness of the HFA-PEFF Diagnostic Scoring System in Identifying Late Elderly Heart Failure With Preserved Ejection Fraction Patients
- Author
-
Yoshihiro Seo, Nobuyuki Ohte, Masaki Ieda, and Tomoko Ishizu
- Subjects
Male ,medicine.medical_specialty ,Scoring system ,medicine.drug_class ,Population ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Healthy control ,Natriuretic peptide ,Medicine ,Humans ,030212 general & internal medicine ,Stage (cooking) ,education ,Subclinical infection ,Aged ,Aged, 80 and over ,Heart Failure ,education.field_of_study ,business.industry ,Stroke Volume ,General Medicine ,Hypertension ,Cardiology ,Biomarker (medicine) ,Female ,Cardiology and Cardiovascular Medicine ,business ,Heart failure with preserved ejection fraction ,Biomarkers - Abstract
Background Diagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging in elderly. This study investigated the diagnostic ability of the HFA-PEFF scoring system in elderly patients (>75 years of age).Methods and Results:This study enrolled 286 subjects aged >75 years (130 men; mean [± SD] age 81.5±5.1 years): 95 healthy controls, 98 with hypertension (HT), and 93 with HFpEF. The HFA-PEFF score was calculated as a sum of points in functional, morphological, and biomarker domains. In the HFpEF group, 84%, 84%, and 70% of subjects met the major functional, morphological, and biomarker criteria for HFpEF, respectively. Thus, 73 subjects with HFpEF (78%) were diagnosed as having HFpEF using the HFA-PEFF scoring system. In contrast, among the healthy controls and subjects with HT, 52% and 72%, respectively, met the major functional criteria for HFpEF, 28% and 53%, respectively, met the morphological criteria, and 0% and 24%, respectively, met the biomarker criteria. As such, 32 subjects with HT (33%) were diagnosed with HFpEF. Even in the healthy control group, 72% were classified as having an intermediate probability of HFpEF, and 3 were diagnosed with HFpEF. Conclusions In the late elderly, the HFA-PEFF scoring system diagnosed subjects with HFpEF precisely. In addition, this scoring system may be able to detect early stage HFpEF in the subclinical population.
- Published
- 2020
44. Abstract 13365: Risk-benefit Evaluation in Cessation of Renin-angiotensin-aldosterone Inhibitors in Hyperkalemic Heart Failure Patients: A Japanese Real-world Study From Nationwide Administrative Database
- Author
-
Tomoko Ishizu, Toshitaka Yajima, Takashi Kikuchi, Shun Kohsaka, Rashad Mogalli, and Suguru Okami
- Subjects
medicine.medical_specialty ,Aldosterone ,Hyperkalemia ,business.industry ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Administrative database ,Physiology (medical) ,Internal medicine ,Heart failure ,Renin–angiotensin system ,ACE inhibitor ,medicine ,Cardiology ,In patient ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Introduction: Hyperkalemia (HK) is frequently encountered in patients treated with renin-angiotensin-aldosterone system inhibitors (RAASi), and is associated with increased mortality in heart failure (HF). While cessation of RAASi is considered an option in HK patients, the serum potassium (sK) threshold for RAASi cessation in HF patients remains unclear . Herein, we sought to assess the impact of RAASi cessation or continuation on risk-benefit balance of hyperkalemic HF patients using propensity score (PS)-matched and cubic spline regression analysis in a nationwide administrative database. Methods: An observational retrospective study was conducted using Japanese hospital claims dataset (April 2008-September 2018). HK was defined as at least two sK ≥5.1 mmol/L within 12-months interval. We examined HK patients on RAASi in HF by employing PS matching to compare risk-benefit between patients with or without RAASi cessation. Cubic spline regression was fit to calculated hazard ratios (HR) in each sK strata for this assessment. Results: Out of 1,208,894 patients, 5,059 HF with HK patients with RAASi prescriptions met inclusion criteria (mean age 76.63 ±10.96 years). Mean follow-up period was 2.75 ± 1.9 years. Cumulative incidence of RAASi cessation was 34.73% at 1 year. Cessation of RAASi was associated with incremental risk of death (+19%, P=0.009) and hospitalization (+14%, P=0.002) , whereas recurrent HK risk was decreased (-60%, P Conclusions: Our results suggest that HK management by RAASi cessation should be avoided especially in HF patients with mild to moderate HK considering the worsening risk-benefit balance.
- Published
- 2020
45. Diagnostic accuracy of left ventricular diastolic transverse strain imaging by speckle tracking echocardiography for diagnosing chest pain in diabetic patients
- Author
-
Atsushi Tanaka, Hiroshi Ito, Yoshihiro Seo, Junichi Yoshikawa, E Hyodo, Katsuhisa Ishii, Hirotoshi Watanabe, Takashi Akasaka, H Kihara, Yusuke Yoshikawa, Tomoko Ishizu, and Masao Daimon
- Subjects
Aortic valve ,medicine.medical_specialty ,business.industry ,Diastole ,Speckle tracking echocardiography ,Diagnostic accuracy ,Chest pain ,Transverse strain ,medicine.anatomical_structure ,Internal medicine ,Right coronary artery ,medicine.artery ,Medical imaging ,medicine ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Two-dimensional speckle tracking echocardiography (2D-STE) has been reported to be useful for the diagnosis of myocardial ischemia by detecting delayed relaxation (diastolic stunning) after an episode of angina. 2D-longitudinal strain is not specific besides ischemia such as diastolic dysfunction, and diabetes have been associated with abnormal longitudinal fibers. The aim is to evaluate the diagnostic accuracy of Left ventricular (LV) diastolic transverse strain imaging by STE to detect the presence of acute coronary syndrome (ACS) in diabetic patients with acute chest pain. Methods 385 consecutive patients with acute chest pain and without wall motion abnormality, who were admitted to an emergency department (ED) at 1 of 12 clinical sites in Japan, were enrolled and underwent 2D-STE at ED. Left ventricular (LV) transverse strain values at aortic valve closure (A) and one-third of diastole duration (B) were measured. The strain imaging diastolic index (SI-DI) was value was determined as: (A − B)/A × 100% to assess the LV diastolic strain imaging and was used to identify the regional LV delayed relaxation. All patients underwent coronary CT or coronary angiography to establish the diagnosis of ACS. Clinicians were blinded to the 2D-STE results. Results Out of 385 patients, 2D-STE analysis was possible in 365 patients (94%). 76 patients were diabetic (DM+), and 289 patients were non-diabetic (DM-). With assessment of coronary CT or coronary angiography, ACS was diagnosed in 125 patients (34%). 2D-STE was obtained at a mean of 5.3 hours after chest pain episode. Transverse SI-DI of ischemic segments were significantly lower than those of non-ischemic segments (p value Conclusion LV diastolic transverse strain imaging by 2D-STE at ED increase the sensitivity, specificity and accuracy to predict the presence of ACS in diabetic patients with chest pain, as well as non-diabetic patients. (UMIN000013859). Figure 1. Transverse Strain (SI-DI): AUC (95% CI) Funding Acknowledgement Type of funding source: None
- Published
- 2020
46. Revisiting the significance of right bundle branch block
- Author
-
Toshimi Sairenchi, Masayoshi Yamamoto, Tomoko Machino, Nobuyuki Murakoshi, Naomi Nakazawa, Kimi Sato, Yasushi Kawakami, Tomoko Ishizu, and Masaki Ieda
- Subjects
medicine.medical_specialty ,business.industry ,Left bundle branch block ,Intraventricular block ,Right bundle branch block ,medicine.disease ,Blood pressure ,Diabetes mellitus ,Cardiovascular epidemiology ,Internal medicine ,Ischemic stroke ,Hyperlipidemia ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background/Introduction The right bundle branch block (RBBB) has been considered a benign finding in asymptomatic individuals. However, this concept based on a few, old, small sample size studies. Recently, the importance of the right ventricular dysfunction was focused on cardiovascular prognosis in clinical cardiology. Purpose To determine the prognostic value of RBBB in community-based health checkups cohort with a large sample size in recent years in Japan. Methods We assessed 88,089 individuals (mean age, 58.3±10.2 years; 66.1% women) who participated in annual community-based health checkups. Exclusion criteria were current or previous history of heart disease, stroke, and intraventricular block such as left bundle branch block other than RBBB. We followed them from 1993 to 2016. The primary endpoint was cardiovascular death, or all-cause death. The Cox regression model was assessed in each gender. The variables included in the multivariate analyses were age, body mass index, systolic blood pressure, hypertension, total cholesterol level, high-density lipoprotein cholesterol level, treated-hyperlipidemia, hyperglycemia, treated-diabetes, estimated glomerular filtration rate (eGFR), current smoking, and drinking habit. Results The prevalence of RBBB was higher in men than women (723/29,863 2.4% in men vs. 581/58,204 1.0% in women, P In women, RBBB was associated with significantly increased cardiovascular mortality with multivariate-adjusted hazard ratios (HR) of 1.26 [95% confidence interval (CI), 1.03–1.54]. Then, we divided them into younger or elder groups according to the cut-off age of 65-year-old. In women ≤65-year-old, RBBB related to greater cardiovascular mortality with multivariate-adjusted HR of 1.89 [95% CI, 1.27–2.80]. However, in women >65-year-old, RBBB did not show the prognostic significance. In men, RBBB did not reach the significant results in all participants, however, men >65-year-old with RBBB showed the significant poor prognosis with HR of 1.26 [95% CI, 1.04–1.53]. Conclusions In this cohort study, contrary to common perception, RBBB was associated with increased cardiovascular mortality in women, especially younger women ≤65-year-old, and elderly men. To the extent we know, the present study is the largest and long-term follow-up study showing that the significance of RBBB differs depending on sex and age. Especially in young women who usually are less prone to show wide QRS, RBBB might represent the pathological abnormality. Although the pathophysiological effect of the RBBB on the cardiovascular outcome needs further investigation in the future, clinicians should alert the RBBB in young women and elder men even if they have no symptoms and evaluate the heart abnormality and follow them up carefully. Funding Acknowledgement Type of funding source: None
- Published
- 2020
47. Utility of updated diagnositc criteria to detect isolated cardiac sarcoidosis
- Author
-
Masaki Ieda, Tomoko Ishizu, Masayoshi Yamamoto, and Kimi Sato
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Radiology ,Cardiac sarcoidosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Prior study reported around one-third of cardiac sarcoidosis (CS) are considered as isolated CS. Detection of CS is challenging due to the limited sensitivity of endomyocardial biopsy and applicability of guidelines, especially in patients without extra-cardiac involvement. Existing diagnostic criteria by Japanese Ministry of health and Welfare (JMHW) or Heart Rhythm Society (HRS) require the presence of extra-cardiac sarcoidosis for clinical diagnosis, isolated CS is not diagnosable in the absence of a positive histological finding. Recently, Japanese Society of Cardiology (JCS) updated diagnostic criteria for CS, which provides the pathway to diagnose isolated CS. Purpose We aimed to assess the reliability of the updated CS guideline in diagnosing CS compared to the prior guidelines. Methods We retrospectively identified 162 consecutive patients who underwent FDG-PET for suspected CS from 2012 through 2019. According to the updated JCS diagnostic criteria, patients were classified as histologic diagnosis of CS, clinical diagnosis of CS, or isolated CS (Figure A). We compared the association between diagnostic criteria and response with anti-inflammatory therapy. Results The JCS criteria classified 24 patients (15%) as having clinical CS, 4 (3%) as histological diagnosis of CS, and 21 (13%) as isolated CS. The JMHW criteria defined 22 patients (14%) as having CS (clinical 11%, histological 3%) and HRS criteria classified 11 patients (7%) as having CS (clinical 4%, histological 3%). Extra-cardiac involvement was detected in 36 patients (22%) with 8% of histological confirmation. Among the 126 patients without extra-cardiac involvement, prevalence of cardiac involvement was higher in isolated CS (P Conclusions Updated JCS diagnostic criteria detects CS patients with active myocardial inflammation which require anti-inflammatory therapy regardless of extra-cardiac involvement better than the prior guidelines. Diagnostic criteria for CS Funding Acknowledgement Type of funding source: None
- Published
- 2020
48. Features of Lead-Induced Tricuspid Regurgitation in Patients With Heart Failure Events After Cardiac Implantation of Electronic Devices - A Three-Dimensional Echocardiographic Study
- Author
-
Masaki Ieda, Hideki Nakajima, Akihiko Nogami, Kimi Sato, Masayoshi Yamamoto, Nobuyuki Ohte, Yoshihiro Seo, Tomoko Ishizu, Tomoko Machino-Ohtsuka, and Noriko Iida
- Subjects
medicine.medical_specialty ,Pacemaker, Artificial ,Exacerbation ,Echocardiography, Three-Dimensional ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,Lead location ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Lead (electronics) ,Retrospective Studies ,Heart Failure ,Tricuspid valve ,business.industry ,General Medicine ,medicine.disease ,Tricuspid Valve Insufficiency ,Defibrillators, Implantable ,medicine.anatomical_structure ,Treatment Outcome ,Heart failure ,Cardiology ,Electronics ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Lead-induced tricuspid regurgitation (TR) after cardiac implantable electronic device (CIED) implantation is not fully understood. This study aimed to reveal the features of lead-induced TR by 3-dimensional echocardiography (3DE) in patients with heart failure (HF) events after CIED implantation.Methods and Results:In 143 patients, 3DE assessments for the tricuspid valve (TV) and right ventricular morphologies were sequentially performed within 3 days after CIED implantations, during TR exacerbations, and at ≥6 months after TR exacerbations. TR exacerbations were observed in 29 patients (median 10 months after CIED implantation, range 1-28 months), 15 of whom had lead-induced TR. In the 29 patients, the tenting height of the TV, tricuspid annular (TA) height, and TA area at baseline were independent predictors for worsening TR. In patients with lead-induced TR, tenting height of the TV and TA area were identified as the risk factors. In addition, all patients with a lead positioned on a leaflet immediately after CIED implantations developed lead-induced TR. At follow up, TR exacerbation of lead-induced TR persisted with TA remodeling, but it was improved in the lead non-related-TR group. Conclusions TA remodeling at baseline and a lead location on a leaflet immediately after CIED implantation were associated with lead-induced TR in patients with HF events after CIED implantation. Persistent TA remodeling may make lead-induced TR refractory against HF treatments.
- Published
- 2020
49. Correction to: Intervendor variability of carotid intima-media thickness measurement: validation study using newly developed ultrasound phantom
- Author
-
Tomoko Ishizu, Hirotoshi Hamaguchi, Naotaka Nitta, Yoshihiro Seo, Hiroshi Matsuo, and Tsuyoshi Shiina
- Subjects
Radiology, Nuclear Medicine and imaging ,General Medicine - Abstract
In the Original publication of the article Table 3 was published incorrectly.
- Published
- 2020
50. Direct oral anticoagulant use and outcomes in adult patients with Fontan circulation: A multicenter retrospective cohort study
- Author
-
Fumie Takechi, Yumi Shiina, Tomoko Machino-Ohtsuka, Masaki Ieda, Terunobu Fukuda, Keita Masuda, Nobuyuki Komiyama, Naoto Kawamatsu, Shigeru Tateno, Hitoshi Horigome, Yuji Hiramatsu, Yasufumi Kijima, Koichiro Niwa, and Tomoko Ishizu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Antiplatelet drug ,Vitamin K ,medicine.drug_class ,medicine.medical_treatment ,Administration, Oral ,030204 cardiovascular system & hematology ,Fontan Procedure ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antithrombotic ,Atrial Fibrillation ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Retrospective Studies ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Anticoagulant ,Anticoagulants ,Retrospective cohort study ,Vitamin K antagonist ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Many adult patients with Fontan circulation are treated with antithrombotic agents, including direct oral anticoagulants (DOACs). However, few studies have investigated the efficacy, feasibility, and safety of DOACs in adult patients with Fontan circulation. Methods and Results In this retrospective cohort study, clinical records of 139 adult patients with Fontan circulation (70 females, 50.4%) from April 2015 to March 2018 were reviewed and classified into five groups according to the therapeutic agents used: DOAC (n = 36), vitamin K antagonist (VKA; n = 41), antiplatelet drug (n = 43), combination of an antiplatelet and anticoagulant (n = 14), and no-antithrombotic prophylaxis (n = 5). In a 1114-patient-year follow-up, 28 major events occurred, including 10 thrombotic and 18 bleeding events; 11 of 18 (61%) female patients had severe menorrhagia. The incidence (% patient-years) of major events was 0.6, 1.42, 3.74, and 5.13 in the DOAC, antiplatelet, VKA, combination, and no-antithrombotic groups, respectively. The Cox proportional hazards analysis revealed that the DOAC group had a lower rate of primary endpoints than the VKA group in males. Conclusions DOAC may be a safe antithrombotic agent for use in adult patients with Fontan circulation, particularly in males. However, these findings should be confirmed in multi-institutional prospective studies.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.